Diet to support Dementia & Alzheimer’s
by Sue Kira, Naturopath & Clinical Nutritionist
About Alzheimer’s, Dementia and cognitive decline
– Features of Alzheimer’s disease
– Beta-Amyloid plaques a symptom not the cause
– APOE4 gene risk factor
– Poor methylation can be part of the picture
– First cases of Alzheimer’s reversal
– The three sub-types of Alzheimer’s disease
Diet to support cognitive decline, dementia and Alzheimer’s
– ‘DESS protocol’: Diet, Exercise, Sleep and Stress
A Case study: Cognitive decline improvement
About Alzheimer’s, Dementia and cognitive decline
To lose your sense of freedom because your memory fails can be devastating and a frightening prospect to face, especially when personality changes start to kick in.
If worked on early in the disorder, or as a prevention where there is family history, support with diet and lifestyle adjustments could make a difference.
Although no cure has been found yet for Alzheimer’s disease, dementia and cognitive decline, studies have shown that by working with potential drivers of these conditions, decline in cognition can be slowed down.
There are new promising studies (particularly with the first cases of Alzheimer’s reversal). Further information below.
Features of Alzheimer’s disease
Alzheimer’s is the most common type of dementia and the numbers are growing at epidemic proportions, with 30 million people worldwide (2014) and this number is expected to double by 2025. Wow!
Features are:
- Clinical dementia e.g. marked cognitive decline, memory loss
- Beta-Amyloid plaques
- Neurofibrillary tangles
- Atrophy of the brain (shrinkage)
- Gene allele called APOE4 which puts us at risk
- Poor methylation part of the picture
- Inflammation
- Trophic factor deficiency like vitamin D
- Glycotoxicity
- Toxicity & neurotoxicity
- Type 3 diabetes (diabetes of the brain)
- Lack of smell: seen as an early warning sign
- Potential auto-immune implications
Following is information about some of these features…
Beta-Amyloid plaques, a symptom not the cause
Much of the research into Alzheimer’s disease has been done on these plaques found in the brains of Alzheimer’s sufferers however, beta-amyloid is not the cause of Alzheimer’s disease, it is a symptom.
Beta-Amyloid plaques are, in fact, produced in response to infection and inflammation to trap potential damaging invading pathogens. The plaques play a protective role, but a problem occurs when this process doesn’t switch off or stop, which then results in a build-up of these plaques.
APOE4 gene risk factor
ApoE4, an allele of the ApoE gene has been implicated in several disease processes such as atherosclerosis and Alzheimer’s disease. This gene may lead to increased levels of inflammation that can trigger the above responses.
Because someone has these genes does not mean that they will get Alzheimer’s or cognitive decline (or heart disease), as these gene expressions need to be ‘switched on’ to activate the disease process.
Having the gene highlights the need to reduce the risk of developing Alzheimer’s disease by managing risk factors that can occur from poor diet and lifestyle choices.
Poor methylation can be part of the picture
Homocysteine is neurotoxic and is known to increase beta-amyloid production, which adds to this toxicity and compromises brain circulation.
Hyperhomocysteinuria (high homocysteine) is associated with accelerated atrophy of ‘grey matter’ and cognitive decline and the progress of Alzheimer’s disease. S-adenosyl homocysteine (SAH) has been shown to be higher in the brains of Alzheimer’s sufferers which inhibit cognitive function.
The reason for the association is unsure as yet, but it seems that the presence of high homocysteine and SAH can lead to a cascade of events which lead to neuronal death and brain atrophy. Homocysteine and SAH can be easily tested and these days, genetic testing is relatively easy and inexpensive.
Methylating nutrients such as folate, B6 and B12 have been used to support those with cognitive decline, but studies are inconclusive if they help or not.
Having said that, if you have adequate nutrients from your food, then it must be of some help to balance some of the potential drivers.
First cases of Alzheimer’s reversal
Dr Dale Bredesen (see ‘Dess Protocol’ below) suggests that failure in the treatment of Alzheimer’s disease is due to incomplete understanding of the disease process. He has identified 36 different factors that contribute to Alzheimer’s. He suggests that using only one therapy is like patching one hole in the roof when there are 36 holes.
Dr Bredesen explains that Alzheimer’s is an imbalance between brain plasticity, remodelling and repair. It is thought to be an imbalance between neuro-trophic and anti-trophic activity. In light of this concept, Dr. Bredesen has developed a multi-faceted holistic approach called MEND (Metabolic Enhancement for Neuro Degeneration) protocol.
This has resulted in the very first reversal of symptoms of those with mild cognitive impairment and early Alzheimer’s. The key of course are the words ‘early’ and ‘mild’. To date, there has been no success for those in late stages of the disease.
I am not going to cover all 36 parameters here, however I will include some of the key factors (below) that can be supported by diet.
If you wish to find out more, then search online for Dr Dale Bredesen.
The three sub-types of Alzheimer’s disease
Type 1 – Inflammation
Inflammation markers are elevated in the brains of those with Alzheimer’s and there are also several inflammation-promoting genes associated with this condition. An anti-inflammatory diet could be of some help in the early stages of cognitive decline and associated conditions.
Magnesium has been seen to be low in cerebrospinal fluid, hair, plasma, red blood cells and brain tissue in people with Alzheimer’s and dementia. A magnesium rich diet may also be beneficial.
Type 2 – Atrophic (atrophy: brain shrinkage)
Insulin resistance, high homocysteine and loss of hormonal support can lead to reduced neural plasticity, which in turn can lead to Alzheimer’s pathology.
What this means from a food perspective is to ensure there are good blood sugar levels by: not eating a high carb diet; eating foods high in B12 and folate (that support homocysteine levels); and ensure that hormones are balanced, especially testosterone in men.
Low Vitamin D is said to be associated with increased risk of all types of dementia. Vitamin D also regulates inflammation, so sunlight and foods rich in Vitamin D can help. For more, see my article The Benefits of Sunlight
Type 1.5 Glycotoxic
This is thought to be a presentation of Alzheimer’s that has elements of both type 1 and 2. Inflammation and insulin resistance are high risk factors for Alzheimer’s (as well as diabetes).
This is seen in ‘metabolic syndrome’, where the amount of insulin transported to the brain is reduced, while maintaining high levels of insulin in the serum. Some have called it ‘diabetes of the brain’.
Diet can play a huge role in balancing blood sugars. New research is showing that a Ketogenic diet has been most helpful for these people. Please speak to your integrative doctor about whether this type of diet would suit your needs better.
I have seen hundreds of clients who suffered from ‘foggy brain’ even without any sign of dementia, and their diet played a huge role in the condition. But when they stopped consuming gluten, dairy, grains and sugar, they told me that their brains felt clearer.
In most cases, they felt completely clear, unless candida or parasites played a role.
Type 3 toxic
Exposure to toxins such as endotoxins (toxins inside bacterial cells that are released when the cells disintegrate), heavy metals, chemical exposure, pesticides, herbicides, over exposure to chlorine (particularly in cleaners) and mycotoxins are associated with this third type of dementia or Alzheimer’s disease.
Many tests need to be done to determine which factors might play a role in the development of dementia, cognitive decline or Alzheimer’s disease. The support of a knowledgeable and experienced practitioner is recommended.
A supportive diet is beneficial. Foods containing pesticides should be abolished. Instead eat organic foods or at least spray free foods.
Also, foods not digested properly can create toxins in the body. See a practitioner for a stool test to determine if this could be the case.
Diet to support cognitive decline, dementia and Alzheimer’s
It appears that there is little scientific or medical support regarding the effects of diet and lifestyle to heal or impede the onset of these conditions, apart from the use of drugs.
While I cannot make any claims that the following dietary suggestions will help cognitive decline, dementia and Alzheimer’s, surely a sensible strategy is to be open and include diet and lifestyle improvements for treating all health conditions.
When I studied naturopathy, one of my teachers said he felt that one major contributor to dementia was dehydration, particularly in nursing homes, where so many cups of tea and coffee (diuretics that dehydrate) are served. Instead, serving more water with a splash of juice for flavour and hydration quality would re-hydrate patients’ brains and perhaps slow down cognitive decline.
Later, another presenter said he felt that dementia is caused because people ‘check out of life’ and dis-engage from others. We see this as people withdraw to their own little online and television worlds. If this is true, what does the future hold for future generations who are disengaging from life because of social media and online obsessions? Food for thought?
Others have said that Alzheimer’s is linked to toxicity (chemical, heavy metal etc.), infections (such as candida, Chlamydia, Lyme’s type infections and Herpes simplex 1) or vitamin deficiency, especially Vitamin D. Another hypothesis is that Alzheimer’s is linked to type 3 diabetes – a ‘diabetes of the brain’.
To help arrest and support these conditions, it is worthwhile to seriously consider diet and lifestyle.
Research on the spices turmeric and saffron indicate they are quite anti-inflammatory and considered beneficial in inhibiting build-up of the beta-amyloid plaque and to increase neuroplasticity.
I suggest including turmeric and saffron in foods and drinks; you may get stronger versions from your health practitioner. Emu and fish oils such as salmon, tuna and mackerel, are excellent for their anti-inflammatory properties.
Also include foods with low toxins (no additives) and rich in Vitamin D, magnesium, zinc and a good balance of carbs, proteins and fats to maintain good blood sugar balance.
While a diet for Alzheimer’s, Dementia and cognitive decline is not considered a cure, the idea is to include foods that support the body, and eliminate foods considered detrimental, to help the body do its natural job of healing. For this reason it is recommended that the diet is predominantly grain free (except rice), low sugar, gluten-free, dairy-free and additives-free.
You may wish to speak to your integrative doctor about the use of the Ketogenic diet for a short period as much research is being done with using this diet to support different types of dementia with good results.
Important: Before you commence a new diet, see your medical or health care professional for qualified guidance about what foods and supplements are best for your body. While on the diet do not stop any medications or supplements previously prescribed unless advised otherwise by your medical or health care professional.
Note: During the early stages of a new diet, you may experience symptoms such as fatigue, headaches or body aches, which may occur because your body is detoxifying. However, if you are unsure about a symptom at any time, check immediately with your medical or health care professional.
DESS protocol’: Diet, Exercise, Sleep and Stress
Dr Dale Bredesen is a Professor of Neurology and Director of Neurodegenerative Disease Research at David Geffen School of Medicine, UCLA. He specialises in Neurology, Alzheimer’s Disease, Dementia and Memory Disorder.
Dr Bredesen has designed a protocol which involves optimising diet, exercise, sleep and stress. He recommends a Mediterranean or mildly ketogenic diet (low carb), minimising high GI foods, eliminating gluten and processed foods, plus increased fasting between dinner and breakfast.
Personally, I feel it’s a great idea to have an extended fast between dinner and breakfast (for example, having dinner as early as possible and breakfast as late as possible, maybe even as a brunch). You could have breakfast in your morning tea break at say 10-11am and have dinner at 5-6pm, with perhaps a light snack of a small handful of almonds and a cup of herbal tea such as Rooibos (high in antioxidants, tastes good and has no caffeine or milk) and drink plenty of water.
Exercise is also prescribed by Dr. Bredesen, including both strength and aerobic movement for 45-60mins 5 times per week. Also, have a good night’s sleep, address any sleep apnoea, and have good wind down time before bed, without stimulation or blue screens (T.V, computers, phones).
Stress management is key to supporting any condition and look at strategies for developing more joy in your life such as meditation, relaxation movements, stretches and simply having some fun.
Case study: Cognitive Decline improvement
Client name and identifying information changed
A husband and wife came to see me; the husband had a degree of cognitive decline. Their doctor could not say if he was heading for dementia at that stage and all tests had been ‘normal’.
Rather than wait until things were not normal, they wanted to see if there was anything that could be done to stop potential progression towards dementia.
There was no family history of dementia which was a plus, but the husband had worked in some toxic environments and had a sweet tooth. He loved coffee with two sugars, and also toast and bread. Now retired, he didn’t have much stress, or much to motivate him and was ‘happy’ doing not much at all. He checked out in front of the TV at night and sometimes during the day.
He seemed oblivious to the fact that there was anything wrong, but his wife had another story (which is why she came along). She shared how she would ask him to do something and sometime later he would swear that she never asked at all.
His forgetfulness was increasing. Even when he had a list of jobs to do, he’d forget he had a list. He would forget how to do simple tasks that were part of his prior life and he was becoming dangerous when driving by not being fully attentive. The list went on, but you get the picture.
We ran some tests including toxicity testing which showed high levels of aluminium and some mercury which we dealt with. After this there was no improvement or further deterioration in his condition – no better and no worse.
We then looked at his diet and lifestyle habits which he was more interested in doing after we tackled the toxins. It appeared something was clearer for him as he was now making these decisions for himself.
We made sure he had a diet regime with a good balance of carbs, good fats and protein, while keeping the carbs as low impact as possible (low GI, low starch, non-stimulating).
I also suggested a mini-detox to get him started where he eliminated coffee, starchy foods, gluten, dairy products, food additives and sugar. In other words, a very healthful, wholesome, nutritious, anti-inflammatory diet.
We also got him to exercise more…a joint effort of my suggestions and his family, to get together to play entertaining active games in the backyard, going out for walks, hikes, paddling a kayak and so on. Fun activities!
Through these activities, he connected with people and took himself away from a ‘blank, passive’ existence to an ‘engaged, active’ lifestyle. In other words, he got more out of life.
The combination of the right diet with the activities, connection with people, getting out in the fresh air charged with healthy ‘negative ions’, more vitamin D from the sun, more stimulation, more fun and healthy eating made an impact.
Six weeks after his previous visit he returned with his wife and a son. They said how much better he was and how they were delighted to have their husband and father back.
Closing Notes
We can see there are many potential factors that can be implicated in Alzheimer’s, dementia and cognitive decline. Most need the support of a doctor and natural health care professional.
Currently it is too early to suggest that diet and lifestyle can help prevent or treat dementia, Alzheimer’s or cognitive decline. However, that does not mean we should wait for proof when you can be pro-active in many ways to help yourself or family members.
Given the right conditions, our body is designed to be self-healing and self-correcting. So why not give it the right conditions where possible? A clean, nutritious diet is a damn good starting point and an excellent way to help you to reclaim your vitality.