As of 2013, 5.2 million Americans had been diagnosed with Alzheimer’s disease, a severe form of dementia,1 and Alzheimer’s diagnoses are projected to triple by 2050.2,3
Over half a million Americans die from the disease each year, making it the third leading cause of death in the US, right behind heart disease and cancer.4,5
Considering there’s no known cure and few if any effective treatments, it’s really important to pay attention to prevention if you want to avoid becoming an Alzheimer’s statistic.
The good news is that your lifestyle choices such as diet, exercise, and sleep can have a significant impact on your risk.
As noted by Dr. Richard Lipton6 of the Albert Einstein College of Medicine where they study healthy aging, lifestyle changes “look more promising than the drug studies so far.”
High-Sugar Diet Raises Your Risk of Alzheimer’s
Mounting research suggests our modern diet is playing a significant role in the skyrocketing prevalence of Alzheimer’s. Processed foods tend to be nearly devoid of healthy fat while being excessive in sugar, and this combination appears to be at the heart of the problem.
Most people (especially Americans) are on a processed food diet, and this virtually guarantees you’ll end up getting inverted ratios of carbs and fats, not to mention both are typically inferior due to processing and adulteration.
The connection between sugar and Alzheimer’s was first broached in 2005, when the disease was tentatively dubbed "type 3 diabetes.” At that time researchers discovered that your brain produces insulin necessary for the survival of your brain cells.
A toxic protein called ADDL removes insulin receptors from nerve cells, thereby rendering those neurons insulin resistant, and as ADDLs accumulate, your memory begins to deteriorate.
Previous research has also shown diabetics have a doubled risk of developing Alzheimer’s disease.
Now, researchers are again warning that Alzheimer’s appears to be intricately linked to insulin resistance. In one recent study,7 the researchers used brain scans to assess 150 middle-aged people who were at risk of Alzheimer’s but showed no signs of it at the outset of the study.
As reported by The Huffington Post:
8 “Brain scans revealed that greater insulin resistance was linked to less sugar in key parts of the brain, often affected by Alzheimer's.
Insulin is the hormone that helps your body use sugar from the foods you eat, and either converts it into energy or stores it away. Insulin resistance is when your body's response to a regular level of the hormone is reduced, creating a need for more insulin.
‘If you don’t have as much fuel, you’re not going to be as adept at remembering something or doing something,’ the study's lead author Auriel Willette...
‘This is important with Alzheimer’s disease, because over the course of the disease there is a progressive decrease in the amount of blood sugar used in certain brain regions. Those regions end up using less and less.
When this happens, the study's authors believe, certain parts of the brain can't carry out complex processes, like forming memories.”
Alzheimer’s and Heart Disease Share Risk Factors
Insulin resistance also raises your risk for heart disease, so it’s not surprising to find that heart disease is associated with Alzheimer’s as well.
Arterial stiffness (atherosclerosis) is associated with a hallmark process of Alzheimer’s, namely the buildup of beta-amyloid plaque in your brain. According to researcher Timothy Hughes,9 “the process of vascular aging may predispose the brain to increased amyloid plaque buildup.”
Recent research also points out that heart disease increases your odds of developing Alzheimer’s — in fact, these two diseases share a number of risk factors.
According to a study published in the journal Radiology, shared risk factors include smoking, alcohol use, diabetes, high fasting blood sugar levels, and obesity. 10
These kinds of findings dovetail with the conclusions reached by neurologist Dr. David Perlmutter, author of the two books: Grain Brain, and Brain Maker.
From his research, Dr. Perlmutter has concluded that Alzheimer’s disease is primarily predicated on lifestyle choices and, in a nutshell, anything that promotes insulin resistance will ultimately also raise your risk of Alzheimer’s.
Alzheimer's Is Directly Related to Elevated Blood Sugar Levels
A study11 published in the New England Journal of Medicine in August 2013 demonstrates that even mild elevation of blood sugar — a level of around 105 or 110 — is associated with an elevated risk for dementia. Dr. Perlmutter believes a blood sugar level of 92 or higher is too high, and that the ideal fasting blood sugar level is somewhere around 70 to 85, with 95 as the maximum.
If your fasting blood sugar is over 95 mg/dl, it's definitely time to address your diet to lower it. If you're fat adapted, there's no reason to shun fasting blood sugar levels below 70, as your body is then able to tap into body fat as an energy source. According to Dr. Perlmutter:
"This notion that your brain needs sugar is really old news. Fat, specifically ketones, which your body produces by metabolizing your fat, is now called a 'brain superfuel.' There is even a pharmaceutical product; a medical food that you can write as a prescription, which raises the level of ketones or fat in the bloodstream of patients, offered up now as a treatment for Alzheimer's disease. Who knew? The point is the brain loves to burn fat. That's what we have to shift it over to..."
Three New Studies Highlight the Importance of Exercise
In related news,12 three new studies looking at exercise and Alzheimer’s show that not only can exercise reduce your risk of the disease, it appears to be an important part of treatment as well. According to Maria Carrillo, chief science officer of the Alzheimer's Association:
“Based on the results we heard reported... at AAIC 2015, exercise or regular physical activity might play a role in both protecting your brain from Alzheimer's disease and other dementias, and also living better with the disease if you have it.”
Findings from these studies include:
“In particular, participants attending 80 percent of exercise classes who exercised vigorously experienced significant improvements in their mental speed and attention.”
After six months, the aerobic exercise group had statistically significant reductions in tau levels compared with those who only did stretching. They also experienced improved attention, planning, and executive function, courtesy of improved blood flow in brain regions associated with memory and processing. According to co-author Laura Baker:
"These findings are important because they strongly suggest a potent lifestyle intervention such as aerobic exercise can impact Alzheimer's-related changes in the brain. No currently approved medication can rival these effects." [Emphasis mine]
“[T]he fact that aerobic exercise can improve cognitive function in VCI means that people with the condition have hope there may soon be a proven tool they can use to prolong their independence and improve their quality of life."
Patients diagnosed with mild to moderate Alzheimer’s who participated in a four month-long supervised exercise program had significantly fewer neuropsychiatric symptoms associated with the disease than the control group that did not exercise. As noted in the featured article:13
The second study focused on how exercise impacts tau tangles — brain lesions that are one of the hallmarks of Alzheimer’s. The brain lesions (tau tangles) form when the protein tau collapses into twisted strands, which ends up killing brain cells. Here, sedentary adults diagnosed with mild cognitive impairment were randomly divided into one of two groups. Four times a week, the first group did supervised aerobic workouts, while the other did stretching exercises.
In the third study, patients with mild vascular cognitive impairment (the second leading cause of dementia) who did supervised aerobic exercise for six months significantly improved their cognitive function compared to patients who received the standard care. Lead researcher Teresa Liu-Ambrose noted that:
It's also been suggested that exercise can trigger a change in the way the amyloid precursor protein is metabolized,14 thus, slowing down the onset and progression of Alzheimer's. Exercise also increases levels of the protein PGC-1alpha. Research has shown that people with Alzheimer's have less PGC-1alpha in their brains15 and cells that contain more of the protein produce less of the toxic amyloid protein associated with Alzheimer's.
Exercise also leads to hippocampus growth and memory improvement.16 On the whole, it seems quite clear that exercise is an important part of any Alzheimer’s prevention plan. For guidance on setting up an effective fitness regimen, please review my Peak Fitness Technique for my specific recommendations.
Sleep Quality and Quantity Also Plays a Role
A number of studies have linked poor sleep or lack of sleep to an increased risk of Alzheimer’s disease. One reason for this is because your brain’s waste removal system only operates during deep sleep.17,18 This waste-removal system has been dubbed the glymphatic system.19,20,21,22,23 By pumping cerebral spinal fluid through your brain’s tissues, the glymphatic system flushes the waste (including the harmful proteins amyloid-beta) from your brain back into your body’s circulatory system, from where it is then eliminated.
However, in order for it to do this work effectively, you have to enter deep sleep for a long enough time. During sleep, the glymphatic system becomes 10 times more active than during wakefulness. Your brain cells also shrink by about 60 percent, allowing for greater efficiency of waste removal. During the day, the constant brain activity causes your brain cells to swell in size until they take up just over 85 percent of your brain’s volume,24 thereby disallowing effective waste removal.
It’s not so surprising then that, as noted in the featured CNN video, poor sleep appears to drive the buildup of amyloid plaques in the brain. In short, people who sleep poorly tend to have higher amounts of amyloid plaques in their brain, which in turn are associated with worse performance on memory tests. As such, poor sleep may actually be an early indicator sign of amyloid buildup, which could be causing very subtle brain changes long before disease develops.
So just how much sleep do you need for optimal health? Based on a review of 300 studies assessing sleep and health outcomes, the latest sleep guidelines state that adults aged 18 to 64 need 7 to 9 hours, and seniors over the age of 65 need 7 to 8 hours each night.
School-age children need 10 to 13 hours, and teens, who tend to be among the most sleep deprived, need 8 to 10 hours of sleep per night. Considering the ramifications of sleeping poorly over decades, it would be wise to address your children’s sleeping habits early on, and to teach them the value of getting enough quality sleep on a regular and consistent basis.
Key Dietary Considerations for Alzheimer’s Prevention
Getting back to where we started, research25 from the Mayo Clinic has revealed that diets rich in carbohydrates are associated with an 89 percent increased risk for dementia while high-fat diets are associated with a 44 percent reduced risk. This combination of very little sugar and carbs, along with higher amounts of healthy fat is essential not only to address Alzheimer's, but diabetes and heart disease as well, since all of these conditions are rooted in insulin and leptin resistance.
Understanding this can make your life a whole lot easier. You don't need to memorize the dos and don'ts for each and every disease you seek to avoid; all you need to do is shift over to a mindset that is focused on optimizing health. Disease prevention then becomes a beneficial "side effect." My optimized nutrition plan can set you on the right path in this regard. In summary, the following four dietary instructions are key for staving off Alzheimer’s:
Eat REAL FOOD, ideally organic. Avoid processed foods of all kinds, as they contain a number of ingredients harmful to your brain, including refined sugar, processed fructose, grains (particularly gluten), genetically engineered (GE) ingredients, and pesticides like glyphosate (an herbicide thought to be worse than DDT, and DDT has already been linked to the development of Alzheimer’s).
Ideally, you’ll want to keep your added sugar levels to a minimum and your total fructose below 25 grams per day, or as low as 15 grams per day if you already have insulin/leptin resistance or any related disorders. Opting for organic produce will help you avoid synthetic pesticides and herbicides.
It’s even more important to choose organic grass-fed meats and animal products, as animals raised in confined animal operations (CAFOs) are routinely fed GE grains contaminated with pesticides, along with a variety of drugs. Some researchers have even suggested Alzheimer’s may be a slow-acting form of mad cow disease, acquired by eating contaminated meats; and mad cow disease originated in the CAFO system, which forces herbivores to eat animal parts...
Replace refined carbohydrates with healthy fats. Your brain does not need carbs and sugars; healthy fats such as saturated animal fats and animal-based omega-3 are FAR more critical for optimal brain function. Healthy fats to add to your diet include:
Avoid all trans fats or hydrogenated fats that have been modified in such a way to extend their longevity on the grocery store shelf. This includes margarine, vegetable oils, and various butter-like spreads.
Avoid gluten and casein (primarily wheat and pasteurized dairy, but not dairy fat, such as butter). Research shows that your blood-brain barrier is negatively affected by gluten. Gluten also makes your gut more permeable, which allows proteins to get into your bloodstream where they sensitize your immune system and promote inflammation and autoimmunity, both of which play a role in the development of Alzheimer’s.
Optimize your gut flora by avoiding processed foods (sugar, GE ingredients, pesticides, and various food additives all discourage healthy bacteria in your gut), antibiotics and antibacterial products, fluoridated and chlorinated water, and by regularly eating traditionally fermented and cultured foods, along with a high-quality probiotic if needed. Dr. David Perlmutter explores the compelling connection between the microbiome and brain health in his book, Brain Maker: The Power of Gut Microbes to Heal and Protect Your Brain for Life, connecting it to a number of neurological diseases, including Alzheimer's.
Other Alzheimer’s Prevention Strategies
Besides the key dietary instructions just mentioned, along with getting regular exercise and enough restorative sleep, the following suggestions may also be helpful for the prevention of Alzheimer’s disease:
Sources and References
1 Alzheimer’s Association 2013 Alzheimer’s Disease Facts and Figures (PDF)
2 CNN June 8, 2015
3 Nature 2014: 20; 415-418
4 Neurology March 5, 2014 [Epub ahead of print]
5 Time Magazine March 5, 2014
6 Journal Gazette August 3, 2015
7 JAMA Neurology July 27, 2015. doi:10.1001/jamaneurol.2015.0613v
8 Huffington Post July 29, 2015
9 Medicinenet.com March 31, 2014
10 Web MD July 28, 2015
11 NEJM August 8, 2013; 369:540-548
12 13 Medical News Today July 24, 2015
14 15 Journal of Neuroscience, April 27, 2005: 25(17); 4217-4221
16 PNAS February 11, 2011: 108(7); 3017–3022
17 University of Rochester Medical Center August 15, 2012
18 Science 18 October 2013: 342(6156); 373-377
19 University of Rochester Medical Center, October 17, 2013
20 Time October 17, 2013
21 Kurzweill.com October 18, 2013
22 Science News October 17, 2013
23 Medical News Today October 18, 2013
24 Time September 11, 2014
25 Mercola.com Dr. David Perlmutter interview April 27, 2014