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Lifestyle changes can prevent and slow cognitive decline. Some say they also reverse it.
Alzheimer’s consists of three sub-types with distinct drivers: infl ammation or infection; harmful environmental exposures; and/or lack of neuron- nurturing hormones. To determine which one to target, he tests patients for blood- sugar, infl ammation and hormone levels, heavy metals and critical nutrients such as D and B vitamins. Then he crafts a personalized plan. He notes that the 10 years it can take to progress from subtle decline to full-blown Alzheimer’s provides a huge opportunity. “Ideally, we want people to come in when they have mild impairment or are asymptomatic,” says Bredesen, advising that tests be done for the APOE4, or “Alzheimer’s gene” in one’s 40s. “People have not wanted to know in the past because they’ve been told there is nothing they can do about it. We completely disagree.” One way to stay cognitively sharp is to eat fewer carbs (which boost blood sugar) and eat more fat, says Perlmutter. “There is a clear relationship between elevated levels of blood sugar and increased risk of Alzheimer’s.” One study, published in 2013 in
the New England Journal of Medicine, tracked 2,067 healthy adults for seven years and found that the higher their average glucose level, even if they weren’t diabetic, the more likely they were to develop dementia. For instance, those with a level of 115 milligrams per deciliter were 18 percent more at risk than those measuring 100 milligrams per deciliter. A 2012 study published in Neurology followed 266 adults for four years and found that those with higher blood sugar saw certain areas of the brain shrink 6 to 10 percent more than those with lower blood sugar. Gluten can also be problematic, advises Perlmutter, when it’s infl ammatory and driving brain degeneration. In contrast, good fat, like that in
avocados, fatty fi sh, coconut oil and walnuts, serves as a foundation for neurons and an effi cient, clean- burning fuel source for the brain. This is particularly helpful in someone with early-stage Alzheimer’s, says Bredesen,
because the disease can make it harder for the brain to use sugar for fuel. In some cases, both doctors recommend an extremely low-carb, or “ketogenic” diet (fewer than 60 grams of carbs per day). Starved of carbohydrates, the liver produces fat-like compounds called ketones, a brain-fuel source shown to stimulate growth of new neural networks. Bredesen also recommends 12 hours of fasting each night, with zero food intake within three hours of going to sleep. Fasting promotes a process called autophagy, by which the brain essentially cleans itself of damaged cellular material. Eight hours of sleep is also vital. According to University of Rochester research, the space between brain cells opens up during sleep, allowing cleansing channels of fl uid to fl ow more freely. “If you were operating your house 24/7 with no time to rest or clean, it would be disastrous,” says Bredesen. “The same is true of your brain.” Also, they say, keep teeth clean because bacterial infections, including those in the gums, have been shown to hasten formation of neuron-killing plaque. Also critically examine the prescription drugs being ingested. A recent study of 74,000 people published in JAMA Neurology found that regular use of heartburn drugs like Prilosec and Nexium increased dementia risk by 42 to 52 percent. Meanwhile, anticholinergic drugs like Benadryl and statin drugs prescribed to manage cholesterol have also been linked to increased dementia. “We see ‘statin brain’ all the time,” observes Perlmutter, who says once patients go off the drugs, they tend to get better.
False Hope or Sound Advice Fargo says researchers are keenly interested in many of the ideas in Bredesen’s paper. Although it’s too early to endorse them, numerous studies are underway. But he wonders if some patients that assert that they’ve reversed dementia actually suffered from something else, like sleep apnea or depression. Bredesen stands by his research, asserting that the 10 patients in his
Supplements Get-Smart
Curcumin: This potent constituent in turmeric (the yellow spice that gives curry its fl avor) has been shown to combat many of the problems that contribute to brain degeneration, including infl ammation, free radical damage and high blood sugar. It also boosts growth of new brain cells. Take 500 milligrams (mg) twice daily or eat a diet rich in curry.
DHA (docosahexaenoic acid): This omega-3 fatty acid serves as a key building block for brain cell membranes. Take 1,000 mg daily (derived from fi sh oil or algae) or eat lots of fatty fi sh.
Coconut oil: It’s rich in medium-chain triglycerides, an effi cient, clean- burning fuel source for the brain. Take one or two teaspoons daily.
Probiotics: These help fortify the intestinal lining, reducing the gut permeability and infl ammation that can impact cognitive health. They also support production of key neurotransmitters and the brain-derived neurotrophic factor brain growth hormone. Look for supplements or foods containing Lactobacillus plantarum, Lactobacillus acidophilus, Lactobacillus brevis, Bifi dobacterium lactis and Bifi dobacterium longum.
B vitamins: High levels of the amino acid homocysteine have long been linked to increased risk of Alzheimer’s disease; have levels
checked and if they’re elevated, B6 and B12
can reduce them.
Source: David Perlmutter November 2016
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