The Case for Nutrition in Preventing AD

Note: This Review was compiled for educational purposes only. This is not intended to diagnose or treat any disorder. If you have a concern regarding your health, or what to take or do for any mental or physical ailment you should consult a licensed physician.

Of all the changes we can make that might help our brain and memory, dietary changes may be the most important. Exercise, as we have noted, is very important, but I’ve spoken to many people who exercised a great deal who still developed dementia, and one of the reasons is likely due to their diet. You see, exercise results in oxidation and free radicals, and if the body can not produce or ingest enough antioxidants, all this exercise might even hasten our demise. And perhaps the best way to address this oxidative stress is by increasing antioxidants in our diet, but that is not the only nutrient critical for the brain.

In 1997 an epidemiological investigation of dementia rates in 11 different countries revealed that individuals in rural areas of several countries had significantly fewer incidents of Alzheimer’s disease and related disorders (ADRD) than in more industrialized nations like the United States.1 In fact rural China had only 1/3 the incidents of the US. Some parts of South Africa, Italy and India were similar. A closer analysis of the factors involved revealed that diet was a primary factor, if not the “cause” of this disparity. It was a much stronger predictor than was genetics.

To reinforce the fact that age, ethnicity or genetics are not the primary drivers here, another study was conducted in New York, using the Mediterranean diet. In this trial they found those who adhered to this diet the closest were 68% less likely to develop Alzheimer’s than those whose meals were comprised largely of processed or “junk” food, and least like the Mediterranean diet.2 That is a huge effect.

So what were the dietary differences that accounted for this variation? A closer analysis showed that what the rural Asian, African and Mediterranean diets had in common were: far more vegetables, fruits and fish; whole grains, nuts, seeds, and legumes (beans, peas, lentils etc.), and far less other meat, trans fats, salt, sodas and processes foods – “junk food” than is common in the typical American diet. More recent studies in France and Japan have shown similar results – i.e. those whose diets where comprised primarily of vegetables, fruits, and fish; and less fried, or hydrogenates fats, had significantly lower levels of dementia.3 In short they had a better quality and lower quantity of fats, fewer refined foods, and more vitamins, minerals, antioxidants, flavonoids and other phyto-nutrients in their diet.

Mind The Fats In Your Diet

Of all of these dietary elements the strongest correlation with AD has been with fats, and here we find some fats being very good for the brain while others are very bad. Moreover, this subject of fats is one of the most controversial. That is why you did not receive this Review sooner, as I was still reviewing books and articles on this subject to make sure I had my fat facts straight.

It is easy to understand why fats (oils, lipids) are so important in the study of AD, since the brain is primarily made of fats. Also, it’s important to realize that our neurons or brain cells are constantly renewing themselves, and if we are learning new things we are building new brain cells. Moreover, the billions of walls and synapses of these cells are all made from fats in our diet. Perhaps the best fats for this important work are the Omega-3 poly-unsaturated fatty acids (PUFA), especially those that come from fish and algae, because they contain DHA, and approximately 30% of the brain is made up of DHA. Moreover in UCLA and UC Irvine studies DHA has been found to protect the brain against the development of beta amyloid plaque and slow the accumulation of tau, a protein that leads to the development of neurofibrillary tangles. Both have been linked to AD. (For a good review of the importance of DHA and fish oil see my March 08 Monthly Review, available upon request.) Vegetarians may suggest you can get all the good fats you need from plant sources such as flax seed, nuts, etc., and while these are important sources of EFA’s (Essential Fatty Acids), they do not contain the DHA that the brain needs. They do contain linolenic acids which can be converted to DHA in the body, but only in small quantities in most adults. However, the Chicago fish study found that individuals with the ApoE4 gene allele, which increases the risk for Alzheimer’s, have been found to benefit from a higher linolenic diet as well.4

Animals that feed exclusively on range grasses like deer, goats, buffalo or lean beef, may also have some omega-3 containing DHA in their meats, and chickens raised in the wild can have higher levels of Omega-3 in their eggs. However, most animals now spend their last months in feed lots on grains which, unlike grasses, cannot be converted to Omega-3’s. Therefore, they are no longer good sources of DHA, and contain too many fats that can be harmful for the body and brain. Plus, they tend to make the body more acidic, which may make us more vulnerable to a variety of disorders including AD (see below).

Greg Cole, professor of medicine and neurology at UCLA (University of California in Los Angeles) and associate director of UCLA’s Alzheimer Disease Research Center, and his colleagues have determined that the presence of the omega-3 fatty acid docosahexaenoic acid (DHA) near neurons increases production of a protein called LR11. Found at low levels in Alzheimer’s patients, this protein functions as a destroyer of the plaques in the brain believed to cause, or at least contribute to the disease.5

Wild cold water fatty fish, like salmon, seem to be our best source for DHA- unless you have a hankering for seaweed or algae. The EPA (another fatty acid) in fish oil is also helpful in reducing systemic inflammation, believed to be a significant contributor to Alzheimer’s.6

What is not helpful in fish is mercury. Therefore, it’s usually best to eat fish that are “wild caught,” or small fish like sardines, krill, or tuna packed in water. Or like most people, you can obtain your Omega-3’s from fish oil. Cod liver oil, umm yumm! This is especially good in winter months, because it also contains vitamin D3, (the sunshine vitamin) which is also important for the brain, and often lacking on cloudy Winter days. And fortunately most cod liver oil is now flavored, or in capsules.

But fried fats and trans fats such as hydrogenated and partially hydrogenated oils – typically used in peanut butter, salad dressings, and baked goods (which often contain baking powder with aluminum), frozen waffles, margarine, and most fried food are “a disaster” for the brain. The brain will try to use them, but these fats make rigid, tough, sluggish brain cells that are more susceptible to oxidation and disease.

A Harvard University study, evaluated more than 85,000 women in a long-term prospective study and found that there was a significantly higher intake of partially hydrogenated trans fatty acids in those individuals who developed heart disease. Other studies have found the same link to obesity, diabetes and Cancer.7 And you should know from my class and past reviews that heart disease, obesity and diabetes all increase the odds for Alzheimer’s.

The typical American diet is low in the good fats and high in bad fats, and that is believed to be one reason why we have one of the highest rates of Alzheimer’s disease in the world. But it has not always been this way. On their website, www.originalfastfoods.com James and Colleen Simmons cite a U.S. Department of Agriculture study documenting some of the changes that have occurred in the U.S. diet in the last century.8 They include:

If you want to know why we are seeing such an increase in ADRD (Alzheimer’s and related disorders) consider the above, and the fact that our bodies were not made for those ratios. Moreover, according to Dr. Mary Enig, a researcher at the University of Maryland, and one of the world’s foremost authorities on fats, “trans fatty acids essentially foul up the ‘machinery,’ inside our bodies… [they] inhibit the function of membrane related enzymes resulting in decreased conversion of the good omega-3 fatty acids and escalate the adverse effects of essential fatty acid deficiency.”7 Which includes, heart disease, depression and dementia.

Dr. David Perlmutter, one of the leading Neurologists in the US in this area, notes that:

Then he adds this “Caution: Perhaps the most dangerous aspect of trans-fatty acids is that they crowd out healthier fats. Even if you eat lots of good fat along with trans-fats and take an essential fatty acid supplement [like fish oil] the trans-fatty acids are the ones that will end up in your cell membranes.” [emphasis added]

According to a 1997 landmark New England Journal study, noted by Simmons, replacing even 2 percent of energy formerly eaten in the form of trans or partially hydrogenated fat with non-hydrogenated, unsaturated fat like olive oil drops heart risk by 53%.10 Olive fruit is high in polyphenols which help reduce LDL cholesterol, and increase the good HDL.11 However, Simmons, Enig and others note, extra virgin coconut oil would be the best oil to cook with. Although it is saturated, NO trans fats can be made from it. [Also, unlike vegetable oils, and virtually all other commercial cooking oils, it is resistant to damaging oxidation.]

So how do we identify the hydrogenated or trans fats? Usually it will say on the label if a product has hydrogenated or partially hydrogenated oils. Most peanut butters do, for example. But there are some brands like Adams, which do not. According to Dr Enig all corn and soy oils should be avoided. For those with inflammatory ailments sesame oil is said to be helpful, as it can inhibit the formation of arachidonic acid, a fat that is a major precursor to inflammation.

Many other preservatives, and sweeteners like high-fructose corn syrup are hard for the body to handle as well and may contribute to diabetes, neurological problems and other health problems (more on that in our next issue).

Why Eat More Fruit and Vegetables

In order to apply the essential principles of the Mediterranean diet in our lives it will be helpful to understand why it works. Although we may not understand all of the reasons, at least the following 3 seem important to consider.

First, the emphasis on whole fruits and vegetables, grains, nuts, beans and peas helps insure that our body obtains more of the essential nutrients (vitamins, minerals, enzymes and antioxidants) that we know are important for healthy brain function, like folate, and vitamins C & E, etc.12 How many whole natural foods do you eat currently? Most foods in our modern diet are over cooked and processed in such a way that they lose many if not most of their vitamins, enzymes and other nutritional cofactors needed by our body. Sure, other nutrients are often added, but these are only a fraction of those available in fresh, raw, slow cooked, or unprocessed foods, and often these are not as bioavailable as the original food would be.(For more information see www.originalfastfoods.com and their book by the same title.)

Second, whole vegetables in particular provide calcium and magnesium that help keep the body’s pH alkaline, as opposed to acidic. An increasing amount of research is showing that the more alkaline the body (within limits) the more resistant it is to disease. Babies bodies are reportedly quite alkaline, but as we age and worry and consume more sugar, meat and acidic foods, our bodies tend to become more acidic, and that apparently makes them more vulnerable to deterioration and disease. Calcium and magnesium help to counter that and may help prevent AD. (See below.)

Dr. Harold Foster in his intriguing book, The Real Cause of Alzheimer’s Disease, revives the theory that aluminum may still be playing a key role for many people.13 We definitely know it is a neurotoxin, and that it can disrupt a variety of enzymes important for metabolism and brain function. But the evidence has been confusing, because mere exposure to aluminum clearly does not always result in brain damage. There is something called the blood brain barrier that protects the brain from this potentially toxic mineral. Dr. Foster suggests, however, that the critical factor appears to be the body’s pH. He notes that our nerve cells need calcium and magnesium to function well. But if we do not have sufficient quantities of these two minerals then the body will try to use other minerals instead. It may then allow monomeric aluminum (which is becoming more prevalent in our water, food and environment) to cross this blood brain barrier, and enter into the delicate structures of the brain. There it can result in serious damage, especially in those with a genetic vulnerability, such as the APOE-4 allele (gene).

Foster notes, international studies have shown that if a population’s drinking water and/or diet are high in calcium and magnesium and related nutrients they are less likely to develop AD, even though they may be exposed to aluminum. On the other hand, if their water is “soft” and/or their diet is low in calcium and magnesium, or more acidic in nature, then they appear to be more vulnerable to aluminum accumulation in the brain and Alzheimer’s Disease.

Another reason, therefore, why the Mediterranean diet may be so protective, is because it encourages a lot of foods (veggies, nuts and grains) which are high in calcium and magnesium, which tend to keep the body more alkaline. And on the flip side, Dr. Foster believes one of the reasons why America and Utah in particular has such a high rate of AD, may be because our diet is so acidic. I recently was told that Utah has one of the highest per capita rates of soda (Pepsi, Coke, Mtn Dew, Sprite, etc) consumption in the US. The reason given was many in Utah, due to religious convictions, do not drink coffee, black tea or beer, and it gets hot out here. So, we tend to turn to more acidic soda pop, which may also, if left in the can long enough, leach aluminum from the can.14

In his review of a similar theory, Dr. Paolo Zatta, of Italy, a respected researcher in the field, expresses doubt that aluminum is the root cause of Alzheimer’s, but he does note most seniors are low in magnesium, and this deficiency can contribute to enzyme damage and vascular rigidity “commonly present in AD”15 – problems that may be avoided with a diet high in vegetables, nuts, whole grains and fruit – such as the Mediterranean diet.

Third, I find it interesting that while there are many nutritional supplements available, to date the best researched supplement, the only one (other than MemoyXL) shown in more than 20 University studies to be truly effective in reducing homocysteine, oxidation, and other key contributors to cardiovascular and brain wellness is a simple food supplement made from 17 dehydrated fruits, grains and vegetables called Juice Plus®. Some vitamin/mineral supplements appear to be useless, and others may even be harmful for seniors.16.

(For more information on Juice Plus® and related nutritional studies, contact Dr. Edward Fila at 801-298-5452, or visit his web site at www.drfila.com. For more information on The Mediterranean Diet read the book by that title by Marissa Cloutier, M.S., R.D.. But whatever we do, it seems wise to eat a variety of vegetables, fruit, nuts, grains, beans, peas and seeds, as well as Omega-3s. Our mental health may depend on it. For more info on the value of a whole food diet go to www.originalfastfoods.com

Finally, if you or someone you love, are experiencing mild cognitive impairment or memory problems I want to invite you to join me in a new exploratory project funded by the national Association on Aging, which we call “Cognasium.” In this project we intend to demonstrate the value of dietary and lifestyle changes in slowing or arresting cognitive decline. If you are interested give me a call at 1 801 529-8238.

References

1. Grant, William B., Dietary Links to Alzheimer’s Disease. Alzheimer’s Disease Review 2, 1997, 42-55.
2. Scarmeas, Nicholas, Mediterranean Diet, Alzheimer’s Disease, and Vascular Mediation. Archives of Neurology, vol 63, Dec 2006, 1709-1717.
3. French study http://healthday.com/Article.asp?AID=609900. Dr. Otsuka in the department of Neurology, JichiMedical School, Omiya Medical Center in Japan in a study involving 64 Alzheimer’s patients found Alzheimer’s disease patients ate more meat and less fish, as well as less green-yellow vegetables.
4. Morris MC, Evans DA, Bienias JL, et al. Consumption of fish and omega-3 fatty acids and risk of incident Alzheimer disease. Archives of Neurology, 2003 Jul; 60(7):940-6.
5. http://www.naturalnews.com/022649.html Omega 3 fatty acid confirmed to deter Alzheimer’s. Originally published February 15 2008.
6. Chilton, Floyd H., PhD. Inflammation Nation. Simon & Schuster, NY, 2006.
7. Mary Enig, PhD., University of Maryland, interview with Richard A. Passwater, Ph.D. http://articles.mercola.com/sites/articles/archive/2000/06/10/trans-fats.aspx
8. Major Trends in U.S. Food Supply, 1909-1999; Food Review Volume 23, Issue 1; Credit and Source: USDA’s Economic Research Service; http://www.ers.usda.gov/publications/foodreview/jan2000/frjan2000b.pdf
9. Perlmutter, David, M.D. The Better Brain Book, 2004, p. 65.
10. Simmons, James & Colleen, Original Fast Foods, American Fork, UT, 2008.
11. Go to www.lef.org put Olive Oil in the search window and look for the special report titled “The Purest EPA-DHA Fish Oil in The World.”
12. Cloutier, Marissa, MS, The Mediterranean Diet, Harper Collins, NY 2001.
13. Foster, Harold D., What Really Causes Alzheimer’s Disease, Canada, 2004. You can download a copy by going to http://www.hdfoster.com and clicking publications.
14. Abercrombie, D.E., and Fowler, R.C. (1977). Possible aluminum content of canned drinks. Toxicology and Industrial Health, 13(5), 649-654.
15. Zatta, Paolo, Alzheimer’s disease: A Vexata Questio between uncertain data and a lot of imagination. Journal of Alzheimer’s Disease 10 (2006) 33-37, 33 IOS Press.
16. A finding noted by many, but investigated by Doctors Edward Fila and Robert Morrow, MD, and shared by Dr. Fila with this author in June 2007, noting that in clinical studies some food supplements actually caused damage to cells.