In Part 1 of this blog series on Alzheimer’s disease, we discuss how Alzheimer’s disease (AD) is caused by metabolic stresses producing ROS. ROS (reactive oxygen species) are free radicals that result in damage to micro-structures within the brain cells. This damage then results in an immune response by the body to repair the damage and when excessive causes inflammation.

This inflammation causes destruction of the nerves, collapse of their exoskeletons and the formation of inflammatory tangles. A sticky substance called amyloid collects on the nerves, causing further problems. As the destruction progresses, the memory and the mind deteriorate and ultimately result in the frail debilitation and slow death we see in AD patients.

None of us wants this, so our emphasis should therefore be to prevent the problem. Prevention is the best and only medicine for AD that we have currently that really works. There is no cure. So, let’s discuss what you can do to prevent AD from ruining and shortening your life.

Keys to Prevention of AD: Reduce Metabolic Stress

Focus should be on prevention of Alzheimer’s disease. If you can prevent the formation of ROS, perhaps you could help prevent the disease. Preventing ROS is a multifactorial process that must be started early in life. Changes in the brain from AD start 20 to 30 years before the symptoms appear, and no one knows who will be affected.

Thus, you must start at least in your 30’s to 40’s for the best benefit. But starting even earlier is also good to develop the right habits for a healthy lifestyle. Regardless of your age now, start to practice good healthy lifestyle habits to enhance your health. In addition, embrace the benefits of what we have learned about maintaining hormone levels and natural supplements to enhance these benefits. Here’s a short list:

1) If you’re weight is normal, keep it that way. Don’t allow yourself to gain weight. If you’re overweight, lose the extra pounds. We’ll talk more about this shortly

2) Exercise regularly and keep moving daily. Vigorous exercises for 30 minutes a day is probably one of the best things you can do to prevent Alzheimer’s disease. Exercise also improves heart health, and the better your heart health, the less you may develop Alzheimer’s disease. You can potentially reduce your risk of developing Alzheimer’s disease by 60% to 70% if you start in your 40’s and concentrate on keeping your body fit.[1] An added benefit is that keeping yourself fit also improves your attractiveness.

3) Next take supplements that reduce ROS and reduce inflammation within your body. There are a variety of supplements you can take that can do this. Concentrate on anti-inflammatory compounds and fat-soluble ones, like omegas, CoQ10, curcumin, and Vitamin D. Water soluble ones may include green tea and vitamin C.

4) When you reach middle age, especially if you become symptomatic from menopause or andropause, improve your quality of life and your health by maintaining adequate hormone levels. Starting early with hormone therapy has been shown to decrease your risks of developing not only Alzheimer’s disease, but also cardiovascular disease.

5)Other actions that may prevent ROS and inflammation in your body include stress reduction, adequate sleep habits, staying social, and maintaining good sex throughout your life. All are good for the soul, so when you nourish your sole and send good feelings within with a positive attitude, good things come to you. All these improve your quality of life, plus they may help prevent this root cause of Alzheimer’s disease.

Lose Weight and Eat Right

The first action you can do to prevent AD is to lose weight if you’re overweight and to eat right. If you’re overweight or obese during midlife you increase your risk of developing AD by 59%.[2] Then if you develop diabetes plus your cholesterol and your blood pressure is high, your risk increases for developing AD is six-fold higher than the normal risk. High blood sugars result in excess ROS and inflammation everywhere, including the brain. Elevated blood glucose and high insulin levels have been shown to be toxic to brain cells and cause further ROS formation.

If you become diabetic or even prediabetic, this destruction occurs in the small vessels that feed all your organs and cells, called your microvascular system. These are all the small capillaries in your brain, your eyes, your kidneys, and everywhere else. The ROS that injures these tiny vessels due to these changes from diabetics results in inflammation of these capillaries, thus it is called a microvascular disease.

The damage that occurs to this microvascular system in diabetics causes the symptoms you see in diabetics, including the destruction of cells in the kidneys resulting in kidney failure, or the destruction of cell structures in the back of the eye, the retina, resulting in blindness. The destruction to the microvasculature that feeds nerve cells results in the numbness in the hands and feet you see in diabetics, called peripheral neuropathy.

A similar destruction occurs in the brain, and this is called Alzheimer’s disease. The incidence of AD in diabetes is so high that some doctors have actually called Alzheimer’s disease Type 3 diabetes. There is no question that the high blood sugars and high insulin levels are toxic to the brain, so you must stop this destruction before it happens.

Hemoglobin A1c and Diabetes

There is a blood test you can do that will tell you if you are starting to develop diabetes. This blood test is called hemoglobin A1C (HA1C). It is the level of the hemoglobin in your red blood cells that have excess glucose attached on to it, called glycation. You want the levels to be below 5.0. Levels between 5.7 and 6.3 are considered prediabetic, and levels > 6.4 are considered diabetic.

HA1C is a great awakener to let you know that you must change your lifestyle if you want to prevent diabetes and its sequelae (including AD) from ruining your life. Being overweight can increase levels and if you stay overweight or obese the level of HA1C continues to rise because the process of ROS and increased inflammation progress if you don’t correct them early.

This destruction is the destruction of your microvasculature. Yes, it can start even though you’re not diabetic. It probably has started at least when you are prediabetic, but it gets worse as the disease progresses.

It may happen even in those who maintain a normal weight. Interestingly, HA1C can be mildly elevated in around 10% to 20% of people with normal weight. Thus, it is a good idea to have this test done even if you’re at a normal weight. If you are one of these, then what do you do? It’s not like you can lose weight because you’re already at a normal weight. But there is something you can do.

Maintain a Keto-Medi Diet

You probably have heard of a Mediterranean Diet and that it has been associated with a decreased risk of developing heart disease and other chronic medical illnesses.[3] Some studies suggest more than a 30% reduction. This diet is different than the Standard American Diet (SAD) by emphasizing eating more fish while minimizing beef. Eating more vegetables and lot of fats, but primarily good fats is common. But what you may not know is that increasing fat intake even more than in a typical Mediterranean diet reduces these problems even more.[4]

A high fat diet is a ketogenic diet where you eat mostly fat for your body’s fuel needs. The fat consumed, and the extra fat in your body and the byproduct of this is ketones. Ketones are another energy source for your body and your brain. In fact, your brain cells utilize ketones better than they do glucose. In addition, ketones act like growth factors to brain cells and stimulate the formation of new brain cells.[5] Remember, retaining a memory requires the formation of new brain cells and you can do this even better by maintaining a good level of ketones in your brain.

One way to maintain ketones in your blood is to do a ketogenic diet. Here, you consume 70% to 80% of your calories in the form of fats. But the best ketogenic diet encourages the use of good fats instead of bad fats. Good fats are in olive oil, olives, nuts, and naturally formed fats such as butter, cream, or coconut oil. Bad fats are hydrogenated vegetable oils or excess beef fat.

Reducing your carbohydrate (carb) intake is essential in doing any type of ketogenic diet. Carbs must be reduced to less than 5% to 10% of your total calories. In addition, eating a lot of protein is not necessarily a ketogenic diet. Protein should be limited to around 15% of total calories. It’s all about the fats, but emphasis on the good fats.

Studies have shown that maintaining ketosis can decrease your risks of developing Alzheimer’s disease.[6] They do this by decreasing ROS and inflammation which is toxic to brain cells and is responsible for the destruction of the brain cells and formation of inflammatory tangles as seen in Alzheimer’s patient’s brains.

With less destruction of neural tissues, ketogenic diets decrease the deposition of amyloid on the brain cells which is associated with AD. In addition, they improve the circulation of blood to the brain, which improves your heart health. And, as stated previously, improving heart health is one of the most important actions you can do to prevent AD. We will discuss this more in Part 3 of this series.

Summary

There is a plethora of actions you can embrace that will help decrease your risks of developing Alzheimer’s disease. These include losing weight and eating right. Reducing your weight can reduce your risk of developing AD significantly. Get your hemoglobin A1C level tested, even if you’re not overweight. It can be a sign that you should embrace better lifestyle changes, including a more ketogenic and Mediterranean diet. These may not only improve brain function and decrease risk of development of AD, but they may also improve cardiovascular health, which we will discuss next.

 

[1] Sabia, S, et al. Association of ideal cardiovascular health at age 50 with incidence of dementia: 25-year follow-up of Whitehall II cohort study. BMJ 2019; 366 doi: https://doi.org/10.1136/bmj.l4414

[2] Alford S, et al. Obesity as a risk factor for Alzheimer’s disease: weighing the evidence. Obesity Reviews. October 2017. 19(2). https://doi.org/10.1111/obr.12629

[3] Sofi F, Abbate R, Gensini GF, Casini A. Accruing evidence on benefits of adherence to the Mediterranean diet on health: an updated systematic review and metaanalysis. Am J Clin Nutr 2010;92:1189- 96. https://academic.oup.com/ajcn/article/92/5/1189/4597540

[4] Estruch R, Ros E, Salas-Salvadó J, et al. Primary prevention of cardiovascular disease with a Mediterranean diet. N Engl J Med, April 2013;368(14):1279-1290 . DOI:10.1056/NEJMoa200303.

[5] Lange KW, et al. Ketogenic diets and Alzheimer’s disease. Food Science and human Wellness. 6(1), March 2017: 1-9. doi.org/10.1016/j.fshw.2016.10.003

[6] IBID. doi.org/10.1016/j.fshw.2016.10.003