Did you know that one in two Americans who live to be 85 will get Alzheimer’s disease or some form of dementia? That is correct, 1 in 2. After decades of research and errors in medical judgement about the causes of Alzheimer’s and pharmaceutical treatments which actually worsen dementia when stopped due to intolerable side effects, there is finally hope for preventing and reversing Alzheimer’s (dementia).
We have been arriving at the answers slowly and questioning our theories about the causes of dementia. Twenty years ago when I began seeing increasing numbers of patients with memory loss, I intuitively felt that inflammation was the likely cause. I took inventory on patient’s lifestyle – their level of stress, exercise, and considered their food choices to learn if what they were eating could be causing inflammation. Inflammation is not just localized to one part of the body. When present, it pervades the entire body and brain. What if a person was to change their diet, get more exercise, and learn relaxation techniques? Could this help memory loss? Without any research evidence, merely from a medical intuitive sense, I began making these recommendations to my patients. Not only did it help their memory, it helped their overall health as well. Now there is a compelling study with specific suggestions based on scientific research, many of which align with the recommendations I have made to my patients for nearly two decades.
If this is the case, why not use these recommendations to prevent dementia. How many of us have noticed memory impairment in midlife, when we begin forgetting names of people, grocery lists, where we last placed our keys, or even words while in a conversation? These are all signs of our changing brain and it feels scary to think we are headed down a degenerative path. These changes are actually normal for most people in midlife. As hormones shift and decrease, brain wiring also changes. Neurotransmission is affected and recall is impaired. But for some (nearly 50%), this is just the beginning of what may be a progressive loss of memory. The longer a person has followed a lifestyle that is contrary to the one listed below, the more the blood brain barrier is impaired and neural cell death is underway. Our lifestyle in the first half of our life does catch up with us in midlife and beyond. It is absolutely worth creating the lifestyle changes needed to protect our brain and prevent and reverse any progression of memory loss that may be underway. Some are predisposed to dementia through genetics, but research has shown that genetic expression (2) can remain switched-off or even be turned-off with positive lifestyle changes which heal the environment of our body.
An increase in beta-amyloid in the synapse was found to be present in the brains of Alzheimer’s patients. Beta-amyloid was thought to be the cause of Alzheimer’s and is still considered to be an important contributor, but now we know that amyloid also plays a positive role in the body(3). It protects the body from infections, repairs leaks in the blood-brain barrier, promotes recovery from injury, and regulates synaptic function. It is only when beta amyloid production increases that it interferes with neuronal transmission as well as causes an important protein in the brain called tau protein, (4) to become toxic. Toxic tau protein creates neurofibrillary tangles (5) in the brain, a pathognomonic finding in Alzheimer’s disease. This affects neuronal function by interfering with neurotransmission. A leaky gut, inflammatory foods, insulin resistance, viral infections, toxins like copper and iron, and other heavy metals increase beta amyloid concentrations abnormally. The following will increase beta amyloid abnormally in the brain:
- Hormone imbalance
- Insulin resistance
- Toxins (increased copper to zinc ratio – reduced zinc is found prominently in patients who use Proton pump inhibitors like omeprazole (Prilosec, Protonix, Previcid, Nexium)
Apo E (7) is a gene that we all carry. Two alleles form the Apo E gene. One is inherited from our mother and one from our father. There are three types of Apo E genes, Apo E2, E3 and E4.
- E2, reduces risk of Alzheimer’s but increases risk of cardiovascular disease and cholesterol
2. E3 confers no increased risk of Alzheimer’s disease.
3. E4 confers an increased risk of Alzheimer’s disease especially if you inherit two E4 alleles,
one from each parent.
Not to worry too much, though. If you have one or two Apo E alleles, you may never get Alzheimer’s disease as long as you create an environment in your body that keeps the genes switched off as mentioned above. This is called epigenetic regulation. The environment you create in your body has an impact on which genes are turned on or off.
Dr. Dale Bredesen in his landmark study (8) mentioned above, has created a protocol after trying it on patients with MCI and Alzheimer’s dementia, called Recode (9). What he found is that patients with the Apo E4 gene can alter their amyloid load by making specific changes in their lifestyle.
Biomarkers which have been shown to be correlated with dementia are:
- Elevated hs-crp due to sugar, processed carbohydrates, animal protein and increased levels of stress. Keep level less than 1.0 mg/L
- Elevated homocysteine (due to folate and b12 deficiency): The higher the level, the more rapidly the hippocampus and gray matter declines. Keep level less than 7 mm/L
- Elevated insulin levels due to high intake of sugar and processed carbohydrates, and lack of exercise contributing to insulin resistance. Insulin Degradation Enzyme (IDE) degrades insulin as well as beta amyloid. When insulin levels are elevated, IDE favors insulin degradation over amyloid degradation thereby elevating levels of beta amyloid. Keep level less than 5 ulU/ml
- A1C level. Increases with elevated blood glucose from diet and lack of exercise. Keep level less than 5.6%
- Low Vitamin D. Keep level between 50 to 80 ng/ml
- Low B12 level. Keep level greater than 500
- High Copper to Zinc ratio: Keep ratio 1:1
- Hormonal imbalance: Optimal thyroid panel with TSH <2 and estrogen and progesterone balance in women and testosterone balance in men, including normal DHEA levels in both
Lifestyle changes that improve cognitive function, prevent dementia, and reverse Alzheimer’s:
- Eat a plant based/rich diet rich in color (antioxidants).
- Heal your leaky gut with the correct probiotics (10).
- Decrease to eliminate animal protein.
- Keep biomarkers optimal and add supplementation based on blood levels.
- Stimulate ketosis (Do not eat any food for 12 hours after your last meal of the day to increase ketones (11) in the body and brain, which improves brain function and cognition).
- Exercise at least 20 min per day. Start slow and increase your exercise tolerance till you are able to exercise daily.
- Reduce the fat load in your body. Adipose tissue is highly inflammatory and is a risk factor for cognitive decline.
- Add Omega 3 fish oil or DHA. This has been shown to support brain health, memory issues, and mood. In fact, it reverses cortisol (12) induced brain changes due to stress.
- Reduce toxin exposure, keep your liver healthy and reboot it. It is the most important detoxifier in your body. Eat foods like green leafy vegetables that chelate metals and reduce or eliminate your consumption of alcohol. Do detoxification cleanses, (13) periodically.
- Increase Vitamin E rich foods – nuts, seeds, and green leafy vegetables.
- Manage your stress with assistance from professionals, meditation, and self-care.
Knowing what we now know about the rising epidemic of dementia and Alzheimer’s disease and how preventable it is, we must engage our consciousness and our knowledge base to create a healthy environment to protect our brain. It is never too late to start, but we must.
It is imperative for our health and the health of our families and communities.
©June 2019 Kalpana (Rose) M. Kumar M.D., CEO and Medical Director, The Ommani Center for Integrative
Medicine, Pewaukee, WI. www.ommanicenter.com Author of 2nd Edition – Becoming Real: Reclaiming Your
Health in Midlife 2014, Medial Press.