I have just finished watching a well-produced series of 14 videos called Awakening From Alzheimer’s. The series is hosted by Peggy Sarlin. Sarlin conducted hour-long interviews with a range of neuroscientists, nutritionist and experts in natural and alternative medicines. The series promotes her book and related information. Nevertheless, the video interviews contained a wealth of great information.
The primary theme of the series is consistent with the MINDRAMP message. We already know how to prevent, slow or even reverse cognitive decline and dementia. I’ll use this edition of the Synapse newsletter to give you some of the highlights of the Awakening From Alzheimer’s book and videos.
TWENTY FIRST CENTURY MEDICINE – TREATABLE DEMENTIA
Dale Bredesen, of UCLA and the Buck Institute, stated that we are entering a very exciting era in terms of prevention and treatment of cognitive decline and dementia. He calls it the “dawn of the era of treatable dementia.” That’s right, treatable. Beyond being able to prevent or slow the development of cognitive decline and dementia, Bredesen states – credibly - that we can now treat and reverse some dementias.
It is Bredesen’s research in particular, that makes this statement valid. Bredesen has developed and tested a personalized, multi-factorial protocol that, for the first time, has demonstrated that the symptoms of dementia can be reversed. People who stopped working because of memory loss and confusion have been able to resume their old jobs. Bredesen combines, exercise, nutrition, stress management, sleep and a total of 45 different factors in his treatment plan.
Bredesen’s approach, and the approach of the other scientists interviewed can be characterized as 21st Century medicine. The older 20th Century medicine uses small data-sets for diagnosis and seeks one-size-fits-all interventions – an approach that has been unable to address the complex nature of neurodegenerative diseases.
The modern approach uses large data sets (lifestyle behaviors and metabolic profiles) to diagnose the multiple root causes of chronic illness. This approach integrates the best of both Western and Eastern approaches to medicine. 21st Century medicine creates comprehensive and pragmatic interventions that are personalized to each individual.
The new approach taken by Bredesen incorporates what MINDRAMP has characterized as the Rule of the C’s (Causes, Combinatorial, Customized and Continual). Evidence shows that successful interventions target root causes, combine multiple interventions, are customized and personalized to each individual
Here is a link to Bredesen’s website where he describes the protocol and offers a number of free research papers. https://www.drbredesen.com/thebredesenprotocol. Bredesen has also published a book called The End of Alzheimer’s.
ADDRESS THE CAUSES OF DEMENTIA, NOT THE SYMPTOMS
All of the scientists interviewed by Sarlin stressed that dementia is a complex, multi-factorial condition. Prevention and treatment of dementia, therefore, must focus on the root causes. Rather than try to disperse the smoke, put out the fire!
So, what causes cognitive decline and dementia? What causes neurodegenerative diseases?
It is increasingly clear that amyloid plagues do not cause Alzheimer’s. They are a response to disease and may even serve a protective function. Dementia is caused, instead, by a host of systemic, metabolic conditions that combine to wreak havoc on body and mind.
Dr. David Perlmutter points to chronic inflammation as being implicated in almost forms of cognitive decline and dementia.
Dr. David Katz is a specialist in integrative medicine. He runs the Yale Prevention Research Center. He claims, quite confidently, that we already know how to slash the risk of Alzheimer’s disease by 80%. He cites three domains of evidence, two theoretical and one empirical.
Theoretical #1 – Cardiovascular problems are a major risk factor for dementia. Many dementias are called vascular dementia because they can be traced to strokes and mini-strokes. But any condition that robs the brain of blood and therefore, oxygen and fuel, does damage to brain cells. We know how to prevent and treat cardiovascular disease.
Theoretical #2 – Insulin resistance, metabolic disease and diabetes are closely associated with dementia, so much that some called Alzheimer’s Diabetes Type III. We know how to prevent and treat diabetes Type II. When we prevent insulin and blood sugar problems and we reduce the risk of dementia.
Empirical - We know that not all older adults get dementia. There are many examples of people who are healthy. Dan Beuttner, in his book The Blue Zones, identified five populations around the globe that live extraordinarily long and healthy lives. He has documented similarities in lifestyle that seem to clearly reduce the risk of dementia. These include eating wholesome foods, getting a lot of exercise, having cultural mechanisms to manage stress, having strong social support systems and getting enough sleep.
Katz points out that adopting healthy living practices, such as eating well, is easier when the culture supports these practices, as in the Blue Zone areas. Unfortunately, the American culture does the opposite since there is too much money to be made selling junk food. So healthy lifestyle practices take not only will power, but also skill power. We need master a variety of skills to support healthy eating and other healthy living choices.
Perlmutter is a neurologist and nutritionist. He has written two, excellent, best-selling books, Grain Brain and Brain Maker. Perlmutter has done as much as anyone to point out that our food choices have a profound effect on our overall health, and on our susceptibility to cognitive decline and dementia.
Perlmutter stresses the role of inflammation in dementia and a host of other chronic diseases. Much of this systemic inflammation can be linked back to leaky guts that occur when our gut bacteria becomes compromised. A permeable gut, caused by poor nutrition, leaks toxins into the blood stream that can cross the blood/brain barrier and get into the brain. Further, the toxins stimulate can systemic immune response which causes a whole host of problems.
Perlmutter’s major dietary recommendations are to eliminate sugar and drastically reduce our intake of simple carbohydrates. And, welcome fat back to the table. Fat has gotten a bad rap. Good fat (coconut oil, olive oil, avocados, nuts, fish oils) promote health and feed the brain, which is 70% fat. To keep our gut bacteria healthy we need to eat more fermented foods (kefir, sauerkraut, kimchi), more prebiotic foods high in fiber (onions, garlic, leeks, Jerusalem artichokes, apple cider vinegar, dandelion greens).
As you might expect, in addition to good dietary practices, Perlmutter also stresses the importance of what we characterize as the CogWheels of Brain Health. These are: physical exercise (aerobics, strength, flexibility), mental stimulation, positive social interaction, stress management and good sleep.
A majority of the Sarlin interviews feature folks who rely on supplementation as an important component of their overall approach to brain health. I will characterize this group as being members of new medical specialty called “personalized metabolic medicine.” They use increasingly sophisticated diagnostic tools to get individual metabolic profiles of their patients. They then use the information to rebalance hormonal systems that have been thrown out of whack, either by disease or by the aging process.
While I remain skeptical about supplementation in general, I am now convinced that targeted use of supplements can be an important component of a combinatorial approach to health care. I don’t think it a good idea to self-medicate, or self-supplement. What does make sense is to work with a professional metabolic specialist to help you get your personalized metabolic profile. The natural medicine professional can then prescribe and monitor specific supplements to target specific deficiencies that have been identified.
In case you want to learn more, the metabolic doctors featured in the series include: Dr. Dr. Richard Brown (Columbia Univ.) and his wife Patricia Garbarg (The Rhodiola Revolution); Dr. Jacob Tieltlebaum; Dr. Mary Newport (coconut oil advocate); Dr. Jay Faber of the Amen Clinics; Dr. Pamela Warthian Smith, who runs the Center for Personalized Medicine and Fred Pescatore a clinical nutritionist.
KETONES TO FEED THE BRAIN
One particularly interesting episode featured Dominic D’Agostino and Dr. Angela Poff of University of South Florida. They are doing some fascinating work on ketones and the ketogenic diet. They argue that ketones are an alternative source of fuel for aging brains.
One of the main points is that the human brain is metabolically demanding but also metabolically flexible. The brain uses 25% of the available energy and usually relies on glucose. But, in times of stress, such as starvation, fasting and advancing age, the brain can convert to utilization of ketones to get its energy. D’Agostino likened the human brain to a hybrid car that can use gasoline, or switch to electricity, or diesel.
Apparently, as we age, our tolerance for carbohydrates ebbs and the capacity to utilize glucose declines. The aging brain ends up getting less glucose (fuel) than normal. Less fuel = less functionality. The ability to use ketones for brain fuel, however, does not decline with age. D’Agostino recommends that older adults begin to transition from their normal diet to a low-carb or even ketogenic diet to make sure that their brains get the energy they need to function well. I find this a credible recommendation.