“Steve Blake presents accurate, understandable information.”
Nutrients for Memory
The Hawaii Dementia Prevention TrialSteve Blake, ScD
July, 2017
"It was good meeting you today and I very much appreciated your informative discussion of nutritional approaches to prevention and treatment of Alzheimer's disease and related dementias."
BRENT P. FORESTER, MD Instructor in Psychiatry, Harvard. Director Mood Disorders Division, Geriatric Psychiatry Research Program and Site Director, McLean Hospital,
Harvard Medical School.
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Nutrition and Alzheimer's Disease
By Steve Blake, ScDWe all know that our diet can affect our chances of getting diabetes and heart disease. What about Alzheimer's disease? Evidence from medical journals indicates that we may be able to dramatically cut our risk of Alzheimer's disease—simply by getting enough of four vitamins. Further reduction of risk may be possible with a diet high in antioxidant fruits and vegetables. Are there dietary factors that increase our risk? Yes, the saturated fats in meat and dairy products can double our risk of developing Alzheimer's disease. In fact, high blood cholesterol levels can triple the risk. Let’s take a look at how this dreaded disease develops?
How amyloid plaques develop
Brain cells have certain long proteins embedded in their surrounding membranes. These long proteins are called "amyloid precursor proteins." They cause no trouble while in the membranes. The trouble begins when enzymes inside brain cells begin snipping off protein chains. These snipped-off proteins are called amyloid-beta. The snipped-off amyloid-beta proteins form clumps between the brain cells. These clumps are called amyloid-beta plaques and they are one signature feature of Alzheimer's disease.
The amount of amyloid-beta formed is controlled by secretase enzymes inside brain cells. If there is more secretase, then we produce more amyloid-beta. If these secretase enzymes are quenched, then the risk of forming amyloid-beta plaques is greatly reduced. [The following sentence could be in a box or otherwise highlighted] The interesting part is that we can control these enzymes and thus the build-up of amyloid plaque.
We need two B-vitamins to quench the secretase enzymes, and thus the formation of amyloid plaque. Vitamin B12 and folate work together to create SAMe (s-adenosylmethionine). SAMe quenches the genes that produce secretase enzymes inside our brain cells.
Many diets do not supply enough folate. However, it is simple and easy to get enough folate from green leafy vegetables and beans. It is not so easy to get enough vitamin B12 and to absorb it properly. A cheap and safe sublingual vitamin B12 supplement is good insurance against Alzheimer's disease. People with dementia might consider taking SAMe supplements. SAMe needs to be taken in the morning and can react with certain drugs.
Just getting enough folate and vitamin B12 can cut the risk of Alzheimer's disease by one quarter.
Advanced Glycation Endproducts
When sugars react with proteins or fats, they can cause advanced glycation endproducts. The acronym AGE is appropriate as these malformed proteins are a major cause of aging. These AGEs can lodge in the amyloid plaques in the brain. The AGEs then create massive amounts of free radicals that cause the cooking and shrinking of an Alzheimer's brain. First, it is a good idea to get enough folate and vitamin B12 to lower the production of amyloid plaques. Second, it is important to reduce our internal production and intake of AGEs.
AGEs are made inside our bodies when blood sugar is high. After drinking a big, sugary drink, AGE formation will be higher than normal. These AGEs can circulate to the brain and build up in amyloid plaques. Happily, when we eat slow-releasing carbohydrates, we do not tend to create AGEs inside our bodies. Beans, vegetables, and yams are examples of slow-releasing carbohydrate sources that are safe to consume. White bread, white rice, and sugary desserts are examples of foods that boost blood sugar and AGE formation.
AGEs can also be taken in from certain foods. The presence of water or steam prevents AGEs from forming during cooking. Plant foods are generally safe from high amounts of AGEs because of their water content. When meat, chicken, or fish are fried, broiled, or barbequed, AGEs are produced in large quantities. High amounts of AGEs are also found in cheese. This is because milk sugar reacts with milk protein to produce AGEs during the aging process. This is another good reason to avoid these animal products.
Avoiding fried meat and sugary drinks can reduce your risk of Alzheimer's disease by half or more.
Antioxidants
We have learned that free radicals are produced in amyloid plaques studded with advanced glycation endproducts. These free radicals cause the oxidation and inflammation in Alzheimer's dementia. Antioxidants are helpful to lower the risk of Alzheimer's disease as well as other chronic diseases such as cancer and arterial disease. There are two types of antioxidants. Some come to us in plant foods. Other antioxidants are created inside our bodies. The antioxidants created inside our bodies need certain minerals to function.
Antioxidants are abundant in fruits and vegetables. Vitamin C and carotenes are examples of antioxidants found in plant foods, but they are not found in animal foods. Polyphenols are found in berries and grapes. Not coincidentally, consumption of berries and grapes has been found to lower the risk of Alzheimer's disease.
The most important antioxidant for cell membranes is vitamin E. Vitamin E protects the cell membranes in the brain from attack by free radicals. This is especially important because the cell membranes in the brain are particularly vulnerable to free radicals. The best sources of vitamin E are walnuts, almonds, sunflower seeds, and hazelnuts. Certain cold-pressed oils are the only other dietary source. Most vitamin E supplements are not helpful because they contain only the synthetic form of alpha-tocopherol and little or none of the other tocopherols that make up vitamin E.
Getting enough antioxidant vitamins can reduce the risk of Alzheimer's disease by four to eight times.
One of the main antioxidants inside our bodies is called glutathione peroxidase. Glutathione peroxidase needs the mineral selenium to function. The high amount of free radicals generated in Alzheimer brains depletes glutathione peroxidase and selenium. Many nuts and seeds are high in selenium, especially Brazil nuts and brown sesame seeds.
The other important antioxidant enzyme formed within our bodies is called SOD (SuperOxide Dismutase). SOD needs three minerals to function. Copper, zinc, and especially manganese are needed to quench free radicals with this enzyme. Manganese has been found to be lacking in some diets, particularly high-meat diets. Whole grains, spinach, peanut butter, and sunflower seeds are good sources of these three minerals.
Other dietary influences
It is interesting that DHA from fish or fish oil has been found to be unhelpful in preventing or treating Alzheimer's disease. A recent, pivotal study showed that DHA is useless in treating Alzheimer's disease.
Medical plants are vegetables with concentrated nutrients. There are two medical plants that have been shown in several double-blind studies to be quite helpful for Alzheimer's patients. One of these plants is the most-purchased medical plant in Europe. Gingko biloba increases circulation in the brain. Nine double-blind, randomized, placebo-controlled trials showed that ginko biloba helped both in delaying the onset of Alzheimer’s disease and in treating it. Ginkgo biloba is contraindicated if there are bleeding tendencies or with blood-thinning medication.
Another medical plant used for Alzheimer's disease is gotu kola (centella asiatica). One study found that gotu kola lowered amyloid-beta in the hippocampus of the brain. The Hippocampus is a memory area of the brain. Another study using gotu kola showed an improvement over six months in moderate Alzheimer's disease, rather than the all-too-common degeneration.
Diet can also influence our intake of pollutants. Certain pollutants have been found to double the risk of Alzheimer's disease. Solvents and pesticides were found to double the risk. Pesticide exposure is vastly lower in plant foods than in animal products.As we have seen, it is possible to greatly reduce the risk of this dreaded dementia.
Table of Contents
Introduction 2
Table of Contents 4
Table of figures 11
Chapter 1: Diet can be powerful 13
Age and delaying dementia 13
The Nurses’ Health Study 14
The MIND diet 15
Rush Memory and Aging Project 16
Supplements to improve cognition 18
The Hawaii Dementia Prevention Trial 20
Chapter 2: Overview of Alzheimer’s disease 24
Changes to the brain in Alzheimer’s disease 25
What are amyloid plaques 27
Meet tau tangles 29
An epidemic of Alzheimer’s disease 31
Junk food, diabetes, and Alzheimer’s disease 33
Diabetes and dementia risk 34
Drugs and Alzheimer’s disease 34
Prevalence of dementia 37
Chapter 3: Food and nutrient changes that worked 40
Vitamin E 40
Advanced glycation endproducts 41
Berries for memory 43
Vascular dementia and saturated fat 44
Supplements used in the trial 46
Two B-vitamins 46
SAMe 47
Antioxidants 48
Vitamin E supplement used 49
Vitamin C supplement used 50
Coenzyme Q10 51
Four antioxidant minerals 52
Two medical plants used 53
Ginkgo biloba 54
Centella asiatica (gotu kola) 54
Chapter 4: Folate, vitamin B12, homocysteine, and SAMe 56
How amyloid plaques are made 56
How two B-vitamins reduce the formation of amyloid plaques 59
Folate and vitamin B12 transform homocysteine into SAMe. 61
Homocysteine and Alzheimer’s disease 62
Are we getting enough Folate and Vitamin B12? 65
Getting enough vitamin B12 66
SAMe and Alzheimer’s disease 69
Chapter 5: Advanced Glycation Endproducts 72
Absorption of AGEs 73
Formation of AGEs 74
AGEs as a cause of brain damage in Alzheimer’s disease 79
Cooking methods to reduce AGEs in food 81
Chapter 6: Antioxidants and Alzheimer’s disease 83
Vitamins E and C protect brain cell membranes from free radical attack 84
Causes of excess free radicals 85
Radiation and medical testing as sources of free radicals 86
Plant Antioxidants Defend Us from Free Radicals 88
Vitamin E and Alzheimer’s disease 88
Why synthetic vitamin E is ineffective 90
Food sources of vitamin E 95
Vitamin C and Alzheimer’s disease 97
Dietary sources of antioxidants 99
Plant antioxidants 102
Antioxidants made in your body 106
Protecting our little energy factories, the mitochondria 109
Coconut oil, ketones, and mitochondrial function 110
Coenzyme Q10, the only fat-soluble antioxidant made in the body 113
Are statins related to memory loss? 115
Antioxidant content in diets 119
Chapter 7: Saturated fat and dementia 121
Saturated fat in diets 123
Blood cholesterol and risk of Alzheimer’s disease 126
Oxidized dietary cholesterol and vascular dementia 128
Crystallized cholesterol 133
Lowering cholesterol using phytosterols 135
Fiber and blood cholesterol 138
Chapter 8: Medical plants to treat Alzheimer’s disease 140
Ginkgo biloba 140
How does ginkgo work? 141
How ginkgo protects brain cells 142
Ginkgo and bleeding 143
Ginkgo and memory 144
Gotu kola 145
Gotu kola as an antioxidant 146
Gotu kola improves memory scores 146
Gotu kola for memory in healthy elders 147
Chapter 9: Exercise and Alzheimer’s disease 149
Exercise and vascular dementia 150
Muscle strength and Alzheimer’s disease 150
Exercise decreases brain shrinkage 151
Exercise can reduce risk of dementia 152
Exercise can cut risk of dementia in half 152
More exercise cuts risk further 153
Chapter 11: Environmental toxins and Alzheimer’s disease 155
Seafood, mercury, and DHA 155
Organophosphate pesticides and dementia 158
Organochlorines and dioxins 159
Aluminum, does it cause Alzheimer’s disease? 160
Chapter 10: Nutritional approaches to Alzheimer’s disease 162
Acknowledgements 166
Index 167
Reference citations 172
Table of figures
Figure 1 Three supplements helped cognition 19
Figure 2 Improvement in our trial 21
Figure 3 No degeneration was noted with food changes 22
Figure 4 Normal decline of memory score 22
Figure 5 Normal brains on the left and advanced Alzheimer’s disease on the right 25
Figure 6 Amyloid plaques look like fuzz balls between neurons. 27
Figure 7 Amyloid plaques and tau tangles 28
Figure 8 Tangled neuron looks like a fried egg 29
Figure 9 The great increase in Alzheimer's death rate 31
Figure 10 Dementia forecast for less developed countries 37
Figure 11 Forecast increase in Alzheimer's disease 38
Figure 12 Types of dementia graph 45
Figure 13 Folate and vitamin B12 and amyloid plaque 57
Figure 14 How amyloid plaque is formed 58
Figure 15 Homocysteine and B-vitamins 60
Figure 16 Folate can be low on an American diet 64
Figure 17 Folate in food from the Diet Doctor 66
Figure 18 Folate and vitamin B12 in diets 68
Figure 19 List of foods highest in AGEs 77
Figure 20 Synthetic vitamin E structure 92
Figure 21 Nut and seed sources of vitamin E 96
Figure 22 Vitamin E in some common foods 97
Figure 23 Vitamin C in food graph 100
Figure 24 Antioxidants in common diets 101
Figure 25 A tiny amount of manganese on an Atkin's diet 108
Figure 26 Cognitive performance among the elderly in relation to the intake of plant foods. The Hordaland Health Study. 120
Figure 27 Saturated fat in various food servings 123
Figure 28 A mostly clogged artery 125
Figure 29 LDL diagram showing signaling proteins 131
Figure 30 Cholesterol crystals in plaque 135
Figure 31 Sources of plant sterols to block cholesterol 137Reference Citations:
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