Turning the Tide on Lifestyle Diseases: What Alzheimer’s is, and 5 ways to help prevent it

One of the most feared diseases to affect us is Alzheimer’s.  It not only damages your mind and physical faculties, but it destroys your ability to relate to family and friends. It cuts you off from all that is meaningful and beautiful in life.

Geneticists tell us the gene involved in Alzheimer’s disease is the APOEε4 allele.  We know that the risk of developing Alzheimer’s is significantly increased if one or your parents suffered (3 times more likely), but very significantly if both were affected (10-15 times greater).  Are you doomed to suffer the same fate, then?  Is there nothing you can do to evade this horrible plague?

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According to Drs Dean and Ayesha Sherzai, co-directors of the Brain Health and Alzheimer’s Prevention Program at Loma Linda University Medical Centre, 90% of Alzheimer’s cases can be prevented.   They say: “There is hope. There is a way to prevent cognitive decline, to slow its progression and improve quality of life for those who already have a diagnosis.”

Fifteen years of research and clinical practice dealing with patients in cognitive decline has revealed ground-breaking protocols for Alzheimer’s treatment and prevention.  This is good news for the nearly 47 million people living with Alzheimer’s around the world.  In South Africa up to 6% of people are affected, even traditional rural communities.

In their book “The Alzheimer’s Solution, they state: “Direct links exist between poor nutrition, lack of exercise, chronic stress, poor sleep, the extent to which we challenge and engage our brains and neurodegenerative disease. The truth is that the choices we make every day determine our cognitive fate.”

Here are the five principles of a healthy lifestyle that are encompassed in the NEURO plan for prevention and reversal:

Nutrition:  A whole-food, plant-based diet low in sugar, salt and processed food

Exercise:  An active lifestyle that incorporates movement every hour – not just a stop at the gym after an otherwise sedentary day.

Unwind:  Stress management in the form of meditation (that includes personal devotions), yoga, mindful breathing exercises, time spent in nature and the support of strong communities.

Restore:  Seven to eight hours of regular detoxifying sleep through intensive sleep hygiene, treatment for sleep disorder, and management of medications and foods that adversely affect sleep.

Optimise:  Multimodal activities (like music) that challenge and engage many of the brain’s capacities, as well as meaningful social interaction.

Studies have shown that both dietary reform as well as regular exercise (like brisk walking) can increase the size of the hippocampus – that part of the brain that processes memory, in as little as one year.

“Poor nutrition damages the brain in so many ways: it causes inflammation and the build-up of oxidative by-products, clogs blood vessels, and deprives your brain of the nutrients it needs to strengthen neurons, their connections and critical support structures.  Thus, food is the single greatest tool we have in the fight against Alzheimer’s”.

The brain is only 2% of the body in size but consumes 25% of the body’s energy. 

For this reason the diet has a profound effect on the function of the brain.  If dietary indiscretions can result in obesity, high blood pressure, high cholesterol and diabetes, surely the brain is not going to be spared either.  Because it uses so much of the nutrients ingested, it is no wonder people with these lifestyle diseases suffer from brain “fog”, forgetfulness, depression, fatigue and moodiness.

If you believe going 100% onto a completely whole-food, plant based, low sugar diet with little meat and dairy is too extreme for you, a lot of research shows that even going part of the way brings significant benefits.

Here are 10 recommended foods that you can include in your diet to improve your mind:

1. Leafy greens like kale, spinach, mustard greens – foods high in folate and B9 to improve cognition and reduce depression
2. Cruciferous vegetables. Broccoli, cauliflower, bok choy, Brussels sprouts and kale.  Apart from folate they also have carotenoids that lower homo-cysteine – an amino acid linked with cognitive impairment.
3. Beans and legumes. More folate, iron, magnesium and potassium.  These help neurons to work better.  They also contain choline, a B vitamin that boosts a neurotransmitter critical to brain function.
4. Whole grains. (These particular authors discourage gluten containing whole grains, preferring quinoa, brown rice, maize and gluten-free oats, and avoidance of bread and processed cereals.)
5. Berries and cherries. These fruits contain anthocyanins which together with vitamins E and C are powerful anti-oxidants which counteract damaging free radicals.
6. Pumpkin, squash, asparagus, tomatoes, carrots and beets. These vegetables when lightly cooked are a good source of vitamin A and folate, as well as iron.
7. People whose diet contains daily Omega-3s have a 26% less risk of having beta-amyloid deposits (protein deposits between neuronal cells characteristic of Alzheimer’s disease). Sources of omega 3 are fatty fish, flax and chia seeds.
8. Nuts such as almonds, cashews, peanuts, walnuts and pecans. Don’t take more than a tablespoonful a day – rather than munch on a packet, add to breakfast cereal or salads.
9. Sunflower and pumpkin seeds are rich in choline, zinc and vitamin E.
10. Cinnamon, sage, turmeric and cumin can actually help to break up brain plaque and reduce inflammation of the brain (as well as inflammation in other parts of the body) which can cause memory issues.

Other things to avoid are toxins in your foods like pesticides and herbicides; unnecessary stress (easier said than done), caffeine, sugar, drugs alcohol and sugar.

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Dr Neal Barnard of the Physician’s Committee for Responsible Medicine quotes research (the Chicago Health and Ageing Project that carefully followed-up hundreds of patients of varying diets).  People who ate around 26gm of saturated fat per day compared to 13 gms per day had a 3,5 x greater risk of developing Alzheimer’s disease.  Trans fats, as found in hard margarine and baked goods and fast foods, also showed up striking connection, similar to the saturated fats.  A study in Finland following 1340 fifty year olds for 21 years showed that even mild cognitive impairment was also affected significantly by the consumption of saturated fats.  They then looked at just those who had the APOEε4 gene for Alzheimer’s.  Those who ate a lot of fats had a 5 times greater risk of developing Alzheimer’s than those who had a low fat diet, even though they were genetically programmed towards Alzheimer’s disease.  Dr Barnard quips: “Genes are not destiny”.  Gene expression is modified by diet and lifestyle factors.

Many people consider taking multivitamin supplements to be beneficial.  However, the brain protective Vitamin E as found in nature, for instance, has 8 different forms, whereas the Vit E found in food supplements is legally only allowed to be one form.  Studies have shown that taking only one form inhibits the absorption of all the others.  Natural sources of Vitamin E are foods like nuts, seeds, avocados and spinach.

At Cincinnati University, studies were done on a group of elderly volunteers, average age 78 years, already demonstrating memory problems.  They were put onto one cup of red grape juice or blueberry juice twice per day.  After just 3 months both memory and recall were better than before thanks to the powerful antioxidant effects of anthocyanins found in red grapes and blueberries.

Other colourful foods also have benefits for brain health – green, orange, red and yellow foods have many different types of phytonutrients that are essential for normal function of the brain and other organs.

Forty minutes of brisk walking three times per week (start gradually) can reverse shrinkage of the hippocampus and improve memory and cognitive function.

So, if we can implement all these interventions – cut way down on saturated and trans fats, eat enough colourful anti-oxidant rich foods, exercise regularly, get enough sleep, spend regular time in spiritual meditation, stretch our brain function through multimodal brain activities, reduce stress and improve social connectedness, we can arrest the inexorable progress of cognitive deterioration.  That is surely an objective worth changing our lifestyles to achieve.

To health and wellness,

Dave Glass

Dr David Glass graduated from UCT in 1975.  He spent the next 12 years working at a mission hospital in Lesotho, where much of his work involved health education and interventions to improve health, aside from the normal busy clinical work of an under-resourced mission hospital. 

He returned to UCT in 1990 to specialise in obstetrics/gynaecology and then moved to the South Coast where he had the privilege of, amongst other things, ushering 7000 babies into the world.  He no longer delivers babies but is still very clinically active in gynaecology.

An old passion, preventive health care, has now replaced the obstetrics side of his work.  He is eager to share insights he has gathered over the years on how to prevent and reverse so many of the modern scourges of lifestyle – obesity, diabetes, ischaemic heart disease, high blood pressure, arthritis, common cancers, etc.

He is a family man, with a supportive wife, and two grown children, and four beautiful grandchildren. His hobbies include walking, cycling, vegetable gardening, bird-watching, travelling and writing.  He is active in community health outreach and deeply involved in church activities.  He enjoys teaching and sharing information.

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