Dementia is a condition where there is a decline in memory, thinking and behaviour, to a point where your day to day life is affected. Alzheimer’s Disease is the most common form of dementia. Though older age is one of the biggest risk factors for Alzheimer’s Disease (AD), it is not a part of normal ageing. The disease starts 20-30 years before your doctor diagnoses you with Alzheimer’s Disease. And at present, there is no treatment for it. However, not all cognitive decline is dementia.
According to the World Health Organization, worldwide there are about 50 million people living with dementia. (In context, the population of Canada is about 37 million). Unfortunately, about 60% are in resource-poor countries, where the primary support for them is their family.
A pretty grim picture, right? Maybe not! It IS possible to prevent cognitive decline by using multiple modalities. Food is one of the big ones.
Different Paths To Alzheimer’s Disease
We don’t know the exact cause of Alzheimer’s Disease but we do know that there are many paths that lead to cognitive decline. For some people, it may be multiple overlapping paths.
The commonest pathways leading to Alzheimer’s Disease are
- Diabetes: People with Type 2 Diabetes are at a high risk of dementia.
- Insulin resistance of the brain. Alzheimer’s Disease is sometimes called Type 3 Diabetes. The brain has a problem using glucose as a fuel-a condition called brain glucose hypometabolism.
- Chronic inflammation.
- Oxidative stress: An imbalance of free radicals and antioxidants in the body, causing cellular damage.
How can you improve insulin resistance with food?
- Eating low carbohydrate food. How low? It will depend on your personal carbohydrate threshold. (YouTube Video)
- Time-Restricted Eating (TRE) / Intermittent Fasting (IF)
What About The MIND Diet?
The MIND Diet is a combination of the Mediterranean Diet and the DASH (Dietary Approach To Systolic Hypertension) diet. In this study called MIND diet slows cognitive decline with aging, the authors devised a MIND diet score. They followed about 900 people, mostly women, with an average age of 81 years for almost 5 years. Every year their MIND diet scores were accessed using a Food Frequency Questionnaire.
What food is considered good in the MIND Diet?
- Green leafy vegetables
- Olive oil
- Whole grains.
- Fish (not fried)
Inflammatory Food and Cognition
The Dietary Inflammatory Index (DII) is a score based on research that looked at different components of food in relation to blood markers of inflammation and chronic disease. They use a 24-hour dietary recall to access the inflammatory potential of your food. Ref
Highly inflammatory food are sugar, refined grains, highly processed food, soda , processed meats. Dark green leafy vegetables, berries, spices, fatty fish and nuts are considered as less inflammatory.
In multiple studies, a higher DII score (more inflammatory) was associated with worse disease outcomes.
Personalized multi-modality approach to preventing Alzheimer’s Disease.
Neurologist, Dr. Richard Isaacson from the Weill Cornell Medicine and New York-Presbyterian at New York, USA runs the unique Alzheimer’s Prevention program for first-degree relatives of people with Alzheimer’s Disease. In this 2018 perspective paper, The clinical practice of risk reduction for Alzheimer’s disease: A precision medicine approach, he and his team use a multi-modality approach to address several risk factors. Ref
One size does not fit all! You knew that, right?
What does this mean for you:
If you changed your diet from one containing a lot of processed fast food, sugar, soda, cookies and pasta, alcohol to one more like the MIND diet or a lower inflammatory diet, you will definitely see a ton of benefits.
But what if your diet is already reasonably healthy? You eat “real food” and lots of fruit and vegetables. Then you need to do a deeper dive. For example, you will find many well-respected doctors and nutritionists talk about “healthy whole grains”. Are whole grains really healthy? (Podcast episode). In some people without diabetes, grains can raise blood glucose levels to the diabetes range. Ref. That is definitely not what you want!
What about beans and lentils? If you are severely insulin resistant, the quantity of carbohydrates in beans and lentils may be too much for you!
Making healthier food choices by eating a low carbohydrate diet, no sugar, and no processed food is a good place to start. But many of you will need more nuanced recommendations. Food is one component of a brain-healthy lifestyle and creates a good foundation, but it may not be enough.
The other areas that need attention are your blood pressure, sleep, stress reduction, movement and exercise, toxic exposure, alcohol intake, targeted supplementation.