Blog 4 of 6

By Terry Willard Clh, PhD

This material will be presented at the Kootenay Herb Conference on July 8^th, 2023 (https://herbconference.com/kootenay-herb-conference/).

I think we might really be onto something here as this blog was taken down for over 2 weeks. We now have access to it, so we will be posting this and the last two over the next few days.

So far in this blog series on Alzheimer’s disease (AD) we have focused on its possible causes (Blog 1) and diagnosis (Blog 2) along with a few dietary suggestions (Blog 3). In today’s blog post we will focus our investigation to looking at some of the strategies we can employ to improve our chances of stopping the progress of AD or even reversing it.

Strategy #1: Diet

The human brain is an incredibly complex and powerful organ, containing roughly 500 trillion synapses that mediate communication between cells. These communication processes require a steady supply of energy and nutrients to keep the brain functioning optimally. With the burgeoning evidence linking cognitive decline, obesity, insulin resistance, diabetes, and hypersensitivity to dietary habits, it is now more important than ever for us to adopt a new nutritional diet—such as the Brain Food Pyramid mentioned below—which focuses on providing the brain with all of its necessary fuel and nutrition. 

This is a particular diet plan that includes intermittent fasting along with consuming anti-inflammatory foods while also avoiding dairy and sugar. Although it can’t fully reverse Alzheimer’s disease that has already been diagnosed, adhering to this dietary protocol has been shown to have significant impacts in reversing the effects of cognitive decline when implemented early in the disease progression. Furthermore, it could also be beneficial for individuals who may be at risk for AD due to family history or lifestyle choices.

Other diets have a similar nature and can be modified, including the Mediterranean Diet, Brain diet, a modefied healthy Japanese/Korean diet (minus deep fried foods). In other words lots of fruits, vegetables, fish, with fewer grains. 

This dietary Bredesen protocol is broken into 5 “pyramid” levels which are as follows, starting with the bottom foundational level:

1. Fasting (Clean House)
2. The right foods (Eat Freely) – non-starchy vegetables & healthy fats
3. Gut health (Upgrade Your Gut) – prebiotics, resistant starches & probiotics
4. Protein sources and fruits (Choose Wisely)
5. Indulgences – Foods that normally need to be avoided but small amount can be eaten – e.g., sweeteners, cocoa flavanols, A2 dairy, and red wine

Pyramid Level 1: Fasting (Clean House)

This Protocol is a nutritional plan that seeks to restore metabolic flexibility and promote long-term brain health. The key point is that the diet pyramid and for that point the whole program is focused mostly on intermittent fasting, with the goal of achieving insulin sensitivity, while encouraging the body to burn fats for fuel rather than just glucose, thus leading to improved cognition. The protocol requires participants to fast for at least 12 hours between supper and breakfast and to begin their fast at least 3 hours before bedtime (12/3). Those with ApoE4 genetics may find it beneficial to extend their fast to 16+ hours in order to reach optimal effectiveness. 

Additionally, the protocol emphasizes maintaining an appropriate BMI as a means of preventing loss of lean muscle mass, bone loss, and cognitive decline due to unhealthy weight loss. Don’t get too skinny! For women under 65 years of age, the recommended minimum BMI is 18.5. For men under 65 years of age, the corresponding value is 19. In general, those over the age of 65 should aim for higher values than these minimums in order to ensure their overall health and well-being. 

Pyramid Level 2: The Right Foods (Eat Freely)

Make sure to go wild in the produce aisle, or even better, your own garden or a local farmers’ market. Indulge mainly in non-starchy vegetables such as leafy greens and cruciferous vegetables for maximum nutrition density. These can be consumed raw or cooked however you like.

Cruciferous vegetables are some of the most powerful and nutrient-rich foods, containing cancer-fighting chemicals that can also help protect against various diseases. It would also be ideal to incorporate “fruits disguised as vegetables” into meals (e.g. avocados, olives and tomatoes which are full of beneficial fats and carotenoids)—older adults with diets rich in these carotenoids combined with omega-3s have been shown to have improved cognitive performance, memory recall, and greater brain network efficiency.

Consume 6 – 9 cups of organic, in-season, non-starchy vegetables per day (on average) to gain the benefits of their antioxidants and nutrients; this amount should be increased gradually over time. To further maximize intake of beneficial micronutrients, include spices such as turmeric and saffron alongside herbs like parsley, basil, and cilantro; teas such as hibiscus, medicinal mushrooms, matcha or green tea containing the EGCG flavonoid, are also great for improving brain health.

Pyramid Level 3: Gut Health (Upgrade Your Gut)

Gut health is a fundamental component of any healthy lifestyle, and for those suffering from cognitive decline, it represents an invaluable opportunity to improve their condition. The gut microbiome plays a crucial role in the overall functioning of the body, and its delicate balance should be carefully nurtured. 

Bone broth has been found to provide numerous benefits, especially in repairing leaky gut; however, it should only be consumed 2 – 5 times per week to prevent overconsumption. If consumed every day the bone broth can affect the microbiome too much and start to produce a negative effect. I suggest the use of botanicals that have berberine (e.g., Oregon grape, barberry, Coptis, goldenseal) as constituents. In addition, it’s wise to address the underlying root causes of chronic GI issues while gradually increasing the intake of prebiotic fiber with each meal. Lastly, experiment with incorporating various probiotic foods into the new diet for maximum benefit: eating fermented foods such as sauerkraut, tsukemono (Japanese quick pickles), and kimchi that are rich in probiotic bacteria can help boost intestinal health by restoring microbial balance within the gut.

Pyramid Level 4: Protein Sources (Choose Wisely)

When selecting protein sources, it is important to maintain an optimal balance of essential amino acids. Methionine, an essential amino acid found mainly in muscle meat (fish is best, but any clean, organic, or wild meat will do), has been linked with a more favorable metabolic state and longevity when slightly restricted. This means it’s helpful to get enough methionine, but too much can become problematic. This type of ‘keto’ hybrid is not a high protein carnivore diet. It is one of balance. Glycine—another essential amino acid present in collagen, organ meat, bone, and skin—should also be included for its numerous health benefits. 

Remember that the program is meant to be plant forward. The KetoFLEX 12/3, inherent in its name (FLEX = flexitarian), provides an opportunity to include animal protein or not. If there is a decide to include animal protein, think of it as a condiment or a side dish, not a main course. There are several sources of vegetarian proteins.

All plants contain some protein, making it unnecessary to limit sources of protein to animal products. Instead, a variety of plants should be consumed for optimal health benefits. Vegetarians and vegans can obtain adequate amounts of protein from legumes, nuts, seeds, and vegetables – for example, one ounce of pistachios contains the same amount of protein as one pastured egg. However, plant proteins may be incomplete and less absorbable in comparison to animal sources. Those solely consuming plant-based proteins should consider the potential deficiencies of omega-3s, vitamin B12, retinol, vitamin D, zinc, and choline—all of which are vital for brain health. 

If animal-based protein is used, wild fish and pastured eggs are recommended as healthy and nutritious sources of protein. Adults should aim for 0.8 – 1 gram of protein per kilogram of lean body mass per day from non-plant proteins. Additionally, adding heirloom seasonal fruits to meals can provide natural digestive enzymes; small portions of wild berries and tropical fruits are particularly beneficial for this purpose. 

Lemons and limes are excellent sources of vitamin C and can be consumed liberally as part of a balanced diet.

Pyramid Level 5: Foods to Avoid 

When selecting snacks and desserts, it is important to be mindful of the risk factors associated with their consumption. Chocolate that is high in cacao and low in sugar is a healthier option for receiving flavonoid benefits; however, commercial cocoa powder and cacao powder should be avoided if they contain added sugar content. 

Similarly, all conventional animal dairy products should be eliminated from the diet due to their high sugar levels. Alcoholic beverages are considered neurotoxins, so they should always be moderate to low, if not avoided if cognitive decline or potential cognitive decline is an issue. If sweeteners are necessary, honey, maple syrup, and pure monk fruit sweetener are acceptable alternatives but should be consumed in limited amounts. 

DAIRY

Because dairy products cause inflammation in so many people, and since inflammation is a key driver of Alzheimer’s disease, it is recommended to exclude dairy from the diet. If you’re used to pouring a generous dollop of cream in your coffee, this recommendation can seem daunting.  Humans have been consuming cow’s milk since the start of agriculture and animal domestication around 10,000 years ago. The majority of dairy in the western world today is comprised of A1 milk which differs from its ancestral form (A2) by just one amino acid at the 67th position. This small difference may be enough to trigger inflammation in those sensitive to it, causing a variety of symptoms including stomach pain, bloating, gas, diarrhea, eczema, and sinusitis. Non-Europeans are especially vulnerable to this condition; up to 90% of East Asians are affected due to their low levels of lactase production. Additionally, casein proteins found in dairy can be mistaken for gliadin proteins (found in gluten) and trigger the same inflammatory response.

For those looking to reduce rather than eliminate their dairy intake, A2 dairy is available in most grocery stores and grass-fed varieties are preferable; using dairy in small quantities from other animals (such as goat, sheep, or water buffalo) is another option. There are also a variety of animal milk alternatives such as unsweetened versions of almond, coconut, flax, hazelnut, hemp, or macadamia milk. Cashew milk may be too high in lectins so should be avoided if possible. Rice milk is too carbohydrate-heavy for many diets, so it’s best used sparingly. Coconut oil or ghee can be added to coffee during fasted states but don’t forget that other forms of dairy and dairy substitutes will break the fast. Those with insulin resistance who want to extend their fasts should try to incorporate a little bit of coconut oil into their diet. 

Overall, it’s important to be aware of the potential risks associated with A1 dairy products and consider the possible benefits of switching to A2 products . It is up to each individual to decide whether to try A2 dairy and also to make sure that they have the right information and support to make the best decision for their health.

Another option with dairy is the use of fermented dairy, which can be beneficial as a snack and also includes probiotics. It is best to use A2 dairy.

YOGURT 

Give permission to indulge in some delectable yogurt from time to time—just make sure it’s sourced from any of the approved animals, is organic and grass-fed with live, and has active cultures. Skip the sugar rush and go for unsweetened instead—add some nuts and wild berries if you want sweetness. If feeling bold, try some unsweetened organic coconut or soy yogurts too! Or why not get creative and make some at home? 

KEFIR 

Need something a bit sour? Kefir is your answer—it’s full of healthy probiotics and bacteria. All the same rules apply as yogurt: make sure to get organic and grass-fed! 

CHEESE

You can indulge in some delicious cheese every now and then—choose goat, sheep or even water buffalo if you can find it. Just try to keep portions small if possible.

In our next blog we will look at various  treatments that can help in your pursuit to reduce cognitive decline.