Feed Your Brain

Everything we put in our mouths affects the health of our brains. What we are learning now is that sweets don’t appear to be good for our brains, while healthy fats are good brain food. The story, however, gets much more complex than that.

Grace Slick was close to my new slogan for baby boomers when she wrote White Rabbit:

When logic and proportion have fallen sloppy dead
And the white knight is talking backwards
And the red queen's off with her head
Remember what the dormouse said
Feed your head, feed your head.

(Did you know that it was a dormouse, rather than “door mouse” and it is in fact a very cute little mouse with a furry tail, but has no relation to doors.)

Feed Your Head

The pills that the doctors have for you, when logic and proportion and memory have “fallen sloppy dead” have been based on the theory that amyloid plaques cause Alzheimer’s Disease, the most common cause of memory loss in aging people, accounting for 60-80% of all cases. It is perhaps the most likely cause of dementia when memory loss and difficulty thinking are the only problems, without difficulty moving, controlling your bladder, or speaking. When you can find no other cause for dementia (after looking for vascular disease, Parkinson’s, dementia with Lewy bodies, and more), you are considered to have Alzheimer’s. Alzheimer’s can strike young people (as in the book and film Still Alice), in which case it is more rapidly progressive, but most commonly strikes those 65 and older. Partly because the medications have slowed but not reversed the changes of Alzheimer’s and partly because normal people have apparent amyloid plaque, competing theories are emerging that suggest alternative hypotheses.

At this point the truly exciting news about Alzheimer’s is not a breakthrough in identifying the cause but rather discovering patterns of disease that have led to insights about a novel and effective treatment program for dementia.

For a few years, news has followed the association between sugars and dementia: high levels of sugar – in either the diet or the bloodstream – correlate with increased rates or risk of Alheimer’s. A study released in 2012, following a known association between a high calorie diet and risk of impaired cognition, asked the question: is it just calories, or does it depend what kind of calories we’re talking about. An observational study, it can only suggest associations or areas for further study, it cannot prove causation. Nevertheless, the study followed almost 1000 elderly subjects for 3.7 years and observed that 200 developed symptoms of dementia during that time. Those whose dietary history recorded the highest percentage of carbohydrate calories had an increased risk, almost double compared to those with lower carbohydrate intake. Those who were eating the highest percentage of fats had about half (0.56) the incidence of dementia, and the avid protein eaters had about ¾ (0.79) the incidence of dementia, suggesting that “a dietary pattern with relatively high caloric intake from carbohydrates and low caloric intake from fat and proteins may increase the risk of dementia in elderly persons.”

There are more dietary studies, and lots of very focused experiments investigating the effects of one or two factors on the likely development, or amelioration of dementia. Many have elaborated the specific dynamics on a microscopic physiological level with attention to factors that affect those dynamics. The multitude of factors that affect pertinent physiology suggests that “the pathobiology of AD dictates a system or program rather than a single targeted agent.” A systems approach has been used successfully with other diseases, particularly in a public mixed with private health arena. You can check your blood pressure at the drug store, and be reminded almost everywhere that you shouldn’t smoke! So, without having to understand the details of the highly technical neurological science involved in Alzheimer’s, it is relatively straightforward to grasp the collection of individual interventions that have been studied singly and when taken together might consist of a worthwhile effort to reverse a devastating disease process.

Dale Bredesen and John Varghese have done amazing work in this realm, publishing a theoretical article detailing the history and the rationale for a life-choices systems intervention model. Impressive, it sounds great, but does it work?

How handy, they were evidently working in the scholastic and real worlds at the same time, and in October of last year published a report of ten subjects with whom they were able to apply some of 22 identified potential beneficial actions their folks could take. One very advanced person failed to show any benefit, but the results with nine of the ten were truly impressive. Three of their personal stories are detailed in the article here.

There are some drugs used with Alzheimer’s patients, but none of them claims to nor has been seen to reverse the disease. Some symptoms or expressions of the disease may be temporarily controlled, but cognitive function does not return as it did with 9 of Bredesen’s 10 subjects.

What does this mean?

The implications are two-pronged, if you will, with one clear lead to the research community to take on the question with a larger group being studied. Meanwhile, there is every good reason for clinicians who are comfortable with the types of interventions used to add them to the tool bag of today.

In fact, there is good reason to share this information – healthful for more than just cognitive function – with all of our aging patients. The biggest problem, as I see it – is that some of the interventions will be novel to physicians (“How does one normalize Pregnenolone levels?”) and more worrisome, that the scope of the program is daunting to people with perfectly intact memories. There are a good number of lifestyle changes to make, and many, many supplements or prescriptions to consider adopting.

Here’s a summary of the 21 interventions.

1. Reduce nutritional inflammation: choose a low-carb, possibly grain-free, and high-fat eating plan. Avoid allergenic foods, Reduce sugars!
2. Clean your brain.  Fasting is a good break for the brain, allowing it to “clean itself out”:  fast for 12 hours a day.
3. Stress management.  Reduce your level of stress with yoga or meditation.
4. Brain recovery and cleansing happen during sleep. Optimize sleep with a goal of 8 hours nightly. Rule out sleep apnea, and supplement with tryptophan or melatonin if needed.
5. Exercise. 30-60 minutes, 4-6 days a week, is great.
6. Reduce brain toxins, specifically keep homocysteine <7.0. The first supplements to try are methylated versions of B12 and folate, as well as B6 in the Pyridoxal-5-Phosphate form. (These are all combined in Thorne Research Medi-Pro multi-vitamin.)
7. Feed the nervous system in general. Keep B12 levels in the upper half of the normal range.
8. Measure and manage inflammation.  Check and normalize lab tests, including hsCRP and the albumin/globulin ratio.
9. Hormones.  Balance and replace hormones, including
   • Optimized thyroid hormones
   • Estrogen (estradiol, not Premarin), progesterone (not Provera) and testosterone – it’s not too late
   • Pregnenolone and Cortisol
10.  Digestion must function normally. Evaluate gastrointestinal health and repair as needed.
11.  Prevent scarring in the brain. Reduce amyloid beta formation with curcumin and/or ashwaganda.
12.  Reasoning mechanisms. Take supplements that enhance cognitive function:  Bacopa monniera or magnesium-l-threonate.
13.  Vitamin D. Optimize vitamin D3 levels 50-100 ng/mL
14.  Brain repair. Increase neurotrophic growth factor: H. erinaceus or Acetyl-L-Carnitine
15.  Support brain structure. Structural components of the brain need feeding, too, with Citi- or phosphatidylcholine, DHA, or the magnesium-l-threonate.
16.  Anti-oxidants. Optimize antioxidants using foods (blueberries) and supplements (mixed tocopherols, N-acetyl cysteine, and alpha lipoic acid.)
17.  Zinc and copper are key. Optimize Zinc/Copper ratio (1.1-1.5)
18.  Mitochondrial support. Optimize mitochondria: lots of vegetables, fruits and colors … and supplements such as Ubiquinol, alpha lipoic acid, selenium, zinc, and others.
19.  Mental focus. **Increase focus with pantothenic acid.
20.  Toxicity? Rule out heavy metal toxicity. Treat if present.
21. Beneficial brain foods.  Ketones are great for the brain, whether they come from a ketogenic diet, or supplementation with MCT Oil, or by prescription: Axona.

Some of these supplements are available to you in a simple stroll through either my online store or your local health food store. They are generally regarded as safe for generally healthy people. If you have any health concerns, OR if you want to pursue the program in its full complexity, I highly recommend you work with an experienced practitioner who knows how to test, supplement and prescribe for these 20 recognized areas relevant to brain health.