Friday, October 25, 2013

Brain Power: Reducing the Risk of Alzheimer's Disease


Memory is as critical to human survival as food, water and oxygen. Not only are memories treasure troves of our passions and experiences, they're reminders of the most basic functions in everyday life. Without them, simple tasks like buttoning a blouse or remembering a pot of boiling water on the stove could become unmanageable or even dangerous. That's what makes Alzheimer's disease such a cruel illness. It robs its victims of both the small and grand moments in life, leaving loved ones and caregivers to fill in the blanks. It is also among the most expensive illnesses to treat.

Medical researchers are diligently working to better understand this neurodegenerative disease, hoping to gain more insight into its causes and ultimately find a cure. Initial steps have been made in treatment options for patients with Alzheimer’s but, as with any disease, prevention is the best option.

Primary Risk Factors for Alzheimer's Disease
Our current understanding of Alzheimer's disease is that it results from a combination of factors that cause damage to the brain over time. There are some people who have a genetic risk for the disease; they fortunately represent a minority of cases. For most people who develop the disease, lifestyle and environmental factors play a larger role.

History of Head Trauma
People who have experienced severe or repeated head trauma have a higher risk of developing Alzheimer's disease. Researchers have also noticed a connection  between mild traumatic brain injury and damage to the white matter of the brain, which is a phenomenon resembling Alzheimer's-related dementia.

Because of the likely relationship between head trauma and Alzheimer's, it's possible that hyperbaric oxygen therapy (HBOT) can lower Alzheimer's risk in those who've experienced such injuries. HBOT is known to be protective against a number of neurological problems by helping the brain to heal itself on a cellular level.

Poor Dietary Choices
There are always going to be strong opinions about what is the best diet to promote a healthy brain or healthy heart or healthy sex life. Increasingly, studies show that our high carb, low fat diet that has been promoted since the 1970’s has contributed to an explosive increase in type 2 diabetes, obesity, cardiovascular disease and Alzheimer’s disease. Many integrative physicians side with Dr. David Perlmutter in his recent book Grain Brain. Eliminating high sugar and starchy processed foods and drinks, including fruit juice, is a great first step to reducing your risk of Alzheimer’s disease. Eliminating most commercial vegetable oils for cooking and margarine is a great second step. And eliminate all sources of gluten (see below).

Dr. Perlmutter explains how to change our diets to avoid Alzheimer’s disease. Here is a list of "brain foods" which are also "heart healthy":
  • Fish (choose ones low in mercury)
  •  Eggs (yes, they are good for your heart and your brain)
  • Grass fed meat, wild game
  • Free range, organic poultry
  • Extra virgin olive oil
  •  Flaxseed oil
  •  Coconut oil
  • Avocados
  • Tomatoes
  • Seeds and nuts
  • Legumes
  • Cruciferous vegetables
  • Dark green leafy vegetables
  • Berries
  • Citrus fruits
  • Orange-colored fruits and vegetables
  • Vegetable juices
  • Turmeric spice
Opt for a Paleo-style diet that avoids grains especially refined pasta, bread and other baked goods. It should be heavy on omega-3 and limited omega-6 fatty acids (fish, olive oil, flaxseed oil, avocados, nuts and seeds), vitamins (fruits, vegetables), flavonoids (berries, citrus fruits, spinach, dark chocolate), mixed carotenoids (carrots, winter squash), and medium chain triglycerides (coconut oil). This will boost prevention.

Gluten Sensitivity
People with celiac disease have a severe immune reaction to foods that contain gluten, such as wheat, barley, and rye. The damage may not be limited to the gut. Unfortunately, those with celiac disease may have a higher risk of developing dementia. The good news is that the same research that found this connection also discovered that people with celiac disease may be able to reverse cognitive decline by adhering to a gluten-free diet.

Many others are gluten sensitive, which still causes significant inflammation. Inflammatory responses may include brain fog in the short-term, and can contribute to dementia over time. Sometimes the routine tests used to diagnose gluten sensitivity are not sensitive enough. A new, highly sensitive test of gluten intolerance, endorsed by Dr. Perlmutter, is available:  Cyrex labs Array 3.

Poorly-controlled Blood Sugar
There has been such a notable connection between Alzheimer's disease and poorly- controlled blood sugar that Alzheimer's disease is sometimes referred to as "type 3 diabetes." While this term may not be entirely accurate since it doesn't account for other causes of Alzheimer's disease, it does point to an important link.

A long-term Japanese study found that Alzheimer's disease developed two times more often in participants with diabetes than in those with normal glucose tolerance. A study in Germany showed that proteins that were glycated (or had a sugar molecule permanently attached to them) produced nearly 50 times more free radicals than non-glycated proteins. In the brain these free radicals damage adjacent neurons. Physicians measure the percent of one molecule that is glycated in our bodies every day in their offices: Hemoglobin A1c. This is just one of 1000’s of proteins that are glycated every time blood sugar gets high.

Cholesterol and Statin Usage
Having high levels of HDL cholesterol, which is known as "good" cholesterol, may help reduce the risk of late-onset Alzheimer's disease. In the past, it was also believed that low levels of LDL, or "bad” cholesterol, helped prevent Alzheimer's disease. Thus, statin drugs were often considered helpful in reducing the risk of the disease. Studies into the connection between statins and Alzheimer's have not found this to be the case, however. In fact, because statins, beta-blockers, and diabetes drugs lower coenzyme Q10, they may actually contribute to dementia. Coenzyme Q10 is believed to help protect against dementia. Research is ongoing.

Additionally, the membranes of brain cells are made of cholesterol, fish oil and other fats. Cholesterol is critically important for communication between brain cells. Too low a level of cholesterol robs the brain of essential building blocks and compromises function of nerve cells. This increases the risk of dementia.

Vitamin and Nutritional Deficiencies
Numerous studies have suggested that optimal vitamin levels may play a major role in Alzheimer's prevention. Research into the effectiveness of vitamin E has been mixed; however, studies examining vitamin C, beta-carotene (a precursor form of vitamin A), and vitamin D have been more positive. Research that measured the levels of these particular vitamins in patients with and without Alzheimer's disease found that participants with dementia tended to have lower levels of vitamin C, beta-carotene and vitamin D than patients with higher cognitive function.

Additionally, supplementing with vitamin B6, vitamin B12, and folate appear to slow down cognitive decline. Herbs such as gingko biloba (which enhances blood flow to the brain), lemon balm (which is calming, and raises GABA to improve focus), and bacopa monnieri (which raises dopamine levels to enhance focus) may also play roles in preventing Alzheimer's disease. Other supplements decrease inflammation. (See below.)

Hormonal Imbalance
As people age some will experience obvious changes in brain function when they go through menopause or Andropause. Some will notice deterioration in memory when they experience chronic stress.  Herbs, lifestyle changes or hormone therapy may improve brain function and prevent further deterioration.

Sedentary Lifestyle
The same study that found a link between a high saturated-fat diet and memory loss in rats and mice discovered a potential correction to the problem—despite fat intake. According to the research, exercise helped reverse the memory damage in the rodents. Rats and mice that remained on the high-fat diet but were given access to a running mill achieved memory restoration over a period of seven weeks.

So, while a healthy diet is important to Alzheimer's prevention, exercise can help negate the effects of an unhealthy diet, as it relates to cognition. Optimal brain health is achieved through a combination of healthy diet and regular exercise.

Exercise that requires thinking while moving...ballroom and square dancing, tennis, and golf maybe more beneficial than running on a treadmill.

Smoking

High Levels of Aluminum, Mercury and other toxins
Mercury can cause nerve cell deterioration in the brain, even at very low levels—something other metals are unable to achieve. This suggests that people with high levels of mercury in their bodies are more susceptible to Alzheimer's disease. Key sources of mercury exposure in most people are dental amalgam (silver) fillings, polluted air from coal-fired power plants, immunizations and some fish.

There is also growing evidence that aluminum is linked to the advancement of Alzheimer's disease. Exposure to aluminum can come through cookware and aluminum foil, antiperspirants, ground water (in certain areas), immunizations and a variety of environmental toxins. The primary treatment for ridding the body of toxic metals like mercury and aluminum is chelation. Other toxins accumulate over time and frequently damage the brain. Consider reducing your exposure to toxins and making cleansing or detoxing a part of your daily lifestyle.

Lack of Active Learning and Social Engagement
There is a definite link between an active brain and a healthy brain. Lifelong learning and social interaction are activities that are believed to help ward off Alzheimer's disease. Higher and continuing education, mentally challenging work and hobbies, and an active social life are all ways of keeping the brain young and agile. Some studies have even found a link between late retirement and reduced Alzheimer's risk.

Check Your Genes
While most genes are turned off and on every time we eat a donut or an organic apple, there is one gene that can have a significant impact on your risk of Alzheimer’s disease. If you have a family member with autism, Alzheimer’s disease or other neurodegenerative disorder, consider obtaining an Apo E test. This genetic marker has to do with the movement of cholesterol around the body and it reveals your ability to eliminate mercury from your body. Around 25 percent of the population has a score of 3/4 or 4/4, which corresponds to a reduced ability to detoxify mercury and eliminate it from the body, and is therefore associated with an increased risk of developing Alzheimer’s at an earlier age.

Checklist for Prevention
Now that you know the risk factors involved with Alzheimer's disease, you can take steps toward reducing or removing those risks. Here's your healthy brain checklist: 
  •  Avoid head trauma. Consider HBOT therapy if you've ever suffered a concussion or other head trauma.
  • Start making changes to your diet. Fortunately, the foods that help reduce your Alzheimer's risk are usually both delicious and healthy. Take a Paleo-style cooking class to motivate you. Also avoid genetically modified foods (GMO/GE).  These may contribute to many illnesses including Alzheimer’s.
  • If you have celiac disease or are gluten sensitive, eliminate gluten from your diet. These days going gluten free is much easier than it has ever been in the past. There are a plethora of gluten-free foods and cookbooks on the market.
  • Have your blood sugar levels tested. If you're already diabetic, talk to your doctor about how you can control your blood sugar levels better. Changing your diet as listed above is an important start. Even if you don’t have diabetes, get a fasting insulin and blood sugar (FBS) and Hemoglobin A1C (HgbA1C) checked. The optimal goals are: fasting insulin below 8microIU/ml, FBS less than 95 mg/dL and Hgb A1C less than 5.2% – much lower than the level of 6.5, which confirms a diagnosis of diabetes.
  •  Get your good cholesterol up. One of the easiest ways to improve your HDL numbers is to add foods high in omega-3 fatty acids to your diet. These foods are good for the heart and the brain! And talk with your doctor about mental side effects from statins or other drugs. Not everyone experiences these, but if you do: take CoQ10 and consider letting your cholesterol trend a bit higher than the very low levels now being recommended.
  • Have your vitamin levels measured. Vitamins D, B-12 and folic acid are easy to measure. A simple blood test can determine whether your levels are in the upper 1/3 of normal range. If they aren't, talk to your doctor about a supplement regimen that can improve your health. Also check homocysteine. This is a pro-inflammatory molecule that speeds up the progression toward dementia when folic acid, B6 and B12 are low.
  • Supplement for optimal brain function. Alpha lipoic acid, resveratrol, turmeric and probiotics all reduce inflammation or enhance detoxification or act as antioxidants. The first three also penetrate the brain for enhanced benefits.
  •  Harmonize your hormones. If you are noticing symptoms, get your hormone levels tested. Work with someone to enhance brain function as you age.
  • Get off the sofa! If a rat on a running mill in a cage can reverse its memory problems, then surely you can achieve similar results much more creatively and pleasurably by hiking, running, cycling or any number of physical activities.
  • Quit smoking. You now have another really good reason to give up the habit.
  •  Have your aluminum and mercury levels tested. The best test is a provoked urine test using chelating agents. (A blood or random urine test only shows evidence of recent exposure.) Depending on the results, you may want to consider undergoing chelation therapy to remove the heavy metals from your body. Another important step is to have your amalgam fillings removed and replaced with composite fillings.
  • Avoid, detox and eliminate the toxins. The world is polluted and we are too. Dealing with these toxins must become part of our lifestyles.
  • Engage your mind. Take a class in a new subject, start a new hobby, spend your spare time on stimulating activities like reading or assembling puzzles. Consider online programs like www.lumosity.com. And don't forget to make time for friends and family.
  • Research your genetics. If you have a 3/4 or 4/4, don’t panic. Lots of people do. It’s better to know what you’re dealing with than to let fear paralyze you. Get counseling to decide how to best manage your risk if you have either of these gene combinations. Get informed so that you can take appropriate actions to avoid developing Alzheimer’s disease. This may include removal of your amalgam fillings and chelation of the mercury to prevent your developing dementia.

Lastly, if you or a loved one already has signs of early dementia, work with your doctor AND consider all the above as first-line treatments to reverse and prevent early progression. Once Alzheimer’s disease is well established, the degree of recovery will be proportionally less. Act sooner, not later. 

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