We all know someone who has been diagnosed with Alzheimer’s, but how many of us know that research is now categorising it as a ‘disease of civilisation’ – i.e. caused by our modern diet and lifestyle?

Alzheimer’s disease is currently the 3rd leading cause of death and it’s anticipated numbers will only increase, as western populations get older.  It’s clearly not an inevitable consequence of old age as 50% of over 85’s show no signs of it, and whilst there can be a genetic component, twin studies have proven that having the genes does not make these diseases inevitable.  It is environmental factors that the individual has been exposed to during a lifetime that can tip the balance, causing any rogue genetic mutations to express, and diet is now considered to be the most significant influencing environmental factor of them all.  

In fact Alzheimer’s shares a few causative factors with Diabetes and Cardiovascular disease, leading some scientists to label it Type 3 Diabetes.  What?another metabolic disease?  Well yes – whilst Alzheimer’s pathology does ultimately affect the brain, insulin resistance is an underlying factor, from  high glucose metabolism, with brain inflammation being another feature.

With regard to the inflammation, research is looking at the role played by glial cells in the brain.  These are the brain’s immune cells, tasked with editing, pruning and clearing out the brain’s waste at the end of the day.  They perform a sterling job when functioning properly, but just as our immune systems can become deregulated in cases of autoimmune conditions, (which sees our immune cells direct their attack on our own tissues and organs), so research is looking to see if glial cells can get similarly deregulated and do more damage to the brain than good.  If this proves the case, and there is an autoimmune component to Dementia, it might explain the very high levels of glial cells found in the brains of Alzheimer’s patients.  However if a ‘type 3 diabetic’ inflammatory pathology is occurring, perhaps the glial cells are simply triggered by this.

So I eagerly anticipated the September 2016 conference: “Why NUTRITION is the key to Alzheimer’s” having just read the extraordinary results of some research led by Professor Dale Bredesen MD, of UCLA who would be presenting, and has spent 30 years researching the treatment and prevention of Alzheimer’s.

At the conference he shared the scientific basis of his hypothesis as well as the  unprecedented clinical results demonstrated by a series of case studies using ‘The Bredesen Protocol’, a multi-factorial, lifestyle and nutrition based approach to treating and reversing early stage Alzheimer’s symptoms. His first pilot study involved just 10 cases, but his second – a clinical trial with 110 subjects – all with early stage Alzheimer’s, resulted in more than 90% of them having their symptoms reversed.  To date, no drug has come anywhere near this.

These results have been questioned by the detractors of nutrition-based therapy, who wonder if Professor Bredesan might be presenting his ‘best cases’, cherry picked from a larger cohort, how else to explain such extraordinary results?  One can sympathise to an extent with such cynics, because to date, there is no pharmaceutical cure for even the early stages of the disease.  Drugs currently slow disease progression, but none, not one, reverses or cures it.  My response to such detractors, were it to be a case of cherry picking, and there’s no suggestion that he has, is that Professor Bredesan has still shown nutrition and lifestyle interventions are capable of reversing signs and symptoms in some cases.  Oh – and without any side effects of course.

The key finding of his research is that ‘cognition does not exist in isolation‘.  Mainstream medicine a long time ago compartmentalised the body into organ specialties, the neurologist would rarely confer with the cardiologist or the gastroenterologist, and the psychiatrist was out on a very isolated branch.  Which is a shame, because it turns out Cognition and Metabolism actually go hand in hand, so by focussing on the patient as a whole entity, rather than a set of isolated cognitive symptoms, and looking upstream at causation, rather than focussing on symptom suppression, Bredesen has achieved some remarkable results.

He likens the disease to having a roof with 36 holes in it, and patients do invariably present with multiple metabolic disturbances alongside the cognitive impairment.  So to date, mono-therapy drugs are failing because in reality they need to have dozens of therapeutic routes in their sights, to plug all the different causative holes.  If a variety of lifestyle factors conspire to ultimately produce those holes in the roof (brain degeneration being one aspect), then it makes sense to me that multiple lifestyle interventions might be needed to plug those holes.

Bredesen’s approach involves many of the old familiar lifestyle enhancements, better sleep, the consumption of healthy dietary fat with less carbohydrate consumption – for improved blood glucose control, stress reduction, exercise to improve insulin sensitivity, management of homocysteine levels, optimising vitamin D3 and the supplementation of other critical nutrients if testing reveals insufficiencies.  It also involves investigations of tissue toxicity, genetic errors, soluble/insoluble beta-amyloid, tau tangles, hormone imbalance and inflammation.  But crucially, the application of any intervention depends on an individual’s assessment of need, which is based on their own particular habits/dietary shortfalls and test results, so this is not a one size fits all protocol.

The detractors to this holistic approach would prefer to see large, randomised, double-blind, placebo controlled trials – before they will even consider the worth of such a new approach.  Such trials work well to test the efficacy of a single drug on a single biomarker, in a controlled setting, but are not best suited to test something as broad and varied as diet and lifestyle factors on what is crucially a multifactorial pathology.  And it is the multiplicity of both the causes of the disease and the lifestyle interventions required that is key.

Nutrition science is still the new kid on the block, but some of the most potent modifiers of systemic and neurological inflammation and insulin resistance are dietary, nutritional and lifestyle factors.  This much is a proven fact.  Evidence from clinical intervention case studies of the sort conducted by Professor Bredesen is building and needs recognition as being far better suited to test multifactorial conditions resulting from a multitude of causes.

This is the Functional Medicine model as taught to Nutritional Therapists and endorsement by Dr Rangan Chatterjee of the BBC ‘Doctor in the House’ series and the cardiologist  Dr Aseem Malhotra is to be welcomed.  They both advocate the use of lifestyle and nutritional interventions in the management of health and chronic disease.  Dr Chatterjee will be the lead clinician for the Bredesen Protocol in the UK in collaboration with Cytoplan.

See also ‘The Over-medicated Population’: Doctors are misinformed, patients are misled and millions of people are taking medication with no benefit for them.” http://bit.ly/2dhCHQz

References

Bredesen D (2014) Reversal of cognitive decline: A novel therapeutic program. Aging 6(9):707-717 http://www.aging-us.com/article/NjJf3fWGKw4e99CyC/text