Alzheimer’s is a devastating condition for anyone affected by it and is the third leading cause of death in New Zealand. Alzheimer’s is the most common form of dementia, an umbrella term that describes the cognitive and functional impairment that affects brain functioning. The signs and symptoms of Alzheimer’s include loss of memory, reduced capacity to carry out tasks of everyday living, inability to recall words and impaired reasoning.
Of course, we are all likely to suffer from one of these symptoms on any given day. Lack of sleep, periods of high stress or a poor diet can all be explanations for why we walk into a room and completely forget why we are there. It’s the frequency and severity of these things that may because for further investigation.
As our ageing population increases, the rates of dementia are predicted to double from 2026 to 2050. With statistics like this, you could be forgiven for thinking that it is an inevitable part of the ageing process. But this isn’t the case for most people. There is certainly a genetic component to Alzheimer’s; there are deterministic genes that are directly linked to its development and many generations within a family will develop Alzheimer’s, often from an early age. This accounts for about 5 per cent of Alzheimer’s cases. There are also genes, specifically a variantin the ApoE lipoprotein gene, that increase the risk associated with developing the disease.
However, although we used to think that our genetics could not be changed, what we now know is that our lifestyle directly impacts on how these genes are expressed — they can be switched on or off according to our exposure to environmental triggers.
In fact, this process happens well before we were a twinkle in our parents’ eyes, and in part our health is influenced by the lifestyle decisions made by our parents and their parents, before them. It doesn’t determine our fate though, as decisions we make now can turn our genes on or off and influence our overall risk.
Genes aside, research has revealed other conditions that are associated with (or increase our risk of) developing Alzheimer’s. There are proteins in our brain called betaamyloid and when they build up and form clusters, they can bind to our synapses and break them down (which has implications for our memory formation).
The build-up of these plaques occurs when the brain isn’t given the right machinery to clear it out. Sleep is one of the biggest influencing factors in this. When we enter slow-wave (restorative) sleep, cerebrospinal fluid flushes through the space between our neurons and synapses, clearing out metabolic waste including beta amyloid plaques. Beta amyloid are thought to be part of our innate immune response, however chronic inflammation; head trauma, high intakes of processed, refined food, chronically high stress hormone levels and circulating insulin levels all contribute to their build-up. The less sleep (or the less quality sleep) you get, the less opportunity your body gets to flush them out and start afresh.
There are many things that affect sleep: a lot of it comes down to discipline, such as getting to bed earlier, not using our devices (smartphones, tablets, watching TV) two hours before bed — the blue light emitted disrupts the production of melatonin, our sleep hormone that aids in sleep and helps regulate other hormones — or if we do, wearing blue light blocking glasses to minimise their impact. Sleeping in a dark room is recommended and avoiding caffeine, heavily processed food and alcohol later in the day.
Alzheimer’s is distinguished by three different sub-types; inflammatory, non inflammatory and cortical. In all sub-types additional metabolic abnormalities may also be present, such as high blood sugar, increased waist circumference, low HDL cholesterol (“protective”), high blood pressure, high homocysteine levels, low vitamin D levels, high cortisol levels and underactive thyroid and insulin resistance.
In one research study, 100 per cent of dissected tissue in Alzheimer’s cases revealed high levels of insulin in the brain. In the third, cortical, the disease affects the brain on a much wider scale. It was formerly thought of as “atypical”, affects relatively younger people and severe zinc deficiency is typically seen. Although research is not able to determine that the presence of accompanying metabolic abnormalities play a causal role in the development of Alzheimer’s, a US research group has looked into the association with these and other lifestyle factors that influence the progression of the disease.
This has led to the development of a lifestyle and nutrition protocol (Metabolic Enhancement for Neurodegeneration, MEND) alongside a pharmaceutical approach personalised to help manage the symptoms associated with Alzheimer’s, with some incredibly encouraging results.
It can seem like a long list of things to consider but they are all related and often working on one aspect can improve others as a byproduct. For example, an anti-inflammatory, low-sugar diet can help dampen down systemic inflammation, which in turn affects the ability to absorb nutrients. The inclusion of nutrient-rich foods (such as liver, butter, eggs, seafood, grass-fed beef and dark leafy greens) will impact on our nutrient status, and iron, zinc, iodine and vitamin D levels will rise.
Not only do blood sugar levels begin to regulate but thyroid function is improved, our homocysteine levels reduce and overall stress hormone production will decrease. Lowering our homocysteine can positively influence the production of our feel good hormones too. The replacement of processed refined carbohydrate for more wholefood options (such as potato, kumara and yams) is also encouraged and serving vegetables alongside a dose of healthy fat will help the absorption of the vitamins.
Supplemental support is an important part of this protocol also, focusing on those herbs and nutrients that have clinical and scientific basis for their inclusion, such as vitamin D3 (along with vitamin K2), CoQ10, curcumin, active B vitamins, to name a few.
As exposure to environmental toxins is a risk factor for those who cannot effectively detoxify and clear these from their system, minimising exposure to heavy metals and choosing to use natural body care products that are free from chemicals is recommended.
Finally, adequate sleep, appropriate exercise, time in the sun free of sunblock (for 10-15 minutes) and time spent in nature are other non nutritional factors that are included in this lifestyle protocol.
A lot to consider? Yes, but like many diseases, Alzheimer’s is multi-factorial and requires a multi-pronged approach. Would you expect to fix a leaking roof by plugging just one hole if you knew it had 36 of them?
Liver is an incredibly nutrient-dense food that's rich in the fat soluble vitamins (including vitamin D), minerals such as zinc and iron and antioxidants to support brain, gut and heart health. Here's a collection of our favourite liver recipes.
Oily fish, leafy greens, eggs, nuts and seeds, and lean beef are just some of the foods that are important for a healthy brain. These brain food recipes are packed with nutritious ingredients high in protein, omega-3 fatty acids, vitamins and minerals.
Through her subscription service of meal plans and nutritional support, nutritionist Mikki Williden helps people manage their diets in an interesting way, at a low cost. Find out more at mikkiwilliden.com