Today I watched Episode 06 of Alzheimers – Science of Prevention, a groundbreaking documentary series, featuring David Perlmutter, MD, board-certified neurologist and #1 NYT bestselling author, along with leading experts in the field of brain health. For my notes on Episode 05, click here.
This fantastic series reveals the powerful ways we can decrease our chances of developing Alzheimer’s disease. According to Wikipedia, Alzheimer’s is a chronic neurodegenerative disease that usually starts slowly and worsens over time. It is the cause of 60–70% of cases of dementia.
With Alzheimers reported to be the fastest growing epidemic among the aging, I want to know what I can do now to optimize my brain health long-term. I took copious notes while watching this episode and want to share these important insights from the series with you below.
For full access to this series, as well as for bonus interviews not included in the free series, check out access to the series here.
Episode 06 Notes:
Your Brain’s Destiny Is In Your Hands.
Sugar and Refined Carbohydrates Contribute to Inflammation
Food is far more important than just fuel. It is information. Food directly communicates with our bodies, our brains and even our DNA. When it comes to our cognitive health, the food we eat influences both the actual structure of our brains and how well they work.
Our diets play a direct role in determining our levels of inflammation. When we eat lots of processed foods like refined carbohydrates and sugars, and don’t eat enough fibers and healthy fats, our bodies and our brains pay a hefty price.
A “highly processed diet leads to rising insulin resistance, chronic inflammation, and for too many people, development of Type 2 diabetes, and Type 3 diabetes which affects the brain and sets the stage for Alzheimers.”
“We’re being inundated throughout the day with high-glycemic sugars and carbohydrates and that keeps that ancient hormone of insulin chronically elevated throughout the day. It’s a growth hormone so it contributes to adiposity which is a scientific term for fatness. But it also might wreak havoc on the brain and contribute to brain and insulin resistance which is now considered one of the hallmarks of Alzheimer’s disease.” – Max Lugavere, Author of Genius Foods
Two signature ingredients of a modern diet that cause inflammation are the refined carbohydrates – sugar, flour, processed cereal foods and fruit juices, things like that – and the refined vegetable oils – soybean, sunflower oil, etc. Both of those are very powerful promoters of inflammation and those ingredients are almost in every product of processed food in the grocery store. Sugar has been found to be as addictive as cocaine. A lot of people just can’t stop cold turkey without support and education. – Georgia Ede, MD
Good Carbs vs. Bad Carbs
“So everyone tries to vilify carbs but there are good carbs. There’s a difference between carbs. There are good carbs and there are bad carbs. Good carbs are the complex carbohydrates that are bound with fiber and micronutrients in your gut and they incredibly slowly release a steady flow of glucose – the low glycemic kinds of foods. The high glycemic kinds of foods are the simple sugars and the processed foods like sodas and donuts that rapidly go up into your circulation and the body goes into a frenzy and the brain doesn’t know how to use it. And that’s what develops a lot of inflammation in the brain. It causes a lot of production of oxidative by-products – these are like acid that damage the walls of the cells, the walls of the arteries. So there’s a lot of dysfunction in the brain. And what does that represent as? It represents as fogginess. As not being able to remember things well. Lack of coordination. And over a long period of time it causes damage to the brain cells and to the arteries to the point that people develop vascular dementia and strokes. – Ayesha Sherzai, MD
“A major determinant of chronic disease risk at any body weight is the amount and type of carbohydrates. Not all carbohydrates are bad. Some digest slowly and contain many protective plant substances, including fiber which would be good for the microbiome. The greatest risk factor for diabetes is obesity. The most important dietary factors relating to Type 2 diabetes risk is the processed carbohydrates in our diet now. Not just white sugar but white bread, white rice, potato products. And the higher the amount of processed carbohydrates we eat, the higher the insulin levels in the body go. And insulin itself can cause insulin resistance and metabolic misfunction. But closely related to that is chronic inflammation.” – David Ludwig, MD
“We eat too many of the wrong carbohydrates too often. The refined carbohydrates, the processed sugar, flour, fruit juice, processed cereal products, those cause very big blood sugar spikes and crashes throughout the day, not just in the body but also in the brain. So you definitely want to avoid those refined carbs and they’re virtually in every food product in the grocery store – even some that we think of as healthy, like energy bars.” – Georgia Ede, MD
The Insulin & Weight Gain Connection
High carb diets can contribute to weight gain for a number of reasons but mainly by jacking up the hormone insulin and keeping it elevated, especially chronically. One of insulin’s primary roles is inhibiting lipolysis, inhibiting the breakdown of fat. If you want to lose body fat and you have chronically high insulin, you cannot release fat from the fat cells. That’s what insulin does. It’s like a security guard that stands outside that fat cell and keeps the fat in. So that’s how it hinders weight loss. How it can contribute to weight gain is that it’s a storage hormone. Carbohydrate affects blood glucose and insulin tends to respond to the blood glucose level so when we eat a lot of carbs, it raises the blood sugar and the insulin. – Amy Berger, MA, Author of The Alzheimers Antidote
We know that certain fats are really beneficial for the brain. For example, Omega-3 fats are critical for the chemical transmissions that happen for regulating inflammation, for developing brain function and helping to activate all these healing mechanisms in the brain. We know that saturated fat may be very stabilizing because it’s a very stable fat that makes the cell membranes and makes them less likely to be injured. And we know that people who consume higher levels of saturated fat have much lower risk of stroke, for example. So we know that this boogeyman of saturated fat may not be the boogeyman when it comes to the brain, even the heart, it turns out. There’s not a diet that’s good for the heart and not good for the brain. There’s one that’s good for all your body systems.- Dr Mark Hyman
The oils and fats that people should generally avoid for brain health are the unnatural ones. So, all the vegetable oils that we would never find in nature. They have to be manufactured in a factory. Think about how much processing needs to go into turning a pile of canola beans into a bottle of canola oil. So, the natural fats that exist in the world, as-is, are animal fats, believe it or not, The fats of fruits and plants. So, avocado oil, olive oil, palm fruit oil, coconut oil. These types of oils you would come across in nature. So those are the ones – the animal fats and the plant fats, even the saturated fats like coconut oil, those are the ones that are the healthiest for the brain. – Georgia Ede, MD
The right types of carbs are the unprocessed, low glycemic, fibrous carbs like leafy greens, asparagus, and low sugar fruits like berries. The right type of fats are naturally occurring fats like avocados, olives and olive oil, nuts, seeds, as well as specific types of fatty fish, grass-fed meat can also provide some good fats if you choose to eat animal products.
Which ‘foods’ should you avoid?
The first dietary intervention is to just cut out all the junk food – so much of what makes the American Standard Diet, the SAD. Go to fresh, whole foods. Vegetable, fruits, then good sources of protein. But stay away from the snacks and the processed foods. An ideal plate will vary whether your diet is vegan, lacto, ovo, vegetarian, paleo. So there’s not one ideal plate. But it will always include vegetables. And in terms of the volume, about twice as much vegetables as everything else. Characteristics of that diet are that it should be dense in nutrients, and very low in what we’ll call empty calories – added sugar, added fat – foods that supply calories without nutrients or foods that tend to raise blood sugar. Vegetables, fruits, diets that are high in bio-flavenoids, and carotenoids, those are plant-derived chemicals, often very colorful so they make your diet colorful. Thoe have well-documented anti-inflammatory effects. – Leo Galland, MD
You want to feed your brain the nutrients it needs to grow new healthy brain cells, and also fend off the many insults thrown at it by the modern world. So, cruciferous vegetables, dark leafy greens, low sugar fruits like avocados and berries. These are some of the healthiest foods that are available in your supermarket. Grass-fed beef, eggs. – Max Lugavere
The Importance of Water For Brain Health
Water is really important for brain health because the brain is 80% water. Every single chemical reaction that takes place inside the brain needs water to occur. Energy production, synthesis of neurotransmitters. And that means that the brain is the organ that is most sensitive to dehydration. So even minimal dehydration like 2% water loss in the brain can trigger neurological symptoms like brain fog, dizziness, confusion, memory slippage. In brain scans show that there’s also brain shrinkage associated with dehydration. It can be easily reversed just by drinking more water. Usually my #1 tip for foods to avoid for a healthy brain is just to avoid processed food. Processed food really should not be part of anyone’s diet for anyone who’s concerned about Alzheimer’s prevention. – Lisa Mosconi, PhD
Avoid Processed Food (Anything in a box or package. Eat real, living foods.)
Reduce the processed foods that flooded our diet during the low-fat years. Sugar but also the refined starchy foods. Replace those fast-digesting carb calories with nutritious and delicious high-fat foods. So, nuts, nut butters, avocados, olive oil. Get an adequate amount of protein, which can also be from plant sources. And have an abundance of non-starchy vegetables which you can either cook or dress with some of these high fat foods, making it a win-win. – David Ludwig, MD
High processed foods have high calories and are very low in nutrients that are good for the body. It’s usually very high in simple sugars, in simple carbs, in unhealthy fats and salt, those are the things that damage the connections between brain cells. They damage the arteries which are the highways of how nutrients are carried to the brain. And this inflammation and oxidation and dis-regulation between glucose and metabolism destroy brain cells.
On the contrary, when you eat unprocessed food, say unprocessed plants, they’re low in calorie and high in nutrients so you get fiber and vitamins and the great kinds of proteins and the kinds of carbs that make those brain cells to provide the kind of material for your brain cells and arteries to function in a normal way. One of the easiest things you can do is to cut down on processed foods because the results are immediate. You get to see a reversal in your insulin and cholesterol. – Ayesha Sherzai, MD
The Powerful Benefits of Eating Plants
When you eat plants, you eat more than 8000 polyphenols, the colored compounds that are in plants, whether they’re greens, berries or whole grains. And you eat resistant starches and soluble starches which keep feeding your good gut bacteria and keep feeding your good gut bacteria and create the chemicals and hormones that build your brain. So a whole-food plant based diet is important to manage the vascular risk factors that cause brain disease to providing the necessary fuel – vitamins, minerals, the good kind of proteins and carbs. Greens are one of the healthiest foods on the planet. They have the necessary antioxidants and anti-inflammatories that fight against inflammation and oxidation. Then comes berries. Berries have a lot of polyphenols and nutrients that fight against inflammation and oxidation. And beans are the cornerstone of longevity. – Ayesha Sherzai, MD
Can A Ketogenic Diet Help Reverse Alzheimer’s?
Ketones are byproducts of fat metabolism but they can be elevated in the body by ketogenic fat. Fats are a critical and key macronutrient for giving our body energy. The body and most importantly the heart, run most efficiently when using fat as an energy source. So having a robust source of fat in the diet and getting our body fat adapted which means transitioning our metabolism from a glucose or carb-based metabolism to being adapted to metabolize and utiliize fat more efficiently can be advantageous for exercise performance and also for our brains. – Dominic D’Agostino, PhD
The ketogenic diet has been around for a long time. In fact, it’s been pioneered to treat epilepsy when no drugs would work. So if you’re having seizures, and nothing works, they use a ketogenic diet. We’re learning more of the beneficial effects of many other brain problems – brain cancer, autism, Parkinsons, and Alzheimers. The body has two alternate fuel systems. A backup system – we have sugar we can run on. We can also run on fat. And it turns out that running on fat is much cleaner than running on, for example, coal vs solar energy, it’s a very different way the body runs through using fats. It turns out that it activates so many healing mechanisms, reverses insulin resistance, it increases stem cell production, it increases muscle mass, bone density, it increases brain function and cognitive function, it has tremendous benefits as a therapy for people who already have dementia or pre-dementia. – Dr Mark Hyman
What we recommend to people is the brain food pyramid. Our approach, we call Keto-Flex-12-3 and it’s simple because, #1 we want to get you into mild ketosis, it’s flexitarian so if you want to be a vegetarian or vegan, fine. But if you want to have meat as a condiment, fine. And then 12-3, you want to have a minimum of 12 hours fasting between finishing dinner and starting your next meal. You’ll be a breakfast, brunch or lunch. And then you want to have 3 hours between finishing your dinner and going to bed. – Dr Dale Bredesen
There are a number of studies that show that ketogenic diet can improve brain health. And the reasoning for that, we believe, is the rewiring of the brain metabolism. So the brain is now forced to use ketone bodies, as well as sugar, for fuel and we believe that that transition can reprogram the brain to function differently and function better, and that’s the evidence. – Victor Longo, PhD
The most important thing for inducing mild ketosis is to lower glucose intake in your diet. Well, where does glucose come from? Well, of course it comes from sugar, but it also comes from time-release sugar which are carbohydrates. The more the carbohydrate source has been refined, the more available that glucose is to go into the blood stream and prevent the buildup of ketones. Because your body will preferentially use glucose before it starts to go into a metabolism of fat. So what that means is eliminating simple carbohydrates and fine carbohydrate intake and minimum amounts of long-chain unrefined carbohydrates so that you are inducing the body to go into fat metabolism. – Jeffrey Bland, PhD
If you can transition rapidly into the ketogenic diet from eating high carb to eating high fat-low carb, and you’re comfortable with that, I think the faster you get into ketosis I think the more benefit you get. And even the benefits your body goes through to get into a state of ketosis kicks on adaptive mechanisms that help us adapt faster. One way to ease that transition is to use things like coconut oil or medium chain triglycerides or now we have ketone supplements and that can help give the brain a source of energy as it’s essentially withdrawing from the glucose that it was getting from a high carb diet. – Dominic D’Agostino, PhD USF
A Ketogenic Diet for Women
With the approach I take to empower women hormonally, is to work on those plant-based, micro-nutrients, low carbohydrate grains, and herbs and spices that can help with digestion and detoxification, to add that into a healthy ketogenic diet. So the healthy fats and the healthy proteins. So we’re getting good amounts of that which we need for hormone balancing. We need healthy fats for healthy hormones and that’s an important distinction. But we also need those nutrients to balance our hormones. And when we have that combination as women, we do really well. We get that clarity and improved cognitive function. – Anna Cabeca, DO
Give yourself time to adapt to a ketogenic diet
Some people will have a “keto flu” in the beginning. As Dr Ludwig pointed out, it typically takes a few weeks before you are keto-adapted. So, if (keto is not working for you in the beginning) it may mean you haven’t finished your adaptation, it may mean that you are not able to generate the ketones if you’re too thin. So in that case, they should cycle and that actually helps many people. You keep metabolic flexibility so that you can use either. And then it may be because you’ve changed diet or you’ve changed microbiome. So yes, you need to work with your doctor to get yourself optimized. – Dr Dale Bredesen
Support Your Mitochondria To Promote Brain Health
Your mitochondria are your cells’ energy generators. They are key players in Alzheimer’s disease. Lower carb, higher fat diets help the mitochondria produce energy more efficiently. When insulin levels are low because we’re eating a very low carbohydrate intake, it transitions the body from running primarily on carbohydrates, from having a primarily glucose based metabolism to having a more fat and fatty acid based metabolism. And the fatty acids are more of a clean burning fuel, if you will, they are less damaging to the mitochondria. The burning of fats in the mitochondria which is where we produce energy inside the cells, the burning of fat in the mitochondria produces fewer free radicals, it’s less damaging to the physical structure of the mitochondria. – Amy Berger, MS, Author of The Alzheimer’s Antidote
A proper ketogenic diet should include plenty of above ground fibrous vegetables that are considered carbohydrates.
Intermittent Fasting & Brain Health
Like the ketogenic diet, fasting is another tool we can use to improve brain health and prevent Alzheimers.
With fasting, we’re seeing evidence of regeneration in the brain, neurostem cells being activated in certain regions of the brain, and going to work and producing new functional neurons. So we’re seeing a clear effects on neuro-inflammation so the brain as it gets older it become dysfunctional and one of the dysfunctions has to do with immune reaction. Those are believed to be key in Alzheimer’s and Parkinson’s Disease. Fasting revolutionizes energy production. Usually we’re working on sugar. And carbs come in and they’re sufficient to fuel the system and they can be stored in the form of glycogen in the liver. So for 12-24 hours the body can use sugar for energy even though we’re not necessarily eating. Fasting changes all that very slowly. Let’s say you do an overnight fast, the glycogen is not going to be depleted or is barely going to be depleted by that time. But if you do two to three days of fasting, then the brain begins to change into a ketogenic mode. And then the body, particularly visceral fat is going to become a source of energy. So now the fuel, instead of coming from the outside in the form of sugar, is going to come from the inside in the form of visceral fat. And this is beginning to fuel the entire body, in the form of fatty acids, and ketone bodies. – Valter Longo, PhD
Intermittent fasting and getting our body into ketosis is really a key concept to having healthy neurologic function as we’re aging and to prevent Alzheimers. The benefits are allowing our body to get into a state of autophagy and getting our body to working that muscle to use ketones as fuel which are brain uses preferentially over glucose especially as we‘re aging. – Anna Cabeca, DO
Thank you, Dr. David Perlmutter and experts featured in this series for sharing your life-changing knowledge, practical tips and habits to help us optimize our brain health. It’s incredibly empowering and inspiring to know that we have more control over our cognitive health than statistics suggest.
Practical Ways To Take Action Today
The new science of a keto diet holds promise for protecting cognitive health.
Foods you should avoid:
- Processed foods (anything in a box, can or package)
- Other forms of refined carbs
- Foods that have a high glycemic index
- Things that have added sugar in the form of:
- High fructose corn syrup
- Cane sugar
- Rice syrup
- Any added sugar is bad for your brain
- Unhealthy fats like:
- Trans fats
- Vegetable oils
- Soybean oil
- Canola oil
- Artificial sweeteners like:
- Artificial sweeteners like:
Food you WANT to INCLUDE:
- Whole, unprocessed foods
- Low glycemic carbohydrates (leafy greens, kale, cruciferous vegetables, broccoli, cauliflower, beans, blueberries, apples)
- Healthy fats from plant sources ( olives, olive oil, nuts, seeds, avocados)
- Fatty fish (SMASH) – Salmon, mackerel, anchovies, sardines, herring)
- Organic full fat dairy products (if tolerated)
- Free range organic chicken and pasteurized eggs
- Time restricted eating: limit your eating to a specific time during the day
- Don’t eat within 3 hours of going to sleep
- Fast for 12 out of 24 hours a day
- Consider a keto diet and fasting for longer periods like 24-48 hours
- 8 Steps to Reverse Memory Loss – Dr Mark Hyman shares tips at The Women’s Alzheimer’s Movement
- PubMed: Role of Ketogenic Diets in Neurodegenerative Diseases (Alzheimer’s Disease and Parkinson’s Disease)
- Alzheimer’s – The Science of Prevention
- ReCODE: The Reversal of Cognitive Decline – by Dr Dale Bredesen
- The End of Alzheimer’s: The First Program to Prevent and Reverse Cognitive Decline