Recently, a neighbor expressed great concern (actually fear) regarding the fact that because her parents developed dementia, she too would follow that same course.

I immediately and emphatically responded that we have more control than we think over whether or not we develop a particular illness…even if there is a genetic predisposition for it to occur. Genes are a factor for certain. However, new research tells us that we can often override genetics, and that the fate of our brain (and our health in general) lies less with our genes and more with our lifestyle choices, particularly with the food we eat. Neurologist, David Perlmutter, MD, is the author of the # 1 NY Times best seller, The Grain Brain in which he explains how our disdain for healthy fats and cholesterol and our love affair with sugar, processed carbohydrates and yes, even whole grains has contributed to not only our obesity epidemic but to the explosion in the number of people affected by Alzheimer’s. Currently, 5 million Americans are affected by dementia (the most common form is  Alzheimer’s), and this number is expected to triple by 2050. (1) Dr. Perlmutter also explains how sugar, and most carbs including many grains are packed with irritating ingredients like gluten that cause inflammation and irritate our nervous systems. I think most of us have known about the health deteriorating effects of sugar and white flour for a long time…but grains? How could they possibly be a culprit in brain disease? It turns out that any substance that causes the blood sugar to rise quickly triggers the release of insulin from the pancreas. In the normal course of events, insulin transports glucose from the blood into the muscle, fat and liver cells so it can be used for fuel. But when our cells are constantly exposed to high levels of glucose and subsequently insulin (which is also a fat storage hormone) as a result of our over indulgence in processed foods, refined sugars etc., our cells begin “resisting” insulin. This is referred to as “insulin resistance”, which due to the higher than normal levels of sugar in the blood, leads to Type 2 Diabetes. When the intricate system that nature designed to allow insulin to escort glucose into the cell for fuel fails or goes awry, one of many consequences is inflammation. Chronic inflammation is now considered to be the underlying cause of many chronic illnesses including heart disease, diabetes, asthma and yes, brain disorders.

In his seminal book (which basically flips conventional wisdom on its head), Dr. Perlmutter explains that the cascade of events starting with recurring spikes in blood sugar, leading to insulin resistance and ending with chronic inflammation contribute to brain shrinkage. And although this sugar/insulin roller coaster ride leading to Diabetes might not be the cause of dementia, there certainly seems to be a strong association. Dr. Perlmutter states: “Diabetes and brain disease are this country’s costliest and most pernicious diseases, yet they are largely preventable and are uniquely tied together. Having diabetes doubles your risk for Alzheimer’s.” (2) Since the CDC predicts that 100 million of us will be diagnosed with Diabetes by 2050 (with 90-95% of all Diabetes being the diet-related Type 2 form), (3) and having Diabetes doubles our risk for developing dementia, I’d say the very first area for us to focus on in our attempt to keep our brains healthy as we age is DIET!

So what does neurologist, Dr. Perlmutter, Sally Fallon, the director of the Westin A. Price Foundation and author of the popular Nourishing Traditions, as well as many other advocates of returning to the unprocessed diets of our ancestors recommend? Their unanimous suggestion is to get the sugar out, restrict the carbs (except vegetables) and STOP FEARING FAT (the good kind, that is). And speaking of fat, did you know that some studies (including the infamous Framingham Heart Study) have shown a positive association between higher total cholesterol levels and improved mental function? (4) Crazy right? That’s what I thought too. But it turns out that the brain is 70% fat and it needs cholesterol to thrive. So why then are so many people prescribed statin drugs to lower cholesterol? You guessed it…statin drugs are a 28 (inching toward a 29) Billion dollar a year industry. New research indicates that statin drugs lessen brain function and actually increase ones risk of developing heart disease! (5)

In another study, postmenopausal women who were put on statins had a nearly 48% percent increased risk of developing diabetes compared to those who were not given the drug. (6) And in case I haven’t mentioned it enough…diabetes doubles your risk for Alzheimer’s disease.

Let’s just stop and connect the dots here: So a high carb, sugar laden diet sets us up for insulin resistance, which leads to diabetes. Having diabetes doubles our risk for developing Alzheimer’s…but, wait there’s more. In the process of eating a high sugar, carb diet we develop inflammation. Inflammation (which I explained in a previous article) causes the body to manufacture more cholesterol. Statins are then prescribed to lower cholesterol which is needed for optimal brain health. Now we are learning that by lowering cholesterol with statins, we lessen brain function which can contribute to Alzheimer’s and increase our risk for developing heart disease!

Enough of where we’ve gone wrong! Here’s what we can do to lessen our chances of developing dementia:

1. Eat an organic, plant-based diet with healthy sources of protein every few hours to balance your blood sugar level. Include healthy fats such as organic coconut oil (considered super fuel for the brain, is great added to protein based smoothies or used for cooking at high temperatures), nuts, avocados, cold-pressed olive oil etc. . Also include a wide variety of foods rich in antioxidants which are protect our brain cells from free radicals. These include dark green vegetables such as broccoli, kale, Swiss chard, etc. Raw cacao (has the highest antioxidant ORAC score 95,000 of any super food), blueberries etc. Consume foods that have a low glycemic index. As a result of hybridization and the genetic engineering of grains, wheat and other grains bear little resemblance to the wild varieties that our ancestors consumed. Gluten and a high carb diet prompt inflammatory reactions which irritate the nervous system. Therefore, consider minimizing grains in general and avoid gluten containing grains (wheat, barley, oats, rye, spelt, kamut etc.) For on this topic read The Wheat Belly and The Grain Brain.
2. Exercise: Regular and rapid walking can help our neurons stay nimble and has been shown to, improve motor function, cognitive processing speed and improve auditory and visual attention. One study showed that in the group that was the least active they had a 230% > risk for developing Alzheimer’s compared to the group with the highest activity level. (7)
3. Maintain a good weight. One study showed that excess weight in our middle triples our risk for developing dementia. (8)
4. Decrease exposure to Heavy Metals and Toxins:
   1. Avoid pesticide and lawn chemicals
   2. Consider removal of amalgam fillings (done properly by an experienced, qualified, holistic dentist)
   3. Consider installing a good water filter to minimize exposure to heavy metals from water pipes
   4. Consider using non-toxic cosmetics and personal care products 
   5. Include foods that assist in the body in detoxification: chlorella, milk thistle, cilantro etc.
   6. Avoid vaccines with mercury (thimerosal), which by the way remains in the flu vaccine.
5. Supplements for Brain Health:
   1. Probiotics: play a role in producing, absorbing and transporting neurochemicals (such as dopamine & serotonin) which are essential for a healthy brain. The gut/brain communication system is vital to our health and sense of wellbeing. A good probiotic should contain at least 10 Billion active bacteria per capsule.
   2. Vitamin D: which is actually a fat soluble steroid hormone helps protect neurons from damage by free radicals. One 7 year study showed a 77% decreased risk for developing Alzheimer’s in those participants with higher vitamin D levels. It’s recommended that a blood level be done first before taking up to 5000 IU per day.
   3. Fish oil: Rich in DHA, an omega 3 that represents 90% of the Omega 3’s found in the brain. 50% of plasma neurons is composed of DHA. Purchase from a reputable company that screens for mercury and take at least 1000mg of DHA per day.
   4. A comprehensive Multi with high levels of B vitamins and folate
   5. Resveratrol: an antioxidant found in grapes and red wine that can activate genes which affect longevity, increases blood flow to the brain. (9)
   6. Alpha Lipoic Acid: antioxidant and known for its ability to cross the blood brain barrier
   7. Turmeric: Improves glucose metabolism, is anti-inflammatory and has antioxidant activities. Has been shown to protect cell’s mitochondria.
   8. Ginkgo biloba: has been shown to slow down the process of memory loss (10) (when starting supplements, start 1 at a time. Begin with a low dose and gradually work up to the full dose before adding the next supplement. This gives your body a chance to acclimate to the new substance and if you were to have a negative reaction, you’d be able to more easily pin point the culprit).
6. Sleep: 10% of Americans report chronic insomnia and 40% of older adults have issues with sleep often due to various medical conditions such as sleep apnea. Sleep deprivation causes a decrease in the hormone Leptin which controls our metabolism.
7. Helpful activities to keep our brain healthy and sharp:
   1. Cross word puzzles
   2. Reading
   3. Board games
   4. Musical instrument
   5. Adult education course (10)
8. Socializing, Laughter and a little red wine: You didn’t think a good Irish woman like myself was going to end my list of recommendation on brain health without including the importance of friends, laughter and a wee bit of the old nip now did you? I don’t think we need scientific studies to prove how healthy engaging in good conversation and having fun is. However, in doing the research for this article, in addition to learning about good fats and specific nutrients, it was reassuring to read that my own daily habit of enjoying a glass of red wine (only one!) actually reduces inflammation, provides a bit of the antioxidant resveratrol and promotes heart and brain health!

References 1. Http;//aiafoundation.org/patients-families/facts-figures

2. Having DB doubles risk for Alzheimer’s Japanese study:

3. http://www.cdc.gov/media/pressrel/2010/r101022.html

4. Penelope K, et all “Serum cholesterol and cognitive performance in the Framingham Heart Study” Psychosomatic Medicine 67, no 1 2005 24-30.

5. Aloka et al, Clin Cardiol. 2009 Dec;32(12):684-9. doi: 10.1002/clc.20644.Statin therapy decreases myocardial function

6. Culver, et al, “Statin Drugs and Risk of Diabetes Mellitus in Postmenopausal Women in the Women’s Health Initiative” Archives of Internal Medicine 172, no 2 (2012): 144-52

7. Buchman et al. “Total Daily Physical Activity and the risk of AD and Cognitive Decline in Older Adults” also Rush Unive Medical Center “ Daily Physical activity May Reduce Alzheimer’s Disease Risk at Any Age” Science Daily April 18 2012.

8. Neurology 2008, 71- 1057-64

9. Baur et all. “Therapeutic Potential of Resveratrol in Vivo Evidence”, Nature Reviews Drug Discover 5, no 6 June 2006 493-506.

10. Psychopharmacology: 201 156: 481-84 11. NEnglJMed; 2003 348:2508-16