Think of the human brain as a city of lights.
Having Alzheimer’s or another dementia means that the lights are fading. A gradually spreading power failure is underway.
What’s more, the city is shrinking. The brain’s white matter is slowly shriveling up.
Unfortunately, there are no breakthrough medical therapies to cure this horrible loss of cognition.
But new research is now proving the power of prevention.
Heart Health = Brain Health
And the really good news is that it’s prevention with double action. The lifestyle that appears to guard against dementia is the very same lifestyle that guards against heart attacks. Key are measures like:
- Exercising daily
- Staying lean
- Eating a plant-based, whole-foods diet like the Pritikin Eating Plan
“What is good for the heart is essentially good for the brain,” sums up Dr. Tom Rifai, MD, FACP, founder of Reality Meets Science LLC, Diplomate of the American Board of Lifestyle Medicine, and member of the Pritikin Scientific Advisory Board. “With a lifestyle that delivers excellent blood pressure, blood sugar, and cholesterol levels, as lean a body as one can reasonably achieve, good physical fitness, no smoking, minimal or no alcohol, and good social connections, the chances of dementia likely drop by 80%.
“This healthy lifestyle should optimally start early in life, although there are neurologists who believe there’s plenty of potency in therapeutic lifestyle change later in life.”
Causes of Alzheimer’s
We’ll summarize recent lifestyle-related research on preserving brain health, but first let’s talk a little about Alzheimer’s disease in general.
Many of us know that a chief cause of Alzheimer’s is amyloid plaques that collect in the brain.
But mounting data1 are now showing that Alzheimer’s is also a vascular disease. Just as there is inadequate blood flow to the heart, there is inadequate blood flow to the brain. The result is not only strokes but Alzheimer’s. Poor blood flow shows up as damage to the brain’s white matter; it starts deteriorating and shrinking. That’s troubling because white matter is very important. It enables the communication of information among the many regions of the brain.
And it’s not an either/or situation. Approximately half of people with memory loss and other forms of cognitive decline have both amyloid plaques and vascular damage.
In fact, one may feed the other. Vascular damage caused by heart disease risk factors, for example, may increase the amount of amyloid plaques in the brain.
High levels of bad cholesterol such as LDL have for several years been recognized2 as a risk factor for the development of Alzheimer’s disease. In fact, research indicates3 that too much cholesterol in our blood could potentially triple the odds of getting Alzheimer’s.
And now, researchers are learning that in those who already have Alzheimer’s, a high cholesterol level may escalate the progression of the disease.
Autopsy studies have found4 that the brains of people with Alzheimer’s have significantly more cholesterol than normal brains. Moreover, the cholesterol appears to build up5 in the amyloid-Alzheimer’s plaques in the brain.
Explains Dr. Michael Greger, MD, FACLM, who leads the nonprofit NutritionFacts.org and speaks nationally on the benefits of a plant-based, naturally low-in-fat diet: “We used to think the pool of cholesterol in the brain was separate from the pool we had in our blood, but there is now growing evidence to the contrary. For example, LDL cholesterol may be able to cross6 the blood–brain barrier into the brain. So, a high-fat diet may not only increase cholesterol levels in the blood, but also the influx of cholesterol into the central nervous system.”
For 20 years, scientists followed 322 middle-aged men and women in three U.S. communities (Washington County, Maryland; Forsyth County, North Carolina; and Jackson, Mississippi).7 When the study began, their average age was 52.
The researchers found that being overweight at mid-life significantly increased the amount of amyloid plaques in the brain two decades later.
Having additional cardiovascular risk factors like type 2 diabetes and hypertension increased the amount of amyloid plaques even more.
Scientists have long known that there is a strong link between type 2 diabetes and Alzheimer’s disease. In fact, Alzheimer’s is often referred to as type 3 diabetes.
Hypertension, or high blood pressure, is also strongly connected with cognitive decline. The good news: recent research has found that following the DASH diet (like Pritikin, DASH is high in fiber-rich whole foods and low in fat and salt) plus aerobic exercise yielded improvements in mental sharpness in just four months.8
A recent study9 from the University of Cambridge looked at the impact of obesity on brain structure across the adult lifespan, analyzing data from 473 individuals between the ages of 20 and 87.
Using MRI images of the brain, the researchers discovered that middle-aged participants who were overweight or obese had increased shrinkage of the brain.
Keep in mind that the brain naturally shrinks with age, and cognitive ability can decline. But this process appeared to begin earlier and accelerate faster in people carrying excess weight.
The results indicated that an overweight or obese person at age 50 will exhibit a loss of white brain matter equal to the loss experienced by a 60-year-old of normal weight.
The study’s senior author, Professor Paul Fletcher, pointed out that the striking discrepancies in the volume of white matter between lean and overweight participants was only observable “from middle age onward, raising the possibility that we may be particularly vulnerable at this age.”
“While a healthy food and exercise program are important at any age, it may be especially beneficial for your brain in your midlife years,” sums up Dr. Danine Fruge, MD, Medical Director at the Pritikin Longevity Center in Miami. Pritikin has been helping people lose weight and learn heart-healthy habits since 1975.
“So whatever motive inspires you, from protecting your heart to protecting your brain, do as we do at Pritikin. Eat well and keep that treadmill moving. It will enhance the vigor of your body and, very likely, the vitality of your mind.”
In the Finnish Geriatric Intervention Study (FINGER),10 researchers recruited 1,260 men and women between the ages of 60 and 70. All had some cognitive decline.
They were divided into two groups: 1) the control group, which received regular health advice; and (2) the intervention group, which targeted several lifestyle and vascular risk factors simultaneously.
The intervention group components were:
1. Dietary guidance
Intense training in a diet similar to the Pritikin Eating Plan. It was low in fat and very low in saturated fat; high in fruits, vegetables, whole grains, and beans (legumes); and low in sugar and salt. Like Pritikin, it also recommended at least 2 servings of fish weekly.
2. Exercise training
Individually tailored, progressive muscle strength training and aerobic exercise programs, including exercises to maintain and improve postural balance. “The guidelines closely matched those we teach at the Pritikin Longevity Center,” observes Jamie Costello, MSC, Director of Exercise at Pritikin.
3. Cognitive training and social activity
Ten group sessions led by a psychologist as well as computer programs previously shown to be effective in improving memory, executive function, and mental speed. Social activities occurred through all intervention components.
4. Intensive monitoring and management of metabolic and vascular risk factors
Factors monitored included weight, belly fat, blood pressure, blood sugar, trigylcerides, and cholesterol. Regularly, the participants were given oral and written information on the importance of reducing these risk factors.
“…a significant beneficial intervention effect”
At the end of two years, the scientists found “a significant beneficial intervention effect on overall cognitive performance” in the participants in the comprehensive lifestyle intervention group. “The beneficial effect was seen on each cognitive domain: memory; executive function, and psychomotor speed.”
Follow-up analysis11 of the FINGER participants found that comprehensive lifestyle intervention was especially beneficial among higher-risk individuals.
Optimal Brain Health
So strong are the data linking brain and heart health that the American Heart Association and American Stroke Association recently produced an advisory report12 that identified 7 heart-health parameters that should be followed to prevent cognitive decline and dementia.
- Avoid smoking
- Exercise regularly
- Maintain a healthy diet, like DASH and Pritikin
- Have a body mass index below 25
- Lower blood pressure to below 120/80, optimally with lifestyle changes instead of drugs
- Lower total cholesterol to below 200, optimally with lifestyle changes instead of drugs
- Lower fasting glucose to below 100, optimally with lifestyle changes instead of drugs
Summing Up | Save Your Heart and Brain. Live Well.
In a recent essay in the physicians’ online newsletter Medscape titled “Lifestyle Interventions That Can Decrease Cognitive Decline,” Dr. Hans-Cristoph Diener, MD, PhD, urged his colleagues to review the compelling data linking a healthy lifestyle with brain health, and take action.
“Ladies and gentlemen,” he wrote, “it’s time to change your lifestyle. It’s time to advise your patients about what they can do to prevent cognitive impairment and dementia by changing the way they live.”
“We couldn’t agree more,” says Pritikin’s Medical Director Dr. Fruge. “Every day for the past 45 years here at Pritikin, we’ve seen how a healthy lifestyle can transform people’s lives.
“We have long known the Pritikin Program protects the heart, but the evidence continues to mount that it will almost certainly help protect the brain not just by reducing the risk of stroke but also by reducing Alzheimer’s disease and other dementias.”
Concurs Dr. Rifai: “There is no question in my mind that people reap huge rewards when they progressively shift from sedentary living and a CRAP (calorie rich and processed) diet towards a healthy lifestyle , with Pritikin being one of the best examples. They lower the risk for not only cardiovascular but also cerebrovascular and cognitive-related disease.”
“Clean arteries and a clear mind… Isn’t that what we all want?” smiles Kimberly Gomer, MS, RD, Director of Nutrition at Pritikin. “We see it happening every day here at Pritikin.”
- 1 Alzheimer’s & Dementia: the journal of the Alzheimer’s Association, 2017; 13 (6): 613..
- 2 Molecular Nutrition and Food Research, 2011; 55 (2): S162..
- 3 Neuroepidemiology, 1998; 17 (1): 14..
- 4 Sub-Cellular Biochemistry, 2010; 51: 47..
- 5 Seminars In Cell and Developmental Biology, 2005; 16 (2): 193..
- 6 Nature Neuroscience, 2003; 6 (4): 345..
- 7 JAMA, 2017; 317 (14): 1443..
- 8 Hypertension, 2010; 55 (6): 1331..
- 9 Neurobiology of Aging, 2016; 47: 63..
- 10 The Lancet, 2015; 385 (9984): 2255..
- 11 Journal of Alzheimer’s Disease, 2017; 59 (4): 1459..
- 12 Defining Optimal Brain Health In Adults: A Presidential Advisory Report From the American Heart Association/American Stroke Association, 2017, 48:e284.