Blog – Real Food for Thought in the Fight Against Dementia

If you are familiar with our food for thought podcast series here at Dementia Researcher you will know that our format is usually to bring on physicians or nutritionists to talk about the impact of what we eat on our brain health. The conclusion is often the same; if you eat well (lots of fresh fruits, veggies, legumes etc.) you can dramatically reduce your risk of developing dementia. We have discussed a myriad of potential mechanisms, and we know that the quality of your gut microbiome is a big influencing factor.

You are what you eat and it’s very important to remember that garbage in always results in garbage out. On one episode we interviewed New York Times bestseller Dr Michael Greger, author of ‘How Not To Die’ and ‘How Not To Age’. In that interview he mentioned a study that was ongoing under Dr Dean Ornish, a rockstar in the field of nutrition in preventative medicine. Dr Ornish’s team were conducting the first ever randomised controlled trial to investigate whether a comprehensive, intensive lifestyle intervention could affect the progression of mild cognitive impairment (MCI) or early dementia due to Alzheimer’s disease (AD).

At the time, Dr Greger was confident that it would help the patients with MCI; this is something that had been shown in other studies. Where he was less sure was in the patients with AD. We are all told the same thing; once a patient is diagnosed the damage is done. Surely food could not reverse some of these effects that pharmaceutics have been unable to touch?

In June last year, the study was finally published and the results surprised me. I am a huge advocate for the power of diet on our brain health so I expected to see some benefits. What I did not expect to see was a change in diet positively impacting the cognition of patients post-diagnosis. Before we get to that, what was this magical diet that seemed so effective?

If you are an avid listener of food for thought, chances are you already know what I am about to say. A whole-food, minimally processed, plant-based diet low in harmful fats, refined carbohydrates, sweeteners, alcohol; i.e. fruits, vegetables, legumes, nuts, seeds (not too far from the MIND diet). This was paired with moderate exercise and some holistic practices like meditation and regular support groups.

The result? Significantly improved performance in four cognition and function tests for the patients on the lifestyle intervention. The researchers performed Clinical Global Impression of Change (CGIC), Alzheimer’s Disease Assessment Scale (ADAS-Cog), Clinical Dementia Rating–Sum of Boxes (CDR-SB), and Clinical Dementia Rating Global (CDR-G) tests after 20 weeks. All three cognition tests showed a significant improvement in patients on the diet and lifestyle program. Even more staggering, the CDR-SB test showed that patients on this diet had significantly slower progression. That is huge. An improvement in clinical progression of AD from diet alone. No ‘mabs’ (AD drugs) with significant side effects. Just a diet change where side effects include healthier waste lines, improved energy levels and (according to this study) a healthier gut microbiome. Moreover, the patients also exhibited higher ratios of plasma Aβ42/40 which is indicative of an improvement in AD progression.

In short, after just 20 weeks, patients on the lifestyle program showed clear cognitive gains across all major Alzheimer’s tests, with CDR-SB results revealing slowed or even paused disease progression. And it all came from diet and lifestyle changes alone, not drugs. I never expected this!

One thing that is less clear, however, is the extend of the improvement in the AD patients. After diagnosis we know each patient will have lost a lot of neurons and other neural cells as the disease progressed. We have no idea if this diet let to any form of neuro-regeneration. The conventional thinking is that once the neural circuitry is lost it cannot be regained. That could well be (and I think likely is) the case here. I think we are seeing a slowing of progression but would hesitate to call it a recovery or reversal. Either way, we are seeing the effects you normally get from a multi billion dollar drug with ingredients you can buy from the supermarket.

So what next? Well for us, the priority is to try and get Dr Ornish on the show to tell us more. This is landmark and worthy of our time to digest it (pun intended). Other than that, I would love to see more studies like this. Only 1% of AD is purely genetic which means it is a disease that is heavily influenced by our environment and I am convinced that diet and exercise is a huge contributor to protection. This could be the start of a new era. One where Alzheimer’s isn’t just managed, but meaningfully slowed by the way we live. And that’s a story worth telling. You are what you eat and it seems your brain follows that exact same principle.

Dr Sam Moxon

Author

Dr Sam Moxon is a Research Fellow at the University of Birmingham. His expertise falls on the interface between biology and engineering. His PhD focussed on regenerative medicine and he now works on trying to develop 3D bioprinting techniques with human stem cells, so that we better understand and treat degenerative diseases. Outside of the lab he hikes through the Lake District and is an expert on all things Disney.

Follow @DrSamMoxon