Can Diet Prevent Alzheimer’s

Written by Dr. Steve Chaney on . Posted in Diet and Alzheimer's

Preserving Your Memories In Your Golden Years

Author: Dr. Stephen Chaney

 

can diet prevent alzheimer'sAlzheimer’s is a scary disease. There is so much to look forward to in our golden years. We want to enjoy the fruits of our years of hard work. We want to enjoy our grandkids and perhaps even our great-grandkids. More importantly, we want to be able to pass on our accumulated experiences and wisdom to future generations.

Alzheimer’s and other forms of dementia have the potential to rob us of everything that makes life worth living. What is the use of having a healthy body, family, and fortune if we can’t even recognize the people around us?

That is why anything that might reduce the risk of Alzheimer’s is BIG news, which brings me to the recent buzz about the MIND diet.  Can diet prevent Alzheimer’s.

 

What Is The MIND Diet?

the mind dietThe MIND diet is the brainchild of Dr. Martha Clare Morris, a nutritional epidemiologist at Rush University Medical Center. She started with the Mediterranean and DASH diets, which I have described in a previous issue of “Health Tips From the Professor,” because both of those diets have been shown to reduce the risk of dementia. Then she researched the literature for studies linking specific foods and nutrients to improving cognition and/or preventing dementia.

In short, she combined the brain-healthy features of the Mediterranean and DASH diets and further modified them based on the best scientific data available. She emphasized some components of those two diets and minimized others. She also modified the number of servings of some foods, based on the best available evidence.

She acknowledged that when she eliminated or reduced foods that were parts of those two diets, it did not mean those foods might not play an important role in preserving cognitive function as we age. It simply meant we don’t currently have strong evidence to prove their beneficial effects in preserving cognition.

The MIND diet is a whole food, plant-based, diet.

 

  • It includes 10 “brain-healthy” food groups: green leafy vegetables, other vegetables, nuts, berries, beans, whole grains, fish, poultry, olive oil, and wine (in moderation, too much alcohol kills brain cells).
  • It limits red & processed meats, butter and margarine, cheese, pastries & sweets, and fried & fast foods.
  • It neither recommends nor discourages low fat dairy foods and fruit other than berries. Dr. Morris notes that while those are healthy foods, they have no proven benefit for preventing cognitive decline.

 

Can Diet Prevent Alzheimer’s?

 

As you can tell, a lot of thought went into the design of the MIND diet, but does it work? Dr. Morris partnered with 5 of her colleagues at Rush University Medical Center to test the hypothesis (Morris et al., Alzheimer’s & Dementia 11: 1007-1014, 2015). They enrolled 923 participants, ages 59 to 98 years (average age = 81) from retirement communities and senior public housing units in the Chicago area. All participants were free of Alzheimer’s disease when the study began.

doctor's studyAt the beginning of the study each participant filled out a detailed food frequency questionnaire. Participants were given an extensive physical and neurological exam designed to diagnose the onset of Alzheimer’s disease and/or dementia on an annual basis. Participants were followed for an average of 4.5 years, during which time 144 of the participants developed Alzheimer’s and another 14 developed non-Alzheimer’s dementia.

At the end of the study the food frequency data were analyzed to determine how closely participants adhered to the MIND diet, the Mediterranean diet, and the DASH diet.  Adherence to each of these diets was then correlated with the onset of Alzheimer’s disease. [To be perfectly clear, none of the participants were given any dietary instruction. Nor were they advised to change their diet. This study simply looked at the diets they were already eating and determined how closely their diet matched the standards set for MIND, Mediterranean, and DASH diets.] The results were striking:

  1. Strict adherence to all 3 diets significantly decreased the risk of developing Alzheimer’s disease. The decreased risk was:
    • 53% for the MIND diet.
    • 54% for the Mediterranean diet.
    • 39% for the DASH diet.
  2. When the investigators looked at moderate adherence to each of the diets, the MIND diet performed slightly better than the other two diets:
    • Moderate adherence to the MIND diet decreased Alzheimer’s risk by 35%.
    • Moderate adherence to the Mediterranean and DASH diets had no significant effect on Alzheimer’s risk.

What Does This Study Mean For You?

Dr. Morris concluded that healthy diets, such as the Mediterranean and DASH diets, provide substantial protection against dementia. She stated that as new studies come along, these diets can be modified to provide even better protection. She considers the MIND diet is the first step in that process.

alzheimer's riskA 53% decrease in Alzheimer’s risk is impressive. However, if you are really concerned about dementia and Alzheimer’s disease, you should think of diet as only one component of a holistic approach. As I described in a recent article How to Prevent Memory Loss, a holistic approach to preserving your cognitive function includes:

  • A healthy diet
  • B vitamins & omega-3s
  • Weight control
  • Exercise
  • Adequate sleep
  • Socialization
  • Memory training (mental exercise)

The Bottom Line

 

  1. The Mediterranean and DASH diets have already been shown to preserve mental function as we age, thus reducing the risk of developing dementia and Alzheimer’s.
  2. Martha Morris at Rush University Medical Center used the latest studies on specific foods and nutrients that preserve mental function to modify those diets into something she calls the MIND diet.
  3. Morris and colleagues at Rush then evaluated the effectiveness of all 3 diets on reducing Alzheimer’s risk. Strict adherence to all 3 diets significantly decreased the risk of developing Alzheimer’s disease. The decreased risk was:
    • 53% for the MIND diet.
    • 54% for the Mediterranean diet.
    • 39% for the DASH diet.
  4. When the investigators looked at moderate adherence to each of the diets, the MIND diet performed slightly better than the other two diets:
    • Moderate adherence to the MIND diet decreased Alzheimer’s risk by 35%.
    • Moderate adherence to the Mediterranean and DASH diets had no significant effect on Alzheimer’s risk.
  5. Morris concluded that healthy diets, such as the Mediterranean and DASH diets, provide substantial protection against dementia. However, she feels that as new studies come along, these diets can be modified to provide even better protection. She considers the MIND diet as the first step in that process.
  6. Healthy diet is only one component of a holistic approach for preserving mental function. Other components include:
    • B vitamins & omega-3s
    • Weight control
    • Exercise
    • Adequate sleep
    • Socialization
    • Memory training (mental exercise)

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure or prevent any disease.

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Comments (2)

  • Barbara Wagner

    |

    I have a Shaklee distributor and have received your newsletter for years. I was at the recent Science Symposium in Portsmouth, NH.

    Re the Mind diet, I included an excerpt from your newsletter below. How do you reconcile a’ whole foods plant based diet’ and then include fish, poultry, meat and dairy as you’ve done below. I have found the research/writing done by T. Colin Campbell to be the most convincing case for a healthy diet (including for the brain). He recommends a whole foods plant based diet without animal products. Michael Greger, MD, and his book ‘How Not to Die’ also recommends a whole food plant based diet without animal products.

    ‘The MIND diet is a whole food, plant based, diet.

    • It includes 10 “brain-healthy” food groups: green leafy vegetables, other vegetables, nuts, berries, beans, whole grains, fish, poultry, olive oil, and wine (in moderation, too much alcohol kills brain cells).

    • It limits red & processed meats, butter and margarine, cheese, pastries & sweets, and fried & fast foods.

    • It neither recommends or discourages low fat dairy foods and fruit other than berries. Dr. Morris notes that while those

    Reply

    • Dr. Steve Chaney

      |

      Dear Barbara,

      As Joe Friday used to say in the TV show “Dragnet”: “Just the facts, mam.” I am a big fan of a Vegan diet and the writings of T. Colin Campbell. However, the data are very clear that a plant based diet with some healthy animal proteins, such as the Mediterranean diet, also dramatically decreases the risk of heart disease, diabetes, cancer, and dementia. The MIND and DASH diets are very closely related to the Mediterranean diet. I consider all of them healthy diets. Whether you want to go Vegan, Mediterranean, MIND or DASH is a matter of personal preference.

      Dr. Chaney

      Reply

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Latest Article

Is Coconut Oil Bad For You?

Posted July 25, 2017 by Dr. Steve Chaney

Nutty About Coconut Oil

Author: Dr. Stephen Chaney

is coconut oil bad for youCoconut oil is the latest miracle food. Bloggers and talk show hosts are telling us how healthy it is. We are being told to cook with it, spread it on our toast, and put it in our smoothies. We are told to be creative. The more coconut oil you can get in your diet, the better.  But, is coconut oil bad for you?

The hype is working. 72% of the American public believes coconut oil is healthy. This is why the recent American Heart Association (AHA) Presidential Advisory on saturated fats has proven so controversial.

Interestingly, most of the AHA advisory was about the linkage between saturated fats from meat & dairy and heart disease risk. Only one paragraph of the 24-page report was devoted to coconut oil, but the AHA recommendation to avoid coconut oil generated the lion’s share of headlines.

What Did The AHA Presidential Advisory Say?

The AHA advisory concluded that saturated fats from meat and dairy foods increased the risk of heart disease. This conclusion was based on randomized clinical trials in which the diet was carefully controlled for a period of at least two years. More importantly, the conclusion was not based on LDL cholesterol, particle size, HDL cholesterol, inflammation or any other potential marker of heart disease risk. It was based on actual cardiovascular outcomes – heart attacks, strokes, deaths due to heart disease.

I have reviewed the AHA report in a previous issue of “Health Tips From the Professor,” Are Saturated Fats Bad For You, and have concluded their statement that saturated fats from meat and dairy increase the risk of heart disease was based on solid evidence. We can now say definitively that those saturated fats should be minimized in our diets.

 

Is Coconut Oil Bad For You?

 

coconut oil bad for heartIn contrast to the saturated fats in meat and dairy, there have been no studies looking at the effect of coconut oil on cardiovascular outcomes. Instead, the authors of the AHA report relied on studies measuring the effect of coconut oil on LDL cholesterol levels. There have been 7 controlled trials in which coconut oil was compared with monounsaturated or polyunsaturated oils.

  • Coconut oil raised LDL cholesterol in all 7 studies.
  • The increase in LDL cholesterol in these studies was identical to that seen with butter, beef fat, or palm oil.

This evidence makes it probable that coconut oil increases the risk of heart disease. However, LDL is not a perfect predictor of heart disease risk. The only way to definitively prove that coconut oil increases the risk of heart disease would be to conduct clinical studies in which:

  • Coconut oil was substituted for other fats in the diet.
  • All other dietary components were kept the same.
  • The study lasted at least 2 years.
  • Adherence to the “coconut oil diet” was monitored.
  • Cardiovascular outcomes were measured (heart attack, stroke, death from heart disease).

In short, one would need the same type of study that supports the AHA warning about saturated fats from meats and dairy. In the absence of this kind of study, there is no “smoking gun.” We cannot definitively say that coconut oil increases the risk of heart disease.

Is Coconut Oil Healthy?

coconut oil healthyDoes that mean all those people who have been claiming coconut oil is a health food are right? Probably not. At the very least, their health claims are grossly overstated.

Let’s start with the obvious. In the absence of any long-term studies on the effect of coconut oil on cardiovascular outcomes, nobody can claim that coconut oil is heart healthy. It might be, but it might also be just as bad for you as the saturated fats from meat and dairy. It’s effect on LDL cholesterol suggests it might increase your risk of heart disease, but we simply do not know for certain.

I taught human metabolism to medical students for 40 years. I was also a research scientist who published in peer reviewed journals. When I look at the health claims for coconut oil on the internet, I am dismayed. Many of the claims are complete nonsense. Others sound plausible, but are based on an incomplete understanding of human metabolism. None of them would pass peer review, but, of course, there is no peer review on the internet.

In addition, some of the claims have been “cherry picked” from the literature. For example, claims that coconut oil increases metabolic rate or aids weight loss are based on short-term studies and ignore long-term studies showing those effects disappear over time.

Let me review some of the more plausible-sounding claims for coconut oil.

  • Coconut oil increases HDL levels, which is heart healthy. The effects of HDL cholesterol are complex. Elevated HDL levels are not always heart protective.

For example, a few years ago a pharmaceutical company developed a drug that raised HDL levels. They thought they had a blockbuster drug. You didn’t need to exercise. You didn’t need to lose weight. You would just pop their pill and your HDL levels would go up. There was only one problem. When they did the clinical studies, their drug had absolutely no effect on heart disease risk. It turns out it is exercise and weight loss that reduce heart disease risk, not the increase in HDL associated with exercise and weight loss.

The implications are profound. Just because something increases HDL levels does not mean it will reduce cardiovascular risk. You have to actually measure cardiovascular risk before claiming something is heart healthy. That has not been done for coconut oil, so no one can claim it is heart healthy.

  • Coconut oil consists of medium chain triglycerides, which are absorbed more readily than other fats. That is true, but it is of interest to you only if you suffer from a fat malabsorption disease. Otherwise, it is of little importance to you.
  • Medium chain triglycerides are preferentially transported to the liver, where the fats in coconut oil are converted to energy or released as ketones rather than being stored as fat. This is partially true, but it is misleading for two reasons.
    • First, the fat in coconut oil actually has three possible fates in the liver. Some of it will be converted to energy, but only enough to meet the immediate energy needs of the liver. If carbohydrate is limiting, the excess will be converted to ketones and exported to other tissues as an energy source. If carbohydrate is plentiful, the excess will be converted to long chain saturated fats identical to those found in meat and dairy and exported to other tissues for storage.
    • Secondly, nobody has repealed the laws of thermodynamics. If the fat in coconut oil is being preferentially used as an energy source by the liver and being exported as ketones to other tissues as an energy source, you need to ask what happens to the calories from the other components in your diet. If you are eating a typical American diet, the carbohydrate that would have been used for energy will be converted to fat and stored. If you are eating a low carbohydrate diet, the other fats that would have been used for energy will simply be stored. Simply put, if you are preferentially using the calories from coconut oil for energy, the calories from the other foods in your diet don’t just evaporate. They are stored as fat.
  • Coconut oil increases metabolic rate, which will help you lose weight. When you look at the studies, this is only a temporary effect. This is due to a phenomenon called metabolic adaptation that is often seen when one makes a dramatic shift in diet composition. Initially, you may see an increase in metabolic rate and weight loss. After a few weeks, the body adapts to the new diet,and your metabolic rate returns to normal.
  • Coconut oil is metabolized to ketones which have many beneficial effects. There is some truth to this claim. As I discussed in my analysis of the keto diet,  ketones have some real benefits, but not nearly as many as proponents claim. Furthermore, the amount of ketones produced by coconut oil will depend on the availability of carbohydrate. Much of the coconut oil in the context of a very low carbohydrate diet will likely be converted to ketones. Coconut oil spread on a piece of bread or used in baking is more likely going to be converted to fat.

I could go on, but you get the point. The hype about the benefits of coconut oil sounds good, but is misleading. There may be some benefits, but in the absence of long-term studies we have no convincing evidence that coconut oil is good for us.

What Does This Mean For You?

coconut oil bad or goodWhen you started reading this article, you were probably hoping that I would settle the coconut oil controversy. Perhaps you were hoping that I would tell you the American Heart Association was right, and you should avoid coconut oil completely. More likely you were hoping I would tell you the coconut oil proponents were right and you could continue looking for more ways to incorporate coconut oil into your diet. As usual, the truth is somewhere in between.

Coconut oil may increase our heart disease risk, but the evidence is not definitive. We cannot say with certainty that coconut oil is bad for us. On the other hand, most of the hype about the benefits of coconut oil is inaccurate or misleading. We have no well-designed, long-term studies on health outcomes from coconut oil use. We cannot say with certainty that coconut oil is good for us.

I recommend moderation. Small amounts of coconut oil are probably alright. If you have a particular recipe for which coconut oil gives the perfect flavor, go ahead and use it. Just don’t add it to everything you eat.

Finally, there are other oils we know to be healthy that you can use in place of coconut oil. If you are looking for monounsaturated oils, olive oil and avocado oil are your best bets. Olive oil can be used in salads and low temperature cooking. Avocado oil is better for high temperature cooking. Also, less frequently mentioned, safflower and sunflower oils are also good sources of monounsaturated fats.

If you are looking for a mixture of monounsaturated and polyunsaturated fats, safflower oil, canola oil and peanut oil are your best bets. Peanut oil is also good for high temperature cooking.

Corn oil and soybean oil are your best sources of omega-6 polyunsaturated fats, while flaxseed oil is your best vegetable source of omega-3 polyunsaturated fats.

 

The Bottom Line

 

  • Coconut oil is the latest diet fad. It is highly promoted by the popular press, and 72% of Americans think it is healthy, even though it is a saturated fat.
  • The American Heart Association (AHA) has recently advised against the use of coconut oil because it likely increases the risk of heart disease and “has no offsetting beneficial effects.”  Because this statement is controversial, I have carefully analyzed the pros and cons of coconut oil use.
  • Coconut oil may increase our heart disease risk, but the evidence presented by the American Heart Association is not definitive. We cannot say with certainty that coconut oil is bad for us.
  • On the other hand, most of the hype about the benefits of coconut oil is inaccurate or misleading. We have no well-designed, long-term studies on health outcomes from coconut oil use. We cannot say with certainty that coconut oil is good for us.
  • I recommend moderation. Small amounts of coconut oil are probably alright. If you have a particular recipe for which coconut oil gives the perfect flavor, go ahead and use it. Just don’t add it to everything you eat.
  • For details of my analysis and suggestions for healthy fats you can substitute for coconut oil, read the article above.

 

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure or prevent any disease.

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