The good news about Alzheimer’s is that while there is no real evidence that you can bring back brain cells (neurons), although they can regenerate slowly, there is lots you can do right now to make sure you don’t get the accelerated brain shrinkage that leads gradually from memory decline to Alzheimer’s. Given that brain shrinkage starts, for many, in their 40’s these prevention steps should be actioned now, not just later in life.
The other good piece of news it that it is highly likely that, at least half of all cases of Alzheimer’s could be prevented right now by checking your homocysteine level and acting accordingly to ensure your level is well below 10mcmol/l, which is the level associated with accelerated loss of brain cells.
But it is probable that most of your risk could be eliminated by not only keeping your homocysteine level down (more on this later) but also building these prevention steps into your daily life.
But the first, and most important, is to check your memory with the free on-line Cognitive Function Test at www.foodforthebrain.org, act accordingly and do this every year from the age of 50 since this will give you an accurate measure of your memory, and a yardstick against which to measure the benefits of these prevention steps.
Eat fish three to four times a week, with at least two servings of oily fish (salmon, mackerel, herrings, kippers, sardines or tuna). Eating more nuts and seeds, preferably, raw.
Eating one serving of oily fish a week is associated with halving the risk of Alzheimer’s. Supplements of one kind of fish omega 3 fish oil, called DHA, has been shown to enhance memory in adults who don’t eat fish, and to prevent memory loss in those in the early stages of memory decline. But it’s not just oily fish. The more fish you eat the better your memory test performance. Fish is also an excellent source of vitamins B12, D and choline, all essential for the brain. Chia and flax seeds have the most omega 3. As well as eating these foods I’d recommend you aim to supplement about 250mg of DHA a day. If your supplement contains DPA this converts readily to DHA so add to the DHA level and aim for a total of 250mg.
The studies above used around 1,000mg a day, which is what I’d recommend if you don’t score well on the Cognitive Function Test. This would mean adding a 1,000mg fish oil capsule to your daily supplements, as well as eating oily fish at least three times a week.
Eat at least six servings of brightly coloured vegetables and berries a day. Half a plate of vegetables counts as two servings. A glass of good quality red wine counts as one.
The more fruit and vegetables you eat the lower is your risk of cognitive decline with vegetables being particularly protective.The best kinds of vegetables are carrots, cauliflower, broccoli, Brussels sprouts, cabbage, spinach, mushrooms and the best fruits are berries, especially blueberries and strawberries. Flavonoids and polyphenols, found not only in fruit and vegetables, but also in tea, red wine and dark chocolate, are associated with preserving memory. The most protective effect is found eating six servings (500g) a day of fruit and vegetables.
Supplementing both vitamin C (1g) and vitamin E combined is associated with halving the risk of Alzheimer’s disease.
Minimise sugar – Eat a Low GL Diet
Follow a low GL diet, with slow-releasing ‘whole’ carbohydrates. Minimise sugar, sugary drinks and juices.
Keeping you blood sugar levels down, which also means you make less insulin, preserves your memory. That means avoiding sugar as much as possible and eating slow-releasing ‘whole’ carbohydrate foods such as wholegrain bread or pasta and oat cakes. Eating white bread is associated with a poorer cognitive test performance, whereas high fibre bread is associated with better performance. Eating carbohydrate foods with protein, for example brown rice with fish, or porridge oats with seeds further reduces the glycemic load (GL) of a meal. Best fruits in this respect are berries, cherries and plums while too many grapes, raisins or banana are high GL. These kind of foods are consistent with a Mediterranean diet which has also been shown to reduce risk. Eat your fruit, don’t drink it. Fruit juice has a lot of sugar in it.
Supplement B vitamins – Check your homocysteine
Supplement vitamin B6 (20mg), B12 (10mcg) and folic acid (200mcg) as a sensible precaution. But do check your homocysteine level to find out how much you need. If above 10mcmol/l supplement high dose B6 (20mg), folic acid (800mcg) and B12 (500mcg) preferably in a supplement that also provides zinc and TMG.
Having a higher intake and blood level of vitamin B12 and folic acid is associated with a quarter of the risk of developing Alzheimer’s. Vitamin B6, B12 and folic acid, especially in combination, lower blood levels of homocysteine, which is a key predictor of risk. Lowering your homocysteine, if above 10mcmol/l by supplementing high dose B6 (20mg), folic acid (800mcg) and B12 (500mcg) has been shown to greatly reduce the rate of brain shrinkage and memory loss in those at risk of Alzheimer’s. That is why it is VITAL to check your homocysteine level and, if above 10, supplement high doses of B vitamins. Homocysteine is also lowered by the combination of zinc and TMG, which are included in homocysteine-lowering formulas.
Otherwise, supplementing a daily multivitamin or B complex giving at least 20mg B6, 200mcg of folic acid and 10mcg of B12.
B12 absorption can greatly worsen with age, and is inhibited by the diabetes drug metformin, and antacid ‘proton-pump inhibitor (PPI) medication. If you are taking these be sure your GP checks your homocysteine level.
Limit coffee – Green tea is better
Limit coffee and choose herbal or green tea instead.
While there is inconsistent evidence linking coffee with more or less risk, drinking lots of coffee both raises homocysteine levels) and promotes the excretion of protective B vitamins. For example, two cups of coffee raises homocysteine by 11% in 4 hours.
Green tea, on the other hand, is associated with a lower risk of cognitive impairment. Ordinary tea drinking was also associated with better cognition. My advice is to limit coffee to one a day and drink tea, ideally green, instead. The occasional or daily glass of red wine is also likely to lower your risk.
Keep mentally, physically and socially active.
Keeping fit,learning new things and stimulating your mind, and staying in touch with friends and family all helps to reduce your risk. If you don’t use it you lose it. There may also be a benefit in exercises that require more mind-body coordination, such as t’ai chi or yoga, and exercising outdoors – we make vitamin D in the presence of sunlight. These activities also help to reduce stress, which is another prevention step in the right direction as is keeping your blood pressure down.
The Cognitive Function Test is a free on-line screening test that checks four key types of cognitive ability that decline in dementia. If your score isn’t great you’ll get a letter to take to your GP recommending homocysteine testing. If your homocysteine level is above 10mcmol/l (which you can test privately and with a home-test kit) you’ll be advised to supplement high dose B vitamins (see above).
Homocysteine testing can be carried out by your doctor. You can also do it privately through many laboratories, or with a hometest kit purchased from YorkTest.
Need help? The Brain Bio Centre, which is the outpatient clinic of Food for the Brain, offers consultation on all mental health concerns, including dementia and Alzheimer’s. Visit www.brainbiocentre.com.
This article was contributed by Patrick Holford