Alzheimers: Cure or Obscure?

Well-known and respected medical journalist, Jerome Burne, gives us some hard hitting food for thought as he explores through personal experience, the latest research for an Alzheimer’s cure

Over two decades ago, I discovered I carry the APOE4 gene, which is associated with a higher risk of developing Alzheimer’s disease. With nearly a million people affected by Alzheimer’s in the UK and projections suggesting this number could rise to six million by 2050, my personal and professional interest in this area is keen. As a medical and health journalist, I knew how to stay abreast of scientific advancements, yet for
years, optimism was hard to come by. Vaccines or targeted pharmacological solutions were expected to produce breakthroughs, but these usual suspects remain as elusive as Keyser Söze.

However, a new and promising approach has stepped forward. An increasingly credible way of reducing dementia risk is being offered up from the soft end of medical care; rather than relying solely on pharmaceuticals, the case is being made for looking to a combination of diet, supplements and lifestyle changes.

Significant resources (billions, not mere millions) have been dedicated to developing drugs that target the amyloid plaques and tangles found in the brains of Alzheimer’s patients – thought to be the cause of the disease – but despite hundreds of trials, these plaque-busting drugs have yielded disappointing results, barely impacting the rate of brain cell death.

This has paved the way for independent researchers and academics to explore a different path: eschewing the notion of a single cause and promoting overall bodily health to support brain health. After all, the brain is intricately connected to various body systems, including the cardiovascular system, metabolism (how energy is used), the immune system, the vast colony of bacteria and other microbes (the microbiome) in our guts, and the processes involved in rest and repair.

The encouraging news is that improvements in these areas can begin with simple dietary and lifestyle changes. I’ve been exploring this radical new approach with the help of my nutritionist friend and co-author Patrick Holford, who runs a charity called foodforthebrain.org.

The website is a mine of information where you can take a free cognitive function test and discover your ‘Dementia Risk Index’ (DRI) based on answers to a questionnaire designed to reveal your mental and physical health.

The ‘Food for the Brain’ test explores things like how well you handle cognitive challenges, how effective is your exercise regime, how well you sleep, what your diet and social life is like and how effectively you look after the microbiome, home to much of the immune system.

Guiding the advice is an impressive scientific board of a dozen consultants and researchers, whose work focuses on Alzheimer’s. They include Professor Emeritus David Smith of Oxford who has run pioneering studies on the brain-sparing combination of B vitamins and omega3 fats, Professor Emeritus Robert Lustig, expert on the metabolic effects of blood glucose and insulin at the University of California San Francisco, and Dr

Tommy Wood, Assistant Professor of paediatrics and neuroscience at the University of Washington whose studies are uncovering why exercise is so good for the brain.

My first reassuring discovery was that while the APOE4 gene could increase risk, there were many straightforward simple diet and lifestyle changes that could reduce it. One of them was to junk the conventional dietary advice to cut back on fat and fill up with carbs. Down at Food for
the Brain you were encouraged to do precisely the opposite. It was sugar and refined carbs that had been driving our other epidemics of obesity and diabetes and they were now fuelling Alzheimer’s.

But there was much more to it than overturning the all-too familiar healthy balanced diet dogma. Crucial was a home pin prick biochemical
test, available alongside the DRI that few doctors’ surgeries would routinely check. It measures your omega-3 index, vitamin D, homocysteine (a marker for B vitamin status), and HbA1c.

HbA1c shows a person’s blood sugar resilience and is used to diagnose diabetes. Professor Lustig has shown that if it is too high, it could be damaging brain cells and causing weight gain. “Essentially, lowering blood sugar changes your metabolism in ways that help reduce Alzheimer’s risk,” he said.

“The high levels of blood glucose from a carb-rich diet will come with too much insulin because its job is to clear it away into storage as fat. Fairly soon, however, your system stops responding to insulin – insulin resistance – which is bad news because insulin delivers the glucose needed for energy in the brain and muscles.”

The members of the board emerged as a crack team of biological engineers, with a grip on nutrition and the effects of lifestyle that few regular doctors could match. What they also had was
a deep knowledge of the underlying biology and how to shift it in a healthier direction. If only such a lifestyle special forces unit had been around when I got my genetic diagnosis.

The more I learnt from the team, the more I made changes in my diet and lifestyle. High carb and low-fat eating was reversed, visits to the gym stepped up and I started paying attention to my microbiome. Along with an increase in fibrous vegetables, I’ve now been making and drinking kefir, a fermented drink that delivers probiotics to the guts. The results are impressive.

The last strand of Food for the Brain’s approach involves testing for nutritional and vitamin deficiencies that directly affect the brain and boosting them if they are low. But it is here, it seems to me, that the charity comes into direct conflict with the rest of the Alzheimer’s establishment, especially over giving high doses of vitamin B6, B12 and folate.

It’s a perfectly logical approach and is now backed by an impressive body of trial evidence gathered over the last ten years. However, the Alzheimer’s charities have doggedly refused to examine it, test it themselves or recommend it. I would say they seem to deny it exists. There is a strong case for saying that this has been a culpable disaster for patients.

The battle dates back ten years when Oxford Professor of Pharmacology David Smith, who was the Chair of the charity’s scientific advisory board, ran a trial on over 200 people with Mild Cognitive Impairment (MCI), sometimes called pre-dementia, when memory and clear thinking is starting to go.

It’s the stage before an Alzheimer’s diagnosis. Half got a high dose of the B vitamins, the others a placebo. Crucially, a The results were astonishing.
Brain shrinkage – a critical indicator of Alzheimer’s – was 73% greater in the placebo group than among those getting the vitamins, especially in those with good omega-3 blood levels.

You might have expected such dramatic good news would have been rushed out by the Oxford press office. Instead, even though the results seemed to promise what everyone had been praying for – a safe, effective, and cheap treatment – they were ignored. Undaunted by this refusal to acknowledge his work in any way, Smith continued, unsuccessfully, to apply for funding for the obvious follow up, to find out if giving B vitamins to patients with Mild Cognitive Impairment (MCI), slowed or blocked the progression to Alzheimer’s.

The boost from good levels of omega-3 fats also makes sense at a biological level because the omega 3 is needed inside brain cell membranes where they transfer information, while the B vitamins are needed to bind them in. They are like a hammer and a nail.

I had been more intrigued by the potential of B vitamins when I discovered they provided the answer to my personal quest – how to lower the risk from the APOE4 gene. Once again it was a matter of following the underlying biochemistry. B vitamins are essential for a process known as methylation, which is the way that the action of genes, such as APOE4, can be changed. Omega-3 has become part of my daily cocktail of nutrients.

There are a couple of other tests set up to fight Alzheimer’s. One is ARUK’s Think Brain Health Check, and the other is the Zoe project, which does check both the blood glucose and the microbiome of members, as well as advocating lifestyle changes but it too draws the line at taking any supplements.

Meanwhile foodforthebrain.org has now tested 430,000 people and is aiming for a million by the end of next year. And they also offer many other health related tests as well.

It’s hard to understand the continuing refusal to test the effectiveness of B vitamins and the keeping of information from patients, other than as a conspiracy. Could something that can significantly reduce brain cell damage, costs pennies and has virtually no side effects be considered a serious threat to a billion-dollar market?

The free Cognitive Function Test is available at: www.foodforthebrain.org