How Nutrition, Proper Specific Hydration, Inflammation, and Body Flora affect Alzheimer’s/Dementia

(Peer Review Acceptance)

To see the article below on ResearchGate click Here.

By Keith David Kantor, PhD

Alzheimer’s disease (AD) is a specific disease that causes dementia. It is a progressive brain disease. Alzheimer’s destroys brain cells, causing problems with memory, thinking and behavior severe enough to affect work, lifelong hobbies or social life. Alzheimer’s gets worse over time, and it is fatal. It is the most common form of dementia.

Alzheimer’s disease (AD), the most frequent cause of dementia, is a form of amyloidosis. It has been known for a century that dementia, brain atrophy and amyloidosis can be caused by chronic bacterial infections, namely by Treponema pallidum in the atrophic form of general paresis in syphilis. Bacteria and viruses are powerful stimulators of inflammation. It was suggested by Alois Alzheimer and his colleagues a century ago that microorganisms may be contributors in the generation of senile plaques in AD. (8)

Dementia is an impairment of thinking and memory that interferes with a person’s ability to do things which he or she previously was able to do. Dementia is a symptom much like pain is a symptom. Many different injuries and illnesses can cause pain – the same is true for dementia. When you go to the doctor because you hurt, you won’t be satisfied if the doctor diagnoses “pain” and sends you home. You want to know what is causing the pain, and how to treat it. “Dementia” simply means the symptom of a deterioration of intellectual abilities resulting from an unspecified disease or disorder of the brain.

Dementia is not a specific disease. It’s an overall term that describes a wide range of symptoms associated with a decline in memory or other thinking skills severe enough to reduce a person’s ability to perform everyday activity. Alzheimer’s disease (AD) accounts for 60 to 80 percent of cases. Vascular dementia, which occurs after a stroke, is the second most common dementia type. But there are many other conditions that can cause symptoms of dementia, including some that are reversible, such as thyroid problems and vitamin deficiencies.

Dementia is often incorrectly referred to as “senility” or “senile dementia,” which reflects the formerly widespread but incorrect belief that serious mental decline is a normal part of aging.

Alzheimer’s is a type of dementia and that is the main difference between dementia and Alzheimer’s.

Let’s explore additional causes of Alzheimer’s/Dementia.

While scientists know Alzheimer’s disease (AD) involves progressive brain cell failure, the reason cells fail isn’t clear. Like other chronic conditions, experts believe that Alzheimer’s develops as a complex result of multiple factors rather than any one overriding cause.

The greatest risk factors for Alzheimer’s are:

AGE

  • Older age* and Alzheimer’s: Although Alzheimer’s is not a normal part of growing older, the greatest risk factor for the disease is increasing age. After age 65, the risk of Alzheimer’s doubles every five years. After age 85, the risk reaches nearly 50 percent.
  • *Alzheimer’s is not just a disease of old age. Younger-onset (also known as early-onset) Alzheimer’s affects people younger than age 65. Up to 5 percent of the more than 5 million Americans with Alzheimer’s have younger-onset.

Many people with early onset are in their 40s and 50s. They have families, careers or are even caregivers themselves when Alzheimer’s disease strikes. In the United States, it is estimated that approximately 200,000 people have early onset.

  • Having a family history of Alzheimer’s and carrying the APOE-e4 gene. (10)
  • Mapping family history of the APP (amyloid precursor protein) gene, and the PSEN1 and PSEN2 (presenilin) genes. MAPT (microtubule associated protein tau) gene and GRN (progranulin) gene, which have been associated with inherited forms of another illness involving memory loss called frontotemporal dementia. (9)

The discovery of additional risk factors through research will deepen our understanding of why Alzheimer’s develops in some people and not others.

Inflammation affects brain disorders

Even slight blood sugar elevation raises the binding of glucose to protein. This process, known as glycation profoundly increases the production of inflammatory chemicals in the body and is the main reason we check the A1c blood test as it measures this process. (1)

There is a great deal of interest, in the relationship between cognitive decline and vascular conditions such as heart disease, stroke, and high blood pressure (3), as well as metabolic conditions such as diabetes (1) and obesity. (4,5)

One large observational study performed at the Institute of Medicine at the University of Gothenburg (Sweden) pooled more than 353,000 patients with type 2 diabetes who were monitored for the development of dementia for a span of 4.8 years. The study population was separated into six groups “according to baseline HbA1c: <6% (n = 118,433); 6% to <7% (n = 117,397); 7% to <8% (n = 49,049); 8% to <9% (n = 23,143); 9% to <10% (n = 9,096); ?10% (n = 8,354).” The average age was about 68 years, with over half the patient population being male and the period of diabetes varying from 4 to 10 years. With the consideration of other variables, the study found that patients with a HbA1c level of 10.5% or greater were 50 percent more likely to be diagnosed with dementia in comparison to people with HbA1c levels of 6.5 percent or less. Likewise, patients who had a history of stroke were 40 percent more likely to have an overall deterioration in memory and thinking capacities. (1)

What’s even more interesting is newer research indicating a strong relationship between peripheral inflammation (inflammation outside of the brain) and risk for developing dementia. (6) An innate immune response facilitating recovery from injury (7) and pathogenic invasion (8), is positively associated with age-related cognitive decline and may play a role in risk for dementia. The realization that pathogens can produce slowly progressive chronic diseases has opened new lines of research into Alzheimer’s disease.

Research is increasingly finding that not only are many cognitive disorders such as Alzheimer’s and other forms of dementia related to inflammation among brain tissues, but classic mental diseases such as schizophrenia and depression may also be connected to brain inflammation.

Recent research from Japan’s Kyushu University Medical School and Saga University have been revealing that many mental disorders are produced by inflammation involving the microglia cells of the brain.

What are microglia?

The microglia are immune cells categorized as macrophages, but they are focused upon the health of the central nervous system — particularly the brain and spine. Microglia roam the neurons of these areas in search for toxins, intruders and possible infections.

Particularly at issue in cognitive issues such as dementia and Alzheimer’s disease is the buildup of amyloid plaque among brain cells. The microglia are the immune cells that prevent and clean up plaque buildup among brain cells. (18)

When the microglia populations are damaged or otherwise altered, the brain and CNS becomes increasingly susceptible to mental disorders such as dementia, schizophrenia, depression and mental fatigue.

Neuroinflammation and microglia

Neuroinflammation is the result of damage among brain cells. Healthy microglia populations are focused upon preventing inflammation among neurons, in turn preventing damage to brain cells.

However, when brain cells are damaged, microglia work harder to repair the damage by producing a variety of inflammatory factors. The damage to neurons, evidenced by these inflammatory factors, hamper the brain’s function.

Like other types of macrophages, the microglia are formed within the bone marrow. Once they migrate to the brain, they differentiate into particular responsibilities and different regions. Some microglia are focused on infections; others are focused upon toxins or damaged cells.

Others stimulate the repair of brain tissues.

Plaque and neuroinflammation

The build-up of plaque among brain cells — connected to dementia — stimulates the microglia as they work to try to remove the damage. Damage from oxidative stress and glycation byproducts have been linked to this buildup of plaque among brain cells.

Research by Dr. Akira Monji and associates has connected mental disorders such as schizophrenia (17), depressive states and cognitive issues to these increases in microglia inflammatory factors such as nitric oxide and cytokines. When the microglia have rapidly expanded in the face of damage to brain cells, they produce these inflammatory factors. Dr. Monji’s research has shown that the brain tissues of schizophrenia, depression and dementia patients have increased levels of these microglia inflammatory factors. (17)

Furthermore, their research has found that one of the central mechanisms of psychiatric drugs is that they reduce levels of these inflammatory factors — temporarily.

Like most pharmaceuticals, this temporary reduction of inflammatory factors does little to prevent or reduce the cause of the inflammation. Furthermore, by blocking inflammatory factors, the drugs work to interfere with the damage repair that is taking place, driven by the microglia immune cells. This is often the scenario for drugs that are focused upon the symptoms rather than the causes of a condition.

What causes neuroinflammation?

The cause of neuroinflammation, as shown in numerous dementia studies, relates to oxidative damage. Oxidation is produced through an imbalance between toxins that form oxidative radicals and those antioxidants that neutralize those radicals. When the system is not balanced, oxidation takes place, not only among tissues among the cardiovascular system, but also among brain tissues.

This of course is why recent research, such as a new French and Finnish INSERM study, has linked cognitive decline to increased obesity, diabetes and heart disease.

The study, led by Dr. Mika Kivimaki and associates from the French government’s investigative body, INSERM, studied 6,401 adults between 39 and 63 years old. They found that people who were obese and suffered from metabolic disorder (cardiovascular disease and/or diabetes) had more than a 22% greater cognitive decline than those who were of normal weight with no metabolic disorder.

This nutrition plan will help reduce inflammation

It is rich in Omega 3 fatty acids, low in processed sugar, gluten free, optimal high quality proteins, dye free and chemical pure whole foods are recommended as much as possible.

This plan incorporates healthy fats, antioxidants, fiber and optimal macro nutrient breakdowns.

This plan will help optimize gut flora balance, and brain function. Specific foods that can help fight inflammation include: Hydroxide rich alkaline water (details below), heart healthy nuts, nut butters and seeds like walnuts, pumpkins seeds.

Heart healthy oils like coconut oil, extra virgin olive oil, and antioxidant rich produce, including berries and dark leafy greens.

Lifestyle/Environmental Impact

Certain lifestyle trends and habits may contribute to the increase or decline of Dementia and Alzheimer’s symptoms.

Poor nutrition, infections, and substance abuse (including cigarette and alcohol use) may be contributing factors.

Regular exposure to toxins, such as dyes, chemicals, pollution can also affect brain health 2. Performing daily activities that challenge the brain will also help prevent and ward off the onset of Dementia and Alzheimer’s.

Consuming a balanced diet, rich in nutrients, is essential for preserving the health of one’s brain and metabolic systems. (12)

We all know that diet and nutrition play an integral part in our health. The plan recommends the below guidelines.

The seven guidelines to reduce risk of Alzheimer’s disease are:

  1. Minimize your intake of saturated fats and trans fats. Saturated fat is found primarily in dairy products, meats, and certain oils (coconut and palm oils). Trans fats are found in many snack pastries and fried foods and are listed on labels as “partially hydrogenated oils.” The older population tends to turn to processed convenient prepackaged foods more, as they are not cooking for large families anymore and their energy levels are not as high as they used to be.
  2. Eat plant-based foods. Vegetables, legumes (beans, peas, and lentils), fruits, and whole gluten free grains like quinoa, steel cut oats should replace large portions of meats and dairy products as primary staples of the diet. The darker the fruit (berries, grapes, etc. the lower the sugar content).
  3. To control the insulin levels, we like to recommend a ratio of 3 servings of vegetables to every 1 serving of fruit. Yes, fruit is healthy but large quantities can still raise blood sugar levels.
  4. Consume 15 milligrams of vitamin E, from foods, each day. Vitamin E should come from foods, rather than supplements. Healthful food sources of vitamin E include seeds, nuts, nut or seed butters, green leafy vegetables, and whole grains.
  5. Note: The RDA for vitamin E is 15 milligrams per day. (11)
  6. Take a B12 supplement. A reliable source of B12, such as fortified foods or a supplement providing at least the recommended daily allowance (2.4 micrograms per day for adults), should be part of your daily diet.
  7. Note: Have your blood levels of vitamin B12 checked regularly, as many factors, including age, and poor gut flora balance impair absorption.
  8. Avoid vitamins with iron and copper. If using multivitamins, choose those without iron and copper, and consume iron supplements along with vitamin C (ascorbic acid) only when directed by your physician.
  9. Choose aluminum-free products. While aluminum’s role in Alzheimer’s disease remains a matter of investigation, those who desire to minimize their exposure can avoid the use of cookware, antacids, baking powder, deodorant or other cosmetic and cleaning agent products that contain aluminum.
  10. Exercise for 120 minutes each week. Include aerobic exercise in your routine, equivalent to 40 minutes of brisk walking, three times per week. Exercise promotes healthy hormone balance. (11)

Other preventive measures, such as getting a minimum of seven hours of sleep each night and participating in 30 to 40 minutes of mental activity most days of the week, such as completing crossword puzzles, reading the newspaper, or learning a new language, can only help boost brain health. (15)

Gut Flora Balance

The recognition of the human microbiome (HM) as a substantial contributor to nutrition, health and disease is a relatively recent one, and currently, peer reviewed studies linking alterations in microbiota to the etiopathology of human diseases are few. Emerging studies indicate that the HM may contribute to the regulation of multiple neuro-chemical and neuro-metabolic pathways through a complex series of highly interactive and symbiotic host-microbiome signaling systems that mechanistically interconnect the gastrointestinal (GI) tract, skin, liver, and other organs with the central nervous system (CNS). Experts have concluded that healthy gut has a positive impact on management of brain related issues like dementia and Alzheimer’s.

Dementia/Alzheimer’s are one of several nervous system disorders related to cellular inflammation. This inflammation is controlled by the immune system. Essentially, you need your immune system to be in balance for good health.

Here are the top 5 simple steps anyone can use to help rebalance their gut bacteria.

  1. Reduce all processed sugars from your diet. Focus on whole foods and reduce your intake of all bread based products which are a source of elevated glucose levels in the blood and may lead to overgrowth of the wrong bacteria.
  2. Include fermented foods in your diet. Traditional choices would be yogurt and sauerkraut, but try and include more choices such as Kimichi, Tempeh, fermented meats, cultured condiments and Kefir for a better range of bacteria.
  3. Include foods high in fiber, which are an important pre-biotic that allows for healthy gut bacteria to proliferate. Garlic, onions, leeks, chicory and Mexican yams are great examples.
  4. Consider a quality probiotic supplement. Consult a qualified professional to help you choose an appropriate product.
  5. Get 20 minutes of daily aerobic exercise. This is at least indirectly related to optimizing brain health. Research shows exercise reduces dementia/Alzheimer’s risk and even supports new brain cell growth.

 

This plan has implemented these concepts in addition to the anti-inflammation nutrition plans.  Food chemicals are not new, but years ago people were only exposed to them sporadically. Unfortunately, today’s population is exposed to harmful food chemicals every day resulting in inflammation and metabolism disruption. (2)

In order to minimize the amount of chemicals you consume, be sure to purchase quality, all-natural, additive-free beef, poultry, seafood and produce.

As mentioned before, consuming foods that will reduce inflammation including Hydroxide rich alkaline water* (details below) raw fatty nuts, nut butters and seeds, avocados, dark berries, leafy greens (16), healthy oils and fatty fish like wild caught salmon.

Foods to include in daily nutrition:

Omega 3 fatty acids from walnuts, wild caught salmon, avocados

Brain boosting healthy fat from coconut oil

Copious amounts of vegetables and some fruit

Foods to Avoid:

Gluten

Sugar

Syrups

Processed meats

Juice

Candy

Pastries

Seasonings that contain harmful chemicals

Proper Hydration through Hydroxide Rich Water for Treating Alzheimer’s, Dementia, and Inflammation

Acidity and inflammation go hand in hand. By chemical definition, acidity is a problem of too much hydrogen (H+). Too much acidity in the body can stem from diet, disease, exercise, and other life style factors. It is generally recognized that excess acidity in the body creates inflammation which leads to other disease conditions. Acidity causes a lack of oxygen and a lower pH condition in which pathogens flourish.

Hydroxide (OH) is a natural hydrogen hunter that does not merely buffer the body against excess hydrogen but eliminates it by combining with it to form harmless water. That water can then be used for hydration or eliminated through urination. Here is the formula of the elimination reaction: OH + H+ = H2O.

Most alkaline waters attempt to help the body buffer acidity by providing alkaline minerals. But this does not address the underlying problem of excess hydrogen and instead only helps the body maintain pH balance. Potential hydrogen (pH) balance helps the body but it does not fix the issue. The main goal of most alkaline waters is pH balance but this misses the point.

A water rich in hydroxide seeks to eliminate acidity by eliminating the excess hydrogen. Most alkaline waters contain some hydroxide if they claim either to contain negative ions or have gone through ionization. The problem is most alkaline waters rely more on alkaline minerals to buffer the excess hydrogen than they use the hydroxide to eliminate hydrogen. This is why it is imperative to find a hydroxide rich water because elimination is far more effective in restoring balance to the body than mere buffering.

Benefits of a hydroxide rich water:

  • Hydroxide eliminates acidity rather than just buffering the acidity.
  • Hydroxide produces no toxic by-products. It produces only water which can be used for hydration or eliminated through urination.
  • By eliminating excess acidity (hydrogen), it frees up the body’s own oxygen to use for other biological processes.
  • Hydroxide restores completely the acid-alkaline balance beyond just pH balance.
  • Hydroxide helps reduce inflammation by eliminating acidity and not just buffering it.

 

Alzheimer’s and Dementia Nutrition Plan
MEAL MONDAY TUESDAY WEDNESDAY THURSDAY FRIDAY SATURDAY SUNDAY
BREAKFAST 1-2 c stable hydroxide rich water Squash pancakes* 1 egg Egg Muffin* Coconut yogurt parfait* Banana and almond butter* Protein coffee shake* Toast with Avocado, egg and tomato* Southwest egg scramble* and fruit
SNACK 1-2 c stable hydroxide rich water ¼ c Almonds and walnuts Celery with almond or cashew butter Coconut yogurt (none dairy) 1 serving Low sugar fruit- berries, apple, plum, grapes Celery with almond or cashew butter 1 serving Low sugar fruit- berries, apple, plum, grapes ¼ c Almonds and walnuts
LUNCH 1-2 c stable hydroxide rich water Bunless BLT turkey burger* and side salad Butternut Squash Soup* and gluten free crackers Lime chicken skewers* and side salad Stuffed acorn squash* Berry, feta, spinach and chicken tossed salad* Turkey Tacos with honey cilantro slaw* Egg salad* and tossed side salad
SNACK 1-2 c stable hydroxide rich water 1 c grapes Coconut dairy free yogurt Celery or apple with nut butter (no sunflower) 1 c berries 1 serving low sugar fruit ¼ c nuts (no pine or sunflower seeds) Celery or apple with nut butter (no sunflower)
DINNER 1-2 c stable hydroxide rich water Grilled chicken with wilted arugula and mushrooms Orange glazed pork chops with sweet potato hash Brussel Sprouts with balsamic glazed pecans *and grilled chicken breast Broiled Grouper Parmesan Cherry pan fried chicken* Spinach Stuffed Pork chops* Crock pot homemade BBQ chicken*

*See recipes

References:

  1. DIABETES CARE, VOLUME 26, NUMBER 4, APRIL 2003.
  2. Gore AC, Chappell VA, Fenton SE, et al. “Executive Summary to EDC-2: The Endocrine Society’s Second Scientific Statement on Endocrine-Disrupting Chemicals. ” The Endocrine Society. 2015.
  3. Sunil Kumar Raina, Vishav Chander, Sujeet Raina, Dinesh Kumar, Ashoo Grover, and Ashok Bhardwaj. “Hypertension and diabetes as riskfactorsfor dementia: A secondary post-hoc analysisfrom north-west India.” Ann Indian Acad Neurol. 2015 Jan-Mar; 18(1): 63-65.
  4. Thomas Jefferson University Hospital. “Scientists Discover Mechanism Tying Obesity to Alzheimer’s Disease.” ScienceDaily, 30 December 2005.
  5. A. Leboucher, C. Laurent, F.-J. Fernandez-Gomez, S. Burnouf, L. Troquier, S. Eddarkaoui, D. Demeyer, R. Caillierez, N. Zommer, E. Vallez, K. Bantubungi, C. Breton, P. Pigny, V. Buee-Scherrer, B. Staels, M. Hamdane, A. Tailleux, L. Buee, D. Blum. Detrimental Effects of Diet-Induced Obesity on Pathology Is Independent of Insulin Resistance in Transgenic Mice. Diabetes, 2012; DOI: 10.2337/db12-0866.
  6. Mayo Clinic. “Mayo Clinic Discovers Potential Link Between Celiac Disease and Cognitive Decline.” ScienceDaily, 12 October 2006.
  7. G. Scott, A. F. Ramlackhansingh, P. Edison, P. Hellyer, J. Cole, M. Veronese, R. Leech, R. J. Greenwood, F. E. Turkheimer, S. M. Gentleman, R. A. Heckemann, P. M. Matthews, D. J. Brooks, D. J. Sharp. Amyloid pathology and axonal injury after brain trauma. Neurology, 2016; DOI: 10.12121WNL.0000000000002413.
  8. IOS Press. “The Emerging Role of Infection in Alzheimer’s Disease. Journal of Alzheimer’s Disease. May 2008.
  9. Carlos Cruchaga, Sumitra Chakraverty, Kevin Mayo, Francesco L. M. Vallania, Robi D. Mitra, Kelley Faber, Jennifer Williamson, Tom Bird, Ramon Diaz-Arrastia, Tatiana M. Foroud, Bradley F. Boeve, Neill R. Graff-Radford, Pamela St. Jean, Michael Lawson, Margaret G. Ehm, Richard Mayeux, Alison M. Goate. Rare Variants in APP, PSENI and PSEN2 Increase Risk for AD in Late-Onset Alzheimer’s Disease Families. PLoS ONE, 2012; 7 (2): e31039.
  10. Ingmar Skoog, Margda Waern, Paul Duberstein, Kaj Blennow, Henrik Zetterberg, Anne Börjesson-Hanson, Svante Östling, Xinxin Guo, Jürgen Kern, Deborah Gustafson, Pia Gudmundsson, Thomas Marlow, Silke Kern. A 9-Year Prospective Population-Based Study on the Association Between the APOE*E4 Allele and Late-Life Depression in Sweden. Biological Psychiatry, 2015; 78(10).
  11. American Chemical Society. “In New Alzheimer’s Studies, Lab Tests Show Vitamin E and Other Antioxidants Preventing Brain Cell Death.”
  12. Dietary changes appear to affect levels of biomarkers associated with Alzheimer’s disease. JAMA and Archives Journals, June 14, 2011.
  13. Rush University Medical Center. “High-fat, Copper-rich Diets Associated with Increased Rates of Cognitive Decline in Older Adults.” August 16, 2006.
  14. Cyrus A. Raji, David A. Merrill, Harris Eyre, Sravya Mallam, Nare Torosyan, Kirk l. Erickson, Oscar L. Lopez, James T. Beckere, Owen T. Carmichael, H. Michael Gach, Paul M. Thompson, W.T. Longstreth, Jr., Lewis H. Kuller. Longitudinal Relationships between Caloric Expenditure and Gray Matter in the Cardiovascular Health Study. Journal of Alzheimer’s Disease, March 2016 DOI: 10.3233/JAD-160057.
  15. Robert S. Wilson, Eisuke Segawa, Patricia A. Boyle and David A. Bennett. Influence of late-life cognitive activity on cognitive health. Neurology, April 4, 2012 DOI: 10.1212ßNNL.Ob013e31824f8c03.
  16. Federation of American Societies for Experimental Biology (FASEB). “Eating green leafy vegetables keeps mental abilities sharp.” ScienceDaily, 30 March 2015.
  17. Mizoguchi Yoshito, Kato Takahiro A., Horikawa Hideki, Monji Akira. Microglial intracellular Ca2+ signaling as a target of antipsychotic actions for the treatment of schizophrenia. Frontiers in Cellular Neuroscience. 2014:8 370. DOI=10.3389/fncel.2014.00370.
  18. Ohgidani M, Kato TA, Kanba S. Introducing directly induced microglia-like (iMG) cells from fresh human monocytes: a novel translational research tool for psychiatric disorders Frontiers in Cellular Neuroscience. 2015;9 184. doi:10.3389/fncel.2015.00184. PMID: 26074765; PMCID: PMC4444822.

Resources:

https://en.wikipedia.org/wiki/Physicians_Committee_for_Responsible_Medicine

 

http://www.alz.org/research/science/alzheimers_disease_causes.asp#apoe

 

http://www.drperlmutter.com/wp-content/uploads/2014/03/inflammation-cognitive.pdf

 

https://www.nia.nih.gov/alzheimers/topics/causes

 

http://www.pcrm.org/health/reports/dietary-guidelines-for-alzheimers-prevention



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