Dietary Prevention of Mental and Physical Decline in Alzheimer's and Dementia

Written By Bonnie Lu

by Rakhi Khurana

Concerning Alzheimer's and Dementia, studies investigating the relationship between diet and health conditions are still advancing, yielding mixed outcomes. The question of whether the impact of nutrition on the brain is independent or linked to other healthy  

behaviours is still an ongoing debate. The objective is to leverage these scientific advancements to demonstrate how adopting healthy and consistent nutritional practices can positively impact individuals and serve as a preventive measure against cognitive decline.  

A healthy diet reduces inflammation and cellular damage by:

  • Increased production of mitochondria (cells that make energy) 

  • Decreased blood-brain barrier leakage (a semipermeable barrier that prevents toxins from entering the bloodstream)

  • Eliminate free radicals (highly reactive molecules that damage cells) 

  • Enhanced autophagy (the elimination of damaged cells) 

Recommended dietary strategies to prevent Alzheimer's and dementia encompass the following:  

Mediterranean Diet (MEDI) 

The Mediterranean diet is believed to be neuroprotective due to its high anti-inflammatory and antioxidant properties. This eating pattern emphasizes a rich intake of fruits, vegetables, nuts, fish, seafood, whole grains,  and cold-pressed extra virgin olive oil while restricting meat consumption. 

  • This diet is high in omega-3 fatty acids, most often found in fish, seafood, eggs and nuts. Omega-3 fatty acids include alpha-linolenic acid (ALA), eicosapentaenoic acid (EPA), and docosahexaenoic acid (DHA). Although there are differing findings in the literature, the recommended ratio of omega-3 to omega-6 is 4:1.  

  • Excessive omega-6 fatty acids stimulate inflammation as they act as precursors to pro-inflammatory signalling molecules. Seed oils, such as sunflower, safflower, canola, and soybean oil contain omega-6 fatty acids. 

  • Omega-3 fatty acids reduce inflammation by controlling the generation of pro-inflammatory cells, affecting cell membrane structure and flexibility, and supporting immune function.

MIND Diet (Mediterranean–DASH Intervention for Neurodegenerative Delay) - The MIND diet seeks to reduce cognitive decline by encouraging the consumption of plant-based foods, grass-fed butter, fish, dairy, vegetables, nuts, poultry, whole grains, and moderate wine intake.

  • This diet is a hybrid of the Mediterranean and the DASH (Dietary Approaches to Stop Hypertension) diet. The MIND diet promotes healthy gut microbiota, includes healthy fats, and boosts the body's utilization of antioxidants to reduce systemic inflammation.  

  •  The key distinction between the Mediterranean and MIND diets lies in their emphasis on certain food groups. The MIND diet favours increased consumption of green leafy vegetables while discouraging excessive cheese and milk intake. Conversely, the MEDI diet encourages higher vegetable consumption overall, without specifying green vegetables, and restricts dairy intake, except for cheese.

Ketogenic Diet - Low carbohydrate (5-10%): High Fat (70-80%) 

  • The ketogenic diet diminishes dependence on glucose as the primary fuel for the brain and shifts towards utilizing ketones. The liver produces ketones, which serve as an alternative energy source when the body primarily consumes fats. 

  • People with Alzheimer's disease experience brain insulin resistance (BIR), a condition where the brain becomes less sensitive to insulin. BIR results in an energy deficit and reduced blood flow, which can worsen cognitive symptoms.

  • Ketogenic diets enhance the production of mitochondria. This diet helps extract energy from carbohydrates, fats, and proteins, increasing energy production in the brain. 

Other dietary options linked to optimal brain health include the following: 

  • Saffron  

  • Cinnamon 

  • Rosemary  

  • Green Tea 

  • Coenzyme Q10  - a naturally occurring substance that generates energy within the mitochondria

  • Grass Fed Tallow/Butter/Beef  

  • Dark Chocolate 

A well-rounded diet prevents the accumulation of physiological stressors. A healthy diet improves the body's reserves to deal with and recuperate from acute or chronic illnesses,  promoting a resilient state of well-being.


References  

Alabduladhem, T. O., & Bordoni, B. (2022, November 23). Physiology, Krebs Cycle.  PubMed; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK556032/ 

Calder, P. C. (2017). Omega-3 fatty acids and inflammatory processes: from molecules to  man. Biochemical Society Transactions, 45(5), 1105–1115. https://doi.org/10.1042/ bst20160474  

Fox, D. J., Park, S. J., & Mischley, L. K. (2022, December 6). Comparison of associations between mind and Mediterranean diet scores with patient-reported outcomes in parkinson’s disease. Nutrients. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9739738/ 

Li, J., Capuano, A. W., Agarwal, P., Arvanitakis, Z., Wang, Y., Phillip De Jager,  Schneider, J. A., Tasaki, S., Katia, Hu, F. B., Bennett, D. A., Liang, L., & Grodstein, F.  (2023). The MIND diet, brain transcriptomic alterations, and dementia. MedRxiv (Cold  Spring Harbor Laboratory). https://doi.org/10.1101/2023.06.12.23291263 

Jk, I., & Pc, C. (2018, May 1). Omega-6 Fatty Acids and Inflammation. Prostaglandins,  Leukotrienes, and Essential Fatty Acids. https://pubmed.ncbi.nlm.nih.gov/29610056/ 

National Institute on Aging. (2023, November 20). What Do We Know About Diet and  Prevention of Alzheimer’s Disease? National Institute on Aging. https://www.nia.nih.gov/ health/alzheimers-and-dementia/what-do-we-know-about-diet-and-prevention alzheimers-disease 

Tabaie, E. A., Reddy, A. J., & Brahmbhatt, H. (2021). A narrative review on the effects of  a ketogenic diet on patients with Alzheimer's disease. AIMS public health, 9(1), 185–193.  https://doi.org/10.3934/publichealth.2022014 

Panagiotakos, D. B., Kastorini, C.-M., Pitsavos, C., & Stefanadis, C. (2011). The Current  Greek Diet and the Omega-6/Omega-3 Balance: The Mediterranean Diet Score Is  Inversely Associated with the Omega-6/Omega-3 Ratio. Karger.com. https://doi.org/ 10.1159/000327791 

Phillips, M. C. L., Deprez, L. M., Mortimer, G. M. N., Murtagh, D. K. J., McCoy, S.,  Mylchreest, R., Gilbertson, L. J., Clark, K. M., Simpson, P. V., McManus, E. J., Oh, J.-E., 

Rakhi Khurana  

Yadavaraj, S., King, V. M., Pillai, A., Romero-Ferrando, B., Brinkhuis, M., Copeland, B.  M., Samad, S., Liao, S., & Schepel, J. A. C. (2021). Randomized crossover trial of a  modified ketogenic diet in Alzheimer’s disease. Alzheimer’s Research & Therapy, 13(1).  https://doi.org/10.1186/s13195-021-00783

Yassine, H. N., Samieri, C., Livingston, G., Glass, K., Wagner, M., Tangney, C.,  Plassman, B. L., Ikram, M. A., Voigt, R. M., Gu, Y., O’Bryant, S., Minihane, A. M., Craft,  S., Fink, H. A., Judd, S., Andrieu, S., Bowman, G. L., Richard, E., Albensi, B., & Meyers,  E. (2022). Nutrition state of science and dementia prevention: recommendations of the  Nutrition for Dementia Prevention Working Group. The Lancet Healthy Longevity, 3(7),  e501–e512. https://doi.org/10.1016/s2666-7568(22)00120-9

Bonnie Lu
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