Why the MIND diet excludes cheese, butter, and margarine -- now we may know

In the longitudinal studies the late Dr. Martha Clare Morris conducted that led to the development of the MIND diet, Dr. Morris found an association between consumption of red meat, butter, stick margarine, and cheese with the development of Alzheimer's disease.  So these are excluded from the MIND diet, even if they might be more tolerated in the Mediterranean diet.  When I speak to a group about diet, and I say that avoiding saturated fats helps insulate you from Alzheimer's disease, I hear groans.  Especially when I mention the cheese.

Longitudinal studies look at associations of behaviors and possible consequences over time, without necessarily explaining the reason for the associations.  So correlation isn't causation, and maybe there's some weird reason for the association that, if understood, would allow us to go back to cheese.  Unfortunately...

Saturated fats, cholesterol, and high-fat diets got a lot of bad press in the 1980s and 90s as being strongly correlated with heart disease.  But it turned out that the evidence for these associations was weak, and the government and health authorities backed off on strong recommendations that food high in saturated fats and cholesterol be avoided.  For example, it seemed like eggs were just poison, because they have so much cholesterol in the yolks.  But later research failed to find the strong link between egg consumption and the actual heart disease postulated by the cholesterol-heart disease hypothesis.  So they told us to go back to eating eggs.

So while the evidence of an association between a diet high in saturated fats and heart disease began to weaken, the association with Alzheimer's disease actually strengthened.  But what was the basis for the association?  I've been wondering this for a while.  And maybe we now know.

I came across this article on the science news web site, PsyPost.  It cites research from the journal, Nutrients, which claims to have found evidence that could explain the association between saturated dietary fats (cheese, butter, etc.) and Alzheimer's disease.  But it's kind of complicated, so you may just want to know that they think they're better able to explain the relationship between consumption of saturated fats and the development of obesity, type 2 diabetes, and Alzheimer's disease.  (Note that this particular study does not connect heart disease with a diet with saturated fats.)

Going a little deeper, the study examined the role of microRNAs (miRNA) in the "expression of genes."  Which means how proteins are generated when genes in DNA are read by messenger RNA (mRNA).  The miRNA (which have only been recently discovered) are supposed to regulate the production of proteins by exercising control over the mRNA that's making the proteins.  There are many different types of miRNA influencing the production of many different proteins.  Many of the miRNA live in parts of the brain like the hippocampus -- ground-zero for Alzheimer's disease.  Some can influence the development of insulin resistance in the brain.  As we explained in Beating the Dementia Monster, as insulin resistance advances we call it type 2 diabetes and it is strongly associated with Alzheimer's disease.

With that background, the researchers studied the diets of mice (again...) along with changes in their memories and other abilities.  The researchers also examined the mouse brains in autopsy.  They controlled the mouse diets so that the mice consumed known amounts of saturated fats.  The researchers found that a diet high in saturated fat seemed to disrupt the miRNA in its task of allowing proper generation of proteins and the work of insulin in signaling cells to consume glucose.  An important part of both type 2 diabetes and Alzheimer's disease is the failure of cells to properly take up and metabolize glucose.  And so they call Alzheimer's disease type 3 diabetes.  (We discussed all of this in Beating the Dementia Monster.)

It appears to me that this is a very different pathway to type 2 diabetes than the one we discussed in Beating the Dementia Monster.  The better known pathway is excessive consumption of carbohydrates generates a steady output of insulin that overwhelms the cells.  The insulin is supposed to signal the cells to take up glucose, but it hits a point where the overwhelmed cells stop taking up glucose.  Then glucose levels in the blood get excessively high and begin damaging organs.

This was all fascinating to me, but I'm not sure how many of you are still here.  The bottom line?  Staying away from red meat, butter, stick margarine, and cheese remains part of a diet for those of us avoiding or fighting Alzheimer's disease.

It's not just me, folks!

When I tell my story, I'm often met with skepticism.  And why shouldn't people doubt me?  The concept in popular culture about Alzheimer's disease is that it is genetic, with a steady, inevitable progress to the grave.  Most people have known someone, likely in their own family, who developed the disease and followed that seemingly inevitable path of memory and cognitive degeneration.  I don't mind telling you that I sometimes wonder myself ... until I recall how my life was in 2015 and 2016.  So, is my story credible?  Am I somehow unique?   

I recently came across this article in the New York Post about two people who claimed to have "reversed" their biomarkers for Alzheimer's disease through changes in diet and exercise.  Sound familiar?  The article references a documentary series on CNN about Alzheimer's disease, which, in turn, highlights research by the well-known diet doctor, Dr. Dean Ornish.  The series is narrated by Dr. Sanjay Gupta.  Ornish has been conducting research in how lifestyle changes can influence the advance of Alzheimer's disease, and he is now publishing his results.  

The key to understanding the evidence (and the skepticism about our experience) is to recognize that the role of lifestyle is only obvious following significant and often difficult changes in lifestyle.  Some people are already living well and/or do not have any predisposing characteristics.  Others have genetic markers and/or have poor habits regarding exercise and diet.  But it's rare to see someone change their lifestyle and record how it affects memory and cognition.

Ornish uses the phrase "for the first time" regarding his research on reversing Alzheimer's disease, without giving due to the FINGER study, which we hope will be confirmed by the US POINTER study.  Of course, as we pointed out in Beating the Dementia Monster, Dr. Dale Bredesen also claims credit for reversing Alzheimer's disease "for the first time."  I won't claim to be "for the first time;" I'll say instead that I have company.  

I'd like to say I have a lot of company, but I don't have enough.  My mission at this point in my life is to encourage as many people as possible to change how they live, hoping they will be happier and more productive.

In Gupta's series, one thing he did was travel to Okinawa where the longest lived people in the world live.  He hoped to find out what in their diet causes their longevity.  He may be wasting his time.  Many people in Hawaii who identify as Japanese are of Okinawan heritage.  After living in American culture for generations, they are consuming as much pizza and McDonald's as anyone.  My wife is of Okinawan ancestry, the youngest of eight.  We visited Hawaii a couple of months ago and spent some time with her oldest brother.  At 91, he still plays golf twice a week.  It seems to me that (if Alzheimer's doesn't interfere) it's genetic makeup causing Okinawans to live long lives.

Exercise and Dementia - A much more complex picture

In Beating the Dementia Monster, we tried to provide a reasonably straightforward understanding of how it was that exercise, especially sustained aerobic exercise, might have such a powerful effect in countering Alzheimer's and some other diseases associated with metabolic syndrome.  The simple narrative was that during exercise, the body generates the brain-derived neurotrophic factor (BDNF) protein that repairs damaged neurons and prompts stem cells in the hippocampus to form new neurons.  While that all appears to be true, it turns out that there's a much more complicated story.  According to some new research, exercise, one way or another, does something in just about every tissue in the body.  And many of these effects make additional contributions to brain health.

Since 2016, the Molecular Transducers of Physical Activity in Humans Consortium (MoTrPAC), has been conducting a 10-year project funded by the NIH Common Fund to further investigate these phenomena.  The results are pretty remarkable.  (But you may want to take a Dramamine before you visit their web site.)

So far, MoTrPAC has produced three peer-reviewed studies.  One paper published in the journal Nature maps molecular responses to endurance training across 18 organs, including the brain and the cardiovascular system.  Another, in Nature Communications, reports that endurance training influences the expression of disease-associated genes.  A third, published in Nature Metabolism, identified sex differences in how fat tissue responds to training.  (It turns out that males burn more fat than females.) 

The most important of these studies was "Temporal dynamics of the multi-omic response to endurance exercise training," published in Nature.  But, well, the study was based primarily on work with rats.  They compared rats who worked out hard on the cage wheel with rats denied access to any way of exercising.  However, the researchers meshed what they learned about rats with other research with humans to draw conclusions about exercise by humans.

What did they find?  Exercise provoked an incredible array of molecular changes across the entire body. Some were shared across tissues, suggesting common responses, while others only happened in one or a few organs.  Some of these molecular responses rose or fell as endurance training progressed.  While all tissues showed changes in response to exercise, some showed more change than others.  Blood, brown and white fat, adrenal gland, and colon cells changed dramatically, while there were only small changes in the hypothalamus, cortex, testes, and vena cava.  For proteins, the calf muscle, heart, and liver experienced the biggest effects.  And, of course, they confirmed what we said about BDNF in Beating the Dementia Monster. 

The ALZFORUM concludes, "Researchers have long puzzled over whether the benefits of physical activity on cognition and memory might be due to a direct effect on the brain, and/or to improvements in other tissues, such as the cardiovascular and immune systems.  [MoTrPAC] could help them tease apart these effects, and point to the most optimal exercise interventions."

So ... more research is necessary.

That online test and ... chocolate!

Last time I wrote, I talked about the online cognitive test from LANGaware.  The first time I took it on April 23, I came up as cognitively impaired.  I took the test two more times since then and came up normal.  However, my "normal" had some deficits.  In my post of April 23, I shared the map of my cognition, showing those of my strengths and deficits that had been measured.  I took one more test after that showing a wider range of strengths, but still substantial deficits.  Still within normal.

The obvious question is "the practice effect."  Did I do better simply because I had practiced their test?  All I can say is that, with each test, they based their results on largely differing measures.  I presume that helps with the practice effect, since I studied the results for each test to understand where I'd been short before taking the next test.  So ... who knows?

But I also came across a very reassuring video reinforcing my joy in eating dark chocolate!  Now I've sworn off milk chocolate since its sugar content surely causes more problems than it helps.  But dark chocolate contains flavanols, polyphenols, and catechins that are powerful antioxidants.  Maybe even more than blueberries.  These are great for both heart health and brain health.  (The neurologists always say, "What's good for the heart is good for the brain!")

In the video, the neurologist describes the benefits of eating dark chocolate, noting that chocolate with too much sugar won't help you.  (So no milk chocolate.)  If fact, you should verify that it is 70% or more cacao

I noticed that brands like Lindt and Ghirharde can be a bit pricey.  However, Sam's Club at Walmart, 72% cacao, is reasonably priced.  For a while, we could get Jojo's Dark Chocolate Bars at Costco, but they have been discontinued.  That was my favorite.

I love chocolate, so the warnings that come with this dietary recommendation from the experts can be discouraging.  Only one or two pieces a day.  Otherwise, they say, you negate the positive effects with the amount of sugar you will be consuming.