Winter 2018

Fighting Alzheimer’s with Nutrition and Diet

A good diet—and positive sleep habits, stress management, and cognitive activities—help disease prevention, expert tells Tufts audience.

By Julie Flaherty

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“You can win the tug of war against your genes,” said physician Richard Isaacson, founder of the first Alzheimer’s prevention clinic in the country. Photo: Jake Belcher

While people may not show symptoms of Alzheimer’s disease until they are in their sixties or seventies, neurological changes start in the brain more than twenty years before the first symptom. “Alzheimer’s disease is not an older person’s disease. It’s a disease of younger and middle-aged people,” said Richard Isaacson, director of the Alzheimer’s Prevention Clinic at New York-Presbyterian/Weill-Cornell Medical Center. “And that’s how we have to shift the paradigm.”

Looking at Alzheimer’s disease as a lifelong progression is an opportunity, said Isaacson, the keynote speaker at the Drs. Joan and Peter Cohn and Family Lecture on Nutrition, Inflammation, and Chronic Disease, held October 12 at the Jean Mayer USDA Human Nutrition Research Center on Aging (HNRCA) at Tufts. In 2013, he opened the first Alzheimer’s prevention clinic in the country, focusing on nutrition, exercise, and other lifestyle interventions that people can begin well before they reach old age.

While some risk factors for dementia—such as age, family history, and history of head trauma—can’t be changed, others can. Isaacson pointed to a 2017 report in the journal The Lancet that said one in three cases of dementia could be prevented through lifestyle choices. The report identified nine ways to reduce risk: avoiding high blood pressure, obesity, diabetes, and smoking; focusing on education, physical activity, and social contact; and treating hearing loss and depression.

“Genetics is part of the puzzle, but genes are not your destiny,” he said. “You can win the tug of war against your genes.” Having the ApoE4 gene, for example, slightly increases your risk of developing Alzheimer’s, but one study has shown that exercise works particularly well in reducing dementia risk in people with the gene. “This is exciting,” he said. “This means that even people who are at higher risk potentially may benefit more from these very low-risk and cost-effective interventions.” These include exercise and nutrition, good sleep habits, stress management, cognitive activities, and social engagement. Weight management, and particularly reduction of visceral fat, are key. “As the belly size increases,” he said, “the memory center in the brain gets smaller.”

As for what to eat, a Mediterranean-style diet has the most robust scientific evidence behind it for brain health, Isaacson said. Diet patterns such as very-low carbohydrate and intermittent fasting are promising for Alzheimer’s prevention, but more research is needed. The same with wine, cocoa powder, vitamin D, and coffee.

Some interventions work better for some people than others, leading him to believe that diets have to work in conjunction with a person’s genetic makeup to prevent dementia. “Precision nutrition,” he said, “is really where I think the field is going to go.”

Watch the video of the lecture at hnrca.tufts.edu/cohn-family-lecture.

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