When New York-based filmmaker and musician Max Lugavere was his mother Kathy's patient wingman a few years ago, he became frustrated by what he calls a "diagnose and adios" approach to treating her memory loss. "Basically they tell you what they think is going on, they prescribe drugs which aren't very effective and that's it," Lugavere says. "I saw very little in the way of lifestyle or diet interventions."
Lugavere took his mother to neurology departments at university hospitals throughout the country to figure out what was wrong, but her condition was hard to pin down. "I sort of had to put on my detective hat to use my understanding of science and biology," Lugavere says.
Lugavere's mother still hasn't been diagnosed with one precise condition, but her "confluence of mysterious symptoms" point to cognitive impairment, memory loss and Parkinsonism. She's being treated for memory loss and is stable. Meanwhile, Lugavere has started taking proactive steps toward preventing his own potential disease onset. While researching his mother's condition, he discovered something he says was once taboo to imply: You can help prevent Alzheimer's disease. At least in part. According to an analysis in the Lancet Journal of Neurology last August, more than half of Alzheimer's cases worldwide might be attributed to potentially modifiable risk factors. And one of these risk factors is diet.
"I came across some very interesting insights," Lugavere says. "They found striking similarities between the brain cells in Alzheimer's disease and the muscle cells in people with Type 2 diabetes."
Studies have shown a correlation between high blood sugar and increased risk of dementia, adds David Perlmutter, a neurologist based in Naples, Florida, who is internationally recognized in the field of nutritional influences in neurological disorders. For example, one study published in the New England Journal of Medicine measured blood sugar in 2,000 people for seven years and found that those with higher blood sugar levels were at a significantly higher risk of dementia, Perlmutter continues. "There's a perfect correlation between sugar and Alzheimer's disease." The exact reason why that's the case isn't yet known, but some researchers believe the insulin resistance in people with high blood sugar affects brain cells.
Higher blood sugar levels also correlate with brain shrinkage, Perlmutter adds. And the brain consumes a lot of the calories that we take in -- another reason to be mindful of the content of those calories, Lugavere says. "The brain at rest uses as much energy as one leg during a marathon," he says. "It's a very hungry organ."
Low-Carb, High-Fat Diet
If there's one consistent message across most diets these days, it's to consume carbohydrates sparingly. The same is true for brain health. "There isn't a special brain-smart diet that is different than a heart-healthy diet or a diabetes prevention diet," Perlmutter says. "There is really one dietary approach." That approach involves reducing free radicals and inflammation through the body, he continues. Specifically in the brain, inflammation destroys brain cells and interferes with cognitive function.
"Inflammation is the cornerstone of everything that can go wrong in the brain," Perlmutter says, adding that 99 percent of the genetic material in the body is contained in the gut bacteria, or micro-biome. Research shows that this good bacteria in the lining of our gut contributes to the regulation of signaling between the gastrointestinal tract and other organs and the central nervous system.
Refined carbohydrates like white bread incite inflammation by firing up proteins called cytokines, while whole carbohydrates such as fruits, vegetables and legumes fight inflammation. "Anything we can do to make sure our bodies are using glucose as efficiently as possible makes sense for our brain health," Lugavere says. Because the brain is such a fatty organ, eating good fats is also important. These include coconut oil, salmon and grass-fed red meat, he adds.
Richard Isaacson, director of the Alzheimer's Prevention Clinic at the Weill Cornell Memory Disorders Program, designs personalized nutrition plans for people at risk of Alzheimer's disease because of a family history of the disease. "One of the most important things is that anyone can take control of brain health by changing the food they eat," Isaacson says. "There isn't a one size fits all."
That said, there's strong evidence that the Mediterranean diet is good for brain health, as well as elements of the paleo diet, he adds. He recommends consuming a lot of omega-3s in fatty fish, flavonoid-rich berries and lean meats such as chicken and turkey.
Don't Delay Eating for Brain Health
Lugavere, who's 32, adopted his own brain-healthy diet shortly after delving into research for his mother, and after a blood test revealed that he has both the genetic variants and high levels of an amino acid that put him at increased risk of dementia. "Based on everything I know, I have opted to eat a diet low in carbs and high in good fats," he says. "I feel as lean and strong as I've ever been."
Lugavere just finished making a documentary film called "Bread Head," that includes interviews with several top Alzheimer's researchers in the U.S. who endorse a low-carb diet for brain health. One researcher, Suzanne de la Monte, an associate professor of pathology and medicine at Brown University, coined the concept that Alzheimer's is Type 3 diabetes because of the strong correlation between carb-rich foods and memory loss.
Lugavere wants to use his film to reach as many people as possible, including peers. That could be a significant audience, since 5.2 million people in the U.S. had Alzheimer's disease in 2014, and that number is expected to triple by 2050. The key, Lugavere says, is to reach enough people in time, since changes in the brain occur decades before symptoms of disease appear. "Prevention really is the new frontier," he says. "I hope I can help it get here faster. We don't have time to lose."