
Some strategies may help against Alzheimer’s disease and other dementias - tuxguy
https://www.nytimes.com/2019/03/01/health/dementia-prevention-supplements.html
======
smileysteve
This article seems to have come out in a vacuum while there has been notable
research published in the last months. All of these articles have been
published on HN.

* On Prions and Alzheimer's being transmissible [https://news.ycombinator.com/item?id=19127520](https://news.ycombinator.com/item?id=19127520)

* On insulin resistance linked to the disease [https://www.psychologytoday.com/ca/blog/diagnosis-diet/20160...](https://www.psychologytoday.com/ca/blog/diagnosis-diet/201609/avoiding-alzheimer-s-disease-could-be-easier-you-think)

* On gum disease's links

* On HIV and Herpes medication links to reducing [https://news.ycombinator.com/item?id=17540094](https://news.ycombinator.com/item?id=17540094) [https://news.ycombinator.com/item?id=19099157](https://news.ycombinator.com/item?id=19099157)

~~~
nabla9
All the links you mention may have something in common.

There seems to be bacteria in the gut and diabetes link or inflammation and
diabetes link. Gum disease is known to have effects trough letting bacteria
and byproducts into the blood. Antiviral medication (HIV and herpes
medication) may fight Alzheimer for the same reasons (they kill viruses and
reduce inflammation indirectly).

Infections (bacterial, viral or prion) and/or inflammation they cause may be
the common link.

It could be that anything that increases inflammation has link to Alzheimer's.

Exercise, sleep, stress reduction and good nutrition may be linked to
infections or inflammation as well. Link may be trough improving immune system
to fight infections and/or reducing inflammation.

~~~
DoreenMichele
Inflammation and infection tend to go hand in hand. My best understanding is
that each can promote the other and treating either successfully can reduce
the other.

Chemical conditions that promote inflammation tend to promote infection.
Infection tends to cause inflammation.

You likely cannot neatly separate these two health issues.

~~~
nabla9
inflammation is biological response to infection (as well as other irritants).

~~~
DoreenMichele
I'm aware of that. But inflammation also can be caused by, for example, excess
acidity. Reversing excess acidity has been shown to effectively break up
biofilm, thereby reversing antibiotic resistance.

Seems pretty clear to me that the connection thus runs both ways. It isn't a
one way street.

~~~
krageon
Can you explain what you mean with "excess acidity"? Excess acidity where? In
the mouth? What is it in excess of?

~~~
DoreenMichele
Throughout the body, though most medical sources seem to talk about blood pH.

My understanding:

Life was not able to leave the oceans until there were bony fish not simply
because of the need for a frame on land, but also because of the need to
regulate the blood chemistry. In the ocean, animals don't need this. The
minerals in the water regulate their blood chemistry. Out of the water, bones
serve as a store of calcium to draw upon to neutralize excess acidity.

If you are seriously and chronically acid, the body will strip the bones of
calcium to keep you alive as long as possible, leading to osteoporosis. Blood
needs to remain in a very narrow pH range or you quickly die. Diabetics
diagnosed with acidosis are hospitalized. It is a medical emergency that can
kill you in two or three days.

Most Westerners dismiss the idea of an alkaline diet as nonsense. It gets
lumped in with "nutcase" anti-vaxxers for how "scientific" it is deemed to be.
But the first defense against acidosis is diet. You need to not be eating too
much of the wrong thing.

Correcting it is tricky because if the stomach gets too alkaline, you become
incapable of digesting food and you begin throwing up. So brute force methods
of consuming strongly alkaline stuff can go bad places. You really need to
straighten out your diet as a first line of defense. Trying to "hack" this
doesn't work well.

You can google it, though you will probably get a lot of hits that the HN
crowd would outright mock. Here are a couple of "respectable" links to get you
started:

[https://www.livestrong.com/article/381592-normal-body-ph-
ran...](https://www.livestrong.com/article/381592-normal-body-ph-range/)

[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC137247/](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC137247/)

~~~
nabla9
This theory is total BS.

Acidosis is medical emergency. Human body contains several pH buffers, is
someone would be able to saturate them by eating, they would die.

There is absolutely no connection between alkaline foods and blood pH levels.
Eating acidic or alkaline foods has no effect on stomach pH, nor does it has
effect on the pH of blood.

Alkaline food can alter urine pH, but there is no effect on elsewhere in the
body unless you are really sick.

------
philg_jr
Peter Attia did a podcast with Francisco Gonzalez-Lima. Its a pretty
fascinating listen where he explains the vascular hypothesis of Alzheimer’s
which describes one the problem of impaired blood flow to the brain. The
podcast is called "The Drive" if anyone wants to look it up.

------
andrewla
This is a trash article that belongs in a tabloid. All of those supplements
showed preliminary progress but then were refuted by evidence showing that
they were garbage.

Saying "these steps might" is as bad as the initial pimping of the supplements
in the first place. The failures in this space should put is in a mode of
"extraordinary claims" \-- until these results get exhaustively researched and
replicated it is irresponsible to report on them as any more effective than
using hexes and energy crystals to stave off dementia.

~~~
jrauser
Did you even read the headline? “Supplements won’t prevent dementia...”

The first half of the article is all about various dietary supplements and how
there is no good evidence for them. But there is decent evidence for exercise,
controlling blood pressure, and congnitive training.

~~~
andrewla
I mention the supplements as a comparison. Like the nonsense peddled here, the
techniques (increased physical activity, blood pressure management, and
cognitive training) have shown preliminary promise. But all three (I boldly
predict) will fail on further testing, and even now, as the article itself
notes, have failed to produce results that exceed statistical significance.

This is irresponsible reporting that is falling for the exact same magical
thinking that led to the hype around supplements. Because attempts to prevent
dementia have been previously shown to be without merit, we should report on
new ideas with a great deal of skepticism until the evidence becomes very
strong.

~~~
rajadigopula
> we should report on new ideas with a great deal of skepticism until the
> evidence becomes very strong

A nutritionist with Ph.d with good credibility claims that he got good results
with using black sesame seeds. The way he used it is - roast 2 spoons of black
sesame seeds and eat once a week for 6 months (no need/should not take every
day). He claims to have cured them in 6 months. If I have someone I know I
would try as there is no harm in having a regular food item taken once a week.
Don't know how it works or if any studies already done to back it up.

~~~
gus_massa
Great! Until he does a double-blind pre-registered randomized study (with a
control group) and it is published in a serious peer review journal (and
reproduced a few times by independent research groups), it should be treated
like snake oil.

The harm is indirect, because they are mixing real medicine wit pseudoscience.
There are a lot of miracle "cures" that appear every month. Many of them steal
the patients or the family money, other steal just time and hope. And in some
cases, people following the alternative cures avoid following the standard
treatment that is better ot at leas reduces the suffering.

~~~
rajadigopula
May be you forgot the context I mentioned it in. We have to look for
alternatives when there is no definitive one present for the time being.

He's been curing patients for past 20 years with diet changes alone. So, I am
impressed with his results and shared his idea. Doing a study on it and not
using it until you study is your problem. In other words, I sense your worry
of how your medicine will react since it's posion (full of unnatural
chemicals) compared to a natural food item in it's unaltered form which is
being used in daily food consumption in many cultures. Are you suggesting
people taking medicine to stop eating food on a daily basis? I never suggested
to stop any medication.

I am more than willing to contact him, will you be able to fund the study?

~~~
gus_massa
> _He 's been curing patients for past 20 years with diet changes alone._

From your other comment:

> _He claims to have cured them in 6 months._

I'm not sure how long it takes to transform a 6 month treatment to a paper. I
guess 1 year before for designing, filling all the forms and preparations. And
I guess 1 year after to process all the statistics, write the results in a
nice form, fighting with the referee/editor. So in 2.5 years it could be
published. Let's round it to 3 years because it's not my field of study. [1]

So in 20 years he has enough time to publish a serious paper on a cure an a
popular illness that has a lot of people working on it. (Perhaps if the evil
Big Pharma is blocking his study, he can replace the pre-registration to a
single big announcement in a blog post an a hash of the post in the bitcoin
blockchain. It's not official, but any good registration is enough. Most of
the other steps, like double-blind, can be made anyway.)

[1] In Physics the typical time is 3 month, but there are very few paperwork
because the study doesn't use humans. In Math the typical time is more than 1
year, perhaps 2, because math is forever and the review is proportional.

~~~
rajadigopula
I totally agree. It will be beneficial for everyone.

------
concinds
I'll echo another commenter's "trash" qualifier for the article.

Dr. Bredesen published a study in 2014 that found his protocol effective in
people in the early stages of Alzheimer's disease. Some (all?) of his protocol
is listed here:
[https://www.apoe4.info/wiki/Bredesen_Protocol](https://www.apoe4.info/wiki/Bredesen_Protocol)

It includes interventions ranging from dietary (daily fasting, autophagy
promotion, minimise inflammation & insulin resistance, prebiotics and
probiotics), lifestyle (stress, sleep, exercise, sleep apnea, mitochondrial
function), vitamins & minerals, hormonal balance, and more.

The recent articles linking Alzheimer's with insulin resistance, gum disease,
HIV/herpes, and more are just bite-size recycling of what Bredesen talked
about back then, but strangely without mentioning the whole protocol.

The article is trash not because vitamins aren't helpful (they are, but not on
their own without the rest of the protocol), but because the Bredesen study
has become quite well-known, and not mentioning it seems akin to malpractice.
They might want to present the Bredesen study skeptically or critically, but
pretending it doesn't exist, when it's shown success, is eerie. It's like
writing an article about sugar in 2019 without mentioning its toxic effect on
the body.

~~~
gamblor956
The point of this article was that a large part of the Bredesen Protcol
doesn't work or is not backed by any studies...

------
throwaway-1283
Nothing on fasting or low carb diet...I've read multiple studies that inducing
autophagy through either is linked to reducing Alzheimer's risk...

~~~
cheesymuffin
Autophagy's great, but I prefer to boost mitochondrial function. Coconut oil
is great to enhance fat burning. Eat a cup of salt to improve your osmotic
potential. Watch out for keto flu!

"We're really on a roll catching all this food. We should fast for three days
for autophagy and then post on the internet about it" \- every good hunter
ever

------
spraak
Dr Christopher Exley of Keele University believes in part that Alzheimer's is
caused by accumulation of aluminum -
[https://youtu.be/mPX9Xseot2U](https://youtu.be/mPX9Xseot2U)

------
vanderZwan
> _“The same things we recommend for heart health turn out to be important for
> cognition,” she told me. “It’s a blossoming field.”_

Well, the article just mentions exercise, but you can obviously also take
dietary steps to improve artery function, and that includes certain food
supplements. So either none of the tested supplements mentioned earlier in the
article improve artery function, or there is something else going on that
warrants further research.

Anyway, to continue the "foods for a healthier vascular system" train of
thought, nutritionfacts.org has a lot of information on what kind of foods
cause stiffer arteries, and which ones help improve artery function. I know
from past discussions that this is a controversial site on HN, presumably
since it so makes extraordinary claims about a plant-based diet being a cure-
all for many illnesses associated with Western lifestyles. However, it is not
exactly controversial to call the Western diet unhealthy. Furthermore, the
website actually cites nutrition research papers that it bases its claims on.
That is a whole lot better than food blogs without scientific sources, or
worse: people getting defensive over their food habits and sharing their
unsourced opinions on what is and isn't a healthy diet.

The short version is: avoid meat, lots of foods rich in phytonutrients,
fibres, and polyphenols. So vegetables, leafy greens, legumes, fruits and
berries.

As for magical supplements: crushed flax seeds and the Indian gooseberry both
appear to have very positive effects on artery health, cholesterol levels
(healthy and unhealthy kinds) and hypertension[0][1][2][3].

Sugar spikes/crashes from foods that are too easy to digest can be mitigated
when eaten together with the right ingredient, like blue-berries, cocoa, and
vinegar[4][5][6][7][8][9]. On top of being a good thing on its own, it
indirectly helps because it reduces overeating.

Both coffee and tea also improve artery function, as long as you avoid adding
milk[10][11]. Hibiscus tea works even better, but contains so much manganese
that you should probably not drink more than one cup of it per day[12][13].

Oh, and that "one or two glasses of wine is better than none" story? False:
the research that this claim comes from did not control for people who don't
drink alcohol for _other_ health reasons. Fix that and drinking no alcohol at
all is the healthiest option[14]. Sorry.

So yeah, all of that together probably will improve your chances at staying
healthy into your old age, especially if you have a family history of
hypertension (like me). And that might include a reduced chance of dementia.

[0] [https://nutritionfacts.org/video/flax-seeds-for-
hypertension...](https://nutritionfacts.org/video/flax-seeds-for-
hypertension/)

[1] [https://nutritionfacts.org/video/which-are-better-chia-
seeds...](https://nutritionfacts.org/video/which-are-better-chia-seeds-or-
flax-seeds/)

[2] [https://nutritionfacts.org/video/amla-versus-
diabetes/](https://nutritionfacts.org/video/amla-versus-diabetes/)

[3] [https://nutritionfacts.org/video/amla-vs-drugs-for-
cholester...](https://nutritionfacts.org/video/amla-vs-drugs-for-cholesterol-
inflammation-and-blood-thinning/)

[4] [https://nutritionfacts.org/video/benefits-of-blueberries-
for...](https://nutritionfacts.org/video/benefits-of-blueberries-for-heart-
disease/)

[5] [https://nutritionfacts.org/video/The-Benefits-of-Acai-vs-
Blu...](https://nutritionfacts.org/video/The-Benefits-of-Acai-vs-Blueberries-
for-Artery-Function/)

[6] [https://nutritionfacts.org/video/cocoa-good-chocolate-
bad/](https://nutritionfacts.org/video/cocoa-good-chocolate-bad/)

[7] [https://nutritionfacts.org/video/vinegar-mechanisms-side-
eff...](https://nutritionfacts.org/video/vinegar-mechanisms-side-effects/)

[8] [https://nutritionfacts.org/video/can-vinegar-help-with-
blood...](https://nutritionfacts.org/video/can-vinegar-help-with-blood-sugar-
control/)

[9] [https://nutritionfacts.org/video/apple-cider-vinegar-help-
we...](https://nutritionfacts.org/video/apple-cider-vinegar-help-weight-loss/)

[10] [https://nutritionfacts.org/video/tea-and-artery-
function/](https://nutritionfacts.org/video/tea-and-artery-function/)

[11] [https://nutritionfacts.org/video/does-adding-milk-block-
the-...](https://nutritionfacts.org/video/does-adding-milk-block-the-benefits-
of-coffee/)

[12] [https://nutritionfacts.org/video/hibiscus-tea-vs-plant-
based...](https://nutritionfacts.org/video/hibiscus-tea-vs-plant-based-diets-
for-hypertension/)

[13] [https://nutritionfacts.org/video/how-much-hibiscus-tea-is-
to...](https://nutritionfacts.org/video/how-much-hibiscus-tea-is-too-much/)

[14] [https://nutritionfacts.org/video/is-it-better-to-drink-
littl...](https://nutritionfacts.org/video/is-it-better-to-drink-little-
alcohol-than-none-at-all/)

~~~
cgh
nutritionfacts.org is not a credible reference. It's a vegetarian propaganda
site.

------
dev_dull
ketogenic diet. Intermittent fasting. The science is catching up.

------
sleepysysadmin
The brain is 60% fat and basically the rest if cholesterol; ignoring water.

If you eat a diet which is low in fat and cholesterol, you are going to lack
the building blocks for your brain. You're going to have a degrading mind.

~~~
vanderZwan
That is grossly oversimplified: there are multiple types of cholesterol, and
you are very likely eating the wrong one.

~~~
mallomarmeasle
There is only one chemical entity called cholesterol. More formally known as
(3β)-cholest-5-en-3-ol. Different dietary fats (or other constituents) may
play a role in the blood levels of the different _lipoproteins_, such as HDL
and LDL.

~~~
vanderZwan
Nitpick all you want, but this misses the forest for the trees. When we talk
about health and cholesterol levels, it is almost always in the context of
lowering LDL and increasing HDL. Even Center for Disease Control and
Prevention calls them "cholesterols" because that currently is the public
understanding of how it affects their health:

> _Cholesterol travels through the blood on proteins called “lipoproteins.”
> Two types of lipoproteins carry cholesterol throughout the body:_

> _LDL (low-density lipoprotein), sometimes called “bad” cholesterol, makes up
> most of your body’s cholesterol. High levels of LDL cholesterol raise your
> risk for heart disease and stroke._

> _HDL (high-density lipoprotein), or “good” cholesterol, absorbs cholesterol
> and carries it back to the liver. The liver then flushes it from the body.
> High levels of HDL cholesterol can lower your risk for heart disease and
> stroke._

[https://www.cdc.gov/cholesterol/ldl_hdl.htm](https://www.cdc.gov/cholesterol/ldl_hdl.htm)

~~~
sharph
Except that when you eat cholesterol, it is digested and absorbed from the
food as cholesterol, not lipoproteins. So it's really silly to say there's
"bad" or "good" cholesterol in food.

The main purpose of lipoproteins such as LDL and HDL is to carry fatty fuel
around the body. Cholesterol just gets a ride-share along with the fat since
it is not water (and by extension blood) soluble.

And the thing that makes levels of HDL and LDL in the blood "bad" has more to
do with high blood sugar messing up the lipoproteins' ability to identify
itself to the liver (search oxidation & glycation of lipoproteins) which
causes excess levels in the blood, than it has to do with cholesterol.

IMO the focus on cholesterol (edit: as the source of disease) in popular
science and medicine has been a huge mistake.

