The politics of Alzheimer’s prevention - what works?

  • 22 Jul 2011
  • Reading time 3 mins
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A recent Lancet Report claims that 3 million less Alzheimer’s cases could result from dealing with seven apparently contributory causes - diabetes, midlife hypertension, midlife obesity, smoking, depression, cognitive inactivity or low educational attainment, and physical inactivity. However, the authors point out that this assumes there is a causal relationship between the risk factors examined and Alzheimer's disease, and that modifying the risk factors will lower Alzheimer's risk, but that this important assumption that has not yet been proven. You can see where this is going: more drugs for diabetes, hypertension, obesity, depression and, no doubt, Alzheimer’s. And meanwhile, ignoring the giant elephant in the room – the most obvious factor – poor nutrition.

On the basis of the science to date the strongest modifiable risk factor is simply lowering homocysteine with B vitamins. Unlike these other candidates, we now have two impeccable studies that show that taking high dose B vitamins, if your homocysteine is above 10, both stop accelerated brain shrinkage and further memory loss, as today’s study shows. A recent study in the International Journal of Geriatric Psychiatry was a two-year, double-blind clinical trial involved 266 people over the age of 70 with Mild Cognitive Impairment. The group was randomly assigned to receive either a daily dose of vitamins comprising 800mcg folic acid, 500mcg vitamin B12 and 20 mg vitamin B6, or a dummy pill. Those with raised homocysteine stabilized further memory loss. David Smith of the Department of Pharmacology and Founding Director of OPTIMA, Oxford University, says “The striking parallel effect of B vitamins in slowing brain atrophy and at the same time reducing cognitive decline is consistent with a disease-modifying effect of this treatment.” This should be front page news and should prompt doctors to test homocysteine in anyone with memory concerns. Even better would be early screen for memory, for example using Food for the Brain’s free on-line Cognitive Function Test. But the point is all these health issues – diabetes, hypertension, midlife obesity, depression and memory loss – are all the classic consequences of sub-optimum nutrition.

All are associated with a high glycemic load diet. All are associated with high homocysteine levels. Most are associated with a lack of vitamin D. It’s a ‘systems based’ problem. When your body and brain’s metabolism goes up the spout due to a lack of the right nutrients, too much sugar and refined carbohydrates, you get tired, can’t think straight, feel down, gain weight and reach for stimulants such as cigarettes and coffee. Of course you don’t feel like exercising. The only reason why I can explain intelligent people not seeing this obvious connection is bias. The author of the Lancet prevention paper does declare a conflict of interest with three pharmaceutical companies, at least one of whom has Alzheimer’s drugs in the testing phase. There’s no money in nutrition based solutions. You can’t patent B vitamins so anyone can sell them. When in mainstream medicine going to wake up to the fact that all the major 21st century diseases have faulty nutrition at their core? It’s a nutrition revolution we need – not more drugs.