Part 1 of this article discussed what Alzheimer’s disease (AD) is and who is prone to get it. This part 2 article will discuss what lifestyle changes you can make to help prevent AD. If you already have the cognitive decline that is pathognomonic of AD, the recommendations in this article can help reverse these changes and give you your life back. Since I have the ApoE4 gene in my family history, I have started using all of these strategies in order to decrease my chances of becoming an AD victim. An added bonus for me has been some body fat/ weight loss with this new strategy!

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In The End of Alzheimer’s, The First Program to Prevent and Reverse Cognitive Decline, Dr. Dale Bredesen has created the ReCODE plan. ReCODE is an acronym for Reversal of Cognitive Decline. The ReCODE program incorporates the following ideas:

• Ketoflex 12/3 Diet
• Exercise (aerobic & strength)
• Sleep (7-8 hours)
• Stress reduction
• Brain training

Ketoflex 12/3 Diet

The keto in the ketoflex 12/3 diet refers to ketosis. Ketosis is a metabolic state characterized by elevated levels of ketone bodies in the blood or urine. Ketosis is a normal response to low glucose (sugar) availability, such as with low-carbohydrate diets or fasting. Mild ketosis is optimal for cognitive function. To promote ketosis, you combine a low-carb diet, moderate exercise (to be discussed below), and fasting for at least 12 hours between your last meal of the night and your first meal of the next morning. The 12 in the ketoflex 12/3 diet means that you will fast for at least 12 hours every day. This isn’t very long considering that if your last meal is at 7pm and you sleep from 10pm till 6am, you can eat again at 7am. Consuming fats such as MCT oil (medium-chain triglyceride oil) or unsaturated fats such as olive oil or avocado or nuts also promotes mild ketosis. This will switch your metabolism from carb-burning and insulin resistant, which promotes Alzheimer’s disease, to fat-burning and insulin sensitive, which helps prevent it. The 3 in the ketoflex 12/3 diet refers to 3 hours as the minimum time from your last meal till you go to bed. If you plan to go to bed at 10pm, your last meal needs to be completed before 7pm.

Keto Diet Tip: When you shift from a predominantly carb-burning diet to a fat-burning one, you may have some cravings or feel lethargic for a few days. If so, take medium-chain triglycerides (MCT) oil as capsules (1 gm) or liquid (1 tsp). Alternatively, you can take coconut oil, which is a solid, anywhere from 1tsp to a Tbsp 3 times per day (careful as this can cause diarrhea if too much consumed too quickly!).

The flex in the ketoflex 12/3 diet refers to a flexitarian diet. This is largely a plant-based diet with an emphasis on vegetables, especially non-starchy ones. Include both uncooked (salads) and cooked veggies and choose as many colors as possible. Some fish, poultry and red meat are fine, but meat is a condiment, not a main course. Ideally, you would limit your meat consumption to just a few ounces per day.

Summary of foods to eat & avoid for the ketoflex diet:

Eat frequently– mushrooms, broccoli , cauliflower, Brussels sprouts, kale, spinach, lettuce, cilantro, cabbage, turnips, watercress, kohlrabi, arugula, horseradish, Maca, rapini, daikon, wasabi, bok choy, avocado, artichoke, beets, dandelion, grapefruit, lemon, oilve oil, seaweed, wild-caught 🐠, pastured eggs, sweet potato, rutabagas, parsnips, green banana, sauerkraut, kimchi, jicama, leeks, onion, garlic, herbal tea, black tea, green tea 

Eat occasionally– potatoes, corn, peas, squash, beans, eggplant, peppers, tomatoes , berries, pastured 🐓, grass-fed 🥩, 🍷 (2 glasses per week), coffee 

Avoid – sugars, bread, pasta, pie, cookies, cakes, candy, grains, gluten, dairy, processed foods with an ingredient list, high-mercury 🐠, sugary fruit like pineapple and mango 

Here is a list of optional supplements that can also be helpful in the ReCode plan:

Exercise

The exercise recommendations for reversing the cognitive decline associated with AD are similar to what we want everyone to commit to doing for health and longevity. You must add daily walking to your routine. Please, please, please walk at least 30 minutes per day! I’m not talking about a walk from your desk at work to the lunch room (although that is a good start!). I’m talking about putting a leash on your dog and getting a nice dose of fresh air while you intentionally walk 30+ minutes to just exercise your body.

The next level of exercise is strength training. Find an exercise class or get a gym membership and 2-3 times per week do body weight exercises like squats, lunges, step ups, push ups and bar pull ups until that is too easy and you have to start adding weights like dumbbells, barbells and cable pulleys to challenge your body.

If you really want to maximize how exercise can help your brain, add in high intensity interval training (HIIT). This can be as simple as sprinting for 15-20 seconds 2-3 times per workout. At Back to Function, we use the CAR.O.L stationary bike for our HIIT. This consists of a 10-minute bike ride that incorporates 2 x 20-second all-out sprints. It is a quick and intense way to get major benefit to your body in a short 10-minute workout.

Sleep

This is, again, a generic recommendation for general health. Adults need to sleep at least 7-8 hours per night (children need 8-10 hours). If you want to maximize your health, you need adequate recovery and sleep is the way. I wrote an article on Sleep & Athletic Performance that was geared towards athletes, but provides some nice strategies if you have issues with sleep.

Stress Reduction

Too much stress will break down the body (and brain). Use modalities like meditation, breathing and yoga to help manage your stress. Don’t be too proud to get help if you feel that your stress is affecting your health. Talk to a therapist about strategies that you can use to reduce your stress and regain your health.

Brain Training

Many of us have jobs that don’t require us to learn or acquire new knowledge. Make sure you are flexing your brain by challenging it. Do crossword puzzles, sudoku and read new books. Try apps like Lumosity, that present brain games that rank you according to your age. You want to be in the 50th percentile or better and keep trying to improve your scores. Do 10-20 minutes of brain training everyday.

Thankfully, there is a relatively large window of opportunity not only to prevent, but also to reverse Alzheimer’s disease. The earlier the causes of synapse loss and cognitive decline are identified and corrected, of course, the better your chance of avoiding full-blown Alzheimer’s disease (so start right now!). If you have any questions regarding this topic, please contact us at 310-534-1900 or by email at [email protected]. 

References:

Bredesen, Dale E. The End of Alzheimer’s, The First Program to Prevent and Reverse Cognitive Decline. 2017.