Amy Berger is a certified nutrition specialist and nutritional therapy practitioner who holds a master's degree in human nutrition from the University of Bridgeport, and is the author of The Alzheimer's Antidote: Using a Low-Carb, High-Fat Diet to Fight Alzheimer’s Disease, Memory Loss, and Cognitive Decline.
What I discuss with Amy in this episode:
Why the prevailing hypothesis behind Alzheimer's disease doesn't seem to add up—and what Amy and I believe is a more plausible explanation.
What a ketogenic diet in tandem with exogenous ketones can do to fight back against the advance of Alzheimer's disease.
How a caregiver can help a patient with dementia who is resistant to a change in diet.
What young people can do right now to proactively reduce the chances of picking up Alzheimer's disease later in life.
Supplements Amy recommends for targeted brain health.
And much more!
While there are multiple hypotheses as to why Alzheimer's disease develops, the prevailing wisdom of the past few decades has aligned with the amyloid hypothesis—that Alzheimer's is caused by plaque buildup in the brain. Unfortunately, amyloid hypothesis-directed drug trials for Alzheimer's disease treatment have a 99.6 percent fail rate.
On the other hand, there's a growing number of both researchers and clinicians who believe that Alzheimer's disease is a form of diabetes of the brain that is metabolic in origin. This is the camp where I find myself, and I'm in good company with Amy Berger, author of The Alzheimer's Antidote: Using a Low-Carb, High-Fat Diet to Fight Alzheimer’s Disease, Memory Loss, and Cognitive Decline.
A Late Start
Amy's journey into nutrition—and specifically how it relates to Alzheimer's disease—started later in life.
"Like so many people out there, I was overweight—despite doing what I believed were all the right things," says Amy. "I ate a low-fat diet, lots of good, whole grains, whole wheat bread, cereals, skim milk. I exercised a lot—I was not afraid of a hard workout. And yet I was still carrying all this extra weight. At the time I was young enough that I didn't really have any health problems, but I could not understand why I could not lose weight no matter what I did.
"There were people around me, friends and family who ate far worse than I did—wouldn't know a barbell from a jingle bell—and they looked better than I did!"
But around 1999, Amy came across an early copy of Dr. Atkins' New Diet Revolution and it changed everything.
"Having realized that I could actually lose weight and be healthy—and feel great—eating things like steak and blue cheese and coconut oil and butter and fatty pork chops and bacon—you name it—how could I not want to share that with other people who were struggling, too?" says Amy.
This prompted Amy to change careers and return to school to study nutrition. Now she specializes in low-carb, ketogenic, and paleo-style diets not only to help others with weight loss, but also for managing blood sugar, hormone imbalances, and other medical conditions improved by a change in nutrition.
"Just Because We Don't Know Everything Doesn't Mean We Don't Know Something."
Like Dr. Atkins himself, Amy knows what it's like to hold opinions that run counter to those promoted by the mainstream—and how maddening it can be when abundant evidence supports what she finds to be obvious. One of these obvious positions is the connection between Alzheimer's disease, glucose, and insulin, which she examined in great detail in the course of writing her thesis.
"When I started looking for scientific papers, I was blown away by what I found. It is everywhere in the scientific literature. Alzheimer's disease is regularly referred to as 'type 3 diabetes,' 'diabetes of the brain,' sometimes they call it 'brain insulin resistance.' If people out there have heard of metabolic syndrome, they also call Alzheimer's 'metabolic cognitive syndrome.' I mean, this is everywhere! How did I never hear of it? As someone who's actually really interested in low-carb and interested in insulin issues and ketones, how did I not come across this before a book? Not hearing it from a doctor, not hearing it from a specialist, but hearing it from a journalist [Gary Taubes] who wrote a book [Good Calories, Bad Calories] about low-carbohydrate diets.
"I wrote the thesis, did the research, and having learned what I learned, I couldn't imagine keeping it to myself...it's overwhelming to me that we're being told there's nothing you can do about Alzheimer's; you just have to accept your fate and prepare for the worst. Granted, there's a lot of unanswered questions. There are a lot of things we don't know. But just because we don't know everything doesn't mean we don't know something. It doesn't mean we have no actionable information right now."
Fueling the Brain with Ketones
Neurons in patients afflicted with Alzheimer's disease show a reduced ability to derive fuel from glucose—they starve to death and atrophy, which can be detected in scans as a loss of matter in the brain.
"The synapses, the connect neurons go away; communication between these neurons breaks down," says Amy. "The obvious result is memory loss, behavioral changes, and personality changes. The bottom line: whatever else is going on in Alzheimer's, in my opinion, the number one thing we can do is nourish these starving brain cells. And there's a lot of other things we need to do, but to me, that's step one."
Amy believes the best way to nourish these starving brain cells is by observing the ketogenic diet, which provides ketones as a fuel alternative to glucose. Additionally, supplementing with exogenous ketones can help further improve cognitive function—but shouldn't be seen as a substitute for the diet.
"Exogenous ketones are a great short-term way to manage symptoms," says Amy. "They do improve cognitive function, but they do nothing to actually reverse or slow the disease process. And I think a ketogenic diet can."
In cases where a patient is resistant to a change in diet (particularly if advanced dementia is present), Amy recommends caregivers introduce MCT oil or coconut oil as good sources of fat that readily convert to ketones in the body.
Listen to this full episode to learn more about the benefits of low-carb and ketogenic diets for young people proactively looking to reduce their chances of picking up Alzheimer's disease later in life (and positive cognitive effects they may even experience right away), metabolic flexibility, the diet Amy recommends to someone seeking to optimize cognitive performance, supplements Amy recommends for targeted brain health, nutrition recommendations for ApoE4 carriers, Amy's take on HDL and LDL cholesterol levels, and lots more.
Resources from this episode:
Is the Alzheimer's "Amyloid Hypothesis" Wrong? by Sarah Zhang, The Atlantic
Dr. Atkins' New Diet Revolution by Robert C. Atkins
Alzheimer's Disease Is Type 3 Diabetes—Evidence Reviewed by Suzanne M. de la Monte et al., Journal of Diabetes Science and Technology
Diabetes of the Brain by Alissa Sauer, Alzheimers.net
Demonstrated Brain Insulin Resistance in Alzheimer's Disease Patients Is Associated with IGF-1 Resistance, IRS-1 Dysregulation, and Cognitive Decline by Konrad Talbot et al., The Journal of Clinical Investigation
Metabolic-Cognitive Syndrome: A Cross-Talk between Metabolic Syndrome and Alzheimer's Disease by Vincenza Frisardi et al., Ageing Research Reviews
Are Exogenous Ketones Right for You? by Marty Kendall, Optimising Nutrition
What Is Metabolic Flexibility, and Why Is It Important? J. Stanton, Gnolls.org
Supplements Amy mentions:
Genius Foods: Become Smarter, Happier, and More Productive While Protecting Your Brain for Life by Max Lugavere and Paul Grewal M.D.
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