Optimize diet
Goal: Optimize diet: minimize simple carbohydrates (CHO), minimize inflammation.
Approach: Patients given choice of several low glycemic, low inflammatory, low grain diets.
Rationale: Minimize inflammation, minimize insulin resistance.
Simple carbohydrates (see more on carbohydrates) are foods that rapidly break down to glucose in the blood. Examples include sugar, honey, candy, syrup, juice, cereal, soda, white bread, instant oatmeal, junk food, and most foods that come in a box in the center aisles of the grocery store.
Low glycemic foods take longer to break down to glucose in the blood. Good examples of low glycemic foods are green vegetables, non-starchy vegetables, beans, lentils, resistant starch, and super starch. Lower glycemic fruits such as berries, lemons, limes tomatoes and avocados are best, and go for the whole fruit, not juices. Whole wheat bread, undercooked pasta, potato, brown rice and corn are examples of carbohydrate rich foods that break down a little more slowly, but not recommended by Dr. Bredesen. Generally, he recommends that foods with a glycemic index lower than 35 should make up the bulk of you diet. The more protein, fat, and fiber a food contains, the less glycemic a food is likely to be. Overall, low glycemic foods tend to be unprocessed and whole foods.
Insulin is the hormone produced when you eat carbs, telling your body to take glucose out of the bloodstream. High blood glucose and fructose causes those molecules to stick to places they shouldn't be, aging your body. The higher your blood glucose levels, the more insulin your pancreas has to produce to take it out of the bloodstream. The cells of your body get accustomed to the high insulin levels and start ignoring it. Once that happens you become insulin resistant. Over decades insulin resistance can turn into diabetes. Diabetics have higher rates of cancer, heart disease, and stroke as well as Alzheimer's.
Insulin is also produced when you eat protein, telling your body to take amino acids out of the bloodstream. The protocol recommends very limited animal protein, mostly wild caught fish in 2-3 ounce servings a few night per week.
Dr. Bredesen recommends healthy oils from avocados, nuts, seeds and olive oil. He feels MCT oil can help to improve insulin sensitivity, but he recommends switching to the healthy oil list once insulin resistance improves.
Inflamation is the body's way of repairing injuries. As we get older, our bodies become more and more inflamed all the time due to dietary, environmental and other health-related assaults. The types of fat in your diet can have an effect inflammation levels. Foods with trans fats have recently been outlawed because they are linked to increased inflammation and poor health outcomes. Omega-6 oils are more inflammatory than omega-3. Unfortunately, most processed food is loaded with soybean oil and other inexpensive omega-6 oils.
When livestock are raised, they are typically given high omega-6 diets based on corn and soy. Their own fat is then enriched in this inflammatory fat. Grass fed meat provides a better omega 3:6 ratio. Dairy like milk, cheese, and butter as well as eggs are usually enriched in omega-6 fats because the cows and chickens they come from are grain fed. As with meats, grass fed is better ('pastured' in the case of eggs) and becoming more available all the time.
More people are sensitive to grains like wheat and oats than is commonly thought. Some argue that everyone is sensitive, to some degree. Foods containing gluten include bread, pasta, noodles, crackers, cereal, pancakes, tortillas, beer, most processed foods, even sauces and cosmetics. Grains and dairy are not recommended both because of their carbohydrate content and potential for allergic response. Cyrex labs is an example of a company that has good tests for gluten sensitivity.
References
Recent research has suggested a modified Mediterranean diet is associated with lower rates of dementia. Check out the Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) diet. Do note, that ApoE4 carriers on this forum often report being sensitive to grains and legumes, but this whole-foods focused diet can provide a good outline.
Although not specifically included in the Bredesen Protocol, a diet that a number of ApoE4 forum members have adopted that is low carbohydrate and anti-inflammatory, characteristics that the ReCODE Protocol calls for, is Dr. Gundry's Diet Evolution. The third stage is the one you want. Here is his list of safe and forbidden foods. Apoe4 carriers should limit animal based fat.
Another diet option is the Wahls Protocol.
See also:
Insulin Resistance, for ideas on improving your insulin sensitivity.
Inflammation & LPS, for background on why diet, and it's relationship to leaky gut are important.
Omega-3 fatty acids, for more on why Omega-3s, from eating fish or taking fish oil, are important.
Return to Diet Strategies.