Alzheimer's Disease

A complication of poor diet and digestion on mitochondrial health?

When I heard Alzheimer's be referred to as "Type III diabetes", I didn't understand the reference as I don't know of Alzheimer's having a similar relationship with insulin.  However, it is relatable as it involves a different sort of metabolic hormone resistance, and it is strongly impacted by diet.  Of course, genetics has an important part to play in all of this, as genetics impacts everything from digestion to cravings and even the genetics of the mitochondria inside of our cells.  But to get on with our discussion, let's explore the involvement that mitochondria play in this disease.

Mitochondria are the "fuel-factories" inside every cell in the body- they produce ATP, the energy that is utilized to fuel every function that needs to occur.  [Interesting note- mitochondria are inherited from our mothers.] A recent study found that in Alzheimer's, mitochondrial use of calcium changed, and somehow this leads to cells creating more proteins that are not helpful.  What this means is that the metabolic function of mitochondria changes, as a result of being damaged and not functioning properly.  The cells that the mitochondria reside within change the proteins they produce to try to help with this, but those proteins actually cause more problems.

In another study, these proteins (beta-amyloid and tau proteins) then attach to & block ghrelin receptors (ghrelin is the "hunger hormone" produced by the stomach).  Ghrelin receptors and dopamine receptors work together in the hippocampus (where most damage in Alzheimers occurs and is a memory headquarters), and beta-amyloid blocks ghrelin and therefore blocks dopamine receptors as well. (I don't fully understand why the two have to work together, but that's what the article says!)

Essentially, this pattern is quite similar to insulin resistance, as ghrelin resistance occurs.

While there is ample evidence showing that intermittent fasting can help reverse Alzheimer's, there is now research showing that low-carb Mediterranean keto diets help stop progression of Alzheimers and repair damage from the illness. Exactly how this occurs is not yet fully explained, but the evidence is there, and I can say that in other illnesses linked to mitochondrial damage (fibromyalgia, autoimmune illnesses...), we have found great success in low-carb diets improving their conditions.  This helped many patients at the collaborative care clinic I worked at for the past 5 years.  There is something about carbs that seem to jam up mitochondria.  This will be my next area of perusing the research vaults!

A Mediterranean diet is known to be healthy and promote long life, but an important note for this research is that it needs to be a ketogenic Mediterranean diet.  This would require eliminating bread, pasta, and even rice, potatoes, and alcohol.  There are many excellent recipes to help replace these things, such as "cauliflower rice" or breads made from beans, so I recommend trying some recipes or finding solutions to help with yummy keto meals!

Ketogenic diets have risk involved, and need to be monitored by your doctor (especially for heart health and to make sure you don't deplete minerals).  There is also much debate about taking calcium supplements, and the step of discontinuing supplemental calcium can also be discussed with your doctor.  Nutritional calcium can be had through consumption of dark leafy greens and bone broth.

Ketogenic diets should also include digestive enzymes to help break down and absorb proteins and fats.  You can absorb digested proteins (amino acids) and digested fats (essential fatty acids), but this requires breaking down the proteins and fats with enzymes such as protease and lipase, plus bile salts.  (BTW- no gallbladder?  You MUST take bile salts!)  Poor digestion of proteins and fats will cause your digestive tract to flush them into lymph, where lymphedema can become an issue.  I have seen patients on Keto diets have particularly bad bouts of lymphedema, and digestive enzymes plus bile salts help resolve this!

As always, discuss your concerns and plans with your doctor, as there are many conditions that can become complicated on a Keto diet.