Dr. Richard Isaacson and His AD Masterclass - Episode 2
The Alzheimer’s Hub of Hope has four sections: Heroes, Highlights, Headlines and Helpers/Caregivers. This post is aligned to the Highlights section.
When I started this blog my planned approach was to shed light on individuals that bring hope to AD sufferers, caregivers and those who don’t want to become an AD sufferer (us). I knew there had to be people in the medical, research and other fields working on the AD problem. Through my investigation I’ve identified eight people that are making positive strides in understanding, preventing and treating the disease and caring for its sufferers. I called these people the “Alzheimer’s Heroes of Hope” for their positive go-forward approaches. An overview of these heroes can be found here.
So far I’ve posted on heroes Deborah Kan and Being Patient, Dr. Dale Bredesen and the Functional Approach, Dr Nate Bergman and Kemper Cognitive Wellness, and Teepa Snow's Positive Approach to Care.
Dr. Richard Isaacson is one of these heroes and I will be featuring his Masterclass over four posts. The first episode can be found here where I covered the first five courses of the Masterclass. Today’s post will summarize courses Vascular Brain Health, Prevention and Treatment Strategies, Diet and Nutrition I, Diet and Nutrition II, and Supplements and Vitamins. I found the “how to eat” (not what to eat) discussion in Nutrition II to be very interesting.
Thanks to subscriber Taylor W. for providing me with the link to the Seed Oil Scout application which I refer to in my summary of the Nutrition I course.
Below are links to all 19 of the Masterclasses.
6. Vascular Brain Health
Vascular risk factors can cause cognitive changes independent of Alzheimer’s.
Vascular risk independently or in collaboration with other factors are a major contributor to brain health. Vascular risk factors “fast forward AD”.
It’s important to know your numbers for blood pressure, cholesterol and blood sugars.
Being in the normal range may not be good enough from a brain health perspective. It is better to be optimal.
People with blood pressure of 120/70 have a 20% lower risk of AD than 140/80 which many doctors consider normal.
The video is silent to total cholesterol but indicates that HDL (good cholesterol) may be protective against AD and LDL (bad cholesterol) may have a negative impact. LDL under 70 may have protective effects.
It is important to know that blood sugars (glucose) can contribute to AD. Diabetics have double the rate of AD than non-diabetics.
Three blood tests are necessary: glucose, insulin, and A1C to determine blood sugar health. The optimal blood sugar level from a brain health perspective is 95. Insulin is the hormone the body secrets to breakdown carbohydrates. All three assessments need to be assessed together to determine the likelihood of suffering from AD.
7. Prevention and Treatment Strategies
There is no silver bullet for prevention or treatment but a multi-domain, evidence based, targeted, individualized treatment plan can give us the best chance of success.
A multiple modal strategy includes pharmacologic strategies which contains drugs, vitamins, supplements and medical foods.
There are no FDA approved drugs to prevent or treat AD (note, this video was produced before the recent FDA controversial approval of several AD drugs).
Drugs can be used to manage the symptoms of AD such as anxiety and sleep issues.
Vitamins should be obtained from foods but for specific people certain vitamins may be needed at higher levels and in different forms to protect the brain.
Physical exercise promotes brain health and is the only thing that we know of today that can reduce the accumulation of amyloid in the brain.
Omega 3 fats, vitamin B12, vitamin D from foods and how you eat (e.g. time restricted eating and intermittent fasting) are important for brain health.
Cognitive engagement (brain training) is important. If you don’t use it you will loose it. Cognitive stimulation such as playing musical instruments and learning a new language build brain resilience or backup.
Stress and poor sleep “fast forwards” brain aging.
8. Diet and Nutrition I
Diet has a significant impact on brain health. The mediterranean diet is the most studied dietary pattern but other diets should be explored.
There are three macro nutrients: carbohydrates (carbs), fats and protein. There are good carbs and bad carbs, brain healthy fats and brain unhealthy fats, high quality protein and lower quality protein.
Good carbs delay cognitive decline and include dark green leafy vegetables which are known to stimulate brain functions and berries such as blueberries and strawberries. Bad carbs are processed foods desserts such as cakes which significantly accelerate brain aging.
Many experts limit bad carbs to a maximum of 50 grams per day but Dr. Isaacson believes 30 grams is optimal for brain health. To put this into perspective a 12 oz can of coke has 39 grams, a Starbucks venti cappuccino has 20 grams, and a McDonald’s Big Mac has 44 grams (flour, sugar, corn starch).
When it comes to sugar “less is more” since it increases insulin spikes that cause inflammation and insulin resistance which increases amyloid production.
A ketogenic diet may be a brain healthy choice because of its low carb intake. However, more research is needed.
Omega 3 fats found in salmon, sardines and other fish is brain healthy. Omega 6 fats found in nuts can be brain healthy in moderation but they need to be in proper balance with omega 3 fats. In the video he shows the proper serving of nuts which is surprisingly small.
Monounsaturated fats in extra virgin olive oil is considered miracle grow for the brain. However, 60% of olive oil in the market has been adulterated by dilution or adding chemicals. So do some research on the brands you buy.
For high quality protein, Dr. Isaacson recommends eating grass feed meats since the grass in the diet increased the omega 3’s in the meat.
Dark cocoa flavonoids can improve memory and benefit insulin resistance and blood pressure. Be sure to buy a brand with low sugar content. He recommends Cocovia.
Eating out can be problematic since you never know what is put in the food or what oils are used. He recommends asking what oils are used in food preparation. Often “terrible processed oils that fast-forward cellular aging” is used. (Note - if you want to know which oils restaurants in your location are using you can start with the Seed Oil Scout app).
9. Diet and Nutrition II
Eating for optimal brain health isn’t just what you eat but how you eat.
Time-restricted eating and intermittent fasting are two options for how to eat.
Time-restricted eating requires a period of 12 hours or more typically between dinner and breakfast. During this extended period of no food consumption the body depletes its store of carbs/sugar and switches to fats/ketones for energy.
Fats/ketones are a cleaner burning fuel. It is believed that burning ketones will slow down brain aging. The longer the time-restriction the better. 18 hours may be ideal.
Dr. Isaacson recommends 4 to 5 days a week of 14 to 16 hours of time-restricted eating.
Intermittent fasting is going 24 hours or more without eating. Dr. Isaacson personally fasts 24 to 28 hours once every other week. This forces the body to use its backup fuel, ketones, as an energy source for a longer period of time.
10. Supplements and Vitamins
There are several evidenced based nutrients that benefit for brain health.
It’s always best to obtain these nutrients from whole foods, however, everybody is different and up to 40% of people can’t get them from foods and should supplement.
Supplementation is not a “one size fits all” exercise. Blood levels should be checked to determine the type and amount of supplementation needed.
The most evidence based high yield vitamins for brain health are B-complex and vitamin D. The USDA recommends supplementing with vitamin B12 for people over 50 because it is difficult for these people to absorb it.
Elevated blood homocysteine levels should be addressed by supplementing with B-complex.
B12, folic acid and B6 are evidence based brain healthy vitamins. (Note - Vitamin B12 is present in foods of animal origin, including fish, meat, poultry, eggs, and dairy products)1.
Vitamin D is another evidence based brain healthy nutrient. The optimal level is 50. People with the APOE genetic disposition will benefit more from vitamin D supplementation. Dr. Isaacson stressed that vitamin D needs to be taken with fat or it won’t be absorbed.
DHA and EPA fats from fish (or fish oil) provides the “biggest bang for the buck” for brain health. It is interesting to me that he is silent regarding ALA omega 3’s that come from chia seeds, walnuts, flax seeds and other plant sources.
The Twilight Zone
Like the Twilight Zone TV show of the 1960s, the Twilight Zone section of a post will have thought provoking paradoxes and surprises that makes one think deeply.
In a previous Twilight Zone post, I discussed how Australia changed its position on sun exposure to be more risk based. Based on skin type, some people have 30 times (not percent) the sun exposure risk compared to others. Yet the government’s recommendations were the same for all skins types. The government’s skin protection recommendations made perfect sense for high-risk people but not the lower risk population. This is especially true when you consider that the benefits of sun exposure are minimized by sun protection protocols.
Here’s the article discussing the changes to Australia’s skin protection recommendations. Balancing the risks and benefits of sun exposure: A revised position statement for Australian adults.
As I was researching sun exposure I came across a theory that wearing sunglasses increases the risk of getting sunburned. The theory is simple. Bright sun triggers the brain to send signals to the body to produce more melanin. Melanin is the pigment that darkens the skin which acts as a natural sunscreen reducing the likelihood of sunburns. When the bright light is blocked, the melanin isn’t produced so the skin isn’t proteted.
This may or may not be true. I’ve included three videos discussing this so you can decide for yourself.
Sunglasses: Protecting Eyes but Risking Sunburn? (2 min video)
5 Reasons Not to Wear Sunglasses | Dr. Janine (3 min video)
THE DARK SIDE OF SUNGLASSES - When you should and shouldn't wear them! (sunburn discussed at 20 minute mark)
https://ods.od.nih.gov/factsheets/VitaminB12-HealthProfessional/