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Reversing Cognitive Decline

The end of Alzheimer’s?

By Joseph E. Scherger, MD, MPH

Fifty percent of Americans will have dementia by age 85. This is a growing epidemic. Cognitive decline starts much earlier. We now know the causes: too much sugar and other carbs in our diet and an unhealthy lifestyle with too much stress, not enough exercise, not enough sleep and a lack of the right brain stimulation.

Two books came out in the summer of 2017 by leading academic neurologists who are able to reverse cognitive decline and even early and middle stage Alzheimer’s disease. Their protocols are similar, based on major nutrition and lifestyle change. These results for a disease that was considered untreatable are a game changer.

Dale Bredesen, MD, is professor of neurology at UCLA and founding president of the Buck Institute for Research on Aging. His protocol for preventing and reversing cognitive decline is called ReCODE (reverse cognitive decline). His book is The End of Alzheimer’s (Avery, 2017). ReCODE uses at least 12 hours of daily fasting to achieve nutritional ketosis and a healthy Mediterranean diet of nuts, seeds, vegetables including avocado, olive oil and wild-caught fish. The book covers foods in detail, along with the supplements he recommends. Other parts of the protocol are exercise, sleep and stress reduction. Dr. Bredesen’s research findings reversing Alzheimer’s disease have been published since “patient zero” in 2014.

Dean Sherzai, MD, and Ayesha Sherzai, MD, are husband and wife neurologists at Loma Linda University. They are co-directors of the Brain Health and Alzheimer’s Prevention Program at Loma Linda University Medical Center. Their new book is The Alzheimer’s Solution (Harper One, 2017). Their NEURO protocol is very similar to ReCODE and uses Nutrition, Exercise, stress reduction (Unwind), Restorative sleep, and Optimize brain function through multiple cognitive exercises. Their nutrition plan differs from ReCODE in that it is a whole food plant based diet (vegan or vegetarian). Their results are amazingly similar so anyone could use ReCODE, NEURO or a combination of each.

Bredesen is a basic scientist who worked in a lab studying the biology of Alzheimer’s disease for over 20 years. Like many, he was hoping to find a single biochemical solution to the debilitating disease. In his book he explains why that is not possible. Having Alzheimer’s disease is like having a leaky roof with 36 holes. Fixing one will not solve the problem. Fortuitously, his wife is a family physician trained in, and practicing, Functional Medicine. She told him the only solution to fixing Alzheimer’s disease is to fix the lifestyle. Turns out she was right.

A remarkable difference between the books by Dr. Bredesen and Drs. Sherzai is the recommended supplements. Dr. Bredesen recommends more than 20 for most people, something that would be very expensive. His diagnostic evaluation, which is calls a cognoscopy, would also be expensive for tests not covered by most health insurance. By contrast Drs. Sherzai recommend just two supplements, fish oil and vitamin B12, getting the rest of your vitamins and minerals in foods. The diagnostic work-up is simpler and more likely covered by insurance. This contrast reflects the current difference between a comprehensive Functional Medicine approach and a vegan Seventh Day Adventist approach to health. Take your choice or follow a combination of the two approaches. Both protocols eliminate toxic sugars and processed foods. I suggest you consider a combination of the two approaches until more is known.

One of my favorite chapters in The End of Alzheimer’s is “How to Give Yourself Alzheimer’s: A Primer.” All you need to do is to eat a standard American diet and live a standard American frenetic lifestyle. No wonder 50% of us will have Alzheimer’s by age 85! It does not need to be that way. Alzheimer’s disease is very rare in the healthiest communities on Earth who eat only real local food and live a low-stress life with good sleep and good family and community relationships. Such a life is always within our grasp. Start living this way today. It is never too late to change.

Dr. Scherger is Vice President of Primary Care at Eisenhower Medical Center. He is also the Marie E. Pinizzotto, MD, Chair of Academic Affairs, and the Clinical Professor of Family Medicine at both the University of California, San Diego School of Medicine, and the University of Southern California Keck School of Medicine.

7 Responses to “Reversing Cognitive Decline”

  1. john dixon says:

    Hi Dr. Scherger,
    I enjoyed your article. Thanks for letting us know about the Sherzai’s book. I had not heard of it. I just thought I’d comment based on what I have experienced.

    I attended Dr. Bredesen’s advanced training in March. I think you would find he is very clear that every patient’s needs for supplements is different and personalized. There is no blanket recommendation for all 20 supplements.

    His approach is the same with the diagnostic work-up. That is left up to the attending provider and his/her clinical judgement. It doesn’t necessarily involve expensive testing. This is based on which sub type of Alzheimer’s that the patient is presenting with clinically. Again, it’s individualized and personalized.

    John R. Dixon DC CCN

  2. Joseph Scherger says:

    Thank you John for your comments. They are very reassuring to me. I am delighted to hear that you have this training. I hope many of us will do this in the Valley so we may help as many as possible with this problem.

    Joe Scherger, MD

  3. Pat Roach says:

    I think you missed the big main difference in approaches. Dr Bredesen recommends a keto diet, high in good fat, and protein, no grains, whereas Dr. ‘s Sherzai say do just the opposite: reduce fat and protein, and focus on grains.
    Both agree on healthy vegetables. it is a dilemma which to follow. Which is better for the brain; glucose or ketones?

    • Joe Scherger, MD says:

      Thanks Pat for your comment. The whole food plant based diet proposed by the Sherzais allows whole grains but does not prioritize them. Such a vegetarian diet does not carry a high glycemic load. Bredesen is clear that his recommended diet is Mediterranean with enough fasting to have fasting insulin levels below 5. He does not call it a keto diet. The important point is that high glucose levels are toxic to the brain. Neither diet is high protein since excess protein is converted to sugar. Both recommend a diet high in plants.

      • Lauren Del Sarto says:

        Thank you, Dr. Joe!

        Lauren

      • Joe Scherger, MD says:

        I have an additional comment. We met with the Sherzais as guest speakers at Eisenhower. They do not claim to reverse cognitive decline, rather to preserve cognitive function. Their publisher pressured them to have improvement language on the cover of their book. Some people report improvement on the NEURO protocol but they do not measure hippocampus growth like Dale Bredesen. This tells me that only the Bredesen protocol has been proven to get a reversal of early Alzheimer’s disease. I think the low and stable blood sugars are critical. That is our natural state eating only the foods of nature and eating once or twice a day.

        • Lauren Del Sarto says:

          Interesting. Thank you for the update, Dr. Joe. May be worth an article in the next issue to further explain!

          Lauren Del Sarto
          Publisher

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