Preventing Alzheimer’s Through Time-Restricted Eating
As
explained in “The Effects of Caloric Restriction and Its Mimetics in
Alzheimer’s Disease Through Autophagy Pathways,”2 two of the pathology hallmarks
of Alzheimer’s are amyloid beta plaques and neurofibrillary tangles formed by aggregates
of tau protein.
“The
aberrant accumulation of these misfolded and aggregated proteins results in
neurotoxicity, and AD is therefore recognized as a proteinopathy,” the paper states.
Other pathological events frequently seen in the brains of Alzheimer’s patients
include:3
- Synaptic deficits and axonal
degeneration
- Mitochondrial dysfunction
- Abnormal metal homeostasis
- Oxidative stress
- Neuroinflammation
Many of
these occur as a result of “insufficient elimination of neurotoxic proteins or
damaged intracellular organelles,” the paper notes. In other words, they occur
when there’s insufficient autophagy occurring in your body. The good news
is you can upregulate autophagy, and one of the simplest ways is by
implementing time restricted eating. As explained in this
review:4
“Autophagy
is a catabolic mechanism that ensures the removal of misfolded or aggregated
proteins and maintains the turnover of cytoplasmic components.
Under
conditions of starvation or energy deficiency, phagophores are synthesized de
novo in the cytoplasm from newly synthesized lipids or from intracellular
organelles with membrane structures, such as the endoplasmic reticulum.
Phagophores
elongate and curve to form double-membrane autophagosomes, which then
encapsulate cytosolic materials, misfolded proteins, or long-lived proteins.
After
fusion with lysosomes, any cargo is degraded by lysosomal enzymes. The
autophagic process provides a strategy for clearing misfolded or aggregated
proteins in proteinopathic disorders. Failure of autophagy leads to the
accumulation of aggregates, which results in neurotoxicity and disease
progression.”
Autophagy Dysfunction in Neurodegenerative
Disorders
Autophagy
dysfunction has been identified in several neurodegenerative and
neuropsychiatric disorders and diseases, including Alzheimer’s, Parkinson’s,
amyotrophic lateral sclerosis (ALS), Huntington’s disease,ischemic stroke, schizophrenia and even drug
addiction.5
Hence, it
is believed that autophagy activation has an important role to play in the
prevention and treatment of these conditions. Importantly though, using
autophagy stimulators such as drugs, gene therapy or supplements can have
undesirable side effects in some people, and may not be ideal.
Time-restricted
eating, or calorie restriction, the authors note, is a safer and likely more
effective strategy for most. So, just how does calorie restriction or
intermittent fasting induce autophagy?
There are
several mechanisms at play, but two important ones are activation of
monophosphate-activated protein kinase (AMPK) and inhibition of the mammalian
target of rapamycin (mTOR) pathway.6
Calorie
restriction also helps ameliorate Alzheimer’s and other degenerative conditions
by lowering inflammation and improving insulin sensitivity, mitochondrial
function and oxidative stress.
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The Benefits of AMPK Activation
AMPK is
an enzyme essential for maintaining energy balance. It consists of three
proteins (called sub-units) that together create a functional enzyme. AMPK is
expressed in various tissues, including the brain, liver, skeletal muscle and
fat cells, and is essential for activating autophagy.
It’s
sometimes referred to as a "metabolic master switch" because it plays
an important role in regulating metabolism.7 It shifts energy toward cellular repair and
maintenance, thus helping your body return to homeostasis (balance).
Low AMPK
has been linked to insulin resistance, mitochondrial dysfunction, obesity,
neurodegeneration and chronic inflammation. Activating AMPK produces many of
the same benefits as exercise, dieting and weight loss,8 all of which are known to
benefit a range of chronic diseases and ill health.
AMPK is
also an important neuroprotector,9 thus making it particularly relevant in
Alzheimer’s prevention and treatment. In addition, AMPK stimulates cellular and
mitochondial autophagy(mitophagy) and
mitochondrial biogenesis, as well as five other critically important pathways:
- Insulin
- Leptin
- mTOR
- Insulin-like growth factor 1
(IGF-1)
- Proliferator-activated
receptor gamma co-activator 1-alpha (PGC-1α)
Benefits of mTOR Inhibition
MTOR is
also an important pathway responsible for controlling autophagy. When you
inhibit mTOR — which you can do through time-restricted eating — you activate autophagy.
MTOR is basically a nutrient sensor. While insulin primarily senses your intake
of carbohydrates, mTOR primarily senses protein.
That
said, other nutrients can also activate or inhibit mTOR. Nutrients that
activate mTOR include branched-chain amino acids, glutamine, methyl folate and vitamin b12.
Nutrients
that inhibit mTOR include polyphenols like curcumin, fisetin, quercetin,
resveratrol (found in wine) and epigallocatechin gallate (EGCG, found in green
tea). Organic coffee and dark chocolate also contain high amounts of mTOR
inhibiting polyphenols.
Why Cycling in and Out of Autophagy Is so Important
One of
the reasons time-restricted eating works so well is because you’re cycling
through autophagy on a daily basis (opposed to only occasionally, were you to
do longer fasts once a month or quarterly, for example).
This
cycling is really crucial. You don’t want to inhibit mTOR and activate
autophagy all the time. There needs to be a balance between breaking down and
building back up.
When you
eat, your insulin goes up, mTOR is activated and autophagy is inhibited, thus
allowing for cellular rebuilding and growth. Then, when you fast, insulin goes
down, mTOR is inhibited and autophagy activated, thus allowing for the
breakdown and elimination of dysfunctional cellular components. The next time
you eat, the cycle of rebuilding begins anew, and so on.
When
you’re continuously eating, autophagy will be severely inhibited. As a result,
damage continues to build up as damaged cells cannot be efficiently eliminated
and regenerated. Many hormonal shifts also occur during fasting, including
growth hormone.
Opinions
about how long one should fast each day varies. As a general rule, the
recommended range is between 12 and 18 hours of fasting each day. I’m of the
opinion that 16 to 18 hours of fasting might be the sweet spot, as this allows
your body to deplete the glycogen stores in your liver more and suppress mTOR
and activate autophagy better.
Time-Restricted Feeding Improves Brain Function
As noted
in “The Effects of Caloric Restriction and Its Mimetics in Alzheimer’s Disease
Through Autophagy Pathways,” a number of animal studies have demonstrated that
time-restricted eating helps prevent memory loss and improve cognition. The
authors state, in part:10
“[Intermittent
fasting] has been reported to optimize brain function and increase neuronal
resistance to injury and disease … Behavioral improvements in AD mice that
undergo IF might occur because of the effects of IF on balancing hippocampal
excitability.
In
addition, IF prevents memory loss in ovariectomized rats infused with amyloid
beta in hippocampal regions … short-term fasting (24 or 48 hours) was capable
of enhancing neuronal autophagy in 5xFAD mice, which is a severe AD model …”
The Case for Eating Less, Period
Both
animal and human studies also suggest people with a low calorie intake overall
have a reduced risk for Alzheimer’s compared to those eating a high-calorie
diet.11
In one
animal study, animals whose diet was 30% lower in calories than normal restored
memory performance after 10 months. High-calorie diets were also shown to
result in autophagic failure in the hippocampus.12
Animal
studies have further demonstrated that low-calorie diets reduce the amount of
amyloid beta and tau in the brain, while high-calorie diets increase them.13
The
beautiful characteristic of time-restricted eating is that it appears to
replicate most of the metabolic benefits of calorie restriction without
actually restricting calories. Additionally, because it is such a restricted
eating window and a person’s appetite is reduced, they typically wind up eating
fewer calories anyway without any feeling of deprivation.
Siim Land
does a great job on expanding on the differences between these two as they
relate to longevity in the video at the top of the article. Even though the
comparison is to longevity, the same pathways are also active in Alzheimer’s,
such as sirtuins, AMPK and NAD+.
Calorie Restriction Mimetics
“The
Effects of Caloric Restriction and Its Mimetics in Alzheimer’s Disease Through
Autophagy Pathways” also addresses the use of calorie restriction mimetics,
compounds that mimic the effects of calorie restriction. The most thoroughly
studied and well-recognized mimetic is resveratrol, a polyphenol found in grape skins
and certain berries, including blueberries and cranberries. According to the
authors:14
“Several
studies have revealed the potential efficacy of resveratrol supplementation for
the prevention and treatment of AD. For example, treatment with resveratrol
prevents neurotoxicity in cultured cells exposed to amyloid beta.
In
addition, in a rodent model of AD, resveratrol alleviated memory deficits,
maintained the integrity of the blood-brain-barrier, ameliorated the plaque
burden, in habited tau pathology, and suppressed microglial activation …
The
anti-amyloidogenic and neuroprotective effects of resveratrol in AD appear to
be strongly associated with enhanced autophagic activity. Resveratrol activates
SIRT1-dependent autophagy, which contributes to an attenuation of the
neurotoxicity caused by amyloid beta. Moreover, resveratrol represses mTOR
signaling and induces autophagy by activating the AMPK signaling pathway.”
Other Alzheimer’s Prevention Guidelines
Aside
from time-restricted eating, there are many other strategies that will help
prevent (and in some cases, treat) Alzheimer’s. Here’s a rundown of what I
believe are some of the most important:
Avoid
trans fat and industrially processed vegetable oils — While diets high in healthy
fats and antioxidants can go a long way toward warding off dementia, diets
high in trans fats and processed omega-6 oils will promote it.
Research15 published in the October 2019
issue of Neurology found a strong link between trans fat consumption and
incidence of dementia and its various subtypes, including Alzheimer’s. The
worst dietary culprits were pastries, margarine, candy, caramels, croissants,
nondairy creamers, ice cream and rice crackers.16 Similarly, the oxidized
omega-6 fat found in processed vegetable oils can cause significant harm to your
brain when consumed in excess.
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Avoid
sugar and refined fructose — Ideally, you’ll want to keep your sugar levels
to a minimum and your total fructose below 25 grams per day, or as low as 15
grams per day if you have insulin resistance or any related disorders.
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Increase
consumption of healthy fats, including marine-based omega-3 — Beneficial health-promoting
fats that your brain needs for optimal function include coconut oil, organic
butter from raw milk, ghee, grass fed raw butter, olives, organic virgin
olive oil, nuts like pecans and macadamia, free-range eggs, wild Alaskan
salmon and avocado.
Also
make sure you’re getting enough animal-based omega-3 fats from small fatty
fish such as anchovies and sardines, or take a phospholipid-based supplement
such as krill oil. High intake of the omega-3 fats EPA and DHA help prevent
cell damage caused by Alzheimer's disease, thereby slowing down its
progression, and lowering your risk of developing the disorder.
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Avoid
gluten and casein (primarily wheat and pasteurized dairy, but not dairy fat,
such as butter) —
Research shows your blood-brain barrier is negatively affected by gluten.17 Gluten also makes your gut
more permeable, which allows proteins to get into your bloodstream, where
they don’t belong. That then sensitizes your immune system and promotes
inflammation and autoimmunity, both of which play a role in the development
of Alzheimer’s.
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Optimize
your gut flora by
regularly eating fermented foods or taking a high potency and high quality
probiotic supplement.
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Improve
your magnesium level — Magnesium threonate appears promising for
supporting cognition and may be superior to other forms. To learn more, see “Cognitive Benefits of Magnesium L-Threonate.”
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Optimize
your vitamin D levels with safe sun exposure — Researchers believe optimal
vitamin D levels may enhance the amount of important chemicals in your brain
and protect brain cells by increasing the effectiveness of the glial cells in
nursing damaged neurons back to health.
Vitamin
D may also exert some of its beneficial effects on Alzheimer's through its
anti-inflammatory and immune-boosting properties. Sufficient vitamin D is
imperative for proper functioning of your immune system to combat
inflammation that is also associated with Alzheimer's. For more information,
see “Link Between Vitamin D Deficiency and Dementia Confirmed.”
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Avoid
and eliminate mercury from your body — Dental amalgam fillings, which are 50% mercury
by weight, are one of the major sources of heavy metal toxicity. However, you
should be healthy before having them removed. Once you have adjusted to
following the diet described in my optimized nutrition plan, you can follow the mercury detox protocol and then find a
biological dentist to have your amalgams removed.
Also
avoid flu vaccinations as most contain mercury, aka thimerosal, a well-known
neurotoxic and immunotoxic agent.
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Avoid
and eliminate aluminum from your body — Sources of aluminum include antiperspirants,
nonstick cookware and vaccine adjuvants. For detox guidance, see “The Three Pillars of Heavy Metal Detoxification.”
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Exercise
regularly — It's
been suggested that exercise can trigger a change in the way the amyloid
precursor protein is metabolized,18 thus slowing down the onset and progression of
Alzheimer's. Exercise also increases levels of the protein PGC-1alpha.
Research has shown that people with Alzheimer's have less PGC-1alpha in their
brains and
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