Compelling science versus fuel for hypochondriacs – you judge

This story may well strike a nerve in those of us who tend to worry about our health – or the sky falling on our heads. Picture the dinner table debate; Angelina Jolie's name bandied about for having the breast cancer gene and getting hers lopped off as a precaution, and/or wives' teasing their husbands for carrying on as if they're dying when they catch a cold. But I will confess, I have an 89-year-old mother who raised three sets of twins and two singles who regularly confused our names growing up and now struggles to remember their partner's names. That's the overshare, not the confession. The confession is that I worry that my forgetfulness may be due to a gene I inherited – upon reading this I had a brief surge of fear-driven attraction to a gym. The evidence of a very targeted diet and rigorous exercise improving cognitive function and memory is compelling, from many studies I've come across as a health journalist. Here's the latest one. Judge for yourself whether I fall into the coughing-husband bracket, but just please leave my breasts out of it. And perhaps, see where you fit in. – Chris Bateman.The link between diet, exercise and Alzheimer's.By Sumathi Reddy(The Wall Street Journal) – In his 40s and a self-described fitness nut, Stephen Chambers doesn't seem like someone who would be worrying about Alzheimer's. ___STEADY_PAYWALL___.But when his father was diagnosed with the disease about five years ago, he went to the Alzheimer's Prevention Clinic in New York to see what he could do.Though he had no noticeable memory issues, cognitive testing showed less than ideal levels in certain areas. His neurologist told him there were a number of lifestyle changes that might help his cognition and possibly reduce the risk of developing Alzheimer's disease.Mr. Chambers, a 48-year-old physical therapist in Jersey City, NJ, modified his sleep, diet and exercise routines. Eighteen months later, his performance on a battery of cognitive tests improved, particularly in areas like processing speed and executive function, such as decision-making and planning."I feel a certain sense of comfort in knowing that there are factors that I can control that can contribute to the decreased risk of me getting Alzheimer's," says Mr. Chambers..Mr. Chambers is among 154 patients in a study, published Wednesday in Alzheimer's & Dementia: The Journal of the Alzheimer's Association, that doctors say shows encouraging results. Among healthy patients, people who made changes in nutrition and exercise showed cognitive improvements on average. People who were already experiencing some memory problems also showed cognitive improvement – if they followed at least 60% of the recommended changes.It's unclear whether the lifestyle changes can actually help prevent the development of Alzheimer's disease, or simply improve cognition."This is a therapeutic approach that was shown to not only maintain, but improve cognition in people with the earliest stages of Alzheimer's," says Richard Isaacson, a neurologist and first author on the study.While researchers struggle to develop a drug to treat or cure Alzheimer's, some doctors are recommending lifestyle changes. Dr. Isaacson began developing personalised prevention plans for patients of all ages in 2013 when he started the Alzheimer's Prevention Clinic at Weill Cornell Medicine and NewYork-Presbyterian, of which he is now director.Read also: To know or not to know you have Alzheimer's – dangers of genetic testingAlzheimer's disease starts in the brain some 20 to 30 years before symptoms emerge, so intervening early through personalised medicine and lifestyle changes can make a difference, says Dr. Isaacson.For the study, Dr. Isaacson and co-researchers enrolled 154 patients, who ranged in age from 25 to 86, in two groups. There was a small group of 35 patients with mild cognitive impairment (MCI), often a precursor to dementia, and a larger group of 119 patients who had no symptoms of memory loss, though some had less-than-ideal performance on cognitive tests.Based on a battery of blood, genetic and cognitive tests, as well as measurements of their body fat and muscle mass, patients received a couple of dozen personalised recommendations ranging from eating specific types of fish and berries, to taking certain vitamins, and tailored exercise plans.Eighteen months later, they took a series of very sensitive cognitive tests which may detect cognitive decline before memory problems outwardly appear, says Dr. Isaacson. The majority of both groups of patients showed statistically significant improvements when compared with their baseline, as well as compared with historical control groups..Most surprising, says Dr. Isaacson, is that the MCI patients who followed at least 60% of their recommendations showed cognitive improvement. However, MCI patients who followed less than 60% of the recommendations experienced cognitive declines similar to the control groups, he notes.In the larger group of patients, everyone – including those who didn't follow a large percentage of recommendations – performed better on the cognitive tests compared with their baseline and control groups 18 months later. On average, younger people showed more improvement on the cognitive tests compared with people over 60, says Dr. Isaacson. Patients in both groups had a family history of Alzheimer's disease.Researchers monitored cholesterol, blood pressure and blood sugar levels because they are linked to an increased risk of Alzheimer's disease. And the study tracked patients' body fat and muscle mass; studies show the memory centre of the brain, called the hippocampus, gets smaller as belly size gets larger, says Dr. Isaacson. Patients were assigned exercises based on their body metrics. Other recommendations included targeting stress reduction through activities like meditation, and encouraging brain stimulation by learning a new instrument or foreign language.Marwan Sabbagh, director of the Cleveland Clinic Lou Ruvo Centre for Brain Health in Las Vegas, says the results are promising. "The people who had the targeted intervention and who were high in their adherence did very, very well over the span of 18 months, showing that these strategies work, and I think that's a very encouraging result," says Dr. Sabbagh of the study. "That is where the trend is going."Read also: What next for Alzheimer's research after latest trial failure?Ronald Petersen, director of the Mayo Clinic Alzheimer's Disease Research Centre in Rochester, Minn., called the study encouraging but cautioned that lifestyle changes aren't a magic bullet. "Does that mean we're going to prevent Alzheimer's disease?" he says. "No." But measures that might help delay the onset are significant. "If we can postpone the onset or slow the progression of cognitive impairment and Alzheimer's disease, that's very important," he says.Mr. Chambers says he now eats blueberries or strawberries, which are high in antioxidants, at least two to three times a week. He eats more of certain kinds of fish to get more Omega 3 fatty acids, which can decrease inflammation and improve cardiovascular and brain health. And he adds powdered cocoa flavanols to his morning coffee because studies show they can combat insulin resistance and promote cognitive function.He also listens to more music, particularly classical music, and tweaked his workouts to include more high-intensity interval training. The biggest change, he says, was a concerted effort to get more and better sleep by meditating and cutting back on screens before bedtime. "I took a lot of steps to really try to be consistent and to prioritize sleeping more and improve the quality of my sleep," he says. "Once that changed, we really started to see improvements in all areas." He is no longer prediabetic and his blood pressure and cholesterol levels have improved..Diana Gabriel, a 74-year-old artist and fashionista in Manhattan, says five years ago she couldn't remember what restaurant she went to the night before. After hearing Dr. Isaacson speak, she went to see him at his clinic.Within a year she says she noticed major improvements in her memory – improvements which were validated through cognitive tests.Changes she has made, she says, include intermittent fasting – or not eating for 12 hours overnight, which is linked to lower insulin resistance. She cut out most carbohydrates from her diet and also eats wild fish. She started taking about eight different types of vitamins and supplements and she does weight lifting twice a week with a personal trainer to gain muscle mass. "It's working," she says. "I'm getting biceps.""I can tell you yesterday I went for training and then I went to a jewellery workshop and I went for wine with my friend and we met an interesting guy at the bar with the Newport Jazz Festival," she says. "I remember yesterday. For a year or almost two, I could not. My memory is not perfect. But this has really given me a new lease on life."Brain boostersHere are some of the lifestyle changes that Dr. Richard Isaacson, director of the Alzheimer's Prevention Clinic at Weill Cornell Medicine and NewYork Presbyterian, says might help improve your cognitive abilities, depending on your body type and medical profile. Patients should consult a doctor before taking any steps.Eat a half-cup of blueberries and strawberries two to three times a week.Eat two to three servings per week of wild fish, which are high in Omega-3 fatty acids.Add powdered cocoa flavanols to coffee, smoothies or skim milk.Practice good sleep hygiene: Sleep at least 7.5 hours a day, avoid caffeinated drinks after 1 p.m., go to bed and wake up at the same time every day, and avoid electronics, texting and email 30-45 minutes before bed.Exercise at least three times a week with a mix of aerobic and resistance/weight training.Have one tablespoon of extra-virgin olive oil daily.Cut back on sugar and carbohydrates and look for whole grains and foods with high amounts of fibre.Play a musical instrument.Learn something new, such as a foreign language.Minimise stress through activities like meditation.– Write to Sumathi Reddy at sumathi.reddy@wsj.com

Compelling science versus fuel for hypochondriacs – you judge

Related Stories

Meet Tshepo Mahloele – Big Capitec shareholder, ABSIP’s “CEO of the Decade” now accused by Holomisa as kingpin of corrupt network

PREMIUM: Making of a great editor – the George Palmer playbook

Premium – BizNews global portfolio: ASML joins – so does Adobe as Bull takes hold again

Alec Hogg: Helen Zille predicts SA choice will be DA or EFF