Introduction: Preventing Alzheimer’s Disease with Nutrition
If you’ve picked up this book, it’s probably because you’ve witnessed the ravages of Alzheimer’s disease on someone you love—perhaps your mother or father, or even your sister or brother—and you fear the day when you might find yourself in the same position.
You’re not alone. Alzheimer’s ranks among the greatest health-care crises of the twenty-first century, and the numbers become even more dire with every passing year. According to the Alzheimer’s Association, there are currently 5.4 million people diagnosed with Alzheimer’s disease in the United States alone and up to 27 million affected people worldwide. In the States, they’re nurtured by 14.9 million unpaid caregivers. According to the Alzheimer’s Association, these nearly 15 million Alzheimer ’s and dementia caregivers provide 17 billion hours of unpaid care valued at $202 billion annually. Because of the toll this takes on their own health, these caregivers had $7.9 billion in additional health-care costs in 2010. Many of these caregivers are simultaneously parenting healthy young family members, a distinction that’s earned them the unenviable label of the “sandwich” generation. As they struggle to care for both younger and older loved ones, they often fail to take care of their own health in the process—a perfectly understandable, but potentially hazardous, oversight. As a result, many of them suffer from higher rates of health problems, particularly depression.
With the rapidly aging baby boomer population, Alzheimer’s disease—currently the sixth leading cause of death in the United States—will continue to affect more and more of us. Some estimate that one in eight baby boomers could develop Alzheimer’s. In the first six years of this century, while deaths from stroke, prostate cancer, breast cancer, heart disease, and HIV fell, Alzheimer’s disease deaths increased by a shocking 66 percent. Approximately one in every ten Americans over the age of sixty-five now suffers from Alzheimer’s, and every year, an estimated 100,000 people die from the disease.
Alzheimer’s affects so many of us: we either have a loved one who suffers from it, or know someone whose life has been drastically altered by caring for a relative or friend with the disease. The total cost of caring for Alzheimer’s patients in 2011 was a staggering $183 billion, an $11 billion increase over the preceding year. This figure will continue to rise if we don’t take immediate steps to protect the long-term health of our brains.
There is, of course, no known cure for Alzheimer’s disease to date. Once a patient has been diagnosed with Alzheimer’s (and this seldom happens before the disease has progressed far beyond the mildest stages), doctors can do little to stop the devastation. Treatment options are limited at this point, and while medications can improve symptoms, they have no real effect on the disease itself.
But the news isn’t all grim. I’m here to tell you that there are easy, concrete steps every single one of us can take to avoid adding to the ranks of Alzheimer’s sufferers and becoming just another sobering statistic. Even taking risk factors into account, we can fight to delay the onset of Alzheimer’s altogether—and one of the most effective ways of doing this is to retool our diets. That’s right. Eating better might help your brain work better and ultimately might stave off Alzheimer’s.
Sound too good to be true? Well, a number of recent large, population-based studies have provided strong evidence linking a higher dietary intake of specific foods—those rich in the B-complex vitamins (especially B6, B12, and folates), antioxidants, anti-inflammatories, and unsaturated fatty acids—to a lower risk of developing Alzheimer’s. Common foods, many of which you already have in your kitchen, can be your frontline weapons in the battle against dementia and cognitive decline. And if those benefits weren’t enough to convince you, you’ll also be combating obesity, cancer, heart disease, and a range of other ailments, some of which have been directly linked to Alzheimer’s.
The inspiration behind this book is simple: With knowledge comes power. That is, with knowledge of current scientific findings, we gain the power to make potentially life-altering changes. And it is only after understanding this science—such as the damage free radicals do to the brain and body, and the link between the degenerative process of Alzheimer’s and that of diabetes—that you will feel empowered to safeguard the health of your brain. This book is meant to empower you to take concrete steps toward reducing your risk of developing Alzheimer’s. Since changes in the brain start decades before onset of symptoms, any modification you make now may reap huge rewards in future years.
I’m not saying acquiring this knowledge is a simple process, not at all—especially when there’s still so much we don’t know and the information changes so rapidly. We’re bombarded daily with new and often contradictory information, and the constant updates can be confusing even to those of us who study Alzheimer’s disease for a living. New studies seem to come out every day of the week, and the recommendations of one don’t always line up with those in another. But while we are still a long way from conclusively understanding the interaction between environment and genetics that ultimately leads to the brain changes associated with Alzheimer’s, we do have a good deal of useful, and potentially lifesaving, information at our disposal already. In fact, nutritional science research has identified trends in food consumption that appear to lead to lower rates of Alzheimer’s and cognitive decline. That’s the information we hope to put at your fingertips in The Alzheimer’s Prevention Cookbook.
As a practicing medical doctor, geriatric neurologist, dementia specialist, and the director of research at a major teaching and learning institution, I’m engaged in investigations that make headline news. My colleagues and I have spent decades working to uncover the cause, treatment, prevention, and cure of Alzheimer’s disease. Having led or participated in dozens of clinical trials and clinical research studies in Alzheimer’s disease and other brain degenerative and medical conditions, I know exactly how overwhelming all the competing facts and figures out there can be. And that’s another big reason I’ve written this book: to distill all the current research on how diet can alter your risk of developing Alzheimer’s into straightforward language everyone can understand.
As a medical doctor, I’m daily confronted with the tragedy and devastation of Alzheimer’s disease in the patients, and the fear and dread in the family members who take care of them. People—especially these legions of Alzheimer’s caregivers—always ask what they can do to prevent getting the disease themselves. I tried to address that question in my first book, The Alzheimer’s Answer: Reduce Your Risk and Keep Your Brain Healthy, which covered many aspects of Alzheimer’s risk reduction but only touched on the all-important subject of diet.
Doctors and researchers have long advocated prescriptive diets for many conditions including heart disease, high cholesterol, high blood pressure, diabetes, and cancer. So why not Alzheimer’s? Since we all must eat to stay alive, I wanted to write a book that focused on how diet affects Alzheimer’s for better or worse, and how constructive changes in how and what we eat can have long-term benefits on our brains and bodies. The science of the brain continues to advance, and the more we learn about how our brains work, the more convinced we are that food can help us in the fight against Alzheimer’s and dementia.
While there are still tremendous gaps in our knowledge, I’ll start by focusing on what we do know. For example: We know that people with diets that are high in saturated fats and low in antioxidants and vitamins have higher rates of Alzheimer’s disease. We know that obesity, diabetes, and other diet-related inflammatory conditions often correspond with, contribute to, or predate Alzheimer’s diagnoses. We know that, even if you have a genetic predisposition to Alzheimer’s, you could significantly delay the onset of symptoms for many years by adopting preventive strategies like dietary modification in your thirties through sixties.
And even a short delay would reap huge rewards for the entire US health-care system: if we could somehow manage to delay symptoms by even a year, we could bring down the prevalence of Alzheimer’s by 5 percent by the year 2030. If, on the other hand, we sit back and do nothing to stop the rising tide of diagnoses, an estimated 14 to 16 million Americans will have Alzheimer’s by 2050. In fact, some advocates and health economists predict that Alzheimer’s could cost society $1 trillion dollars by midcentury if left unchecked. While researchers have long focused on developing innovative treatments for Alzheimer’s once symptoms have manifested, a growing consensus maintains that preventing Alzheimer’s is far preferable to treating it. That’s why we’ve started paying so much attention to how our diets affect our brains: diet remains one of the easiest lifestyle factors to modify, and anyone can start making these changes right away.
There are, of course, caveats, and fairly large ones at that. For one thing, prevention is much harder to quantify than a cure—and the pharmaceutical industry is much more successful in treating symptoms than erasing the underlying disease.
While we could be waiting decades for an Alzheimer’s cure, leading scientists now believe that we might be able to suppress, or delay the onset of, the awful illness. We’re currently investigating a variety of dementia-fighting devices, including exercise, vitamins and supplements, hormone therapy, anti-inflammatory medications, cholesterol-lowering drugs, and—you guessed it—diet.
We had two primary motivations for writing a book about this last, and most promising, avenue of Alzheimer’s prevention: (1) because a wide range of studies have already shown real brain-protective benefits of certain foods, and (2) because unlike hormone treatments and cholesterol drugs, good nutrition is available to everyone at minimal expense—and with no negative side effects.
I am not claiming that Alzheimer’s is entirely preventable; it isn’t. Certain risk factors—genetics, age, and gender—are unalterable for the foreseeable future. And we just don’t know if even the healthiest of diets can altogether overcome a genetic predisposition to Alzheimer’s. But that does not mean that developing Alzheimer’s is inevitable, or that there’s absolutely nothing we can do in the face of genetics.
While the genetic factors of Alzheimer’s disease certainly shouldn’t be ignored, there are many nongenetic causes as well, and these are the ones that deserve our attention—and intervention. Unhealthy dietary choices can lead to obesity and diabetes, which are in turn linked to Alzheimer’s; healthy dietary choices can benefit both our brains and our waistlines.
So even if there’s still a tremendous amount we’ve yet to learn about this incredibly complex disease, why not make the most of the ample knowledge that we already possess? Can we really afford to wait for every scientific fact and discovery to be proven beyond a shadow of a doubt? Absolute certainty might take decades. With Alzheimer’s rates spiraling upward at such out-of-control rates, can we really afford to adopt a passive approach? Why not take charge of our health proactively? That’s the core philosophy behind The Alzheimer’s Prevention Cookbook.
So yes, there is an alternative to waiting passively for a cure for Alzheimer’s—or to waiting for Alzheimer’s to set in. We’ve written this book to give you the culinary road map you need to make Alzheimer’s prevention an achievable goal. Consider our plan a science-to-table-to-brain-health protocol (our spinoff of the farm-to-table concept). It’s delicious, simple, fun, and extremely affordable (especially when compared to the estimated $30,000 to $70,000 spent annually treating each and every Alzheimer’s sufferer in the United States).
And the lessons and recipes in this book won’t just help you fight Alzheimer’s. The potential upside is that adhering to the recommendations of the book may improve your cardiovascular and overall health as well, by trimming your waistline, improving your energy level, and reducing your susceptibility to other inflammatory diseases. By learning how to cook and eat smarter, you won’t just be protecting your brain, but your whole body. And you can rest assured that your taste buds won’t suffer in the process, either. In fact, they very well may thank you.
Much of our dietary plan depends on everyday fruits, vegetables, spices, and proteins, including pomegranates, leafy greens, cinnamon and other spices like turmeric, fish, and chicken. We borrow some of the healthiest and most delicious dietary tricks from all over the world, everywhere from the Mediterranean to South Asia, offering simple, delicious recipes that bring disease-prevention science right to your table.
And once again, it all starts with arming you with the right information. For instance, did you know that eating just three fish meals each week can reduce the risk of Alzheimer’s disease by 40 to 60 percent, or that a single teaspoon of cinnamon provides more than the recommended daily dose of antioxidants, those free-radical-scrubbing powerhouses that directly combat the effects of aging? What about the fact that India has the lowest incidence of Alzheimer’s disease in the world, and that scientists attribute this amazing statistic to South Asians’ fondness for the spice turmeric? And if you knew that a half a teaspoon of cloves contains double the antioxidants you’re supposed to get in a day, you’d surely eschew chocolate-chip cookies in favor of the humble ginger snap.
Through the magical talents of Chef Beau MacMillan, executive chef of Sanctuary on Camelback Mountain and its signature restaurant, the recipes in The Alzheimer’s Prevention Cookbook
transform turmeric, cinnamon, cloves, and a host of other proven protective ingredients into culinary friends as trusted as salt and pepper. But despite the inclusion of some standard Indian spices, this is not a book of vindaloos and heavy curries. All of the food in this book—from power bars and energy shakes to stews and simple salads—is tailored to the American palate. Chef MacMillan, who has cohosted the Food Network’s hit series Worst Cooks in America and currently appears on their shows The Best Thing I Ever Ate and Chopped: All-Stars, knows all about making familiar food that’s as nourishing as it is delicious. Chef Beau and I discussed at length which ingredients most help in the fight against Alzheimer’s, and he brilliantly incorporated those ingredients into an array of healthful and delicious meals. The Alzheimer’s Prevention Cookbook
is about making doable, scientifically based changes to our diets. Our recipes allow every reader—whether an experienced cook or a complete kitchen novice—to choose from daily prescriptive menus that include delicious recipes such as protein-packed Gingered Spinach, Chicken, and Sun-Dried Tomato Omelet (page 114), which provides a low-saturated-fat breakfast alternative; or Spiced Dried-Fruit Compote (page 214), which fulfills the daily requirements of antioxidants; Wild Rice with Root Vegetables (page 200), a quick, delicious dinner that shows just how easy it is to embrace the Mediterranean diet at home; Lamb Stew with Fragrant Spices (page 182), which allows the uninitiated to use turmeric in a standard American recipe; and our signature turmeric-accented Brain-Boosting Broth (page 130), which can form the base of virtually all soups.
So forget the food pyramid. Forget points, calories, and carbs versus proteins. Our philosophy is simple: feed your head first, and good health will follow. Our diet will revolutionize the way you eat. Instead of picking your way around the prescribed five servings a day of this and that, or counting calories, or solely watching carbohydrates, you’ll strive to hit as near as possible a prescriptive daily dose of the foods that are believed to prevent Alzheimer’s disease. In the process, you’ll reduce your susceptibility to other inflammatory illnesses as well, including heart disease, cancer, and diabetes.
We call it “eating from the top down,” a new and empowering way to think about food. Feeding your brain nourishes the body, protects your mind, and will forever improve your family’s future health. So whether you’re taking care of an aging parent or a houseful of young children—or just trying to take care of yourself—The Alzheimer’s Prevention Cookbook
will equip you to extend the healthy functioning of your brain and help you to feel great in the process.
If Dr. Sabbagh thinks red wine is good for the brain, Chef Beau isn’t going to argue. This is a super easy recipe. All it takes is some mixing and pouring. Pomegranates contain resveratrol, just like red wine does.
Makes about 21/2 quarts
1 (750 ml) bottle Cabernet Sauvignon (or other red wine)
2 cups sparkling water
1 cup pomegranate juice
1 cup freshly squeezed orange juice
1/2 cup honey
1/4 cup freshly squeezed lemon juice
2 tablespoons Grand Marnier (or other orange-flavored liqueur)
1 cup pomegranate seeds
1 lemon, sliced into thin rounds
1 orange, sliced into thin rounds
4 cups ice cubes
Combine the wine, sparkling water, pomegranate juice, orange juice, honey, lemon juice, Grand Marnier, pomegranate seeds, lemon slices, and orange slices in a large pitcher and stir to blend in the honey. Add the ice and serve.
Excerpted from The Alzheimer's Prevention Cookbook by Dr. Marwan Sabbagh and Beau MacMillan. Copyright © 2012 by Dr. Marwan Sabbagh and Beau MacMillan. Excerpted by permission of Ten Speed Press, a division of Random House, Inc. All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.