New Research on Alzheimer’s from Dr. Dean Ornish

Today, we hear about new research on Alzehimer’s from Dr. Dean Ornish.  And, we share the results of the first randomized, controlled trial investigating whether a plant-based diet and lifestyle program may reverse the course of early-stage Alzheimer’s disease.

Dr. Dean Ornish was the first to show, in a randomized, controlled trial, that a plant-based diet and lifestyle program could apparently reverse the progression of our number one killer, heart disease––opening up arteries without drugs, without surgery.

Then, he showed the same plant-based program could potentially reverse the course of early-stage prostate cancer and also elongate telomeres, suggesting an anti-aging effect as well.  But when he told me he was going to see if he could reverse the progression of Alzheimer’s disease, surely, he was biting off a little more than he could chew.

Dementia is the most feared condition of later life. There’s a common misconception that we have no control over whether or not we develop dementia, but the good news is that although Alzheimer’s may be incurable, at least it is preventable.

There is an emerging consensus that “What’s good for our hearts is also good for our heads,” because clogging of the arteries inside the brain with atherosclerotic plaque is thought to play a role in the development of Alzheimer’s dementia.

Too much cholesterol in our blood is unanimously recognized to be a risk factor for the development of Alzheimer’s disease. Those with a total cholesterol of 225 or more may have nearly 25 times the odds of ending up with amyloid plaques in their brain 10 to 15 years later. After all, what is the Alzheimer’s gene, APOE? It codes for the major cholesterol carrier inside the brain.

This may explain the so-called Nigerian Paradox: where they have among the highest rates of the Alzheimer’s gene but some of the lowest rates of Alzheimer’s disease. How is that possible? Genes load the gun, but lifestyle pulls the trigger. The paradox may be explained by their low cholesterol levels, probably due to their diets low in animal fat.

So, in terms of dietary guidelines for the prevention of Alzheimer’s, we should center our diets around vegetables, legumes (beans, split peas, and lentils), fruits, and whole grains. In other words, the dietary pillar of lifestyle medicine: whole food, plant-based nutrition. Or, if that’s too complicated, plants, plants, and more plants. That may help explain why vegetarians may be up to three times less likely to become demented later in life. But it’s not all-or-nothing. Even just substituting five percent of animal protein with plant protein appears to significantly reduce the risk of dying from dementia.

But prevention isn’t sexy. When prevention works, nothing happens. But the same diet and lifestyle that help prevent heart disease were proven to help reverse it. Until then, it was believed that heart disease progression could only be slowed, not stopped or reversed––similar to how Alzheimer’s disease is viewed today. So, what if you put people with Alzheimer’s on the same plant-based program? You don’t know until you put it to the test.

A randomized, controlled, phase 2 clinical trial to see if the progression of Alzheimer’s disease may be slowed, stopped, or perhaps even reversed, by randomizing about 50 men and women diagnosed with early-stage Alzheimer’s to either make no lifestyle changes for 20 weeks, or to eat a whole food, plant-based diet (with supplements like vitamin B12), moderate exercise (like walking half an hour a day), stress management (like relaxing with breathing exercises), and getting group support (over Zoom).

They measured standard tests of cognition and function before and after in each group, as well as objective experimental biomarkers of disease progression. On the Clinical Dementia Rating Global scale, which is used to stage the severity of dementia, the control group continued to get worse, but the diet and lifestyle group started to get better. People diagnosed with Alzheimer’s getting better? The same seemed to happen when measured with the Alzheimer’s Disease Assessment Scale, though this did not reach statistical significance. Using what’s called the Clinical Dementia Rating Sum of Boxes scoring, both groups continued to deteriorate, but the decline was significantly less in the healthy living group. Overall, using what’s called the Clinical Global Impression of Change scoring, most of the people in the control group kept getting worse, and none showed any improvement, which is what you’d expect with Alzheimer’s, whereas about 40 percent of those in the diet and lifestyle group appeared to be getting better within five months of eating and living healthier. Why did some get better and others not? Well, the more the study participants complied with the recommendations, the greater the beneficial impact on their cognition and function. This helps to explain why studies of less-intensive lifestyle interventions were not sufficient to stop disease progression, let alone actually improve cognition and function.

The biggest limitation of the study is that, unlike drug trials where you can give people a disguised placebo sugar pill, when a study involves major diet and lifestyle changes, you can’t rule out the placebo effect, especially for self-reported, subjective  “How’s your memory been?” type questions. But the researchers also measured objective investigational biomarkers of disease progression and saw the same trajectory—improvements in the interventional group and worsening in the control group, with the same apparent dose-response effect, meaning the more they improved their diet and lifestyle, the more dramatic the effect.

Compare that to the latest Alzheimer’s drugs, which may even not work at all. All you may get for your $56,000 is a one-in-three chance of swelling or bleeding in your brain. When the U.S. Food and Drug Administration approved the drug anyway, the head of the American Geriatrics Society replied, “My head just exploded.”

The bottom line is that there is only one diet that has been shown to help reverse our leading cause of death, heart disease, in the majority of patients: a plant-based diet. If that’s all a plant-based diet could do—reverse the number one killer of men and women, then shouldn’t that be the default diet until proven otherwise? And the fact that it can also be effective in preventing, arresting, and reversing the progression of other leading killers, like high blood pressure, type 2 diabetes, and now maybe even early-stage Alzheimer’s disease, would seem to make the case for plant-based eating simply overwhelming.

In our next story, we look at the human impact of improving the cognition and function of Alzheimer’s patients.

I released a video profiling Dr. Dean Ornish’s landmark new study in the leading peer-reviewed Alzheimer’s translational research journal, a randomized, controlled trial showing that a plant-based diet and lifestyle program may significantly improve cognition and function after 20 weeks in many patients with early-stage Alzheimer’s disease. About 70 percent remained stable or actually improved in the plant-based intervention group, whereas, in the control group, about 70 percent got worse, and not a single person got better. But no matter how significant the results, the dry statistics just don’t convey the human impact.

Many patients who experienced improvement reported regaining cognition and function they had lost. But how does that actually translate into real life? Well, for example, several patients in the intervention group reported that they had been unable to read a book or watch a movie because they kept forgetting what they had just read or watched, and had to keep starting over. But, after the plant-based diet and lifestyle changes, they got better, such that now they were able to read and watch shows again. One individual reported that it used to take him weeks to finish reading a book, but after participating in the study, he was able to do it in a matter of days.

Another participant, a former business executive, reported regaining the ability to manage his own finances and investments. “It was so much a part of my life,” he said—”who I am, and who I was—it was hard saying that part of me was just gone. But now I’m back to reconciling our finances monthly; I keep up-to-date on our investments. A lot of self-worth comes back.”

Another said that for five years she had been unable to prepare their family business’s financial reports, but now she is able to do so accurately. “A deep sense of identity is returning. It’s given me a new lease on life, and yet it’s a familiarity and something I’ve always prided myself on. I’m coming back like I was prior to the Alzheimer’s disease being diagnosed. I feel like I’m me again—an older but better version of me.”

But even words are hard to describe such transformations. One of Dr. Ornish’s study participants gave us permission to share his story: Dan Jones, is a musician at military events and parades, who was diagnosed with Alzheimer’s disease.

“What do you notice that you could do now that you couldn’t do before?”

“Well, for one thing, I had a set of about eight tunes that I played in the parade, right? And I could just go straight through them from one into the other. I played for an hour and a half without stopping. I think it was pretty close. They move darn slow in that parade. I was leaving them behind walking. I kept having to stop and wait for them to catch up.”

“Was that something different?”

“Yeah.”

“And what was?”

“Well, that I could remember the order. I could make the transition from tune to tune without messing up and getting confused about which tune I was playing. Those were all problems I’d had when we were playing at the graduation ceremony. You know, I’d forget which tune was coming next. I’d get worried about it, and I’d start making mistakes. And this just went like clockwork. A lot of it had to do with practice, but the tunes we played before, I had played hundreds of times, and I was messing up. And in the parade, I hardly messed up at all.”

“And you were messing up because you had a hard time remembering?”

“Because I had a hard time remembering. I’d get confused about different tunes. It was not a pleasant experience. It was unpleasant enough that, like I said, I went home and put [the bagpipes] down. And now, there was one day a couple of weeks ago when I really had the drones in tune. It was in the evening. I was out on the front porch playing, and it was just so beautiful. I played for two hours. I just stood there and played.”

“Joy. Just happy. It was just so nice to be able to do that again.”

“Did that make you feel better about yourself, too?”

“It did.”

“In what way?”

“I just felt like I could do something. I had worth again, so to speak. Something that was important to me was given back.”

Here’s what the head of Harvard’s brain center at Mass General had to say: Big Pharma has invested billions in the effort to find medications to treat the disease, but only two Alzheimer’s drugs have been approved in the past 20 years. One of which has already been pulled off the market, and the other is minimally effective, extremely expensive, and often has pesky side effects, such as brain swelling or bleeding into the brain. In contrast, the intensive lifestyle changes implemented in this study have been shown here to improve cognition and function, at the cost of buying broccoli. And the only side effects are positive ones.