Optimize diet

The first intervention to reverse mild Alzheimer's in the Bredesen Protocol is:

Goal: Optimize diet: minimize simple carbohydrates (CHO), minimize inflammation.

Approach: Patients given choice of several low glycemic, low inflammatory, low grain diets.

Rationale: Minimize inflammation, minimize insulin resistance.

Simple CHO (carbohydrate) are foods that rapidly break down to glucose in the blood. Examples include sugar, honey, candy, syrup, juice, cereal, soda, white bread, instant oatmeal, junk food, and most foods that come in a box in the center aisles of the grocery store.

Low glycemic foods take longer to break down to glucose in the blood, or in the case of fat, don't at all. Whole wheat bread, undercooked pasta, potato, brown rice, fruit, and corn are examples of carbohydrate rich foods that break down a little more slowly, but are still not recommended. Even less glycemic are green vegetables, non-starchy vegetables, beans, lentils, resistant starch, and super starch. The more protein, fat, and fiber a food contains, the less glycemic a food is likely to be. These tend to be natural and whole foods.

Insulin is the hormone produced when you eat carbs, telling your body to take glucose out of the bloodstream. High blood glucose and fructose causes those molecules to stick to places they shouldn't be, aging your body. The higher your blood glucose levels, the more insulin your pancreas has to produce to take it out of the bloodstream. The cells of your body get accustomed to the high insulin levels and start ignoring it. They become insulin resistant. Over decades insulin resistance can turn into diabetes. Diabetics have higher rates of cancer, heart disease, and stroke as well as Alzheimer's.

Inflamation is the body's way of repairing injuries. As we get older, our bodies become more and more inflamed all the time, eventually causing death. Junk food speeds up this process.

The types of fat in your diet can have an effect on how inflammatory it is. Foods with trans fats have recently been outlawed because of this. Omega 6 oils are more inflammatory than omega 3. Unfortunately, most processed food is loaded with soybean oil and other cheap omega 6 oils. The fats from extra virgin olive oil, avocado, and nuts are recommended to be the majority of your calories, served on organic, local, and seasonal produce.

(It is unclear whether plant saturated fats like those in coconut oil are safe for ApoE4 individuals. While they include healthful medium chain saturated fats, they also include long chain saturated fats, too much of which may raise LDL cholesterol. In the absence of good evidence for us, some will try coconut products and decide whether it can stay in their diet based on their biomarkers.)

When livestock are raised, they are typically given high omega 6 diets based on corn and soy. Their own fat is then enriched in this inflammatory fat. Grass fed meat is becoming more widely available and provides a better omega 3:6 ratio. Dairy like milk, cheese, and butter as well as eggs are usually enriched in omega 6 fats because the cows and chickens they come from are grain fed. As with meats, grass fed is better ('pastured'in the case of eggs) and becoming more available all the time. Insulin is also produced when you eat protein, telling your body to take amino acids out of the bloodstream. The protocol recommends very limited animal protein, mostly wild caught fish.

More people are sensitive to grains like wheat and oats than is commonly thought. Some argue that everyone is, to some degree. That's also unfortunate because grains are a cornerstone of the western diet. Foods containing gluten include bread, pasta, noodles, crackers, cereal, pancakes, tortillas, beer, most processed foods, even sauces and cosmetics. Grains and dairy are not recommended both because of their carb content and allergy issues. Cyrex labs is an example of a company that has good tests for gluten sensitivity.

References

Although not specifically included in the Bredesen Protocol, a diet that a number of ApoE4 forum members have adopted that is low carbohydrate and anti-inflammatory, characteristics that the Bredesen Protocol calls for, is Dr. Gundry's Diet Evolution. The third stage is the one you want. Here is his list of safe and forbidden foods. Apoe4 carriers should limit animal based fat.

Another is the Wahls Protocol.

Blood Sugar

Inflammation & LPS

Omega-3 fatty acids

The next intervention in the Bredesen Protocol is Enhance autophagy, ketogenesis.