Author: June Pomeroy RN, BSN
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For years, researchers have been conducting studies to find a way to reverse and prevent cognitive decline/Alzheimer's Disease. One notable researcher, Dr. Dale Bredesen MD, professor at UCLA and founding president of the Buck Institute for Research on Aging, has dedicated the last 30 years of his career to this research. Dr. Bredesen is internationally recognized as an expert in the mechanism of neurodegenerative diseases such as Alzheimer's Disease.
Dr. Bredesen and his colleagues have published several peer-reviewed studies, starting in 2014, in leading medical journals. His studies show that mild cognitive impairment (MCI) and early Alzheimer's Disease can be reversed with the use of his protocol. He has identified at least 36 causative factors that must be addressed to reverse cognitive decline. To address these factors, he has developed a program called ReCODE which stands for reversal of cognitive decline. One of the main components of the ReCODE program is the ketogenic diet. His specific version is called KetoFLEX 12/3.
Dr. Bredesen in his book, The End of Alzheimer's. The First Program to Prevent and Reverse Cognitive Decline, states "Insulin resistance is arguably the single most important metabolic contributor to Alzheimer's Disease development and progression."
According to the Mayo Clinic, if you carry the so-called Alzheimer’s gene (ApoE4), this variant seems to interfere with the brain’s ability to utilize insulin appropriately. This insulin resistance can cause the brain cells to starve and die. It is unofficially called Type 3 Diabetes.
Many of us are insulin resistant from eating a diet high in simple carbohydrates such as sugar and processed foods full of high-fructose corn syrup. Sedentary lifestyles, stressful jobs, and stressful home lives also contribute to insulin resistance. Dr. Bredesen's ReCODE program addresses insulin resistance and the other identified causative factors. His ReCODE program which is a personalized program based on individual test results includes:
Diet (KetoFLEX 12/3)
Exercise
Sleep
Stress reduction
Targeted supplementation
Medication (as a last resort)
Our bodies can switch between burning glucose/carbohydrates as fuel or burning fat as fuel. This is called metabolic flexibility. Most people with Alzheimer's Disease have insulin resistance and altered metabolic flexibility. Dr. Bredesen states" Restoring insulin sensitivity and metabolic flexibility are critical for trophic factor production, response to the trophic effects of insulin, minimizing inflammation, reducing obesity and lipid storage, improving cardiovascular status, optimizing hormones and hormonal responses, and thereby enhancing cognition."
Dr. Bredesen’s approach to reversing cognitive decline is multifaceted, with a ketogenic diet being a cornerstone. A ketogenic diet means eating a low-carbohydrate diet, so the body enters a state of ketosis. If we fast or follow a low-carbohydrate diet for several days, our bodies run out of stored glucose and are forced to start burning fat. The liver breaks down the fat and forms ketones which are then burned as fuel. These ketones give the name to the ketogenic diet. The ketones produced by the liver provide excellent fuel for cognition and increase the production of BDNF (brain-derived neurotrophic factor) which supports the neurons and synapses.
What is KetoFLEX 12/3?
Keto refers to the state of ketosis discussed above. One would utilize a low-carbohydrate diet to promote ketosis while minimizing simple carbs like sugars, bread, white potatoes, white rice, soft drinks, alcohol, candy, cakes, and processed foods. Consuming MCT oil (medium-chain triglyceride) or unsaturated fats such as olive oil, avocado oil, avocado, or nuts promotes mild ketosis.
FLEX refers to two different facets of the plan. First, the KetoFLEX 12/3 lifestyle is heavy on vegetables but can be flexible to include meat or can be vegetarian. Second, it promotes metabolic flexibility, restoring the body's ability to burn either fat or glucose as fuel. This maintains insulin sensitivity to maximize the fuel supply to your brain. Eating fish is optional but remember that quality is a top priority. Avoid large-mouthed species like sharks, swordfish, and tuna, which live long and will have the highest levels of mercury. Instead, choose SMASH fish (salmon, mackerel, anchovies, sardines, and herring). Whenever possible, get wild-caught fish, not farmed fish, which will provide a better omega-3 to omega-6 ratio and fewer toxins.
12/3 refers to fasting times. Fasting is a highly effective way to encourage ketosis, improve insulin sensitivity, and enhance cognition. Bredesen states: "Fasting also leads to a decrease in inflammation and enhances mitochondrial function, boosting longevity. Additionally, fasting reduces the risk of heart disease, cancer, and autoimmune conditions." The 12 in KetoFLEX 12/3 refers to fasting for 12 hours between the end of dinner and the first meal of the next day. If you carry the ApoE4 genotype, the strongest genetic risk factor for Alzheimer’s, aim for 16 hours of fasting. This fasting encourages autophagy, where cells “clean house,” recycling and destroying damaged proteins and mitochondria. The three in the KetoFLEX 12/3 refers to a minimum of three hours between the end of dinner and bedtime. This three-hour window keeps your insulin level from spiking before bedtime. An insulin spike before sleep will contribute to insulin resistance. It will also inhibit melatonin and growth hormone production, which aid in sleep, immune function, and repair.
Using Dr. Bredesen's multifaceted approach to reverse cognitive decline gives hope to those suffering from memory loss. The vast majority of those who follow his ReCODE plan see positive changes! Dr. Bredesen has a companion book that spells out the specifics of his protocol. This book is The End of Alzheimer's Program. The First Protocol to Enhance Cognition and Reverse Decline at Any Age. Dr. Bredesen also partners with Apollo Health which uses his protocol to provide care for those affected by cognitive decline, or those wanting to prevent such decline. They offer his PreCODE (prevention) protocol or the ReCODE (reversal) protocol. A free cognitive assessment is available on their website to help determine which program would be most appropriate. Apollo Health can be reached at ApolloHealthco.com.
Sources:
Bredesen, Dale. The End of Alzheimer’s. The First Program to Prevent and Reverse Cognitive Decline. New York, Avery, 2017.
Bredesen, Dale. The End of Alzheimer’s Program. The First Protocol to Enhance Cognition and Reverse Decline at any Age. New York, Avery, 2020. https://www.mdpi.com/journal/biosensors