Alzheimer’s disease: A Plan to Slow the Progression through Diet and Exercise
By Cindy Cobb
April 14, 2006
Abstract
The aging community is highly susceptible to Alzheimer’s disease and other forms of memory deteriorating diseases.
I have done a pilot study of the effects of diet and exercise upon 24, 12 men 12 women. All were recently diagnosed patients.
The patients had no history of mental illness or diet related disorder. There were four randomly assigned groups. The study
is an attempt to reduce or stop the progression of Alzheimer’s disease through diet and exercise. The findings are that
diet is a way to reduce the effects of damage due to bad habits. Exercise is also good, but the best plan is through a low
cholesterol diet and exercise. The study shows the most improvement in the patient’s condition is through both diet
and exercise. This pilot study is exciting in that it gives reason to do a larger study involving a wider selection of patient
from a larger population. Also it leads the science into an area free from medications and drugs that can have unknown side
effects.
INTRO Alzheimer’s
disease is cruel debilitating disease that affects a large population of our aging community. With the large amount of baby-boomers
approaching the golden years it is imperative to find as many ways as possible to prevent or slow the progression of this
disease, which there is no current cure. I have lost a family member to this disease and know of many others who suffer. With
the rising cost of health care it is also important to find low tech or low cost treatments for diseases such as this. In
this study I intend to pursue research projects that have been done to examine the effects of fat/ high cholesterol in the
diet and exercise upon brain function and memory.
PROBLEM I
propose to examine if recently diagnosed Alzheimer’s patients progression of disease lesions will be affected by a low
fat diet, exercise, or a combination of both factors. With the rising cost of health care and the increased amount of aging
baby boomers it is imperative to find low cost and simple measures to stave off this disease as well as many others. Alzheimer’s disease is a problem of growing
concern for the entire population. As a firm believer
in the benefits of exercise it is worth our time to investigate if it can be used to keep our aging population healthy. The
more ways we can find simple solutions to health problems the better off our population would be. There are people diagnosed every day and we hear on the evening
news that there are tests that can identify those that are likely to develop the disease two to three years prior to early
symptoms are noticed. With no cure and no drugs that can definitively stave off the disease it is imperative that we examine
any other treatment options or preventative measures.
REVIEW LIT
William Jagust (2006) uses MRI and PET to determine who will be at risk for Alzheimer’s disease far sooner than
actual symptoms occur. Martha A. Sanchez-Rodriguez (2005) found that elders in rural Mexico had less oxidative stress which
leads to cognitive impairment. Rural people traditionally have been more apt to work in a farming type lifestyle which affects
activity level and diet. In a study by Spindler (1996), patients with Alzheimer’s disease were compared to cognitively
normal patients and found that patients suffering from the disease required a higher dietary intake than those without the
disease to maintain body weight.
With the necessity for higher dietary intake it is important
to consider the effects of the food they take in. Patil and Chan (2005) examined the role of fatty acids in causing
hyperphosphorylation (H) of the tau protein, one of the characteristics of AD. H of the tau disrupts the cell cytoskeleton
and leads to neuronal degeneration. The study identified the effects of free fatty acids in the tau, and found it causing
neuronal degeneration.
Valerie Temple (2005) compared
the behavior and emotional characteristics of Alzheimer’s dementia in individuals with and without Down syndrome. The
findings were that the Alzheimer’s patients were more sedentary, and the Down’s patients were more active and
had fewer behavioral problems. In a different study by Gonzalo-Ruiz (2005) it was determined that the aged rats given the
high cholesterol diets had the most neuronal loss, second only to the aged rats given the high fat diet. The results of this
test support the supposition that cholesterol, lowering drugs can reduce the progression of AD-type dementia. A study by Molten (2003) indicated that exercise interacted with the same molecular systems disrupted by the high fat diet, reversing
their effects on neural function. Nicholas Panniccuilla (2005) studied brain
abnormalities in obesity using MRI and PET scans. Results unveil a possible molecular mechanism by which lifestyle factors
can interact at a molecular level, and provide information for potential therapeutic applications to decrease the risk imposed
by certain lifestyles. M.R. Descanes (2005) found that increases and decreases in exercise have a direct effect on neuromuscular
branching. The more exercise that is done the greater the amount of branches, these branches are where the synaptic impulses
are firing, thus giving a better brain function. These findings correlate with the study by Den’etsu Sutoo (2003) in
which the findings lead to the belief that some symptoms of Parkinson’s disease or senile dementia may be improved by
exercise. The findings and studies I have found lead me to the same hypothesis. Diet and a program of physical activity should
help stave off senile dementia if not reverse the effects.
METHOD I have petitioned East Tennessee State
University’s
IRB to do a pilot study on twenty-four patients selected randomly from the approved population for three months from Mountain
City Nursing home. The patients are in a rural setting and must have been recently diagnosed with senile dementia or Alzheimer’s
disease and free of drugs as determined by medical history, physical examination, and laboratory screening tests. Alcohol
and drug abuse (and/or history of substance abuse or addiction), endocrine disorders (including abnormal thyroid function
and type 2 diabetes), hypertension, and pulmonary, cardiovascular, gastrointestinal, hepatic, renal, and central nervous system
(CNS) disorders were excluded at screening. Behavioral or psychiatric conditions (such as claustrophobia, major depression,
presence of psychotic symptoms, bulimia nervosa) were screened for using the Structured Clinical Interview (SCID) for DSM-IV-R
(American Psychiatric Association, 2004).
The
study will track the progression of the disease as it correlates with the participant’s dietary intake and exercise
level. 12 men (M) and 12 women (W) were randomly selected from separate male
and female populations as to eliminate a gender variance. All 24 people were found to participate in the above study in which
we acquired PET measurements of regional cerebral blood flow (rCBF) to examine the functional neuroanatomical correlates of
hunger, satiation, and taste, as reported in a number of publications (Del Parigi et al., 2002bMRIs of the brain were also performed in all these subjects to rule out gross anatomical abnormalities and facilitate
comparisons between brain structure and function, as described in the above publications (Del Parigi et al., 2002b,)This study was restricted to the VBM analysis of the 24 subjects
who were studied on the same MRI scanner to minimize the likelihood of introducing scanner-dependent noise or artifacts in
the analysis and interpretation of findings. The participants nursing staff were also required to make a daily report of dietary
intake and exercise levels of all participants. The participants were given first a PET pretest and MRI scans.
The study participants were then randomly divided into four groups. (1) Control – 3(M) 3(W) received no alteration
in behavior or diet. (2) 3(M) 3(W) placed upon a low cholesterol diet with no alteration to their usual activity patterns.
(3) 3(M) 3(W) were put on the low cholesterol diet and incorporated moderate exercise (4) 3 (M) 3 (W) were on a regular diet
and moderate exercise. The participants were then tested and scanned with PET and MRI.
The
results were then graphed to display the percent of difference in the change of brain lesions in each group of the study.
A graph shows the results :(1) a continued growth of area of damage of 5 %.(2) a
growth area of 2% (3) decline in damage area 1% (4) a growth area of 3%. Daily activity and dietary reports are required for
the three month period. The protocol was approved by the Institutional Review Boards of the National Institute of Diabetes
and Digestive and Kidney Diseases and our East Tennessee’s IRB, and informed written consent was obtained from all subjects, or their legal representative
before participation in accordance with the patient confidentiality requirements of HIPPA. The beginning and end results were then compared to dietary intake and level of physical exercise. A parametric
study of the MRI’s based on the exercise levels as an independent variable. Each group of participant’s dietary
intake can be studied as separate independent variable. An analysis of covariance (ANCOVA) test for variance was also done
to ensure the results were correct due to age and gender variances. The progression
of the degenerated brain tissue was compared with a t-test. MRI tests can be
evaluated with anthropometric and metabolic parameters examined by using the SAS statistical package (SAS Institute, Cary, NC). The dietary intakes were monitored to determine wants and resultant progression of the disease. The
exercise levels were monitored to determine caloric usage. Data were analyzed using statistical parametric mapping software
package (SPM2, Wellcome Department of Cognitive Neurology London UK. This study examines the effects of exercise
and reduced fat/cholesterol diets on those who suffer from Alzheimer’s disease.
DISCUSSION The findings are that the patients were initially all open to the dietary
and activity level changes. The level of impairment the patient had going into the study was a factor in the results. The
less neural degeneration the easier it was to encourage the patient’s participation. The study shows the best improvements
in the patients with the low cholesterol diet and exercise. Through the study there were some patients that would protest
the exercise. The improvements were small in the patients with only modified diet, this displays that the necessity for exercise
as well as dietary changes, and the same with those who made activity changes without dietary changes. The patients did not
acquire the previous habits, or the diet in a short time and it cannot be expected to eliminate the condition in such a short
time, but improvement was seen.
CONCLUSION The
increasing number of elders makes it imperative that we find different ways to keep them healthy and functioning independently
longer. The rising costs of health care it is of utmost importance to prevent disease and find other cures. This study also
gives importance to the choices that the younger population makes for themselves today to have a habit of exercise and lower
cholesterol. The study does not prove causation only correlation. The cause of the predisposition is unknown. Medications have side effect that are unknown for many years. It would be interesting to test the
effectiveness of the cholesterol lowering drugs as compared to a low cholesterol diet and exercise.
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