Just out:

Effects of intensive lifestyle changes on the progression of mild cognitive impairment or early dementia due to Alzheimer’s disease: a randomized, controlled clinical trial, Alzheimer’s Research & Therapy, 7 June 2024

Dr. Dean Ornish was the lead author.

Conclusions: Comprehensive lifestyle changes may significantly improve cognition and function after 20 weeks in many patients with mild cognitive impairment (MCI) or early dementia due to Alzheimer’s disease (AD).

Dr. Greger covered it, the diet part at least:

You can visit Greger’s site for a transcript of his video. I find that helpful.

The intervention was not just diet. There were several components:

• Diet (Food was provided)
• Exercise (Aerobic at least 30 minutes/day and mild strength training at least three times/week)
• Stress Management (Meditation, gentle yoga, stretching, progressive relaxation, breathing exercises, and imagery for a total of one hour per day)
• Group Support (One hour/session, three days/week)
• Supplements (See below)

Here’s the diet component:

A whole foods minimally-processed plant-based (vegan) diet, high in complex carbohydrates (predominantly fruits, vegetables, whole grains, legumes, soy products, seeds and nuts) and especially low in harmful fats, sweeteners and refined carbohydrates. It was approximately 14-18% of calories as total fat, 16-18% protein, and 63-68% mostly complex carbohydrates. Calories were unrestricted.

I don’t have a feel for the actual food. 63% carb seems kind of low. 14-18% fat is of course low fat, relative to an American’s diet, but relative to some other low-fat diets it’s getting up there:

Kempner Rice Diet patients: 2-3% fat
Okinawans before 1960s: 6%
Cubans during Special Period: 10%
Barnard’s 2006 study (High-Carb, Low-Fat For Diabetes) : 19% (their goal was 10%)

Let me not split hairs over the diet. It was, after all, plant-based (vegan) and, with two food deliveries a week, it probably included a good amount of fresh food, something older adults don’t eat enough of.

What I do take issue with is this list of supplements:

Omega-3 fatty acids with Curcumin (1680 mg omega-3 & 800 mg Curcumin, Nordic Naturals ProOmega CRP, 4 capsules/day). Omega-3 fatty acids: In those age 65 or older, those consuming omega-3 fatty acids once/week or more had a 60% lower risk of developing AD, and total intake of n-3 polyunsaturated fatty acids was associated with reduced risk of Alzheimer disease [24]. Curcumin targets inflammatory and antioxidant pathways as well as (directly) amyloid aggregation, [25] although there may be problems with bioavailability and crossing the blood-brain barrier [26].

Multivitamin and Minerals (Solgar VM-75 without iron, 1 tablet/day). Combinatorial formulations demonstrate improvement in cognitive performance and the behavioral difficulties that accompany AD [27].

Coenzyme Q10 (200 mg, Nordic Naturals, 2 soft gels/day). CoQ10. May reduce mitochondrial impairment in AD [28].

Vitamin C (1 gram, Solgar, 1 tablet/day): Maintaining healthy vitamin C levels may have a protective function against age-related cognitive decline and AD [29].

Vitamin B12 (500 mcg, Solgar, 1 tablet/day): B12 hypovitaminosis is linked to the development of AD pathology [30].

Magnesium L-Threonate (Mg) (144 mg, Magtein, 2 tablets/day). A meta-analysis found that Mg deficiency may be a risk factor of AD and Mg supplementation may be an adjunctive treatment for AD [31].

Hericium erinaceus (Lion’s Mane, Stamets Host Defense, 2 grams/day): Lion’s mane may produce significant improvements in cognition and function in healthy people over 50 [32] and in MCI patients compared to placebo [33].

Super Bifido Plus Probiotic (Flora, 1 tablet/day). A meta-analysis suggests that probiotics may benefit AD patients [34].

What are all these pills doing? How do they interact? Because they sure do interact.

I quickly priced a few I was unfamiliar with, the Lion’s mane, Omega-3 with Curcumin, Solgar VM-75, Magtein, the probiotic. It might cost about $10 a day to take all these supplements. Do people regularly spend upwards of $300/month on dietary supplements? Do the researchers think they would?

It’s hard to say which component of the intervention had the greatest effect, or which may have been superfluous.

It’s really not that difficult, expensive, or time consuming to keep your brain healthy. Just get your cholesterol down in the 150 mg/dl range. You can do that by changing what you eat. See: What To Eat On A Plant-Based Diet (McDougall Starch Version)