Are we thinking about Alzheimer’s the wrong way?

Alzheimer’s Talks host Meryl Comer spoke with best-selling author Dr. Mark Hyman of the UltraWellness Center and Cleveland Clinic, about his field of functional medicine and its innovative approaches to Alzheimer’s and dementia.

“We are in an exciting time in medicine where we’re realizing that the ways we think about disease don’t really fit the chronic illnesses that we have,” Dr. Hyman said. “We need to rethink our whole approach, particularly around the brain.”

He believes we should shift from seeking a single disease path or drug, to a more dynamic framework that considers the many factors that may contribute to Alzheimer’s—and then tailoring therapy to the individual.

Press the 'Play' button under the image at left to hear the full conversation.

“There are a few fundamental things that drive all disease, whether it's heart disease, cancer, dementia or diabetes,” he said. “Chronic illnesses that are affecting one out of two Americans have these common roots, yet we treat them all separately.”

He noted that silos in medicine are breaking down but that progress is still needed. “Particularly around the brain, we're understanding that it's connected to all these other diseases by common pathways,” he said. Those pathways include inflammation, mitochondrial issues, microbiome and nutrition. “I think when we treat the root causes, all the problems tend to go away.”

For Alzheimer’s, functional medicine analyzes these variables to find dysfunction and imbalances, using what Dr. Hyman calls a cognoscopy. A functional medicine model for Alzheimer’s might look like an immersion program, educating patients and their families on diet, exercise and sleep best practices, optimizing their health and iterating over time.

Diet plays a critical role in brain health, he says. He is a firm believer that you are what you eat, and the idea of food as medicine has been a focus of his work for decades. “In order to build tissues, to build brain cells, to regulate your immune system, to regulate your microbiome, you’re actually required to have the right nutrients and ingredients,” Dr. Hyman said.

The American diet has moved from an unprocessed, whole foods diet to a highly processed, industrial diet. “This has had a huge impact on our biology, particularly the brain,” Dr. Hyman said. Over the last 40 years, our diet culture has included a fear of fat, which led to increased starch and sugar intake. “If you're really looking at the one thing driving so much chronic disease, it's the level of starch and sugar in our diet.”

“Our brains are made mostly of fat. We need all the good fats that help our brains function,” he said. “I think food plays a huge role and is a huge lever for change, both in terms of prevention as well as treatment.”

Comer and Dr. Hyman discussed an upcoming report from our ResearchersAgainstAlzheimer’s network analyzing the science behind lifestyle changes that seem to delay, slow or reduce risk for Alzheimer’s. The report shows strong levels of evidence for including chocolate, essential fatty acids such as Omega-3, and B-vitamins. Supplements are one way to help get those nutrients, but they can be tricky because of the lack of regulation of supplements.

Dr. Hyman described it as very exciting. “We need to realize we can’t just focus on drug targets. By focusing on the non-pharmacologic targets, we’re going to be able to actually advance the field further.”

To optimize our bodies’ systems, the keys are diet and exercise. Sleep hygiene is also critical for long-term brain health. “At night your brain has a special system that cleans itself up, called the glymphatic system,” Hyman said. “It literally gets rid of all the waste products and everything that's going to create inflammation and oxidative stress and all the things that cause dementia.”

In addition, excess stress can shrink the hippocampus, a mark of Alzheimer’s. Dr. Hyman recommends stress reduction to clear out stress hormones. “Meditation is one of the most powerful things to improve the function of your brain.”

To succeed in making lifestyle changes to prevent, reverse or delay disease, he said the answer may lie in our social networks and peer pressure. “It’s about our ability to help each other change our behavior.” It’s never too early—or too late—to start making these changes, he said.

More research is needed, especially as functional medicine would be such a different way of delivering health care. Hyman said, “The solution is putting everything together in a personalized way for each person, to optimize their health, and that will help the brain as well.”

In closing, Comer encouraged viewers to visit bebrainpowerful.org to sign up for the 30-day brain health challenge, which offers daily things to do to take care of your brain.