Updated on March 27, 2023
After watching someone you know struggle with dementia, the prospect of developing the condition yourself can be terrifying, especially given the fact that effective therapies continue to elude researchers. That’s especially true for those with a family history of Alzheimer’s and other genetic risk factors. Widespread public concern about dementia and Alzheimer’s risk have sparked decades of research on how to support brain health, including strategies that focus on food and nutritional supplements. Although this remains a broad area of research exploration, the strongest published data suggests that special diets (like the Mediterranean diet), specific foods (such as olive oil and coffee), and certain nutritional supplements (including phenolic compounds like curcumin and quercetin) can make a difference. If you are concerned about Alzheimer’s and dementia, then food support could be the best place to start.
The Mediterranean Diet was first identified as a possible strategy for Alzheimer’s disease based on observations of longer life expectancies and lower incidence of Alzheimer’s disease in the Mediterranean region, particularly around Naples, Italy. Unlike other specialized diets, the Mediterranean Diet is not strictly defined but generally understood to include high consumption of fruits, vegetables, whole grains, beans, nuts, and seeds, combined with moderate consumption of fish, poultry, and dairy products. The diet is also characterized by a low level of red meat consumption.
During the last several decades, a combination of laboratory, clinical, and epidemiological studies highlight the Mediterranean diet as a possible measure for combating Alzheimer’s disease. For instance, a community-wide study was conducted on 2,200 individuals in New York between 1992 and 1999. The participants’ diets were monitored every 1.5 years, and the researchers reported a statistically significant association between adherence to the general principles of the Mediterranean Diet and Alzheimer’s disease risk.
More recently, researchers have taken advantage of advanced technology to provide more solid evidence for a connection between the Mediterranean Diet and Alzheimer’s disease. In 2018, researchers at the University of Florence published a breakthrough study in which they used brain imaging to examine the neurological biomarkers of Alzheimer’s disease in individuals who adhered closely to a traditional Mediterranean Diet, as opposed to those who did not. The participants ranged in age from 30 to 70 years old, and the study lasted three years. Based on a combination of clinical and neuropsychological measures, the researchers estimated that adherence to a Mediterranean Diet could provide between 1.5 to 3.5 years of protection against Alzheimer’s disease. Although they caution that further investigations are necessary, the results indicate the Mediterranean Diet has clear potential as food support for Alzheimer’s disease.
Some critics of the research on the Mediterranean Diet warn that the diet is too general to produce reliable research results. Although the researchers who have studied the effects of the Mediterranean Diet developed rigorous methods for measuring patients’ adherence to the diet, these intricate scoring schemes can be hard for patients (and even clinicians) to understand and implement. Put more simply: it’s too hard for a person to know if their Mediterranean Diet is similar enough to those of the study participants for whom improvements were observed. Therefore, some researchers have begun to look at the specific benefits of individual components of the Mediterranean Diet, which can be more easily integrated into a patient’s daily meal plan. One of the most promising foods is extra-virgin olive oil—a characteristic element of the Mediterranean diet.
In the past few years, several animal studies offer strong evidence that extra virgin olive oil provides support against Alzheimer’s disease. For instance, in a 2015 study at the University of Louisiana, researchers observed that exposure to extra virgin olive oil reduced amyloid beta and tau buildup—both of which are hallmarks of Alzheimer’s disease onset and progression—in the brains of mouse models of Alzheimer’s. In 2017, another study confirmed these findings in mouse models, indicating that extra virgin olive oil could inhibit the amount of amyloid beta deposition and overall buildup in mouse models while lowering the amount of phosphorylated tau protein. The researchers also propose the activation of cell autophagy as a potential mechanism through which these anti-Alzheimer’s activities might be mediated.
The most recent studies in the field are providing increasing insight into the specific mechanisms through which the compounds in extra virgin olive oil could be supporting neurons during the onset and progression of Alzheimer’s disease. For instance, one study in the journal Advances in Experimental Medicine and Biology highlighted the role of olive oil-derived phenolic compounds—especially oleuropein aglycone and oleocanthal—in several key processes related to Alzheimer’s disease onset: amyloid-beta peptide and tau aggregation, the impairment of autophagy, and neuroinflammation. These multifunctional phenolic compounds not only have antioxidant activities that help reduce inflammation in the brain, but they are also associated with the activation of autophagy and the regulation of other pathways that are relevant to the disease development process, such as the phosphorylation of tau protein. Because it appears that olive oil-derived phenolic compounds target Alzheimer’s disease from multiple directions, it is a particularly appealing form of Alzheimer’s and dementia food support.
Although the increased consumption of certain foods is one possible way to modulate dementia and Alzheimer’s disease risk, some clinicians and patients prefer more targeted strategies. This has sparked research on which nutritional supplements can best support cognitive health. The nutritional supplements that show the most potential are plant-based, multifunctional phenolic compounds well-known for their antioxidant activities.* Considering that the Mediterranean Diet contains many foods that are high in these compounds, this should come as no surprise.
One of the most promising polyphenolic compounds is curcumin, which is derived from turmeric. Curcumin could provide support for maintaining cognitive health in many of the same ways as the phenolic compounds in olive oil. According to a 2017 review of in vitro and in vivo research, studies indicate that curcumin can resist the formation of amyloid plaques, promote the disaggregation of existing plaques, modify microglial activity to improve neuroprotection, disrupt the oxidative processes that contribute to inflammation, and regulate other pathways with known relevance to diminished cognition.* Because the data indicate that curcumin can have broad beneficial impacts on the brain when it comes to neural health, the authors conclude that it has “the potential to be . . . efficacious . . . .”
However, the researchers acknowledge that curcumin has a naturally low level of bioavailability. That’s why it’s better for curcumin to be taken in supplement form rather than in the form of food; i.e., because curcumin is so poorly absorbed in the gut, it is nearly impossible to add enough of it to food to make a clinical difference. Therefore, choosing a curcumin supplement that is scientifically formulated for bioavailability is the best way to take advantage of the multiple benefits of this phenolic compound for maintaining long-term cognitive health.*
Another phenolic compound that has shown promise for maintaining long-term cognitive health is quercetin. Quercetin is naturally found in some of the foods that characterize the Mediterranean diet, including leafy greens, red wine, citrus fruit, and garlic. Quercetin is also the key phenolic component in coffee, another food known to have potent neuroprotective effects. In fact, in a study conducted by researchers at the University of British Columbia in 2016, it was quercetin—not caffeine, as others had previously proposed—that was found to be the major neuroprotective component in coffee.* Like curcumin and the phenolic compounds in olive oil, quercetin helps maintain long-term cognitive health through multiple mechanisms, including the attenuation of the release of several key inflammatory proteins and the regulation of key proteins in several cell signaling pathways associated with cognitive dysfunction, such as the MAPK pathway and the NFkB pathway.
Another study out of the University of Kentucky indicates that the exposure of primary neurons to quercetin can inhibit the accumulation of amyloid beta, similar to curcumin and the phenolic compounds in olive oil.* The researchers measured free radical production in neurons in cell culture, and their findings suggest that the effects of quercetin are partially mediated by the compound’s antioxidant activities. After exposure to quercetin, the researchers observed lower levels of amyloid beta-related cytotoxicity, protein oxidation, lipid peroxidation, and apoptosis. When considered in the context of the other studies on phenolic compounds, these data further support the notion that phenolic compounds help maintain long-term cognitive health through multiple mechanisms.*
When it comes to maintaining long-term cognitive health, especially in the context of healthy aging, there is no clear consensus on which foods are best, although strong evidence points to the benefits of the Mediterranean Diet, especially phenolic-compound-containing elements like olive oil. Because food is not always the best way for patients to consume the compounds that support neural health, researchers are also exploring supplement options, with phenolic compounds like curcumin and quercetin showing particular promise. More comprehensive studies in the future will help clarify the clinical benefits of different dietary options, but clinicians and patients can already make health choices based on the strongest studies, using what is known to take action today.
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