On February 11th, we hosted a special version of the WAM Summit, this one honoring the work of WAM Research Grant recipients. Below we’ve given you a taste of the range of the research they are doing. Maria Shriver and Dr. Sanjay Gupta were our moderators. If you want to watch the entire hour, please click HERE.

 

Sanjay Gupta: Dr. Sanderlin, what do you hope to learn about the connection between a ketogenic diet and sleep specifically, and what do you think the relevance will be for the average person out there?

Ashley Sanderlin, PhD: What we’ve seen in the past is that a ketogenic diet is something that changes the way the brain works. When we reduce carbs, it causes our brains to increase more inhibitory signaling, which we think helps to reduce the accumulation of beta-amyloid in those who have MCI or Alzheimer’s disease. Inhibitory signaling reduces the neural firing that can become out of whack as we move into cognitive impairment. We’ve seen in previous research that the reduction in neural signaling seems to also help people with their REM and deep sleep stage, and the time that they spend in those sleep stages. 

So with our research, we’re looking at whether changing the diet of people who have a cognitive impairment may impact their brain function in a positive way, in this case, by reducing the neuro firing so that beta-amyloid does not accumulate at a rate that we would not want to see. And we hope to monitor whether this change in diet helps them get a better night’s sleep or increases the amount of time they spend in REM and deep sleep stages, both of which are important for memory consolidation. Our sleep hygiene, or the habits that we have related to sleep, are very important not just for our body health, but for our brain health as well.

Find more information about the Wake Forest School of Medicine here.

 

Maria Shriver: Dr. Brinton, we don’t hear a lot of talk about the connection between type 2 diabetes and Alzheimer’s. Are you saying sugar and Alzheimer’s go together or are connected?

Roberta Brinton, PhD:  The brain requires glucose, but it requires the right amount of glucose. And part of what happens during menopause for women is that there’s a change in the energy system of the brain to utilize glucose as its primary fuel. The brain is a Hummer, it’s an energy hog. It weighs 2% of the body weight and consumes 20% of the fuel. And that can actually put the brain at risk. Type two diabetes, a dysfunction in glucose metabolism, can put the brain at risk because it’s primarily dependent on glucose. And so when you dysregulate, you have a problem with glucose metabolism. The brain is actually the first organ to probably be affected. 

So maintaining proper glucose metabolism really benefits brain function and brain health. We know that type two diabetes is a risk factor for Alzheimer’s disease, so now we are looking into the therapies that are being utilized for type two diabetes, and what’s the impact on the risk of developing Alzheimer’s disease later in life.

 

Maria Shriver: If someone has type 2 diabetes or is on the cusp of it, and hasn’t been informed on how it might make them more susceptible to Alzheimer’s, what is the takeaway? You’re studying this right now, but what are some things people could do today?

Roberta Brinton, PhD:  There are a couple of takeaways: first, if there is a history of type two diabetes in your family, be very, very conscious of that. And discuss the therapeutic options (with your doctor.)  The other is, we can all purchase a glucose blood monitor, and do our own glucose testing at home in the morning when we wake up, a fasting blood glucose. And finally, keeping our weight in check. A big challenge for women and menopause is weight gain and that’s because the brain has switched to a different system of fuel. That menopausal transition is, in many respects, two things, a glucose metabolism transition, and a neurological transition. We think about it as reproduction, but it’s really so much about brain function.

For more information on the trial or if you would like to get involved, learn more here.

 

Dr. Sanjay Gupta: Dr. Mosconi, what do we know about hormones and a women’s risk for Alzheimer’s and what is your research?  

Lisa Mosconi, PhD: We’ve learned that women’s brains age differently than men’s brains and that menopause really plays a key role here for women, and we don’t talk about this enough. It’s important to know that estrogen is not only involved in reproduction and having children, estrogen is also a neuroprotective form and it literally gives energy to the brain by shielding the brain from harm.

So by using brain scans we demonstrated that many women show a decline in brain energy levels as they go through menopause. And we also show that some women start developing Alzheimer’s plaques during their perimenopause, and then during the onset of menopause. So that’s really important information to know because it gives us a timeline to start talking about Alzheimer’s prevention in women earlier than we’ve been doing so far as a clinical community. This is also important because by the year, 2030 1.2 billion women will be in menopause, all over the world. 1.2. billion.

This year, thanks to WAM, we’re looking into very practical information that women can put to their advantage because it is true that we’ve been doing so much work on menopause, but there’s so much more to women than just menopause. Women are exposed to estrogen throughout their entire lives. So we really want to focus on women’s entire reproductive history and find ways by which estrogen exposure may delay menopause, make it better, and also be protective against Alzheimer’s disease.

Find more information about the Women’s Brain Initiative at Weill Cornell Medicine here.

 

Maria Shriver: Dr. Cox, your study focuses on how the gut impacts the brain. What’s your thinking on probiotics,  and are they gender specific?

Laura Cox, PhD: Researchers have found in other experiments where they’ve given antibiotics to Alzheimer’s mice, that the antibiotics can clear the plaques, but only in males. And females, don’t get any protection at all. So, we do think that there’s going to be new probiotics that we can develop for Alzheimer’s disease and we think that they’re going to be different for men and women. Now, these aren’t, unfortunately, the probiotics, that you can take over the counter today, but we do think that very soon we’ll be able to identify the microbes and also the neuroprotective substances they produce so that we can hopefully develop new therapeutics for Alzheimer’s disease.

 

Maria Shriver: Is there something that today you know could be helpful in terms of diet?

Laura Cox: For diet, I always take a step back and I say, “do what your grandmother told you…an apple a day keeps the doctor away and eat your vegetables.” It turns out fiber is really important for promoting a healthy gut microbiome. So, making sure you have enough fiber in your diet is very important in our studies.

And then another thing to look at are compounds or dietary elements that have antioxidant properties, and there are these things called polyphenols and they seem to promote some of these good microbes as well. Polyphenols are very bitter tasting so they’re in things like raw cranberry, and other things like that. This came with Camu Camu powder, it’s a fruit from Brazil with a lot of antioxidants and a lot of vitamin C. So, I think those three things fiber, potential of calorie restriction but very cautiously, and potentially some antioxidants are ways to promote a healthy microbiome today.

Find more information on the Ann Romney Center for Neurologic Diseases at Brigham and Women’s Hospital here.

 

Sanjay Gupta: Dr. Ornish, on what does your new Alzheimer’s study focus, and what advice do you have for anyone wondering what lifestyle changes they can make to reduce their risk for developing the disease? 

Dean Ornish, MD: I’m currently conducting the first randomized trial to see whether intensive lifestyle changes that we found could reverse heart disease, type two diabetes, early-stage prostate cancer, lengthen telomeres, change gene expression can also stop or even reverse the progression of early-stage Alzheimer’s disease. 

These changes include a whole foods plant-based diet that is low in fat and sugar, moderate exercise, meditation and other yoga-based stress management techniques, and support groups or psychosocial support. Reducing it, in essence, to eat well, move more, stress less, and love more. That’s it. 

For more information on the trial or if you would like to get involved, learn more here.

 

Maria Shriver: Dr. Isaacson, what are you hoping to learn in your new study funded by WAM?

Richard Isaacson, MD: Our goal is to put together a precision communication plan for women of color. Two out of every three brains affected by Alzheimer’s are women’s brains, and women of color are at even higher risk. So we need to specifically address a roadmap for preventative care, communicate this, and really understand what the unique racial, ethnic, and cultural differences are. Then we need to see if we can give a targeted program to improve risk.

 

Maria Shriver: Why do you think women of color are at even greater risk?

Richard Isaacson, MD: There are unique risk factors, vascular risk factors: high cholesterol, diabetes, high blood pressure. These are unique vascular risk factors, but it’s even more complicated than that. There are genetic factors. Different people with different genes are going to have different outcomes. So what we need to do is really go down deep and understand why a specific woman is on the road to Alzheimer’s disease and get them off that road because different women may be sitting on similar roads, but they may be in the fast lane when a man is sitting in traffic. 

Find more information about the Alzheimer’s Prevention Clinic, Weill Cornell Memory Disorders Program here.