The authors, two qualified neurologists, have developed an empirical and scientific based approach to reducing and preventing the symptoms of Alzheimer’s disease. I read this book fairly shortly after reading the equally excellent “The End of Alzheimer’s” by Dale Bredesen. As can be expected both respective authors/books approach to managing and reducing the risk of Alzheimer’s Disease (AD) overlap a lot. Their approaches are based on healthy lifestyle modifications.
While Bredesen is mainly focused on nutrition and fasting, the Sherzais have a more multidimensional approach including also exercise, meditation, sleep, and building cognitive reserves (exercising your brain in different ways). Bredesen does touch on some of those subjects but often merely in passing. In contrast, the Sherzais dedicate an entire chapter on each of those subjects, including surveys of self-assessment and plans for self-improvements in each of those areas.
The Sherzais are also really strong in explaining the different causal mechanisms that cause AD including: 1) oxidation; 2) inflammation; 3) glucose dysregulation; and 4) lipid dysregulation. By contrast, Bredesen is mainly focused on inflammation. He also mentioned inadequate nutritional and hormonal support to the brain as a second factor and toxicity (mercury, etc.) as a third factor. However, on this count I do find the Sherzais explanation of AD much more thorough from a physiological standpoint.
Just about all the Sherzais’ earmarked chapters addressing any single topic are excellent. Even a mundane topic like exercise is really insightful. They also make suggestions that are original and helpful. What you get is that our sedentary lifestyle is slowly killing us. Sitting all week behind a computer then running a half marathon on the weekend is not optimal. The human body was made to be in almost permanent motion. So, they recommend you do a little exercise just about every hour on the hour. It could be for just a minute. But, it is a lot better than nothing. Also, what you get is that exercise is truly a brain-rebuilding machine. Exercise can literally regrow brain cells, brain matter and neuronal pathways. Similarly, their last chapter on optimizing your brain (building cognitive reserve) is truly outstanding and is genuinely encouraging. By engaging in mental and social complex activities, you develop numerous neural pathways that create a healthy redundancy. Later in life if your brain has some of the physiological symptoms of AD (amyloid tangles, tau plaque) that impair some of those pathways, you will have enough other pathways whereby you could still be 100% cognitively fit. They call this building your cognitive reserve.
There is one chapter where one has to express reservation, and it is the one on nutrition. They stick to a low fat, low cholesterol mantra relying on the research by Ancel Keys dating back to 1951. We now know his research was highly biased, and his conclusion very much wrong. Extensive scientific rebuttals have been disclosed in numerous books. Probably the best one on the subject is Uffe Ravnskov’s “The Cholesterol Myth” published in 1999. But, other current books also hammer away on the fallacies of Keys’ studies, including Dr. Mercola’s “Fat for Fuel” among many others. In view of the Sherzais diverging views on nutrition, they constantly warn against the profound ill impact of saturated fats and eggs (cholesterol). Well, in both cases they are deemed inaccurate by many other neurologists and nutritionist experts much concerned about overall health and the health of the brain. In this camp you will find not only Ravnskov and Mercola, but also Dale Bredesen, and Steven Gundry (the author of “The Plant Paradox”).
Among Ancel Keys followers there is much confusion regarding saturated fats. They are known to boost LDL cholesterol, which is deemed the bad cholesterol. However, LDL cholesterol is subdivided into two different categories: small, dense LDL vs. large not so dense LDL. The small LDL is a heart disease risk. The large LDL is not. And, it is the one that saturated fat enhances. Thus, from this standpoint saturated fats do not cause heart disease. Additionally, saturated fats are associated with numerous health benefits including enhancing absorption of numerous vitamins and minerals, boosting HDL levels (the good cholesterol), enhancing mitochondria energy metabolism, contributing to brain health (the brain does need much fat to function).
Another area where the Sherzais impart questionable information is concerning the overall risk of AD. On page 22, they indicate that if you have no ApoE4 genes, you have a 50% risk of developing AD by 85 years old. 23andme, a genetic testing company, relying on a very large sample of Caucasians, discloses an AD risk that is more than 5 x lower than the Sherzais. They come up with a risk of 5-8% for men and 6-10% for women. The Framingham Study comes up with an overall risk of AD (that does not exclude individuals that have the ApoE4 genes) by 85 years old of 12% for men and 20% for women. I have mentioned those data divergences to the Sherzais. And, they have not responded. I suspect they never will.
The two above caveats (nutrition and AD risk) are material. And, this is why I can’t give this book a 5 rating. Otherwise, the book is excellent and still warrants a very strong 4 rating. Additionally, the Sherzais have provided much supplementary information to Bredesen’s book on the same subject. By reading both books, you will know much more about AD then reading just either one of them.