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EngineerGuy responded:
Hi jc,

Interesting paper. I saved it to my computer when you posted it, and I'd like to thank you for posting it. I did learn several things from it.

May I offer comments from my perspective, for the consideration of anyone reading who might be interested? For anyone who does not know, I am a near vegan, following the Fuhrman Eat to Live program, similar to Pritikin, McDougall, Esselstyn, Ornish.

The purpose of the investigation in the paper appears to suggest what modification can be made to our Standard American Diet (SAD), to reduce the chance of Alzheimer's disease (AD). My answer is "good luck". I would propose a large change, not a small modification.

The paper discusses many studies that compare people all on the SAD. All the data mentioned in the paper acutally supports my thesis, but the authors do not realize it. For example, the authors say early Alzheimer's correlates with two factors:

"Several researchers have noted a strong correlation between insulin resistance in the brain and early AD, suggesting that AD might be considered a neuroendocrine disorder of the brain or so-called "type 3 diabetes" [8,9>."

"Others have noted an association of AD with mitochondrial
dysfunction [10>."

Adopting the Fuhrman diet strongly reverses insulin resistance, and strongly improves a person's exercise tolerance, which demonstrates improved mitochondrial function.

We know that the risk factors for Alzheimer's disease are exactly, precisely, identically the same as the risk factors for heart disease. We know that "native" populations have no heart disease, diabetes, hypertension or alzheimers.

So why is there no mention that native societies have no AD, in the paper?

High levels of Advanced glycation end-products (AGEs) are correlated with AD. Levels of AGEs plummet, on Fuhrman.

A fascinating secion of the paper suggests that infectious h pylori and other bacteria may be factors correlate strongly with AD. (I hadn't heard this.) No fear. The immune system is greatly strengthened by a diet high in vegetables.

Are we faced with a contradiction between avoiding heart disease, and avoiding AD, per this quote?:

"A study published in 2007 compared three elderly population
groups: subjects with dementia, subjects with depression, and
controls [29>. They found that those with dementia and depression had significantly lower serum cholesterol levels than the controls."

The authors did not mention that often cholesterol levels decline on their own, when the elderly near the end of life. This is possibly the body in the end decline. Lower cholesterol as a result of improved diet is a good thing. Lower cholesterol that lowers on it's own, is a bad sign. Trying to raise cholesterol by diet, in that case, will not help.

In the "Learning Points" section at the end, there is this unwarranted conclusion:

"Simple dietary modification, towards fewer highly-processed
carbohydrates and relatively more fats and cholesterol, is likely a protective measure against Alzheimer's disease."
We agree about eliminating refined carbs (white flour, etc). However, they seem totally unaware of an almost guaranteed way to make AD risk plummet, namely follow the mostly whole plant based diet route.

There obviously can never be a randomized controlled double blind study on AD to compare the SAD vs my diet (nobody cannot know which diet they are on), and AD takes too long to develop, etc). However, when viewed as a whole, blood values, animal studies, epidemiological studies, and nutrition studies overwhelmingly support the reduction of AD risk with a mostly whole plant based diet, with the concommitent weight loss, calorie reduction, and nutrition increase. Unfortunately, this paper appears to be completely unaware of any of this. The paper's recommendations, are highly speculative, and based on the quoted data, can at best provide a minimal improvement, and at the worst, be totally irrelevent or harmful.

Best regards, EngineerGuy
jc3737 replied to EngineerGuy's response:
EG,You did an good job of shooting that down.I know this is a debate forum and its my job to disagree but II can't find anything in your analysis to attack.

The strongest correlations with AD are AGE and insulin resistance which you point out are eliminated on the McDougall/Fuhrman/Essee diets,so it follows that AD should be elim on Fuhrman..
DoloresTeresa replied to jc3737's response:
EG, in following Fuhrman do you eschew potatoes, sweet potatoes, brown rice, corn and other whole food starches? Do you keep them to a bare minimum if you do eat them?

I eat more starches than Fuhrman uses in his six week eat to live diet but fewer than McDougall seems to use. And more beans and fruit as Fuhrman recommends. I only rarely eat nuts and seeds. Esselstyn's patients do not seem to need them.

jc3737 replied to DoloresTeresa's response:
I eat tons of starches(brown rice and 3 baked potatoes a day) and 3 cups of beans per day.I also eat plenty of nuts and a small raw salad with every meal.Hopefully,I'm getting the best of both worlds.

Low fat may be good for those with heart disease but as Fuhrman says low fat can also be bad for ones health casuing other problems.Essee may be right that for his patients with serious heart disease the problems caused by low fat may be minor compared to the threat of dying from heart disease.

However for those without serious heart diesase getting a good level of fat from nuts and avocados may be very healthy.
DoloresTeresa replied to jc3737's response:
If insulin resistance prevents cholesterol from doing its job in the brain, and lower cholesterol levels are associated with AD, then one wonders what will happen to diabetic patients who rely on meds rather than diet to control blood sugars while at the same time taking statins. Another reason to be wary of any drug that makes your numbers look good but which might be doing some kind of damage anyway.

It is easy to say that someone needs fat but hard to say exactly how much. I looked up the percentages of fat in some vegetables and found between 3 and 15 per cent in the ones I looked up. We are told by some that plant foods have ample protein if one eats a varied plant based diet. Why wouldn't the same hold true for fat in plant foods including whole grains?

jc3737 replied to DoloresTeresa's response:
Dr Fuhrman noticed that his patients that went on a low fat diet had a number of health problems so it would seem that the fat found in vegetables is not enough without adding some fat boosting foods such as nuts and avocados.

I don't know why Dr McDougall has not reported the same thing but at present I agree with Dr Fuhrman.
DoloresTeresa replied to jc3737's response:
what problems did he notice? The only one I do remember is tremor. My mother and grandfather had a tremor of their hands and they were by no stretch of the imagination low fat eaters. And nuts were often included in the family diet. I am surprised that Esselstyn did not remark about any of these problems in patients that he has been seeing for many years.

jc3737 replied to DoloresTeresa's response:
This is from pg 116 of his book "Super Immunity".

Fat Deficiency and Failure to thrive:problems from not getting enough fat:

dry skin
poor sleep
muscle cramps
thinning hair
high triglycerides
poor exercise tolerance

Getting enough fat has benefits:(from pg 117)

better muscle and bone mass
increased protection against cancer
prevention of cardiac arrthythmias
more effective reversal of heart disease
better absorption of phytochemicals from vegetables
lower tryclycerides
better antioxidant status
lower cholesterol
lower blood sugar
lower weight
DoloresTeresa replied to jc3737's response:
So do all the Asians on traditional rice diets suffer from the above? How much fat is enough? The one ounce of nuts Fuhrman recommends for overweight people?

jc3737 replied to DoloresTeresa's response:
I don't know.Thats something you would have to ask Dr Fuhrman,Those are things he observed with his patients he treated on a low fat diet.

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