Dean Sherzai, M.D., PhD. and Ayesha Sherzai, M.D., The Alzheimer’s Solution

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sherzai*Recent findings about the impact of lifestyle changes—diet, exercise, sleep, stress reduction, and healthy challenges for our brain—support the premise of this new book by leading experts in brain health.
The Alzheimer’s Solution asserts great news about a dreaded disease: 90% of Alzheimer’s disease cases are preventable through lifestyle factors. While medical advances have extended our lifespans, keeping our hearts and bodies active into old age, brain science has lagged behind. Over 50% of individuals over the age of 85 suffer from Alzheimer’s, dementia, and debilitating cognitive decline.
The Alzheimer’s Solution is the first book for a wide readership to offer a solution to Alzheimer’s, and is essential reading for both health professionals and laypeople. The authors are leaders in the field of Alzheimer’s and cognitive health and co-directors of the Alzheimer’s Prevention Program at Loma Linda University Health (Loma Linda, CA is America’s only Blue Zone).
Ayesha Sherzai is also a professionally trained cook with an emphasis on brain health. The book provides 25 easy-to-make recipes that feature the healthiest foods for the brain.

Ayesha Sherzai, MD, is Co-Director of the Alzheimer’s Prevention Program at Loma Linda University Health, where she leads the Lifestyle Program for the Prevention of Neurological Diseases. She completed a dual training in Preventative Medicine and Neurology at Loma Linda University, received a Masters degree in Advanced Research Methodology from UC-San Diego, and completed a fellowship in Lifestyle and Vascular Brain Diseases at Columbia University. She will soon complete a PhD in Epidemiology from Loma Linda University, where her dissertation focuses on nutrition and its role in cognitive aging and neurological disease. Ayesha has published more than a dozen scientific papers, and in 2015, she won the American Heart Association’s Trudy Bush Fellowship Award for Cardiovascular Disease Research in Women’s Health. She is the lead researcher in the landmark study at Loma Linda that investigates the effects of a comprehensive lifestyle intervention on individuals at risk for Alzheimer’s.

Dean Sherzai, MD, PhD, is Co-Director of the Alzheimer’s Prevention Program at Loma Linda University Health, where he was previously the Director of the Memory and Aging Center as well as Director of Research. During his years at Loma Linda, a Blue Zone community where residents live measurably longer and healthier lives, he was the lead scientist studying the effects of healthy living on cognitive aging. Dean trained in Neurology at Georgetown University School of Medicine and completed fellowships in neurodegenerative disease and dementia at the National Institutes of Health and UC-San Diego, where he studied under Dr. Leon Thal, one of the world’s most renowned dementia researchers, and Dr. Dilip Jeste, the world’s foremost specialist in cognitive aging. He also holds a PhD in Healthcare Leadership with a focus on community health, and a Masters in Public Health from Loma Linda University, where his research focused on the prevention of cognitive decline through lifestyle changes. Dean has won several awards and published numerous scientific papers, including comprehensive reviews on nutrition and neurodegenerative disease and a recent meta-analysis of cognitive training and memory improvement.

More at www.teamsherzai.com

Since 2009, It’s All About Food, has been bringing you the best in up-to-date news regarding food and our food system. Hosted by Caryn Hartglass, a vegan since 1988, the program includes in-depth interviews with medical doctors; nutritionists; dietitians; cook book authors; athletes; environmental, animals and health activists; farmers; food manufacturers; lawyers; food scientists and more. Learn about how we can solve many of the world’s problems today and do it deliciously, here on It’s All About Food.

TRANSCRIPTION:

Caryn: Hello everybody. I’m Caryn Hartglass and it’s time for It’s All About Food. Thank you for joining me today. You are going to learn so much during this program and once again, we will discover how it truly is all about food. This time it’s about the Alzheimer’s solution. I can’t wait to get started. I have the authors of this new book, The Alzheimer’s Solution, which is coming out next week. We have Dr. Ayesha Sherzai MD and Dean Sherzai MD PhD. Ayesha is the co-director of the Alzheimer’s Prevention Program at Loma Linda University Health where she leads the Lifestyle Prevention Program for the prevention of neurological diseases. She completed a dual training in Preventative Medicine and Neurology and Loma Linda University. Received a Master’s Degree in Advanced Research Methodology from UC San Diego and completed a fellowship in Lifestyle and Vascular Brain Diseases at Columbia University. Dean Sherzai MD PhD is also co-director of the Alzheimer’s Prevention Program at Loma Linda University Health, where he previously was the Director of Memory and Ageing as well as Director of Research. During his years at Loma Linda, a blue zone community where residents live measurably longer and healthier lives. He was the lead scientist studying the effects of healthy living on cognitive ageing. Dean trained in Neurology at Georgetown University School of Medicine and completed fellowships in Neurodegenerative Disease and Dementia at the National Institutes of Health and UC San Diego where he studied under Dr. Leon Ty- one of the world’s most renowned Dementia researchers and Dr. Philip Jest- the world’s foremost specialist in cognitive ageing. He also holds a PhD in Healthcare Leadership with a focus on Community Health and a Master’s in Public Health from Loma Linda University where his research focused on cognitive decline through lifestyle changes. Welcome to It’s All About Food, Ayesha and Dean.

Ayesha: Hi Caryn, thank you so much for having us it’s a pleasure to be here.

Dean: Hi Caryn.

Caryn: The pleasure is mine. I’ve been carrying around your book all week. It’s been a very unusual week for me because I have ageing parents and we spent a lot of time this week in clinics and the emergency room. It was an interesting time. I carried this book around showing people the title because I wanted to engage in conversation and share everything that I learned. Let’s jump in and talk about this very, very important book. The first thing I wanted to talk about was your brave choice to pursue lifestyle research. Can you share that story and the choices that you made to do that?

Dean: Yes. This came out of years of working in clinics. Both in the hospital in the clinics and realizing what we have in the clinics in the hospital is not healthcare, it’s a disease care model. By the time patients come to us, disease has fully manifested and then if you want to reverse it, that’s not the best place to do so. You can give some information, but usually patients won’t accept it. Health care takes place in the home, in the community. Health care takes place in conversations like what you’re doing probably more than any physician. This is why we decided that although there isn’t a lot of research or funding in it, it is actually the most important thing we can do. Given that both of us saw two of our brilliant grandparents dying from Alzheimer’s, we knew the approach had to be different. When we came to Loma Linda, we chose to come to Loma Linda from UCSC was because this is the place lifestyle is not just studied but lived. From validated data shown.

Ayesha: We had the privilege of working with different researchers with different Universities in Loma Linda University and Columbia University and just essentially learning more about the impact of lifestyle on diseases. We realized that, like Dean said, what we do is essentially [disease] care, and we need to get out of this model and promote lifestyle.

Caryn: You write early in the book that this lifestyle research is important and yet there’s very little coverage in the mainstream media and the scientific interest is negligible. You say this is not a conspiracy, this is a cultural disconnect. A lot of us really think that it is a conspiracy. The pharmaceutical companies benefit with the drugs, and the fast food companies, they seem like they’re all together in it like making us sick so that we get the drugs. Everybody seems a part of this craziness.

Dean: From our perspective it doesn’t seem to be conspiracy in that sense. The meat companies want to make money and they will obscure the data the way they want to. All the sudden paper comes out on eggs and nobody checks where the source is and who funded it and how strong the paper is. The next day Time Magazine comes out that eggs are no longer bad for you. Or butter…what was it? Butter is no longer…butter is back. It’s not that. You’re pushed on what would be popular and what people want to hear in fact. This is this obscuration, industry driven. This happened with the cigarette industry and it’s still happening. For decades, and it’s happening again when it comes to the kind of foods we eat and the kinds of resources. I don’t think it’s a collaborative kind of a thing. The meat industry is trying to do whatever to sustain their footprint. But, the data had never been in question.

Ayesha: I also think it has to do a little bit with our desire for quick fixes. We’re always looking for a diet du jour, a pill, a vitamin, a very quick fix of what the problem is. We’ve been demanding it from the health industry. So, the doctors, in order to have that satisfaction, they essentially end up pushing pills. On the other hand, I think there’s very little faith in the general public’s capacity to take care of themselves.

Dean: From the physician’s perspective.

Ayesha: From the physician’s perspective. A lot of us are trained in medical school believing that we’re not able to change our lifestyle. We’re not able to eat healthier; we’re not able to exercise. That’s all we’ve assumed when the patient contacts the doctor. It’s just this viscous cycle that we’re stuck in and hopefully we can come out of it.

Dean: Now let’s look at the physician’s life history. 4 years of college and a lot of them their Mom and Dad told them. I’m going to get myself in trouble there. So they go 4 years of college, very focused, nothing else as far as prevention, lifestyle in there they’re not the ideals. Then 4 years of medical school. Then 4 years of residency. Then 4 years of other stuff. Now already you have 16 years, 12 years to 16 years gone by and all you’ve done is look at disease. A cursory little class here and there on prevention, which most of the students didn’t attend. They don’t believe it, even though right now when we actually bill patients- we have to write down that more than 50% of our time was spent giving education. Everybody does it, but they don’t give more than 50% education. I know this for a fact. The disconnect comes because we’re not trained on the physician side and therefore we don’t believe what we’re not trained in. Then on the other side, the industry pushes what they have to market their product.

Caryn: I’m laughing because when I visit a physician I spend most of the time educating them.

Dean: Absolutely.

Caryn: I love that you write, that when we nourish our bodies we nourish, we strengthen our brains. And if we fail to do that, if we fail to nourish our bodies, we fail to nourish our brains. It’s all connected. You were talking about how people believe that the brain is very different from the rest of our bodies.

Ayesha: Yes. So there’s somehow there’s this perception that the brain is a completely foreign object that is completely outside the realm of the body. Whatever we do to it, it’s been blocked. It’s like a black box. But, it’s one of the most; well it’s the most important organ in the body. It never stops working, it’s on 24/7 and it weighs only about 3 pounds but it consumes more than 25% of the body’s energy on a regular basis. So whatever we do to our self actually effects the brain first, and all the other organs second. It’s one of the most resilient and at the same time, one of the most sensitive organs. If we eat well, if we sleep well, if we exercise and do all the other lifestyle important factors, it actually affects our brain. And if the brain is healthy, the rest of the body’s going to be healthy as well. More important than just the physiological change, I think if we’re happy and if our emotions are stable, we actually have the motivation to take care of ourselves. Food and exercise and all the other lifestyle factors actually do that.

Dean: In the book, we say that if you work on fixing the brain, or healing the brain, you don’t have to worry about the other organs. Because whatever you’re doing for the brain, it’s the same things you would be doing for the heart, or the liver, or the kidneys. At the same time, you’re working on motivational centers, emotional centers, and everything else. But that’s why it’s so important to focus on the incredible organ. As Ayesha said, it is the most sensitive because it’s overwhelmed. We talk about sugar at some point. We say that I’m going to age myself a little, the Pinto old car, one of the worst cars and if you put it on junk food, on sugar, on saturated fats, at 24 hours a day you’re going to run it down. It’s going to break apart. But if you take care of it, it actually forgives you. It’s forgiving. It’s incredibly forgiving. So that’s why we’re actually moving toward the brain-centered health system basically.

Caryn: On this program, It’s All About Food, which I’ve been doing for about 9 years. I’ve talked to lots of experts and I see the people who are praising your book, Dr. Joel Fuhrman, T. Colin Campbell, Dr. David Katz. We’ve all talked about the benefits of a whole, plant based diet and how it can prevent and reverse heart disease, prevent and reverse diabetes, reduce dramatically your risk of cancer, and all kinds of other chronic diseases. But, I’ve never seen this information applied to Alzheimer’s and Dementia. So many of us believe that we hit 85 if we are lucky to even get to 85, it’s just natural to lose our minds.

Ayesha: Right, right. I think the data is, it’s 12:39 now. I had the privilege of working with some of my mentors at Columbia University where we studied large populations and how dietary patterns affected them. It was quite clear with that, a diet that is primarily plant based, a whole foods plant based diet, among the population of about 144,000 showed results in reduction of Alzheimer’s disease and stroke and other disease of the brain. We actually have experience of working with this directly, and then there’s so much data from so many years coming from studies like The Nurses Health Study, and The Health Professional Study, and scientists in Harvard and here in Loma Linda. Loma Linda was actually one of the first places where they studied the consumption of meat and how it affected brain. They found out that the chances of having cognitive impairment was very high among people who ate meat compared to those who ate essentially a plant-based diet.

Caryn: This is very exciting. So people who have what they believe is a genetic disposition to Alzheimer’s, they may actually have things that they can do to reduce that risk significantly?

Ayesha: By all means. Absolutely. We believe that there are certain genotypes that if somebody has it, they’re bound to have Alzheimer’s disease no matter what. At an early age. But those are less than 5% of the population. For the rest of us, for the rest of the 95% of the population we can actually prevent the disease and push it by 15-20 years. That’s the message that we actually give in the book. I think the genetic variation or the genetic predisposition of Alzheimer’s disease has been exaggerated quite a bit. It’s just not that way. We now know that food is probably one of the most important environmental risk factors in developing the disease.

Dean: There are diseases where if you have the gene you’re going to get the disease. Huntington’s Disease is one of those. Some of the other ones. For a lot of the chronic diseases of ageing, genes basically give you a range. So far, they’ve identified close to 30 genes associated with Alzheimer’s. These genes are not anything in particular that say they’re Alzheimer’s disease. These are genes that have to do with inflammation or body’s response to inflammation. Immune response, body’s vascular resilience, and what they call garbage disposal, lysosomes. Getting rid of waste. Basically, those genes tell you how good your body is in maintaining health and fighting disease. That gives you a range anywhere, 10, 20, 30, 40 years. What you do though, throughout your life, determines if you’re going to move that edge that precipice closer to your 60′s and 70′s or way out into the 100′s. That’s the picture of genes in Alzheimer’s. I said there are about 5% of Alzheimer’s are presenilin 1, presenilin 2 and APP; those are, even those can be affected by genes. We looked at the population down syndrome population who have a high risk of Alzheimer’s and even that population lifestyle had significant effect on developing Alzheimer’s. It’s time to, yes we look at genetics, we look at how genetics affect a person. The genetics actually, in the next 10 years will become more important as far as what type and what areas and what manifestation and what are your risks and what you should do in your life because you have this risk. You can vascular risk so you should do this. So, in that sense, genetics has been pushed back as secondary and lifestyle is the thing that affects everything else.

Caryn: You have a number of testimonials in the book. Stories about people who came seeking assistance with their cognitive decline. Can you share the most dramatic recovery you’ve ever seen?

Dean: There are many. One thing we want to say is there are others who have written books about reversing Alzheimer’s. We’ve never made that claim. I think science says that it’s irresponsible to say that. The data that the people have presented has been questioned by everybody. But, even people who have Alzheimer’s can be affected significantly as far as lifestyle by slowing down the disease quite a bit. Also, more importantly affecting the quality of life and awareness and alertness and all of that. We’ve spoken about that. The populations that we’ve affected significantly are those that are right at the edge or have Pre-Alzheimer’s, Pre-Dementia and there isn’t one, but dozens of cases. A lady who came in who had significant cognitive decline to the point that there was although she could still do everything, it was effecting her driving to an extent, and it was effecting her ability to do her finances. Yet, when we instituted the lifestyle change, which took some time, this is when we tell people you have to be patient. You have to build around your strengths and that’s actually not a part of the book. Step-wise. It’s not an all or nothing phenomenon. So don’t worry. Slowly. When we did this with this lady, she actually came back saying she was better than ever before. I don’t know if I believe that, but we definitely saw complete reversal of symptoms.

Ayesha: We also have objective evidence of her blood test and of her cognitive tests that actually showed so much improvement. She came in and she was a big mess. She had a lot of inflammatory markers, her sugar was high, her cholesterol was just off the roof. She was, her attention scores were just horrible. It was less than the 20th percentile. She was a very, very high functioning woman. She had her own business, she had a law degree, she was taking care of so many other corporations. So this is somebody who worked quite a bit and she always complained of brain fog and it was amazing to see her get better with all the lifestyle measures.

Dean: With every step that she was improving, that was actually motivational factor. One of my definitions, or our definition for motivation is its repeated successes. Stepwise successes and that builds the motivation. So we’ve had many successes like that and especially when we build the program around the person’s own capacities and strengths, that was significant.

Caryn: I love this book for so many reasons. One of the reasons is it’s your voice, your voices are compassionate, easy to understand, you speak to us in ways we can understand complicated concepts. I love most your stories about how you’ve transitioned, and how you admit that there were challenges that you had to learn to like dark chocolate instead of sweet milky chocolate. The little things that we love that are important for many reasons, how they connect to different things in our life and we have to work to make change. I really appreciated that.

Ayesha: Thank you. Thank you. I appreciate that comment because to be honest with you, I think that’s at the core of everything. Learning and knowing what the other person goes through to make changes of lifestyle, that empathy part. We pride ourselves in our education and the research opportunities that we’ve had, but it comes down to sitting in front of somebody who is devastated. Day in and day out. Devastated because they can’t remember. You see the sadness and the tears in the family’s eyes. You see how this amazing, incredible person who was free, who was strong, who was living the life, is now beholden to somebody to take them to the restroom. That’s painful. Instead of showing them with medication, we realize that there are other ways to help them. One of the reasons I actually went to cooking school when I was a fellow at New York at Columbia University was just that. I realized that if I talk about hypertension and hyperglycemia and high cholesterol for my patients. Most of this just goes through and they really don’t understand what’s going on. But, if I spend 10-15 minutes of my time and show them how to make a bean, lentil chili, because it’s actually good for them. It has plant proteins, it has fiber, it’s low in saturated fats and if they replace one of their meals with that. Then make a chickpea sandwich for a snack and get rid of that BLT sandwiches they’ve been eating for the last 10 years. That’s progress. That’s moving in the direction of betterment.

Caryn: That’s healthcare, thank you. Absolutely. Everything in this book, not just the data which is so necessary, but how to do it. Everybody who listens to this show, maybe there are so new folks who are listening, what we talk about is healthcare is delicious. It’s not deprivation and when you take the time and energy and learn these new things, you’ll love it.

Ayesha: Absolutely, absolutely.

Caryn: Now, you are a couple and you have children. How old are your children?

Ayesha: Our children are 12 and 10. Alex is 12 and Sophia is 10.

Caryn: And you’ve brought them along with this healthy lifestyle of course?

Ayesha, Absolutely. They’ve been raised in a healthy environment.

Caryn: OK, so I’m just wondering if you’re sitting at the table and the two of you are chatting about your work, are the kids like rolling their eyes and saying no, not amyloid plaque again.

Dean: No, no. They have a website called thesciencekids.com so they’re very much into science and the brain and programming for some reason. I don’t know where they got that one from. Programming and they do all these kinds of videos on health and the signs of health on their website, trying to teach kids about healthy living. So they’re very much into the conversation and ironically, they actually bring up and question and challenge, and that’s actually something that’s very open in our family. Challenge every idea. We come up with an idea and their job is to challenge it. We have open conversations about it. We’ve talked about food, we’ve talked about the challenges we face, the environment, animal activism and all that stuff. But most importantly, they’re open to ask their own questions and challenges any time.

Caryn: I may have to have your children on your show some other time. They would probably be great guests.

Ayesha: They’d be happy to.

Dean: They would be happy to.

Caryn: Fantastic. One of my favorite lines in the book is, “Your rescue is in your stories and what made you who you are.”

Dean: We’ve written about the concept of islands of consciousness. Who are we? Where does that reside? That’s where your recovery of the brain takes place. I don’t know if you remember the story of Ms. Collins of course that’s not a real name but for privacy sake. Who had Dementia and was sick and one day she was in the hospital for a month and I was rounding with all these residents. They told me this is Ms. Collins and she has this and this and this. She has not spoken for 2 months. She just looks straight in the room. I said so tell me about her. And they said oh the sodium is this and this and I said no no no tell me about her. They kept giving me medical jargon. I said I’ve looked at the medical jargon, tell me about her. They went to the chart and they came back with she was a child of this many, she had this many children. By the way she was a piano teacher for 60 years. I said oh OK. So I got in front of her and I said Ms. Collins, Ms. Collins. The residents were getting a little antsy. She doesn’t speak. She hasn’t spoken in months. She’s been in the hospital. I said Ms. Collins, who is a better composer, Beethoven or Mozart? It didn’t register she looked right through me. I said Ms. Collins, who was the better composer? Beethoven or Mozart? Then you saw this flicker of connection. In a soft voice she said what a stupid question. It was a stupid question, I knew that. If anybody, Bach, Beethoven Mozart…you like them. But the point being, that was her island, her center island. We needed to connect to that. So from then on we brought music, we had people talk to her about music and slowly she got better, and better, and better. Never back to base line but she started talking a little. That’s true for all of us. We have our story, our stories give us resilience, our stories give us connectivity. Our stories give us the story of how to be healthy. Where is the opportunity to be healthy? Where is the challenge of the thing that keeps failing over and over again? This book is a little different. It actually goes into that, figuring out the story and where your story gives you the opportunity to build better health and better brain.

Caryn: There’s another book that just came out. I haven’t read it. A couple of weeks ago, The End of Alzheimer’s by Dr. Bredesen. I’ve heard a little bit about his work. I’m assuming you’re familiar with it. Is this something that’s complimentary to what you’re doing or are there nuances?

Dean: No. It isn’t actually complimentary. It’s a little broad. It’s definitely not plant based. In fact, bone broth is a component of it. That word actually, would be problematic in any healthcare environment. The other thing is it’s very gimmicky. If you mix this with this, and so on and so forth. So, to us it’s not complimentary and I think the people that support it as you know are people who are trying to catch the public interest and find things like fat is good for you. The irony is he’s actually a good scientist but when you write completely contrary to science and say that this is what I believe and the science…that kind of throws you off.

Ayesha: Yeah, we haven’t read the book yet but from his supporters, it seems like the people who actually promote a ketogenic diet and a Paleo diet are the main people who support this concept. As far as a ketogenic and Paleo diet is concerned, a diet that’s very high in animal protein and animal fat, we know for a fact that there is no data to support that, at all.

Dean: Zero.

Ayesha: It’s been almost 30-40 years with all the large databases, observational studies and epidemiological studies. Flawed, as they may be of course, the data is consistently pointing toward a diet low in saturated fat, a diet that is high in plants, plant food and whole and not processed. The rest doesn’t really make any sense. In that regard, it’s a completely different book that talks about a completely different approach not really supported by the data so far.

Caryn: OK that was the impression that I got, just from reading through the testimonials. I’m glad to hear it from you both. I just want to summarize that this book is everything. It tells you what the problem is in some comprehensive scientific terms. We learn what we need to do. It’s all in this book. Meal plans, delicious recipes, all kinds of discussions on meditation and exercise. Everything that you need to reduce the risk of probably one of the most scariest things that can happen to anyone.

Dean: And most important or as important. Because we saw this in the community, disparity between the healthiest community, which is the Loma Linda Seventh Day Adventists, the community where Dementia was almost non-existent or very low prevalence, and the outside community center which was devastated. The only difference was lifestyle. All the profits of the book are going back to the communities and educating the communities and creating resources. This book is not for anything except the communities and furthering the knowledge, the true facts and opposed to all facts out there.

Caryn: I want everyone to read this book! I will do my part. Thank you for writing it. Best of luck with your release next week and thank you so much for joining me on It’s All About Food. Ayesha and Dean Sherzai thank you so much.

Ayesha: Thank you for promoting the latest information on health. We’re big fans, thank you for having us on your show.

Dean: Thank you so much.

Caryn: Be well!

Transcribed by Adella Finnan, 9/11/2011

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