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> [Changes] in dietary behaviors and certain medications could potentially reduce blood concentration of these toxic fat-protein complexes, [subsequently] reducing the risk for Alzheimer’s

What would be some recommended changes in dietary behaviors if this link were also verified in humans?

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avoid oxidized lipids and especially oxysterols

very good primer: https://csroldsite.wordpress.com/2013/03/04/oxysterols-the-t...

How do you relate this to the study at hand? Oxysterol isn't mentioned once.

I don't even disagree or something, but your advice seems rather automatic than based.

The study used atherogenic diets as offense. So all the consensus on heart health seems to apply: LDL bad; salt bad; cholesterol bad; saturated fats bad - inflammation bad.

In mice.

Oxysterols seem to stimulate amyloid beta formation in the liver and even in the brain directly:

> We have shown that patients with AD have increased brain levels of 27-hydroxycholesterol, which may affect the production of beta-amyloid.

https://pubmed.ncbi.nlm.nih.gov/16866910/

So, it's unrelated to the study at hand.

tl;dr avoid fried foods :<

chicken is more susceptible to lipid oxidation than beef or pork. lower temperature cooking methods are preferable.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5055878/

So exactly what kind of foods to avoid?

There have been several studies done showing that a healthy keto diet can reduce or even reverse Alzheimers symptoms in many patients. Just do a quick Google or YouTube search, lots of content on the subject.

Not exactly what they hint at in this study...

> In wild-type (WT) C57BL/6J mice, a saturated fatty acid (SFA)-enriched diet was found to strongly stimulate biosynthesis and secretion of TRL-Aβ, concomitant with a reduction in cerebral capillary endothelial tight junction proteins, blood-to-brain extravasation of TRL-Aβ, and marked neurovascular inflammation [6]. In contrast, mice fed unsaturated fatty acid–rich diets had no evidence of exaggerated TRL-Aβ secretion and capillary integrity was unremarkable [6,7].

...

> Moreover, synergistic effects of TRL-Aβ with exaggerated central nervous system (CNS) synthesis of human Aβ are also suggested by the findings of accelerated amyloidosis in amyloid precursor protein/presenilin 1 (APP/PS1) mice maintained on atherogenic diets [9].

Not saying keto is inherently an atherogenic diet, but surely saturated fat and salt isn't exactly avoided by most followers.

> Just do a quick Google or YouTube search, lots of content on the subject.

Yeah.......... sure. Content.

Mice trials don't interest me much. Human trials of various diets for Alzheimer's have been done along with lots of individuals who have tested it on themselves or family members with positive results.

I can't find one of the more comprehensive studies I was looking at before, but a quick search pulls up this video which discusses a recent human trial which showed significant improvement on the keto diet (links to the study in description):

https://youtu.be/jK6-r1zWOI0

That looks like a 12-week keto diet, applied to 21 patients who already have AD. The measured results were cognitive scores on testing, which improved.

Consequently, it suggests someone who is already impaired due to AD may be able to improve symptoms from a keto diet (vs a low-fat one).

But the general consensus is that reversing or alleviating AD symptoms is a different task than preventing it in the first place.

The linked article here is talking more about the latter, and specifically for preventing non-hereditary AD.

If the diet can reverse the usual decline and ultimately cure the disease given enough time, surely that would imply it would also prevent onset, no?

I'll take a more detailed look into the other resources I've studied and post another reply in a few hours.

Alzheimer's research and drug development is littered with decades of ideas that were implied, but didn't bear out.

And nutritional research... well, there's a lot of money in food, and that's funded a lot of noise around the signals.

I agree. I'm not talking about a one-off study showing a minor improvement though (which would be likely to not replicate, etc.), I'm referring to a much stronger effect which in principle is addressing the origin of the disease.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6720297/ - a review of various studies, concludes that "Keto diet may modulate a broad array of metabolic and signaling changes underlying the pathophysiology of neurodegenerative disorders. Based on the limited animal studies and clinical trials, keto diet has beneficial effects for enhancing mitochondrial function and cellular metabolism. It is associated with improved cognitive performance in elderly adults with Alzheimer's disease. The improvement of the cognitive outcomes depends on the level and duration of ketosis."

https://alzres.biomedcentral.com/articles/10.1186/s13195-021... - study from video I linked above, concludes that "patients on the ketogenic diet improved in daily function and quality of life".

https://academic.oup.com/advances/article/11/6/1583/5864685?... - another review, concludes that "The results underline that, collectively, the efficacy of ketogenic therapy in MCI/AD appears promising, indicating that it is more than a symptomatic remedy (137). Nevertheless, research is still scattered and heterogeneous in terms of study design, intervention, participants, and outcomes of interest."

https://pubmed.ncbi.nlm.nih.gov/15123336/ - study on MCT oil which raises levels of ketones, abstract says "Higher ketone values were associated with greater improvement in paragraph recall with MCT treatment relative to placebo across all subjects (P=0.02). Additional research is warranted to determine the therapeutic benefits of MCTs for patients with AD and how APOE-4 status may mediate beta-OHB efficacy."

Additionally Alzheimer's is actually referred to by a large number of folks in the field as "type 3 diabetes" & as far as I understand there is a large amount of overlap between the two diseases; we have studies showing that diabetes can be nearly or totally cured by carbohydrate restriction:

https://pubmed.ncbi.nlm.nih.gov/29417495/ - of 349 participants, 94% were able to eliminate or reduce insulin therapy after 1 year (57% discontinued their prescriptions entirely).

The book "The Alzheimer's Antidote" by Amy Berger is a great resource if you are open minded enough to be willing to look at informational resources once step above scientific controlled studies (unfortunately many folks are not).

> willing to look at informational resources once step above scientific controlled studies (unfortunately many folks are not).

The End of Alzheimer's by Dr Dale Bredesen is all about "scientific controlled studies" and comes to the same conclusion about keto diets. No need to be open-minded :)

All the books I read cite plenty of studies, including the one I mentioned, which is why I call it "one step above scientific studies", but you get called a whacko nonetheless if you or the author hold any opinions even moderately outside of the mainstream dialogue / mainstream medicine.

My original comment on this thread is at -1 even though what I said was factually correct (and I found all my linked sources above via exactly what I said, a quick Google search). Another of my comments on this post has the classic reply "ah but the author of your study has been accused of quackery if I google his name".

So I'd say a bit more open-mindedness would be in order.

Yes, I am sorry you are getting such responses. The bottom line is there are multiple causes and types of Alzheimer's. So there are also multiple preventative measures. I'm no expert but, like you, have studied and read a lot, and that's my take.

Here is an example of a ketogenic diet:

  - 2 hard-boiled eggs for breakfast.
  - 1 cup of walnuts or almonds or pecans as a snack.
      - Eaten with a slice of sharp cheddar cheese (4g saturated fat).
      - Always rinse the nuts to make them more palatable.
      - This meal may be eaten twice a day.
  - 3 tablespoons of chia seeds soaked in water, as a snack.
      - Like a high fat/protein version of oatmeal.
  - Peanuts and macadamia nuts as needed for hunger.
  - Steamed vegetables (broccoli, kale, spinach, brussels, zuchini, tomatoes).
      - Eaten with 8 tablespoons of olive oil.
      - A very large serving of steamed vegetables.
      - Salt/seasoning however you prefer.
      - This is dinner.

Once a week, eat a cheeseburger. Or twice a week: rotisserie chicken and olive oil, or coleslaw and guacamole and chicken.

This high-fat, low carb diet can be maintained with no difficulty for decades. Also, it is an ideal diet for insulin-dependent diabetics.

It's cheap, healthy, and you won't be hungry.

Anyone reading this, please ignore it and learn about keto properly, not from a random comment from a green account on hacker news.

I’m not going to tell you anything else, because I too am a random commenter on hacker news - except please don’t take the comment as a good example of how to put together a keto diet.

Good points, but I would just add once I ate almost nothing but salad and salmon or sardines for two weeks and it completely transfigured my physiology in a way that continues to astound me. As a result of that my primary recommendation is that people experiment with the best diet plans they can find and try them in two week blocks to let changes set in.

How do you prepare your salads, if you don't mind me asking?

> - steamed vegetables (broccoli, kale, spinach, brussels, zuchini, tomatoes) - eaten with 8 tablespoons of olive oil

I am not entirely sure that my body is ready to down half a cup of oil as part of a regular meal.

The large serving of olive oil is small relative to the bulk of the steamed vegetables.

It's typical for ketogenic dieters to use vegetables as a carrier for olive oil, and for a large fraction of the day's calories to come from that oil.

I think I read that Italians use something like 3oz/day of olive oil on average, aka 6 tablespoons. I wouldn't eat 8 tablespoons directly (lol) but if you just put a good amount on all your meats and vegetables it adds up a lot faster than you think.

> Always rinse the nuts to make them more palatable.

OK, I have to ask...what is this about? "More palatable" in what way?

You're not a real health nut unless you're activating your almonds

Some nuts will have trace amounts of mold on them, depending on how they're sourced or how long they're sitting around. I've read that it's most common on pistachios. Not sure to what extent it actually happens but rinsing the nuts certainly won't do any harm.

Buy some walnuts. Try rinsing them before eating, to wash away the walnut dust. You may find you prefer the taste after washing.

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