Is Alzheimer’sdisease a neurodegenerative or a vascular disorder? (Jack C. de laTorre)

[David PS]

The medical/pharmaceutical industry has embraced the amyloid hypothesisdespite its repeated failures.. At first it seems to be the best and the only option. However 20 years ago, Jack C. de la Torre provided analternative hypothesis that Alzheimer's (AD) is the results of decades of hypoperfusion in the brain. I think that it is time to revisit the hypoperfusion hypothesis which does not require pharmaceuticals or gene therapy.

From 2004: Is Alzheimer’s disease a neurodegenerative or a vascular disorder?

Thecause of Alzheimer’s disease (AD) is unknown. This gap in knowledge has created a stumbling block in the search for a genuinely effective treatment or cure for this dementia. This article summarises the arguments for a causal role for either amyloid deposition or cerebrovascular pathology as the primary trigger in the development of non-genetic AD. A bare-bones survey of the published research reveals no compelling evidence that amyloid deposition is neurotoxic in human beings or that it results in neurodegenerative changes involving synaptic, metabolic, or neuronal loss in human ortransgenic-mouse brains. By contrast, the data supporting AD as aprimary vascular disorder are more convincing. Findings suggesting avascular cause of AD come from epidemiological, neuroimaging,pathological, pharmacotherapeutic, and clinical studies. The consensus of these studies indicates that chronic brainhypoperfusion is linked to AD risk factors, AD preclinical detection and pharmacotherapeutic action of AD symptoms.

Dr. McDougall has a video of Roy Swank (1909–2008) showing blood sludge and reuleux formation in the blood after a high fat meal. In the second video., Dr. McDougall states that there are no healthy fats. Here on the forum PUFAs (including fish oil) have been recognized as not being healthy. From a blood flow perspective, I could not find any evidence that saturated fats are healthy



View: https://www.youtube.com/watch?v=t7U_IJPXwqE




View: https://www.youtube.com/watch?v=7yv_0uXUtxg

 

[Apple]

Dr. McDougall has a video of Roy Swank (1909–2008) showing blood sludge and reuleux formation in the blood after a high fat meal. In the second video., Dr. McDougall states that there are no healthy fats. Here on the forum PUFAs (including fish oil) have been recognized as not being healthy. From a blood flow perspective, I could not find any evidence that saturated fats are healthy




View: https://www.youtube.com/watch?v=7yv_0uXUtxg

McDougall looks really old in this video. Typical white hair like many vegetarians have.

 

[David PS]

McDougall looks really old in this video. Typical white hair like many vegetarians have.

He was born in 1947. McDougall stated that his interest in medicine started in 1965 (at age 18) after suffering a massive stroke which rendered half of his body paralyzed for two weeks. Many people who are not vegetarian and who were born in 1947 also have white.

John A. McDougall - Wikipedia

en.wikipedia.org

 

[Apple]

@David PS
Caldwell Esselstyn is pretty good for 90+ yo.
I will just post this for reference, he talks about fats and oxidizing

View: https://www.youtube.com/watch?v=xDJhFn-pRwM&t=327s

 

[oxphoser]

I’ve always wondered about this. Maybe if the cause of AD is hypoperfusion, it might be good to invert your head occasionally to facilitate bloodflow to the head, as many yoga exercises do. Also, taking blood thinners would help, like aspirin to keep the sludge down.

 

[Lizb]

I’ve always wondered about this. Maybe if the cause of AD is hypoperfusion, it might be good to invert your head occasionally to facilitate bloodflow to the head, as many yoga exercises do. Also, taking blood thinners would help, like aspirin to keep the sludge down.

Dr Peat recommended aspirin and Losartan when I asked him.

 

[David PS]

@David PS
Caldwell Esselstyn is pretty good for 90+ yo.
I will just post this for reference, he talks about fats and oxidizing
View: https://www.youtube.com/watch?v=xDJhFn-pRwM&t=327s

I agree, he does look good. He is a former Olympic rowing champion and he continues to look athletic for his age (despite being a vegetarian). Caldwell was born in 1933 (currently 90 years old and will be 91 this December) and the video is 5 years old.

Caldwell Esselstyn - Wikipedia

en.wikipedia.org

A healthy plant-based diet (which is low in fats) improves blood flow throughout the body. Caldwell is known for insisting that his patients eat meals with no added oils (not one drop). In this 4 minute video clip posted 12 years ago, they talk about how a low fat diet can "raise the flag". Vegan is the new Viagra

View: https://www.youtube.com/watch?v=z4ECnqXQpDA


Getting back to the vascular hypothesis of AD, the same blood sludge and reuleux formation in the blood after a high fat meal is also impeding blood flow in the small capillaries in the brain. When I look at images of the AD brain, I think that it is suffering from decades of malnutrition.

 

[David PS]

I’ve always wondered about this. Maybe if the cause of AD is hypoperfusion, it might be good to invert your head occasionally to facilitate bloodflow to the head, as many yoga exercises do. Also, taking blood thinners would help, like aspirin to keep the sludge down.

Dr Peat recommended aspirin and Losartan when I asked him.

If the root cause of AD is blood sludge from eating a high fat diet for decades, it would seem to me that eating a low fat diet would eliminate the need for blood thinners. Inverted positions in which the head inverted in its relation to the heart does not eliminte the blood sludge. I think the blood sludge persists for several hours. Doing yoga for several hours after each meal until the body has de-sludged the blood seems extreme.

 

[David PS]

Jack C. de la Torre published a paper in 2012 which has an interesting flow chart.

Cardiovascular Risk Factors Promote Brain Hypoperfusion Leading to Cognitive Decline and Dementia

Heart disease is the major leading cause of death and disability in the world. Mainly affecting the elderly population, heartdisease and its main outcome, cardiovascular disease, have become an important risk factor in the development of cognitive decline and Alzheimer’s disease (AD). This paper examines the evidence linking chronic brain hypoperfusion induced by avariety of cardiovascular deficits in the development of cognitive impairment preceding AD. The evidence indicates a strong association between AD and cardiovascular risk factors, including ApoE4, atrial fibrillation, thrombotic events, hypertension, hypotension, heart failure, high serum markers of inflammation, coronary artery disease, low cardiac index, and valvularpathology. In elderly people whose cerebral perfusion is already diminished by their advanced age, additional reduction of cerebra lblood flow stemming from abnormalities in the heart-brain vascular loop ostensibly increases the probability of developing AD. Evidence also suggests that a neuronal energy crisis brought on by relentless brain hypoperfusion may be responsible for protein synthesis abnormalities that later result in the classic neurodegenerative lesions involving the formation of amyloid-beta plaques and neurofibrillary tangles. Insight into how cardiovascular risk factors can induce progressive cognitive impairment offers an enhanced understanding of the multifactorial pathophysiology characterizing AD and ways at preventing or managing the cardiovascular precursors of this dementia.

 

[Apple]

@David PS
Caldwell Esselstyn is pretty good for 90+ yo.
I will just post this for reference, he talks about fats and oxidizing

View: https://www.youtube.com/watch?v=xDJhFn-pRwM&t=327s

Esselstyn recommends nitric oxide (NO), the most powerful vasodilator we have, so arteries will dilate to their fullest. (starting on 10:32)

Eat (chew) a fist-size (after cooking) serving of high nitrate veggies, with a few drops of balsamic vinegar or other vinegar, six times spaced throughout the day from breakfast to bedtime. This promotes the formation of nitric oxide (NO), the most powerful vasodilator we have, so arteries will dilate to their fullest. Esselstyn’s favorite 6 ‘greens’ for NO production are KALE, SPINACH, SWISS CHARD, ARUGULA, BEET GREENS, BEETS (yes, beets!) Dr. E also has a ‘greens’ jingle which mentions bok choy, collard greens, mustard greens, turnip greens, napa cabbage, Brussels sprouts, broccoli, cauliflower, cilantro, parsley and asparagus.

Spoiler: Dr Esselstyn’s Basic Recommendations

1) NO OIL. Oils cause vasoconstriction and raise blood pressure as well as being damaging to the arterial endothelium (lining). Hidden fats may also be called hydrogenated mono and diglycerides, or lethicin.

2) Eat starches, non-starchy veggies and a max of 3 fruit servings. Starches are important for satiation so you do not get hungry. Being hungry is not sustainable. Starches are root veggies (potatoes, sweet potatoes), beans/peas/lentils, winter squash and 100% whole grains.

3) Eat (chew) a fist-size (after cooking) serving of high nitrate veggies, with a few drops of balsamic vinegar or other vinegar, six times spaced throughout the day from breakfast to bedtime. This promotes the formation of nitric oxide (NO), the most powerful vasodilator we have, so arteries will dilate to their fullest. Esselstyn’s favorite 6 ‘greens’ for NO production are KALE, SPINACH, SWISS CHARD, ARUGULA, BEET GREENS, BEETS (yes, beets!) Dr. E also has a ‘greens’ jingle which mentions bok choy, collard greens, mustard greens, turnip greens, napa cabbage, Brussels sprouts, broccoli, cauliflower, cilantro, parsley and asparagus.

4) Avoid all smoothies and juices. Chew your food.

5) Avoid all high fat foods like nuts, nut butters, coconut, olives, avocado, tofu, coconut, seeds (see flaxseed reference below)

6) Avoid processed sugars like agave and maple syrup.

7) Avoid caffeinated coffee.

8) Avoid all animal foods/meat/dairy/eggs

9) Avoid salt in cooking and at the table, and be careful with condiments. The rule of thumb is no more milligrams of sodium in a serving as there are calories. Adding a SMALL amount of a higher sodium condiment to a whole low sodium meal is OK.

Dr Esselstyn's Latest Basic Recommendations - Food As Prevention

Here is a concise list of Dr Esselstyn’s latest basic recommendations from a Facebook group you may want to join

www.foodasprevention.com

 

[David PS]

Esselstyn recommends nitric oxide (NO), the most powerful vasodilator we have, so arteries will dilate to their fullest. (starting on 10:32)

Eat (chew) a fist-size (after cooking) serving of high nitrate veggies, with a few drops of balsamic vinegar or other vinegar, six times spaced throughout the day from breakfast to bedtime. This promotes the formation of nitric oxide (NO), the most powerful vasodilator we have, so arteries will dilate to their fullest. Esselstyn’s favorite 6 ‘greens’ for NO production are KALE, SPINACH, SWISS CHARD, ARUGULA, BEET GREENS, BEETS (yes, beets!) Dr. E also has a ‘greens’ jingle which mentions bok choy, collard greens, mustard greens, turnip greens, napa cabbage, Brussels sprouts, broccoli, cauliflower, cilantro, parsley and asparagus.

Spoiler: Dr Esselstyn’s Basic Recommendations

1) NO OIL. Oils cause vasoconstriction and raise blood pressure as well as being damaging to the arterial endothelium (lining). Hidden fats may also be called hydrogenated mono and diglycerides, or lethicin.

2) Eat starches, non-starchy veggies and a max of 3 fruit servings. Starches are important for satiation so you do not get hungry. Being hungry is not sustainable. Starches are root veggies (potatoes, sweet potatoes), beans/peas/lentils, winter squash and 100% whole grains.

3) Eat (chew) a fist-size (after cooking) serving of high nitrate veggies, with a few drops of balsamic vinegar or other vinegar, six times spaced throughout the day from breakfast to bedtime. This promotes the formation of nitric oxide (NO), the most powerful vasodilator we have, so arteries will dilate to their fullest. Esselstyn’s favorite 6 ‘greens’ for NO production are KALE, SPINACH, SWISS CHARD, ARUGULA, BEET GREENS, BEETS (yes, beets!) Dr. E also has a ‘greens’ jingle which mentions bok choy, collard greens, mustard greens, turnip greens, napa cabbage, Brussels sprouts, broccoli, cauliflower, cilantro, parsley and asparagus.

4) Avoid all smoothies and juices. Chew your food.

5) Avoid all high fat foods like nuts, nut butters, coconut, olives, avocado, tofu, coconut, seeds (see flaxseed reference below)

6) Avoid processed sugars like agave and maple syrup.

7) Avoid caffeinated coffee.

8) Avoid all animal foods/meat/dairy/eggs

9) Avoid salt in cooking and at the table, and be careful with condiments. The rule of thumb is no more milligrams of sodium in a serving as there are calories. Adding a SMALL amount of a higher sodium condiment to a whole low sodium meal is OK.

Dr Esselstyn's Latest Basic Recommendations - Food As Prevention

Here is a concise list of Dr Esselstyn’s latest basic recommendations from a Facebook group you may want to join

www.foodasprevention.com

Thanks for the link. A the bottom of the page he recommends 1-2 tablespoons ground flaxseed and /or chia seeds daily (preferably 2 tablespoons). I think that is estrogenic. It reminds me that these experts are like story about The Blind Men and The Elephant.

 

[David PS]

I’ve always wondered about this. Maybe if the cause of AD is hypoperfusion, it might be good to invert your head occasionally to facilitate bloodflow to the head, as many yoga exercises do. Also, taking blood thinners would help, like aspirin to keep the sludge down.

View: https://www.youtube.com/watch?v=zrHT-s4Lb_g


This video includes a graph showing that the amount of sludging increases for about 5 hours after I high fat meal. That would be a long yoga session.

Fatty Meals May Impair Artery Function | NutritionFacts.org

We finally discovered why a single high-fat meal can cause angina chest pain.

nutritionfacts.org

 

[oxphoser]

I think they said practicing yoga one hour a week helps improve mild cognitive impairment :

To reduce pre-Alzheimer’s cognitive impairment, get to the yoga mat

Inner peace and a flexible body may not be the most valuable benefits that yoga and meditation have to offer, suggests new research by a UCLA-led team of neuroscientists.

newsroom.ucla.edu

Yoga includes head inversion. Not recommended if you have high blood pressure or glaucoma already.

This doesn’t say anything about yoga reducing sludge, though.

By the way, have you seen Bredesen’s work?

Abstract​

This report describes a novel, comprehensive, and personalized therapeutic program that is based on the underlying pathogenesis of Alzheimer's disease, and which involves multiple modalities designed to achieve metabolic enhancement for neurodegeneration (MEND). The first 10 patients who have utilized this program include patients with memory loss associated with Alzheimer's disease (AD), amnestic mild cognitive impairment (aMCI), or subjective cognitive impairment (SCI). Nine of the 10 displayed subjective or objective improvement in cognition beginning within 3-6 months, with the one failure being a patient with very late stage AD. Six of the patients had had to discontinue working or were struggling with their jobs at the time of presentation, and all were able to return to work or continue working with improved performance. Improvements have been sustained, and at this time the longest patient follow-up is two and one-half years from initial treatment, with sustained and marked improvement. These results suggest that a larger, more extensive trial of this therapeutic program is warranted. The results also suggest that, at least early in the course, cognitive decline may be driven in large part by metabolic processes. Furthermore, given the failure of monotherapeutics in AD to date, the results raise the possibility that such a therapeutic system may be useful as a platform on which drugs that would fail as monotherapeutics may succeed as key components of a therapeutic system.

Bredesen DE. Reversal of cognitive decline: a novel therapeutic program. Aging (Albany NY). 2014 Sep;6(9):707-17. doi: 10.18632/aging.100690. PMID: 25324467; PMCID: PMC4221920.


His protocol can be found here:

The Bredesen Protocol: 6 Strategies (Plus, does it work?) - PrimeHealth Denver

The Bredesen Protocol is designed to prevent and reverse the symptoms of Alzheimer’s using an individualized approach to diet, sleep, exercise, stress and more.

primehealthdenver.com

It is against Ray Peat in many ways: he’s an advocate of fasting and wants you to avoid dairy.

 

[InChristAlone]

I disagree with how to get good vascular health. Nitric oxide in high amounts is NOT good.

“The basic control of blood flow in the brain is the result of the relaxation of the wall of blood vessels in the presence of carbon dioxide, which is produced in proportion to the rate at which oxygen and glucose are being metabolically combined by active cells. In the inability of cells to produce CO2 at a normal rate, nitric oxide synthesis in blood vessels can cause them to dilate. The mechanism of relaxation by NO is very different, however, involving the inhibition of mitochondrial energy production (Barron, et al., 2001). Situations that favor the production and retention of larger amounts of carbon dioxide in the tissues are likely to reduce the basic “tone” of the parasympathetic nervous system, and there is less need for additional vasodilation.” Ray Peat

“Nitric oxide is increasingly seen as an important factor in nerve degeneration (Doherty, 2011). Nitric oxide activates processes (Obukuro, et al., 2013) that can lead to cell death. Inhibition on the production of nitric oxide protects again various kinds of dementia (Sharma & Sharma, 2013, Sharma & Singh, 2013). Brain trauma cases large increase in nitric oxide formation, and blocking its synthesis improves recovery (Huttenmann, et al., 2008); Gahn, et al., 2006).

Organophosphates increase nitric oxide formation, and the protective anticholinergic drugs such as atropine reduce it (Chang, et al., 2001; Kim, et al., 1997). Stress, including fear (Campos., et al., 2013) and isolation (Zlatokovic & Filipovic, 2013) can activate the formation of nitric oxide, and various mediators of inflammation also activate it. The nitric oxide in a person’s exhaled breath can be used to diagnose some diseases, and it probably reflects the level of their emotional well-being.”

“Niacianamide, like progesterone, inhibits the production of nitric oxide, and also like progesterone, it improves recovery from brain injury. (Hoane, et al., 2008).”

“The unsaturated fats and estrogen contribute to the increased release of serotonin and nitric oxide (NO). Nitric oxide is produced during inflammation, and, like ethane, can be detected in the breath when the lungs are inflamed. Nitric oxide, as a pro-inflammatory free radical, stimulates the peroxidation of the unsaturated fats. Both NO and serotonin inhibit mitochondrial respiration, shifting metabolism toward glycolysis.”

Serotonin doesn’t “cure depression,” and both serotonin and nitric oxide impair circulation and are toxic to brain cells. Both of them poison mitochondrial respiration. Estrogen increases the viscosity of blood, and impairs circulation and oxygenation in many other ways.”

“Estrogen and PUFA create insulin resistance, and the resulting state of “diabetes” and stress de-energizes tissues, with the mitochondria that are damaged by unsaturated fatty acids, nitric oxide, tumor necrosis factor (TNT), serotonin, etc., failing to meet the tissues’ energy needs. Stress, endotoxinemia, and increased estrogen tend to activate TNF, which has a role in brain degenerative diseases and osteoporosis and multiple organ failure. Much research has focussed on a search for a single substance that is responsible for the inflammatory conditions of Alzheimer’s disease, but inflammation and aging are processes that involve many causes and mediators, with each individual’s history causing variations in the details.”

“Nitric oxide, a third cultic substance along with serotonin and estrogen, is invoked as a normalizer of brain circulation and protector of nerve cells from peroxidation. Whether a substance is an antioxidant or pro-oxidant depends on its environment, and both nitric oxide and estrogen are pro-oxidants, promoters of lipid peroxidation and other forms of cell damage, under a variety of physiological situations.”

....and more

Ray Peat, PhD on Nitric Oxide – Functional Performance Systems (FPS)

 

[David PS]

I disagree with how to get good vascular health. Nitric oxide in high amounts is NOT good.

Thank you. I knew Dr. Peat's statements about nitric oxide. And I agree that high amounts of nitric oxide is NOT good. The issue for me is how much well cooked leafy greens (mentioned by Dr. Peat) produces too much NO.

Esselstyn notes that nitric oxide (NO) produced from leafy greeens will will dilate the arteries to their fullest. (starting on 10:32). He recommends:

Eat (chew) a fist-size (after cooking) serving of high nitrate veggies, with a few drops of balsamic vinegar or other vinegar, six times spaced throughout the day from breakfast to bedtime. This promotes the formation of nitric oxide (NO), the most powerful vasodilator we have, so arteries will dilate to their fullest. Esselstyn’s favorite 6 ‘greens’ for NO production are KALE, SPINACH, SWISS CHARD, ARUGULA, BEET GREENS, BEETS (yes, beets!) Dr. E also has a ‘greens’ jingle which mentions bok choy, collard greens, mustard greens, turnip greens, napa cabbage, Brussels sprouts, broccoli, cauliflower, cilantro, parsley and asparagus.

Esselstyn's clinical successes are certainly note worthy. How can one reconcile his clinical findings with Dr. Peat's quotes? It reminds me that these two ideas are like story about The Blind Men and The Elephant.

The tau protein wild-goose chase for a new drug has fallen apart. I intended this thread to be about Alzheimer's and looking back in time to see if there are any ideas that have been rejected by the medical and the pharmaceutical industries that deserve a reconsideration. For me, Jack de laTorre's ideas fit the bill.

 

[Apple]

@David PS , @InChristAlone
I din't delve into Nitric oxide topic much, just quoting what Esselstyn says. At age 50 you produce twice less NO than at age 25.
Everying RP says should be revisited and revalidated. RP just liked to be against mainstream.

here is a different opinion :
Studies in experimental models and even humans reveal that constitutive production of nitric oxide (NO) is reduced with aging. It appears that the inability to produce sufficient NO under the right preclinical conditions enhances the risk for a number of diseases that plague the older population. If true, then there exist an opportunity to intervene early during this process, implement strategies to restore NO homeostasis

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3390088/#:~:text=Studies%20in%20experimental%20models%20and,that%20plague%20the%20aging%20population.

 

[InChristAlone]

@David PS , @InChristAlone
I din't delve into Nitric oxide topic much, just quoting what Esselstyn says. At age 50 you produce twice less NO than at age 25.
Everying RP says should be revisited and revalidated. RP just liked to be against mainstream.

here is a different opinion :
Studies in experimental models and even humans reveal that constitutive production of nitric oxide (NO) is reduced with aging. It appears that the inability to produce sufficient NO under the right preclinical conditions enhances the risk for a number of diseases that plague the older population. If true, then there exist an opportunity to intervene early during this process, implement strategies to restore NO homeostasis

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3390088/#:~:text=Studies%20in%20experimental%20models%20and,that%20plague%20the%20aging%20population.

So continuing in the spirit of Peat to be contrarian, he was very much against NO, how did he make it to 86 then if NO is greatly decreased? He did nothing to promote it.

 

[RealNeat]

Thank you. I knew Dr. Peat's statements about nitric oxide. And I agree that high amounts of nitric oxide is NOT good. The issue for me is how much well cooked leafy greens (mentioned by Dr. Peat) produces too much NO.

Esselstyn notes that nitric oxide (NO) produced from leafy greeens will will dilate the arteries to their fullest. (starting on 10:32). He recommends:

Esselstyn's clinical successes are certainly note worthy. How can one reconcile his clinical findings with Dr. Peat's quotes? It reminds me that these two ideas are like story about The Blind Men and The Elephant.

The tau protein wild-goose chase for a new drug has fallen apart. I intended this thread to be about Alzheimer's and looking back in time to see if there are any ideas that have been rejected by the medical and the pharmaceutical industries that deserve a reconsideration. For me, Jack de laTorre's ideas fit the bill.

also red light and nasal breathing both produce NO, so there is more to the story than just pro or anti here.

 

[David PS]

@David PS , @InChristAlone
I din't delve into Nitric oxide topic much, just quoting what Esselstyn says. At age 50 you produce twice less NO than at age 25.
Everying RP says should be revisited and revalidated. RP just liked to be against mainstream.

here is a different opinion :
Studies in experimental models and even humans reveal that constitutive production of nitric oxide (NO) is reduced with aging. It appears that the inability to produce sufficient NO under the right preclinical conditions enhances the risk for a number of diseases that plague the older population. If true, then there exist an opportunity to intervene early during this process, implement strategies to restore NO homeostasis

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3390088/#:~:text=Studies%20in%20experimental%20models%20and,that%20plague%20the%20aging%20population.

Thanks for the link.

As always, Perceive Think Act

 

[David PS]

So continuing in the spirit of Peat to be contrarian, he was very much against NO, how did he make it to 86 then if NO is greatly decreased? He did nothing to promote it.

Did he eat well cooked green leafy vegetables? The nitrates in them convert to NO in the human body. One might think that if cooked green leafy vegetables were unsafe he might have warned us.

Esselstyn goes to an extreme eating cooked green leafy vegetables 5 times a day. It works for him and his heart diseased patients.