Diet taboos for Alzheimer’s disease

Long-term excessive intake of highly processed foods that are high in sugar, salt, and oil, any alcoholic beverages, foods or tableware with excessive aluminum content, and other foods that are "absolutely untouchable" that are spread online lack universal evidence, so there is no need to blindly avoid them across the board.

I have been doing cognitive intervention for the elderly in the community for almost three years, and I have encountered many family members who asked me if they couldn't eat tofu with the "taboo list" on the Internet. Should I give up egg yolk? Even the millet porridge that the elderly love to drink is blocked, saying that rising blood sugar will damage the brain. In fact, there is really no need to be so tight.

To tell the truth, last year, Aunt Zhang in our area was diagnosed with mild cognitive decline. She scored 24 points on the MMSE scale for routine cognitive testing (a full score of 30, and a score below 27 is considered to be cognitively impaired). Her family members loved the elderly and always followed her tastes to buy honeysandao, soy pork elbows, and pickled vegetables. She had to have these with every meal to make them delicious. As a result, when she was reviewed six months later, her score dropped to 20 points, and she often misremembered her building number. Later, we worked with the nutrition department to adjust her diet, replacing all the heavy processed foods with fresh vegetables and meats. She was given at most a small piece of her favorite peach cake every day to satisfy her cravings, along with cognitive training three times a week. After more than half a year, we checked again and the score stabilized back to 23 points. She can still go downstairs to buy groceries by herself.

Why are there restrictions on heavily processed foods high in sugar, salt and oil? In fact, it’s not that you can’t touch even one bite, it’s that you don’t have to eat every meal every day. The trans fats, excess sodium and free sugars in these foods will accelerate systemic vascular sclerosis. The blood supply to the brain of the elderly with cognitive impairment is poorer than that of ordinary people. The cerebral blood vessels will clog faster, neurons are ischemic and hypoxic, and the rate of brain atrophy will naturally increase. This is clearly mentioned in the intervention guidelines released by the International Alzheimer's Association in 2023, and there is little controversy.

As for alcohol, don’t believe in the saying that “one or two drinks a day will activate blood circulation”. There used to be an uncle Li who drank liquor for thirty years, two taels a day. Even after he was diagnosed with mild cognitive impairment, he refused to quit. He said he felt uncomfortable without drinking. As a result, he could no longer recognize his son in less than two years. Oh, by the way, let me talk about a controversial point here: There are epidemiological studies with small samples that indeed found that healthy elderly people who drink a very small amount of red wine every week will have a slightly slower rate of cognitive decline. However, this conclusion only applies to healthy elderly people with no cognitive problems at all, and the sample size is very small, and it has not been confirmed by large-scale studies. There is really no need to bet on the odds for the elderly who already have signs of cognitive decline. Even if it is a medicinal wine that is said to be "brain-tonifying", it not only contains alcohol, but the messy Chinese medicinal materials may also react with the anti-hypertensive and anti-diabetic drugs that the elderly take daily. The gain outweighs the loss.

There are also high-aluminum foods and tableware, such as fried dough sticks with a lot of baking powder, inferiorly processed puffed foods, as well as aluminum pots and aluminum lunch boxes that have been used for many years. Try to replace them as much as possible. Aluminum ions metabolize very slowly and are easily deposited in the brain, damaging hippocampal neurons responsible for memory. This pathological evidence is very clear. Of course, some scholars say that it is difficult for the aluminum intake in the daily diet to reach the pathogenic dose, and there is no need to deliberately avoid it. However, for the elderly with cognitive impairment who have poor metabolic abilities, they can avoid it if they can. There is no need to take this unnecessary risk, right?

In addition to these things that you should definitely pay attention to, in fact, there are many taboos posted on the market, but many of them are deceptive. For example, many people say that soy products are inedible and that they contain aluminum that is harmful to the brain. This is all from the past when tofu was illegally cooked with alum. Nowadays, tofu and soy milk produced by regular manufacturers are cooked with brine or gypsum, and the aluminum content is lower than that of rice. On the contrary, soybeans The lecithin and isoflavones in it have a protective effect on the brain nerves. I met a family before who believed the advice on the Internet and did not allow the elderly to eat tofu. After half a year, the elderly had low albumin and became languid. They were too lazy to talk, which in turn aggravated cognitive decline. There are also those who say they shouldn’t eat egg yolks for fear of high cholesterol. In fact, the DHA and choline in egg yolks are essential nutrients for maintaining cognitive function. As long as the elderly do not have severe hypercholesterolemia, one egg a day is completely fine. The latest cardiovascular guidelines in the past two years have also relaxed the cholesterol intake limit for healthy people. There is really no need to abandon food due to choking.

When we do cognitive intervention, we often say that the diet of elderly people with cognitive impairment must be "strict and strict". What is strict is the long-term eating habits. Don't drink heavily every day and drink every day. What is strict is the occasional craving. The elderly tend to forget things easily and are emotionally sensitive. If they are not allowed to touch even one bite of their favorite food and become emotional every day, it will be worse for their condition. For example, there was an old man who loved to eat pickled radishes. We asked his family to give him only half a piece at a time and eat it with porridge. This not only satisfied his craving, but also kept his salt intake within the standard. The old man was happy and cooperative. It was much better than forcing him to eat those "healthy but disliked" things.

In fact, to put it bluntly, the core of caring for this kind of elderly has never been "how to make the disease recover quickly", but how to make the elderly live more comfortably for the rest of their lives. The purpose of taboos is to improve the quality of life, not to put shackles on the elderly. Don't do the opposite.