Trans fats linked to increased risk for Alzheimer’s
Story at-a-glance -
- Three dietary components shown to promote dementia and Alzheimer’s disease are sugar (especially processed fructose), grains and trans fats
- Research published in the October 2019 issue of Neurology found a strong link between trans fat consumption and incidence of dementia and its various subtypes, including Alzheimer’s disease
- People in the highest quartile of trans fat levels were 74% more likely to develop dementia. Those in the second-highest quartile had a 52% higher risk
- Diets rich in carbohydrates are associated with an 89% increased risk for dementia while diets high in healthy fats are associated with a 44% reduced risk
- Up to half of all Alzheimer’s cases could also be prevented by addressing other modifiable lifestyle contributors such as physical inactivity, depression, smoking, high blood pressure, midlife obesity and diabetes
As noted by neurologist Dr. David Perlmutter, author of “Grain Brain” and “Brain Maker,” your diet and other lifestyle factors have major implications for your Alzheimer’s risk.
Indeed, according to research1,2 published in the journal Lancet Neurology in 2011, up to half of all Alzheimer’s cases could be prevented by addressing modifiable lifestyle contributors such as physical inactivity, depression, smoking, high blood pressure, midlife obesity and diabetes.
Three dietary components shown to promote this neurological degeneration are sugar (especially processed fructose), grains and trans fats. Research3,4 from the Mayo Clinic, published in the Journal of Alzheimer’s Disease in 2012, found diets rich in carbohydrates are associated with an 89% increased risk for dementia while diets high in healthy fats are associated with a 44% reduced risk.
As noted by the authors,5 “A dietary pattern with relatively high caloric intake from carbohydrates and low caloric intake from fat and proteins may increase the risk of MCI [mild cognitive impairment] or dementia in elderly persons.” Similarly, a 2013 study6 in the journal BioMed Research International reported that:
“Increasing epidemiological studies suggest that diet and nutrition might be important modifiable risk factors for AD [Alzheimer’s disease].
Dietary supplementation of antioxidants, B vitamins, polyphenols, and polyunsaturated fatty acids are beneficial to AD, and consumptions of fish, fruits, vegetables, coffee, and light-to-moderate alcohol reduce the risk of AD … Adherence to a healthy diet, the Japanese diet, and the Mediterranean diet is associated with a lower risk of AD.”
Trans Fat Consumption Increases Your Dementia Risk
Most recently, research7 published in the October 2019 issue of Neurology found a strong link between trans fat consumption and incidence of dementia and its various subtypes, which includes Alzheimer’s disease (AD).
The study included 1,628 Japanese seniors aged 60 and older. None had dementia at the outset of the study, which went on for 10 years. Levels of elaidic acid — a biomarker for industrial trans fat — in the participants’ blood were measured using gas chromatography/mass spectrometry.
Based on those levels, the hazard ratios for all-cause dementia, AD and vascular dementia were calculated using the Cox proportional hazards model. As reported by the authors:8
“Higher serum elaidic acid levels were significantly associated with greater risk of developing all-cause dementia and AD after adjustment for traditional risk factors. These associations remained significant after adjustment for dietary factors, including total energy intake and intakes of saturated and polyunsaturated fatty acids.”
This increase in risk was not slight. As reported by CNN,9 people in the highest quartile of elaidic acid levels were 74% more likely to develop dementia. Those in the second-highest quartile had a 52% higher risk. No association between trans fat and vascular dementia was found.
Of the various processed foods found to contribute to elevated elaidic acid levels, pastries were the biggest contributors, followed by margarine, candy, caramels, croissants, nondairy creamers, ice cream and rice cakes.10
Dr. Richard Isaacson, a neurologist and director of the Alzheimer's Prevention Clinic at Weill Cornell Medicine in New York, who was not involved in the study, commented on the findings to CNN:11
"The study used blood marker levels of trans fats, rather than more traditionally used dietary questionnaires, which increases the scientific validity of the results. This study is important as it builds upon prior evidence that dietary intake of trans fats can increase risk of Alzheimer's dementia."
What Is Trans Fat?
As explained by CNN:12
“… artificial trans fats are created by an industrialized process that adds hydrogen to liquid vegetable oils to make them more solid (think of semi-soft margarine and shortening).
The food industry loves trans fats because they are cheap to produce, last a long time and give foods a great taste and texture. Besides fried foods, trans fats are found in coffee creamer, cakes, pie crusts, frozen pizza, cookies, crackers, biscuits and dozens of other processed foods.”
Trans fats are different from an unsaturated fat by a single hydrogen molecule on the opposite side of a carbon bond.13 This one positional change is responsible for the difference in characteristics of the fat, and the increased danger to your health.
Aside from dementia, strong evidence also links trans fats with inflammation and the development of insulin resistance and heart disease (all of which also happen to be risk factors for Alzheimer’s).
Faced with overwhelming evidence of harm, the U.S. Food and Drug Administration removed partially hydrogenated oils (a primary source of trans fat) from the list of “generally recognized as safe” (GRAS) list of food ingredients in 2015, and as of June 18, 2019, food manufacturers are no longer allowed to use partially hydrogenated oils in foods14 due to their health risks.
Processed foods manufactured before this date, however, are allowed to remain on the market until January 1, 2021.15 (Compliance dates vary depending on whether manufacturers had “limited use” permissions for partially hydrogenated oils, but these are the final dates where all use must cease.)
However, that doesn’t mean that trans fats have been entirely eliminated and are of no further concern. What’s more, as long as a food contains less than 0.5 grams of trans fat per serving, food manufacturers are allowed to label it as trans fat free.
The problem with this is that many experts agree there is no safe threshold below which trans fats are safe.16 To determine whether a product might still contain trans fats, carefully read the ingredients list.
Any item containing partially hydrogenated vegetable oil is bound to contain trans fat, even if the label says “0 Trans Fat.” Fried food and baked goods in general are also suspect.17,18 As lead study author Dr. Toshiharu Ninomiya, a professor at Kyushu University in Fukuoka, Japan, noted in a press release:19
"In the United States, the small amounts still allowed in foods can really add up if people eat multiple servings of these foods, and trans fats are still allowed in many other countries."
Trans Fat Has Killed Millions
The rise of trans fat can be directly attributed to the wrongful vilification of saturated fats and cholesterol. We now have decades’ worth of data showing saturated fat and dietary cholesterol have no impact on heart disease and mortality. Meanwhile, studies have revealed the switch from saturated fat to trans fat-rich partially hydrogenated vegetable oils have led to the premature death of millions.
When New York severely limited the amount of trans fat allowed to be served at restaurants, it offered a unique opportunity for researchers to study20 the effects on residents and compare rates of heart attack and stroke before and after the restriction.
Three or more years after the restrictions were imposed on specific counties in New York City, researchers found a 6.2% reduction in heart attacks and stroke in those counties compared to areas of the city where the restrictions on trans fat were not imposed.
Considering trans fat has proliferated in the American diet since the late 1950s, the unnecessary death toll attributable to trans fat likely numbers in the millions each year, nationwide. Similar findings have been reported by Danish researchers. Denmark was the first country to act on research demonstrating the dangerous health effects of trans fat.
The study,21 published in 2016, found that in the three years after trans fats were regulated, which nearly eliminated it from the Danish food supply, the annual mean death toll from cardiovascular disease was reduced by an average of 14.2 deaths per 100,000 people per year.
We’ve Known Trans Fat Takes a Toll on Cognition for Years
One can only guess how many people have lost their minds thanks to trans fat over these past decades. The 2019 Neurology study certainly wasn’t the first to demonstrate a clear link between trans fat consumption and dementia risk.
For example, in a 2012 study,22 Dr. Gene Bowman, assistant professor of neurology at Oregon Health and Science University, reported a strong correlation between trans fat and cognitive performance.
People with high levels of trans fat in their blood performed significantly worse in cognitive testing and had reduced brain volume. Bowman commented on the results to HuffPost:23
"It's clear that trans fats are bad — both for your heart and now, we see, for your brain. So I would recommend that people stay away from all trans fats.
If you aren't sure whether something has them, just look at the ingredients … if there's vegetable shortening, partially hydrogenated anything ... just put it down. That's the big message here."
Similarly, a 2015 study24 led by Dr. Beatrice Golomb found trans fat intake was linked to memory impairment in people under the age of 45. Each gram of trans fat consumed per day was linked to a 0.76 word decrease in word recall.
In the highest trans fat group, participants could recall on average 11 fewer words than those with the lowest trans fat intake, who had an average word recall of 86 words. The research, while unable to establish cause and effect, suggests trans fats may act as a pro-oxidant, contributing to oxidative stress that causes cellular damage.
Oxidized Omega-6 — Another Harmful Fat to Beware Of
It is clearly important to avoid trans fat, but as you will find out next year in an interview I am doing with Dr. Chris Knobbe about his Ancestral Health Symposium presentation, it is processed oils that are the primary culprit for nearly all Western diseases. Assiduously avoiding them is the key to staying healthy.
This is largely related to the oxidized omega-6 fat found in many processed foods, which may actually be even worse than trans fat. Now, omega-6 fat (linolenic acid) in and of itself is not the problem. Linoleic acid is also found in foods such as nuts, seeds and eggs, and is important for health.
The problem is oxidized omega-6 fat, and the fact that most people eat far too much of it. Intakes of omega 6 fat more than century ago were typically below 5 to 10 grams a day, and most of us now eat FAR more than that. For years, I’ve stressed the importance of balancing your omega-3 to omega-6 intake to protect your health.
Eating too much damaged omega-6 fat (found in abundance in processed vegetable oils) and too little marine-based omega-3 sets the stage not just for Alzheimer’s but also for diabetes, cardiovascular disease, rheumatoid arthritis, cancer and depression — and that’s the short list.
It is very easy to overeat omega-6 fats. I recently switched from macadamia nuts to pecans, which are also low in carbs and protein, but I did not realize pecans are loaded with omega-6 fats, relative to macadamia nuts. I only discovered this by using the terrific nutrient tracker Cronometer.com. I have since realized that is not wise to eat more than a handful of nuts and not every day.
I discuss some of the most significant hazards of omega-6-rich vegetable oils in “This Fat Is Actually Worse Than Trans Fat.”
The ideal ratio of omega-3 to omega-6 fats ranges from 1-to-1 to 1-to-5, but the typical Western diet tends to be between 1-to-20 and 1-to-50. Most people, especially Americans, are guilty of this lopsided omega-3 to omega-6 ratio, and to correct it, you typically need to do two things:
1. Significantly decrease intake of damaged omega-6 by avoiding processed foods and foods cooked in vegetable oil at high temperatures. A number of studies25,26 have found that people who regularly eat deep-fried foods have a significantly increased risk of stroke and death.
Common sources of harmful omega-6 to avoid include corn oil, canola oil, soy oil, hydrogenated or partially hydrogenated fats, margarine and shortening.
2. Increase your intake of animal-based omega-3 fats. Ideal sources include small fatty fish such as sardines, anchovies and herring, along with wild-caught Alaskan salmon, or a supplement such as krill oil.
Examples of Healthy Fats to Eat More Of
When it comes to dietary fats, remember this simple ground rule: Natural is best. The tips that follow can help ensure you're eating the right fats for your health:
• Use organic butter (preferably made from organic grass fed raw milk) instead of margarines and vegetable oil spreads — Butter is a healthy whole food that has received an unwarranted bad rap.
• Ghee is even better, as you remove the milk solids that many have problems with. Ghee is pure fat with no carbs and is what I personally use. The best way to make it is to place it in a glass container in a dehydrator and don’t heat it higher than 100 degrees F. to preserve the quality.
You can suck off the milk solids with a glass baster. Once you have the ghee you don’t even need to refrigerate it as it is stable at room temperature for many weeks.
• Use organic pastured pork lard for cooking and baking — A 2015 analysis27 of more than 1,000 raw foods ranked raw separated pork fat, also known as pork lard, as the eighth healthiest food on a list of 100.28 Valuable nutrients found in lard include:
◦ Vitamin D29
◦ Omega-3 fats30
◦ Monounsaturated fats31 (the same fats found in avocados and olive oil32)
◦ Saturated fats33
• Coconut oil is another excellent cooking oil that is loaded with health benefits.
• To round out your healthy fat intake, be sure to eat raw fats, such as those from avocados, raw nuts, raw dairy products and olive oil. Also increase your animal-based omega-3 fat intake by eating more sardines, anchovies, mackerel, herring or wild-caught Alaskan salmon, or take a supplement such as krill oil. We also offer test kits that enable you to measure your levels and see how well you're doing.
Following my nutrition plan will automatically reduce your modified fat intake, as it will teach you to focus on healthy whole foods instead of processed junk food. You can also learn more in my interview with Dr. Cate Shanahan, author of “Deep Nutrition: Why Your Genes Need Traditional Food.”
In it, she delves deep into the pros and cons of various fats. The following chart was also created by her, which gives you a quick overview of the good, the bad and the ugly.
Eating Right Can Help Prevent Dementia
In closing, remember that, by and large, it is your everyday lifestyle choices that will determine whether your brain will maintain its function throughout your lifetime, or degenerate with age into a potentially deadly neurological disease like Alzheimer’s.
With regard to diet specifically, key factors that will promote lifelong brain health include the following. For a list that also includes other suggested lifestyle modifications, see “How Excess Iron Raises Your Risk for Alzheimer’s.”
Eat real food, ideally organic — Avoid processed foods of all kinds, as they contain a number of ingredients harmful to your brain, including refined sugar, processed fructose, grains (particularly gluten), vegetable oils, trans fats, genetically engineered ingredients and pesticides.
Ideally, keep your added sugar to a minimum and your total fructose below 25 grams per day, or as low as 15 grams per day if you already have insulin/leptin resistance or any related disorders.
Opting for organic produce will help you avoid synthetic pesticides and herbicides. Most will also benefit from a gluten-free diet, as gluten makes your gut more permeable, which allows proteins to get into your bloodstream where they sensitize your immune system and promote inflammation and autoimmunity, both of which play a role in the development of Alzheimer’s.
Replace refined carbs with healthy fats — It’s important to realize that your brain actually does not need carbs and sugars; healthy fats such as saturated animal fats and animal-based omega-3 are far more critical for optimal brain function.
A cyclical ketogenic diet has the double advantage of both improving your insulin sensitivity and lowering your Alzheimer’s risk. When your body burns fat as its primary fuel, ketones are created, which not only burn very efficiently and are a superior fuel for your brain, but also generate fewer reactive oxygen species and less free radical damage.
Pay close attention to the kinds of fats you eat — avoid all trans fats or hydrogenated fats that have been modified in such a way to extend their shelf life. This includes margarine, vegetable oils and various butter-like spreads. For examples of healthy fats to add to your diet, see the section above.
Time-restricted eating in a six- to eight-hour window — Intermittent fasting is a powerful tool to jump-start your body into remembering how to burn fat and repair the insulin/leptin resistance that is a primary contributing factor for Alzheimer’s.
Keep your fasting insulin levels below 3 — If your insulin is high, you’re likely consuming too much sugar and need to cut back.
Optimize your omega-3 level — High intake of the omega-3 fats EPA and DHA help prevent cell damage caused by Alzheimer's disease, thereby slowing its progression and lowering your risk of developing the disorder.
Ideally, get an omega-3 index test done once a year to make sure you’re in a healthy range. Your omega-3 index should be above 8% and your omega 6-to-3 ratio between 1-to-1 to 5-to-1.
Optimize your vitamin D level — Sufficient vitamin D is imperative for proper functioning of your immune system to combat inflammation associated with Alzheimer's and, indeed, research shows people living in northern latitudes have higher rates of death from dementia and Alzheimer's than those living in sunnier areas, suggesting vitamin D and/or sun exposure are important factors.
If you are unable to get sufficient amounts of sun exposure, take daily supplemental vitamin D3 to reach and maintain a blood level of 60 to 80 ng/mL. That said, it’s important to recognize that sun exposure is important for reasons unrelated to vitamin D.
Your brain responds to the near-infrared light in sunlight in a process called photobiomodulation. Research shows near-infrared stimulation of the brain boosts cognition and reduces symptoms of Alzheimer’s, including more advanced stages of the disease.
Delivering near-infrared light to the compromised mitochondria synthesizes gene transcription factors that trigger cellular repair, and your brain is one of the most mitochondrial-dense organs in your body.
Optimize your magnesium levels — Preliminary research strongly suggests a decrease in Alzheimer symptoms with increased levels of magnesium in the brain. Keep in mind that the only magnesium supplement that appears to be able to cross the blood-brain barrier is magnesium threonate.
Vitamin B12 — According to a 2010 study published in the journal Neurology,35,36 people who consume foods rich in B12 may reduce their risk of Alzheimer's in their later years. Very high doses of B vitamins have also been found to reduce memory loss by preventing brain shrinkage.37
Eat plenty of nitrate-rich foods — Beets and other nitrate-rich foods such as arugula provide powerful benefits for your brain and may be a powerful ally in the fight against Alzheimer’s disease.38
Your body transforms plant-based nitrates into nitric oxide,39 which enhances oxygenation, has beneficial impacts on your circulatory and immune systems, and serves as a signaling or messenger molecule in every cell of your body.
The betanin in beets also helps prevent oxidation, particularly oxidation caused when the beta-amyloid is bound to copper, which may help prevent the misfolding and aggregation of amyloid beta.40
Previous research41 has also shown raw beet juice helps improve neuroplasticity, primarily by increasing blood flow and tissue oxygenation. Nitric oxide, in its capacity as a signaling molecule, allows your brain cells to communicate with each other better. Importantly, the beets boosted oxygenation of the somatomotor cortex, a brain area that is often affected in the early stages of dementia.
Optimize your gut flora — To do this, avoid processed foods, antibiotics and antibacterial products, fluoridated and chlorinated water, and be sure to eat traditionally fermented and cultured foods, along with a high-quality probiotic if needed.
Remember that eating factory farmed meats will provide you with traces of antibiotics in each bite. Factory farmed meats are also a suspected route of prions, which are yet another culprit in Alzheimer’s.
Novel Treatments Are Being Explored
Diagnostic guidance and core treatment strategies are detailed in my interview with Dr. Dale Bredesen, featured in “ReCODE: The Reversal of Cognitive Decline.” (You can also download Bredesen’s full-text case paper,42 which details his ReCODE treatment program.)
On a side note, two promising treatment alternatives for Alzheimer’s include photobiomodulation, discussed in “Healing the Body With Photobiomodulation,” and a novel treatment developed at MIT using flickering lights and low frequency sound to stimulate gamma frequencies in the brain,43 which appears to reduce plaque formation.44
MIT neuroscientist Li-Huei Tsai discussed the experiments at a recent Society for Neuroscience meeting, saying the therapy appears to improve survival and health of neurons, improving neuronal connectivity and dilating blood vessels in the brain. His team is now investigating whether it might in fact slow Alzheimer’s disease in humans.45
Over the years, as more and more drug trials have failed to find an answer to Alzheimer’s, researchers are increasingly starting to realize that to be able to address this disease with any measure of success, we have to go back to basics.
There’s a wealth of data showing diet and lifestyle factors are where it’s at when it comes to Alzheimer’s prevention and treatment, and this puts the power right into your own hands. There’s a lot you can do to minimize your risk, and cleaning up your diet is the best place to start.
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