I have included the references so that a reader of the book can simply cut and paste these into the browser and not need to type https://..... each time
Understanding Alzheimer's Disease
Robert Harrison Black
Alzheimer's disease (AD) is named after Dr. Alois Alzheimer. In 1906, Dr. Alzheimer documented changes in the brain tissue of a woman who had died at age 55 of a rare mental illness.
In AD, as neurons are injured and die throughout the brain, connections between networks of neurons may break down, and many brain regions begin to shrink. By the final stages of AD, this process—called brain atrophy—is widespread, causing significant brain volume loss. (NIH, no date)
AD has been studied with microscopes and other scientific equipment. I looked at AD from a global perspective. AD was rare and is now common and becoming a pandemic. As a good scientist, I ask what has changed.
Our genetics have not changed.
We are getting older, which would explain part of the increase.
We are sitting more watching TV or on a computer.
Smoking has declined. I could not find a biochemical link that would increase AD by reducing smoking.
We are consuming a great deal of added sugars. These added sugars include fructose. (Seneff et al., 2010)
We have decreased our consumption of sodium chloride (salt)
We are consuming more inflammatory omega-6 oils.
Life Style Studies:
Livingston, writing in Lancet, said less education, hypertension, hearing impairment, smoking, obesity, depression, physical inactivity, diabetes, low social contact, excessive alcohol consumption, traumatic brain injury, and air pollution account for around 40% of worldwide dementias. These dementias could theoretically be prevented or delayed. The potential for prevention is high and might be higher in low-income and middle-income countries where more dementias occur. (Livingston et al., 2020)
The items on Livingston's list match recommendations for a healthy heart and a lower risk of cancer. These recommendations and those from Baumgart (below) will increase the likelihood of a better life; everyone should follow these recommendations. However, these recommendations show how to reduce the risk of AD but do not show how to reverse AD progression.
Melzer et al. stress the need for micronutrients such as vitamins and minerals to maintain health. They also recommend optimizing macronutrients. This recommendation was not further developed. They assert nutritional status as the most critical modifiable factor regulating the gut microbiota at different time points across the lifespan and under various health conditions. The brain-gut link is identified as essential. (Melzer, Manosso, Yau, Gil-Mohapel, & Brocardo, 2021)
Chart 1 Cognitive decline risk factors for AD
This chart by Baumgart (above) outlines how to avoid AD and other dementias. I have reviewed many clinical studies that describe the Mediterranean diet. They are not consistent, but they have two things in common. They are low in added sugars, and use olive oil and not inflammatory vegetable oils like soybean oil. (Baumgart et al., 2015) Appendix A explains why the term Mediterranean Diet is not useful. Appendix B provides a clear description of a diet to combat AD.
Both gingivitis and E. coli bacteria have been implicated in AD. When I first read the gingivitis study, I thought: Of course, AD patients forget to brush their teeth. Both of these bacteria live on dead tissue. The dead brain cells provide nourishment for these bacteria. (Anderson, 2021) (Zhan et al., 2016) Zahn has noted the fibers in E. coli and their similarity to those in AD. These bacteria may be more a symptom than a cause. In both studies, healthy brains had some gingivitis and E. coli bacteria.
Sugar consumption:
AD increase correlates with the increased intake of added sugars; these include sucrose, high fructose corn syrup, maple syrup, agave, honey, and others. The average American ate only 2 pounds of added sugar a year two hundred years ago. (NH Health, 2014)
Year Consumption
1814 - 2 pounds per year
1970 - 123 pounds per year
2014 - 152 pounds per year
Table 1 Added sugar consumption per year
In one year, we now consume about 152 pounds of added sugar or nearly 3 pounds per week.
Increased sugar consumption is linked to AD. Both correlation and biochemistry show this link.
There is an agreement in the literature that brain glucose uptake is impaired in AD. Can cognitive decline be delayed if this brain energy defect is partly corrected or bypassed early in the disease? The principal ketones (also called ketone bodies), β-hydroxybutyrate and acetoacetate, are the brain's primary physiological alternative fuel to glucose. These two of many studies in mild-to-moderate AD have shown that these brain ketones are as useful to the brain as glucose in healthy age-matched controls. (Cunnane et al., 2016) (Juby 2022) Published clinical trials demonstrate that increasing ketone availability to the brain via moderate nutritional ketosis with medium-chain triglyceride oil has a beneficial effect on cognitive outcomes in mild-to-moderate AD and mild cognitive impairment. (Juby 2022)
Dietary Fats:
We are also consuming omega 6 seed oils. These oils cause inflammation that damages all tissue, including the heart, brain, kidneys, and pituitary.
Oil Type 1814 1909 1999 Percent increase since 1909
Soybean 0 0.01 11.6 116,300
Canola1 0 0.01 0.8 16,700
Safflower3 0 0.04 0.05 25
Cottonseed 0 0.4 0.31 −21
Table 2 Consumption of omega-6 oils in Kilograms per person per year
Omega 6 oil consumption has also tracked AD. Something changes in the brain from being able to use glucose for fuel to needing β-hydroxybutyrate and acetoacetate. The cause of this change in brain metabolism has not been found. Double-blind and biochemical studies are required to know what these oils do to us.
In addition omega-6 fats are unsaturated and more likely to become oxidized in LDL cholesterol. These oxidized LDL particles cannot be used in cells and will continue circulating, causing systemic inflammation. Oxidized LDL will also stick to the walls of the arteries causing plaques. Fats sticking to the walls of arteries causes a cascade of events that lead to clots. This cascade consists of continued accumulation of fatty deposits, attempts by white blood cells to clear the oxidized LDL from the arterial walls, inflammation signals from the white cells, inflammation of the blood vessels that have the deposits, and finally, the buildup of deposits and the formation of clots. Ravnskov and Kromer focused on heart disease, but the findings may also apply to the even finer capillaries in the brain. (Ravnskov et al., 2014) (Kromer, 2018)
Omega 3 fatty acids, primarily from fish, have been shown to reduce the probability of AD (Ma, 2020). Olive oil is low in omega-6 fatty acids, which may be why some Mediterranean diets show positive results.
Studies:
Kane et al. have done a compensative study of attempts to cure AD. Some of the studies provided temporary symptom relief, but none prevented the progress of the disease. "We found mostly low-strength evidence that a wide variety of interventions had little to no benefit for preventing or delaying age-related cognitive decline." (Kane, M.D., Butler, Ph.D., MBA, & Fink, M.D., MPH, 2017) Ketogenic and medium-chain triglyceride diet was not on the list of treatments studied by Kane et al..
A high-fat ketogenic diet can achieve nutritional ketosis by providing 20–70 g/day of medium-chain triglycerides containing the eight- and ten-carbon fatty acids octanoate and decanoate or by ketone esters. (de la Rubia et al., 2020) Insulin blocks the metabolism of fats and promotes the storage of body fat. To use eight- and ten-carbon fatty acids, octanoate, and decanoate, carbohydrates must be limited. Given the acute dependence of the brain on its energy supply, it seems reasonable that the development of therapeutic strategies aimed at AD must target how the underlying problem of deteriorating brain fuel supply can be corrected or delayed.
There are many patients on a ketogenic diet to prevent seizures. The ketogenic diet is high in fat, adequate in protein, and very low in carbohydrates. A typical ketogenic diet for controlling seizures consists of 70% to 80% fats, 20% proteins, and 5% to 10% carbohydrates. Doctors typically recommend the keto diet to treat epilepsy in children of all ages, including infants. Ketogenic diets usually are not preferred by adults because the limited food choices make the diet hard to maintain. The keto diet has also been used in other neurological conditions, including AD and an autism spectrum disorder. (Caraballo, n.d.)
Taylor et al. found that AD could be reversed using medium-chain triglycerides and a ketogenic diet. Their trial only succeeded with subjects with very mild or mild cognitive impairment. With the more severely cognitively impaired, the dropout rate was 100%. These studies have a problem with the subject's unwillingness to stay on the diet or the heavy caregiver burden being too hard. (Taylor, Sullivan, Mahnken, Burns, & Swerdlow, 2018)
Melzer et al. recognized the loss of the ability of the brain to use glucose and the effectiveness of medium-chain triglycerides in the pathology of AD. This revelation was not further developed. (Melzer, Manosso, Yau, Gil-Mohapel, & Brocardo, 2021)
Coconut oil is high in medium-chain fatty acids, easily converted to beta-hydroxybutyrate and acetoacetate; our brain can use these in place of glucose. Many studies have been done on both coconut oil and medium-chain triglyceride oil. I reference one by W M A D B Fernando. (Fernando, 2015) All of the studies with medium-chain triglyceride oil show positive results. Most studies with coconut oil studies show positive results.
The study by Xu et al. showed a significant (p < 0.01) reduction in the AD assessment scale scores used by Xu. There was a 2.62 improvement for the medium-chain triglyceride oil. And a 2.57 reduction in the score for the placebo over 30 days. They used medium-chain triglycerides (MCT) oil with canola oil as a control. The TC, HDL-C, β-hydroxybutyrate, and acetoacetate concentrations were significantly higher in the MCT group than in the placebo group. (Xu et al., 2020)
Roy et al. used multimodal imaging to show that a ketogenic intervention in mild cognitive impairment improved the functional, metabolic and structural integrity of the dorsal attention network. This network enables us to interact with the environment. The 6-month ketogenic medium chain triglyceride supplementation increased functional connectivity within the dorsal attention network as a direct function of improved brain energy status due to higher brain ketone availability. Attention also improved as a function of enhanced functional connectivity. Analysis of the comprehensive structural map of neural connections in the brain revealed increased fiber density within the dorsal attention network following ketogenic medium-chain triglyceride consumption. (Roy et al., 2022)
Rebello et al. "Consumption of 56 g/day of medium chain triglycerides for 24 weeks increases serum ketone concentrations and appears to be a candidate for larger randomized control trials in the future that quantify the modulation of cognitive function through supplementation with ketone precursors in patients with mild cognitive mild impairment." (Rebello et al., 2015)
Mental exercises have a minimal long-term effect in preventing a decline in cognitive function. The researchers found that mental stimulation improved memory and thinking test scores for those with dementia, equivalent to about a six to nine-month delay in worsening symptoms. Some studies found dementia patients who engaged in such activities had increased feelings of well-being and a better quality of life, including improved communication and interactions with those around them. They were, however, no better able to care for themselves or function independently. (Woods, Aguirre, Spector, & Orrell, 2012)
Changes from baseline scores for exercise program patients showed a slower decline than in patients receiving routine medical care. No effect was observed for behavioral disturbance, depression, or nutritional assessment scores. (Rolland et al., 2007)
Drugs for AD:
Drugs have not been shown to reverse AD. The recently approved drug Aducanumab is one in a long line of failed drugs that prevent or reduce amyloid beta plaques. Aducanumab was approved over the objection of the scientific review panel. Trials of Aducanumab have shown mixed results. It will likely fail because the prevention of amyloid beta has consistently failed to delay or reverse AD. Other drugs stimulate the brain and provide the temporary appearance of delay or reversal. None have been shown to delay or reverse AD permanently.
Tampi, Forester, & Agronin also reviewed the clinical trials of Aducanumab. They did not find evidence of a long-term benefit from Aducanumab. They showed why the Drugs Advisory Committee of the FDA voted, with ten members against it and one member uncertain that it was not reasonable to consider the evidence of clinical benefit from Study 302 as primary evidence of the effectiveness of aducanumab. (Tampi, Forester, & Agronin, 2021)
Until recently, in the United States, only five treatments were approved by the US FDA for neurocognitive symptoms of AD. These include three cholinesterase inhibitors (donepezil, galantamine, and rivastigmine), one N-methyl-D-aspartate receptor antagonist (memantine), and a combination of donepezil and rivastigmine. The first four drugs are also licensed in the European Union. In the United States, a fixed-dose combination of donepezil and memantine was approved in 2014 for treating individuals with moderate to severe AD dementia who are stable on donepezil. These drugs reduce symptoms but do not slow the progression of AD. (Tampi, Forester, & Agronin, 2021)
Mehta et al. studied the failure of AD drugs. The article was titled "Why do trials for AD drugs keep failing?" They reviewed drugs that were anti-amyloid monoclonal antibodies, used gamma-secretase to decrease the production of amyloid, controlled tau protein, enhanced neurochemicals, and blocked antihistamines. All were failures. (Mehta, O'Donnell, and Yusuf, 2021)
The Indian spice curcumin is a principal constituent of the spice turmeric. Recent research on amyloid-β and curcumin has revealed that curcumin prevents amyloid-β aggregation and crosses the blood-brain barrier (BBB), reaches brain cells, and protects neurons from various toxic insults of aging and amyloid-β in humans." (Reddy et al., 2018) Molecular variations of curcumin may also be effective against AD.
Salt:
"There is evidence that high salt intake is associated with poor cognition. However, findings are mixed due to poor methodological quality and the studies' heterogeneous dietary, analytical, and cognitive assessment methods and design. Reduced sodium intake may be a potential target for intervention. High-quality prospective studies and clinical trials are needed." (Mohan et al., 2020)
O'Donnell found that a salt intake between 3 and 6 grams per day was associated with a lower risk of death. This quantity is what we naturally consume. The lowest level of AD was when consuming salt to taste. This level of salt intake is between 3 to 5 grams per day. Low salt may be part of the problem; I did not find any double-blind clinical studies on salt and AD. (O’ Donnell et al. 2014)
Discussion:
Correlation is not causation; we must have good clinical studies and biochemical mechanisms.
Genetics have been studied concerning AD. Some genetics have been linked to an increased risk of AD, but no studies show a new gene is spreading in the adult population.
An aging population has more time for AD symptoms to become apparent. We are getting older, which would explain at least part of the increase. Also, more people are being diagnosed earlier.
Our increasingly sedentary lifestyle is likely a cause of a portion of the increase. Intellectual stimulation has been shown to slow the development of AD. By delaying the diagnosis, some people who would have been diagnosed with AD may die of other causes before diagnosis.
I did not find a link to smoking cessation.
This linkage is also true of Omega 6 oils. Both correlation and biochemistry show this link. We do not have a way to determine the percentage is caused by sugar and what percentage is Omega 6 oils.
Eliminating carbohydrate consumption to obtain at least partial ketosis and providing medium-chain triglycerides successfully stopped the progression and partially reversed cognitive decline. (De la Rubia Ortí JE, 2020) Age Successfully Second Edition provides a diet that meets the requirements of De la Rubia Ortí JE to prevent and reverse cognitive decline (Black, 2020). This diet prevents further neuron death. New brain cells are added slowly to the brain in older subjects. The brain is plastic, and some recovery can be made by brain reorganization. To live a normal life, including personal hygiene, the diet must be started before significant neuron death has occurred.
Conclusion:
Diet is the only treatment shown to work in the long run. (De la Rubia Ortí JE, 2020) Age Successfully Second Edition, pages 135-136, provides the diet that meets the requirements of De la Rubia Ortí JE to prevent and reverse cognitive decline. An updated and improved version of this diet is in appendix B. (Black, 2020).
Appendix:
A) The Mediterranean diet MD
MD is recommended in many studies, used against control in clinical studies, and is recommended in most health literature. Often it is not defined, and the reader is left to determine what it is. Is the MD lots of pasta and red wine? When the MD is defined, it is usually a diet high in fruits and vegetables with whole grain cereals, olive oil, and fish. There are many flaws in this diet description. I have been to Italy, eaten in their restaurants, visited their grocery stores, and observed what the people eat. Italian pasta and Italian bread are not whole grains. Cereals on the shelves in the United States, even when they claim to contain whole grain, typically have little whole grain and large quantities of added sugars.
Fruits and vegetables are not the same. Most vegetables have evolved to contain toxins against microbes and animals who would eat them (D, D, A, & I V, 2016). Recommending green leafy vegetables is not specific enough. For example, spinach contains oxalic acid, and if it were a large part of a diet, oxalic acid would block iron absorption, thereby causing anemia. Fruits typically have toxins when the seeds have not been developed enough to pass through the vector unharmed. Fruit seeds usually contain toxins to prevent them from being eaten (Medical News). Fruits are high in sugar, with fructose being the most concerning.
Some fructose from sugar will gain access to the brain, increasing appetite and blocking the signal that tells the brain to stop eating. Fructose can not be used by cells for energy. It must be converted to fat by the liver. Some of this fat is stored by the liver, causing fatty liver disease; some is released into the bloodstream as small particle triglycerides; These particles can cause arterial blockages.
We need to stop using the term Mediterranean diet and be specific when recommending a diet.
B) A diet for AD based on the AD diet in Age Successfully and additional research:
The Cunnane and the Seneff papers explain the principles of changing the brain from glucose fuel to ketone fuel to combat AD and other health problems. We need to provide medium-chain fatty acids that can be converted to ketones and reduce glucose availability to force the conversion. The conversion happens when in or partially in ketosis. This treatment is based on the theory that the brain loses its ability to use glucose and does not lose its ability to use ketones for energy. The brain can grow more cells and synapses, but this is slow. This treatment must be started early before a significant part of the brain is lost. If Cunnane is right, amyloid and tau proteins can be thought of as brain scar tissue and not the cause of the problem. This diet will provide the ketones without being in full ketosis.
Stopping the loss of intellectual capacity is not easy and requires the person progressing to or with AD to put in the effort. Any attempt to cure AD will only work if the subject has a reason to be intellectually active. This need for motivation is particularly important for the spouse or caregiver. There needs to be a life purpose or life goals. If the subject is simply in a retirement facility waiting to die, they have no incentive to improve their intellectual capacity. Without a life purpose, why not have AD? In later stages, it is less stressful.
An effective AD cure requires diabetes to be cured first. The presence of significant insulin will prevent ketone metabolism.
After the diabetes is cured, start the first step to eliminate AD: take two tablespoons of Medium Chain Triglyceride (MCT) oil three times a day. (de la Rubia et al., 2020) MCT oil can have a laxative effect and can cause digestive upset. It may need to be added incrementally.
Use coconut oil for cooking at low temperatures and virgin olive oil for higher temperatures. Eliminating omega-6 fatty acids will reduce inflammation.
Eat two eggs a day to increase protein and cholesterol availability. Our brain can be considered a bag of cholesterol with an embedded electronic quantum computer.
Eliminate added sugars to reduce A1c.
Take 2 grams of turmeric (curcumin) daily to clear amyloid plaque proteins from the brain. (Reddy et al., 2018)
Eat sufficient animal protein. For persons over 60, this can be daunting. Baum et al. recommend between 1.2 and 2 grams per day for the elderly. I weigh 175 pounds (79kg) and am 83 years old. I ride my bike and work out in the gym daily. Based on that, I should consume 85 grams of protein per day. An egg has 14 grams of protein. Four oz of raw ground beef has 21 grams of protein. (Baum, 2016)
Take an omega-3 oil supplement that has DHA.
Maintaining an adequate fiber intake and carbohydrate reduction to less than 10% will require replacing potatoes, sweet potatoes, rice, corn, bread, carrots, beets, and other starchy foods with high-fiber vegetables.
Physical exercise and mental exercise are needed to keep the brain active. Both physical and mental activity encourages new brain cell formation and synapse formation.
Use intermittent fasting to clear inactive proteins and mitochondria.
Authors note: I use a modified version of this diet every day. I consume more carbohydrates than the diet above and fast 18 hours daily from 6:00 pm until Noon the next day. My brain is still intact.
References:
Anderson, P. (n.d.). Gum Disease Bacteria a New Treatment Target for AD? Retrieved October 2, 2022, from https://www.medscape.com/viewarticle/963574?uac=362670CN&faf=1&sso=true&impID=3824361&src=wnl_edit_tpal#vp_2
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Click here for a Short summary of Age Successfully.
Robert back packing in Laos in 2016 showing metabolic syndrome belly (Now gone)
Lifelong Plan for long and healthy life:
Kick the caffeine habit and only use Caffeine for times when extra physical or mental demands are expected.
It is important to stay hydrated without over drinking and losing too many minerals.
Everyone should eliminate unsaturated vegetable fats like corn oil, soybean oil and other seed oils.
Everyone should eliminate all added sugars. No sugar soft drinks, no cookies, no candy, no sugar containing cereals, no packaged foods with any sugar, no ketchup, no salad dressing with sugar.
Limit starches to 50% of calories or less.
Use MCT oil or olive oil for salads only. Cook with saturated fats Lard, Butter, Coconut oil or Tallow.
Eat at least one serving of cruciform vegetables at least 2 times each week.
Schedule at least 8 hours of sleep and eliminate blue light at least two hours before bed time.
Use a multivitamin, magnesium, calcium with vitamin D, Turmeric, vitamin D3 and vitamin C supplements.
Consume some fish or take an Omega 3 supplement or both.
Exercise at least three times a week. This exercise should include: aerobic, weight bearing and three short periods of high intensity exercise.
Do some intermittent fasting at least once a week. The easiest fasting is 18 hours by only eating from Noon to 6:00 PM each day.
Consume at least 20 grams of fiber per day.
Consume the recommended amount of protein
Limit fruit to one serving a day
For someone that is not diabetic, prediabetic or obese simply doing what is suggested above should be all that is necessary for leading a long life without unnecessary infirmities. Prediabetics and Diabetics need to further reduce carbohydrates.
Age Successfully
For Alzheimer's disease prevention and cure:
Read the Cunnane papers and the Philips paper, to understand the principles of changing the brain from glucose fuel to ketone fuel. We need to provide the medium chain fatty acids that can be converted to ketones and reduce glucose availability to force the conversion. The conversion happens when in or partially in ketosis. This treatment is based on the theory that the brain loses its ability to use glucose and does not lose its ability to use ketones for energy. The brain can grow more cells and more synapses, but this is slow. It is important that this treatment be started early before a significant part of the brain is lost. If Cunnane is right, amyloid and tau proteins can be thought of as brain scar tissue and not the cause of the problem.
Any attempt to cure Alzheimer’s will only work if the subject has a reason to be intellectually active. There needs to be life purpose or life goals. If the subject is simply in a retirement facility waiting to die, they have no incentive to improve their intellectually capacity. Without life purpose, why not have Alzheimer’s, in later stages it is less stressful.
The Alzheimer’s cure will cure diabetes first. This is the first step and will reduce insulin that would will prevent ketone metabolism.
Take two tablespoons of MCT oil three time a day. MCT oil can have a laxative effect and can cause digestive upset. It may need to be added incrementally.
Use coconut oil, lard or Tallow for cooking.
Take 3 grams of Turmeric each day to clear amyloid plaque proteins from the brain. This is a high dose of turmeric compared to the lifelong plan.
Eat two eggs a day to increase cholesterol availability.
Eliminate added sugars to reduce A1c and Eliminate potatoes, sweet potatoes, rice, corn, bread, carrots, beets, and other starchy foods.
Eat 50 grams of protein a day. This is about two McDonalds patties. An egg has 7 grams of protein. Nuts are from 18 to 25% protein and beans are 8 to 12% protein
Reduce carbohydrates to less than 10% of calories while maintaining fiber intake.
Physical exercise and mental exercise are needed to exercise the brain. Both physical and mental exercise encourage new brain cell formation and synapse formation.
Use intermittent fasting to clear inactive proteins and mitochondria. I recommend 18 hours a day fasting. I fast from 6:00PM to Noon the next day.
This diet may be needed for months to slowly bring back lost cognitive function. Because glucose metabolism has been lost this diet may be needed forever.
Cunnane, S. C., Courchesne-Loyer, A., St-Pierre, V., Vandenberghe, C., Pierotti, T., Fortier, M., … Castellano, C. A. (2016). Can ketones compensate for deteriorating brain glucose uptake during aging? Implications for the risk and treatment of Alzheimer’s disease. Annals of the New York Academy of Sciences, 1367(1), 12–20. https://doi.org/10.1111/NYAS.12999
Randomized crossover trial of a modified ketogenic diet in Alzheimer’s disease
Matthew C. L. Phillips https://alzres.biomedcentral.com/articles/10.1186/s13195-021-00783-x
The Ketogenic Diet and Alzheimer's DiseaseH Hersant 1, G Grossberg
https://pubmed.ncbi.nlm.nih.gov/30554068/
Age Successfully describes how to age without having all of the infirmities blamed on age. It describes how the author did it wrong, did the research and now at 82 years old lives a life with minimum infirmities. It describes how to minimize, and in most cases eliminate diabetes, heart disease, stroke, degraded cognition, fall fractures, diabetic amputations, cancer, and vision loss. More than one half of all medical care is needed because of lifestyle diseases. There is no need to be in that half. The book covers why calorie restriction, exercise and reduction of dietary fat does not cure obesity and what does. How to cure prediabetes and type 2 diabetes. How to minimize the chance of Alzheimer’s disease. Understand and prevent what causes high blood pressure, , low HDL and high A1c. (High LDL is sometimes good not bad)
How to lose weight without a great deal of willpower, pain, or suffering
Understand the science:
Calorie restriction fails to reduce weight 99% of the time. The metabolic system will slow down to compensate for calorie restriction, at the same time, step up the production of ghrelin, the hunger hormone, and decrease the hormones that would reduce hunger.
Exercise in moderation is an excellent way to be healthy. It is only a minimally effective weight-loss strategy. Exercise increases hunger, and moderate exercise does not significantly increase the metabolic rate. Long-duration high-intensity exercise can be harmful. (Most marathon runners do not age well.)
Fructose is in all added sugars. (table sugar, honey, maple syrup, high fructose corn syrup, and agave) Fructose increases the production of ghrelin. Fructose can not be used by the body for energy and must be converted to fat by the liver. Fat from the liver is stored in a fatty organ surrounding the intestines; this belly fat is the most visible sign of metabolic syndrome. Metabolic syndrome leads to heart disease, fatty liver disease, cancer, diabetes, and Alzheimer’s.
Weight loss requires fat burning and can only happen when the level of insulin in the body is low. Sugars, starches, and proteins keep insulin high.
Steps to effective weight loss:
Eliminate all added sugars: no cookies, fruit juices (not even orange juice), candy, cakes, pies, condiments with added sugar (catsup), etc. Limit fruit to one serving a day. Learn to read food labels to avoid buying foods with added sugar.
Eat a high-fat, low carbohydrate diet. Saturated fats are the best. (See life401.com August 27, 2021 blog post) Fat will reduce apatite. Unfortunately many obese people lose the signal from fat to stop eating. Eat about 0.4 grams of protein per day for each pound of target weight. For those over 65, eat 0.5 grams of additional protein. Read food labels and do the math.
Set a realistic target. A reduction of 10% of your current weight is realistic; after hitting this target and maintaining this weight, you may want to set a new target. Unrealistic targets can lead to disappointment and giving up.
Do not snack. Snacks keep insulin levels high and prevent fat burning.
Use intermittent fasting. Pick a time window and only eat within that window. I fast from 6:00 PM until Noon the next day, an 18 hour fast. Everyone is different; you may only be able to fast for 13 hours a day.
Stay busy. Everyone has found that they have been active on some project and missed a meal. If you follow the above, you will quickly lose several pounds of water. After the first few pounds, the loss will be fat. It will be slow, but it is essential to stay with it. A slow loss over a long time is the most healthful. Cycling loss, gain, loss, gain is deadly.
The basics of eliminating sugar was known in 1863 Banting, W. (1863). Letter on Corpulence, Addressed to the Public. https://archive.org/details/letteroncorpulen00bant/page/10/mode/2up