Dispelling Brain Health Misunderstandings: A Response to Joe Rogan and Max Lugavere

This episode is dedicated to clarification of a podcast between Joe Rogan and Max Lugavere, two popular influencers that have a large audience. They discussed Alzheimer’s disease and brain health in general and some of the information that was shared was not accurate, which can be really harmful. This is by no means an attack on Rogan or Lugavere. After listening to the conversation, we think Lugavere may not be quite familiar with the data regarding brain health, and it would be important to set the record straight and share the evidence with people and let them decide what’s best for them. Having seen thousands of patients with dementia, whether it’s Alzheimer’s disease, frontotemporal lobe dementia, Lewy Body Dementia and others, we feel it’s our responsibility to share evidence based data as opposed to feel-good, self confirming anecdotes. Relevant references: Ketogenic Diet: Phillips, M. C et al. (2021). Randomized crossover trial of a modified ketogenic diet in Alzheimer’s disease. Alzheimer's research & therapy, 13(1), 1-12. Lilamand, M et al. (2022). Efficacy and Safety of Ketone Supplementation or Ketogenic Diets for Alzheimer's Disease: A Mini Review. Frontiers in Nutrition, 1324. Włodarek, D. (2021). Food for thought: the emerging role of a ketogenic diet in Alzheimer’s disease management. Expert Review of Neurotherapeutics, 21(7), 727-730. Cronjé, H et al. (2021). Ketogenic therapies in mild cognitive impairment and dementia. Current Opinion in Lipidology, 32(5), 330-332. LDL Cholesterol metabolism and risk of Alzheimer’s: Andrews, S et al., collaborators of the Alzheimer's Disease Genetics Consortium. (2021). Causal associations between modifiable risk factors and the Alzheimer's phenome. Annals of neurology, 89(1), 54-65. Olmastroni, E et al. (2022). Statin use and risk of dementia or Alzheimer’s disease: a systematic review and meta-analysis of observational studies. European Journal of Preventive Cardiology, 29(5), 804-814. Iwagami, M et al. (2021). Blood cholesterol and risk of dementia in more than 1· 8 million people over two decades: a retrospective cohort study. The Lancet Healthy Longevity, 2(8), e498-e506. Tan, Z. S et al. (2003). Plasma total cholesterol level as a risk factor for Alzheimer disease: the Framingham Study. Archives of Internal Medicine, 163(9), 1053-1057. Kivipelto, M et al. (2002). Apolipoprotein E ε4 allele, elevated midlife total cholesterol level, and high midlife systolic blood pressure are independent risk factors for late-life Alzheimer disease. Annals of internal medicine, 137(3), 149-155. Zhou, Z et al. (2020). Low-density lipoprotein cholesterol and Alzheimer's disease: a systematic review and meta-analysis. Frontiers in aging neuroscience, 12, 5. Sáiz-Vazquez, O et al. (2020). Cholesterol and Alzheimer’s disease risk: a meta-meta-analysis. Brain sciences, 10(6), 386. Wingo, A. P et al. (2022). LDL cholesterol is associated with higher AD neuropathology burden independent of APOE. Journal of Neurology, Neurosurgery & Psychiatry, 93(9), 930-938. The Nigerian Paradox Study: Hall, K et al. (2006). Cholesterol, APOE genotype, and Alzheimer disease: an epidemiologic study of Nigerian Yoruba. Neurology, 66(2), 223-227. Vascular health and Alzheimer’s disease: Levit, A et al. (2020). Neurovascular unit dysregulation, white matter disease, and executive dysfunction: the shared triad of vascular cognitive impairment and Alzheimer disease. Geroscience, 42(2), 445-465. The Effect of Lifestyle on Alzheimer’s Risk: Dhana, K et al. (2020). Healthy lifestyle and the risk of Alzheimer dementia: Findings from 2 longitudinal studies. Neurology, 95(4), e374-e383.  Risk Reduction of Cognitive Decline and Dementia: WHO Guidelines. Geneva, Switzerland: World Health Organization; 2019.  https://apps.who.int/iris/bitstream/handle/10665/312180/9789241550543-eng.pdf. Accessed December 4, 2019. MIND Diet: Morris, M. C et al. (2015). MIND diet associated with reduced incidence of Alzheimer's disease. Alzheimer's & Dementia, 11(9), 1007-1014. Morris, M. C et al. (2015). MIND diet slows cognitive decline with aging. Alzheimer's & dementia, 11(9), 1015-1022. van den Brink, A. C et al. (2019). The Mediterranean, Dietary Approaches to Stop Hypertension (DASH), and Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) diets are associated with less cognitive decline and a lower risk of Alzheimer's disease—a review. Advances in Nutrition, 10(6), 1040-1065. Kheirouri, S., & Alizadeh, M. (2021). MIND diet and cognitive performance in older adults: a systematic review. Critical Reviews in Food Science and Nutrition, 1-19. Hosking, D. E et al. (2019). MIND not Mediterranean diet related to 12-year incidence of cognitive impairment in an Australian longitudinal cohort study. Alzheimer's & Dementia, 15(4), 581-589. Melo van Lent, D et al. (2021). Mind diet adherence and cognitive performance in the Framingham heart study. Journal of Alzheimer's Disease, 82(2), 827-839. Dhana, K et al. (2021). MIND diet, common brain pathologies, and cognition in community-dwelling older adults. Journal of Alzheimer's Disease, 83(2), 683-692. Thomas, A et al. (2022). Association of a MIND Diet with Brain Structure and Dementia in a French Population. The Journal of Prevention of Alzheimer's Disease, 1-10. Arjmand, G et al. (2022). Effect of MIND diet intervention on cognitive performance and brain structure in healthy obese women: a randomized controlled trial. Scientific Reports, 12(1), 1-14. Nutrition and Dementia Prevention: Yassine, H. N et al. (2022). Nutrition state of science and dementia prevention: recommendations of the Nutrition for Dementia Prevention Working Group. The Lancet Healthy Longevity, 3(7), e501-e512. Scarmeas, N et al. (2018). Nutrition and prevention of cognitive impairment. The Lancet Neurology, 17(11), 1006-1015.   Publications by Lugavere’s mentor, Dr. Richard Isaacson: Isaacson, R. S et al. (2019). Individualized clinical management of patients at risk for Alzheimer's dementia. Alzheimer's & Dementia, 15(12), 1588-1602. Amini, Y., Saif, N., Greer, C., Hristov, H., & Isaacson, R. (2020). The role of nutrition in individualized Alzheimer’s risk reduction. Current nutrition reports, 9(2), 55-63.  Isaacson, R. S. (2019). Advances in early diagnosis and treatment strategies in the management of Alzheimer’s disease. Journal of Managed Care Medicine, 22(4), 17-21. Berkowitz, C. L., Mosconi, L., Rahman, A., Scheyer, O., Hristov, H., & Isaacson, R. S. (2018). Clinical application of APOE in Alzheimer’s prevention: a precision medicine approach. The journal of prevention of Alzheimer's disease, 5(4), 245-252. BOOK: The Alzheimer's Prevention & Treatment Diet: Using Nutrition to Combat the Effects of Alzheimer’s Disease. Isaacson, R. S., & Ochner, C. N. (2016). Square One Publishers, Inc. Podcast episodes mentioned: The Proof with Simon Hill: The carnivore diet, veganism and nutrition misinformation | Dr Alan Flanagan.  The Proof with Simon Hill: Debate: Seed Oils And Heart Disease | Tucker Goodrich And Dr Matthew Nagra   Our publications relevant to this topic: Sherzai, A., Edland, S. D., Masliah, E., Hansen, L., Pizzo, D. P., Sherzai, A., & Corey-Bloom, J. (2013). Spongiform change in dementia with Lewy bodies and Alzheimer disease. Alzheimer Disease & Associated Disorders, 27(2), 157-161. Whitehair, D. C., Sherzai, A., Emond, J., Raman, R., Aisen, P. S., Petersen, R. C., & Fleisher, A. S. (2010). Influence of apolipoprotein E ɛ4 on rates of cognitive and functional decline in mild cognitive impairment. Alzheimer's & Dementia, 6(5), 412-419. Lazar, E., Sherzai, A., Adeghate, J., & Sherzai, D. (2021). Gut dysbiosis, insulin resistance and Alzheimer’s disease: review of a novel approach to neurodegeneration. Frontiers in Bioscience-Scholar, 13(1), 17-29. Sherzai, D., & Sherzai, A. (2019). Preventing Alzheimer’s: Our most urgent health care priority. American journal of lifestyle medicine, 13(5), 451-461. Sherzai, A. Z., Sherzai, A. N., & Sherzai, D. (2022). A Systematic Review of Omega-3 Consumption and Neuroprotective Cognitive Outcomes. American Journal of Lifestyle Medicine, 15598276221117102. Sherzai, D., Sherzai, A., & Sherzai, A. (2022). Lifestyle Intervention and Alzheimer Disease. The Journal of Family Practice, 71(1 Suppl Lifestyle), eS83-eS89. Sherzai, D., Sherzai, A., Lui, K., Pan, D., Chiou, D., Bazargan, M., & Shaheen, M. (2016). The association between diabetes and dementia among elderly individuals: a nationwide inpatient sample analysis. Journal of Geriatric Psychiatry and Neurology, 29(3), 120-125. Sherzai, A., Sherzai, D., Pilot, M., & Ovbiagele, B. (2016). Prevalence of the Diagnoses of Alzheimer's Dementia, Non-Alzheimer's Dementia and Vascular Dementia Among Hospitalized Stroke Patients: A National Inpatient Sample Analysis, 1999-2012 (P1. 125).   Follow us on social media: Instagram: The Brain Docs @thebraindocs Facebook: The Brain Docs Website: TheBrainDocs.com