393: Alzheimer's Starts Decades Before Symptoms…Here's Why | David Perlmutter
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How is the traditional amyloid hypothesis for Alzheimer's being challenged?
Alzheimer's, it's a fatal condition. Do we know an Alzheimer's survivor? I don't.
A theory that Alzheimer's is all about amyloid plaque buildup and misfolded proteins may not be what we should be focused on.
The seeds of Alzheimer's, they are sown in our 40s and in our 50s. It's not now that you suddenly can't remember grandchildren's names, Wi-Fi codes. or where you put your keys, that's way into this experience. Dr. Rudolph Tanzi and Dr. Dean Ornish from Harvard, they took actual Alzheimer's patients and they changed their diet. They said, we're going to ask you to do some exercise every day. We're going to reduce your stress and we're going to do some cognitive assessments on you and see how you're doing. 70% of these people not only stabilized, but some of them actually improved in their cognitive function by changing their lifestyle.
You're listening to Be Well by Kelly Levesque.
Hey, everyone. Welcome back to the Be Well by Kelly podcast. It is such a pleasure to welcome back a repeat offender, Dr. David Perlmutter. He's a board-certified neurologist, a fellow of the American College of Nutrition, and one of the most influential voices in the intersection of neurology, nutrition, and lifestyle medicine. He's been a New York Times bestseller multiple times. You've heard of his books, Grain Brain, Brain Maker, and Drop Acid. His newest book is here in my hands. It's called Brain Defenders. And in today's episode, we're going to talk about how the theory that Alzheimer's is all about amyloid plaque buildup and misfolded proteins may not be what we should be focused on. And instead, we should be focused on the immune system of the brain.
And he's going to break it all down for us in today's 101 episode. Dr. Perlmutter, welcome back to the show.
Well, I'm delighted to be back, and I've been called a repeat offender many times in my past, so I feel very honored to be a repeat offender on your program.
Well, you've always done such a good job of breaking down the science of what you're seeing in the literature for the lay people, for everyone, you know, making choices at the farmer's market, at the grocery store, how they should be sleeping, how they should be moving to protect their brain. And this new book, I think, does an amazing job of really giving us the keys to the kingdom and how to do that, to really, truly defend our brain and not be... shackled with some type of neurological disease when we get older. So thank you so much for all of your work.
I mean, that's really what it's all about. And as you just said that, I'm thinking, why should this be unique and strange? You know, this should be what neurologists do. That, you know, we understand the incredibly huge impact that our lifestyle choices have on our ability to be the architects of our brain's destiny, why shouldn't this be top of mind? Why shouldn't, you know, Ideal World, they would teach this in medical school and neurology residency.
What are microglia and how do M1 vs M2 states affect brain health?
But, you know, that's why we have Kelly Levesque around to get the word out. So thank you.
My pleasure. Well, I'm curious, what made you want to write Brain Defenders? What do you say in this book that you felt like you couldn't say before?
Well, I couldn't say what I'm about to say before because I didn't understand it. And this is relatively new information really for everyone. And what this book really represents is a convergence of so many of the things that I've been exploring for the past 35 years. The idea that a refined carbohydrate diet, now we call it ultra processed foods, lack of exercise, not getting restorative sleep, lack of socialization, All of these things are inroads to making a good brain go bad, but we never really understood how they work, right? We've known that type 2 diabetics have as much as a threefold increased risk for developing Alzheimer's, that they have an 85% increased risk of developing Parkinson's above people who do not have type 2 diabetes, but we never really got the why.
We just said, well, that's it. Maybe we shouldn't be diabetic.
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Chapters
8 chapters
1
How is the traditional amyloid hypothesis for Alzheimer's being challenged?
0:00–2:54
2
What are microglia and how do M1 vs M2 states affect brain health?
2:54–9:49
3
What is immunometabolism and how does insulin resistance become 'Type 3 diabetes' in the brain?
9:49–17:36
4
How does long COVID reveal mitochondrial and microglial dysfunction in the brain?
17:36–26:58
5
Which lifestyle changes (diet, sleep, exercise, social connection) most strongly protect memory?
26:58–34:09
6
How does the gut microbiome influence brain inflammation and microglial polarization?
34:09–49:46
7
What biomarkers and tests (LPS, p‑tau217, CRP, fasting insulin) should people consider for early detection?
49:46–1:06:49
8
How should women consider menopause, hormone replacement, and GLP‑1s in relation to dementia risk?
1:06:49–1:14:18
Speakers
2 identifiedMore from Be Well by Kelly Leveque
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396: What Every Parent Needs to Know About Sleep, Behavior + Brain Development