Reversal of cognitive decline: A novel therapeutic program

"Gluten free, intermittent fasting" are pseudoscience health trends and trying to strawman them as "eating healthy" is disingenuous.

There is a long discussion about the metabolic underpinnings of neurological diseases but the paper's reasoning about the underlying mechanism of disease is weak.

For example, the paper stresses that there is a dysfunctional signaling in AD and comes to a conclusion that it is inducted by a metabolic dysfunction. While this is a true statement, the amount of overall cellular damage happening under the conditions of insufficient metabolism goes way beyond that. The patients have not only "bad signalling", but also autoimmune-like response to damaged tissues. The paper fails to discuss that but suggests as a treatment target in "Therapeutic System 1.0".

The suggested treatment, however, contains the crucial elements that should bring the improvement to patients.

This is not a bad paper by all means. It is useful and even enlightening to some degree, but the theoretical part is tiny and not sound.

Regarding the critical article from The Lancet [1], it's full of emotions and nihilism. I.e. it is bad. I mean, really bad.

For example, here are some excerpts from critical article. "high out-of-pocket cost to implement" - bullshit. While the whole protocol may be costly depending on country, the mitochondrial (the most essential part of it) is dirt cheap, like tens-of-dollars per month cheap. Anti-inflammatory part of protocol can be implemented even with Aspirin.

"Readers might not be aware that the three case series evaluating the Bredesen protocol appear in journals considered by some to be predatory open access journals. Predatory open access journals are scientific-sounding publications that hijack the open access model for profit" - come on. The predatory closed-access model, on the other hand, has its own downsides, e.g. slow progress, walled gardens of authority, review rings.

"There are elements of the Bredesen protocol that could be beneficial and are largely free to patients. It is standard of care in dementia clinics to educate patients, without cost, on the lifestyle interventions" - and that's it. No mentions to metabolic corrections other that "lifestyle change". Which is not sufficient by itself. It only works in conjunction with mitochondrial + anti-inflammatory parts.

"When presented with this information, there are people who continue to hold a strong belief in the protocol’s efficacy." - because it is. Rather than loudly criticizing other's work, it is way better to join the ranks and improve the research by covering the missing parts.

"When carefully examined, multiple red flags appear in the scientific studies supporting the Bredesen protocol." - that's true.

"To date, the evidence does not support its claim to prevent and reverse cognitive decline" - oh well, don't get me started. To date, the neurologists try to treat such patients with... antidepressants. And that's it. Most of them do not even know about neuro-metabolical cause and effect connections.

[1] https://sci-hub.se/downloads/2020-04-23/63/10.1016@S1474-442...

Your comment is an example of good knowledge without public recognition as it was downvoted. Probably the public goes by keywords like "schizophrenia" and concludes "oh well, that guy is mad I shoulda downvote him for all's good". But I think your comment is good and worthy, as it brings a small bit of data to a metabolic-neurological connection theory.

>ketosis does something to the immune system

Keto utilizes a bit different metabolic pathway compared to the aerobic glycolysis [1, 2]. The reason you observe immune system response when you lower keto and increase hydrocarbons is because glucose metabolic pathway is broken in such patients. Their bodies cannot consume glucose in full and start to starve in ATP, up to the point of tissue damage, all that with excessive lactic acid excretion. When the tissues are damaged, immune system gets activated and attacks them. By doing so, it also affects nearby healthy tissues, leading to wavy but gradual disease progression.

This process is believed to play the crucial role in progression of neurological and cardiovascular disorders.

The part of glucose metabolism that gets often broken in a human is aerobic cellular respiration [2]. It may be an inherited genetical condition or an acquired mitochondrial dysfunction.

By the way, do you happen to have an insulin resistance? If this parameter is not ok, this can be an additional hint. But even if it is ok, the given pathological process may be in place and slowly progress, eventually leading to insulin resistance as well.

[1] https://en.wikipedia.org/wiki/Glycolysis

[2] https://en.wikipedia.org/wiki/Cellular_respiration

The major issue with this paper and this protocol is that it is not reproducible.

As the protocol is not accessible / published, we cannot determine how the difference in the set of measures between participants were determined and as such no researcher can independently replicate this study.

This is why those licensed diet / lifestyle change are never science: by definition. Even if they actually produce the desired outcome, all the research is produced either by the creator or by researchers that entered a license agreement and thus have conflicting interests and bias.

Absolutely. In the case of one uncle he was tea total, healthy diet, distance running, skiing up to his 70s when he got Alzheimer's. Declined in 2 years to the point where he couldn't be at home as he was too strong for his wife to handle. Covid proved the end of any attempt to cling on to his past as it was made illegal for family to visit him. He's gone completely now. But I suspect his physical fitness will see him last longer than he should.

My mother going this way now too.

Suspect it will be me one day.

Certainly genetic factors involved.