Alzheimer's disease has a multifactorial origin: genes and environment both contribute. Genes cannot be changed, but an important part of the risk is linked to lifestyle. This guide summarizes what science knows so far and how to turn it into achievable habits.
In short
- About 40% of dementia cases worldwide are associated with 12 potentially modifiable risk factors.
- What is good for the heart is usually good for the brain: blood pressure, blood sugar, weight, movement and sleep all count.
- An eating pattern based on vegetables, legumes, fish and good-quality fats is the foundation of care.
- Supplements are complementary and individualized: they do not replace lifestyle or medical treatment.
01
What can be modified
Growing evidence links lifestyle to the onset and progression of dementia, including Alzheimer's. The factors most often associated are an unhealthy diet, physical inactivity, emotional stress and social isolation.
There are 12 potentially modifiable risk factors that together account for about 40% of the global burden of dementia. Many of them also raise the risk of heart disease and other chronic conditions.
- High blood pressure, type 2 diabetes and obesity.
- Smoking and excessive alcohol use.
- Physical inactivity and social isolation.
- Depression and untreated hearing loss.
- High LDL cholesterol, low education, head injury and air pollution.
These factors share mechanisms such as chronic inflammation, oxidative stress and insulin resistance. Taking care of them protects the brain and the heart at the same time. The link is one of risk, not certainty: no one controls every factor, and that is no reason for guilt.
02
What the studies show
Food
In observational studies, people who ate more vegetables had up to a 38% lower risk of Alzheimer's, and those who ate fish or omega-3 sources at least once a week had about a 60% lower risk. Excess saturated and trans fats more than doubled the risk of dementia. Observational studies show association, not proof of cause.
Combined intervention
In older adults at increased risk of dementia, a program of diet, physical activity, cognitive training and vascular risk monitoring preserved cognition over 2 years. At the end, global cognition in the intervention group was 25% higher than in the control group, regardless of APOE ε4.
2024 study in diagnosed Alzheimer's
A randomized trial (Ornish et al., 2024) followed 49 people with mild cognitive impairment or early dementia due to Alzheimer's. Over 20 weeks, an intensive program of plant-based diet, moderate exercise, stress management and support groups was compared with usual care. The results are promising, but the study is small and short, and meals and supplements were provided to participants. It does not prove that Alzheimer's can be reversed.
03
The essentials on the plate
You do not need to follow the study's protocol to look after your brain. What the research has in common helps build an achievable routine:
More vegetables and minimally processed foods
Vegetables, fruit, beans, lentils, chickpeas, whole grains, nuts and seeds at every meal. Varying the colors broadens the range of nutrients.
Good-quality fats
Olive oil, nuts, avocado and fish such as sardines and salmon at least once a week. Cut back on processed meats, fried foods, margarine, filled biscuits and fat from processed meat.
Less sugar and refined carbohydrates
Soft drinks, sweetened juices, frequent sweets and refined flours promote insulin resistance, which is linked to dementia risk.
Calories without unnecessary restriction
Older adults at risk of losing weight and muscle mass need enough energy and protein. The goal is quality, not a restrictive diet.
The 2024 study's diet was vegan and very low in fat. It is one possible approach, but not the only one: the Mediterranean and MIND patterns also have a solid scientific basis and are usually easier to keep up. Anyone with few protein sources or at risk of low vitamin B12 or iron should have guidance before cutting out foods.
04
Move the body, the mind and the mood
Physical activity
A walk of at least 30 minutes on most days, and strength training two to three times a week, adapted to age and health conditions.
Stress management
Meditation, stretching, slow breathing, gentle yoga and relaxation help lower sympathetic nervous system activation. A few minutes a day already count.
Mental stimulation and connection
Reading, games, learning something new and regular contact with family, friends and support groups. Social isolation is among the risk factors.
Sleep, hearing and vision
Regular, good-quality sleep, hearing aids when indicated, and follow-up of vision and oral health are part of prevention.
05
A day of eating
Educational example, with no set portions. Adapt it to your needs, preferences and your professional's guidance.
- Breakfast
- Oats with berries and seeds; or whole-grain bread with egg and tomato. Coffee or tea without sugar.
- Lunch
- Half the plate with colorful vegetables; beans or lentils, brown rice and fish, chicken or tofu. Olive oil to finish.
- Snack
- A whole fruit with a small handful of unsalted nuts; or plain yogurt with chia.
- Dinner
- Vegetable soup with chickpeas or lentils; or baked sardines with salad and sweet potato.
06
And supplements?
In the 2024 study, participants received a set of supplements, including omega-3, curcumin, an iron-free multivitamin, coenzyme Q10, vitamin C, vitamin B12, Hericium erinaceus (lion's mane) and a probiotic. Each has some research behind it, but benefit, dose and safety vary.
Omega-3
Eating fish is the first choice. Capsules can be useful when intake is low or in specific situations, at an individual dose.
Vitamin B12 and other nutrients
B12 deficiency is common in older adults and in people taking metformin or stomach acid protectors, and is linked to cognitive impairment. It is worth testing before replacing.
Curcumin, coenzyme Q10, Hericium and probiotics
Early results are interesting, but the evidence in Alzheimer's is still limited. The choice of formulation and dose should be individual, taking medicines in use into account, such as anticoagulants.
Do not take supplements on your own or copy the study's doses. Interactions with medicines, kidney or liver disease and pregnancy need to be assessed. Supplementing does not replace food or medical treatment.
07
Knowing your own risk
Some people have more questions because of family history. The Bio Alzheimer test assesses the APOE ε4 variant, associated with a higher risk of late-onset Alzheimer's. The result is not a diagnosis: it helps guide an individualized prevention program. It is also important to check blood pressure, blood sugar, cholesterol, thyroid, vitamins and gut health.
Caring for the brain starts today
In the consultation, I assess your diet, tests, medicines, routine, sleep and family history to build an individualized plan, follow your response and adjust, together with your doctor. I can also guide the caregiver, who needs care too.
Dra. Daniely Catharino TooleyClinical, functional and orthomolecular nutritionist · CRN3/6794
References (4)+
- Livingston et al. Dementia prevention, intervention, and care: 2024 report of the Lancet standing Commission. Lancet, 2024.
- Ornish et al. Effects of intensive lifestyle changes on the progression of mild cognitive impairment or early dementia due to Alzheimer's disease: a randomized, controlled clinical trial. Alzheimer's Research & Therapy, 2024.
- Ngandu et al. A 2 year multidomain intervention of diet, exercise, cognitive training, and vascular risk monitoring versus control to prevent cognitive decline (FINGER). Lancet, 2015.
- Morris et al. MIND diet associated with reduced incidence of Alzheimer's disease. Alzheimer's & Dementia, 2015.
Educational content for adults. This guidance does not replace an individual consultation, diagnosis or treatment.