The brain is the body's hungriest organ. Nutritional therapist Edelle O'Doherty-Nickel on how to feed it well
The brain is the body's hungriest organ. Fran Power asks nutritional therapist Edelle O'Doherty-Nickel how to feed it well.
One of the biggest dietary shifts we've seen in recent years has been the return of fats to the table. For so long, they were regarded as the stuff of heart attacks. But, says nutritional therapist and former research chemist Edelle O'Doherty-Nickel, when it comes to brain function, "Healthy fats are very important. People don't realise the percentage of your brain that is actually made of fat - 60pc of your cerebral cortex is fat - so when you're talking about trying to regrow neurons, you need to provide the raw material to the body to be able to do that."
It's just one element of the food plan she tailors for her clients with cognitive decline. O'Doherty-Nickel trained with Dr Dale Bredesen (see page 5) and now works with Dr Wilma Lourens, who also trained in his approach, putting his theory to work in Ireland.
The ketoflex approach
In general, O'Doherty-Nickel advocates what Bredesen has called the 'ketoflex 12/3' for a healthy brain.
"Not because it's a ketogenic diet," she says, "it's not - it's a way of eating where you try to promote periods of fasting. You stop eating at 7pm and don't eat until 7am the following morning, leaving a 12-hour period where you don't take in any food."
The long overnight fast allows your body time to clear out waste products, she explains. "Amyloid plaques are broken down while you sleep, so you want a good quality sleep cycle."
And it also drives your body towards the production of ketones in the system. "When you wake in the morning, you will be in a mild ketosis, not because you're eating a ketogenic diet, but because your body begins to break down fat for fuel rather than using sugar for fuel. That's good for the brain. Ketone bodies are an excellent alternative fuel for the brain. Fasting allows your body to increase your receptors' sensitivity to insulin which is what's lost when you become insulin resistant."
It's also an underlying factor in the development of Alzheimer's disease for many people.
As for the 'flex' aspect, she says, "you can eat this way whether you're an omnivore, carnivore or vegetarian. A lot of ketogenic diets would drive you towards a meat or paleo style diet, but this is more a Mediterranean style of eating and you can eat this way and be vegetarian."
Next, she advises eating 'real food'. "Increase your levels of low GI vegetables [cruciferous vegetables, greens, peas, squash] and fruit. Avoid simple carbohydrates [biscuits, etc] - they are broken down very quickly by the body and converted into sugar. Avoid saturated fat.
"What you want people to do is convert from a carb-based, inflammatory, fat-based diet - one where you would use a lot of hydrogenated oils and fats - and switch to a healthy fat-based diet using olive oil, coconut oil, cocoa butter, avocado, seeds such as flax and sesame and walnuts and their oils, as well as oily fish.
"What that does for a person is regains their insulin sensitivity, increases the nutrient density of their food, and makes the diet more predominantly plant-based."
O'Doherty-Nickel recommends reducing red meat and chicken to once a week, and switching to organic and grass-fed choices if the budget allows. While large fish such as tuna can have a high mercury load and so may be best avoided, she recommends upping oily fish intake (salmon, mackerel, anchovies, sardines and herring) to 2-3 times a week.
But, she warns, "You're thinking very much about a veg-based diet and then adding protein to it. You're talking about a piece of protein the size of the palm of your hand."
Ideally, a dinner plate of food would be made up of a quarter protein, a quarter non-starchy carbs, and the remaining half a plate would contain a mix of cooked and raw green leafy vegetables and salad, as well as fibrous veg such as Jerusalem artichoke, asparagus and cruciferous veg.
She advocates low glycaemic fruits such as blueberries, raspberries, pears and apples, which are excellent for healing the gut. "Definitely no fruit juice," she says, and limit high GI fruits like pineapple.
Go with your gut
Gut health is crucial when it comes to the brain, and she recommends daily doses of kefir, kimchee, sauerkraut or kombucha, "but in very moderate amounts. Along with nutrients it brings high levels of histamine which some people can be very sensitive to. Go very small and slow at first." All of these will support good levels of beneficial bacteria in the gut (see psychobiotics, page 4).
Bone broth is another goodie to introduce - it contains elements that support connective tissue and cartilage, and helps to heal the gut lining.
As for that modern bugbear, gluten, "If you're aware that you have a gluten sensitivity, avoid it, certainly limit it. I'm not against bread," she explains, "but we have gone towards eating cereal and orange juice and toast for breakfast, a sandwich for our lunch and then pasta or whatever for dinner. If you were to do any one thing now, it's to look at your dietary intake of wheat and reduce that, not because wheat is an issue, it's the volume.
"It's the same with sugar, your brain is the organ in the body with the highest requirement for glucose, but it's the levels that we eat it in that are the problem."
When advising those with a diagnosis of Alzheimer's, she removes alcohol from the diet completely. For those on a programme to prevent cognitive decline, she suggests a limit of 1-2 glasses of red wine a week. "From a nutrient point of view, there's very little in alcohol. But you do have to live so if you're having a drink, choose wisely."
Does she recommend supplements? "I don't like to put people on lots of supplements. I view supplements as scaffolding - your body is the building and the supplements are scaffolding. You put the supplements in place while you rebuild the building and then you remove the supplements as soon as possible. However, I would recommend that everybody take a broad spectrum multi-mineral and vitamin." There is a bewildering choice of brands available. O'Doherty-Nickel prefers 'food state' supplements, which are easier to absorb and generally of a higher quality. She works with Cytoplan, which are produced by UK charity AIM that, she says, ploughs its profits back into research, and policy prevention and support work.
On top of that, she recommends a good-quality probiotic with high levels of Bifido bacteria, "because your levels decrease as you age". And finally, an Omega 3 oil such as those by Nordic Naturals or Cytoplan's R-Omega, which are bound to fats called phospholipids which are more easily absorbed.
How she works
O'Doherty-Nickel sends her clients for simple blood tests to check various biomarkers before they come to see her. She reviews the results in consultation with Dr Lourens. Typically, there will be much to work on in terms of optimising diet.
"Almost everybody I see," she says, "has really low Vitamin D levels." They also tend to have high homocysteine levels, which is a indicator of B12 and folate deficiency, but she never supplements without first testing levels. She also looks at lifestyle interventions such as quality of sleep and stress management.
She warns, "It's not a quick process. It takes 6-10 months to see changes. It's very personalised, you need to look at the individual."
Edelle O'Doherty-Nickel; remedyclinic.ie
What is A ketogenic diet?
The ketogenic diet has been used for years to treat epilepsy successfully. Increasingly, studies are looking at other benefits. Ketosis switches the body from using carbohydrates as the primary source of energy to using fat. As a result, the body breaks down its fat stores directly instead of using glucose and it produces ketones as a by-product. While Edelle O'Doherty-Nickel doesn't use a ketogenic diet, she does advocate a mild form of ketosis which is induced with overnight fasting.