Whats so complicated about it? What's more important than caring about your nutrition and health? You don't have to follow the diet. Not every aspect of it. The exercise element IS very important. That's just my view
The research didn't just use a 'vegan diet'. It used a whole foods vegan diet which utilized lots of fiber, a lack of dietary oil, a lack of refined sugar, grains, etc. I'm glad that my state of evolution permits me to eat this way and at age seventy after living whole food vegan for eleven years I'm in excellent shape, both physically and cognitively.
That's because the professor's talk can be dry, unengaging, or delivered like every student attending the class, knows what they know. I'm a technical person as well.
As an old man, the better I feel, the better my brain works. Good nutrition, social interaction, exercise and rest should help anyone's cognition scores no matter who.
My mother had dementia and I noticed her diet for many years. This was her basic diet: no fruits, no veggies, no salads. She ate only cooked foods, candy and donuts. She had colon cancer and years later breast cancer, but she did not die from cancer (early detection).
Thank you So Much! - Dr Gil! My husband has YOD due to AD, and so much of the media is so terribly negative about this disease. It's seldom mentioned with out "dreaded" or "terrible" preceding it, which impacts of those people with it, affecting them emotionally and increasing feelings of hopelessness and despair which are so bad for them! - and most of the emphasis is on how to "avoid" or "prevent" it, as though once you're diagnosed you're a lost cause and of little interest and without hope. This video and your other one re. diet for Alzheimer's is encouraging. All the best to you.
Great review, thanks! The intervention prongs remind me of the Blue Zone study. I find amazing that after only 5 months some improvement is shown. Lifestyle changes are wonderful, no drugs, no side effects, yet most people agonize about leaving behind lousy habit. Never understood that.
Not hard to understand. Do you understand drug addiction? Gambling addiction? Why so hard to understand food addiction. Our industrial food system includes addictive, unhealthy, inflammatory ingredients in their products. People are addicted to the crap! I suppose someone who has infinite discipline and constant self awareness might not get it.
I saw one participants crying while telling his story. He now can play musical instruments without confusing the notes and forgeting the next notes to play. Massive respect for researchers
Also, they used one-tailed tests, so they had a lower threshold for significance than other studies. Most of their results wouldn't be significant with a two-tailed test. This is not necessarily a flaw, but it's worth keeping in mind
First 🥇 PS. Best video ever !!!! I really love how u covered all parts that affect person health. Nowadays nutrition pretty straightforward and it is good to cover other parts as well , holistic approach where all segments are covered also it's worth mentioning individual, personalized programs and approaches not everything fits for everyone. Keep doing such videos more often !
Our minds and bodies are interconnected. Some of the people in this study got their lives back. Pretty impressive. Dr. Ornish obtained a result that no drug ever did despite all the controlled, randomized trials and billions upon billions of dollars spent. N=1 is pretty powerful if you happen to be that particular 1. Well done Dr. Ornish! Dr. Ornish should get the Nobel prize in medicine for his work.
I would have loved to see two more groups in the study: 1) lifestyle intervention only, and 2) plant-based diet intervention only. And or course more participants to help determine statistical significance. Either way, encouraging findings.
Thanks for the (as much as humanely possible) objective analysis! What this tells me, is that yet again, we see some more positive than negative improvement on a serious disease, when including elements that we see in the longest living people: Whole foods diet predominately based on plants, meditation/spiritual practice, exercise/more moving, community (I'm talking about the zoom calls here, feeling like you are part of a group, and working on something larger together).
I do find myself wondering how much of any benefit received is simply that these participants had A LOT of contact with other humans during the trial. It was almost like they now had a "job", which was surely stimulating--physically, mentally and emotionally. The old adage about keeping one's brain busy to stay healthy probably has some merit.
I thought the same thing. Placebo effect as well. Given that exercise, diet , mindful activity are all rewarding in many ways. The ones with no change or worsening did they have a healthy life before hand - ie the observation those who have fluid minds from speaking another language, playing instruments will starve of old timers and dementia in early stages, but then go down more quickly, so this could of caught some of those people just as starting to show . Yes I know is alzheimer's just like the play on words. I would have been surprised if no benefit. Plus i think I have seen evidence exercise helps already - could be wrong
@@johnnnoise My understanding is that the control group ( I wouldn't really call it placebo because there was no drug involved) didn't get that attention. Here is a quote from an article about the study: "an intensive lifestyle intervention group with no drugs added or a usual-care control comparison group who were told not to make any lifestyle changes."
Great analysis of the clinical trial. I love the unbiased, objective reviews on this channel. Is a great fact check. By the way, many Alzheimer’s trial, for the new biological Alzheimer’s medications, including the two that have been FDA approved, have a similar number of participants.
Thank you for this breakdown! There are two doctors that are called the Brain Docs! The Sherzais. They promote a lot of these interventions I would be curious to hear their opinion on this as well. But again thank you.
Veganism is not a diet. It is a moral stance against animal cruelty. On another note. People need to stop downplaying the power of a whole foods plant based diet.
@@Auguur I agree. The elimination of processed foods is huge. My hypothesis is that you would see similar results if you used any diet centered around Whole Foods in this study - whether that is paleo, keto, Mediterranean, etc. Moving away from the standard American diet does wonders for health. Also, can’t underestimate the power of exercise for a healthy body and brain. There’s loads of research on the benefits of exercise and improvement of neurodegenerative diseases.
Practicing animal cruelty with diet is so easy. It's anonymous, and guilt-free for those with weak empathy. (Empathy resides in the anterior insular cortex and is actually vital to a complete intellect.)
Great study. Normally we look at small factors making an (often minimal) impact, this study threw the kitchen sink at the problem. Now we have a "lifestyle maximum" so to speak. Together we should strive for a simpler and stronger intervention if possible, and it seems like drugs will still be necessary.
A vegan diet may or may not cure Alz's disease...but what it DOES cure, and is extremely important to the planet, to morality and to our animal kingdom, is the desire to consume dead animal flesh and the refusal to treat sentient beings with the respect and ethical treatment they deserve. Please learn this if you are still unaware.
@martyrichard3092 TY for your heartfelt comment re our consumption of animals. My answer is to eat eggs. Lucky for many who can consume as many as we want; but not for my family members who are allergic to eggs. Also a great protein source is fish. I eat canned sardines often (msg'd: June 26, 2024)
Seems that if you really wanted to find out if diet was the most important factor, you would make sure everything else remained the same for both groups. Scheduled walks, meditation, exercise and community are large factors in everything.
Their goal wasn't to find out the impact of diet singularly, it was the net impact of lifestyle changes as a whole. Future research can break down each component, pointless to start with a single factor if the combined changes weren't statistically significant.
Agreed. This channel is the best I’ve found. Gil does a great job at explaining/breaking down data from studies. The results aren’t earth shattering. A healthy lifestyle = a healthier brain. But the media headline is that a plant-based/vegan will reverse Alzheimer’s disease. Many folks are claiming that the WFPB diet is the magic bullet here, although there is no way to prove that the exercise, meditation, yoga, and emotional support didn’t also improve neurocognition. Thank you, Gil!!
Absolutely true. The vegan bit is going to get latched onto and held as critical by vegans --- already seen through the comments -- yet there is already significant evidence that exercise (and the resulting exerkines) alone is a significant shield against cognition decline. Given that, it's possible that you can couple exercise with almost anything -- gambling, buying an EV, watching game shows -- and show the same effect, but then making the latter component the pitch of the research.
I think the main point was to find out if it’s possible to reverse brain disease using lifestyle changes already shown by studies to be likely helpful in brain health
Exceptional, clear and concise review of this study! Interesting that the control and lifestyle groups started at the same level of cognitive decline, but in that first graph of CDR, it looks like the lifestyle group starts with worse function. Visuals can be deceptive, as you say, and we need to stick with our statistical tools to draw valid conclusions. Thanks again! ~ Marian
This was a good video. Probably not what everyone wanted to hear, and not super exciting, but it seemed like a very honest review. So lifestyle changes help, but don't cure. USA Today and Plant Based News thinks there was a "marked difference". Thanks for posting because I am looking at these issues for my own brain health.
I would have loved to see an analysis of sleep included in the study; especially considering the massive impact poor sleep can have on cognitive function.
My friend in Cleveland with early onset ALZ started drinking Fiji water to try and get rid of aluminium in the brain, went on a MIND diet plus exercise regime. Got better and was even in a show with me in August and remembered 98% of her lines (she had the bulk of the lines). Read 'Imagine You Are An Aluminum Atom'. A quirky name for the best little book on the subject. Good luck! (Fiji water contain silicic acid which may chelate the aluminum if you are lucky. It comes out via the kidneys).
@@lesterlasa3367 I forgot to mention that Chris Exley (40 years of researching this connection) said sweating during exercise can also help to remove the aluminum. Also read labels to avoid Al, e.g. it's in antacids, fast baking powders, multi supplements, antiperspirants, poisoned needles and many more. More in the book!
Great analysis! I’m hoping Ornish does another intervention group where there is no control (or a different one), and the focus is more focused on compliance and intensity. Then, having that data he dives more deeply into the statistical significance of the results. I certainly hope he doesn’t go on the talkshow circuit and declare this a success when the data is preliminary and isn’t demonstrating the degree to which there is or isn’t benefit. Plus, where is the breakdown between male and female participants? No, this should be considered a starting point for the next research phase. This disease is devastating and deserves more attention in the lifestyle realm.
You deserve way more subscribers. Unfortunately it’s natural for people to seek videos that confirm their own preconceived notions. I used to think a vegan diet was borderline child abuse but because of you I’m vegan so I really shouldn’t say much 😂
funny when you think about it. For me feeding kids dead animals (that they would love to pet at a petting zoo) is the borderline abuse. Sums up cognitive dissonance, mankinds biggest problem?!
Isn’t it generally accepted that some lifestyle factors, such as exercise and weight management, help to slow the progression of AD? If so, I’m not sure I understand how telling the control group to keep doing whatever they were doing is ethical.
Because here in North America fat and sedentary is fashionable, even something to be proud of. It's the norm. There's nothing unethical in telling the control group to just stick to their current lifestyle.
Thanks for yet another great video and study analysis. A few thoughts came up... How much did exercise etc play a role previously in studies on Alzheimer's? How long does it usually take to see significant improvements? I'm guessing that, while there's some statistical significance, these findings aren't necessarily clinically significant, but there seems to be a trend? I find it very sad and frustrating that especially vegan channels seem to pick this study up and try to analyse it and forget major factors plus involve so much bias (including choice of words).
When there's a non significant improvement most you can say is that the probability that the intervention causes an improvement is higher than the probability that it causes a worsening, so the direction of the result actually tells you something, it's just that it's not a definitive answer but only a probabilistic one. Even when it reaches statistical significance it really means that this probability is much higher, so it's always just about the higher or lower probability of a certain outcome.
Yes, andreac5152 ; By the means of labs re our blood work; proves the truth; plus other variables that are can influence the outcome of the blood labs. (response on: June 26, 2024)
I am glad there was mention of lead levels, but there needs to be more attention to "heavy metals," especially Mercury amalgam fillings, cigarettes (Cadmium), Aluminum, etc.
Interestingly I watched a recent discussion with Dena Dubal (runs a lab on aging and neurodegeneration) who discussed the effects of alpha-Klotho (an enzyme made by our KL gene) on brain function and Alzheimer's and how Klotho can be upregulated a lot by exercise. My take away was that this is just one mechanism by which exercise can improve brain function. Separately, there is a connection between kidney health and levels of Klotho with higher eGFR correlated to higher Klotho. Would be surprised if improved exercise and diet did not improve brain function.
I would like to see a study that looks at just the effects of stress on longevity. I suspect that stress plays a much larger part in our longevity and overall health. I know plenty of people who ate a terrible diet and never exercised but had a general 'love for life' attitude and they lived well into their 90's. I also know people who ate a very healthy diet but lived a stress filled life and passed earlier than expected.
usually the love for life people are very active too, movement and work (even gardening) really a factor for sure. wfpb diet also gives me a lightness and love for life!!
I have been researching this for a while now. Alzheimer's is imo primarily a mitochondrial disease that is impacted by "all the factors" in this study and others. If one's mitochondria is saturated with glucose it has high oxidative stress is low functioning and divides. If mitochondria is saturated with fatty acids, the exact same results occur. The net result is reduced ATP for the nerve cell which has negative effects.... The key thing is to reduce the absorption rate of glucose by having high fiber (low GI) to give cells time to use glucose. Don't oversaturate with a heavily fat diet. Exercise and use your mind (social/reading/puzzles/hobbies) to burn glucose and fat and keep cells from being over saturated. Lastly avoid sugars (fructose) which have negative effects by causing fat retention, triggering the desire/craving to eat more, increase serum uric acid and reduced nitric oxide release in blood vessels (high BP). There is no single risk factor that can be pinpointed as the root cause, though in the western diet, sugar (fructose) is the primary culprit. Note too many carbs or fats into a cell over a short period of time is converted into fructose using up 2 ATPs per molecule which then in the brain starves the nerve cells of energy. Sorry for the long discourse.
@@Claude_van It is very complex and beyond my level of expertise. However, in my understanding only a very small amount of consumed Fructose makes it into our cells (brain) most having been processed in the small intestines and liver. In mitochondria it is one of the many chemical products in a chain of products that end up giving us our ATPs. In mitochondria that is grossly over fed with either by Fat or Glucose, ROS (reactive oxidative species) are produced that create a charge (positive / negative) imbalance between the inner mitochondria membrane. This gradient imbalance doesn't remain static as ROSs react with other molecules using up the fat or glucose by interrupting the production cycle and reducing ATP production. A UCP (UnCoupling Protein) pathway actually forms in the inner membrane which allows for passage of proton species as a means of protection from ROS. All this causing damage to the mitochondria. - I could not find the exact videos where part of this discussion occurred, but one of them was in the Physionic channel. The creator is a Mitochondria researcher.
The study gave p-values, but no test statistics. Had to dig up the supplementary analyses. They used Mann-Whitney-Wilcoxon tests, which have low statistical power. Given the tiny sample, N = 51, I would suspect that their findings might have serious problems with outliers. Unfortunately, they don't give access to their data. A mixed-model ANOVA with planned contrasts would have been appropriate.
How did they control for the lessening of stress by having the need to decide on food and exercise and meditation program? The lack of guilt because of failure to do anything to help yourself? Does having someone take the load off you for deciding and controlling your own life improve your test taking on its own.
It seems to me that higher compliance might just reflect greater ability to comply. That is, compliance might serve as an indirect measure of progression, as people who progress faster might have lower compliance.
I appreciate your approach, Gil. Incremental science is a noble pursuit and being reserved and unbiased in your recommendations is certainly consistent with good science. But you're also a doctor, and I think you realize it's time to take a stand against animal products. Think of all the suffering, human and animal, that will occur before the evidence becomes unequivocal from its current state of being merely highly compelling. The clock is ticking. People and animals are suffering. Doctors need to make a judgement call about our food system and diets and make their recommendations accordingly and with all dietary consequences in mind.
Ornish loves his confounding variables. This isn't a trial. It's an intervention because he changed everything. Shocker, you do healthier things you have better outcomes. You cannot however allocate the success to any single part of the intervention except as a whole.
Thats not an issue per se, depends on the question you want to answer... he focuses on lifestyle changes, other researchers focus on just one factor (e.g kevin hall with domiciled feeding studies)... both are helpful, but in different ways
That was not the point of the study. The point, as Gil states was to see if healthy lifestyle changes would impact cognition in AD. We know that each one of the factors may have a very small benefit from other studies. You try a plethora of positive lifestyle factors and you might see a benefit. With a disease like AD it might be worth throwing the kitchen sink (of potentially beneficial habits) to see if it works. It at least gives some hope. Obviously more studies will be helpful.
I work for big pharma. This would be a proof of concept study and if this intervention was a drug would for sure be moved to development and tested in a bigger trial. 2nd point: most drugs gets approved based on showing significant difference between groups as was tested here, NOT based on significance of change from baseline within one group. So what they did is exactly how trials would be done to submit for registration (as mentioned on a larger sample size). The amount of benefit would be weighed against risk. The smaller the benefit of a drug, the safer it needs to be to be approved ( in addition to considering existing treatments available/medical need)
Thanks Gill for providing unbiased clarity around this. I'm no longer subscribed to all the vegan and WFPB channels I used to be 5 years ago, but I can imagine they are basically saying "look, WFPB, cures Alzheimer's, this study PROOVES it!" :) I eat a generally WFPB diet still, no animal products and just a very small amount of oil here and there, but I no longer am drinking the Kool-Aid thanks to you and others who keep talking facts rather than rhetoric. While it's nice to have more studies, the main problem I see here is the person who is running the study is enormously biased in favor of a vegan diet. Even though we don't know whether this study actually provides any backing for such a diet based on incomplete data, if these numbers were even less APPARENTLY positive in terms of comparing one group's improvement/lack of improvement to the other, then I somehow doubt that Ornish would come out with the results stating that "Vegan diet (+ other lifestyle interversions)" do not make any statistical signifance in treating Alzheimers." No, because that would be seriously against his interest, his brand. He is a total partisan when it comes to this stuff, not a neutral party, so why should we even look at this study in the first place? What I really want to know (other than actually having a complete set of data from the trial) is: 1) What did the control group eat? If it was the standard American Diet, well, duh, any diet other than that is probably going to improve health 2) You mention "arms" of the study that separated out different lifestyle factors, does this mean that the overall comparison was between no intervention and an average of all the arms? 3) If so, how did the different lifestyle arms compare? 4) Did they try combining multiple arms to see if doing more than one type of lifestyle intervention had a compounding effect? (Realizing that we don't even know if the effect that is stated in the conclusions here are accurate since they only give us a partial picture of the data).
@@tamcon72 no? I watched Mic the Vegan's take on it yesterday and you're right in that he didn't portray it s proof, but pretty much just inferred that it was the diet caused these improvements, and said nothing about the limitations of the study - other than complaining that it wasn't technically vegan/plant based because of the fish oil. I wonder if that particular aspect of it has made the response less fervent in some way, because it indicates that EVEN when there was some animal product included, people still improved? If there are others who have had a more nuanced reaction, I'd be interested to know...
As I read the study, the "arms" are just control vs intervention group. They do get broken down into adherence groups to further delineate if greater adherence lead to better results, but overall they all still got the same "lifestyle interventions."
Interesting presentation. Gill mentioned one variable in the beginning of the difference between the two groups, “whole food diet” that was not discussed further. What is the effect of processed foods on the gut and how does that impact the absorption of the nutrients? Just because you swallowed it did the intestines absorbed it? Why does that matter? The brain is an organ and it requires certain nutrients to function. Certain foods I.E. sugar disrupts the Ph of the stomach and can affect the absorption of some nutrients. Just food for thought.
I’m mad that I’ve finished watching all of your videos already, I need more! I had been listening to these sort of like podcasts while working out and/or cleaning, now what am I going to do 😂
How are those confounding factors? The goal of the study was to find out the impact of lifestyle changes, not a single diet. This is how research is done. Since it's statistically significant, you can break down the impact of each component in future studies.
Who cares? The goal is Alzheimer's. That's a big target, and I want to throw the whole battery of safe lifestyle interventions that might help. Lifestyle interventions notoriously tend towards small effects, and the reality of lifestyle intervention is that it is all-encompassing. Give me pooled small effects when searching for an effective intervention. Additionally, Alzheimers is not a one gene/one problem, one outcome disease like PKU. It is multifactorial, and I think the scientistic obsession with reductionism is fatal toward science itself. Who says that Alzheimers is going to have a single, isolatable treatment? It will likely need a protocol rather than a pill. Tease the differences within groups once the differences between groups is clear!
Yes - however, if you have alzheimers (or don't want it) - doing everything in the study gives you a good chance (essentially a very healthy lifestyle that some people already have, think "Blue Zone Plus" lifestyle). I imagine they'll try to be more specific in the future.
Part of the intervention! Becuz diet alone is nothing.. It's like- You know fruits are good for you but you can't just eat fruits.. you have to incorporate other food groups like grains, pseudograins, lentils , beans , veggies , nuts and seeds.. Likewise, it's crucial for each of us to excercise, sleep and supplement if necessary
It's good to know that a healthy lifestyle, possibly capable of halting AD, a piece of that puzzle, was a whole food plant based diet. I know when a family member gets AD you'd try anything to keep them for longer, at least this gives some guidance aside from just "take these pills"..
I love the rigor. Because we need to adhere to the science. However as a layperson, with an interest in this topic I believe that it is likely that a WFPBD alone (given adequate scientific attention) will demonstrate a mitigation of the effects of Alzhimer's disease.
Now do a video on the many experiments and studies on ketones and ketogenic diets on the brain vis a vis Alzheimer’s. Plenty of great research out there (thanks in part to MCT oil) - on people and dogs.
I wish someone would run this trial with a new control group, doing everything Ornish had them do, the exercise, the therapy, etc. BUT do it with a keto diet, under 20 carbs per day. I would be very interested in the results.
Right - lots of research out there including brain imaging on the impact of ketones on Alzheimer’s brain. the idea is that Alzheimer’s is characterized by inflammation and a well formulate anti-inflammatory ketogenic diet would be best for the Alzheimer’s brain, since ketones can get to parts of the brain where glucose has trouble.
Given that this study was partly prompted by the growing correlation between saturated animal fat consumption and cognitive impairment, it would have to be done by some other group that operates on some other hypothesis.
The more I think about this Ornish trial the more I don’t like it. The right trial would be to simply put the group on a vegan diet without all the extra things, the books, the therapy, the exercise. See if the vegan diet did anything. It’s a classic mistake of making too many changes. As a person who has cared for many with dementia, any of those things could make a difference. I’m actually surprised that the changes weren’t bigger. To me it suggests the vegan diet was the least impactful. But maybe that’s my bias. The point is, who knows what this study shows? My experience shows the exercise alone would show a statistically significant improvement. Or any of the others. But all together? C’mon. It makes me think the trial itself was disingenuous.
Concise analysis... its not just one thing. I still like the analysis where they frame diet as 50 to 60% of the lifestyle pie. Obese ppl have far more disease. 10 minutes of eating trash food can erase 2+ hours of exercise
I wonder if the social interaction and the exercise might be the primary drivers of a reduction in Alzheimer's creep. I also wonder what additional benefit might be achieved if it was possible to add an hour of mental exercise each day.
I think that's got to be a factor, but of the elderly people I've known three succumbed to vascular dementia and they were all daily meat eaters; one a butcher also had CV problems. others that lived to 90s fully compos mentis were eating meat maybe two/three times a week but less in early life.
I recommend watching a lot of good analysis of this research with four videos like "Blue Zones and Lifestyle Medicine: The Secrets to Longevity Unlocked," "Study: Vegan Omega 3 is BETTER Than Fish? Plant-based ALA vs EPA/DHA," "Vegan Diet for Alzheimer's Study Results Are In," "A Testimonial from Dr. Ornish's Alzheimer's Progression Reversal Study."
Yeah, one issue is no placebo control, what if just doing anything makes people feel that they are going to do better and be more confident at all the tests. Another is - why are the control going bad so fast
One thing to also keep in mind is the possibility of reverse causality with the adherence data. Perhaps those participants who naturally had a slower progression of their alzheimer's disease were more likely to adhere to the intervention, rather than adherence to the intervention causing them to progress more slowly.
I wish someone would do a study on PB diet that controlled for exercise. Many advocating for a vegan diet - Furhman, Esselstein, Campbell, for ex. - also exercise a lot, so I always wonder how much of the good results are from the exercise itself.
The results of all these studies, regardless of end points (MI/Stroke/Dementia/Diabetes/Cancer), always reiterate the same 4 points. 1/ more plants 2/ less SF and junk food 3/ exercise 4/ lower stress. However, one that rarely gets addressed : "don't be poor" so you can afford 1 thru 4 (especially 4). Do we really expect any studies to say reduce chances of AD (or any modern disease) by : a/Eating junk food, b/sofa surfing, c/working 3 jobs and living in a polluted, high crime zip code. How many more studies do we need to just to repeat the same tired mantra. Anyone that watches health podcasts such as your excellent YT's know this, the people who need to know it, don't watch medical podcasts - most don't have time as they are working 3 jobs (and even of they did, don't have the resources to follow a plant forward, healthy lifestyle .. too busy staying alive). Maybe a better way to present this data would be 1+2=3+4 = 25% reduction, 1=5%, 2=5%, 3=5%, 4=5% ... we all know (and have been endlessly told) 1+2+3+4 is the answer for every health question ... its like deep thought ... the answer is exercise/diet/stress reduction/no junk food/SF (42) .. what's the question.
Conflating plant-based into all this is the error.. Plants + something else does not equal "it's the plants!!!!". Also yea.. stressed poor people dont think about this stuff much. However they CAN live a simple healthy life in terms of food. However getting 2000 Calories out of whole non-starchy plants is damn expensive. Not buying ultra-processed empty calories saves lots of money, and cooking instead of eating out also saves money. Poor people still waste money on junk food..
"Aβ42/40 ratio increased in the intervention group and decreased in the control group (p = 0.003)." This is one of the most important markers of AD. Why are you not focusing more on this? This is a clear indication of reversal.
hi, see the 2nd part of the video where the biomarker changes were covered, this ratio is the biomarker the video refers to. The way the change is described in the trial has the exact same issue explained for the cognitive tests; in order to claim an "increase" or "decrease" in any of the groups biomarker level before vs after the trial has to be compared and this wasn't reported. so there is uncertainty there but the overall trend appears favorable compared to the controls (similar situation to the cognitive tests)
Encouraging study but too short and seems underpowered. If Ornish can't show a significant deterioration within the control group then its too small/too short a study to have a chance of showing a convincing benefit in the treatment group.
Even if eating a vegan diet shaved years from our life it would still be the right thing to do, ethically. Animals suffer heinously because we consume them -- not to mention the myriad other downsides. By now though it should be clear to anyone who's not hanging on to their confirmation bias by their fingernails that plant based eating is as close to a panacea as we've got. I've been eating this way for 14 years and it is the best decision I've made. The only downside is realizing that your friends and family are delusional, cruel and oppressive in their food choices -- and are ultimately harming their health.
indeed, and yet somehow the wfpb vegan diet correctly supplemented (b12, iodine, omega3 the last two can be done with food) and correct BMI seem to point to a longer healthspan and better activity and cognition into your 90's, possibly even better than mediterranean diet and bluezones
Gill, I just saw a video that suggests there are studies on allulouse showing it "shrinks belly fat" by Thomas DeLauer. I would love to see a video from you on this.
A number of comments seem to punch holes in this study, but that isn't the thrust of this review. The point is surely that the Ornish intervention, by its very structure, is limited. It would be a poor response to say he should have done for separate tests because one point might be that the result of combining strategies leads to something greater than the sun of its parts. I suppose a study that had a control group, a diet only group, a meditation only group, etc. and a combination of all might be interesting. But the intervention needs to be a bit more extensive in number and time. Overall, though, this is still an interesting intervention if others or the Ornish people can build on it.
That's the point of substitution analysis right. For instance, if you substitute eggs for lentils and the biomarkers improve, but at the same time you change other 27 lifestyle factors, how can you know it's the lentils?
The study assumes that MCI for all participants is due to the same factors. Maybe for some is infections, to other vascular and others metabolic challenges or toxins. Unless we understand and measure better all the factors that affect cognitive decline, it is going to be difficult to come to a clear solutions.
Thanks doctor. You're the most sensible channel in nutrition. Ornish is the only "scientist" claiming reversal. I did Ornish 35 years ago! It worked to lower cholesterol 100 points. It is the most joyless, unsustainable diet imaginable. Keto also did wonders for my labs. I've always exercised & worked to eat well. I have cad. So both diets worked. Neither prevented disease . After 40+ years of touting his miserable diet why doesn't he have more substantial evidence & scientific data??? I'd follow it if he did. I greatly appreciate your videos.
The current perspective among most academically-trained epidemiologists (and informed journal editors) is that "statistical significance" is a poor indicator of the clinical significance of an intervention.
This time you missed something: There was obviously no placebo control and in addition, the intervention group did a highly extensive and motivating program. Studies indicate that the placebo effect alone can induce improvement in cognitive tests. In this case, there might be a direct effect of motivation in addition. The participants in the experimental group, who have shown effort for so long, might show more effort during testing at the end as well. I guess at least some effect is simply due to these factors, and not to the intervention at all. The findings are therefore only suggestive but not conclusive at all. Not only do we not know which component of the intervention is effective (as you rightly point out), but we do not even know whether the program as a whole is effective. We really need a placebo control (at least a placebo medication) and in addition, we need some measures for explicit effort of participants during testing. Really, a promising trial, but now we require a better one!
yes, all the attention by the coaches and the awareness that they're going through this extensive program could have an effect on their self-confidence and their cognitive performance. It would technically still be an effect of the program in the context of the trial but the key component would be the belief in the program´s potential rather than one of the other prongs. I agree that should be considered. This caveat applies to many lifestyle interventions since it's hard to do a proper placebo. Controlling for it would be hard but maybe doable. Maybe by having time-matched sessions with some activity that isn´t expected to affect cognition much
@@NutritionMadeSimple Yes, time matched sessions or at least a placebo medication + some activity, which would make the results much stronger, in particular in case there is one pure waiting group in addition and not much difference between placebo group and waiting group.
Hard to say when there are so many more variables than vegan vs omnivore. I suspect we'll get some sensational headlines by people who take away the wrong conclusion. What we know is that a reasonable diet at maintenance calories (or below if you're overweight), with a decent amount of physical activity is good for just about anything. I hope that message gets emphasized.
Statistically speaking, how legitimate is it to remove a single "outlier" out of say, 25 subjects, and thereafter claim the results of a certain trial or test within a trial, with that removal effected, were statistically significant? I don't know the answer, just wondering...
It's completely normal to report that. It's a procedure called sensitivity or robustness analysis where you check if and how the results will change if you change the input just a tiny bit.
You might have mentioned this but I missed it… did the control group continue their medications as prescribed for Alzheimer’s by their doctors and the test group discontinue their medication? If so, then I’d say that this study was more beneficial than just trend based analysis
If there was a clamp down on the spread of misinformation, this channel would be one of the few nutrition channels still standing. Great job.
Correct.
The solution: A vegan diet with a daily multivitamin. Why do we all have to make eating so complicated?
Whats so complicated about it? What's more important than caring about your nutrition and health? You don't have to follow the diet. Not every aspect of it. The exercise element IS very important. That's just my view
The research didn't just use a 'vegan diet'. It used a whole foods vegan diet which utilized lots of fiber, a lack of dietary oil, a lack of refined sugar, grains, etc. I'm glad that my state of evolution permits me to eat this way and at age seventy after living whole food vegan for eleven years I'm in excellent shape, both physically and cognitively.
I think refined sugar/ white flour is the biggest culprit.
@@Booark12 By what mechanism?
inspiration!!! I bet you still look 50!
It is funny because I have a degree in math and data analytics and you explain complicated statistics better than every professor I had.
I read some of Gils' own personal research, he practices multiple studies and and is a masterclass in researching.
That's because the professor's talk can be dry, unengaging, or delivered like every student attending the class, knows what they know. I'm a technical person as well.
What a great compliment.
Gil is really good at statistics. Never heard nonsense from him. If he says take care of interpreting this results, you should do it.
Isn't that amazing? I think his PhD is in public health or epidemiology. I think that helps. I love listening to him!
As an old man, the better I feel, the better my brain works. Good nutrition, social interaction, exercise and rest should help anyone's cognition scores no matter who.
Certainly can’t hurt! Even if it just slows someone’s decline or gives him/her more joy along the way, that’s a big win!
My mother had dementia and I noticed her diet for many years. This was her basic diet: no fruits, no veggies, no salads. She ate only cooked foods, candy and donuts. She had colon cancer and years later breast cancer, but she did not die from cancer (early detection).
You've got me worried about your mother. How is she doing now?
Seems like an expensive way to live.
Welcome back. I applauded your succinct and knowledgeable style of sharing impressive and important medical information.
I like how you add on-screen cues about what’s coming next. Helpful teasers.
Thank you So Much! - Dr Gil! My husband has YOD due to AD, and so much of the media is so terribly negative about this disease. It's seldom mentioned with out "dreaded" or "terrible" preceding it, which impacts of those people with it, affecting them emotionally and increasing feelings of hopelessness and despair which are so bad for them! - and most of the emphasis is on how to "avoid" or "prevent" it, as though once you're diagnosed you're a lost cause and of little interest and without hope. This video and your other one re. diet for Alzheimer's is encouraging. All the best to you.
Great review, thanks! The intervention prongs remind me of the Blue Zone study. I find amazing that after only 5 months some improvement is shown. Lifestyle changes are wonderful, no drugs, no side effects, yet most people agonize about leaving behind lousy habit. Never understood that.
Not hard to understand. Do you understand drug addiction? Gambling addiction? Why so hard to understand food addiction. Our industrial food system includes addictive, unhealthy, inflammatory ingredients in their products. People are addicted to the crap! I suppose someone who has infinite discipline and constant self awareness might not get it.
I saw one participants crying while telling his story. He now can play musical instruments without confusing the notes and forgeting the next notes to play. Massive respect for researchers
Was this on a documentary or something?
Where did you saw it bro?
I recently saw it on a micthevegan 'short'
Gil sets the standard in influencers interpreting this study correctly. Thank you!
Probably only nutrition channel worth watching..top class.
Awesome breakdown of a phenomenal trial. Thanks always for your balanced and honest approach.
7:38 - I had the same qualm when I read the study. All great points.
Omg my two favorites follow and comment on each other! Love it! Learned so much from you both
Also, they used one-tailed tests, so they had a lower threshold for significance than other studies. Most of their results wouldn't be significant with a two-tailed test. This is not necessarily a flaw, but it's worth keeping in mind
First 🥇
PS. Best video ever !!!!
I really love how u covered all parts that affect person health.
Nowadays nutrition pretty straightforward and it is good to cover other parts as well , holistic approach where all segments are covered also it's worth mentioning individual, personalized programs and approaches not everything fits for everyone.
Keep doing such videos more often !
Our minds and bodies are interconnected. Some of the people in this study got their lives back. Pretty impressive. Dr. Ornish obtained a result that no drug ever did despite all the controlled, randomized trials and billions upon billions of dollars spent. N=1 is pretty powerful if you happen to be that particular 1. Well done Dr. Ornish! Dr. Ornish should get the Nobel prize in medicine for his work.
This channel is the gold standard for information on nutrition.
Great video 💪 thank you so much for educating about scientific work 💝
Thank you so much for the breakdown.
Amazing analisys, as always.
I would have loved to see two more groups in the study: 1) lifestyle intervention only, and 2) plant-based diet intervention only. And or course more participants to help determine statistical significance. Either way, encouraging findings.
Excellent information and as always impartial and sensible explanation of the data. Well done 👍
Thanks for the (as much as humanely possible) objective analysis! What this tells me, is that yet again, we see some more positive than negative improvement on a serious disease, when including elements that we see in the longest living people: Whole foods diet predominately based on plants, meditation/spiritual practice, exercise/more moving, community (I'm talking about the zoom calls here, feeling like you are part of a group, and working on something larger together).
Given our longer life expectancy and rising incidence of Alzheimer-dementia, we need the equivalent of a Framingham Study for these diseases
And we know the results of that study - cholesterol and saturated fats lead to heart disease, especially with elevated blood pressure.
@rafaelgelpi2718 *BRILLIANT COMMENT* !!! (June 26, 2024)
@@roseappelhoff9282 Thank you for the kind comment
I do find myself wondering how much of any benefit received is simply that these participants had A LOT of contact with other humans during the trial. It was almost like they now had a "job", which was surely stimulating--physically, mentally and emotionally. The old adage about keeping one's brain busy to stay healthy probably has some merit.
Well said!
@@jeffreywp why didn't the placebo work then?
I thought the same thing. Placebo effect as well. Given that exercise, diet , mindful activity are all rewarding in many ways.
The ones with no change or worsening did they have a healthy life before hand - ie the observation those who have fluid minds from speaking another language, playing instruments will starve of old timers and dementia in early stages, but then go down more quickly, so this could of caught some of those people just as starting to show . Yes I know is alzheimer's just like the play on words.
I would have been surprised if no benefit. Plus i think I have seen evidence exercise helps already - could be wrong
@@johnnnoise My understanding is that the control group ( I wouldn't really call it placebo because there was no drug involved) didn't get that attention. Here is a quote from an article about the study: "an intensive lifestyle intervention group with no drugs added or a usual-care control comparison group who were told not to make any lifestyle changes."
@@johnnnoise Which placebo?
Great analysis of the clinical trial. I love the unbiased, objective reviews on this channel. Is a great fact check. By the way, many Alzheimer’s trial, for the new biological Alzheimer’s medications, including the two that have been FDA approved, have a similar number of participants.
Thank you for this breakdown! There are two doctors that are called the Brain Docs! The Sherzais. They promote a lot of these interventions I would be curious to hear their opinion on this as well. But again thank you.
Pretty good video. Of course we all want definitive, cut and dry answers, but this guy knows it's not always that simple
Veganism is not a diet. It is a moral stance against animal cruelty.
On another note. People need to stop downplaying the power of a whole foods plant based diet.
Thank you! Vegan schmegan, processed foods are part of the problem.
tell that to Zoe Harcombe
Yeah you can eat meat as a vegan, (lab grown meat)
@@Auguur I agree. The elimination of processed foods is huge. My hypothesis is that you would see similar results if you used any diet centered around Whole Foods in this study - whether that is paleo, keto, Mediterranean, etc. Moving away from the standard American diet does wonders for health. Also, can’t underestimate the power of exercise for a healthy body and brain. There’s loads of research on the benefits of exercise and improvement of neurodegenerative diseases.
@@Auguur Brilliant comment... chemicals in our foods, who knows what that can affect our bodies!!!
Practicing animal cruelty with diet is so easy. It's anonymous, and guilt-free for those with weak empathy. (Empathy resides in the anterior insular cortex and is actually vital to a complete intellect.)
Great study. Normally we look at small factors making an (often minimal) impact, this study threw the kitchen sink at the problem. Now we have a "lifestyle maximum" so to speak.
Together we should strive for a simpler and stronger intervention if possible, and it seems like drugs will still be necessary.
A vegan diet may or may not cure Alz's disease...but what it DOES cure, and is extremely important to the planet, to morality and to our animal kingdom, is the desire to consume dead animal flesh and the refusal to treat sentient beings with the respect and ethical treatment they deserve. Please learn this if you are still unaware.
Marty. You're absolutely spot on. Couldn't agree more
Wishful thinking not based on reality.
@martyrichard3092 TY for your heartfelt comment re our consumption of animals. My answer is to eat eggs. Lucky for many who can consume as many as we want; but not for my family members who are allergic to eggs. Also a great protein source is fish. I eat canned sardines often (msg'd: June 26, 2024)
Thank you!
Seems that if you really wanted to find out if diet was the most important factor, you would make sure everything else remained the same for both groups. Scheduled walks, meditation, exercise and community are large factors in everything.
Their goal wasn't to find out the impact of diet singularly, it was the net impact of lifestyle changes as a whole.
Future research can break down each component, pointless to start with a single factor if the combined changes weren't statistically significant.
Lifestyle is the intervention. Not broccoli. Just saying
Agreed. This channel is the best I’ve found. Gil does a great job at explaining/breaking down data from studies. The results aren’t earth shattering. A healthy lifestyle = a healthier brain. But the media headline is that a plant-based/vegan will reverse Alzheimer’s disease. Many folks are claiming that the WFPB diet is the magic bullet here, although there is no way to prove that the exercise, meditation, yoga, and emotional support didn’t also improve neurocognition. Thank you, Gil!!
Absolutely true. The vegan bit is going to get latched onto and held as critical by vegans --- already seen through the comments -- yet there is already significant evidence that exercise (and the resulting exerkines) alone is a significant shield against cognition decline. Given that, it's possible that you can couple exercise with almost anything -- gambling, buying an EV, watching game shows -- and show the same effect, but then making the latter component the pitch of the research.
I think the main point was to find out if it’s possible to reverse brain disease using lifestyle changes already shown by studies to be likely helpful in brain health
I think this is a great stepping stone that will hopefully allow for a future more robust study.
Exceptional, clear and concise review of this study! Interesting that the control and lifestyle groups started at the same level of cognitive decline, but in that first graph of CDR, it looks like the lifestyle group starts with worse function. Visuals can be deceptive, as you say, and we need to stick with our statistical tools to draw valid conclusions. Thanks again! ~ Marian
This was a good video. Probably not what everyone wanted to hear, and not super exciting, but it seemed like a very honest review. So lifestyle changes help, but don't cure. USA Today and Plant Based News thinks there was a "marked difference". Thanks for posting because I am looking at these issues for my own brain health.
I would have loved to see an analysis of sleep included in the study; especially considering the massive impact poor sleep can have on cognitive function.
I shared this with my family as we have Alzheimer’s in our family
My friend in Cleveland with early onset ALZ started drinking Fiji water to try and get rid of aluminium in the brain, went on a MIND diet plus exercise regime. Got better and was even in a show with me in August and remembered 98% of her lines (she had the bulk of the lines). Read 'Imagine You Are An Aluminum Atom'. A quirky name for the best little book on the subject. Good luck! (Fiji water contain silicic acid which may chelate the aluminum if you are lucky. It comes out via the kidneys).
@@DavidSmith-rz1pc excellent
@@lesterlasa3367 I forgot to mention that Chris Exley (40 years of researching this connection) said sweating during exercise can also help to remove the aluminum. Also read labels to avoid Al, e.g. it's in antacids, fast baking powders, multi supplements, antiperspirants, poisoned needles and many more. More in the book!
Excellent.
I find Gil’s what I eat while traveling simplifies information more than the videos analyzing studies. I recommend watching it
Great analysis! I’m hoping Ornish does another intervention group where there is no control (or a different one), and the focus is more focused on compliance and intensity. Then, having that data he dives more deeply into the statistical significance of the results.
I certainly hope he doesn’t go on the talkshow circuit and declare this a success when the data is preliminary and isn’t demonstrating the degree to which there is or isn’t benefit. Plus, where is the breakdown between male and female participants? No, this should be considered a starting point for the next research phase.
This disease is devastating and deserves more attention in the lifestyle realm.
All the nutritional studies done to date point in the same direction. It is clear as day. Whole plants are the answer to almost EVERY chronic illness.
I wonder why you do not have millions of subscribers. Best health / nutrition channel on TH-cam
What I've learnt is.....hope to not be in a controlled group.
Very good. Thx
You deserve way more subscribers. Unfortunately it’s natural for people to seek videos that confirm their own preconceived notions. I used to think a vegan diet was borderline child abuse but because of you I’m vegan so I really shouldn’t say much 😂
funny when you think about it. For me feeding kids dead animals (that they would love to pet at a petting zoo) is the borderline abuse. Sums up cognitive dissonance, mankinds biggest problem?!
Isn’t it generally accepted that some lifestyle factors, such as exercise and weight management, help to slow the progression of AD? If so, I’m not sure I understand how telling the control group to keep doing whatever they were doing is ethical.
Because here in North America fat and sedentary is fashionable, even something to be proud of. It's the norm. There's nothing unethical in telling the control group to just stick to their current lifestyle.
@@paulmaxwell8851 I don’t agree that is fashionable, it’s just common
@@paulmaxwell8851not sure how many fat and sedentary people get AD.
I am disappointed that all participants were not given everything the same EXCEPT the diet to answer the question if the WFPB can reverse Alzheimer's.
Thanks for yet another great video and study analysis. A few thoughts came up... How much did exercise etc play a role previously in studies on Alzheimer's? How long does it usually take to see significant improvements? I'm guessing that, while there's some statistical significance, these findings aren't necessarily clinically significant, but there seems to be a trend?
I find it very sad and frustrating that especially vegan channels seem to pick this study up and try to analyse it and forget major factors plus involve so much bias (including choice of words).
When there's a non significant improvement most you can say is that the probability that the intervention causes an improvement is higher than the probability that it causes a worsening, so the direction of the result actually tells you something, it's just that it's not a definitive answer but only a probabilistic one. Even when it reaches statistical significance it really means that this probability is much higher, so it's always just about the higher or lower probability of a certain outcome.
Yes, andreac5152 ; By the means of labs re our blood work; proves the truth; plus other variables that are can influence the outcome of the blood labs. (response on: June 26, 2024)
I am glad there was mention of lead levels, but there needs to be more attention to "heavy metals," especially Mercury amalgam fillings, cigarettes (Cadmium), Aluminum, etc.
Interestingly I watched a recent discussion with Dena Dubal (runs a lab on aging and neurodegeneration) who discussed the effects of alpha-Klotho (an enzyme made by our KL gene) on brain function and Alzheimer's and how Klotho can be upregulated a lot by exercise. My take away was that this is just one mechanism by which exercise can improve brain function. Separately, there is a connection between kidney health and levels of Klotho with higher eGFR correlated to higher Klotho. Would be surprised if improved exercise and diet did not improve brain function.
I would like to see a study that looks at just the effects of stress on longevity. I suspect that stress plays a much larger part in our longevity and overall health. I know plenty of people who ate a terrible diet and never exercised but had a general 'love for life' attitude and they lived well into their 90's. I also know people who ate a very healthy diet but lived a stress filled life and passed earlier than expected.
usually the love for life people are very active too, movement and work (even gardening) really a factor for sure. wfpb diet also gives me a lightness and love for life!!
I have been researching this for a while now. Alzheimer's is imo primarily a mitochondrial disease that is impacted by "all the factors" in this study and others. If one's mitochondria is saturated with glucose it has high oxidative stress is low functioning and divides. If mitochondria is saturated with fatty acids, the exact same results occur. The net result is reduced ATP for the nerve cell which has negative effects.... The key thing is to reduce the absorption rate of glucose by having high fiber (low GI) to give cells time to use glucose. Don't oversaturate with a heavily fat diet. Exercise and use your mind (social/reading/puzzles/hobbies) to burn glucose and fat and keep cells from being over saturated. Lastly avoid sugars (fructose) which have negative effects by causing fat retention, triggering the desire/craving to eat more, increase serum uric acid and reduced nitric oxide release in blood vessels (high BP). There is no single risk factor that can be pinpointed as the root cause, though in the western diet, sugar (fructose) is the primary culprit. Note too many carbs or fats into a cell over a short period of time is converted into fructose using up 2 ATPs per molecule which then in the brain starves the nerve cells of energy. Sorry for the long discourse.
Fats are converted into fructose?🤔
@@Claude_van It is very complex and beyond my level of expertise. However, in my understanding only a very small amount of consumed Fructose makes it into our cells (brain) most having been processed in the small intestines and liver. In mitochondria it is one of the many chemical products in a chain of products that end up giving us our ATPs. In mitochondria that is grossly over fed with either by Fat or Glucose, ROS (reactive oxidative species) are produced that create a charge (positive / negative) imbalance between the inner mitochondria membrane. This gradient imbalance doesn't remain static as ROSs react with other molecules using up the fat or glucose by interrupting the production cycle and reducing ATP production. A UCP (UnCoupling Protein) pathway actually forms in the inner membrane which allows for passage of proton species as a means of protection from ROS. All this causing damage to the mitochondria. - I could not find the exact videos where part of this discussion occurred, but one of them was in the Physionic channel. The creator is a Mitochondria researcher.
Great point at 11:48. This could also be a Lions Mane Trial, or a stress management trial as much as it could be a diet trial.
Great video!
The study gave p-values, but no test statistics. Had to dig up the supplementary analyses. They used Mann-Whitney-Wilcoxon tests, which have low statistical power. Given the tiny sample, N = 51, I would suspect that their findings might have serious problems with outliers. Unfortunately, they don't give access to their data. A mixed-model ANOVA with planned contrasts would have been appropriate.
How did they control for the lessening of stress by having the need to decide on food and exercise and meditation program? The lack of guilt because of failure to do anything to help yourself? Does having someone take the load off you for deciding and controlling your own life improve your test taking on its own.
It seems to me that higher compliance might just reflect greater ability to comply. That is, compliance might serve as an indirect measure of progression, as people who progress faster might have lower compliance.
Hmmm ... rather an interesting topic for discussion Mr. Creelman; TY :) (June 26, 2024)
I appreciate your approach, Gil. Incremental science is a noble pursuit and being reserved and unbiased in your recommendations is certainly consistent with good science. But you're also a doctor, and I think you realize it's time to take a stand against animal products. Think of all the suffering, human and animal, that will occur before the evidence becomes unequivocal from its current state of being merely highly compelling. The clock is ticking. People and animals are suffering. Doctors need to make a judgement call about our food system and diets and make their recommendations accordingly and with all dietary consequences in mind.
Statistically interesting, worth a larger, longer study, and may help sell a bunch of diet books...
Ornish loves his confounding variables. This isn't a trial. It's an intervention because he changed everything. Shocker, you do healthier things you have better outcomes. You cannot however allocate the success to any single part of the intervention except as a whole.
Thats not an issue per se, depends on the question you want to answer... he focuses on lifestyle changes, other researchers focus on just one factor (e.g kevin hall with domiciled feeding studies)... both are helpful, but in different ways
That was not the point of the study. The point, as Gil states was to see if healthy lifestyle changes would impact cognition in AD. We know that each one of the factors may have a very small benefit from other studies. You try a plethora of positive lifestyle factors and you might see a benefit. With a disease like AD it might be worth throwing the kitchen sink (of potentially beneficial habits) to see if it works. It at least gives some hope. Obviously more studies will be helpful.
How do we know the lifestyle group actually followed the diet? Did someone monitor that?
I work for big pharma. This would be a proof of concept study and if this intervention was a drug would for sure be moved to development and tested in a bigger trial. 2nd point: most drugs gets approved based on showing significant difference between groups as was tested here, NOT based on significance of change from baseline within one group. So what they did is exactly how trials would be done to submit for registration (as mentioned on a larger sample size). The amount of benefit would be weighed against risk. The smaller the benefit of a drug, the safer it needs to be to be approved ( in addition to considering existing treatments available/medical need)
Thanks Gill for providing unbiased clarity around this. I'm no longer subscribed to all the vegan and WFPB channels I used to be 5 years ago, but I can imagine they are basically saying "look, WFPB, cures Alzheimer's, this study PROOVES it!" :) I eat a generally WFPB diet still, no animal products and just a very small amount of oil here and there, but I no longer am drinking the Kool-Aid thanks to you and others who keep talking facts rather than rhetoric. While it's nice to have more studies, the main problem I see here is the person who is running the study is enormously biased in favor of a vegan diet. Even though we don't know whether this study actually provides any backing for such a diet based on incomplete data, if these numbers were even less APPARENTLY positive in terms of comparing one group's improvement/lack of improvement to the other, then I somehow doubt that Ornish would come out with the results stating that "Vegan diet (+ other lifestyle interversions)" do not make any statistical signifance in treating Alzheimers." No, because that would be seriously against his interest, his brand. He is a total partisan when it comes to this stuff, not a neutral party, so why should we even look at this study in the first place?
What I really want to know (other than actually having a complete set of data from the trial) is:
1) What did the control group eat? If it was the standard American Diet, well, duh, any diet other than that is probably going to improve health
2) You mention "arms" of the study that separated out different lifestyle factors, does this mean that the overall comparison was between no intervention and an average of all the arms?
3) If so, how did the different lifestyle arms compare?
4) Did they try combining multiple arms to see if doing more than one type of lifestyle intervention had a compounding effect? (Realizing that we don't even know if the effect that is stated in the conclusions here are accurate since they only give us a partial picture of the data).
They are not doing this, actually.
@@tamcon72 no? I watched Mic the Vegan's take on it yesterday and you're right in that he didn't portray it s proof, but pretty much just inferred that it was the diet caused these improvements, and said nothing about the limitations of the study - other than complaining that it wasn't technically vegan/plant based because of the fish oil. I wonder if that particular aspect of it has made the response less fervent in some way, because it indicates that EVEN when there was some animal product included, people still improved? If there are others who have had a more nuanced reaction, I'd be interested to know...
As I read the study, the "arms" are just control vs intervention group. They do get broken down into adherence groups to further delineate if greater adherence lead to better results, but overall they all still got the same "lifestyle interventions."
Interesting presentation. Gill mentioned one variable in the beginning of the difference between the two groups, “whole food diet” that was not discussed further. What is the effect of processed foods on the gut and how does that impact the absorption of the nutrients? Just because you swallowed it did the intestines absorbed it?
Why does that matter? The brain is an organ and it requires certain nutrients to function. Certain foods I.E. sugar disrupts the Ph of the stomach and can affect the absorption of some nutrients.
Just food for thought.
40Hz light and sound therapy. Also some interesting research ongoing there at MIT and similar.
I’m mad that I’ve finished watching all of your videos already, I need more! I had been listening to these sort of like podcasts while working out and/or cleaning, now what am I going to do 😂
Think too many confounding factors. Exercise? Supplements? Diet? Stress reduction?
How are those confounding factors? The goal of the study was to find out the impact of lifestyle changes, not a single diet.
This is how research is done. Since it's statistically significant, you can break down the impact of each component in future studies.
Who cares? The goal is Alzheimer's. That's a big target, and I want to throw the whole battery of safe lifestyle interventions that might help. Lifestyle interventions notoriously tend towards small effects, and the reality of lifestyle intervention is that it is all-encompassing. Give me pooled small effects when searching for an effective intervention. Additionally, Alzheimers is not a one gene/one problem, one outcome disease like PKU. It is multifactorial, and I think the scientistic obsession with reductionism is fatal toward science itself. Who says that Alzheimers is going to have a single, isolatable treatment? It will likely need a protocol rather than a pill. Tease the differences within groups once the differences between groups is clear!
Yes - however, if you have alzheimers (or don't want it) - doing everything in the study gives you a good chance (essentially a very healthy lifestyle that some people already have, think "Blue Zone Plus" lifestyle). I imagine they'll try to be more specific in the future.
That's not a confounding factor, it's part of the intervention
Part of the intervention!
Becuz diet alone is nothing..
It's like-
You know fruits are good for you but you can't just eat fruits.. you have to incorporate other food groups like grains, pseudograins, lentils , beans , veggies , nuts and seeds..
Likewise, it's crucial for each of us to excercise, sleep and supplement if necessary
It's good to know that a healthy lifestyle, possibly capable of halting AD, a piece of that puzzle, was a whole food plant based diet.
I know when a family member gets AD you'd try anything to keep them for longer, at least this gives some guidance aside from just "take these pills"..
I love the rigor. Because we need to adhere to the science. However as a layperson, with an interest in this topic I believe that it is likely that a WFPBD alone (given adequate scientific attention) will demonstrate a mitigation of the effects of Alzhimer's disease.
Now do a video on the many experiments and studies on ketones and ketogenic diets on the brain vis a vis Alzheimer’s. Plenty of great research out there (thanks in part to MCT oil) - on people and dogs.
I wish someone would run this trial with a new control group, doing everything Ornish had them do, the exercise, the therapy, etc. BUT do it with a keto diet, under 20 carbs per day. I would be very interested in the results.
Right - lots of research out there including brain imaging on the impact of ketones on Alzheimer’s brain. the idea is that Alzheimer’s is characterized by inflammation and a well formulate anti-inflammatory ketogenic diet would be best for the Alzheimer’s brain, since ketones can get to parts of the brain where glucose has trouble.
Given that this study was partly prompted by the growing correlation between saturated animal fat consumption and cognitive impairment, it would have to be done by some other group that operates on some other hypothesis.
The more I think about this Ornish trial the more I don’t like it. The right trial would be to simply put the group on a vegan diet without all the extra things, the books, the therapy, the exercise. See if the vegan diet did anything. It’s a classic mistake of making too many changes. As a person who has cared for many with dementia, any of those things could make a difference. I’m actually surprised that the changes weren’t bigger. To me it suggests the vegan diet was the least impactful. But maybe that’s my bias. The point is, who knows what this study shows? My experience shows the exercise alone would show a statistically significant improvement. Or any of the others. But all together? C’mon. It makes me think the trial itself was disingenuous.
@@RC-qf3mpwhere glucose has trouble? I think you either made this up or were misled.
Not going to be Ornish, believe me.
Concise analysis... its not just one thing. I still like the analysis where they frame diet as 50 to 60% of the lifestyle pie. Obese ppl have far more disease. 10 minutes of eating trash food can erase 2+ hours of exercise
I wonder if the social interaction and the exercise might be the primary drivers of a reduction in Alzheimer's creep. I also wonder what additional benefit might be achieved if it was possible to add an hour of mental exercise each day.
I think that's got to be a factor, but of the elderly people I've known three succumbed to vascular dementia and they were all daily meat eaters; one a butcher also had CV problems. others that lived to 90s fully compos mentis were eating meat maybe two/three times a week but less in early life.
I recommend watching a lot of good analysis of this research with four videos like "Blue Zones and Lifestyle Medicine: The Secrets to Longevity Unlocked," "Study: Vegan Omega 3 is BETTER Than Fish? Plant-based ALA vs EPA/DHA," "Vegan Diet for Alzheimer's Study Results Are In," "A Testimonial from Dr. Ornish's Alzheimer's Progression Reversal Study."
Curious to see how you think this study compares to the Recode/Bredesen paper. Always easy mode when you compare an intervention vs SAD.
Yeah, one issue is no placebo control, what if just doing anything makes people feel that they are going to do better and be more confident at all the tests.
Another is - why are the control going bad so fast
Even without having a diagnosis of disease, some lifestyle intervention program could help improve health. Where do I sign up?
Although not definitively conclusive, it does look like a promising approach to managing Alzheimer’s. Hopefully a more extensive study will be done.
One thing to also keep in mind is the possibility of reverse causality with the adherence data. Perhaps those participants who naturally had a slower progression of their alzheimer's disease were more likely to adhere to the intervention, rather than adherence to the intervention causing them to progress more slowly.
I wish someone would do a study on PB diet that controlled for exercise. Many advocating for a vegan diet - Furhman, Esselstein, Campbell, for ex. - also exercise a lot, so I always wonder how much of the good results are from the exercise itself.
The results of all these studies, regardless of end points (MI/Stroke/Dementia/Diabetes/Cancer), always reiterate the same 4 points. 1/ more plants 2/ less SF and junk food 3/ exercise 4/ lower stress. However, one that rarely gets addressed : "don't be poor" so you can afford 1 thru 4 (especially 4).
Do we really expect any studies to say reduce chances of AD (or any modern disease) by : a/Eating junk food, b/sofa surfing, c/working 3 jobs and living in a polluted, high crime zip code.
How many more studies do we need to just to repeat the same tired mantra. Anyone that watches health podcasts such as your excellent YT's know this, the people who need to know it, don't watch medical podcasts - most don't have time as they are working 3 jobs (and even of they did, don't have the resources to follow a plant forward, healthy lifestyle .. too busy staying alive).
Maybe a better way to present this data would be 1+2=3+4 = 25% reduction, 1=5%, 2=5%, 3=5%, 4=5% ... we all know (and have been endlessly told) 1+2+3+4 is the answer for every health question ... its like deep thought ... the answer is exercise/diet/stress reduction/no junk food/SF (42) .. what's the question.
Conflating plant-based into all this is the error..
Plants + something else does not equal "it's the plants!!!!".
Also yea.. stressed poor people dont think about this stuff much.
However they CAN live a simple healthy life in terms of food. However getting 2000 Calories out of whole non-starchy plants is damn expensive.
Not buying ultra-processed empty calories saves lots of money, and cooking instead of eating out also saves money.
Poor people still waste money on junk food..
I agree. Vote in progressive politicians who will shift our economic policy to one which is more people and planet centered.
"Aβ42/40 ratio increased in the intervention group and decreased in the control group (p = 0.003)."
This is one of the most important markers of AD. Why are you not focusing more on this? This is a clear indication of reversal.
hi, see the 2nd part of the video where the biomarker changes were covered, this ratio is the biomarker the video refers to. The way the change is described in the trial has the exact same issue explained for the cognitive tests; in order to claim an "increase" or "decrease" in any of the groups biomarker level before vs after the trial has to be compared and this wasn't reported. so there is uncertainty there but the overall trend appears favorable compared to the controls (similar situation to the cognitive tests)
Encouraging study but too short and seems underpowered. If Ornish can't show a significant deterioration within the control group then its too small/too short a study to have a chance of showing a convincing benefit in the treatment group.
Even if eating a vegan diet shaved years from our life it would still be the right thing to do, ethically. Animals suffer heinously because we consume them -- not to mention the myriad other downsides. By now though it should be clear to anyone who's not hanging on to their confirmation bias by their fingernails that plant based eating is as close to a panacea as we've got. I've been eating this way for 14 years and it is the best decision I've made. The only downside is realizing that your friends and family are delusional, cruel and oppressive in their food choices -- and are ultimately harming their health.
indeed, and yet somehow the wfpb vegan diet correctly supplemented (b12, iodine, omega3 the last two can be done with food) and correct BMI seem to point to a longer healthspan and better activity and cognition into your 90's, possibly even better than mediterranean diet and bluezones
Gill, I just saw a video that suggests there are studies on allulouse showing it "shrinks belly fat" by Thomas DeLauer. I would love to see a video from you on this.
A number of comments seem to punch holes in this study, but that isn't the thrust of this review. The point is surely that the Ornish intervention, by its very structure, is limited. It would be a poor response to say he should have done for separate tests because one point might be that the result of combining strategies leads to something greater than the sun of its parts. I suppose a study that had a control group, a diet only group, a meditation only group, etc. and a combination of all might be interesting. But the intervention needs to be a bit more extensive in number and time. Overall, though, this is still an interesting intervention if others or the Ornish people can build on it.
What about diabetes and insulin resistance? I think that's an important factor. Socializing is also crucial.
What about nicotine (patches) to treat Alzheimer's? Does fasting regularly have any impact?
Dr. Bredesen uses overnight fasting for long periods of time.
That's the point of substitution analysis right. For instance, if you substitute eggs for lentils and the biomarkers improve, but at the same time you change other 27 lifestyle factors, how can you know it's the lentils?
You know from the bulk of evidence out there.
The study assumes that MCI for all participants is due to the same factors. Maybe for some is infections, to other vascular and others metabolic challenges or toxins. Unless we understand and measure better all the factors that affect cognitive decline, it is going to be difficult to come to a clear solutions.
Thanks doctor. You're the most sensible channel in nutrition. Ornish is the only "scientist" claiming reversal. I did Ornish 35 years ago! It worked to lower cholesterol 100 points. It is the most joyless, unsustainable diet imaginable. Keto also did wonders for my labs. I've always exercised & worked to eat well. I have cad. So both diets worked. Neither prevented disease . After 40+ years of touting his miserable diet why doesn't he have more substantial evidence & scientific data??? I'd follow it if he did. I greatly appreciate your videos.
It’s not as miserable anymore. Lots of great recipe content on here. Wonder what your cholesterol was on each diet? Trying to decide which way to go.
The current perspective among most academically-trained epidemiologists (and informed journal editors) is that "statistical significance" is a poor indicator of the clinical significance of an intervention.
This time you missed something: There was obviously no placebo control and in addition, the intervention group did a highly extensive and motivating program. Studies indicate that the placebo effect alone can induce improvement in cognitive tests. In this case, there might be a direct effect of motivation in addition. The participants in the experimental group, who have shown effort for so long, might show more effort during testing at the end as well. I guess at least some effect is simply due to these factors, and not to the intervention at all. The findings are therefore only suggestive but not conclusive at all. Not only do we not know which component of the intervention is effective (as you rightly point out), but we do not even know whether the program as a whole is effective. We really need a placebo control (at least a placebo medication) and in addition, we need some measures for explicit effort of participants during testing. Really, a promising trial, but now we require a better one!
yes, all the attention by the coaches and the awareness that they're going through this extensive program could have an effect on their self-confidence and their cognitive performance. It would technically still be an effect of the program in the context of the trial but the key component would be the belief in the program´s potential rather than one of the other prongs. I agree that should be considered. This caveat applies to many lifestyle interventions since it's hard to do a proper placebo. Controlling for it would be hard but maybe doable. Maybe by having time-matched sessions with some activity that isn´t expected to affect cognition much
@@NutritionMadeSimple Yes, time matched sessions or at least a placebo medication + some activity, which would make the results much stronger, in particular in case there is one pure waiting group in addition and not much difference between placebo group and waiting group.
Hard to say when there are so many more variables than vegan vs omnivore. I suspect we'll get some sensational headlines by people who take away the wrong conclusion.
What we know is that a reasonable diet at maintenance calories (or below if you're overweight), with a decent amount of physical activity is good for just about anything. I hope that message gets emphasized.
Statistically speaking, how legitimate is it to remove a single "outlier" out of say, 25 subjects, and thereafter claim the results of a certain trial or test within a trial, with that removal effected, were statistically significant? I don't know the answer, just wondering...
It's completely normal to report that. It's a procedure called sensitivity or robustness analysis where you check if and how the results will change if you change the input just a tiny bit.
it's legitimate if done right, there are actual statistical tests to select outliers so that it's not a human hand-picking
You would take an equal amount of outliers on both sides
You might have mentioned this but I missed it… did the control group continue their medications as prescribed for Alzheimer’s by their doctors and the test group discontinue their medication? If so, then I’d say that this study was more beneficial than just trend based analysis
Who were the study participants? Changing a SAD diet is gonna have great effects no matter what you change it to. Meathead here.
Ornish's studies frustrate me so much. To many variables in the "lifestyle" changes to be very meaningful.