Women and Alzheimer's Disease

By Britni Vincent, RD, LD
April 27, 2025

With the high rate of Alzheimer's disease, I know that many of you have witnessed a loved one experience the devastating effects of Alzheimer's. Unfortunately, these numbers are continuing to rise each year. I often get clients that have had a family member diagnosed with Alzheimer's and tell me “I will do whatever you tell me with my diet if it can help prevent Alzheimer's.”

Like many of you, I also have a personal connection with Alzheimer's because my grandmother had it. She was very special to me and a large part of my childhood. It was heartbreaking to watch the disease progress!

Before we dive into how lifestyle and diet can impact Alzheimer's I want to provide some statistics that are alarming...

• Alzheimer’s is a progressive disease and is the most common form of dementia. Alzheimer's disease affects memory, thinking abilities, and behavior
• Dementia is a general term for memory loss and other intellectual inabilities that are severe enough to impact daily life.
• As of 2024 nearly 7 million Americans are living with Alzheimer's disease.
• 1 in 3 seniors die with Alzheimer's or another form of dementia.
• It's projected that 14 million Americans will have Alzheimer's by 2060.

There’s currently no known cure for Alzheimer’s and very few truly effective treatments. But there is hope in prevention and lifestyle factors. Dr. Richard Lipton of the Albert Einstein College of Medicine said it well:

“Lifestyle changes look more promising than drug studies so far.”

We know that generally Alzheimer's is multifactorial and that diet and lifestyle do impact the risk of developing Alzheimer's. If I told you how to change your nutrition to protect your brain from developing Alzheimer's, would you do it? I think anybody who has witnessed the devastating affects of the disease would say yes.

Why are more women affected by Alzheimer’s than men?

Alzheimer’s disease affects both men and women, but women are disproportionately impacted. Nearly two-thirds of Americans living with Alzheimer’s are women. While women generally live longer than men, longevity isn’t the only reason for the greater number. The reason for this is likely a combination of lifestyle, genetics and biological factors.

Emerging research suggests a biological and hormonal connection, particularly tied to estrogen levels. Research suggests estrogen has a protective effect on the brain including the hippocampus, which is the learning and memory center of the brain. Estrogen's (particularly the form estradiol) sharp decline during perimenopause and menopause may influence the development and progression of Alzheimer's.

Some additional factors that put women at greater risk for Alzheimer's disease:

• Women experience more drastic hormonal changes in midlife than men.

• The genetic risk factor APOE4 may impact women more strongly.

• Women are also more likely to take on caregiving roles, increasing chronic stress, which negatively affects brain health.

• Many studies indicate that depression is a risk factor for Alzheimer's disease, and women have a higher lifelong prevalence of depression than men.

Contributing factors to developing Alzheimer's disease

Research on Alzheimer's disease has not found just one or even a few things that cause Alzheimer's disease, but rather it's likely multiple factors that contribute to the development of the disease. This is probably why drug treatments for Alzheimer's haven't been very effective thus far. Here are some possible contributing factors.

• Nutrient deficiencies, especially vitamin B12

• Poor methylation (Methylation is a biochemical process that has a significant positive impact on many biochemical reactions in the body that regulate the activity of the cardiovascular, neurological, reproductive, and detoxification systems. Methylation also affects gene expression)

• Elevated homocysteine levels (this can be related to poor methylation)

• Imbalanced gut health

• Infections in the body (some examples are: H. Pylori, gingivitis, Herpes simplex and Lyme)

• Insulin resistance (this includes pre-diabetes and type 2 diabetes)

• Toxin exposure including heavy metal toxicity

• Chronic stress (too much cortisol becomes toxic to our memory center, the hippocampus)

• History of traumatic brain injuries, including concussions

• APOE4 gene

• Chronic sleep deprivation

Nutrition and Alzheimer's disease

Alzheimer’s doesn’t just appear overnight. It develops slowly, over years and sometimes even decades, and is influenced by chronic inflammation, insulin resistance, nutrient deficiencies, oxidative stress, and even gut health. The good news? These are all areas where nutrition can make a meaningful difference.

Diet can play a large role in the development of Alzheimer's disease and on the flip side, diet can help prevent cognitive decline and lower the risk of Alzheimer’s disease.

For prevention focus on an anti-inflammatory, real, whole food diet that includes:

• Lots of colorful vegetables that flood your body with antioxidants, fiber, and phytochemicals.

• Low sugar fruits like berries that are rich in brain-loving polyphenols.

• Healthy fats with an emphasis on omega 3 fatty acids -these are key for reducing inflammation and building brain cell membranes.

• High-quality protein from real food sources like grass-fed beef, eggs, poultry, and fish, especially fatty fish to get more omega 3 fatty acids. Protein helps to keep your blood sugar stable and support neurotransmitter production.

By focusing on balanced nutrition with a variety of different foods you're going to get antioxidants and nutrients to support your brain and entire body. This will help to address many of the contributing factors listed above.

Simply put: nutrition matters. A lot. And the earlier you start nourishing your brain, the better. It’s not about being perfect—it’s about being intentional and consistent with your food choices and giving your brain the best chance to thrive.

Blood Sugar and Alzheimer's disease:

There is a huge connection between high blood sugar and the development of Alzheimer's disease. Research has found that the risk of developing Alzheimer's is 65% higher in individuals that have type 2 diabetes. There is even an increased risk for individuals that have prediabetes. This connection is so strong that Alzheimer's is often referred to as type 3 diabetes.

Just like muscle and fat, your brain cells need insulin to utilize glucose for energy and insulin resistance can occur in the brain. Insulin resistance in your brain means your neurons don't get the energy they need, which impacts the communication between different parts of the brain and the rest of the body. Overtime, your brain won't function efficiently and cell death can occur.

Another mechanism is that high blood sugar causes chronic low-grade inflammation systemically in your body. Inflammation is a driver for the development of amyloid plaque in the brain, which is a hallmark of Alzheimer's disease. High glucose also damages blood vessels in the brain, which can contribute to Alzheimer's.

Optimal glucose levels:

Optimally, your fasting glucose should be 70-90 mg/dL, your A1C should be 5.4% or below and your fasting insulin should be 5 μU/mL or below. If your levels are higher than this it is possible to get into these optimal ranges, I have even had clients reverse their type 2 diabetes.

Here are some things you can do to reduce your insulin resistance and lower your glucose:

• Focus on getting your carbohydrates from mostly vegetables. This will also increase your fiber intake, which helps to lower glucose levels.

• Reduce or eliminate the processed carbohydrates and sugar like bread, crackers, candy, baked goods and cereal.

• Aim to get regular movement (movement improves insulin sensitivity). Taking a 10 minute walk after eating a meal can make a significant impact on your glucose number, because the movement helps to push to glucose into the cells more efficiently.

• Prioritize sleep to optimally get at least 7 1/2 hours each night.

Gut Health & Alzheimer's

It may be surprising to hear how much of an impact your gut health may have on the development of Alzheimer's disease. The reality is that gut health is really the foundation of your health. The gut microbiome and the brain are connected through the gut-brain axis, which is a complex network of neurons, proteins, and chemicals that relay messages between the digestive system and the brain. If there is inflammation in your gut that will contribute to inflammation in the brain.

Currently, there are studies being done on the possibility of targeting the health of the microbiome to slow the disease progression of Alzheimer's. The National Institute on Aging is funding the Alzheimer's Gut Microbiome Project. Some research has even suggested that eating a high fiber diet can reduce inflammation in the brain.

So, what can you do to optimize your gut health?

• Eat a diet rich in fiber. Think lots of vegetables; nuts, seeds and avocadoes are also great sources of fiber.

• Include fermented foods to get more probiotics. Kimchi, sauerkraut, yogurt (plain), low sugar kombucha, pickles (without vinegar) are some examples of probiotic rich foods.

• If you aren't consuming many fermented foods or you have poor gut health consider taking a daily probiotic.

For more info on gut health and the brain: The Gut-Brain Connection

For more info in healing your gut: How To Rest and Heal Your Gut

 

Damaged fats may be contributing to the risk of Alzheimer’s

Did you know that the brain is made up of about 60 percent fat? Knowing that most of your brain is fat, does it make sense to be limiting your fat intake? Also, does it make sense that the fats you choose make a difference?

Many Americans follow a low fat diet or have a history of eating a low fat diet. The small amount of fat they do consume is mostly damaged fat.

Damaged fats (also called refined oils or seed oils) include:

• Corn oil

• Vegetable oil

• Soybean oil

• Canola oil

• Cottonseed oil

These damaged fats are found in many food products such as crackers or pastries, but they can even be in roasted nuts, mayonnaise, salad dressing or hummus. These oils are typically high in omega-6 fatty acids and prone to oxidation, which can promote inflammation—a major driver of developing Alzheimer’s.

When oils are damaged (by heat, refining, or processing), they create free radicals in the body. These unstable molecules can damage brain cells and contribute to oxidative stress, which is a known factor in the development of neurodegenerative diseases.

Take Steps Today to Protect Your Brain (Eat Good Fats!)

While you can’t change your genetics, lifestyle and environment effect how your genes are turned on and turned off. We can control what we eat and how we live—and that has a major impact on brain health. One of the most powerful things you can do? Choose nourishing fats that support and protect your brain.

Your Brain Needs Healthy Fat to Thrive

Your brain is mostly made of fat, and it relies on quality fat to function properly. Damaged fats—like refined oils (soybean, corn, canola, cottonseed)—can cause inflammation and oxidative stress in the brain, contributing to memory problems and cognitive decline.

Instead, fuel your brain with real, anti-inflammatory fats:

• Avocados

• Butter or ghee

• Extra virgin olive oil

• Olives

• Nuts and seeds (raw is best)

• Virgin (unrefined) coconut oil (more on that below)

We recommend aiming for 1 tablespoon oil or butter, 1/2 avocado or 1/4 c. nuts or seeds at each meal and snack to keep your brain well-fed and focused.

To learn more about coconut oil and Alzheimer's, listen to our podcast episode:
Alzheimer’s—A Family Affair with Dr. Mary Newport

Optimize your intake of omega 3 fatty acids, also important for brain health

In contrast to damaged oils, omega-3 fatty acids—especially DHA—are anti-inflammatory and essential for brain structure and function. DHA makes up about 15-20% of the brain’s gray matter and helps maintain the fluidity of cell membranes, which is crucial for neuron communication.

Benefits of Omega-3's for brain health:

• Better memory and cognitive function

• Reduced brain shrinkage with age

• Lower risk of Alzheimer’s and other dementias

Best sources of Omega-3's:

• Fatty fish like salmon, tuna, herring, sardines, and mackerel

• High-quality fish oil supplements

• Flaxseeds and walnuts (though these provide ALA, a less efficient form and should not replace the other sources)

Try Nutritional Weight & Wellness’ recipe for Salmon Cakes for a delicious, omega-3-rich meal.

If you’re not consuming fatty fish several times per week, consider supplementing with 3000 mg of omega-3 fish oil each day.

Nutrition Strategies for Prevention

While there’s no magic food to prevent Alzheimer’s, consistent, real-food nutrition makes a difference.

Here is a recap of some key principles:

• Blood sugar balance is critical. Repeated blood sugar spikes can damage brain tissue and impair memory. A balanced diet with protein, healthy fat, and fiber at each meal helps keep blood sugar stable.

• Antioxidant-rich foods (berries, leafy greens, colorful veggies) protect the brain from oxidative stress.

• Support gut health. A healthy microbiome produces compounds that benefit the brain and reduce systemic inflammation.

• B vitamins, especially B6, B12, and folate, help lower homocysteine, an amino acid associated with higher dementia risk.

For additional support

More research needs to be done for us to understand how to prevent and treat Alzheimer’s, but hopefully you now feel ready to start protecting your brain by eliminating damaged fats from your diet and including several healthy fats daily.

If you would like additional support to change your diet to protect your memory and your brain, you can schedule a one-on-one consultation with a nutritionist at one of our offices or schedule a phone or video visit appointment if you don’t live in the Minneapolis/St. Paul area.

Also, learn more by listening to our podcast: Women & Alzheimer's

Sources & References:

• Alzheimer's Association. (2024). 2024 Alzheimer’s Disease Facts and Figures. Retrieved from https://www.alz.org/alzheimers-dementia/facts-figures

• National Institute on Again. (2023). Beyond the brain: gut microbiome and Alzheimer's disease. https://www.nia.nih.gov/news/beyond-brain-gut-microbiome-and-alzheimers-disease#inflammation

• Mosconi, L. (2020). The XX Brain: The Groundbreaking Science Empowering Women to Maximize Cognitive Health and Prevent Alzheimer’s Disease. Avery Publishing.

• Alzheimer's Disease Research. 2021. Diabetes: A Modifiable Risk Factor for Alzheimer's Disease. https://www.brightfocus.org/resource/diabetes-a-modifiable-risk-factor-for-alzheimers-disease/

• Calder, P. C. (2006). n−3 Polyunsaturated fatty acids, inflammation, and inflammatory diseases. The American Journal of Clinical Nutrition, 83(6), 1505S–1519S.

• Reger, M. A., et al. (2004). Effects of β-hydroxybutyrate on cognition in memory-impaired adults. Neurobiology of Aging, 25(3), 311–314.

• Wei BZ, Li L, Dong CW, Tan CC; Alzheimer’s Disease Neuroimaging Initiative; Xu W. The Relationship of Omega-3 Fatty Acids with Dementia and Cognitive Decline: Evidence from Prospective Cohort Studies of Supplementation, Dietary Intake, and Blood Markers. Am J Clin Nutr. 2023 Jun;117(6):1096-1109. doi: 10.1016/j.ajcnut.2023.04.001. Epub 2023 Apr 5. PMID: 37028557; PMCID: PMC10447496.