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Shannon Adkins eats fish -- lots of fish -- for the most powerful of reasons: She's determined to avoid her mother's fate.
Adkins is only 32. But her mother, Suzie Smith, was diagnosed with Alzheimer's disease at age 52. Five years later, Smith can't feed or dress herself.
Could something as simple as eating fish save Adkins from a disease that is progressively destroying her mother's mind? Well, there's fresh evidence that fish -- often dubbed ''brain food'' -- also may be something far more potent: brain-saving food.
People who frequently eat fish may protect themselves from Alzheimer's, according to separate scientific studies by top researchers at Tufts University in Boston, Rush University in Chicago and the University of California-Los Angeles.
Fish is fast becoming to Alzheimer's candidates what an aspirin-a-day regimen is to many heart patients. This movement toward fish already has started to change the way some Americans live their daily lives. It's changing the way many Americans shop and eat. (The purported health benefits of fish have helped push seafood consumption to record levels, going from 15.6 pounds consumed per person in 2002 to more than 16.3 pounds consumed in 2003.) And it has empowered people such as Adkins to help themselves not by visiting the clinic or hospital, but the fish aisle of the local grocery store.
No one touts fish as a cure-all. In fact, experts also say that people should avoid eating certain fish species (shark, swordfish and king mackerel) likely to be contaminated with mercury. But increasingly, the experts now also say that a healthful diet, one that includes fish, might help delay or even prevent the dreaded disease that killed such American icons as former president Ronald Reagan, boxer Sugar Ray Robinson and actress Rita Hayworth.
This disease also unhinges the lives of everyday Americans, like those of Adkins and her mother.
Adkins first realized that something was seriously wrong with her mom in 1997, when Smith, who was driving on a multilane highway, suddenly took her hands off the wheel. Adkins, who was sitting in the passenger seat, had to steer the car to safety.
''That was pretty scary,'' she says. Soon after, her mom got the diagnosis of Alzheimer's, a disease that can take eight years or longer to kill.
Adkins has no idea how much longer her mom will survive. But she does know this: She never wants to get this disease.
Her mom is only 57, but her world of work, friends and hobbies, like gardening, has all but vanished.
''It's a very different life now,'' Adkins says. ''She spends a lot of time confused. She doesn't know where she is or who she's with.'' And some days she doesn't recognize Shannon at all.
And that hurts.
Adkins can't do anything to save her mother's mind, but she might be able to change the future for herself. So she pops a fish oil capsule once a day. She grills salmon for dinner. And she piles her plate high with fruits and vegetables, which also have been shown to possibly ward off Alzheimer's.
''What's the risk?'' she asks. Besides, she adds, the same low-fat, veggie-rich diet can help ward off heart disease.
Adkins embodies the can-do approach that some younger Americans are taking to a disease that is considered unstoppable by most.
Increasingly, experts are beginning to voice that same optimism.
''I listen to people talk about Alzheimer's and they say, 'Nothing works,' '' says Ernst Schaefer of Tufts University. ''But the data suggest that Alzheimer's might be a disease that one can prevent.''
New scientific findings by Schaefer and others suggest that people who eat fish frequently may stave off this brutal disease -- perhaps for years.
''If you can delay the disease until you're in your mid-80s, then you've won the battle,'' says Gayatri Devi, director of the New York Memory Services.
High-fat diet holds other dangers
Experts such as Devi have increasingly blamed the American diet, one laden with fats, to killer rates not just of heart disease, diabetes and obesity, but Alzheimer's as well.
In Japan and other parts of the world where people traditionally have eaten low-fat foods and fish almost every day, the rates of Alzheimer's have been far lower, says Robert Friedland, a neurologist at Case Western Reserve University in Cleveland.
Scientists have widely credited the Alzheimer's protection found in fish to certain fats called omega-3 fatty acids. Oily fish such as salmon, sardines, herring, tuna or mackerel contain lots of those beneficial fats.
Martha Clare Morris of the Rush University Medical Center conducted a study of 815 men and women, and found that those who ate fish at least once a week had a 60% reduced risk of developing Alzheimer's over four years.
Fish is the most concentrated natural source of a particular omega-3 called docosahexaenoic acid, or DHA. That fat is known to play a crucial role in learning and memory.
And most Americans fall short when it comes to DHA. ''Unless you're eating fish every day, you're not getting enough DHA,'' says Sally Frautschy, a University of California-Los Angeles neuroscientist.
Another study shows just how risky that shortfall might be: Researchers at the Framingham Dementia Study found that people with the highest blood levels of DHA cut their risk of developing dementia, including Alzheimer's, by half. The people in this study ate two to three fish meals a week to get that brain protection.
''Fish is good for the brain,'' says Schaefer, lead researcher for the team.
Experts know that Alzheimer's is probably caused by many factors, including genes. And many experts still believe that Alzheimer's is a formidable enemy.
''Alzheimer's is a bad disease -- much like cancer,'' says Lennart Mucke, an Alzheimer's expert at the University of California-San Francisco.
Mucke doesn't believe that a diet ever will completely block Alzheimer's damage. Only powerful drugs will do that. ''But diet might help,'' he says.
A mouse study supports that view.
UCLA's Frautschy, Greg Cole and colleagues studied mice with mutations that cause an Alzheimer's-like disease. One group ate a diet without much DHA, and another got food enriched with the fat.
After five months, the team gave the mice a memory challenge:
* Mice that got the enriched food passed the test most of the time by swimming directly to an underwater platform.
* Mice that didn't get the enriched food flunked: Time after time, these mice couldn't remember how to get to the platform. These mice also had signs of the brain damage that goes along with advanced disease in humans, Cole says.
Such studies provide strong evidence that DHA might push back Alzheimer's, Mucke says. ''But the proof will have to await a rigorous clinical trial,'' he says, noting that to get solid evidence, scientists will have to give humans DHA either in pill form or in a diet, and then see if they can prevent the disease.
People might not have to wait for that proof.
The heart-brain connection
''There are lots of good reasons to add fish to a healthy diet,'' says Bill Thies, vice president of medical and scientific affairs for the Chicago-based Alzheimer's Association.
For example, scientists have demonstrated that fish can help ward off heart disease. In fact, the American Heart Association now recommends that all Americans add two fish servings a week to a low-fat diet that also includes a variety of fruits and vegetables.
That diet helps keep fatty deposits from forming in arteries that supply the heart with blood, helping prevent heart attacks. But the same diet also may keep the brain healthy, says Marilyn Albert, a neurologist at the Johns Hopkins University in Baltimore. Arteries free of clogs are more likely to provide brain cells with enough nourishing blood, she says.
That theory, and the scientific evidence that goes with it, offers Adkins some hope.
Over the years, Adkins has watched this disease take away much of her mother's memory, her humor and -- on bad days -- even her love of dancing.
''I've said goodbye to my mother one piece at a time,'' she says, adding that she has no idea whether she has inherited a gene that may put her at risk.
Adkins made sure she talked to her boyfriend about the disease. ''Who knows if I'll get it,'' she told him. But Rob didn't flinch, and two years ago, the couple got married.
No one can give Adkins a guarantee that a diet will protect her brain. She knows that. Still, she figures she has to give this a go -- for Rob's sake as well as her own:
''I'm doing everything I can to make sure I am here 30 years from now.''Cover story Please see COVER STORY
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