which of the 36 holes in the roof can you plug? | by Functional Nutritionist Andrea Nakayama of Holistic Nutrition Lab

which of the 36 holes in the roof can you plug?

A few years ago, I attended the Cleveland Clinic Grand Rounds where Dr. Dale Bredesen spoke about the reversal of cognitive decline associated with Alzheimer’s Disease.

Even if you’re not interested in dementia and it does not or has not affected your life or your work, read on. There was something poignant that the good doctor said that speaks directly to practitioners who work with diet and lifestyle modification.

My ears perked up, and I think yours will too!

Dr. Bredesen spoke about the mistake the medical community has been making in regards to Alzheimer’s—trying to target the disease with one single agent.

Just like the reversal of AIDS requires a “cocktail” therapy, he said Alzheimer’s also requires a many-pronged approach.

That’s because Alzheimer’s is multifactorial. It has many underlying causes, and we need to take a personalized approach to target all of the underlying root causes of the condition.

In other words, we need to take a Functional approach!

Dr. Bredesen went on to compare Alzheimer’s to having 36 holes in a roof…

You can’t just plug one hole and expect the problem to resolve.

Instead, we have to plug multiple holes.

In fact, what he found in his research was that essentially plugging even half the holes can lead to complete reversal of symptoms.

One hole isn’t enough. Many holes make a difference!

It’s when Dr. Bredesen said this that my ears perked up. Do you know why?

Because this means that we all have a role. We can all feel confident that when we work together (practitioners in partnership), we’re plugging multiple holes and making a bigger difference.

I got excited because I was thinking of you.

I was wondering…what holes can you comfortably plug?

I went and looked up Dr. Bredesen’s published research and his therapeutic protocol. Each step is based on the following:

  • Goal—What is contributing to the disease, and the goal to eliminate the culprits (Ex: Sugar and other inflammatory foods contribute to the disease, so the goal is to reduce or eliminate those foods.)
  • Approach—How to achieve the above goal (Ex: Educate the client on how sugar impacts her health, and offer her action steps to remove it from her diet)
  • Rationale—Why the above actions need to be taken (Ex: There are several biological pathways impacted by sugar)

And when I looked at the actual list I just had to share it with you…Dr. Bredesen's therapeutic research protocol | Holistic Nutrition Lab

Look at how much you can do!

Seriously, look what a role you can play in helping to reverse the symptoms of Alzheimer’s disease. Print out this table, get out your highlighter, and draw a big circle around the areas that are within your scope and feel comfortable to you to address.

If you’re overwhelmed by the language or the appreciations, just search for the words and things you can do.

I bet there’s more than one. And remember, every hole matters, even though no single one will do the trick alone.

And this isn’t just for dementia!

There are 36 (or more!) holes in the roof for every chronic condition.

The holes you can plug matter.

Please plug them with confidence and the best know-how you can.

That’s how we #dochange in healthcare.

Your first step to join the Resolution is easy. Download my ebook—Roadmap to Resolution: Your Blueprint for Thriving in Practice by Addressing the Root Causes of Chronic Illness—and see just how important you are in this new healthcare paradigm.



Bredesen, D. (2014) Reversal of cognitive decline: A novel therapeutic program. AGING, Vol 6, No 9 , pp 707-717

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Functional nutritionist and educator Andrea Nakayama (FNLP, MSN, CNC, CNE, CHHC) is leading patients and practitioners around the world in a revolution to reclaim ownership over our own health. Her passion for food as personalized medicine was born from the loss of her young husband to a brain tumor in 2002. She’s now regularly consulted as the nutrition expert for the toughest clinical cases in the practices of many world-renowned doctors, and trains a thousand practitioners online each year in her methodologies at Functional Nutrition Lab. Learn more about Andrea here.

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Perhaps Senior Care facilities and Medicare could share this information for all to take better care of their Brains (and bodies). I am not that old but am doing all I can as I learn more to optimize my health.


I just read this in dr Bredesen’s book! I cannot wait to join in on his IFM webinar Dec 2-3. We are on to something big. I am looking to parterning with a local lab to begin “cognoscopy testing” beginning with me. so many possibilities. but i don’t know where to start! lol

Kay Jennings
Kay Jennings

Great summary of a very important work we can all contribute to.

Tita Nieves
Tita Nieves

As I read this blog, I think more clearly on how many holes in the chronic conditions of clients and family can I assist in plugging, starting with my father’s dementia. I see my role in this area of Functional Nutrition and lifestyle counseling more clearly and I become more committed to the What, the How and the Why of a chronic condition. Thank you Andrea.

Jacquie walburn

Funny how a doc on FB told me you can’t help Alz/Park w/diet & said my client I reversed 80% of his Parkinson’s must have been misdiagnosed! When I asked to explain, no response.