With the world’s population aging at a rapid rate, the prevalence of Alzheimer’s disease (AD) has significantly increased. These statistics are alarming given recent evidence that a third of dementia cases may be preventable. The role of lifestyle factors, such as diet and exercise, can directly alter the risk of disease development. However, an understanding of the effectiveness of dietary patterns and exercise strategies to reduce AD risk or improve brain function is not fully understood. The aim of this review is to discuss the effects of diet and exercise on AD risk. Key components of the Western and Mediterranean diets are discussed in relation to AD progression, as well as how physical activity promotes brain health. Components of the Western diet (saturated fatty acids and simple carbohydrates) are detrimental to the brain, impair cognition and increase AD pathologies. While components of the Mediterranean diet, (polyunsaturated fatty acids, polyphenols, and antioxidants) are considered to be neuroprotective. Exercise can significantly reduce the risk of AD, however specific exercise recommendations for older adults are limited and optimal intensity, duration, and type remains unknown. This review highlights important modifiable risk factors for AD and points out potential avenues for future research. Novelty Bullets •Diet and exercise are modifiable factors that can improve brain health and reduce the risk of Alzheimer’s disease •Polyunsaturated fatty acids, polyphenols, and antioxidants are considered to be neuroprotective •Exercise reduces neuroinflammation, improves brain insulin sensitivity, and increases BDNF

Neuronatin (NNAT) is a transmembrane protein in the endoplasmic reticulum involved in metabolic regulation. It shares sequence homology with sarcolipin (SLN), which negatively regulates the sarco(endo)plasmic reticulum Ca2+‐ATPase (SERCA) that maintains energy homeostasis in muscles. Here, we examined whether NNAT could uncouple the Ca2+ transport activity of SERCA from ATP hydrolysis, similarly to SLN. NNAT significantly reduced Ca2+ uptake without altering SERCA activity, ultimately lowering the apparent coupling ratio of SERCA. This effect of NNAT was reversed by the adenylyl cyclase activator forskolin. Furthermore, soleus muscles from high fat diet (HFD)‐fed mice showed a significant downregulation in NNAT content compared with chow‐fed mice, whereas an upregulation in NNAT content was observed in fast‐twitch muscles from HFD‐ versus chow‐ fed mice. Therefore, NNAT is a SERCA uncoupler in cells and may function in adaptive thermogenesis.

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Background: Lithium, a commonly used treatment for bipolar disorder, has been shown to have neuroprotective effects for other conditions including Alzheimer’s disease via the inhibition of the enzyme glycogen synthase kinase-3 (GSK3). However, dose-dependent adverse effects of lithium are well-documented, highlighting the need to determine if low doses of lithium can reliably reduce GSK3 activity. Objective: The purpose of this study was to evaluate the effects of a low-dose lithium supplementation on GSK3 activity in the brain of an early, diet-induced Alzheimer’s disease model. Methods: Male C57BL/6J mice were divided into either a 6-week or 12-week study. In the 6-week study, mice were fed a chow diet or a chow diet with lithium-supplemented drinking water (10 mg/kg/day) for 6 weeks. Alternatively, in the 12-week study, mice were fed a chow diet, a high-fat diet (HFD), or a HFD with lithium-supplemented drinking water for 12 weeks. Prefrontal cortex and hippocampal tissues were collected for analysis. Results: Results demonstrated reduced GSK3 activity in the prefrontal cortex as early as 6 weeks of lithium supplementation, in the absence of inhibitory phosphorylation changes. Further, lithium supplementation in an obese model reduced prefrontal cortex GSK3 activity as well as improved insulin sensitivity. Conclusion: Collectively, these data provide evidence for low-dose lithium supplementation to inhibit GSK3 activity in the brain. Moreover, these results indicate that GSK3 activity can be inhibited despite any changes in phosphorylation. These findings contribute to an overall greater understanding of low-dose lithium’s ability to influence GSK3 activity in the brain and its potential as an Alzheimer’s disease prophylactic.

Sporadic Alzheimer’s disease (AD) is a neurodegenerative disease characterized by neurofibrillary tangles composed of hyperphosphorylated tau proteins and amyloid‐beta (Aβ) plaques. Together, these two histopathological detriments in the brain lead to progressive cognitive decline. Glycogen synthase kinase‐3 β (GSK3β), a kinase found abundantly in the brain, has been implicated in the development of these AD pathologies. GSK3β remains constituently active until phosphorylated at its inhibitory Ser9 residue. When active, GSK3β is capable of inducing tau hyperphosphorylation and can phosphorylate amyloid‐precursor protein (APP), influencing greater levels of Aβ peptide production. Lithium (Li), a GSK3β inhibitor, has been suggested as an AD prophylaxis. However, Li has also been associated with several dose‐dependent adverse side effects. The purpose of this study was thus to examine the effects of a prophylactic low‐dose Li supplementation on brain GSK3β signaling and activity. C57BL/6J male mice were given 10mg/kg/day Li or no Li in their drinking water for 6 weeks (n=12/group) and the prefrontal cortex (PFC) and hippocampal (HIP) tissues were collected for GSK3 activity assay and western blot analyses. Li mice had increased serum Li concentrations (p<0.0001) and decreased hippocampal GSK3 activity (p=0.06) as compared to control mice. pAkt Thr308 phosphorylation, a kinase immediately upstream of GSK3β capable of inducing inhibitory pGSK3β Ser9 phosphorylation, was increased in the PFC of Li mice compared to control mice (p<0.05). However, no differences in pGSK3β Ser9 or Tyr216, an activating residue, were observed between control and Li mice in both the PFC and HIP. Changes in GSK3 activity without changes in inhibitory Ser9 phosphorylation may suggest that a longer supplementation is needed to affect significant changes in the brain. Furthermore, these results demonstrate that the phosphorylation status of GSK3β may not always be a direct translation of its activity. This highlights the importance of measuring GSK3β activity alongside of measures of upstream kinases (i.e. PI3K/Akt signaling) and downstream targets to obtain a better indication of GSK3β’s overall activity within the brain. Overall, this initial work provides evidence that Li can inhibit hippocampal GSK3 activity and alter the phosphorylation status of upstream kinases at a low‐dose. Future work will examine Li’s potential prophylactic effects in a diseased model which better mimics AD (i.e. aged and metabolically‐distressed mice). This is important to further elucidate the efficacy of low‐dose Li in the prevention of AD pathologies. Support or Funding Information This work is supported by the Alzheimer Society of Brant, Haldimand Norfolk, Hamilton Halton and NSERC.