The Alzheimer’s Antidote
Date AIRED: May 26, 2017
In the West, at age 85, the chances of having Alzheimer’s Disease is fifty percent. Forgetting names and forgetting why we go into a room could be harbingers of future cognitive decline. As there is no magic pill to treat Alzheimer’s Disease, prevention is important. Some scientists refer to Alzheimer’s Disease as diabetes, type three. A Harvard Study in the New England Journal of Medicine in 2013 showed that elevated blood sugar correlated with the development of dementia. Diabetes increases the risk of dementia four times, and a high carbohydrate diet increases the risk of dementia by 88 %. High blood sugar shrinks the hippocampus (the brain memory center). Amy connects the dots between the effects of sugar and insulin on cognitive decline and what we can do to prevent cognitive decline.
- Alzheimer’s pathological feature is that affected areas of brain lose ability to harness energy from glucose
- Decrease in glucose metabolism of brain happened long before plaque is deposited
- There is a fuel shortage in the brain causing neurons to wither and atrophy and synapses to degrade.
- The next step is memory loss, confusion, and personality change
PROGRESSSION TO ALZHEIMER’S DISEASE
- Progression to Alzheimer’s Disease takes a long time.
- One of the warning signs of a progression to Alzheimer’s disease is that PET scans find lower glucose use in parts of the brain.
- When people are young, the brain can compensate until the brain can no longer compensate
- The first part of the brain that is affected is the hippocampus (the memory center)
ALZHEIMER’S DISEASE RISK FACTORS
I. GENETIC RISK FACTORS
APO e genotype determines shape and structure of lipo-
proteins which carry cholesterol, fatty acid, fat soluble
nutrients such as vitamins A, E D, K
- Help lipoprotein dock to connect with cells
- Different type very slight change in structure
- Implications for lipid processing
- Increases susceptibility: does not cause Alzheimer’s Disease
- Increases risk for cardiovascular disease and heart attacks
- One APO e 4 increases risk for Alzheimer’s Disease
- Two APO e 4 increases risk for Alzheimer’s Disease even more
- Groups with the longest exposure to eating grains through out history, have the lowest rates of APOe 4
II. AMYLOID PLAQUE
- Used to think amyloid plaque causes Alzheimer’s Disease: it is not the primary cause
- Plaques contribute to the pathology of Alzheimer’s Disease, but are not the cause.
- Drugs targeting plaques have failed in treating Alzheimer’s Disease
- Decreasing plaque does not decrease progression of illness
- Under autopsy, many Alzheimer’s patients do not have significant plaque
- Patients without Alzheimer’s Disease may have significant plaque.
III. HIGH LEVELS OF INSULIN:
What is insulin?
- A hormone that directs metabolism
- After eating a lot of carbs, insulin sends glucose into the cells, the liver cells and fat cells
- The higher the insulin level, the more it signals to burn glucose in muscle and to store fat
- It helps build muscle
- Carbohydrates and protein raise insulin: fat does not
Chronic High Insulin Levels (insulinemia)
- Insulin levels are too high too often
- This risk factor is independent any other factor
- Many people have high insulin levels and don’t know it
- Most physicians do not measure insulin levels
- When the body does not respond to insulin
- Insulin resistance occurs when insulin levels are high (the insulin receptors are down graded, meaning the cells stop getting the message of insulin.)
- If blood sugar levels are high with high level of insulin, the answer is not to give insulin as these people already have an excess of insulin. The answer is to have a diet that resensitizes the body to the insulin that is already there
- Short sleep results in a short term impaired insulin sensitivity which means more insulin is needed to process the same amount of food
- Physical Activity can help increase insulin sensitivity and decrease insulin resistance
- The answer is not to give insulin because these people already have too much
High levels of insulin: risk factor for Alzheimer’s Disease
- High insulin levels are associated with Alzheimer’s Disease
- Some refer to Alzheimer’s disease as diabetes type 3
- Insulin crosses the blood brain barrier and is active in the brain
- A rise in insulin causes problems in the brain
- There is insulin resistance in the brain as well
- Brain insulin resistance can impair ability of brain to use glucose
- One can have too much insulin in periphery and have too little insulin in the brain
- Different parts of the body (Liver, brain adipose) respond to insulin different in ways
- Insulin nasal spray some dementia can show short term cognitive improvement
- Low insulin in brain decreases the insulin degrading enzyme (IDE) which is the same enzyme that clears amyloid beta (which is increased in Alzheimer’s Disease) from the brain.
- Insulin resistance decreases IDE which means that there is less IDE to clear amyloid beta.
- No one is measuring insulin levels so there are not studies to assess the comorbidities of insulin resistance
Relationship between blood sugar levels and Brain Health
- high blood sugar levels shrink the hippocampus (the brain’s memory center)
- A lot of glucose uptake in the brain is not insulin dependent.
How to Measure Pathway to Diabetes
- The pathway to diabetes is a continuum. Typically doctors measure the morning fasting glucose
levels to assess the progress toward diabetes
- Diabetes diagnosed by fasting blood glucose levels, HbA1C (the average levels over three months or the Glucose Tolerance Test (GTT)
- These tests can be normal for people on the continuum towards diabetes so people can have increased risk factors and not know it.
- However, morning fasting glucose levels and HbA1c (the average glucose levels over the last three months) are the last markers to rise during the progression towards diabetes. For these patients, they have the increased risks of heart disease and Alzheimer’s disease, but they don’t know it.
- Fasting insulin levels can point to the diagnosis of diabetes years before.
- Note other earlier measures of diabetes can be made by measuring adiponectin or postprandial glucose (blood glucose levels after a meal)
- Amyloid proteins make diabetes worse
- Statins lower cholesterol which is a major component of the brain
- Deplete Co Q 10 and adiponectin
- Cause memory problems
- Antacids (PPIs)
- Interfere with healthy digestion
- Interfere with the absorption of vitamins and mineral (for example vitamins B12, zinc, DHA, and choline all of which are needed for proper cognitive function.
- PPIs can cause osteoporosis (interfere with absorbing calcium and magnesium)
- PPIS can increase dementia risk by 44 %
- Antacids disrupt the microbiome leading to and inflammation cascade
- Cancer treatment
- As we age, we become insulin resistant, less active and lose muscle mass.
- As we age, it is harder to cook and diets tend to have high carbohydrates
- A larger stomach (associated with diabetes) is associated with a smaller memory center
VIII. CARDIO VASCULAR DISEASE
IX. SLEEP APNEA (also contributes to insulin resistance and
X. HEAD INJURIES (TBI)
XI. ARTIFICIAL SWEETENERS
DELAY /REVERSE? COGNITIVE DECLINE
I . KETOSIS
- According to Samuel Henderson, the body expects ketones from time to time because in the old days food was not always available.
- research indicates elevate ketones can improve cognitive function seen in Alzheimer’s Disease
- The brain thrives on ketones
- Neurons that lose the ability to metabolize glucose can metabolize ketones
- Ketones can reverse damage or manage and improve symptoms in the short term
- Mary Newport put coconut oil in her husband’s oatmeal which improved his deteriorating cognition
- Production of Ketones
- With a low carbohydrate diet, insulin levels are low. There are not a lot of carbs for fuel, and fat is used instead as a fuel.
- When fat is broken down faster than the body can use it, some of the fat is converted to ketones.
- MCT oil (Medium Chain Triglycerides)
- Coconut oil
- Palm Kernel Oil
- For most popping in and out of ketosis good enough
II. Ketosis vs ketoacidosis
- This is different from diabetic ketoacidosis which is when there are very high, uncontrolled ketone levels due to the lack of any insulin.
- As long as there is any insulin at all there are not expected to be any adverse affects from a ketogenic die.t
Measurement of Ketosis
- urine ketone strip test
- measures excreted ketones which the body is not using.
- ketone levels will look higher when dehydrated
- over time ketones may appear to decrease because they are used more efficiently by the body.
- blood ketones
- ketones in the breath
SLOWING ALZHEIMER’S DISEASE
I. Fix leaky gut
- Stop continuous snacking: frequent eating does not allow insulin a chance to come back to baseline
- Occasional fasting
- Reduce consumption of carbohydrates
- Increase body ketone levels
- Healthy fats are important for cell membrane fluidity so that substances can go in and out of the cell.
- Fats absorb fat soluble vitamins
- The more stable the fat ,the better
- duck fat, butter are stable fats
- Coconut oil
- MCT oils
Oils to Avoid
- Avoid corn, safflower soybean oil highly processed,
- Trans fats
- soybean fat and fats found in canned frosting and crackers
- Don’t eat from a package
Omega 3 Oils
- Smaller fish such as mackerel are a good source of omega 3 without a high risk of mercury toxicity
- Omega three is in pasteurized meats and poultry
- Free range meats are better because they consume less insecticides
- Nuts and seeds monounsaturated have omega 6 and omega 3
- Don’t be afraid of omega six as it is essential for the body. It is the ratio of omega 3 to omega 6 that is important
- “miracle grow” for neurons
- generates BNDF brain derived neurotropic factor which supports neurogenesis.
- Is good for insulin resistance even after a high carbohydrate diet
- Increases insulin sensitivity
- Amyloid plaques are cleared more effectively when we sleep
- Sleep is when metabolic and neurotoxic waste are cleared out of the brain.
VI, Vitamin B 12
- Vitamin B12 for brain health (liver, red meat, shell fish, egg yolks
- Vitamin B12 absorption decreases with age.
VII. DR BREDESEN’s WORK
Dale Bredesen has made significant inroads in reversing Alzheimer’s Disease through a multi-prong approach which included diet, exercise, fasting, micronutrients, hormones
- volume of brain had recovered (brain shrinkage hallmark sign Alzheimer’s Disease
- Maintain insulin sensitivity
- Maintain healthy blood sugar
- Can do with proper diet but not everyone will need a n ketogenic diet
Foods to Avoid
- Grains – Never died of whole grain deficiency
- Sugar- has no nutrition
- Bad oils: corn, safflower soybean oil highly processed,
- refined grains and sugars