Preventing Alzheimer's - The Diabetes Connection

Today in England and Wales, dementia, which includes Alzheimer’s disease, is the leading cause of death, having overtaken heart disease. In fact, rates of Alzheimer's are rising worldwide. Despite roughly about $84 billion being spent thus far on trying to find a drug to cure Alzheimer's, all but two clinical trials have failed outright and, in most cases, those on a placebo have fared better than those on the drug being tested.

Knowledge however is power. With today’s understanding that the most important risk factors seem to be linked to diet and lifestyle¹, prevention and intervention become paramount. A California neurologist, Dr Dale Breseden, is attacking Alzheimer’s in a new and ground-breaking way. This blog looks at his protocol, which is finally giving some hope to millions.

In an interview on NBC’s special series on Alzheimer's, Dr Breseden explained that he and a team had spent 27 years in a laboratory, looking at the features that drive the underlying problem. He believes Alzheimer's is caused by dozens of imbalances in the body and he has designed a programme to correct them. This new protocol to fight Alzheimer's, called the Breseden Program, is achieving striking results for some patients. The daily protocol includes:

• Eating a Mediterranean diet high in vegetables and good fats;

• Regular cardio exercise;

• Fasting every night for 12 hours after dinner;

• Brain training exercises;

• Getting at least 8 hours of sleep;

• A regimen of supplements to address each patient’s deficiencies.

...Dr Breseden found his programme boosted cognitive functioning in 9 out of 10 Alzheimer’s patients within 6 months.

In a small published study in 2014, Dr Breseden found his programme boosted cognitive functioning in 9 out of 10 Alzheimer’s patients within 6 months. So much so that some even managed to return to work. However,  Dr Breseden warns that, at this stage, his programme only works for people in early stages of the disease. The longest time a person has stayed on the programme for is 4 and a half years. Of the hundreds of patients who have undergone treatment, none who have maintained the programme have gotten worse. Dozens of doctors across America have now been trained to administer the treatment. The Breseden Program is based on diet and lifestyle interventions. For this reason, my next few blogs will explore the current understanding, backed by years of scientific and epidemiological studies, of the impact of certain diet and lifestyle factors on brain health.

Effects of a high sugar and processed carb diet on the brain.

The link between Alzheimer's and diabetes is such that many doctors are calling it 'Type 3 Diabetes.' New research is showing that eating a diet that is high in carbs and sugar and low in fat, over time leads to insulin resistance, which leads to inflammation, which robs half of people in their 80’s of their memory. However, Dementia actually starts when you are younger, often taking decades to develop and worsen. Recent studies show that people with diabetes have a four-fold risk of developing Alzheimer’s. Even people with pre-diabetes, or metabolic syndrome have an increased risk of pre-dementia or mild cognitive decline (MC). Importantly, you can develop brain damage and memory loss from insulin resistance and high insulin levels and you do not have to have full-blown type 2 diabetes.

Trying to understand the link between diabetes and Alzheimer's

 By keeping your blood sugar levels low and including healthy fats into your diet, you are giving your brain an opportunity to tap into this alternative fuel source.

The brain is a voracious consumer of glucose and for this reason it is important for it to remain as sensitive to insulin as possible. Insulin is the hormone that takes glucose out of the bloodstream and into the cells where the glucose is needed. When certain cells become insulin resistant, they can no longer absorb glucose. There is an emerging body of evidence indicating an increased prevalence of insulin resistance in Alzheimer’s sufferers that may be contributing to the disease pathophysiology and clinical symptoms.^2,3

In fact, insulin resistance has been observed in the brains of most Alzheimer's sufferers. Glucose, we are taught, is what the brain runs on. You need sugar for your brain, yet sugar is implicated in insulin resistance. Some parts of the brain are glucose dependant, but about 60% of the brain’s fuel can be supplied by ketones. Glucose is an essential energy ingredient for the brain. The brain uses glucose to make ATP, which is the fuel that all living cells require to survive. However, many people are unaware that glucose is not the only source of ATP. Ketones are also effective and are actually a much cleaner source of fuel. Ketones come either through consuming fat or from your body’s own catabolism (breakdown of molecules) of your own stored fat. Today we are actually living in a ketone deficient food landscape. Most people are addicted to glucose and their brains are rarely offered a respite from this glucose addiction (considered a ‘dirty fuel’).  By keeping your blood sugar levels low and including healthy fats into your diet, you are giving your brain an opportunity to tap into this alternative fuel source. If the cells in your body are struggling to handle sugar properly and are therefore becoming resistant to insulin, you may no longer be able to regulate your blood sugar, leading to brain problems. Slowly increasing blood glucose levels leads to a process called glycation. Glycation is like the crust on a crème brulee – proteins and sugars form this crust in your brain and in your body, damaging your tissues and creating AGEs which are implicated in inflammation, free radical damage and ageing in general. Brains with Alzheimer's have dramatically increased amounts of AGEs.

Foods to avoid

 Diet is profoundly important. It is vital to be aware of what to avoid and what to include in your diet. The most important foods to avoid are the dramatic blood sugar instigators like grains, bread, sugar, refined carbohydrates, biscuits, pasta, cookies, pizza, cakes and fructose. Fructose is particularly damaging. It has 10 times more glycating potential than glucose. Does this mean fruit is harmful for the brain? There are certain fruits that are better than others and there is a lot of research indicating that of all the fruits, berries are neuroprotective. In addition, they are low sugar fruits. Fruit juice, no matter the fruit that is juiced, should be avoided. Fructose packaged in a whole fruit is wrapped in a matrix of fibre and other plant nutrients such as polyphenols and in this form small amounts of fructose are less harmful.

It is time to make friends with fat and to start including healthy fats...

Eat more healthy fats

High levels of Omega-3 fats are very healthy and there is evidence that these fats are protective against dementia. The mechanism – EPA fats act as an anti-inflammatory for your body and your brain (Alzheimer's is an inflammatory disease of the brain). DHA is one of the main structural lipids in the brain. In other words, DHA is one of the building blocks of brain cells. DHA bolsters membrane fluids which are very important for every cell in the body but in particular, brain cells. You don’t want stiff hard neuron cell membranes and eating too many omega-6s promotes more rigid membranes. You want a balance. Omega-6s are essential fatty acids as well (the word essential means our body does not make them so we have to get both omega-3 and omega-6 fatty acids from our diet). The ratio of omega-3 to omega-6 should be 1:1 but unfortunately omega-3 fatty acids are rare (some fish, seeds and algae) and omega-6 fatty acids are present in every processed food. You can be eating tablespoons of omega-6s daily and be unaware – it’s in foods like crackers, sauces, salad dresses, processed meats, cakes, biscuits etc.

Cholesterol is still being labelled as ‘the bad guy’ in many areas of healthcare. However, cholesterol plays a vital role in brain function, with 25% of total cholesterol in the body found in the brain. It is time to make friends with fat and to start including healthy fats from olive oil, avocado, nuts, seeds and coconut oil in your diet. If necessary, and particularly if you are not getting enough oily fish in your diet, consider a daily omega 3 fish oil supplement.  

Look out for my next blog on the benefits of coconut oil for the brain and TT’s tips on some of the best ways to keep your brain healthy. 

[1] Grant WB (2016) Using multicountry ecological and observational studies to determine dietary risk factors for Altzheimer’s disease. J Am Coll Nutr 35(5): 476-489.

[2] Watson GS, Craft S (2003) The role of insulin in the pathogenesis of Alzheimer’s disease: Implications for treatment. CNS Drugs 17(1): 27-45.

[3] De Felice FG, Lourenco MV, Ferreira ST (2014) How does brain insulin resistance develop in Alzheimer’s disease? Altzheimers Dementia 10(1 Supp): S26-32.

[4] Thomas j, Thomas CJ, Radcliffe J, Itsiopoulos C (2015) Omega-3 Fatty Acids in Early Prevention of Inflammatory Neurodegenerative Disease: A Focus on Alzheimer's Disease. Biomed Res Int.