{"id":1112,"date":"2014-01-20T07:26:23","date_gmt":"2014-01-19T20:26:23","guid":{"rendered":"http:\/\/blog.panicola.com\/?p=1112"},"modified":"2014-01-20T07:28:32","modified_gmt":"2014-01-19T20:28:32","slug":"diabetes-and-the-brain","status":"publish","type":"post","link":"https:\/\/blog.panicola.com\/?p=1112","title":{"rendered":"Diabetes and the brain"},"content":{"rendered":"<ul>\n<li>Good summary on the state of understanding the strengthening relationship between glucose metabolism and dementia<\/li>\n<li>Type 2 diabetes is a very strong risk factor for dementia &#8211; Alzheimer&#8217;s disease is sometimes referred to as &#8220;Type 3 diabetes&#8221;<\/li>\n<li>It also results in brain atrophy<\/li>\n<li>Metabolic syndrome is also implicated in dementia<\/li>\n<li>High insulin in the body means lower insulin in the brain due to a reduction in BBB insulin receptors, and insulin helps clear toxic beta-amyloid from the brain<\/li>\n<li>The key to lowering blood sugar and insulin is lose excess weight and exercise more<\/li>\n<li>a diet high in high GI carbs and saturated fat is associated with higher unbound beta-amyloid fragments in their CSF. Subjects on lower GI carbs and low saturated fat had less<\/li>\n<li><\/li>\n<\/ul>\n<p><a href=\"http:\/\/www.nutritionaction.com\/daily\/diabetes-and-diet-cat\/the-effect-of-diabetes-on-the-brain\/\">http:\/\/www.nutritionaction.com\/daily\/diabetes-and-diet-cat\/the-effect-of-diabetes-on-the-brain\/<\/a><\/p>\n<header>\n<h1>The Effect of Diabetes on the Brain<\/h1>\n<h2>Can high blood sugar lead to brain atrophy?<\/h2>\n<div>\n<div><a title=\"Posts by Bonnie Liebman\" href=\"http:\/\/www.nutritionaction.com\/author\/bonnie-liebman\/\" rel=\"author\">Bonnie Liebman<\/a>\u00a0\u2022 January 16, 2014<\/div>\n<\/div>\n<div><\/div>\n<div><span style=\"line-height: 1.5;\">\u201cType 2 diabetes is a very strong risk factor for dementia,\u201d says Jae Hee Kang, assistant professor of medicine at Harvard Medical School and the Brigham and Women\u2019s Hospital in Boston. \u201cSome people call Alzheimer\u2019s disease type 3 diabetes.\u201d<\/span><\/div>\n<\/header>\n<div>\n<p>(In type 1 diabetes, blood sugar soars because the body makes no insulin, the hormone that acts like a key to allow sugar into cells. In the more common type 2 diabetes, blood sugar soars because insulin no longer works properly\u2014that is, people are insulin resistant.)<\/p>\n<div>\n<p>Act now to download your FREE copy of\u00a0<em><a href=\"http:\/\/www.nutritionaction.com\/FREE-Health-Advice-Diabetes-and-Diet\/Decoding-Diabetes\">Diabetes and Diet: Decoding Diabetes<\/a><\/em>without cost or obligation.<\/p>\n<\/div>\n<p>\u201cThere\u2019s no question that diabetes damages small blood vessels,\u201d says David Knopman, professor of neurology at the Mayo Clinic in Minnesota.<\/p>\n<p>It may also shrink parts of the brain. A recent study found more brain atrophy in 350 people with diabetes than in 363 people without the disease.<\/p>\n<p>It\u2019s not just those with diabetes who are at risk. People who have what doctors call \u201cmetabolic syndrome\u201d also have a higher risk of cognitive decline. That\u2019s roughly one out of three U.S. adults.<\/p>\n<p>Their blood sugar levels are higher than normal, but not high enough to be diabetes. That gives them an increased risk of dementia.<\/p>\n<p>And they may have high blood insulin levels because obesity\u2014especially an oversized waist\u2014has made them insulin resistant. (When insulin doesn\u2019t work well, the pancreas responds by pumping out more.)<\/p>\n<p>That may also spell trouble for the brain. Men with high blood insulin levels declined more on cognitive tests over three years than those with lower levels.<\/p>\n<p>Why would high levels of insulin in the blood matter?<\/p>\n<p>\u201cHigh insulin in the body means lower insulin in the brain,\u201d says Angela Hanson, a physician and senior fellow at the University of Washington School of Medicine.<\/p>\n<p>That\u2019s because, over time, high levels of insulin in the blood may shrink the number of receptors for insulin in the blood-brain barrier, allowing less to enter the brain, says Hanson. And insulin may help keep the brain healthy.<\/p>\n<p>\u201cInsulin helps clear toxic beta-amyloid out of the brain,\u201d Hanson explains. \u201cSo if you put someone on a diet that increases brain insulin, you might have less of the toxic amyloid around.\u201d<\/p>\n<p>The key to lowering sugar and insulin in the blood\u2014and presumably raising insulin in the brain\u2014is to lose excess weight and exercise more.<\/p>\n<p>But one pilot study suggests that it\u2019s not just how much, but what you eat that matters.<\/p>\n<p>Hanson and her colleagues assigned 20 older adults without mild cognitive impairment and 27 older adults with MCI to eat one of two diets. The LOW diet was low in saturated fat, and its carbs had a low glycemic index\u2014that is, they didn\u2019t cause a bump in blood sugar. The HIGH diet was high in saturated fat, and its carbs had a high glycemic index.<\/p>\n<p>The HIGH diet was unusually high in saturated fat and sugar, but it wasn\u2019t off the charts. \u201cIf you look at a fast-food combo meal, it\u2019s got a sugary soda and a high-fat burger,\u201d notes Hanson.<\/p>\n<p>After four weeks, people who got the HIGH diet had higher levels of unbound beta-amyloid fragments in their cerebrospinal fluid (which bathes the brain and spinal cord), while people who ate the LOW diet had lower levels.<\/p>\n<p>\u201cThe theory is that the beta-amyloid that\u2019s not bound to fats or other lipids is free, and it\u2019s free to wreak havoc, if you will,\u201d says Hanson. \u201cWe believe it\u2019s a more toxic form of beta-amyloid because it\u2019s less likely to be cleared. But that\u2019s hard to test in humans.\u201d<\/p>\n<p>The results seemed to fit with a finding from a similar, earlier study: the LOW diet raised insulin levels in cerebrospinal fluid (and presumably the brain), while the HIGH diet lowered insulin levels.<\/p>\n<p>\u201cA Western diet or obesity or other things that cause high blood insulin may decrease brain insulin,\u201d says Hanson. \u201cIf you make someone less insulin resistant with weight loss or a diet, they may have more brain insulin.\u201d<\/p>\n<p>Until more studies are done, it\u2019s too early to know if a diet lower in saturated fat and sugars can protect the brain. But the research is encouraging.<\/p>\n<p>\u201cThe most striking finding from these studies was that you could change the brain chemistry of people who have mild cognitive impairment,\u201d says Hanson.<\/p>\n<p>\u201cWhen I\u2019m in my clinic, I can tell patients with MCI that if they eat a healthier diet and exercise, things might get better. That\u2019s the message that keeps me going.\u201d<\/p>\n<p>Sources:\u00a0<em>J. Am. Geriatr. Soc. 56<\/em>: 1028, 2008;\u00a0<em>Exp. Gerontol. 47<\/em>: 858, 2012;\u00a0<em>Diab. Care 36<\/em>: 4036, 2013;\u00a0<em>JAMA 292<\/em>: 2237, 2004;\u00a0<em>N. Engl. J. Med. 369<\/em>: 540, 2013;\u00a0<em>Eur. J. Pharmacol. 719<\/em>: 170, 2013;\u00a0<em>Neuroepidemiol. 34<\/em>: 200, 2010;\u00a0<em>JAMA Neurol. 70<\/em>: 967, 972, 2013;\u00a0<em>Arch. Neurol. 68<\/em>: 743, 2011.<\/p>\n<\/div>\n","protected":false},"excerpt":{"rendered":"<p>Good summary on the state of understanding the strengthening relationship between glucose metabolism and dementia Type 2 diabetes is a very strong risk factor for dementia &#8211; Alzheimer&#8217;s disease is sometimes referred to as &#8220;Type 3 diabetes&#8221; It also results in brain atrophy Metabolic syndrome is also implicated in dementia High insulin in the body &hellip; <a href=\"https:\/\/blog.panicola.com\/?p=1112\" class=\"more-link\">Continue reading <span class=\"screen-reader-text\">Diabetes and the brain<\/span> <span class=\"meta-nav\">&rarr;<\/span><\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[26,10,13],"tags":[],"class_list":["post-1112","post","type-post","status-publish","format-standard","hentry","category-facts-data-points","category-healthy-habits","category-nutrition"],"_links":{"self":[{"href":"https:\/\/blog.panicola.com\/index.php?rest_route=\/wp\/v2\/posts\/1112","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/blog.panicola.com\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/blog.panicola.com\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/blog.panicola.com\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/blog.panicola.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=1112"}],"version-history":[{"count":3,"href":"https:\/\/blog.panicola.com\/index.php?rest_route=\/wp\/v2\/posts\/1112\/revisions"}],"predecessor-version":[{"id":1115,"href":"https:\/\/blog.panicola.com\/index.php?rest_route=\/wp\/v2\/posts\/1112\/revisions\/1115"}],"wp:attachment":[{"href":"https:\/\/blog.panicola.com\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=1112"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/blog.panicola.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=1112"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/blog.panicola.com\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=1112"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}