Alzheimer's & Sugar
The Frightening Connection
Alzheimer’s, a form of dementia, is a brutal disease where plaque builds up in the brain, preventing signals from being transferred between nerve cells, ultimately causing the cells to die. Over time Alzheimer’s will affect all aspects of a patient’s life: how they think, feel, and act. Each person is affected differently. Generally it causes a reduction in the ability to think, reason, understand, remember and communicate. It causes changes in mood, emotions and behaviour. Unlike many diseases, because it leads to changes in how we think, act and feel, it actually changes who we are.
It has a crushing impact both on the people who develop it and the loved ones who care for them. Over 1/2 million Canadians are living with dementia, with 25,000 new cases annually, and the rates of Alzheimer’s diagnosis are rising.
The rise in diagnosed cases is in stark contrast to what we would expect based on many of Alzheimer’s known risk factors; smoking, alcohol consumption, blood pressure, cholesterol. All of these have had massive educational campaigns associated with them to reduce their prevalence. Canadians know about these risk factors and public health agencies have worked (and continue to work) to keep them in check. So why is Alzheimer’s getting worse?
A theory posed by Melissa Schilling, a New York University professor, is that there is a strong connection between blood sugar levels and Alzheimer's. In 2016 she published a review finding people who have type 2 diabetes are approximately twice as likely to get Alzheimer’s, and people who have diabetes and are treated with insulin are also significantly more likely to get Alzheimer’s.
Dr. Schilling’s results were confirmed with a recently published large study following over 5,000 people for over 10 years. This study found people with high blood sugar had a faster rate of cognitive decline than those with normal blood sugar, even if they were not clinically diabetic. In other words, the higher your blood sugar, the faster the rate of cognitive decline.
Dr. Schilling believes insulin-degrading enzyme (a product of insulin) is responsible for breaking down insulin as well as amyloid proteins — proteins in the brain that cause plaque and lead to Alzheimer’s disease. People who don’t have enough insulin, aren’t going to make enough of this enzyme to break up brain plaque. Meanwhile, in people who use insulin to treat their diabetes and end up with a surplus of insulin, most of this enzyme gets used up breaking that insulin down, leaving not enough enzyme to address amyloid brain plaque.
According to Schilling, this can happen to anyone, even in people who don’t have diabetes yet—who are in a state known as “prediabetes.” It simply means your blood sugar is higher than normal. Diabetes, and prediabetes combined effect over 13 million (32%) Canadians.
Dr. Roberts, with the Mayo Clinic agrees with Schilling’s interpretations. In 2012 Dr. Roberts studied 1,000 people, dividing them into four groups based on how much of their diet consisted of carbohydrates. The group eating the most carbohydrates had an 80 percent higher chance of developing cognitive impairment than those who ate the smallest amount of carbohydrates.
Dr. Rebecca Gottesman from Johns Hopkins states there are multiple other ways that elevated blood sugar contributes to cognitive decline. High blood sugar weakens blood vessels. which increases the likelihood of mini-strokes in the brain, causing dementia. A high sugar intake makes cells, including those in the brain, insulin resistant, which leads to brain cell death. Additionally, overeating causes obesity. The extra fat in obese people releases inflammatory proteins that contribute to cognitive deterioration. Dr. Gottesman found obesity doubled a person’s risk of having elevated amyloid proteins (and possibly Alzheimer’s) in their brains later in life.
These findings increase our understanding of Alzheimer's. Yes - there are other factors which we can’t control such as genetics, but we can control our blood sugar levels. The combination of what we eat, how we eat and how we move determines our blood sugar levels.
Choose the right foods:
Carbohydrates are broken down in our bodies, contributing energy (to fuel us) in the form of glucose (blood sugar). Doctors and dietitians have known for some time that certain foods (and food ingredients) raise blood sugar levels higher and faster than others. An entire diet and weight control program is based on this concept (the Glycemic Index diet). In general, the more processed a carbohydrate food or ingredient is, the greater its impact on blood sugar and the less fulfilling it is causing you to eat more. Food processing usually involves reducing (if not completely removing) the fibre naturally found in foods. It is the loss of fibre that causes problems. Fibre acts to balance sugar found in foods. It slows down the rate of carbohydrate digestion and thus the effect on blood sugar.
Try avoiding highly processed low fibre foods (sugar, white rice, white flour, and syrups). Instead look for their less processed fibre-filled versions ( whole grain flour, brown rice, wild rice). In the case of sugar, look for healthier natural options such as stevia, inulin (a mildly sweet fibre), and erythritol. Try reducing the amount of sinful sweets (we all have some) and replacing them with sweet balanced treats such as fruits and berries.
Avoid liquid sweets as they spike your blood sugar faster. The real culprits here are sugary drinks and some you may have not thought about, namely your cup of coffee or tea. Many people just drown their caffeine in sweeteners. Another issue is processed fruit. Juice is no better than soda, often containing equivalent amounts of sugar with virtually no fibre. Dried fruit is packed full of sugar. Yes there is some fibre, but the amount of concentrated sugar is overwhelming turning fruit into confectionery candy.
Add fibre to your food and drinks. By increasing fibre levels each time you eat, you can slow down the rate of carbohydrate digestion, reducing their effect on blood sugar levels. There are many fibre supplements available; just avoid any that are sweetened or flavoured. Ideally use one that is fibe and nothing else.
People with diets overly heavy in carbohydrates tend to have high blood sugar levels. Ideally you want to have a well-balanced diet containing a good mix of carbohydrates, proteins and healthy fats.
No matter what you eat, exercise will help regulate blood sugar - reducing spikes and overall levels. Don’t go nuts. Regular and consistent mild intensity exercise is best, but will not erase bad choices. Unfortunately walking for 20 minutes won’t erase a chocolate eclair.
Living a long healthy life includes being of sound mind to enjoy and remember life and those important to us. Controlling blood sugar has numerous health benefits, one of which is reducing the risk of dementia including Alzheimer’s. Take care, make good choices and remember!
Joel Thuna, MH, is a master herbalist with over 30 years of experience. Dr. Claude Gallant holds a PhD in Microbiology.