This Journal presents further commentary about important biochemical pathways which are associated with brain health.
A number of people who read the prior Brain Health writing expressed an interest in learning more about some of the causative factors which contribute to dementia onset. In that writing there is a rather long and comprehensive listing of negative causative factors which affect all of us to some degree.
This Journal will touch on one of the most common contributing causes of dementia in our society, which is blood sugar elevation. Other causes of dementia will be addressed to some degree in future writings.
There are a number of links presented as further informational reference points for you to explore as you may, when you have time and interest.
Brain Health and Blood Sugar
For the purposes of this writing:
- Pre-diabetes is defined as a fasting blood sugar level of 100-125 mg/dL. Blood sugar levels rise with aging, especially in our society where sedentary lifestyles and poor food choices are so common. Optimal blood sugar levels are 75-85 mg/dL. In the aging population of American culture, pre-diabetes is now very common. It is also becoming more and more common in younger people.
- Diabetic states can be classified as: 1) insulin dependent diabetes mellitus (IDDM), which can be of juvenile or adult onset, 2) non-insulin dependent diabetes which can also span the age ranges, 3) the metabolic syndrome constellation of associated disorders, 4) insulin resistant diabetes mellitus, and 5) pre-diabetes.
IDDM is also known as Type I diabetes. Non-insulin dependent diabetes, commonly called “adult-onset diabetes” is also known as Type II diabetes.
Due to food choices and lifestyle issues, these conditions are becoming more common in younger people, including juveniles. Conditions 2, 3, 4, and 5 can usually be remedied by diet and lifestyle changes. Most cases of IDDM can be vastly improved by diet and lifestyle changes.
There have been decades of research connecting Alzheimer’s disease and diabetes. As it turns out, some timely medical journal articles have recently appeared which will assist this writing.
In a recent writing which was reported in the Journal of Alzheimer’s Disease in early April, 2016, a researcher at NYU elaborates on biochemical pathways which connect Alzheimer’s and diabetes. The full extent of this article may be read here.
Here is a summary of the text of this well-referenced and extensive article…the enzymes which break down insulin are the same enzymes which break down the beta-amyloid plaques that develop in the brains of those with Alzheimer’s. In those with elevated insulin levels due to elevated glucose or insulin resistance, the enzymes are diverted to the process of breaking down the elevated insulin load, and are not as available to break down the beta-amyloid.
This mechanism would allow the beta-amyloid to accumulate in the brain as the typical tangles and plaques which are noted as a prominent histopathological feature of the condition.
The American Diabetes Association estimates that over 8 million Americans have undiagnosed diabetes. Another 86 million have a pre-diabetic condition, but remain unaware of their condition.
In another recent report in the March-April, 2016, edition of the Journal of the American Board of Family Medicine only 25% of pre-diabetic patients received lifestyle recommendations from their physician. This would imply that the risks of Alzheimer’s disease, dementia, and other health conditions related to elevated blood sugar is being largely overlooked, or even dismissed by health care providers.
It becomes important for health care consumers to become aware of these facts and equally important for primary care physicians to counsel their patients in lifestyle changes which incorporate dietary changes, nutritional support, and exercise when even the mildest of blood sugar elevations is discovered.
Based on conclusions garnered from the 2 articles referenced above, we can infer that much can be done to reduce Alzheimer’s risk and occurrence through attempts at lifestyle education to offset diabetes, pre-diabetes, and insulin resistance.
Patients should be educated about the conditions of pre-diabetes, diabetes, obesity, metabolic syndrome, and insulin issues. In addition, glycosylated hemoglobin, or hemoglobin A1c (HgbA1c), should be routinely checked, along with fasting blood sugars.
Fasting insulin levels should be determined in any at-risk patient. If the fasting blood sugar is elevated and if the fasting insulin is also elevated, then it may be assumed that insulin resistance is present.
The best dietary practice for brain health is to construct a meal plan which is low glycemic, high in fats, and moderate in protein. Daily fiber intake above 20 grams is an important consideration to blend into this diet practice.
This last couple of sentences can be explored and explained with slightly more complicated considerations…
To calculate your daily maximum protein intake, use no more than 1 gram of protein per kilogram of body weight per day. However, based on the metabolic science of mTOR regulation, eating less protein per day is better…like 0.60 to 0.75 gr. protein per kilogram of body weight per day, depending on one’s severity of disease disorder.
Your kilogram weight is determined by dividing your weight in pounds by 2.2 lb/kg. The body weight you use in this calculation should be based on your ideal lean body weight. To derive your ideal lean body weight subtract off your percent of body weight which is the amount of excess fat above your ideal body fat weight.
So, a few important calculations about your corpus are very helpful. Please don’t be afraid and resistant to do some simple arithmetic on your own behalf.
Charts which show protein contents of foods are commonly available, and it is easy to memorize your common food favorites which have significant amounts of protein. Here is a selection of charts.
Charts which show fiber content of your favorite foods, and other foods which you need to be considering can be studied here.
And here is a selection of many charts which will assist your understanding of glycemic indexing of foods.
Low glycemic diet plans mean that the food choice is low in sugars and also low (zero is best) in any type of processed foods, which are typically loaded with sugars. Processed foods are also typically loaded with undesirable trans fats, and a variety of unsavory and harmful (toxic) food additives. Sugars, trans fats, and added anti-food chemicals are known to complicate brain health chemistry and cellular microanatomy.
A diet plan which comes close to these suggestions might be your own sort of personalized hybrid between the Mediterranean diet, which is relatively high in non-processed healthy whole grain choices, and the Paleo types of plans, which are low in grain based carbohydrates.
Being one of the major contributing factors to the development of the leaky gut problem, grains can be a problem food for many. This is because all grains contain prolamines, which is the grains’ anti-predation chemical mechanism. Prolamines raise zonulin levels in the gut lining and the zonulin causes the leaky gut process to develop.
Autoimmune diseases then occur as large food macromolecules migrate into the blood and evoke immune system reactions to the abnormally large food molecules. By the process of “molecular mimicry” the body’s own cellular systems fall victim to the stimulated immune system’s memory mechanism.
The only way to know if you should avoid grains is to conduct blood studies from advanced immunological testing labs, like Cyrex Labs, which assess for immunological reactions in your blood to glutens and gluten associated cross reactive foods. Knowing if one should avoid grains is very helpful information in aiding your immunological health through correct individualized dietary choices.
A diet high in healthy fats, which can be fashioned from considering a hybrid of the Mediterranean and Paleo diets, would feed the brain and central nervous system the kinds of fats from which it is actually made, would improve important hormonal molecular signalling pathways, and would also naturally mitigate excessive carbohydrate intake.
The recently published popular best-selling book, Eat Fat, Get Thin, by Dr. Mark Hyman, offers ideas about how you might achieve such an approach. The many positive reviews presented about this book should be convincing enough as to the efficacy of this diet plan.
Although Dr. Hyman doesn’t express it, the hormonal signalling goal you are striving to practice on a daily basis is to keep insulin, mTOR, and leptin low by keeping daily intake of sugars and protein low.
Leptin, a hormone made in fat cells, signals the hypothalamus in the brain about satiety levels. It keeps you from becoming a predator who stalks in the kitchen. Leptin is regulated more by sugar consumption than by fat.
The important point to remember and to achieve is that low insulin, low mTOR, and low leptin improves health and increases lifespan.
So, eat fat and get thin. The author does not mention mTOR and leptin signalling biochemistry in his nice book, which makes the presentation rather incomplete, in my opinion. However, this opinion fades away into insignificance if you can eat fat and get thin. You get my point.
Surely, Dr. Mark Hyman, M.D., who is the director of the Center for Functional Medicine at the renowned Cleveland Clinic and is the chairman of the Institute for Functional Medicine, understands the importance of MTOR and leptin signalling in the biochemistry of blood sugar, diabetes, and obesity…or, maybe he doesn’t. Or maybe his editors had him remove the explanation because of its seeming complexity.
Of course, good fats are what the book is all about, and so I recommend that you get this book to learn about good fats, dispel all of the foolish fat myths of times past from your thinking and habituation, and make the information in this book a part of your nutrition and lifestyle and health.
Because the biochemical science about the interrelationship between insulin, MTOR, and leptin is beyond the scope of this Journal, I refer the reader back to the link to mTOR, which is presented above. This link will lead you to a nice article and a video compiled from 2 noted holistic health teachers who are able to vastly simplify this complicated interrelationship of biochemical pathways into a digestible form.
Indulging yourself in a study of the information presented here will be well worth your time. It is a very good starting point and introduction to understanding some aspects of our biochemical heritage from billions of years of nature’s evolution.
Nutritional Supplement Recommendations
In addition to a high fat, low glycemic, moderate protein diet, one may also consider a variety of effective nutritional supplements which assist in blood sugar control and reduction of insulin resistance and elevated insulin levels.
There are a variety of beneficial micronutrient supplements which are available from Designs for Health (DFH) which I have recommended in my practice to those who have blood sugar problems. Improvement, or normalization, is noted in all cases; especially in those who pursue dietary and exercise recommendations.
Such a listing of nutritional supplements would include the 3 front-line supplements listed below. The first 2 of these products have direct beneficial effects on blood sugar levels and insulin function. The third product is used to provide anti-glycating effects which protect our structural and functional proteins from degradation by sugar molecules:
- Metabolic Synergy…this formulation contains alot of specially chosen nutrients for blood sugar normalization and protection. It contains the minerals chromium, zinc, manganese, vanadium, molybdenum, magnesium, iodine, selenium, and potassium, the correct array of B vitamins, vitamins A, C, and D, and the blood sugar regulating compounds alpha lipoic acid, taurine, and inositol. All of these micronutrients are essential for healthy sugar and insulin metabolism. Carnosine is also present to assist in anti-glycation, a subject which was covered in the previous Brain Health Journal writing.
- Sensitol…a combination of the myo and D-chiro isomers of inositol, along with lipoic acid, designed to support normal insulin function and cellular metabolism.
- Carnosine Supreme…a combination of carnosine and benfotiamine for anti-glycation of proteins by sugars. This compound is not used to treat blood sugar or insulin levels. Instead it is used as an anti-glycating agent to help prevent the negative effect of sugar on protein structure and function. Glycosylated end products are thought to assist the formation of beta-amyloid and tau protein.
There are several other DFH supplements which are helpful in blood sugar control and insulin regulation:
For those individuals who may need further support to reduce insulin resistance when these essential nutrients are not enough, the herb berberine should be considered. Berberine exerts its beneficial metabolic effects via a variety of mechanisms which are independent of the mechanisms of the commonly used pharmaceutical metformin, and so this herbal compound can be safely used alone or in conjunction with conventional pharmaceuticals.
It also has beneficial effects on body composition (waist circumference and waist to hip ratio), dyslipidemia conditions, non alcoholic fatty liver disease, and other markers of liver health which are not seen with metformin usage.
DFH has 2 excellent berberine based supplements:
- Berberine Synergy…supplies high potency bereberine and lipoic acid to support optimal blood sugar and insulin levels, cardiovascular health, and liver health. Lipoic acid is best known for its antioxidant properties and is very important in this regard for mitochondrial health; being a key co-factor for mitochondrial enzymes involved in cellular metabolism and ATP (cellular energy) production.
- Berb-Evail…provides 400 mg. of the berberine alkaloid for the support of healthy blood sugar levels and enhancement of insulin sensitivity. Being downstream effects of these main actions, berberine also helps improve dyslipidemia and other features of metabolic syndrome. In addition, berberine has specific antimicrobial properties against pathogenic bacteria, viruses, and parasites. It is often used as part of a foundational regimen to treat gastrointestinal dysbiosis, along with other DFH products aligned for this effect.
In addition, another formulation is helpful when higher insulin levels are called for, as in true diabetic conditions…
- GlucoSupreme Herbal…supports healthy insulin and glucose levels via a synergistic formula combining cinnamon, banaba extract (for the corosolic acid), kudzu extract (for the isoflavones), ginsenosides from American ginseng, Gymnema extract, fenugreek, and finally, salacia, which is an Ayurvedic herb known to support leptin and insulin signaling. This supplement will actually help raise insulin levels when an increased output in insulin is needed. It is important to measure fasting insulin levels in all cases that fall in the spectrum of diabetes and metabolic syndrome.
Exercise should be pursued on a daily basis to develop:
- cardiovascular conditioning and resilience
- lean muscle mass and strength
Development in these 4 areas confers what I call “body command.” Your body performs and does what you want it to do when you want it to do what you want it to do. Body command becomes more challenging as aging and injuries accumulate over time. Despite the handicap which aging and injuries might present, much good can come from pursuing all four of these aspects of exercise training.
One does not have to join a gymnasium to get the full benefit of training and development in these 4 areas of physical health. One can accomplish much with one’s own body, assisted by no more than the force of gravity.
My favorite set of exercises does not require a gym or equipment, and it also develops all 4 of the exercise benefits mentioned above. This is a set of 5 yoga movements brought to us westerners at the beginning of the 20th Century, courtesy of a group of Tibetan lamas who practiced and bestowed it as part of their teachings. This set of exercises is known simply as “The 5 Tibetans.” You can read and visualize and practice to your heart’s content based on the information presented here and here and here.
The neurological signalling to the brain from the biochemistry and electrical make-up of a toned, flexible, and balanced body is powerful enough to counterbalance most of the negative causal factors for dementia development which were mentioned in the long list of causal factors in the previous Journal writing about brain health.
Aside from increasing blood flow to the brain, which brings oxygen and nutrients to the brain and carries away waste metabolites, exercise also increases a number of nerve protecting compounds such as brain derived neurotrophic factor, or, BDNF.
BDNF encourages the growth of new brain cells through the processes of neurogenesis and neuroplasticity. As mentioned in the previous Journal on “Brain Health,” mutation events in BDNF and NTRK2, which helps make BDNF, are rather common.
BDNF is particularly active in the brain’s memory center, the hippocampus. It is known from human studies that the hippocampus can enlarge by 1% to 2% per year in adults who exercise regularly. Typically the hippocampus tends to shrink with age, and this change is a prominent part of dementia processes.
The importance of body movement and conditioning and maintenance cannot be overstated.
At the very least, exercise helps control blood sugar elevations and helps to lower insulin resistance, which is the general substance of this Journal writing.
The development of lean muscle mass assists in fat burning and weight loss. Muscular strength helps us to resist injuries and to recover from them when they inevitably occur. It is important to continue to pursue lean muscle mass development because we lose about 8-10% of lean muscle mass per decade after age 50. Such a loss of lean muscle means that less fat burning will occur, and it will be easier to accumulate weight, insulin resistance, and elevated blood sugar.
I recommend that you purchase this video, Cereal Killers 2, which documents the story of a pre-diabetic sugar burning elite athlete who changed his fuel consumption from dense carbs to fat. This is a very important and very interesting and very well produced documentary, and it tells the story well.
Of course, the most important muscle to keep developing is your heart muscle. The heart cells require proper feeding, exercise, and calming…on a daily basis. The electromagnetic and neuromuscular signalling to the brain from a strong heart is a blessing for the brain.
The heart can be calmed through a variety of practices ranging from meditation, contemplation, and prayer to just about any creative pursuit which requires immersion and focus. One nice way to practice immersion is to just go out into nature and observe yourself as integral to the natural order of things. Contemplate yourself and nature as one entity. Contemplate how you fit into nature, quietly reveling in its wonder and beauty as often as you can inside of a day.
When you are still and quiet, you might be able to feel your heart ceaselessly engaging in its interior neuromuscular workings. You might feel the closing of the 2 sets of paired heart valves which make the first and second heart sounds. You might be able to feel the spiral contraction of the ventricular muscle as the blood is moved out of the right and left ventricles to the lungs and the body.
The best science about what the heart is doing besides pumping blood around, and how one can learn to understand techniques to help improve heart intelligence and function is available from the HeartMath Institute. Here is a recent article from HeartMath which will help expand your thinking about heart intelligence and primacy.
The heart has more mitochondria per cell than any other organ; numbering in the thousands of mitochondria per cardiocyte. Mitochondria produce the energy molecule (ATP) for every cell in the body, and the nutritional requirements for healthy mitochondrial ATP production are fairly precise biochemical requirements. In addition, mitochondrial biogenesis (the creation of new mitochondria) also requires nutritional factors, and furthermore, it is now known that exercise stimulates mitochondrial biogenesis.
Like muscle mass retention, mitochondrial biogenesis declines with age. Mitochondrial dysfunction is now a subject of large consideration and study, and I intend to write more about this important subject later on. If the mitochondria are not robust in number and healthy in their function, then the cells will not perform correctly.
The heart calming practices described in previous paragraphs will help mitigate another blood sugar and brain health demon…which is stress. Stress deranges the important hormonal communication cascades which exist between the hypothalamus, the pituitary gland, and the adrenal glands…the HPA axis.
HPA-D is the acronym bestowed for HPA-Dysregulation, commonly present as a source of blood sugar problems and insulin resistance. This is a complicated subject, and this somewhat complicated link will give you some ideas to think about on this subject. Specialized testing for this very common problem can lead to the kind of helpful information which can help one onto the road to recovery of hormonal balance, good energy, and weight loss.
An Important Note about Exercise Trainers
In addition to personal “trainers” who work in a gymnasium type of setting, one can consult and work with a variety of teachers of alternative forms of exercise, including dance, tai chi, qigong, yoga, Pilates, and others. Walking, bicycling, and pool therapy will be perfect for many.
In addition, one can also pursue “lifestyle exercise.” This is the kind of exercise one does in performing physical tasks in the course of one’s daily life activities which require significant amounts of exertion and calorie burning. As a simple example, one of my former surgical professors always used the stairs instead of the elevators in his downtown big city hospital in Baltimore. The effects of lifestyle exercise do add up, and they count toward good body use and motion.
Your exercise trainer/teacher should be aware of your pre-existing injuries and physical limitations and should not lead you into exercises which injure you further. This last point is rather important.
If you have prior injury problems, consult with a skilled and knowledgeable physical therapist before you turn yourself over to a trainer who does not fully understand body mechanics and injuries, and may push you too hard. In the perfect world, the trainer should demand that you consult with a physical therapist first, and the trainer should collaborate with the physical therapist’s recommendations and guidelines for those who have had injuries. You can request that type of approach, and make that connection happen if you want to.
On this note, physicians are not the correct category of professional to consult with regarding injuries and exercise. Their advice will usually be too superficially generic, and they are usually too compressed and harried to give this important consideration adequate time, thought, and evaluation. Physicians are not trained to evaluate your injuries like a physical therapist who is so trained.
Please consult with an experienced physical therapist prior to working with any exercise trainer if you have suffered injuries.
As the old Chinese proverb says…If you don’t change the direction you are headed, you will wind up where you are going.
The 2 foundations of success are commitment and consistency. Without commitment, you will never start, and without consistency you will never finish.
Meaningful lifestyle changes are often viewed by many with a cultured sense of dread, or overwhelm. This generally means that we are wasting too much time and energy on other sorts of activities and behaviors to which we have developed an unhealthy sort of attachment. We may categorize such activity entanglements as addictions.
An addiction is simply any behavior which we do that is a fear of internal growth.
Just as our addictions develop one day at a time, the meaningful and healthy lifestyle changes which we really desire can also be developed one day at a time.
So, it is good to start now, and just stay inside of this day with your dreams and aspirations. Keep your dreams and goals alive inside of this day.
Any good long term vision in life requires some sort of immediate daily practices to build it into reality.
Thank you for reading.
Signing off from Crestone and Beyond
Other Helpful References and Resources:
- What Happens to Your Body When You Stop Exercising
- Exercise & Brain Aging
- New study demonstrates that omega-3 fatty acids promote clearance of beta-amyloid peptides
- New study links inflammation and changes in the gut microbiome to type-1 diabetes
- Kellogg’s Breakfast–A Threat to Your Health?
- Some Lesser Talked About Blood Sugar Regulating Herbs