Sugar on the Brain & Belly!
Compelling and staggering statistics about the projected state of our health as a nation makes for some grim reading………..
Since 1996 the number of people diagnosed with diabetes has increased from 1.4 million to 2.6 million. By 2025 it is estimated that over four million people will have diabetes and one million, will have a diagnosis of dementia.
So what are we doing wrong? - I propose we need to consider that there can be a number of contributing factors to dis-ease (moving away from ease) and that the “treatment” for “disease” with a single drug, the model of monotherapy is too linear for the explosion of chronic conditions that is crippling our NHS system.
A Functional Medicine approach offers a framework that addresses the many possible underlying causes of these conditions, dementia being just one.
A growing body of research indicates that Dementia is closely linked to poor blood sugar control (the step before diabetes) and diabetes. Searching on PubMed today (8th June 2019) bought up 1471 published studies linking dementia & blood sugar.
Dr. Dale Bredesen, an internationally recognised expert on neurodegenerative disease, states that Alzheimers and dementia is a multifactor condition and that Amyloid-beta is not the main problem, but rather the brain’s response to one (or more than one) insults (1). He has identified several types of AD, each with unique causes (4, 5):
Type 1 (“inflammatory”) is due to an antimicrobial response to pathogens or other inflammatory causes.
Type 2 (“atrophic”) is associated with reductions in factors that support brain health, like oestradiol, progesterone, testosterone, insulin, and vitamin D.
Type 1.5 (“glycotoxic”) is a composite of types 1 and 2. Inflammation from high blood glucose levels combines with a trophic loss of insulin sensitivity.
Type 3 (“toxic” or “cortical”) is associated with exposure to toxins such as heavy metals, insecticides/pesticides, antimicrobials, and commercial/industrial toxins.
Type 4 (“vascular”) is associated with reduced vascular support.
Type 5 (“traumatic”) is associated with previous head trauma.
So let us take a closer look at the area of blood sugar control, insulin resistance and diabetes, which links with type 1.5 and 2 in his model.
Insulin resistance and blood sugar control
Do you feel exhausted all the time? Are you overweight? Or just starting to gain weight around your midriff? Do have serious blood sugar imbalances, or have elevated cholesterol, blood pressure, and triglyceride levels? Even if just one or two of these points resonate with you, it is highly likely that you need to address your blood sugar and insulin levels.
Your body’s preferred fuel source is glucose, which it needs for energy. Glucose is released from your food and then is carried in the blood to the cells where it’s converted into energy. For the glucose to be able to enter the cells, it requires a transport mechanism. This is where insulin comes into play.
Insulin is a hormone secreted by the pancreas and its purpose is to “unlock” the cells and facilitate the transport of glucose into the cells where it can be converted into energy. As we eat a meal, our blood sugar levels rise. However, carbohydrate-based foods raise blood sugar levels significantly more than protein or fat, and the type of carbohydrate we eat has even more significance. Overly-processed carbohydrate foods such as cakes, biscuits, pizza, white bread and pasta, together with fizzy drinks and alcohol cause a far more rapid rise in blood sugar levels. Wholegrain breads, pasta, rice, fruits and vegetables provide a more slow and sustained release, in the main because of the fibre content still present.
If the body is continuously exposed to high levels of blood sugar from eating these overly-processed types of carbohydrates, then the pancreas has to compensate by secreting excessive levels of insulin to be able to move all this excess sugar/glucose out of the bloodstream and into the cells. The body can cope with this state of excess for a period of time, but certainly not indefinitely, and if continued, the insulin receptors on the cells start to become quite literally deaf to the call of this extra insulin, and the “unlocking” process of allowing sugar into the cells to form energy becomes blunted. This is a condition called insulin resistance, and eventually, if left unchecked, will lead to full-blown diabetes.
Insulin resistance is part of a health spectrum, also referred to as metabolic syndrome, that includes many all-too-common health conditions:
High blood triglycerides (fats)
Increased abdominal fat and obesity
Increased hunger / sugar cravings
Low/high blood sugar
Poor circulation to extremities
Skin tags
Polycystic ovary syndrome
High blood pressure
How blood sugar dysregulation harms brain function
We’ve established that glucose, a form of sugar, is the primary source of energy for every cell in the body. Because the brain is so rich in nerve cells, or neurons, it is the most energy-demanding organ, using one-half of all the sugar energy in the body.
Brain functions such as thinking, memory, and learning are closely linked to glucose levels and how efficiently the brain uses this fuel source. If there isn’t enough glucose in the brain, for example, neurotransmitters, the brain’s chemical messengers, are not produced and communication between neurons breaks down. In addition, hypoglycemia, a common complication of diabetes caused by low glucose levels in the blood, can lead to loss of energy for brain function and is linked to poor attention and cognitive function.
Although the brain needs glucose, too much of this energy source can be a bad thing. A 2009 study conducted by a team of scientists at the University of Montreal and Boston College, linked excess glucose consumption to memory and cognitive deficiencies.
The effects of glucose and other forms of sugar on the brain may be the most profound in diabetes - either type 1 or type 2. High blood glucose levels can affect the brain’s functional connectivity, which links brain regions that share functional properties, and brain matter. It can cause the brain to atrophy or shrink. And it can lead to small-vessel disease, which restricts blood flow in the brain, causing cognitive difficulties and, if severe enough, spurring the development of vascular dementia.
Optimise glycemic control to protect health
A Functional Medicine approach that addresses diet, physical activity, and gut health can help optimise glycemic control and prevent the onset of dis-ease associated with diabetes and insulin resistance.
My top diet tips are:
Cut refined sugar: Toss the refined sugar products (crackers, crisps, pies, scones, biscuits, etc). These types of products are low in fibre and high in emulsifiers and wheat, all of which cause a spike in blood sugar - and what goes up - has to come down! And in the case of blood sugar that means coming down far too quickly and resulting in hypoglycemia.
Lower saturated fat intake: This is a type of fat that contains triglycerides with only saturated fatty acids. Foods with high saturated fats include cheese, fatty meats, lard, coconut oil and butter. I am not advocating to stop butter and cheese all together, rather think about your intake in an overall day. Butter, for example, is a fantastic source of vitamin A, which is needed for a balanced immune system but a daily diet of croissants and cheese on toast is tipping the balance too far. Similarly, the fad of all fats being replaced with coconut oil is somewhat flawed too! Fat in the bloodstream, either form your own stores of being overweight or from diet, can build up in the muscle cells, create free radicals that block insulin receptors(1)
Increase the amount of fibre and polyphenols in your diet by aiming for 10 serves of vegetables a day. Fibre increases the production of short chain fatty acids by certain species of gut bacteria, Short-chain fatty acids have been shown to increase enzyme activity in the liver and muscle tissue, resulting in better blood sugar control (2)
Eat 2-3 meals a day rather than snack and graze all day. Without even realising many of us are eating up to 16 hours a day. Leaving 4-5 hour gaps between meals or practising eating in an 8-hour window during the day reduces inflammation and also stimulates a wonderful protein called Brain-derived neurotrophic factor (BDNF). BDNF influences a variety of functions including: preventing the death of existing brain cells (sounds good!), inducing the growth of new neurons and synapses and supporting cognitive function. Low levels of BDNF have been linked to: Alzheimer’s, accelerated ageing, obesity and depression.
The broader message is that by removing the “insults” and optimising health we have a far better chance for living a long and healthy life!
In health, Tanya x