scienceofprevention Day 5 https://is-tracking-link-api-prod.appspot.com/api/v1/click/6637082604208128/5075654499893248 Host: David Perlmutter, MD, Board-Certified Neurologist & #1 NYT Bestselling Author EPISODE 5 OCTOBER 12: Diabetes and Alzheimer’s - A Not So Sweet Connection ================ ================ In this episode: - The effects of elevated blood sugar on the body and brain - Why having type 2 diabetes or high blood sugar substantially increases the risk of developing Alzheimer’s - Why Alzheimer’s is now being called type 3 diabetes - What steps you can take to help maintain a healthy blood sugar level ================ tools we have available to lower risk of alz - dietary changes - proper exercise - avoiding various toxins in the environent - reducing and managing stress - nurturing gut microbiome - getting enuf restorative sleep ================ role blood sugar plays in determining the level of inflamation in the body diabedes ::= the body's inability to manage a lot of carbohydrate - eate too much carbohydrate the blood sugar rises too high & body can't handle it - type-2 d. and obesity has explodedd in last 50 years due to - - whole range of processed foods in our diet, esp. the processed carbohydrates if you have type 2 d. you have more than doubled your risk for alz. - because you have both the inf. piece and the insulin resistance piece - too many processed carbs and simple sugars and overly sedentary lifestyle - 50% of people in U.S. have either d. or pre-d. high blood sugar levels - increases risk of heart disease and death and alz type 3 d. - type 1 d where not enough insulin + type 2 d where unable to use insulin = type 3 d where you have both conditions in the brain how type-2 d and high blood sugar is harmful to the brain - hi b.s. causes insulin resistance and also causes infl. insulin resist. in alz - blood sugar is one of the most important biomarkers of health - as insulin gets out of whack blood sugar rises - 60% of cognitive decline is related to how you handle blood sugar - - when you eat your blood sugar goes up... w/certain foods more than others - - insulin is like an escort which takes blood sugar and puts it into 3 diff places - - - inside your muscles, inside your liver or inside your fat - - - if you are, e.g., an athlete then you send most of the blood sugar after eating to your muscles - - - but, eat too many refined carboh. due to stress, because on antibiotics and so micro-biome is out of whack insulin doesn't serve in this fcn, i.e., insulin resistance, i.e., where your cells become numb to insulin, so hard to get blood sugar inside the cell - - - so, insulin resist. is a state of infl. which is associated w/d., metabolic syndrome, alz. - insulin resis. occurs in bodies w/d. but also on outside of brain, it's called the blood brain barrier, a spcl lining that protects the brain - - one of the things that needs to go in is insulin - - eat too many of the wrong carbs too often then damage the insulin receptors that allow insulin into the brain - - - when gthey become damaged and fewer in number then harder & harder for insulin to get into the brain - - - - i.e., the brain has become insulin resistant & the inside of the brain will be lower & lower in insulin - - - high carbohydrates, esp. wrong carbs can damage the brain at any age - - - - now seeing young children w/obesity and insulin resis. & type 2 d. - - body tries to make insulin work, but, over, e.g., 12 yrs, can no longer fcn and then you get type-2 d. - - high insulin levels damage the brain - - - may have cronically high levels of insulin for a decade before developing cronically high level of blood sugar - - misconception: if thin then metabolically healthy; metabolic obesity is not elclusive to people who are obese - regulating blood sugar and role of insulin - - if pre-diab. you get pre-dementia i.e., MCI (mild cog. impairment) - - insulin resistance is driven from eating too much sugar and starch - - sugar is infl, and alz. is an infl disease - - diet hi in sugar and carbs is bad for you - - THE BIGGER YOUR BELLY THE SMALLER YOUR BRAIN Inflamation - having high blood sugar causes infl where proteins & sugars interact in your brain to create damaging crusts that clog up your brain - A1C is a marker of d. and risk of alz. - inflamation damages proteins and cells and creates free radicals which leads to oxidation, e.g., rancid fat in your blood, in your brain - infl is the root cause of chronic disease 16:27 - - initiation phase and resolution phase which usually happens w/n a few days - - - if the resolution doesn't happen, i.e., stuck in the middle - infl is the body's response to bring in the imune cells, kill bacteria and begin process of wound healing - - infl in this setting is self limiting - chronic infl, not acute, but chronic in the lining of the blood vessels and organs - - this is initiated by aspects of lifestyle: poor quality diet, processed foods, other environmental insults - - this type of infl begins to damage internal organs, lining of blood vessels, and even the brain setting stage for heart disease, type2 d and neuro degenerative diseases like alz - - ways it starts: poor diet, lack of exercise, stress, & key factor is insulin resistance esp. related to fat cells - - - when fat cells start growing, taking in extra calories the body can handle metabolically for a period of time - - - - but at some point, lighter weight for some, heavier weight for others fat cells begin to undergo a transition from a nice calm metabolic state to inflamed, white cells rush in and chemicals begin to spew out spreading infl throughout the body; when that infl goes to blood vessels it can promote athrosclorosis, when goes to the pancreas it affects the production of insulin leading to type2d., when goes to brain sets the stage for alz - many ways in which high blood sugar is associated w/infl - - infl will elevate blood sugar... a vicious cycle because high blood sugar causes damage to tissues which causes infl - infl contributes to and is a result of insulin resistance 21:07 - - focus on fibrus vegies, nutrient dence whole foods to help body process glucose which will promote insulin sensitivity which is the inverse of type2d other effects of elevated blood sugar levels on the brain - shrinkage in memory center of brain can happen before shrinkage in other areas - hypocampus needs more insulin than most of rest of brain - - the more sugar you eat and the higher the insulin levels, the less insulin gets into the brain starving the hypoc. of energy - d. accounts for 67% of all cases of alz. steps to control high blood sugar and insulin resis. - reduce intake of simple carbohydrates, optomize micro-biome, insure no leaky gut, ketogenic diet, in fact... a plant based ketogenic diet is recommended, not a bacon based ketogenic diet, helps to improve insulin sensitivity thus burning fats instead of simple carbohydrates - insulin resistance is about eating processed foods, refined carbohydrates, vegetable oils - - if you can eat whole foods, real foods: meat, seafood, pultry, fruits, vegetables, eggs, & LOW carbohydrate diet - - by the time your fasting blood sugar is too high you already have d. - you want to know if you have a high insulin level - - most doctors don't test for that - to find out if you have insulin resistance: 25:52 - - extra belly fat is a sign of insulin resistance - #1 thing is to avoid all processed foods, refined carbohydrates and seed oils - insulin/glucose relationship - - one of the most importate is exercise - - - food you eat raises you blood sugar, stress can raise blood sugar - - - exercise helps you manage hyour blood sugar, it makes your muscles hungry for glucose - - - must make muscles hungry for glucose - to avoid chronic infl associataed w/weight gain, d. & alz - - physically active & eat well balanced diet - fasting sensitizes the cells of the body to insulin so it's an insulin sensitizer - - fasting is a promising tool we have to fight insulin resistance - - - helps cells by restoring insulin sensitivity & making it easier for cells to use glucose as fuel - explore fasting as a way to improve insulin and blood sugar levels - - s/b done under advise of a health care practioner practical ways to make changes today - dramatically reduce intake of simple sugar and refined carbohydrates - optimize microbiome - consume a lower carb or ketogenic diet that is focused on ample amounts of plant foods and fiber - exercise regularly - consider fasting - get good quality sleep KF!