Monthly Archives: July 2018

Artificial Sweeteners and the Risk of Dementia

Artificial Sweeteners and the Risk of Dementia

References: StrokeObesityWashington Post,

Whoa, Nellie! Now artificial sweeteners are bad! Help, help, help. We’ve been telling everyone not to eat sugar, and now you turn around and point at sweeteners. What’s the deal? Better, what’s the evidence?
Ok, an observational study from the long-term, Framingham heart study prospectively followed 4,272 older adults for 10 years with follow-up for risk of stroke and dementia. They found 97 strokes and 81 cases of dementia over that time period and compared those outcomes to the frequency of sugar and artificial sweetener use. Compared to controls within those groups, after statistically accounting for the proper variables, they found a 2.97 times increased risk of stroke and 2.87 for increased risk of dementia by drinking one diet soda a day. One measly, little diet soda. Sugar didn’t show any negative effect.
Well, out come the critics in full force (from the soda industry, of course). They claim it was a lousy observational studies without any proof of causation. (True) They attacked because it wasn’t large enough. They griped because the sugar use wasn’t found to be dangerous when every other study shows it has. And the accompanying editorial in the journal pointed out that the risks go away when incident diabetes and vascular risk factors were taken into account.

Ok, ok, so the evidence isn’t perfect. But it is there. Is there a plausible mechanism we can construe that carries a tiny bit of credibility?
Well yes, there is. Here it is. First and foremost, drinking diet soda has been shown to lead to weight gain, not weight loss. The means by which that happens is thought to be by confusing your brain’s appetite sensor into thinking calories are coming because you taste sweet, and then you secrete some insulin, which lowers your sugar, and 4 hours later, you eat more. Presto, fatso.

It may be along this line that we will find an answer. The interplay of human hormones is so complex, it is extremely hard to parse out a single hormone in isolation. The breadth of knowledge is advancing in that direction. Here is one plausible bench research explanation: there is pretty good evidence that being fat makes you insulin resistant, and higher insulin with higher glucose leads to your tummy fat making more amyloid precursor protein (APP). And it’s APP that breaks off in your brain to make agglomerations of beta-amyloid plaque. Ok, so you drink diet soda, make a little extra insulin, get fatter and gain weight, make more beta-amyloid and there you have it. Diet soda makes for more dementia.
WWW.What will work for me. Well, well. Not the strongest of evidence but the gun is smoking never the less. I just drove for 4 hours yesterday and got a big gulp of 32 oz of diet Pepsi at a QuickTrip because I was sleepy. Bummer. I can feel the beta-amyloid crawling up my neurons. I’m weaning myself off sweeteners bit by bit. Sounds like it’s time to increase that effort. Is Stevia just as bad? Haven’t got a clue.

 

Pop Quiz

 

  1. If you believe this study, you triple your risk of dementia by drinking artificial sweeteners. T or F                                                           Answer: True unless you nit-pick over 2.87 fold vs 3.0
  2. Women who drink diet sodas stay thin. T or F                         Answer: False, they gain weight.
  3. Belly fat makes amyloid precursor protein, which is the protein that then calves beta-amyloid in your brain, the cardinal sign of Alzheimer’s. T or F                      Answer: Bingo
  4. Is sugar safe to put in your drinks?                                            Answer: No, not at all. In fact, to me, that was the weakest sign of this paper because, on every other front, more sugar is worse for you in ever so many ways. This study sort of absolved it.
  5. Now that you know belly fat makes APP, want to lose weight?                    Answer: oh my goodness, yes.

 

Blood Glucose and Cognitive Decline

Blood Glucose and Cognitive Decline

Reference: Crane, NEJMLancet NeurologyELSA StudyDiabetes Care,

Your HgbA1c is your most important blood test. Get to know it well. It is a simple concept. When blood sugar gets higher, more of it sticks to different proteins. Glucose is a very reactive molecule, ready to stick to anything. You know that from spilling a Coke on your car seat and having sticky goo for weeks thereafter. When you eat 4 scoops of ice cream your blood sugar shoots up for 6-8 hours. In that time it sticks to everything in sight, including your hemoglobin molecules in your red cells. That makes it a nice surrogate marker for glucose also sticking to the proteins in your blood vessels, your kidneys, your brain, your joints and on and on. You can sample your blood and there it is, a nice marker. Now, red cells live about 100 days more or less, so your A1c becomes the average of your glucose over the last 100 days. As fat cells get bigger, they require a higher insulin level to make them react to rising glucose, so A1c becomes a marker of how overweight your body thinks you are. Not your spouse, or your friends, your own internal body signal.

We define adult-onset diabetes as a blood sugar of 126 after an overnight fast. That leads to an A1c of about 6.4. But is that accurate? Is blood sugar healthy at 126? The answer is absolutely not. The Whitehall Study from England shows decreasing cardiac mortality down to a blood sugar of 85 before leveling off. Hmmm. Heart disease is one thing, but which would you rather die from, heart disease or dementia? I’m going for neither. I want old age to just spirit me away.
That’s what this week’s studies relate to. What is the risk of dementia from elevated blood sugar? Turns out, a lot. In fact, much lower than 126 or A1c of 6.4.
Crane’s study in the New England Journal is the hallmark study. The Adult Changes in Thought Study took 2067 elderly adults (average age 76) who yielded 524 folks with dementia. The simplest conclusion of the study was that a blood sugar of 100 compared to 115 raised risk of dementia by 18%. Going the other way, dropping blood glucose from 100 to 95 lowered risk 14%. One could extrapolate and say that dropping from blood glucose of 115 to 95 lowers dementia risk 32%.

There are now more studies following this seminal study that say the same thing. Lancet Neurology confirmed the danger in the ELSA Study.
There are some of us who spike our blood sugars quite high when we sneak that ice cream and that is even riskier. The science of that isn’t completely known but it can be measured with a nifty new test called 1,5-AG ratio that adds a layer of understanding to the risk. This may or may not play out. Something to watch. I want to know mine.
We don’t mean to belabor this point. The message is clear. The size of your fat cells matter. If you are overweight, your blood sugar will likely be higher, and your risk of dementia will be higher. Losing weight and lowering your A1c matters. What’s the target? A1c of 5.5 should be your minimum. 5.1 is perfection.
WWW. What will work for me? Well, with a mother with dementia and a father that had diabetes, my genes are in the crosshairs. I was running an A1c of 5.2 for a couple of years there then suddenly I popped up to 5.9 last year. (Nothing like a wedding in the family to gain a little weight and a broken food to cut the exercise.) I’ve been doing the fast mimicking diet for 5 months now and I’m back down to 5.6. This perfection stuff is a pain in the proverbial…..So, I still have a ways to go. Join me. I’m doing the FMD diet last week of the month. Every month until I’m below 5.5. Each month it gets easier.

Pop Quiz

 

  1. Your A1c reflects what?                                                         Answer: Your average blood glucose over the last 100 days.
  2. How can you lower it?                                                            Answer: Stop eating foods that make it go up like grains and sugar, and lose weight with the Fast Mimicking Diet.
  3. What blood sugar is an A1c of 5.1? (Google Blood Glucose A1c Table)             Answer: 5.1
  4. The current definition of diabetes is based on sound science. T or F               Answer: It was a committee decision that was made 40 years ago. Now way out of date.
  5. What’s the first step most folks need to do to lower their blood sugar?           Answer: Stop drinking it. The calories you drink are the calories your store. Sugared soda is the worst. Orange juice and energy drinks, ditto.

 

Chelation Therapy for Coronary Artery Disease – the TACT Study

Chelation Therapy for Coronary Artery Disease – the TACT Study

References: NIHJAMAAHA, EHP,

Imagine my surprise when a doctor calls me and asks me to do chelation on himself for coronary artery disease. He referenced the TACT study which I had not read. Now I have and here are the results. I’ll try and put it into the context of risks and what is going on.
Chelos is Greek for claw. Chelation is making a chemical claw around a substance that is otherwise inert, dangerous or insoluble. Lead meets the inert quality. Iron meets the dangerous criteria. Chelation has been used medically to reduce both of those substances when they are toxic. But there is conflicting evidence about iron levels and risk of coronary artery disease and recent trends of studies appear to be on the side of it NOT being a problem. This flies in the face of initial enthusiasm about iron reduction, like that generated by the Finish study showing an 88% reduction in risk by frequent blood donation. This study from Helsinki followed 2,862 males aged 42-60 for 9 years. Heart attack rates for blood donors was only 0.7%, compared to 12.5% for non-donors. It’s hard to get that sort of effect unless something real is going on. Now, they didn’t account for the frequency of saunas, which many Finns do (building codes in Finland require every new apartment and home to have a sauna built in it). One study from Finland showed that frequent saunas are as beneficial as exercise for reducing heart risk.
What does chelation do? It sucks bad things out of your body by enveloping the target chemical, making it water-soluble by that envelopment, and then excreting it. It’s not just iron that gets enveloped. It’s whatever happens to be around. Lead is one of those enemies. The evidence of lead and hypertension is very strong. The subsequent association with coronary artery disease isn’t quite as robust, but is also strong. Both lead and iron get chelated when exposed to the chelating chemical, typically EDTA. But so is cadmium, mercury, thallium, uranium and on and on. All of these metals are dangerous and to date, not having been studied much. We just don’t know data on multiple, combinations, and likely never will. Research questions tend to focus on one variable at a time.
How do you do chelation? Properly done, you take mineral supplements before and in-between treatments (a fortified vitamin pill). EDTA is given by IV over about 3 hours once a week. And get a reverse osmosis filter at home to keep the dangerous metals out of your water.
What does the TACT study show? Well, in diabetic men, who represent about 1/3 of the 1,708 men in the TACT study, EDTA chelation reduced the risk of subsequent heart attack by 52%, and fatal heart attack by 41%. Taking high dose vitamins and minerals along with the EDTA to rebuild up “good minerals” resulted in the greatest benefit. My read of heart disease risk is that abnormal blood sugar is anything over 86, which differs dramatically from medicine’s range of blood sugar being ok up till 124. But benefit did not accrue to men in the traditional range of diabetes.

WWW.What will work for me. What would I do if I had a heart attack? It is pretty reasonable to suggest that spending 9 months of weekly EDTA visits is worth it. Heart attacks kill. In fact, 50% of us are done in by them.  For now, I’m working on reducing my heart attack risk by getting my blood sugar lower so I turn off the engine that drives heart disease.

Pop Quiz

 

  1. Chelation does what to water-insoluble metals?                                Answer: encases them in a water-soluble “claw” and allows them to dissolve into blood, and be excreted in the urine.
  2. How much can chelation reduce the risk of a heart attack?             Answer: If you are diabetic, your chance of recurrent heart attack can be cut in half.
  3. Is it worth it?                                                                                             Answer: Let’s see. A simple heart attack with 5 days in the hospital and 6 months of rehab will likely run you around $ 75,000 with a 13% chance of death. Your answer.
  4. How do you do chelation?                                                                     Answer: It takes in IV treatment of about 3-4 hours once a week for about 9-12 months.
  5. Is the science robust for reduction of iron and reduction of heart attack risk? Answer: It appears to go back and forth. In younger years, iron deficiency is the most common nutritional deficiency in America. As we get older and keep absorbing iron, it flips.  The conflicting results may be because of that.