Dietary Recommendations for Alzheimer's -- NPR Gets it ... Almost

“There’s a growing body of evidence linking elevated blood sugar to memory problems.”

Mainstream media is catching on, folks. The quote above, taken from this story from NPR over three years ago, is reflective of the growing awareness among the medical community and laypeople alike that there might actually be something to the wild and crazy notion of Alzheimer’s disease and cognitive impairment as “type 3 diabetes” or “diabetes of the brain.” I have written about this over and over again and need not rehash the details here. (If you want to know the full story, consider purchasing my book, The Alzheimer’s Antidote.)  Even The New York Times published a piece just the other day profiling a famous chef who is using a low-carb, high-fat diet to fight dementia. (Shout out to liberal use of butter abd MCT oil in her morning coffee!)

The NPR article is pretty good. It gets the point across while being very succinct – a feat I have proven I am totally incapable of. What I like best about it is that it references this paper, the key finding of which is that elevated blood glucose may be a risk for dementia even at levels lower than the diabetic range. This is not news to me, and probably not to you, but it’s nice to see this getting out to the general public, among whom it probably is news. (Or should have been a few years ago when this came out.) It’s not news to us because you and I already know that hyperinsulinemia alone—not high glucose, but high insulin—is an independent risk factor for developing Alzheimer’s disease. In fact, compared to people with “normal” insulin levels, those who are not diabetic but are hyperinsulinemic have double the risk of developing AD.

ITIS -- It's the Insulin, Stupid (Pt 3/8)

If you made it through the encyclopedic posts that were part 1 and part 2 of this series on insulin, and you’ve come back for more, thank you! It is one of my biggest flaws as a writer: brevity is not my strong suit. (But at least I admit I have a problem. That’s the first step, right?) This post is no exception. In fact, it's probably longer than the first 2. So go grab a cuppa joe, or tea, or whatever you like, and hunker down for a nice, long read.

Okay. So I left off last time pointing out that, in covering the effects of elevated insulin and glucose on the cardiovascular system, reproductive function, the brain, kidneys, eyes, and inner ear & balance mechanisms, I had not said one word about obesity. I hope we’re all on the same page and can agree that insulin resistance is not something limited to people who are carrying around a few—or a couple hundred—extra pounds. Obviously, there are millions of non-overweight people who are infertile, have heart disease, kidney disease, vision problems, dementia, and more. (I have written about this before. One of my personal favorite posts on this entire blog is the one where I explained that obesity is simply one more effect of metabolic derangement, rather than its cause. I also wrote about this topic for Designs for Health.)

Nevertheless, we’d be missing a substantial piece of the insulin puzzle if we didn’t talk about the role of insulin in regulating body weight. Before we get to that, however, we first need to look at the actual functions of insulin, as well as the pancreas. It is an unfortunate byproduct of our epidemic of “diabesity” that we automatically think of blood glucose when we hear the word insulin. And there’s no doubt insulin does have an important role in regulating—or, more specifically, lowering—blood glucose (BG). But that’s not insulin’s only function. In fact, I would argue it’s not even the primary function. We will get to weight, I promise. But just like we did in the cancer series, we’ve got to trudge through a lot of biochemical weeds before we get to the good stuff. So here goes.

Time for a brief extremely verbose endocrinology lesson.

ITIS -- It's the Insulin, Stupid (pt 2/8)

Warning: This is a ridiculously long post. I was going to break it up into two, but I figured, what’s the difference between one really long post, and two semi-long ones? You can always read a couple paragraphs and then come back later if you don’t have time to read it all at once.

Also: My blog has a very eclectic audience. I have physicians, PhDs, and others well-educated in biochem and A&P reading this, but I think the bulk of my readers are interested laypeople. I try to tailor my posts to the laypeople, keeping in mind that they are of above-average intelligence, and certainly above-average knowledge about all this low-carb, high-fat, Paleo, and ancestral health "stuff." Just wanted to remind everyone of the diverse audience here, because this post, in particular, contains simplified explanations of complex processes, and I apologize if any of the pros find themselves bored. :-/ 

OKAY! Now we come to the next part of why all of this insulin stuff is so important. (Missed the first part? Click here. And you’ll notice I’ve changed the title of this post to say it’s part 2 of I-don’t-know-how-many. In starting to write part 3, I realized this is going to be more like 5 or 6. I am learning new things about this every day that I feel are important enough to write about, and the number of posts it will take to include them keeps rising.) 

Here we go...

ITIS -- It's the Insulin, Stupid (pt 1 of 8)

As you can imagine, I spend a lot of time educating myself about health, nutrition, and food. Whether I’m reading papers in the scientific and medical literature, keeping up with posts by intelligent bloggers, or learning more about human anatomy and physiology, a good portion of my week is devoted to ensuring that, as a nutritionist and blogger, I know what I’m talking about, and I provide my clients and readers with reliable information. There’s so much hashing and rehashing of old news in this field, and you can’t walk five feet without bumping into a dead horse that’s been beaten over and over—and over—again. So it isn’t often that something comes along that really blows my mind. (Like this. I am still fascinated by this.) Once in a while, something that’s actually very simple, and which should be totally obvious, blows my mind, if only because it makes me think about things in ways I’d never considered before.

With the help of some very cool people in the low-carb, high-fat (LCHF) world, I have been introduced to a new concept—well, new to me, but certainly not “new” at all—and I’d like to share it with you. There’s a lot to talk about, but the overall theme boils down to this: by focusing almost exclusively on blood glucose, the medical and nutrition professions have been missing the boat on a much larger, much more insidious problem: insulin.

As you know, blood glucose and insulin are intimately related. It’s hard to discuss one without the other. But when was the last time your basic bloodwork panel included a measurement of your insulin levels? Have you ever had a doctor look at anything but your fasting glucose and maybe your A1c if (s)he was concerned about your blood sugar management? (Never mind that the A1c isn’t even included in a typical blood panel. You often have to specifically request it.) If you’ve ever been the victim of experienced an oral glucose tolerance test (OGTT), did your doctor measure your insulin levels, or only your blood glucose?

With a single-minded focus on glucose, glucose, glucose, we have distracted ourselves from what is really driving the ship in type 2 diabetes (T2D), metabolic syndrome, Alzheimer’s disease, and many more conditions that we’ll explore in detail in part 2 of this series. Hence, the title of this post.