Feb 17

Diabetes increases the risk for developing dementia: what control do you have?

diabetes blood sugar testBy Paul R. Burghardt

A recent report by Xu and colleagues in the journal Diabetes, addresses one of the “modifiable risk-factors” for developing dementia. In other words, it tried to identify those things we do and control on a day-to-day basis that ultimately reduce or increase the likelihood of developing disease. These modifiable risk-factors include things like weight-management, blood pressure control, managing diabetes, and exercise. This study focused on how diabetes can influence the chances that we develop dementia depending upon genetic traits and when in the lifespan a person develops diabetes.

Since diabetes increases the risk of developing Alzheimer’s disease, as well as vascular dementia (yep, unfortunately there are a couple of ways to develop substantial cognitive decline), understanding how genetics and lifestyle choices interact during the development of disease will provide a lot of information that can be used for both prevention and treatment. We already know that avoiding diabetes, or managing diabetes effectively, is of the utmost importance.

To address the issue of how the development of diabetes relates to the risk for dementia, Xu and colleagues utilized the Swedish Twin Registry. This is a national survey in Sweden that tracks health information about twins, which is pretty cool for research purposes. Plus, it’s good to know the Doublemint girls are keeping busy, right?

Their general findings weren’t too surprising: diabetes increases the risk for developing dementia whether it be, vascular dementia or Alzheimer’s disease. However, there were some distinct findings in this study emphasizing that timing is everything.

A particularly interesting finding was that the risk for dementia (vascular or Alzheimer’s disease) increased if a person developed diabetes before they turned 65. By the way, the most common time for Alzheimer’s disease diagnoses is in people 65 years of age or older. Remember, this disease takes a number of years to develop, so what you do now may have a substantial impact on how your brain ages.

This probably occurs by the amount of ‘wear-and-tear’ your brain is able to handle under diabetic conditions, particularly if you are genetically predisposed to developing dementia. The concept of cumulative wear-and-tear has a fancy name, “allostatic load.” This idea is important for all aspects of our health as it accounts for the interactions between our genes and environment in a time-dependent manner. But that is for another post….

In general, this study reiterates a couple of issues. First, it highlights the importance of the mind-body link. Although many people think that diabetes is a problem for blood sugar control, it influences a lot of other organs in our bodies, including our brains. Second, if you have a family history of diabetes the longer you avoid developing the disease the better this will be for your brain (and rest of your body).

Unfortunately in this study the authors weren’t able to look at individual’s ability to control/manage their diabetes. But I’d like to be optimistic and believe that better management of a disease like diabetes would help decrease its negative influence on other aspects of our biology. In line with this, please see our blog post for this Thursday!

Reference:
Diabetes. 2009 Jan;58(1):71-7. Epub 2008 Oct 24.

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Feb 13

Think Fast – Feel Better

By Simon J Evans, PhD

I ran across and interesting study recently suggesting that if we think faster we might feel better. There are plenty of anecdotes to back up this theory. People with bipolar (manic depression) disorder feel high levels of elation and positive mood during their rapid thought firing manic phases. Drugs that induce fast thinking states, like caffeine or amphetamines, also typically elevate mood. However, the new study asked whether we could deliberately improve our mood by engaging in fast thinking activities.

Researchers from Princeton and Harvard published their findings supporting this notion in a recent issue of the journal, Emotion. They recruited college students and set them up in various tasks that required either slow and careful thought or rapid fire brainstorming and then tested their mood and feelings of self-esteem right after the experiences.

What they found was that over six different kinds of experiments that manipulated thought speed, subjects in the ‘fast thinking’ group had improved mood every time. The fast thinkers also showed improved creativity, and self esteem and increased energy and sense of power in most of the tests.

These findings are easy to relate with. If you think about times when you really feel great and unstoppable, they were probably times when your mind was working clear and quickly. The cool thing about the research is that it suggests you can manipulate your mood (for the better) by deliberately doing things that require rapid thinking, like fast paced games, intense conversations or even rapid fire brain storming on your own.

Now, it’s likely that the benefit of fast thinking only applies when such thinking is beneficial. We’ve all had the experiences, lying awake at night, trying to shut off our brains and go to sleep. These times are certainly not mood elevating and are usually very frustrating. But during waking functional hours, this little trick may be a good tool to break out of negative mood states.

I think this actually ties nicely into another theory that I wrote about several months ago, put forth by Kelly Lambert from Randolph-Macon College. In her theory Dr. Lambert suggests that the lack of effort required for our survival today is partially responsible for increased rates of depression. After all, we don’t really have to work very hard to find food and shelter anymore. Dr Lambert suggests that this robs us of the rewarding feelings of success from overcoming challenges in our daily lives.

Both of these lines of research relate to quick thinking associated with problem solving. Both also point to the activation of the brain’s ‘reward centers’, controlled mostly by dopamine (which are also stimulated by many drugs of abuse).

When I look at these two lines of research I am reminded of the old adage “Be careful what you wish for, you just might get it.” We have spent centuries developing technologies to make our lives easier, but are we really benefiting from that? Some philosophers argue that human struggle is necessary for happiness. I’m sure there are entire volumes written on this topic, so will just leave it at that.

So if we’re not going to drop out of modern society and go live off the land, what can we do? Maybe we shouldn’t always look for the easy road. That message certainly applies to your physical health. No one has found the magic pill for diet and exercise yet. Maybe that message should apply to our emotional health as well.

Reference:
Emotion. 2008, 8(5):597-612

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Feb 11

Control Your Blood Sugar, Improve Your Memory?

memory string around fingerBy Simon J. Evans, PhD

Remember the ‘monster cereals’? Frankenberry, Booberry and Count Chocula? I liked the little marshmallows in Frankenberry the best, though the chocolate milk left behind by Count Chocula was hard to beat. But can eating these types of breakfast cereals be setting us up for future memory problems?

We’ve learned a lot over the past couple of decades about how the foods we choose to eat as kids and young adults, control our risks for chronic illness as older adults. More recently we are beginning to understand that many chronic diseases are related to each other. Now, a new study published the February 2009 issue of The Proceedings of the National Academy of Sciences (USA), adds a very interesting chapter, linking blood sugar control to memory decline.

Specifically the study examines the role of insulin in countering Alzheimer’s disease progression. But before we get into that, let’s connect a few dots.

We know that high sugar foods, if eaten on a regular basis, increase our risk for insulin resistance and diabetes. What does this mean? When you eat high sugar foods your blood sugar rises quickly and your body brings it back down by releasing insulin. However, if you continue to do this on a regular basis, your body will become less sensitive to its own insulin and require more and more of an insulin release to do the job. This is called insulin resistance and is a step toward diabetes.

In recent years, we have learned that insulin acts in the brain as well. Brain cells rely on this hormone to keep a regular supply of energy so you can think clearly, remember where you parked your car and why you went into the store in the first place. Insulin resistance in the brain may lead to mood and cognitive problems. While this is a young area of research we know that diabetes increases your risk for both depression and Alzheimer’s disease.

The new study gives us some insight into why this might be true. One feature of Alzheimer’s disease is an accumulation ‘tangles’ from a protein called amyloid-beta. It turns out that small pieces of this protein can attack certain cells in your brain that are responsible for making and storing memories. If these attacks get bad enough – boom, Alzheimer’s disease.

What the new study shows us is that insulin helps protect these ‘memory’ cells from attack by amyloid-beta, but only if the cells remain sensitive to insulin. This sheds light on why diabetes puts you at increased risk for Alzheimer’s disease. If you have lost sensitivity to insulin (become insulin resistant) then you may be more susceptible to attack by amyloid-beta proteins and the development of Alzheimer’s disease.

In their study, the researchers were able to ‘help’ insulin out using a diabetic drug that increases insulin sensitivity, and this is promising news for development of therapies to help people going down the Alzheimer’s road. But are there other ways to increase our insulin sensitivity. The answer is emphatically, yes!

First of all, exercise is known to boost insulin sensitivity, even if you are already diabetic. Getting your muscles working helps them regain their sensitivity to insulin and do a better job of maintaining blood sugar. Second, eating a low-glycemic diet, with high fiber and low sugar, help regulate blood sugar and boost insulin sensitivity. Third, sleep is an emerging factor in improving insulin sensitivity and blood sugar control.

Again, this returns to the fundamentals. Exercise more, eat better and get enough sleep. Understanding all the cool neuroscience on why these things help is great, and hopefully provides you with a little extra motivation. Sometimes connecting a behavior to a real change that you can put your finger on can give you that extra sticking power, which is why we write these summaries. But the decision is yours. You know what to do, now can you do what you know?

Reference:
Proceedings of the National Academy of Sciences (USA). 2009, 106(6):1971-1976.

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