From the Seattle Post-Intelligencer (www.seattlepi.com)
25 Jan 2009

Living Well: High blood sugar, Alzheimer's risk linked

By BOB CONDOR
SPECIAL TO THE P-I

While most of us might think "diabetes" when a doctor talks about high blood sugar, it appears that Alzheimer's disease and memory loss would be justifiable next thoughts.

The first studies connecting elevated blood sugar levels and a higher risk of Alzheimer's surfaced in 2006. Since then, researchers have reached a well-shared view that type 2 diabetes raises the incidence of Alzheimer's. A new round of research published within the past month firms up the disturbing association.

What's more, a study presented by Swedish researchers at an international conference showed that simply experiencing higher-than-normal blood glucose levels is enough to potentially develop Alzheimer's. More than 40 million Americans between 40 and 75 have such blood sugar readings, qualifying them as pre-diabetic. That's translates to megaboosting the potential pool of Alzheimer's patients in years to come.

Of course, pre-diabetes presents its own set of adverse outcomes even before Alzheimer's and memory loss are introduced. What worries many public health officials about these most recent findings is that Alzheimer's already is expected to increase fourfold in the next four decades as baby boomers live longer than their parents did. One researcher at the conference said Alzheimer's will "swamp" health care systems worldwide, but especially in the U.S.

In a federally funded study published in the Annals of Neurology last month, researchers at Columbia University Medical Center in New York found that even moderate elevations in blood sugar levels can lead to memory loss that affects everyday function. This finding is compounded by the biological fact that our bodies' ability to regulate blood glucose begins declining by age 50.

Dr. Scott Small, a Columbia neurologist, said it might be no accident that our cognitive abilities begin to waver at the same time of life that our blood sugar regulation falls off.

Similar to the Swedish findings, Small said that even "subtle" increases in blood glucose levels ("not considered a disease state") can lead to memory difficulties.

"It's part of the normal process of aging, much like wrinkling of skin," he said.

While it might seem counterintuitive, the problem of elevated blood sugar levels is that less blood gets to the brain. Small and his colleagues used imaging technology to evaluate the hippocampus region of the brain in 240 elderly volunteers. Those individuals with higher blood sugar readings were found to have lower blood volume flow to the brain when compared to subjects with healthy blood sugar readings.

A third new study confirms the correlation between high blood sugar and low blood volume to the critical part of the brain for memory. In a lab study of human and mice brains, researchers at Northwestern University in Chicago discovered that higher levels of blood sugar appear to create sticky clumps of protein in the bloodstream that eventually make their way to the brain, both disturbing memory work and reducing blood flow.

Northwestern researcher Robert Vassar said the study needs follow-up validation but suggests that health strategies aimed at "improving blood flow to the brain might be effective to prevent or treat Alzheimer's." Currently, most Alzheimer's drugs are designed to break up those protein clumps. Vassar said research shows regular exercise as adults can offset the development of protein clumping in the brain. Other preventive steps includes better management of blood pressure and reducing cholesterol, he said.

"If people start early enough," said Vassar, "maybe they can dodge the bullet."

Eating to control blood sugar is another viable option. Noted University of Toronto diabetes nutrition researcher David J.A. Jenkins -- he's done considerable work on the "glycemic index" that identifies how rapidly or slowly foods are digested -- published a study last month showing that beans, nuts, lentils, fruits and vegetables are the best foods for reducing blood sugar.

What makes Jenkins' newest research so intriguing is it makes a case for rice and pasta cooked al dente, or what might be considered undercooked (not to Italians, mind you), plus "low-glycemic" breads such as pumpernickel and rye.

His study subjects who ate such foods -- along with beans, nuts, lentils, fruits and vegetables -- controlled their blood sugar levels better than individuals who ate a high-fiber diet featuring "brown" choices such as whole-grain breads, whole-grain cereals, brown rice and baked potatoes with skins. The high-fiber group was equally encouraged to eat three servings of fruit and five servings of veggies daily.

Jenkins said this Mediterranean-type diet (which includes healthy fats such as olive oil and olives) is an "extra tool" for regulating blood sugar as we grow older.

bobcondor~aol.com, dailyhealthblog.com

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<snort> I just love that "eating to control blood sugar is another viable option". One would think that, if higher levels of blood sugar are causing the problem, to get rid of the problem one should strive to lower the blood sugar. But then, I'm just a layperson using common sense, not a researcher kissing up to get study funding.