Feb
04
2017

Benefits Of The Ketogenic Diet

Dr. Jeff Volek, PhD, RD gave a talk that clarified the benefits of the ketogenic diet. He is a professor at the Department of Human Sciences at The Ohio State University, Columbus, OH, and teaches in the Kinesiology Program. His lecture was part of the 24th Annual World Conference on Anti-Aging Medicine in Las Vegas, Dec. 9 to 11, 2016.

There were 58 slides, some of them very detailed. I will summarize as best as I can what the presentation was all about.

History of diets

Dr. Volek stated that there were unintended consequences when the low fat/ high carb diet was introduced in the 1970’s and 1980’s. Ancel Keys, a physiologist had proposed in his diet heart hypothesis that saturated fat was the culprit that caused heart attacks.

As a result all major health agencies recommended the low fat/high carb diet. Obesity, diabetes, heart attacks, and strokes were the consequences. Another offshoot later from this was the statin craze where everybody was put on statins as high cholesterol was symptomatically treated. Nothing changed the diabetes and obesity wave and heart attacks and strokes continued to kill the affected persons. Among performance athletes the hypothesis was formed that carb loading would increase muscle performance. Researchers showed evidence that carb loading would improve performance. But athletes were dissatisfied with prediabetes and metabolic problems. Both the average consumer as well as the performance athlete noted that they felt better on a low carb/high fat diet. This is what the ketogenic diet is all about.

Diet heart hypothesis

With the diet heart hypothesis the saturated fat was removed from the diet and replaced by vegetable oils rich in linoleic acid. Dr. Volek explained that blood tests and other investigations were done on people who ingested the low saturated fat/high carb diet. The question was whether this would reduce heart attack rates and deaths by lowering serum cholesterol.

The Minnesota Coronary Experiment was a double blind study, which answered this question.

Cholesterol was reduced in the experimental group. But there was no reduction of heart attacks or strokes compared to a control group. Of concern was the large amount of refined carbohydrate content with the low fat diet. This essentially was responsible for the obesity and diabetes wave. The excess sugar turned into fat deposits and to insulin resistance, which caused diabetes. The low saturated fat/high carb diet of the 1960’s to 1990’s did not reduce heart attacks and strokes. To the contrary: the obesity/type 2 diabetes wave it had caused increased mortality from strokes and heart attacks further.

Laboratory tests on low fat/high carb diet versus the ketogenic diet

Forget hypotheses for a moment. Let us review what the different diets do in terms of lab tests. In a study where physicians put 40 overweight people with metabolic syndrome on a low fat diet or a low carb/ketogenic diet, they received the following blood test results. There were 20 patients in each group.

  1. Low fat/high carb diet

Triglycerides in the blood went down by 20%, saturated fatty acids by 22%. LDL (the bad cholesterol) rose by 4%. Insulin levels went down by 17% and leptin levels also down by 17%. Glucose levels were down by 1%.

  1. Low carb/ketogenic diet

Triglycerides went down by 52%, saturated fatty acids by 57%. LDL (the bad cholesterol) went down by 18%. Insulin levels went down by 49% and leptin levels by 42%. Glucose levels were down by 11%.

In this group of 20 subjects for each group the body mass index went down by 5% for the low fat diet and by 10% for the ketogenic diet after 3 months. The abdominal fat went down in that time by 12% for the low fat diet and by 20% for the ketogenic diet. The conclusion from these laboratory results and from the body measurements is that the low fat diet is showing some results of weight loss, but the ketogenic diet has superior results. The same is true for the blood tests. Only the ketogenic diet showed reduction of 7 key anti-inflammatory markers. In contrast, the low fat diet did not trigger the production of a single anti-inflammatory marker.

Anti-inflammatory benefits of the ketogenic diet

A 2008 study showed that several anti-inflammatory markers were greatly reduced from the ketogenic diet while a low fat diet did not show such a reduction.

As this 2009 study showed the LDL particles were getting bigger under the influence of a ketogenic diet, but they were getting smaller with a low fat diet.

Large LDL particles are also called pattern A particles, while small LDL particles are also called pattern B particles.

As this link shows there is good evidence that small LDL particles oxidize easier and are more atherogenic (causing hardening of the arteries). This means they lead to hardening of the arteries easier translating into heart attacks and strokes down the road. It is one thing that a ketogenic diet leads to larger LDL particles, which are more resistant to oxygenation. But it is another good thing that this diet is also anti-inflammatory. Overall this means that a ketogenic diet is counteracting the development of heart attacks and strokes.

Are saturated fatty acids in the diet causing heart attacks or strokes?

Dr. Volek discussed several large studies that have investigated this question. One of these studies discussed was a metaanalysis from 2010. Like all the other studies it showed that saturated fatty acids do not cause heart attacks and strokes. This is the secret behind the Inuit and the Eskimo diet. It is a high fat and meat diet. There is lots of seafood on the menu as well, which provides omega-3 fatty acids.

Dr. Volek pointed out that if you replace a certain percentage, let’s say 5% of saturated fatty acids with carbohydrates, this would cause 7% more heart attacks. He showed literature evidence to back this up. What causes increased heart attacks and strokes is more refined carbs in your diet (sugar and starchy foods!).

Do saturated fatty acids in your blood increase the risk for disease?

Dr. Volek showed several slides with references to various publications. Elevated saturated fatty acids in the blood cause a higher risk of getting a heart attack, heart failure, metabolic syndrome and diabetes. But this does not happen with a ketogenic diet. The values of the saturated fatty acids in the blood are 4% lower with the start of a ketogenic diet. With a low carb diet the calories derived from carbs are 12%. In comparison a low fat diet has 56% of carbs. Protein content in the low fat diet is 20%, in the ketogenic diet 28%. Saturated fat content in the low fat diet is 24%, in the ketogenic diet it is 59%.

Comparison of saturated fatty acid diet with the ketogenic diet

Let’s assume that both diets remain at 1500 Cal. per day. Then the saturated fat content for the low fat diet is 12 grams and the carbohydrate content is 208 grams. For the ketogenic diet these values are as follows: 36 grams of saturated fat and 45 grams of carbohydrates. Although there was a threefold higher saturated fatty acid intake, measurements of the circulating level of saturated fatty acids were 4% lower.

You are what you eat, but go easy on carbs

Dr. Volek pointed out that what makes you healthy or sick is how many carbs you include in your diet. If you follow a ketogenic diet with only 12% carbs you are much better off than when you follow a diet like the low fat diet with 56% of carbs. The higher the carb percentage in your food, the higher the production of saturated fatty acids in your system and the higher the storage of saturated fatty acids in your body fat. Conversely, the lower the carb percentage in your food is the higher the oxidation of saturated fatty acids will be.

Low fat diet compared to ketogenic diet

In other words the saturated fatty acids disappear from your blood. Also, with a ketogenic diet the storage of saturated fatty acids is lower in your body fat. With a low fat diet your insulin resistance increases, while with a ketogenic diet insulin resistance decreases. The difference in calories in these two diets (56% derived from carbs in a low fat diet versus 12% derived from carbs in a ketogenic diet) explains why the obesity/type 2 diabetes wave has developed and why heart attacks and strokes still top the mortality figures today.

Endurance athletes win medals on a ketogenic diet

Dr. Volek shared a few cases of world-class athletes that are on a ketogenic diet. They did well for themselves winning medals. Tim Olsen won the Western States 100-mile endurance run from Squaw Valley to Auburn, CA in 2012. Zach Bitter was the 100-mile track record holder in 2015. Mike Morton won the American 24-hour distance running record for 172 miles. Two Tour De France bicyclists made first and second place, Chris Froome (first place) and Romain Bardet (second place).

Sports teams also have been successful on a ketogenic diet: the Columbus Crew soccer team; New Zealand national rugby union team, commonly called the All Blacks; the Los Angeles Lakers basketball team are all on ketogenic diets.

Dr. Volek also pointed out that the military has tested the ketogenic diet. A ketogenic diet restores metabolic health, gives the soldiers more endurance, more stress resistance and decreased fatigue.

Benefits Of The Ketogenic Diet

Benefits Of The Ketogenic Diet

Conclusion

A ketogenic diet is on the one end of the carb spectrum with only 10 to 12% of calories derived from carbs. At the other end is the low fat/high carb diet that caused the obesity/diabetes wave. The Mediterranean diet is in the center. The more you are able to cut down the carb percentage in your diet by cutting out sugar and starchy foods, the more your metabolism stabilizes and blood tests can be measure this. The ketogenic diet makes you lose weight down to your ideal weight and makes you gain more muscle strength and physical endurance. Sophisticated blood tests have shown that inflammatory markers go down on a ketogenic diet and factors that lead to hardening of arteries also go down.

The end result of being on a ketogenic diet

The end result on the ketogenic diet is that the rate of heart attacks and strokes goes down, something which was the original goal of Ancel Keys. It did not work, but it promoted a wave of diabetes and heart disease! Ironically adding saturated fat and other healthy fats while cutting down carbs will achieve disease prevention. This is the opposite of what Ancel Keys had recommended to do and what the processed food industry has mimicked. The ketogenic diet lowers mortality by cutting down heart attacks and strokes. With this knowledge it will finally be possible to get people on a path to better health.

More information about ketogenic diet: https://www.dietdoctor.com/low-carb/keto

Jan
14
2017

How To Avoid Being Hungry

Dr. Ludwig gave a lecture about how to avoid being hungry at a conference in Las Vegas. The actual topic was “Always Hungry?” I attended the 24th Annual World Congress on Anti-Aging Medicine (Dec. 9-11, 2016) in Las Vegas where this lecture was given. Dr. Ludwig is a Harvard-based endocrinologist who has been researching weight loss methods and obesity for over 20 years. Here is a list of his major publications.

Dr. Ludwig stated that the low fat/high carb diet popular in the1980’s until the early 2000’s was misguided and probably even harmful. The theory at that time was that obesity was caused by too much saturated fat. This has since been proven to be wrong. Instead it has been proven that increased sugar intake is responsible for the obesity wave.

General information about weight gain

The carbohydrate-insulin model states that without insulin you cannot gain weight, because in order to store fat in fatty tissue you need insulin to transport fatty acids across the cell membrane of fat cells.

In this context it is important to note that high glycemic index food increases the blood sugar. This leads to stimulated insulin production, and the liver converts the extra sugar into fatty acids that get deposited as fat in fatty tissue.

The glycemic load from a person’s diet is the single best predictor for a rising blood sugar level. After food intake the blood sugar goes up, glucagon goes up, epinephrine goes up within 4 hours. It is the epinephrine, which after 4 hours makes you hungry again.

The nucleus accumbens is the addiction center. At 4 hours after a high glycemic index milk shake the nucleus accumbens was stimulated in 12 subjects of a double blind trial.

The nucleus accumbens does not work in isolation. It is not only involved in food satisfaction, but also in sexual satisfaction and even plays a role in satisfaction that some people get from playing video games.

Low-carbohydrate, Mediterranean or low-fat diet

In an Israeli study from the New England Journal of Medicine in 2008 investigators were interested to find out which diet was helping people to lose most weight.

322 moderately obese subjects that were aged 52 years on average were randomized to one of the following diet groups.

They compared

  1. a low fat diet (Atkins type, restricted calorie) with a
  2. Mediterranean diet (low carb, restricted-calorie) and a
  3. Low fat/high carb diet (low fat, non-restricted-calorie)

What was the result? The mean weight losses were: 2.9 kg (low fat group), 4.4 kg (Mediterranean diet group), and 4.7 kg (low fat/high carb group). Of the 272 participants who had completed the intervention after two years of the study the weight loss was 3.3 kg, 4.6 kg, and 5.5 kg in the same sequence as above.

Next the researchers examined the ratio of total cholesterol to high-density lipoprotein cholesterol, which is a measure for the heart attack risk. It was 20% lower from the baseline in group 2 (Mediterranean diet group). The low fat groups (group 1 and 3) were 12% lower from the baseline.

36 subjects had diabetes. There was a clear winner with respect to lower fasting blood sugar and insulin levels, namely the Mediterranean diet (group 2).

The authors concluded that the Mediterranean diet is preferable to low fat diets as they have shown an improvement in lipid profiles and in control of diabetes.

The “POUNDS LOST” study

This was a 2-year study that investigated 4 different lower calorie diets to help people lose weight. Despite the significant difference in diet composition, these 811 free-living overweight or obese adults ages 30-70 from Boston, MA and Baton Rouge, LA lost 16 pounds at 6 months and 9 pounds at the end of two years. The diets were 1) low fat (20%) or 2) high fat (40%) 3) average protein (15%) or 4) high protein (25% of total calories).

The authors concluded that any reduced, calorie-controlled diet would help obese or overweight people to achieve weight loss that lasts. It is interesting that it did not matter whether the diet was low or high in fat, or had low or high protein content. What did matter was that all diets were low in sugar.

Sugar is the driving force

Dr. Ludwig pointed out that without insulin you couldn’t gain weight. High glycemic index food increases blood sugar. The glycemic load is the single best predictor to indicate whether a person will gain weight or lose weight when you consume food. It is an irony that in the 1980’s and 1990’s the wrong assumption that a low fat/high carb diet would be heart healthy created the obesity wave. We have abundant data available that show otherwise: high sugar content of food brings the calorie count up as everybody can read on the food labels.

Sugar stimulates the food addiction center

This will lead to weight increase, which has been abundantly proven. Sugar also stimulates your nucleus accumbens, the food addiction center. As you probably know it is extremely difficult to get out of this food addiction cycle unless you cut out sugar. You even need to go one step further and include many starchy foods that will within 30 minutes of digesting them turn into sugar. Your system makes no difference whether you eat a few teaspoons of sugar or two slices of white bread. The response of your pancreas is insulin, which gladly stores the fatty substances your liver made as fat.

How to get out of the vicious food cycle

As the quoted publications and many other ones have shown, it only matters that you limit your refined carb intake. You can vary the fat content and you can vary the protein content and still lose weight provided you watch the low carb intake. You also need portion control, which is a given! Study glycemic index and glycemic load sites on the Internet. The links I provided are just some examples. The more you educate yourself about carbs, the better for you. Note that many fruit and vegetables belong to the low-glycemic load/index foods. Avoid the high glycemic index foods like dates and cornflakes. Stick to low-glycemic index foods, which are less than 55. With regard to low-glycemic load food the values should be below 10.

The Mediterranean diet is a very desirable diet, which has been proven to be anti-inflammatory.

The zone diet of Barry Sears is also an anti-inflammatory diet and he summarizes this in this link.

How To Avoid Being Hungry

How To Avoid Being Hungry

Conclusion

I have summarized the content of a talk given by Dr. Ludwig. We learnt from this that sugar and refined carbs are the driving force that leads to “feeling hungry”. This stimulates your nucleus accumbens, the food addiction center. Let’s assume that a person is obese or overweight and wants to lose some weight. You need to start by being strict with yourself. Cut out sugar and high-glycemic foods. This will remove the food addiction factor that keeps you going back to the wrong, high calorie foods. You will also consume more low calorie vegetables and fruit, which have more fiber that fills you up.

Monitor your body mass index

Once you are used to the new way of eating, there is no need to count calories. I recommend that you weigh yourself daily on body composition scales and record the results. This allows you to monitor your body mass index (BMI), your weight, your fat percentage, and your muscle percentage. Typically you will lose 2 to 3 pounds per week on such a low-calorie diet. Later the weight loss will slow down to 1 to 2 weeks per week until you reach your goal. Don’t go lower than a BMI of 21.0 to 22.0 and discuss your goal with your doctor.

Dec
31
2016

What Works Against Alzheimer’s?

.Eli Lilly’s promising drug solanezumab failed; so, what works against Alzheimer’s? This drug was supposed to dissolve the amyloid deposits that function like glue and make the patients lose their memory. This phase 3 trial was to test the drug on patients to assess efficacy, effectiveness and safety. But instead it showed that the new drug did not stop the loss of memory.

Brain bleeding as a side effect of potential Alzheimer’s drug

Now all those who were hoping for solanezumab to be effective, will jump on another drug, aducanumab. Biogen from Cambridge, Massachusetts, has developed this drug. Out of 165 subjects only 125 completed preliminary studies. 40 patients who discontinued it, had negative side effects. These included fluid building up in the brain, which was thought to be due to removal of the plaques. But others, had brain bleeding.

Although the drug manufacturer is still hoping that aducanumab will work out as an anti-Alzheimer’s drug, I have my doubts. A drug that can have potential brain bleeding as a side effect does in my opinion not qualify as an anti-Alzheimer’s drug.

Factors that help prevent Alzheimer’s

1. Diet can be as effective as a drug in treating Alzheimer’s

In September 2015 researchers from Rush University published results of putting Alzheimer’s patients on the MIND diet. The MIND diet was a prospective study where 923 people aged 58 to 98 years participated. Researchers followed these people for 4.5 years. Three groups of diets were tested: Mediterranean diet, DASH diet and MIND diet.

The MIND diet study result

The adherence to the diet was measured: those who followed the diet very closely, other participants who were less diligent, and finally those who were not compliant with the diet. With regard to the MIND diet the group with the highest adherence to the diet reduced the rate of Alzheimer’s by 53% compared to the lowest third. This is like a highly effective Alzheimer’s drug! The second group still was able to reduce the rate of Alzheimer’s by 35%, which would be like a regular strength drug. The control diets were the DASH diet and the Mediterranean diet. The group that was strictly adhering to the DASH diet reduced Alzheimer’s by 39%, the group that was very conscientious in adhering to the Mediterranean diet reduced Alzheimer’s by 54%. The middle thirds of both control diets did not show any difference versus the lower thirds.

Findings of Alzheimer prevention by diet

The conclusion was that a strict Mediterranean diet had a very good Alzheimer prevention effect, as did a strict MIND diet. However, when patients did not adhere too well to a diet, the MIND diet was superior still yielding 35% of Alzheimer’s prevention after 4.5 years. The other diets, when not adhered to that well, showed no difference from being on a regular North American diet. Here is more info about the MIND diet.

Conclusion

Avoid the Standard American Diet. Adopt a Mediterranean diet and stick to it in a strict fashion or adopt the MIND diet. The other benefit is that there are no side effects!

2. Stress and Alzheimer’s

2010 study from Gothenburg University, Sweden examined 1462 women aged 38-60 and followed them for 35 years.

Psychological stress ratings went back to 1968,1974 and 1980. 161 females developed dementia (105 of them Alzheimer’s disease, 40 vascular dementia and 16 other forms of dementia). The risk of dementia was higher in those women who had frequent/constant stress in the past. The condition became more severe the more stress they had to face in the past. Women with exposure to stress on one, two or three examinations had higher dementia rates later in life in comparison to women who had no exposure to any significant stress. Specifically, dementia rates were 10% higher after exposure to one stressful episode, 73% higher after two stressful episodes and 151% higher after exposure to three stressful episodes.

Conclusion

Prevention of Alzheimer’s is possible by avoiding stress and seeking counselling when stress occurred .

3. Be creative, prevent Alzheimer’s and dementia

In an April 8, 2015 publication from the Mayo Clinic in Rochester, MN and Scottsdale, AZ 256 participants aged 85 years and older (median age 87.3 years, 62% women and 38% men) were followed for 4.1 years. Psychological tests measured mild cognitive impairment (MCI). At the time of recruitment into the study all of the tests for MCI were normal. As the study progressed it became apparent that there were various risk factors that caused the onset of MCI, which is the immediate precursor of dementia/Alzheimer’s disease.

The finding was that the presence of the genetic marker APOE ε4 allele carried a risk of 1.89-fold to develop MCI and later Alzheimer’s disease.

Further findings of the study

When patient showed signs of depression at the time of enrolment into the study, the risk of MCI development was 1.78-fold. Midlife onset of high blood pressure led to a 2.43-fold increase and a history of vascular disease showed a relationship of 1.13-fold higher MCI development. The good news was that four activities correlated with a lower risk of developing MCI with aging. When the person engaged in artistic activities in midlife or later in life the risk for MCI development 73% lower, involvement in crafts reduced it by 45% and engagement in social activities by 55%. In a surprise finding the use of a computer late in life reduced MCI development by 53%. These are very significant observations. This would be equivalent to highly effective anti-Alzheimer’s drugs.

Conclusion

If you stimulate your mind in older age, even browsing on the computer, this will help you to prevent Alzheimer’s disease.

4. Lifestyle factors contributing to Alzheimer’s

a) Sugar consumption: Sugar consumption and too much starchy food like pasta (which gets metabolized within 30 minutes into sugar) causes oxidization of LDL cholesterol and plaque formation of all the blood vessels including the ones going to the brain. On the long-term this causes memory loss due to a lack of nutrients and oxygen flowing into the brain.

b) Lack of exercise: Lack of exercise is an independent risk factor for the development of Alzheimer’s disease. Exercise increases the blood supply of the brain, strengthens neural connections and leads to growth of neurons, the basic building blocks of the brain. Exercise increases mood-regulating neurotransmitters like serotonin and endorphins.

c) Sleep deprivation leads to memory loss, but so does the use of aspartame, the artificial sweetener of diet sodas. Make your own homemade lemonade. Squeeze the juice of half a lemon. Add mineral water to fill an 8 oz. glass. Add a tiny bit of stevia extract for sweetening. Stir and enjoy. Stevia has been in use for thousands of years.

5. Hormone changes

A lack of testosterone in men and estrogen in women interferes with cognition and memory. For this reason it is important after menopause and andropause (=the male menopause) to replace what is missing with the help of a knowledgeable health professional.

Progesterone is manufactured inside the brain, spinal cord and nerves from its precursor, pregnenolone, but in women it also comes from the ovaries until the point of menopause. The myelin sheaths of nerves requires progesterone and progesterone also has a neuroprotective function. In menopausal women bioidentical progesterone is a part of Alzheimer’s prevention.

Melatonin is a hormone, a powerful antioxidant and a neurotransmitter at the same time. It helps in the initiation of sleep, stimulates the immune system and protects from the toxic effects of cobalt. Lab tests in Alzheimer’s patients found elevated values. In an aging person it is wise to use melatonin at bedtime as a sleep aid and to preserve your brain.

6. Genetic risk of Alzheimer’s

At the 22nd Annual A4M Las Vegas Conference in mid December 2014 Dr. Pamela Smith gave a presentation entitled ”How To Maintain Memory At Any Age”. She pointed out that there are about 5 genes that have been detected that are associated with Alzheimer’s disease and in addition the apolipoprotein E4 (APOE4). About 30% of people carry this gene, yet only about 10% get Alzheimer’s disease, which shows how important lifestyle factors are (in medical circles physicians call this the “epigenetic factors”) to suppress the effect of the APOE4 gene. She also stated that our genes contribute only about 20% to the overall risk of developing Alzheimer’s disease. This leaves us with 80% of Alzheimer’s cases where we can use the brain nutrients and hormones discussed above and exercise to improve brain function.

7. Vitamin D3 protects your brain from Alzheimer’s disease

Alzheimer’s disease is a neurodegenerative disease of old age. We know that it is much more common in patients with type 2 diabetes where insulin levels are high. Studies have shown that Alzheimer’s disease can be termed type 3 diabetes.

The resulting neurofibrillary tangles and amyloid-beta deposits damage nerve cells, which are responsible for the memory loss and the profound personality changes in these patients.

What does vitamin D3 have to do with this?

A 2014 study showed that a low vitamin D level was associated with a high risk of dementia and Alzheimer’s disease.

Specifically, the findings were as follows.

  • Vitamin D level of less than 10 ng/ml: 122% increased risk of Alzheimer’s
  • Vitamin D level 10 to 20 ng/ml: 51% increased risk of Alzheimer’s

The same research group found in two trials that vitamin D deficiency leads to visual memory decline, but not to verbal memory decline.

Generally supplements of vitamin D3 of 5000 IU to 8000 IU are the norm now. But some patients are poor absorbers and they may require 15,000 IU per day. The physician can easily determine what the patient needs in the dosage of vitamin D3 by doing repeat vitamin D blood levels (as 25-hydroxy vitamin D levels). The goal is to reach a level of 50-80 ng/ml. The optimal level with regard to nmol/L is 80 to 200 (according to Rocky Mountain Analytical, Calgary, AB, Canada).

8. Avoid sugar overload

We already mentioned sugar consumption under point 4. But here I am mentioning it again because of the insulin reaction. An overload of refined carbs leads to an overstimulation of the pancreas pouring out insulin. Too much insulin (hyperinsulinemia) causes hormonal disbalance and leads to diabetes type 3, the more modern name for Alzheimer’s. All starch is broken down by amylase into sugar, which means that anybody who consumes starchy food gets a sugar rush as well. Too much sugar in the blood oxidizes LDL cholesterol, which leads to inflammation in the body. The consequence of chronic inflammation are the following conditions: hardening of the arteries, strokes, heart attacks, Alzheimer’s due to brain atrophy, arthritis, Parkinson’s disease and cancer.

What Works Against Alzheimer’s?

What Works Against Alzheimer’s?

Conclusion

In the beginning we learnt about a failed phase 3 trial regarding an anti-Alzheimer’s drug. Next we reviewed several factors that can all lead to Alzheimer’s and that have been researched for many years. It would be foolish to think that we could just swallow a pill and overlook the real causes of Alzheimer’s disease. I believe there will never be a successful pill that can solve the increasing Alzheimer’s problem. It is time that we face the causes of Alzheimer’s. This means cutting down sugar to normalize your insulin levels.

Lifestyle changes necessary to avoid Alzheimer’s

We need to supplement with vitamin D3 because we know that it helps. For women in menopause or men in andropause it is time to replace the missing hormones with bioidentical ones. We need to handle stress and avoid sleep deprivation. And, yes we need to exercise regularly. Following a sensible diet like the Mediterranean diet or the MIND diet makes sense. And let us keep our minds stimulated. Chances are, when we do all of this that we will not need any Alzheimer’s pill. This is not good news for the drug companies, but will be very good news for you. Last but not least, there are no side effects, only health benefits!

Additional resource on how to preserve your memory.

Oct
29
2016

High Insulin Levels Can Cause Alzheimer’s

Research published in April 2016 shows that high insulin levels can cause Alzheimer’s. Alzheimer’s disease is more common in diabetics. But until recently nobody knew why there would be this association. Finally new research from New York University (NYU) has shed light on this puzzle. It seems like the key is an enzyme that breaks down insulin, called insulin-degrading enzyme (IDE). Melissa Schilling (no relation to me), an innovation professor at NYU has discovered the metabolic pathway between diabetes and Alzheimer’s disease. This finding has enormous implications regarding the prevention of Alzheimer’s, as I will discuss below. Here is a link to the original paper.

Background information about Alzheimer’s

Alzheimer’s disease affects about 5.2 million Americans and 44 million people worldwide. Above all, there is a progressive loss of cognitive functioning over a long period of time due to senile plaques in the cerebral cortex and the subcortical areas of the brain. These senile plaques consist of amyloid-beta substance and neurofibrillary tangles. This protein material is like glue, which prevents the neurons from working properly and certainly causes memory loss and the confusion, which is so typical for Alzheimer’s patients. Normally amyloid-beta is in solution and prevents lipoproteins in the brain from oxidizing. But when the insulin-degrading enzyme is busy breaking down high levels of insulin, these processes overload this enzyme system. Amyloid-beta experiences supersaturation, as the body does not eliminate it at a normal speed. Consequently, this leads to the glue-like deposits of amyloid-beta in Alzheimer’s brains.

A 2004 estimate for the direct cost of Alzheimer’s disease to the US amounted to  $214 billion. By 2050 this could go up to $1.5 trillion, if there will be no cure Alzheimer’s.

High insulin levels can cause Alzheimer’s, but other mechanisms too

Professor Schilling found in her research that there are four main malfunctions that can lead to high amyloid-beta in the brain of Alzheimer’s patients.

  1. First, with diabetes type1, when the patient does not receive enough insulin, the insulin-degrading enzyme in the brain is not working hard enough. This results in inadequate removal of amyloid-beta from the brain and neurofibrillary tangles of amyloid-beta accumulate.
  2. Second, IDE requires zinc as a co-factor to work properly in breaking down amyloid-beta. Zinc deficiency is quite common, particularly in older people. In this case insulin levels are normal, but the removal of amyloid-beta from the brain is inadequate, as IDE function has become lower.
  3. Furthermore, in early type 2 diabetes there are high insulin levels and there is a competitive inhibition of the elimination of insulin and amylin-beta. This is probably the most common form of getting Alzheimer’s disease.
  4. Finally, excess production of an amyloidogenic protein can lead to an overabundance of amylin-beta, which overwhelms the insulin-degrading enzyme.

What treatment options are there for Alzheimer’s disease?

These four mechanisms from above have several implications as follows.

  1. If a type 1 diabetic patient is insulin deficient, intranasal insulin would be beneficial.
  2. If the patient has type 2 diabetes, intranasal insulin or insulin by injection would be the wrong approach. As stated earlier, there is the competitive inhibition of the elimination of insulin and amylin-beta. It is the insulin-degrading enzyme, which is the limiting factor. This involves simple dietary changes where the patient cuts out sugar and limits starchy foods in the diet. This normalizes insulin levels and the IDE function returns to normal.
  3. Alzheimer’s patients and patients with mild cognitive dysfunction should be tested with glucose tolerance tests (GTT). It the test is abnormal, a knowledgeable dietician should be consulted.
  4. Obesity is strongly associated with hyperinsulinemia and diabetes. Again frequent GTT should be done followed by dietary intervention when abnormal.
  5. Professor Melissa Schilling stated that 86 million Americans are pre-diabetic, but they have no symptoms. Only glucose tolerance testing can diagnose that condition. This will prevent a lot of cases of diabetes and Alzheimer’s disease.
  6. Large parts of the population have no knowledge of the glycemic index of carbohydrates. In order to limit glucose overload and excessive insulin production there is a need for educational nutritional programs. This will be a powerful tool in Alzheimer’s disease prevention.
High Insulin Levels Can Cause Alzheimer’s

High Insulin Levels Can Cause Alzheimer’s

Conclusion

It has been general knowledge for some time that diabetics have a higher rate of Alzheimer’s disease. People have known Alzheimer’s as “Diabetes of the brain” or “Type 3 Diabetes”. This new research has shed some light on the connection of elevated insulin to Alzheimer’s disease. It was news to me that there is a competitive inhibition of the elimination of insulin and amylin-beta via the insulin-degrading enzyme. It boils down to recognizing that sugar overconsumption causes Alzheimer’s disease. If you want to keep your brain power until a ripe old age, you better eliminate a lot of sugar and adopt a healthy Mediterranean diet.

Jul
16
2016

Mediterranean With Healthy Fat

If you want to lose weight, have you considered eating Mediterranean with healthy fat? A lot has changed in recent years regarding recommendations for healthy food intake. In the eighties and nineties there was a recommendation for a  low fat diet, which unfortunately was high in carbs and led to obesity. We learnt from this that carbohydrates break down in the gut into sugar. This converts into fatty acids, which go in storage as fat.

Studies regarding diets with unhealthy and healthy fats

Prospective study in the US

Here is a prospective study that followed 120,877 U.S. women and men over a longer time. Every 4 years there was weight gain of 1.69 lbs. for potato chips, 1.28 lbs. for potatoes, 1.00 lb. for sugar-sweetened beverages, 0.95 lb. for unprocessed red meats and 0.93 lb for processed meats. On the other hand from vegetables there was a weight loss of −0.22 lb., for whole grains −0.37 lb., for fruits −0.49 lb., for nuts −0.57 lb. and for yogurt −0.82 lb. The researchers checked cheese out and found it mostly neutral in terms of weight gain, while butter did cause weight gain.

Lancet study from Spain

In a study from Spain that was published in the Lancet in June 2016. The researchers followed 7447 asymptomatic men (aged 55–80 years) and women (aged 60–80 years) for about 5 years. They all had type 2 diabetes and three or more cardiovascular risk factors. They were randomly assigned to three Mediterranean diet types: a Mediterranean diet with olive oil, a Mediterranean diet with nuts and a control group on a low fat Mediterranean diet.

Weight loss when on Mediterranean diet

The interesting finding after 5 years was that there was weight loss around the waist in both the patients on the Mediterranean diet with nuts and with olive oil. Their weight loss was 0.95 lbs. for the olive oil group and 2.82 oz. in the Mediterranean diet group with nuts. The Mediterranean diet group with olive oil had lost 0.22 inches in the waistline, the other group on nuts lost 0.38 inches. These are hardly impressive losses! The researchers concluded that fat restriction is not necessary on the Mediterranean diet, as there was no weight gain with unrestricted healthy fats after 5 years.

Summary from a cardiologist

Dr. Dariush Mozaffarian, a cardiologist and epidemiologist of the Tufts Friedman School of Nutrition Science & Policy wrote an editorial regarding this Spanish study: ”A handful of nuts may be 160 calories, which is more calories than a can of Coke, but that doesn’t mean the can of Coke is a better choice”. He added: “Salt, sugar, starch, processed food and trans fats should be off the menu, not fat. Healthy foods are healthy foods, and bad foods are bad. It doesn’t matter, if the food is low fat or high fat. This is a separate issue.”

Mediterranean With Healthy Fat

Mediterranean With Healthy Fat

Conclusion

When wanting to lose weight, the key is to pay attention to your carb intake. Make sure it consists of unrefined carbs. You will do this if you eat vegetables and fruit. Cut out sugar and starchy foods as much as you can. Have lean, clean meats, but avoid red meat except perhaps for every two weeks some grass fed beef. Eat fish (important for its content of omega-3 fatty acids), also enjoy yogurt, nuts, olive oil and avocados. It is an extra benefit if you add regular exercise to this as well. You will notice that you gradually shed the unnecessary pounds. This is not a program for just a month or two. To stay well, make it a new lifestyle!

Nov
28
2015

Diet And Brain Health

The fact that the topic of diet and brain health keeps popping up in the medical literature, is significant. This year has not been any exception.

The Mediterranean diet in particular has been shown to have very positive effects on postponing Alzheimer’s disease by as much as 5 years.

A clinical study on 674 elderly patients (mean age 80.1 years) without dementia, was published in the journal “Neurology”. It examined the question whether adherence to the Mediterranean diet would affect the degree of brain atrophy. Researchers already knew that Alzheimer’s disease was less common on a Mediterranean diet.

The findings were interesting: a high adherence to the Mediterranean diet led to a higher total brain volume, total grey matter volume and total white matter volume as measured with high-resolution structural MRI scans.

Quality of diet influences cortical thickness of brain

Lower meat intake led to higher brain volume. In addition, more fish intake also caused the mean cortical thickness of the brain to increase. Parts of the brain in Alzheimer’s patients showed atrophy like in the cingulate cortex, parietal lobe, temporal lobe, and hippocampus with good volumes on MRI scans when patients adhered to the Mediterranean diet. These volumes started to shrink when the diet was poor.

Those patients adhering to a Mediterranean diet have brains that on MRI scan look 5 years younger and are much less likely to develop Alzheimer’s disease. Physicians have known for a long time that people, who eat a healthy diet, exercise regularly, don’t smoke and who keep mentally stimulated will generally have healthier brains than people who don’t do these things.

What is the Mediterranean diet?

It involves eating meals derived from plants: vegetables, fruit, cereals, beans and nuts. You can eat fish and poultry twice per week. You cut down the amount of meat and dairy you eat, but you can have a glass of wine per day. Instead of butter olive oil is used instead. Here is more information of what is included in the Mediterranean diet.

Because there is less fat and less high glycemic index carbs in this diet, it is also a diet that lends itself for weight management. You shed a few pounds and reach your ideal body mass index without paying much attention to it.

Apart from the Mediterranean diet the MIND diet has also been shown to prevent brain atrophy. This diet is a combination of the DASH, which physicians developed for controlling high blood pressure, and the Mediterranean diet.

The Mediterranean diet makes you live longer

The Nurses’ Health Study that has been going on since 1976 showed that telomeres, the caps on chromosomes, were getting shorter in nurses who lived on junk foods, but surprisingly nurses on the Mediterranean diet preserved their telomeres. Longer telomeres have an association with slower aging. And people with longer telomeres reach an older age without diseases like heart attacks, liver disease or cancer.

Exercise on top of the Mediterranean diet

In addition to relying on a healthy diet, like the Mediterranean diet, for your health, think about doing regular exercises. These two ingredients together will prevent heart attacks, strokes and other diseases. When you combine exercise with a healthy diet your abdominal girth shrinks as this study showed.

Another study showed that when a Mediterranean type diet is combined with regular exercise, adult onset diabetes occurrence could be reduced by 28-59%.

This is quite a significant effect of two simple interventions: a healthy diet and regular exercise.

Don’t smoke

It does not make sense to go on a healthy diet, exercise and then smoke! Interestingly an Iranian study showed that when people became health conscious, adopted a healthy diet and exercised, they also started to quit smoking. People who did all of this, quit smoking, eating healthy and exercising regularly, were also the happiest and most content.

Exercise your brain

The evidence shows that any stimulation of brain activity, particularly anything that requires active and abstract thinking will protect the brain from developing Alzheimer’s disease.

Another study showed that prevention of Alzheimer’s disease is achieved by quitting smoking, treating high blood pressure, stimulating the brain and treating diabetes.

Diet And Brain Health

Diet And Brain Health

Conclusion

us. This approach will be the most successful way to prevent Alzheimer’s disease. It starts with quitting smoking. It goes on to starting a Mediterranean diet and staying on it. Regular exercise will take care of preventing heart attacks and strokes. But exercise also ensures that all of your brain cells continue to get oxygen and nutrients. This in turn prevents brain shrinkage.

Weight loss included in Mediterranean diet

The Mediterranean diet has a lower calorie content than the Standard American diet, there will be weight loss. The weight loss will continue until you reach your ideal body mass index. You can stimulate your brain by actively doing computer work, doing puzzles, playing a music instrument and phoning friends. In addition you may want to read reading books etc.. All this  will contribute to preventing Alzheimer’s. Watching TV or movies is not an active mental activity. This is passive thinking, which means it is not as valuable as the other activities. Pick a hobby that enhances your life, and your brain will thank you for it too!

Aug
29
2015

Problems With The Western Diet

Lately there have been various news reports cautioning us about the Western diet. We eat too much processed food, we eat too much sugar and we have to be careful with how much fat and what kind of fat we eat. Take this story from the CNN. Half the world lives in big cities. And this number will reach 70% in the year 2050, if the urbanization trend continues at the same rate. With it comes the consumption of fast food. The wealthier people are, the more meat they eat. This is exactly what is bad for us. Too much meat can cause gout, particularly when paired with alcohol. First it is time to explain some more about the Western diet. “The biggest features of a Western diet are overconsumption of over-refined sugars, highly refined and saturated fats, animal protein and a reduced intake of plant-based fibers,” says Ian Myles. He is located at the U.S. National Institute of Allergy and Infectious Diseases. This statement is specific enough: we are eating too much fat, red meat, salt and sugar, and too little fiber.

Too much fat

In processed foods we get too many omega-6 fatty acids, which have been shown to cause clogging of arteries and causing heart attacks and strokes, if not balanced with enough omega-3 fatty acids. But many processed foods still have hidden trans fats, which distribute free radicals in your system; this in turn causes hardening of the arteries again. Free radicals also age you faster. A candy bar with palmitic acid and fructose for instance, leads to a slow grade inflammation. The immune system mistakenly takes palmitic acid for the gut bacterium E.coli and mounts an immune reaction. This low-grade inflammation causes inflammation in the blood vessels, but also weakens the immune system. The sugar part of the candy bar oxidizes LDL cholesterol leading to clogging of arteries, which causes heart attacks and strokes.

Too much red meat

Grain fed and antibiotic treated regular beef changes the gut bacteria and can cause super bugs. The change of the gut flora can lead to inflammation in the gut lining and something called “leaky gut syndrome”. We carry almost 2 pounds of gut bacteria in us at any given time. But residual antibiotics from regular beef and chicken reduces that amount and changes the composition of our gut flora.

You can read in this blog that the changes taking place from consuming regular beef changes your liver metabolism and leads to accelerated hardening of the arteries, which in turn causes deadly heart attacks and strokes. On the other hand, grass fed beef or organic beef do not do this. To prevent leaky gut syndrome, heart attacks and strokes from developing you can take probiotics every day, which should include these two species: Lactobacillus acidophilus and Bifidobacterium bifidus. This keeps your gut flora stable and does not allow your food to undermine your health.

To much salt and sugar

Too much salt is often in processed food to prolong the shelf life. But we humans are very sensitive to overdoses of salt. Our kidneys have to work overtime to get rid of the excess salt. We need to drink enough water to allow the kidneys to produce urine, which will eliminate the excess salt. Persistent excessive salt intake will also cause high blood pressure. High blood pressure can cause heart problems, strokes and aortic aneurysms. Restaurant food often contains too much salt and sugar.

Too little fiber

The more food is processed, the less fiber it will contain. If you go for the pizza, it may taste good, but where is the fiber? If you eat bread and butter, where is the fiber? You may say that you like a donut. I ask you again: where is the fiber? The end result is that toxins that normally would have been bound to fiber in the colon and were eliminated in the stool are now interacting with the wall of the colon causing colonic polyps and colon cancer. It may not only be fiber as plant-based diets rich in fruits, non-starchy vegetables, legumes, and whole grains were shown to be associated with a lower risk of the most common cancers. That’s the reason why people who consume a Western diet have higher rates of cancer in general. They lack fruits and vegetables.

Polyunsaturated fatty acids

The recommendation in the 1980’s until about 2010 of a low fat diet to prevent heart attacks and strokes has failed miserably. It turned out that polyunsaturated fatty acids are of the omega-6 type, which gets metabolized into arachidonic acid and causes inflammation. The immune system gets suppressed from the chronic inflammation and the person becomes more prone to infections. As low fat diets are typically high in carbohydrates, there is a calorie surplus causing weight gain. Dr. Fife explains in his book that polyunsaturated acids interfere with the insulin receptor feeding into insulin resistance, which makes it even more difficult to control the metabolism and leads to more weight gain (Ref.1). The end result is what we have observed over the last few decades, a relentless obesity wave in the civilized world. It is a direct result of the Western diet.

Cancer caused by the Western diet

Breast cancer, colon cancer and prostate cancer are cancers that are related to the Western diet. But there are likely many other cancers that are also caused by it.

We know that free radicals cause cancer, such as from trans fats and rancid polyunsaturated fatty acids found in processed foods. Cancer is more common in obese people and people with diabetes.

Habits that make us eat more

There are habits that make us eat more like snacking and falling for so-called “fitness food” which contains dubious ingredients. It may come as a surprise, but married people can also fall prey to unhealthy habits together, forgetting about working out and sneaking in “skinny cocktails”. Read what Cynthia Sass, registered dietician had to say about this on CNN.

Solution to the Western diet

You may expect me to say that you should modify this or that in the Western diet. Modification does not work. You have to get radical here! The real solution is to abandon the Western diet altogether. Replace it with the Mediterranean diet without sugar and starchy foods. It is not that as bad as you can see from 1 week of recipes that my wife included in my book: “A survivor’s Guide To Successful Aging”.

You can eat cooked organic spinach, a piece of meat with slices of Avocado for breakfast. Cooking is done mostly with coconut oil or olive oil. Alternatively you may enjoy an egg or egg white vegetable omelette with lots of greens, mushrooms, onions and salsa and avocado on the side. Add to this caffeinated or decaffeinated coffee with stevia. Alternatively, a bowl of rolled oats, flaxseed and nuts with fresh fruit and organic milk, goat milk or yoghurt would make an excellent, sustaining breakfast. I am mentioning all of this to show you that you can get away from your familiar pancakes with maple syrup, sausages, waffles, toasts and muffins etc.

Food needs to be prepared form scratch with organic ingredients. GMO foods need to be avoided as the final judgment on these is decades away, and you do not want to become a human guinea pig.

Problems With The Western Diet

Problems With The Western Diet

Conclusion

The only way to “improve” a Western diet is to eliminate it and replace it by the Mediterranean diet. Throw all the processed food into the trash where it belongs! Avoid omega-6 fatty acids (polyunsaturated fatty acids), which have been shown to weaken the immune system and cause insulin resistance. The best fats are omega-3-fatty acids from marine oils (fish oil), coconut oil and olive oil. Forget all the other oils that are heavily advertised. They are not healthy.

I stick to organic foods although they are more expensive. Don’t forget that apart from a good diet you need to engage in a regular exercise program in order to prevent heart disease and cancer. And don’t stress out over the changes that you are about to make. Remember to manage your stress and relax!

References:

  1. Bruce Fife, C.N., N.D.: “The Coconut Oil Miracle”, 5th edition,2013, Penguin Books, NY 10014

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Jul
18
2015

MIND Diet Helps Prevent Alzheimer’s

Researchers at the Rush University developed the MIND diet that helps prevent Alzheimer’s disease. MIND stands for “Mediterranean-DASH Intervention for Neurodegenerative Delay” and is a hybrid between the Mediterranean diet and the DASH diet that had been developed to help control high blood pressure.

The MIND diet was a prospective study where 923 people aged 58 to 98 years participated. Researchers followed these people for 4.5 years. Three groups of diets were tested: Mediterranean diet, DASH diet and MIND diet.

The MIND diet study result

The adherence to the diet was measured: those who stuck to the diet very closely, another section of participants that were less diligent, and finally one segment of people who did not take the entire thing too serious. With regard to the MIND diet the group with the highest adherence to the diet reduced the rate of Alzheimer’s by 53% compared to the lowest third. The second group still was able to reduce the rate of Alzheimer’s by 35%. The control diets were the DASH diet and the Mediterranean diet. The group that were strictly adhering to the DASH diet reduced Alzheimer’s by 39%, the group that were very conscientious in adhering to the Mediterranean diet reduced Alzheimer’s by 54%. The middle thirds of both control diets did not show any difference versus the lower thirds. The conclusion was that a strict Mediterranean diet has a very good Alzheimer prevention effect, as does a strict MIND diet. However, when patients do not adhere too well to a diet, the MIND diet is superior still yielding 35% of Alzheimer’s prevention after 4.5 years while the other diets when not adhered to that well showed no difference from being on a regular North American diet.

A brief summary of what Alzheimer’s disease is

A few years back the Pittsburgh PET scan was invented. It uses a Pittsburgh B compound radio-tracer to visualize the pathology in the Alzheimer’s brain. This research tool has made it possible to detect even the earliest Alzheimer’s disease (AD). The basic problem in Alzheimer’s patients is that there is brain atrophy, which can be more located in the front of the brain or in the back. There are two types of AD, the early onset AD (EOAD) and the late onset AD (LOAD). Using the Pittsburgh PET scan it was noted that the brain atrophy with EOAD is severe and located in the back of the brain; in contrast to that with LOAD, which is the more common form of AD the brain atrophy is located in the front of the brain. This imaging tool also allows quantitating the amyloid load; amyloid is a gooey substance that is produced by the inflammatory changes in the brain of Alzheimer’s patients (Ref.1). There are multiple possible causes why Alzheimer’s should develop in a person, but nothing conclusive has been determined. In February, 2015 I summarized a talk given by Dr. Smith at the 22nd Annual A4M Las Vegas Conference that also mentioned that there are many causes that can lead to Alzheimer’s disease.

The bottom line is that atrophy of the brain leads to loss of memory, personality loss and premature death.

The MIND diet

This diet was developed by Martha Clare Morris, Ph.D., a nutritional epidemiologist of Rush University in Chicago and her colleagues. The team observed that some foods were associated with a delay in the onset of Alzheimer’s disease while others contributed to an earlier onset of Alzheimer’s.

This is how they developed the term of the 10 “brain-healthy food groups” and the 5 unhealthy food groups.

Meet the 10 “brain-healthy food groups”: green leafy vegetables, other vegetables, berries, beans, nuts, poultry, olive oil, whole grains, fish and wine.

The 5 unhealthy food groups are: red meats, cheese, pastries and sweets, butter and stick margarine, fried or fast foods.

The 10 brain-healthy food groups are full of anti-oxidants, resveratrol and healthy fatty acids. They prevent hardening of the arteries and prevent the deposits of beta amyloid in the brain, which prevents Alzheimer’s disease. There is a bit of an issue about wine, which I have reviewed in this blog. You can replace wine with resveratrol extract as a supplement in order to get away from the toxic effect of alcohol, which is a cell poison. The choice is yours.

Why are the unhealthy foods unhealthy? There is too much trans fat in butter, cheese and margarine, which accelerate hardening of your arteries. The same problem exists with red meats, pastries and fried or fast foods. Sweets pose another problem: the sugar causes insulin levels in your blood to raise, which in turn causes inflammation in the support tissue of your brain, called glia cells, which secrete the beta amyloid that damages brain cells. At the same time sugar is metabolized by the liver into fat and triglycerides, which causes hardening of the arteries. The end result is earlier onset of Alzheimer’s.

According to Morris blueberries and strawberries, which are part of the brain-healthy food groups have been shown to be the most potent berries in terms of protecting against Alzheimer’s disease and preserving cognitive function.

With the late onset AD (=LOAD) that is the most common form of AD genetic factors hardly play a role. But what we eat will determine whether or not we get AD and we can postpone it significantly, if we eat mostly foods from the 10 brain-healthy food groups.

MIND Diet Helps Prevent Alzheimer’s

MIND Diet Helps Prevent Alzheimer’s

Conclusion

The MIND diet has been shown to be able to postpone the development of Alzheimer’s disease. It was developed based on the observation that some foods are good for us in terms of preserving cognitive function whereas others are bad. Knowing this it is advisable to eat mostly vegetables, poultry, fish, olive oil, nuts, beans, berries, whole grains, and some wine may be enjoyed as well. At the same time you need to avoid the bad foods mentioned above, like pastries, sweets, red meat, cheese and fast foods.

It is a small price to pay to keep your brain function until a ripe old age. The advantage with the MIND diet is that if you should occasionally deviate from the ideal, you still maintain a significant advantage over the DASH diet or the simple Mediterranean diet.

Reference:

1. Goldman’s Cecil Medicine, Twenty-Fourth Edition, Goldman, Lee, MD; chapter by David S. Knopman: Alzheimer’s Disease and Other Dementias, p. 2274-2283 Saunders 2012.

Jul
11
2015

Experiments On Humans With New Statin Drugs?

This article is about experiments on humans with new statin drugs. The FDA released new statin drugs for use on a high-risk segment of the population with genetically high cholesterol. This has the name familial hypercholesterolemia and runs in families. There was a fast track for these drugs strictly to treat a high-risk population. There was a completion of smaller trials, but the the FDA expects the results of larger trials only for 2017. This leaves the uncomfortable question, whether physicians should prescribe these newer statins despite the lack of completion of proper trials.  In other words, are we doing experiments on humans with the new statin drugs, when the final word regarding their safety is not out.

Introduction

There was a news release about this story. There are a number of new super cholesterol lowering drugs. Physicians administer them by injection. They reduce the LDL cholesterol fraction. Oxidation of LDL is what causes hardening of the arteries very quickly. What made the news right now is Amgen’s drug, evolocumab and Sanofi and Regeneron Pharmaceuticals’ drug, alirocumab. The traditional thinking is that when you lower the bad LDL cholesterol you would save the patient from heart attacks and strokes. I have blogged about the cholesterol story and statins in November 2013 pointing out that statins can hurt the consumer. One concerning side effect of statin therapy is myopathy, a painful muscle disorder where statins have to be discontinued.

We need to be cautious about simplifying cholesterol blood results

Cholesterol is vital for cell function, for insulation of nerve fibers (myelin sheaths) and for synthesis of our steroid hormones (sex hormones and vitamin D3, now considered to be a hormone). The medical establishment took most of the information regarding heart attack and stroke prevention from the ongoing Framingham study. This clearly pointed to the importance of lowering the LDL cholesterol fraction (the “bad” cholesterol) and maintaining or increasing the HDL fraction (the “good” cholesterol).

LDL delivers cholesterol to vital organs

LDL cholesterol is actually an important cholesterol fraction that the body uses as transport molecule to all vital organs like the heart, the skeletal muscles and the brain to replace lipids in cell membranes. It is inappropriate to label LDL cholesterol as the “bad cholesterol”. This is an oversimplification.

The assumption in the recent past was that LDL requires a reduction to prevent heart attacks and strokes. But strictly concentrating on this could hurt patients because vital organs require enough nutrients to replace their cell membranes. Without cell membranes there is no life!

Some details about what causes heart attacks and strokes

I like to explain how heart attacks and strokes develop. At the center of the problem is how hardening of the arteries develops. In the 1990’s and in the next decade, from 2000 to 2010 detailed research into this has been completed. It has shown that free radicals have a lot to do with hardening of the arteries. There is not one single cause, but a combination of multiple factors that cause hardening of the arteries. One of the key facts is that people in civilized countries consume too much sugar and starchy food. The digestive process of the gut metabolizes starch into sugar, which the blood absorbs. In response to all this sugar the pancreas secretes an overload of insulin every day.

High insulin levels cause inflammation

The high insulin levels cause inflammation, which releases a number of aggressive molecules that attack the lining of the arteries. Sugar also oxidizes the LDL cholesterol and the HDL cholesterol, which makes the LDL cholesterol more aggressive as it now reacts like a free radical. Macrophages take up the oxidized LDL cholesterol; they turn into fat-laden foam cells, which in turn burrow themselves under the lining of the arteries. Normally the HDL cholesterol incorporates oxidized LDL cholesterol and brings this to the liver for further processing. However, sugar oxidizes HDL itself and it loses its protective function. The end result is that there is an acceleration of the hardening of the arteries and when this reaches a critical point, a heart attack or stroke can occur.

We need to rethink how to prevent heart attacks and strokes

What struck me with the FDA decision is that they seem to doggedly hold on to the hypothesis that heart attacks and strokes develop from LDL cholesterol that is too high. If this were the case, statins would have worked wonders in terms of preventing heart attacks and strokes, yet the number one killer is still hardening of the arteries. What I wrote in my blog in November 2013 is still true.

The solution to preventing heart attacks and strokes may not be attractive to some, but it is found in a proper diet and exercise.

These points are important

  1. We need to cut out sugar and starchy foods. This includes grains. Kellogg’s and cohorts won’t be happy nor will be your friendly baker or the bakery department in your supermarket.
  2. A Mediterranean diet is now the gold standard and adding olive oil and nuts to it will be even more effective in reducing mortality from heart attacks and strokes.
  3. Exercise has been proven to elevate HDL cholesterol significantly, so why not do less sitting and do more moving? When you cut out sugar and starchy foods, HDL is fully functioning and this keeps the LDL cholesterol honest. This means that only LDL without oxidation reaches the vital organs for membrane exchange work, while HDL removes LDL with oxidation like a sponge and inactivates it in the liver.

Misleading statin trials without diet changes

This is all: a three-point approach with no statins and no super statins. Big Pharma does not like this, but the three-point approach was proven to be effective for several years (Ref. 1, 2 and 3).

What I find particularly concerning is the fact that most of the super statin trials will only come out with the full results in 2017. We witness that the FDA has approved these new super statins to be used on the most vulnerable people (familial hypercholesterolemia) on top of regular statins. I fail to see how vital organs can function, if the diet is not changed.

CoQ-10 is essential as a co-factor

It also disturbs me that the average physician does not recommend CoQ-10 as a supplement to counter at least some of the side-effects of statins and super statins. There was no such recommendation. I feel that the FDA allows patients with familial hypercholesterolemia to be subjected to a human experiment of this nature. They are receiving drugs that we do not fully know yet. After 2017 we will know whether they have reduced heart attack and stroke rates or not.

Experiments On Humans With New Statin Drugs?

Experiments On Humans With New Statin Drugs?

Conclusion

I remember very well from the 1980’s what the suggestions were treating patients with high cholesterol. Cholesterol-lowering drug guidelines told practicing physicians to first assess the patient’s diet and exercise status. If modifying these lifestyle factors were ineffective, we would then only be using the statin drugs to lower cholesterol levels. In the meantime the scenario has changed and experienced a complete reversal in terms of diets. The high carb /low fat diet has been replaced with the low carb/medium fat Mediterranean diet, which by itself can be very effective in reducing LDL cholesterol. Recently research has shown that adding olive oil and nuts can lower mortality from heart attacks and strokes even more. It seems that the FDA is completely ignoring all this research.

History teaches us

I think that physicians and patients alike would do well to remember the following. It all started with the introduction of sugar, starchy foods and processed foods into the civilized world about 100 years ago. This caused an increase of heart attacks and strokes because of the processes explained above. The real solution is the 3-point program suggested above. This will likely solve 80% to 90% of all cases of hardening of the arteries causing strokes and heart attacks. Physicians treated the rest cautiously with cholesterol lowering drugs, like the statins; however, there is no room for human experiments.

More info on arteriosclerosis (hardening of arteries).

References

1. Dr. Steven Masley, MD: “The 30-day Heart Tune-Up – A Breakthrough Medical Plan to Prevent and Reverse Heart Disease”, Center Street, A Division of Hachette Book Group Inc. New York, Boston, Nashville, USA © 2014

2. David Perlmutter, MD: “Grain Brain. The Surprising Truth About Wheat, Carbs, And Sugar-Your Brain’s Silent Killers.” Little, Brown and Company, New York, 2013.

3. William Davis, MD: “Wheat Belly Cookbook. 150 Recipes to Help You Lose the Wheat, Lose the Weight, and Find Your Path Back to Health”. Harper Collins Publishers LTD., Toronto, Canada, 2012.

Jun
20
2015

Seventeen Causes Of Blood Vessel Disease

This article is about seventeen causes of blood vessel disease. We tend to ask the question: “What is the cause of blood vessel disease”? Would you have expected that at this point there are not just one cause, but seventeen causes of blood vessel disease identified that can all be treated? In the May 2015 issue of the Life Extension Magazine one of the causes, high homocysteine has been stressed as being an important risk factor that not every health professional has yet appreciated.

In the following overview I will briefly address all of the risk factors for cardiovascular disease and then summarize what can be done to prevent heart attacks and strokes.

17 risk factors of blood vessel disease

1. Excess cholesterol: Too much cholesterol can lead to clogged arteries. When we eat too much red meat too often, this extra dietary cholesterol can elevate your total blood cholesterol.

2. High LDL cholesterol: The LDL cholesterol is often labeled the “bad cholesterol”. In reality it is the cholesterol that is being transported from the liver to all of the body cells, which utilize it to replace the aging membranes that envelop the cells. What is important to know is that sugar and starchy foods (pasta, cakes, cookies, noodles, white rice, potatoes, pizza, muffins etc.) lead to a surge of blood sugar, which stimulates the liver to produce more LDL cholesterol. Any excess sugar in the blood will oxidize the LDL cholesterol, which leads to accelerated hardening of the arteries.

Low HDL cholesterol

3. Low HDL cholesterol: HDL is the type of cholesterol that is transported from the cells back to the liver. Any oxidized LDL cholesterol is also mopped up by HDL cholesterol. HDL cholesterol has been dubbed the “good cholesterol”. It is important that LDL and HDL cholesterol are balanced. It is noteworthy that HDL cholesterol is much higher in athletes and those who exercise on a regular basis (like 5 to 7 times per week). This means that there is a surplus of the protective HDL cholesterol, which prevents hardening of the arteries.

4. Oxidized LDL: As explained above sugar and starchy foods oxidize cholesterol, so does radiation. A Mediterranean diet including olive oil will stabilize your metabolism and protect LDL from being oxidized.

High blood sugar

5. High blood sugar: In pre-diabetes and diabetes, the blood sugars are high, but they are normal in people with a normal metabolism. As explained before it is this scenario, which leads to oxidation of LDL cholesterol and accelerated hardening of arteries. This is the reason why diabetics have severe blood vessel disease with closure of major arteries like the one going to the legs. If arterial by-pass surgery is not feasible because of the severity, often a physician has no other choice but to amputate a lower leg.

6. Excess triglycerides: People with excessive weight have a change in metabolism called metabolic syndrome, where triglycerides are high. But diabetics also often have high triglyceride levels in their blood. This is an independent risk factor to develop hardening of the arteries.

Chronic inflammation

7. Elevated C-reactive protein: Dr. Paul Ridker published a landmark study in 2002 where he concluded that the blood test C-reactive protein was a reliable indicator to identify people who were at risk of developing a heart attack. It measures inflammation in the body. What is inflamed here is the lining of the arteries from oxidized LDL cholesterol. You can see a pattern. Some of these points are actually connected.

8. Low blood EPA/DHA: Essential fatty acids are not contained in processed foods. Instead the food industry puts omega-6-fatty acids into processed foods, as this is much cheaper and leads to a longer shelf life of the processed food products. Omega-6 fatty acids are the precursor for arachidonic acid, which causes inflammation, hardening of the arteries and arthritis. By introducing fish oil or wild salmon two or three times per week you can achieve a counter balance to omega-6-fatty acids. Our bodies want us to balance omega-6 fatty acids with omega-3.

Excess insulin

9. Insulin is too high: with type 2 diabetes there is a high fasting insulin level. This leads to inflammation of the blood vessel wall and triggers accelerated hardening of the arteries. It also causes narrowing of the brain arteries, and as a result the brain develops Alzheimer’s and dementia. Alzheimer’s now also has the name “type 3 diabetes”. An overweight or obese person who cuts out sugar in the diet and exercises can often control excessive weight, lower insulin and normalize cognitive deficits.

10. Excess fibrinogen: Your liver produces blood clotting factors and fibrinolytic factors that circulate in the blood balance this. In certain conditions like diabetes, or the metabolic syndrome there is too much fibrinogen production. This can lead to blood clots.

Excess homocysteine

11. Homocysteine blood level too high: Some people are born with gene defects that program our cells to run abnormal biochemical reactions in our cells. Correct methylation pathways are important for normal cell function. However, if there is a methylation defect, abnormalities set in and homocysteine accumulates. As we age, there is also a weakening of certain enzymes that facilitate the methylation pathway. With any of these enzyme defects you need to use appropriate supplements to normalize this metabolic defect. Vitamin B2, B6 and B12 supplementation will often stabilize methylation defects and homocysteine levels return to normal. Methyl folate 1 mg per day is also very useful. Some people in older age cannot metabolize folate very well. This is important as severe, familial cardiovascular disease, where people often suffer heart attacks during the best years in their lives, can be postponed this way by several years or decades.

High blood pressure

12. High blood pressure: Many people are not aware that high blood pressure is a disease where inflammation of the lining of the arteries leads to a lack of production of nitric oxide. Nitric oxide is a signaling substance contained in many vegetables, particularly in red beets. Nitric oxide is the body’s tool to keep blood pressure normal by widening the diameter of arteries. High blood pressure leads to accelerated hardening of the arteries, because the oxidized LDL cholesterol deposits itself right under the diseased lining of the arteries. Just lowering the blood pressure with medications will not remove the other risk factors; the physician will tell the patient that they have to address them separately. Nutritional researchers developed the DASH diet as a tool to lower elevated blood pressure.

Low nitric oxide

13. Low nitric oxide: Too much sugar and starch in one’s diet cause oxidation of LDL cholesterol as explained and this causes a dysfunction of the lining of the arteries resulting in less production of NO (nitric oxide). The lack of nitric oxide causes constriction in the arteries throughout the body, which will in turn elevate the blood pressure. Exercise will also lead to more nitric oxide production, but the right diet is the other factor. There is a supplement you can buy, called NEO40. The dosage is one or two Neo40 per day as a supplement, available on Amazon in the US, in health food stores in Canada. But make no mistake: it’s not about supplements; it is about the proper diet and lifestyle!

Low vitamin D3 intake and low vitamin K2 consumption

14. Vitamin D3 deficiency: I have blogged about the importance of vitamin D3 before. Researchers now consider vitamin D3 as a hormone, as all cells have receptors for this molecule. It has anti-inflammatory qualities. It helps in the prevention of heart attacks and strokes.

15. Low vitamin K2: In this blog I have explained that vitamin K2 and vitamin D3 co-operate in removing calcium from the blood and transporting it into the bone. This way they both help in the prevention of osteoporosis. A co-factor in the prevention of osteoporosis is estrogen in women and testosterone in men.

Low testosterone

16. Low free testosterone: Researchers established low free testosterone as an independent risk factor for heart attacks and strokes. In the man there are a lot of testosterone receptors located in the heart and in the brain; this explains why with a lack of testosterone there is not only erectile dysfunction, but also the risk of developing a heart attack or a stroke.

High estrogen

17. Excess estrogen: When a woman approaches menopause, her menstrual cycles can become irregular due to the fact that there are anovulatory cycles, and the progesterone production is starting to slow down. Dr. John Lee gave this hormonal state the name “estrogen dominance“, because estrogen dominates over progesterone. In other words, the ratio of progesterone over estrogen is less than 200 to 1 (progesterone/estrogen ratio) when the physician measures saliva hormone levels. This is a risk factor for hardening of the arteries. In males with a “beer belly” there is too much estrogen floating around due to an enzyme in fatty tissue, called aromatase. This enzyme manufactures estrogen out of testosterone and contributes along with other factors to causing heart attacks in that scenario.

How can we protect ourselves from these factors?

As already indicated above, there are lifestyle issues that need to be addressed as follows.

  1. First adopt a healthy diet, such as the Mediterranean diet, which includes olive oil. No sugar, no bread, pasta, potatoes, and go extremely easy on certain fruit that is high in sugar, such as dried fruit, mango, bananas and grapes, because we do not want to oxidize our LDL cholesterol for reasons explained already.
  2. Exercise regularly. If you like, go to a gym (my wife and I do this regularly). If you are insecure, ask a trainer initially to guide you through the exercise equipment. It really is not that difficult to do. You develop a routine that is good for you. Alternatively, you may want to go for a brisk walk, run or participate in dancing. If you find a particular activity boring, rotate the activities, but do not skip days, let alone weeks! Remember that your heart works 24/7!
  3. Take some vitamins and supplements: I mentioned the importance of vitamin B2, B6, B12 and methyl folate before. Take vitamin D3 in a good dose like 5000 IU per day or more and vitamin K2 200 micrograms per day. Omega-3 supplements (EPA/DHA) are very useful to keep inflammation under control. For more on vitamins and supplements follow this link.
  1. Have your hormones checked. Some doctors do not feel comfortable about this; maybe you want to see a naturopath about it instead. Your body needs the hormone receptors satisfied by adequate bioidentical hormone levels; otherwise you age prematurely and give up body functions that you would rather keep. Normal hormone levels prevent osteoporosis, premature hardening of the arteries, Alzheimer’s, erectile dysfunction and premature wrinkles.
Seventeen Causes Of Blood Vessel Disease

Seventeen Causes Of Blood Vessel Disease

Conclusion

All of these 17 factors explained above are independent risk factors for developing hardening of the arteries, which affect mainly the heart, brain and kidneys. All you need is one of these factors, and you could develop a heart attack, stroke or kidney failure. You have no problem accepting a preventative maintenance program for your car. Think of having appropriate tests at least once a year done through your doctor. There are blood tests available to monitor hormone and vitamin levels, as well as C-reactive protein and homocysteine levels. Here are also three tests that will assess your heart function.

Your doctor may not order the tests spontaneously. Ask for it!

More info about heart attack prevention: http://nethealthbook.com/cardiovascular-disease/heart-disease/heart-attack-myocardial-infarction-or-mi/prevention-heart-attack/

More info about stroke prevention: http://nethealthbook.com/cardiovascular-disease/stroke-and-brain-aneurysm/stroke-prevention/

More on arteriosclerosis (blood vessel disease):http://nethealthbook.com/cardiovascular-disease/heart-disease/atherosclerosis-the-missing-link-between-strokes-and-heart-attacks/