Wednesday, August 8, 2012

This is your brain on diabetes, or not.

If you are someone who has a family history of a chronic debilitating disease, chances are you are looking (actively or not) for ways to prevent this disease in your own body and any progeny you have.  Some diseases definitely seem more frightening to us than others, and one disease that really strikes fear into the hearts of those who have dealt with it is Alzheimer's disease (AD).  As mentioned before, SkepticRD works with an elderly population and I get to see what the caregivers of people with disease go through, and I’ve seen other people constantly doing puzzles or other things to engage their mind and hopefully prevent the onset of this.  Many people are also interested in dietary approaches to prevention, so I was interested when I saw this articleshared by a friend.
The usual alarm bells go off in my head.  The main alarm comes from past history of dealing with the emotional appeal of this disease; typically when something frightens us as humans it can be very easy to let our fear over ride our logic.  One of the other alarms that went off was because the author of this blog is, to put it mildly, not exactly fond of science.  He has written at least one article excoriating skeptics, including such statements as “Skeptics believe that thehuman body has no ability to defend itself against invading microorganism and that the only things that can save people from viral infections are vaccines.” (Link) Those of you who have been following my blog will know that I have already expounded on how our body has evolved to defend itself, but otherwise SkepticRD will not take the time to refute all of his points in this blog post, although I might at some later date.  Otherwise you can read my blog and look through some other blogs like, the Skeptical Raptor,, or even do a search for the names Dr. Harriet Hall, Dr. Michael Shermer, or Dr. David Gorski to get an idea for yourself of what Skeptics accept based on evidence.   In the meantime, let’s have a quote from Michael Shermer:
 “When lecturing on science and pseudoscience at colleges and universities, I am inevitably asked, after challenging common beliefs held by many students,`Why should we believe you?’ My answer: ‘You shouldn't.'  I then explain that we need to check things out for ourselves and, short of that, at least to ask basic questions that get to the heart of the validity of any claim.”

The other thing that set off alarm bells is when they talked about a study published in “The Journal of Alzheimer’s Disease.” Sounds good, but I had to do a little digging to find out whether or not this was a peer-reviewed journal, meaning that it has been subjected to review by others in the field to help maintain certain standards.  We were ok on that front, and it appears Rhode Island Hospital is also a legitimate place.  SkepticRD actually had to do a little more digging to find the actual studies that this article was referring to, and after some Googling found that the studies published were from….seven years ago.  (1, 2).  Now, I'm not saying that research done 7 years ago can't still be relevant, but once again, the fact that the author of this article is plying this as "new research" should raise some more red flags that somebody might be pushing an agenda here.

Since the author of this article didn't link the relevant information, there may have been an assumption here that people weren't actually going to read the article (I've lost count of the red flags here).   SkepticRD was able to read some of the full research articles online, however, and it seems that they may have not wanted you to read them because they draw false equivalencies.  There's this quote from the article, for example "having found in her research that diabetes is closely associated with several key neuronal factors implicated in dementia."  If you read through her research, you will find that there isn't enough data to say that Type 2 diabetes provides a causative effect for Alzheimer's disease and that this "Type 3 diabetes is completely separate from Type 1 and Type 2 diabetes."(Link)  Now, there is data that shows that poorly controlled diabetes is associated with cognitive impairment, but not the same pathology associated with Alzheimer's disease.   Just because there might be a correlation with Type 2 diabetes does not mean there is a causation!

There is another suspicious quote in the article, supposedly from Dr. DeLaMonte herself, that ends with "Restoring insulin responsiveness and insulin depletion will help, but we need to reduce brain stress and repair the metabolic problems that cause the brain to produce toxins."
First of all, I cannot find any other place on the internet that she said this.  Second of all, any physician and researcher that actually has any credibility would not use the unscientific/vague term "toxins."  This person has actually done research into possible link between nitrates in the food supply and the development of chronic diseases, and did actually use the word "detoxify" in the context of removing said compounds from the water supply (a legitimate use of the term), but it just doesn't make sense that someone would risk their credibility by saying this. (Link).  And also, she mentions that ""The implication is that treating type 1 or type 2 diabetes may have no impact on Alzheimer's disease. We believe that therapeutic agents need to be designed that specifically influence the actions of insulin in the brain." In other words, dietary measures taken to control Type 1 or Type 2 diabetes will not impact Alzheimer's disease, and she is actually advocating the use of pharmaceuticals to treat it. (1, 2

Now we really start to go off the rails: "Since many elderly individuals that have been diagnosed with Alzheimer's take statin drugs to lower their cholesterol levels, the first logical step would be to stop taking these drugs. Not only have statins been shown to cause and exacerbate Alzheimer's, they have also been shown to cause diabetes. So taking them, as many elderly dementia patients do, runs contrary to common sense, and will only make the problem worse."  First of all, there is no data to support the "many patients" statement.  It is 90%, or 50%, or 75% or what?  How do you know?  And there is no evidence that statin's cause AD or any other form of dementia.  Yes, there have been people who have experienced memory impairment on statins, but this is not the same as "dementia" which is a long standing chronic condition.  (Link)

And then? "Consuming more healthy saturated fats like coconut oil can not only help repair the inflammation problem that promotes the progression of Alzheimer's, but it can also increase the absorption of cholesterol in the brain, which in turn promotes healthy neuronal function."  Notice the only reference that they give is to their own website, and they are using the "miracle" story of one person who ate coconut oil and his Alzheimer's was "cured."  No scientific evidence given, again.
Finally, there very last statement of the article was this: "There has also been tremendous success in controlling and eliminating diabetes through a low-carb and high-fat diet."    Ok, but remember, we are talking about a condition SEPARATE from Type 2 diabetes here.  What they might be referring to in relation to "Type 3 diabetes" is about three years ago there was a study published that states using a ketogenic diet is "a promising new area of research" in AD.  Promising, yes.  Tremendous success and an elimination of Alzheimer's disease, no. (Link).  Also, not to be a complete Negative Nelly, but if a ketogenic diet does show promise I wonder how well this is going to be implemented.  Anyone who has worked with or cared for someone with dementia knows that sometimes they lose their appetite, sometimes they forget to eat, sometimes they go on "food jags" where they only want to eat one thing, and some people might have trouble chewing protein foods.  I know there are dedicated caregivers out there who will fight the battle of keeping their elderly parent/spouse, etc away from the bread and other carbohydrate foods that the person is asking for (or angrily demanding), but it can be difficult to take away dessert from your 88 year old grandmother who has enjoyed dessert her entire life.

Take away message—if you are at risk for Type 2 diabetes or already have it there are many excellent reasons to keep the blood sugar under control and avoid diabetes complications (like blindness, kidney disease, etc).  There isn't enough evidence to state that Type 2 diabetes or peripheral (body) insulin resistance will lead to Alzheimer's disease.  And of course, be very, very careful when people try to give you information on such a heart wrenching disease, as they might be counting on you not using your mind.

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