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HEALTH
The Startling Link Between Sugar and Alzheimer's
A high-carb diet, and the attendant high blood sugar, are associated with cognitive
decline.
OLGA KHAZAN
JAN 26, 2018
Cupcakes
TIM WIMBORNE / REUTERS
In recent years, Alzheimer’s disease has occasionally been referred to as “type 3”
diabetes, though that moniker doesn’t make much sense. After all, though they share
a problem with insulin, type 1 diabetes is an autoimmune disease, and type 2
diabetes is a chronic disease caused by diet. Instead of another type of diabetes,
it’s increasingly looking like Alzheimer’s is another potential side effect of a
sugary, Western-style diet.
In some cases, the path from sugar to Alzheimer’s leads through type 2 diabetes,
but as a new study and others show, that’s not always the case.
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According to Schilling, this can happen even in people who don’t have diabetes yet—
who are in a state known as “prediabetes.” It simply means your blood sugar is
higher than normal, and it’s something that affects roughly 86 million Americans.
In a 2012 study, Roberts broke nearly 1,000 people down into four groups based on
how much of their diet came from carbohydrates. The group that ate the most carbs
had an 80 percent higher chance of developing mild cognitive impairment—a pit stop
on the way to dementia—than those who ate the smallest amount of carbs. People with
mild cognitive impairment, or MCI, can dress and feed themselves, but they have
trouble with more complex tasks. Intervening in MCI can help prevent dementia.
But she says there are several theories out there to explain the connection between
high blood sugar and dementia. Diabetes can also weaken the blood vessels, which
increases the likelihood that you’ll have ministrokes in the brain, causing various
forms of dementia. A high intake of simple sugars can make cells, including those
in the brain, insulin resistant, which could cause the brain cells to die.
Meanwhile, eating too much in general can cause obesity. The extra fat in obese
people releases cytokines, or inflammatory proteins that can also contribute to
cognitive deterioration, Roberts said. In one study by Gottesman, obesity doubled a
person’s risk of having elevated amyloid proteins in their brains later in life.
Roberts said that people with type 1 diabetes are mainly only at risk if their
insulin is so poorly controlled that they have hypoglycemic episodes. But even
people who don’t have any kind of diabetes should watch their sugar intake, she
said.
“Just because you don’t have type 2 diabetes doesn’t mean you can eat whatever
carbs you want,” she said. “Especially if you’re not active.” What we eat, she
added, is “a big factor in maintaining control of our destiny.” Roberts said this
new study by Xie is interesting because it also shows an association between
prediabetes and cognitive decline.
“Alzheimer’s is like a slow-burning fire that you don’t see when it starts,”
Schilling said. It takes time for clumps to form and for cognition to begin to
deteriorate. “By the time you see the signs, it’s way too late to put out the
fire.”
We want to hear what you think about this article. Submit a letter to the editor or
write to letters@theatlantic.com.
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