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Feb 18

(Note - when I say keep blood sugar levels low - I mean within the acceptable human range, but try for the low end of the spectrum (see below for the ranges). Additionally, try to halt the normal age related increase of blood sugar levels - and keep your levels in the young and healthy range)

Another very simple brain hack for better memory and cognitive function is do what you can to keep low, safe blood sugar levels. Sure someday we might develop drugs to improve your cognitive ability, but you can do something right now to increase your brain ability and that is not to let your blood sugar levels get too high.

Previous research has indicated that diabetics are 1.5 more likely to experience a cognitive decline and dementia (Cukierman et. al., 2005). I don’t think any of you would want to develop dementia. Beyond the increase in dementia in people with diabetes there is also an increase in incidence of Alzheimer’s disease. So what should you do - exercise and eat well so you don’t develop type II diabetes. Lower your intake of carbohydrates, of the carbs you eat try to insure they are low glycemic. And yes volume counts. Instead of just thinking of glycemic index you should think of glycemic load, which is simply glycemic index x the number of grams of carbs for a particular food.

In a new study examining 2,997 diabetics researchers explored the relationship between blood glucose levels (A1C levels) and the performance of 4 cognitive tasks (Cukierman-Yaffe et. al., 2009).

 

A simple 1% increase in blood sugar levels was linked with lower scores in memory, multiple task management, global cognitive function, and psychomotor speed. Hence, you can see that there was a global decrease in mental ability in those with higher blood sugar levels. The researchers will subsequently examine if lowering blood sugar levels can improve the cognitive ability.

Take home message:

What else can I say to convince you that you must strive to keep your blood sugar levels in the healthy range. Some would even argue if you want to decrease you mental aging you should try for the low end of normal.

Question?

Do you even know your blood sugar levels? Or maybe you know one reading - but like blood pressure measurements there can be large difference depending on what you are doing, time of day, and for blood sugar levels obviously when and what you last ate.

One simple and fairly cheap solution to this is that you can buy a blood glucose meter from any drug store and they are realitively cheap (they make money selling the test strips). Go out and buy one and periodically test your blood sugar levels. The simplest measurement you should obtain is your overnight fasting level. This is the one you can best compare to the published and ‘normal range’ levels.

Background info - normal blood sugar values:

Despite widely variable intervals between meals or the occasional consumption of meals with a substantial carbohydrate load, human blood glucose levels normally remain within a remarkably narrow range. In most humans this varies from about 80 mg/dl to perhaps 110 mg/dl (3.9 to 6.0 mmol/litre) except shortly after eating when the blood glucose level rises temporarily (up to maybe 140 mg/dl or a bit more in non-diabetics).

There are many other times that you might find it useful to see what your blood sugar levels are - e.g. after various meals. You can develop your own individual glucose response to foods. Are you getting large spikes after eating X, etc? I will discuss more about this in another piece.

And you might want to consider lowering your carb intake, and of the carbs you eat pick low glycemic ones. You could try a Mediterranean based diet (which is already linked with improved cognitive ability), or any other diet that keep your blood glucose levels at a nice low healthy level.

Very simple daily healthy choices in food selection could go along way in keeping your blood sugar levels low and hence maintain your current cognitive ability - what could be more important than keeping your brain functioning normally.

 

Dec 31
Two mice; the mouse on the left has more fat s...
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Lifestyle diseases are the ones we induce on ourselves by how we live our lives. They include being overweight/obese, insulin resistance, metabolic syndrome, type II diabetes (really a spectrum here), all leading to increased cardiovascular disease (and a number of other deadly diseases such as cancer, but to a lesser amount).

The easy solution to all of these is simple lifestyle changes – exercise and healthy eating. However, despite the well known ‘simple’, virtually no cost solutions most people fail. They want their cake and eat it too. They want to be healthy but they do not want to actually do anything about it.

A new paper might offer a potential solution.

Morino et. al., 2008 (PLOS one: freely available) examined if mild electrical stimulation (MES) combined with heat shock (HS) (not as bad as it sounds) could alleviate insulin resistance and obesity in a mouse model of diabetes.

Previous research with direct-field electrical stimulation have demonstrated decreased inflammation, better bone healing, reduction in pain, and inhibition of tumor growth (so don’t think of cell phones and electrical lines in this context of electrical stimulation) (see introduction of paper).

Experiment:

Twice a week the animals received 10 minutes of treatment (12 V (0.1 ms pulse duration) together with ‘heat shock’ at 42 degrees Celsius),(just for your information a hot tub is usually in the 38 to 40 range) or the individual treatments by themselves for a 12 – 15 week period. The researchers point out that the electrical simulations were ‘well tolerated and did not cause pain or annoyance behavior in the mice’ – the animals would sit still or doze off.

Two different strains of mice were used. One was fed a high-fat diet (which is typical for these types of paradigms) and in the other a leptin receptor deficiency causes them to overeat, and within one week after the initiation of the diet the treatment would start.

After 12 weeks on the diet (and treatment) the mice receiving the HS or the HS + MES had lower fasting glucose levels compared to the control group. However, fasted insulin levels were not lower in the HS group compared to controls, but the HS + MES group did have lower levels. In a glucose tolerance test (insulin sensitivity test) the HS + MES group had better glucose tolerance (quicker removal from blood stream) than the other groups. Another test for insulin resistance (HOMA-IR index – which is really fasting blood glucose x fasting insulin/22.5) was also significantly improved in the combined treated group.

Food intake or body weight did not differ between all the groups. Meaning that the treatment did not cause the animals to eat less – thereby the treatment positive effects are not simply due to a reduction of food intake.

They basically repeated the study for a longer period of time (25 weeks) to see if it would work in the more chronic setting. The combined treatment produced all the same results and additionally reduced the levels of TNF-alpha.

They also found that the serum levels of adiponectin (an adipocytokine secreted by fat tissue) were increased in the treated rats. Adiponectin is widely recognized to be inversely correlated with the amount of fat. Therefore, the researchers decided to investigate the amount of adipose tissue in the groups. White adipose tissue was reduced in the combined treated animals compared to the controls along with a reduction in the cell size of the adipocytes. More importantly visceral fat was decreased. Additionally, the brown fat (which burns calories to produce heat - called thermogenesis) expression of uncoupling protein one (UCP-1) was increased in the combined treated group, which would help explain the overall results.

In a second model of type II diabetes db/db mice (leptin receptor deficiency so they become obese) were used and the same overall results observed.

Interestingly, and intriguing is they tried the same treatment in standard fed mice which do not develop obesity and reported no differences in any of the above mentioned measurements (e.g. fasting glucose, insulin) between the control group and the HS + MES group.

They further tested which pathways they think the treatment is working through but I won’t go into those details here, but will present the authors summary of this part:

The effect of HS+MES on insulin signaling is likely through the capacity of electrical signal to trigger the activation of Akt (Fig. 8, [8]) and of HS to up-regulate Hsp72, which in turn inhibits JNK and activates the insulin signaling pathway (Fig. 4C, Fig. 9 [24,41]). Although the core body temperature of the mice was less than 42 C, the method of mild HS that we used was enough to induce the expression of Hsp72 (Fig. 4D).

One caveat:

The HS + MES treatment started within one week after the initiation of the high fat diet. We do not know if this treatment would ‘reverse’ the effect if started in the normal human situation – after they have become obese and insulin resistance or diabetic. However, in the db/db mice because of the genetic reduction in leptin receptor it could be argued the animals are on their way already when the treatment started (but I am not familiar enough with this transgenic strain to fully comment).

An interesting experiment would be too test this treatment further along the progression of insulin resistance/diabetes/obesity. But we know exercise and serious changes in diet can have dramatic effects on these conditions, so it is still possible that the HS + MES could work even if started after the condition is full blow – but it wasn’t tested in this paper.

Could we translate this to humans?

The authors point out the low levels of electrical stimulation as well as heat shock are used in the clinical setting. However, I would point out in both of these situations (from the references I read) the treatments were for relatively short time periods. In the treatment outlined above for the human situation, assuming the individuals are going to continue with an unhealthy lifestyle it would suggest they would have to continue with the treatment indefinitely. The long term health consequence would have to be studied – but it appears to be positive based on the above results as the animals were treated for a relatively long period of time (and no negative effects observed in the normally fed animals – but also no positive effects).

Of course in reality the goal is to live a healthy lifestyle so you do not develop these lifestyle linked diseases - but if you are unable to live a healthy lifestyle this might an option in the future - but it should be a last action of last resort.

Jun 27

New data released from CDC indicates that the number of cases of diabetes in USA has risen to 24 million (2007), up from 21 million 2 years ago (2005). Now, 8 % of the American population have diabetes. A further 57 million Americans are in the pre-diabetic stage, which makes this group prone to developing full blown diabetes. That would make a total of 81 million Americans being diabetic or pre-diabetic out of the 303 million population, a startling 25.7 % of the population.

The latest headlines about the obesity rate in America for teens claim great headlines about the rate leveling off. That is almost comical because all that means is that the rate is not rising as fast. The rate of obesity is still increasing, so not sure if people should be celebrating. 32 % of Americans kids still remained overweight or obese. With that high of a percentage of overweight children what do you think is going to happen to diabetes rate when these children hit adulthood or middle age?

As for American adults an article from 2007 indicates that 66% are overweight or obese (2003-4 data). According to the CDC website 33.3 % of men and 35.3% of women are obese. And remember these adults were not at the same level of obesity as the children of today, so again what will happen to these adult numbers when the current children become adults?

Gasoline, as we are all painfully aware of keep skyrocketing, with new record highs it seems almost everyday. On June 26th 2008 oil prices his just below $ 140 per barrel and speculation of $ 170 by the end of summer (update: today oil hit $ 142).

Obvious thought, why doesn’t America do a little less driving and a bit more walking. Lose weight, reduce the prevalence of diabetes, and save money and oil. Additionally, don’t you think carrying all those extra pounds add up to reduced gas mileage?

Not practical many would arguie, instead we are inventing more ways to make us lazy, such as power assisted luggage.

Funny how the models they used don’t represent the population of people that would really be using such a device. I thought the general idea of wheeled luggage and backpack devices was misguided to begin with. Carry the weight get some exercise.

What are the current trends: rising diabetes, obesity is not going away, rising oil prices, but we keep on wanting to reduce our bodies energy output. Does this compute ?

Well for you the betterment of your pocket book and health, why not this summer trying to increasing overall body energy output, for example by walking a bit more, and driving less.

What do you have to lose, other than some weight and more money in the bank. Even if you don’t need to lose weight (33 % of the population) I am sure getting in better shape would be good for your general health and you can still use the extra money.

Have a good weekend, get outdoors and enjoy the summer.