Monday, March 28, 2016

Sugar, Obesity and Alzheimer’s: A National Crisis

The CDC is correct in calling attention to a health condition, prediabetes, afflicting 86 million Americans. Laudably, they have publicized lifestyle programs in community centers, pharmacies, faith based organizations and online to reverse this condition.  Prediabetes is officially defined by the American Diabetic Association as having an elevated A1C level of 5.7 or more, but less than 6.5, the level at which diabetes is diagnosed. A1C measures blood sugar over the past two or three months. The goalposts for diagnosis have shifted; not long ago you needed to have a level of 6.0 to be called prediabetic and 7.0 to be diabetic. Diabetes can be prevented and in many instances reversed by proper nutrition and exercise.

The prevention of diabetes is extremely important as a public health measure. In the US, we will be spending billions of dollars on diabetes care in coming decades. There is increasing recognition that diabetes and Alzheimer’s disease are inextricably related. In fact, the concept that Alzheimer’s is Type 3 diabetes has been around for a decade. Type 1 diabetes develops from childhood and Type 2 is adult onset (although many children are now getting Type 2 diabetes). The cost of Alzheimer’s in the US in 2015 was $226 billion. There are new initiatives for reversing Alzheimer’s, mainly with lifestyle modification. Blood sugar control is a central aspect of these programs. In the Bredesen protocol, which reversed 6 out of 7 cases of early Alzheimer’s in a pilot program, the AIC goals was 5.3, much stricter than the current prediabetes marker.

In fact, even before blood sugar problems are detectable, there can be dysfunction in the beta cells of the pancreas causing insulin resistance.  Before diabetes with actual insulin deficiency develops, high insulin levels can occur due to lack of sensitivity to insulin. Insulin resistance is the major cause of obesity. The epidemic of obesity, with a large percentage of the U.S. youth unfit for military service, has profound implications for our combat readiness and national security. Obesity is also a big factor in the poor U.S. ranking in maternal mortality statistics. Insulin resistance can damage the brain even before blood sugar rises, and is a contributing factor to cancer, cardiovascular disorders and hormonal infertility.

No comments:

Post a Comment