The Surprising Link Between Type 2 Diabetes & Alzheimer’s
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The Surprising Link Between Type 2 Diabetes & Alzheimer’s
This is Dr. Rhonda Patrick. She’s a biomedical scientist with expertise in the areas of aging, cancer, and nutrition. In the past five years she has expanded her research of aging to focus more on Alzheimer’s and Parkinson’s, as she has a genetic predisposition to both.
What does that genetic predisposition look like? People who (like her) have the APOE-ε4 allele have a twofold increased risk of Alzheimer’s disease—and if you have two copies (i.e., one from each of two parents), the risk can be up to tenfold. Globally, 13.7% of people have at least one copy of this allele.
So while getting Alzheimer’s or not is not, per se, hereditary… The predisposition to it can be passed on.
What’s on her mind?
Dr. Patrick has noted that, while we don’t know for sure the causes of Alzheimer’s disease, and can make educated guesses only from correlations, the majority of current science seems to be focusing on just one: amyloid plaques in the brain.
This is a worthy area of research, but ignores the fact that there are many potential Alzheimer’s disease mechanisms to explore, including (to count only mainstream scientific ideas):
- The amyloid hypothesis
- The tau hypothesis
- The inflammatory hypothesis
- The cholinergic hypothesis
- The cholesterol hypothesis
- The Reelin hypothesis
- The large gene instability hypothesis
…as well as other strongly correlated factors such as glucose hypometabolism, insulin signalling, and oxidative stress.
If you lost your keys and were looking for them, and knew at least half a dozen places they might be, how often would you check the same place without paying any attention to the others?
To this end, she notes about those latter-mentioned correlated factors:
❝50–80% of people with Alzheimer’s disease have type 2 diabetes; there is definitely something going on❞
There’s another “smoking gun” for this too, because dysfunction in the blood vessels and capillaries that line the blood-brain barrier seem to be a very early event that is common between all types of dementia (including Alzheimer’s) and between type 2 diabetes and APOE-ε4.
Research is ongoing, and Dr. Patrick is at the forefront of that. However, there’s a practical take-away here meanwhile…
What can we do about it?
Dr. Patrick hypothesizes that if we can reduce the risk of type 2 diabetes, we may reduce the risk of Alzheimer’s with it.
Obviously, avoiding diabetes if possible is a good thing to do anyway, but if we’re aware of an added risk factor for Alzheimer’s, it becomes yet more important.
Of course, all the usual advices apply here, including a Mediterranean diet and regular moderate exercise.
Three other things Dr. Patrick specifically recommends (to reduce both type 2 diabetes risk and to reduce Alzheimer’s risk) include:
(links are to her blog, with lots of relevant science for each)
You can also hear more from Dr. Patrick personally, as a guest on Dr. Peter Attia’s podcast recently. She discusses these topics in much greater detail than we have room for in our newsletter:
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Fixing Fascia
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Fascia: Why (And How) You Should Take Care Of Yours
Fascia is the web-like layer of connective tissue that divides your muscles and organs from each other. It simultaneously holds some stuff in place, and allows other parts to glide over each other with minimal friction.
At least, that’s what it’s supposed to do.
Like any body part, it can go wrong. More on this later. But first…
A quick note on terms
It may seem like sometimes people say “myofascial” because it sounds fancier, but it does actually have a specific meaning too:
- “Fascia” is what we just described above
- “Myofascial” means “of or relating to muscles and fascia”
For example, “myofascial release” means “stopping the fascia from sticking to the muscle where it shouldn’t” and “myofascial pain” means “pain that has to do with the muscles and fascia”. See also:
Myofascial vs Fascia: When To Use Each One? What To Consider
Why fascia is so ignored
For millennia, it was mostly disregarded as a “neither this nor that” tissue that just happens to be in the body. We didn’t pay attention to it, just like we mostly don’t pay attention to the air around us.
But, much like the air around us, we sure pay attention when something goes wrong with it!
However, even in more recent years, we’ve been held back until quite new developments like musculoskeletal ultrasound that could show us problems with the fascia.
What can go wrong
It’s supposed to be strong, thin, supple, and slippery. It holds on in the necessary places like a spiderweb, but for the most part, it is evolved for minimum friction.
Some things can cause it to thicken and become sticky in the wrong places. Things such as:
- Physical trauma, e.g. an injury or surgery—but we repeat ourselves, because a surgery is an injury! It’s a (usually) necessary injury, but an injury nonetheless.
- Compensation for pain. If a body part hurts for some reason, and your posture changes to accommodate that, doing so can mess up your fascia, and cause you different problems somewhere else entirely.
- This is not witchcraft; think of how, when using a corded vacuum cleaner, sometimes the cord can get snagged on something in the next room and we nearly break something because we expected it to just come with us and it didn’t? It’s like that.
- Repetitive movements (repetitive strain injury is partly a myofascial issue)
- Not enough movement: when it comes to range of motion, it’s “use it or lose it”.
- The human body tries its best to be as efficient as possible for us! So eventually it will go “Hey, I notice you never move more than 30º in this direction, so I’m going to stop making fascia that allows you to go past that point, and I’ll just dump the materials here instead”
“I’ll just dump the materials here instead” is also part of the problem—it creates what we colloquially call “knots”, which are not so much part of the muscle as the fascia that covers it. That’s an actual physical sticky lumpy bit.
What to do about it
Firstly, avoid the above things! But, if for whatever reason something has gone wrong and you now have sticky lumpy fascia that doesn’t let you move the way you’d like (if you have any mobility/flexibility issues that aren’t for another known reason, then this is usually it), there are things can be done:
- Heat—is definitely not a cure-all, but it’s a good first step before doing the other things. A heating pad or a warm bath are great.
- Here’s an example of a neck+back+shoulders heating pad; you can get them for different body parts, or just use an electric blanket!
- Massage—ideally, by someone else who knows what they are doing. Self-massage is possible, as is teaching oneself (there are plenty of video tutorials available), but skilled professional therapeutic myofascial release massage is the gold standard.
- Foam rollers are a great no-skill way to get going with self-massage, whether because that’s what’s available to you, or because you just want something you can do between sessions. Here’s an example of the kind we mean.
- Acupuncture—triggering localized muscular relaxation, an important part of myofascial release, is something acupuncture is good at.
- See also: Pinpointing The Usefulness Of Acupuncture ← noteworthily, the strongest criticism of acupuncture for pain relief is that it performs only slightly better than sham acupuncture, but taken in practical terms, all that really means is “sticking little needles in does work, even if not necessarily by the mechanism acupuncturists believe”
- Calisthenics—Pilates, yoga, and other forms of body movement training can help gradually get one’s fascia to where and how it’s supposed to be.
- This is that “use it or lose it” bodily efficiency we talked about!
Remember, the body is always rebuilding itself. It never stops, until you die. So on any given day, you get to choose whether it rebuilds itself a little bit worse or a little bit better.
Take care!
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Considering taking Wegovy to lose weight? Here are the risks and benefits – and how it differs from Ozempic
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The weight-loss drug Wegovy is now available in Australia.
Wegovy is administered as a once-weekly injection and is approved specifically for weight management. It’s intended to be used in combination with a reduced-energy diet and increased physical activity.
So how does Wegovy work and how much weight can you expect to lose while taking it? And what are the potential risks – and costs – for those who use it?
Let’s look at what the science says.
Halfpoint/Shutterstock What is Wegovy?
Wegovy is a brand name for the medication semaglutide. Semaglutide is a glucagon-like peptide-1 receptor agonist (GLP-1RA). This means it makes your body’s own glucagon-like peptide-1 hormone, called GLP-1 for short, work better.
Normally when you eat, the body releases the GLP-1 hormone which helps signal to your brain that you are full. Semaglutides enhance this effect, leading to a feeling of fullness, even when you haven’t eaten.
Another role of GLP-1 is to stimulate the body to produce more insulin, a hormone which helps lower the level of glucose (sugar) in the blood. That’s why semaglutides have been used for several years to treat type 2 diabetes.
Wegovy is self-injected once a week. S Becker/Shutterstock How does Wegovy differ from Ozempic?
Like Wegovy, Ozempic is a semaglutide. The way Wegovy and Ozempic work in the body are essentially the same. They’re made by the same pharmaceutical company, Novo Nordisk.
But there are two differences:
1) They are approved for two different (but related) reasons.
In Australia (and the United States), Ozempic is approved for use to improve blood glucose levels in adults with type 2 diabetes. By managing blood glucose levels effectively, the medication aims to reduce the risk of major complications, such as heart disease.
Wegovy is approved for use alongside diet and exercise for people with a body mass index (BMI) of 30 or greater, or 27 or greater but with other conditions such as high blood pressure.
Wegovy can also be used in people aged 12 years and older. Like Ozempic, Wegovy aims to reduce the risk of future health complications, including heart disease.
2) They are both injected but come in different strengths.
Ozempic is available in pre-loaded single-dose pens with varying dosages of 0.25 mg, 0.5 mg, 1 mg, or 2 mg per injection. The dose can be slowly increased, up to a maximum of 2 mg per week, if needed.
Wegovy is available in prefilled single-dose pens with doses of 0.25 mg, 0.5 mg, 1 mg, 1.7 mg, or 2.4 mg. The treatment starts with a dose of 0.25 mg once weekly for four weeks, after which the dose is gradually increased until reaching a maintenance dose of 2.4 mg weekly.
While it’s unknown what the impact of Wegovy’s introduction will be on Ozempic’s availability, Ozempic is still anticipated to be in low supply for the remainder of 2024.
Is Wegovy effective for weight loss?
Given Wegovy is a semaglutide, there is very strong evidence it can help people lose weight and maintain this weight loss.
A recent study found that over four years, participants taking Wevovy as indicated experienced an average weight loss of 10.2% body weight and a reduction in waist circumference of 7.7cm.
For those who stop taking the medication, analyses have shown that about two-thirds of weight lost is regained.
Wegovy can help people lose weight and maintain their weight loss – while they take the drug. Mladen Mitrinovic/Shutterstock What are the side effects of Wegovy?
The most common side effects are nausea and vomiting.
However, other serious side effects are also possible because of the whole-of-body impact of the medication. Thyroid tumours and cancer have been detected as a risk in animal studies, yet are rarely seen in human scientific literature.
In the four-year Wegovy trial, 16.6% of participants who received Wegovy (1,461 people) experienced an adverse event that led to them permanently discontinuing their use of the medication. This was higher than the 8.2% of participants (718 people) who received the placebo (with no active ingredient).
Side effects included gastrointestinal disorders (including nausea and vomiting), which affected 10% of people who used Wegovy compared to 2% of people who used the placebo.
Gallbladder-related disorders occurred in 2.8% of people who used Wegovy, and 2.3% of people who received the placebo.
Recently, concerns about suicidal thoughts and behaviours have been raised, after a global analysis reviewed more than 36 million reports of adverse events from semaglutide (Ozempic or Wegovy) since 2000.
There were 107 reports of suicidal thoughts and self-harm among people taking semaglutide, sadly including six actual deaths. When people stopped the medication, 62.5% found the thoughts went away. What we don’t know is whether dose, weight loss, or previous mental health status or use of antidepressants had a role to play.
Finally, concerns are growing about the negative effect of semaglutides on our social and emotional connection with food. Anecdotal and scientific evidence suggests people who use semaglutides significantly reduce their daily dietary intake (as anticipated) by skipping meals and avoiding social occasions – not very enjoyable for people and their loved ones.
How can people access Wegovy?
Wegovy is available for purchase at pharmacists with a prescription from a doctor.
But there is a hefty price tag. Wegovy is not currently subsidised through the Pharmaceutical Benefits Scheme, leaving patients to cover the cost. The current cost is estimated at around A$460 per month dose.
If you’re considering Wegovy, make an appointment with your doctor for individual advice.
Lauren Ball, Professor of Community Health and Wellbeing, The University of Queensland and Emily Burch, Accredited Practising Dietitian and Lecturer, Southern Cross University
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Under Pressure: A Guide To Controlling High Blood Pressure – by Dr. Frita Fisher
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Hypertension kills a lot of people, and does so with little warning—it can be asymptomatic before it gets severe enough to cause harm, and once it causes harm, well, one heart attack or stroke is already one too many.
Aimed more squarely at people in the 35–45 danger zone (young enough to not be getting regular blood pressure checks, old enough that it may have been building up for decades), this is a very good primer on blood pressure, factors affecting it, what goes wrong, what to do about it, and how to make a good strategy for managing it for life.
The style is easy-reading, making this short (91 pages) book a very quick read, but an informative one.
Bottom line: if you are already quite knowledgeable about blood pressure and blood pressure management, this one’s probably not for you. But if you’re in the category of “what do those numbers mean again?”, then this is a very handy book to have, to get you up to speed so that you can handle things as appropriate.
Click here to check out Under Pressure, and get/keep yours under control!
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Strawberries vs Raspberries – Which is Healthier?
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Our Verdict
When comparing strawberries to raspberries, we picked the raspberries.
Why?
They’re both very respectable fruits, of course! But it’s not even close, and there is a clear winner here…
In terms of macros, the biggest difference is that raspberries have more than 3x the fiber. Technically they also have twice the protein, but that’s a case of “two times almost nothing is also almost nothing”.
But still, for the fiber, we’ll call this a clear win for raspberries on macros.
When it comes to vitamins, raspberries sweep this category. They’re higher in vitamins A, B1, B2, B3, B5, B6, E, K, and also choline, which is sometimes considered a vitamin. Strawberries, meanwhile, boast only a higher vitamin C content.
All in all, another easy win for raspberries.
In the category of minerals, guess what, raspberries win this hands-down, too. They’re higher in calcium, copper, iron, magnesium, manganese, phosphorus, and zinc. Strawberries have nothing to boast in this regard.
Adding up all the individual wins (all for raspberries), it’s not hard to say that raspberries win the day.
Want to learn more?
You might like to read:
Strawberries vs Cherries – Which is Healthier?
Take care!
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Can We Do Fat Redistribution?
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The famous answer: no
The truthful answer: yes, and we are doing it all the time whether we want to or not, so we might as well know what things affect our fat distribution in various body parts.
There’s a kernel of truth in the “no”, though, and where that comes from is that we cannot exclusively put fat on in a certain area only, and nor can we do “spot reduction”, i.e., intentionally lose fat from only one place.
How, then, do we do fat redistribution?
Your body is a living organism, not a statue
It’s easy to think “I’ve been carrying this fat in this place for 20 years”, but during that time the fat has been replaced several times and moved often; in fact, the cells containing the fat have even been replaced. Because: fat can seem like a substance that’s alien to your body because it doesn’t respond like muscles, isn’t controllable like muscles, doesn’t have the same sensibility as muscles, etc. But, every bit of fat stored in your body is stored inside a fat cell; it’s not one big unit of fat; it’s lots of tiny ones.
In reality, any given bit of fat on your body has probably been there for 18–24 months at most:
Fat turnover in obese slower than average
…and there are assorted factors that can modify the rate at which our body deals with fat storage:
Human white adipose tissue: A highly dynamic metabolic organ
So, how do I get rid of this tummy?
There are plenty of stories of people who try to lose weight from one part of their body, and lose it from somewhere else instead. Say, a person wants to lose weight from her hips, and with careful diet and exercise, she loses weight—by dropping a couple of bra cup sizes while keeping the hips.
So, we must figure out: why is fat stored in certain places? And the main driving factors are:
- hormones
- metabolic health
- stress
Hormones affect fat distribution insofar as estrogen and progesterone will favor the hips, thighs, butt, breasts, and testosterone will favor a more central (but still subcutaneous, not visceral) distribution. Additionally, estrogen and progesterone will favor a higher body fat percentage, while testosterone will favor a lower one.
This is particularly relevant later in life, when suddenly the hormone(s) you’ve been relying on to keep your shape, are now declining, meaning your shape does too. This goes for everyone regardless of sex.
See:
- What You Should Have Been Told About The Menopause Beforehand
- The BAT-pause! ← this is about the conversion of white adipose tissue to brown adipose tissue, and how estrogen helps this happen
- Topping Up Testosterone?
Metabolic health affects fat distribution insofar as poor metabolic health will result in more fat being stored in the viscera, rather than in the usual subcutaneous places. This is a serious health risk.
See: Visceral Belly Fat & How To Lose It
Stress affects fat distribution insofar as chronically elevated cortisol levels see more fat sent to the stomach, face, and neck. This fat redistribution isn’t dangerous itself, but it can be indicative of the chronic stress, which does pose more of a general threat to health.
See: Lower Your Cortisol! (Here’s Why & How)
What this means in practical terms
Assuming that you would like the fat distribution that says “this is a healthy woman” or “this is a healthy man”, respectively, then you might want to:
- Check your sex hormone levels and get them adjusted if appropriate
- Improve your overall metabolic health—without necessarily trying to lose weight, just, take care of your blood sugars for example, and they will take care of you in terms of fat storage.
- Manage your stress (which includes any stress you are experiencing about your body not being how you’d like it to be).
If you are doing these things, and you don’t have any major untreated medical abnormalities that affect these things, then your fat will go to the places generally considered healthiest.
Can we speed it up?
Yes, we can! Firstly, we can speed up our overall metabolism:
Let’s Burn! Metabolic Tweaks And Hacks
Secondly, we can encourage our body to “move” fat by intentionally “yo-yoing”, something usually considered bad in dieting when people just want to lose weight and instead are going up and down, but: if you lose weight healthily, it comes off everywhere evenly, and if you gain weight healthily, it goes mostly to the places where it should be.
So, a sequence of lose-gain-lose-gain might look like “lose a bit from everywhere, put it back in the good place, lose a bit more from everywhere, put it back in the good place”, etc.
So, you might want to gently cycle these a few months apart, for example:
How To Lose Fat (Healthily!) | How To Gain Fat (Healthily!)
You can also cheat a little, if it suits your purpose! By this we mean: if you’d like a little extra where you already have a little fat, then you can put muscle on underneath it, it will pad it up, and (because of the layer of actual fat on top) nobody will know the difference unless you flex it with their hand on it.
Let’s put it this way: people doing squats for a bubble-butt aren’t doing it to put on fat; they’re putting muscle on under the fat they have.
So, check out: How To Gain Muscle (Healthily!)
And finally, for all your body-sculpting needs, we present these excellent books:
Women’s Strength Training Anatomy Workouts – by Frédéric Delavier
Strength Training Anatomy (For Men) – by Frédéric Delavier
Enjoy!
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Foot Drop!
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It’s Q&A Day at 10almonds!
Have a question or a request? We love to hear from you!
In cases where we’ve already covered something, we might link to what we wrote before, but will always be happy to revisit any of our topics again in the future too—there’s always more to say!
As ever: if the question/request can be answered briefly, we’ll do it here in our Q&A Thursday edition. If not, we’ll make a main feature of it shortly afterwards!
So, no question/request too big or small
❝Interesting about DVT after surgery. A friend recently got diagnosed with foot drop. Could you explain that? Thank you.❞
First, for reference, the article about DVT after surgery was:
DVT Risk Management Beyond The Socks
As for foot drop…
Foot drop is descriptive of the main symptom: the inability to raise the front part of the foot due to localized weakness/paralysis. Hence, if a person with foot drop dangles their feet over the edge of the bed, for example, the affected foot will simply flop down, while the other (if unaffected) can remain in place under its own power. The condition is usually neurological in origin, though there are various more specific causes:
When walking unassisted, this will typically result in a distinctive “steppage gait”, as it’s necessary to lift the foot higher to compensate, or else the toes will scuff along the ground.
There are mobility aids that can return one’s walking to more or less normal, like this example product on Amazon.
Incidentally, the above product will slightly shorten the lifespan of shoes, as it will necessarily pull a little at the front.
There are alternatives that won’t like this example product on Amazon, but this comes with the different problem that it limits the user to stepping flat-footedly, which is not only also not an ideal gait, but also, will serve to allow any muscles down there that were still (partially or fully) functional to atrophy. For this reason, we’d recommend the first product we mentioned over the second one, unless your personal physiotherapist or similar advises otherwise (because they know your situation and we don’t).
Both have their merits, though:
Trends and Technologies in Rehabilitation of Foot Drop: A Systematic Review
Of course, prevention is better than cure, so while some things are unavoidable (especially when it comes to neurological conditions), we can all look after our nerve health as well as possible along the way:
Peripheral Neuropathy: How To Avoid It, Manage It, Treat It
…as well as the very useful:
What Does Lion’s Mane Actually Do, Anyway?
…which this writer personally takes daily and swears by (went from frequent pins-and-needles to no symptoms and have stayed that way, and that’s after many injuries over the years).
If you’d like a more general and less supplements-based approach though, check out:
Steps For Keeping Your Feet A Healthy Foundation
Take care!
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