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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  • What Is Making The Ringing In Your Ears Worse?

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    Dr. Rachael Cook, an audiologist at Applied Hearing Solutions in Phoenix, Arizona, shares her professional insights into managing tinnitus.

    If you’re unfamiliar with Tinnitus, it is an auditory condition characterized by a ringing, buzzing, or humming sound, and ffects nearly 10% of the population. We’ve written on Tinnitus, and how it can disrupt your life, in this article.

    Key Triggers for Tinnitus

    Several everyday habits can make your tinnitus louder. Caffeine and nicotine increase blood pressure, restricting blood flow to the cochlea and worsening tinnitus. Common medications, such as pain relievers, high-dose antibiotics, and antidepressants, can also exacerbate tinnitus, especially with higher or long-term dosages.

    Impact of Diet and Sleep

    Dietary choices significantly impact tinnitus. Alcohol and salt alter the fluid balance in the cochlea, increasing tinnitus perception. Alcohol changes blood flow patterns and neurotransmitter production, while high salt intake has similar effects. Poor sleep quality elevates stress levels, making it harder to ignore tinnitus signals. Addressing sleep disorders like sleep apnea and insomnia can help manage tinnitus symptoms.

    Importance of Treating Hearing Loss

    Untreated hearing loss worsens tinnitus. Nearly 90% of individuals with tinnitus have some hearing loss. Hearing aids can reduce tinnitus perception by restoring missing sounds and reducing the brain’s internal compensatory signals. Combining hearing aids with sound therapy is said to provide even greater relief.

    Read more about hearing loss in our article on the topic.

    Otherwise, for a great guide on managing tinnitus, we recommend watching Dr. Cook’s video:

    Here’s hoping your ear’s aren’t ringing too much whilst watching the video!

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  • Peace Is Every Step – by Thích Nhất Hạnh

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    Mindfulness is one of the few practices to make its way from religion (in this case, Buddhism) into hard science. We’ve written before about its many evidence-based benefits, and many national health information outlets recommend it. So, what does this book have to add?

    Thích Nhất Hạnh spent most of his 95 years devoted to the practice and teaching of mindfulness and compassion. In this book, the focus is on bringing mindfulness off the meditation mat and into general life.

    After all, what if we could extend that “unflappability” into situations that pressure and antagonize us? That would be some superpower!

    The author offers techniques to do just that, simple exercises to transform negative emotions, and to make us more likely to remember to do so.

    After all, “in the heat of the moment” is rarely when many of us are at our best, this book gives way to allow those moments themselves to serve as immediate triggers to be our best.

    The title “Peace Is Every Step” is not a random collection of words; the goal of this book is to enable to reader to indeed carry peace with us as we go.

    Not just “peace is always available to us”, but if we do it right: “we have now arranged for our own peace to automatically step in and help us when we need it most”.

    Bottom line: if you’d like to practice mindfulness, or practice it more consistently, this book offers some powerful tools.

    Click here to check out Peace Is Every Step, and carry yours with you!

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  • The Hormone Therapy That Reduces Breast Cancer Risk & More

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    The Hormone Balancing Act

    We’ve written before about menopausal HRT:

    What You Should Have Been Told About Menopause Beforehand

    …and even specifically about the considerations when it comes to breast cancer risk:

    Menopausal Hormone Replacement Therapy

    this really does bear reading, by the way—scroll down to the bit about breast cancer risk, because it’s not a simple increased/decreased risk; it can go either way, and which way it goes will depend on various factors including your medical history and what HRT, if any, you are taking.

    Hormone Modulating Therapy

    Hormone modulating therapy, henceforth HMT, is something a little different.

    Instead of replacing hormones, as hormone replacement therapy does, guess what hormone modulating therapy does instead? That’s right…

    MHT can modulate hormones by various means, but the one we’re going to talk about today does it by blocking estrogen receptors,

    Isn’t that the opposite of what we want?

    You would think so, but since for many people with an increased breast cancer risk, the presence of estrogen increases that risk, which leaves menopausal (peri- or post) people in an unfortunate situation, having to choose between increased breast cancer risk (with estrogen), or osteoporosis and increased dementia risk, amongst other problems (without).

    However, the key here (in fact, that’s a very good analogy) is in how the blocker works. Hormones and their receptors are like keys and locks, meaning that the wrong-shaped hormone won’t accidentally trigger it. And when the right-shaped hormone comes along, it gets activated and the message (in this case, “do estrogenic stuff here!” gets conveyed). A blocker is sufficiently similar to fit into the receptor, without being so similar as to otherwise act as the hormone.

    In this case, it has been found that HMT blocking estrogen receptors was sufficient to alleviate the breast cancer risk, while also being associated with a 7% lower risk of developing Alzheimer’s disease or related dementias, with that risk reduction being even greater for some demographics depending on race and age. Black women in the 65–74 age bracket enjoyed a 24% relative risk reduction, with white women of the same age getting an 11% relative risk reduction. Black women enjoyed the same benefits after that age, whereas white women starting it at that age did not get the same benefits. The conclusion drawn from this is that it’s good to start this at 65 if relevant and practicable, especially if white, because the protective effect is strongest when gained aged 65–69.

    Here’s a pop-science article that goes into the details more deeply than we have room for here:

    Hormone therapy for breast cancer linked with lower dementia risk

    And here’s the paper itself; we highly recommend reading at least the abstract, because it goes into the numbers in much more detail than we reasonably can here. It’s a huge cohort study of 18,808 women aged 65 years or older, so this is highly relevant data:

    Alzheimer Disease and Related Dementia Following Hormone-Modulating Therapy in Patients With Breast Cancer

    Want to learn more?

    If you’d like a much deeper understanding of breast cancer risk management, including in the context of hormone therapy, you might like this excellent book that we reviewed recently:

    The Smart Woman’s Guide to Breast Cancer – by Dr. Jenn Simmons

    Take care!

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  • What are house dust mites and how do I know if I’m allergic to them?

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    People often believe they are allergic to house dust. But of the 20% of Australians suffereing with allergies, a number are are actually allergic to microscopic house dust mites.

    House dust mites belong to the same family as spiders and ticks. They measure just 0.2-0.3 mm, with 50 fitting on a single pinhead. They live for 65–100 days, and females lay 60–100 eggs in their life.

    House dust mite
    Some 50 house dust mites can fit on one pinhead. Choksawatdikorn/Shutterstock

    House dust mites love temperate climates and humidity. They feed off the skin cells we and animals shed, as well as mould, which they digest using special enzymes. These enzymes are excreted in their poo about 20 times a day. They also shed fragments of their exoskeletons.

    All these fragments trigger allergies in people with this type of allergic rhinitis (which is also known as hay fever)

    shuttertock. PeopleImages.com – Yuri A/Shutterstock

    What are the symptoms?

    When people with house dust mite allergy inhale the allergens, they penetrate the mucous membranes of the airways and eyes. Their body recognises the allergens as a threat, releasing chemicals including one called histamine.

    This causes symptoms including a runny nose, an itchy nose, eyes and throat, sneezing, coughing and a feeling of mucus at the back of your throat (known as a post-nasal drip).

    People with this type of allergy usually mouth breath, snore, rub their nose constantly (creating a nasal crease called the “dust mite salute”) and have dark shadows under their eyes.

    House dust mite allergy can also cause poor sleep, constant tiredness, reduced concentration at work or school and lower quality of life.

    For people with eczema, their damaged skin barrier can allow house dust mite proteins in. This prompts immune cells in the skin to release chemicals which make already flared skin become redder, sorer and itchier, especially in children.

    Symptoms of house dust mite allergy occur year round, and are often worse after going to bed and when waking in the morning. But people with house dust mite allergy and pollen allergies find their year-round symptoms worsen in spring.

    How is it diagnosed?

    House dust mite allergy symptoms often build up over months, or even years before people seek help. But an accurate diagnosis means you can not only access the right treatment – it’s also vital for minimising exposure.

    Doctor talks to patient
    Your clinician can talk you through treatment options and how to minimise exposure. Monkey Business Images/Shutterstock

    Doctor and nurse practitioners can order a blood test to check for house dust mite allergy.

    Alternatively, health care providers with specialised allergy training can perform skin prick tests. This involves placing drops of the allergens on the arm, along with a positive and negative “control”. After 15 minutes, those who test positive will have developed a mosquito bite-like mark.

    How is it treated?

    Medication options include one or a combination of:

    • daily non-sedating antihistamines
    • a steroid nasal spray
    • allergy eye drops.

    Your health care professional will work with you to develop a rhinitis (hay fever) medical management plan to reduce your symptoms. If you’re using a nasal spray, your health provider will show you how to use it, as people often use it incorrectly.

    If you also have asthma or eczema which is worsened by dust mites, your health provider will adapt your asthma action plan or eczema care plan accordingly.

    If you experience severe symptoms, a longer-term option is immunotherapy. This aims to gradually turn off your immune system’s ability to recognise house dust mites as a harmful allergen.

    Immunotherapy involves taking either a daily sublingual tablet, under the tongue, or a series of injections. Injections require monthly attendances over three years, after the initial weekly build-up phase.

    These are effective, but are costly (as well as time-consuming). So it’s important to weigh up the potential benefits and downsides with your health-care provider.

    How can you minimise house dust mites?

    There are also important allergy minimisation measures you can take to reduce allergens in your home.

    Each week, wash your bedding and pyjamas in hot water (over 60°C). This removes house dust mite eggs and debris.

    Opt for doonas, covers or quilts that can be washed in hot water above 60°C. Alternatively, low-cost waterproof or leak proof covers can keep house dust mites out.

    If you can, favour blinds and wood floors over curtains and carpet. Dust blinds and surfaces with a damp cloth each week and vacuum while wearing a mask, or have someone else do it, as house dust mites can become airborne during cleaning.

    But beware of costly products with big marketing budgets and little evidence to support their use. A new mattress, for example, will always be house dust mite-free. But once slept on, the house dust mite life cycle can start.

    Mattress protectors and toppers commonly claim to be “hypoallergenic”, “anti-allergy” or “allergy free”. But their pore sizes are not small enough to keep house dust mites and their poo out, or shed skin going through.

    Sprays claiming to kill mites require so much spray to penetrate the product that it’s likely to become wet, may smell like the spray and, unless dried properly, may grow mould.

    Finally, claims that expensive vacuum cleaners can extract all the house dust mites are unsubstantiated.

    For more information, visit healthdirect.gov.au or the Australian Society of Clinical Immunology and Allergy.

    Deryn Lee Thompson, Eczema and Allergy Nurse; Lecturer, University of South Australia

    This article is republished from The Conversation under a Creative Commons license. Read the original article.

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  • Beetroot For More Than Just Your Blood Pressure

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    Beetroot is well-known for being good for blood pressure, but what else can it do?

    Firstly, blood pressure, yes

    This is because… Well, we’ll quote from a paper:

    ❝As a source of nitrate, beetroot ingestion provides a natural means of increasing in vivo nitric oxide (NO) availability and has emerged as a potential strategy to prevent and manage pathologies associated with diminished NO bioavailability, notably hypertension and endothelial function❞

    Source: The Potential Benefits of Red Beetroot Supplementation in Health and Disease

    That’s a little modest in its wording though, so let’s just be clear, it does work:

    …where you can see that it significantly reduced systolic and diastolic blood pressure.

    Note: this does mean that if you suffer conversely from hypotension (dangerously low blood pressure) you should probably skip the beetroot.

    For your blood sugar levels, too

    The fiber in whole beetroot or powdered beetroot extract (but not beetroot juice) is, as usual, good for balancing blood sugars. However, in the case of beetroot, it (probably because of the betalain content, specifically betanin) also improves insulin sensitivity, resulting in lower fasting and postprandial (after-dinner) insulin levels:

    Evaluation of 12-Week Standardized Beetroot Extract Supplementation in Older Participants: A Preliminary Study of Human Health Safety

    See also (cited in the above paper): Post-prandial effect of beetroot (beta vulgaris) juice on glucose and lipids levels of apparently healthy subjects

    For your blood lipids, also

    This one has less readily available research to support it, so in the category of “papers that aren’t paywalled into oblivion”, here’s one that concludes with the entertainingly specific:

    Results: Beetroot juice intake increased plasma high density lipoprotein (t= -60.88, P<0.05). Triglyceride, total cholesterol, and low density lipoprotein were reduced (P<0.05). Compared with placebo, beetroot juice reduced the concentrations of triglyceride, total cholesterol, and low density lipoprotein (P<0.05).

    Conclusion: Regular beetroot juice intake has significant effects on lipid profile in female soccer players, hence its suggestion for preventing diseases such as hypercholesterolemia and hypertension in female soccer players.❞

    However, even if you are not a female soccer player, chances are it will have the same effect on your physiology as theirs (but, credit where it’s due, it’s right that they make claims about only what they know for sure).

    Here’s the paper: Efficacy of Beetroot Juice Consumption on the Lipid Profile of Female Soccer Players

    What’s good for your blood, is good for your brain

    …and that’s just as true here:

    Exploring beetroot (Beta vulgaris L.) for diabetes mellitus and Alzheimer’s disease dual therapy: in vitro and computational studies

    When reading that, you’ll see that as well as two health outcome benefits (antidiabetic and anti-Alzheimer’s), there are also two mechanisms of action, which are:

    • The blood sugar lowering, insulin sensitivity increasing, lipid improving, qualities we discussed already
    • Its fabulous flavonoid content

    These two things each in turn have a lot of other components and nuances, so here’s an infographic covering them ← this flowchart makes it all a lot clearer

    On which note, those flavonoids aren’t the only active compounds present that result in…

    Antioxidant & anti-inflammatory action

    This one’s pretty straightforward, but it’s worth mentioning also that (as is commonly the case) what fights oxidation also fights cancer:

    ❝In recent years, the beetroot, especially the betalains (betanin) and nitrates it contains, now has received increasing attention for their effective biological activity.

    Betalains have been proven to eliminate oxidative and nitrative stress by scavenging DPPH, preventing DNA damage, and reducing LDL.

    It also has been found to exert antitumor activity by inhibiting cell proliferation, angiogenesis, inducing cell apoptosis, and autophagy.❞

    Read in full: Beetroot as a functional food with huge health benefits: Antioxidant, antitumor, physical function, and chronic metabolomics activity

    Want to try some?

    We don’t sell it, but you can easily grow your own or find it at your local supermarket; if you prefer it in supplement form, dried is better than juice (for a multitude of reasons), so here for your convenience is an example product on Amazon 😎

    Enjoy!

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  • Reduce Your Stroke Risk

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    ❝Each year in the U.S., over half a million people have a first stroke; however, up to 80% of strokes may be preventable.❞

    ~ American Stroke Association

    Source: New guideline: Preventing a first stroke may be possible with screening, lifestyle changes

    So, what should we do?

    Some of the risk factors are unavoidable or not usefully avoidable, like genetic predispositions and old age, respectively (i.e. it is possible to avoid old age—by dying young, which is not a good approach).

    Some of the risk factors are avoidable. Let’s look at the most obvious first:

    You cannot drink to your good health

    While overall, the World Health Organization has declared that “the only safe amount of alcohol is zero”, when it comes to stroke risk specifically, it seems that low consumption is not associated with stroke, while moderate to high consumption is associated with a commensurately increased risk of stroke:

    Alcohol Intake as a Risk Factor for Acute Stroke

    Note: there are some studies out there that say that a low to moderate consumption may decrease the risk compared to zero consumption. However, any such study that this writer has seen has had the methodological flaw of not addressing why those who do not drink alcohol, do not drink it. In many cases, someone who drinks no alcohol at all does so because either a) it would cause problems with some medication(s) they are taking, or b) they used to drink heavily, and quit. In either case, their reasons for not drinking alcohol may themselves be reasons for an increased stroke risk—not the lack of alcohol itself.

    Smoke now = stroke later

    This one is straightforward; smoking is bad for pretty much everything, and that includes stroke risk, as it’s bad for your heart and brain both, increasing stroke risk by 200–400%:

    Smoking and stroke: the more you smoke the more you stroke

    So, the advice here of course is: don’t smoke

    Diet matters

    The American Stroke Association’s guidelines recommend, just for a change, the Mediterranean Diet. This does not mean just whatever is eaten in the Mediterranean region though, and there are specifically foods that are included and excluded, and the ratios matter, so here’s a run-down of what the Mediterranean Diet does and doesn’t include:

    The Mediterranean Diet: What Is It Good For? ← what isn’t it good for?!

    You can outrun stroke

    Or out-walk it; that’s fine too. Most important here is frequency of exercise, more than intensity. So basically, getting those 150 minutes moderate exercise per week as a minimum.

    See also: The Doctor Who Wants Us To Exercise Less & Move More

    Which is good, because it means we can get a lot of exercise in that doesn’t feel like “having to do” exercise, for example:

    Do You Love To Go To The Gym? No? Enjoy These “No-Exercise Exercises”!

    Your brain needs downtime too

    Your brain (and your heart) both need you to get good regular sleep:

    Sleep Disorders in Stroke: An Update on Management

    We sometimes say that “what’s good for your heart is good for your brain” (because the heart feeds the brain, and also ultimately clears away detritus), and that’s true here too, so we might also want to prioritize sleep regularity over other factors, even over duration:

    How Regularity Of Sleep Can Be Even More Important Than Duration ← this is about adverse cardiovascular events, including ischemic stroke

    Keep on top of your blood pressure

    High blood pressure is a very modifiable risk factor for stroke. Taking care of the above things will generally take care of this, especially the DASH variation of the Mediterranean diet:

    Hypertension: Factors Far More Relevant Than Salt

    However, it’s still important to actually check your blood pressure regularly, because sometimes an unexpected extra factor can pop up for no obvious reason. As a bonus, you can do this improved version of the usual blood pressure test, still using just a blood pressure cuff:

    Try This At Home: ABI Test For Clogged Arteries

    Consider GLP-1 receptor agonists (or…)

    GLP-1 receptor agonists (like Ozempic et al.) seem to have cardioprotective and neuroprotective (thus: anti-stroke) activity independent of their weight loss benefits:

    Neuroprotective Mechanisms of Glucagon-Like Peptide-1-Based Therapies in Ischemic Stroke: An Update Based on Preclinical Research

    Of course, GLP-1 RAs aren’t everyone’s cup of tea, and they do have their downsides (including availability, cost, and the fact benefits reverse themselves if you stop taking them), so if you want a similar effect from a natural approach, there are some foods that work on the body’s incretin responses in the same way as GLP-1 RAs do:

    5 Foods That Naturally Mimic The “Ozempic Effect”

    Better to know sooner rather than too late

    Rather than waiting until one half of our face is drooping to know that there was a stroke risk, here are things to watch out for to know about it before it’s too late:

    6 Signs Of Stroke (One Month In Advance)

    Take care!

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