During the examination and treatment of a patient yesterday, naturally the topic of diet came up. After proclaiming his love for vegetables, this man also confessed to having a lifelong sweet tooth. He began to describe an intervention style sweet addiction that he carried from childhood up through present day. He described eating fairly moderate most of the time, but every month or so he would buy bags of candy and go to town. As we continued to speak, the conversation led to him stating that, before meeting his demise, his father was diagnosed as having “softening” of the brain. After describing the symptoms we both agreed that it was most likely some form of dementia. He then informed me that his mother and two uncles were also diagnosed with Alzheimer’s. He recalled that he had joked when he told his wife that they are both “doomed.” After sharing a laugh with him, I decided to capitalize on the cue and attempt to treat by way of education. While there does tend to be a strong familial tendency when it comes to Alzheimer’s disease, more and more of the signs are pointing to what is called epigenetics. This theory does acknowledge genetic predispositions for various diseases, but places more of the emphasis on the internal and external stimuli that lead to suppression or expression of ones inborn genetics. In this man’s case, this sweet tooth could very well lead to the unfortunate expression of these inherited genes.
The problem arises here due to something called excitotoxicity. This occurs in nerves when they become stimulated at such a rate that they cannot keep up with elevated level of constant stimulation. The nerves then begin to adapt and function at a lower level in order to attempt to survive. If the stimulus continues the nerves eventually burn out and die. When this takes place with the nerves in your brain, you literally kill brain cells and a decline in function is sure to follow. The degree and type of dysfunction that occurs is contingent upon the location of the neuronal death.
So what causes this excitotoxicity? In this man’s case it was bought up because of his self-admitted month long candy binges. However, the key culprit here is a high carbohydrate load. This can without a doubt come from your traditional sugar loaded candy, cookies, ice cream, etc. But other things such as your grains and pastas also have an extremely high carb load. These carbs are then broken down in your body to glucose and used as fuel for the body to run. However, when you are too carb heavy or overeat in general, one of the places that the glucose is then delivered to is the brain. Glucose is converted to a chemical or neurotransmitter called glutamate which is the primary excitatory neurotransmitter of your central nervous system (it is responsible for activating and firing nerves). Due to the chemical pathways that exist, all glucose that enters the brain is first converted to glutamate before it is either used (at controlled levels it is necessary for proper function) or converted to other vital neurotransmitters. The issue occurs when there is a flooding of glucose to the brain at such a rate that the necessary conversions cannot keep up and the presence of glutamate persists, leading to an overstimulation of your neurons. Again, this occurs when you consume too many carbohydrates, in particular foods that rank high on glycemic index (meaning a faster delivery of carbs to your system, vs. low glycemic foods that release carbs at a slower rate at which your body should be able to utilize and convert appropriately).
And don’t think that you are dodging that bullet by consuming those impossibly sugar free/low carb snacks and diet sodas. The reason these items are not only edible but taste so damn good is due to artificial sweeteners. One of the most common and worst offenders of them all is aspartame. While it is true, this miracle concoction does not pack any carbs (or any nutritional value for that matter); it is a key component in the conversion of glucose to glutamate. Translation: aspartame exponentially amplifies the production of glutamate in the brain and the entire excitotoxic cascade described above. And watch your back out there. The manufacturers of this product are well aware of the hazards as well as the bad rap ol’ aspartame is catching. Apparently being linked to headaches, dizziness, panic attacks, mood changes, and seizures all as a result of this accelerated excitotoxicity doesn’t lead to a product selling itself. In a brilliantly deceptive, strategic marketing move they have begun to change the name of the product. Hard to believe that this is actually legal, but “aminosweet” is one of the aliases to keep an eye open for.
(A major source of this is most chewing gums. If you are somewhat of a gum junkie like me, you may want to check out your local health food store and look for gums like Spry, Glee, Pur, etc. as an alternative. These contain a sweetener known as xylitol, which is substantially less potent, that aspartame. Best option would be to cut back on the gum altogether, but this is an alternative.)
Certain drugs prescribed to manage Alzheimer’s symptoms such as Namenda work by blocking NMDA receptors, thus blocking the excitotoxicity of glutamate. Question is, if excitotoxicity is recognized by doctors and the pharmaceutical companies as a major contributing factor to many neurodegenerative diseases, including Alzheimer’s, then why isn’t the initial mode of attack education on limiting excitotoxicity? The prescriptive application of the costly drug and side effects is a clear example of the monetarily driven, reactive sick care model that many unfortunately fall victim to.
Another factor linking excitotoxicity and Alzheimer’s is the strong correlation between diabetes and Alzheimer’s. This linkage is so strong that some references are now referring to Alzheimer’s as diabetes type III. When you have diabetes there is an issue with how your body handles glucose, aka sugar, aka carbohydrates. Normally the introduction of glucose to your blood stream would be handled by insulin delivering the glucose to the tissues in need. However, with diabetes, the body either doesn’t produce enough insulin (type I), or the tissues have become resistant to it (type II) due to already being full (carbohydrate overload). This leaves more circulating glucose in your blood stream. As stated above, glucose is now delivered to your brain which does not require insulin for its delivery in the first place. This glucose overload to the brain causes a spike in glutamate, which excites your brain cells to fire at such a rate that they cannot keep up and eventually burn out and die. This mechanism and strong correlation just further reinforces the theory of excitotoxicity due to glutamate overload so much so that even being classified as borderline diabetic increases the risk for developing Alzheimer’s by as much as 70%.
Diabetes other linkage to Alzheimer’s is by way of formation of AGEs (advanced glycation end products). These are formed when glucose reacts with proteins in the body. Our bodies have built in mechanisms to break these downs, but again, when they are formed at increased rate the body cannot keep pace and the AGEs persist. This is a presumed culprit of issues all throughout the body, including the brain. As a matter of fact the presence of AGEs in the brain are elevated in Alzheimer’s patients and have been linked to the formation of one of the diagnostic signs of Alzheimer’s, plaque on your brain. It must also be understood this is not just a diabetic we are talking about here. Any type of overeating or high carb load leads to the overload of AGEs throughout the body.
While definitive research on the precise causes of various neurological disorders is not absolutely conclusive, increasing attention is being directed towards excitotoxicity as one of the key mechanisms behind the irreversible neuronal damage and death that is seen with Parkinson’s Disease, ALS (Lou Gehrig’s Disease), Huntington’s Disease, epilepsy, schizophrenia, and of course, Alzheimer’s.
So what can you do to limit excitotoxicty and it’s potentially devastating wrath?
1) Control your blood sugar levels. Remember, blood sugar (glucose) isn’t just elevated from your traditional sweets. Remember that carbohydrate (grain, pasta, etc.) equals glucose. Try to cut down on the high carb loaded foods, particularly the processed and refined ones that also are void of any other nutritional benefits. Learn about the glycemic index and when you consume carbs, consume more on the lower side of the scale. The longer it takes the glucose to be delivered to your blood stream, the longer your system has to process and convert appropriately. You can also manage this level by avoiding the feeling that you need to eat until you are “stuffed.”
2) EXERCISE. The more physical activity you do, the more fuel in the form of glucose your entire body will utilize and thus have room for. This means you deplete the levels that are already stored and create instant room for more to be consumed, utilized, and stored appropriately. This is the reason that exercise is deemed as a top treatment choice for lowering and controlling blood sugar levels in those with type II diabetes.
3) Lastly, be wary of artificial sweeteners. While the verdict is still out on some (i.e. Stevia), ones such as aspartame and sucralose are bad news. The true perfect storm can be witnessed by someone ordering a carb heavy meal with a diet soda, setting the stage for unadulterated excitotoxcity.
I know these seem like simple solutions to complex problems, but why make it difficult? Of course there are other reasons problems may arise and being checked regularly by a qualified professional can increase your chances of success, but for the majority of Americans improvement in quality of diet and consistency in physical activity can fortify the prospects of a quality life by limiting the self-inflicted brain damage. So knock it off.