Blood Sugar…shrinks the brain?

Check out this week old study! Subjects had their brain volume examined through MRI four years ago to evaluate changes that may occur prospectively.

“The aim of this study was…to investigate in cognitively healthy individuals, who did not have T2D, whether higher fasting plasma glucose levels falling in the normal range as defined by the World Health Organization were associated with declines in hippocampal and amygdalar volumes.”

The results?

Plasma glucose levels were found to be significantly associated with hippocampal and amygdalar atrophy and accounted for 6%–10% in volume change after controlling for age, sex, body mass index, hypertension, alcohol, and smoking.

High plasma glucose levels within the normal range (<6.1 mmol/L) were associated with greater atrophy of structures relevant to aging and neurodegenerative processes, the hippocampus and amygdala. These findings suggest that even in the subclinical range and in the absence of diabetes, monitoring and management of plasma glucose levels could have an impact on cerebral health. If replicated, this finding may contribute to a reevaluation of the concept of normal blood glucose levels and the definition of diabetes

Pretty fascinating stuff. Keep in mind that diabetic/prediabetic/normo ranges for blood glucose are usually changing. They used WHO guidelines in this study but a range of <6.1 nmol/L is usually the beginnings of pre diabetes for many other guidelines.

From the mayo clinic – Fasting blood sugar test. A blood sample will be taken after an overnight fast. A fasting blood sugar level less than 100 mg/dL (5.6 mmol/L) is normal. A fasting blood sugar level from 100 to 125 mg/dL (5.6 to 6.9 mmol/L) is considered prediabetes

However, the study took this into consideration:

…subanalyses using even tighter inclusion criteria for fasting glucose (<5.6 mmol/L) and for BMI (<25 kg/m2) produced essentially identical findings or, in the case of BMI, slightly stronger findings. This result suggests that the effect of plasma glucose on cerebral structural integrity is not restricted to the upper normal range.

Update: Another study this week showing the differences between Teens with Metabolic syndrome and those that don’t in regards to cognitive function. As expected, cognitive scores were lower in the teens with metabolic syndrome.

References:

Higher normal fasting plasma glucose is associated with hippocampal atrophyThe PATH StudyNicolas Cherbuin, PhD, Perminder Sachdev, MD, PhD, FRANZCP and Kaarin J. Anstey, PhD. Neurology September 4, 2012 vol. 79 no. 10 1019-1026

Obesity and Metabolic Syndrome and Functional and Structural Brain Impairments in AdolescencePo Lai Yau, PhDa, Mary Grace Castro, BSa, Adrian Tagania, Wai Hon Tsui, MSa, and Antonio Convit, MD doi: 10.1542/peds.2012-0324

 

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National Cholesterol Awareness Month and Alcohol Policy to Solve Obesity?

Did you know that September is National Cholesterol Awareness Month? Via our US Department of Health and Human Services:

September may be “back to school month”, but it is also Cholesterol Awareness Month. Take a few moments to study up on this important health issue.

Yes sir! They were kind enough to even link a PDF pamphlet that you can give to all your friends and family. It has handy tips like:

Diet. Saturated fat and cholesterol in the food you eat make your blood cholesterol level go up. Saturated fat is the main culprit, but cholesterol in foods also matters. Reducing the amount of saturated fat and cholesterol in your diet helps lower your blood cholesterol levels

Err…wait a minute…story is a little more complex than that man!

Other tips include eating a:

a low- saturated-fat, low-cholesterol eating plan that calls for less than 7 percent of calories from saturated fat and less than 200 mg of dietary cholesterol per day…Foods low in saturated fat include fat-free or 1 percent dairy products, lean meats, fish, skinless poultry, whole grain foods, and fruits and vegetables. Look for soft margarines (liquid or tub vari- eties) that are low in saturated fat and contain little or no trans fat (another type of dietary fat that can raise your cholesterol level). Limit foods high in cholesterol such as liver and other organ meats, egg yolks, and full-fat dairy products.

Looks like it’s the same old story. If you’ve followed this blog or some of the other people in TheFatNurse’s links, you’ll know the story is way more complex and these diet guidelines may not work for everyone. Saturated fat’s relationship with heart disease is definitely debatable and cholesterol absorption from dietary factors may not have a significant effect on serum cholesterol. In addition, cholesterol as a predictive marker may not even be that accurate in predicting risk for certain people. Perhaps a better (and more informative yet light) way is to spread the cholesterol knowledge through TheFatNurse comics!

Another interesting report from last month that TheFatNurse didn’t see until now is from the CDC via RAND regarding the use of alcohol control policies in controlling obesity and it’s related diseases. They are proposing hypothetical solutions in controlling obesity through similar measures taken in regulating alcohol in the states. The report is aware of the potential controversy that such measures would face:

However, alcohol policies, especially those seen to infringe on individual choice (such as restrictions in outlet density) or to negatively affect moderate drinkers who do not cause harms (such as excise taxation) have been controversial. Over time, many of these measures have become widely accepted and do work in curbing problems related to alcohol use.

In otherwords, people will be upset at having their food choices regulated in order to control obesity…but its for their own good and they’ll get use to it! So what are some ideas? Below is a table from the report. The left column is the alcohol related control policy and how it could be translated to an obesity food regulation policy:

Wow…some of this stuff can look pretty extreme. You’ll see that “fat” foods are targeted. Perhaps before making all these regulatory theories one should question whether dietary fat is a cause of obesity in the first place?

Bottomline: It’s national cholesterol awareness month but the Dept of HHS seems to be putting out the same ol same ol on cholesterol and heart disease. Additionally, some reports are discussing potential ways to control obesity through hypothetical regulations derived from alcohol regulation. As seen with the knowledge on cholesterol, without a true consensus on what causes obesity and it’s related diseases, is food regulation really that wise of a choice? Let’s work on getting the message out on dietary fat and cholesterol beyond fat & LDL cholesterol = bad and HDL = good before working on policies that could potentially cause more harm than good.