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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“When you cut the fat in half you save a lot of lives” – Dr. Oz 5:03

Dr. Oz, arguably more influential than the US Surgeon general, is seen here vilifying fat again. “When you cut the fat in half you save a lot of  lives,” has a lot of implicit meaning and portrays fat in a conclusive manner as harmful.

It’s interesting to see that he has made up his mind about the manner even tho the evidence is so controversial with experts arguing on both sides. Oz has already interacted with Gary Taubes twice on national TV about the manner, as seen below, so he has been exposed to the arguments. While I am not saying Taube’s is right, vilifying fat in such a conclusive manner often closes the door for further investigation and brings with it unintended consequences and the creation of medical dogma.

Looking at refined carbohydrates and not fat is so……..1986?

While I’m anxiously waiting for Dr. Lustig’s UCSF series on obesity to come out, I came upon a video that echoes exactly what he’s talking about…more than 25 years ago. While the video is more focused on refined sugar instead of carbohydrates as a whole, the basic arguments are all there. Additionally, Nobel laureate Dr. Linus Pauling is found in the video stating he has never seen any correlation with saturated fat intake and heart disease in the studies he has seen, but has seen some correlation of sugar consumption and heart disease.

Its in a study…in a respected academic journal…of course I can trust it!

In the previous post, the fat nurse took a look at a critique showing the inconsistencies and biased research in a study involving statins. How often does biased research occur? According to UCSD Medical School professor Dr. Beatrice Golomb…a heck of a lot:

The entire video is worth a look and is meant to address data manipulation as a whole and she uses Statins quite a bit as examples. The main points:

1) Funding: Pretty much all of the large randomized trials for drugs such as statins are funded by the drug companies. NIH is the second largest but has ties to industry.

2) Publishing: There is evidence showing that studies funded by the drug companies are vastly more likely to be published while studies that are negative are not published, or they are publish in a manner that conveys the drug as having potential outcomes. There is also a part where positive studies are duplicated and resubmitted using different authors (this sounds too unbelievable to be true)!?

3) Comparison study results are determined by the sponsor: 5:55 in the video had me laughing. When comparison of one drug vs another are done, the drug on top is usually the sponsor. Which is how you can find logic in statin studies that show: A beats B. B beats C. C beats D. And D beats A.

4) Results can be interpreted as positive in the conclusion even when results are a negative outcome.

5) Biased Authors: Not surprisingly, authors that have ties to certain drugs will portray them in positive light versus authors without ties.

6) Ghost writing: Drug companies pay for positive articles and then pay other doctors and pharmacists to sign their name to the articles as if they wrote them originally and independently.

7) Medical Journals are biased: Journals can be used for laundering and promoting products in which Dr. Golomb reports can be up to $100,000 per positive article.

8) Medical Education: The Drug companies spend $18.5 billion a year which is roughly $30,000 annually for every doctor in America. In addition, the Accrediting Commission for Continuing Medical Education has almost half of its members linked in some form to the pharmaceutical industry.