Alzheimer's: Diabetes of the Brain? l Suzanne DeLaMonte doctoroz.com

By Dr. Suzanne DeLaMonte
Alpert Medical School, Brown University
Neuropathologist, Rhode Island Hospital

Although we’ve always known that Alzheimer’s disease is typically associated with numerous tangles and plaque in the brain, the exact cause of these abnormalities has been hard to pin down. Now, we may be closer to an answer.

 

In many respects, Alzheimer’s is a brain form of diabetes. Even in the earliest stages of disease, the brain’s ability to metabolize sugar is reduced. Normally, insulin plays a big role in helping the brain take up sugar from the blood. But, in Alzheimer’s, insulin is not very effective in the brain. Consequently, the brain cells practically starve to death.

 

How is that like diabetes?

These days, most people with diabetes have Type 2 diabetes mellitus. Basically, cells throughout the body become resistant to insulin signals. In an effort to encourage cells to take up more sugar from the blood, the pancreas increases the output of insulin. Imagine having to knock louder on a door to make the person inside open up and answer. The high levels of insulin could damage small blood vessels in the brain, and eventually lead to poor brain circulation. This problem could partly explain why Type 2 diabetes harms the brain. In Alzheimer’s, the brain, especially parts that deal with memory and personality, become resistant to insulin.

 

Why does the brain need insulin?

As in most organs, insulin stimulates brain cells to take up glucose or sugar, and metabolize it to make energy. Insulin also is very important for making chemicals known as neurotransmitters, which are needed for neurons to communicate with each other. Insulin also stimulates many functions that are needed to form new memories and conquer tasks that require learning and memory.

 

Where does the insulin come from in the brain?

Very sensitive tests showed that insulin is made in the brain. It’s made in neurons, and the hormone made in the brain is the same as that produced in the pancreas. This point may seem surprising, but if you consider the fact that every other gut hormone is also made in the brain, it only makes sense that insulin would be among them. Insulin that’s made by the pancreas and present in blood does gets into the brain as well.

Are people with diabetes more likely to get Alzheimer’s?

Absolutely. Their risk is doubled, at least. Obesity also increases the risk of cognitive impairment, or mental decline. This doesn’t mean that everyone who has diabetes will develop Alzheimer’s or that all people with Alzheimer’s have diabetes.  The important thing to recognize is that there is considerable overlap between Alzheimer’s and diabetes.

I’ve never heard that. Is this idea new?

In reality, before about 1980, there was very little overlap between Alzheimer’s and diabetes.  In fact, up until about 1980, deaths from diabetes were declining in the United States. That’s probably because of the improvements in medical treatment. But, between 1980 and now, the deaths from Alzheimer’s and diabetes have skyrocketed at alarming rates. The diabetes story is especially frightening because, everyone agrees that today we have much better medical treatments for diabetes than we did in the 1960s and 1970s – so, why should the death rates be so high now?

 

Maybe people are just living longer. Isn’t that the case?

People are living longer, but more important, they are surviving with various diseases that used to be fatal. On the surface, this argument might explain the increasing death rate trends for diabetes and Alzheimer’s. But, closer examination of the data demonstrated something entirely different and, in fact, surprising.

 

We compared the Alzheimer’s death rates in 1980, to those in 2005, but instead of looking at the entire population as a single group, we examined the death rates according to age group.  We looked at Alzheimer’s death rates in people between 45 and 54 years old, 55 and 64, 65 and 74, and so on. We found that within every single age group, the Alzheimer death rate was much higher in 2005 than it was in 1980.  In other words, deaths from Alzheimer’s were considerably higher for 60 year olds in 2005 than they were in 1980. Worse yet, over that time period and until these days, the Alzheimer’s death rates continued to climb, year by year. Diabetes death rates increased sharply within each age group, just as they did for Alzheimer’s.

 

Most people think Alzheimer’s is caused by a gene problem.

Alzheimer’s disease occurrences are not strictly genetic. In fact, the vast majority of Alzheimer’s occurs sporadically.

If it’s not genetic, what else could be the cause of Alzheimer’s?

Truly genetic diseases do not change over a 30-year period. That interval is too short to affect rates of genetic diseases that arise only in middle-aged or elderly people. The human breeding, growth, development and aging cycle is much longer than 30 years. In contrast, disease like HIV/AIDS and lung cancer are clearly exposure-related, so their mortality rates can be modified within a short period if the exposure to the disease-causing agents are reduced.

 

Could diabetes and Alzheimer’s be caused by some types of exposures?

We have reasonable evidence that human exposure to nitrosamines is at the root cause of not only Alzheimer’s, but several other insulin-resistance diseases, including Type 2 diabetes, fatty liver disease, also known as NASH, and visceral obesity. 

 

The elimination of local farms in favor of mega-farms requires transport of food for long distances. To prolong shelf-life, preservatives are added. The problem is worsened with transport of “fresh” foods from across the Pacific Ocean. Nitrites are added to meats and processed foods for flavor and coloring. High levels of nitrates added to fertilizers can be incorporated into produce and then converted to nitrites and finally nitrosamines in the body.

 

Nitrosamines contaminate many processed foods, including fish, cheeses, hotdogs, ground beef, smoked meats like bacon, smoked turkey and ham, and beer. Originally, nitrites were added to food as preservatives to prevent salmonella infection from contaminated meet. The policy remains in place. Although efforts have been made to reduce the levels, nitrites are still added as preservatives. Over time, Western societies, particularly in the US, have been chronically exposed to increasing amounts of nitrosamines due to continuous consumption of processed foods.

 

Nitrosamines are well-recognized cancer-causing agents. In high doses, they cause cancers in many organs. One of the main toxins in tobacco is a nitrosamine. However, low chronic exposures have cumulative effects. 

 

Years ago, a few scientists suggested that nitrosamines might cause diabetes. The concept was not pursued until now. We performed experiments in the laboratory and showed that very low, limited exposures to nitrosamines (the type found in food) cause Alzheimer’s-type brain degeneration, dementia, diabetes, fatty liver disease and obesity. Adding high fat to the diet made the disease-causing effects of nitrosamines much worse.

How were these findings reached?

We were working on the idea that insulin resistance in the brain was an important cause of disease and injected another drug into the brain to see what would happen. Instead of getting what we were looking for, we found Alzheimer’s. Very soon after that, I realized that the drug I used was a nitrosamine. A bell went off in my head and suddenly I understood the problem.  All of the major diseases related to insulin resistance, which are now epidemic in the United States, could be caused by exposure to low doses of nitrosamines over a period of years.

 

How can I reduce my risk?

For now, the main message is to stop getting exposed. There are small steps and larger ones. Protect yourself by looking for sodium nitrite on food labels. Avoid processed foods. Eat organically grown foods. Push policies to return farming back to local environments to gain control over how food is produced and eliminate requirements for toxic preservatives. Educate children and provide only healthful food choices. Learn to cook and teach cooking in public schools. Pack a healthful lunch the night before for easy grab-and-go in the morning.

 

 

Thomas Jefferson, science enthusiast | Guardian News

Whatever flawed versions of Thomas Jefferson are peddled by the American right, we know he loved his science.

If you want to enter an alternative reality, all you need to do is type words like Jefferson , religion and history into Google. The American right wing's attitude to some aspects of science is deeply troublesome, but so too is their rewriting of their national history. The Jefferson Lies: Exposing the Myths You've Always Believed About Thomas Jefferson, by David Barton, is a case in point. It is endorsed by Glenn Beck despite enormous criticism from historians and publishers.

In July, readers of History News Network voted it the Least Credible History Book in Print for its distortion of history and of Jefferson's views. The particular issues are identified around religion, slavery and the relationship between church and state, which Barton presents among seven lies told about the third president of the United States.

Barton has little to say about Jefferson's intense interest in science. He would have done if Jefferson had lived a couple of generations later, as the statesman then might have accepted the geological evidence of the Earth's age (which he was not inclined to do in the first decade of the century, when there was much dispute among geologists) and Darwin's theory of evolution, and Barton might have had an eighth lie to deal with.

But there is little in established 18th and early 19th century science that the Tea Party would feel the need to reject. This is a reminder of the fact that in Jefferson's time there was no perception of a war between science and religion and, indeed, that the American right do not necessarily have a blanket anti-science approach, but theological, political and ideological issues with particular fields.

However, where Barton does bring up science, he goes rather wrong. The main passage focuses on this Jefferson quote:

Bacon, Locke and Newton, I consider them as the three greatest men that have ever lived, without any exception, and as having laid the foundation of those superstructures which have been raised in the Physical and Moral Sciences.

Quite rightly, of course, Barton can point to the religiosity of these heroes of science, but he glosses over Newton's unorthodoxy, denies Locke's and presents this quote as part of his argument against the lie that Jefferson promoted secular education. This is quite bizarre, turning a blind eye to Locke's advocacy of religious tolerance and the separation of church and state. A quick read of Locke's A Letter Concerning Toleration would put him right.

An interest in science and advocacy of secularism in public life were, and are, by no means necessary bedfellows. Likewise, the interest of leaders and politicians of all stripes in many or most aspects of science and technology, which underpin national and military success in so many areas, goes without saying. Yet Jefferson's interest in science was part of his personal identity in a way that it is hard to imagine the likes of Glenn Beck celebrating.

This summer I visited the American Philosophical Society (APS) in Philadelphia, of which Jefferson was a key early member, to do some research into the Lewis and Clark Expedition across the American continent in 1804-06, a scientific and imperialistic venture that was Jefferson's pet project.

What I found fascinating in reading about this expedition was not just Jefferson's support for a prestige national project, but his close involvement in the scientific training of Merriweather Lewis, his secretary, in preparation, and ready input to discussions about instrumentation. Jefferson was, according to an article on the instruments of the expedition, inordinately fond of an equatorial theodolite he owned, made by London instrument-maker Jesse Ramsden, and thought they should take something similar.

At the APS I dipped into some of Jefferson's correspondence with Robert Patterson, the professor of mathematics at Philadelphia. More than once he wrote to thank Patterson for copies of the Nautical Almanac (the small books of astronomical tables for navigation published by the British Board of Longitude), as well as other scientific tracts, and for advice on buying and repairing instruments.

On 21 March 1811 he added:

before I entered on the business of the world I was much attached to Astronomy & had laid a sufficient foundation at College to have pursued it with satisfaction and advantage. but after 40 years of abstraction from it, and my mathematical acquirement coated over with rust, I find myself equal only to such simpler operations & practices in it as serve to amuse me. but they give me great amusement, and the more as I have some excellent instruments...

I don't suppose that there is anything here that would particularly challenge the Tea Partyers. It is not climate science or evolution, but an enthusiasm for tracking Jupiter's satellites. In any case, Barton's claims have already been thoroughly taken down by historians. And yet, throwing up an image of a Founding Father who enjoyed tinkering with precision instruments, perusing astronomical tables and corresponding with university professors seems as good a response as any to some of the painfully bad history being produced.

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Reconsidering the Citizens United Decision | Lawrence Lessig The Atlantic Reuters

Lawrence Lessig | Aug 4, 2012

The (Almost) Brilliance of Representative Dingell and His Friends

Can the longest-sitting member of Congress force the Supreme Court to reconsider its Citizens United decision?

Representative John Dingell (D-MI), the longest-sitting member of Congress, introduced a bill Thursday designed to force the Supreme Court to reconsider its Citizens United decision. Along with at least ten co-sponsors, Dingell's Restoring Confidence in Our Democracy Act, would ban corporations and unions from making independent political expenditures. It would also subject Super PACs to the same contribution limits that exist with other PACs. Dingell intends the bill to provide the factual record which details the negative effects of increased spending in our elections. That factual record, he hopes, will get the Court to reverse itself, and restore Congress' power to limit a form of spending that Dingell (rightly) believes has eroded even further America's confidence in our democracy.

Dingell's bill, however, is effectively two bills-- one that would require the Court to reverse itself, if indeed the new law were upheld, and the other that would not require the Court to reverse itself but would instead give the Court a chance to address a kind of corruption that so far the Supreme Court has ignored. It is unlikely (in the extreme) that the Court is going to reverse itself. But if framed properly, Dingell's bill could well map a way for Congress to staunch the corrupting influence of Super PAC spending without forcing the Court to eat its Citizens United words.

Despite all the ruckus, the holding in Citizens United is actually quite narrow. All the Court decided was that an (effectively) absolute ban on independent political expenditures by corporations could not survive First Amendment review, because nobody could believe that the speech that was being abridged was speech that betrayed quid pro quo corruption. Citizens United is a non-profit corporation. Its desire was to fund the distribution of a film about Hillary Clinton. The Bipartisan Campaign Reform Act seemed to forbid such funding, at least from the corporation's treasury. The Supreme Court had to decide whether such an absolute ban should be permitted.

In the past, the Court had upheld limitations on political speech when they were necessary to avoid corruption or the appearance of corruption. So the question for the Court in Citizens United was whether every dollar spent by a corporation (independently of a campaign) to promote one political candidate over another was an instance of corruption.

The Court held -- and was right to hold -- that it wasn't. Not every independent political expenditure is evidence of a bribe or quid pro quo influence peddling. Sometimes, believe it or not, an independent expenditure is just an independent expenditure. So if the only basis the Court has for upholding a restriction on political speech is quid pro quo corruption, or the appearance of quid pro quo corruption, that ground is not solid enough to bear the weight of a complete ban on independent expenditures by corporations or by anyone.

The first part of Dingell's bill is inconsistent with this principle. But interestingly, the second part is not -- or at least, is not necessarily. And if effectively insulated from the constitutional taint of the first part, could provide a critical vehicle for reestablishing a power that Congress certainly should have.

The second part of Dingell's bill simply limits contributions to so called Super PACs, by requiring that they be subject to the same contribution caps that any other PAC must obey. Crucially, the justification for this limit need have nothing to do with quid pro quo corruption.

As I've explained on these pages again and again, the Framers of our Constitution gave us a Republic. By a Republic, they meant a representative democracy. And by a representative democracy, they meant a government that in the legislative branch at least was to be, as Federalist 52 describes it, dependent upon the People alone.

In the 225 years since, Congress has evolved a different dependence -- a dependence not upon the People alone but increasingly, a dependence upon the funders of campaigns as well.

But here's the obvious problem: the Funders are not the People. As I've written again and again, .26 percent of America gives more than $200 to any congressional candidate; .05 percent of America gives the maximum amount to any congressional campaign; .01 percent gives more than $10,000 in an election cycle; through February, .000063 percent of America -- 196 citizens -- gave close to 80 percent of Super PAC contributions. And according to U.S. PIRG and Demos, 1,000 citizens of the United States (or so we assume) have given more than 94 percent of Super PAC contributions so far.

No one could deny that politicians are dependent upon their funders. Nor could anyone believe these funders are a fair representation of the People. And thus, no one should doubt that we have allowed the system our Framers intended to be -- in a word -- corrupted. Ours is not a government with a legislature dependent upon the People alone. It is a government with a legislature dependent upon the People and upon a different and conflicting group -- the Funders.

That gap between the Funders and the People was large enough before Citizens United. It has only grown worse since. And it is this gap that constitutes the corruption of our political system. Not quid pro quo corruption but dependence corruption -- a type of corruption that was if anything more important to the Framers than the corruptions of Rod Blagojevich or Randy Duke Cunningham.

The way to attack this corruption is not to ban all speech by corporations, or unions, or individuals. It is instead to limit contributions that any individual or corporation can make, so that no one could reasonably believe that such contributions created a dependence that conflicted with a dependence upon the People alone. In my view, even that wouldn't be enough: We will end dependence corruption only when Congress enacts a system of citizen-funded campaigns. But Congress should be free to start somewhere, and beginning with the explosion of large and dominating independent contributions is a reasonable first step.

This is precisely what the second part of Representative Dingell's bill does: It doesn't purport to limit the spending of Super PACs; it instead limits the contributions made to Super PACs. And the justification for that limit, at least from the perspective of the Framers, could not be clearer: Congress is fully justified in limiting the role that contributors to Super PACs play, so that Members do not become dependent upon those contributors to Super PACs, and thereby less dependent upon the People.

Not because anyone need believe that Congress is being bought. Maybe it is, maybe it isn't, but that's not the point. The point is dependence: to assure our political system is not dependent on an influence that conflicts with a dependence upon the People alone. The conflict is a corruption. The First Amendment should permit Congress to remedy that corruption.

Dingell deserves real credit here. Among Democrats especially, all the action is either with the Disclose Act, or in the amend the Constitution crowd. But disclosure alone won't solve anything. And there's a better chance that I'd win a gold medal at the Olympics than that the United States Senate is going to muster 67 votes for any constitutional amendment. It takes insight and wisdom to see where reform might be possible -- something I missed in my recent testimony to the Senate. Let's hope it is a point more in the House, and at least 50 in the Senate, come to see.

Copyright 2012 The Atlantic Monthly Group