From Wisdom to Alzheimer’s: Are we poisoning ourselves with affluent malnutrition and sedentary life style?

Wise elders, grand parents or statesmen have been the traditional roles for aging adults. Older people were revered as the repository and sources of wisdom in many traditional cultures.  Presently the development of aging into wisdom is being overshadowed by the specter of Alzheimer’s disease. Wisdom transforming into Alzheimer’s disease does not compute.  How come that in slightly more than a century after it was first described by the neuropathologist Alois Alzheimer in 1906, the fear of contracting and possible having Alzheimer’s disease with the concurrent  loss of cognitive and body functions is becoming a possibility? How could this have occurred?

Today more people are living to older ages; however, in traditional cultures some people also lived to very old age (the major increase in present day longevity is due to the elimination of infant and maternal mortality and medical treatment to survive trauma).

Is it possible that the prevention of Alzheimer’s will not be found in pharmaceutical treatment but in promoting organic food diet and movement?   The research data is starting to find that our life style patterns are risk factors for Alzheimer’s.  Changing lifestyle factors is a more promising treatment approach than drugs.  A significant risk factor may be the confluence of a sedentary lifestyle and affluent malnutrition. Researchers are even reporting that the built up of the beta amyloid plaques in brains of people with Alzheimer’s disease is not  the result of aging but the body’s attempt to cope with the influx of environmental and dietary poisons or decreases in essential foods or body activities.

Risk: Sedentary lifestyle-Too little exercise

Over the last hundred years–and rapidly accelerated in the last 30 years–we have transformed work into sitting. By sitting in front of a computer screen, we have created a new disease: Immobilization Syndrome. Lack of exercise is recognize as a major factor in numerous illnesses such as cardiovascular disease, obesity, and diabetes. Movement in many different forms reduces the risk of illness.  Older people who exercise have a significant reduction in the risk of developing Alzheimer’s  (Larson, 2006; Radak et al, 2010).

Regular movement lowers the risk. Even though there is overwhelming scientific evidence that movement and exercise are required for health, there is a disconnect with the medical and educational practices.  Insurances will pay for medical treatment; however, they usually will not pay for prevention or exercise.  At the same time physical education in schools is reduced or eliminated to reduce the risk of litigation (an injured child on the playground could sue the school).  Children now spend most of their time in front of a screen while exercising their thumb and index fingers instead of playing and moving outdoors.

Risk: Affluent malnutrition-too much sugar and simple carbohydrates

Affluent malnutrition appears to be another risk factor. Recent findings suggests that the beta amyloids plagues, as the marker for Alzheimer’s in the brain, may be a protective response to the modulating insulin levels triggered by affluent malnutrition and sedentary life style. This disease has been labeled as type 3 diabetes by Associate Professor Suzanne de la Monte at Brown University (Steen et al, 2005). Namely, the disease occurs as the brain tissue becomes resistant to insulin.

Rats that are fed high-fructose corn syrup laced water experienced learning and memory problems in less than 6 weeks and became less responsive to insulin.  At the same time if the animals were given omega 3 fatty acids, they appear to escape the cognitive decline.  In other research rats developed Alzheimer like brain changes and became demented when Suzanne de la Monte interfered with how the rats brains respond to insulin (Trivedi, 2012).

Alois Alzheimer first described these abnormal protein structure in the brains  a little more than a hundred years ago. At that time  the European diet had increased sugar intake as shown in figure 1. While more recently there has been a significant   increase in high fructose corn syrup as shown in figure 2.

Figure 1 sugar

Figure 1. Radical increase in sugar consumption in the last 200 years.  From: http://blog.zestos.co.nz/2010/09/sugar-consumption-been-high-before.html

Figure 2 High fructose corn syrup

Figure 2. Increase in the type of sugar consumption in the last thirty years.  From: http://blog.zestos.co.nz/2010/09/sugar-consumption-been-high-before.html

We are now becoming concerned with the Alzheimer’s disease as an upcoming epidemic.  It cannot be just sugar; since, its consumption has been high since the beginning of the 20th century. A possible contributor could be the high-fructose corn syrup; however, it is most likely the interaction between reduced exercise and sugar.

Sugar set the stage for pathogenesis to occur in the brain and the absence of movement/exercise promotes and supports the pathogenesis. People continue to decrease movement:  from walking or riding horses to sitting cars or standing on escalators and elevators; from doing physical housework to automated washing machines, driers and dishwashers; from preparing foods from raw materials to prepackaged foods; from filing and typing to computer work; from playing family games to watching TV and searching the net; from face to face communication to texting; etc.

We have separated from our biological evolutionary heritage.  I am not surprised that Alzheimer’s disease and immobility and sugar are linked.   Adopt the precautionary principle  and assume that sugar and high-fructose corn syrup in conjunction with reduced movement (immobilization syndrome) is  harmful.

As a reader, you will probably have to wait another 20 years before these findings have been scientifically proven against the overt and covert lobbying efforts of agribusiness and pharmaceutical industry.  Remember it took 30 years to demonstrate that smoking was harmful.  Begin to move and eat in concert with your evolutionary background (See Part III Self-care in Gorter and Peper, 2011).

Begin now!

Eat food not sugars! Eat the foods great grandparents would recognize as food as Michael Pollan (2009) describe in his superb book, In Defense of Food: An Eater’s Manifesto. Eat foods that have not been processed or adulterated by additives. Take charge by eating brain supporting foods such as organic vegetables, roots, fruits, nuts, fish, some organ meat, and eliminate all those sugary, fatty processed highly advertised fast foods.

Move and exercise!  Get up and move every hour. Walk up the stairs instead of the escalator. Meet new people and move by going  hiking,  dancing,  Tai Chi or yoga classes or volunteer by helping others.

References

Gorter, R. & Peper, E. (2011). Fighting Cancer-A Non Toxic Approach to Treatment. Berkeley: North Atlantic.

Larson, E.G., Wang, L., Bowen, J.D., McCormick, W. C., Teri, L., Crane, P., & Kukull, W. (2006).  Exercise Is Associated with Reduced Risk for Incident Dementia among Persons 65 Years of Age and Older. Ann Intern Med, 144(2), 73-81.

Pollan, M. (2009).  In Defense of Food: An Eater’s Manifesto. New York: Penguin Books.

Radak, Z., Hart. N., Sarga, L., Koltai, E., Atalay, M., Ohno, H., & Boldogh, I. (2010). Journal of Alzheimer’s Disease, 20(3), 777-83.

Steen, E., Terry, B.M.  Rivera, E.J., Cannon, J.L., Neely, T.R., Tavares, R., Xu, X. J., Wands, J.R., & de al Monte, S. M.  (2005). Impaired insulin and insulin-like growth factor expression and signaling mechanisms in Alzheimer’s disease-is this type 3 diabetes? Journal of Alzheimer’s Disease, 7(1), 53-80.

Trivedi, B. (2012). Eat your way to dementia. New Scientist, 215(2880), 32-37.


Simple Ways to Manage Stress- An experiential lecture for people impacted by the March 11, 2011 Great East Japan Earthquake

Stress can be reduced by simple pragmatic exercises. This 99 minute participatory lecture was presented in Sendei, Japan, on July 20, 2013 to people who were impacted by the 2011 Tohoku earthquake and tsunami disaster.* The lecture includes practices that demonstrate 1) how thoughts, emotions and images affect the body, 2) how simple movements can reduce muscle tension, 3) how breathing can be used to reduce stress, 4) how changing posture can change access to positive or negative memories, 5) how acceptance is the beginning step for healing. This approach based upon a holistic evolutionary perspective of stress and health can be used to reduce symptoms caused or increased by stress such as neck, shoulder and back tension, digestive problems, worrying and insomnia. The video lecture is sequentially translated from English to Japanese.  Click on the link to watch the video lecture.

http://cat-vnet.tv/movie/medical_health/suimin_02/001_02.html

Presentation1

*The program was organized by Toshihiko Sato, Ph.D., Dept. Health and Social Services, Faculty of Medical Sciences and Welfare Tohoku Bunka Gakuen University, Sendai.


Epilepsy: New (old) treatment without drugs

Nothing is so hard as watching a child having a seizure.

           –Elizabeth A. Thiele, MD, PhD, professor of neurology at Harvard Medical School

Until recently, when people asked me, “What would I suggest as a non-toxic/non-invasive biofeedback approach for the treatment of epilepsy?” I automatically replied, “A combination of neurofeedback, behavioral analysis treatment, respiration training, a low glycemic diet, and stress management and if these did not work, medications.” I have now changed my mind!

Epilepsy is diagnosed if the person has two or more seizures. About one to two percent of the population is diagnosed with epilepsy and it is the most common neurological illness in children. Medication is usually the initial treatment intervention; however, in about one third of the people, the seizures will still occur despite the medications. In some cases, people -often without the support of their neurologist/healthcare provider–will explore other treatment strategies such as diet, respiration training, neurofeedback, behavioral control, diet, or traditional Chinese medicine.

It is ironic that one of the tools to diagnose epilepsy is recording the electroencephalography (EEG)– brain waves–of the person after fasting while breathing quickly (hyperventilating). For some, the combination of low blood sugar and hyperventilation will evoke epileptic wave forms in their EEG and can trigger  seizures (hyperventilation when paired with low sugar levels tends to increase slow wave EEG which would promote seizure activity).
If hyperventilation and fluctuating blood sugar levels are contributing factors in triggering seizures, why not teach breathing control and diet control as the first non-toxic clinical intervention before medications are prescribed. This breathing approach has shown very promising clinical success.  (For more details  see the book, Fried, R. (1987). The Hyperventilation syndrome-Research and Clinical Treatment. Baltimore: The Johns Hopkins University Press).

Self-management should be the first clinical intervention and not the last. Similarly, neurofeedback– brain wave biofeedback–is another proven approach to reduce seizures. This approach was developed by Professor Maurice B. Sterman at UCLA and was based upon animal studies. He demonstrated that cats who were trained to increase sensory motor rhythm (SMR) in their EEG  could postpone seizure onset when exposed to a neurotoxin that induced seizures. He then demonstrated that human beings with epilepsy could equally learn to control their EEG patterns and inhibit seizures. This approach, just as the breathing approach, is non-toxic and reduces seizures.

Underlying both these approaches is the concept of behavioral analysis to identify and interrupt the  chained behavior that leads to a seizure. Namely, a stimulus (internal or external) triggers a cascading chain of neurological processes that eventually results in a seizure. Thus, if the person learns to identify and interrupt/divert this cascading chain, the seizure does not occur. From this perspective, respiration training and neurofeedback could be interpreted to interrupt this cascading process. Behavioral analyses includes all behaviors (movement, facial expressions, emotions, etc) which can be identified and then interrupted. As professors Joanne Dahl and Tobias Lundgren from Uppsala University in Sweden state, The behavior technology of seizure control provides low-cost, drug free treatment alternative for individual already suffering from seizures and the stigmatization of epilepsy.

Until recently, I would automatically suggest that people explore these self-control strategies as the first intervention in treatment of epilepsy and only medication for the last resort. Now, I have changed my mind. I suggest the ketogenic diet as the first step for the treatment of epilepsy in conjunction with the self-regulation strategies—medication should only be used if the previous strategies were unsuccessful.

A ketogenic diet  has a 90% clinical success rates  in children–even in patients with refractory seizures. This diet stabilizes blood sugar levels  and is very low on simple carbohydrates, high in fat,  some protein, and lots of vegetables (a ratio of 4 grams of fat to 1 gram of carbohydrates and protein). In adults, the success rates drops to about 50%. The lower success rate may be the result of   the challenges in implementing these self-regulatory diet approaches. As Elizabeth A. Thiele, MD, PhD, professor of neurology at Harvard Medical School points out, dietary therapy is the most effective known treatment strategy for epilepsy. Even though, ketogenic diet is the most effective therapy, it is less likely to be prescribed than medications—there are no financial incentives; there are, however, many financial incentives for prescribing pharmaceuticals.

These lifestyle changes are very challenging to implement. They need to be taught and socially supported. Just telling people what to do does not often work. It is similar to learning to play a musical instrument.  The person needs step by step coaching and social support which is an intensive educational approach. To learn more about the research underlying the ketogenic diet as the first level of intervention for epilepsy, watch Professor Thiele’s presentation from the 2012 Ancentral Health Symposium, Dietary Therapy: Role in Epilepsy and Beyond.


There is hope for neurological recovery: Redirect behaviors of habit

Although many neurological disorders appear to be structural and the result of neurological dysfunctioning, recent research suggests that there is much more hope that people can learn to restore function.  Even people affected by  stroke, cerebral palsy, or epilepsy can regain function.  The observed symptoms and dysfunctional movement patterns can be understood as the nervous system’s best strategy to solve a problem at that moment and is the best response the person could perform under the circumstances.  For example in the case of  stroke, a spastic movement is the best solution that becomes a conditioned habit pattern. It may occur because the person tries to achieve the previous motor behaviors which  can no longer be performed because of the neurological damage. With cerebral palsy, the initial damage at birth changed the motor patterns as the child attempted to walk.  While in cases of epilepsy, the spreading of the seizure across the brain is not inhibited. Despite the neurological damage, improvement is possible as demonstrated by Jill Bolte Taylor’s presentation of her experience and  remarkable recovery from a left hemisphere stroke.

Application to stroke rehabilitation

A useful premise underlying neural regeneration and development is that it healing follows developmental movement sequences which cannot be skipped.  Thus after a neurological injury such as a stroke, the movement sequence needs to be re-integrated. It is not relearning what was lost; it is learning the new skills as if the skills are being learned for the first time. This includes an attitude of acceptance, non judgment, fun, play and exploration concurrent with many, many, many training practices until the skills are mastered.  Thus stroke patients sitting in wheelchairs may try to repeat movements which were present before the stroke but which are now beyond the biological developmental stage due to the neural damage. The person instead needs to learn anew the movement sequences that a baby mastered (lifting the head, rolling over, cross crawl moment, crawling, etc). This takes lots of practice. Compare the many hours a baby/child practices in order to be able to stand to the limited time people with strokemay spent performing their prescriptive exercises.  Thus, children usually show mastery while many people with stroke demonstrate limited improvement.  It is practice, practice and practice; it is not mindless practice, it is practice with awareness and intent.

Dysfunctional patterns can be understood as over learned conditioned chained behaviors which occur automatically. A superb explanation of this process is described by Charles Duhigg in his book, The power of habit-Why we do what we do in life and business. Clinical success is to identify these chains and the sequential steps  and then teach the person to redirect the behavior.

Application to epilepsy

Some people with epilepsy can learn to identify the initiation of the seizure and then interrupt the cascading sequence by doing something different. In this way the seizure process is interrupted and no seizure will occur.  For example, one man hyperventilated before a grand mal seizure. When the therapist taught him to become aware and  change his breathing pattern each he began to hyperventilate, his epileptic seizures did not occur. Similarly, a young woman with epilepsy turned her head to the right and slightly lifted her chin upward just before an absence seizure occurred. Teaching her to interrupt her initial head movement and looking straight ahead while slowly exhaling inhibited her seizures. The efficacy of this type of behavioral analysis for the treatment of epilepsy has been described by psychologists, Joanne Dahl, PhD and Tobias Lundgren, PhD in their superb article, Behavior analysis of epilepsy: Conditioning mechanisms, behavior technology and the contribution of ACT.

Another powerful treatment approach to treat seizures was developed by M. B. Sterman, Ph.D. at UCLA who taught people with epilepsy to control their own electrical activity of their brain with neurofeedback. Many people benefited from neurofeedback training and significantly reduced their seizures.

Application to cerebral palsy

To appreciate the power of interrupting the chained behaviors and the possibility that there is hope for people with cerebral palsy. This is illustrated in the remarkable TEDx Winnepeg talk, Baby brains DO recover, but habit hides it, by Karen Pape, MD.