A recent study by BYU has linked lifestyle choices, at least in part, to Alzheimer’s disease, through findings showing a possible energy gap between the amount of glucose and ketones used to power the brain.
BYU professor Ben Bikman, who studies diabetes and insulin resistance, thought of a fundamental question related to Alzheimer’s and insulin resistance in the brain.
Bikman said there is growing evidence that the brains of people with Alzheimer’s disease are deficient in glucose.
“The brain has a certain demand for energy, say that’s 100%,” said Bikman. “In most cases, glucose provides practically all of the energy, almost 100%. There is a secondary fuel known as ketones so the average brain uses almost all of its energy from glucose, with some energy coming from ketones at any given point. In some people, the brain begins to interfere with its ability to use glucose. Now glucose can only provide around 60% of that energy, and then ketones are expected to replenish the rest of that energy. The tragedy is that the average person has almost undetectable levels of ketones, and that’s entirely a lifestyle choice. “
This lack of ketones, as well as the brain’s insulin resistance, are lifestyle related. Insulin is expected to stimulate tissues or cells to take up the glucose and use it for energy.
When the brain becomes more insulin resistant, it can no longer absorb glucose, and this has been shown in other research, according to Bikman. BYU research expanded some of these findings.
“We found that the expression of genes involved in glucose metabolism actually decreased significantly and was very broad across every cell type we looked at in the brain,” said Bikman. “All of the cell types we studied had significant reductions in glucose-related genes, but the ketone-related genes were almost completely normal.”
This is important as it shows that if the brain can receive more ketones, then there is a chance that this energy gap can be bridged. While it may not be filled with glucose, it can be ketones, but ketones must be made by your own body.
Many people on diets high in refined sugars and starches have high levels of insulin and ketones only when insulin levels are low. These conditions include fasting or low-carbohydrate diets, also known as keto diets.
Ph.D. Student Erin Saito is another of the study’s lead authors and is doing this project as her dissertation. Another collaborator was the Washington University of Saint Louis, which gave the BYU research team access to various brain banks.
“BYU is a wonderfully collaborative environment that encourages collaboration not only within the university but also outside the university,” said Bikman. “Therefore, communication with our internal and external employees was very easy and very natural. There was a shared interest in working together on this project, a shared enthusiasm for answering a question that had not yet been asked. This would not have been possible without this mutual cooperation and enthusiasm. “
He added that managing the project with enthusiastic students is a joy which it makes easy due to the excitement that surrounds the project.
Bikman said he was delighted to be able to contribute to what little is known about Alzheimer’s disease as traditional strategies and approaches have continued to fail.
“Viewing Alzheimer’s disease as a metabolic problem is the biggest breakthrough in our understanding of the disease in decades,” said Bikman.
If you look at it through the metabolic side of things, you can potentially identify the problem years in advance and examine changes in the brain’s glucose metabolism long before Alzheimer’s onset.
Bikman believes that one day the metabolic approach will be the standard of care in Alzheimer’s disease.
Going forward, Bikman hopes people will feel empowered when it comes to Alzheimer’s disease. He wants people not to see it as a passive process of being the victim, but rather to acknowledge that their lifestyle choices can act as either a culprit or a remedy.
“For too long we have viewed Alzheimer’s disease as a disease that has no respect for the person, no respect for decisions, and which is just not true,” said Bikman. “We have long known that people with metabolic disorders like type 2 diabetes and insulin resistance are at significantly higher risk of developing Alzheimer’s, and we have more evidence that dietary habits and changes make a person’s cognition significantly better.”
Even someone in the midst of Alzheimer’s disease can see improvements in memory and learning with lifestyle changes, according to Bikman. He hopes that this evidence will help strengthen this view and empower individuals to take matters into their own hands.