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About Amy Berger, MS, CNS, NTP
Amy Berger, MS, CNS, NTP, is a Certified Nutrition Specialist and Nutritional Therapy Practitioner. She is a US Air Force veteran who now specializes in using low-carbohydrate nutrition to help people reclaim their vitality through eating delicious, wholesome foods, and teaching them that achieving vibrant health doesn’t require starvation, deprivation, or living at the gym. Her motto is, “Real people need real food!” You can read her blog at www.tuitnutrition.com, where she writes about a wide range of health and nutrition-related topics, such as insulin, metabolism, weight loss, thyroid function, and more.
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02:16 The Alzheimer’s Brain: In a significant variant of Alzheimer’s, neurons in a certain region in the brain lose the ability to use glucose efficiently as a fuel. It is an energy crisis. The connections enlarge, the synapses atrophy and the cells starve. There is something we can do about this.
03:54 Brain Fuel Metabolic Disorder: We do not know why the neurons struggle to harness energy from glucose. Research is beginning to show that many of these people are hyperinsulinemic. They may not have it in the periphery, but they have it in the central nervous system. A blood test may show that they might not have chronically high insulin, yet in their brain they have a deficit of insulin. Insulin has functions inside your brain. It is one of the things that helps your brain use glucose. There may be a problem getting glucose into the brain or glucose in the brain into the cells to be used properly.
05:04 Type 3 Diabetes: Alzheimer’s has similarities to type 2 diabetes. There is still debate about what causes type 2 diabetes.
06:21 Diabetes and Alzheimer’s: Some of us will have normal blood glucose and normal hemoglobin A1C because of very high insulin. Sometimes Alzheimer’s patients have normal glycemic response, but not in the brain. A PET scan will show the cerebral uptake of glucose.
07:35 Early Detection: Even people in their 30s and 40s can show a decline in cerebral glucose uptake. They do not yet have symptoms. This is the time to intervene. Brain fog at these early ages is often cleared with a low carb ketogenic diet.
09:31 Ketogenic Diet to Restore Cellular Energy: In an Alzheimer’s affected brain, ketones will enter the brain and they will be used. This has been studied it in animals and humans. The impairment of glucose metabolism does not affect ketone metabolism. The brain still needs glucose, but much of the brain’s energy can be supplied by ketones, so the requirement for glucose is less. One mouse study showed that the uptake of ketones actually improved the usage of glucose as well.
14:10 Beta Amyloid: Beta amyloid is a protein. A few types of these fragments are specifically tied to Alzheimer’s pathology. These fragments accumulate in the brain in all of us. The problem in Alzheimer’s is that they accumulate and solidify into plaques. Amy believes that they are an exacerbating or defensive factor once the cause is established. When they become abundant, they will block synapses and cellular communication between neurons. They can also become glycated.
16:24 Insulin Degrading Enzyme: It is an enzyme that gets rid of insulin once it has been used. It also gets rid of amyloid proteins. The Alzheimer’s brain does not appear to produce more of these amyloid proteins. The problem is that they are not cleared away properly. There are people with Alzheimer’s who do not have the plaques and young people with the plaques that do not have Alzheimer’s. The plaques are not causing the disease.
20:57 Sleep Dysregulation: People with Alzheimer’s disease tend to have sleep issues and altered circadian rhythms. Alzheimer’s may cause sleep issues, or sleep issues may contribute to Alzheimer’s. Amy thinks that it is both. Metabolic waste is cleared from the brain all the time, but it is upregulated during sleep. The clearance of beta amyloid proteins is greater during sleep.
23:48 Brain’s Need for Glucose: The brain’s requirement for glucose does not imply a need for dietary carbohydrate. We can make glucose from other things. Your body makes glucose. Gluconeogenesis occurs at the same time as ketosis. Glucose is not toxic. Problems occur when it is too high for too long too frequently. Protein raises glucose, but it does not spike it. Blood glucose and insulin are supposed to rise a little with protein consumption. The average person who wants to lose weight, is probably better off eating a little more protein. The elderly generally need more protein than they are currently consuming.
31:25 Exogenous Ketones: With the cellular energy crisis in the brain, neurons atrophy. Axons atrophy and recede back into the neuron, breaking down cellular communication. The cells are not dead. We know this because when people receive exogenous ketones improve cognition. If you are doing a ketogenic-type diet for general health and fitness, exogenous ketones are not necessary. For neurodegeneration, exogenous ketones can be powerful. It is a short term symptom fix, unless coupled with a ketogenic or low carb diet. The ketogenic diet, which promotes your body to produce its own ketones, and other lifestyle interventions can, to some degree, reverse the damage. High glucose and high ketones in the body at the same time is type 1 diabetic ketoacidosis.
41:36 Lifestyle Changes: Exercise is good for brain plasticity. Brain-derived neurotrophic factor is a protein that helps neurogenesis. Give neurons a reason to stay active. Being in nature has a big impact. Exercise also improves the insulin sensitivity system and glucose dynamics. Stress reduction and management is important. Many Alzheimer’s patients have been under chronic stress for a long period. A lot of type A people get Alzheimer’s.
47:40 ApoE4 Gene: It is the biggest genetic risk factor for Alzheimer’s is the ApoE4 genotype. It does not cause Alzheimer’s. It is a risk factor. It increases susceptibility in the context of a high carb diet and a sedentary lifestyle. There are people who are homozygous E44 who do not develop Alzheimer’s. Most people with Alzheimer’s are not E44s.
50:29 Statin Contribution to Alzheimer’s: The brain is practically built from cholesterol. If you are not getting enough cholesterol to the brain or your brain is not synthesizing cholesterol, it is a disaster. Statins probably contribute significantly to the disease. Cholesterol is important for healthy cognition.
55:08 Amy’s Morning Routine: Do as I say, not as I do. She has no morning routine. She must drink coffee upon waking. She tries to do a long walk in the morning. Being in the daylight, even when it is overcast, makes her feel better. She walks or exercises fasted.
56:58 Amy’s Favorite Exercise: For BDNF, higher intensity like sprinting or lifting would be best for making yourself and your brain more robust. Walking is one of the most beneficial things to do for general maintenance.
01:00:01 Amy’s Favorite Nutrient: Grass fed beef is her preference. Beef provides iron, zinc, B12, and selenium.
01:01:03 Amy’s Elevator Speech: End grain subsidies to bring price parity.