Alzheimer's Disease. Michelle Deetken

      The Problem

      Alzheimer's disease (AD) is on the rise not only in the United States, where over 5.4 million Americans have experienced the disease as of 2011, but also worldwide. The World Health Organization warned that AD might affect sixteen million Americans and possibly 115 million people worldwide by 2050. According to the National Institute of Aging in the United States, one in eight baby boomers will experience AD in their later years of life. The countless numbers of people who will develop AD represent a crisis. Additionally, because of the long duration of the disease and the high cost of managing it, AD poses one of the greatest challenges to our society medically, economically, and emotionally. Prevention may be the best tool to defend against this frightening disease.

       Why the Increase?

      What is contributing to this accelerating rate of incidences of AD? Interestingly enough, the major contributing factor is that we are living longer and healthier lives. Age is the foremost risk factor for Alzheimer's disease that is not related to genetic factors; people over the age of eighty-five have a 30 percent chance of showing signs of dementia. Our great-grandparents typically died of complications from heart disease or cancer in their sixties or seventies, and therefore the incidence of AD was low. To date, there is no evidence that AD is spreading throughout the baby boomer population other than the fact that Americans are living longer. Simply put, there are now more middle-aged people at risk for brain aging conditions once they reach their eighties or nineties.

      At present, the average life expectancy is eighty-seven years and is expected to climb steadily. Living over a century is no longer rare. Longevity has come about through better health care and pharmaceuticals, a larger variety of food choices, readily available supplements for every health concern, an increased awareness of the importance of exercise, and the reduction of cigarette smoking. On a side note, current smokers are 50 percent more likely to develop AD or other dementias then those who do not smoke or those who are past smokers (Reitz, C., et al., 2007). Even though old age is the number one risk factor, there is another side to the increase of Alzheimer's disease. Mental disorders like dementia do not represent the process of normal aging. Memory loss is normal in older people but that does not mean that they have dementia. Today many people age gracefully into their nineties and beyond without any signs of AD or other dementia. There must be other environmental and lifestyle reasons for the enormous predicted increase of this devastating disease.

      Over the last one hundred years or so, our world has become more and more industrialized, most of which has been to our benefit; but unknown health consequences have arisen that are now highlighted because of our long lives. Beneficial advances have been made in animal husbandry, synthetic fertilizer and pesticide use, and most importantly, in food processing and distribution. Instead of raising our own animals or produce, which is hard work and time consuming, everything has become readily available at the local grocery store. One disadvantage is that consumers have thousands of overly processed and refined food choices. Another disadvantage includes the fact that modern animal husbandry has changed the composition of the fat content of farm animals. These animals were taken from the field where they grazed on grass to be raised in warehouses were they consume corn and soybean products while receiving antibiotics and growth hormones. Synthetic fertilizers and pesticides have made their way into our tissues, a problem we are not equipped to handle because our bodies can not break them down so these chemicals can then build up inside our cells and disrupt their activities. Processed and refined foods have lost their natural nutritional composition because most of their nutrients have been stripped away or destroyed. Consuming these foods leads to poor assimilation of whatever nutrients are left after processing. Though some vital nutrients are added back into foods after processing, these nutrients are usually synthetic and are poorly assimilated, if at all. Distribution often leaves even wholesome foods such as fruits and vegetables with little or no nutrient content because the minute these foods are harvested, they start to lose their nutritive benefits—especially the vitamins. If foods travel long distances and then wait in a warehouse before going to a store, most of the nutrients have decayed by the time they get to our homes (Jensen and Anderson, 1990).

      There is also the problem of convenience. It is much easier, and sometimes more economical, to throw something into the microwave oven or to obtain meals from a fast-food restaurant—especially a drive-through establishment—when life gets too busy for cooking at home. Shopping, preparing, and cooking food takes time, and time is a luxury some households think they cannot afford. Some people believe it is too much trouble to cook all of the time—or at all—and are unaware that their choice of convenient foods is unhealthy, while others have no idea how to cook, opting for prepackaged foods rather than starvation. There are also those people who live in what are called the “food deserts” of inner cities, where food choices are limited because there are no local grocery stores. Instead, there are many fast-food restaurants and convenience stores that usually do not carry fresh foods. Even more disturbing is that over the last two decades, fast foods and sugary drinks have become a dominant part of the food culture at an ever-earlier age. This trend has created an unbalanced chemical makeup in many people, with the unknown health consequences resulting in a host of chronic diseases. The main examples are heart disease, strokes, obesity, type 2 diabetes, many types of cancer, Alzheimer's disease, and other dementias.

       Biochemistry out of Balance

      One example of an unbalanced chemical is glucose. Glucose is a simple sugar or simple carbohydrate found in abundance in our modern food supply and might be one of the culprits responsible for the decline of cognitive function. Glucose is vital to the brain because it is the brain's preferred energy source. For instance, the energy that glucose provides is required for the synthesis, release, and uptake of neurotransmitters such as serotonin, norepinephrine, and acetylcholine (a neurotransmitter that is known to be low in AD patients). As a result of this unbalance, metabolic conditions may interfere with the brain's ability to obtain and utilize glucose. Although the brain will try to adapt through the use of other fuels, low glucose levels cause a decline in the brain's overall metabolic activity.

      What “metabolic conditions” interfere with glucose's availability to the brain if it is so abundant in today's foods? This abundance is the problem—there is too much of a good thing! You might notice that if you read the nutritional facts of foods, glucose is not listed. Nevertheless, it is there—hidden in ingredients like sugar, brown sugar, sucrose, dextrose, maltose, corn syrup, and high fructose corn sugar.

       Carbohydrates

      Let's have a short lesson on carbohydrates to understand the importance of glucose. Dietary carbohydrates are either simple carbohydrates (sugars) or complex carbohydrates (starches and fibers). The building blocks of all carbohydrates are three sugars: glucose, fructose, and galactose. Fructose is the sweetest of the sugars and is found naturally in fruit and honey. Galactose binds together with glucose to form lactose, or milk sugar. Fructose and galactose will be converted to glucose in the liver. Glucose is the most abundant sugar in nature, and it is found in all plants as starch. Starch is the way that plants store their glucose for energy, which is in long chains of hundreds or thousands of glucose molecules. Since all animals consume some plants, glucose is the main energy source for almost every living thing. When a body consumes plants, the complex carbohydrates (starch and fiber, along with their associated minerals and vitamins) are slowly digested, and the glucose is released at a modest, regulated rate so that the blood glucose levels rise only slightly. Starches like those found