Sugar Isn't Always a Villain

According to Some Nutritionists

"Cartoons and Poems following each article are created and copyrighted by Dr. Ackerman and cannot be copied or reproduced without his permission."

Sometimes I run across an article that's a bit old, but contains important information, which I had not been aware of before, and I feel that my readers should know about it. Although I usually prefer to use the most current material, this article caught my attention when it was forwarded to me by a friend, and I noticed that many people may be wrongly assuming that sugars and carbohydrates are always without redeeming values. It was written by a group of Canadian researchers led by Randall J. Kaplan from the Department of Nutritional Sciences at the Faculty of Medicine of the University of Toronto and supported by a grant from the Natural Sciences and Engineering Research Council of Canada so we appear to be dealing with a reliable source of nutritional information. The article was published in September of 2000 in a well-respected journal, The American Journal of Clinical Nutrition, with the title "Cognitive performance is associated with glucose regulation in healthy elderly persons and can be enhanced with glucose and dietary carbohydrates."

It seems that the idea behind this study was really nothing new. For example an article by Strachan and colleagues in Diabetes Care back in 1977 showed that elderly subjects with type 2 diabetes (the common late onset form) usually do worse on memory tests than do control subjects. Other articles noted that even people who have no evidence of frank diabetes, but do show poor regulation of glucose, perform worse, and furthermore, if you improve glucose regulation by giving hypoglycemic pills to patients with cognitive defects caused by diabetes, the defects may also improve. It wasn't long before the list of studies testing glucose drinks grew rather long. The conclusion was usually that people who have poor glucose regulation, or perhaps for some reason have memory deficits, would do better, and incidentally, even healthy subjects showed improvement with glucose drinks. This sort of improved performance extends to healthy elderly subjects, and Alzheimer patients - as a matter of fact, more so than it does in healthy youngsters. Others have shown that a blood glucose concentration range of 8 to 10 millimols per liter provides the best results. Apparently, the greatest benefit is to the ability to recall facts or events over the long term, which relates this effect to the medial temporal lobe and hippocampus areas of the brain.

When cognitive function was tested, using meals instead of a drink given to healthy adults, conclusions were indefinite. Since some of this testing failed to correlate with regard to such things as the time element and the age range, the authors of this study decided to be more specific. They therefore concentrated on testing glucose regulation in healthy elderly persons in order to determine if there is any benefit of glucose and common carbohydrate foods on cognition, while carefully noting the point at which this occurred following ingestion.

Their results backed up the contention that glucose regulation does appear to improve cognitive performance in the healthy elderly whose glucose tolerance was normal. When they tested individuals whose memories were somewhat impaired by giving them potatoes and barley to increase their dietary carbohydrates improvement was evident. Overall performance, in general, did not improve, but these subjects did improve with regard to immediate and delayed paragraph recall when ingesting potatoes, barley, and glucose. Beta-cell function was also tested due to its known correlation to relative cognitive impairment. A conflicting discovery was that patients who were impaired at baseline - prior to eating the test foods - improved when given the carbohydrate, but individuals who were not impaired at baseline actually got somewhat worse.

In the final analysis the study showed that a high glucose response curve, poor beta-cell function, good insulin sensitivity, and a low basal metabolism index were indicative of poor cognition in healthy older individuals even though their glucose tolerance was normal. When given foods containing carbohydrates or glucose, those individuals who were healthy, but had relatively poor memories, or had poor beta-cell function, showed improved cognition. Even a minor deficit in glucose regulation seems to create a problem. Cognitive tests are worse. However, if such individuals are given carbohydrates, they improve, unlike their counterparts who do not start out with a deficit, and actually get worse after ingesting them.

What all this means to the type 2 diabetic is not exactly clear. According to the authors, there seems to be strong evidence from earlier studies that these individuals, like others with impaired glucose tolerance, but not frank diabetes, fair worse on cognitive tests. In this study it was shown that even having a normal glucose tolerance didn't matter. A recent study of young adults showed the same thing. It seems that brain function may already be impaired very quickly once glucose management becomes deregulated. They propose, therefore, that appropriate diet may help prevent this problem. Perhaps reducing saturated fat intake, which is associated with poor glucose regulation and cognition, may be one way to help avoid trouble.

Cartoons and Poems following each article are created and copyrighted by Dr. Ackerman and cannot be copied or reproduced without his permission. Copyright © 2007 by Marvin Ackerman, M.D.

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