A former student and friend recently asked me about a claim she had seen on social media about Alzheimer’s disease (AD)—dementia, in general—being “type 3 diabetes”. It was current for me, as I am presently teaching a course called “Pathophysiology & Exercise” and Alzheimer’s/dementia was a current topic. She sparked my interest. This claim was new to me, so I told her I would have to do some research. de la Monte and Wands1 seemed like a good place to start.
There seems to be reason to call AD “type 3 diabetes”. de la Monte and Wands concluded that the label “accurately reflects the fact that AD represents a form of diabetes that selectively involves the brain and has molecular and biochemical features that overlap with both type 1 diabetes mellitus and (type 2 diabetes mellitus)”. Insulin deficiency and insulin resistance may mediate Alzheimer’s disease-type neurodegeneration and give cause to evaluate our diets, body compositions, and exercise habits.
Central to metabolic syndrome (the coexistence of insulidemia, hyperlipidemia, and hypertension) is obesity. AD, to my knowledge, does not have the same ties to obesity as does type 2 diabetes. It does, however, raise concern about sugar in the diet—particularly refined sugars and processed foods.
The current evidence regarding AD—as well as cardiovascular disease—would certainly warrant the limiting of sugar from the diet. I have suggested this in several previous posts. I don’t think we have to go to extremes, after all, what is the point of living longer if one can’t enjoy some pleasures like an occasional good dessert (i.e., “opportunity costs” when it comes to dessert—make it worth the indulgence). We have to be careful, however, and not go to the extreme of eliminating carbohydrates all together. It is a matter of making more healthy choices and maintaining consistency.
I am inclined to think a more keto-friendly diet is warranted for most sedentary individuals. And, considering the benefits for epileptics, it might be beneficial for those at risk of AD. As exercise and activity levels increase, however, carbohydrates are going be increasingly important—especially to maintain performance. So, balance is most important.
There is no known cure for AD, but one can likely reduce the risk by managing body fat, limiting refined sugars, and exercising regularly and consistently. In consideration of diet, low carbs should not mean zero carbs. The high-fat “bacon” approach to a keto-friendly diet is not recommended. Rather, one should focus on lean protein sources, healthy fats (e.g., fish oils, avocado, olive oil, nuts, etc.), and lots of vegetables. Avoid added sugars and simple carbohydrates. Avoid foods with a lot of additives. Limit alcohol and sweets. If you decide to splurge, make worthwhile decisions—a dessert in a cellophane wrapper will not be nearly as rewarding as something homemade or chef prepared. (In other words, indulges should be guilt- and regret-free—and only occasional.)
It will be interesting to see where how the “type 3 diabetes” classification develops. With regards to insulin resistance, we know there are things we can do to minimize our risk. These are things that we should already be doing: maintain a healthy body composition, exercise, eat right, and get sufficient sleep. These require regularity and consistency. In other words, be habitual about diet and exercise.
Be your best today; be better tomorrow.
Carpe momento!
1de la Monte, S.M. & Wands, J.R. (2008). Alzheimer’s diseases is type 3 diabetes—evidence reviewed. J Diabetes Sci Technol. 2(6):1101-1113. doi: 10.1177/193229680800200619