Diabetes Self-Management Blog

We’re all getting older. And while there’s not too much we can do about it, for most of us, our hope is that we age with grace, dignity, and some semblance of normal cognitive and physical functioning. Others also hope to preserve their youthful appearance.

When diabetes comes into the picture, things can get murky. By this I mean that some evidence points to the link between Type 2 diabetes and a decrease in the ability to concentrate, problem solve, and provide thoughtful answers to questions. Other research indicates that people who have uncontrolled diabetes have almost twice the risk of cognitive dysfunction as people without diabetes. Why? It’s possible that constant high glucose levels impair small blood vessels in the brain, leading to ministrokes. Another possibility is that high glucose levels damage neurons (nerve cells) in the brain.

And not to spread doom and gloom, but evidence shows that people with both Type 1 and Type 2 diabetes have a 30% to 65% higher risk of developing Alzheimer disease compared with people who don’t have diabetes. Some researchers have coined a “new” type of diabetes, called “type 3 diabetes” that is marked by insulin deficiency in the brain. Folks at Rhode Island Hospital and Brown University discovered that insulin and certain kinds of protein are made in the brain; low levels of both can lead to degeneration of neurons, increasing the risk for Alzheimer disease.

So that brings us to this question: What, if anything, can be done to prevent a decline in cognitive function? Is there anything that we can do, take, or eat that will keep our brains and nervous system functioning at a high level as we get older? The answer? Maybe.

Dietary Supplements
It would be so easy to pop a pill or two and expect miraculous results. The reality, though, is that, at least when it comes to aging, there’s not a lot of evidence that any one particular supplement can help slow mental decline. But it’s early days yet, and hopefully scientists will discover the fountain of youth. Here are a few of the leading candidates that have been marketed as “brain supplements”:

  • Ginkgo biloba. Ginkgo biloba is an herb that has been used as a medicine for thousands of years. It’s one of the most commonly used supplements for brain health; in fact, Americans spent more than $100 million dollars on ginkgo in 2007. Why? While ginkgo is used for a number of different reasons, it’s often touted as helping to enhance memory and treat Alzheimer and dementia. Some early studies indicated that this herb might be beneficial for these conditions, but in a new study, published in The Journal of the American Medical Association, ginkgo failed to live up to its promise of slowing cognitive decline (the same authors of this study published another study last year that ginkgo also doesn’t help prevent Alzheimer and dementia). Ginkgo may possibly help with other conditions such as asthma, tinnitus (ringing in the ears), and fatigue, but it likely isn’t going to help boost brain function. Is taking ginkgo harmful in any way? Ginkgo can increase the risk of bleeding, and also cause headaches, nausea, dizziness, and skin reactions. There’s likely no reason to start taking ginkgo at this point. However, a typical dose is 120–240 milligrams per day divided into two to three doses.
  • Beta-carotene. Beta-carotene is part of a family of carotenoids — natural, fat-soluble pigments that give many fruits and vegetables their color. Beta-carotene is a provitamin (a substance that is converted into a vitamin in the body) because it gets converted to vitamin A. Carotenoids are considered to be antioxidants. Beta-carotene has been linked with cognitive functioning in the Physicans’ Healthy Study, a study designed to evaluate the benefits and risks of aspirin and beta carotene in preventing cardiovascular disease and cancer.

    Cognitive testing was added to the Physicians Health Study II, a second trial designed to evaluate various supplements for their ability to prevent cardiovascular disease, cancer, age-related eye disease, and cognitive decline. In this study, 4,052 men were given either 50 milligrams of beta-carotene or low-dose aspirin every other day from 1982 to 1995. An additional 1,904 men were also given either 50 milligrams of beta-carotene or low-dose aspirin every other day from 1998 to 2001. The men who had been taking beta-carotene long-term (for about 18 years) had a better memory than the placebo (inactive treatment) group. The researchers concluded that taking beta-carotene for many years improves thinking skills and memory. One of the study authors noted that the benefits seen with beta-carotene were greater than what was observed in a study with donepezil (Aricept), a drug used to treat Alzheimer.

    So should you start popping beta-carotene supplements? It’s hard to say. Beta-carotene supplements may increase the risk of lung cancer, prostate cancer, cerebral hemorrhage, and overall mortality in people who smoke or who have been exposed to high levels of asbestos. Beta-carotene from food sources (which include sweet potatoes, winter squash, carrots, spinach, kale, broccoli, and cantaloupe) are safe, although to get the equivalent of 50 milligrams of beta carotene, be prepared to eat about 4 cups of spinach every day!

More next week!

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Boosting Brain Health: Do Supplements Really Help? (Part 1)
Boosting Brain Health: Do Supplements Really Help? (Part 2)
Boosting Brain Health: Do Supplements Really Help? (Part 3)


Comments
  1. Its easy to overdose with beta-caroteen supplements too. I have and was told by my doctor that the high concentration of vitamin A is the reason why Eskimos were always unable to eat Polar Bear Liver.

    Posted by Harry......................... |
  2. Thanks Harry. You’re right — one can take too high a dose of beta-carotene in supplement form, which may slighty increase the risk for heart disease and, in those who smoke, lung cancer. However, just to clarify: Beta-carotene is a much safer form of vitamin A. Polar bear liver contains extremely high doses of vitamin A, not beta-carotene, which can be fatal for humans.

    Posted by acampbell |
  3. An otherwise helpful article posted by acampbell Jan 14 2010 at 4:08 pm contains the statement “Polar bear liver contains extremely high doses of vitamin A, not beta-carotene, which can be fatal for humans.”.
    Is the author stating that vitamin A can be fatal for humans — or– carotene can be fatal for humans. Appreciate clarification.

    Posted by Bill |
  4. so if I began taking beta carotene, what is a safe dose for a woman with diabetes type2?

    Posted by gigi |
  5. Hi gigi,

    Six to 15 milligrams of beta carotene is a fairly standard dose.

    Posted by acampbell |
  6. Hi Bill,

    Too much vitamin A can be fatal. However, this is a very rare occurence, since most people don’t eat polar bear liver!

    Posted by acampbell |
  7. Amy, having taken nutritional supplements for many years, I’m a big believer in supplements and have found Healthy Humans as my current supplier. They are following an entirely new health care paradigm. Please contact me directly as I’d like to discuss this in more detail with you.

    Posted by Will Ryan |
  8. Thanks for the information and the peace of mind…
    I’ve been taking these vitamin A supplements for a while but was concerned when I heard you could overdose so was pleased to read your article and find it was still a sensible decision because I couldn’t eat that much spinach!

    Posted by Steve |
  9. You’re welcome, Steve. But I’m hoping you’re taking beta carotene, not vitamin A!

    Posted by acampbell |
  10. It’s not often you actually see an author replying to comments. I don’t know how relevant but I don’t take vitamin A supplements but do drink 2-3 bottles of carrot juice (Nake Juice) per week, which contains 400% of beta carotene.

    In fact, I really don’t take many supplements other than Vitamin B/Biotin for hair health (yeah.. I’m “maintaining”) and Vavalert brain supplement for improved focus and short/long term memory. i tried other products that contained very little more than synthetic (not food based) vitamins and was rather unimpressive. The differentiator for me with vavalert was the main ingredients of cocoa and green tea, which I researched and found studies that showed their synergy.

    Look forward to any suggestions/thoughts you have.

    P.S. Everything in moderation!

    thanks!

    Posted by Rami |
  11. I’d rather enhance my odds with positive bet on supplements. Dark red wine, Fish Oil, and others.
    Unless they hurt, I rather fault on safe side by taking.

    I got hemorages off my retina’s and healed up by gettin A1c down and Lutein, Vitamin C, Vitamin E and others. Did supplements help - who knows; my body and eyes did better.

    Posted by jim snell |
  12. Hi Rami,

    Vavalert is new to me. It contains theobromine, which is a chemical that is similar to caffeine. Theobromine is a stimulant, so it can cause rapid heart beat and can lower blood pressure. However, it appears to be relatively safe. Beyond that, though, I’m really not familiar with this supplement, so, as with kind of supplement, take it with some caution and stop taking it if you have any side effects.

    Posted by acampbell |
  13. Thanks for the great info, Amy.

    In reference to vavalert, i’ve been taking it along with my wife now since mid 2010 and it has had a profound impact on us both, in different ways… My chiropractor suggested it to me.

    I’m a cyclist and she is a marathon runner, we have 2 very active kids (thankfully they don’t need meds or supplements yet!) and so with that and owning our own businesses, lots of steady and unjittery mental energy and physical endurance is needed. We found that is exactly what vavalert offers. The claim the company makes is 6 hours of effectiveness but I’ve had days where I’ll really feel that extra kick for 9 or 10 hours. If I’m really tired and unrested, it won’t compensate for that but I don’t believe that’s what the product is supposed to accomplish.

    Lastly, I honestly don’t believe our experiences are placebo but who really knows! :)

    I still would love your feedback about any other products you might recommend. I know supplements affect us all differently.

    If I’m not mistaken, I believe the ingredients (cocoa & green tea extracts) of the product have been shown to help diabetics as well.

    Cheers from Newburyport, MA!

    Posted by Richard Madison |
  14. Hi Richard,

    I think the use of supplements needs to considered on an individual basis, for the most part. However, a few exceptions include vitamin D (because it’s hard to get enough from dietary sources), calcium (mostly for women), and omega-3 fatty acids. You mentioned cocoa and tea, and they contain polyphenols that may promote heart health, among other things. Other supplements, such as alpha-lipoic acid or evening primrose oil may help someone who has diabetic neuropathy, but these aren’t supplements that everyone needs to take or should take. You’ll see, in one of my other postings, that many people take cinnamon for blood glucose control (these are mostly people with Type 2 diabetes, though). Cinnamon hasn’t been shown to be so effective for people with Type 1 diabetes. So, my roundabout answer is: It depends on your health goals and what you’re aiming to do. You also need to consider your diet and the amount of certain nutrients that you get from food sources. I say this a lot, but it really can help to sit down with a dietitian to discuss issues such as this.

    By the way, Newburyport is a beautiful town!

    Posted by acampbell |

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