Go back one hundred years and these diseases were largely non-existent in most countries in the world. Now, they represent a global epidemic of disease that is not only causing terrible suffering but also crippling our health care services and economies.
The attributable risk for these diseases averages more than 80% environment and 20% hereditary, however ‘hereditary’ does not mean only genes. Studies of identical twins have a hard time teasing out the inherited behavioural traits that lead, for example, to similar diet and exercise habits. Only one in a hundred cases of Alzheimer’s is attributed to inherited genes.
I have long thought the primary cause of these diseases is a) ignorance and b) addiction. If we knew what to do to prevent these diseases we would not get them but, by the time we start to know, we are already addicted to sugar, caffeine, alcohol, nicotine etc. The real tragedy is that children still are not taught the fundamentals about health and how their body works to encourage awareness at an early age. As a consequence the average ignorant teenager is guzzling sugar-laden fizzy drinks, smoking despite vast taxes, drinking and eating junk food.
Back in December yet another study showed that type-2 diabetes, which accounts for over 90% of diabetes, is reversible with a low calorie diet (read my blog). The key is a low GL diet, which cuts the need for insulin production. In 2016 the ground-breaking work of Professor David Smith and colleagues at Oxford University showed that dementia could be prevented, and to an extent reversed, in those with high homocysteine levels (the majority of older people) with B vitamins and sufficient omega-3 fats in the early stages of the disease. Then there are the consistent studies showing high vegetable and fruit intake, and high intake of specific antioxidants such as vitamin C, quite dramatically cuts risk of heart attacks, strokes, diabetes and several cancers.
In this paragraph I have introduced four of the five simple steps that account for the majority of risk for these diseases:
Eat a low GL (glycemic load) diet, free from sugar
- Ensure sufficient omega-3
- Up your intake of B vitamins
- Increase your intake of antioxidants, including vitamin C
You probably know these simple truths but are you putting them into practice? If your waistline is increasing the answer is no. If you neither know your homocysteine level nor take supplements on a daily basis, you are not disease-proofing your life.
B Vitamins – are you getting enough?
Two out of five people in the UK over 60 have insufficient B12 levels to prevent accelerated brain shrinkage. The key is keeping your homocysteine levels below 10mcmol/l. This can be tested with a home-test kit. It is a medical tragedy that UK GPs still know so little, and rarely request homocysteine testing in patients despite being able to do so. A European study last year found that a quarter (27%) of those over 65 had insufficient B12 in their blood.
The key B vitamins that offer disease protection are B12, folate and B6. A good daily intake of B12 is 10mcg, which is what I supplement daily, but even this is not enough if you are older since poor absorption of vitamin B12, largely due to insufficient stomach acid production, is an extremely common phenomenon. How do you know? Test your homocysteine. If it is below 10mcmol/l you have functional level of B12 since homocysteine measures methylation, and it is a breakdown in methylation that drives, not only Alzheimer’s, but also most cancers, insulin production and arterial disease. Those with raised homocysteine often have to supplement 500mcg. The other ‘red rag’ for B12 risk is use of proton-pump inhibitor (PPIs) antacids – with names ending with ‘azole’. A study in the Journal of the American Medical Association in 2016 reported a 44% increased risk of developing dementia in older people taking these PPI drugs compared to those not. Another group at risk of insufficient B12 are those following a vegan diet who do not supplement vitamin B12. The only known sources of B12 in the vegetable kingdom is laver seaweed (such as nori) and shiitake mushrooms. You have to eat 100 grams of shiitake to get 1 mcg of B12. The best is laver seaweed, as in laver bread, a staple food along the coast of Wales, providing about 5mcg per 100grams. Fermented foods may also contain B12 due to their bacterial content.
Eleven studies have now examined the preventive effect of folate supplementation on stroke risk in those with cardiovascular disease. Combining these studies supplementing folate clearly works, reducing stroke risk by up to 22%, especially if homocysteine level also reduces with supplementation. I aim for 400mcg of supplemental folate plus plenty from fresh vegetables, nuts, seeds, beans and lentils, which are the best food sources.
Eat a low glycemic load (GL) diet
For those new to my low GL diet, there are two ways to keep your blood sugar level lower, or more even, which means less need to produce insulin, the hormone that drives excess sugar out of the blood into cells as needed or storage as fat. High insulin levels are a consistent risk factor for many cancers, diabetes, heart disease and obesity. The more often your blood sugar level goes high the more insulin you produce. Then you start to become insulin ‘resistant’ or insensitive to its effects, so you produce even more. Now, one big problem with insulin, and something called insulin-like growth factor (IGF-1) is that it makes cancer cells grow faster. This is true for all cancer cells but most clearly demonstrated for breast, prostate and colon cancer.
There are two ways to raise your glycemic load. One is to eat fast sugar releasing foods, quantified as ‘high glycemic index’ foods. The other is to eat lots of carbs (e.g. more quantity). More eloquent is to control your total glycemic load (GL) which is calculated by knowing how much carbs you eat and how fast-releasing (e.g. what their glycemic index is) they are and multiplying the two together to give a best estimate of total sugar load hitting your blood stream.
The higher your glycemic index or glycemic load the higher your risk for breast cancer, concludes a recent study. One Italian study attributed 15% of breast cancer risk to eating sweet foods. Milk, by the way, promotes the release of IGF-1 so a combo on high sugar, high carbs and lots of dairy products is a recipe for increasing cancer risk. Dairy intake, for example, is now known to a) increase risk for prostate cancer because of its promotion of IGF-1; b) increase re-occurrence of prostate cancer and c) increase risk of mortality from prostate cancer.
Despite flagrant resistance from the sugar industry there is incontrovertible evidence that a high GL diet is the main driver of diabetes. In a study of over 200,000 health workers, free from diabetes at the start of the study, eating a high GL diet, or high glycemic index diet, low in cereal fibre, the risk for developing type-2 diabetes was 50% higher.
We now have more than a decade of evidence linking a high glycemic load with increased risk for dementia, Alzheimer’s and age-related cognitive decline. Studies from Ireland to Sweden have shown that a high sugar intake, high glycemic load, and blood sugar peaks are clearly linked to declining cognitive abilities.
Increase your antioxidants
Every year, I learn something new about vitamin C. One that caught my eye last year was headed ‘Vitamin C - A new player in regulation of the cancer epigenome; In other words, vitamin C may not only kill cancer cells, it switches off aberrant cancer promoting genes. The study goes on to say ‘Recent in vitro studies suggest that vitamin C at physiological concentrations, combined with hypomethylating agents (think homocysteine lowering B vitamins) may act synergistically to cause DNA demethylation [that is deactivation of cancer genes] through active and passive mechanisms, respectively. Additionally, several recent studies have renewed interest in the use of pharmacological (high) doses of vitamin C injected intravenously to selectively kill tumor cells.’ So, not only does a high intake of vitamin C dramatically reduce cancer risk; and mega doses, oral or intravenous, act as powerful chemotherapy agents killing cancer cells, but also vitamin C may also switch off cancer causing genes. Read my report on ‘vitamin C and cancer’ to find out more.
Vitamin C also lower cardiovascular risk, high blood pressure, diabetes risk, improves thyroid function and, of course, reduces risk and duration of infectious diseases. The best overall effects are seen at a daily dose of between 500mg and 2,000mg. I take 2,000mg a day just to be on the safe side. However, for cancer treatment much higher doses are needed, more akin to what works for colds – 1 gram an hour to keep blood levels super-saturated with this non-toxic water-soluble vitamin. Vitamin C is but one of many potent antioxidants found in fruits and vegetables. In recent years the focus has been on polyphenols, often also antioxidants, as another molecular superpower in the fight against disease. I wrote about these, and the best food sources of both antioxidants and polyphenols in the 81st issue of my 100% Health Newsletter back in 2014. Since then studies are poring in on the merits of polyphenols, such as resveratrol in red grape skin, isoflavones in beans, curcumin in turmeric, cinnamic acid in cinnamon and anthocyandins in blue and blackelderberries. Cinnamon, for example, a marvellous stabiliser of blood sugar levels, has now been touted in a role for Alzheimer’s prevention. Whether you look at all vegetables, cruciferous vegetables, onions and garlic, flavonoids rich in berries, cherries and pomegranate, polyphenols in olives, turmeric, and onions, big reductions in disease risk and mortality are shown in those eating the equivalent of seven servings a day of fresh vegetables and fruit in the order of halving premature mortality, most often from cardiovascular disease, diabetes, the complications of obesity and cancer. These are the kind of foods you want to be eating on a regular basis.
Artichoke, red onion, broccoli, asparagus, spinach, olives, beetroot, avocado, kale
Blackcurrants, blueberries, plums, blackberries, raspberries, strawberries, cherries, apples, pomegranate.
Chestnuts, pecan nuts, almonds, chia, flax
HERBS & SPICES
Cloves, oregano, turmeric, capers, mint, star anise, sage, rosemary, basil, thyme, ginger, curry powder, cinnamon
Dark chocolate, red wine, coffee, peppermint (tea), black tea, green tea As well as eating antioxidants and polyphenols there’s a good logic in supplementing concentrations of the key molecular superpowers. This includes vitamins A, C, E, selenium, zinc but also alpha-lipoic acid, resveratrol, co-Q10 and glutathione or its precursor N-acetyl cysteine (NAC). I do both, taking an AGE Antioxidant supplement daily as part of my 100% Health Pack.
When I first proposed that there were ‘essential’ fats we needed to eat for health, back in 1981, the idea was strongly resisted. But now, there is no doubt that optimising your intake of omega-3 fats in particular reduces risk for diabetes, heart disease, cancer and dementia. Countries with a high intake have a low risk for these diseases – and better mood and lower suicide rates.
Japan has among the highest levels of fish consumption and very low disease rates; the UK and most other developed Western societies, are the reverse. One of the measures of cardioprotection is a high heart rate variability (HRV). A high intake of omega-3 is both associated with high HRV and low risk of cardiac death.
Conversion of dietary omega-3, found in seeds and nuts as well as fish, to DHA is especially important in pregnancy to build the baby’s brain. A substantial study of women and their children in the Avon area measured the fish intakes of women while pregnant and the subsequent development of their children. Following analysis, the recommendations stated that “consumption of less than 340g/week (three servings of fish a week) in pregnancy was detrimental, that is, increased the risks for low verbal IQ and abnormal behaviours among children.” Lead researcher Commander Joe Hibbeln, in charge of the health of the US navy, concludes: “The optimum level, however, may be even higher and remains to be determined.” In our own 100% Health Survey, significant health benefits were seen in those consuming three or more servings of fish a week.
According to Hibbeln, one of the world’s leading experts on omega 3 and disease risk, “The majority of the populations (98-99%) are protected from… increased risk of chronic illnesses [with an intake of] 2g a day of EPA/DPA/DHA.” A 100g serving of salmon provides about this amount. If you supplement essential omegas on a daily basis, as I do, that gives about 700mg a day, or almost 5g a week. That, plus three servings of oily fish and some vegetarian sources of ALA, such as chia or flax seeds, would appear to be optimum. This is what I aim for.
This is especially important during pregnancy, but also for those with an inflammatory disease such as arthritis, diabetes, cardiovascular disease, dementia or depression.
Consciously increasing dietary sources of omega 3 compared to omega 6, which is the principle fat found in sesame and sunflower seeds, is also important as the brain’s ratio is 2:1 omega 6 to omega 3, whereas most Western diets have a ratio more like 15:1. Using walnut, chia or flax oil in salad dressings, olive oil as opposed to sunflower oil in cooking, and ground chia, flax or pumpkin seeds, as opposed to sesame or sunflower seeds, on cereals or smoothies is therefore a step in the right direction.
This is another nutrient that is hard to ensure you’re getting enough of without daily supplementation. I take two capsules of Essential Omegas every day.
The 5th step
The 5th step is to take at least 2,000 steps every day, and ideally more, – that is exercise and keep physically active. Those who exercise substantially reduce their risk of all the big five – obesity, diabetes, heart disease, cancer and dementia. Having a physically, socially and intellectually active lifestyle is a key for good health, together with good sleep and time to relax.
I interviewed Dr David Smith as part of my Brainstormers podcast series in September 2020. If you missed it, listen now.
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