Ultraprocessed Foods Redux

We wrote previously about ultraprocessed foods, referring to them as the "highway to Alzheimer's disease."  Some estimate that 73% of the American food supply is composed of ultraprocessed foods.  I'm thinking that, putting together my many-year history of living off of ultraprocessed foods and my history of shingles infections, perhaps there is an explanation for my disease.  But who knows.

In any event, I came across this article about some research on the effects of living on ultraprocessed foods.  The article references research published in the journal Cell Metabolism in 2019.  The researchers worked with one cohort of subjects living on ultraprocessed foods and another living for the same period on unprocessed foods.  The upshot of their finding was that, over the period of a month of living under controlled conditions, the people consuming ultraprocessed foods gained an average of two pounds, while those living on unprocessed foods lost an average of two pounds.

Those results don't say much about the influence on brain health, but in her book Diet for the Mind, the late Dr. Martha Clare Morris rounds up other research making the connections.  Ultraprocessed foods are bad for your brain.  But they taste so good...

Some commentators provide guidance that the unprocessed foods are on the outer perimeter of what's in you're supermarket, and the processed and ultraprocessed foods are on the interior.  That's consistent with my observation.  

We've listed examples of ultraprocessed foods before, but here's the list we've used in the past:

Carbonated soft drinks 

Sweet, fatty, or salty packaged snacks 

Candies (confectionery) 

Mass-produced packaged breads and buns 

Cookies (biscuits) 

Pastries 

Cakes and cake mixes 

Margarine and other spreads 

Sweetened breakfast cereals 

Sweetened fruit yogurt and energy drinks 

Powdered and packaged instant soups, noodles, and desserts 

Pre-prepared meat, cheese, pasta, and pizza dishes 

Poultry and fish nuggets and sticks 

Sausages, hamburgers, hot dogs, and other reconstituted meat products

Shingles Is Still Causing Dementia

We've written before in this blog ... and in Beating the Dementia Monster ... that there is a correlation between episodes of shingles with the development of dementia.  Shingles is caused by the herpes zoster virus which also causes chicken pox.  In fact, shingles is probably caused by the herpes zoster virus living in the body after a childhood chicken pox infection.

This topic is interesting to me because I don't have many risk factors for Alzheimer's disease.  But I did have shingles several times over the years; at least three times.  So maybe that explains my disease.

There was a new study published in August in the journal Alzheimer's Research and Therapy.  It reported on research with almost 150,000 subjects in three large cohorts of medical professionals.  Researchers followed them over decades, beginning as long ago as 1976.  Consistent with other research, they found a correlation between shingles events and the onset of dementia.  Surprisingly (to me, at least) they found that, in the context of shingles infections, carrying the APOE ε4 gene variant affected men much more than women.  (The ε4 variant of the APOE gene is what 23andMe tests for when predicting your risk of developing Alzheimer's disease.  It's the strongest genetic risk factor for Alzheimer's disease, although there are many others.)

But how much did shingles infection affect risk of dementia?  With such a large sample size and such a long period of time, we should see some reliable answers to this question.  So what did they find?

The researchers found that a history of shingles infection raised the risk of dementia by about 20%.  That's actually kind of a lot when you think about it.  

They further wrote, "Findings from these three large independent cohorts of women and men suggest herpes zoster was associated with a higher long-term risk of subjective cognitive decline. The risk may be greater for the APOE ε4 allele carriers among men, but not among women. The relation did not differ among those with potentially immunocompromising conditions. The magnitude of the elevated long-term risk of [subjective cognitive decline] may potentially be reduced by [shingles] vaccination, but further study is needed."

Note that, loosely defined, "subjective cognitive decline" is cognitive decline concerning enough to the patient to cause him or her to seek medical advice.  Statistically, these people are more likely to be diagnosed with actual Alzheimer's disease.

My college classmate, Roy, sent me a link to this article in The Economist. It refers to an article in the prestigious journal, The Lancet, updating us on where medical science is at with respect to lifestyle and development of dementia.  It's an update to an article we discussed before that endeavored to say how much each modifiable lifestyle factor affects the probability that we will develop dementia.  Of course, the researchers who wrote the article emphasized all elements of the Dementia Toolkit and then added a couple more.  And this update adds two more as well.

The new factors in this updage were high LDL cholesterol in mid-life and untreated vision loss in later life.  The correlation with LDL is quite strong, although the correlation with vision loss is weaker.  

In discussing the MIND diet, we noted previously that there's an association between consuming saturated fats (such as in cheese and red meat) with development of dementia.  (This is in spite of the fact that the association of dietary cholesterol and cardio-vascular disease is much weaker than previously thought.)  So maybe that's related to the newer finding on LDL.  But the vision finding is quite interesting -- and I think it goes with the previously recognized association of hearing loss with dementia.  We're told that the hearing loss factor is associated with social isolation.

So my take is that, when human beings connect with each other in relationship, the brain is strengthened.  Therefore, factors impairing our ability to communicate and otherwise socialize with other people affects brain health negatively -- they contribute to the probability someone might develop dementia.  So when you have trouble hearing other people, it makes it harder to form or exercise the human bonds that strengthen our brains.  It looks to me like the same thing applies to vision loss.  When you have trouble seeing others, it interferes with your ability to socialize with them.  And that encourages the development of dementia.

Is my time up yet?

In Beating the Dementia Monster, we recalled an interview with a neuropsychologist/Alzheimer's disease researcher who reviewed my condition and concluded that I was on track to be dead by the age of 75.  At the time, I was 66 and had pretty strong evidence of my advancing condition.  Later, when I began learning more about the disease, I could see that the researcher recognized that I was on a very typical trajectory.  It was very easy to see my end at 75.

Well, without posting my exact birthday, let me say that I recently reached 75.  And I'm not dead.  If fact, I feel great.

Of course, if you're familiar with the story of this encounter, you know that I told the researcher that I had just joined the gym and otherwise flipped my lifestyle.  I told him that I believed I had begun to see improvements in my memory and cognition.  By sketching a graph on a piece of paper, he indicated that if I would keep my new lifestyle going, I could expect to live at least to 85.

I don't know how I'll feel when I'm 85, but from here, that looks pretty good to me.

Where I'm at...

With so much of my time being eaten up by insomnia and so many things going on in my life (for example, an upcoming wedding...) I haven't written as much as I'd like about how things are going with me.  So I'd like to catch up on a couple of things.  And there have been a few things worth writing about.

You'll recall that a year ago I was diagnosed with cerebellar dysfunction (CD) in addition to Alzheimer's disease.  This is another degenerative brain disease, but it's not as well defined as Alzheimer's disease.  In fact, I'd call it more of a syndrome -- a set of symptoms -- with multiple possible causes.  Some causes are hereditary, some may be due to dietary deficiencies, and other causes are simply unknown.  (If the cause of a disorder is unknown, it's called idiopathic.) 

Right now, this is a much bigger deal for me than Alzheimer's disease.  The Alzheimer's is very much under control, but the CD is not.  The main consequences of CD for me have been serious balance problems, as well as minor problems with my speech, handwriting, and a few other things.  If fact, one sleep specialist said he believed it was causing my insomnia.  The balance problems interfere with most of the things I want to do.

On YouTube, I found an expert on CD in Seattle who seemed to be well respected in his field.  I was able to get an appointment to see him, which wasn't easy.  But I did see him in July.  After a comprehensive exam, he ordered another MRI, which I've gotten.  But it won't be until November before I can follow up with him.  I did read the radiologist report, but wasn't able to gain much insight from it.

During the exam, he seemed optimistic about doing something helpful.  But, as he looked more closely at my condition, he seemed to be leaning more and more toward an idiopathic diagnosis.  Aside from the physical therapy I'm already doing, there's probably not much more to be done.  I guess I'll get a final prognosis in November, but I'm not optimistic about turning anything around.  And CD is progressive.

As far as memory and cognition go, I actually believe I've had recent improvement.  For two years I've been participating in a memory tracking study from the University of Washington Alzheimer's Disease Research Center (ADRC), and I've also been followed by the University of California San Francisco (UCSF) Brain Health Registry.  For the ADRC tracking study, I've taken a brief memory test every week for two years.  For the Brain Health Registry, I complete a comprehensive questionnaire and take a memory and cognition test every six months.  Because these are controlled studies, I'm not privy to results.  But, for both studies, I am told whenever I get a question wrong.  I therefore have an intuitive sense for how I'm doing.

At the two year mark last month, I completed my participation in the ADRC study.  The test questions were straightforward, usually testing short term memory.  Each week, there would be a topic.  For example flags of Caribbean nations.  The test gradually introduced me to the flags of one nation after another, and I'd need to recall which flag was for which nation.  The test question answers were multiple choice.  My sense was that I did about the same throughout the whole two year period.  Not perfect, but respectable.  Which is, of course, good.

The UCSF tests were a lot harder.  It's hard to describe, but you needed to remember some very weird little figures and how they were arranged (and hidden) on the screen.  You start out remembering the locations of two figures but work you way up to eight.  I took these tests over the period of a several years, every six months.  I believe that, on the test I took a year ago, I got zero right on the top two levels.  So I just skipped the test six months ago, somewhat in discouragement.  I remembered looking at the little figures a year ago and being totally baffled at how to correctly respond to the test.  I probably did OK, with two figures, but with four, six, and eight ... not at all.

Well, I thought UCSF had given up on me, but they hadn't.  I got an inquiry from them last week, and I took their test on Saturday.  I was absolutely amazed at how well I did.  I got all the way to the top level (eight figures), and got them all right on the second or third try.  I couldn't believe it.  What was amazing was just how I felt when taking the test.  A year ago, I would just look at the screen and see nothing meaningful.  I couldn't even remember what the little figures looked like.  This time, when I looked at the screen, I had relatively little trouble remembering what the figures looked like and where to place them.

Why should I suddenly be doing better?  I don't know, but this was the day after my first acupuncture treatment.  Peer reviewed studies have definitely associated acupuncture with improved memory and cognition, and maybe that's why.  On the other hand, my Fitbit tells me that, the night after that first treatment, I slept much better than I normally do.  So maybe it was just a matter of sleep.

For the two nights following the acupuncture treatment, my sleep quality was better than it's been in years.  I still woke up in the middle of the night.  But it was much easier to get back to sleep, and I was able to sleep longer.  

But after two nights of that, the spell was broken.  Subsequent nights were just as difficult as they've been for a couple of years now.  

I'm looking forward to my next treatment tomorrow.  The most important study I read with good outcomes had test participants receive at least six treatments over a one to three month period before they drew conclusions.  I'm hoping that more and consistent treatments will have a more lasting effect.

Dementia, Insomnia, and Acupuncture

Recently, I've been posting less often, partly because insomnia has been eating up so much of my time.  As we said in Beating the Dementia Monster, insomnia is associated with dementia partly because of the brain's need for deep sleep.  My insomnia got suddenly worse in 2021, and at least one doctor associates it with my cerebellar dysfunction.  This is the new brain disease I was diagnosed with in 2022.

My Fitbit tells me that I often get only a few minutes of deep sleep a night, with a sleep score as low as 35.  "Poor" is below 60.  Recently, my usual score has been in the 40s and 50s.  I often get less than 5-1/2 hours, sometimes less than 4 hours of sleep.  I try napping during the day to catch up, but I may have insomnia at noon.  And I feel the effects of lack of sleep all day long.

I usually fall asleep pretty quickly at around 10 p.m.  Then, sometime between 12 and 2, I'll be wide awake.  I feel like I just drank a gallon of Starbuck's finest.  After getting up and doing some things for 90 minutes or so, I go back to bed.  In the past, I could usually get back to sleep then.  But lately I haven't.  So I just lie there.

I subscribe to the mailing lists for several medical journals, and a couple weeks ago one article flew across my computer screen.  It was about a study of applying acupuncture to sleep disorders in dementia patients, finding acupuncture actually could help with their insomnia.  I made a mental note to follow up, but now I can't find the email or the article it pointed to.  We wrote about research on acupuncture and dementia once before.  A number of studies have found that acupuncture can help with dementia, but the studies are few and of limited quality.  Checking more recently, I found this larger study of acupuncture in Canada that included some positive results with respect to insomnia.  Again, positive, but not necessarily stunning results.

After a particularly bad week of insomnia, I decided to give acupuncture a try.  So I researched local acupuncturists, and saw one that seemed to be associated with the local medical community.  But she wasn't taking any new patients.  I found another one with a perfect score in Healthgrades.com and decided to give her a try.

The acupuncturist was a young, very pleasant Chinese woman.  The man I took to be her husband (also very likable) seemed to be the business manager.  They were immigrants from somewhere across the ocean, giving them an aura of authenticity.  (Call me a racist...)  

I had a 90 minute session which included reviewing my intake paperwork, a discussion of my issues, and an explanation of what to expect.  I lay on the bed while she put a bunch of needles in my head, neck, arms, abdomen, and legs.  Every once in a while, there was the slightest stinging, but it was mostly quite painless.  After that, she turned off the lights and left the room to attend other patients.

About 45 minutes later, she returned and took out the needles.  I was afraid she'd forget one, but she didn't.  She said it would take a series of weekly treatments to see real results, so I scheduled another visit for the following week.  (Subjects in the research we cited earlier received at least six sessions over one to three months.)

So I've only had one session, but how did I sleep that night?  Well, the night before was pretty nasty, and I had a lot of sleep debt.  As usual, I fell asleep pretty quickly.  And, as usual, I was very awake soon after midnight.  I got up and did my usual nighttime activities, but I noticed that going back to sleep was easier than usual.  My Fitbit said my sleep score was "fair," which I haven't seen for a while.  And I slept quite soundly between 6:30 and 8:30 a.m.  This is an improvement, although it took 12 hours to get, probably, 7 hours of sleep.

We'll see what happens tonight.  And we'll see what happens after a reasonable series of sessions.  Stay tuned.