Could Preventing Diabetes Prevent Alzheimer’s

In a December 2016 letter to Financial Times Weekend, Chris Norwood, founder and executive director of Health People, a South Bronx Community Group located in New York, underscored the importance of diabetes prevention for brain health in the face of failed Alzheimer’s treatment trials. Here is the letter in full:

Sir, Further to David Crow’s article “Alzheimer’s: a ray of hope?” (November 19): the UCLA Mary S Easton Center for Alzheimer’s Disease Research and the Buck Institute for Research on Aging in 2014 first reported on a significant reversal of memory loss in nine of 10 Alzheimer’s patients who took part in the trial of a “complex approach”. Since confirmed in further research, this “complex approach” included major changes in diet, increased exercise, stress reduction and a programm of micronutrients and supplements tailored to individual participants.

In contrast to the “plaque theory” of Alzheimer’s, on which governments and pharmaceutical companies have spent more than $1bn in failed treatment trials, the complex theory seeks to address multiple contributors to brain deterioration. While the authors of the complex approach themselves point out that patients can have trouble following the detailed individual plans they receive, the major elements of nutrition, exercise and stress reduction highlight significant pathways to Alzheimer’s prevention.
For example, a recent study found that people with diabetes had a 39 per cent increased risk of dementia; however, even for those already pre-diabetic, diabetes is 60 per cent preventable through the basic National Diabetes Prevention Program (NDPP) of losing 5 to 7 per cent of body weight and exercising — even walking — 30 minutes a day five days a week. Even regular walking has been found to reduce dementia risk by 30 to 40 per cent.

Unfortunately, almost no insurance companies pay for such basic prevention. There seems to be an attitude among insurers and public health elites alike that the low-income people of all ethnic groups at highest risk for diabetes won’t adhere to a multi-session course in making “lifestyle” changes such as the NDPP.

As a community health education group in the South Bronx, the US’s poorest urban Congressional district, we have found just the opposite: when we manage to obtain funding to provide NDPP group courses, the participants regularly meet the weight loss and exercise goals.

While the FT’s follow-up editorial (November 26) makes a case for prioritizing Alzheimer’s research, the stronger case is to target and prioritize prevention. With Alzheimer’s, at this time, prevention is the treatment — but it is not funded.

Chris Norwood
Founder and Executive Director,
Health People,
The Bronx, NY, US

Norwood is founder and executive director of Health People in the South Bronx, an entirely peer educator-based health education and disease prevention organization, which has achieved groundbreaking progress in bringing well evaluated chronic disease and AIDS education to the US’s poorest Congressional District by training local residents to become effective educators.

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