Food: Juices vs Sugar in Alzheimer's Disease & Dementia

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Juices vs Sugar in Alzheimer's Disease & Dementia
Thursday, August 31, 2006

It has been found recently that a glass of fruit or vegetable juice every other day can stave off the dreaded Alzheimer's disease, a prospective study of older Japanese-Americans suggests. Compared with a control group of individuals who averaged less than one glass of juice per week, people who drank three or more glasses of juice per week experienced a 76% less likely chance to develop Alzheimer's disease, according to Qi Dai, M.D., Ph.D. Dr. Dai is from the Vanderbilt School of Medicine in Nashville, Tennessee. He reported his findings from this study in the September issue of The American Journal of Medicine. The study was supported by a grant from the US National Institute on Aging.

The findings do not name specific kinds of juices that participants drank, but previous studies have shown that apple, grape, and citrus juices are very high in polyphenols, which seem to have a protective effect against Alzheimer's disease. Recent studies of antioxidant vitamins used for preventing Alzheimer's have been less than effective, despite the initial promise of these vitamins, the investigators said. The current study looked at fruit and vegetable juices, an abundant source of polyphenols. Polyphenols are usually found in the skin and peel of various fruits and vegetables and research has shown that when fruits and vegetables are mechanically squeezed to make juice, high concentrations of polyphenols from the peel and pulp are squeezed into the juice.

The current study belongs to the Kame Project, included 2,000 dementia-free Japanese-Americans who live in the Greater Seattle area. Their average age was 72 at the beginning of the study, and half were men and half were women. Alzheimer's is uncommon in Japan, but its prevalence has been raising in Japanese-Americans, suggesting environmental and lifestyle factors at work, as well as non-Japanese DNA. Participants completed a food frequency questionnaire and clinical evaluation for baseline readings in 1992-1994, followed by clinical evaluation for Alzheimer's every two years through 2001.

After adjusting for potential confounding (confusing) variables of age, gender, Body Mass Index, education, vitamin intake, and smoking, participants who drank three or more servings of juice per week were at a significantly reduced risk for Alzheimer's disease (hazard ratio=0.24; 95% confidence interval=0.09 to 0.61; P<.01). Even people who drank only 1-2 servings per week experienced some protection from Alzheimer's, compared with those who consumed less juice (HR=0.84; 95% CI=0.31 to 2.29; marginal significance). Interestingly, it turned out that the consumption of vitamins E, C, and beta-carotene were not related to Alzheimer's risk. Heretofore, these vitamins were felt to be vital in guarding against this condition.

The relation between risk and level of consumption of juices tended to be stronger among those who were former or current smokers, those who drank tea less often, were less physically active, and tested positive for the e-4 allele of apolipoprotein E. Previous research suggests that all of these factors may be linked to Alzheimer's risk. The oxidation damage to brain tissue in Alzheimer's may be staved off by hydrogen peroxide, polyphenols offering possible stronger neuroprotection against hydrogen peroxide than do antioxidant vitamins. Despite promising results, the public should not believe blindly that fruit and vegetable juice will prevent Alzheimer's, Dr. Dai cautioned. "A few years ago, hormone replacement therapy, NSAIDs (aspirin, Tylenol, etc), and antioxidant vitamins showed promise, but recent clinical trials indicate that they do not," he said.

Fruit and vegetable juice consumption raises blood sugar levels in the consumer, and in related research, it has been found that chronically elevated blood glucose (sugar) inhibits the cognitive function of older women. Thus, sugar intact through additional consumption of fruit and vegetable juice may present a health problem.

Postmenopausal women with glycosylated hemoglobin (HbA1c) levels of 7% or higher had four times the risk of mild cognitive impairment, or dementia, over a four year time span, compared with women having HbA1c lower than 7%, reported Kristine Yaffe, M.D., of the University of California San Francisco and colleagues, in the current issue of the Journal of Nutrition, Health and Aging.

The American Diabetes Association recommends maintaining HbA1c levels below 7%. And The American Association of Clinical Endocrinologists recommends HbA1c levels at 6.5% or below. The investigators in this blood glucose research conducted a four-year prospective study of 1,983 postmenopausal women experiencing osteoporosis, with HbA1c levels measured at baseline before the study began. The 102 women, 53 of whom were known to be diabetic, had an average age of 67.2 years. Researchers followed the participants for signs of mild cognitive impairment, or dementia, as an additional dementia study. The subsequent statistical analysis included the risk for dementia and mild cognitive impairment related to each 1% increase in HbA1c level, and the risks associated with HbA1C of 7% or greater. The average level of HbA1c was 5.8% at the beginning of the study. Over the time of the study, 86 women (4.3%) actually developed mild cognitive impairment or dementia.

For every 1% increase experienced in HbA1c level, the women participating in this study experienced a greater likelihood of developing mild cognitive impairment or dementia. For the 49 women with HbA1c levels of 7% or higher at baseline before the study began, the age-adjusted risk of developing such mild cognitive impairment was increased nearly four times, and nearly three times for developing either mild cognitive impairment or dementia. When the 53 diabetic women were excluded from the analysis, the relation between HbA1c level and mild cognitive impairment was less evident, but still elevated. A physician and dietitian likely should be consulted regarding the use of fruit and vegetable juices in the preventing the onslaught of Alzheimer's disease, given the possible ill effects of sugar upon cognitive function.

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