By Dr. Mercola
At first glance, heart disease and dementia may seem to have little in common, but these two chronic degenerative conditions appear to have a common underlying thread.
This was recently revealed by new research looking at how to best test for your future risk of these conditions. It turns out that the same test that predicts your future risk of heart disease is better at predicting your risk of dementia than a specific dementia-risk test.1
Heart Disease Test Better at Predicting Dementia Risk
During the 10-year study, middle-age participants were tested for their risk of both heart disease/stroke and dementia.
While the heart disease and stroke risk tests factored in age, blood pressure, cholesterol levels, smoking and diabetes, the dementia risk test included such factors as education, body-mass index (BMI), and whether the participant had a gene associated with dementia.
The heart disease and stroke risk scores were taken from the Framingham study. Memory and thinking abilities were tested three times over the study duration, and each time all three tests were able to predict cognitive decline.
However, the heart disease and stroke risk tests had a stronger association with dementia risk, suggesting that they are better tools for predicting future cognitive decline than the dementia risk test. This makes perfect sense, since many of the risk factors associated with heart disease are also associated with poor brain health as you age.
Heart Disease and Dementia Have Similar Risk Factors
The sooner you realize that your entire body is interconnected, and imbalances or damage occurring within it can impact your health on multiple levels, including leading to numerous chronic diseases, the better.
This is certainly the case with heart disease, stroke and dementia, which share several underlying risk factors; for instance, arterial plaque. If plaque builds up in your carotid arteries, the blood flow to your brain can be compromised, since your carotids are the primary arteries serving your brain.
This arterial obstruction can lead to many different serious conditions, including stroke, heart attack and dementia.
Diabetes is another risk factor for both heart disease and Alzheimer’s, a form of dementia. And while it’s widely known that heart disease is often caused by a poor diet, recent research showed that Alzheimer’s disease may have dietary roots as well.2
It's becoming increasingly clear that the same pathological process that leads to insulin resistance and type 2 diabetes may also hold true for your brain.
As you over-indulge on sugar and grains, your brain becomes overwhelmed by the consistently high levels of insulin and eventually shuts down its insulin signaling, leading to impairments in your thinking and memory abilities, and eventually causing permanent brain damage.
Insulin resistance is the basis of all of the chronic diseases of aging, including heart disease, dementia and diabetes.
One of the Best Tests for Determining Your Heart Disease Risk
Most conventional heart-disease risk tests factor in your cholesterol levels as a primary component of the score. But you can have low or normal LDL (“bad”) or total cholesterol and still be at high risk from heart disease. Alternatively, you can have high or normal total or LDL cholesterol yet be at low risk.
I recently spoke with Chris Kresser, L.Ac., an acupuncturist and a licensed integrative medicine clinician, who has investigated risk factors for heart disease and promotes the use of a relatively novel method for assessing your heart disease risk based on your LDL particle number. According to Kresser, this is a much more accurate predictor of your heart disease risk. He explains:
“To use an analogy: if you imagine your bloodstream’s like a river, the LDL particles are like the boats that carry the cholesterol and fats around your body. The cholesterol and fats are like cargo in the boats. Right now doctors are usually measuring the amount of cargo or cholesterol in the LDL particles.
But what we should be measuring is the number of LDL particles, or the number of boats in the river, so to speak, because that’s a much more accurate risk factor for heart disease.”
Where to Find the LDL Particle Test: NMR LipoProfile
The NMR is a relatively expensive test so another inexpensive alternative to determine if you have a large number of LDL particles is to simply measure your triglyceride:HDL ratio. Ideally that ratio should be below 2.0. However, clearly the NMR is a more precise measure of LDL particles. Some groups, such as the National Lipid Association, are now starting to shift the focus toward LDL particle number instead of total and LDL cholesterol, but it still has not hit mainstream. Fortunately, if you know about it, you can take control of your health and either ask your doctor for this test, or order it yourself.
There are several ways to test for your LDL particle number. Kresser recommends using the NMR LipoProfile, offered by a lab called Liposcience. The test uses FDA-approved technology for testing LDL particle number, and it’s the test used in most of the scientific studies on LDL particles.
The NMR LipoProfile test is easy to get and all major labs offer it, including LabCorp and Quest. Most insurance policies cover the test as well. Best of all, even if your doctor were to refuse to order it, you can order it yourself via third-party intermediaries like Direct Labs, or you can order the test online, and get blood drawn locally.
In Europe and other parts of the world, LDL particle number is more commonly measured using an indirect marker, apolipoprotein B (apoB). ApoB is a protein required for the formation of the LDL particle. About 90-95% of apoB particles are LDL particles, which makes apoB a fairly accurate measure of LDL particle number. If you live in a country where the NMR profile is not available, you can use the ApoB test to roughly determine your LDL particle number, and then use triglycerides, HDL, fasting blood sugar, blood pressure and waist-to-hip ratio to determine if you have insulin resistance.
Remember, since your heart disease risk may be an accurate predictor of your future dementia risk, the NMR profile test may be useful for assessing both your heart disease and dementia risks.
Reducing Fructose is Essential for Preventing Both Heart Disease and Cognitive Decline
You may already know I have become passionate about warning of the dangers of fructose. There is no question in my mind that regularly consuming more than 25 grams of fructose per day will dramatically increase your risk of heart disease, dementia and Alzheimer's disease, as consuming too much fructose will inevitably wreak havoc on your body's ability to regulate proper insulin levels. This does not mean you can’t have any fruit, rather it just means keeping your total fructose below 25 grams every day. There are charts on our site that show how much fructose is in most fruits.
Although fructose is relatively "low glycemic" on the front end, it reduces the affinity for insulin for its receptor leading to chronic insulin resistance and elevated blood sugar on the back end. So, while you may not notice a steep increase in blood sugar immediately following fructose consumption, it is likely changing your entire endocrine system's ability to function properly behind the scenes.
Additionally, fructose causes damage to your circulatory system, upon which the health of your nervous system and heart depend. Since the average American is exceeding the 25 grams a day fructose limit by 300%, this is a pervasive and serious issue. I view significantly reducing fructose consumption as the MOST important step you can take to lower your risk of Alzheimer's disease, dementia and heart disease.
More Tips for Protecting Your Heart and Brain Health
The good news about finding the similarities between common chronic diseases is that many of the preventive strategies are overlapping. For instance, the beauty of following my newly revised nutrition plan is that it helps treat and prevent all chronic degenerative diseases, from heart disease, cancer and diabetes to obesity and Alzheimer's. So please read the plan, and implement it in your life, as soon as you can. It is divided into three helpful sections, Beginner, Intermediate and Advanced to help you start at the right level. My other top tips for optimal heart and brain health include:
- Optimize your vitamin D levels with safe sun exposure
- Keep your fasting insulin levels below 3 (following the nutrition plan will help you do this); if your fasting insulin level is not lower than three, consider limiting or eliminating your intake of grains and sugars until you optimize your insulin level
- Consume enough high-quality animal-based omega-3 fats, such as krill oil
- Exercise regularly, including high-intensity interval training like the Peak Fitness Technique