Too Much Sugar: Not Too Sweet for Your Brain

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If the risk of weight gain, heart disease, and cavities doesn’t make you reduce your sugar intake, this may stop you in your sweet tracks. Recent research finds that excess sugar intake may raise your risk of dementia.

Excess sugar intake over time may impact cognitive function with higher consumption possibly raising the risk of Alzheimer’s disease, based on a study presented at the Alzheimer’s Association International Conference.

According to Christopher N. Ford, Ph.D., MPH of Rush University Medical Center in Illinois, “Aberrations in glucose metabolism have been observed in Alzheimer’s disease, notably the progressive decrease in glucose utilization in the cortex and the reduced expression and binding of insulin and insulin-like-growth-factor receptors in the cerebellum”.

Sugars include monosaccharides (glucose and fructose) and disaccharides (lactose, sucrose, and maltose), which share the same basic chemical structure. Most sugars convert to glucose readily, and metabolism is regulated by insulin and insulin-mediated glucose transporter GLUT4. This transporter is expressed in the hippocampus of the brain and may be related to memory.

For his study, Dr. Ford and colleagues evaluated data of 837 subjects of the Rush Memory and Aging Project to analyze the link between cognition and sugar intake. Included were data of participants with complete food frequency questionnaires who were not missing sugar intake had at least 2 evaluations of cognitive function and did not have baseline dementia.

Global cognition based on the outcomes of 19 cognition was assessed. Linear random effects regression models were utilized to look at the connection between the total calorie-adjusted quintile of sugar consumption and global cognition, working memory, semantic memory, episodic memory, perceptual orientation, and perceptual speed. Scientists included race, ethnicity, age, sex, and time interactions for education, total calorie intake, alcohol use, and HDL as well as a continuous base term for the time in the linear random effect models.

They also evaluated the association between total sugar consumption and risk for Alzheimer’s disease, and studied the potential effect and confounding by race/ethnicity, age, sex, HDL, total calorie intake, alcohol use, education, and history of diabetes and hypertension using Cox proportional hazards models.

Their study found an inverse relationship between the regular quintile of sugar intake and global cognition, episodic memory, semantic memory, working memory, and perceptual speed in adjusted linear random-effects models. The researchers reported 200 cases of Alzheimer’s disease across nearly 5100 person-years of follow-up.

The researchers advise that future research should examine the role of added sugar in addition to the potential mediation of the relationship between total sugar consumption and cognition within total calorie intake. Ford notes that “Studies have shown a relationship between intake of sugary beverages and preclinical markers of Alzheimer's dementia. In our future directions, we aim to examine the impact of total sugar intake on brain imaging.” 1

How can you get your clients to un-sweeten? Here are a few tips:
1. Eat enough food! Calorie restriction may lead to overeating, especially sugary treats.
2. Reduce overall sugar intake. While the jury is out about “sugar addiction”, it is highly palatable and just one cookie can easily become too many cookies.2
3. Eat the carbs in your meal, last. One study suggested this helped reduce post-prandial blood sugar.3
4. Get enough sleep. Lack of sleep can raise cortisol levels, which may increase cravings for sweets.4
5. Enjoy fresh, seasonal fruit after meals instead of high-calorie desserts with excess added sugar.

Lisa Andrews, MEd, RD, LD

PDF handout: Why eating too much sugar is a problem and what you should do about it

1. Ford CN, et al. Total sugar intake and cognition in community-dwelling older adults. Presented at: Alzheimer’s Association International Conference; July 26-30, 2021 (virtual meeting).
2. Lennerz B, Lennerz JK. Food Addiction, High-Glycemic-Index Carbohydrates, and Obesity. Clin Chem. 2018 Jan;64(1):64-71. doi: 10.1373/clinchem.2017.273532. Epub 2017 Nov 20.
3. Alpana P Shukla, Jeselin Andono, Samir H Touhamy, Anthony Casper, Radu G Iliescu, Elizabeth Mauer, Yuan Shan Zhu, David S Ludwig, Louis J Aronne. Carbohydrate-last meal pattern lowers postprandial glucose and insulin excursions in type 2 diabetes. BMJ Open Diabetes Research and Care, September 1, 2017.
4. Chao AM, Jastreboff AM, White MA, Grilo CM, Sinha R. Stress, cortisol, and other appetite-related hormones: Prospective prediction of 6-month changes in food cravings and weight. Obesity (Silver Spring). 2017 Apr;25(4):713-720.


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