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For the past four to five years I have encountered people here in Finland who talked about their relatives suffering from Alzheimer's disease. These people lived what appears to be a typical healthy lifestyle, then suddenly their memory just deteriorated. According to wikipedia:
Alzheimer's disease (AD) is a neurodegenerative disease that usually starts slowly and progressively worsens.[2] It is the cause of 60–70% of cases of dementia.According to WHO:
Dementia is a syndrome in which there is deterioration in cognitive function beyond what might be expected from the usual consequences of biological ageing.
Although dementia mainly affects older people, it is not an inevitable consequence of ageing. Currently more than 55 million people live with dementia worldwide, and there are nearly 10 million new cases every year.
Dementia results from a variety of diseases and injuries that primarily or secondarily affect the brain.
Alzheimer's disease is the most common form of dementia and may contribute to 60-70% of cases.
Dementia is currently the seventh leading cause of death among all diseases and one of the major causes of disability and dependency among older people globally.
Dementia has physical, psychological, social and economic impacts, not only for people living with dementia, but also for their carers, families and society at large.55 million victims globally looks like a massive amount of people, and it is, but the prevalence on a population of 8 000 000 000 people, expressed in percentage, is 0,69%
Applying that number on a country like the USA, you would expect to find 0,69%*320 000 000=2 200 000 persons. But according to Bright Focus Foundation:
More than 6 million of all Americans, or an estimated 6.5 million Americans older than 65, have Alzheimer's disease.Applying the global number on a country like Finland, the expected amount of Alzheimer's cases would be 38 000. that is, people who are still living with the disease.
According to statistics Finland: 10,673 people died because of dementia in 2020. If 60-70 % of these people suffered from Alzheimer's, that means that 6000 - 7000 Finnish people died because of Alzheimer's in 2020. The same amount of people died from dementia (including Alzheimer's) 2019. According to World health ranking, Finland is the number one Dementia and Alzheimer's country on the planet.
Link to source.
Why?
In 1971, ~25 men and ~25 women died because of Alzheimer's, and that number was steady until 1980. Then the number of cases started to increase (link).
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| Diagram from Statistics Finland. |
What happened in 1980?
The early 1980s saw the introduction of new dietary guidelines which were influenced by the result from The Seven countries study. Two cohorts in the study came from Finland, and many people still remember North Karelia Project (NKP), where saturated fats and cholesterol was attributed as the cause of heart diseases in north Karelia (995/10 000 compared to Crete: 9/10 000). As late as March 2022, Finnish Institute for Health and Welfare wrote this on their home page:
On the same page, The Finnish institute for Health and Welfare (THL) presents a diagram of life expectancy in Finland between 1971-2020:
But do people at THL claim causality between life expectancy and change in diet, or even correlation, of is it just the Influence of a third variable?
Note, in parallel with extended life expectancy, cases of Alzheimer's started to increase over time. There's a small delay in the onset of the increase of Alzheimer's, but from 1980, the curves are more or less parallel.
In an older version of the description of the projekt, published on University of Helsingfors home page, the explaining is a bit different. Instead of blood pressure and cholesterol, the text fokus om fatty food:
Why on Earth would people at THL change the story, from fatty food, to blood pressure and cholesterol?
What about the advise to limit the consumption of butter (saturated fats) and salt? Was those conclusions and advise to the Finish people consistent with science?
In 2006, a paper based on the largest study of Women's health was published (Howard et al. 2006). In the section for main results, there was no link between saturated fats and heart issues.
2014, investigate journalist and adjunct professor Nina Teicholz published The Big Fat Surprise: Why Butter, Meat and Cheese Belong in a Healthy Diet. Teicholz spent 10 years exploring research about nutrition, including Seven countries study and the North Karelia Project (NKP). Teicholz noticed that there was another cohort in Finland that was never mentioned - Åbo in the southwest. This is actually visible on the map of the countries in Seven countries study:
Finland is known for having two cultures. One Swedish-Finnish in the southwest and one Ural-Finnish in the northeast; people migrated from Europe via Sweden to the coastal areas of Finland, and from the Ural mountains to the northeast (Lamnidis et al. 2018). Then sometime after the Viking era (750-1050) southern Finland and mid-Sweden (Svitjod) merged to a kingdom that lasted for about 760 years. The Uralfinns spoke, and still speak, a remote language that is not associated to any other language. That leads to isolation and tribalism (Pagel, 2019). The Finns in the south, on the other hand, sustained their Swedish heritage, including the language. Still, most people in the south speak Swedish. According to Findings from the Seven countries study, physical health was better in the Swedish-speaking area. The people in Åbo and Karelia ate a similar diet, but the people in Åbo only had a third of the heart related deaths compared to Karelia. Was Åbo excluded because of selection bias?
In 2016, another paper was published, with raw data originating from The Seven countries study. The data was found in the basement of one of the researchers in the project, and therefore forgotten. The result of the study, again rejected any causal link between dietary saturated fats and CVD.
In 2019, a team of paleo anthropologist published a paper with some interesting findings. After digging in the Afar region in northern Ethiopia, they found stones and crushed bones from big dead animal. The researchers concluded the Human Predatory Pattern-theory, meaning that Lucy's kind used stones to extract bone marrow from big dead animals. Bone marrow is dense in micro-nutrients like heme-iron, zink, and DHA and so forth. A previous study by Aiello and Wheeler (1995) had proposed another theory - The Expensive-Tissue Hypothesis - which suggests that if the brain expanded, the gut will shrink- suggesting that is important for Brain health.
And their brains started to expand, from the occipetal lobe and forward, expanding the frontal cortex. After more than three million years, our species, the Homo Sapiens, entered the stage, and 250 000 years after that, Homo Sapiens Sapiens emerged. We have an unusually big brain, which despite weighing 2 % of our body mass, consumes >20 % the energy we consume.
In 2019, Georgia Ede published an interesting paper in Psychology Today - The brain needs animal fats - where she conclude that our brains need docosahexaenoic acids (DHA) and eicosapentaenoic acids (EPA) to sustain normal cognitive functioning.
One other important component is salt. Since early 1970s, based on the findings from NKP, people at THL have been convinced that salt is bad. I remember a similar approach from my upbringing in Sweden, and in Helsingfors, most people I speak to believe that salt is bad.
But current research on salt suggest that we should consume 1.5-2.5 teaspoons a day, because salt is a systemic component that regulates all sorts of things in the body. Check out Dr Andrew Mente's presentation for an orientation about salt: A/Prof. Andrew Mente - 'Dietary Sodium Consumption and Cardiovascular Disease and Mortality'
In October 2022, Currenti et al. concluded:
The consumption of SFA does not seem to be harmful to cardio-metabolic health and, on the contrary, SCSFA may exert beneficial effects. Further studies are needed to clearly validate the results of the present study.Why is this story about fats important in a discussion about Alzheimer's?
Alzheimer's/Type 3 Diabetes. In 2005, Steen et al.:
The strikingly reduced CNS expression of genes encoding insulin, IGF-I, and IGF-II, as well as the insulin and IGF-I receptors, suggests that AD may represent a neuro-endocrine disorder that resembles, yet is distinct from diabetes mellitus. Therefore, we propose the term, "Type 3 Diabetes" to reflect this newly identified pathogenic mechanism of neurodegeneration.In 2008, de la Monte and Wands conducted a review and concluded:
We conclude that the term “type 3 diabetes” accurately reflects the fact that AD represents a form of diabetes that selectively involves the brain and has molecular and biochemical features that overlap with both type 1 diabetes mellitus and T2DM.In 2022, Mudge wrote a popular science article on the topic - The term ‘type 3 diabetes’ in increasingly being used to describe Alzheimer’s disease
Type 3 diabetes is not a medically recognised term and is not something doctors use for diagnostic purposes. However, insulin resistance and decreased insulin signaling in the brain may play a role in the development of Alzheimer's disease. Not to mention, the risk of developing Alzheimer's disease is significantly higher in those with type 2 diabetes.
A review on insulin resistance in Frontiers in Neuroscience(opens in new tab) indicates that insulin is involved in multiple common conditions, such as obesity, dementia and diabetes. The review discusses how antidiabetic medications may be used to prevent and/or treat Alzheimer’s dementia, along with addressing stress, life events and other environmental challenges.
“Finally, type 2 diabetes doubles the risk for developing Alzheimer's disease. This is likely due to the fact that in both diabetes and Alzheimer's disease, there is a deficiency of insulin signaling.”This is a list of behavioral markers associated with Alzheimer's/Type 3 diabetes:
Early to moderate symptoms of Alzheimer's include:
- Lack of judgment
- Memory loss
- Confusion
- Agitation/anxiety
- Problems with reading, writing, numbers
- Difficulty recognising family and friends
- Disorganized thoughts
- Lack of impulse control
It's likely to state that after THL's focus on the North Karelia Project (but not Åbo?) and the implementation of new dietary guidelines in early 1980s, three things happened: (1) Life expectancy increased, (2) but so did obesity and (3) Alzheimers.
But, life expectancy is not associated with lowering the consumption of butter and salt.
Lowering the consumption of fat and salt leads to an increased consumption of sugar, which is linked to welfare diseases (Hall et al. 2019; Lustig, 2009, 2017).
It seems that Alzheimer's has a similar explanatory model.
Our species demand a diet rich in DHA and EPA fatty acids, and dense in micro-nutrients: 13 vitamins, 15 minerals, and choline (a 5 minute lecture by Dr. Smith), all served together.
But why doesn't THL communicate these simple facts to the public?
In January 2020, the head of the department at the Department of Food and Nutrition at the University of Helsingfors invited me to do a presentation: What’s the Prospect of Sustainable Food: The Case for Mental health:
Link to source.
On the one hand I met people whose careers were built on the claims from the North Karelia Project, and still depend on it. They defended their viewpoint. On the other hand I met people who were open to anthropology, and current research about fat and salt. With them I reasoned.
A few month later, the Finnish guvernement decided to basically shut down Nyland, the main region of Finland where Helsingfors is situated, in an effort to stop the spread of the newly discovered virus: Sars-Cov (2) which, if it travels through our species, may cause Covid 19. Finland's neighboring country Sweden opted for another strategy, keeping the country open, on the premise that the best way to fight a virus is to reach herd immunity. The Finnish government's decision caused an increase of depression and anxiety, marked by a sudden escalation of suicide by 15 % during the spring of 2020 (Yle News).
The commonality is that in neither of NKP or the lock-down has anyone admitted they were wrong.
Members of our species tend to get stuck in our convictions. In the academy this may be referred to as the continued Influence bias, or as Max Planck stated: "Science progresses one funeral at a time". Also Remember Festinger, Riecken and Schacter in When Prophecy fails:
"A man with a conviction is a hard man to change. Tell him you disagree and he turns away. Show him facts or figures and he questions your sources. Appeal to logic and he fails to see your point" (p. 3).
Excellent article
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