Presentation by Rhona Creegan on

1. Rhona Creegan
MSc Clinical Biochemistry, Dip ACN
Master of Nutrition Medicine
PhD (cand), ECU
Associate of the Australasian College of Nutritional and
Environmental Medicine (ACNEM)
“Optimising Health with Nutrition and
Lifestyle”
rhona@omeganutrition.com.au www.omeganutrition.com.au

2. Neurodegeneration:
unravelling the puzzle
A Nutrition Medicine
Perspective

3. Beta amyloid
NFT
Nutrients
Ω3
Oxidation
Inflammation
APOE
cholesterol
Hormones
NTs
Toxins
The Alzheimer’s Puzzle
Insulin
Resistance

4. What is insulin resistance?
• Elevated cholesterol
• Elevated triglycerides
• Low HDL
• High blood pressure
• Increased waist to hip ratio

5. AD and Atherosclerosis- Siblings in a
Dysfunctional Family?
• Amyloid plaque and atherosclerotic plaque have
so much in common
• Both are damage control responses to high
cholesterol in a pro-inflammatory environment,
usually associated with Insulin Resistance

7. Alzheimer’s Disease is a
Neuroendocrine Disorder resembling a
form of Diabetes.
Individuals with Type 2 diabetes have a
higher risk of learning and memory
problems and cognitive decline.
Starr VL, Convil A. Curr Opin Pharmacol 2007;7:638-42

8. The Emergence of Type 3 Diabetes:
The Dementia of the 21st Century
“The co-existence of brain insulin deficiency and
resistance suggests that AD may represent a brain-
specific form of diabetes, i.e type 3 diabetes”
de la Monte et al. J Alz Dis 2006; 10: 89-109
• AD – low CSF insulin levels, higher plasma insulin
levels, and reduced glucose disposal compared to
healthy controls.
Watson and Craft, CNS Drugs 2003: 17(1):27-45

9. Insulin – So much more than glucose
regulation!
• Brain’s consumption of glucose critical to fuel high
energy machinery. 18-30% glucose consumed
but only 2% of body weight.
• Master hormone regulating other hormones (sex
steroids, thyroid, adrenal)
• Growth factors such as IGF-1, cell signalling
• Influences plasticity - ability to form new
connections

10. Insulin and β-amyloid
• Insulin increases Aβ trafficking from inside to
outside the cell. β-amyloid needs to be outside
the cells to be degraded.
• The enzyme that degrades insulin (IDE) also
degrades β-amyloid. Insulin competes for
enzyme.
• β-amyloid affects function of insulin by moving
receptor from cell surface to inside cell causing
IR.

11. Insulin and Acetylcholine
The Importance of Insulin in Memory Formation

12. Inflammation
Chronic low grade inflammation causes
cellular damage, reduced energy production
and increased oxidative stress.
Elevated cytokines disrupt BBB
LIFE IS INFLAMMATORY
Unrelenting stress, modern diet, excess body
fat, metabolic syndrome, chronic illness

13. Oxidation
CNS vulnerable to free radical damage:
•High metabolic rate
•High lipid content
•Relatively low antioxidant enzymes
compared to other tissues

14. Hormonal Balance
• Insulin affects other hormones such as
testosterone and oestrogen
• High and low oestrogen can impact memory.
Oestrogen receptors found in cholinergic
neurones
• IR reduces SHBG. Insulin affects adrenal steroid
synthesis

15. Insulin Resistance
Insulin
Resistance
Fatty liver ↓
detox
↓ SHBG and
hormonal
imbalance
Increased
body fat
Elevated
cytokines and
inflammation
hypertension
Elevated fatty
acids
Elevated
cholesterol
and
dyslipidaemia

16. Nutrition Medicine Approach
to Healthy Brain Ageing
Environmental
Inputs – Diet &
Exercise
Hormonal and
Neurotransmitter
Balance
Detoxification and
Biotransformation
Energy
Production
and Oxidative
Stress
Immune and
Inflammatory
Balance
Gastrointestinal
Balance

17. Diet (Eating plan)
Optimised to correct for insulin resistance and
dyslipidaemia
(insulin – fat storing)
Protein, carb and fats in right ratio
don’t be SAD, tour the Mediterranean
Remove reactive foods
Maximise antioxidant intake

18. Dietary Carbohydrate
Low GI/GL complex carbohydrates
(vegetables, fruits, legumes, whole grains)
Limit simple sugars and fructose <10% daily
energy intake – depend on how much
metabolic rehab required
High carbohydrate diets can cause insulin
resistance, dyslipidaemia, high blood
pressure and fatty liver

19. Dietary Fat
Required for energy, cell membrane structure, immune
function, hormone synthesis, bile acid production and
cell signalling
Type of fat is important and contributes to disease risk
Monounsaturated fats – olive oil, vegetable oils,
avocado, nuts
Helps to lower cholesterol levels by binding esters
within the cell
Unsaturated : saturated fat ratio should be approx 2:1

20. Polyunsaturated fats
High Insulin
Trans fats,
ageing, alcohol,
nutrient
deficiencies, high
cholesterol

21. Fatty Acid Balance
• DHA most abundant PUFA in brain- major
structural and functional role
• Forms neuroprotectin D1 – anti-inflammatory and
prevents programmed cell death
• Binds to nuclear receptors which activate genes
involved with anti-inflammatory processes and
lipid metabolism – FAT BURNING!

22. Antioxidant status
• High levels to prevent lipid peroxidation and
mitochondrial damage
• Vit C , mixed tocopherols, tocotrienols, flavonoids,
carotenoids, selenium, resveratrol, alpha lipoic
acid, green tea, turmeric
• N-acetylcysteine increases glutathione levels

23. Specific Nutrients
Insulin Sensitivity:
DHA, alpha lipoic acid, Cr, Hops, proanthocyandins,
cinnamon, acetyl carnitine, vitamin D
Mitochondrial energetics:
CoQ10, ALA, B complex, Mg
Alzheimer’s Disease
ginkgo, turmeric, acetyl carnitine, green tea,
phosphatidylserine, vitamin D

24. Preventing “D”ecline
• VDR present in neurons and glial cells
• Supports immune function in brain
• Reduction in VDR expression in hippocampal cells
in AD
• Helps rebuild brain connections
• Role in insulin signalling

26. Recipe for Health
Eat fresh whole foods, high in
protein and limit processed foods
that are high GI and contain sugar,
synthetic fats and preservatives
Exercise regularly to increase
metabolic rate, reduce body fat,
improve CV function and stimulate
lymphatic removal of toxins
Drink plenty of purified water

27. Recipe for Health
Exercise – every opportunity

28. Healthy Body
Composition
↓Inflammation ↓Oxidation ↓Toxin load
↓Cellular
Degeneration
Healthy Brain Ageing
Supplement the diet with a broad range of
nutrients which will address the key
contributors to chronic neurodegenerative
disease and ageing