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World Brain Day 2024: Too much sugar spoils brain health

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The international “World Brain Day” on July 22, 2024, focused on the prevention of neurological diseases such as Parkinson’s, dementia, strokes or migraines. 40% of all dementia cases and 90% of all strokes alone could be prevented. Nevertheless, the burden of neurological diseases is increasing worldwide – increased efforts in prevention are therefore urgently needed. The German Society of Neurology (DGN) and the German Brain Foundation would like to use the day of action to focus on the far too high consumption of sugar. Because it damages brain health.

The Global Burden of Diseases Study1 has been investigating the number of deaths and the number of years of life lost for a total of 288 diseases on behalf of the Bill & Melinda Gates Foundation since 1990. The evaluation for 2021 has just been published – and two neurological diseases, stroke and dementia, are among the ten most common causes of death. This illustrates how important preventive measures are to keep the brain healthy. This includes a healthy, active lifestyle with sufficient exercise and sleep, but also avoiding harmful substances such as alcohol, nicotine or other drugs and pollutants.

Germans eat too much sugar

For Brain Health Day 2024, the German Society of Neurology and the German Brain Foundation are looking at sugar as a “neurotoxic” substance. “Of course, the dose makes the poison here, because the brain, as the body’s high-performance organ, needs glucose to function. That is the reason why people with hypoglycemia faint,” explains Prof. Dr. Frank Erbguth, President of the German Brain Foundation. “But if blood sugar levels are permanently increased by too many and too lavish meals and by constantly snacking and “snacking” on the side, we are pushing the cup over the top and fueling the development of neurological diseases, especially dementia and strokes.” Per capita sugar consumption in the 2021/22 financial year was 33.2 kg – almost twice as high as recommended. The German Nutrition Society (DGE) advocates that a maximum of ten percent of energy should come from sugar.2. With 2,000 kilocalories (average calorie requirement per day) that is 50 grams per day, or 18 kg per year. This includes not only added sugar, but also naturally occurring sugar, e.g. in fruit, honey or juices.

How sugar damages brain health and becomes a “dementia driver”

But what does sugar do to the brain? On the one hand, high blood sugar levels damage the brain vessels and lead to deposits on the vessel walls, which constrict the vessels and reduce the blood supply and thus the supply of nutrients to the brain cells. This can lead to various restrictions – depending on which part of the brain is “undersupplied” – and ultimately even result in vascular dementia. After Alzheimer’s, this is the most common cause of dementia. In Germany, around 250,000 people develop dementia every year, 15 to 25 percent of whom suffer from vascular dementia.3That’s between 40,000 and 60,000 new cases per year.

In addition, complex sugar molecules in the brain, so-called glycosaminoglycans, can also directly limit cognition. They impair the function of synapses, the switching points between nerve cells, and thus neuronal plasticity. This is the ability of nerve cells and brain areas to adapt and expand when necessary, an important property for cognitive development and learning. This was shown by experimental data presented last year at the American Chemical Society Congress.420 years ago, a study had already shown that a diet rich in fat and sugar disrupts neuronal plasticity and, in the long term, also impairs the function of our memory area in the brain, the hippocampus.5. A recent, large meta-analysis6 comes to similar conclusions: In the 2 to 12 hours after sugar consumption, mental performance increases in the short term, but long-term sugar consumption causes lasting damage to cognitive function.

There is also an indirect brain-damaging effect of excessive sugar consumption on the brain, via diabetes mellitus. Since the 1990s, it has been known that people with type 2 diabetes have a significantly increased risk of dementia and it is assumed that glucose metabolism is also disturbed in the neurons and thus contributes to the development of Alzheimer’s disease.7especially since insulin also plays a role in the development of Alzheimer’s plaques8th.

Why it is so difficult for us to give up sugar

The DGN and the German Brain Foundation recommend conscious consumption of as little sugar as possible. Unfortunately, many people find this difficult – and the reasons for this can also be found in the brain. It has been proven that after just a small “dose” of sugar, the intestines send signals to the brain via the vagus nerve, triggering a strong desire to consume more sugar.9“This could be the reason why some people eat the whole bar after eating one piece of chocolate,” says Prof. Dr. Erbguth, commenting on the research results. “In addition, when sugar is consumed, dopamine is released in the brain, a ‘feel-good hormone’, which means that you want more and more of it. “It makes sense to avoid this vicious circle by largely avoiding sugar,” explains Prof. Dr. Peter Berlit, General Secretary and Press Officer of the DGN. “The effort is worth it; 40% of all cases of dementia and 90% of all strokes are preventable, and many of them are caused by industrial sugar.”

Together with the German Brain Foundation, the DGN supports the political demand to impose a tax on drinks that contain particularly high levels of sugar. But many other foods also contain hidden sugar, such as yogurt or tomato ketchup. Alcohol also causes blood sugar levels to rise sharply.

1: GBD 2021 Causes of Death Collaborators. Global burden of 288 causes of death and life expectancy decomposition in 204 countries and territories and 811 subnational locations, 1990-2021: a systematic analysis for the Global Burden of Disease Study 2021. Lancet. 2024 May 18;403(10440):2100-2132. doi: 10.1016/S0140-6736(24)00367-2. Epub 2024 Apr 3. Erratum in: Lancet. 2024 May 18;403(10440):1988. doi: 10.1016/S0140-6736(24)00824-9. PMID: 38582094; PMCID: PMC11126520.

2:https://www.dge.de/forschung/stellungnahme-und-fachinformationen/stellungnahme/quantitative-recommendation-zur-zuckerfutter-in-deutschland/

3: https://gesund.bund.de/vaskulaere-demenz#risk factors

4: American Chemical Society. https://www.acs.org/pressroom/newsreleases/2023/august/sugars-affect-brain-plasticityhelping-with-learning-memory-recovery.html

5: Molteni R, Barnard RJ, Ying Z, Roberts CK, Gómez-Pinilla F. A high-fat, refined sugar diet reduces hippocampal brain-derived neurotrophic factor, neuronal plasticity, and learning. Neuroscience. 2002;112(4):803-14. doi: 10.1016/s0306-4522(02)00123-9. PMID: 12088740.

6: Gillespie KM, White MJ, Kemps E, Moore H, Dymond A, Bartlett SE. The Impact of Free and Added Sugars on Cognitive Function: A Systematic Review and Meta-Analysis. Nutrients. 2023 Dec 25;16(1):75. doi: 10.3390/nu16010075. PMID: 38201905; PMCID: PMC10780393.

7: Sandhir R, Gupta S. Molecular and biochemical trajectories from diabetes to Alzheimer’s disease: A critical appraisal. World J Diabetes. 2015 Sep 25;6(12):1223-42. doi: 10.4239/wjd.v6.i12.1223. PMID: 26464760; PMCID: PMC4598605.

8: Kandimalla R, Thirumala V, Reddy PH. Is Alzheimer’s disease a type 3 diabetes? A critical appraisal. Biochim Biophys Acta Mol Basis Dis. 2017 May;1863(5):1078-1089. doi: 10.1016/j.bbadis.2016.08.018. Epub 2016 Aug 25. PMID: 27567931; PMCID: PMC5344773.

9: Tan HE, Sisti AC, Jin H et al. The gut-brain axis mediates sugar preference. Nature 2020 Apr;580(7804):511-516. doi: 10.1038/s41586-020-2199-7. Epub 2020 Apr 15. PMID: 32322067; PMCID: PMC7185044.

Source: German Society of Neurology

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