Health & Views –January 2020 – 3rd issue By Harold Gunatillake
Alzheimer’s disease is a degenerative disease of the brain described as early as 1906
by Dr. Alois Alzheimer.
There is progressive memory loss and loss of cognitive function.
Now what does cognitive function means?
Cognitive function.is an intellectual process by which one becomes aware of,
perceives, or comprehends ideas.
It includes multiple mental abilities, learning, thinking, reasoning, remembering,
problem solving, decision making and attention.
Alzheimer’s disease is the most common form of dementia.
Dementia is a general term for declining mental ability which affects the
performance of daily activities and routine.
Dementia became the leading cause of death in 2016 for Australian women,
surpassing heart disease.
It is the third cause of death for men.
In 2019, there is an estimated 4 hundred thousand Australians living with dementia.
Alzheimer’s disease is more specific and is the most common type of dementia accounting for 80% of cases.
Short term memory loss is one of the earliest symptoms.
In 2009 the number of Australians with dementia was estimated to be 245,000. Due to our ageing population, the incidence of dementia is estimated to rise above 1.1 million by 2050. Every five years after the age of 65, the likelihood of living with dementia doubles and the disease affects one in four people aged 85 and over.
There are two types of Alzheimer’s disease, sporadic and familial (hereditary). In the sporadic form, the disease is usually diagnosed after the age of 65 and is by far the most common form. In the less common familial form, the disease runs in families and usually affects people in their 40s or 50s.
Anatomy of the brain
Brain is full of cells called neurons.
Each neurone has a body which contains the genetic blueprint that directs and regulates the cell’s activities.
Dendrites are the branches of the brain cells which collect information from other neurons.
Axon the 3rd part of the neurone is a cable which transmits messages to other neurones.
In Alzheimer’s disease many neurones stop functioning, lose connections with other neurones, and die.
When neurones and their connections are destroyed, it involves memory, including hippocampus. Hippocampus lies below the temporal lobes of the brain.
Later it affects areas in the cerebral cortex responsible for language, reasoning and social behaviour.
Over time, a person with Alzheimer’s gradually loses his or her ability to live and function independently. Ultimately, the disease is fatal.
Let’s talk about Amyloid plaques.
Beta- amyloid protein involved in Alzheimer’s comes in several different molecular forms that collect between neurons.
In the Alzheimer’s brain, abnormal levels of this naturally occurring protein clump together to form plaques that collect between neurons and disrupt cell function.
Let’s talk about the Neurofibrillary Tangles Neurofibrillary tangles are abnormal accumulations of a protein called tau that collect inside neurons. This is a protein an important component of nerve cell, helping to maintain their function and structure: in the brain, distortions in the protein’s molecular shape is associated with the onset of Alzheimer’s disease.
Healthy neurons, in part, are supported internally by structures called microtubules, which help guide nutrients and molecules from the cell body to the axon and dendrites. In healthy neurons, tau normally binds to and stabilizes microtubules. In Alzheimer’s disease, however, abnormal chemical changes cause tau to detach from microtubules and stick to other tau molecules, forming threads that eventually join to form tangles inside neurons. These tangles block the neuron’s transport system, which harms the synaptic communication between neurons.
It appears that abnormal tau collects in certain regions of the brain that are involved in memory.
So, the Beta-amyloid clumps into plaques between neurons and the tau seems to spread throughout the brain.
There are scavenging cells called glial cells in the brain to help keep the brain free of debris. One type of glial cells is called microglia and another called Astrocytes. They destroy waste and toxins in a healthy brain.
In Alzheimer’s disease these cells fail to clear away the waste, debris and protein collections, including beta-amyloid plaque.
There is a gene called TREM2. Normally, TREM2 tells the microglia cells and astrocytes, to clear beta-amyloid plaques from the brain and helps fight inflammation in the brain.
In the brains of people where this gene does not function normally, plaques build up between neurons.
There is an abnormal build-up of a protein called beta amyloid which forms plaques outside the brain cells and disrupts its functions.
Tau is an important protein component of nerve cell, helping to maintain their function and structure: in the brain, distortions in the protein’s molecular shape is associated with the onset of Alzheimer’s disease.
These microglia and astrocytes collect around the neurons but fail to perform their debris-clearing function.
In all these situations the brain cells seem to dysfunction and die.
That is the story of Alzheimer’s disease.
So far, we know how Alzheimer’s disease builds up, but no solutions have been found to arrest the damage to the brain cells.
People who live a healthy lifestyle, especially from mid-life onwards, are less likely to develop Alzheimer’s disease.
This includes doing regular physical exercise and keeping to a healthy weight, not smoking, eating a healthy balanced diet and drinking alcohol within the limits recommended by your doctor.
Keeping physically, mentally and socially active will help to reduce the risk of developing dementia.
We at the eLanka team wish our eHealth writer Dr Harold Gunatillake a very Happy 90th Birthday, and thank you for all your support and contributions to eLanka!
Dilani wife of HE. Nimal Bandara -Consul General of Sri Lanka in Sydney, had her birthday celebrations, at their residence in Strathfield, Sydney, on 3rd January 2020. With the staff of the Consulate Office.
Invited guests: Jaya Jayawardena, his wife and Dr. Harold Gunatillake and his wife Irangani.
It was a private and homely event with traditional foods and lavish home-made dinner.
This is a question that comes to one’s mind when you become a victim.
It is totally a preventable disease like heart disease. One could say that these are “Life-Style” diseases that people create for themselves.
Risk factors can be reduced by making lifestyle changes.
Age is a factor. People tend to have a stroke over the age 65. But younger people also can get.
You should be extremely careful if any close relatives like your parents had a stroke, then your risk is likely to be higher.
Strokes are common among men more than women, obviously, heavy drinking and eating the wrong foods are the main reasons. If you are pot bellied and overweight- sure you are a candidate for a stroke, or a heart attack.
I am here to give you good advice and please listen to me. I am a party goer too, and I could see how our people indulge in the type of food they get to eat at these social events and the volumes of alcohol they drink.
Most of our so called youthful healthy adults are ‘pot-bellied’ and they have no shame to go about with such an unhealthy profile.
These pot bellies are due to visceral fat that give out toxins to harm your heart and cause stroke.
They are also referred to as “sugar bellies”, because eating too much of food containing carbs, deserts and beverages with added sugar are stored as fat in your belly.
Avoid those deep-fried tasty foods that also gives you the flavours and desire to eat more.
A stroke belt has been identified in the Atlantic coastal plain countries of North and South Carolina, and Georgia in the US. where it has been observed that consumption of high fried foods by the black Americans and consequently, the death rate seems to be high.
Eat more foods cooked with water like our mothers did. All curries were cooked with water with added spices to get the flavour.
Today, most Asian foods are deep fried even before they are made into curries.
Look after your blood vessels.
Eating fatty food with added sugar, calorie dense foods can increase your fat in your blood vessel lining. These are roads or pathways in your body to transport digested food to provide energy for the survival of each cell in your body.Just imagine a truck carrying loads of rubbish for disposal, drops the rubbish on the roadside on the way,We refer to these dropped rubbish as ‘plaques’ that get deposited and grows in your main arteries.
This causes reduced blood supply to organs.
In this discussion, it is the part of the brain that is prevented from getting oxygen and
nutrients. Brain cells begin to die.
Such loss of blood supply to the brain due to a blockage of an artery is referred to as an ‘Ischaemic stroke’.
Some people may have a temporary disruption of blood flow to the brain, and that would be referred to as a transient ischaemic attack (TIA), that does not cause permanent damage to brain cells, provided immediate medical intervention is given in hospital.
In such a situation, a small piece of the plaque in your carotid arteries in the neck can get dislodged and cause a temporary blockage to the blood supply and cause a stroke.
Or, a blood clot can be released from the plaque that can travel to the brain and cause the temporary episode.
These TIA’s are warning signs for a bigger attack, unless immediate steps are taken to dissolve the clot through clot dissolving regimes.
The other type of major episode is called haemorrhagic stroke in contrast to the ischaemic stroke already briefed.
In this condition, the bleeding occurs in the brain vessel due to bursting of a vessel. The main cause for such episode is high blood pressure, the commonest cause in old people when the blood pressure has not been checked regularly.
In some situations, you are born with minute bulges in the brain vessels called berry aneurysms.
As said earlier, stroke is preventable. It is a lifestyle disease. By reversing to a healthy lifestyle is the solution.
Eat home cooked foods cooked with water and use very little oil in the process.
Limit your alcohol consumption, only a social drink or two weeklies.
Exercise daily- 25,000 steps brisk walk be ideal for older people.
Keep your weight within the normal range.
If you are a diabetic, enjoy a low carb diet and tight control of blood sugar with medication. Check your blood pressure regularly. Reduce your stress factors. Maintain a good lovable relationship with your immediate family and socialise with friends at least once a week.
See your family doctor for regular medical check-ups. Conclusions:
Hope this talk was useful. Please be health conscious daily to improve your life to give your health and happiness. What more can we expect?
Also surf my website: www.Doctorharold.com
There are many health benefits and uses of Parsley. You could grow them in pots on your balcony- needs full sun and needs watering daily.
This is a herbal plant native to the Mediterranean. There are two most common kinds- French curly and Italian flat-leaf.
Today, it is widely used to treat high blood pressure, allergies, and inflammatory diseases due to the health benefits of its micronutrients. Please watch the video and enjoy with your family and friends.
What alcohol does to you.
It is the season we all indulge and drag into excess drinking. This video is for us to be cautious.
Yes, it is for us to think twice before getting intoxicated during this holiday season. Alcohol is also called ethyl alcohol or ethanol. It is made from grains, fruits or veggies through a process called fermentation- when yeast or bacteria react with the sugars in such food and the by-product is ethanol and carbon dioxide.
Sri Lankans in the villages drink a fermented product from potatoes and other fruits called “Kasippu” very toxic to the liver. One gram of alcohol has 7 calories, which is more than one gram of carbs having 4 calories, proteins -4 calories and fat has 9 calories.
A 12 ounces regular beer has 14 grams of pure alcohol. What this means is that one beer drink puts on 14 into 7 calories- amounting to 98 Cals.
This is how you could account for the beer bellies, seen in the way-side pubs.This is all empty calories from beer drinking which is stored in the belly as visceral fat.
A standard drink of alcohol is defined as 12 oz. of regular beer, 5 oz. of wine and 1.5 oz of spirits. What this means is that a standard serving sizes of all alcoholic beverages- beer, wine, and liquor- are equal in alcohol, strength and effect on the body. So habitual drinking does put on weight which will affect your health and wellbeing. Alcohol enters the blood stream from the mouth and rest of the gut without burning extra calories. So, alcohol provides empty calories which is stored without the body using extra calories to break down.
On the other hand, the food you eat has a ’thermic effect’ meaning that energy is used to digest our food in the gut, and no energy is used for any breakdown of alcohol you drink. Did you know that drinking cool water uses about 5 calories to make it warm in your stomach?
So, if you are thinking of maintaining a healthy weight, it is advisable to drink cool water more than warm water.
How the liver treats alcohol?
When digested food and alcohol enters the liver through the portal veins, the latter being a toxic molecule, the liver seem to prioritize metabolizing alcohol first, before metabolizing the food you eat. Liver can only metabolize and clear alcohol at the rate of an ounce liquor per hour. In a standard drink of alcoholic beverage contains 14 grams of pure alcohol, equivalent to 0.6 fluid ounces of pure alcohol, which is about ½ tablespoon.
What this implies is that if you drink more than two drinks of alcoholic drinks you will feel tipsy within the first hour.
Your brain feels the alcohol within thirty seconds after the first sip. This will slow down the chemicals and pathways your brain cells use to send messages.
This will alter your mood, slow down your reflexes and may feel unsteady. It will affect your driving and your reflex actions may not be prompt in an emergency.
Alcohol drops your blood sugar
Insulin in your blood stream couriers the sugar to its destinations like the liver, muscles and fat cells for storage and produce energy for metabolic activities. Liver stores the sugar as glycogen. It also controls the blood sugar level. Alcohol consumption causes an increase in insulin secretion, which can lead to lowering of blood sugar.
It is also observed that moderate amount of alcohol may cause blood sugar to rise,as beer and sweet wine contains carbs, though excess alcohol can decrease your blood sugar level.
Uncontrolled diabetics should be very careful in drinking alcoholic beverages, as they may cause your blood sugar to either rise or fall, in addition to adding calories to affect your body weight.
What this means is that people with diabetes can have an occasional drink if your blood sugar is well controlled with medication.
You need to check with your doctor to see if drinking alcohol is safe for you. Drinking alcohol stimulates your appetite, which can cause you to overeat and may affect your sugar control.
Alcohol can affect and interfere with the positive effects of oral diabetes medicines or insulin.
Alcohol tends to increase your blood pressure.
Do not drink more than two drinks of alcohol in a one-day period if you are a man, or one drink if you are a woman. (Example: one alcoholic drink = 5-ounce glass of wine, 1 1/2-ounce “shot” of liquor or 12-ounce beer).
Drink alcohol only with food.
Avoid “sugary” mixed drinks, sweet wines, or cordials.
Mix liquor with water, club soda, or diet soft drinks.
Alcohol affects your brain cells
If you drink heavily regularly your brain cells gets smaller and shrink the brain. Shrunken brain may influence your thinking, memory, learning, and affect your control of body temperature.
Should you drink alcohol to sleep?
After a hard day’s work, you may feel okay to have a small drink to wind down.Alcohol’s slow-down effect on your brain can make you drowsy, so you may doze off more easily. It will unwind you, but you won’t sleep well.
Your body processes alcohol throughout the night and when the effect goes off, you may toss and turn in your bed and keeps you awake. Your mouth would be dry by morning after even a small drink. Keep a bottle of water with you and sip it every time you wake, and you may feel fresh in the morning.
Alcohol on the stomach
If you suffer from indigestion, be cautious of drinking alcohol. Alcohol irritates your stomach lining, and you may feel nauseated and you may throw up.
Drinking alcohol for a long time can cause stomach ulcers. If you suffer from heart burn, drinking alcohol relaxes the muscles that prevent acid juice refluxing into the gullet, and you may suffer from worse heart burn. You may not absorb all the nutrients you need for your wellbeing and health, drinking regularly for a long time.
You may become malnourished.
Your small gut and colon also get irritated. Your food may not be digested properly and may lead to lose motions.
Alcohol leads to liver damage
A drink of alcohol may take the liver 6 hours to get rid of it from your blood.Your second drink meanwhile remains in your blood waiting to enter the liver.Your third drink may be in queue after the second and may take over 12 hours to enter your liver from your blood to break down.
Now you can understand why RBT is on action, the morning after, to catch that third drink, and inevitably you will be over the limit. Heavy drinking causes a fatty liver and become hard or fibrous. That limits blood flow, so liver cells don’t get enough oxygen required for the liver cells to survive. Liver cells can get scarred and lead to a disease called cirrhosis.
Are you a poor methylator?
Alcohol you consume needs to be detoxified in the liver through a biological process called, ’methylation’ A gene called MTHFR plays a key role in methylation.
If this gene is deficient in your body detoxification of alcohol is slow and you may
have a severe hang over the next morning
To combat that holiday hangover, MTHFR activity can be enhances by taking-
• Eating veggies such as broccoli, cauliflower, and Brussels
• Taking Vitamin D, E and B
• Supplementing melatonin
Stay well hydrated after drinks. Alternate between having alcohol and water
Pick low calorie alcohol alternatives:
Red or white wine: 5 ounces | Calories; 125, Carbohydrate: 4g
Light beer: 12 ounces | Calories: 100; Carbohydrate: 5g
Champagne: 5 ounces | Calories: 100; Carbohydrate: 1g
Vodka, whiskey, rum or gin: 1.5 ounces | Calories: 96; Carbohydrate: 0g
Holiday cocktails like eggnog, punch and champagne can also add sugar and calories
to your body, and diabetics should be careful not to over-indulge.
Try not to overindulge in sugary drinks. One trick is to avoid the highly sweetened mixers, where most of the sugar sneaks in. Your best bet is to stick with beer, wine and low-sugar mixers like soda water or a splash of fruit juice.
Alcohol damages your pancreas Pancreas manufactures insulin to maintain your blood sugar level, also other chemicals help intestines breakdown food.
Alcohol causes inflammation of the gland, which can lead to serious damage.
Think of all these detrimental factors when you take the first sip of any alcohol.
Siva, master-chef and caterer organizes a Christmas lunch every year. This year it was held at the Cherry-brook community centre in Sydney. Siva provides a lavish exquisite lunch enjoyed by all. Merry Christmas to all our viewers. Produced by Dr. harold Gunatillake