Blood Sugar Management Linked to Brain Health in Landmark Study

A new international study, led by Ben-Gurion University of the Negev as part of the DIRECT PLUS Brain MRI trial, has brought to light how blood sugar control can significantly impact brain health.

Brain age is a concept that refers to the biological age of your brain, as opposed to your chronological age. It is based on the idea that certain brain structures and functions decline as we age, and that these changes can be measured using brain imaging techniques like MRI scans.

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Brain age is not a perfect measure, but it can be a useful tool for understanding how healthy our brains are and how well they are functioning. A brain age that is significantly higher than your chronological age may indicate that your brain is aging faster than expected, and that you may be at increased risk for cognitive decline and other age-related brain problems.

There are several ways to measure brain age. One common method is to use MRI scans to measure the volume of different brain regions.

As we age, the volume of some brain regions, such as the hippocampus and prefrontal cortex, tends to decline. By comparing the volume of these regions to a large database of healthy individuals, researchers can estimate a person’s brain age.

The scientists explain that brain age, as evaluated by MRI measurements of the hippocampus and lateral ventricles, reflects the biological aging of the brain, which can differ from a person’s chronological age. Chronological age is the number of years lived, while brain age indicates the brain’s actual health. Typically, as we age, the hippocampus shrinks and the lateral ventricles expand, serving as markers of brain aging. Some individuals have a brain age younger or older than their chronological age. A younger brain age suggests better cognitive health, while an older brain age may indicate accelerated aging and an increased risk of cognitive decline.

The study, which was published recently in The American Journal of Clinical Nutrition 2024, was conducted by an international team of brain and nutrition experts, including researchers from Ben-Gurion University, Harvard University, Leipzig University, and more. The research was primarily carried out by PhD student Dafna Pachter and overseen by Prof. Iris Shai, along with several international collaborators.

The DIRECT PLUS trial, one of the longest and largest brain MRI studies conducted to date, involved approximately 300 participants who were divided into three dietary groups. Whole-brain MRI measurements were taken before and after the 18-month trial to track changes in brain health. The researchers used Hippocampal Occupancy (HOC), as a proxy for brain age which predicts future risk of dementia. HOC typically decreases with age. Interestingly, some participants exhibited a brain age either younger or older than their chronological age.

Using NeuroQuant, an FDA-authorized fully automated tool, the research team quantified and segmented the brain MRI-derived data. The study aimed to examine whether improved glycemic control and specific dietary components could slow down brain aging. The results indicated that participants who managed to improve their blood sugar levels and achieve normal glucose status experienced a more pronounced attenuation of brain aging. Notably, those who consumed higher amounts of green tea and Mankai duckweed shakes demonstrated the most significant improvements in both blood sugar levels and brain health.

The study’s lead researcher, Prof. Iris Shai, from Ben-Gurion University, an adjunct professor at Harvard University, and an Honorary Professor at Leipzig University, explains, “Maintaining low blood sugar levels, even within the normal range, shows promise for preserving a younger brain, especially when combined with a healthy diet and regular physical activity. Specifically, polyphenols found in plant-based foods may cross the blood-brain barrier and help reduce brain inflammation, which is crucial for memory”.