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Diet/Brain-Heart Connection
  July 18, 2017
A Mediterranean-style diet rich in oily fish, fresh vegetables and nuts could help cut the risk of dementia.
"the study showed changing your dietary pattern "really is quite impactful....You can change your trajectory of cognitive decline if you are adherent, for example, to Mediterranean diets or other diets low in saturated fats, low in processed flour and processed sugar....Good fats are important....poor nutrition may increase inflammation in the body and lead to brain shrinkage.....People that perhaps eat a lot of junk food and processed foods may end up having less brain cognition over time as they age and may actually have smaller brains.....A Mediterranean diet includes vegetables, fruit, nuts, seeds, fish, olive oil and whole grains, while being low in red and processed meat and with alcohol kept to a minimum. People considered to get maximum benefit from the diet have less than one alcoholic drink a day for women, or one to two for men. They also eat several servings of fruit and vegetables per day, one serving of wholegrains and up to four servings of fish per week."
⋅Falls are the leading cause of fatal and non-fatal injuries in older adults, and one-third of adults over age 65 fall every year.
⋅Falls in which your head is injured may affect your brain's ability to function normally, causing unconsciousness, confusion and other symptoms.
⋅Engage in regular physical activity to improve your strength and balance and reduce your risk of falling.
⋅At home, cover or put objects out of the way that may increase your risk of tripping and falling, such as shoes or electrical cords.
⋅Turn on lights when you enter a room so you can clearly see obstacles. Consider installing extra lighting in areas that tend to be dark.
Mediterranean-style diet linked to lower risk of dementia
In particular, the Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) diet lowered people's risk of dementia, two studies concluded.
The MIND diet is a hybrid of the Mediterranean diet and the DASH (Dietary Approaches to Stop Hypertension) diets, both of which were originally designed to help improve heart health.
⋅ These foods may help keep the brain young
Seniors who carefully followed the MIND diet had a 35 percent lower risk of declining brain function as they aged.
Even people who halfheartedly adhered to a MIND diet reduced their risk of brain decline between 18 to 24 percent.
"We've always been saying that a healthy heart is a healthy brain," said Dean Hartley, director of science initiatives for the Alzheimer's Association.
"Your brain uses 20 percent of your cardiac output for getting oxygen and glucose. If you don't have a good pump, that saps the brain of a lot of things needed to sustain its normal function," he said.
A heart-healthy diet also protects the blood vessels inside the brain, reducing the chances of micro-strokes or other health problems that could affect brain function, said Dr. Marc Gordon, chief of neurology at Zucker Hillside Hospital in Glen Oaks, N.Y. "What's good for the vessels of the heart is good for the vessels of the brain," Gordon said.
The DASH diet is intended to reduce blood pressure by promoting consumption of foods that are low in saturated fat, total fat and cholesterol. People are asked to eat lots of fruits, vegetables, low-fat dairy, whole grains, poultry, fish and nuts, while limiting their intake of red meats, sugar and salt.
The Mediterranean diet shares many of the same goals and diet guidelines, with some specific substitutions. For example, people are asked to replace butter with healthy fats like olive oil, and to use herbs rather than salt to flavor foods.
The first MIND diet study involved almost 6,000 seniors participating in the Health and Retirement Study, sponsored by the U.S. National Institute on Aging.
Those seniors who held firm to the MIND guidelines were about 35 percent less likely to perform poorly on tests of brain function, said lead researcher Claire McEvoy, a postdoctoral scholar at the University of California, San Francisco. Those who were moderately adherent were 18 percent less likely to exhibit signs of brain decline. "Eating a healthy diet could be an important way to preserve cognitive function during aging," McEvoy said.
However, none of the studies were designed to prove a cause-and-effect relationship between diet and dementia risk.
The second study of the MIND diet's effectiveness involved more than 7,000 women participating in the U.S.-based Women's Health Initiative Memory Study for an average of 10 years.
Women who closely followed the MIND guidelines were 34 percent less likely to develop Alzheimer's disease, compared to women not following the guidelines at all, said lead researcher Kathleen Hayden, an associate professor of social sciences and health policy at Wake Forest School of Medicine in Winston-Salem, N.C.
Those women who moderately adhered to the MIND diet were between 21 and 24 percent less likely to develop Alzheimer's, researchers found.
Hayden said people likely reap health benefits from the diet, but also from other healthy behaviors in their lifestyle.
"Somebody who eats a really healthy diet probably takes care of themselves in other ways as well," Hayden said.
Findings from these studies were scheduled to be presented Monday at the 2017 Alzheimer's Association International Conference in London. Research presented at meetings are typically considered preliminary until they've been published in a peer-reviewed journal. The other two studies presented at the Alzheimer's Association meeting also focused on brain effects of nutrition:
⋅ A Swedish study of more than 2,000 people found that those eating a healthy diet called the Nordic Prudent Dietary Pattern over six years had better brain health. This diet calls for people to limit their intake of root vegetables (potatoes, carrots), refined grains, butter and margarine, sugary foods and fruit juice.
⋅ A Columbia University-led study of 330 people with a mean age of 80 found that people following a dietary pattern that encourages inflammation performed poorly on brain games. MRI scans revealed that they also had a smaller total volume of brain gray matter. This pattern of eating involved high intake of cholesterol, beta-carotene and lutein, and low intake of omega-3 fatty acids, calcium, folate and vitamins.
Experts disagreed on whether you need to eat healthy starting at an early age to protect your long-term brain health.
Gordon noted that the MIND and Nordic diet studies focused on people age 60 or older, showing that even late-in-life changes can help a person's brain.
"Sooner is better than later, but it's still not too late if you're collecting Social Security to change your diet," Gordon said.
But Hayden said people shouldn't dally if they want to eat in a way that protects them from dementia.
"We don't know how long you need to be eating a healthy diet to reap benefits for your brain, but I suspect it's a long-term thing," Hayden said.
Mediterranean and MIND diets may lower risk of cognitive impairment up to 35 percent
LONDON, July 17, 2017 - Results from four large population-based studies support a connection between good dietary practices and better cognition in old age. Study results were reported at the 2017 Alzheimer's Association International Conference (AAIC 2017) in London.
A group of U.S. scientists found that, among nearly 6,000 older adults in the Health and Retirement Study, those who consistently followed diets long known to contribute to cardiovascular health were also more likely to maintain strong cognitive function in old age. They found that sticking to the specially designed MIND diet and Mediterranean diet was associated with 30 to 35 percent lower risk of cognitive impairment in healthy older adults. In fact, the investigators discovered that those with healthier diets exhibited meaningful preservation of cognitive function.
⋅ The Mediterranean and DASH (Dietary Approaches to Stop Hypertension) diets were originally developed or codified to help improve cardiovascular health.
⋅ A hybrid of these diets, called the Mediterranean-DASH Intervention for Neurodegenerative Delay, or MIND diet, is gaining attention for its potential positive effects on preserving cognitive function and reducing dementia risk in older individuals. A 2015 study found that individuals adhering to this diet exhibited less cognitive decline as they aged (Morris et al. Alzheimer's Dement. 2015; 11:1015-22).
Other diet-related studies reported at AAIC 2017 included:
⋅ Researchers from the Karolinska Institute in Sweden found that - in a group of more than 2,200 older adults - people sticking to a Healthy Nordic Diet (including non-root vegetables, certain fruits, fish and poultry) enjoyed better cognitive status than individuals who ate a less healthy diet.
⋅ From more than 7,000 participants in the U.S.-based Women's Health Initiative Memory Study, researchers found that older women who ate diets traditionally thought of as heart-healthy, in particular the MIND Diet, were less likely to develop dementia.
⋅ A team of researchers at Columbia University presented data suggesting that poor diet may promote premature signs of brain aging through inflammatory mechanisms, which were also associated with smaller brain volume.
"Although the idea that a healthy diet can help protect against cognitive decline as we age is not new, the size and length of these four studies demonstrate how powerful good dietary practices may be in maintaining brain health and function," said Keith Fargo, PhD, Alzheimer's Association Director of Scientific Programs and Outreach. "That said, we must understand that what we eat is just one part of the puzzle. Adapting our lifestyles as we get older – for example by exercising regularly, watching what we eat and engaging in lifelong learning – is important in order to maximize the potential to reduce risk of cognitive decline and dementia."
LONDON-An adherence to a healthy diet appears to be associated with higher scores on cognition tests among older, community-dwelling individuals, researchers reported here at the Alzheimer's Association International Conference.
The risk of a lower global cognition score was reduced from 35 percent to 15 percent, depending on adherence levels to two diets: The Mediterranean diet and the Mediterranean-DASH Intervention for Neurodegeneration Delay (MIND), reported Claire McAvoy, PhD, a visiting fellow at the University of California, San Francisco and a research fellow at Queen's University, Belfast, Northern Ireland, United Kingdom. "Higher scores in each dietary pattern were independently associated with significantly better cognitive function in a dose-response manner," Dr. McAvoy told the Neurology Today Conference Reporter at her poster presentation.
The Mediterranean Diet emphasizes eating vegetables and legumes, fresh fruit, olive oil, and moderate amounts of fish, poultry and red wine. The MIND diet encourages eating vegetables, berries, nuts, fish and other brain-healthy foods, including whole grains and wine, and discourages eating fried or fast food, red meat, cheese, butter or margarine, or sweets and pastries.
Subjects who had low adherence to the Mediterranean diet had an average Global Cognition Score of 14.8; participants with medium adherence to the diet had a average Global Cognition Score of 15.2 - a 15 percent reduced risk of having a lower score (p=0.08).
Individuals who were determined to have high adherence to the diet had a Global Cognition Score of 15.7, a 35 percent decrease in the risk of lower cognition scores (p<0.001), she reported.
The results were similar when the MIND diet adherence was assessed, Dr. McAvoy said. Low adherence on the diet produced an average Global Cognition score of 14.9; medium adherence produced an average score of 15.2 (p=0.10); and high adherence resulted in an average score of 15.6 (p=0.001).
Dr. McAvoy said the study population comprised people who were considered to be healthy cognitively. "We were not aiming to see a difference between the diets. They seemed to have similar findings," she said.
Dr. McAvoy and colleagues accessed data from the nationally-representative, population-based Health and Retirement Study. The researchers included 5,907 community-dwelling older adults: the median age was 68 years, and approximately 60 percent of the participants were women.
The researchers developed their own score for adherence to each of the diets studied. In the Mediterranean diet, there were 1,261 individuals who scored in the lowest tertile of diet adherence, based on self-reported diet consumption on an extensive questionnaire. There were 2,064 people in the medium adherence group, and 1,733 people in the high adherence category.
For the MIND diet, 2,219 fell into the low adherence category; 1,825 were in the medium adherence group, and 1,863 were considered high adherers. Participants who achieved higher educational levels, who were women, who were not current smokers, and who were not obese tended to have higher adherence to the diets (p<0.001).
Dr. McAvoy said the diets are similar, with the MIND diet having a greater emphasis on berries, and less emphasis on fish – one meal per week rather than 2 as in the Mediterranean diet.
Commenting on the study, Paul Wright, MD, chair of neurology at North Shore University Hospital in Manhasset, NY and Long Island Jewish Medical Center in New Hyde Park, NY, told the Neurology Today Conference Reporter: "An important finding is the decrease in inflammatory markers with certain diets. We need to elucidate the role of inflammatory markers with cognitive decline. We do see that there is a major role; therefore I feel that this is an additional significant benefit."
"I would recommend adhering to these diets," he continued. "While they may not reverse dementia, they may slow the decline and defer additional medical complications that contribute to this."
The Alzheimer's Association offers 10 Ways to Love Your Brain, including broad dietary guidance, based on the latest research.
Heart Healthy is Brain Healthy
Claire McEvoy, Ph.D. at the University of California, San Francisco, and colleagues examined the association between adherence to the Mediterranean and MIND diets and cognitive performance in a large, nationally representative population of 5,907 older, community-dwelling adults in the Health and Retirement Study. The researchers found that the more healthfully people ate, the better they functioned cognitively.
After controlling for demographic, lifestyle and health variables, participants who were highly adherent to these diets were 30 to 35 percent less likely to exhibit poor performance on a measure of cognitive function. Study participants who were moderately adherent to either diet were 18 percent less likely to exhibit signs of cognitive impairment.
Benefits of a Healthy Nordic Diet
Weili Xu, M.D., Ph.D., at the Karolinska Institute, Stockholm, and colleagues sought to identify dietary habits associated with preserved cognitive function in 2,223 community-dwelling, dementia-free adults in Sweden. The investigators found during six years of follow-up that even moderate adherence to a healthy diet known as the Nordic Prudent Dietary Pattern (NPDP) resulted in better cognitive status than individuals who ate a less healthy diet that included fatty foods, sweets and processed foods. In this population, NPDP was found to be a better predictor of preserved cognitive function than the MIND diet, Mediterranean diet, DASH diet and Baltic Sea Diet.
The NPDP included:
⋅ More frequent consumption of non-root vegetables, apple/pears/peaches, pasta/rice, poultry, fish, vegetable oils, tea and water, and light to moderate wine intake.
⋅ Less frequent intake of root vegetables, refined grains/cereals, butter/margarine, sugar/sweets/pastries, and fruit juice.
Women Who Eat Well Less Likely to Develop Dementia
Research published in 2015 found that the MIND diet was associated with a reduced incidence of Alzheimer's disease in a sample of 923 older individuals (Morris et al. Alzheimer's Dement. 2015; 11:1007-1014). Kathleen Hayden, Ph.D., Wake Forest School of Medicine in Winston-Salem, North Carolina, and colleagues sought to replicate these findings in 7,057 women participating in the Women's Health Initiative Memory Study (WHIMS). Using data from WHIMS, they categorized the participants (mean age 71) into quartiles based on level of adherence to the MIND diet, with the 1st quartile being least adherent and the 4th being the most adherent. There were 615 incident cases of Alzheimer's during a mean follow-up of 9.7 years.
Compared with women in the first (lowest) quartile of MIND adherence, WHIMS participants in the 2nd, 3rd, and 4th quartiles had 24 percent, 21 percent, and 34 percent reductions in the risk of developing Alzheimer's. It is noteworthy that the largest share of the risk reduction occurred from the poorest dietary habits to the modestly adherent diet. These results corroborate results from previous research in smaller populations, and suggest that it may not require wholesale diet changes to help preserve the aging brain.
Poor Diet Linked to Inflammation
Building on solid evidence that eating well is brain healthy, researchers are beginning to explore mechanisms through which dietary mechanisms may influence cognitive status and dementia risk. Yian Gu, Ph.D., at Columbia University, New York, and colleagues examined whether an inflammation-related nutrient pattern (INP) was associated with cognitive function and structural MRI findings in the brain.
Using data on 330 community-dwelling, non-demented elderly individuals (mean age 79.7), the investigators found that an INP characterized by high intake of cholesterol, beta-carotene and lutein, and low intake of omega-3 polyunsaturated fatty acids, calcium, folate and vitamins (B1, B2, B5, B6, D, E), was positively associated with levels of inflammatory markers (C-reactive protein and interleukin-6). In addition, closer adherence to this INP was associated with smaller total brain gray matter volume and worse performance in executive function. Additional research in larger populations is needed to confirm the role of inflammation-related dietary components in brain and cognitive health, and help elucidate inflammatory or other mechanisms through which eating habits may alter brain function and structure.
While the U.S. Congress has recently provided additional funding for Alzheimer's research at the National Institutes of Health, the commitment falls far short of the need. Congress must continue its commitment to the fight against Alzheimer's and other dementias by increasing funding for Alzheimer's research by at least an additional $414 million in fiscal year 2018.
About Alzheimer's Association International Conference (AAIC)
The Alzheimer's Association International Conference (AAIC) is the world's largest gathering of researchers from around the world focused on Alzheimer's and other dementias.
As a part of the Alzheimer's Association's research program, AAIC serves as a catalyst for generating new knowledge about dementia and fostering a vital, collegial research community.
AAIC 2017 home page: www.alz.org/aaic/
AAIC 2017 newsroom: www.alz.org/aaic/press.asp
About the Alzheimer's Association®
The Alzheimer's Association is the leading voluntary health organization in Alzheimer's care, support and research. Our mission is to eliminate Alzheimer's disease through the advancement of research, to provide and enhance care and support for all affected and to reduce the risk of dementia through the promotion of brain health. Our vision is a world without Alzheimer's. Visit alz.org or call +1 800.272.3900.
⋅ Claire McEvoy, Ph.D., et al. Neuroprotective Dietary Patterns Are Associated with Better Cognitive Performance in Older US Adults: The Health and Retirement Study.
(Funder(s): The Wellcome Trust)
⋅ Weili Xu, MD, Ph.D., et al. Which Dietary Index May Predict Preserved Cognitive Function in Nordic Older Adults? (Funder(s): CoSTREAM project; EU's Horizon 2020 Research & Innovation Programme)
⋅ Kathleen Hayden, Ph.D., et al. The Mind Diet and Incident Dementia, Findings from the Women's Health Initiative Memory Study. (Funder(s): National Institutes on Aging)
⋅ Yian Gu, Ph.D., et al. An Inflammatory Nutrient Pattern Is Associated Both Structural and Cognitive Measures of Brain Aging in the Elderly. (Funder(s): U.S. National Institute on Aging)

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