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Mediterranean Diet Is Strongly Protective Against Alzheimer's...

"Studies associate Mediterranean diet with lower risk of Alzheimer's disease, cognitive decline"

Studies published in the August 12, 2009 issue of the Journal of the American Medical Association (JAMA) reveal a d[b]ecreased risk of Alzheimer's disease (AD) and cognitive decline among individuals who report greater adherence to a Mediterranean type diet.[/b] The diet includes high amounts of fruits, vegetables, legumes, cereal, fish, and monounsaturated fats, lower amounts of saturated fats, red meat and poultry, and moderate alcohol consumption.

In one article, Nikolaos Scarmeas, MD, of Columbia University Medical Center and his associates evaluated data from 1,880 elderly men and women who did not have dementia upon recruitment into the Washington Heights-Inwood Columbia Aging Project. The subjects received neurological and neuropsychological testing every 1.5 years for an average 5.4 year follow-up period, during which 282 participants were diagnosed with Alzheimer's disease.

[b]Greater physical activity alone was associated with a lower risk of Alzheimer's disease, with a 25 percent average reduction in risk associated with some activity compared to no activity. [/b]Those who were categorized as participating in "much" physical activity experienced a 33 percent average lower risk.

[b]When adherence to a Mediterranean diet was considered,[/b] those in the middle third of participants had an average 2 percent reduction in the risk of developing Alzheimer's disease, while [b]those in the top third had experienced a 40 percent reduction compared to those in the lowest third.[/b]

Having both high levels of physical activity and adherence to the diet were also associated with a protective benefit. “Compared with individuals with low physical activity plus low adherence to a diet, high physical activity plus high diet adherence was associated with a 35 percent to 44 percent relative risk reduction," the authors write. “In summary, our results support the potentially independent and important role of both physical activity and dietary habits in relation to AD risk. These findings should be further evaluated in other populations.”

In a second study published in the journal, greater adherence to a Mediterranean diet was associated with a reduction in cognitive decline.

Catherine Féart, PhD, of the Université Victor Ségalen in Bordeaux, France, and colleagues evaluated data from 1,410 participants aged 65 years and older in the Three-City cohort, a study of vascular risk factors and dementia. Participants were assessed for cognitive performance during 2001-2002 and were re-examined at least once over the following 5 years. Dietary questionnaires were scored from 0 to 9 for Mediterranean diet adherence.

Although greater adherence to the diet was associated with fewer errors over time on one neuropsychological test, indicating a reduction in cognitive decline, the risk of developing dementia was not associated with diet adherence.

“A variety of approaches to mitigating cerebrovascular disease in midlife exist, including diet, exercise, treatment of hypertension, treatment of diabetes, avoidance of obesity, and avoidance of smoking," writes David S. Knopman, MD, of the Mayo Clinic in an accompanying editorial. "The findings of Scarmeas et al and Féart et al fit into a larger and potentially optimistic view of prevention of late-life cognitive impairment through application, at least by midlife, of as many healthy behaviors as possible, including diet. ba<x>sed on these 2 studies, diet may play a supporting role, but following a healthy diet does not occur in isolation.”

“The scientific value of these studies cannot be disputed, but whether and how they can or should be translated into recommendations for the public is the question.”

April 19, 2006
[b]Mediterranean diet linked with Alzheimer's disease reduction[/b]
In an article published online in advance of print in the Annals of Neurology researchers funded in part by the National Institutes on Aging reported an [b]association between consuming a Mediterranean diet and having a lower risk of developing Alzheimer's disease. [/b]The Mediterranean diet contains high amounts of fruits, vegetables, legumes and grains, some fish and alcohol, and less meat and dairy products. Recent research has revealed a lower risk of cardiovascular disease and certain cancers associated with this pattern of eating.
Nikolaos Scarmeas of Columbia University Medical Center and his New York team conducted the current study of 2,258 men and women enrolled in the Washington Heights-Inward Columbia Aging project. Participants were free of dementia at the beginning of the study, and were followed for an average of four years. Medical and neurological histories were obtained, and physical and neurological examinations were conducted at the beginning of the study and every 18 months to determine whether dementia had developed. Dietary questionnaires completed by the participants were evaluated to determined how closely the subjects followed a Mediterranean diet, and participants were scored from 0 to 9 according to their adherence.
Two hundred sixty-two subjects were diagnosed with Alzheimer's disease over the follow-up period. [b]Subjects whose diet adherence scores were among the top third of participants had a 40 percent lower risk of developing Alzheimer's disease than those in the lowest third, while those whose scores fell in the middle third experienced a 15 percent lower risk. [/b]The response to the diet appeared to be dose-dependent, with each Mediterranean diet score point associated with a reduction in Alzheimer's disease risk of 9 to 10 percent.
"We conclude that higher adherence to the Mediterranean diet is associated with a reduction in risk for Alzheimer's disease," the authors write.

February 11, 2009Mediterranean diet may help protect against mild cognitive impairment and Alzheimer’s disease
In the February, 2009 issue of the journal Archives of Neurology, Nikolaos Scarmeas, MD, and colleagues at Columbia University report an association between consumption of a Mediterranean diet and a reduced risk of developing mild cognitive impairment, which precedes Alzheimer’s disease in older individuals. A Mediterranean diet is characterized by increased intake of vegetables, fruits, legumes, cereals, fish and unsaturated fatty acids, and low intakes of dairy products, meat and saturated fats.
The study included 482 men and women with mild cognitive impairment and 1,393 who were cognitively normal upon enrollment in the Washington Heights–Inwood Columbia Aging Project. Participants completed dietary questionnaires and were screened for cognitive impairment at regular intervals during an average 4.5 year follow up period.
Two hundred seventy-five of the subjects who did not have mild cognitive impairment at the beginning of the study developed the condition during follow-up. [b]For participants whose adherence to the Mediterranean diet as evaluated in the initial dietary assessment was among the top one-third of subjects, the risk of developing cognitive impairment was 28 percent lower than those whose scores were among the lowest third.[/b] [b]For the 482 subjects who had cognitive impairment upon enrollment, those whose adherence to the diet was among the top third had a 48 percent lower risk of developing Alzheimer's disease[/b] during a 4.3 average period, and those whose scores were among the middle third experienced a 45 percent lower risk.
Potential protective mechanisms cited for the diet against cognitive impairment are improved cholesterol and glucose levels, better vascular health, and reduced oxidative stress and inflammation. "Exploration of such mechanisms and potential future interventional studies will provide a more complete and convincing picture of the conceivably important role of a healthy diet in the risk of cognitive impairment and Alzheimer's disease," the authors conclude.
—D Dye

Emphases added by conceptualclarity.

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