Alzheimer’s disease, a major form of dementia, has no cure. Luckily, diet and lifestyle can be modified to reduce the risk. For instance, Mediterranean diet and physical activity may each independently reduce the risk of the condition, according to a study in the Aug 2009 issue of Journal of American Medical Association. Dr. N. Scarmeas and colleagues of Taub Institute for Research in Alzheimer’s Disease and the Aging Brain and Department of Neurology at Columbia University Medical Center found men and women those who adhered most closely to Mediterranean diet were 40 percent less likely to be diagnosed with Alzheimer’s disease during a average of 5.4-year follow-up, compared to those who adhered to the diet least closely.
The researchers also found those who most actively engaged in physical activity were up to 33 percent less likely to be diagnosed with Alzheimer’s compared with those who were least active. For the study, Scarneas et al. followed 1880 community-dwelling elderly people who lived without dementia at baseline in New York for their dietary habits and physical activity.
Adherence to a Mediterranean-style diet was assessed on a scale of 0-9, or trichotomized into low, middle, or high and dichotomized into low and high. Physical activity was trichotomized into no physical activity, some, and much and dichotomized into low and high. Neurological and neuropsychological measures were conducted about every 1.5 years from 1992 to 2006. During the 5.4-year follow-up, 282 incident cases of Alzheimer’s were identified.
Those who adhered to the Mediterranean diet with a high score were at 40 percent reduced risk of Alzheimer, compared to those on the diet with a low score. A Mediterranean diet with a middle score did not seem to help compared to a diet with a low score. Those who engaged in some physical activity or much physical activity were at a 25 percent or 33 percent reduced risk of Alzheimer’s disease, respectively, compared with those who did no physical activity. Men and women who had neither followed Mediterranean diet nor much physical activity had an absolute Alzheimer’s risk of 19 percent. This is compared to 12 percent for those who followed both high scored Mediterranean diet and engaged in much physical activity – a difference of 45 percent.
The researchers concluded “both higher Mediterranean-type diet adherence and higher physical activity were independently associated with reduced risk for AD (Alzheimer’s disease).”
Breast cancer patients who have a strong social support system in the first year after diagnosis are less likely to die or have a recurrence of cancer, according to new research from investigators at Vanderbilt-Ingram Cancer Center and the Shanghai Institute of Preventive Medicine. The study, led by first author Meira Epplein, Ph.D., assistant professor of Medicine, was published in a recent edition of the Journal of Clinical Oncology.
Patients in the study were enrolled in the Shanghai Breast Cancer Survivor Study, a large, population-based review of female breast cancer survivors in China, which Vanderbilt University Medical Center and the Shanghai Institute of Preventive Medicine have carried out since 2002 under the leadership of principal investigator Xiao Ou Shu, M.D., Ph.D., professor of Medicine, and senior author of the study.
From 2002 to 2004, a total of 2,230 breast cancer survivors completed a quality of life survey six months after diagnosis and a majority responded to a follow-up survey 36 months postdiagnosis. The women were asked about physical issues like sleep, eating, pain, psychological well-being, social support and material well-being. The answers were converted to an overall quality of life score. During a median follow-up of 4.8 years after the quality of life assessment, the investigators documented participants who had died or been diagnosed with a cancer recurrence.
Six months after diagnosis, only greater social well-being was significantly associated with a decreased risk of dying or having a cancer recurrence. Compared to women with the lowest scores, women who scored highest on the social well-being quality of life scale had a 48 percent reduction in their risk of a cancer recurrence and a 38 percent reduction in the risk of death.
Among the facets that comprise the social well-being domain, emotional support was the strongest predictor of cancer recurrence. Specifically, women reporting the highest satisfaction with marriage and family had a 43 percent risk reduction, while those with strong social support had a 40 percent risk reduction and those with favorable interpersonal relationships had a 35 percent risk reduction.
“We found that social well-being in the first year after cancer diagnosis is an important prognostic factor for breast cancer recurrence or death,” said Epplein. “This suggests that the opportunity exists for the design of treatment interventions to maintain or enhance social support soon after diagnosis to improve disease outcomes.” While a strong social support network influenced cancer recurrence and mortality during the first year, the association tapered off and was no longer statistically significant by the third year after diagnosis.
This may be related to a smaller sample size of patients who answered the questionnaire, or other factors beyond quality of life that take precedence in the later years of survival. The study was supported by grants from the U.S. Department of Defense Breast Cancer Research Program and the National Cancer Institute.
Findings from a new study of 141 adults add to an ongoing medical debate over which patients with symptoms of celiac disease should go on a gluten-free diet. Published in ACS' Journal of Proteome Research, the study concludes that people currently diagnosed as “potential” celiac disease patients and not advised to follow a gluten-free diet may not be “potential” patients at all. Rather, the scientists found that these patients have the same distinctive metabolic fingerprint as patients with full-blown disease who do benefit from gluten-free diets.
In the study, Ivano Bertini and colleagues explain that celiac disease is an autoimmune digestive disorder characterized by the inability to digest a protein called gliadin, a component of gluten, which is found in wheat, rye, and barley. The condition causes diarrhea, bloating, and other symptoms in over 3 million people in the United States alone. Treatment is avoidance of foods containing gluten. But the disease is often undiagnosed or misdiagnosed. Definitive diagnosis involves biopsy of the small intestine, showing tissue damage. People with a positive blood test for the condition but no positive biopsy usually are diagnosed as “potential” celiac patients and may or may not be advised to follow a gluten-free diet.
The scientists used magnetic resonance metabolic profiling to analyze the biochemical markers in the blood and urine of 61 patients with celiac disease, 29 with potential celiac disease, and 51 healthy people. They found that those with potential disease largely shared the same profile as those with the confirmed disease and that the biochemical markers in both groups differed significantly from those of the healthy individuals. “Our results demonstrate that metabolic alterations may precede the development of small intestinal villous atrophy and provide a further rationale for early institution of gluten-free diet in patients with potential celiac disease, as recently suggested by prospective clinical studies,” the scientists conclude.
Individuals with either type 1 or type 2 diabetes know that maintaining a nutritious diet is one of the most important things they can do to control their disease. The findings of a new study suggest that the services of a registered dietitian may help individuals accomplish this goal.
A team of investigators from the American Dietetic Association reviewed evidence from previous research and summarized their findings in a report published in the Journal of the American Dietetic Association.
In their write-up, researchers laid out a set of exhaustive dietary guidelines for individuals affected by diabetes. Researchers said that the services of registered dietitians may be key in helping individuals follow the guidelines, which could help them significantly improve their condition.
“The evidence is strong that medical nutrition therapy provided by registered dietitians is an effective and essential therapy in the management of diabetes. Registered Dietitians are uniquely skilled in this process,” said Marion Franz, who led the investigation.
The guidelines developed by the research team lay out 29 nutritional points that can help diabetics improve their blood sugar control.
The prospective Rotterdam Study involved 5,395 people over age 55 with no dementia at baseline. All of the participants, who lived in one section of the Rotterdam area, provided dietary information when the study began in 1990.
The researchers previously reported a similar association of vitamin E intake with a lower risk of dementia and Alzheimer's disease over six years of follow-up among the cohort.
The current study found that after 9.6 years of follow-up, 465 of the participants had developed dementia; 365 of these cases were classified as Alzheimer's disease.
Higher baseline vitamin E consumption correlated with lower long-term risk of dementia in models minimally adjusted for age only and those adjusted for age, education, apolipoprotein genotype, total caloric intake, alcohol and smoking habits, body mass index, and use of supplements (both P=0.02 for trend).
Dietary surveys indicated that margarine was by far the biggest contributor to vitamin E intake at 43.4%, followed by sunflower oil at 18.5%, butter at 3.8%, and cooking fats at 3.4%.
Participants with vitamin E intakes in the top third, averaging 18.5 mg per day, were 25% less likely to develop dementia of any kind over almost 10 years of follow-up than those in the bottom third, who averaged only 9.0 mg per day. Higher baseline vitamin E consumption correlated with lower long-term risk of dementia (both P=0.02 for trend).
While the top versus bottom tertile comparison was significant, the middle group with vitamin E intake averaging 13.5 mg per day was no less likely to develop dementia than the lowest intake group.
For Alzheimer's disease alone, the multivariate-adjusted risk was 26% lower among those with the highest intake compared with the lowest (95% confidence interval 3% to 44%, P=0.03 for trend). But intermediate intake again appeared to have no impact.
Other antioxidants — vitamin C, beta-carotene, and flavonoids — held no significant associations with dementia or Alzheimer's disease risk (multivariate adjusted P=0.50 to >0.99 for trend).
Sensitivity analyses excluding participants who reported taking supplements at baseline showed similar results.
The researchers noted that the vitamin intakes seen in the study were consistent with a typical Western diet but cautioned about the possibility of residual confounding in the observational results.
All had reported on their diet at the beginning of the study. During follow-up, about 2,358 died.
The top calcium consumers had a 25 percent lower risk of dying from any cause and a 23 percent lower risk of dying from heart disease during follow-up relative to men that had the least amount of calcium in their diet. Calcium intake didn't significantly influence the risk of dying from cancer.
Men in the top third based on their calcium intake were getting nearly 2,000 milligrams a day, on average, compared to about 1,000 milligrams for men in the bottom third. The US Recommended Dietary Allowance (RDA) for calcium intake is 1,000 milligrams for men 19 to 50 years old and 1,200 milligrams for men 50 and over. “Intake of calcium above that recommended daily may reduce all-cause mortality,” Kaluza and her colleagues conclude.
Calcium could influence mortality risk in many ways, they note, for example by reducing blood pressure, cholesterol, or blood sugar levels. For the men in the study, the main sources of calcium in the diet were milk and milk products and cereal products. In contrast to calcium, there was no relationship between magnesium consumption and overall mortality or deaths from cancer or heart disease. Study participants' intakes ranged from around 400 milligrams per day to around 525 milligrams; the RDA for magnesium is 420 milligrams for men 31 and older.
This analysis, the researchers say, may have found no effect for magnesium because all of the men in the study seemed to be getting enough of the mineral in their diet. “Further studies are needed in other populations with lower dietary magnesium intakes to address this issue,” they say. Future research should also look into calcium and magnesium intake from drinking water, they add, which can be a significant source of these minerals.
SOURCE: American Journal of Epidemiology