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).”
A new study shows following a Mediterranean style diet rich in vegetables, olive oil, and fish may keep the mind sharp and slow age-related cognitive decline.The diet typified by the Italians, Greeks, and other Mediterranean cultures has already been shown to reduce the risk of heart disease, diabetes, and some types of cancer. But this and other studies are now suggesting that the diet may also have healthy benefits for the mind.
The Mediterranean diet emphasizes fruits and vegetables, fish, legumes, non-refined cereals, olive oil, and moderate wine consumption, usually at meals. Researchers found older adults who followed the diet more closely had slower rates of age-related cognitive decline than those who didn't, even after adjusting for other factors such as educational level. “The more we can incorporate vegetables, olive oil, and fish into our diets and moderate wine consumption, the better for our aging brains and bodies,” says Christy Tangney, PhD, associate professor of clinical nutrition at Rush University, in a news release.
In the study, published in the American Journal of Clinical Nutrition, researchers analyzed information gathered by the ongoing Chicago Health and Aging Project, which follows 3,759 adults over the age of 65 living on the South Side of Chicago. Every three years, the participants took tests of memory and basic math skills and filled out a questionnaire on how often they eat 139 different foods. The study follow-up time was 7.6 years on average.
Researchers looked at how closely the participants followed a Mediterranean diet and then compared it to their scores on age-related cognitive decline. Out of a maximum score of 55 for total adherence to a Mediterranean diet, the average score was 28. The results showed those with higher than average scores had a slower rate of age-related mental decline than those with lower scores. Researchers also looked at how closely the participants followed the Healthy Eating Index-2005, which is based on the 2005 Dietary Guidelines for Americans. They found no relationship between adherence to this type of diet and the rate of age-related cognitive decline.
Could the Mediterranean diet actually help prevent diabetes? The Mediterranean Diet, which is rich in vegetables, fruits, whole grains, healthy fats from nuts and olive oil, with moderate amounts of fish, low-fat dairy, and wine, and minimal red meat and processed meats, is considered to be an especially healthy eating plan.
Previous research conducted on newly diagnosed diabetic participants showed the diet did indeed help control the sugar spikes. The previous study found the mediterranean diet eating diabetics had better glycemic control. Furthermore, they had less needs for diabetes medications when adhering to the Mediterranean diet as opposed to a simple low-fat diet.
Recently, a team of researchers in Spain conducted a study using data from a large clinical trial to determine the effects of the Mediterranean Diet on preventing the onset of Type-2 diabetes. Participants were followed for an average of 4 years. Upon completion of the study, 54 participants had developed diabetes–but the split varied significantly among groups. The researchers found that the risk of developing diabetes was reduced by 52% among both groups of people who followed the Mediterranean Diet plans compared to the low-fat control group. In analyzing diet adherence, the researchers further noted that the closer an individual followed the Med-Diet plan, the lower their risk of developing diabetes. Interestingly, the weight of all participants did not change significantly throughout the study, nor did it vary significantly among the three groups.
The participants were divided in one of three groups: adherence to the Med-Diet with 1 liter per week of extra virgin olive oil, adherence to the Med-Diet with 1 oz per day of mixed nuts, or a standard low-fat diet as a control. No calorie restrictions were imposed on any of the groups. The two Med-Diet groups were instructed to increase fruit and vegetable intake, decrease meat intake, stay away from refined sweets and unhealthy fats such as butter, and consume red wine in moderation, if desired. The control group was given general instructions to lower overall fat intake. Baseline measurements and annual follow-up involved an oral glucose tolerance test and interviews to assess diet adherence.
Interestingly, the weight of all participants did not change significantly throughout the study, nor did it vary significantly among the three groups.
This study reinforces prior study results suggesting that the Mediterranean Diet – even without weight loss – may be protective against Type-2 diabetes. The researchers suggest that future studies should focus on the Med-Diet’s effects on younger people, and point out the possible benefits of the Mediterranean Diet as an effective intervention against complications of Type-2 diabetes.
Eating a Mediterranean-style diet may help people with type 2 diabetes keep their disease under control without drugs better than following a typical low-fat diet.A new study from Italy shows that people with type 2 diabetes who ate a Mediterranean diet rich in vegetables and whole grains with at least 30% of daily calories from fat (mostly olive oil) were better able to manage their disease without diabetes medications than those who ate a low-fat diet with no more than 30% of calories from fat (with less than 10% coming from saturated fat choices).
After four years, researchers found that 44% of people on the Mediterranean diet ended up requiring diabetes medications to control their blood sugars compared with 70% of those who followed the low-fat diet.
It’s one of the longest-term studies of its kind, and researchers, including Katherine Esposito, MD, of the Second University of Naples, say the results “reinforce the message that benefits of lifestyle interventions should not be overlooked.”
Best Diet for Diabetes Control
In the study, researchers randomly assigned 215 overweight people recently diagnosed with type 2 diabetes who had never been treated with diabetes medications to either a Mediterranean-style diet or a low-fat diet.
The Mediterranean diet was rich in vegetables and whole grains and low in red meat, which was replaced with fish or poultry. Overall, the diet consisted of no more than 50% of daily calories from carbohydrates and no less than 30% of calories from fat.
The low-fat diet was based on American Heart Association guidelines and was rich in whole grains and limited in sweets with no more than 30% of calories from fat and 10% from saturated fats, such as animal fats.
After four years of follow-up, the Mediterranean diet group had better glycemic (blood sugar) control and were less likely to require diabetes medications to bring their blood sugar within healthy levels.
In addition, people who followed the Mediterranean diet group also experienced improvement in other heart disease risk factors. Interestingly, weight loss was relatively comparable between the two groups by the end of the trial, suggesting that attributes of the Mediterranean diet beyond weight loss affect blood sugar control.
SOURCES: Esposito, K. Annals of Internal Medicine, Sept. 1, 2009; vol 151: pp 306-315. News release, American College of Physicians.
The Unesco world heritage list is normally associated with towering religious monuments and ancient Greek temples, crumbling castles and areas of outstanding natural beauty. It recognises the cultural value of the Hindu complex at Angkor Wat and the Acropolis in Athens, alongside the Great Pyramid of Giza and the Banaue rice terraces in the Philippines.
Now Italian officials are certain the UN will add a salad of tomato and mozzarella, topped off by a splash of olive oil to its list of global patrimony worth protecting.
The Mediterranean diet, with its mix of fresh fruit and vegetables, grilled fish and olive oil faces a final vote in November for ranking on Unesco's list of “intangible” cultural heritage, launched in 2003 to complement the collection of monuments and natural wonders, and covers oral traditions, performing arts, social practices, rituals and festivals.
A plate of pasta washed down with a glass of wine could join the list of 178 cultural experiences including the tango, the polyphonic singing of the Aka Pygmies of central Africa and Croatian lacemaking.
“This is a big success for our country, our dietary traditions and our culture,” said the Italian agriculture minister, Giancarlo Galan.
Rolando Manfredini of the Italian farmers' lobby group, Coldiretti, said: “It is a bit strange putting a diet on the list, and the first time they would do it, but it makes perfect sense. Not only is this culture, but it also makes you live longer and better.”
While trying not to dampen Italy's enthusiasm, a spokeswoman for Unesco warned that no decision would be made before a meeting in November. “The committee is free to make up its mind and there is no indication on what it will approve,” said Sue Williams.
Galan said the proposal was first made by Italy, Greece, Spain and Morocco four years ago, and was turned down. The countries resubmitted it, stressing the cultural content of the diet, and this time he was convinced it would get the nod.
“A positive recommendation made by Unesco will now be ratified,” he said. The diet would join Sicilian puppet theatres and Sardinian pastoral songs, which already represent Italy on the list.
The diet took off in the rest of the world in the late 20th century, with postwar cookery writer Elizabeth David helping to promote it among English speakers. Today, said Williams, protecting a plate of tortellini was no different to stopping people scratching their initials in the Great Wall of China: “Being on the intangible list means the host country must promote and protect it exactly as it would a monument like Stonehenge,” she said.
Recent activities sponsored by Unesco include the revival of the intergenerational transmission of Georgian traditional polyphony and the “safeguarding” of Somali board games.
While the Mediterranean diet has found favour with chefs around the world, Coldiretti said it was in desperate need of protection in its native countries.
“In Italy today parents are still in good shape, but their children are increasingly suffering from obesity,” said Manfredini. “There has been a complete break in eating habits from one generation to another.”
Researchers have long speculated that the diet may help explain why nations in the Mediterranean region have historically had lower rates of heart disease and some cancers, including breast cancer, compared with other European countries and the U.S.
Until now, only two other studies have looked at the relationship between Mediterranean-style eating and the risk of breast cancer, both done in the U.S. Each found a connection between the diet and lower breast cancer risk, although in one the link was limited to breast cancers that lack receptors for the hormone estrogen — which account for about one-quarter of breast tumors.
The current study focused on women in Greece, as it is the “cradle” of the Mediterranean diet, and a large segment of the population still adheres to it, Dr. Dimitrios Trichopoulos, the senior researcher on the work, told Reuters Health by email.
At the outset, the study participants completed detailed dietary questionnaires and gave information on their lifestyle habits and demographics. Each woman was given a Mediterranean diet score, ranging from 0 to 9, based on how often they consumed vegetables, legumes, fruit and nuts, whole grains, fish and olive oil or other sources of monounsaturated fats; they also won points by limiting meat and dairy.
Of the 14,800 women included, 240 were diagnosed with breast cancer over an average follow-up of 10 years.
Overall, postmenopausal women whose Mediterranean diet scores were in the 6-to-9 range were 22 percent less likely to develop breast cancer than their counterparts with scores between 0 and 3. That was with factors such as age, education, smoking history, weight and exercise habits taken into account.
The findings show an association between Mediterranean eating and lower breast cancer risk, but do not prove cause-and-effect, according to Trichopoulos, who is with the Harvard School of Public Health in Boston and the Bureau of Epidemiologic Research at the Academy of Athens in Greece.
Further studies are needed to confirm the results, he said.
However, other evidence suggests ways the Mediterranean diet might curb cancer risk.
Research has found, for instance, that women who closely follow the diet tend to have lower levels of estrogen, which fuels the growth of the majority of breast cancers, than other women do. Other studies in the lab suggest that the fats found in the Mediterranean diet — both olive oil and the omega-3 fats in oily fish — may slow the growth of cancer cells.
The diet is also typically rich in antioxidants, which protect body cells from damage that can eventually lead to disease, including cancer. Trichopoulos said that if the Mediterranean diet does have a protective effect against cancer, it is “likely” to involve that antioxidant component.
It also makes sense, said the researcher, that the diet could affect the risk of postmenopausal, but not premenopausal, breast cancer.
Younger women who develop breast cancer, he explained, often have a genetic vulnerability to the disease, whereas in older women, lifestyle and environmental exposures may be relatively more important contributors to risk.
Based on their findings, Trichopoulos and his colleagues write, the association between the Mediterranean diet and breast cancer is of “modest, but not negligible, strength.”
In the U.S., a woman's chance of being diagnosed with breast cancer rises from about a half a percent, or one in 233, during her 30s, to about four percent, or one in 27, during her 60s.
Established risk factors for breast cancer include older age and having had a first-degree relative diagnosed with the disease. Research has also linked obesity, sedentary lifestyle, use of hormone replacement therapy and high alcohol intake to an increased risk.
SOURCE: Journal of Clinical Nutrition
Before treatment, the couple completed detailed questionnaires on their eating habits over the past month. When the researchers analysed the data, they identified two common diet patterns among the women. 1). The Mediterranean diet – defined as high in vegetables, vegetable bits, fish and beans, but low in snack foods and 2). The health conscious diet – which is high in fruits, vegetables, whole grains, beans and fish, and low in meat and snack foods.
The researchers found there was no link between the health-conscious diet and rates of pregnancy. But, the group that most closely adhered to the Mediterranean diet was more likely to become pregnant. The researchers did not assess pregnancy outcome, so the diet's relationship to the ultimate success of fertility treatment is not clear.
The Mediterranean and health-conscious diets had many similarities, but there are a few potential reasons why the former may affect fertility treatment success said the researchers.
One is the high intake of vegetable oils in the Mediterranean diet. Researchers noted that the Omega-6 fatty acids in these oils are the precursors to hormone-like substances in the body called prostaglandins. Prostaglandins, in turn, are involved in the menstrual cycle, ovulation and pregnancy maintenance.
In addition, the study found that women who most closely followed the diet Mediterranean way had higher levels of vitamin B6. One previous study found giving vitamin B to women who were having difficulty getting pregnant increased their chances of conception.
Still, diet is part of a person's overall lifestyle and the study could not account for all of the factors that could clarify the connection between the natural ways to Increase fertility Mediterranean diet and pregnancy rates
Many countries around the world have developed their own food guidelines in various forms similar to the Healthy Food Pyramid, many of which are useful in making healthy choices when dining out.
• USDA: Inside the current US food pyramid
• CNPP: Original food pyramid
• BWH: Comparison of the US food guide pyramid and other food guides
• American Dietetic Association: Comparison of international food guides
• EUFIC: European dietary guidelines
• Asian: The Asian food pyramid
• Latin: The Latin American food pyramid
• Mediterranean: The Mediterranean food pyramid
• Native American: The Native American food pyramid
• Spanish: The USDA food pyramid in Spanish
• Arabic: The Arabic food pyramid
• Chinese: The Chinese food pyramid
• Cuban: The Cuban food pyramid
• Indian: The Indian food pyramid by region
• Mexican: The Mexican food pyramid
• Portuguese: The Portuguese food pyramid
• Russian: The Russian food pyramid
• Thai: The Thai food pyramid
• Japanese: The Japanese food guide spinning top
• Singapore: The Singapore food pyramid
• Canadian: The Canadian food guidelines
• USDA: Inside the pyramid-what is physical activity?
• Keep Kids Healthy: Kid's food guide pyramid
• Penn State: Preschooler's activity pyramid
• University of Missouri: Nutrition and cancer food guide pyramid
• Elderly Nursing: Elderly diet
• Dietitians.ca: Food guide for North American vegetarians
• VDH: Interactive food pyramid tracker for ages 7-10
• Teen’s Health: The food guide pyramid for teens
The new study comprised 366 people with RA from eight separate trials. Fasting followed by eating a vegetarian diet for 13 months or eating a Mediterranean style diet replete with fruits, vegetables, healthy fats, and legumes for 12 weeks may relieve pain, the study showed. These diets did not improve morning joint stiffness or physical function when compared to regular diets.
There was not enough data to draw any conclusions about how vegan and/or elimination diets affect RA symptoms.
The positive changes seen with vegetarian and Mediterranean diets may be a result of simply adapting a healthier way of eating as opposed to any specific diet, the study researchers conclude.
People with RA who were put on special diets were more likely to drop out of the studies, suggesting that some people may have difficulty adhering to the eating plans.
Some special diets also resulted in weight loss which may not always be a good thing people with RA who are already at risk for nutritional shortfalls.
“There is a need for more and better research on dietary interventions for RA,” conclude researchers led by Geir Smedslund, PhD, a senior researcher at the Centre for Rehabilitation in Rheumatology at the Diakonhjemmet Hospital in Oslo, Norway.