Alzheimer’s Disease, metabolic disorders and the role of diet

Accumulating evidence for the role of metabolic disorders such as insulin resistance, diabetes, obesity and hypertension in increasing the risk of Alzheimer’s disease and vascular dementia, is reviewed in a new paper published this month in the Archives of Neurology.

alzheimersbrain

In the same journal, compelling evidence is presented that higher pre-diagnosis total cholesterol, low-density lipoprotein cholesterol, and diabetes are associated with faster cognitive decline in patients with incident Alzheimer’s disease.

A cohort of 156 patients with incident Alzheimer’s Disease (mean age 83 years) were followed for up to 10 years.  Changes in a composite score of cognitive ability were monitored from diagnosis onwards.

“These findings indicate that controlling vascular conditions may be one way to delay the course of Alzheimer’s, which would be a major development in the treatment of this devastating disease as currently there are few treatments available to slow its progression,”

said Yaakov Stern, Ph.D., a professor at the Taub Institute for the Research on Alzheimer’s Disease and the Aging Brain and director of the Cognitive Neuroscience Division of the Gertrude H. Sergievsky Center at Columbia University Medical Center, and senior author of the paper.

“Preventing heart disease, stroke and diabetes – or making sure these conditions are well managed in patients diagnosed with them – can potentially slow the disease progression of Alzheimer’s,” said Dr. Stern.

Diets high in fruit, vegetables, fibre and unsaturated fats, and low in sugar, salt and saturated fat are known to reduce the risk of a range of chronic conditions, such as diabetes, heart disease and stroke.  This means eating more plant-based foods and less processed and animal-based foods.

wholegrainsandveg

Stabilising blood sugar is crucial.  This may be done by eating a diet with a low glycaemic load, that is, one that includes moderate quantities of complex carbohydrates which release glucose slowly into the bloodstream.  Whole grains, such as whole-wheat bread, brown rice, quinoa, millet and buckwheat are valuable for helping to ensure smooth regulation of blood sugar.  In contrast, highly refined carbohydrates, such as white bread, white rice, white pasta and table sugar, create a roller-coaster of blood sugar highs and lows, which if left unchecked, can ultimately give rise to insulin resistance and eventually to diabetes.  Potatoes release sugar into the bloodstream almost as fast as table sugar and thus should be eaten sparingly, unless you are lean and exercise regularly.  Consuming protein with carbohydrates at every meal has also been found to help regulation of blood sugar.

Increasing the quantity of vegetables and fruit in the diet is also vital.  Blood sugar levels are easier to maintain if vegetables are emphasized more than fruit, as some fruit contains a lot of sugar.  A minimum of 5 portions of fruit and vegetables per day is recommended.  For easy tips for increasing the amount of fruit and vegetables in your diet please click here.

Unsaturated fats found in plant oils, such as olive oil and the oils of nuts and seeds, and in oily fish, are beneficial for preventing heart disease and other vascular health conditions.  For practical suggestions for ways to incorporate more healthy unsaturated fats in your diet please click here.

For information and practical tuition in how to put all these recommendations together to create fabulous food that protects you from diabetes, heart disease and Alzheimer’s Disease, please come to a Cooking for Health course, run by nutrition expert, Dr Jane Philpott.

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Over-eating when eating out

Recently, I gave the menu of a well-known chain restaurant to a group of students and asked them to select what they would eat if they were dining there. 

 

They selected a starter (garlic bread with cheese), a main course (traditional lasagne with a salad), a dessert (ice cream) and a drink (a can of coke). 

 

Using the restaurant’s own nutritional information, they calculated the nutrient content of what they had chosen (Table 1).  The results left the students open-mouthed.

 

Their menu selection had provided:

 

n 106% of the guideline daily amount of calories (assuming 2000 kcal per day);

n 141-171% of the guideline daily amount of protein (depending on whether they were male or female);

n 61% of the guideline daily carbohydrate;

n 109% of the guideline daily amount of total fat;

n 192% of the guideline daily amount of saturated fat

n 52% of the guideline daily amount of salt. 

 

It is worth noting that the dietary reference value for salt in the UK is 6 g per day, compared with 2.3 g per day in the USA.

 

Thus, one meal out would have provided more than the entire day’s requirement for calories; enough protein to last for one and a half days; and enough saturated fat to last for two days.

 

Most people have no idea of the nutrient content of the food they are eating, nor of the potentially damaging effects on their health of a dietary excess of sugar, saturated fat and salt. 

 

Given that at least one–third of household expenditure on food and drink is spent on food eaten outside the home in the UK, food manufacturers and caterers have a real opportunity to contribute to an improvement in public health whilst also making a profit themselves. 

 

There is now convincing research evidence to suggest that increasing the amount of fruit, vegetables and whole grains in the diet, whilst decreasing the amount of sugar, saturated fat and salt, helps to protect the body from chronic conditions such as obesity, type 2 diabetes, heart disease and various cancers.

 

A two-day professional training course is offered, tailored to equip caterers, and those involved in encouraging healthier catering practices, with information and practical tools to achieve healthier eating in the population.

 

By the end of the course, participants will:

  • Understand the basic principles of nutrition
  • Be aware of the importance of food in the maintenance of health and well-being
  • Appreciate the role of lifestyles and culture in influencing diet
  • Recognise the potential benefits for both caterers and customers of providing a choice of healthier options
  • Know more about ingredient selection and methods of food production and processing that can be used to create healthier options, whilst being attractive and convenient to modern tastes and lifestyles
  • Be able to apply appropriate and relevant skills and knowledge when advising catering businesses or when planning, preparing, promoting and serving healthier foods

For further information on the course content and the course tutor, Dr Jane Philpott, please click http://cookingforhealth-uk.com/healthier-catering.php.

 

 

Table 1

Menu item

Calories per portion

Protein g per portion

Carbohydrate g per portion

Total fat g per portion

Saturated fat g per portion

Salt g per portion

 

Starter

 

568

 

29.8

 

35.6

 

34

 

16.5

 

1.15

 

Main course

 

934

 

 

42.2

 

74.4

 

33.1

 

14.6

 

1.84

 

Dessert

 

 

475

 

5.5

 

18.8

 

18.1

 

11.1

 

0.15

 

Drink

 

 

139

 

0

 

35

 

0

 

0

 

0

 

 

 

 

 

 

 

 

Total

 

 

2116

 

77.5

 

163.8

 

85.2

 

42.2

 

3.14

 

Gov guideline

 

 

2000 kcal

 

45 g/day (women)

55 g/day (men)

 

267 g per day

 

78 g per day

 

22 g per day

 

6 g per day

 

% of guidelines

 

 

106%

 

171% (women)

141% (men)

 

 

61%

 

109%

 

192%

 

52%

 

 

 

Mediterranean diet reduces risk of heart attack and stroke

A new analysis of data from the Nurses’ Health Study has shown that women whose diets most closely resemble a traditional Mediterranean diet are significantly less likely to develop heart disease and stroke [1].

Lead researcher Dr Teresa T Fung (Harvard School of Public Health, Boston, MA) commented that many other studies have looked at the effects of this diet on cardiovascular mortality, but this is one of few with enough participants to look at nonfatal events and also is the first to examine stroke as a separate outcome. Fung and colleagues report their findings online February 16, 2009 in Circulation.

“What this adds to the existing literature is that it shows a reduced risk of nonfatal events as well,” she notes. “My take on this is that all the data from different studies with different types of dietary patterns are pointing in the same kind of direction: a minimally processed, mostly plant-based diet, with an abundance–not just in terms of quantity but in terms of variety–of different plant foods and fish. I will single out fish because we included fish in our score. Oily fish seem to have a very strong relation in terms of being beneficial.”

29% Reduced Risk of MI, 13% Reduction in Stroke Risk

Fung and colleagues used data on 74 886 women who participated in the Nurses’ Health Study, and the current analysis averaged data from six different dietary assessments self-reported between 1984 and 2002. Previous studies have shown an association between the Mediterranean diet and a reduced risk of cardiovascular death in both men and women, they note. 

They calculated the Alternate Mediterranean Diet (aMed) score, a measure constructed to assess US-based diets for their similarity to a traditional Mediterranean diet, for the women and divided them into quintiles. Relative risks for incident coronary heart disease, stroke, and combined fatal cardiovascular events were estimated and adjusted for cardiovascular risk factors.

During 20 years of follow-up, there were 2391 incident cases of CHD, 1763 incident cases of stroke, and 1077 cardiovascular disease deaths (fatal CHD and strokes combined).

Women in the top aMed quintile were at lower risk for both CHD and stroke compared with those in the bottom quintile (relative risk for CHD 0.71; p for trend <0.0001; relative risk for stroke 0.87; p for trend=0.03).

CVD mortality was also significantly lower among women in the top quintile of the aMed score (relative risk 0.61; p for trend <0.0001).

“These are dramatic results,” says Fung. “We found that women whose diets look like the Mediterranean diet are not only less likely to die from heart disease and stroke, but they are less likely to have those diseases.”

She stressed that these results–particularly the stroke finding–would need to be replicated in men, however.

An Easy-to-Follow Diet

Compared with a typical US diet, the Mediterranean-type diet requires a shift toward a more plant-based diet, which means eating less meat and getting more of the day’s protein from plant sources such as beans and nuts.  It also emphasises unprocessed whole grains and unsaturated oils, such as olive oil.

vegetables

The typical US dietary pattern of fast food and red meat high in saturated fats may be replacing the traditional Mediterranean diet even in Mediterranean countries.  Greece, for example, has one of the highest prevalences of obesity in Europe.  A recent study by researchers at the University of Michigan suggested a link between number of fast food restaurants in a neighbourhood and the risk of stroke.

You can learn how to cook delicious and heart-healthy food based on Mediterranean dietary principles at Cooking for Health courses, held throughout the year in Somerset, UK.

  1. Fung TT, Rexrode KM, Mantzoros CS, et al. Mediterranean diet and incidence of and mortality from coronary heart disease and stroke in women. Circulation 2009; DOI:10.1161/CIRCULATIONAHA.108.816736. Available at: http://circ.ahajournals.org.

 

Cook your way to a healthier life

Ancient wisdom and modern science teach us that the quality of the food we eat is intrinsically linked with our level of health and well being.

 

The development of agriculture 10,000 years ago and the radical changes in the production and processing of food  which have occurred in the last 200 years, have led to our diet moving further and further away from the natural foods which sustained our earliest ancestors 2.5 million years ago.  From an evolutionary perspective, these changes have taken place too rapidly for the human genome to adjust.  Biochemically and physiologically, we are virtually identical to the hunter-gatherers who roamed the earth 20,000 years ago[i],[ii].

 

ecuador-family

 

There is growing scientific evidence that the evolutionary collision of our ancient genome with the nutritional qualities of recently introduced foods may underlie many of the chronic diseases of Western civilization, such as obesity, diabetes, heart disease and cancer[iii], as well as problems such as depression, mood swings, PMS, hot flushes, chronic fatigue, inability to cope with stress, allergies and susceptibility to illness and infection.

 

In particular, food staples and food-processing procedures introduced during the Neolithic and Industrial Periods have fundamentally altered seven crucial nutritional characteristics of the ancestral hominin diets of the Paleolithic era: 1) glycaemic load (or the impact of food on blood glucose levels), 2) fatty acid composition (the balance between good fats and bad fats), 3) macronutrient composition (the proportion of energy coming from carbohydrates, proteins and fats), 4) micronutrient density (the amount of vitamins and minerals per calorie), 5) acid-base balance, 6) sodium-potassium ratio, and 7) fibre content.

 

north-carolina-family

 

Today, a few societies in the world are noted for their healthy longevity, including Okinawans in Japan, Hunzans in Pakistan and Vilcabambans in Ecuador[iv].  Scientific studies have shown that these people consume a predominantly plant-based diet high in whole grains, locally grown vegetables, beans, fruits, nuts and seeds, with small amounts of animal foods, sea vegetables, natural sweeteners and condiments.  In other words, natural, unprocessed foods similar to those consumed by the earliest human beings.

 

We too can be full of energy, in excellent physical health and with minds as sharp as razors into advanced old age if we move away from eating refined, processed foods and return to a more natural diet.

 

You can learn how to cook with these natural ingredients at Cooking For Health courses held throughout the year in Somerset, UK.   The classes cover the basics of healthy eating and focus on different aspects of the link between nutrition and optimum health and well being.  Topics include Managing Your Weight Naturally, Food and Emotions, Balancing Your Hormones, Beating Stress and Fatigue and Boosting Your Immune System.

 

The classes not only include cooking healthy and appetising recipes, but also slowly unfold a fascinating and comprehensive study of the healing power of food.

 

Whether you are young or old, male or female, vegan, vegetarian or omnivorous, a novice or an experienced cook, if you are seeking a natural approach to health and well being, you will find these classes valuable, interesting and potentially life-changing.


[i] Cohen MN (1989): Health and the Rise of Civilization. New Haven: Yale Univ. Press

[ii] Eaton, SB; Eaton SB III and Konner, MJ (1997).  Paleolithic nutrition revisited: A twelve-year retrospective on its nature and implications.  European Journal of Clinical Nutrition (1997) 51, 207-216

[iii] Cordain L.; Eaton,SB; Sebastian A.; Mann,N.; Lindeberg,S; Watkins,B.A.; O’Keefe,JH; Brand-Miller, J. (2005).  Origins and evolution of the Western diet: health implications for the 21st century American Journal of Clinical Nutrition (2005), 81, 341–54.

[iv] Robbins, J. (2007).  Healthy at 100.  Ballantine Books.