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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Engineering food for health?

Agricultural economists have suggested that if everyone were to comply with government dietary guidelines, significant changes would be required in the global agricultural system. 

For example, if everyone ate less sugar, there would be serious ramifications for sugar cane plantations and sugar beet growers.  Maize production would also be affected as corn syrups now account for more than half the total energy-containing sweetener consumption.

At present, at least one-third of cereal grain production is fed to animals.  If the demand for lean meat increases, retail prices would rise, and higher fat products would shift to pet food or industrial uses, or be shipped to export markets.  A reduction in total fat consumption would reduce the requirement for soybeans by 36 per cent and countries exporting tropical oils would also be affected.

mackerelinsea

If everyone ate more fish, as dietary guidelines suggest, there would be serious implications for fish production.  According to experts, the oceans have already reached their maximum productivity and the quality of available fish has declined markedly.  Fish farming is of concern due to its damaging effects on the environment.

National Diet and Nutrition Surveys in the UK show that the population is consuming much less fish than is necessary to supply the essential omega 3 fatty acids to the diet.  Deficiency of omega 3 oils and the high level of saturated and trans fats in the diet has been linked with many physical health problems, including heart disease and stroke, cancer, inflammatory conditions and auto-immune diseases. Research also shows that a lack of omega-3 may increase the risk of depression and other mental health conditions.

Some scientists and economists believe that the changes to global agriculture necessary to meet dietary requirements would be so expensive or disruptive that they cannot be contemplated.  Instead of trying to encourage healthier eating in the population, they propose improving existing food using biotechnology, nutrient fortification and development of ‘functional’ foods with added nutritional value.

Food scientists at the University of Massachusetts have recently reported investigations into more economical and reliable ways to incorporate omega-3 fatty acids into foods.  They are developing new microgel capsules to trap the omega-3 fatty acids, chemically stabilize them to prevent spoilage, and allow them to be easily incorporated in beverages, yogurts, dressings, desserts and ice cream, for example. All this apparently without sacrificing taste, appearance or texture.

Other research is looking into the possibility of time-release nanolaminated coatings around fat droplets for delivery at different levels in the human body. For example, coating droplets with dietary fibres so some will break down in the mouth to deliver flavour immediately, while others break down in the stomach or small intestine to deliver peptides that signal fullness or satiety.

Still others might be designed not to break down until they reach the large intestine, where the laminated droplets would deliver anti-hypertensive or cancer-fighting food compounds that can’t survive digestive acids in the stomach. By manipulating food structure, food scientists are also exploring ways to increase solubility in the small intestine so more of the nutrients are absorbed.

Altering food in this kind of way takes us even further from the natural foods our bodies evolved to depend on and raises a whole new set of ethical questions.  Importantly, will such changes to the structure of food have unintended consequences for human health?  Or is this the only way forward in a world with a burgeoning population facing a burgeoning health crisis?

If you would prefer to eat natural whole foods, why not come along to a Cooking for Health course, held throughout the year in the UK.  Whether you are young or old, male or female, ominivorous, vegetarian or vegan, if you are looking for a natural approach to your health and well-being, you will find this course fascinating and potentially life-changing.

Obesity in children

Overweight and obesity among children is widely regarded as being even more serious than it is among adults, with a very rapid rise in prevalence in the last two decades. Child obesity is likely to continue into adulthood, and many of the problems linked to obesity are more severe if the obesity has been present for a long period. Adults with the highest risk of diabetes, cardiovascular disorders, liver malfunction and orthopaedic dysfunction, are likely to have the most extreme levels of obesity and to have been obese since childhood[i].

fat_kid

Projections of child obesity based on trends from the 1980s and 1990s indicate that the annual increase in child obesity prevalence is itself increasing[ii]. By the year 2010, some 26 million school children in the EU are expected to be overweight, of which 6 million will be obese. The numbers of overweight children will rise by some 1.3 million per year, of which the numbers of obese children will rise by over 0.3 million per year.

At a conservative estimate, over a million obese children in the EU are likely to show a range of indicators for cardiovascular disease, including high blood pressure and raised blood cholesterol levels, and to have three or more indicators of the metabolic syndrome[iii]. Over 1.4 million children could have early stages of liver disorder.

The costs of childhood obesity have not been estimated but should include lost educational opportunity. A study of children’s quality of life found the psychological effects of severe obesity to be equivalent to a diagnosis of cancer[iv].

Behaviour, learning and mental health problems in children are rising as fast as rates of obesity and diabetes. Food affects brains as well as bodies, and early malnourishment can have devastating effects on both. Conversely, improving nutrition can help reduce antisocial behaviour as well as symptoms of ADHD, dyslexia, depression and related conditions[v].

The only pan-European estimates of children’s food consumption patterns are from self-reported surveys of health behaviours of children aged 11-15 years[vi]. The most recent (for 2001-2002) found:

  • In virtually all countries fewer than 50 per cent of children ate vegetables every day. On average, 30 per cent of children said they ate vegetables daily, but the children in countries once famous for their Mediterranean diets reported lower than average levels, especially Spain, where vegetables were typically eaten daily by only 12 per cent of children.
  • In virtually all countries fewer than 50 per cent of children ate fruit every day. On average, 30 per cent of boys and 37 per cent of girls reported eating fruit daily, but in sixteen countries only 25 per cent of children were eating fruit more than once a week. Lowest levels of consumption were reported among children in Northern European countries.
  • Soft drinks and confectionery were consumed daily by about 30 per cent of children (over 40 per cent in some countries).

According to the last National Diet and Nutrition Survey in the UK[vii]:

  • 92 per cent of children consume more saturated fat than is recommended
  • 86 per cent consume too much sugar
  • 72 per cent consume too much salt
  • 96 per cent do not consume enough fruit and vegetables

Governments are trying to improve children’s diets, but young people’s exposure to marketing pressures in our time-poor, anxiety-ridden, media-driven society is at an all-time high.

Widespread action is needed to reverse current trends – and we all need to take responsibility for what we are feeding young bodies and minds.

In a Cooking for Health class focused on Healthy Cooking for Your Children, we look at:

  • The best and the worst food for children
  • Easy steps to free your child from food traps
  • Simple, child-friendly recipes
  • Practical tips to help your child make the best food choices

The class involves 100% hands-on practical cooking in a small, supervised group, combined with teaching of up-to-date information and research findings on the effects of diet on health. Clear, easy-to-follow presentations and handouts are provided with plenty of opportunity for questions and discussion.

References

[i] Policy options for responding to obesity. Summary report of the EC-funded project to map the view of stakeholders involved in tackling obesity – the PorGrow project. Dr Tim Lobstein and Professor Erik Millstone. http://www.sussex.ac.uk/spru/porgrow

[ii] Jackson-Leach R, Lobstein T. Estimated burden of paediatric obesity and co-morbidities in Europe. Part 1. The increase in the prevalence of child obesity in Europe is itself increasing. Int J Pediatric Obesit 2006;1:26-32.

[iii] Lobstein T, Jackson-Leach R. Estimated burden of paediatric obesity and co-morbidities in Europe. Part 2. Numbers of children with indicators of obesity-related disease. Int J Pediatric Obesity 2006;1:33-41.

[iv] Schwimmer JB, Burwinkle TM, Varni JW. Health-related quality of life of severely obese children and adolescents. J Am Med Ass 2003;289:1813-9.

[v] Richardson, A. They Are What You Feed Them. Harper Thorsons (5 Jun 2006)

[vi] HBSC. Young people’s health in context: Health Behaviour in School-aged Children 2001/2002. Health Policy for Children and Adolescents 4. C Currie et al (eds) Copenhagen: WHO Regional Office for Europe, 2004.

[vii] Gregory, J. et al. National Diet and Nutrition Survey: Young People Aged 4-18 years (The Stationery Office, 2000)

 

 

 

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.