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%

 

 

 

Salt in popular restaurant meals twice the amount a child should have in a day

New research published on 2 February 2009 by Consensus Action on Salt and Health (CASH) shows that many popular meals eaten in UK high-street restaurants can contain large amounts of salt, in some cases more than twice the daily maximum limit for an adult in a single meal.

CASH worked with Trading Standards officers around the country to measure the salt content of 96 popular menu items from 16 high street restaurant chains.  Samples were purchased from the restaurants and analysed for their salt content by the Public Analyst.

Nearly three quarters (72%) of the main course dishes contained 3g of salt or more, the maximum daily limit for a six year-old and half the adult daily limit, and seven of these contained 6g of salt or more, the maximum daily limit for an adult.  The saltiest dishes were not confined to one or two restaurants – six out of the sixteen (over one third, 38%) restaurants surveyed served a popular main course dish containing 6g of salt or more.

The saltiest main course surveyed was Old Orleans Chicken Fajitas, with 8.8g of salt per serving.  Old Orleans also serves Wings and Ribs with 7.6g of salt per portion.  A Pizza Express American Hot Pizza contains 7.5g of salt per portion and a Wagamama Ramen contains 7.2g of salt per serving.  By comparison, a popular main meal at Beefeater of Sirloin Steak, grilled tomato, flat mushroom and chips contains only 0.4g of salt.

American Hot Pizza

American Hot Pizza

Starters and side dishes were also surveyed, with Old Orleans Chicken Wings with spicy BBQ sauce and blue cheese dressing containing almost 5g of salt per portion. Strada Aglio Garlic Bread contains 3.3g of salt per portion, over half the adult recommended daily limit.

Restaurant

Dish

Salt per Portion (g)

Old Orleans

Chicken Fajitas

8.84

Old Orleans

Wings and Ribs (with fries)

7.59

Pizza Express

American Hot Classic Pizza

7.5

Wagamamas

Wagamama ramen

7.2

Zizzi

Pizza Sofia

6.7

ASK

Fiesta Di Carne Pizza

6.55

Frankie and Benny’s

Chicken Penne Romana

6.0

 

Professor Graham MacGregor, Professor of Cardiovascular Medicine at St George’s Hospital in London said:

“Keeping our salt consumption below the recommended maximum levels is vital.  If we are to reduce the numbers of people needlessly dying from heart attacks and strokes, then we all need to keep a check on our salt intake.  The food industry in this country is leading the world in reducing the amount of salt it adds to the foods we buy in shops and supermarkets, and labelling those foods clearly so that we can make informed decisions about the products we buy.  Unfortunately the same cannot be said for foods we eat in restaurants.  It simply beggars belief that almost five years after the Food Standards Agency launched its salt reduction programme, and with all the publicity there has been about the 6g a day target, some high street restaurants have done nothing to reduce the amount of salt they add to their meals.  If they had even considered this issue then we wouldn’t be finding meals containing more than a day’s salt limit in a single course.  By comparison, ready meals sold in supermarkets have had their salt content reduced considerably over the last few years, and when we last surveyed them, we found only a very few with salt contents over 3g salt per serving.”

Raymond Blanc, Chef Patron of the Manoir Au Quat’ Saisons said,

“I believe that good food does not need more than the very lightest of seasoning – there is no reason for good chefs to mask the flavour of their ingredients by adding too much salt. Remember herby, sour, bitter and acid are also wonderful catalysts of flavour.”

For information about a two-day course in Somerset, UK, tailored to equip caterers, and those involved in encouraging healthier catering practices, with information and practical tools to achieve healthier eating in the population, please click here.