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.

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.

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.

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%

 

 

 

Recipe for quinoa, apricot and walnut porridge

Quinoa (pronounced KEEN-wah) is a species of the broad-leaf goosefoot family (Chenopodium quinoa) grown as a crop primarily for its edible seeds. It is not a grass. Its leaves are also eaten as a leafy vegetable, much like amaranth, but the commercial availability of quinoa greens is currently limited.Quinoa originated in the Andean region of South America, where it has been an important food for 6,000 years. The Incas, who held the crop to be sacred, referred to quinoa as “chisaya mama” or “mother of all grains”, and it was the Inca emperor who would traditionally sow the first seeds of the season using ‘golden implements’.

Quinoa has come to be highly appreciated for its nutritional value, as its protein content is very high (14 to 20 per cent). Unlike wheat or rice (which are low in lysine), quinoa contains a balanced set of essential amino acids for humans, making it an unusually complete food.  It is a good source of dietary fibre and phosphorus and is high in copper, magnesium and iron. Quinoa is gluten free and considered easy to digest. In its natural state quinoa has a coating of bitter-tasting saponins, making it unpalatable. Most quinoa sold commercially in North America and Europe has been processed to remove this coating.

Quinoa is as versatile as rice, cooks rapidly (10 to 15 minutes) and can be used in creamy porridges, soups, salads, stir-fries and stews.

RECIPE

Quinoa, apricot and walnut porridge

Serves 1

Ingredients

50g quinoa
200ml rice milk
4 organic dried apricots (chopped)
15g walnuts (chopped)

Method

Wash the quinoa thoroughly and place in pan. Add rice milk and chopped apricots and simmer gently for 20 to 30 minutes, until the quinoa is soft. Mix in the chopped walnuts and serve.

For more recipes ideas, information about diet and health, and practical tuition in cooking with whole foods, come along to a Cooking for Health course on Cooking with Whole Foods, in Somerset, UK, with nutrition consultant and cookery teacher Dr Jane Philpott.