Mediterranean Diet Alzheimers Disease Cognitive Decline

Life Extension Update Exclusive

August 11, 2009

Studies associate Mediterranean diet with lower risk of Alzheimer's disease, cognitive decline

Studies associate Mediterranean diet with lower risk of Alzheimer's disease, cognitive decline

Studies published in the August 12, 2009 issue of the Journal of the American Medical Association (JAMA) reveal a decreased risk of Alzheimer's disease (AD) and cognitive decline among individuals who report greater adherence to a Mediterranean type diet. The diet includes high amounts of fruits, vegetables, legumes, cereal, fish, and monounsaturated fats, lower amounts of saturated fats, red meat and poultry, and moderate alcohol consumption.

In one article, Nikolaos Scarmeas, MD, of Columbia University Medical Center and his associates evaluated data from 1,880 elderly men and women who did not have dementia upon recruitment into the Washington Heights-Inwood Columbia Aging Project. The subjects received neurological and neuropsychological testing every 1.5 years for an average 5.4 year follow-up period, during which 282 participants were diagnosed with Alzheimer's disease.

Greater physical activity alone was associated with a lower risk of Alzheimer's disease, with a 25 percent average reduction in risk associated with some activity compared to no activity. Those who were categorized as participating in "much" physical activity experienced a 33 percent average lower risk.

When adherence to a Mediterranean diet was considered, those in the middle third of participants had an average 2 percent reduction in the risk of developing Alzheimer's disease, while those in the top third had experienced a 40 percent reduction compared to those in the lowest third.

Having both high levels of physical activity and adherence to the diet were also associated with a protective benefit. “Compared with individuals with low physical activity plus low adherence to a diet, high physical activity plus high diet adherence was associated with a 35 percent to 44 percent relative risk reduction," the authors write. “In summary, our results support the potentially independent and important role of both physical activity and dietary habits in relation to AD risk. These findings should be further evaluated in other populations.”

In a second study published in the journal, greater adherence to a Mediterranean diet was associated with a reduction in cognitive decline.

Catherine Féart, PhD, of the Université Victor Ségalen in Bordeaux, France, and colleagues evaluated data from 1,410 participants aged 65 years and older in the Three-City cohort, a study of vascular risk factors and dementia. Participants were assessed for cognitive performance during 2001-2002 and were re-examined at least once over the following 5 years. Dietary questionnaires were scored from 0 to 9 for Mediterranean diet adherence.

Although greater adherence to the diet was associated with fewer errors over time on one neuropsychological test, indicating a reduction in cognitive decline, the risk of developing dementia was not associated with diet adherence.

“A variety of approaches to mitigating cerebrovascular disease in midlife exist, including diet, exercise, treatment of hypertension, treatment of diabetes, avoidance of obesity, and avoidance of smoking," writes David S. Knopman, MD, of the Mayo Clinic in an accompanying editorial. "The findings of Scarmeas et al and Féart et al fit into a larger and potentially optimistic view of prevention of late-life cognitive impairment through application, at least by midlife, of as many healthy behaviors as possible, including diet. Based on these 2 studies, diet may play a supporting role, but following a healthy diet does not occur in isolation.”

“The scientific value of these studies cannot be disputed, but whether and how they can or should be translated into recommendations for the public is the question.”

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Health Concern Life Extension Highlight

Alzheimer's disease

The most exciting research today in Alzheimer’s disease focuses on the role of inflammation and oxidative stress, as well as the role of receptors in reducing glutamate excitotoxicity. Alzheimer’s disease, like so many other diseases, is being redefined as an inflammatory condition in which excess pro-inflammatory chemicals in the body cause damage to normal healthy cells. Although most doctors remain unaware of this developing hypothesis, the Life Extension Foundation has assembled the latest research to provide a comprehensive approach to preventing Alzheimer’s disease.

There are many choices of both drugs and nutritional supplements available for patients with Alzheimer's disease. In light of new evidence that oxidative stress and inflammation are central to Alzheimer’s disease, people at risk of Alzheimer’s (or those who have early dementia) are advised to take supplements that reduce inflammation and oxidative damage. These include:

  • Curcumin—900 to 1800 milligrams (mg) daily
  • EPA/DHA—1400 mg daily of EPA and 1000 mg daily of DHA
  • Vitamin E—400 international units (IU) daily (with 200 mg of gamma-tocopherol)
  • Vitamin C—1 to 3 grams daily
  • Ginkgo biloba—120 mg daily
  • Acetyl-L-carnitine arginate—750 to 2000 mg daily
  • CoQ10—100 to 600 mg daily
  • N-acetylcysteine—600 mg daily
  • Aged garlic—1200 mg daily
  • Vinpocetine—15 to 20 mg daily
  • Green tea extract (93 percent polyphenols)—725 mg daily
  • B vitamins—A full complement of B vitamins (including folate, vitamin B6, and vitamin B12) to lower homocysteine. Specific suggested doses include 1000 micrograms (mcg) of vitamin B12, 250 mg of vitamin B6, and 800 mcg of folic acid.
  • Niacin—Up to 800 mg daily. Start slowly and take with food to avoid flushing.
  • Melatonin—1 to 3 mg each night
  • DHEA—15 to 75 mg daily. Have blood tested in 3 to 6 weeks to determine optimal dose.
  • Huperzine—50 mcg up to four times per week
  • Blueberry extract—500 to 2000 mg daily. If you eat blueberries, you don’t need to take this much blueberry extract.
  • Grape seed extract—100 mg daily

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