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Does eating a Mediterranean diet protect against memory loss and dementia?

Adapted from an article from the American Academy of Neurology, May 6, 2021

Eating a Mediterranean diet that is rich in fish, vegetables, and olive oil may protect your brain from protein buildup and shrinkage that can lead to Alzheimer’s disease, according to a new study. The research is published in the May 5, 2021, online issue of Neurology.

The study looked at abnormal proteins called amyloid and tau. Amyloid is a protein that forms into plaques, while tau is a protein that forms into tangles. Both are found in the brains of people with Alzheimer’s disease but may also be found in the brains of older people with normal cognition.

The Mediterranean diet includes high intake of vegetables, legumes, fruits, cereals, fish, and monounsaturated fatty acids such as olive oil, and low intake of saturated fatty acids, dairy products, and meat.

“Our study suggests that eating a diet that’s high in unsaturated fats, fish, fruits and vegetables, and low in dairy and red meat may actually protect your brain from the protein buildup that can lead to memory loss and dementia,” said study author Tommaso Ballarini, PhD, of the German Center for Neurodegenerative Diseases (DZNE) in Bonn, Germany. “These results add to the body of evidence that show what you eat may influence your memory skills later on.”

The study involved 512 people. Of those, 169 were cognitively normal, while 343 were identified as being at higher risk of developing Alzheimer’s disease. Researchers looked at how closely people followed the Mediterranean diet based on their answers to a questionnaire asking how much they ate of 148 items over the previous month. People who often ate healthy foods typical of the Mediterranean diet, like fish, vegetables, and fruit, and only occasionally ate foods not typical of the Mediterranean diet like red meat, received the highest scores, for a maximum score of nine.

Cognitive skills were assessed with an extensive test set for Alzheimer’s disease progression that looked at five different functions, including language, memory, and executive function. All the participants had brain scans to determine their brain volume. In addition, the spinal fluid of 226 study participants was tested for amyloid and tau protein biomarkers.

Researchers then looked at how closely someone followed the Mediterranean diet, and the relationship to their brain volume, tau and amyloid biomarkers, and cognitive skills. After adjusting for factors like age, sex, and education, researchers found that in the area of the brain most closely associated with Alzheimer’s disease, each point lower people scored on the Mediterranean diet scale equated to almost one year of brain aging.

When looking at amyloid and tau in people’s spinal fluid, those who did not follow the diet closely had higher levels of biomarkers of amyloid and tau pathology than those who did. When it came to a test of memory, people who did not follow the diet closely scored worse than those who did.

“More research is needed to show the mechanism by which a Mediterranean diet protects the brain from protein buildup and loss of brain function, but findings suggest that people may reduce their risk for developing Alzheimer’s by incorporating more elements of the Mediterranean diet into their daily diets,” Ballarini said.

Reference: Ballarini T, van Len DM, Brunner J, et al. Mediterranean diet, Alzheimer disease biomarkers and brain atrophy in old age. Neurology. 2021; doi.org/10.1212/WNL.0000000000012067

Heart health: Mediterranean versus low-fat diet

Adapted from an article by Timothy Huzar in Medical News Today, December 15, 2020

In a recent study, scientists compared the effects of a Mediterranean diet with those of a low-fat diet on key biological processes linked to heart health.

The researchers found that a Mediterranean diet could improve endothelial function in people with coronary heart disease. The endothelium is a thin membrane that coats the inside of blood vessels and the heart. It plays a number of roles that are important for the functioning of the cardiovascular system.

Heart disease

As the Centers for Disease Control and Prevention (CDC) report, heart disease accounts for around 1 in 4 deaths in the United States, making it the leading cause of death. Modifying the diet is a keyway to reduce the risk of heart disease. For many years, researchers have demonstrated the benefits of a Mediterranean diet on heart health. It includes olive oil, vegetables, nuts, legumes, fruits, and whole grains, with small amounts of dairy and meat and a moderate amount of fish and red wine. Health experts, including the American Heart Association (AHA), have also linked low-fat diets with improvements in heart health. This type of diet contains reduced amounts of all types of fat and increased amounts of complex carbohydrates.

The team behind the present study set out to test the effects of each type of diet on the endothelium because endothelial dysfunction is a predictor of cardiovascular disease. According to Prof. José López-Miranda, the corresponding author of the study and coordinator of the Nutritional Genomics and Metabolic Syndrome research group at the Maimonides Biomedical Research Institute of Córdoba, in Spain:

The degree of endothelial damage predicts the occurrence of future cardiovascular events, as in acute myocardial infarctions. If we can take action at the initial stages, prompting endothelium regeneration and better endothelial function, we can help prevent heart attacks and heart disease from reoccurring.

The researchers analyzed data gathered as part of the Coronary Diet Intervention with Olive Oil and Cardiovascular Prevention study, an ongoing, single-blind, randomized, controlled study. The study included 1,002 people with coronary heart disease who had not had a coronary event in the past 6 months. The researchers determined a baseline level of endothelial dysfunction among the participants. They then assigned the participants to two groups: one followed a Mediterranean diet for 1 year, and the other followed a low-fat diet for 1 year.

At the end of the year, the team measured the participants’ endothelial function again. In total, 805 participants completed the study.

Compared with the low-fat diet, the Mediterranean diet significantly improved the participants’ endothelial function—no matter how severe the dysfunction had been.

The researchers also found that the Mediterranean diet resulted in improved levels of high-density lipoprotein cholesterol and reductions in fasting glucose and C-reactive protein (a marker of inflammation) among the participants, compared with the low-fat diet.

The findings suggest that switching to a Mediterranean diet could help reduce the known risk of endothelial damage, coronary heart disease, and future coronary events.

Reference: Yubero-Serrano EM, Fernandez-Gandara C, Garcia-Rios A, et al. Mediterranean diet and endothelial function in patients with coronary heart disease: an analysis of the CORDIOPREV randomized controlled trial. PLOS Med. 2020;17(9):e1003282. https://doi.org/10.1371/journal.pmed.1003282

Healthy habits are key to maintaining health even while taking multiple prescriptions

Adapted from an article in Science Codex, November 9, 2020

Lifestyle habits including adherence to the Mediterranean diet, getting regular exercise, and not smoking can reduce the risk of death, even for people taking multiple medications, according to preliminary research presented at the American Heart Association’s Scientific Sessions 2020. The meeting, held virtually, Friday, November 13 – Tuesday, November 17, 2020, was a premier global exchange of the latest scientific advancements, research and evidence-based clinical practice updates in cardiovascular science for health care worldwide.

“We’ve long known about the benefits of leading a healthy lifestyle. The results from our study underscore the importance of each person’s ability to improve their health through lifestyle changes even if they are dealing with multiple health issues and taking multiple prescription medications,” said lead author Neil Kelly, Ph.D., a medical student at Weill Cornell Medicine of Cornell University in New York City.

The study analyzed data from more than 20,000 participants of the Reasons for Geographic and Racial Differences in Stroke (REGARDS) study (average age of 64; 56% women). At the start of the study, 17% were taking 10 or more prescription medications, 39% were taking five to nine prescription medicines, and 44% of participants were taking four or fewer prescription medications.

Researchers evaluated the number of medications taken, level of participation in four healthy behaviors and all-cause death rates. The types of medications and the conditions they were used to treat (e.g., heart disease, diabetes, kidney disease, cognitive impairment, etc.), varied widely among study participants. The healthy lifestyle behaviors were physical activity; smoking abstinence; low sedentary time; and following a Mediterranean diet, which emphasizes legumes, fruits, vegetables, whole grains, fish, and olive oil, and moderation for dairy products and wine.

At follow-up roughly 10 years later, the analysis found that a healthy lifestyle decreased the risk of death regardless of the number of medications a person was taking; and the higher the number of healthy lifestyle habits a person had, the lower their risk of death.

“It’s especially important for health care professionals to counsel patients and develop interventions that can maximize healthy lifestyle behaviors, even among patients with several prescription medications,” Kelly added. “It’s important for the public to understand that there is never a bad time to adopt healthy behaviors. These can range from eating a healthier diet to taking a daily walk in their neighborhood. A healthier lifestyle buys more time.”

Reference: Presentation P929, American Heart Association Virtual Scientific Sessions 2020, November 13 -17, 2020.

Mediterranean Chicken Wing Recipe with Olive Oil

As fall gears up, I love to get in the kitchen and revisit recipes from around the world. Sharing them with you and highlighting super-healthy ingredients are very important to me because this message is so important: Delicious food can, and should be, healthy food…and healthy food can be delicious! Whether you follow the Mediterranean diet, have adopted a Keto or Paleo plan, or are vegetarian or vegan, once you have access to a repertoire of great recipes, you can tailor them to your diet by swapping ingredients as needed. Below you’ll find my favorite alternative chicken wing recipe.

Let’s get cooking with…

Piri-Piri Drumsticks with Blue Cheese Dip

You don’t have to be a football fanatic to love sports bar food like Buffalo hot wings, named for the city that lays claim to them. I like to indulge not only by recreating this favorite dish at home, but also by elevating it with an alternative chicken wing recipe that switches from wings to drumsticks—more meat!—glazed with piri-piri, a Portuguese chile sauce available in larger supermarkets or online.

  • Piri-Piri Drumsticks with Blue Cheese Dip Piri-Piri Drumsticks with Blue Cheese Dip

    Nando’s Peri-Peri Sauce is my go-to brand (both spellings are correct!). For the blue cheese dip, the ultimate is Cabrales, an artisanal blue from Asturias, Spain. And for even more flavor, I’m replacing celery sticks with fresh fennel. The only prep work—still fast and easy—is the marinade for the drumsticks. Since they need time to absorb all the spices, I like to do this early in the day.

    Ingredients

    For the drumsticks

    • 2 tablespoons pimentón (smoked Spanish paprika) 
    • 2 teaspoons coarse kosher or sea salt
    • 1-1/2 teaspoons ground cumin
    • 1-1/2 teaspoons dry mustard 
    • 1-1/2 teaspoons ground fennel seed
    • 1 teaspoon freshly ground black pepper 
    • 12 meaty chicken drumsticks
    • Extra virgin olive oil 
    • Large fennel bulb

    For the glaze

    • 3 tablespoons butter
    • 1 clove garlic, minced
    • 1/2 cup Nando’s Peri-Peri Sauce or your favorite hot sauce
    • 1 tablespoon fresh lemon juice

    For the dip

    • 1/2 cup crumbled Cabrales or other artisanal blue cheese 
    • 3/4 cup sour cream
    • 1/4 cup mayonnaise
    • 1 teaspoon Worcestershire sauce
    • 1 to 2 tablespoons milk or cream (optional) 
    • Extra virgin olive oil

    Directions

    Step One

    Combine the pimentón and other spices in a small bowl. Place the drumsticks in a large bowl (or a large resealable plastic bag) and coat them with olive oil. Add the spice mixture and use your hands to distribute it evenly. Cover and refrigerate for 4 to 8 hours.

    Step Two

    To cook, preheat your oven to 400°F. Line a rimmed baking sheet with foil, then top with a wire rack. Oil the rack and arrange the drumsticks on it. Bake until cooked through, 40 to 45 minutes, turning once or twice with tongs. (Alternatively, you can grill the drumsticks.) 

    Step Three

    While the chicken is cooking, make the dip and the glaze. For the dip, mash the blue cheese in a bowl with a fork. Whisk in the sour cream, mayonnaise and Worcestershire sauce. If desired, thin with the milk or cream. Transfer to a serving bowl and drizzle with olive oil.

    Step Four

    For the glaze, melt the butter in a small saucepan over medium-low heat. Add the garlic and cook for 2 to 3 minutes. Stir in the piri-piri sauce and lemon juice and bring to a simmer. When the drumsticks are cooked through, remove from the oven, brush on all sides with the glaze, and return to the oven for 5 minutes to set. 

    Step Five

    To plate, trim the fennel bulb, reserving the feathery fronds. Cut in half lengthwise, remove the core, and then slice each half into small wedges. Arrange them on a platter with the drumsticks, garnish with the fronds, and serve with the dip.

    Yields 4 appetizers or 2 hearty main dish servings. ​

Healthy Ingredient Spotlight Icon

Healthy Ingredient Spotlight

Cumin, the seed of the Cuminum cyminum plant, is a relative of caraway, fennel and parsley and has been used in medicine and cooking for over 4,000 years. Originally found in Egypt, cumin was introduced to the Mediterranean region and Asia (notably India and China) before being brought to the Americas by the Portuguese and Spaniards. Its earthy flavor adds a unique richness to dishes, and it’s a mainstay in countless cuisines…from Indian curries and chutneys to Moroccan tagines to Mexican salsas and moles. Buy cumin in seed form. When a recipe calls for ground cumin, do it yourself in a spice grinder.

Healthy Kitchen Nugget Icon

Healthy Kitchen Nugget

Eating garlic every day is one of the tastiest ways to enhance your health. To maximize garlic’s benefits, whenever you chop or crush cloves, wait 15 minutes before adding to a recipe. That’s the time it takes for a key enzyme to trigger allicin, one of many compounds in garlic that help fight heart disease, inflammation and damage from oxidative stress. For the greatest benefits, eat garlic raw, as in salad dressings, or minimally cooked, like in a fast stir-fry.

For Your Best Health Icon

For Your Best Health

When it comes to bone health, most of us think of calcium and vitamin D. But another needed nutrient is the trace mineral selenium. New research shows that a shortage could lead to problems including increased bone turnover, reduced bone mineral density and a higher risk for bone disease. Selenium is also important for reproductive health, proper thyroid hormone function, and combating oxidative damage and infections. All it takes is 55 micrograms a day. You can get about that much from 1.5 ounces of yellowfin tuna, 3 ounces of halibut, 4 ounces of shrimp or sardines, 7 ounces  of light meat chicken or just one Brazil nut—a crazy-rich source!

Fitness Flash Icon

Fitness Flash

There’s no doubt that we’re all spending more and more time on social media and tapping into streaming services, sometimes as a way to cope with stress or as an antidote to physical distancing. But these are trends that started long before the pandemic. Problem is, excessive screen time can take a toll on emotional and physical health. It can actually increase stress thanks to bad news overload and lead to weight gain, sleep disorders and even addiction to social media or other outlets, like computer games or online gambling. 

According to a study published in the Journal of Medical Internet Research, the takeaway is that media in general and social networks in particular can help you cope when they provide support and fact-based, positive information and when you steer clear of both sensationalized and false news. Also, put exercise in your playbook—it can work wonders on stress, anxiety and insomnia as well as give you a break from day-to-day problems.

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