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Mediterranean-Style Diet Good for Brain & Heart

Lowers Alzheimer’s Risk and Improves Heart Beat

Foods Work Together

Previous research has shown the many positive effects of omega-3 fish oil. For example, we learned that fish oil slows the rate of aging in white blood cells (a marker of overall aging) and keeps young people from progressing to full-blown schizophrenia: http://www.cbass.com/FishOil&Telomeres.htm. Both are narrow effects with broad implications.

Researchers have broadened the investigation beyond fish oil to food patterns. That makes sense, no one eats only one food. We all eat a range of foods which interact. Two new studies compared the effect of different food combinations—basically a Mediterranean-style diet (includes fish) and a Western-type diet. One study looked at Alzheimer’s risk, a limiting factor in brain function. The other looked at heart rate variability, a measure of heart function. Again, narrow effects with broad implications.

The study on how food pattern may affect Alzheimer’s risk was published in the June 2010 issue of Archives of Neurology.

Lowers Alzheimer’s Risk

Yian Gu, PhD, of Columbia University Medical Center and colleagues gathered dietary information from 2,148 adults 65 or older living in New York City. People with dementia were excluded. Participants were evaluated for development of Alzheimer’s disease (AD) every 18 months for about 4 years; 253 subjects developed AD during the follow-up period.

They identified a dietary pattern strongly associated with lower risk of Alzheimer’s disease (AD).

Dietary pattern calculations were based on their ability to reflect a diet rich in monounsaturated fat, omega-3 fat, vitamin E, vitamin B12, and folic acid, but lower  in saturated fat and omega-6 fat—seven nutrients in all.  

Participants fell across the spectrum, and were scored as low, middle, and high adherence to the diet pattern.

Diet Pattern Matters

Dr. Gu and colleagues explained that “current literature regarding the impact of individual nutrients or foods on Alzheimer’s disease is inconsistent, partly because humans eat meals with complex combinations of nutrients or food items that are likely to be synergistic.” (More on this point shortly)

Diet pattern (DP) analysis made sense and, as noted, was productive.

“We identified a DP strongly associated with lower AD risk…This diet pattern was characterized by higher intakes of salad dressing, nuts, fish, tomatoes, poultry, cruciferous (cabbage family) vegetables, fruits, and dark and green leafy vegetables and a lower intake of high-fat dairy products, red meat, organ meat, and butter.”

The low-AD risk pattern “strongly resembles what’s been called a Mediterranean-style diet.”

The Western-type diet is, of course, often rich in high-fat dairy products, red meat, organ meat, and butter.

The report laid out several reasons why diet pattern is important.

First, individual nutrient/food items may have opposite effects on AD risk. “High or low intake of a single food/nutrient might reveal little information without taking into account other foods/nutrients,” the researchers explained. “An example is the...intake of vitamin B12…, which might lead to an interpretation of vitamin B12 as an independent risk factor for AD. However, source foods of vitamin B12, like meat and dairy products may also contain high levels of saturated fat, which is a potential AD risk factor.”

The researchers analyzed several different diet patterns in the course of looking for a pattern strongly associated with lower AD risk. “In fact, all these results reinforce the importance of studying diet patterns rather than individual foods or nutrients,” they wrote. “The effect of a single nutrient or food item may be too small to detect. Indeed, none of the nutrients was significantly associated with AD risk in a fully adjusted model. Or, a statistically significant association might be simply found by chance alone because of multiple comparisons of many nutrients/foods or the interactions among them,” they continued.

Gu and colleagues also reflected on various pathways in the development of AD that may be at work in the low-risk dietary pattern. For example, vitamin B12 and folic acid lower homocysteine, an amino acid thought to play a role in dementia. “Vitamin E might prevent Alzheimer’s disease via its strong antioxidant effect, and fatty acids may be related to dementia and cognitive function through atherosclerosis, thrombosis, or inflammation via effect on brain development and membrane functioning or via accumulation of beta-amyloid,” the chief components of the plaques associated with Alzheimer’s disease.

Although the study wasn’t designed to prove cause-and-effect, Gu said, “We controlled for a variety of other lifestyle factors in our analysis, so the relationship between this dietary pattern and Alzheimer’s disease could be considered as independent of these controlling factors, including smoking, status, Body Mass Index,  etc.”

That was a little into the weeds, I know, but it shows the importance of eating a balanced diet.

It also makes it easier to describe and understand the next study, which explains—for the first time—the way in which a Mediterranean-type diet helps reduce the risk of heart disease. (The diet pattern included cereal, olive oil, and moderate alcohol consumption; otherwise it was basically the same as in the Gu study.)

The second study (published online June 15, 2010 in Circulation: Cardiovascular Quality and Outcomes) targets heart rate variability (HRV), a factor we’ve not discussed before.

Improves Heart Function

Jun Dai, MD, PhD (assistant professor of nutrition and epidemiology at Indiana University in Bloomington) and her colleagues analyzed the dietary pattern and cardiac data obtained from 276 middle-aged male twins. They scored each participant on how close his food intake correlated with the Mediterranean diet; the higher the score the greater the similarity to a Mediterranean-style diet. A low score indicated a Western-type diet.

The methodology was essentially the same as the Gu study, except using twins allowed the team to gauge the influence of the diet on heart rate variability (HRV) while controlling for genetic and other familial influence.

As noted, the end point was heart rate variability. HRV refers to the time interval between heart beats during everyday life—reduced HRV is a risk factor for coronary artery disease and sudden death. (Less is bad; more is good.)

One standard deviation increase in HRV is associated with “24% to 45% lower risk of coronary heart disease death,” the researchers explained. In heart attack patients, lower HRV is associated with “at least 2-fold higher risk for all-cause death.”

To measure HRV, subjects wore an ECG monitor for 24 hours.

“We found that the more an individual’s diet conformed to the Mediterranean diet, the greater the heart rate variability, indicating better cardiac autonomic function.”

Prior studies had shown an association between individual dietary components and HRV, but this is the first to demonstrate an association between the Mediterranean diet pattern and HRV.

The way (specific physiological effect) the Med-diet reduces the risk of coronary disease has been unknown—until now. (We still don’t fully understand the mechanisms linking the Mediterranean diet to HRV.)

The team quantified the change in heart rate variability—and the reduction in risk.

“In our study, the highest quartile of the Mediterranean diet score compared with the lowest quartile was associated with 11% to 58% higher HRV,” Dr. Dai and her team reported. “Based on mortality studies, these differences would translate into 9% to 14% reduction in cardiac mortality.”

Finally, they capsulized what the study adds that doctors and the rest of us can use: “Whether or not a person has an adverse genetic background or other risk factors for cardiovascular disease, [he or she] would be likely to have better [heart] function if [they follow] a diet similar to the Mediterranean diet.”

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The overall message is simple. Improve the function of your brain and your heart. Eat a diet low in saturated fat (high fat dairy, red meat, butter) and high in fish, fruits, vegetables, legumes (peas, beans, lentils), nuts, olive oil, grains and moderate in alcohol consumption. While you’re at it, get fit.

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