Research confirms Mediterranean diet is good for the mind

Over recent years many pieces of research have identified a link between adherence to a Mediterranean diet and a lower risk of age-related disease such as dementia.

Until now there has been no systematic review of such research, where a number of studies regarding a Mediterranean diet and cognitive function are reviewed for consistencies, common trends and inconsistencies.

A team of researchers from the University of Exeter Medical School, supported by the National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care in the South West Peninsula (NIHR PenCLAHRC), has carried out the first such systematic review and their findings are published in Epidemiology.

The team analysed 12 eligible pieces of research, 11 observational studies and one randomised control trial. In nine out of the 12 studies, a higher adherence to a Mediterranean diet was associated with better cognitive function, lower rates of cognitive decline and a reduced risk of Alzheimer's disease.

However, results for mild cognitive impairment were inconsistent.

A Mediterranean diet typically consists of higher levels of olive oil, vegetables, fruit and fish. A higher adherence to the diet means higher daily intakes of fruit and vegetables and fish, and reduced intakes of meat and dairy products.

The study was led by NIHR PenCLAHRC researcher Iliana Lourida. She said: "Mediterranean food is both delicious and nutritious, and our systematic review shows it may help to protect the ageing brain by reducing the risk of dementia. While the link between adherence to a Mediterranean diet and dementia risk is not new, ours is the first study to systematically analyse all existing evidence."

She added: "Our review also highlights inconsistencies in the literature and the need for further research. In particular research is needed to clarify the association with mild cognitive impairment and vascular dementia. It is also important to note that while observational studies provide suggestive evidence we now need randomized controlled trials to confirm whether or not adherence to a Mediterranean diet protects against dementia."

Physical Activity Decreases Sudden Cardiac Death Risk in Unfit Men

Physical activity decreases the risk of sudden cardiac death in unfit men, reveals research presented at the ESC Congress today by Dr Jari Laukkanen and Dr Magnus Hagnas from Finland.

Dr Laukkanen said: "Sudden cardiac death (SCD) accounts for approximately 50% of deaths from coronary heart disease. SCD typically occurs shortly after the onset of symptoms, leaving little time for effective medical interventions, and most cases occur outside hospital with few or no early warning signs. Finding ways to identify individuals at elevated risk of SCD would allow early interventions on risk factors to be implemented." The current study investigated the impact of high leisure-time physical activity (LTPA) combined with cardiorespiratory fitness (CRF) on risk of SCD. It included 2,656 randomly selected men aged 42 to 60 years from the Kuopio Ischemic Heart Disease Risk Factor Study, a Finnish study of risk predictors for cardiovascular outcomes and SCD in the general population. Baseline cycle exercise test and risk factor assessment were performed in 1984-89. SCD was defined as death with cardiac origin within 24 hours after onset of symptoms.

LTPA was assessed using a 12-month physical activity questionnaire. One third of subjects had low LTPA (energy consumption <191 kcal/day, equal to around 35 minutes of slow walking or 25 minutes of jogging for a 70 kg male). CRF was assessed with a maximal symptom limited cycle exercise test and peak oxygen uptake was calculated in metabolic equivalents (MET). One third of men had a low CRF (<7.9 METs).

For the analyses the study population was divided into 4 groups: 1) high CRF and high LTPA, 2) high CRF and low LTPA, 3) low CRF and high LTPA and 4) low CRF and low LTPA. Group 1 was used as a reference. The risk of SCD was adjusted for previously established cardiovascular risk factors (age, smoking, alcohol consumption, body mass index, systolic blood pressure, low density lipoprotein cholesterol, C-reactive protein, prevalent type 2 diabetes and previously diagnosed coronary heart disease).

During the mean 19 years of follow-up 193 SCDs occurred. There was a 2-fold increased risk of SCD in men with low CRF and LTPA (group 4, see figure) compared to men with high CRF and high LTPA (hazard ratio [HR] 2.0, 95% confidence interval [CI] 1.3-2.9). Men with low CRF and high LTPA (group 3) did not have a statistically significant increased SCD risk compared to men with high CRF and high LTPA (HR 1.3, 95% CI 0.9-1.8). Dr Laukkanen said: "This indicates that a higher amount of leisure-time physical activity might reduce the risk of SCD among men with low cardiorespiratory fitness."

The amount of LTPA did not affect the risk of SCD among the men with high CRF (groups 1 and 2). Dr Laukkanen said: "Our study shows that CRF is a risk factor for SCD. High leisure-time physical activity exerts a protective effect on the risk of SCD among men with low cardiorespiratory fitness but does not affect risk in men with high baseline CRF."

He added: "It is widely believed that the level of CRF is determined by physical exercise, genetics and other lifestyle factors. Our study shows that exercise training and LTPA may be especially important in individuals with low CRF. One possible explanation is that CRF can be improved with regular exercise training."

Dr Laukkanen concluded: "The importance of CRF has often been neglected in the equation of SCD risk, despite appearing to be one of the most important correlates of overall health status. Our study emphasises the importance of regular physical exercise, especially among men with low CRF. An exercise test could be used to identify individuals with low CRF and high risk of SCD, who should then be urged to exercise more."

Glass of Wine a Day May Ward Off Depression,

In the same way that a little wine may be good for the heart, it might also help avoid depression, a Spanish study suggests.

So while drinking a lot of wine or other alcohol may be a sign of depression or other mental health problems, alcohol in moderation may benefit mental health, the study authors contend.

"One drink a day, preferentially wine, may help prevent depression," said lead researcher Dr. Miguel Martinez-Gonzalez, chair of the department of preventive medicine and public health at the University of Navarra, in Pamplona.

But several mental health experts not involved with the study had reservations about the findings. And the research only found an association between moderate drinking and emotional well-being; it didn't prove cause-and-effect.

Martinez-Gonzalez said he thinks the apparent benefit of wine in preventing depression may work the same way that moderate drinking helps prevent heart disease.

"Depression and heart disease seem to share some common mechanisms because they share many similar protective factors and risk factors," he said. However, he added that depression prevention is not a reason to start drinking.

"If you are not a drinker, please don't start drinking," he said. "If you drink alcohol, please keep it in the range of one or less drinks a day and consider drinking wine instead of other alcoholic beverages."

The report was published Aug. 30 in the online journal BMC Medicine.

Tony Tang, an adjunct psychology professor at Northwestern University, in Evanston, Ill., said the new research "is consistent with other studies suggesting modest health benefits of very modest drinking."

But, Tang said other factors may be at work in the potential connection between wine and depression. He noted that compared to nondrinkers, those in the Spanish study who drank a moderate amount of wine were more likely to be married men who were also physically active.

Being single or divorced, living alone and being sedentary "are well-established risk factors of depression. Thus, perhaps the correlation between modest drinking and depression is a coincidence caused by these other known factors," he said.

"An adequate social life is the most important factor we know that protects people from depression," Tang said. "Perhaps not drinking is a sign of serious social isolation in Spain while drinking a glass of wine a day is simply a sign of having a normal social life."

For the study, researchers followed more than 5,500 light-to-moderate drinkers for up to seven years. All the participants were part of a large Spanish study on nutrition and cardiovascular health, and were between 55 and 80 years old.

None of the individuals had suffered from depression or had alcohol-related problems at the start of the study. Over seven years, with medical exams, interviews with dietitians and questionnaires, the researchers kept tabs on participants' mental health and lifestyle.

Wine was the most popular drink and participants who drank two to seven glasses a week were the least likely to suffer from depression, compared to nondrinkers.

These findings remained significant even after the researchers took factors such as smoking, diet and marriage into account.

Eva Redei, a distinguished professor in the department of psychiatry and behavioral sciences at the Feinberg School of Medicine at Northwestern University, in Chicago, also expressed doubts about the direct effect of wine on depression.

"Considering the increase of major depression in the age group examined in this study, the finding of protective effects of moderate alcohol consumption is intriguing," she said.

However, it raises more questions than answers. "Is moderate wine consumption related to increased socialization, decreased cardiovascular events, or as it seems, increased activity? These questions are not answered by this study, but the findings are definitely worth noticing," Redei said.

"Is it possible that 'in vino veritas' [in wine there's truth] reflects a bigger truth?" she asked.

More protein intake with diet and exercise protects muscle loss

New research in The FASEB Journal shows that consuming twice the recommended daily allowance of protein protects muscle mass while promoting fat loss; tripling protein had no additional benefits

A new report appearing in the September issue of The FASEB Journal challenges the long-held adage that significant muscle loss is unavoidable when losing weight through exercise and diet. In the report, scientists show that consuming twice the recommended daily allowance (RDA) of protein while adhering to a diet and exercise plan prevents the loss of muscle mass and promotes fat loss. Tripling the RDA of protein, however, failed to provide additional benefits.

"It is our hope that the findings from this well-controlled study will be discussed and cited by the Institute of Medicine for the updated Dietary Reference Intakes on protein," said Stefan M. Pasiakos, Ph.D., a researcher involved in the work from the Military Nutrition Division at the U.S. Army Research Institute of Environmental Medicine in Natick, MA. "We believe that the RDA for protein should be based on a level to optimize health, as well as prevent deficiencies, and our data demonstrate a potential inadequacy of the current RDA for sparing muscle mass during weight loss, which may affect a significant portion of the population."

To make this discovery, Pasiakos and colleagues assigned young men and women controlled diets for 31 days that provided dietary protein at three different levels: 1) the U.S. RDA, 2) twice the U.S. RDA, and 3) three times the U.S. RDA. Volunteers were given adequate total calories to maintain constant body weight for the first 10 days to allow their metabolism to adapt to the dietary protein level, and then for the following three weeks, weight loss was induced by restricting the total calories and increasing daily exercise sufficiently to elicit an average two-pound weight loss per week. All meals were prepared and administered by research staff and exercise was highly controlled. Body composition and measurements of muscle protein metabolism were performed at the end of both the stable weight maintenance and weight loss phases of the study. Results of this study demonstrated that there are limits to the protective effect of extra protein. As such, these data suggest an optimal, and perhaps maximal, level of protein for young, active adults who may undergo short-term periods of intentional or unintentional weight loss.

"This study essentially confirms what body builders have shown us for a long time—a high protein diet helps prevent muscle loss when trying to lose fat," said Gerald Weissmann, M.D., Editor-in-Chief of The FASEB Journal. "Although eating a well balanced diet is still necessary for health and weight maintenance, upping one's protein intake when dieting might be a useful tool in the short term."

Statins may slow human aging

Statins may slow human aging by protecting against telomere shortening: A feature of senescent cells

New research in The FASEB Journal suggests that statins protect against DNA shortening by telomerase activation and promote healthy aging free of age-related diseases like heart disease, diabetes and cancer

Not only do statins extend lives by lowering cholesterol levels and reducing the risks of cardiovascular disease, but new research in the September 2013 issue of The FASEB Journal suggests that they may extend lifespans as well. Specifically, statins may reduce the rate at which telomeres shorten, a key factor in the natural aging process. This opens the door for using statins, or derivatives of statins, as an anti-aging therapy.

"By telomerase activation, statins may represent a new molecular switch able to slow down senescent cells in our tissues and be able to lead healthy lifespan extension," said Giuseppe Paolisso, M.D., Ph.D., a researcher involved in the work from the Department of Internal Medicine, Surgical, Neurological Metabolic Disease and Geriatric Medicine at Second University of Naples in Naples, Italy.

To make this discovery, Paolisso and colleagues worked with two groups of subjects. The first group was under chronic statin therapy, and the second group (control), did not use statins. When researchers measured telomerase activity in both groups, those undergoing statin treatment had higher telomerase activity in their white blood cells, which was associated with lower telomeres shortening along with aging as compared to the control group. This strongly highlights the role of telomerase activation in preventing the excessive accumulation of short telomeres.

"The great thing about statins is that they reduce risks for cardiovascular disease significantly and are generally safe for most people. The bad thing is that statins do have side effects, like muscle injury," said Gerald Weissmann, M.D., Editor-in-Chief of The FASEB Journal. "But if it is confirmed that statins might actually slow aging itself—and not just the symptoms of aging—then statins are much more powerful drugs than we ever thought."

Broccoli Fights Osteoarthritis

A compound found in broccoli could be key to preventing or slowing the progress of the most common form of arthritis, according to new research led by the University of East Anglia (UEA).

Results from the laboratory study show that sulforaphane slows down the destruction of cartilage in joints associated with painful and often debilitating osteoarthritis. The researchers found that mice fed a diet rich in the compound had significantly less cartilage damage and osteoarthritis than those that were not.

The study, which also examined human cartilage cells and cow cartilage tissue, was funded by medical research charity Arthritis Research UK, the Biotechnology and Biological Sciences Research Council's (BBSRC) Diet and Health Research Industry Club (DRINC) and The Dunhill Medical Trust.

Sulforaphane is released when eating cruciferous vegetables such as Brussels sprouts and cabbage, but particularly broccoli. Previous research has suggested that sulforaphane has anti-cancer and anti-inflammatory properties, but this is the first major study into its effects on joint health.

The researchers discovered that sulforaphane blocks the enzymes that cause joint destruction by stopping a key molecule known to cause inflammation. They wanted to find out if the compound got into joints in sufficient amounts to be effective and their findings are published today in the journal Arthritis & Rheumatism.

More than 8.5 million people in the UK have osteoarthritis, a degenerative disease affecting the hands, feet, spine, hips and knees in particular. According to Arthritis Research UK, the annual cost of the condition to the NHS is £5.2 billion. In 2011, more than 77,000 knee and 66,000 hip replacements were carried out due to osteoarthritis -- approximately one every four minutes.

Aging and obesity are the most common contributors to the condition and due to their effects, the number of people in the UK consulting a GP about knee osteoarthritis alone could rise from 4.7 million in 2010 to 8.3 million by 2035. Currently one in five people over the age of 45 has osteoarthritis in their knee. There is no cure or effective treatment for the disease other than pain relief, which is often inadequate, or joint replacement.

The study involved researchers from UEA's schools of Biological Sciences, Pharmacy and Norwich Medical School, along with the University of Oxford and Norfolk and Norwich University Hospital.

Researchers from the School of Biological Sciences and Norwich Medical School are now embarking on a small scale trial in osteoarthritis patients due to have knee replacement surgery, to see if eating broccoli has similar effects on the human joint. If successful, they hope it will lead to funding for a large scale clinical trial to show the effect of broccoli on osteoarthritis, joint function and pain itself.

Ian Clark, professor of musculoskeletal biology at UEA and the lead researcher, said: "The results from this study are very promising. We have shown that this works in the three laboratory models we have tried, in cartilage cells, tissue and mice. We now want to show this works in humans. It would be very powerful if we could.

"As well as treating those who already have the condition, you need to be able to tell healthy people how to protect their joints into the future. There is currently no way in to the disease pharmaceutically and you cannot give healthy people drugs unnecessarily, so this is where diet could be a safe alternative.

"Although surgery is very successful, it is not really an answer. Once you have osteoarthritis, being able to slow its progress and the progression to surgery is really important. Prevention would be preferable and changes to lifestyle, like diet, may be the only way to do that."

Prof Clark added: "Osteoarthritis is a major cause of disability. It is a huge health burden but a huge financial burden too, which will get worse in an increasingly aging and obese population such as ours.

"This study is important because it is about how diet might work in osteoarthritis. Once you know that you can look at other dietary compounds which could protect the joint and ultimately you can advise people what they should be eating for joint health. Developing new strategies for combating age-related diseases such as osteoarthritis is vital, both to improve the quality of life for sufferers and to reduce the economic burden on society."

Arthritis Research UK's medical director Prof Alan Silman said: "This is an interesting study with promising results as it suggests that a common vegetable, broccoli, might have health benefits for people with osteoarthritis and even possibly protect people from developing the disease in the first place.

"Until now research has failed to show that food or diet can play any part in reducing the progression of osteoarthritis, so if these findings can be replicated in humans, it would be quite a breakthrough. We know that exercise and keeping to a healthy weight can improve people's symptoms and reduce the chances of the disease progressing, but this adds another layer in our understanding of how diet could play its part."

For the small scale trial, funded by DRINC, half the 40 patients will be given 'super broccoli' -- bred to be high in sulforaphane -- to eat for two weeks before their operation. Once the surgery has taken place the researchers will look at whether the compound has altered joint metabolism and if it can be detected in the replaced joints.

Regular drinking before first pregnancy increases breast cancer risk

Here's a sobering fact for millions of young women heading back to school: The more alcohol they drink before motherhood, the greater their risk of future breast cancer.

That's according to new research from Washington University School of Medicine in St. Louis that, for the first time, links increased breast cancer risk to drinking between early adolescence and first full-term pregnancy. Previous studies have looked at breast cancer risk and alcohol consumption later in life or at the effect of adolescent drinking on noncancerous breast disease.

“More and more heavy drinking is occurring on college campuses and during adolescence, and not enough people are considering future risk. But, according to our research, the lesson is clear: If a female averages a drink per day between her first period and her first full-term pregnancy, she increases her risk of breast cancer by 13 percent,” said co-author Graham Colditz, MD, DrPH, associate director for cancer prevention and control at Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine.

The study is published online Aug. 28 in the Journal of the National Cancer Institute.

Colditz also is the Niess-Gain Professor of Surgery at Washington University School of Medicine. He worked on the study with first author Ying Liu, MD, PhD, a School of Medicine instructor in the Division of Public Health Sciences, and colleagues from Brigham and Women's Hospital, Harvard Medical School, Beth Israel Deaconess Medical Center and Harvard School of Public Health.

The researchers also found that for every bottle of beer, glass of wine or shot of liquor consumed daily, a young woman increases her risk of proliferative benign breast disease by 15 percent. Although such lesions are noncancerous, their presence increases breast cancer risk by as much as 500 percent, Liu said.

"Parents should educate their daughters about the link between drinking and risk of breast cancer and breast disease," she said. "That's very important because this time period is very critical."

The findings are based on a review of the health histories of 91,005 mothers enrolled in the Nurses' Health Study II from 1989 to 2009. Colditz was key to the development and administration of that and similar studies that track disease risk in female nurses.

Colditz and Liu didn't consider the effects of adolescent and early adulthood drinking on women who didn't have a full-term pregnancy because not enough were represented among those studied, Liu said.

Breast tissue cells are particularly susceptible to cancer-causing substances as they undergo rapid proliferation during adolescence and later. Adding to the risk is the lengthening time frame between the average age of a girl's first menstrual cycle and the average age of a woman's first full-term pregnancy. Colditz doesn't foresee any shortening of that, which is why young women should drink less, he said – to lower average daily consumption and, therefore, risk.

"Reducing drinking to less than one drink per day, especially during this time period, is a key strategy to reducing lifetime risk of breast cancer," he said.

Colditz said the findings call for more research into what young women can do to counteract alcohol's adverse effects if they choose to drink. Past studies that didn't consider alcohol use suggest that eating more fiber and exercising more lowers cancer risk for everyone.