Mediterranean diet delays death in Alzheimer's

HD Lighthouse Contributing Editor's Comment: HDlighthouse readers are eating antioxidant and Omega-3 rich foods, blueberries and curry (for curcumin), and drinking green tea as part of a proactive strategy to maintain good health.

There is no recommended Huntington's Disease diet, but research in Alzheimer's suggests that the Mediterranean diet is a good bet. We've been following the research of Dr. Nikos Scarmeas at Columbia University. Last fall, we learned that a Mediterranean diet helps prevent Alzheimer's. In the newest study, Dr. Scarmeas and colleagues report that Alzheimer's patients on the diet live longer.

The Mediterranean diet was defined in this study as high consumption of fruits, vegetables, cereals, legumes, and fish, low consumption of meat and dairy products, mild to moderate consumption of alcohol, and more monounsaturated fats such as olive oil and less saturated fat such as butter.

-- Marsha L. Miller, Ph.D.
Posted to the HDL: 17 Sep 2007

ST. PAUL, Minn. – A Mediterranean diet may help people with Alzheimer’s disease live longer than patients who eat a more traditional Western diet. The study is published in the September 11, 2007, issue of Neurology®, the medical journal of the American Academy of Neurology.

The study followed 192 people with Alzheimer’s disease in New York for an average of four and a half years. During that time, 85 of the people died. Researchers found that those who most closely followed a Mediterranean diet were 76 percent less likely to die during the study period than those who followed the diet the least.

“The more closely people followed the Mediterranean diet, the more they reduced their mortality,” said study author Nikos Scarmeas, MD, MSc, of Columbia University Medical Center in New York, and member of the American Academy of Neurology. “For example, Alzheimer’s patients who adhered to the diet to a moderate degree lived an average 1.3 years longer than those people who least adhered to the diet. And those Alzheimer’s patients who followed the diet very religiously lived an average four years longer.”

Previous research by Scarmeas and his colleagues demonstrated that healthy people who eat a Mediterranean diet lower their risk of developing Alzheimer’s disease. Studies have also shown that healthy people who follow a Mediterranean diet live longer than those who eat a more traditional Western diet, higher in saturated fat and meats and lower in fruits and vegetables.

“New benefits of this diet keep coming out,” said Scarmeas. “We need to do more research to determine whether eating a Mediterranean diet also helps Alzheimer’s patients have slower rates of cognitive decline, maintain their daily living skills, and have a better quality of life.”

The Mediterranean diet includes a high intake of vegetables, legumes, fruits, cereals, fish, monounsaturated fatty acids; a low intake of saturated fatty acids, dairy products, meat and poultry; and a mild to moderate amount of alcohol.

The Abstract:

Background

We previously reported that the Mediterranean diet (MeDi) is related to lower risk for Alzheimer disease (AD). Whether MeDi is associated with subsequent AD course and outcomes has not been investigated. OBJECTIVES: To examine the association between MeDi and mortality in patients with AD. METHODS: A total of 192 community-based individuals in New York who were diagnosed with AD were prospectively followed every 1.5 years. Adherence to the MeDi (0- to 9-point scale with higher scores indicating higher adherence) was the main predictor of mortality in Cox models that were adjusted for period of recruitment, age, gender, ethnicity, education, APOE genotype, caloric intake, smoking, and body mass index.

Results

Eighty-five patients with AD (44%) died during the course of 4.4 (+/-3.6, 0.2 to 13.6) years of follow-up. In unadjusted models, higher adherence to MeDi was associated with lower mortality risk (for each additional MeDi point hazard ratio 0.79; 95% CI 0.69 to 0.91; p = 0.001). This result remained significant after controlling for all covariates (0.76; 0.65 to 0.89; p = 0.001). In adjusted models, as compared with AD patients at the lowest MeDi adherence tertile, those at the middle tertile had lower mortality risk (0.65; 0.38 to 1.09; 1.33 years' longer survival), whereas subjects at the highest tertile had an even lower risk (0.27; 0.10 to 0.69; 3.91 years' longer survival; p for trend = 0.003).

Conclusion

Adherence to the Mediterranean diet (MeDi) may affect not only risk for Alzheimer disease (AD) but also subsequent disease course: Higher adherence to the MeDi is associated with lower mortality in AD. The gradual reduction in mortality risk for higher MeDi adherence tertiles suggests a possible dose-response effect.

Source: Neurology 2007 Sep 11;69(11):1084-93.

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