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Another study finding more benefits of exercise was recently published in the journal Neurology. The study by researchers at Duke University found that in older adults who were already experiencing  cognitive (thinking) problems, but did not have dementia - that after just 6 months of exercise they showed improvements in thinking. What were their original thinking problems? The individuals had difficulty concentrating, making decisions, or remembering, but it was not severe enough to be diagnosed as dementia. However, these persons were considered at risk for progressing to dementia.

The 160 individuals in the study were 55 years or older (mean age 65), mainly women, evenly divided between whites and minorities, were sedentary (didn't exercise), and had heart (cardiovascular) disease or were at risk for heart disease. They were randomly assigned to one of 4 groups: 1) aerobic exercise (with no dietary changes), 2) DASH diet (with no exercise), 3) DASH diet plus exercise, and 4) the control group, who had no dietary or exercise changes - they just received some educational phone calls. The study lasted 6 months, and there were no drop outs.

In the study, the aerobic exercises were done 3 times per week: 10 minutes of warm up exercises followed by 35 minutes of continuous walking or stationary cycling. The Dietary Approaches to Stop Hypertension or DASH diet is a heart healthy diet that emphasizes eating fruits, vegetables, whole grains, as well as fish, poultry, beans, and nuts. It stresses lowering the intake of salt (sodium), sweets, sugar sweetened beverages, and fatty foods (both trans fats and saturated fats). [Note that in many ways it's similar to the Mediterranean diet with its emphasis on fruits, vegetables, whole grains, legumes, seeds, nuts, and lowering intake of meat. Studies find cognitive benefits from the Mediterranean diet.]

The six months of exercising improved thinking skills called executive function - in both the exercise alone or exercise + DASH diet group. The largest improvements were in the exercise + DASH diet group (as compared to the control group, which actually showed decline in functioning). Executive function is a person's ability to regulate their own behavior, pay attention, organize and achieve goals, and was measured in this study with a group of cognitive tests (a "standard battery of neurocognitive tests"). These executive function improvements did not occur in the DASH diet alone group or the control group. The study found no improvement in memory or language fluency in any of the groups. The exercise alone, DASH diet alone, and the combined exercise and DASH group had other health benefits by the end of the study, for example they lowered their risk factors for heart disease. Other improvements: the exercise groups had improvements in insulin levels, and the DASH groups decreased their intake of blood pressure medicines.

To illustrate how amazing these results are: at the start of the study (baseline) all participants scored as if they were in their early 90s on cognitive tests - as if they were on average about 28 years older than their actual chronological age! Then at the end of 6 months, the persons in the exercise + DASH diet showed an improvement of almost 9 years on the tests. In contrast, the control group showed an approximately 6 month worsening performance. When researchers looked at physical markers of the exercisers, they found that physical improvements and improvements in heart disease risk factors (e.g. losing weight, lowering blood pressure) were correlated with executive functioning improvements.

Other studies have found related findings, such as higher physical activity and a Mediterranean diet is associated with lower levels of dementia. The researchers point out that there is growing evidence that combining several lifestyle factors (e.g., exercise, not smoking, a healthy diet, lowering salt intake) and not just exercise alone, has the best results for better cognitive functioning among older adults. Bottom line: eat a diet rich in fruits, vegetables, whole grains, seeds, nuts and get exercise. Walking briskly, gardening, housework, walking up stairs - it all counts.  ...continue reading "Can Exercise and Dietary Changes Help Older Adults With Thinking Problems?"

A number of recent studies and articles have discussed the effectiveness of diet in treating or preventing depression with the main conclusion that yes, it helps. Now an observational study (that will be presented in April) found that elderly people following the DASH diet most closely were 11% less likely to become depressed over time than those that did not.

Researchers studying 964 elderly participants over six and a half years found that those who followed the DASH diet, which emphasizes whole grains, fruits, and vegetables, had lower rates of depression, while those who ate a traditional Western diet were more prone to depression. The DASH (Dietary Approaches to Stop Hypertension) diet also emphasizes low sodium (salt) to lower blood pressure, as well as foods rich in nutrients (such as potassium, calcium, and magnesium) that are thought to lower blood pressure.

The study's lead author L. J. Cherian (at Rush Medical Center in Chicago) said that "we need to view food as medicine”. Yes. Eating more fruits and vegetables, whole grains, legumes, seeds, nuts have many health benefits (such as cardiovascular benefits, improving the gut microbes) -  a win-win. From Science Daily:

Diet shown to reduce stroke risk may also reduce risk of depression

People who eat vegetables, fruit and whole grains may have lower rates of depression over time, according to a preliminary study that will be presented at the American Academy of Neurology's 70th Annual Meeting in Los Angeles, April 21 to 27, 2018. The study found that people whose diets adhered more closely to the Dietary Approaches to Stop Hypertension (DASH) diet were less likely to develop depression than people who did not closely follow the diet. In addition to fruit and vegetables, the DASH diet recommends fat-free or low-fat dairy products and limits foods that are high in saturated fats and sugar. Studies have shown health benefits such as lowering high blood pressure and bad cholesterol (LDL), along with lowering body weight ...continue reading "DASH Diet Linked To Lower Rate of Depression"

Gout is something that is not discussed that much, but it has been increasing in recent years and now afflicts about  3.9% of adults in the US. Gout is a form of inflammatory arthritis, characterized by recurrent attacks of pain, tenderness, and swelling of a joint, frequently the joint of the big toe. It is caused by elevated levels of uric acid in the blood (known as hyperuricaemia).

Gout occurs more commonly in men ages 40 and older, who eat a lot of meat and seafood, drink a lot of alcohol (especially beer) or sweetened drinks, have high blood pressure, metabolic syndrome, or are overweight.  Gout used to be known as "the disease of kings" or "rich man's disease". [On the other hand, past research has shown that consumption of coffee, cherries, vitamin C foods, and dairy products, losing weight and physical fitness seems to decrease the risk.]

Recent research showed that the DASH diet reduces blood pressure and reduces uric acid in the blood, which is why a research team (study in The BMJ) now looked at  whether it lowers the risk of gout. The Dietary Approaches to Stop Hypertension or DASH diet is high in fruit, vegetables, whole grains, legumes, nuts, and low-fat dairy, and low in red and processed meats, salt, and sugary drinks. On the other hand, the typical Western diet has higher intakes of red and processed meats, sweetened beverages, sweets, desserts, French fries, and refined grains. The researchers analysed data on a total of 44,444 male health professionals, who had no history of gout at the start of the study. During the 26 years of the observational study, they documented 1731 cases of gout.

The researchers found that eating a more DASH type diet - a diet rich in fruits, vegetables, legumes, nuts, whole grains, and low in salt, sugary drinks, and red and processed meats, is associated with a lower risk of gout. On the other hand, a more 'Western' diet is associated with a higher risk of gout. They found that the effects are dose dependent - the more DASH-type diet, the lower the risk of gout. Bottom line: Once again, eating lots of fruits, vegetables, nuts, legumes, and whole grains is linked to health benefits. From Science Daily:

Diet rich in fruit, vegetables and whole grains may lower risk of gout

A diet rich in fruit and vegetables, nuts and whole grains and low in salt, sugary drinks, and red and processed meats, is associated with a lower risk of gout, whereas a typical 'Western' diet is associated with a higher risk of gout, finds a study published by The BMJ.

Gout is a joint disease which causes extreme pain and swelling. It is most common in men aged 40 and older and is caused by excess uric acid in the blood (known as hyperuricaemia) which leads to uric acid crystals collecting around the joints. The Dietary Approaches to Stop Hypertension (DASH) diet reduces blood pressure and is recommended to prevent heart disease. It has also been found to lower uric acid levels in the blood. Therefore, the DASH diet may lower the risk of gout.

To investigate this further, a team of US and Canada based researchers examined the relationship between the DASH and Western dietary patterns and the risk of gout. They analysed data on over 44,000 men aged 40 to 75 years with no history of gout who completed detailed food questionnaires in 1986 that was updated every four years through to 2012.

Each participant was assigned a DASH score (reflecting high intake of fruits, vegetables, nuts and legumes, such as peas, beans and lentils, low-fat dairy products and whole grains, and low intake of salt, sweetened beverages, and red and processed meats) and a Western pattern score (reflecting higher intake of red and processed meats, French fries, refined grains, sweets and desserts). During 26 years of follow-up, a higher DASH score was associated with a lower risk for gout, while a higher Western pattern was associated with an increased risk for gout.

 Gout. Credit: NHS in the UK

Another study finds health benefits to eating a Mediterranean based diet (here combined with the DASH diet) - the MIND diet. The researchers found that the older adults who followed the diet best were about 7.5 years younger cognitively than those who followed it least, thus suggesting that it may slow the cognitive decline of aging. Earlier research had suggested that it may reduce a person's risk in developing Alzheimer's disease. Foods to eat: fruits, vegetables, berries, whole grains, legumes (beans), nuts, fish, a little wine, and some chicken. Foods to limit on this diet: butter, red meat, margarine, sweets and pastries, whole fat cheese, and fried or fast food. From Medical Xpress:

Eating away at cognitive decline: MIND diet may slow brain from aging by 7.5 years

While cognitive abilities naturally diminish as part of the normal aging process, it may be possible to take a bite out of this expected decline. Eating a group of specific foods known as the MIND diet may slow cognitive decline among aging adults, even when the person is not at risk of developing Alzheimer's disease, according to researchers at Rush University Medical Center. This finding is in addition to a previous study by the research team that found that the MIND diet may reduce a person's risk in developing Alzheimer's disease.

The recent study shows that older adults who followed the MIND diet more rigorously showed an equivalent of being 7.5 years younger cognitively than those who followed the diet least. The results of the study recently were published online in the journal Alzheimer's & Dementia: The Journal of the Alzheimer's Association.

The National Institute of Aging funded study evaluated cognitive change over a period of 4.7 years among 960 older adults who were free of dementia on enrollment. Averaging 81.4 years in age....residents of more than 40 retirement communities and senior public housing units in the Chicago area. .... Martha Clare Morris, ScD, a nutritional epidemiologist, and colleagues developed the diet, whose full name is the Mediterranean-DASH Diet Intervention for Neurodegenerative Delay. As the name suggests, the MIND diet is a hybrid of the Mediterranean and DASH (Dietary Approaches to Stop Hypertension) diets. Both diets have been found to reduce the risk of cardiovascular conditions, like hypertension, heart attack and stroke.

"Everyone experiences decline with aging; and Alzheimer's disease is now the sixth leading cause of death in the U.S., which accounts for 60 to 80 percent of dementia cases. Therefore, prevention of cognitive decline, the defining feature of dementia, is now more important than ever," Morris says.

The MIND diet has 15 dietary components, including 10 "brain-healthy food groups" and five unhealthy groups - red meat, butter and stick margarine, cheese, pastries and sweets, and fried or fast food. To adhere to and benefit from the MIND diet, a person would need to eat at least three servings of whole grains, a green leafy vegetable and one other vegetable every day—along with a glass of wine—snack most days on nuts, have beans every other day or so, eat poultry and berries at least twice a week and fish at least once a week. In addition, the study found that to have a real shot at avoiding the devastating effects of cognitive decline, he or she must limit intake of the designated unhealthy foods, especially butter (less than 1 tablespoon a day), sweets and pastries, whole fat cheese, and fried or fast food (less than a serving a week for any of the three).

Berries are the only fruit specifically to be included in the MIND diet. "Blueberries are one of the more potent foods in terms of protecting the brain," Morris says, and strawberries also have performed well in past studies of the effect of food on cognitive function.