A study published in The American Journal of Medicine 2018, has demonstrated that maintaining a healthy diet in midlife is independently associated with a larger hippocampus years later and may protect against cognitive decline. The hippocampus is a structure located in the temporal lobe of each brain hemisphere and is directly involved in the process of memory. The volume of the hippocampus can be determined by brain magnetic resonance imaging (MRI). Decreasing of its volume is related to cognitive impairment and is used in clinical practice for the diagnosis of Alzheimer’s disease (hippocampus atrophy).

MRI Brain Diet

In this study, the quality of the diet of 459 participants (average age at baseline = 49 years) was assessed with a food-frequency questionnaire, which was administered in 1991-1993 and 11 years later, in 2002-2004. At the end of the follow up, around 13 years after the first questionnaire, participants underwent brain MRI with study of the hippocampus. Long-term healthy diet (showed by higher cumulative score on the Alternative Healthy Eating Index), was associated with a larger total hippocampus volume. This association was independent of sociodemographic factors, smoking habits, physical activity, cardiometabolic factors, cognitive impairment, and depressive symptoms and was more pronounced in the left hippocampus than in the right hippocampus.

A healthy diet, based on recommendations in the Alternative Healthy Eating Index 2010 (AHEI-2010) score is rich in vegetables, fruits, whole grains, nuts, legumes, omega-3 fats, and polyunsaturated fatty acids, and is light on sugar-sweetened drinks, red and processed meat, trans fat, and sodium-rich products. It is also characterized by low alcohol intake. 

The findings of this study support the hypothesis that overall diet may affect brain structures with a specific impact on hippocampus volume. 

Some other studies have demonstrated the influence of diet in brain structures. In most of these studies, diet quality was assessed by Mediterranean diet score, and higher scores (healthier diet) were found to be associated with larger cortical thickness, lower white matter hyperintensity burden, and preserved white matter microstructure. All these findings indicate better preservation of normal brain structure. 

Another previous study, published in 2015 in the BMC Medicine, had already shown that higher intakes of unhealthy foods, normally present in the Western diet, were independently associated with smaller hippocampal volume. This finding was originally observed on experimental animal models and suggested that a high-energy diet rich in saturated fats and refined sugars adversely affect neuronal plasticity and function. Animals maintained on a high-energy diet rich in fat and sugar showed lower performances in hippocampus-dependent spatial learning, object recognition, reduced hippocampus levels of brain-derived neurotrophic factor (BDNF) and impaired in blood-brain barrier integrity.

Accounting for the importance of hippocampus with long-term, declarative, episodic memory, as well as for flexible cognition network, this study reaffirms the need to recognize diet and nutrition as potential determinants of cognition, mental health and social behavior.

Conclusion:

A Long-term healthy diet (and not various episodic restrictive diets) is the key to promote brain health and prevent dementia.

Thus, routine dietary counseling as part of a doctor’s office visit is very important at a patient’s level, but it should also be a high-priority public health goal.

To know more: https://kompetenz-statt-demenz.de/en/prevention-treatment/nutrition/the-mind-diet/

  1. Akbaraly, T et al. Association of Long-Term Diet Quality with Hippocampal Volume: Longitudinal Cohort Study. The American Journal of Medicine 2018 https://www.ncbi.nlm.nih.gov/pubmed/30056104
  2. Gu Y, Brickman AM, Stern Y, et al. Mediterranean diet and brain structure in a multiethnic elderly cohort. Neurology 2015;85 (20):1744–1751. https://www.ncbi.nlm.nih.gov/pubmed/26491085
  3. Mosconi L, Murray J, Tsui WH, et al. Mediterranean diet and magnetic resonance imaging-assessed brain atrophy in cognitively normal individuals at risk for Alzheimer’s disease. J Prev Alzheimers Dis. 2014;1(1):23–32.https://www.ncbi.nlm.nih.gov/pubmed/25237654
  4. Staubo SC, Aakre JA, Vemuri P, et al. Mediterranean diet, micronutrients and macronutrients, and MRI measures of cortical thickness. Alzheimers Dement. 2017;13(2):168-177. https://www.ncbi.nlm.nih.gov/pubmed/27461490
  5. Jacka, F.N, Cherbuin, N, Anstey, KJ et al. Western diet is associated with a smaller hippocampus:a longitudinal investigation. BMJ 2015; 13:215 https://www.ncbi.nlm.nih.gov/pubmed/26349802
  6. Stranahan AM, Norman ED, Lee K, et al. Diet-induced insulin resistance impairs hippocampal synaptic plasticity and cognition in middleaged rats. Hippocampus. 2008;18(11):1085–1088. https://www.ncbi.nlm.nih.gov/pubmed/18651634
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The negative effects of trans fats (also known as trans fatty acids, TFA) on our cardiovascular health have been known for a long time, they are among the most unhealthy food components of all.

In recent years, there has been an increase in the number of studies that prove an association between trans fat and  AD, as already reported by AMM in 2015 (https://spitzen-praevention.com/2015/08/14/transfettsaeuren-und-kognitive-schwaechen-da-fehlen-einem-die-worte/). 1,628 healthy Japanese seniors were followed by a current study from Japan over a period of 10 years. In this context, the researchers examined TFA elaidic acid in the blood as a marker substance, which allows direct conclusions about the total TFA intake. 377 participants developed dementia, of which 247 developed Alzheimer’s and 102 vascular dementia.  Higher serum elaidic acid levels were significantly associated with a greater risk of developing Alzheimer’s disease, vascular dementia and total dementia. Patients whose blood trans fatty acid levels were in the higher range were 90% more likely to develop Alzheimer’s disease. These relationships remained significant even after adjustment for nutritional factors, including total energy intake and the intake of saturated and polyunsaturated fatty acids.

Current situation in Germany

In the Japanese study, the TFA was consumed with sweet baked goods, crackers, ice cream and such, but what is the current exposure situation in Germany?

TFA can get into food in different ways:

  •  produced by bacterias in the rumen of ruminants (such as cows, sheep and goats) and thus enter muscle meat and milk. A health-promoting effect is even being discussed concerning these ruminant TFA.
  • industrially produced when processing vegetable oils, the so-called partial hydrogenating process. These TFA have been used extensively in industrial food production.
  • while frying and deep-frying processes, whereby the TSF are almost completely transferred from the fat into the fried food.

In 2016, the EU Commission published a draft law to limit trans fats in foods, according to which the content of industrial TSAs is to be limited to 2% in the total fat from 2021. National regulations exist only in individual member states (e.g. Denmark, Finland) and in Switzerland. The WHO has also launched a global initiative with the ‘REPLACE’ programme, which aims to eliminate it (to 1% of total calories) worldwide by 2023.

The good news is that although there is still no mandatory national regulation in Germany, fortunately, industrial TFA are virtually no longer used in pre-packaged foods. They have been almost completely replaced by palm oil or palm kernel oil, which is at least better for health, but unfortunately causes different kinds of problems. Problems with regard to TFA contents of more than 2% in total fat are posed by unpackaged, bulk or industrially-like prepared foods sold in snack bars and bakery chains, as no list of ingredients is required by law, and single cases with extremely high TFA contents are still being identified.

Risk of TFA formation by radicals in the body

Biological membranes, which occur in every cell of the body, consist of a double layer of phospholipids. They contain a high proportion of fatty acids, whereby their content of unsaturated (non-trans) fatty acids positively influences the properties of these cell membranes. Therefore, the formation of TFA in the membranes poses an apparently great danger: As soon as the fatty acids within the membranes are converted to the trans configuration and thus, TFA are generated, this can have a negative effect on the fluidity of the membrane and promote the development of chronic diseases.

A few years ago, a study showed that rats fed TFA-free food for lifetime had implemented trans-isomers of mono- and polyunsaturated fatty acids (oleic, linoleic, linolenic and arachidonic acid) in liver, kidneys, heart, adipose tissue and erythrocytes. Thus, it was proven that TFAs can be formed in the organism even if the food does not contain any TFAs. Subsequent studies have also shown that free radicals are responsible for the formation of TFAs in the body. Free radicals can be produced in the organism during essential metabolic processes under physiological conditions, but also by external influences such as cigarette smoke, air pollution, organic solvents or irradiation. Due to their high chemical reactivity, these free radicals can cause oxidative damage to cellular macromolecules. In addition, the increased occurrence of TFAs formed in the body, especially of trans arachidonic acid, has been observed due to accumulated radical stress in various pathological states, such as inflammation, diabetes and Alzheimer’s disease.

This became very obvious when a study using an Alzheimer’s animal model revealed that TFAs were found only in the brain and hippocampus of mice carrying a gene specific for Alzheimer’s disease, but not in healthy animals. This result suggests that stress due to amyloid β-mediated radicals that accumulated during the development of Alzheimer’s disease causes cis-trans isomerisation of fatty acids in neurons of Alzheimer’s mice. In a subsequent study, it was further shown that the animals had significantly reduced levels of TFA in the brain and hippocampus after administration of two antioxidant substances for 3 months. These studies thus imply that the administration of antioxidant substances may be a possible strategy to prevent the body’s own formation of TFA during the development of chronic diseases such as Alzheimer’s disease. Based on the results of all intervention studies, a variety of antioxidant vitamins and polyphenolic compounds derived from plants, including curcumin and resveratrol, appear to inhibit TFA formation in the body (Figure 1, modified after Hung et al. 2016).

Inhibition Trans Fatty Acids
Figure 1: Potential Inhibition of the Formation of Trans Fatty Acids in Human Membranes by Dietary Antioxidants

Conclusion:
The connection between Alzheimer’s disease and the consumption of trans-fatty acids (TFA) is becoming increasingly evident, although the exposure to TFA through pre-packaged food to TFA in Germany has decreased in recent years. The industry has reacted to the EU’s legal regulation, which will come into force in 2021, of a maximum of 2% of total fat. However, when you visit the snack bar and the bakery chain, remember that trans fats may still play a not inconsiderable role here.

However, the real danger of TFA seems to be in the body, as they can be produced there by free radicals. But you can do something about it with a healthy diet: Ensure your supply of antioxidant micronutrients from food and, if necessary, supplements, before the TFA otherwise formed in your body damage your cell membranes and drive you insane!

References:

  1. Honda,T et al (2019) Serum elaidic acid concentration and risk of dementia: The Hisayama Study. Neurology, 2019
  2. Informationsblatt der Europäischen Union 2019
  3. Bähr M, Jahreis G, Kuhnt K (2011) Trans fatty acids in foods on the German market and in human tissue. Ernährungsumschau 9
  4. Ghebreyesus T, Frieden TR (2018) REPLACE: a roadmap to make the world trans fat free by 2023. The Lancet 391
  5. Messdaten zu Trans-Fettsäuren aus der amtlichen Überwachung zu insgesamt 2.633 Proben aus den Jahren 2014-2017, Auskunft des Bundesamts für Verbraucherschutz und Lebensmittelsicherheit (BVL) vom 31. März 2017
  6. Kuhnt K, Degen C, Jahreis G (2015) Evaluation of the Impact of Ruminant trans Fatty Acids on Human Health: Important Aspects to Consider. Crit Rev Food Sci Nutr. 56
  7. Hung, WL et al (2016) Endogenous formation of trans fatty acids: Health implications and potential dietary intervention, Journal of Functional Foods 25

Photo by Khairul Onggon on Pexels

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Red wine drinkers are generally good-natured people and known for mastering life with pleasure and relaxation. These alone are two protective factors against dementia, because stress is poison for the brain (but more about this later on). In addition, a secondary plant substance present particularly in red wine is increasingly attracting the interest of research and prevention in Alzheimer’s disease: resveratrol.

Resveratrol has numerous biological and pharmacological protective effects and became well-known back in the mid-1990s in connection with the ‘French Paradox’. It stands for the observation that French people live longer than Germans and Americans despite their supposedly unhealthier lifestyle, especially because of their higher alcohol consumption, and that the frequency of heart attacks in France is three times lower than in the USA. In the following years, resveratrol became the focus of research and showed anti-inflammatory, antioxidant, cancer-inhibiting, heart protecting and life-prolonging properties in numerous test models both in vitro and in vivo and was considered a new miracle cure.

Resveratrol and Alzheimer

The first indications that resveratrol could also be responsible for the protective effect of red wine in Alzheimer patients were shown by epidemiological studies conducted by a French research group in 1997, which showed an inverse correlation between moderate wine consumption and the occurrence of Alzheimer’s disease: in the group of moderate wine drinkers (250 – 500 ml per day) the risk of dementia was reduced by a factor of 5.

It showed that resveratrol not only unfolds its positive effects in a single way, but also has a multi-mechanistic effect. It has a beneficial effect on various processes, all of which play a decisive role in the development of Alzheimer’s disease:

  1. reduction of amyloid plaques 
  2. reduction of neurofibrillary tangles 
  3. regulatory role in autophagy processes 
  4. anti-inflammatory effect 
  5. antioxidant effects

Detailed explanations on these topics can be found on the page: Resveratrol

Clinical studies

Based on these convincing results, the therapeutic potential of resveratrol in Alzheimer’s patients is currently being tested in clinical trials. Two recent pilot studies have shown that resveratrol can easily cross the blood-brain barrier in humans and penetrate brain tissue – as it has been detected in cerebrospinal fluid. Resveratrol was well tolerated by all volunteers and had no side effects up to a dose of 5 grams per day. Both double-blind studies show evidence of positive effects of resveratrol in humans. 

In addition, resveratrol is already part of the multifactorial approach of the American neurologist Dale Bredesen, who, with his therapy known as ‘ReCode’ (Reversal of Cognitive Decline), has managed to clinically reverse Alzheimer’s courses in early stages (see also the interview with Dr. Bredesen in the media library).

Conclusion:
Whether fed with a glass of red wine in the evening or by other non-alcoholic means – but preferably from natural sources – the secondary plant substance resveratrol appears to be responsible for protective effects in the development of dementia due to its diverse mechanisms of action. It could therefore be a promising preventive and possibly therapeutic approach in the fight against Alzheimer’s disease.

In this sense: treat yourself to a glass of red wine or grape juice in the evening and enjoy life. Your grey cells will be grateful!

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This descriptive documentation of the Arte TV channel shows very clearly the connections between an unbalanced diet, the resulting micronutrient deficiencies and the effects on the brain. Various experiments have shown that mice that grow up with a deficiency of omega-3 fatty acids have deficits in the formation of their neurons and are much more anxious.

A particularly striking example showed an experiment with field hamsters. Here a simple vitamin B3 deficiency was sufficient to trigger aggressive behaviour during mating in over 80% of females. In the further course of the experiment, these females even ate their offspring directly after birth. After the vitamin B3 deficiency had been remedied, the females showed normal behaviour again, despite continued unbalanced diet  (thus the vitamin B3 factor could be clearly identified as the trigger).

In humans, long-term observations and studies showed similar results. Already in the uterus, the nutrition of the mother decides about the brain development and the emotional development of the fetus and newborn.

Mothers who eat “junk food” with a low omega-3 fatty acid concentration and high sugar content give birth to children that tend to act more aggressive. If this form of nutrition is continued in childhood, aggressive  behaviour, anxiety and attention disorders are pre-programmed. If there is a lack of omega-3 fatty acids, the function of the brain is disturbed, the communication between neurons and the neurogenesis are impaired.

The second cardinal error of Western nutrition is the flooding of highly processed foods with cheap refined sugars. Experiments have shown that this hidden sugar poisoning may show higher addiction effects  than cocaine. The consequences are insulin resistance, diabetes and dementia.

Of course, this form of unbalanced nutrition also has an effect on the intestines and the gut microbiota (and their genetic diversity, the microbiome), which have a significant influence on the health of our body and mind. Concrete examples show that the density of nutrients in food influences the way we   make decisions and solve daily problems. But we do not want to reveal too much here, watch for yourself:

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Unfortunately this excellent video don’t provide English subtitles, a more scientific alternative about the MIND diet in English can be found here:

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Conclusion:

As far as mental and brain health is concerned, nutrition seems to be a major component of prevention, particularly with regard to dementia.  An alteration towards the Mediterranean diet or even better the MIND diet  increases our chances to remember the names of our grandchildren in the future and to actively participate in life. Just leave the “industrial garbage” on the shelf, even if it is sometimes difficult.

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Curcumin is a yellow pigment contained in turmeric (Curcuma longa). The benefits of curcumin in different organ systems have been extensively documented in the past in several neurological diseases and cancer. Curcumin has received worldwide recognition for its potent antioxidant, anti-inflammatory, anti-cancer and antimicrobial activities. Curcumin has been successfully used to treat diabetes and arthritis, as well as liver, kidney and cardiovascular diseases. Recently, attention has focused on the use of curcumin to prevent or delay the onset of neurodegenerative diseases. A recently published review study (https://www.ncbi.nlm.nih.gov/pubmed/31185140) summarized the use of curcumin in different neurological diseases, including Alzheimer’s disease. Recent advances in curcumin formulations and strategies to overcome low bioavailability are discussed as well as toxicity and ongoing clinical trials.

Conclusion:

There is good evidence that turmeric consumption has various potential health benefits not only for older people. In addition to its role in treatment and prevention, curcumin acts in AD therapies as an antioxidant, anti-inflammatory, inhibitor of Aβ aggregation and chelator of metal ions. These effects are, regardless of the results of clinical studies, a good reason to include curcuminoids in our regular diet – e.g. in the form of strong curries.

Further information about the effect of curcumin on Alzheimer’s can be found at Curcumin and Alzheimer’s Dementia…

 

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