The Mediterranean diet is generally characterized by high consumption of vegetables, fruits, cereals, legumes, seeds and nuts; moderate consumption of dairy products, fish and poultry, olive oil as the primary source of monounsaturated fats; low to moderate intake of wine with meals; and low intake of all kinds of meats and saturated fats. It has been touted by the United Nations as an “intangible cultural heritage of humanity” and has been associated with longer and healthier life and reduced premature death.
There is growing evidence that high adherence to the Mediterranean diet, are associated with lower Alzheimer’s disease risk, as well as slower cognitive decline. A recent review of multiple studies on the Mediterranean diet (a meta analysis) showed that this dietary pattern seemed to cause benefit in multiple central nervous system aspects: it reduces the risk of mild cognitive impairment, depression, Parkinson’s Disease and stroke. The diet has been also associated with less brain lesions such as small strokes that eventually lead to cognitive impairment. But which constituents of the Mediterranean diet are responsible?
When scientists tried to tease out the protective components, fish consumption showed no benefit, neither did moderate alcohol consumption. The two critical pieces appeared to be vegetable consumption, and the ratio between unsaturated fats and saturated fats, essentially plant fats to animal fats.
In studies across 11 countries, fat consumption appeared to be most closely correlated with the prevalence of Alzheimer’s disease, with the lowest fat intake and Alzheimer’s rates in China to the highest fat intake and Alzheimer’s rates in the United States. But this is grouping all fats together.
Harvard researchers examined the relationships of the major fat types to cognitive change over 4 years among 6,000 healthy older women (WHI) , and found that higher saturated fat intake was associated with a poorer trajectory of cognition and memory. Women with the highest saturated fat intake had 60 to 70% greater odds of worst change on brain function. The magnitude of cognitive change associated with saturated fat consumption was equivalent to about 6 years of aging, meaning women with the lowest saturated fat intake had the brain function of women 6 years younger.

In numerous epidemiological studies, greater adherence to the Mediterranean diet has been associated, with longevity and with lower prevalence of several chronic diseases. In specific, greater adherence to the Mediterranean diet has been associated with a significant reduction in total mortality, mortality from cardiovascular disease and cancer mortality, both in Mediterranean and non-Mediterranean populations

What if one already has Alzheimer’s, though? Previously, this group of Columbia University researchers reported that eating a Mediterranean-style diet was related to lower risk for Alzheimer’s disease, but whether a Mediterranean diet—or any diet for that matter—is associated with the subsequent course of the disease and outcomes had not been investigated, until now. They found that adherence to the Mediterranean diet may affect not only risk for Alzheimer disease but also subsequent disease course: Higher adherence to the MeDi is associated with lower mortality. And the more they adhered to the healthier diet, the longer they lived. Within 5 years, only 20% of those with high adherence died, with twice as many deaths in the intermediate adherence group, and in the low diet adherence group, within 5 years, more than half were dead, and by 10 years, 90% were gone, 80% were gone, or less than half. And by the end of the study, the only people still alive were those with higher adherence to the healthier diet. The question arises: which one is better, a diet based on low meat or a meat free diet? A couple of years ago, a review looked at all the randomized controlled trials to date. Using a meat-eating group as the control, it compared people eating like a Mediterranean-style diet that minimizes meat, versus a meat-free diet, versus a meat, dairy and egg-free diet. Even though the studies could not be compared appropriately, but generally those who cut out most meat from their diet reduced their chances of of cardiovascular diseases by a quarter, and those who eliminated all meat cut their risk in half, and those that eliminated dairy and eggs, did even better still. In addition, an all plant, whole food diet containing seeds and nuts as healthy fats seemed to reduce the risk even further, up to 80%!
Bottomline: Go with plants. the message is clear that a primary plant based diet not only prevents cognitive decline, but slows down the process of dementia. The Mediterranean diet is a way to get balanced quantities of polyunsaturated fats, vitamins, and antioxidants, as well as a way to avoid saturated fats and animal proteins. As far as supplements go, there is evidence that the use of high doses of vitamin B12, B6, and folic acid in some groups of patients could lead to lesser cognitive decline and a to slower neurodegenerative process. For the rest of the vitamins, there is no evidence that support their use can reduce the risk of dementia. However, studies show that consumption of vitamins derived from healthy diet is associated with better cognitive performance.

Prospective studies regarding association of AD with Saturated Fats:
In the Chicago Health and Aging Project, individuals who consumed higher amount of saturated fat (in the higher quintiles) had twice the risk of developing Alzheimer’s disease during a 4-year study period, compared with participants who consumed the least amount. In the Washington Heights-Inwood Columbia Aging Project in New York and the Cardiovascular Risk Factors, Aging, and Dementia study in Finland, Alzheimer’s disease risk was positively, but non-significantly, associated with saturated fat intake. A number of well-controlled studies of cognitive decline have found that high saturated fat intake increases the rate of decline in cognitive abilities with age.

Increased saturated fat intake is associated with risk of cardiovascular disease and type 2 diabetes, which, in turn, are associated with increased risk of Alzheimer’s disease. A large study of Kaiser Permanente patients showed that participants with high total plasma cholesterol levels in midlife had a 57% higher risk of Alzheimer’s disease 3 decades later, compared with participants with cholesterol levels <200 mg/dL. Additional evidence of mechanistic associations between saturated or trans-fat intake and Alzheimer’s risk comes from the fact that the APOEε4 allele, which is strongly linked to Alzheimer’s risk, produces a protein that plays a key role in cholesterol transport and from the observation that high-fat foods and/or the increases in blood cholesterol concentrations they may cause may contribute to beta-amyloid production or aggregation in brain tissues. We believe this aspect of health is the most important aspect of health. So we will start with this aspect of health change. This aspect of health behavior change is also the hardest and most froth with failure. After all this is the behavior that we undertake 3-5 or more times per day, and one that is subject to our greatest addictions, and failures. So besides listing the guidelines of nutritional factors proven to be beneficial for the brain and for avoiding Alzheimer’s in particular, we will also provide you with steps that will ensure you can institute a healthy diet as well as maintain the diet and make it your lifestyle. VEGAN AND VEGETARIAN DIET Vegetables, berries, and whole grains provide healthful micronutrients important to the brain and have little or no saturated fat or trans fats. In both the Chicago Health and Aging Project, the California Teachers Study, and the Nurses’ Health Study cohorts, high vegetable intakes were associated with reduced cognitive decline. Legumes and fruits merit emphasis, not because of an association with reduced Alzheimer’s disease risk, but because, like grains and vegetables, they provide macronutrient nutrition that is essentially free of saturated and trans fats. MEDITERRANEAN DIET REDUCE SUGAR AND SIMPLE CARBOHYDRATES Reducing sugar from your diet could seem impossible, because, just like salt, you can find sugar in almost in everything you eat. The other obvious challenge is the obvious -- sugar tastes great, and it is as addictive as any drug. So what can we do? Well lets start with some simple steps. But most importantly start slow, as the National Health Services has suggested, sugar can be one of the most powerful addictions, and going cold turkey is usually a recepie for failure. Switch from the Soda A single can of soda can be the source of nearly 105 grams of sugar. When you feel thirsty drink a glass of water or use the new sugar free additives such as erythrothol, or better yet add green tea into the diet. If you are a two can drinker, by eliminating the soda you would significantly reduce the sugar from your diet. If you like the fizziness of the drink then now there ………………….. Processed foods can hide a great deal of sugar. The cereals, bars, yogurts, ……… High Fructose Corn Serups (HFCS) -- Become a label expert. -- LESS MEAT AND DAIRY PRODUCTS
If you are a big meat eater it can be fairly difficult to cut meat and dairy products completely from your diet over nigth. So lets have a plan.
Start cutting red meat from your diet
or cut off meat from your diet 2 or 3 days a week, but on preassigned days.
Or strat by cutting off red meat from your diet and then go to chicken and so forth.
but what ever paradigm you hope to follow make sure it is achievable and you have a very clear plan ahead of you.
Make sure you are prepared for out of the home venues like restaurants, parties, and restaurants.
Have the language ready. This means that when ever you are in venues where your are tempted by the food or tempted by others have the language repeated internally and to others that will make it easy to keep to your plan.

INCREASE VEGETABLE INTAKE
We have all heard from everyone to increase your vegetable intake. This is one of the only facts that is indisputable by anyone. The problem is that most of us don’t have the habit or the knowledge of how to incorporate vegetables into our diet. Ease, access, and planning are the three concepts that I will repeat over and over.
Plan ahead on the vegetables you will eat, how often (what meals), and how you will prepare it so is easily accessible and tasty.
Have a list of vegetables that you need to buy and precut and organize them in accessible containers in your frig.
Have variety of easy vegetable dishes, salads, soups, and big old meals around vegetables.

SHAKE A DAY MAY KEEP THE DOCTOR AWAY
How to make shakes, and what the usual pitfalls are, and how to overcome the pitfalls, and some examples of how to incorportate it into daily routine.

INCREASE FOODS RICH IN OMEGA 3 AND DHA
List of foods high in Omega 3 and by quantity and how to incorporate them into daily diet.

FIST FULL OF NUTS
List of best nuts by nutrient and also how to incorporate them into diet, along with creams and spreads.

BERRIES ARE YOUR FRIENDS
List of berries by nutrient and also how to incorporate them into diet, along with shakes and in regular foods.

FROM TRANS FATS TO MONO AND POLYUNSATURATED FATS
List of good fats their nutrients and also how to incorporate them into diet.

DON’T WORRY ABOUT YOUR PROTEIN — NOW YOU HAVE BETTER SOURCE OF PROTEIN
List of all the healthy sources of protein their nutrient and also how to incorporate them into diet.

LESS PROCESSED AND MORE WHOLE FOODS
First lets start with definition of processed food, how to identify them, and how to change your life towards more whole foods.

LEARN TO READ LABELS
Some basic tricks of how to read labels, and what to look for.

REDUCE SALT
How to look for salt, how to read labels for salt, and how to just be wize about what could possibly have salt. Also how to replace the taste of salt with healthy replacement.

SUPPLEMENTS THAT HAVE SHOWN SOME BENEFITS:
List of supplements that have been shown to be beneficial. Their proven sources, and how to incorporate them.
Vitamins B 12, E, D, D3, folic acid

Vitamin E should come from foods, such as green leafy vegetables, nuts, seeds and whole grains, rather than supplements. A reliable source of vitamin B12, such as fortified foods or a supplement providing at least the recommended daily allowance (2.4 mg per day for adults), should be part of your daily diet. Have your blood levels of vitamin B12 checked regularly as many factors, including age, may impair absorption.

Healthful sources of folate include leafy green vegetables, such as broccoli, kale, and spinach, beans, peas, citrus fruits, and cantaloupe. Vitamin B6 is found in green vegetables in addition to beans, whole grains, bananas, nuts, and sweet potatoes.

CONTROVERSY OF METALS
Aluminum’s role in Alzheimer’s disease remains controversial. Some researchers have called for caution, citing the fact that aluminum has been demonstrated in the brains of individuals with Alzheimer’s disease. However, because there are only a few studies that have proved this, there are no recommendations regarding aluminum as a contributor to Alzheimer’s disease risk.

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