Exploring the sense and nonsense of food and health

Heart Health and Alzheimer’s Disease

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Could it be that if you protect yourself against heart disease that you may also be helping to prevent late-onset cognitive problems or dementia?   The causes of dementia depend on the age at which symptoms begin. In the elderly population (usually defined in this context as over 65 years of age), a large majority of cases of dementia are caused by Alzheimer’s disease (AD), vascular dementia or both. Vitamin B12 deficiency may also be the basis for symptoms of difficulty in maintaining balance, depression, confusion, dementia, and poor memory that mimic AD or vascular problems. Fortunately, vitamin B12 – induced dementia can be reversed with the administration of either oral or injected cobalamin (B12).

Recent research on dementia has centered more on AD, since it is estimated that by 2050, 15,000,000 people may have this devastating condition. The studies on nutrition and AD have been sparse, but now it is believed that what is good for your heart is also good for your brain. AD patients have more cases of metabolic syndrome and diabetes than non-demented patients. This leads us back to the risk factors for heart disease as well as for AD (low HDL, high LDL, high triglycerides, abdominal obesity (being an apple), high blood pressure, and impaired glucose tolerance. A new study with 1,130 Medicare patients found that people with low levels of beneficial HDL were 60% more likely to develop late-onset AD than people with higher HDL levels. They also had higher levels of LDL and total cholesterol, but after adjusting for age, sex, ethnicity, vascular risk factors, and statin treatment, only HDL remained significant.

What happens between the heart and the brain? It is thought that cardiovascular risk factors have one thing in common at least – that nitric oxide (NO) is depleted in the cells lining the blood vessels, which is called endothelial dysfunction. NO helps to keep the blood vessels dilated allowing more blood flow to body cells. Research tells us that endothelial dysfunction initiates a series of events in the brain that encourages its production of amyloid plaques precursors, that are characteristic of AD.

How to we raise our HDL? The classic ways are weight loss, smoking cessation, exercise, taking statins or other lipid-lowering medications, drinking alcohol in moderation, and eating a heart-heatlhy diet. OK, there are the magic words – what is a heart healthy diet? We used to think that lowering saturated fat was the key – now we are looking at the low-carbohydrate diet for help. From the studies I have read so far – low refined carbohydrate diets when compared with low-fat diets raise HDL cholesterol levels and lower triglyceride levels.   There, I’ve said it (I remember when saturated fat was so taboo). This may account for the new generation of low carbohydrate diet books such as the French Dukan Diet and a new revival of the Atkins Diet (yes, once again).  I am not promoting these fad diets which appear to be very restrictive.  However, limiting refined carbohydrates and including the healthy ones like vegetables, berries, whole grains could be a better approach for some people.  (more later on these diets).

Again as said in other posts, know your risk factor numbers for heart disease and now possibly AD – it just might make a difference in the future for your brain health as well as your heart.


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