mediterranean-diet-may-lower-risk-of-co-occurring-heart-conditions
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Mediterranean diet may lower risk of co-occurring heart conditions

ByJessica Freeborn

Share on Pinterest The Mediterranean diet may lower the risk of developing several cardiometabolic conditions at the same time. Image credit: Gabi Bucataru/Stocksy. The Mediterranean diet has many known health benefits, and experts are still learning about the benefits of this dietary pattern. One study found that following the Mediterranean diet may help decrease the risk of transition from one to multiple cardiometabolic diseases like heart attack and stroke, particularly over shorter timeframes. People can take multiple action steps to help decrease their risk for cardiometabolic multimorbidity. The Mediterranean diet focuses on plant-based foods, uses olive oil, and includes lots of fruits, vegetables, and whole grains. There has been much interest in the health benefits of this diet, particularly when it comes to cardiovascular health . Researchers found that following the Mediterranean diet may decrease the chances of someone going from developing a first cardiometabolic disease to cardiometabolic multimorbidity — multiple co-occurring conditions related to cardiovascular and metabolic health — during 10 and 15-year follow-up periods. As noted in this study, cardiometabolic diseases include conditions like stroke, heart attack, and type 2 diabetes. Having two or more of these conditions is called cardiometabolic multimorbidity. This research wanted to find if following the Mediterranean diet could decrease the risk for first cardiometabolic disease and cardiometabolic multimorbidity. The research included 21,900 participants who did not have heart attack, stroke, or type 2 diabetes at baseline. Researchers measured participants’ adherence to the Mediterranean diet using two scores: pyramid-based Mediterranean diet score and median-based Mediterranean diet score. The median follow-up time was 21.4 years, and researchers looked at the incidences of heart attack, stroke, type 2 diabetes, and death. They accounted for covariates like age, education, family history of heart attack or stroke, particular medication use, and physical activity levels. Throughout the study, 5,028 participants experienced one cardiometabolic disease, and 734 participants experienced cardiometabolic multimorbidity. Overall, following the Mediterranean diet had a demonstrated benefit. Looking at both types of Mediterranean dietary scores, researchers found that following this dietary pattern was associated with a decreased risk for cardiometabolic multimorbidity for the 21.4-year follow-up. Researchers next focused on how the Mediterranean diet affected transitioning from first cardiometabolic disease to cardiometabolic multimorbidity. At the 10 and 15-year marks, the Mediterranean diet was associated with a decreased risk of this transition. Further analysis suggested that this observed risk reduction may be particularly related to first experiencing a heart attack or developing type 2 diabetes. However, over the follow-up of more than 20 years, researchers did not find a statistically significant risk reduction for this transition associated with the Mediterranean diet. The researchers also conducted some additional analyses to look at how social class may have played into risk association. Non-manual workers appeared to reap the most benefit from following the Mediterranean diet over the median follow-up of just over 20 years. This group saw a decreased risk for first cardiometabolic disease and a decreased risk for this first instance transitioning to cardiometabolic multimorbidity. In contrast, manual workers did not appear to have this decrease in transition risk. Rigved Tadwalkar, MD, a board-certified consultative cardiologist and medical director of the Cardiac Rehabilitation Center at Providence Saint John’s Health Center in Santa Monica, CA, who was not involved in this research, shared his thoughts on the study’s findings with Medical News Today. According to Tadwalkar, “the study provides strong evidence that adherence to the Mediterranean diet can significantly lower the risk of transitioning from a first cardiometabolic event, like a heart attack or stroke, to additional cardiometabolic conditions, like type 2 diabetes mellitus.” Moreover, he noted: “The finding that this association is more apparent in shorter follow-up periods [of] 10–15 years suggests that the protective effects of diet are most impactful in earlier stages of disease development. It also highlights how socioeconomic factors, including social class, may modify dietary impacts on health. Specifically, [it highlights] that diet quality and access to Mediterranean foods may be less accessible to some populations.” It is also critical to understand the limitations of this research. For example, the data primarily focused on people of European heritage, which limits generalizability. The participants were also adults aged 40 and older, so looking at younger demographics may be helpful in future research. Researchers did not identify participants who had baseline chronic coronary syndromes, which could have ultimately led to an overestimation of the Mediterranean diet’s effects. They also did not differentiate between stroke subtypes. The researchers only measured participants’ adherence to the Mediterranean at baseline, which could have further affected the results. Moreover, participants also self-reported their dietary choices and adherence, which might not have matched their actual diets. Other information related to lifestyle was also self-reported. Additionally, the scoring methods to measure Mediterranean dietary adherence were not without error risk. The researchers also acknowledged a few possible reasons why adherence to the Mediterranean diet appeared to have the most effect on the transition from first cardiometabolic disease to cardiometabolic multimorbidity at the 10 and 15-year follow-up periods. For one, baseline dietary scores could decrease in accurately reporting diet quality over time. Thus, more research may be needed to look at the long-term effects of the Mediterranean diet on this health area. They also noted a few reasons for the differences between manual and non-manual workers. For example, their research did not look at the specific types of food items, and participants with lower socioeconomic status could

dementia:-physical-activity-of-any-intensity-may-help-lower-death-risk
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Dementia: Physical activity of any intensity may help lower death risk

ByJessica Freeborn

Share on Pinterest Scientists have found cognitive benefits from regular exercise for people at risk for dementia. sofie delauw/Stocksy Exercise is related to many health benefits, and researchers are interested in discovering how physical activity affects specific sub-populations. One study suggests that people who maintain or start physical activity after receiving a dementia diagnosis may be at decreased risk for all-cause mortality. People with dementia can work with doctors, physical therapists, and caregivers to implement helpful physical activity routines. Physical activity can offer multiple benefits , from weight management to decreasing the risk of heart disease. It may also help lower the risk of developing dementia. Another area of interest is the effects of physical activity after dementia has already been diagnosed. A study published in the British Journal of Sports Medicine evaluated the relationship between levels of and changes in physical activity and mortality among people with dementia. The researchers found that maintained physical activity before and after diagnosis was associated with the lowest mortality risk. All levels of sustained physical activity were associated with decreased mortality risk. In addition, the researchers found that starting physical activity after a dementia diagnosis could reduce mortality risk by 20% or more. The results suggest that exercise should be greatly encouraged among people with dementia. As noted by the study authors, Alzheimer’s disease is in the top ten leading causes of death, and the number of people with dementia is continuing to increase. This study aimed to explore how physical activity before and after dementia diagnosis affected mortality risk, taking into account the level and amount of physical activity. The study was a nationwide population-based cohort study. Researchers utilized the Korean National Health Insurance System Database to gather information. The study included over 60,000 individuals ages 40 or older who had received a dementia diagnosis between 2010 and 2016. All participants had gotten health check-ups within two years before and after their dementia diagnosis. The researchers identified people who had dementia based on their use of anti-dementia medications and certain scores that assess dementia. They assessed physical activity using data from the International Physical Activity Questionnaire. The researchers were then able to break down physical activity levels after dementia diagnosis into categories of vigorous, moderate, and light physical activity and note the amount of exercise per week. They defined regular physical activity as engaging in vigorous physical activity for twenty minutes or more at least three times weekly or engaging in moderate physical activity for thirty minutes or more at least five times weekly. They then noted how participants’ activity levels changed before and after dementia diagnosis. The average follow-up time was 3.7 years, and during this time, 16,431 participants died. The researchers were able to look at how physical activity related to all-cause mortality. Overall, the researchers observed “a dose-response association between an increased amount of PA [physical activity] and a decreased risk of all-cause mortality.” 29% decrease in mortality risk The researchers observed that participants who kept doing regular physical activity before and after dementia diagnosis saw the lowest mortality risk compared to participants who remained inactive, with a 29% reduction in mortality risk. Compared to non-active participants, participants who increased their physical activity to at least 1,000 metabolic equivalent of tasks (METs)-minutes a week saw a reduced mortality risk. METs have to do with measuring the amount of energy required to perform physical activities. The researchers also observed a 3% mortality risk reduction for every 100 METs-minutes per week that participants increased physical activity following their dementia diagnosis. There was also a slight reduction in mortality risk for participants with all-cause dementia and Alzheimer’s disease who ceased regular physical activity after diagnosis. When looking at intensity levels of physical activity, researchers observed that in participants with all-cause dementia and Alzheimer’s disease, maintaining physical activity helped decrease mortality risk, with similar risk reductions in categories of light, moderate, and vigorous physical activity. Among participants with vascular dementia, researchers saw that sustained light or vigorous physical activity was linked to lower mortality risk. Eric D. Vidoni, PT, PhD, an associate professor of neurology with the KU Medical Center, the University of Kansas, who was not involved in the study, noted the following about the study’s findings to Medical News Today: “Capturing dementia diagnoses and physical activity on a national level adds compelling evidence to what we already know — that maintaining physical activity supports health, even after a dementia diagnosis. [O]ne of the interesting findings in this study was that light activity held almost as much benefit as moderate and vigorous activity.” Some limitations exist for this research. First, the study focused on Korean individuals, so there should be caution in generalizing the findings. Additional research with greater diversity could be helpful. Over 60% of participants were women, so it may also be helpful to include more men in future research. Second, physical activity levels and other lifestyle habits relied on self-reports from participants, which could have had varying levels of accuracy. However, participants could receive help from caregivers in answering questions. It is also possible that people who had less severe dementia and better functionality were more likely to maintain their physical activity levels. Thirdly, researchers acknowledge that reverse causality is possible. Fourth, using administrative data to note dementia might not perfectly match actual dementia diagnoses. The researchers also lacked data on the type of physical activity that participants did