Today we're going to take a closer look at which foods are associated with an increased risk of dementia, and which foods may help prevent risk of developing dementia...Alzheimer’s is the most common form of dementia, which is a general term for memory loss and decreased cognitive abilities that interfere with daily life. Alzheimer’s is a progressive disease that typically affects people over 65 years of age. While there is still much to learn about the cause of Alzheimer’s -- like many other chronic medical conditions -- Alzheimer’s probably develops due to multiple factors including age, genetics, environment, lifestyle, and coexisting medical conditions including high blood pressure, diabetes, and high cholesterol.According to a 2016 report in the Journal of the Alzheimer’s Association, someone in the United States develops Alzheimer’s disease every 66 seconds, and by 2050 that is expected to increase to a new diagnosis every 33 seconds, resulting in nearly 1 million new cases of Alzheimer’s disease every year. Alzheimer’s is currently the sixth leading cause of death in the United States. Between 2000 and 2013, deaths resulting from stroke, heart disease, and prostate cancer decreased 23%, 14%, and 11%, respectively, while deaths from Alzheimer's disease increased 71%. While research on the exact causes of Alzheimer’s and how to prevent this disease is inconclusive, epidemiological studies show that regular physical activity and a healthy diet may help support brain health. These are the same lifestyle changes that also decrease risk of heart disease and diabetes, which reinforces the belief that an overall healthy lifestyle has a major impact on chronic disease. So, how can you build an overall healthy lifestyle? This site has tons of resources, and from a dietary perspective, check out the three nutrition strategies below...

1. Oxidative stress can lead to cellular damage throughout the body, including possibly increasing the development of amyloid plaques that are found in the brain in people with Alzheimer’s disease. Important antioxidants that help reverse this damage include vitamins A, C, and E; beta-carotene, selenium and polyphenols.
   • Vegetables and fruit high in vitamin C include bell peppers, broccoli, collard greens, grapefruit, oranges, raspberries, blackberries, spinach, and strawberries.
   • Vegetables and fruit high in vitamin A and beta-carotene include cantaloupe, carrots, collard greens, spinach, mango, and sweet potato.
   • Vitamin E is found in spinach, broccoli, vegetable oils (like wheat germ, sunflower, and safflower oils) almonds, hazelnuts, and sunflower seeds.
   • Brazil nuts are higher in selenium than any other food. In fact, 6-8 Brazil nuts contain 777% of the RDA for selenium. Other good sources include tuna, herring, turkey, chicken, cottage cheese, spinach, and whole grains.
   • Polyphenols are compounds that plants produce to protect themselves, and are found in higher amounts in grapes, apples, pears, cherries, and berries.
2. B vitamins including folic acid, B6, and B12 have been shown to limit oxidative stress and also lower homocysteine levels which have been associated with Alzheimer’s disease.
   • Folate is found in asparagus, Brussels sprouts, spinach, mustard greens, oranges, peanuts, black-eyed peas and kidney beans. Whole grains naturally are a good source of folate, and folate is also added to most grain products, including bread and cereals.
   • Vitamin B6 is found in chickpeas, tuna, salmon, chicken, turkey, potatoes and bananas.
   • Vitamin B12 is found only in animal products, including seafood, poultry, meat, eggs and milk.
3. The types of fats we consume play an important role in cardiovascular health, and possibly also in Alzheimer’s disease. While total fat consumption is not associated with increased risk of Alzheimer’s, consuming foods that are higher in saturated fat and lower in monounsaturated fat is strongly associated with worse cognitive function.
   • Foods high in monounsaturated fat include olive oil, peanut oil, canola oil, safflower oil, avocado, nuts, and seeds.
   • Foods high in saturated fat (and thus foods to avoid) include red meat, lamb, pork, poultry with skin, cream, butter, cheese, full-fat milk and yogurt, and many processed and commercially-fried foods.

Now, what does this mean in terms of the foods that we eat on a daily basis? Consuming more of these four types of foods will increase your intake of anti-oxidative nutrients and healthy types of fat for overall improved health as well as potentially decreasing your risk of Alzheimer’s disease:

1. Seafood, especially salmon, herring, tuna and sardines, is high in omega-3 fatty acids. One study with 815 participants age 65 to 94 showed that eating fish more than once each week was associated with 60% decreased risk of Alzheimer’s disease compared to people who ate fish less often.
2. Vegetables and fruit are high in a variety of antioxidative nutrients and naturally low in saturated fat. Eating a variety of colors of vegetables and fruit provides a wider range of antioxidants. Here are a few examples...
   • Red:  tomatoes, red bell peppers, watermelon, cherries
   • Green:  cabbage, spinach, kiwi
   • Yellow/orange:  carrots, oranges, yellow bell peppers
   • Purple/blue:  purple cabbage, blueberries, eggplant
   • Brown/white:  onions, garlic, bananas
3. Milk and yogurt are good sources of vitamin D, phosphorus and magnesium that may reduce the risk of developing dementia. Choose skim milk and non-fat, unsweetened yogurt to avoid saturated fats, which have a negative impact on overall health and dementia.
4. Choose healthier types of oils, including olive oil, canola oil, and safflower oil and use these sparingly since all types of oils and fats are high in calories.

By Lynn Grieger, RDN, CDE, CPT, CHWCReferences:

1. 2016 Alzheimer’s disease facts and figures. Alzheimer’s Association. Alzheimers Dement. 2016 Apr;12(4):459-509.
2. Alzheimer’s Association. What is Alzheimer’s? https://www.alz.org/alzheimers_disease_what_is_alzheimers.asp  Accessed 2-10-18.
3. Alzheimer’s Association. Prevention and Risk of Alzheimer’s and Dementia. https://www.alz.org/research/science/alzheimers_prevention_and_risk.asp   Accessed 2-10-18.
4. Hu N, Yu J-T, Tan L, Wang Y-L, Sun L, Tan L. Nutrition and the Risk of Alzheimer’s Disease. BioMed Research International. 2013;2013:524820. doi:10.1155/2013/524820.
5. Fruit and Veggies More Matter. Vitamin C in Fruits & Vegetables. https://www.fruitsandveggiesmorematters.org/vitamin-c-in-fruits-and-vegetables   Accessed 2-11-18
6. Fruit and Veggies More Matter. Vitamin A in Fruits & Vegetables. https://www.fruitsandveggiesmorematters.org/vitamin-a-in-fruits-and-vegetables  Accessed 2-11-18
7. National Institutes of Health. Office of Dietary Supplements. Vitamin E Fact Sheet for Consumers. https://ods.od.nih.gov/factsheets/VitaminE-Consumer/  updated 5-9-16. Accessed 2-11-18.
8. National Institutes of Health. Office of Dietary Supplements. Selenium Fact Sheet for Health Professionals. https://ods.od.nih.gov/factsheets/Selenium-HealthProfessional/  Updated 2-11-16. Accessed 2-11-18.
9. Pandey KB, Rizvi SI. Plant polyphenols as dietary antioxidants in human health and disease. Oxidative Medicine and Cellular Longevity. 2009;2(5):270-278.
10. National Institutes of Health. Office of Dietary Supplements. Folate Fact Sheet for Consumers. https://ods.od.nih.gov/factsheets/Folate-Consumer/  Updated 4-20-16. Accessed 2-11-18.
11. National Institutes of Health. Office of Dietary Supplements. Vitamin B6 Fact Sheet for Health Professionals. https://ods.od.nih.gov/factsheets/VitaminB6-Consumer/  Updated 2-11-16. Accessed 2-11-18.
12. National Institutes of Health. Office of Dietary Supplements. Vitamin B12 Fact Sheet for Health Professionals. https://ods.od.nih.gov/factsheets/VitaminB12-HealthProfessional/  Updated 2-11-16. Accessed 2-11-18.
13. American Heart Association. Monounsaturated fats. https://healthyforgood.heart.org/eat-smart/articles/monounsaturated-fats  Updated 3-24-17. Accessed 2-11-18.
14. American Heart Association. Saturated fat. https://healthyforgood.heart.org/eat-smart/articles/saturated-fats  Updated 3-24-17. Accessed 2-11-18.
15. Morris MC. Nutrition and risk of dementia: overview and methodological issues. Annals of the New York Academy of Sciences. 2016;1367(1):31-37. doi:10.1111/nyas.13047.

PDF Handout: Diet and Dementia Handout