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Dear Colleagues and Friends,
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Non-alcoholic fatty liver disease
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The Mediterranean diet is considered one of the healthiest dietary patterns to prevent diseases, in particular for the reduction of cardiovascular risk factors. Most recently its potential to prevent cognitive decline and neurodegeneration drew particular attention, especially after discovering the molecular mechanisms of how polyphenols, which are abundant in a fruit and vegetable rich MedDiet, alter brain structures. In their review Townsend et al. confirmed the impact of the MedDiet on neuronal health, visible in reduced brain atrophy over aging and protection against metabolic aberrations. Brain glucose metabolism is higher in people with high adherence to the MedDiet and therefore assures sufficient energy supply in neurons preventing onset of neurodegeneration. Besides, cerebral deposition of Aβ protein, an Alzheimer disease related biomarker, was found reduced. Many of these beneficial actions are linked to improved vasculature functioning involving healthy cerebral blood flow, reduced inflammation and oxidative stress. The authors highlight the connection between cardiovascular diseases and neurodegeneration as both share pathological changes in blood vessels as major factor in pathogenesis.
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Further evidence for a neuro-beneficial effect was added by a case-control sample nested within the Nurses' Health Study (NHS) comparing women, between 80 and 87 years old, of exceptionally good episodic memory with participants showing average episodic memory function. An interesting finding was that adherence to MedDiet and physical activity at middle age (52-62 years) particularly stood out as predictors for later memory function. These findings point out first the importance to invigorate a healthy lifestyle including both sports and a high-quality diet and sIn econdly that prevention starts much earlier than disease onset. The association of Meddiet with memory functions confers credibility to the idea that the abovementioned Meddiet related mechanisms of neuroprotection influence clinical outcomes in the long run and sometimes with a certain lag phase as disease progression takes time.
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The combination of physical activity and a healthy diet to prevent decline in cognition was further supported by a new cross-sectional analysis within the Health and Retirement Study. Adding the MIND diet, which is a dietary pattern close to the MedDiet with particular emphasis on intake of leafy greens and berries, to high-intensity physical activity was associated with higher global cognition when compared with high-intensity physical activity only. Unlike the above described findings of the NHS, these analyses imply a relevance of both lifestyle factors for prevention of neurodegeneration at advanced age, too.
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In sum, the MedDiet deserves further promotion as it can slow down cognitive decline and the onset of neurodegenerative diseases. It appears that CVD and neurological diseases share common pathways, some of which are related to vascular pathologies. Therefore, the MedDiet, ideally combined with physical activity, offers a powerful preventive measure to address both public health challenges.
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