MedicalResearch.com Interview with:

Emily Y. Chew, M.D.Director of the Division of Epidemiology and Clinical ApplicationsDeputy Clinical Director at the National Eye Institute (NEI),National Institutes of Health

MedicalResearch.com: What is the background for this study?

Response: Dementia is a common disorder that was estimated to have a worldwide prevalence of 44 million in 2016 and is projected to hit 115 million by 2050. Many phase 3 trials of various therapies have failed and we have no treatment currently available for the prevention or reduction of the course of dementia. A slow neurocognitive decline throughout life is part of the normal process of aging. However, there is a subset of individuals who may have accelerated aging and is at high risk of development dementia. If the course of such accelerated decline could be altered in any way, it would be important to evaluate. The role of diet with biologic aging has been studied and diet has been also found to be associated with age-related conditions linked to dementia, including cardiovascular disease and diabetes.

We were interested in the cognitive function of our participants who had another neurodegenerative disease, age-related macular degeneration (AMD). We had conducted two randomized controlled clinical trials designed to evaluate the role of oral supplements for the treatment of AMD. We also studied cognitive function in both clinical trials of nearly 8,000 participants who were followed for 10 years. We also evaluated the dietary habits of the participants with food frequency questionnaires (FFQ) at baseline. Cognitive function testing was conducted in the first study, the Age-Related Eye Disease Study (AREDS) near the end of the clinical trial while the AREDS2, the second study, evaluated cognitive function testing at baseline and every 2 years until year 6. AREDS study evaluated cognitive function with in-clinic study visits while AREDS2 was conducted using telephone interviews.

Our aim was to determine whether closer adherence to the alternative Mediterranean diet (aMED) was associated with impaired cognitive function these two studies. We were interested in the particular components of the Mediterranean diet that may be important. We also evaluated the interaction of genetics with the diet.

MedicalResearch.com: What are the main findings?

Response: Mediterranean diet adherence was associated with decreased risk of cognitive impairment. There was a dose response relationship in that the higher the adherence, the better the beneficial effect. The results were consistent between the two clinical trials of persons who did not have cognitive impairment at the baseline of the study but did have varying degrees of severity of AMD. The strength of this relationship of diet with cognitive function was fairly large with 40 to 50 % reduction.

Higher fish consumption was associated with decreased risk of cognitive impairment and slower cognitive decline. Fish may be the component that drives the effects of the Mediterranean diet on cognitive function to a certain extent. But in general, the Mediterranean diet with all its components may play a very important role in cognitive function.

MedicalResearch.com: What role did theApoE gene have on the results?

Response: Although APOE risk haplotypes were significantly associated with faster decline in cognitive impairment scores (p<0.0001) in general, APOE status did not influence the association of the Mediterranean diet with decreased risk of cognitive impairment and nor did it have an influence on the association of fish consumption with decreased risk of cognitive impairment and slower cognitive decline.

MedicalResearch.com: What should readers take away from your report?

Response: It is important to consider possible modification with your diet. These are not the results of a randomized trial but the data are quite compelling. And other studies have supported this theory that you are what you eat. Eating fish twice a week has beneficial effects and having a Mediterranean diet has been demonstrated to reduce the risk of heart disease and impairment in cognition.

MedicalResearch.com: What recommendations do you have for future research as a result of this study?

Response: This is a study of association so it would be important to have randomized controlled clinical trials to test the effect of a Mediterranean Diet on cognitive function. A randomized trial (PREDIMED) conducted in Spain with comparisons between Mediterranean diet vs. low fat diet found that participants randomized to a Mediterranean diet had higher cognitive function scores after 6.5 years than those randomized to a low-fat control diet. The NIH is also supporting the Mediterranean-DASH Diet Intervention for Neurodegenerative Delay (MIND) Study. This is a Phase III randomized controlled trial designed to test the effects of a 3-year intervention of a hybrid of the Mediterranean and DASH diets, called MIND, on cognitive decline among 600 individuals 65+ years without cognitive impairment who are overweight and have suboptimal diets, as described the clinicaltrials.gov. That would be the gold standard for establishing a potential treatment for cognitive impairment. This study is done in persons who are high risk of developing cognitive decline.

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Effect of Mediterranean Diet on Cognitive Function in Patients with Age-Related Eye Disease - MedicalResearch.com

Life expectancy cannot be predicted with absolute certainty but informed predictions can be made based on your overall lifestyle. That's because the leading causes of death in the world are mostly attributed to unhealthy lifestyle habits. The most obvious being heart disease, which is directly caused by eating an unhealthy diet.

Committing to a healthy diet can therefore provide some guarantee of a long life.

There is no single miracle worker but evidence suggests certain ingredients provide numerous health benefits so it would be wise to include them in your diet.

One such superfood is sage, a staple herb used to spruce up various dishes.

Sage has shown promise in combating the mechanisms that may lead to serious health conditions, such as heart disease.

READ MORE:How to live longer: Limit one necessary, daily activity to increase your lifespan

The herb has been shown to lower LDL cholesterol, a fatty substance that is a precursor to heart disease.

In one study, consuming sage tea twice daily lowered bad LDL cholesterol and total blood cholesterol while raising good HDL cholesterol after just two weeks.

HDL cholesterol counters the negative effects of LDL cholesterol by transporting the harmful cholesterol to your liver where it is flushed out of your body.

The perennial herb has also been shown to lower blood sugar and increase insulin sensitivity, factors that underpin type 2 diabetes, another precursor to heart disease.

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In one study, sage leaf extract lowered blood sugar and improved insulin sensitivity with comparable results to rosiglitazone, another anti-diabetes drug.

Another study in mice with type 2 diabetes found that sage tea acts like metformin a drug prescribed to manage blood sugar in people with the same disease.

What's more, it may boost memory and brain health, factors that may reduce the risk of developing Alzheimer's disease, a degenerative brain condition.

In one study, 39 participants with mild to moderate Alzheimers disease consumed either 60 drops (2 ml) of a sage extract supplement or a placebo daily for four months.

Those taking the sage extract performed better on tests that measured memory, problem-solving, reasoning and other cognitive abilities

The benefits are partly attributed to the compounds found in sage, which can act as antioxidants.

Antioxidants are compounds that intercept unstable molecules called free radicals in the body.

Free radicals cause cell damage and are associated with the negative effects of ageing, such as brain decline.

In addition to packing your diet with healthy items, it is important to exercise regularly to ward off heart disease and other serious health conditions.

"Regular exercise will make your heart and blood circulatory system more efficient, lower your cholesterol level, and also keep your blood pressure at a healthy level," explains the NHS.

It also helps you to maintain a healthy weight, which is also essential for longevity.

Obesity is linked to heart disease, type 2 diabetes and some types of cancer, warns the NHS.

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How to live longer: Sprinkle this 70p herb on your meals to increase your life expectancy - Express

SCOTS have been urged to give up smoking and cut down their alcohol consumption in a bid to reduce complications linked to conroavirus.

The countrys interim chief medical officer, Dr Gregor Smith, has called on people to cut their intake of alcohol and tobacco during the lockdown to reduce the likelihood of becoming more unwell if they contract Covid-19.

Dr Smith had called on the public to enjoy a balanced diet during the lockdown.

He said: Now more than ever, its important that we all take the steps possible to look after ourselves. Eating well, staying active are really important for both our physical health and our mental wellbeing.

Eating a balanced, healthy diet which includes a variety of different foodswill help ensure that you get all the essential nutrients and energy you need throughout the day. Foods an important part of our daily lives and something that many of us enjoy.

Dr Smith has he understood many found it tempting to turn to cigarettes or alcohol during times of stress, such as the lockdown.

He said: This is a stressful time for people. Sometimes, when we feel this way, we use substances like tobacco or alcohol more than we usually do.

READ MORE:Coronavirus in Scotland: SNP MSP says Covid-19 could have 'positive impact'

We know that both these habits can be harmful - particularly in relation to coronavirus.

Evidence suggests that smoking may contribute to the severity of Covid-19 disease. We know that people who smoke are much more likely to experience other respiratory infections such as flu.

READ MORE:Warning over 'backlog of surgeries' that could 'break' NHS as 72% cut in urgent cancer referrals revealed

Please, if you can, try to cut down or even stop your smoking. If you continue, please remember to wash your hands before and after so that theres less opportunity for the virus to spread.

He added: Alcohol can also reduce the immune systems ability to fight off infectious disease and also have an impact on your heart and your lungs.

Choosing to cut back on how much you drink may reduce some of the complicationslinked to coronavirus.

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Coronavirus: Scots told to give up cigarettes and reduce alcohol from lockdown diet - HeraldScotland

There is no single food item that can prevent or cure coronavirus (COVID-19) at present, the Dietitians Association of Nigeria has said.

The association, however, said an adequate diet would help support the bodys immune system to fight infections. It said its attention was drawn to several claims regarding nutrition and COVID-19, and that dietitian-nutritionists have also received several questions concerning what to eat to prevent coronavirus infection.

The dieticians said their association and relevant regulatory agencies have also not approved any single supplement or combinations to prevent, treat or cure COVID-19. There is no evidence that any supplement or health product will protect the body against the coronavirus.

Nigerians are hence advised to be wary of unregulated supplement claims, the association said in a statement signed by its National President, Prof. Elizabeth Kanayo Ngwu.

Nutrition, immunity and COVID-19

The dieticians said the immune system depends on both macro and micro-nutrients (substances in foods) for proper functioning and as such, many nutrients were involved in the proper functioning of the immune system.

These nutrients cannot be sourced from a single food rather by consuming a variety of healthy foods. A healthy diet will, therefore, strengthen the immune system and enable it to play its role of defending the body against infections and fight diseases. Examples of these nutrients include proteins, vitamins A, B6, B12, C and D, copper, folate, iron, selenium and zinc, omega 3 and omega 6 fatty acids, etc, they said.

They advised that to obtain these nutrients, food selection should be done from different food groups and that these groups are:

Cereals and grains: The foods in this group include rice, maize, wheat, bread, pasta, hungry rice (acha), sorghum and others.

Roots, tubers and plantain: Examples of foods in these groups include yam, cassava, garri, fufu, plantain, alubo and others.

Legumes and nuts: Examples of foods in this group include beans, bambaranut (okpa), yam, bean (Azam or Ijiriji or Ozaki), soybeans, walnut, cashew nut, groundnut and others.

Meat, poultry and fish: Examples include beef, chicken, eggs, fish and meat.

Milk and milk products: These include milk, yoghurt, cheese, nono, and other milk products.

Fruits: include banana, avocado pear, mango, watermelon, pawpaw, orange, apple, African star apple (udara or agbalumo), Velvet Tamarind (icheku, awin, tsamiya) and many other common ones in various states.

Vegetables: include all leaves used in cooking meals, carrots, garden eggs, cucumber, green beans, onions and many others.

Water: Drink clean uncontaminated water, at least three litres a day (about six sachets). Do not wait until you are thirsty.

According to the experts, in order to keep the immune system functioning optimally, people should maintain the consumption of an adequate diet with lots of variety.

An adequate diet should supply nutrients such as proteins, carbohydrates, fibre, vitamins and minerals, among others in the right quality and quantity. Fruits and vegetables are especially important; selecting a colourful array; such as carrots, green leafy vegetables, fresh tomatoes, oranges, will provide you with vitamins which play important roles in immune function.

Once you are consistent with an adequate diet and maintain a healthy lifestyle (exercise, not smoking, adequate sleep, managing stress etc.) you would not need any supplement marketed around COVID-19.

The dieticians association also called on the government to come to the aid of Nigerians who could not afford food to eat, especially numerous daily wage earners and unemployed youths.

While citizens do their best to stay at home to help reduce the spread of the disease, it is also important that necessary measures be taken to cushion the effects of staying at home, especially as it concerns food supplies to the poor, the association said.

Food safety and hygiene

The dieticians said there was no evidence to suggest that COVID-19 was transmitted through food handling or food preparation, adding that the primary aim of food safety and hygiene was to prevent food poisoning and other food-borne illnesses.

Poor food handling and inadequate food safety can cause infections especially in young children, older adults, pregnant women and people with weakened immune system, they stated.

They said some of the ways to maintain adequate food safety and hygiene include:

Washing hands thoroughly with soap and running water.

Cleaning surfaces regularly with disinfectant.

Keeping appliances clean.

Washing food products like fresh vegetables and fruits with salt and water (under running water if available) before usage.

Use separate cutting boards for raw meats, vegetables and cooked foods.

Keep hot food hot and cold food cold.

Protective measures against coronavirus

They advised the public to protect their health and that of others by doing the following:

Wash your hands regularly and thoroughly with soap and water for at least 20 seconds.

Sanitise with an alcohol-based hand rub or sanitiser. This would kill viruses that may be on your hands.

Maintain social distancing. This means keeping at least two metres (six feet) distance between yourself and anyone who is coughing or sneezing, to protect you from liquid droplets which may contain the virus from coughs or sneezes of people who may have coronavirus disease.

Avoid touching eyes, nose and mouth unnecessarily. The hands pick up viruses from surfaces and once contaminated, can transfer the virus to the eye, nose or mouth and make you sick.

Practice respiratory hygiene. This means covering your mouth and nose with your bent elbow when you cough or sneeze. If you use tissue, dispose of it immediately.

The dieticians also advised the public to improve physical and mental activity as they remained in the confines of their homes. There is the need to find space for little indoor exercises appropriate for our age and physiological states, eg aerobics, rope skipping etc.

You are also encouraged to exercise your mind and emotions for general wellbeing through games like ludo, scrabble, chess etc. Reach out to loved ones and engage in heart-warming and cheerful conversations.

They advised the public to receive information on nutrition from trustworthy sources, adding that Registered Dietitians-Nutritionists (RDNs) are the health professionals trained in providing evidence-based information and individualised dietary advice/counselling.

Related

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COVID-19: Diets that boost immune system - Experts - Daily Trust

Operation Transformations Aoife Hearne has told people that they should stop trying to lose weight at the moment.

The dietician said that although people may think its the perfect time to cut back due to being stuck at home, now isnt a good time to focus on weight loss.

She revealed that is important not to be too restrictive during these complicated times.

I think this is potentially a high-risk time for people to get sucked into the diet mentality, she told the Irish Daily Mirror.

Id really encourage people to not even have weight as a focus to get through this. I think if we are focusing on that, it actually doesnt help long term.

Many of us are gaining COVID kilos and it is so hard right now. We are being bombarded with so much information and much is very negative.

When it comes to eating, peoples expectations at the moment are too high.

This is not being perfect with our eating. It is about eating as well as we can and allowing the treats because they are going to come in.

This is all about survival in my mind.

Aoife Hearne was back on our screens last week as Operation Transformation returned for a new spin-off show.

It focused on the different ways that people can keep their minds and bodies healthy while staying at home.

During the show, viewers were introduced to a number of households around the country and the different ways they were surviving and keeping themselves busy.

Viewers loved Operation Transformation: Keeping Well Apart and took to social media to gush over the show.

Well done to everyone #OTKWA, one fan wrote.

That was a really great show which I think will really resonate with lots of people right now. Compassionate, supportive and nonjudgmental. Looking forward to next episode already.

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Operation Transformations Aoife Hearne explains why you DONT need to diet right now - Extra.ie

Eating a diverse and varied diet provides the best chance of boosting the immune system to fight Covid-19, according to a scientist.

Philip Calder, a professor of nutritional immunology at the University of Southampton, has produced a report advising the public to ensure they eat a mixed diet to help combat the virus.

His research also shows that supplements are a safe, effective and low cost way to support an optimal immune system.

A university spokesman said: A diet with a diverse and varied mixture of vegetables, fruits, nuts, seeds and pulses, along with some meat, fish and dairy products provides the vitamins, minerals and other nutrients the immune system needs for optimal function.

Prof Calder said: The strength of somebodys immune systems will not influence whether they get coronavirus; handwashing and social distancing are the best ways to avoid that.

However, the immune system helps the body deal with the virus if they are infected and what we want is a system that functions properly when its challenged with bacteria and viruses.

The university spokesman added: Among the foods Professor Calder recommends are a variety of fruits and vegetables which are a good source of vitamins and minerals that are important for supporting the immune system.

Foods that are high in fibre are also important as some of the undigested fibre in the gut can promote the growth of good bacteria which interact with the immune system to make it work better.

The third recommendation is oily fish which is a source of omega 3 fatty acids that help to regulate and control the immune system.

Finally, meat is important as a good source of nutrients such as iron and vitamin B12, so people who do not eat meat should consider supplements.

Whilst consuming commercial probiotic products can have a role to play by seeding good bacteria in the gut Professor Calder recommends plant-based food and fibre as an alternative as these provide an environment to grow the good bacteria that are already in the large intestine.

Professor Calder added: The present situation with Covid-19 shows that we cannot just rely on vaccinations to limit the impact of respiratory infections.

Improving our nutrition is a very straightforward step that we can all take to help our bodies deal with infections and limit the emergence of new, more virulent strains of viruses.

We therefore strongly encourage public health officials to make sure nutritional strategies are included in all their messaging about coping with viral infections.

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Eating a varied diet help fight the Covid-19 virus, says university professor - NW Evening Mail