The mediterranean way. Should elderly people eat leafy vegetables and beetroot to lower high blood pressure?

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Mediterranean diet and cognitive decline

AbstractObjective:To investigate the possible role of diet in age-related cognitive decline (ARCD) and cognitive impairment of both degenerative (Alzheimer's disease, AD) and vascular (vascular dementia, VaD) origin.Design:Literature review.Results:In an elderly population of southern Italy with a typical Mediterranean diet, high energy intake of monounsaturated fatty acids (MUFA) appeared to be associated with a high level of protection against ARCD. In addition, dietary fat and energy in the elderly seem to be risk factors, while fish consumption and cereals are found to reduce the prevalence of AD in European and North American countries. Finally, the relative risk of dementia (AD and VaD) was lower in the subjects of a French cohort who drank three or four glasses of red wine each day compared with total abstainers.Conclusion:Essential components of the Mediterranean diet – MUFA, cereals and wine – seem to be protective against cognitive decline. As such, dietary antioxidants and supplements, specific macronutrients of the Mediterranean diet, oestrogens and anti-inflammatory drugs may act synergistically with other protective factors, opening up new therapeutic interventions for cognitive decline

Apolipoprotein E (APOE) polymorphism influences serum APOE levels in Alzheimer's disease patients and centenarians.

Vascular factors may play a role in the etiology of Alzheimer’s disease (AD) and increased serum apolipoprotein E (APOE) levels in AD could be of interest, as APOE concentration is associated with vascular disease. Aims of this study were to evaluate the inluence of APOE genotype on serum APOE levels, and, secondly, to study serum APOE concentrations in relation to age and AD. APOE genotypes, serum total cholesterol, LDL cholesterol, HDL cholesterol, total cholesterol/HDL cholesterol ratio, triglycerides, and serum APOE were performed on 52 healthy centenarians, 49 AD patients, 45 age-matched controls, and 72 young healthy adults. In all study population a significant trend in reduction of serum APOE levels from APOE E2- to E4 carriers was observed.The diffeerence in serumAPOE levels amonga ge groups signi¢cantly decreased in E4 carriers only, includingH DL cholesterol; no significant differences between AD patients and age-matched controls were found. In these highly selected populations, APOE genotype distribution strongly influences serum APOE concentration, not suggesting, at present, a possible role as a biochemical marker for AD, but only as a putative longevity factor

Vascular risk and genetics of sporadic late-onset Alzheimer's disease.

In recent years, it is becoming apparent that genes may play an important role in the development of late-onset Alzheimer’s disease (LOAD), and genetic studies could unravel new clues. Based on a growing vascular hypothesis for the pathogenesis of LOAD and other dementias, there is increasing interest for environmental and genetic vascular factors. Polymorphisms in different susceptibility genes already implicated in vascular disease risk are now also being suggested as possible genetic markers for increased risk of developing LOAD; however, many of these studies have shown conflicting results. Thus far, the apolipoprotein E (APOE) gene seems to be the only vascular susceptibility factor that is agreed to play a role in the multifactorial pathogenesis of AD although emerging genetic and biological evidence is now strengthening the case for additional inclusion of angiotensin I-converting enzyme 1 (ACE1) into this category. This review will focus on the current knowledge on genetic and nongenetic vascular factors likely to be involved in LOAD, with special emphasis placed on the APOE and ACE1 genes

Hemostasis and Thrombosis

Hemostasis is a complex phenomenon involving numerous coagulation factors. These factors circulate as inactive zymogens (inactive enzyme precursor) and act by cleaving downstream proteins so that they become active enzymes. The role of FVII in secondary hemostasis while forming a complex with TF is of primary importance. It was thought that the two pathways of coagulation cascade, the intrinsic (platelet) pathway and the extrinsic (FVII) pathway were equally important, but it is now known that the primary pathway for the initiation of blood coagulation is the TF-activated extrinsic pathway. FVII has a pivotal role in activating the common pathway of the clotting cascade and thrombin formation. The Mediterranean Diet, (MeD) Extra Virgin Olive Oil (EVOO), and polyphenols have been shown to affect several coagulation factors. The circulating level of FVII is deeply influenced by diet. There is a substantial increase in FVII circulating levels in the postprandial phase. The intake of dietary fat is the main determinant of the postprandial FVII plasma level. The ratio of Saturated Fatty Acids to Mono-Unsaturated Fatty Acids (MUFA) is crucial to postprandial levels of FVII. Diets rich in MUFA (i.e., olive oil, are associated with a significantly lower postprandial peak level of FVII and likely explain the lower rates of Coronary Heart Disease (CHD). in countries in which the diet is habitually rich in MUFAs, such as the Southern European countries. Gene polymorphisms in the FVII promoter region modulate FVII circulating levels. Some of these polymorphismsare associatedwithlower levels of circulating FVII. Also, platelet activity is influenced by diet. The n-3 Polyunsaturated Fatty Acids (PUFAs) Eicosapentaenoic Acid (EPA) and Docosahexaenoic Acid (DHA) actively reduce platelet aggregation. This effect results from several mechanisms (i) competition with arachidonic acid, replacing active TxA2 with TxA3; (ii) inhibition of cyclooxygenase; and (iii) a direct antagonistic effect on the TxA2e prostaglandin H2 receptor in human platelets. Polyphenols of EVOO, particularly luteolin, also reduce platelet aggregability, acting as an inhibitor of platelet PDE3. Probably the most exciting data are those concerning the effects of the MeD in modulating gene expression. Dietary interventions have been demonstrated to modulate the expression of pro-atherothrombotic and inflammation genes actively even in high-risk populations. SFAs upregulate both proinflammatory and proatherothrombotic genes, whereas the MeD, EVOO, and polyphenols downregulate the expression of these genes. The MeD, which is rich in olive oil, MUFAs, and polyphenols were demonstrated to exert a modulatory effect toward a protective mode on genes related to chronic degenerative diseases, oxidation, inflammation, and thrombosis (modulating the activity of TF, TFP1, and thrombin). The phenolic compounds present in EVOO appear to be responsible for the transcriptomic effects, as demonstrated in randomized, controlled human studies in which similar olive oils, but with different phenolic contents, were tested

The Mediterranean way: why elderly people should eat wholewheat sourdough bread-a little known component of the Mediterranean diet and healthy food for elderly adults

Sourdough bread has been considered a healthy food since as far back as ancient times. The wheat used is ground in stone and not in roller mills that destroy some of the nutrients in wheat germ (vitamins, minerals and enzymes). It is made using a sourdough starter composed of natural yeast and lactobacilli (beneficial bacteria). Left to rise for 7–8 h and then baked, the bread contains all the nutrients present in whole grains and, in particular, those in wheat germ. In addition to high-quality proteins and essential fatty acids, it contains a wealth of vitamins and minerals. Sourdough bread, in fact, provides vitamin-E, vitamin-B1, B6, B12, thiamin, niacin, folate, riboflavin, potassium, zinc, iron, magnesium, selenium, calcium, phosphorus and manganese. The bread’s numerous beneficial effects are for the most part linked to two of its peculiar characteristics: the sourdough starter and wheat germ

Increasing Our Understanding of How Dietary Components Can Affect Cellular Mechanisms That Regulate Aging and Slow the Onset of Frailty and Chronic Diseases

The current average life expectancy at birth is well over 80 years [...

Benefits of the Mediterranean Diet in the Elderly Patient

This book illustrates the role of Mediterranean diet in connection with well-being and particularly its impact on health and elderly care, as well as on the mechanisms of aging. Aging is a natural process of human life. The knowledge that a healthy dietary regimen like the Mediterranean diet can effectively prevent or delay many diseases typically affecting aging people may help to better manage the aging process. From this point of view, knowledge of the numerous benefits of the Mediterranean-style diet may effectively promote better management of the burden of elderly care. As early as the 1950s, Ancel Keys pointed out the effectiveness of the Mediterranean diet in helping to control, and possibly avoid, myocardial infarction and/or cholesterol metabolism. Quite soon after the first studies were published, it became clear that the Mediterranean diet was beneficial not only in connection with cardiovascular disease but also many other diseases, from diabetes to hypertension, from cancer and thrombosis to neurodegenerative diseases, including dementia. Examining those benefits in detail, this book offers a valuable educational tool for young professionals and caregivers, as well as for students and trainees in Geriatrics and Nutrition

The Mediterranean Diet Reduces the Risk and Mortality of the Prostate Cancer: A Narrative Review

Prostate cancer is the second most common cancer in the world among men, and is the fifth most common cause of cancer death among men. The aim of our review was to analyze observational and case–control studies to point out the effects of overweight and diets components on the cancer risk, particularly on risk of prostate cancer, and the effect of the Mediterranean diet (MD) on the reduction of risk and mortality of prostate cancer. It is known that incidence and progression of cancer is multifactorial. Cancer of the large bowel, breast, endometrium, and prostate are due also to a high body mass index and to high consumption of high carcinogenic dietary factors, as red and processed meat or saturated fats rich foods, and to a low consumption of vegetables and fruits. Previous meta-analysis suggested that high adherence to diet model based on the traditional MD pattern gives a significant protection from incidence and mortality of cancer of all types. The main component of the MD is olive oil, consumed in high amount by Mediterranean basin populations. In addition, phenolic compounds exert some strong chemo-preventive effects, which are due to several mechanisms, including both antioxidant effects and actions on cancer cell signaling and cell cycle progression and proliferation. The protective effect of the MD against the prostate cancer is also due to the high consumption of tomato sauce. Lycopene is the most relevant functional component in tomatoes; after activating by the cooking of tomato sauce, it exerts antioxidant properties by acting in the modulation of downregulation mechanisms of the inflammatory response. MD, therefore, represents a healthy dietary pattern in the context of a healthy lifestyle habits. In conclusion, our narrative review allows us to reaffirm how nutritional factors play an important role in cancer initiation and development, and how a healthy dietary pattern represented by MD and its components, especially olive oil, could exert a protective role by the development and progression of prostate cancer