Exercise and Mediterranean-type diet combined associated with lower risk for Alzheimer's

Both being more physically active and adhering to a Mediterranean-type diet appears to be associated with reduced Alzheimer's risk, according to a new report in the August 12, 2009 issue of the Journal of the American Medical Association (JAMA).

While previous studies have only investigated the association between either physical activity or diet and Alzheimer's disease risk separately, this new research explored their combined association.

"Often times people who exercise also follow a healthy diet and vice versa. We wanted to tease out which of these two behaviors may be associated with lower risk for AD, or if the combination of the two is associated with decreased risk even further," said Nikos Scarmeas, M.D., lead author of the study and associate professor of clinical neurology in the Department of Neurology, in the Sergievsky Center and in the Taub Institute for Research on Alzheimer's Disease and the Aging Brain at Columbia University Medical Center.

This population-based study in a multi-ethnic community living in Northern Manhattan, observed 1880 elderly subjects, with an average age of 77. The participants were interviewed about their level of physical activity and dietary habits, and their responses were then summarized into two single scores. The study subjects were then followed to observe which subjects went on to develop Alzheimer's over the course of approximately five and a half years.

To learn about their physical exercise routine, participants were queried about their activity during a two week period prior to the interview. The subjects were asked to quantify how many times they engaged in physical activity and for how long. Participants were queried regarding three categories of activities: vigorous activity (i.e., jogging etc), moderate activity (i.e., hiking, bicycling, etc), and light activity (i.e., golfing, gardening, etc).

For the dietary portion of the study, subjects were asked regarding their food consumption over the course of the previous year. Their responses were then grouped into nine food categories, the sum of which represented the Mediterranean-type diet score. A Mediterranean-type diet is typically characterized by high intake of fish, vegetables, legumes, fruits, cereals and monounsaturated fatty acids; relatively low intake of dairy products, meats and saturated fats; and moderate alcohol consumption.

The study found that those subjects who were very physically active had a 33 percent risk reduction of Alzheimer's; those who adhered more strongly to a Mediterranean-type diet had a 40 percent risk reduction. In addition, Dr. Scarmeas and his colleagues found that there was a gradual decreasing risk for Alzheimer's in study participants who were reporting that they were both exercising a lot and following a diet closer to the Mediterranean-type: those subjects had a 60 percent reduction in their risk for developing Alzheimer's disease.

"So it seemed that the more that they were doing in terms of both diet and exercise, the lower was their risk for the disease," said Dr. Scarmeas.