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Mediterranean and 3 other diet types may lower dementia risk, especially in women

Mediterranean and 3 other diet types may lower dementia risk, especially in women

Many factors can affect a person's risk of developing dementia later in life.Research has shown that diet is one factor that might influence dementia risk. One study suggests that following certain diets, like the Mediterranean diet, could decrease dementia risk, while pro-inflammatory diets may increase risk. Can what people eat affect their dementia risk? A new study suggests that this may likely be the case.Researchers explored in depth how certain dietary habits are related to dementia risk. Using data from the UK Biobank, the results confirm the benefits of dietary patterns like the Mediterranean diet and the MIND diet and suggest that inflammatory diets may increase someone's chances of developing dementia.The results also indicate that the impact of diet on dementia risk may be more significant for women and older adults. The study was published in The Journal of Nutrition, Health and Aging.How diets affect dementia riskThis study examined diet and dementia risk while also considering the impact on people with certain characteristics, such as obesity or older age. Researchers evaluated participants' diets based on several scoring indices. One looked at adherence to the Mediterranean diet, and another at adherence to the Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) diet. The MIND diet combines the DASH and Mediterranean diets and focuses on components like nuts, leafy vegetables, and berries. Next was the Recommended Food Score, which helps evaluate diet quality based on how much people eat certain foods like lean meat, low-fat dairy, fruits, and vegetables. There was also the Alternative Healthy Eating Index-2010, which looks at how well someone is following American Dietary Guidelines. Finally, researchers also used the Energy-adjusted Dietary Inflammatory Index (EDII) to look at how inflammatory diets were. This index considered components like some vitamins and minerals and components like alcohol and fat intake. Researchers then divided dietary index scores into four groups. They also considered covariates, including physical activity, smoking, and body mass index. Researchers were able to analyze data from 131,209 participants, who did not all have a baseline dementia diagnosis. They then had exact matching in each of the five dietary categories for sex and age. Exact matching is a strategy used in cohort studies that can help with confounding. At baseline, the average age of participants was age 56. The average follow-up time was 13.5 years, and throughout the follow-up, 1,453 participants developed dementia. Which diets lowered dementia risk the most?Overall, participants with the lowest scores for the Mediterranean diet, the MIND diet, and the Recommended Food Score experienced the 'highest incidence of dementia.' Researchers also observed that those with the lowest inflammatory diet scores and the highest Alternative Healthy Eating Index scores had 'the lowest incidence of dementia after the follow-up period.' However, for these two groups, there were no quartile group differences that reached a significant level. Researchers observed that higher scores for the Mediterranean diet, the MIND diet, the Recommended Food Score, and the Alternative Healthy Eating Index were all linked to decreased dementia risk. Following more of an inflammatory diet was linked to an increased dementia risk. They also found that higher scores for the MIND diet, the Recommended Food Score, and the Alternative Healthy Eating Index were all linked to a decreased risk for mild cognitive impairment. Time was also an important factor. For example, at the less than five-year follow-up, only the MIND appeared to be associated with a decreased dementia risk. At the five to ten-year follow-up, more closely following the MIND diet, the Recommended Food Score, and the Alternative Healthy Eating Index appeared to decrease dementia risk. At the ten-year or more mark, some associations remained significant, such as how greater following of the Mediterranean diet appeared to lower dementia risk by 24%. Does age or sex affect which diet helps?Subgroup analyses looked at sex, age, and obesity. Researchers found that for participants ages 60 and older, more closely following the Mediterranean diet and the Alternative Healthy Eating Index reduced dementia risk, but this wasn't the case for younger participants. The associations with other scoring indexes were still significant regardless of age. For women, closer adherence to all healthy diets and lower inflammatory diet scores all appeared to lower dementia risk. For men, only the Recommended Food Score appeared to significantly decrease dementia risk, and the effects were still better for women.Following the Mediterranean diet appeared to help with dementia risk regardless of weight. A greater inflammatory diet score was associated with an increased risk for dementia in participants with obesity. The other healthy dietary patterns besides the Mediterranean diet helped lower dementia risk for participants who did not have obesity. Finally, researchers looked at how these diets impacted people with the ApoEε4 genotype, which can increase risk for Alzheimer's disease. For non-ApoEε4 carriers, higher scores of all healthy diets helped to decrease dementia risk, and higher inflammatory diet scores increased risk. For ApoEε4 carriers, only adherence to the Recommended Food Score appeared to help decrease dementia risk. Amarish Dave, DO, an osteopathic physician specializing in neurology, who was not involved in the study, commented with his thoughts on the findings: 'This study adds hard numbers to what we know intuitively, which is that healthy diets lower your dementia risk, and inflammatory foods raise it. It confirms that healthy eating patterns matter when it comes to reducing dementia risk. The size and quality of the data make these results hard to ignore.'What the study may be missingThis study adds information regarding potential dietary interventions related to dementia. There are limitations, such as the study was only in participants in the U.K., and some information comes from participant reporting. There may be restrictions on generalizability to other groups, and future research can have more diversity. Any general limitations of the UK Biobank also apply to this study. Researchers note that the self-reporting of food intake increases the risk of recall bias; people can make mistakes such as incorrectly estimating portions and nutrients. They also note the possibility of an underestimation of the association between diet and risk for dementia. Participants were between ages 40 and 69 at baseline, and researchers only did follow-up for a certain timeframe. Researchers suggest that using other follow-up periods and working with diverse age groups could be helpful, as this could reveal variation. Diet information was collected in a narrow window, and researchers did not take into account how participants' diets could have changed during the follow-up. The researchers suggest that examining dietary changes could be helpful in truly looking at the potential long-term impact of diet on people's chances of developing dementia. Some dietary data was lacking. For example, researchers note that they lacked information on how much olive oil participants were consuming, so they weren't able to include this in the scoring when considering the Mediterranean diet. Olive oil is a major component of the Mediterranean diet. Researchers also lacked data from the original Dietary Inflammatory Index, so they only included some elements of this index. The researchers acknowledge that the use of exact matching in this study was also limiting. They explain that 'the estimated effect can only be generalized to a small population and lacks precision.' Finally, there is the risk for residual confounding, which researchers acknowledge could impact 'dietary choices and dementia risk.' Inflammatory diets may raise dementia riskThis study highlights the diet's important role in possibly protecting against dementia. Alex Dimitriu, MD, double board certified in Psychiatry and Sleep Medicine and founder of Menlo Park Psychiatry & Sleep Medicine, who was also not involved in the study, noted the following clinical implications of the research: 'This study speaks to the importance of long-term adherence to diet and the benefits of this. It also demonstrates how diet may play a greater role for older women than for other groups. Also of interest, the study confirms prior findings that pro-inflammatory diets (high in saturated fats, and refined carbohydrates) can be a risk factor for dementia.'The results also suggest the need for doctors to keep discussing diets with their clients. As noted by Dave: 'Doctors should be talking to patients about brain-healthy diets just like we talk about heart health. Eating less processed food and more whole, anti-inflammatory foods could be a powerful tool to prevent cognitive decline. These results show that food should be part of the prescription.'
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'It destroyed my life': The drug addiction leaving users in chronic pain
'It destroyed my life': The drug addiction leaving users in chronic pain

Sky News

timean hour ago

  • Sky News

'It destroyed my life': The drug addiction leaving users in chronic pain

Nicole will always remember the first time she took ketamine. It was the start of a night out and she didn't want to drink. So instead, she picked up the bag of white powder she found in her friend's car. It was a decision that had life-altering consequences. "I tried it and remember having it and just thinking, this is it," she recalls. "This is my saviour. This is my drug." Instead of rescuing her from her mental health struggles like she hoped it would, ketamine sent her into a spiral. Less than four years on, the 31-year-old mother of one from Southport is now living in a detox centre, separated from her son and living in chronic pain. 9:33 Nicole's journey from recreational use to a deep addiction that caused her severe bladder and kidney problems may be just one extreme case, but ketamine use is now at record levels. Experts believe this could cause a tidal wave of issues the country is not prepared for, placing severe pressure on the NHS, as well as addiction and mental health services. Currently a Class B drug, ketamine is used in clinical settings as an anaesthetic for people and animals. It is usually taken recreationally as a crushed powder, but also sometimes injected or swallowed - making people feel detached and dreamlike. Referred to as "ket" and "special k", it's easily available and costs around £30 a gram. Between 2023 and 2024, the number of children and young people who reported having a problem with the drug surpassed cocaine for the first time. The number of ketamine deaths in England and Wales also increased from seven in 2015 to 53 in 2023. 'I don't remember the last three years' I met Nicole at Birchwood, a residential drug and alcohol detox facility on the Wirral. In the week before I arrived, 14 out of 25 beds were taken by ketamine users. As we walk through the corridors, Birchwood manager Jo Moore tells me that in more than two decades of working in healthcare, she's never dealt with a challenge as big as the wave of people she's seeing addicted to ketamine, arriving with extreme and complex health issues. "They're all presenting with urinary incontinence, some can't even walk, they've lost their muscle tone, some are in wheelchairs, and the crippling pain they're going through is significant," she says. As well as running Birchwood, Jo speaks about the drug at conferences and holds a weekly video call, offering support for a growing group of parents whose children are addicted. I also met Callum, who describes himself simply as "just a lad from Cheshire ways". While speaking, he often pauses for thought, struck by how quickly his life has taken a turn since his addiction began three years ago. When his dad died following a struggle with alcoholism, Callum, who had been his carer, turned to ketamine. Until then, the 24-year-old had only taken the drug at festivals, but it quickly took over his life. "I was so out of it constantly," he says. "I don't remember the last three years properly because of just, you know, you've taken it the whole time." Daily use nearly cost Callum his life. He had multiple organ issues and weighed just six stone by the time Jo, who knew his family, told his mother that he needed to come to rehab. Callum's experience is a reminder of how hard it can be to break a dependency on ketamine. As an anaesthetic, it creates a vicious cycle. Users need it to help ease the pain it causes them. "It's only once you get off the ketamine you realise the pain that you've got and the problems that you've got," Callum tells me. "When you're on it, you know you've sort of got pains, but you don't think they're that bad. "People I know drank for 30, 40 years and my liver is worse than theirs, just from ketamine alone." 'Ketamine destroyed my life' Nicole also turned to ketamine because it felt like a way out. She'd had a difficult childhood, been in an abusive relationship as an adult and struggled with mental health issues her whole life. In a moment of blunt honesty, she tells me she does not regret taking ketamine. "If I didn't take ketamine in that period of time, I wouldn't be here," she says. "It was a coping mechanism for a while, before it destroyed my life." As her bladder and kidneys deteriorated, Nicole was taken to hospital several times, often treated by medics who could not understand the problems caused by heavy ketamine use. On one occasion, she was sent home with chlamydia tablets. On another, she had an invasive kidney procedure with no anaesthetic, because doctors were concerned about giving her pain relief due to her ketamine use. Becoming more animated, Nicole tells me: "To be in that situation where you need help, you don't know what's going on yourself, the only place you can go to is the hospital and not even they know what is going on with you. That is like a complete state of isolation, loneliness." Nicole now starts her days in severe agony. She says the chronic pain will last the rest of her life, and pauses at one point in conversation to tell me her bladder is spasming as we speak. Despite how difficult the last few years have been for them, Nicole and Callum both have hopes for their lives beyond Birchwood. In the months after I met him, Callum successfully completed his detox and rehab. He has also made good on a promise to "get his life back on track" by finding a full-time job. Things have been more difficult for Nicole, who is still in Birchwood and has been in and out of hospital for a range of bladder and kidney complications. She is still waiting to find out whether her bladder will be removed. Nicole has made it her mission to raise awareness, posting regularly on TikTok about her appointments and her day-to-day life. Her ultimate hope is to one day join Jo in delivering talks across the country about the drug and its dangers. Life-changing injuries within a year Away from Birchwood, the struggles of people like Callum and Nicole are also being felt in the NHS. Alison Downey is a consultant urologist at Pinderfields Hospital in West Yorkshire, where "ketamine bladder" has become an increasingly common phrase to describe the severe damage the drug can do. "We've seen an explosion in numbers over the past, particularly two to three years," she says. "Maybe about four or five years ago we would have one or two cases a month, we're now seeing eight or nine a month." Ms Downey says while urologists are continuing to learn about the drug's impact, there is one certainty: ketamine causes complex challenges for medics. "There's no other drug that does this amount of damage this quickly to your kidneys and your bladder," she says. "We obviously see patients who have drug addiction problems from heroin and cocaine in A&E or on the wards, but ketamine has this very specific, quick damage to the kidneys and bladder specifically that we just don't see in any other drug use." With balloons and a jug, Miss Downey explains the impact the drug can have on someone's bladder, reducing its capacity. "We know that the average (bladder) capacity of a person that's been using ketamine for a long amount of time is about 100ml, which is about the size of this balloon," she says. "If you compare that to a normal adult bladder, which holds about 500ml, so five of these balloons, you can see that the capacity is severely reduced. That can result in needing to go to the toilet every 15 to 20 minutes throughout the day or night." Framing the issues being seen on the frontline are the ongoing discussions around reclassification. Earlier this year, the government announced it would look into the possibility of making ketamine a Class A drug, which would carry greater penalties for making and selling it. Dr Caroline Copeland is a senior lecturer in pharmacology and toxicology at King's College London and also the director of the National Programme on Substance Use Mortality. For her, this debate is nuanced and needs to go beyond criminalisation. "I think that instead of necessarily focusing on the punitive measures, which is what comes with the reclassification, we need to be thinking more about how we can actually spend that time and money towards helping the people who are using ketamine and education programmes to stop people starting to use ketamine in the first place," she said. Dr Copeland also thinks reclassification needs to be a process that takes into account the wider context, because this is a drug that is commonplace and being used casually by many, without significant health consequences. She added: "Since ketamine was last reclassified from C to B, the landscape of its use has changed somewhat. "There's much more recreational use in a younger demographic. So we need to do a comprehensive assessment of its harms to determine whether it warrants escalating to being a Class A substance." However, for those whose lives have been changed by casual use spiralling into addiction, solutions are needed urgently. I can still remember Jo Moore's words as she walked me out of Birchwood on my first day of filming this story. She sees this as an issue that needs tackling, with a national framework to bring systems together. "We're really trying to fight, because we see the damage," she says. "I've looked after heroin addicts and after 20 years of them using heroin, they don't have anything related to the harm that we've got now for the ketamine users, only after a very short time. "And I think that's what's been so shocking about seeing these ketamine users come through. They can use ketamine for 10 months, two years, and have life-changing injuries. "That's why we're fighting for this. I think that we have all been very slow to react as a nation to these health concerns." Anyone feeling emotionally distressed or suicidal can call Samaritans for help on 116 123 or email jo@ in the UK. In the US, call the Samaritans branch in your area or 1 (800) 273-TALK.

Nurses union to reject pay deal as strike vote looms
Nurses union to reject pay deal as strike vote looms

BBC News

timean hour ago

  • BBC News

Nurses union to reject pay deal as strike vote looms

Nurses will overwhelmingly reject their pay award in England this week, raising the possibility of strikes later in the year, the BBC Royal College of Nursing (RCN) has been holding a consultative vote on their 3.6% pay rise, previously describing it as "grotesque" to award nurses a lower increase than doctors, teachers, prison officers and the armed decision on formal strike action would not be made until later in the government accepted in May the pay review body's recommendations of a 3.6% rise for nurses this year. The union will announce the results of its indicative vote later this week but the BBC understands it will show an "overwhelming" rejection of the turnout is expected to be well over the 50% threshold needed for industrial union will demand ministers negotiate over the summer to avoid a formal ballot for strike action in the RCN is understood to be open to talks on wider pay structures, not just headline pay.A union spokesman said: "The results will be announced to our members later this week. As the largest part of the NHS workforce, nursing staff do not feel valued and the government must urgently begin to turn that around."On Friday the GMB union representing thousands of health workers, including ambulance crews, rejected the government's pay deal in an initial consultative GMB said its members voted by 67% against the 3.6% pay award offered for 2025/26 in union has written to Health Secretary Wes Streeting calling for an urgent meeting to discuss pay and other national secretary Rachel Harrison said: "Our national NHS and ambulance committees met on 24 July to discuss the ballot results and determine what the next steps should be."Today, we have written to Secretary of State Wes Streeting, asking him to meet with us to discuss pay and other issues of significant importance to GMB members."We await his reply with interest."Thousands of resident doctors in England, previously known as junior doctors, began a five-day strike on Friday after the government and the British Medical Association failed to reach an agreement over health secretary said while it was not possible to eliminate disruption to the NHS, it was being kept to a minimum.

Demand for weight loss drugs is becoming unsustainable, say pharmacists
Demand for weight loss drugs is becoming unsustainable, say pharmacists

The Guardian

time2 hours ago

  • The Guardian

Demand for weight loss drugs is becoming unsustainable, say pharmacists

Demand for weight loss drugs is becoming so 'unsustainable' that demand may soon outstrip supply, pharmacists have warned. The National Pharmacy Association (NPA) said supply problems could encourage people to turn to unregulated online sources, despite the risks involved. The number of people in the UK using drugs such as Wegovy and Mounjaro has soared to well above a million, with most patients paying to get them privately. During April, 1.6m packs of Mounjaro and Wegovy were bought in Britain, with the number thought to correlate closely with the number of people using them. 'Spiralling demand for weight loss medication risks going far beyond what is clinically deliverable', the NPA said. The drugs might need to be reserved for those in greatest need because they are so overweight instead of being given to the 'worried well', it added. New polling has found that 21% of Britons have tried to get hold of the medications over the past year, a figure that rises to 35% among 18- to 34-year-olds. The same survey found that 41% of all age groups would use them if they were free on the NHS. This figure rose to 64% among those aged 25-34. Savanta interviewed a representative sample of 2,002 adults aged 18 or over online from 20-23 June for the NPA, which represents 6,000 independent pharmacies. 'Weight loss jabs are one of the biggest drug innovations this century but growing demand for weight loss treatment highlights the need to make sure this is appropriate for those who want it,' said Olivier Picard, the NPA's chair. 'It's clear from this polling that more people are interested in getting weight loss jabs than can benefit from weight loss medication.' Supply of the medicines has been hit by shortages in some parts of the UK, including for higher doses of Mounjaro, the NPA said. Supply has been restricted to some pharmacies, which has stopped some new patients from going on to the drugs. The Medicines and Healthcare products Regulatory Agency, the UK's drugs watchdog, has warned patients to obtain the drugs only with a doctor's prescription, and not from beauty parlours or websites. A Department of Health spokesperson said more people would be able to obtain 'revolutionary' weight loss jabs over the next few years. 'Weight loss drugs are a powerful tool in tackling the obesity crisis head-on as part of our 10-year health plan', they added. 'This government is committed to ensuring that more people have access to these revolutionary drugs when needed, and crucially that they are able to do so in a safe and controlled way. We will ensure that those most in need will receive treatment first.' About 220,000 people in England are due to be offered tirzepatide, a diabetes drug that promotes weight loss, over the next three years. Pharmacies already provide about 85% of all weight loss drugs and need to be closely involved in the expansion of access, Picard added. 'The government should use the massive untapped expertise and skills of pharmacists to help speed up the NHS's weight loss medication programme to millions of the most in need patients,' he said.

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