Advanced Mediterranean Diet

“Aspirin use in healthy elderly persons did not prolong disability-free survival over a period of 5 years but led to a higher rate of major hemorrhage than placebo.”

Source: Effect of Aspirin on Disability-free Survival in the Healthy Elderly | NEJM

I hesitated to link to this story about a porn star, but decided to do it anyway. You judge her lifestyle for yourself.

Looks to me like she could use some weight training.

From Fox News:

“For dinner, Jameson, 44, says she prepares salmon in the oven with lemon, butter and dill around 5 p.m. and serves it with broccoli or asparagus.

Jameson also noted that she doesn’t mix meat and dairy because she eats Kosher, but says her followers should feel welcome to do so.The blonde bombshell, who welcomed daughter Batel Lu in April 2017, says that when she’s hungry, she eats, particularly because she’s breastfeeding — but that she makes it a point to avoid keto breads and snacks and focus solely on whole, organic foods.

The “How to Make Love Like a Porn Star” author has shared her weight loss progress for months.”

Source: Jenna Jameson shares keto diet tips after 80-pound weight loss | Fox News

Is this the diet she used?

“Honey, let’s talk to doc about stopping those drugs.”

I commonly admit patients to the hospital who happen to be taking either Aricept or memantine (or both) in an effort to slow the cognitive decline of dementia. Aricept is a cholinesterase inhibitor, abbreviated ChEI below.

A meta-analysis published in November 2018 in JAMA Network suggests that folks taking those drugs have a more rapid cognitive decline compared to those who don’t. Moreover, the rate of decline for those taking memantine, with or without ChEIs, was faster than those receiving ChEIs only or receiving neither medication.

A typical dose of Aricept (donepezil) is 10 mg/day. The average wholesale price for that pill is $20.23 (USD). One brand of memantine is called Namenda, and the usual dose is 10 mg twice daily. Average wholesale dose for that is $17.80/day.  Take both those drugs daily for one month and it’s $1,140.90. Or $13,690.80 for a year. And that’s the wholesale price.

I can think of a few better uses of that money.

Admittedly, there must be individual patients that respond better than average to these drug, and some respond worse than average. You can’t tell in advance who those are.

Click the link below for the full study. From the Abstract:

Results

Across 10 studies, of 2714 participants, the mean (SD) age was 75.0 (8.2) years, 58% were female, and 9% were racial/ethnic minorities. There were 906 participants (33.4%) receiving ChEIs, 143 (5.3%) receiving memantine, 923 (34.0%) receiving both, and 742 (27.3%) receiving neither. Meta-analysis showed those receiving ChEIs or memantine were associated with significantly greater annual rate of decline on the ADAS-cog [a test of cognition] than those receiving neither medication (1.4 points/y; 95% CI, 0.1-2.7).

Conclusions and Relevance

Similar to observational studies, many participants in AD clinical trials receiving ChEIs or memantine experience greater cognitive decline. This difference is nearly as large as the hypothesized effect sizes of the treatments investigated in the trials. Concomitant use of ChEIs or memantine may be confounded with outcomes on the ADAS-cog and should be considered in design of clinical trials of potential therapeutic agents for AD. Post hoc analyses stratifying by ChEIs or memantine must be interpreted cautiously given the potential for confounding.

Source: Association of Concomitant Use of Cholinesterase Inhibitors or Memantine With Cognitive Decline in Alzheimer Clinical Trials: A Meta-analysis | Dementia and Cognitive Impairment | JAMA Network Open | JAMA Network

From Dr Georgia Edes:

“A new study conducted at the University of Sydney and published in the journal Cell Reports is inspiring headlines around the world, like this one: “Low-protein, high-carb diet may help ward off dementia”

In the study, scientists compared diets containing different amounts of protein and carbohydrate to a low-calorie diet. Their results suggested that diets lower in protein and higher in carbohydrate may, in some cases, provide subtle brain benefits similar to the benefits seen with calorie restriction. The researchers concluded, “A very low-protein, high-carbohydrate diet may be a feasible nutritional intervention to delay brain aging.”

Source: The Truth About Low-Protein, High-Carb Diets and Brain Aging | Psychology Today

This is ground-breaking research if you’re a mouse.

No surprise here:

“A review of studies that looked at the effect of the Mediterranean diet on long-term cognitive function established that people who adhered to this way of eating had less cognitive decline, had improvements in cognitive function, or were less likely to develop Alzheimer’s disease compared to people who did not stick to this diet. The Mediterranean diet emphasizes fruits, vegetables, whole grains, beans, nuts, fish and olive oil, with lesser amounts of poultry and cheese and limited amounts of red meat and sweets.”

Source: Keeping Alzheimer’s Disease at Bay – Diabetes Self-Management