People who followed the diet were up to 40 percent less likely than those who largely avoided it to develop Alzheimer's during the course of the research.
Still, more research must be done before the diet can be recommended to ward off Alzheimer's, said Dr. Nikolaos Scarmeas of the Columbia University Medical Center in New York, lead author of the research.
The diet he tested includes eating lots of vegetables, legumes, fruits, cereals and fish, while limiting intake of meat and dairy products, drinking moderate amounts of alcohol and emphasizing monounsaturated fats, such as in olive oil, over saturated fats. Previous research has suggested that such an approach can reduce the risk of heart disease.
The idea that a heart-healthy diet could also help fight Alzheimer's fits in with growing evidence that "the kinds of things we associate with being bad for our heart turn out to be bad for our brain," said Dr. Marilyn Albert. The list includes high cholesterol, high blood pressure, obesity, smoking and uncontrolled diabetes.
So it makes sense that a diet low in saturated fats and cholesterol would reduce the risk of Alzheimer's, said Albert, who was not involved in the new study.
Scarmeas and colleagues followed 2,258 elderly residents of northern Manhattan for an average of four years. The participants were asked in detail about their dietary habits and evaluated every 18 months or so for signs of dementia. None showed any dementia at the start of the study, but by the end, 262 had developed Alzheimer's.
To look for an effect of diet, the researchers gave each participant a score of 0 to 9 to nine on a scale that measured how closely they followed the Mediterranean diet. Compared to those showing the lowest adherence, those who scored 4 or 5 showed 15 percent to 25 percent less risk of developing Alzheimer's during the study, while those with higher scores had about 40 percent less risk.
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