Mediterranean diet may support both weight loss and bone health

 

According to the International Osteoporosis Foundation, about one in every three women and one in every five men over the age of 50 live with osteoporosis — a disease where bones weaken and become prone to fractures.

Due to rapidly aging global population, studies show that osteoporosis will likely become a bigger burden, with some estimating the amount of osteoporosis-related hip fractures to almost double in 2050, compared to 2018 statistics.

Past studies show there are some ways in which people can help reduce their risk of developing osteoporosis, such as eating a well-balanced diet rich in calcium and vitamin D, not smoking, participating in exercises that strengthen the muscles and bones and maintaining a healthy weight.

New research indicates that a Mediterranean diet may also help improve bone density as well as weight loss results.

The new study found that following a low-calorie Mediterranean diet coupled with physical activity may help reduce weight loss- and age-related bone mineral density decline in older women who have metabolic syndrome and who have obesity or overweight.

This energy-reduced Mediterranean diet is a variation of the traditional Mediterranean diet that contains fewer calories. It still emphasizes healthy foods such as fruits, vegetables, legumes, olive oil and fish, but with controlled portion sizes to support weight loss. The traditional Mediterranean diet is also a healthy dietary pattern, but it is typically food consumed without specific limits on portion sizes.

“As people age, especially women after menopause, BMD (bone mineral density) tends to decline, raising the risk of osteoporosis and fractures, which can significantly affect quality of life and the ability to live independently,” Jesús F. García-Gavilán, a lecturer in the Department of Biochemistry and Biotechnology at the Universitat Rovira i Virgili in Spain, said.

 “The Mediterranean diet has been associated with many health benefits; however, its specific effects on bone health during weight loss and aging have not been thoroughly investigated. Given that physical activity also contributes to maintaining bone strength, we aimed to explore whether combining both in a structured lifestyle intervention could protect against bone loss in older adults, particularly in the context of intentional weight reduction.”

“A reduced-energy Mediterranean diet involves participants consuming a modified version of the traditional Mediterranean diet with approximately 30% fewer calories than their usual intake.”

“Previous research has indicated that losing weight, particularly through diet alone, can lead to a reduction in bone density, which poses risks for older adults. Additionally, exercising alone does not always prevent this issue. What is new in this study is the finding that combining a well-balanced, reduced-calorie Mediterranean diet with physical activity can prevent bone loss in older women, even while they are losing weight,” García-Gavilán said.

“This emphasizes that the type of diet is important during weight loss, not just the calorie intake.”

The new diet was cut to about 30% fewer calories than they typically consumed and only from a Mediterranean-style eating plan.

Upon analysis, researchers found that study participants who followed an energy-reduced Mediterranean diet and increased their physical activity produced significant beneficial effects on BMD, especially at the lumbar level in the lower back, over three years, among women. And it is important to protect the spine, where bone loss can lead to serious fractures and disability.

“This finding is significant because it indicates that weight loss doesn’t have to compromise bone health,” García-Gavilán explained.

However, scientists did report there were no BMD changes observed in male participants.

Mir Ali, a board certified general surgeon, bariatric surgeon and medical director of MemorialCare Surgical Weight Loss Center at Orange Coast Medical Center in Fountain Valley, CA, commented:

“Loss of bone mineral density, especially as you age, can make a person prone to fractures and weakness. And a fracture in older patients, like in their 70s and 80s, can be a very significant thing. Somebody fractures their hip in their 70s, there’s a 20-30% mortality associated with it. So it’s a serious thing, and it’s important to try to reduce that.”

The Mediterranean diet is full of good fats, vitamins, calcium and other minerals that support good bone health.

“The Mediterranean diet is rich in nutrients that promote bone health,” García-Gavilán said. “Nuts and dairy products provide essential calcium, magnesium, and vitamin D. Healthy fats, such as those found in olive oil, have been shown to reduce inflammation.”

Antioxidants such as vitamin C from fruits and vegetables may help protect and support bone cells, García-Gavilán added, while other important vitamins, like vitamin K found in vegetables such as spinach, play a role in bone formation.

“Together, these nutrients can lower the risk of bone loss and support bone maintenance, especially as we age,” García-Gavilán said. “Understanding this nutritional context is crucial for maintaining our long-term quality of life.”

Monique Richard, a registered dietitian nutritionist, recommended:

Mimicking dietary patterns, as culturally appropriate, and accessible, rich in fruits and vegetables, unsaturated fats, lean protein and herbs and spices, such as the DASH diet and Mediterranean Diet, have strong evidence in contributing to overall health and longevity.

Gauging additional dietary and lifestyle behaviors may impact bone health, including soft drink intake, sugar, caffeine, and alcohol intake, as well as whether a person is a smoker, has a genetic predisposition to osteoporosis, osteopenia, and/or specific nutrient pathways affecting absorption and the bone matrix in addition to their current health status.

Moreover, we need to incorporate foods rich in nutrients associated with bone density, such as leafy greens, fruits rich in fiber, fish like sardines, salmon, tuna, tofu, and dairy.

Richard also recommended regularly incorporating weight-bearing movement two to three times a week, such as resistance training using free weights, weight machines, or your own body weight (plyometrics), pilates, yoga and tai chi, in addition to regular aerobic-cardio activity such as walking, running, dancing, or swimming.

“As we age, continued activity and quality of diet remain important priorities. Bone health is an inside-out-outside-in job with adequate nutrition needed as a foundation to keep that skeleton strong and vibrant.”

Is excessive sleepiness a warning sign of dementia?

 

According to the World Health Organization (WHO), “Dementia is currently the seventh leading cause of death among all diseases and one of the major causes of disability and dependency among older people globally.”

The WHO states that around 55 million people have dementia, and the number is increasing by about 10 million every year. and by 2050 the number is likely to be almost 140 million. Between 60% and 70% of people with dementia have Alzheimer's disease.

Dementia is primarily a disease of old age. Many factors may increase a person’s risk of developing dementia such as:

• lack of physical activity
• uncontrolled diabetes
• high blood pressure (hypertension)
• hearing loss
• tobacco and alcohol use.

There is also a genetic component to dementia. However, several studies have shown that even those with a hereditary risk can reduce it by adopting a healthy diet, exercising regularly, and avoiding smoking and too much alcohol.

Another healthy lifestyle is getting enough of the right sort of sleep. And many researchers are now seeing connections between sleep and dementia.

Dr. David Merrill, geriatric psychiatrist, said, “Sleep is a factor that can either be protective or risky for cognitive health. The effects of sleep on cognitive health depend on the attributes of an individual’s sleep, including the quality, quantity, frequency and even the regularity of sleep.”

A new study in women over 80 years of age has linked increased sleepiness with greater dementia risk. It was found that women with increasing 24-hour sleepiness had approximately double the dementia risk of those with stable sleep profiles over the 5 years. However, increased sleepiness was not associated with increased risk of MCI (mild cognitive impairment).

The study appears in the journal Neurology.

Ben Dunkley, a cognitive neuroscientist, said, “the study rightly highlights the bidirectional relationship between sleepiness and dementia; however, as the authors point out, the exact direction of the relationship cannot be concluded with a correlation study such as this.”

Dunkley explained that:

“Sleep disturbances could indeed signal early neurodegenerative changes, acting as precursors to clinical symptoms. Conversely, dementia-related neurological changes might disrupt the brain’s sleep-regulating centers, exacerbating sleepiness. Crucially, sleep-related changes could be used to predict later life dementia risk.”

Steve Allder, MDm consultant neurologist said:

“Older adults in the preclinical stages of dementia may experience increased daytime sleep as a response to brain changes affecting arousal and alertness. Neurodegeneration in regions like the hypothalamus and brainstem, which regulate sleep, could result in greater daytime sleep needs. Inflammation and vascular risk may also be contributing factors. Disrupted sleep patterns and excessive sleep are linked to increased inflammation and cardiovascular risks, both of which are known to play a role in dementia development.”

“Increased sleepiness and frequent napping may be linked to dementia due to several underlying factors. One key reason is sleep fragmentation and neurodegeneration — poor nighttime sleep quality can disrupt deep sleep, which is essential for clearing amyloid-beta, a protein associated with Alzheimer’s disease.”

“Circadian disruption also plays a role, as worsening sleep-wake cycles and irregular circadian rhythms are associated with neurodegenerative changes. Circadian misalignment can impair memory consolidation and contribute to cognitive decline,” he continued.

Concurring with the researchers’ suggestion that increased sleepiness might be a result of early dementia, Allder also explained that excessive sleepiness might act as a compensatory mechanism for brain dysfunction.

This study provides further evidence that altered sleep patterns in older age may contribute to the risk of dementia.

Dunkley offered advice for maintaining good sleep patterns.

“Beyond sleepiness alone, disruptions like fragmented sleep, reduced sleep efficiency, and irregular circadian rhythms are strongly linked to dementia risk,” he said.

He further advised, “Improving sleep quality through lifestyle modifications — such as consistent sleep schedules, minimizing alcohol consumption, and optimizing sleep hygiene — can measurably enhance brain health.”

“It’s recommended — not only for brain health, but for overall health — that people get 7 to 9 hours of quality sleep per night.”

Those who regularly slept for more than 9 hours a night had double the dementia risk of those who slept between 6 and 9 hours, according to a large-cohort study from Boston University. They also had lower brain volumes.

It may be that excessive sleep was a symptom of early neuronal changes rather than the cause. The researchers of this study suggest that long sleep time could be a predictor of dementia risk.

Meanwhile, if sleep is disturbed, brain waste, such as beta-amyloid and tau, may start to build up, eventually forming the plaques and tangles characteristic of Alzheimer’s. Accumulation of beta-amyloid and tau may begin 10-20 years before dementia symptoms become noticeable.

“The disrupted, poor-quality sleep seen in sleep disorders leads to both acute and chronically worsening changes in the brain. Normally, a good night’s sleep literally allows for repair and restoration of brain function to the levels seen at the beginning of the prior day.”

Dr. Porsteinsson explained: “When you sleep, the brain ‘shrinks’ which appears to open up the flow of cerebrospinal fluid that flushes out toxic byproducts such as beta-amyloid and p-tau. The brain also resets its balance (homeostasis) during sleep. The quality of sleep and how much time you spend in deep-sleep matters here as well.”

Moreover, people with sleep apnea are at increased risk of several health conditions. Recent studies have also suggested the links between sleep apnea and dementia.

One study found that the temporal lobes — which are vital for memory — were reduced in thickness in those with sleep apnea, a change that is also seen in people with dementia.

Another study found that the hippocampus was reduced in volume in people with sleep apnea — hippocampal atrophy is a feature of Alzheimer’s disease.

This study also showed that two toxins — tau and beta-amyloid, which are thought to be responsible for many of the symptoms of dementia — build up in the brains of people with sleep apnea, probably because of a lack of oxygen in the blood.

Two more studies added to these findings. One detected raised tau levels in those with sleep apnea; the other found them to have amyloid plaques.

A 2019 review of studies found that sleep disorders, including sleep apnea, insomnia, inadequate or overlong sleep, and sleep disturbance were linked to cognitive decline and dementia.

Maintaining a healthy lifestyle and ensuring you get enough quality sleep may reduce the risk of both dementia and many other health problems. Thus improving sleep might be a way of alleviating dementia symptoms.

But no study has yet proved a causative link — or which way the relationship acted. Did sleep problems predispose to dementia, or were sleep problems a sign of the early stages of dementia? Is it possible that treating sleep disorders might help prevent dementia?

RFK Jr. wants to make America healthy again

 

Toxic chemicals used in food preparation can leach into human bodies.

However, Americans love ultraprocessed foods. Ultraprocessed foods comprise more than half the calories the average American adult eats. They are up to 70% of the American diet. But they are linked to a wide variety of health issues including heart disease, obesity and diabetes.

In October 2023, California in US banned four substances — BVO, red dye No. 3, potassium bromate and propylparaben due to their links with serious health concerns as cancer, endocrine and reproductive issues, and heart and liver problems. For example:

Brominated vegetable oil, or BVO, is vegetable oil modified with bromine. It is used to suspend citrus flavorings into sodas and juice drinks, where it prevents the flavoring from separating during shipping and storage.

BVO leaves residues of bromine triglycerides in body fat and fat in the liver, heart, and brain. Excessive bromine accumulation in the body results in bromine toxicity, which causes damage to the central nervous system, headaches, nausea, memory loss and loss of coordination,

Another case, red dye No. 3, a synthetic color additive made from petroleum and chemically known as erythrosine, was used to give foods, candy and beverages a bright cherry-red color. But scientists have discovered its links to cancer in animals.

Meanwhile, black-colored plastic used for kitchen utensils and toys is linked to banned toxic flame retardants.

Robert F Kennedy Jr, the newly confirmed lead of the Department of Health and Human Services in US has pledged to tackle these ultra-processed foods, food dyes and additives and spoken out against these ingredients that hurt health.

In fact, he has frequently advocated for eliminating ultra-processed foods which are “poisoning” people, particularly children. These foods altered to include added fats, starches and sugars, like frozen pizzas, crisps and sugary breakfast cereals, that are linked to health problems like cancer, cardiovascular disease and diabetes.

And so Kennedy wants to ban ultra-processed foods from school cafeterias.

The former Democrat has also singled out other controversial health issues including seed oils, pasteurized milk and fluoride in drinking water.

He has come after seed oils, writing on social media that Americans are being “unknowingly poisoned” by products like canola and sunflower oil that are used in fast foods.

But public health experts and former officials said a number of Kennedy’s goals were not worthwhile - and in some cases, harmful.

For instance, he believes raw milk has health benefits despite the increased risk of bacterial contamination. But drinking raw milk that has not been pasteurized - a process that helps kill bacteria - can make people sick or even kill them.

“There's no evidence of any nutritional benefit of any magnitude that we know that comes from non-pasteurizing of milk,” said Dr Peter Lurie, executive director for the Center for Science in the Public Interest, a non-profit group in US that advocates for food safety.

Kennedy’s proposal to remove fluoride from drinking water and be banned altogether also could be problematic, because fluoride, in the low levels found in water, has been proven to improve dental health, said University of Michigan nutritional sciences professor Jennifer Garner.

And his claim that seed oils are helping drive the obesity epidemic is not based in science, either, Dr Lurie said. 

“We see no evidence for that. In fact, they seem like important products to the extent that they substitute for saturated fats such as butter”, he said.