A New Contender For “Best Diet For Heart & Brain” In Aging
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We previously wrote about how the Mediterranean diet‘s close cousins DASH and MIND were voted (by a panel of 69 doctors and nutritionists) as best for heart and brain health, respectively.
Here is that article, for reference: Which Diet? Top Diets Ranked By Experts
When we say “close cousins”, in this case we mean that DASH and MIND are variations of the Mediterranean in any case; see: Four Ways To Upgrade The Mediterranean Diet
And for more on the Mediterranean Diet itself, see: The Mediterranean Diet: What Is It Good For? ← More to the point: what isn’t it good for?
- It’s also been found, societally, to reduce general healthcare costs—basically, people get sick less and so have fewer healthcare costs.
- It’s been found to reduce all-cause mortality, which is about the best thing one can say of any diet.
- It’s especially good for heart health and against cancer.
- It’s particularly recommended for the prevention or management of diabetes.
What about best against aging?
We’ve written about eating vs aging, too:
How Much Does A Vegan Diet Affect Biological Aging? ← the answer is, it’s a lot, measurable even over the course of just 8 weeks of vegan eating:
As to the difference it made over the course of the 8 weeks…
❝Various measures of epigenetic age acceleration (PC GrimAge, PC PhenoAge, DunedinPACE) were assessed, along with system-specific effects (Inflammation, Heart, Hormone, Liver, and Metabolic).
Distinct responses were observed, with the vegan cohort exhibiting significant decreases in overall epigenetic age acceleration, aligning with anti-aging effects of plant-based diets. Diet-specific shifts were noted in the analysis of methylation surrogates, demonstrating the influence of diet on complex trait prediction through DNA methylation markers.❞
~ Dr. Varun Dwaraka et al. ← there’s a lot of “et al.” to this one; the paper had 16 collaborating authors!
This is not too surprising, since the Mediterranean diet is mostly plant-based anyway with very little meat and some fermented dairy,
Is there an alternative?
Yes there is! So if you don’t want to put aside all animal products, the diet we’ll talk about now is the one you want.
On the other hand: if you do want to put aside all animal products or are already vegan, then, this diet does not require animal products; it merely permits the inclusion of a few of them.
It’s called the Alternative Healthy Eating Index (AHEI), and (though one could quibble over definitions) it is generally considered to have been launched in 2010.
You may be wondering: if it was launched in 2010, why is it being described as a new contender for “best for heart and brain” in aging?
And the answer is: that is new, in the category of anything we want longitudinal studies for. While some markers of aging can be measured over the duration of a short RCT, as in the vegan study we quoted above, to be able to categorically declare its long-term benefits to organs, we need long-term science, and that takes time.
All so recently, a 15-year longitudinal study has “matured”, as it were, and been published. Specifically, the study followed 2,473 adults aged 60+ for 15 years to examine the effect of dietary patterns on multimorbidity (two or more chronic conditions).
The diets they examined:
- Alternate Mediterranean diet (AMED)
- Mediterranean–DASH Intervention for Neurodegenerative Delay (MIND)
- Alternate Healthy Eating Index (AHEI)
- Empirical Dietary Inflammatory Index (EDII)
What they found, in few words: The AMED, AHEI, and MIND diets were linked to a slower accumulation of chronic diseases, especially cardiovascular and neuropsychiatric conditions, while a pro-inflammatory diet (EDII) was (shocking nobody) associated with faster disease accumulation.
This was “dose dependent”, too, in the sense that those with the highest adherence to MIND and AHEI accumulated about two fewer chronic diseases over 15 years compared to those with the lowest adherence, and AHEI generally showed the most consistent protective associations.
It’s also worth noting that the benefits for cardiovascular disease appeared greatest in women and in participants aged 78+, though the extent to which those benefits showed themselves depended slightly on the statistical modelling method used.
You can read the paper here: Dietary patterns and accelerated multimorbidity in older adults
What’s in the AHEI Diet?
There is a little room for flexibility, and different studies may have slightly different definitions (which we will discuss), there is a clear general theme.
When we discussed the AHEI a few months ago, talking about a 30-year retrospective study (so, looking back on previous data and tallying it against the index that was created after the data was collected), and for that study it was parametered as essentially the Mediterranean diet with three small tweaks:
- no seafood, but long-chain omega-3 fatty acids include to compensate
- no sugar-sweetened beverages or fruit juices
- “no” sodium (in other words, minimal sodium, since almost everything contains trace amounts)
Indeed, they noted:
❝Higher intakes of fruits, vegetables, whole grains, unsaturated fats, nuts, legumes and low-fat dairy products were linked to greater odds of healthy aging, whereas higher intakes of trans fats, sodium, sugary beverages and red or processed meats (or both) were inversely associated.❞
Read in full: Optimal dietary patterns for healthy aging
With this in mind, in this 15-year longitudinal study, they included three additional stipulations, namely:
- little to no butter/cheese, ideally none
- little to no red meat, ideally none
- no processed meats
…which latter may be considered a de facto necessity under the “minimal sodium” directive, but the point is, this time it was spelled out.
Want to learn more?
You might like:
Better Than The Mediterranean? ← this is about what happens if we simply remove the remaining animal products from the Mediterranean Diet.
Enjoy!
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Osteoarthritis Of The Knee
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It’s Q&A Day at 10almonds!
Have a question or a request? We love to hear from you!
In cases where we’ve already covered something, we might link to what we wrote before, but will always be happy to revisit any of our topics again in the future too—there’s always more to say!
As ever: if the question/request can be answered briefly, we’ll do it here in our Q&A Thursday edition. If not, we’ll make a main feature of it shortly afterwards!
So, no question/request too big or small
❝Very informative thank you. And made me think. I am a 72 yr old whitewoman, have never used ( or even been offered) HRT since menopause ~15 yrs ago. Now I’m wondering if it would have delayed the onset of osteoarthritis ( knee) and give me more energy in general. And is it wise to start taking hrt after being without those hormones for so long?❞
(this was in response to our article about menopausal HRT)
Thanks for writing! To answer your first question, obviously we can never know for sure now, but it certainly is possible, per for example a large-ish (n=1003) study of women aged 45–64, in which:
- Those with HRT were significantly less likely to have knee arthritis than those without
- However, to enjoy this benefit depended on continued use (those who used it for a bit and then stopped did not enjoy the same results)
- While it made a big difference to knee arthritis, it made only a small (but still beneficial) difference to wrist/hand arthritis.
We could hypothesize that this is because the mechanism of action is more about strengthening the bones (proofing against osteoporosis is one of the main reasons many people take HRT) and cartilage than it is against inflammation directly.
Since the knee is load-bearing and the hand/wrist joints usually are not, this would mean the HRT strengthening the bones makes a big difference to the “wear and tear” aspect of potential osteoarthritis of the knee, but not the same level of benefit for the hand/wrist, which is less about wear and tear and more about inflammatory factors. But that latter, about it being load-bearing, is just this writer’s hypothesis as to why the big difference.
The researchers do mention:
❝In OA the mechanisms by which HRT might act are highly speculative, but could entail changes in cartilage repair or bone turnover, perhaps with cytokines such as interleukin 6, for example.❞
What is clear though, is that it does indeed appear to have a protective effect against osteoarthritis of the knee.
With regard to the timing, the researchers do note:
❝Why as little as three years of HRT should have a demonstrable effect is unclear. Given the difficulty in ascertaining when the disease starts, it is hard to be sure of the importance of the timing of HRT, and whether early or subclinical disease was present.
These results taken together suggest that HRT has a metabolic action that is only effective if given continuously, perhaps by preventing disease initiation; once HRT is stopped there might be a ‘rebound’ effect, explaining the rapid return to normal risk❞
~ Ibid.
You can read the study here:
On whether it is worth it now…
Again, do speak with an endocrinologist because your situation may vary, but:
- hormones are simply messengers, and your body categorically will respond to those messages regardless of age, or time elapsed without having received such a message. Whether it will repair all damage done is another matter entirely, but it would take a biological miracle for it to have no effect at all.
- anecdotally, many women do enjoy life-changing benefits upon starting HRT at your age and older!
(We don’t like to rely on “anecdotally”, but we couldn’t find studies isolating according to “length of time since menopause”—we’ll keep an eye out and if we find something in the future, we’ll mention it!)
Meanwhile, take care!
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Spelt vs Bulgur – Which is Healthier?
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Our Verdict
When comparing spelt to bulgur, we picked the spelt.
Why?
An argument could be made for bulgur, but we say spelt comes out on top. Speaking of “sorting the wheat from the chaff”, be aware: spelt is a hulled wheat product and bulgur is a cracked wheat product.
Looking at macros first, it’s not surprising therefore that spelt has proportionally more carbs and bulgur has proportionally more fiber, resulting in a slightly lower glycemic index. That said, for the exact same reason, spelt is proportionally higher in protein. Still, fiber is usually the most health-relevant aspect in the macros category, so we’re going to call this a moderate win for bulgur.
When it comes to micronutrients, however, spelt is doing a lot better:
In the category of vitamins, spelt is higher in vitamins A, B1, B2, B3, and E (with the difference in E being 26x more!), while bulgur is higher only in vitamin B9 (and that, only slightly). A clear win for spelt here.
Nor are the mineral contents less polarized; spelt has more copper, iron, magnesium, manganese, phosphorus, potassium, selenium, and zinc, while bulgur is not higher in any minerals. Another easy win for spelt.
Adding these up makes a win for spelt, but again we’d urge to not underestimate the importance of fiber. Enjoy both in moderation, unless you are avoiding wheat/gluten in which case don’t, and for almost everyone, mixed whole grains are always going to be best.
Want to learn more?
You might like to read:
- Grains: Bread Of Life, Or Cereal Killer?
- Gluten: What’s The Truth?
- Why You’re Probably Not Getting Enough Fiber (And How To Fix It)
Take care!
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Metformin vs Cancer/Aging
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…and other items from this week’s health science news:
Metabolic health is more than most people think
Researchers (Dr. Emilie Lavallée et al.) found that ATP5I is a direct molecular target of metformin. This may not mean much to most readers, so: ATP5I is part of the enzyme complex that produces ATP, the primary “energy currency” of cells. Specifically it seems to help organize and assemble the ATP synthase machinery, rather than directly carrying out ATP production itself.
In other words: it helps your cellular energy mechanisms work better
As for why you should care about cellular energy mechanisms: you are made of cells, and the energy they have is the energy you have*.
*unless we want to get pedantic, in which case yes, you also have some gravitational potential energy due to your mass, including non-cellular mass, and its relationship to gravity. But that won’t help you get through your day, for the most part.
Usefully, this also highlights a likely reason why people who take metformin have a lower risk of many cancers, bearing in mind that while things like diabetes and heart disease are thought of as metabolic disorders (and they are), so are cancer and aging:
Read in full: Why metformin matters beyond diabetes: New target could reshape aging and cancer research
Related: How Metformin Reduces Long COVID Risk By 63%
Kidney disease is fast becoming epidemic
Bad news: early chronic kidney disease (CKD) often causes no noticeable symptoms, allowing kidney damage to progress for years before being detected.
Worse news: CKD has entered the world’s top 10 causes of death, with approximately 1.5 million deaths in the US attributed directly to the disease in 2023 (yes, science typically lags with numbers like that, because of peer review, here we are in 2026 at time of writing, reading stats from 2023, but it’s better to have correct stats from a couple of years ago than guess at more recent ones without appropriate scientific rigor).
Further, impaired kidney function contributed to about 12% of global cardiovascular deaths, making all-too-clear the strong connection between kidney disease and heart disease.
Underdiagnosis remains a major problem too: many people are never tested, so the true prevalence may be higher than current estimates suggest; researchers emphasized greater use of urine testing and kidney function screening in at-risk individuals.
Good news: treatment options are improving! Newer medications, including SGLT2 inhibitors, GLP-1–based therapies, and nonsteroidal mineralocorticoid receptor antagonists, can help protect kidney function and reduce cardiovascular risk in appropriate patients.
However, prevention definitely remains much better than treatment, so it’s as well to get ahead of things and check out our “related” link below to learn now:
Read in full: A silent kidney crisis is spreading far faster than experts expected
Related: Are your Kidneys Ok? Detect Early To Protect Kidney Health (Here’s How)
When industry has beef with scientists
Researchers (Dr. Katherine Sievert et al.) researchers reviewed 500 nutrition studies published between 2014 and 2023 that examined links between meat consumption and health outcomes, then compared study conclusions with declared funding sources, author affiliations, and conflicts of interest.
In few words: a lot of those 500 studies had some form of meat-industry involvement (i.e: the meat industry paid for those studies, in part or in full), and these studies were 16x more likely to conclude that meat was harmless, beneficial, or health-promoting than studies without such ties to the meat industry.
So, in other words: when encountering headlines claiming that meat is healthy, it is worth checking who funded the study, whether authors disclosed financial relationships, and whether the findings align with the broader body of independent evidence.
Read in full: How ‘big meat’ shapes science to give steak a healthy glow up
Related: What Health Difference Does Pasture-Raised Beef Actually Make?
Take care!
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Spark – by Dr. John Ratey
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We all know that exercise is good for mental health as well as physical. So, what’s so revolutionary about this “revolutionary new science of exercise and the brain”?
A lot of it has to do with the specific neuroscience of how exercise has not only a mood-boosting effect (endorphins) and neuroprotective effect (helping to guard against cognitive decline), but also promotes neuroplasticity… e.g., the creation and strengthening of neural pathways, as well as boosting the structure of the brain in some parts such as the cerebellum.
The book also covers not just “exercise has these benefits”, but also the “how this works” of all kinds of brain benefits, including:
- against Alzheimer’s
- mitigating ADHD
- managing menopause
- dealing with addiction
…and more. And once we understand how something works, we’re far more likely to be motivated to actually do the kinds of exercises that give the specific benefits we want/need. Which is very much the important part!
In short: this book will tell you what you need to know to get you doing the exercises you need to enjoy those benefits—very much worth it!
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What’s the difference between heat exhaustion and heat stroke? One’s a medical emergency
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When British TV doctor Michael Mosley died last year in Greece after walking in extreme heat, local police said “heat exhaustion” was a contributing factor.
Since than a coroner could not find a definitive cause of death but said this was most likely due to an un-identified medical reason or heat stroke.
Heat exhaustion and heat stroke are two illnesses that relate to heat.
So what’s the difference?
Studio Nut/Shutterstock A spectrum of conditions
Heat-related illnesses range from mild to severe. They’re caused by exposure to excessive heat, whether from hot conditions, physical exertion, or both. The most common ones include:
- heat oedema: swelling of the hands, feet and ankles
- heat cramps: painful, involuntary muscle spasms usually after exercise
- heat syncope: fainting due to overheating
- heat exhaustion: when the body loses water due to excessive sweating, leading to a rise in core body temperature (but still under 40°C). Symptoms include lethargy, weakness and dizziness, but there’s no change to consciousness or mental clarity
- heat stroke: a medical emergency when the core body temperature is over 40°C. This can lead to serious problems related to the nervous system, such as confusion, seizures and unconsciousness including coma, leading to death.
As you can see from the diagram below, some symptoms of heat stroke and heat exhaustion overlap. This makes it hard to recognise the difference, even for medical professionals.
CC BY-SA How does this happen?
The human body is an incredibly efficient and adaptable machine, equipped with several in-built mechanisms to keep our core temperature at an optimal 37°C.
But in healthy people, regulation of body temperature begins to break down when it’s hotter than about 31°C with 100% humidity (think Darwin or Cairns) or about 38°C with 60% humidity (typical of other parts of Australia in summer).
This is because humid air makes it harder for sweat to evaporate and take heat with it. Without that cooling effect, the body starts to overheat.
Once the core temperature rises above 37°C, heat exhaustion can set in, which can cause intense thirst, weakness, nausea and dizziness.
If the body heat continues to build and the core body temperature rises above 40°C, a much more severe heat stroke could begin. At this point, it’s a life-threatening emergency requiring immediate medical attention.
At this temperature, our proteins start to denature (like an egg on a hotplate) and blood flow to the intestines stops. This makes the gut very leaky, allowing harmful substances such as endotoxins (toxic substances in some bacteria) and pathogens (disease causing microbes) to leak into the bloodstream.
The liver can’t detoxify these fast enough, leading to the whole body becoming inflamed, organs failing, and in the worst-case scenario, death.
Who’s most at risk?
People doing strenuous exercise, especially if they’re not in great shape, are among those at risk of heat exhaustion or heat stroke. Others at risk include those exposed to high temperatures and humidity, particularly when wearing heavy clothing or protective gear.
Outdoor workers such as farmers, firefighters and construction workers are at higher risk too. Certain health conditions, such as diabetes, heart disease, or lung conditions (such as COPD or chronic obstructive pulmonary disease), and people taking blood pressure medications, can also be more vulnerable.
Adults over 65, infants and young children are especially sensitive to heat as they are less able to physically cope with fluctuations in heat and humidity.
Firefighters are among those at risk of heat-related illness. structuresxx/Shutterstock How are these conditions managed?
The risk of serious illness or death from heat-related conditions is very low if treatment starts early.
For heat exhaustion, have the individual lie down in a cool, shady area, loosen or remove excess clothing, and cool them by fanning, moistening their skin, or immersing their hands and feet in cold water.
As people with heat exhaustion almost always are dehydrated and have low electrolytes (certain minerals in the blood), they will usually need to drink fluids.
However, emergency hospital care is essential for heat stroke. In hospital, health professionals will focus on stabilising the patient’s:
- airway (ensure no obstructions, for instance, vomit)
- breathing (look for signs of respiratory distress or oxygen deprivation)
- circulation (check pulse, blood pressure and signs of shock).
Meanwhile, they will use rapid-cooling techniques including immersing the whole body in cold water, or applying wet ice packs covering the whole body.
Take home points
Heat-related illnesses, such as heat stroke and heat exhaustion, are serious health conditions that can lead to severe illness, or even death.
With climate change, heat-related illness will become more common and more severe. So recognising the early signs and responding promptly are crucial to prevent serious complications.
Matthew Barton, Senior lecturer, School of Nursing and Midwifery, Griffith University and Michael Todorovic, Associate Professor of Medicine, Bond University
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Enjoy Bitter Foods For Your Heart & Brain
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When Bitter Is Better
A good general rule of thumb for “does this food contain a lot of healthy polyphenols?” is:
“is this (edible) plant bitter/astringent/pungent”?
If it is, it’s probably rich in polyphenols:
Deciphering the role of bitter and astringent polyphenols in promoting well-being
…which is why it’s no surprise that black coffee and bitter chocolate score highly, as do hot peppers and even garlic.
See also: Our Top 5 Spices: How Much Is Enough For Benefits?
Even fruits, generally considered something sweet to eat, often contain more polyphenols when they are bitter—many berries are great examples of this!
Read more: Goji Berries: Which Benefits Do They Really Have?
You can read more about the science of this here:
Sensory Nutrition and Bitterness and Astringency of Polyphenols
Important for multiple reasons (including heart and brain health)
Polyphenols have many benefits, and they’re most well known for their heart-healthy properties, but their antioxidant effect (and other mechanisms) also means these foods are generally neuroprotectants too:
The science of this is not all as obvious as you might think!
It is reasonable to expect “ok, this has antioxidant effect, so it will reduce oxidative damage to brain cells too”, and while that is true (and yes, polyphenols do cross the blood-brain barrier), they also help in other ways, including through the gut:
What if I don’t like bitter/astringent/pungent foods?
If you do not have a medical condition that proscribes them (do check with your doctor if unsure), the best advice is to simply eat them anyway, and your tastes will adapt.
It will also help if you avoid sweet foods (though this too is also a good general rule of thumb!), as this will move the balance of where your brain’s “set range” is for “good taste”.
Bonus tip: dark chocolate (80%+ cocoa if possible, 95% if you can get it) and chilli peppers go great with each other. Here’s an example of a chilli chocolate product on Amazon; it’s 70% cocoa (which is not bad, but could be better). You might be able to get a higher percentage locally, especially if you ask your local chocolatière, or make it yourself!
Enjoy!
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