Could an unhealthy diet increase the risk of developing dementia later in life?
That is the question that led neurodegeneration researcher Jeffery Keller from the Sanders-Brown Institute on Aging in Lexington, Ky., to the Pennington Biomedical Research Center in July to study dementia.
“We saw our work in dementia moving toward understanding how nutrition, obesity and diabetes are emerging as risk factors in dementia and the elderly,” Keller said.
In order to explore that link, Keller said that he and his wife, Annadora Bruce-Keller, a neurobiologist who also studies dementia, came to Pennington where there are the tools and experienced research staff to examine that link. Now, Keller is tasked with starting a new research effort at Pennington, the Institute for Dementia Research and Prevention.
Citing his wife’s research on dementia in people who have contracted the human immunodeficiency virus (HIV), dementia can be brought on by inflammation in the body, he said.
“There’s a lot of evidence dementia is not necessarily a disease of the brain,” Keller said.
Inflammation plays a role in other diseases, such as diabetes. Conditions such as obesity or a poor diet with little exercise can increase inflammation as well.
For example, Keller published a paper in November’s Journal of Neurochemistry that linked the typical high-fat diet of most Americans to the acceleration of brain degeneration in mice bred to have Alzheimer’s disease.
“The biggest risk factor is age,” Keller said. “We still don’t know why that is. Clearly it has something to do with how these different parts of the body change and affect the brain.”
Pennington researchers have been looking at aging and its related conditions for years.
Don Ingram, who researches aging and is among the researchers who will participate in the institute, is looking for a medication or nutritional supplement that could slow the rate of aging and diseases, such as dementia, that develop during the aging process.
This idea comes from studies on caloric restriction of mice and other animals, which Ingram did during his 26-year tenure at the National Institute on Aging.
Animal studies, ranging from dogs to monkeys, have shown that by reducing how much food is eaten by 30 percent, the equivalent of a human going from a 2,500-calorie diet to a 1,750-calorie diet, not only slowed aging but delayed the onset of heart disease, cancer and dementia, he said.

Metabolic syndrome in adults occurs when they have at least three risk factors from among abdominal obesity (waist circumference more than 35 inches for women; 40 inches for men); low HDL (“good”) cholesterol; high triglycerides; high fasting glucose; and high blood pressure.
Although sometimes difficult to diagnosis in children, similar clustering can appear in childhood. The report, published online Jan. 12 in
, called for clinicians to measure and to treat the individual pieces of the syndrome in children while intervening to break bad diet and exercise habits.
“The adverse risk factors and the connections between them that eventually lead to the metabolic syndrome begin in childhood,” Dr. Julia Steinberger, director of Pediatric Echocardiography and Preventive Cardiology at the University of Minnesota Children’s Hospital in Minneapolis, said in an American Heart Association news release. She chaired the group that wrote the report.
Much of the increased risk is tied to the continued increase in childhood obesity, which the heart association said is around 17 percent of all children aged 6 to 19. Having a body-mass index at or above the 95th percentile for the child’s age is considered being obese.
“We can say that childhood obesity is our biggest problem,” Steinberger said. “It’s been shown that when diet and exercise are improved in overweight children, the structure and function of blood vessels improves even in the absence of weight loss.”
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SOURCE: American Heart Association, news release, Jan. 12, 2009

The number of prescriptions for the drugs written for children and adolescents doubled to 4.4 million from 2003 to 2006, in part because of increases in diagnoses of bipolar disorder. Their efficacy in children and Alzheimer’s patients has never been demonstrated, experts said.
Eli Lilly & Co., the manufacturer of Zyprexa, is expected to settle a lawsuit with the federal government as early as today, paying a record $1.4 billion in civil and criminal charges to resolve complaints about the marketing of Zyprexa for unapproved uses. The company has already paid nearly $1.3 billion to states and consumers to settle other complaints about marketing and side effects.
“I am, and have been, very concerned about these drugs,” said Dr. Ian Cook, a psychiatrist at UCLA’s Geffen School of Medicine who was not involved in the new study. “These are powerful medications that affect the brain and the body, and we need to be very thoughtful in their use.”
No one, however, is urging abandonment of the atypical antipsychotics. The nub of the matter is that there are no other drugs with the same beneficial effects.
“The antipsychotics are a godsend,” said Dr. Alan Manevitz, a psychiatrist at Lenox Hill Hospital in New York who was not involved in the study. “They have taken people and unchained them from walls. . . . We don’t want to throw out the baby with the bathwater.”
The drugs are approved only for treatment of schizophrenia and bipolar disorder in the general population. But their use has been expanding to treat aggression in young people and dementia in the elderly.
“We use them because they are somewhat useful in some patients . . . and because we have no alternative,” said Dr. Dilip V. Jeste of UC San Diego.
Researchers already knew that atypical antipsychotics could produce excessive weight gain, increase the risk of diabetes and induce strokes and heart problems in the elderly. The Food and Drug Administration requires both conventional and atypical antipsychotics to carry a so-called black-box warning — the strongest warning possible — informing patients and physicians that the drugs are associated with increased risk of death in elderly patients treated for dementia.
In their federally funded study, published in the New England Journal of Medicine, the researchers analyzed Tennessee Medicaid records for the 15 years ending in 2005. They identified 44,000 users of conventional antipsychotics and 46,000 of atypical antipsychotics. They compared them with 186,600 matched patients taking neither.
The scientists found that patients taking either type of drug were about twice as likely to die of a heart attack as those not taking the drugs, with the risk of death increasing with dose and the length of time on the medication. There were about 3.3 excess deaths per year for every 1,000 patients taking the drugs.
The prescribing of drugs “is a balancing of risks and benefits. Our study gives more information on the risk side of things,” said study leader Dr. Wayne A. Ray of the Vanderbilt University School of Medicine.
Conventional antipsychotics, such as haloperidol (Haldol) and chlorpromazine (Thorazine), were stumbled on by chance in the 1950s and were found to have a powerful calming effect on psychotic patients, but also a number of side effects. Among the most disturbing was tardive dyskinesia, characterized by tremors and other movement disorders that are often irreversible.
The atypical antipsychotics, which also include Clozaril, Geodon and Abilify, were designed to avoid tardive dyskinesia, which is why they were perceived as safer, Ray said. “Today, nearly all people taking antipsychotics are taking the atypical ones,” he said.
In an editorial accompanying the paper, Dr. Sebastian Schneeweiss and Dr. Jerry Avorn of Brigham and Women’s Hospital in Boston argue that the danger can be mitigated by assessing patients’ cardiovascular risk before treatment and after a month on the drugs. Patients with a heightened risk could be counseled on ways to lower it, such as modifications of diet and exercise.