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Alzheimers and Weight Fluctuation - Is There a Connection?

Alzheimers and Weight Fluctuation - Is There a Connection?

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Published by lorenslocum
Unexpected findings of a new Israeli study reveal possible links between weight gain and dementia in middle age.
Unexpected findings of a new Israeli study reveal possible links between weight gain and dementia in middle age.

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Published by: lorenslocum on Dec 10, 2009
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Alzheimer's and Weight Fluctuation – Is There a Connection?
By Sharon KanonDecember 08, 2009
Unexpected findings of a new Israeli study reveal possible links between weight gainand dementia in middle age.
A new study from Israel shows a reduced risk of dementia among men who maintain minimal mid-life weightfluctuations.
Is being overweight a risk factor for Alzheimer's disease and other dementias? Dofluctuations in weight in middle age mean you're in danger of dementia? With obesityand dementia both major health problems in the 21st century, any research that discoversa relationship between the two is news.For years researchers have been exploring the enigmatic connection between dementiaand weight. A long-term study begun at the Tel Aviv University (TAU) School of Medicine in 1963, with a follow-up in 1999-2000, examined possible links betweenweight and dementia.The original study included 10,059 men aged 40-65, all of whom were employed by thecity or state in Haifa, Tel Aviv and Jerusalem. Of the 1,890 men (mean age 82) reachedin a follow-up phone survey 36-37 years later, and further examined medically, 307 (16 percent) had dementia, whereas 1,407 had no cognitive impairment; the others had onlymild cognitive impairment.Characterized by plaques and tangles in the brain, gunky substances called beta amyloids,Alzheimer's afflicts more than 35 million people worldwide, and five million in the USalone. A new report, released in November by Alzheimer's Disease International, madethe ominous forecast that the prevalence of the disease will nearly double every 20 years.It now afflicts one out of every eight people aged 65 years and older, and one in two people over the age of 85.
Israeli study reveals surprises
The TAU research is one of the few major longitudinal studies of a large population thatwas planned and executed according to high standards - each participant was interviewedand assessed in the follow-up - providing important data on the relationship betweenBody Mass Index (BMI), tricep skinfolds, and weight fluctuation and dementia. Some of the TAU study's findings reveal unexpected links."This study showed for the first time a reduced risk of dementia among men survivinglong-term who had maintained minimal mid-life weight fluctuations," says UriGoldbourt, professor of Epidemiology and Preventive Medicine at the Sackler School of Medicine at TAU, speaking at a conference on obesity in Tel Aviv last month.Interviewed by ISRAEL21c, Goldbourt was eager to clarify. "The study did not studydieting specifically," he says emphatically. "Weight changes in mid-age could occur  because of illness, trauma, or other reasons. We are talking about working Israeli men in1963, among whom dieting was rare." Draw your own conclusions about the implicationsfor mid-life dieters who do not keep their weight stable.The follow-up study found dementia in almost 17 percent of the men who had been in the"normal weight" category. Using the BMI (a weight to height ratio), a 30% higher  prevalence of dementia was found in men who had been obese (BMI over 30) during theinitial study. No less at risk, according to the findings, were men who had beenunderweight, with BMI under 20.The difference in dementia between overweight men with body mass indexes between 25and 30 and the "norm" was negligible. Among those slightly overweight men, the prevalence of dementia was very slightly less than in men with normal BMIs.
Jumping to weighty conclusions
Jumping to a conclusion that could appeal to overeaters during the holiday season, oneIsraeli newspaper captioned its story: "Study finds overweight Israelis are better protectedagainst Alzheimer's.""I did not say and do not think that being overweight carries benefits," Goldbourt is quick to point out. "All I said is that the threshold of 25 kg/meters squared mislabels manyindividuals as overweight. The expectation that we in the western world maintain thesame weight from our wedding day to our golden anniversary 50 years later is silly," addsthe professor.Challenging the widespread definition of BMI between 25 and 27 kg per meter squared(55-60 pounds per square foot) as being overweight, Goldbourt asserts: "It is not borneout of long-term observation of disease and mortality among middle-aged or elderly menand women."
Goldbourt is the last person to condone couch potatoes. He, himself, is a runner, hastaken part in several marathons and is past chairman of the Israel Track and FieldFederation, which has close ties to European and to World Track and Field Federations.And the professor is very careful to avoid the pitfall of seeing a cause-effect relationship between "overweight" individuals and Alzheimer's. The study provides only a statisticalassociation between mid-life weight and late-life dementia, he says. He was also involvedin another study that found that people who ruminated over problems (not to the point of neurosis) and survived beyond age 75 years had less dementia in late-life.
The little-known tricep index
The researchers revealed another little known index - the folds in the tricep muscles of the upper arms. Of the men with skinfolds that measured 18 to 43 millimeters (.71-1.69inches) in the initial study, only 15% exhibited dementia in the follow-up; of those whoseskinfolds had initially measured four to seven millimeters (.16-.28 inches), 21% later exhibited dementia."The findings indicate only an inverse association, not a ‘protection' against cognitivedecline," explains Goldbourt. "This measurement was often used in the 1950s and ‘60s.We don't know whether skinfold size correlated in any way with numbers of men whodied in the interim. The association of skinfold size with dementia, if it is valid, may havean unknown mechanism. Perhaps early childhood events, or traumas, or choosing manuallabor led to reduced upper-arm fat later in life."An important difference between the cohort we studied and others is that manual labor was done primarily by the least-educated participants. It is on-the-job occupation I amreferring to. Off-job physical activity, today's style, was quite rare in middle-aged maleimmigrants to Israel in 1963. It was a tough time. Believe me, it was rare to see someone jogging."Last year, the online issue of Neurology (March 26, 2008) reported on a study conductedat Kaiser Permanente, a Division of Research in Northern California, that showed thatthose with a larger belly in mid-life (ages 40 to 45) who were also overweight were 2.3times more likely to be afflicted with dementia in their 70s. Obese individuals, those withBMIs over 30 who have a belly, are 3.6 times at risk. Belly fat produces hormones thatget to the brain, apparently accelerating brain dysfunction.Kaiser findings differ from those of TAU in the study of BMI. Overweight individuals(BMI 25-30) had a 35% increased risk of dementia; while obese (BMI over 30) peoplehad a whopping 74% risk. In a study of skinfold, a direct correlation was found betweenskinfold size and dementia, instead of inverse.

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