Active lifestyle associated with less Alzheimer disease-related brain change among persons with APOE epsilon4 genotype

A sedentary lifestyle is associated with greater cerebral amyloid deposition, which is characteristic of Alzheimer’s disease (AD), among cognitively normal individuals with the ε4 allele of the apolipoprotein E (APOE) gene, according to a report published Online First by Archives of Neurology, one of the JAMA/Archives journals.

16 jan 2012--“The presence of an APOE ε4 allele is the most established genetic risk factor for Alzheimer disease (AD), with a higher percentage of individuals with AD having an ε4 allele in comparison with the general population,” the authors write as background information in the article. “It has been suggested that APOE status may modify associations between lifestyle factors such as exercise engagement and risk of cognitive decline and dementia.”

More information: Exercise Engagement as a Moderator of the Effects of APOE Genotype on Amyloid Deposition, Arch Neurol. Published online January 9, 2012. doi:10.1001/archneurol.2011.845

ABSTRACT

Objective. APOE 4 status has been associated with greater cortical amyloid deposition, whereas exercise has been associated with less in cognitively normal adults. The primary objective here was to examine whether physical exercise moderates the association between APOE genotype and amyloid deposition in cognitively normal adults.
Design APOE genotyping data and answers to a questionnaire on physical exercise engagement over the last decade were obtained in conjunction with cerebrospinal fluid (CSF) samples and amyloid imaging with carbon 11–labeled Pittsburgh Compound B ([11C]PiB) positron emission tomography. Participants were classified as either low or high exercisers based on exercise guidelines of the American Heart Association.
Setting. Knight Alzheimer's Disease Research Center at Washington University, St Louis, Missouri.
Participants. A total of 201 cognitively normal adults (135 of whom were women) aged 45 to 88 years were recruited from the Knight Alzheimer’s Disease Research Center. Samples of CSF were collected from 165 participants. Amyloid imaging was performed for 163 participants.
Results. APOE 4 carriers evidenced higher [11C]PiB binding (P < .001) and lower CSF Aβ42 levels (P < .001) than did noncarriers. Our previous findings of higher [11C]PiB binding (P = .005) and lower CSF Aβ42 levels (P = .009) in more sedentary individuals were replicated. Most importantly, we observed a novel interaction between APOE status and exercise engagement for [11C]PiB binding (P = .008) such that a more sedentary lifestyle was significantly associated with higher [11C]PiB binding for 4 carriers (P = .013) but not for noncarriers (P = .20). All findings remained significant after controlling for age; sex; educational level; body mass index; the presence or history of hypertension, diabetes mellitus, heart problems, or depression; and the interval between assessments.
Conclusion. Collectively, these results suggest that cognitively normal sedentary APOE 4–positive individuals may be at augmented risk for cerebral amyloid deposition.

Provided by Washington University in St. Louis

Look AHEAD Results Favor Intensive Lifestyle Intervention

At four years, this diabetes intervention beats education for CVD risk factor reduction

29 sept 2010 -- Intensive lifestyle intervention (ILI) for patients with type 2 diabetes can result in sustained improvements in cardiovascular risk factors and in fitness, according to a report published in the Sept. 27 issue of Archives of Internal Medicine.

Rena R. Wing, Ph.D., of Brown Medical School in Providence, R.I., and other members of The Look AHEAD Research Group reported four-year results of the ongoing trial, which was designed to obtain long-term data on the effects of ILI compared to diabetes support and education (DSE; the control group) on changes in weight, fitness, and cardiovascular disease risk factors.

Averaged across the four years, the researchers found that ILI patients had significantly greater improvements in weight, treadmill fitness, hemoglobin A1c level, high-density lipoprotein cholesterol, triglycerides, and blood pressure. Low-density lipoprotein cholesterol was more improved in the DSE group, a finding related to greater use of lipid-lowering medications in the DSE group.

"ILI can produce sustained weight loss and improvements in fitness, glycemic control, and cardiovascular disease risk factors in individuals with type 2 diabetes. Whether these differences in risk factors translate to reduction in cardiovascular disease events will ultimately be addressed by the Look AHEAD trial," the authors write.

One author disclosed serving on a scientific advisory committee for Free & Clear and financial relationships with BodyMedia Inc., UPMCHealth Plan, and Proctor & Gamble.

Abstract

Heart group lists 7 essentials for heart health

DALLAS, 22 jan 2010-- – Here are the seven secrets to a long life: Stay away from cigarettes. Keep a slender physique. Get some exercise. Eat a healthy diet and keep your cholesterol, blood pressure and blood sugar in check.

Research shows that most 50-year-olds who do that can live another 40 years free of stroke and heart disease, two of the most common killers, says Dr. Clyde Yancy, president of the American Heart Association. The heart association published the advice online Wednesday in the journal Circulation.

The group also is introducing an online quiz to help people gauge how close they are to the ideal. If you fall a bit short, it offers tips for improving.

"These seven factors — if you can keep them ideal or control them — end up being the fountain of youth for your heart," said Dr. Donald M. Lloyd-Jones, a cardiologist who was lead author of the statement. "You live longer, you live healthier longer, you have much better quality of life in older age, require less medication, less medical care."

Specifically, those with ideal cardiovascular health can answer yes to the following seven questions:

• Never smoked or quit more than one year ago.

• Body mass index less than 25.

• Get at least 150 minutes of moderate exercise or 75 minutes of vigorous exercise each week.

• Meet at least four of these dietary recommendations: 4 1/2 cups of fruit and vegetables a day; two or more 3.5-ounce servings a week of fish; drink no more than 36 ounces of sugar-sweetened beverages a week; three or more 1-ounce servings of fiber-rich whole grains a day; less than 1,500 milligrams a day of salt.

• Total cholesterol of less than 200.

• Blood pressure below 120/80.

• Fasting blood glucose less than 100.

The online quiz calculates a score based on the answers, 10 being the ideal.

Doctors say the quiz is a good way for people to get a handle on how they're doing, especially since people often think they're doing better than they actually are.

The heart association found just that in a recent survey that showed 39 percent of Americans thought they had ideal heart health, yet 54 percent of those had been told they had either a heart disease risk factor or needed to make a lifestyle change to improve heart health, or both.

With America's obesity epidemic, weight especially is a pitfall for patients trying to meet these seven health factors, doctors say.

"Many people are surprised to find out how overweight they may be," said Dr. Randal Thomas, director of the cardiovascular health clinic at the Mayo Clinic.

Lloyd-Jones, also chair of the preventive medicine department at Northwestern University's Feinberg School of Medicine, said, "People I think are far too accepting of their waistlines."

Thomas praises the online tool for giving people a score so they'll have something to work toward. It offers advice for problem areas: for instance, advising someone who's over weight to set a goal of losing a pound a week by burning up to 3,500 more calories than are taken in.

Yancy, the heart association president and medical director of the Baylor Heart and Vascular Institute in Dallas, said the organization has a goal for 2020 of improving cardiovascular health of Americans by 20 percent while reducing deaths from cardiovascular diseases and stroke by 20 percent.

He said that in the last decade, there's already been a nearly 40 percent reduction in death from heart disease and a nearly 35 percent reduction in death from stroke. He said those goals were achieved with improvements in treatments and prevention.

Linda Alvarado, 54, of Houston, said she knows how hard — and important — the changes can be. After having a quadruple bypass at the age of 47, she improved her diet and exercise, losing 40 pounds. Recently though, with a new 40-minute commute, some of those diet and exercise commitments have been put aside. While she's kept the lost pounds off, she would like to lose five more pounds.

"It's really up to you," Alvarado said.

___

On the Net:

American Heart Association's My Life Check, http://www.heart.org/MyLifeCheck

Active lifestyle may prevent cancer: Japan study

11 july 2008--Physically active people are less likely than sedentary types to develop cancer, a research group led by the Japanese health ministry announced on Thursday.
Men in the most active group of people surveyed had 13 percent less risk of developing cancer compared with the least active group, and women in the most active group had a 16 percent lower risk than their sedentary counterparts.
"There has been a lot of research done in the past on the relationship between leisure and development of cancer in the West," said Dr. Manami Inoue, section chief of the National Cancer Centre.
"However, our research is the first in Japan of its size and scope -- we looked at overall exercise and labor, which is not only related to leisure."
According to the study, published in the American Journal of Epidemiology, researchers surveyed around 80,000 men and women between the ages 45 to 74 living in nine Japanese prefectures.
The surveyed population was divided into four groups according to their ratio of individual working metabolic rate, or MET (metabolic equivalent), which was determined by the amount of time respondents spent sitting, walking, standing, sleeping and exercising.
"Our research looked at overall physical activity that people take part in daily, and not just exercise that people take part in for leisure or fitness," said Inoue.
The trend was most noticeable among Japanese women, who were less likely to develop cancer if they were engaging in regular exercise and led an active lifestyle.
The results of the study also showed the trend to be prevalent for colon, liver and pancreas cancer risks for men and the development of stomach cancer among women.
The study, conducted by the Japan Public Heath Centre was first of its kind to survey a non-Western population for clues on the causes of cancer.
Inoue said: "There are a lot of physical differences between Asians and our Western counterparts. Asians are usually leaner, with a lower BMI (Body Mass Index). Many contributing factors for cancer have been suggested ... our research showed that lack of general physical activity is one of such reasons."