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Gu and colleagues1 identified a dietary pattern associated with lower risk of AD. This dietary pattern includes higher intake of salad dressing, nuts, fish, tomatoes, poultry, cruciferous vegetables, fruits, and dark green leafy vegetables and lower intake of high-fat dairy products, red meat, organ meat, and butter. It is similar to the Mediterranean diet, adherence to which is also associated with reduced risk of developing AD.2 Previously, Buijsse et al3 reported that elderly men from Crete, in the Mediterranean south of Europe, had “consistently lower levels of indicators of oxidative stress and iron status and higher concentrations of major antioxidants” than elderly men from Zutphen in the north of Europe. In particular, serum ferritin levels, a useful marker of body iron stores,4 were 2-fold lower in men from Crete (69.8 μg/mL) than in men from Zutphen (134.2 μg/mL). We have proposed that age-associated increase in body iron stores is a pivotal event in AD pathogenesis and progression.5 We predict that dietary patterns similar to the Mediterranean diet that reduce the risk of AD will also be associated with lower body iron stores, as indicated by reduced serum ferritin levels. Unfortunately, iron status was not an endpoint in the study of Gu and colleagues.1 Given the therapeutic interest in iron chelators for neurodegenerative diseases including AD,6 and in controlled phlebotomy to safely reduce body iron stores and avoid iron deficiency,4 design of future epidemiological studies of diet and AD should consider the potential importance of iron status. Correspondence: Dr Dwyer, Research Service 151, Veterans Affairs Medical Center, 215 North Main St, White River Junction, VT 05009-0001 (barney.e.dwyer@dartmouth.edu). Financial Disclosure: None reported. References 1. Gu YNieves JWStern YLuchsinger JAScarmeas N Food combination and Alzheimer disease risk: a protective diet [published online April 12, 2010]. Arch Neurol 2010;67 (6) 699- 706PubMedGoogle ScholarCrossref 2. Scarmeas NStern YMayeux RManly JJSchupf NLuchsinger JA Mediterranean diet and mild cognitive impairment. Arch Neurol 2009;66 (2) 216- 225PubMedGoogle ScholarCrossref 3. Buijsse BFeskens EJMoschandreas J et al. Oxidative stress, and iron and antioxidant status in elderly men: differences between the Mediterranean south (Crete) and northern Europe (Zutphen). Eur J Cardiovasc Prev Rehabil 2007;14 (4) 495- 500PubMedGoogle ScholarCrossref 4. Zacharski LROrnstein DLWoloshin SSchwartz LM Association of age, sex, and race with body iron stores in adults: analysis of NHANES III data. Am Heart J 2000;140 (1) 98- 104PubMedGoogle ScholarCrossref 5. Dwyer BEZacharski LRBalestra DJ et al. Getting the iron out: phlebotomy for Alzheimer's disease? Med Hypotheses 2009;72 (5) 504- 509PubMedGoogle ScholarCrossref 6. Whitnall MRichardson DR Iron: a new target for pharmacological intervention in neurodegenerative diseases. Semin Pediatr Neurol 2006;13 (3) 186- 197PubMedGoogle ScholarCrossref
Archives of Neurology – American Medical Association
Published: Oct 11, 2010
Keywords: iron,mediterranean diet
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