Protein for prevention of cognitive decline

Insights and discussion from the cutting edge with reference to journal articles and other research papers.
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Julie G
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Re: Protein for prevention of cognitive decline

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Julie, I have access through my institution and am happy to share, somehow, the PDF with anyone interested.
Thank you! This feels like an important paper and I really want to see it again. I'll send you a PM with my email address.
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Re: Protein for prevention of cognitive decline

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After reading full text, I see strengths and weaknesses with the methodology. The strength is the very large dataset (77,335 women & men) followed up for approximately 20 years with multiple check-ins. The downside was the reliance on food frequency questionnaires, which is always tricky.

The key takeaway for me was that replacing carbohydrates with protein (plant or animal) appears to be protective against subjective cognitive decline (SCD). Two separate datasets were used: 1. for women, the Nurses’ Health Study (NHS) and 2. for men, the Health Professionals Follow-up Study (HPFS).

See the figure below to find the most protective protein sources for each gender, women on the left and men on the right. (Not sure why it's upside down, but click on it for the correct perspective.) Foods that fall to the left of the center vertical line in each column (divided by the food) protect against cognitive decline. It's super interesting to see the differences. For women, shrimp, scallops & lobster are the most protective with pork, other fish, peas and lima beans the clear winners. For men, string beans, peas, lima beans, beef, and chicken without skin are the winners. Other protein sources appear to have both positive and negative associations.

IMG_0299.jpeg

As Plumster already pointed out, the authors surmise that advanced glycation end products (AGEs) appeared to have a negative association based on the different effects of chicken with skin and chicken without skin. This may underscore the importance of cooking low and slow, with moist heat as in a crockpot. Other ways to protect against AGEs are to use citrus, vinegar and or wine as a marinade with fresh herbs, such as rosemary.

Another takeaway is that the amino acid proline may be particularly protective. Proline is abundant in bone broth and organ meats like liver perhaps underscoring the importance of balancing methionine. Here's a helpful proline article to learn more.
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Re: Protein for prevention of cognitive decline

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Julie G wrote: Sat Jan 22, 2022 3:15 pm After reading full text...
Thanks for sharing your takeaways from that paper and including the chart Julie. I find it intriguing that women have more options that fall strictly left of the line than men.

I was surprised to see canned tuna being beneficial (moreso for women) despite the mercury content. It brings me back to the question of how well selenium in canned tuna may offset the mercury. (That then reminded me of a big tea study that came up a long while back showing good results, despite that the tea consumed most likely wasn't organic or otherwise free of heavy metals.)

I was interested to see that beef appears favorable for both women and men, but while hamburger is favorable for men, it's not for women.

It seems odd that the authors suggest that AGEs account for the favorability or not of a food. While chicken meat with and without skin seem to move in opposite directions, foods that are often prepared to be high in AGEs are found on and toward the left sides of the ledgers: beef, pork, hamburger (men), bacon. Even shrimp, scallops, and fish are often grilled or seared. It would seem unlikely that enough of the Americans contributing data were cooking these foods using low AGE methods to offset a negative signal from the high AGE cooking methods so common in the SAD. Also, the paper I posted earlier in this thread suggests that the technology used to create the dAGE database around 2010 has been superceded by more accurate technology and the food AGE results are quite different from what we've come to expect. I haven't had time to look closely at either paper.

I think you must be right that the key takeaway is to replace some carbs with protein. I'm not knowledgeable enough about statistics to know, but it seems that with this large of a dataset, compounding the contextual variables?, and given the questionnaire approach, there may be a lot of noise in this data beyond that key finding?

Other great kitchen tools that produce food low in AGEs are the sous vide and instant pot. I find that vegetables cooked sous vide with a bit of EVOO are as or more enjoyable than they are roasted in EVOO. (Tonight it was tender fennel and parsnips in EVOO with a bit of salt and Zatar seasoning. Tomorrow night it will be tender curried cauliflower.) When cooking meat or fish using the sous vide, most cooks will sear it afterwards, but that step can be skipped.
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Re: Protein for prevention of cognitive decline

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I was interested to see that beef appears favorable for both women and men, but while hamburger is favorable for men, it's not for women.
Of course, the data was gender specific but the female dataset was much larger. I can't help but wonder if the negative association with "a hamburger" had to do with the bun, fries and shake that accompanied it. ;) If beef is healthful, I can't help but think that a grass-fed beef burger in a different context (such as with a big salad) wouldn't be just as healthful.
It seems odd that the authors suggest that AGEs account for the favorability or not of a food. While chicken meat with and without skin seem to move in opposite directions, foods that are often prepared to be high in AGEs are found on and toward the left sides of the ledgers: beef, pork, hamburger (men), bacon. Even shrimp, scallops, and fish are often grilled or seared. It would seem unlikely that enough of the Americans contributing data were cooking these foods using low AGE methods to offset a negative signal from the high AGE cooking methods so common in the SAD. Also, the paper I posted earlier in this thread suggests that the technology used to create the dAGE database around 2010 has been superceded by more accurate technology and the food AGE results are quite different from what we've come to expect. I haven't had time to look closely at either paper
.
Agree, maybe a premature conclusion. I immediately thought deep fried chicken with breading when I saw the discrepancy. I rarely enjoy chicken, but when I do the skin is a treat for me, rich in oleic acid and collagen. I can't imagine that it's intrinsically bad unless it's overcooked and charred.

I just glanced at your AGEs papers, but need to take a deeper dive. Yes, many foods have high AGEs, not just charred meat, but that doesn't make charred meat healthful, but rather also implicates sweet and processed food cooked at high temps. I think there's also a convergence towards understanding that AGEs come from exogenous and endogenous sources and the overall glycation load in your body can turn even a healthful food into a harmful food. A take away for me is to avoid over-cooking everything, especially protein. Cooking at lower temperatures for longer periods appears to be helpful. Another take-away for me is to avoid sweet and processed food to reduce the overall AGE burden.
I find that vegetables cooked sous vide with a bit of EVOO are as or more enjoyable than they are roasted in EVOO. (Tonight it was tender fennel and parsnips in EVOO with a bit of salt and Zatar seasoning. Tomorrow night it will be tender curried cauliflower.) When cooking meat or fish using the sous vide, most cooks will sear it afterwards, but that step can be skipped.
I'm intrigued and want to learn more about sous vide. I know you're not cooking in plastic; are you using silicone or glass instead? I found this Wellness Mama Sous Vide article helpful. Tell us more about how you are doing it.
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Re: Protein for prevention of cognitive decline

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circular wrote: Sun Jan 23, 2022 7:44 pm Other great kitchen tools that produce food low in AGEs are the sous vide and instant pot. I find that vegetables cooked sous vide with a bit of EVOO are as or more enjoyable than they are roasted in EVOO. (Tonight it was tender fennel and parsnips in EVOO with a bit of salt and Zatar seasoning. Tomorrow night it will be tender curried cauliflower.) When cooking meat or fish using the sous vide, most cooks will sear it afterwards, but that step can be skipped.
After reading this last night, I spent hour reading about sous vide cooking, both in other threads here and elsewhere online. Like Julie, I am interested in knowing more about your set up for sous vide cooking.
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Re: Protein for prevention of cognitive decline

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Julie G wrote: Mon Jan 24, 2022 9:02 am I'm intrigued and want to learn more about sous vide. I know you're not cooking in plastic; are you using silicone or glass instead? I found this Wellness Mama Sous Vide article helpful. Tell us more about how you are doing it.
floramaria wrote: Mon Jan 24, 2022 10:05 am After reading this last night, I spent hour reading about sous vide cooking, both in other threads here and elsewhere online. Like Julie, I am interested in knowing more about your set up for sous vide cooking.
Hi Julie and floramaria!

I bought the Joule sous vide cooker for $150 during Amazon Prime Day. It was on sale again during the last APD, so that's just a heads up if you want one discounted. The only other accoutrement I've bought for it are these silicone pouches. So the total is under $200. This set up might not work too well if you're feeding more than two people. We haven't had many visitors during the pandemic, so I haven't been incentivized to invest in more sous vide equipment.

So I've mostly been cobbling my own system together from things on hand. The silicone pouches I bought two of to use instead of plastic are the exception. I use my big SS stock pot that wasn't getting any other use (since I cook soup now in the Instant Pot). I put a metal trivet in the bottom so that the pouch doesn't rest on the bottom of the pot and water circulates well underneath the food. I clamp the Joule onto the side of the pot. Then I put the food and flavorings into the pouches. If I'm cooking chicken breast, steak or a pork chop I hit with a heavey SS SS meat whammer. I then clip the pouches to the sides of the pot using bag clips and leaving them with as little air as possible as I immerse them. After that, since the dang things float, I rest the heavy SS meat whammer on top to hold them down, trying to use the edges of it so as much of the food has water circulating over it as possible. Vegetables are especially floaty and I often need to use both the meat whammer and my small granite mortar to hold them down.

One of the great things you may have read about it is that it's very easy and, as with a crock pot you don't have to watch your food. If you're out running an errand, or just plain running, and the timer finished, the food will stop cooking and stay warm.

I've noticed the higher quality of meat I'm using the better.

It can take some getting used to the way the meat looks when you eat it without searing it. There's no grilled, roasted or seared crust to it. That is, is doesn't look cooked the way we're used to that. It's just wonderfully tender and may show any herbs, rubs, lemon slices, other other enhancements you've added.

There are other sous vide companies, notably Anova. They may be as good and cheaper. I'll just say that when buying the Joule, especially since it was 25% off on APD, I went with the possibility that with sous vide cookers you may get what you pay for. I can't base that on any experience or hearsay whatsoever. Along the way the clamp on my 1-2 year old Joule started coming off, so that wasn't very high end behavior, but the company immediately sent me a brand new one. I suspect it was a weakness they discovered after it went to market and the new one seems to have a tighter clamp.
ApoE 3/4 > Thanks in advance for any responses made to my posts.
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Re: Protein for prevention of cognitive decline

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I should add that I don't know for certain that sous vide maintains low AGEs. It does cook with low heat over a longer period (but not as long as a crock pot unless you're cooking a huge piece of meat), but the food is sealed off from the water, so it's not the same as steaming or boiling. Would that be considered a dry heat? I've wondered this, but my hunch is telling me that the low temperatures are enough to make it qualify as a low AGE cooking method.
ApoE 3/4 > Thanks in advance for any responses made to my posts.
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Re: Protein for prevention of cognitive decline

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From the 2010 paper I liked to above, they tested cooked foods from 2003 to 2008 using:
Briefly, food samples were homogenized and dissolved in phosphate buffer saline and the supernatants tested for AGEs with enzyme-linked immunosorbent assay [ELISA] based on a monoclonal anti-CML antibody (4G9) (29,30). The AGE content of each food item was based on the mean value of at least three measurements per sample and expressed as AGE kilounits/100 g food.

Selected items from different food categories were tested by a second enzyme-linked immunosorbent assay [ELISA] for content of MG-derivatives using an anti-MG monoclonal antibody (3D11 mAb) (29) and the results were expressed as nmol/100 g or nmol/100 mL food. The test sensitivity for CML and MG was 0.1 U/mL and 0.004 nmol/mL, respectively; the intra-assay variation was ±2.6% (CML) and ±2.8% (MG) and the inter-assay variation was ±4.1% (CML) and ±5.2% (MG).
From the 2017 paper I linked to above, adds these twists:
Early research suggested that Western-style fast foods, including grilled and broiled meats and French fries, contain high levels of proinflammatory advanced glycation end products (AGEs). However, recent studies with state-of-the-art ultraperformance LC-tandem mass spectrometry (UPLC-MS) found that there is no evidence that these foods have elevated levels of dAGEs relative to other foods. Paradoxically, observational research found that the intake of fruits (mainly apples), fruit juices (apple juice), vegetables, nuts, seeds, soy, and nonfat milk, which are foods synonymous with healthy eating, as well as the intake of cold breakfast cereals, whole grains (breads), and sweets, which are sources of high-fructose corn syrup (HFCS), were associated with elevated serum and urinary N-ε-carboxymethyl-lysine (CML). Ironically, these are the same foods found to have lower CML levels, as measured by UPLC-MS. [Emphases added]
This review out in Oct of last year might be interesting and hopefully addresses this issue with the most recent research, but it's behind a paywall:

Translating the advanced glycation end products (AGEs) knowledge into real-world nutrition strategies
Despite the well-elucidated disease mechanisms, little is known about the AGEs/nutrition nexus in the circles of clinical practice recommendations. This review seeks to translate the accumulated knowledge about the biochemistry and pathophysiology of AGEs into a nutritional intervention based on real-world prescriptions.
ApoE 3/4 > Thanks in advance for any responses made to my posts.
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Re: Protein for prevention of cognitive decline

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circular wrote: Tue Jan 25, 2022 7:26 pm
Hi Julie and floramaria!
Thanks, circ, for the detailed description of your sous vide set up!
I appreciate your including the info about having to weigh down your floating silicone pouches.
That gave me a laugh and if I decide to try this, I'm sure being pre-warned and learning from your experience will save me a lot of frustration!
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Re: Protein for prevention of cognitive decline

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floramaria wrote: Tue Jan 25, 2022 9:33 pm
circular wrote: Tue Jan 25, 2022 7:26 pm
Hi Julie and floramaria!
Thanks, circ, for the detailed description of your sous vide set up!
I appreciate your including the info about having to weigh down your floating silicone pouches.
That gave me a laugh and if I decide to try this, I'm sure being pre-warned and learning from your experience will save me a lot of frustration!
You're welcome. There are also sous vide weights available online. Some are heavy cylinders while others look like medieval mail. The sous vide food tanks available usually have vertical racks to hold each food item, and a top latches over the top of them so the food doesn't float. For this setup you'd need food grade silicone bags rather than the ones I'm using.

Like with many new kitchen gadgets, it may seem like more than you want to take time to learn, but it's really made delicious cooking sooooo much simpler and fun for me. I use it all the time. My favorite kitchen tools … none of them cheap … are the sous vide, Instant Pot, BlendTec blender, and countertop oven. I rarely use the last and never use the stove oven. It's helpful that I normally only cook for one or two people at a time.
ApoE 3/4 > Thanks in advance for any responses made to my posts.
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