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2 Minute Medicine Rewind June 29, 2026
Diet Quality and Dementia Risk in Older Adults With Alzheimer Pathology
1. Greater adherence to a dietary pattern with lower inflammatory potential was associated with lower dementia risk among individuals with Alzheimer’s pathology and broader neurobiological risk.
Evidence Rating Level: 2 (Good)
Alzheimer’s disease (AD) is a leading cause of dementia. Evidence suggests that nutrients, foods, and dietary patterns may mitigate AD. However, it is unclear whether higher diet quality slows dementia onset in individuals with AD pathology. This study thus examined the relationship between diet quality and dementia risk among older adults with AD or broader neurodegenerative and glial processes. This cohort study included adults aged >60 years without dementia from a prospective Swedish Study. Adherence to 3 dietary patterns was assessed using specific scoring systems: the Alternate Mediterranean Diet (AMED), Alternative Healthy Eating Index (AHEI), and reversed Empirical Dietary Inflammatory Index (rEDII). Higher dietary pattern adherence scores indicated higher diet quality. Baseline data on blood-based biomarkers reflecting AD-related pathology (phosphorylated tau at threonine 217 [p-tau217]) and neurobiological risk (neurofilament light chain [NFL], glial fibrillary acidic protein [GFAP]) were included. The primary outcome was all-cause dementia. Among the 1865 participants in the study cohort (mean [SD] age at baseline, 70.5 [9.3] years; 1125 female [60.3%]), 240 participants developed dementia over a mean follow-up of 8.4 years (range, <0.1 to 15.9 years). Higher adherence to rEDII was associated with lower dementia risk among those with higher levels of p-tau217 (hazard ratio [HR], 0.71; 95% CI, 0.58-0.88), NFL (HR, 0.79; 95% CI, 0.66-0.95), and GFAP levels (HR, 0.73; 95% CI, 0.60-0.89). Higher adherence to AMED and AHEI was associated with lower dementia risk among participants with lower biomarker levels, but not among those with higher levels. Overall, this study found that greater adherence to a dietary pattern with lower inflammatory potential was associated with lower dementia risk among individuals with AD pathology and broader neurobiological risk. These findings underscore the importance of dietary interventions for dementia prevention for both the general population and those already at a higher disease risk.
Long-Term Resistance Training and Risk of Type 2 Diabetes
1. Resistance training among US adult health care professionals was associated with lower T2D risk, especially when performed consistently over midlife and combined with adequate aerobic activity and limited sedentary television viewing.
Evidence Rating Level: 2 (Good)
Although performing resistance training is recommended in current US guidelines, more research is needed on optimal long-term patterns of resistance training, including volume, consistency, and integration with other lifestyle behaviors. This study thus investigated whether long-term resistance training is associated with reduced type 2 diabetes (T2D) risk, and how combinations with aerobic activity and sedentary behavior are additionally associated with T2D risk. This study included adult health care professionals from three US prospective cohort studies who had undergone at least 3 assessments of resistance training between 40 and 60 years of age. The primary outcome was incident T2D. Among the 143,715 participants analyzed (mean [SD] age, 56.0 [10.5] years; 78.3% women), 10,038 incident T2D cases were reported during a mean (SD) follow-up of 19.2 (5.0) years. Participants engaging in 2 or more hours per week of resistance training had a 27% lower T2D risk (HR, 0.73; 95% CI, 0.66-0.81) compared with those with no resistance training. In trajectory analyses, a lower T2D risk was found for participants with consistently high levels of resistance training (≥0.5 h/week across midlife) (HR, 0.58; 95% CI, 0.45-0.74), a high to low pattern (HR, 0.82; 95% CI, 0.67-0.99), and low to high pattern (HR, 0.79; 95% CI, 0.66-0.94), compared to those with consistently low levels of resistance training. The lowest T2D risk was found for participants who met recommendations for both aerobic activity (≥15 total metabolic equivalent h/week) and resistance training (≥1 h/week) and limited television viewing (<2 h/d) (HR, 0.38; 95% CI, 0.34-0.42) compared with those meeting none of the recommendations. Overall, this study found that among US adult health care professionals, resistance training was associated with lower T2D risk, especially when performed consistently over midlife alongside adequate aerobic activity and limited sedentary television viewing. These findings highlight the importance of including resistance training in the prevention of diabetes.
1. Allophone home care recipients with terminal cancer had an increased risk of death, emergency department visits, and hospital admission within the last 30 days of life compared to anglophones.
Evidence Rating Level: 2 (Good)
Cancer patients and their families with language barriers may face additional challenges when confronted with medical decisions. It is unknown how patient-preferred language impacts health outcomes of patients with cancer. This study thus investigated the association between patient-preferred language and end-of-life outcomes in home care patients who died of cancer. This retrospective cohort study included home care recipients who died of cancer between 2013 and 2018 in Ontario, Canada. The primary outcomes included place of death, emergency department (ED) visits and hospital admissions within the last 30 days of life. Secondary outcomes included aggressive interventions. Among the 33,958 patients analyzed, there were 28,322 (83.4%) anglophones, 786 (2.3%) francophones, and 4,850 (14.3%) allophones. Among allophones, the 5 most spoken languages included: Italian (28.1%), Chinese (12.5%), Portuguese (7.5%), Polish (4.3%), and Russian (3.4%). After adjusting for confounding, allophones had higher odds of death in hospital (OR 1.35, 95% CI 1.25–1.45), hospital admissions (OR 1.16, 95% CI 1.07–1.24), and ED visits (OR 1.16, 95% CI 1.08–1.24) compared to anglophones. Compared to anglophones, allophones also had increased odds of aggressive interventions in the last 30 days of life including mechanical ventilation (OR 1.43, 95% CI, 1.16–1.76), CPR (OR 2.52, 95% CI, 1.73–3.69), initiation of dialysis (OR 1.56, 95% CI, 1.07–2.28), and blood transfusions (OR 1.23, 95% CI, 1.10–1.39). Francophones also had increased odds of death in hospital (OR 1.23, 95% CI 1.04–1.46) compared to anglophones. Overall, this study found that in Ontario, Canada, allophone home care recipients with terminal cancer had an increased risk of death in hospital, ED visits, and hospital admissions compared to anglophones. These findings underscore the importance of language as a determinant of health in end-of-life care.
1. The association between parental body mass index (BMI) and offspring BMI from age 6 months to 8 years may primarily be due to genetic confounding.
Evidence Rating Level: 2 (Good)
Although parental body mass index (BMI) has been associated with offspring adiposity in childhood, the mechanisms behind this relationship remain unclear. This study thus explored whether these associations are due to genetic confounding (inheritance), rather than to a causal effect of parental BMI on offspring obesity traits. This cohort study analyzed data from a prospective study in Norway, which included births between 1999 and 2009 in Norway. The exposures were maternal pre-pregnancy BMI and paternal BMI during pregnancy at baseline (~17 weeks gestation). Offspring outcomes included birth weight and BMI assessed between age 6 months and 8 years, and appetite-related eating behaviour traits assessed at age 8 years. A genetically informed structural equation model (SEM) was used to analyze a population-based sample of twins, siblings and half-siblings, and their children to determine the extent to which associations were due to genetic confounding. Up to 85,866 children (51.3% male) were analyzed, with 50,999 children included in the SEM models. Compared to paternal BMI, higher maternal BMI was more strongly associated with offspring birthweight (β 0.12, 95% CI, 0.12-0.13 vs 0.01, 0.01-0.02). However, this maternal-paternal difference decreased for offspring BMI after birth, with associations becoming similar for offspring BMI at ages 2 to 5 years. Greater maternal and paternal BMI were associated with increased food responsiveness and emotional overeating, and reduced emotional undereating. In SEM analyses, genetic confounding did not explain the association between parental BMI and offspring birthweight; however, it did explain the majority of the association with offspring BMI from 6 months to 8 years. For 8-year BMI, genetic confounding explained 79% (95% CI [62, 95]; p = 1.9 × 10−12) of the association with maternal BMI and 94% (95% CI [72, 113]; p = 2.7 × 10−14) of the association with paternal BMI. Overall, this study found that the association between parental BMI and offspring BMI from age 6 months to 8 years may be primarily due to genetic confounding. These findings suggest that parental BMI do not have a large causal effect on childhood BMI.
1. Male sex and Hispanic ethnicity were associated with increased risk of EOCRC
2. Among females, higher birthweight and older paternal age were associated with increased EOCRC risk.
3. Among males, having a foreign-born mother was associated with lower EOCRC risk.
Evidence Rating Level: 3 (Average)
Early-onset CRC (EOCRC) is defined as CRC diagnosed among individuals <50 years of age and is the leading cause of cancer-related mortality in this population in the US, with the incidence steadily increasing. It is unclear how demographic, birth, and parental characteristics are associated with the risk of EOCRC, particularly among growing minority groups such as Hispanics. This study thus examined the association between demographic, birth, parental characteristics, and risk of EOCRC among individuals in California. This case-control study included cases born and diagnosed with EOCRC at the age of 0 to 39 years in California from 1988 through 2021. Diagnosed cases were frequency-matched to controls (1:50 case to control ratio) based on birth year. This study included 1,221 cases (mean [SD] age at diagnosis, 29.07 [5.80] years), matched to 61,050 controls. The primary outcome was incident EOCRC. In total, 44.88% identified as Hispanic, 36.45% identified as non-Hispanic White, 64.54% were US-born mothers, and of those with foreign-born mothers, 60.97% were born in Mexico. After adjusting for confounding, males had a 34% higher risk of EOCRC compared to females (OR = 1.34; 95% CI, 1.20–1.51), and Hispanic ethnicity was associated with 43% higher risk of EOCRC compared to non-Hispanic White individuals (OR = 1.34; 95% CI, 1.20–1.51). Among males, having a foreign-born mother was associated with a lower risk of EOCRC (OR = 0.79; 95% CI, 0.65–0.95). Among females, every 500-g increase in birthweight was associated with 10% increase in EOCRC risk (OR = 1.10; 95% CI, 1.01–1.21). Having a father aged ≥35 years was also associated with a higher risk of EOCRC (OR = 1.56; 95% CI, 1.08–2.25). Overall, this study found that male sex and Hispanic ethnicity were associated with increased risk of EOCRC. Among females, higher birthweight and older paternal age were also associated with increased EOCRC risk. In contrast, maternal birthplace was found to be protective against EOCRC, particularly among males. Future studies are needed to confirm these findings.
Image: PD
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