You might be interested in…Diet and Lifestyle

Over the last few weeks several interesting papers on the topic of lifestyle and diet have been published. I would like to summarise the most relevant ones that I have found here.

Music, Physical activity and dementia prevention
Dementia is characterised by a progressive worsening of cognitive function leading to a loss of function and independence. Alzheimer’s Disease (AD) is the main cause of dementia and a major cause of mortality.

Dr Ray O’Connor

Importantly, dementia also represents a major public health issue. Keeping the brain active during life has been associated with an increased cognitive reserve, therefore reducing the risk of cognitive impairment in older age. Previous research has identified a potential relationship between musicality and cognition.

This was a nested study1 within the PROTECT‐UK cohort, which collects longitudinal computerised assessments of cognitive function in adults over 40. The objective was to explore the relationship between musicality and cognitive function in a large cohort of older adults. Participants were invited to complete the validated Edinburgh Lifetime Musical Experience Questionnaire (ELMEQ) to assess their musical experience and lifetime exposure to music. Analysis identified an association between musicality and cognition in this cohort.

Playing a musical instrument was associated with significantly better performance in working memory and executive function. Significant associations were also found between singing and executive function, and between overall musical ability and working memory.

The authors concluded that their findings confirm previous literature, highlighting the potential value of education and engagement in musical activities throughout life as a means of harnessing cognitive reserve as part of a protective lifestyle for brain health.

Active travel modes, such as walking and cycling, are feasible and readily embraced forms of physical activity. This prospective cohort study2 included data collected from the UK Biobank from March 2006 to October 2010. The objective was to investigate the long-term association between travel modes and dementia risk and brain structural metrics and to evaluate whether genetic predisposition could modify the association between travel modes and dementia risk.

The incidence of all-cause dementia was the primary outcome, and dementia subtypes, such as AD and brain structure, were the secondary outcomes; all were identified through hospital records and death registers. Brain structure was measured by a magnetic resonance imaging scan. The study encompassed 479,723 participants (mean age 56.5 years; 260,730 females [54.4 per cent]). Over a median follow-up of 13.1 years, 8,845 cases of dementia (1.8 per cent) and 3,956 cases of AD (0.8 per cent) were recorded.

The findings were that cycling and mixed-cycling mode was associated with a reduced risk of all-cause dementia, including Young Onset Dementia, Late Onset Dementia and AD. In addition, active travel modes were associated with increased hippocampal volume, suggesting a promising approach for maintaining brain health.

Steps per day for Health:
Despite the rapid increase in evidence from the past decade on daily steps and health-related outcomes, existing systematic reviews primarily focused on few outcomes, such as all-cause mortality.

This systematic review and meta-analysis3 synthesised the prospective dose-response relationship between daily steps and health outcomes including all-cause mortality, cardiovascular disease, cancer, type 2 diabetes, cognitive outcomes, mental health outcomes, physical function, and falls.

The authors concluded that although 10,000 steps per day can still be a viable target for those who are more active, 7,000 steps per day is associated with clinically meaningful improvements in health outcomes and might be a more realistic and achievable target for some.

They also point out that findings of the study should be interpreted in light of limitations, such as the small number of studies available for most outcomes, a lack of age-specific analysis and biases at the individual study level, including residual confounding.

Alcohol and Pancreatic Cancer
Alcohol is a known carcinogen, yet the evidence for an association with pancreatic cancer risk is considered as limited or inconclusive by international expert panels. The authors of this combined prospective cohort study4 examined the association between alcohol intake and pancreatic cancer risk in a large consortium of prospective studies.

Population-based individual-level data was pooled from 30 cohorts across four continents, including Asia, Australia, Europe, and North America. A total of 2,494,432 participants without cancer at baseline (62 per cent women, 84 per cent European ancestries, 70 per cent alcohol drinkers [alcohol intake ≥ 0.1 g/day], 47 per cent never smokers) were recruited between 1980 and 2013 at the median age of 57 years and 10,067 incident pancreatic cancer cases were recorded.

Their conclusion was that there is a modest positive association between alcohol intake and pancreatic cancer risk, irrespective of sex and smoking status. Associations were particularly evident for baseline alcohol intake of at least 15 g/day in women and 30 g/day in men.

Dietary Modification for Reducing Blood Pressure
People with type 2 diabetes and hypertension are at high risk for blood pressure–related cardiovascular events. Dietary Approaches to Stop Hypertension for Diabetes (DASH4D)5 was a randomized four-period crossover feeding study conducted at a community-based study centre from June 2021 to June 2024. It included adults with type 2 diabetes, a systolic blood pressure of 120 to 159mmHg, and a diastolic blood pressure of less than 100mmHg.

The DASH4D diet is a Dietary Approaches to Stop Hypertension (DASH)–style diet optimized for people with type 2 diabetes (lower carbohydrates, higher unsaturated fats, and lower potassium than the original DASH diet).

Participants were provided all of their food and ate no outside food. Weight was held constant. Data analysis was completed in November 2024. The objective was to determine the effects of dietary patterns and sodium reduction on blood pressure in adults with type 2 diabetes. Participants were randomized to a sequence of four diets, each for five weeks: (1) DASH4D diet with lower sodium, (2) DASH4D diet with higher sodium, (3) comparison (typical US) diet with lower sodium, and (4) comparison diet with higher sodium (reference). The conclusion was that for adults with type 2 diabetes, most of whom were treated with multiple antihypertensive medications, the ASH4D diet combined with sodium reduction achieved a clinically relevant reduction in blood pressure, primarily from sodium reduction.

References:

1. Vetere G et al. The relationship between playing musical instruments and cognitive trajectories: Analysis from a UK ageing cohort. Int J Geriatr Psychiatry. 2024;e6061. https://doi.org/10.1002/gps.6061
2. Hou C et al. Active Travel Mode and Incident Dementia and Brain Structure. JAMA Network Open. 2025;8(6):e2514316. https://doi.org/10.1001/jamanetworkopen.2025.14316
3. Ding D et al. Daily steps and health outcomes in adults: a systematic review and dose-response meta-analysis. Lancet Public Health 2025 Published Online July 23, 2025 https://doi.org/10.1016/S2468-2667(25)00164-1
4. Naudin S et al. Alcohol intake and pancreatic cancer risk: An analysis from 30 prospective studies across Asia, Australia, Europe, and North America. PLoS Med 22(5): e1004590. (Published May 2025) https://doi.org/10.1371/journal.pmed.1004590
5. Pilla S et al. Dietary Patterns, Sodium Reduction, and Blood Pressure in Type 2 Diabetes The DASH4D Randomized Clinical Trial. JAMA Intern Med. doi:10.1001/jamainternmed.2025.1580. Published online June 9, 2025.