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Healthy Ageing in Singapore. Prioritising Brain and Cognitive Health with Diet.

Updated: Apr 5

Singapore Alzheimer's cognitive decline

Multi-ethnic Singapore has a rapidly aging population. In this article we look at what we can do to reduce risk of cognitive decline, from a Singapore dietary perspective.

Before we focus on our tropical city state, it is worthwhile to mention the well-studied health benefits of the Mediterranean diet and provide us with a reference point. The traditional Mediterranean dietary pattern is characterised by a generous intake of fruit, vegetables, legumes, nuts, whole grains and fish. A generally moderate intake of alcohol and dairy products (yogurt and cheese), a low intake of red or processed meats, saturated fats and sweets. The diet has a high ratio of monounsaturated fatty acids to saturated fatty acids and is polyphenol rich from the use of olive oil and herbs. 


While this is a euro-centric eating practice, with Western flavours, it is not dissimilar to other traditional based eating practices across the world: plant forward and rich in whole foods. Using the principles of the Mediterranean diet scientists derived a brain healthy eating pattern, the MIND Diet, that can be practised anywhere. The DASH diet, an hypertensive eating practice has also shown to be neuroprotective.


Taste appropriate traditional Asian diets, in the modern setting, can also be enjoyed healthy with a little attention to the shopping basket and cooking techniques. These can comfortably encompass the principles behind both the MIND and DASH diets.


As ever, please talk to your doctor or medical practitioner most familiar with your medical history before implementing any changes in diet, exercise or lifestyle, especially if you are under treatment. Links to supporting studies and resources are found at the end of page.

 

Singapore Study


Coming closer to home, back to Singapore, what elements of the diet have researchers found to positively affect brain health? Here is what the researchers found as part of the DaHa study that looked at local eating patterns:

“Our cross-sectional data revealed the potential role of mushrooms and its bioactive compounds in delaying neurodegeneration.

In our cohort, whole blood ergothioneine levels declined significantly beyond 60 years of age, and people with MCI had significantly lower plasma ergothioneine levels compared with age-matched subjects with normal cognitive function. Mushrooms are one of the richest sources of ergothioneine. Examination of mushroom consumption found reverse association with the odds of having MCI. Participants who consumed mushrooms >2 portions per week had reduced odds of having MCI than those who consumed mushrooms less than once per week.


mushrooms brain health

In examination of dietary habits, participants with frequent (≥4 days per week) fruit consumption and active (≥4 days per week) bowel movement within 10 minutes were negatively associated with MCI occurrence.

In addition, a cross-sectional evaluation of diet-mental health relationship found that long-term tea consumption was significantly associated with a reduced odds of having depressive and anxiety symptoms among DaHA participants. In a Magnetic Resonance Imaging study, we found that regular tea drinkers had more efficient brain structural network as compared with non-tea drinkers. Those studies will be followed up by examining tea’s bioactive compounds such as L-theanine and catechins in the peripheral blood in cognitively impaired elderly subjects and cognitively normal subjects.


Source: Yu R, Sun Y, Ye KX, Feng Q, Lim SL, Mahendran R, Cheah IK, Foo RSY, Chua RY, Gwee X, Loh M, Sarmugam R, Khine WWT, Chao YX, Larbi A, Lee YK, Kumar AP, Kennedy BK, Kua EH, Feng L. Cohort profile: the Diet and Healthy Aging (DaHA) study in Singapore. Aging (Albany NY). 2020 Nov 18;12(23):23889-23899. doi: 10.18632/aging.104051. Epub 2020 Nov 18. PMID: 33271510; PMCID: PMC7762480.

 

Malaysia, Our Neighbour


Looking across the border to Malaysia, a small scale study also found eating patterns associated with brain health and cognitive decline. The diet that was associated with best brain health? One associated with eating “tropical fruit and oats”.


The diet associated with greatest risk of cognitive impairment was defined as "local snacks - fish and seafoods - high salt foods". Now usually fish and seafood are associated with better brain health; so what is going on? The study speculates that as the fish are deep fried, the positive effect from the healthy omega-3 fats has been destroyed by the cooking technique. Salt is associated with high blood pressure.


deep fried fish omega 3
Deep fried fish, delicious but the healthy omega-3 oils are damaged.
 

Kopi Culture


Another brain healthy habit from both Malaysia and Singapore is a good cup of kopi – coffee. While local studies have show an association with coffee drinking and decreased physical frailty, there is excellent evidence on a global level that consumption of coffee or green tea is neuroprotective.


Just be aware that the caffeine from tea and especially coffee can affect your sleep. And try to have a low sugar option - siew dai or kosong.

 

In this article we have focused on brain healthy eating, and there is more to it than than fruit, oats, mushrooms tea and kopi.


We must also mention the role of, say, polyphenol rich herbs and spices, and the benefits of flavonoid rich dark chocolate. Yum. As well as risk avoidance, especially, cigarettes and alcohol. And enjoying sufficient exercise and restorative sleep. And having a healthy social life.


All these, and more, are the pillars of health, the foundations of self-care and brain health.


Stay Healthy,


Alastair

 

Want to learn more? Enjoy our book recommendation below...


Sherzai Alzheimer's Solution
 

Achieve Your Health Goals


Your health (physical - mental - social) is complex and affected by multiple factors within and outside of your control. Through our personalised consultations and programs, we focus on targeted approaches to optimise your health, enhance performance and boost vitality; unique to your life and circumstances. Longevity and lifestyle medicine is an area that has always been of interest to us and our clients.


Contact us to arrange an introductory call, to discuss how we can support your journey to health. We are based in Singapore and work with clients globally.


Take the first step. Book a Whole Health Consult to assess, identify and prioritise key factors (known and unknown) that affect your health. And receive personalised recommendations on how to address them.


Want to put recommendations into action? Learn more about our programmes for individuals and teams.

 

Related Resources and Studies


Singapore – Dementia Singapore

Townsend RF, Logan D, O'Neill RF, Prinelli F, Woodside JV, McEvoy CT. Whole Dietary Patterns, Cognitive Decline and Cognitive Disorders: A Systematic Review of Prospective and Intervention Studies. Nutrients. 2023 Jan 9;15(2):333. doi: 10.3390/nu15020333. PMID: 36678204; PMCID: PMC9865080.


Huang L, Tao Y, Chen H, Chen X, Shen J, Zhao C, Xu X, He M, Zhu D, Zhang R, Yang M, Zheng Y, Yuan C. Mediterranean-Dietary Approaches to Stop Hypertension Intervention for Neurodegenerative Delay (MIND) Diet and Cognitive Function and its Decline: A Prospective Study and Meta-analysis of Cohort Studies. Am J Clin Nutr. 2023 Jul;118(1):174-182. doi: 10.1016/j.ajcnut.2023.04.025. Epub 2023 Apr 25. PMID: 37105521.

Malek Rivan NF, Shahar S, Fakhruddin NNINM, You YX, Che Din N, Rajikan R. The effect of dietary patterns on mild cognitive impairment and dementia incidence among community-dwelling older adults. Front Nutr. 2022 Aug 8;9:901750. doi: 10.3389/fnut.2022.901750. PMID: 36003836; PMCID: PMC9395130.

Ran LS, Liu WH, Fang YY, Xu SB, Li J, Luo X, Pan DJ, Wang MH, Wang W. Alcohol, coffee and tea intake and the risk of cognitive deficits: a dose-response meta-analysis. Epidemiol Psychiatr Sci. 2021 Feb 11;30:e13. doi: 10.1017/S2045796020001183. PMID: 33568254; PMCID: PMC8061189.

Yu R, Sun Y, Ye KX, Feng Q, Lim SL, Mahendran R, Cheah IK, Foo RSY, Chua RY, Gwee X, Loh M, Sarmugam R, Khine WWT, Chao YX, Larbi A, Lee YK, Kumar AP, Kennedy BK, Kua EH, Feng L. Cohort profile: the Diet and Healthy Aging (DaHA) study in Singapore. Aging (Albany NY). 2020 Nov 18;12(23):23889-23899. doi: 10.18632/aging.104051. Epub 2020 Nov 18. PMID: 33271510; PMCID: PMC7762480.

Wu J, Song X, Chen GC, Neelakantan N, van Dam RM, Feng L, Yuan JM, Pan A, Koh WP. Dietary pattern in midlife and cognitive impairment in late life: a prospective study in Chinese adults. Am J Clin Nutr. 2019 Oct 1;110(4):912-920. doi: 10.1093/ajcn/nqz150. PMID: 31374567; PMCID: PMC6766457. 

Chen JQA, Scheltens P, Groot C, Ossenkoppele R. Associations Between Caffeine Consumption, Cognitive Decline, and Dementia: A Systematic Review. J Alzheimers Dis. 2020;78(4):1519-1546. doi: 10.3233/JAD-201069. PMID: 33185612; PMCID: PMC7836063.

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