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The main strategies to prevent metabolic diseases are lifestyle and dietary interventions, including an emphasis on low-glycemic or low-glycemic-load meals. Meals with a high glycemic load produce a higher blood glucose response and adverse metabolic consequences, including high insulin levels, reactive hypoglycemia, and eventual insulin resistance.

Age-related cognitive decline, defined as non-pathological yet meaningful decreases in memory and mental abilities, can develop with advancing age in any person. Epidemiological studies suggest that better nutritional habits are associated with lower rates of cognitive decline, and polyphenols in fruits and vegetables have specifically been associated with better cognitive function in older adults.

Osteoporosis-related fractures affect as many as half of all women and a quarter of all men over the age of 50. Bisphosphonate medications have been shown to reduce fracture risk, but their use is limited by fears of side effects and a recommended duration of use no longer than 3-5 years. Safer options that can be taken for more extended periods of time are needed to reduce bone loss and fracture risk in older adults.

Effective management of hypertension is an important way to reduce the risk of acute coronary events and stroke. Systematic reviews have concluded that blood pressure can be lowered by losing weight, reducing sodium intake, and increasing potassium intake. Studies such as the PREDIMED trial suggest that a Mediterranean diet pattern and increased nut consumption may also help to lower blood pressure—supporting the concept of a more synergistic effect of the overall dietary pattern. As part of a secondary analysis of data from a weight loss study (HealthTrack), researchers examined the effect of individualized dietary advice and walnut supplementation on blood pressure.

Glaucoma is a chronic condition that progressively damages the optic nerve, leading to vision loss and potential blindness. Because increased intraocular pressure (IOP) can contribute to optic nerve damage, a primary goal in glaucoma management is to lower IOP. IOP-lowering eyedrops are first-line therapy, and surgery is indicated in more advanced cases. Few other options exist to slow the progression of glaucoma.

Chronic inflammation accompanies most chronic diseases, and diabetes is no exception. Vitamin D has been shown to play a role in glycemic control and reducing the risk of diabetes. Increasing evidence points to its anti-inflammatory effect as the primary mechanism of action. For example, vitamin D has demonstrated (in human and animal studies) to improve insulin sensitivity by inhibiting cytokine-induced apoptosis of beta cells. Because of mixed results from cross-sectional and clinical trials, however, there is no consensus on the effect of vitamin D supplementation on inflammation in diabetes. 

Exercise and muscle performance are influenced by nutritional status and might be improved by nutrient supplementation. Short-term studies of up to 7 days have found that L-citrulline malate supplementation improves skeletal muscle metabolism and that the combination of L-citrulline and reduced glutathione (GSH) boosts plasma levels of L-citrulline, L-arginine, and nitric oxide metabolites—compounds that support muscle mass. 

Subjective cognitive decline refers to the self-reported decline in cognitive function without evidence of mild cognitive impairment (MCI) or Alzheimer’s disease (AD). Subjective cognitive decline increases the risk for future dementia and provides a window of opportunity to target modifiable risk factors. Diet and nutritional supplementation are important aspects of risk modification.

Previous prospective studies have found that green leafy vegetables offer more protection against cognitive decline than any other vegetables. To further explore this association and to evaluate individual nutrients in green leafy vegetables, researchers conducted another prospective study, which was published in 2018 in the journal Neurology.

Cognitive function often declines after a stroke, and the prevalence of dementia in stroke survivors is approximately 30%. In a multicenter, randomized, controlled trial, researchers investigated the effects of Ginkgo biloba extract on neurological deficits and cognitive decline after acute stroke.

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