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Sprague BN, Tu W, Unverzagt FW, Moser LR, Adams M, Carter A, Dawkins E, Keith NR, Reinoso DR, Clark DO. Food resources and kitchen skills plus aerobic training (FoRKS+) for black adults with hypertension: A pilot trial protocol. Contemp Clin Trials 2024; 141:107533. [PMID: 38621517 PMCID: PMC11221607 DOI: 10.1016/j.cct.2024.107533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Revised: 03/21/2024] [Accepted: 04/10/2024] [Indexed: 04/17/2024]
Abstract
BACKGROUND Midlife hypertension is associated with cognitive decline and Alzheimer's disease and related dementia (ADRD), suggesting that blood pressure control may be a therapeutic target for dementia prevention. Given excess hypertension in non-Hispanic Black (NHB) adults, blood pressure control may also reduce ADRD disparities. We describe a pilot randomized controlled trial (RCT) to evaluate the feasibility and preliminary efficacy of a multicomponent lifestyle-based intervention versus enhanced usual care on cognition among middle-aged NHB adults. METHODS AND STUDY DESIGN The Food Resources and Kitchen Skills plus Aerobic Training (FoRKS+) study is a 2-arm, single-blinded trial that compares those receiving the FoRKS+ program (target N = 64) versus those receiving enhanced usual care (target N = 64) in local federally-qualified health centers. Key eligibility criteria include self-identified NHB adults between ages 35-75 with a mean systolic blood pressure ≥ 130 mm/Hg obtained from 24-h ambulatory blood pressure monitoring. The FoRKS+ program includes 5 weeks of hypertension self-management courses, 11 weeks of nutrition courses, and 12 weeks of aerobic training in dietitian and health coach-led virtual groups. We will collect data on primary cognitive outcomes, feasibility, hypothesized intervention mediators and moderators, and demographic and health covariates at baseline, near intervention weeks 16-, and 28 (primary outcome assessment), and week 52 follow-up. We will use mixed-effects modeling to examine intervention effects on cognition. DISCUSSION This pilot RCT will examine the feasibility and preliminary effects of a multicomponent lifestyle intervention on cognitive function in NHB adults, which may have implications for reducing health disparities in ADRD.
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Affiliation(s)
- Briana N Sprague
- Department of Medicine, Division of General Internal Medicine and Geriatrics, Indiana University School of Medicine, Indianapolis, IN, USA; Indiana University Center for Aging Research, Regenstrief Institute, Inc, Indianapolis, IN, USA.
| | - Wanzhu Tu
- Indiana University Center for Aging Research, Regenstrief Institute, Inc, Indianapolis, IN, USA; Department of Biostatistics and Health Data Science, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Frederick W Unverzagt
- Indiana University Center for Aging Research, Regenstrief Institute, Inc, Indianapolis, IN, USA; Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Lyndsi R Moser
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Mariah Adams
- Department of Kinesiology, Indiana University Bloomington, Bloomington, IN, USA
| | - Amy Carter
- Department of Biostatistics and Health Data Science, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Emily Dawkins
- Department of Biostatistics and Health Data Science, Indiana University School of Medicine, Indianapolis, IN, USA
| | - NiCole R Keith
- Indiana University Center for Aging Research, Regenstrief Institute, Inc, Indianapolis, IN, USA; Department of Kinesiology, Indiana University Bloomington, Bloomington, IN, USA
| | - Deanna R Reinoso
- Department of Biostatistics and Health Data Science, Indiana University School of Medicine, Indianapolis, IN, USA; Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Daniel O Clark
- Department of Medicine, Division of General Internal Medicine and Geriatrics, Indiana University School of Medicine, Indianapolis, IN, USA; Indiana University Center for Aging Research, Regenstrief Institute, Inc, Indianapolis, IN, USA
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Kmail A. Mitigating digestive disorders: Action mechanisms of Mediterranean herbal active compounds. Open Life Sci 2024; 19:20220857. [PMID: 38645751 PMCID: PMC11032100 DOI: 10.1515/biol-2022-0857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2023] [Revised: 03/06/2024] [Accepted: 03/07/2024] [Indexed: 04/23/2024] Open
Abstract
This study explores the effects of the Mediterranean diet, herbal remedies, and their phytochemicals on various gastrointestinal conditions and reviews the global use of medicinal plants for common digestive problems. The review highlights key plants and their mechanisms of action and summarizes the latest findings on how plant-based products influence the digestive system and how they work. We searched various sources of literature and databases, including Google Scholar, PubMed, Science Direct, and MedlinePlus. Our focus was on gathering relevant papers published between 2013 and August 2023. Certain plants exhibit potential in preventing or treating digestive diseases and cancers. Notable examples include Curcuma longa, Zingiber officinale, Aloe vera, Calendula officinalis, Lavandula angustifolia, Thymus vulgaris, Rosmarinus officinalis, Ginkgo biloba, Cynodon dactylon, and Vaccinium myrtillus. The phytochemical analysis of the plants showed that compounds such as quercetin, anthocyanins, curcumin, phenolics, isoflavones glycosides, flavonoids, and saponins constitute the main active substances within these plants. These natural remedies have the potential to enhance the digestive system and alleviate pain and discomfort in patients. However, further research is imperative to comprehensively evaluate the benefits and safety of herbal medicines to use their active ingredients for the development of natural and effective drugs.
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Affiliation(s)
- Abdalsalam Kmail
- Faculty of Sciences, Arab American University Jenin, P. O. Box 240, Jenin, Palestine
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Ma YY, Li X, Yu JT, Wang YJ. Therapeutics for neurodegenerative diseases by targeting the gut microbiome: from bench to bedside. Transl Neurodegener 2024; 13:12. [PMID: 38414054 PMCID: PMC10898075 DOI: 10.1186/s40035-024-00404-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Accepted: 02/12/2024] [Indexed: 02/29/2024] Open
Abstract
The aetiologies and origins of neurodegenerative diseases, such as Alzheimer's disease (AD), Parkinson's disease (PD), amyotrophic lateral sclerosis (ALS) and Huntington's disease (HD), are complex and multifaceted. A growing body of evidence suggests that the gut microbiome plays crucial roles in the development and progression of neurodegenerative diseases. Clinicians have come to realize that therapeutics targeting the gut microbiome have the potential to halt the progression of neurodegenerative diseases. This narrative review examines the alterations in the gut microbiome in AD, PD, ALS and HD, highlighting the close relationship between the gut microbiome and the brain in neurodegenerative diseases. Processes that mediate the gut microbiome-brain communication in neurodegenerative diseases, including the immunological, vagus nerve and circulatory pathways, are evaluated. Furthermore, we summarize potential therapeutics for neurodegenerative diseases that modify the gut microbiome and its metabolites, including diets, probiotics and prebiotics, microbial metabolites, antibacterials and faecal microbiome transplantation. Finally, current challenges and future directions are discussed.
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Affiliation(s)
- Yuan-Yuan Ma
- Department of Neurology and Centre for Clinical Neuroscience, Daping Hospital, Third Military Medical University, Chongqing, 400042, China
- Institute of Brain and Intelligence, Third Military Medical University, Chongqing, 400042, China
- Chongqing Key Laboratory of Ageing and Brain Diseases, Chongqing, 400042, China
| | - Xin Li
- Army 953 Hospital, Shigatse Branch of Xinqiao Hospital, Third Military Medical University, Shigatse, 857000, China
| | - Jin-Tai Yu
- Department of Neurology and National Center for Neurological Disorders, Huashan Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Shanghai Medical College, Fudan University, Shanghai, 200040, China.
| | - Yan-Jiang Wang
- Department of Neurology and Centre for Clinical Neuroscience, Daping Hospital, Third Military Medical University, Chongqing, 400042, China.
- Institute of Brain and Intelligence, Third Military Medical University, Chongqing, 400042, China.
- Chongqing Key Laboratory of Ageing and Brain Diseases, Chongqing, 400042, China.
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Huang J, Yu Y, Li H, Wei Y, Sun M. Effect of dietary protein intake on cognitive function in the elderly with chronic kidney disease: analysis of the National Health and Nutrition Examination Survey 2011-2014. Ren Fail 2023; 45:2294147. [PMID: 38097960 PMCID: PMC10732213 DOI: 10.1080/0886022x.2023.2294147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 12/07/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND Cognitive dysfunction is prevalent among the elderly diagnosed with chronic kidney disease (CKD). Low protein diets are used for retarding the progression of CKD in clinical practice. Nonetheless, the impact of dietary protein consumption on cognitive function in this population remains uncertain. METHODS We recruited 2306 participants (≥60 years) from 2011 to 2014 National Health and Nutrition Examination Survey (NHANES). 24-h dietary recall questionnaire was utilized to evaluate protein intake. Cognitive function was measured using the Consortium to Establish a Registry for Alzheimer's Disease (CERAD), Animal Fluency Test (AFT), and Digit Symbol Substitution Test (DSST). Participants' characteristics were analyzed, and the interaction between protein consumption and CKD on cognitive impairment were analyzed using a logistic regression model. RESULTS We divided participants into three groups based on CKD stages: no CKD, CKD stage G1 to G2 (19%), and CKD stage G3 to G5 (18%). The average protein intake was 0.97 g/(kg·d). In the higher protein intake group, CKD stages G1 to G2 elevated the risk of immediate memory impairment (OR: 2.441, 95% Cl: 1.161-5.132 for protein consumption in 1.0-1.2g/(kg·d); OR: 2.225, 95% Cl: 1.015-4.876 for protein consumption in >1.2 g/(kg·d)). However, no similar resuts were observed in the lower protein intake group. In addition, the interaction between CKD status and protein intake on immediate memory was statistically significant (p = .041). CONCLUSION A higher probability of cognitive impairment in the elderly with early-stage CKD may be linked to higher protein intake. Low protein diets may be a potential strategy to release cognitive impairment in the elderly with early-stage CKD.
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Affiliation(s)
- Jingda Huang
- Department of Nephrology, First Hospital of Jilin University, Changchun, China
| | - Yang Yu
- The Fourth Clinical Medical College, Hebei Medical University, Shijiazhuang, China
| | - Huimin Li
- Department of Nephrology, First Hospital of Jilin University, Changchun, China
| | - Yihui Wei
- Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing, China
| | - Mindan Sun
- Department of Nephrology, First Hospital of Jilin University, Changchun, China
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Horvat A, Vlašić I, Štefulj J, Oršolić N, Jazvinšćak Jembrek M. Flavonols as a Potential Pharmacological Intervention for Alleviating Cognitive Decline in Diabetes: Evidence from Preclinical Studies. Life (Basel) 2023; 13:2291. [PMID: 38137892 PMCID: PMC10744738 DOI: 10.3390/life13122291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2023] [Revised: 11/15/2023] [Accepted: 11/24/2023] [Indexed: 12/24/2023] Open
Abstract
Diabetes mellitus is a complex metabolic disease associated with reduced synaptic plasticity, atrophy of the hippocampus, and cognitive decline. Cognitive impairment results from several pathological mechanisms, including increased levels of advanced glycation end products (AGEs) and their receptors, prolonged oxidative stress and impaired activity of endogenous mechanisms of antioxidant defense, neuroinflammation driven by the nuclear factor kappa-light-chain enhancer of activated B cells (NF-κB), decreased expression of brain-derived neurotrophic factor (BDNF), and disturbance of signaling pathways involved in neuronal survival and cognitive functioning. There is increasing evidence that dietary interventions can reduce the risk of various diabetic complications. In this context, flavonols, a highly abundant class of flavonoids in the human diet, are appreciated as a potential pharmacological intervention against cognitive decline in diabetes. In preclinical studies, flavonols have shown neuroprotective, antioxidative, anti-inflammatory, and memory-enhancing properties based on their ability to regulate glucose levels, attenuate oxidative stress and inflammation, promote the expression of neurotrophic factors, and regulate signaling pathways. The present review gives an overview of the molecular mechanisms involved in diabetes-induced cognitive dysfunctions and the results of preclinical studies showing that flavonols have the ability to alleviate cognitive impairment. Although the results from animal studies are promising, clinical and epidemiological studies are still needed to advance our knowledge on the potential of flavonols to improve cognitive decline in diabetic patients.
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Affiliation(s)
- Anđela Horvat
- Division of Molecular Medicine, Ruđer Bošković Institute, Bijenička 54, 10000 Zagreb, Croatia
| | - Ignacija Vlašić
- Division of Molecular Medicine, Ruđer Bošković Institute, Bijenička 54, 10000 Zagreb, Croatia
| | - Jasminka Štefulj
- Division of Molecular Biology, Ruđer Bošković Institute, Bijenička 54, 10000 Zagreb, Croatia
- Department of Psychology, Catholic University of Croatia, Ilica 242, 10000 Zagreb, Croatia
| | - Nada Oršolić
- Division of Animal Physiology, Faculty of Science, University of Zagreb, Rooseveltov trg 6, 10000 Zagreb, Croatia
| | - Maja Jazvinšćak Jembrek
- Division of Molecular Medicine, Ruđer Bošković Institute, Bijenička 54, 10000 Zagreb, Croatia
- Department of Psychology, Catholic University of Croatia, Ilica 242, 10000 Zagreb, Croatia
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Gonzalez Casanova I, Alonso-Gómez ÁM, Romaguera D, Toledo E, Li L, Fortuny E, López L, Ramallal R, Salas-Salvadó J, Tojal-Sierra L, Castañer O, Alonso A. Lifestyles, Left Atrial Structure and Function, and Cognitive Decline in Adults with Metabolic Syndrome. J Clin Med 2023; 12:6066. [PMID: 37763005 PMCID: PMC10532379 DOI: 10.3390/jcm12186066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 09/11/2023] [Accepted: 09/13/2023] [Indexed: 09/29/2023] Open
Abstract
Evidence supports associations of lifestyle (including diet and physical activity) and weight with cognitive functioning, but the pathways responsible for these associations have not been fully elucidated. Because healthier lifestyles have been associated with better left atrial structure and function, which in turn is associated with better cognitive functioning, we tested the hypothesis that left atrial structure and function is a potential mediator of the association between lifestyle and cognition. We included 476 participants classed as overweight or obese with metabolic syndrome from three centers in Spain. These participants underwent lifestyle assessments and transthoracic echocardiography at baseline and repeated measurements of the Trail Making A test, a measure of executive function, taken at baseline and at the two-year follow-up. We conducted mediation analyses to test if measures of left atrial structure and function mediated associations between adherence to the Mediterranean diet scores, physical activity, and weight at baseline, as well as a two-year change in Trail Making A scores. The analysis did not find an association between these factors and Trail Making A scores, and no indirect effects appeared to be mediated by echocardiographic measurements. The modest sample size in this analysis is a limitation, and larger studies should be conducted to determine potential cardiovascular factors mediating the association between lifestyle and cognition.
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Affiliation(s)
- Ines Gonzalez Casanova
- Department of Applied Health Science, School of Public Health, Indiana University Bloomington, Bloomington, IN 47404, USA
| | - Ángel M. Alonso-Gómez
- Bioaraba Health Research Institute, Osakidetza Basque Health Service, Araba University Hospital, University of the Basque Country UPV/EHU, 01009 Vitoria-Gasteiz, Spain
- CIBER Consortium, M.P. Physiopathology of Obesity and Nutrition (CIBERObn), Carlos III Health Institute (ISCIII), 28029 Madrid, Spain (E.T.); (J.S.-S.)
| | - Dora Romaguera
- CIBER Consortium, M.P. Physiopathology of Obesity and Nutrition (CIBERObn), Carlos III Health Institute (ISCIII), 28029 Madrid, Spain (E.T.); (J.S.-S.)
- Health Research Institute of the Balearic Islands (IdISBa), 07120 Palma de Mallorca, Spain
| | - Estefanía Toledo
- CIBER Consortium, M.P. Physiopathology of Obesity and Nutrition (CIBERObn), Carlos III Health Institute (ISCIII), 28029 Madrid, Spain (E.T.); (J.S.-S.)
- Department of Preventive Medicine and Public Health, University of Navarra, 31008 Pamplona, Spain;
- IdiSNA, Navarra Institute for Health Research, 31008 Pamplona, Spain
| | - Linzi Li
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA (A.A.)
| | - Elena Fortuny
- Health Research Institute of the Balearic Islands (IdISBa), 07120 Palma de Mallorca, Spain
- Cardiology Service, Manacor Hospital, 07500 Palma de Mallorca, Spain
| | - Luis López
- Cardiology Service, Son Espases University Hospital, 07120 Palma de Mallorca, Spain;
| | - Raúl Ramallal
- Department of Preventive Medicine and Public Health, University of Navarra, 31008 Pamplona, Spain;
- IdiSNA, Navarra Institute for Health Research, 31008 Pamplona, Spain
- Department of Cardiology, University Hospital of Navarra, Servicio Navarro de Salud Osasunbidea, 31008 Pamplona, Spain
| | - Jordi Salas-Salvadó
- CIBER Consortium, M.P. Physiopathology of Obesity and Nutrition (CIBERObn), Carlos III Health Institute (ISCIII), 28029 Madrid, Spain (E.T.); (J.S.-S.)
- Group ANUT-DSM, Human Nutrition Unit, Department of Biochemistry and Biotechnology, Universitat Rovira i Virgili, 43201 Reus, Spain
- Human Nutrition Unit, Institut d’Investigació Sanitària Pere Virgili (IISPV), 43204 Reus, Spain
| | - Lucas Tojal-Sierra
- Bioaraba Health Research Institute, Osakidetza Basque Health Service, Araba University Hospital, University of the Basque Country UPV/EHU, 01009 Vitoria-Gasteiz, Spain
| | - Olga Castañer
- Cardiovascular Risk and Nutrition Research Group, Institut Hospital del Mar d’Investigacions Mèdiques (IMIM), 08003 Barcelona, Spain;
- CIBER Consortium, M.P. Epidemiology and Public Health (CIBEROESP), Carlos III Health Institute (ISCIII), 28029 Madrid, Spain
| | - Alvaro Alonso
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA (A.A.)
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Xiao Q, Li Y, Li B, Li T, Li F, Li Y, Chen L, Zhao Z, Wang Q, Rong S. Dietary Diversity and Mild Cognitive Impairment in Middle-Aged and Older Chinese People: A Cross-Sectional Study. J Alzheimers Dis Rep 2023; 7:1045-1053. [PMID: 37849631 PMCID: PMC10578335 DOI: 10.3233/adr-230060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Accepted: 08/24/2023] [Indexed: 10/19/2023] Open
Abstract
Background The evidence concerning dietary diversity and cognitive function remains insufficient. Objective To investigate the association of dietary diversity score (DDS) with mild cognitive impairment (MCI) and cognitive performance in different domains. Methods Data from The Lifestyle and Healthy Aging of Chinese Square Dancer Study was used in this study. DDS was constructed based on the intake frequencies of 9 food groups assessed by a validated food frequency questionnaire. MCI was diagnosed by Petersen's criteria. A neuropsychological test battery was used to assess the performance on cognitive domains, and test scores were standardized to Z scores. Multiple linear regression models and logistic regression models were used to estimate the β and odds ratios and their 95% CIs, respectively. Results Among 1,982 participants, the mean (SD) age was 63.37 (5.00) years, 1,778 (89.71%) were women, and 279 (14.08%) had MCI. Compared to the DDS quartile (0, 6], the multivariable-adjusted odds ratios (95% CI) were 0.74 (0.48, 1.15) for DDS quartile (6, 7], 0.65 (0.43, 0.97) for DDS quartile (7, 8], and 0.55 (0.37, 0.84) for DDS quartile (8, 9]. Furthermore, higher DDS was positively associated with better performance of cognitive domains, including global cognitive function (β= 0.20, 95% CI: 0.12, 0.30), episodic memory (β= 0.21, 95% CI: 0.07, 0.35), attention (β= 0.15, 95% CI: 0.03, 0.26), language fluency (β= 0.24, 95% CI: 0.10, 0.38), and executive function (β= - 0.24, 95% CI: - 0.38, - 0.10). Conclusions This study indicated that higher DDS was associated with better cognitive function among middle-aged and older Chinese people.
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Affiliation(s)
- Qing Xiao
- Academy of Nutrition and Health, Hubei Province Key Laboratory of Occupational Hazard Identification and Control, School of Public Health, Wuhan University of Science and Technology, Wuhan, China
| | - Yonggang Li
- Hubei Provincial Key Laboratory for Applied Toxicology, Hubei Provincial Center for Disease Control and Prevention, Wuhan, China
| | - Benchao Li
- Academy of Nutrition and Health, Hubei Province Key Laboratory of Occupational Hazard Identification and Control, School of Public Health, Wuhan University of Science and Technology, Wuhan, China
| | - Tingting Li
- Academy of Nutrition and Health, Hubei Province Key Laboratory of Occupational Hazard Identification and Control, School of Public Health, Wuhan University of Science and Technology, Wuhan, China
| | - Fengping Li
- Department of Nutrition, School of Public Health, Wuhan University, Research Center of Public Health, Renmin Hospital of Wuhan University, Wuhan, China
| | - Yuanyuan Li
- Department of Nutrition, School of Public Health, Wuhan University, Research Center of Public Health, Renmin Hospital of Wuhan University, Wuhan, China
| | - Liangkai Chen
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Zhuangju Zhao
- Academy of Nutrition and Health, Hubei Province Key Laboratory of Occupational Hazard Identification and Control, School of Public Health, Wuhan University of Science and Technology, Wuhan, China
| | - Qing Wang
- Academy of Nutrition and Health, Hubei Province Key Laboratory of Occupational Hazard Identification and Control, School of Public Health, Wuhan University of Science and Technology, Wuhan, China
| | - Shuang Rong
- Academy of Nutrition and Health, Hubei Province Key Laboratory of Occupational Hazard Identification and Control, School of Public Health, Wuhan University of Science and Technology, Wuhan, China
- Department of Nutrition, School of Public Health, Wuhan University, Research Center of Public Health, Renmin Hospital of Wuhan University, Wuhan, China
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Hartnett KB, Ferguson BJ, Hecht PM, Schuster LE, Shenker JI, Mehr DR, Fritsche KL, Belury MA, Scharre DW, Horwitz AJ, Kille BM, Sutton BE, Tatum PE, Greenlief CM, Beversdorf DQ. Potential Neuroprotective Effects of Dietary Omega-3 Fatty Acids on Stress in Alzheimer's Disease. Biomolecules 2023; 13:1096. [PMID: 37509132 PMCID: PMC10377362 DOI: 10.3390/biom13071096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Revised: 06/30/2023] [Accepted: 07/04/2023] [Indexed: 07/30/2023] Open
Abstract
BACKGROUND A large number of individual potentially modifiable factors are associated with risk for Alzheimer's disease (AD). However, less is known about the interactions between the individual factors. METHODS In order to begin to examine the relationship between a pair of factors, we performed a pilot study, surveying patients with AD and controls for stress exposure and dietary omega-3 fatty acid intake to explore their relationship for risk of AD. RESULTS For individuals with the greatest stress exposure, omega-3 fatty acid intake was significantly greater in healthy controls than in AD patients. There was no difference among those with low stress exposure. CONCLUSIONS These initial results begin to suggest that omega-3 fatty acids may mitigate AD risk in the setting of greater stress exposure. This will need to be examined with larger populations and other pairs of risk factors to better understand these important relationships. Examining how individual risk factors interact will ultimately be important for learning how to optimally decrease the risk of AD.
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Affiliation(s)
- Kaitlyn B Hartnett
- School of Medicine, University of Missouri-Columbia, Columbia, MO 65212, USA
| | - Bradley J Ferguson
- Interdisciplinary Neuroscience Program, University of Missouri-Columbia, Columbia, MO 65212, USA
- Department of Health Psychology, University of Missouri-Columbia, Columbia, MO 65212, USA
- Department of Neurology, University of Missouri-Columbia, Columbia, MO 65212, USA
| | - Patrick M Hecht
- Interdisciplinary Neuroscience Program, University of Missouri-Columbia, Columbia, MO 65212, USA
| | - Luke E Schuster
- School of Medicine, University of Kansas, Kansas City, KS 66160, USA
| | - Joel I Shenker
- Department of Neurology, University of Missouri-Columbia, Columbia, MO 65212, USA
| | - David R Mehr
- Family & Community Medicine, University of Missouri-Columbia, Columbia, MO 65212, USA
| | - Kevin L Fritsche
- Department of Nutrition and Exercise Physiology, University of Missouri, Columbia, MO 65211, USA
| | - Martha A Belury
- Department of Human Sciences, Ohio State University, Columbus, OH 43210, USA
| | - Douglas W Scharre
- Department of Neurology, Ohio State University, Columbus, OH 43210, USA
| | | | | | - Briann E Sutton
- College of Osteopathic Medicine, William Carey University, Hattiesburg, MS 39401, USA
| | - Paul E Tatum
- Division of Palliative Medicine; Washington University. St. Louis, MO 63110, USA
| | | | - David Q Beversdorf
- Interdisciplinary Neuroscience Program, University of Missouri-Columbia, Columbia, MO 65212, USA
- Department of Neurology, University of Missouri-Columbia, Columbia, MO 65212, USA
- Department of Radiology, University of Missouri, Columbia, MO 65212, USA
- Psychological Sciences, University of Missouri, Columbia, MO 65212, USA
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Carrette J, Chrusciel J, Ecarnot F, Sanchez S. Prospective, observational study of the impact of finger food on the quality of nutrition evaluated by the simple evaluation of food intake (SEFI) in nursing home residents. Aging Clin Exp Res 2023:10.1007/s40520-023-02444-5. [PMID: 37286857 DOI: 10.1007/s40520-023-02444-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2023] [Accepted: 05/15/2023] [Indexed: 06/09/2023]
Abstract
INTRODUCTION Finger food is a type of meal that can be eaten without cutlery, and may, therefore, be easier to consume for patients with cognitive disorders. The objective of this study was to assess whether finger food increased the quantity of food ingested among older nursing home residents. The secondary objectives were to evaluate satisfaction after meals and costs associated with the meals. METHODS This was a single-center prospective study conducted on paired observations, comparing food intake observed during three finger food meals vs. three "control" meals (standard meals), for the same residents, in a public nursing home, from 21 April to 18 June 2021. RESULTS A total of 266 meals were evaluated for 50 residents. The mean intake (simple evaluation of food intake) score was 40.7 ± 1.7 out of 50 with finger food, and 39.0 ± 1.5 for standard meals. Finger food was associated with a higher probability of an intake score ≥ 40 (odds ratio [OR] 1.91 (95% CI 1.15-3.18; p = 0.01). The difference in satisfaction scores following the meals did not reach statistical significance: 3.86 (SD 1.19) vs. 3.69 (SD 1.11) for the finger food and standard meals, respectively; p = 0.2. Finger foods had an excess cost of 49% compared to a standard meal. CONCLUSION The occasional or seasonal (rather than systematic) use of these meals seems to be a valid option to reintroduce novelty and pleasure into the residents' diet. However, potential adopters should be aware that the finger food meals were 49% more expensive than standard meals.
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Affiliation(s)
- Justine Carrette
- Pôle Territorial Santé Publique et Performance des Hôpitaux Champagne Sud, Department of Public Health, Centre Hospitalier de Troyes, 10000, Troyes, France
| | - Jan Chrusciel
- Pôle Territorial Santé Publique et Performance des Hôpitaux Champagne Sud, Department of Public Health, Centre Hospitalier de Troyes, 10000, Troyes, France
| | - Fiona Ecarnot
- EA3920, University of Franche-Comté, Besançon, France
- Department of Cardiology, University Hospital, Besançon, France
| | - Stéphane Sanchez
- Pôle Territorial Santé Publique et Performance des Hôpitaux Champagne Sud, Department of Public Health, Centre Hospitalier de Troyes, 10000, Troyes, France.
- EA3797, University of Reims Champagne-Ardenne, Reims, France.
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10
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Reiss AB, Muhieddine D, Jacob B, Mesbah M, Pinkhasov A, Gomolin IH, Stecker MM, Wisniewski T, De Leon J. Alzheimer's Disease Treatment: The Search for a Breakthrough. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1084. [PMID: 37374288 DOI: 10.3390/medicina59061084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 05/22/2023] [Accepted: 05/31/2023] [Indexed: 06/29/2023]
Abstract
As the search for modalities to cure Alzheimer's disease (AD) has made slow progress, research has now turned to innovative pathways involving neural and peripheral inflammation and neuro-regeneration. Widely used AD treatments provide only symptomatic relief without changing the disease course. The recently FDA-approved anti-amyloid drugs, aducanumab and lecanemab, have demonstrated unclear real-world efficacy with a substantial side effect profile. Interest is growing in targeting the early stages of AD before irreversible pathologic changes so that cognitive function and neuronal viability can be preserved. Neuroinflammation is a fundamental feature of AD that involves complex relationships among cerebral immune cells and pro-inflammatory cytokines, which could be altered pharmacologically by AD therapy. Here, we provide an overview of the manipulations attempted in pre-clinical experiments. These include inhibition of microglial receptors, attenuation of inflammation and enhancement of toxin-clearing autophagy. In addition, modulation of the microbiome-brain-gut axis, dietary changes, and increased mental and physical exercise are under evaluation as ways to optimize brain health. As the scientific and medical communities work together, new solutions may be on the horizon to slow or halt AD progression.
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Affiliation(s)
- Allison B Reiss
- Department of Medicine and Biomedical Research Institute, NYU Long Island School of Medicine, Mineola, NY 11501, USA
| | - Dalia Muhieddine
- Department of Medicine and Biomedical Research Institute, NYU Long Island School of Medicine, Mineola, NY 11501, USA
| | - Berlin Jacob
- Department of Medicine and Biomedical Research Institute, NYU Long Island School of Medicine, Mineola, NY 11501, USA
| | - Michael Mesbah
- Department of Medicine and Biomedical Research Institute, NYU Long Island School of Medicine, Mineola, NY 11501, USA
| | - Aaron Pinkhasov
- Department of Medicine and Biomedical Research Institute, NYU Long Island School of Medicine, Mineola, NY 11501, USA
| | - Irving H Gomolin
- Department of Medicine and Biomedical Research Institute, NYU Long Island School of Medicine, Mineola, NY 11501, USA
| | | | - Thomas Wisniewski
- Center for Cognitive Neurology, Departments of Neurology, Pathology and Psychiatry, NYU School of Medicine, New York, NY 10016, USA
| | - Joshua De Leon
- Department of Medicine and Biomedical Research Institute, NYU Long Island School of Medicine, Mineola, NY 11501, USA
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11
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Hoffman K, Doyle WJ, Schumacher SM, Ochoa-Repáraz J. Gut microbiome-modulated dietary strategies in EAE and multiple sclerosis. Front Nutr 2023; 10:1146748. [PMID: 37063324 PMCID: PMC10090556 DOI: 10.3389/fnut.2023.1146748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 03/14/2023] [Indexed: 03/31/2023] Open
Abstract
Over the last few decades, the incidence of multiple sclerosis has increased as society's dietary habits have switched from a whole foods approach to a high fat, high salt, low dietary fiber, and processed food diet, termed the "Western diet." Environmental factors, such as diet, could play a role in the pathogenesis of multiple sclerosis due to gut microbiota alterations, gut barrier leakage, and subsequent intestinal inflammation that could lead to exacerbated neuroinflammation. This mini-review explores the gut microbiome alterations of various dietary strategies that improve upon the "Western diet" as promising alternatives and targets to current multiple sclerosis treatments. We also provide evidence that gut microbiome modulation through diet can improve or exacerbate clinical symptoms of multiple sclerosis, highlighting the importance of including gut microbiome analyses in future studies of diet and disease.
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Affiliation(s)
| | | | | | - Javier Ochoa-Repáraz
- Department of Biological Sciences, Boise State University, Boise, ID, United States
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12
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Cacciatore S, Calvani R, Marzetti E, Picca A, Coelho-Júnior HJ, Martone AM, Massaro C, Tosato M, Landi F. Low Adherence to Mediterranean Diet Is Associated with Probable Sarcopenia in Community-Dwelling Older Adults: Results from the Longevity Check-Up (Lookup) 7+ Project. Nutrients 2023; 15:nu15041026. [PMID: 36839385 PMCID: PMC9959184 DOI: 10.3390/nu15041026] [Citation(s) in RCA: 18] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 02/15/2023] [Accepted: 02/16/2023] [Indexed: 02/22/2023] Open
Abstract
Muscle strength is a relevant metric of aging. Greater adherence to Mediterranean diet is associated with better health outcomes across all life stages; however, evidence on the relationship between Mediterranean diet and muscle strength in older adults is inconclusive. In this study, we evaluated the relationship between adherence to Mediterranean diet and handgrip strength in a large sample of community-dwelling older adults from the Longevity Check-up 7+ project. A total of 2963 participants (mean age 72.8 ± 5.7 years; 54.4% women) were analyzed. Mediterranean diet adherence was evaluated using a modified Medi-Lite score and categorized as low (≤8), good (9 to 11), or high (≥12). Handgrip strength was categorized as normal or low according to cut-points by the European Working Group on Sarcopenia in Older People 2. Older adults with lower Mediterranean diet adherence had a significantly higher prevalence of probable sarcopenia (25.9%) than those with good (19.1%) or high (15.5%) adherence. The proportion of participants with probable sarcopenia increased with age, but it remained lower in the good and high adherence groups. Logistic regression showed that greater Mediterranean diet adherence was associated with a lower risk of probable sarcopenia. Older age, female sex, and physical inactivity were associated with a greater risk of probable sarcopenia. Our findings emphasize the positive association between healthy lifestyles, including adherence to Mediterranean diet, and physical function in old age.
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Affiliation(s)
- Stefano Cacciatore
- Department of Geriatrics and Orthopedics, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Riccardo Calvani
- Fondazione Policlinico Universitario “Agostino Gemelli” IRCCS, 00168 Rome, Italy
| | - Emanuele Marzetti
- Department of Geriatrics and Orthopedics, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
- Fondazione Policlinico Universitario “Agostino Gemelli” IRCCS, 00168 Rome, Italy
- Correspondence: ; Tel.: +39-06-3015-5669
| | - Anna Picca
- Fondazione Policlinico Universitario “Agostino Gemelli” IRCCS, 00168 Rome, Italy
- Department of Medicine and Surgery, LUM University, 70100 Casamassima, Italy
| | - Hélio José Coelho-Júnior
- Department of Geriatrics and Orthopedics, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Anna Maria Martone
- Fondazione Policlinico Universitario “Agostino Gemelli” IRCCS, 00168 Rome, Italy
| | - Claudia Massaro
- Department of Geriatrics and Orthopedics, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Matteo Tosato
- Fondazione Policlinico Universitario “Agostino Gemelli” IRCCS, 00168 Rome, Italy
| | - Francesco Landi
- Department of Geriatrics and Orthopedics, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
- Fondazione Policlinico Universitario “Agostino Gemelli” IRCCS, 00168 Rome, Italy
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13
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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; 15:nu15020333. [PMID: 36678204 PMCID: PMC9865080 DOI: 10.3390/nu15020333] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 12/17/2022] [Accepted: 12/21/2022] [Indexed: 01/12/2023] Open
Abstract
Dementia prevalence is a global public health concern. Adherence towards a healthy dietary pattern (DP) may reduce the risk of cognitive decline and dementia. This narrative systematic review aimed to synthesise prospective and intervention study data to evaluate the impact of a-posteriori and a-priori derived DPs on cognitive ageing, from cognitive decline to incident dementia. Ninety-three studies were included: 83 prospective studies and 10 randomised controlled trials (RCT). Most prospective studies (77%) examined a-priori DPs, with the Mediterranean diet examined most frequently. A total of 52% of prospective and 50% of RCTs reported a protective relationship between 'healthy' DPs and global cognitive decline. Overall, 59% of prospective studies reported positive associations between healthy DPs and risk of cognitive disorder. Incident cognitive disorder was examined by only one intervention study (subgroup analysis) which reported a beneficial effect of a low-fat diet on risk of probable dementia in women. Unhealthy DPs were examined less frequently (n = 17; 21%), with 41% of these studies reporting associations between adherence and poorer cognitive outcomes. Overall, there were mixed results for healthy and unhealthy DPs on cognition, likely due to between-study heterogeneity. Standardisation of diet exposure and cognitive outcome measurement would help to reduce this. Future research would benefit from investigating effects of culturally appropriate DPs on individual cognitive domains and incident cognitive disorders in diverse and high-risk populations.
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Affiliation(s)
| | - Danielle Logan
- Centre for Public Health, Queen’s University Belfast, Belfast BT12 6BA, UK
| | - Roisin F. O’Neill
- Centre for Public Health, Queen’s University Belfast, Belfast BT12 6BA, UK
| | - Federica Prinelli
- Epidemiology Unit, Institute of Biomedical Technologies, National Research Council, 93 20054 Milan, Italy
| | - Jayne V. Woodside
- Centre for Public Health, Queen’s University Belfast, Belfast BT12 6BA, UK
- Institute for Global Food Security, Queen’s University Belfast, Belfast BT9 5DL, UK
| | - Claire T. McEvoy
- Centre for Public Health, Queen’s University Belfast, Belfast BT12 6BA, UK
- Institute for Global Food Security, Queen’s University Belfast, Belfast BT9 5DL, UK
- Correspondence:
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14
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Beversdorf DQ, Crosby HW, Shenker JI. Complementary and Alternative Medicine Approaches in Alzheimer Disease and Other Neurocognitive Disorders. MISSOURI MEDICINE 2023; 120:70-78. [PMID: 36860601 PMCID: PMC9970340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/18/2023]
Abstract
As our population ages, there is interest in delaying or intervening in cognitive decline. While newer agents are under development, agents in mainstream use do not impact the course of diseases that cause cognitive decline. This increases interest in alternative strategies. Even as we welcome possible new disease-modifying agents, they are likely to remain costly. Herein, we review the evidence behind other complementary and alternative strategies for cognitive enhancement and prevention of cognitive decline.
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Affiliation(s)
- David Q Beversdorf
- Departments of Neurology, Radiology, and Psychological Sciences, and is the William and Nancy Thompson Endowed Chair in Radiology, , University of Missouri-Columbia School of Medicine, Columbia, Missouri
| | - Haley W Crosby
- Fourth-year medical student at the School of Medicine, , University of Missouri-Columbia School of Medicine, Columbia, Missouri
| | - Joel I Shenker
- Department of Neurology, University of Missouri-Columbia School of Medicine, Columbia, Missouri
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15
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Nutrition Patterns of Polish Esports Players. Nutrients 2022; 15:nu15010149. [PMID: 36615806 PMCID: PMC9824454 DOI: 10.3390/nu15010149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 12/22/2022] [Accepted: 12/24/2022] [Indexed: 12/31/2022] Open
Abstract
The aim of this study was to quantify the dietary patterns (DPs) of Polish esports players aged 18-26 years. Data were obtained via questionnaires that assessed dietary habits and frequency of food consumption. Dietary patterns were derived using Principal Component Analysis (PCA) and Factor Analysis (FA). In total, nine distinct DPs were identified. Eight DPs were considered unhealthy; 'fast food', 'High-processed food, meat and confectionery', 'Sweet', 'Fat-diary products', 'Vegetable-fruit', 'Spices and additives', 'Fats' and 'Cereal'; and only one was deemed healthy. E-athletes presented mostly poor dietary habits, which included: irregular eating of meals, frequent snacking, at least three meals a day and composition of snacks, frying of meat dishes and sweetening of hot drinks. Healthy dietary habits included proper hydration during the day and consumption of mainly non-sparkling water. The unbalanced and largely unhealthy dietary habits of esports players raise health concerns for these e-athletes, particularly when combined with a sedentary lifestyle. Future research could assess the nutritional knowledge of this group as it relates to national guidelines, investigate interventions designed to introduce healthier eating options into their lifestyle and examine the relationship between DPs and health or cognitive performance.
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16
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Wei W, Wang S, Xu C, Zhou X, Lian X, He L, Li K. Gut microbiota, pathogenic proteins and neurodegenerative diseases. Front Microbiol 2022; 13:959856. [PMID: 36466655 PMCID: PMC9715766 DOI: 10.3389/fmicb.2022.959856] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Accepted: 10/07/2022] [Indexed: 12/20/2023] Open
Abstract
As the world's population ages, neurodegenerative diseases (NDs) have brought a great burden to the world. However, effective treatment measures have not been found to alleviate the occurrence and development of NDs. Abnormal accumulation of pathogenic proteins is an important cause of NDs. Therefore, effective inhibition of the accumulation of pathogenic proteins has become a priority. As the second brain of human, the gut plays an important role in regulate emotion and cognition functions. Recent studies have reported that the disturbance of gut microbiota (GM) is closely related to accumulation of pathogenic proteins in NDs. On the one hand, pathogenic proteins directly produced by GM are transmitted from the gut to the central center via vagus nerve. On the other hand, The harmful substances produced by GM enter the peripheral circulation through intestinal barrier and cause inflammation, or cross the blood-brain barrier into the central center to cause inflammation, and cytokines produced by the central center cause the production of pathogenic proteins. These pathogenic proteins can produced by the above two aspects can cause the activation of central microglia and further lead to NDs development. In addition, certain GM and metabolites have been shown to have neuroprotective effects. Therefore, modulating GM may be a potential clinical therapeutic approach for NDs. In this review, we summarized the possible mechanism of NDs caused by abnormal accumulation of pathogenic proteins mediated by GM to induce the activation of central microglia, cause central inflammation and explore the therapeutic potential of dietary therapy and fecal microbiota transplantation (FMT) in NDs.
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Affiliation(s)
- Wei Wei
- The Mental Hospital of Yunnan Province, Mental Health Center Affiliated to Kunming Medical University, Kunming, China
- School of Forensic Medicine, Kunming Medical University, Kunming, China
| | - Shixu Wang
- School of Forensic Medicine, Kunming Medical University, Kunming, China
| | - Chongchong Xu
- School of Forensic Medicine, Kunming Medical University, Kunming, China
| | - Xuemei Zhou
- School of Forensic Medicine, Kunming Medical University, Kunming, China
| | - Xinqing Lian
- School of Forensic Medicine, Kunming Medical University, Kunming, China
| | - Lin He
- The Mental Hospital of Yunnan Province, Mental Health Center Affiliated to Kunming Medical University, Kunming, China
| | - Kuan Li
- School of Forensic Medicine, Kunming Medical University, Kunming, China
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17
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Gregory S, Ritchie CW, Ritchie K, Shannon O, Stevenson EJ, Muniz-Terrera G. Mediterranean diet score is associated with greater allocentric processing in the EPAD LCS cohort: A comparative analysis by biogeographical region. FRONTIERS IN AGING 2022; 3:1012598. [PMID: 36568511 PMCID: PMC9780498 DOI: 10.3389/fragi.2022.1012598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Accepted: 11/28/2022] [Indexed: 12/13/2022]
Abstract
Background: Adherence to the Mediterranean diet (MedDiet), a primarily plant-based eating pattern, has been associated with lower dementia incidence. Much of the research has focused on Alzheimer's disease (AD) dementia and mild cognitive impairment (MCI), with less research looking at the preclinical symptomatically silent stages that pre-empt MCI and AD dementia. Although there is evidence from studies conducted globally, no studies have compared the effects of the MedDiet within and outside of the Mediterranean region in one cohort. Methods: Our study explored cross-sectional and longitudinal associations between MedDiet and cognition in the pan-European EPAD LCS, comparing those living within and outside of the Mediterranean region (as classified by European Union biogeographical definitions). After deriving MEDAS scores to quantify adherence to the MedDiet, we used linear regression and linear mixed effects models to test for associations between the MEDAS score and cognitive function measured by the Four Mountains Test (FMT) and the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). We additionally calculated MEDAS continuous and PYRAMID scores to provide alternative measures of MedDiet adherence. Results: We included 1826 participants, mean age 65.69 (±7.42) years, majority female (56.2%) with family history (65.8%) and minority APOEε4 carriers (38.9%). Higher MEDAS scores were associated with better performance on the FMT both cross-sectionally (n = 1,144, ß: -0.11, SE: 0.04, p = 0.007) and longitudinally (slope: 0.10, 95% CI: 0.04-0.17, p: 0.002). The effect was marginally greater in the Mediterranean region in the cross-sectional analysis, with a stronger effect emerging longitudinally. In exploratory analyses, the association between MEDAS and FMT scores was only seen in female participants. A sensitivity analysis excluding Toulouse and Perugia, as cities near, but not within, the biogeographical region, found significant associations between higher MEDAS and MEDAS continuous scores, and a number of RBANS total and index scores. Conclusion: MedDiet adherence is associated with better FMT scores, with effects seen most strongly in the Mediterranean region from longitudinal data. Our sensitivity analysis suggested a more global cognitive benefit of MedDiet adherence. This study highlights the need to further explore for whom and for what brain health outcomes the MedDiet confers benefit. This evidence would identify a window of opportunity in the life-course to maximise the benefit and better inform public health campaigns and patient-level interventions.
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Affiliation(s)
- Sarah Gregory
- Edinburgh Dementia Prevention, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, United Kingdom
| | - Craig W Ritchie
- Edinburgh Dementia Prevention, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, United Kingdom
| | - Karen Ritchie
- Institut National de la Santé et de la Recherche Médicale (INSERM), E361 Epidemiology of Nervous System Pathologies, La Colombière Hospital, Montpelier, France
| | - Oliver Shannon
- Human Nutrition Research Centre, Faculty of Medical Sciences, Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Emma J Stevenson
- Human Nutrition Research Centre, Faculty of Medical Sciences, Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Graciela Muniz-Terrera
- Edinburgh Dementia Prevention, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, United Kingdom.,Department of Social Medicine, Ohio University, Athens, OH, United States
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