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Vauzour D, Minihane AM. Reply to M. Plourde and M. Stiffel. Am J Clin Nutr 2023; 118:1237-1238. [PMID: 37867131 DOI: 10.1016/j.ajcnut.2023.09.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Accepted: 09/22/2023] [Indexed: 10/24/2023] Open
Affiliation(s)
- David Vauzour
- Norwich Medical School, University of East Anglia (UEA), Norwich, United Kingdom
| | - Anne Marie Minihane
- Norwich Medical School, University of East Anglia (UEA), Norwich, United Kingdom.
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Vauzour D, Scholey A, White DJ, Cohen NJ, Cassidy A, Gillings R, Irvine MA, Kay CD, Kim M, King R, Legido-Quigley C, Potter JF, Schwarb H, Minihane AM. A combined DHA-rich fish oil and cocoa flavanols intervention does not improve cognition or brain structure in older adults with memory complaints: results from the CANN randomized, controlled parallel-design study. Am J Clin Nutr 2023; 118:369-381. [PMID: 37315924 PMCID: PMC10447509 DOI: 10.1016/j.ajcnut.2023.06.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Revised: 05/31/2023] [Accepted: 06/09/2023] [Indexed: 06/16/2023] Open
Abstract
BACKGROUND There is evidence that both omega-3 long-chain polyunsaturated fatty acids (PUFAs) (eicosapentaenoic acid [EPA] and docosahexaenoic acid [DHA]) and cocoa flavanols can improve cognitive performance in both healthy individuals and in those with memory complaints. However, their combined effect is unknown. OBJECTIVES To investigate the combined effect of EPA/DHA and cocoa flavanols (OM3FLAV) on cognitive performance and brain structures in older adults with memory complaints. METHODS A randomized placebo-controlled trial of DHA-rich fish oil (providing 1.1 g/d DHA and 0.4 g/d EPA) and a flavanol-rich dark chocolate (providing 500 mg/d flavan-3-ols) was conducted in 259 older adults with either subjective cognitive impairment or mild cognitive impairment. Participants underwent assessment at baseline, 3 mo, and 12 mo. The primary outcome was the number of false-positives on a picture recognition task from the Cognitive Drug Research computerized assessment battery. Secondary outcomes included other cognition and mood outcomes, plasma lipids, brain-derived neurotrophic factor (BDNF), and glucose levels. A subset of 110 participants underwent structural neuroimaging at baseline and at 12 mo. RESULTS 197 participants completed the study. The combined intervention had no significant effect on any cognitive outcomes, with the exception of reaction time variability (P = 0.007), alertness (P < 0.001), and executive function (P < 0.001), with a decline in function observed in the OM3FLAV group (118.6 [SD 25.3] at baseline versus 113.3 [SD 25.4] at 12 mo for executive function) relative to the control, and an associated decrease in cortical volume (P = 0.039). Compared with the control group, OM3FLAV increased plasma HDL, total cholesterol ratio (P < 0.001), and glucose (P = 0.008) and reduced TG concentrations (P < 0.001) by 3 mo, which were sustained to 12 mo, with no effect on BDNF. Changes in plasma EPA and DHA and urinary flavonoid metabolite concentrations confirmed compliance to the intervention. CONCLUSIONS These results suggest that cosupplementation with ω-3 PUFAs and cocoa flavanols for 12 mo does not improve cognitive outcomes in those with cognitive impairment. This trial was registered at clinicaltrials.gov as NCT02525198.
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Affiliation(s)
- David Vauzour
- Norwich Medical School, University of East Anglia (UEA), Norwich, United Kingdom.
| | - Andrew Scholey
- Centre for Human Psychopharmacology, Swinburne University, Australia.
| | - David J White
- Centre for Human Psychopharmacology, Swinburne University, Australia
| | - Neal J Cohen
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Urbana, IL, United States
| | - Aedín Cassidy
- Norwich Medical School, University of East Anglia (UEA), Norwich, United Kingdom; Institute for Global Food Security, Queen's University Belfast, Belfast, Northern Ireland
| | - Rachel Gillings
- Norwich Medical School, University of East Anglia (UEA), Norwich, United Kingdom
| | - Michael A Irvine
- Norwich Medical School, University of East Anglia (UEA), Norwich, United Kingdom
| | - Colin D Kay
- Plants for Human Health Institute, Food Bioprocessing and Nutrition Sciences Department, North Carolina State University, North Carolina Research Campus, Kannapolis, NC, United States
| | - Min Kim
- Translational and Clinical Chemistry, Kings College London, London, Norwich, United Kingdom
| | - Rebecca King
- Centre for Human Psychopharmacology, Swinburne University, Australia
| | | | - John F Potter
- Norwich Medical School, University of East Anglia (UEA), Norwich, United Kingdom
| | - Hilary Schwarb
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Urbana, IL, United States
| | - Anne-Marie Minihane
- Norwich Medical School, University of East Anglia (UEA), Norwich, United Kingdom; Norwich Institute of Healthy Ageing (NIHA), UEA, Norwich, Norwich, United Kingdom
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Flanagan E, Cameron D, Sobhan R, Wong C, Pontifex MG, Tosi N, Mena P, Del Rio D, Sami S, Narbad A, Müller M, Hornberger M, Vauzour D. Chronic Consumption of Cranberries (Vaccinium macrocarpon) for 12 Weeks Improves Episodic Memory and Regional Brain Perfusion in Healthy Older Adults: A Randomised, Placebo-Controlled, Parallel-Groups Feasibility Study. Front Nutr 2022; 9:849902. [PMID: 35662954 PMCID: PMC9160193 DOI: 10.3389/fnut.2022.849902] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Accepted: 04/19/2022] [Indexed: 12/28/2022] Open
Abstract
Background Ageing is highly associated with cognitive decline and modifiable risk factors such as diet are believed to protect against this process. Specific dietary components and in particular, (poly)phenol-rich fruits such as berries have been increasingly recognised for their protection against age-related neurodegeneration. However, the impact of cranberries on cognitive function and neural functioning in older adults remains unclear. Design A 12-week parallel randomised placebo-controlled trial of freeze-dried cranberry powder was conducted in 60 older adults aged between 50 and 80 years. Cognitive assessment, including memory and executive function, neuroimaging and blood sample collection were conducted before and after the intervention to assess the impact of daily cranberry consumption on cognition, brain function and biomarkers of neuronal signalling. Results Cranberry supplementation for 12 weeks was associated with improvements in visual episodic memory in aged participants when compared to placebo. Mechanisms of action may include increased regional perfusion in the right entorhinal cortex, the accumbens area and the caudate in the cranberry group. Significant decrease in low-density lipoprotein (LDL) cholesterol during the course of the intervention was also observed. No significant differences were, however, detected for BDNF levels between groups. Conclusions The results of this study indicate that daily cranberry supplementation (equivalent to 1 small cup of cranberries) over a 12-week period improves episodic memory performance and neural functioning, providing a basis for future investigations to determine efficacy in the context of neurological disease. This trial was registered at clinicaltrials.gov as NCT03679533 and at ISRCTN as ISRCTN76069316.
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Affiliation(s)
- Emma Flanagan
- Norwich Medical School, Faculty of Medicine and Health Sciences, Norwich, United Kingdom
| | - Donnie Cameron
- Norwich Medical School, Faculty of Medicine and Health Sciences, Norwich, United Kingdom
- Department of Radiology, C.J. Gorter Center for High Field MRI, Leiden University Medical Center, Leiden, Netherlands
| | - Rashed Sobhan
- Norwich Medical School, Faculty of Medicine and Health Sciences, Norwich, United Kingdom
| | - Chloe Wong
- Norwich Medical School, Faculty of Medicine and Health Sciences, Norwich, United Kingdom
| | - Matthew G. Pontifex
- Norwich Medical School, Faculty of Medicine and Health Sciences, Norwich, United Kingdom
| | - Nicole Tosi
- Human Nutrition Unit, Department of Food and Drug, University of Parma, Parma, Italy
| | - Pedro Mena
- Human Nutrition Unit, Department of Food and Drug, University of Parma, Parma, Italy
| | - Daniele Del Rio
- Human Nutrition Unit, Department of Food and Drug, University of Parma, Parma, Italy
| | - Saber Sami
- Norwich Medical School, Faculty of Medicine and Health Sciences, Norwich, United Kingdom
| | - Arjan Narbad
- Quadram Institute Bioscience, Norwich Research Park, Norwich, United Kingdom
| | - Michael Müller
- Norwich Medical School, Faculty of Medicine and Health Sciences, Norwich, United Kingdom
| | - Michael Hornberger
- Norwich Medical School, Faculty of Medicine and Health Sciences, Norwich, United Kingdom
| | - David Vauzour
- Norwich Medical School, Faculty of Medicine and Health Sciences, Norwich, United Kingdom
- *Correspondence: David Vauzour,
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Ticinesi A, Mancabelli L, Carnevali L, Nouvenne A, Meschi T, Del Rio D, Ventura M, Sgoifo A, Angelino D. Interaction Between Diet and Microbiota in the Pathophysiology of Alzheimer's Disease: Focus on Polyphenols and Dietary Fibers. J Alzheimers Dis 2022; 86:961-982. [PMID: 35147544 DOI: 10.3233/jad-215493] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Animal studies increasingly indicate that the gut microbiota composition and function can be involved in the pathophysiology and progression of Alzheimer's disease (AD) at multiple levels. However, few studies have investigated this putative gut-brain axis in human beings, and none of them considered diet as a determinant of intestinal microbiota composition. Epidemiological studies highlight that a high intake of fruit and vegetables, such as that typical of the Mediterranean diet, can modulate AD progression. Thus, nutritional interventions are being increasingly studied as a possible non-pharmacological strategy to slow down the progression of AD. In particular, polyphenols and fibers represent the nutritional compounds with the higher potential of counterbalancing the pathophysiological mechanisms of dementia due to their antioxidant, anti-inflammatory, and anti-apoptotic properties. These actions are mediated by the gut microbiota, that can transform polyphenols and fibers into biologically active compounds including, among others, phenyl-γ-valerolactones, urolithins, butyrate, and other short-chain fatty acids. In this review, the complex mechanisms linking nutrition, gut microbiota composition, and pathophysiology of cognitive decline in AD are discussed, with a particular focus on the role of polyphenols and fibers. The gaps between pre-clinical and clinical studies are particularly emphasized, as well as the urgent need for studies comprehensively evaluating the link between nutrition, microbiome, and clinical aspects of AD.
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Affiliation(s)
- Andrea Ticinesi
- University of Parma, Microbiome Research Hub, Parma, Italy.,University of Parma, Department of Medicine and Surgery, Parma, Italy.,Parma University-Hospital, Geriatric-Rehabilitation Department, Parma, Italy
| | - Leonardo Mancabelli
- University of Parma, Department of Chemistry, Life Sciences and Environmental Sustainability, Parma, Italy
| | - Luca Carnevali
- University of Parma, Department of Chemistry, Life Sciences and Environmental Sustainability, Parma, Italy
| | - Antonio Nouvenne
- University of Parma, Microbiome Research Hub, Parma, Italy.,University of Parma, Department of Medicine and Surgery, Parma, Italy.,Parma University-Hospital, Geriatric-Rehabilitation Department, Parma, Italy
| | - Tiziana Meschi
- University of Parma, Microbiome Research Hub, Parma, Italy.,University of Parma, Department of Medicine and Surgery, Parma, Italy.,Parma University-Hospital, Geriatric-Rehabilitation Department, Parma, Italy
| | - Daniele Del Rio
- University of Parma, Microbiome Research Hub, Parma, Italy.,University of Parma, Department of Food and Drugs, Parma, Italy
| | - Marco Ventura
- University of Parma, Microbiome Research Hub, Parma, Italy.,University of Parma, Department of Chemistry, Life Sciences and Environmental Sustainability, Parma, Italy
| | - Andrea Sgoifo
- University of Parma, Microbiome Research Hub, Parma, Italy.,University of Parma, Department of Chemistry, Life Sciences and Environmental Sustainability, Parma, Italy
| | - Donato Angelino
- University of Teramo, Faculty of Bioscience and Technology for Food, Agriculture and Environment, Teramo, Italy
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Coughlan G, Larsen R, Kim M, White D, Gillings R, Irvine M, Scholey A, Cohen N, Legido-Quigley C, Hornberger M, Minihane AM. APOE ε4 alters associations between docosahexaenoic acid and preclinical markers of Alzheimer's disease. Brain Commun 2021; 3:fcab085. [PMID: 34007965 PMCID: PMC8112902 DOI: 10.1093/braincomms/fcab085] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Revised: 02/23/2021] [Accepted: 03/12/2021] [Indexed: 11/25/2022] Open
Abstract
Docosahexaenoic acid is the main long-chain omega-3 polyunsaturated fatty acids in the brain and accounts for 30−40% of fatty acids in the grey matter of the human cortex. Although the influence of docosahexaenoic acid on memory function is widely researched, its association with brain volumes is under investigated and its association with spatial navigation is virtually unknown. This is despite the fact that spatial navigation deficits are a new cognitive fingerprint for symptomatic and asymptomatic Alzheimer’s disease. We investigated the cross-sectional relationship between docosahexaenoic acid levels and the major structural and cognitive markers of preclinical Alzheimer’s disease, namely hippocampal volume, entorhinal volume and spatial navigation ability. Fifty-three cognitively normal adults underwent volumetric magnetic resonance imaging, measurements of serum docosahexaenoic acid (DHA, including lysophosphatidylcholine DHA) and APOE ε4 genotyping. Relative regional brain volumes were calculated and linear regression models were fitted to examine DHA associations with brain volume. APOE genotype modulated serum DHA associations with entorhinal cortex volume and hippocampal volume. Linear models showed that greater serum DHA was associated with increased entorhinal cortex volume, but not hippocampal volume, in non APOΕ ε4 carriers. APOE also interacted with serum lysophosphatidylcholine DHA to predict hippocampal volume. After testing interactions between DHA and APOE on brain volume, we investigated whether DHA and APOE interact to predict spatial navigation performance on a novel virtual reality diagnostic test for Alzheimer’s disease in an independent population of APOE genotyped adults (n = 46). APOE genotype modulated DHA associations with spatial navigation performance, showing that DHA was inversely associated with path integration in APOE ε4 carriers only. This exploratory analysis suggests that interventions aiming to increase DHA blood levels to protect against cognitive decline should consider APOE ε4 carrier status. Future work should focus on replicating our initial findings and establishing whether a specific dose of supplementary DHA, at a particular time in the preclinical disease course can have a positive impact on Alzheimer’s disease progression in APOE ε4 carriers.
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Affiliation(s)
- Gillian Coughlan
- Norwich Medical School, University of East Anglia, Norwich, UK.,Rotman Research Institute, Baycrest, Toronto, ON, Canada
| | - Ryan Larsen
- Decision Neuroscience Laboratory, Beckman Institute for Advanced Science and Technology, University of Illinois, USA
| | - Min Kim
- King's College London, Franklin-Wilkins Building, London, UK
| | - David White
- Centre for Human Psychopharmacology, Swinburne University, Australia
| | - Rachel Gillings
- Norwich Medical School, University of East Anglia, Norwich, UK
| | - Michael Irvine
- Norwich Medical School, University of East Anglia, Norwich, UK
| | - Andrew Scholey
- Centre for Human Psychopharmacology, Swinburne University, Australia
| | - Neal Cohen
- Decision Neuroscience Laboratory, Beckman Institute for Advanced Science and Technology, University of Illinois, USA
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Deák F, Anderson RE, Fessler JL, Sherry DM. Novel Cellular Functions of Very Long Chain-Fatty Acids: Insight From ELOVL4 Mutations. Front Cell Neurosci 2019; 13:428. [PMID: 31616255 PMCID: PMC6763723 DOI: 10.3389/fncel.2019.00428] [Citation(s) in RCA: 66] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Accepted: 09/06/2019] [Indexed: 12/22/2022] Open
Abstract
Elongation of Very Long chain fatty acids-4 (ELOVL4) protein is a member of the ELOVL family of fatty acid elongases that is collectively responsible for catalyzing formation of long chain fatty acids. ELOVL4 is the only family member that catalyzes production of Very Long Chain Saturated Fatty Acids (VLC-SFA) and Very Long Chain Polyunsaturated Fatty Acids (VLC-PUFA) with chain lengths ≥28 carbons. ELOVL4 and its VLC-SFA and VLC-PUFA products are emerging as important regulators of synaptic signaling and neuronal survival in the central nervous system (CNS). Distinct sets of mutations in ELOVL4 cause three different neurological diseases in humans. Heterozygous inheritance of one set of autosomal dominant ELOVL4 mutations that leads to truncation of the ELOVL4 protein causes Stargardt-like macular dystrophy (STGD3), an aggressive juvenile-onset retinal degeneration. Heterozygous inheritance of a different set of autosomal dominant ELOVL4 mutations that leads to a full-length protein with single amino acid substitutions causes spinocerebellar ataxia 34 (SCA34), a late-onset neurodegenerative disease characterized by gait ataxia and cerebellar atrophy. Homozygous inheritance of a different set of ELOVL4 mutations causes a more severe disease with infantile onset characterized by seizures, spasticity, intellectual disability, ichthyosis, and premature death. ELOVL4 is expressed widely in the CNS and is found primarily in neurons. ELOVL4 is expressed in cell-specific patterns within different regions of the CNS that are likely to be related to disease symptoms. In the retina, ELOVL4 is expressed exclusively in photoreceptors and produces VLC-PUFA that are incorporated into phosphatidylcholine and enriched in the light sensitive membrane disks of the photoreceptor outer segments. VLC-PUFA are enzymatically converted into "elovanoid" compounds that appear to provide paracrine signals that promote photoreceptor and neuronal survival. In the brain, the main ELOVL4 products are VLC-SFA that are incorporated into sphingolipids and enriched in synaptic vesicles, where they regulate kinetics of presynaptic neurotransmitter release. Understanding the function of ELOVL4 and its VLC-SFA and VLC-PUFA products will advance our understanding of basic mechanisms in neural signaling and has potential for developing novel therapies for seizure and neurodegenerative diseases.
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Affiliation(s)
- Ferenc Deák
- Department of Geriatric Medicine, Reynolds Oklahoma Center on Aging, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States.,Oklahoma Center for Neurosciences, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States.,Harold Hamm Diabetes Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
| | - Robert E Anderson
- Department of Geriatric Medicine, Reynolds Oklahoma Center on Aging, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States.,Oklahoma Center for Neurosciences, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States.,Dean McGee Eye Institute, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States.,Department of Ophthalmology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States.,Department of Cell Biology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
| | - Jennifer L Fessler
- Department of Cell Biology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
| | - David M Sherry
- Oklahoma Center for Neurosciences, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States.,Department of Cell Biology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States.,Department of Pharmaceutical Sciences, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
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