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Latimer CS, Prater KE, Postupna N, Dirk Keene C. Resistance and Resilience to Alzheimer's Disease. Cold Spring Harb Perspect Med 2024; 14:a041201. [PMID: 38151325 PMCID: PMC11293546 DOI: 10.1101/cshperspect.a041201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2023]
Abstract
Dementia is a significant public health crisis; the most common underlying cause of age-related cognitive decline and dementia is Alzheimer's disease neuropathologic change (ADNC). As such, there is an urgent need to identify novel therapeutic targets for the treatment and prevention of the underlying pathologic processes that contribute to the development of AD dementia. Although age is the top risk factor for dementia in general and AD specifically, these are not inevitable consequences of advanced age. Some individuals are able to live to advanced age without accumulating significant pathology (resistance to ADNC), whereas others are able to maintain cognitive function despite the presence of significant pathology (resilience to ADNC). Understanding mechanisms of resistance and resilience will inform therapeutic strategies to promote these processes to prevent or delay AD dementia. This article will highlight what is currently known about resistance and resilience to AD, including our current understanding of possible underlying mechanisms that may lead to candidate preventive and treatment interventions for this devastating neurodegenerative disease.
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Affiliation(s)
- Caitlin S Latimer
- Department of Laboratory Medicine and Pathology, University of Washington School of Medicine, Seattle 98195, Washington, USA
| | - Katherine E Prater
- Department of Neurology, University of Washington, Seattle 98195, Washington, USA
| | - Nadia Postupna
- Department of Laboratory Medicine and Pathology, University of Washington School of Medicine, Seattle 98195, Washington, USA
| | - C Dirk Keene
- Department of Laboratory Medicine and Pathology, University of Washington School of Medicine, Seattle 98195, Washington, USA
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Levak N, Lehtisalo J, Thunborg C, Westman E, Andersen P, Andrieu S, Broersen LM, Coley N, Hartmann T, Irving GF, Mangialasche F, Ngandu T, Pantel J, Rosenberg A, Sindi S, Soininen H, Solomon A, Wang R, Kivipelto M. Nutrition guidance within a multimodal intervention improves diet quality in prodromal Alzheimer's disease: Multimodal Preventive Trial for Alzheimer's Disease (MIND-AD mini). Alzheimers Res Ther 2024; 16:147. [PMID: 38961421 PMCID: PMC11221015 DOI: 10.1186/s13195-024-01522-8] [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: 03/26/2024] [Accepted: 06/26/2024] [Indexed: 07/05/2024]
Abstract
BACKGROUND Multimodal lifestyle interventions can benefit overall health, including cognition, in populations at-risk for dementia. However, little is known about the effect of lifestyle interventions in patients with prodromal Alzheimer's disease (AD). Even less is known about dietary intake and adherence to dietary recommendations within this population making it difficult to design tailored interventions for them. METHOD A 6-month MIND-ADmini pilot randomized controlled trial (RCT) was conducted among 93 participants with prodromal AD in Sweden, Finland, Germany, and France. Three arms were included in the RCT: 1) multimodal lifestyle intervention (nutritional guidance, exercise, cognitive training, vascular/metabolic risk management, and social stimulation); 2) multimodal lifestyle intervention + medical food product; and 3) regular health advice (control group). Adherence to dietary advice was assessed with a brief food intake questionnaire by using the Healthy Diet Index (HDI) and Mediterranean Diet Adherence Screener (MEDAS). The intake of macro- and micronutrients were analyzed on a subsample using 3-day food records. RESULTS The dietary quality in the intervention groups, pooled together, improved compared to that of the control group at the end of the study, as measured with by HDI (p = 0.026) and MEDAS (p = 0.008). The lifestyle-only group improved significantly more in MEDAS (p = 0.046) and almost significantly in HDI (p = 0.052) compared to the control group, while the lifestyle + medical food group improved in both HDI (p = 0.042) and MEDAS (p = 0.007) during the study. There were no changes in macro- or micronutrient intake for the intervention groups at follow-up; however, the intakes in the control group declined in several vitamins and minerals when adjusted for energy intake. CONCLUSION These results suggest that dietary intervention as part of multimodal lifestyle interventions is feasible and results in improved dietary quality in a population with prodromal AD. Nutrient intakes remained unchanged in the intervention groups while the control group showed a decreasing nutrient density. TRIAL REGISTRATION ClinicalTrials.gov NCT03249688, 2017-07-08.
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Affiliation(s)
- Nicholas Levak
- Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Center for Alzheimer Research QA32, Karolinska Vägen 37 A, 171 64, Solna, Sweden.
- Theme Inflammation and Aging, Karolinska University Hospital, Stockholm, Karolinska Vägen 37 A, 171 64, Solna, Sweden.
| | - Jenni Lehtisalo
- Population Health Unit, Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland
- Department of Neurology, Institute of Clinical Medicine, University of Eastern Finland, Yliopistonranta 8, 70210, Kuopio, Finland
| | - Charlotta Thunborg
- Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Center for Alzheimer Research QA32, Karolinska Vägen 37 A, 171 64, Solna, Sweden
- Theme Inflammation and Aging, Karolinska University Hospital, Stockholm, Karolinska Vägen 37 A, 171 64, Solna, Sweden
- Department of Caring Sciences, Faculty of Health and Occupational Studies, University of Gävle, Gävle, Sweden
| | - Eric Westman
- Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Center for Alzheimer Research QA32, Karolinska Vägen 37 A, 171 64, Solna, Sweden
- Department of Neuroimaging, Centre for Neuroimaging Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, England
| | - Pia Andersen
- Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Center for Alzheimer Research QA32, Karolinska Vägen 37 A, 171 64, Solna, Sweden
- Theme Inflammation and Aging, Karolinska University Hospital, Stockholm, Karolinska Vägen 37 A, 171 64, Solna, Sweden
| | - Sandrine Andrieu
- Department of Clinical Epidemiology and Public Health, UMR 1295, CHU de Toulouse, and Aging Research Team, CERPOP Inserm, Jules Guesde, 31000, Toulouse, France
- IHU HealthAge, Toulouse, 31059, France
| | | | - Nicola Coley
- Department of Clinical Epidemiology and Public Health, UMR 1295, CHU de Toulouse, and Aging Research Team, CERPOP Inserm, Jules Guesde, 31000, Toulouse, France
- IHU HealthAge, Toulouse, 31059, France
| | - Tobias Hartmann
- German Institute for Dementia Prevention (DIDP), Saarland University, 66424, Homburg, Germany
- Department of Experimental Neurology, Medical Faculty, Saarland University, 66424, Homburg, Germany
| | - Gerd Faxén Irving
- Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Center for Alzheimer Research QA32, Karolinska Vägen 37 A, 171 64, Solna, Sweden
| | - Francesca Mangialasche
- Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Center for Alzheimer Research QA32, Karolinska Vägen 37 A, 171 64, Solna, Sweden
| | - Tiia Ngandu
- Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Center for Alzheimer Research QA32, Karolinska Vägen 37 A, 171 64, Solna, Sweden
- Population Health Unit, Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Johannes Pantel
- Institute of General Practice, Goethe University Frankfurt a.M., Frankfurt, Germany
| | - Anna Rosenberg
- Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Center for Alzheimer Research QA32, Karolinska Vägen 37 A, 171 64, Solna, Sweden
- Department of Neurology, Institute of Clinical Medicine, University of Eastern Finland, Yliopistonranta 8, 70210, Kuopio, Finland
| | - Shireen Sindi
- Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Center for Alzheimer Research QA32, Karolinska Vägen 37 A, 171 64, Solna, Sweden
- The Ageing Epidemiology (AGE) Research Unit, School of Public Health, Imperial College London, St Mary's Hospital, Norfolk Place, London, W2 1PG, UK
| | - Hilkka Soininen
- Department of Neurology, Institute of Clinical Medicine, University of Eastern Finland, Yliopistonranta 8, 70210, Kuopio, Finland
| | - Alina Solomon
- Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Center for Alzheimer Research QA32, Karolinska Vägen 37 A, 171 64, Solna, Sweden
- Department of Neurology, Institute of Clinical Medicine, University of Eastern Finland, Yliopistonranta 8, 70210, Kuopio, Finland
- The Ageing Epidemiology (AGE) Research Unit, School of Public Health, Imperial College London, St Mary's Hospital, Norfolk Place, London, W2 1PG, UK
| | - Rui Wang
- Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Center for Alzheimer Research QA32, Karolinska Vägen 37 A, 171 64, Solna, Sweden
- Department of Physical Activity and Health, the Swedish School of Sport and Health Sciences, 114 86, Stockholm, Sweden
- Wisconsin Alzheimer's Disease Research Center, School of Medicine and Public Health, University of Wisconsin, 600 Highland Ave J5/1 Mezzanine, Madison, WI, 53792, USA
| | - Miia Kivipelto
- Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Center for Alzheimer Research QA32, Karolinska Vägen 37 A, 171 64, Solna, Sweden
- Theme Inflammation and Aging, Karolinska University Hospital, Stockholm, Karolinska Vägen 37 A, 171 64, Solna, Sweden
- Department of Neurology, Institute of Clinical Medicine, University of Eastern Finland, Yliopistonranta 8, 70210, Kuopio, Finland
- The Ageing Epidemiology (AGE) Research Unit, School of Public Health, Imperial College London, St Mary's Hospital, Norfolk Place, London, W2 1PG, UK
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Yliopistonranta 8, 70210, Kuopio, Finland
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Tor-Roca A, Sánchez-Pla A, Korosi A, Pallàs M, Lucassen PJ, Castellano-Escuder P, Aigner L, González-Domínguez R, Manach C, Carmona F, Vegas E, Helmer C, Feart C, Lefèvre-Arbogast S, Neuffer J, Lee H, Thuret S, Andres-Lacueva C, Samieri C, Urpi-Sarda M. A Mediterranean Diet-Based Metabolomic Score and Cognitive Decline in Older Adults: A Case-Control Analysis Nested within the Three-City Cohort Study. Mol Nutr Food Res 2024; 68:e2300271. [PMID: 37876144 DOI: 10.1002/mnfr.202300271] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2023] [Revised: 08/04/2023] [Indexed: 10/26/2023]
Abstract
SCOPE Evidence on the Mediterranean diet (MD) and age-related cognitive decline (CD) is still inconclusive partly due to self-reported dietary assessment. The aim of the current study is to develop an MD- metabolomic score (MDMS) and investigate its association with CD in community-dwelling older adults. METHODS AND RESULTS This study includes participants from the Three-City Study from the Bordeaux (n = 418) and Dijon (n = 422) cohorts who are free of dementia at baseline. Repeated measures of cognition over 12 years are collected. An MDMS is designed based on serum biomarkers related to MD key food groups and using a targeted metabolomics platform. Associations with CD are investigated through conditional logistic regression (matched on age, sex, and education level) in both sample sets. The MDMS is found to be inversely associated with CD (odds ratio [OR] [95% confidence interval (CI)] = 0.90 [0.80-1.00]; p = 0.048) in the Bordeaux (discovery) cohort. Results are comparable in the Dijon (validation) cohort, with a trend toward significance (OR [95% CI] = 0.91 [0.83-1.01]; p = 0.084). CONCLUSIONS A greater adherence to the MD, here assessed by a serum MDMS, is associated with lower odds of CD in older adults.
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Affiliation(s)
- Alba Tor-Roca
- Biomarkers and Nutrimetabolomics Laboratory, Department of Nutrition, Food Sciences and Gastronomy, Faculty of Pharmacy and Food Sciences, Food Science and Nutrition Torribera Campus, University of Barcelona, Santa Coloma de Gramenet, 08921, Spain
- Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable, Instituto de Salud Carlos III, Madrid, 28029, Spain
| | - Alex Sánchez-Pla
- Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable, Instituto de Salud Carlos III, Madrid, 28029, Spain
- Department of Genetics, Microbiology and Statistics, Faculty of Biology, University of Barcelona, Barcelona, 08028, Spain
| | - Aniko Korosi
- Brain Plasticity Group, Swammerdam Institute for Life Sciences, Center for Neuroscience, University of Amsterdam, Amsterdam, 1098 XH, The Netherlands
| | - Mercè Pallàs
- Pharmacology Section, Department of Pharmacology, Toxicology and Medicinal Chemistry, Faculty of Pharmacy and Food Sciences and Institut of Neurosciences, University of Barcelona, Barcelona, 08028, Spain
- Centro de Investigación Biomédica en Red en Neurodegeneracion, Instituto de Salud Carlos III, Madrid, 28029, Spain
| | - Paul J Lucassen
- Brain Plasticity Group, Swammerdam Institute for Life Sciences, Center for Neuroscience, University of Amsterdam, Amsterdam, 1098 XH, The Netherlands
| | - Pol Castellano-Escuder
- Biomarkers and Nutrimetabolomics Laboratory, Department of Nutrition, Food Sciences and Gastronomy, Faculty of Pharmacy and Food Sciences, Food Science and Nutrition Torribera Campus, University of Barcelona, Santa Coloma de Gramenet, 08921, Spain
- Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable, Instituto de Salud Carlos III, Madrid, 28029, Spain
- Department of Genetics, Microbiology and Statistics, Faculty of Biology, University of Barcelona, Barcelona, 08028, Spain
| | - Ludwig Aigner
- Institute of Molecular Regenerative Medicine, Spinal Cord Injury and Tissue Regeneration Center Salzburg, Paracelsus Medical University, Salzburg, 5020, Austria
| | - Raúl González-Domínguez
- Biomarkers and Nutrimetabolomics Laboratory, Department of Nutrition, Food Sciences and Gastronomy, Faculty of Pharmacy and Food Sciences, Food Science and Nutrition Torribera Campus, University of Barcelona, Santa Coloma de Gramenet, 08921, Spain
- Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable, Instituto de Salud Carlos III, Madrid, 28029, Spain
| | - Claudine Manach
- Université Clermont Auvergne, INRAE, UNH, Clermont-Ferrand, F-63000, France
| | - Francisco Carmona
- Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable, Instituto de Salud Carlos III, Madrid, 28029, Spain
- Department of Genetics, Microbiology and Statistics, Faculty of Biology, University of Barcelona, Barcelona, 08028, Spain
| | - Esteban Vegas
- Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable, Instituto de Salud Carlos III, Madrid, 28029, Spain
- Department of Genetics, Microbiology and Statistics, Faculty of Biology, University of Barcelona, Barcelona, 08028, Spain
| | - Catherine Helmer
- University of Bordeaux, Inserm, Bordeaux Population Health Research Center, UMR 1219, Bordeaux, F-33000, France
| | - Catherine Feart
- University of Bordeaux, Inserm, Bordeaux Population Health Research Center, UMR 1219, Bordeaux, F-33000, France
| | - Sophie Lefèvre-Arbogast
- University of Bordeaux, Inserm, Bordeaux Population Health Research Center, UMR 1219, Bordeaux, F-33000, France
| | - Jeanne Neuffer
- University of Bordeaux, Inserm, Bordeaux Population Health Research Center, UMR 1219, Bordeaux, F-33000, France
| | - Hyunah Lee
- Department of Basic and Clinical Neuroscience, Maurice Wohl Clinical Neuroscience Institute, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, SE5 9NU, UK
| | - Sandrine Thuret
- Department of Basic and Clinical Neuroscience, Maurice Wohl Clinical Neuroscience Institute, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, SE5 9NU, UK
| | - Cristina Andres-Lacueva
- Biomarkers and Nutrimetabolomics Laboratory, Department of Nutrition, Food Sciences and Gastronomy, Faculty of Pharmacy and Food Sciences, Food Science and Nutrition Torribera Campus, University of Barcelona, Santa Coloma de Gramenet, 08921, Spain
- Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable, Instituto de Salud Carlos III, Madrid, 28029, Spain
| | - Cécilia Samieri
- University of Bordeaux, Inserm, Bordeaux Population Health Research Center, UMR 1219, Bordeaux, F-33000, France
| | - Mireia Urpi-Sarda
- Biomarkers and Nutrimetabolomics Laboratory, Department of Nutrition, Food Sciences and Gastronomy, Faculty of Pharmacy and Food Sciences, Food Science and Nutrition Torribera Campus, University of Barcelona, Santa Coloma de Gramenet, 08921, Spain
- Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable, Instituto de Salud Carlos III, Madrid, 28029, Spain
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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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Loda I, D’Angelo E, Marzetti E, Kerminen H. Prevention, Assessment, and Management of Malnutrition in Older Adults with Early Stages of Cognitive Disorders. Nutrients 2024; 16:1566. [PMID: 38892503 PMCID: PMC11173938 DOI: 10.3390/nu16111566] [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: 04/29/2024] [Revised: 05/11/2024] [Accepted: 05/20/2024] [Indexed: 06/21/2024] Open
Abstract
Malnutrition is common in older adults, and its risk is greater in those living with dementia. Relative to cognitively healthy peers, the prevalence of malnutrition is also increased in individuals with early stages of cognitive disorders owing to pathophysiological, cognitive, and psychosocial changes related to cognitive impairment. Malnutrition is associated with adverse health outcomes, including faster cognitive and functional decline. Here, we provide an overview of the prevention, assessment, and management of malnutrition in older adults, with a special focus on the aspects that are important to consider in individuals with early stages of cognitive disorders. Strategies to prevent malnutrition include systematic screening for malnourishment using validated tools to detect those at risk. If the screening reveals an increased risk of malnutrition, a detailed assessment including the individual's nutritional, medical, and functional status as well as dietary intake should be performed. The management of malnutrition in the early stages of cognitive disorders should be based on the findings of a comprehensive assessment and be personalized according to the individual's specific characteristics. In the article, we also provide an overview of the evidence on vitamin supplements and specific dietary patterns to prevent cognitive decline or attenuate its progression.
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Affiliation(s)
- Irene Loda
- Scuola di Specialità in Geriatria, Università degli Studi di Brescia, Viale Europa 11, 25123 Brescia, Italy;
| | - Emanuela D’Angelo
- Fondazione Policlinico Universitario “Agostino Gemelli” IRCCS, Largo A. Gemelli 8, 00168 Rome, Italy
| | - Emanuele Marzetti
- Fondazione Policlinico Universitario “Agostino Gemelli” IRCCS, Largo A. Gemelli 8, 00168 Rome, Italy
- Department of Geriatrics, Orthopedics and Rheumatology, Università Cattolica del Sacro Cuore, Largo F. Vito 1, 00168 Rome, Italy;
| | - Hanna Kerminen
- Department of Geriatrics, Orthopedics and Rheumatology, Università Cattolica del Sacro Cuore, Largo F. Vito 1, 00168 Rome, Italy;
- Faculty of Medicine and Health Technology, The Gerontology Research Center (GEREC), Tampere University, Arvo Ylpön katu 34, 33520 Tampere, Finland
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Nasab MG, Heidari A, Sedighi M, Shakerian N, Mirbeyk M, Saghazadeh A, Rezaei N. Dietary inflammatory index and neuropsychiatric disorders. Rev Neurosci 2024; 35:21-33. [PMID: 37459114 DOI: 10.1515/revneuro-2023-0047] [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: 04/17/2023] [Accepted: 06/24/2023] [Indexed: 01/10/2024]
Abstract
Neuropsychiatric disorders (NPDs) are considered a potential threat to mental health. Inflammation predominantly plays a role in the pathophysiology of NPDs. Dietary patterns are widely postulated to be involved in the physiological response to inflammation. This review aims to discuss the literature on how dietary inflammatory index (DII) is related to inflammation and, consequently, NPDs. After comprehensive scrutiny in different databases, the articles that investigated the relation of DII score and various NPDs and psychological circumstances were included. The association between dietary patterns and mental disorders comprising depression, anxiety, and stress proved the role of a proinflammatory diet in these conditions' exacerbation. Aging is another condition closely associated with DII. The impact of proinflammatory and anti-inflammatory diet on sleep quality indicated related disorders like sleep latency and day dysfunctions among the different populations are in relation with the high DII score. The potential effects of genetic backgrounds, dietary patterns, and the gut microbiome on DII are discussed as well. To plan preventive or therapeutic interventions considering the DII, these factors, especially genetic variations, should be considered as there is a growing body of literature indicating the role of personalized medicine in different NPDs. To the best of our knowledge, there is a limited number of RCTs on this subject, so future research should evaluate the causality via RCTs and look for therapeutic interventions with an eye on personalized medicine using information about DII in NPDs.
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Affiliation(s)
- Mahsa Golshani Nasab
- Faculty of Veterinary Medicine, University of Tabriz, Tabriz, Iran
- Systematic Review and Meta-Analysis Expert Group (SRMEG), Universal Scientific Education and Research Network (USERN), Tabriz, Iran
| | - Arash Heidari
- Research Center for Immunodeficiencies, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
- Systematic Review and Meta-Analysis Expert Group (SRMEG), Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | - Mohammadreza Sedighi
- Systematic Review and Meta-Analysis Expert Group (SRMEG), Universal Scientific Education and Research Network (USERN), Tehran, Iran
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Narges Shakerian
- Student Research Committee, School of Rehabilitation, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
- Musculoskeletal Rehabilitation Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
- Systematic Review and Meta-Analysis Expert Group (SRMEG), Universal Scientific Education and Research Network (USERN), Ahvaz, Iran
| | - Mona Mirbeyk
- Research Center for Immunodeficiencies, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
- Systematic Review and Meta-Analysis Expert Group (SRMEG), Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | - Amene Saghazadeh
- Research Center for Immunodeficiencies, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
- Meta Cognition Interest Group (MCIG), Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | - Nima Rezaei
- Research Center for Immunodeficiencies, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
- Department of Immunology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
- Network of Immunity in Infection, Malignancy and Autoimmunity, Universal Scientific Education and Research Network (USERN), Tehran, Iran
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7
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McEvoy CT, Jennings A, Steves CJ, Macgregor A, Spector T, Cassidy A. Diet patterns and cognitive performance in a UK Female Twin Registry (TwinsUK). Alzheimers Res Ther 2024; 16:17. [PMID: 38263271 PMCID: PMC10804649 DOI: 10.1186/s13195-024-01387-x] [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: 07/27/2023] [Accepted: 01/04/2024] [Indexed: 01/25/2024]
Abstract
BACKGROUND Plant-based diets may provide protection against cognitive decline and Alzheimer's disease, but observational data have not been consistent. Previous studies include early life confounding from socioeconomic conditions and genetics that are known to influence both cognitive performance and diet behaviour. This study investigated associations between Mediterranean (MED) diet and MIND diets and cognitive performance accounting for shared genotype and early-life environmental exposures in female twins. METHODS Diet scores were examined in 509 female twins enrolled in TwinsUK study. The Cambridge Neuropsychological Test Automated Battery was used to assess cognition at baseline and 10 years later (in n = 275). A co-twin case-control study for discordant monozygotic (MZ) twins examined effects of diet on cognitive performance independent of genetic factors. Differences in relative abundance of taxa at 10-year follow-up were explored in subsamples. RESULTS Each 1-point increase in MIND or MED diet score was associated with 1.75 (95% CI: - 2.96, - 0.54, p = 0.005 and q = 0.11) and 1.67 (95% CI: - 2.71, - 0.65, p = 0.002 and q = 0.02) fewer respective errors in paired-associates learning. Within each MZ pair, the twin with the high diet score had better preservation in spatial span especially for MED diet (p = 0.02). There were no differences between diet scores and 10-year change in the other cognitive tests. MIND diet adherence was associated with higher relative abundance of Ruminococcaceae UCG-010 (0.30% (95% CI 0.17, 0.62), q = 0.05) which was also associated with less decline in global cognition over 10 years (0.22 (95% CI 0.06, 0.39), p = 0.01). CONCLUSIONS MIND or MED diets could help to preserve some cognitive abilities in midlife, particularly episodic and visuospatial working memory. Effects may be mediated by high dietary fibre content and increased abundance of short-chain fatty acid producing gut bacteria. Longer follow-up with repeated measures of cognition will determine whether diet can influence changes in cognition occurring in older age.
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Affiliation(s)
- Claire T McEvoy
- The Institute for Global Food Security, Queen's University Belfast, Belfast, Northern Ireland, UK.
- The Global Brain Health Institute, University of California San Francisco, San Francisco, CA, USA.
- The Global Brain Health Institute, Trinity College Dublin, Dublin, Ireland.
- Centre for Public Health, Institute of Clinical Sciences B, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, Northern Ireland, BT12 6BJ, UK.
| | - Amy Jennings
- The Institute for Global Food Security, Queen's University Belfast, Belfast, Northern Ireland, UK
| | - Claire J Steves
- Department of Twin Research & Genetic Epidemiology, King's College London, St Thomas' Campus, London, UK
| | | | - Tim Spector
- Department of Twin Research & Genetic Epidemiology, King's College London, St Thomas' Campus, London, UK
| | - Aedin Cassidy
- The Institute for Global Food Security, Queen's University Belfast, Belfast, Northern Ireland, UK
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8
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Pontifex MG, Connell E, Le Gall G, Lang L, Pourtau L, Gaudout D, Angeloni C, Zallocco L, Ronci M, Giusti L, Müller M, Vauzour D. A novel Mediterranean diet-inspired supplement ameliorates cognitive, microbial, and metabolic deficits in a mouse model of low-grade inflammation. Gut Microbes 2024; 16:2363011. [PMID: 38835220 PMCID: PMC11155709 DOI: 10.1080/19490976.2024.2363011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Accepted: 05/29/2024] [Indexed: 06/06/2024] Open
Abstract
The Mediterranean diet (MD) and its bioactive constituents have been advocated for their neuroprotective properties along with their capacity to affect gut microbiota speciation and metabolism. Mediated through the gut brain axis, this modulation of the microbiota may partly contribute to the neuroprotective properties of the MD. To explore this potential interaction, we evaluated the neuroprotective properties of a novel bioactive blend (Neurosyn240) resembling the Mediterranean diet in a rodent model of chronic low-grade inflammation. Behavioral tests of cognition, brain proteomic analysis, 16S rRNA sequencing, and 1H NMR metabolomic analyses were employed to develop an understanding of the gut-brain axis interactions involved. Recognition memory, as assessed by the novel object recognition task (NOR), decreased in response to LPS insult and was restored with Neurosyn240 supplementation. Although the open field task performance did not reach significance, it correlated with NOR performance indicating an element of anxiety related to this cognitive change. Behavioral changes associated with Neurosyn240 were accompanied by a shift in the microbiota composition which included the restoration of the Firmicutes: Bacteroidota ratio and an increase in Muribaculum, Rikenellaceae Alloprevotella, and most notably Akkermansia which significantly correlated with NOR performance. Akkermansia also correlated with the metabolites 5-aminovalerate, threonine, valine, uridine monophosphate, and adenosine monophosphate, which in turn significantly correlated with NOR performance. The proteomic profile within the brain was dramatically influenced by both interventions, with KEGG analysis highlighting oxidative phosphorylation and neurodegenerative disease-related pathways to be modulated. Intriguingly, a subset of these proteomic changes simultaneously correlated with Akkermansia abundance and predominantly related to oxidative phosphorylation, perhaps alluding to a protective gut-brain axis interaction. Collectively, our results suggest that the bioactive blend Neurosyn240 conferred cognitive and microbiota resilience in response to the deleterious effects of low-grade inflammation.
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Affiliation(s)
- Matthew G. Pontifex
- Norwich Medical School, Faculty of Medicine and Health Sciences, University of East Anglia, Norwich, UK
| | - Emily Connell
- Norwich Medical School, Faculty of Medicine and Health Sciences, University of East Anglia, Norwich, UK
| | - Gwenaelle Le Gall
- Norwich Medical School, Faculty of Medicine and Health Sciences, University of East Anglia, Norwich, UK
| | - Leonie Lang
- Norwich Medical School, Faculty of Medicine and Health Sciences, University of East Anglia, Norwich, UK
| | | | | | - Cristina Angeloni
- Department for Life Quality Studies, Alma Mater Studiorum, University of Bologna, Alma, Italy
| | - Lorenzo Zallocco
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - Maurizio Ronci
- Department of Pharmacy, University G. d’Annunzio of Chieti-Pescara, Chieti, Italy
| | - Laura Giusti
- School of Pharmacy, University of Camerino, Camerino, Italy
| | - Michael Müller
- Norwich Medical School, Faculty of Medicine and Health Sciences, University of East Anglia, Norwich, UK
| | - David Vauzour
- Norwich Medical School, Faculty of Medicine and Health Sciences, University of East Anglia, Norwich, UK
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9
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Turner A, LaMonica HM, Moroney C, O'Leary F, Naismith SL, Flood VM. Knowledge, Attitudes, and Behaviours Concerning the Mediterranean Diet Among Older Adults in Australia. J Community Health 2023; 48:951-962. [PMID: 37289354 PMCID: PMC10248335 DOI: 10.1007/s10900-023-01237-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/10/2023] [Indexed: 06/09/2023]
Abstract
Despite the growing body of evidence demonstrating the positive health effects of the Mediterranean diet, it is not routinely recommended in practice and adherence is low in the general population in Australia. The knowledge-attitude-behaviour model explains how health behaviours are supported through a process of acquiring knowledge, developing attitudes, and forming behaviours. Evidence has suggested that having a high level of nutrition-related knowledge is associated with more positive attitudes, which is directly linked to positive dietary behaviours. However, reports of knowledge and attitudes towards the Mediterranean diet, and how these directly relate to behaviours in older adults, are lacking. This study explored Mediterranean diet-related knowledge, attitudes, and behaviours among community-dwelling older adults in Australia. Participants were adults aged 55 years and older who completed an online survey that contained three parts: (a) knowledge - Mediterranean Diet Nutrition Knowledge Questionnaire (Med-NKQ); (b) nutrition-related attitudes and behaviours, and barriers and enablers to dietary change; (c) demographics. The sample included 61 adults who ranged in age from 55 to 89 years. The overall knowledge score was 30.5 out of a possible 40 points, with 60.7% classified as having a high level of knowledge. Knowledge was lowest for nutrient content and label reading. Attitudes and behaviours were generally positive and were not associated with level of knowledge. The most common barriers to dietary change were perceived cost and lack of knowledge, and motivational factors. There are a number of key gaps in knowledge that should be addressed through targeted educational programs. Strategies and tools to overcome perceived barriers and improve self-efficacy are needed to facilitate positive dietary behaviours.
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Affiliation(s)
- Ashlee Turner
- Faculty of Medicine and Health, Sydney School of Health Sciences, The University of Sydney, Sydney, NSW, 2006, Australia
| | - Haley M LaMonica
- Faculty of Medicine and Health, Translational Research Collective, The University of Sydney, Sydney, NSW, 2006, Australia
| | - Carissa Moroney
- Faculty of Medicine and Health, Sydney School of Health Sciences, The University of Sydney, Sydney, NSW, 2006, Australia
| | - Fiona O'Leary
- Charles Perkins Centre, The University of Sydney, Sydney, NSW, 2006, Australia
- Faculty of Medicine and Health, Susan Wakil School of Nursing and Midwifery, Discipline of Nutrition and Dietetics, The University of Sydney, Sydney, NSW, 2006, Australia
| | - Sharon L Naismith
- Charles Perkins Centre, The University of Sydney, Sydney, NSW, 2006, Australia
- Brain and Mind Centre, Healthy Brain Ageing Program, The University of Sydney, Sydney, NSW, 2006, Australia
- Faculty of Science, School of Psychology, The University of Sydney, Sydney, NSW, 2006, Australia
| | - Victoria M Flood
- Faculty of Medicine and Health, Sydney School of Health Sciences, The University of Sydney, Sydney, NSW, 2006, Australia.
- Faculty of Medicine and Health, The University of Sydney, University Centre for Rural Health, Northern Rivers, NSW, 2480, Australia.
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10
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Premachandran K, Wilson Alphonse CR, Soundharapandiyan N. Nourishing the Cognition with Millets: A Comprehensive Review of Their Nutritional Impact and Potential as Cognitive Enhancers. Mol Nutr Food Res 2023; 67:e2300450. [PMID: 37899300 DOI: 10.1002/mnfr.202300450] [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: 06/30/2023] [Revised: 08/28/2023] [Indexed: 10/31/2023]
Abstract
Cognition is the mental processes and abilities involved in acquiring, storing, retrieving and using it for decision making. Cognitive decline due to aging, lifestyle factor, chronic health conditions, genetic, and environmental factors are rising global concern and propose a potential threat to the cognitive health. The nutritional imbalance has led to increase in cognitive disorders around the world. Millets can be a nutritional intervention for promoting cognitive health and preventing cognitive decline. Millets has abundant phenolic compounds, flavonoids, and antioxidants to protect against oxidative stress-induced cognitive impairment. Millets exert neuroprotective effects by modulating pathways involved in neuronal-survival, synaptic-plasticity, and release of brain-derived neurotrophic factor. Millets demonstrates anti-inflammatory properties by regulating inflammatory-pathways and suppressing cytokines associated with cognitive impairment. Millets maintain healthy gut microbiota by producing metabolites such as short-chain fatty acids, which influence brain function and cognition. However, further research is needed to elucidate the underlying mechanisms and on optimizing the proportion do exploit its potential. Implementing millet-based dietary strategies through public health initiatives and educational programs can be a practical approach to support cognitive health across populations. Harnessing the potential of millets as a nutritional intervention offers a promising avenue for promoting cognitive health and improving the quality of life.
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Affiliation(s)
| | - Carlton Ranjith Wilson Alphonse
- Neuroscience Lab, Molecular and Nanomedicine Research Unit, Centre for Nanoscience and Nanotechnology, Sathyabama Institute of Science and Technology, Chennai, Tamil Nadu, 600119, India
| | - Nandhagopal Soundharapandiyan
- Neuroscience Lab, Molecular and Nanomedicine Research Unit, Centre for Nanoscience and Nanotechnology, Sathyabama Institute of Science and Technology, Chennai, Tamil Nadu, 600119, India
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11
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Norgren J, Sindi S, Matton A, Kivipelto M, Kåreholt I. APOE-Genotype and Insulin Modulate Estimated Effect of Dietary Macronutrients on Cognitive Performance: Panel Analyses in Nondiabetic Older Adults at Risk of Dementia. J Nutr 2023; 153:3506-3520. [PMID: 37778510 DOI: 10.1016/j.tjnut.2023.09.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Revised: 08/20/2023] [Accepted: 09/07/2023] [Indexed: 10/03/2023] Open
Abstract
BACKGROUND The apolipoprotein E gene (APOE ε-2/3/4, combined as 6 different genotypes: ε-22/23/24/33/34/44) and insulin status modulate dementia risk and play a role in the metabolism of macronutrients. OBJECTIVES We aimed to examine APOE-genotype and fasting insulin as effect modifiers of the slopes between dietary macronutrients and cognitive performance among older adults at risk of dementia. METHODS Panel analyses-with diet and cognition measured at baseline and follow-up at years 1 and 2-were performed in a sub-sample from the FINGER (Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability) trial (n = 676, 60-77 y, 46% females, all nondiabetics). The associations between macronutrients (3-d food records, z-scores) and global cognition (modified Neuropsychological Test Battery, z-score) were analyzed in mixed regression models adjusted for confounders selected a priori. After a gradient was implied by the point estimates in categorical APOE analyses, we investigated a continuous APOE variable [APOE-gradient, coded -1 (for ε-23), -0.5 (ε-24), 0 (ε-33), 1 (ε-34), 2 (ε-44)] as an effect-modifier. RESULTS At increasing levels of the APOE-gradient, a relatively more favorable slope between diet and cognition was observed for a lower carbohydrate/fat ratio [β = -0.040, 95% confidence interval (CI): -0.074, -0.006; P = 0.020 for interaction diet × APOE-gradient), and higher protein (β = 0.075, 95% CI: 0.042, 0.109; P = 9.4 × 10-6). Insulin concentration (log-linear) modulated the association between the carbohydrate/fat ratio and cognition by a quadratic interaction (β = -0.016, P = 0.039). Coherent findings for exploratory predictors (fiber, fat subtypes, composite score, metabolic biomarkers) were compatible with published hypotheses of differential dietary adaptation by APOE, with cognition among ε-33 being relatively independent of dietary parameters-implying "metabolic flexibility." Antagonistic slopes to cognition for ε-23 (positive) compared with ε-34 and ε-44 (negative) were found for a Higher-carbohydrates-fiber-Lower-fat-protein composite score, even as within-subjects effects. CONCLUSIONS APOE-based precision nutrition appears conceptually promising, but replications in wider samples are warranted, as well as support from trials. Both relative hyper- and hypoinsulinemia might modulate the effect of diet on cognition.
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Affiliation(s)
- Jakob Norgren
- Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Center for Alzheimer Research, Karolinska Institutet, Stockholm, Sweden.
| | - Shireen Sindi
- Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Center for Alzheimer Research, Karolinska Institutet, Stockholm, Sweden; Neuroepidemiology and Ageing Research Unit, School of Public Health, Imperial College London, London, United Kingdom
| | - Anna Matton
- Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Center for Alzheimer Research, Karolinska Institutet, Stockholm, Sweden; Neuroepidemiology and Ageing Research Unit, School of Public Health, Imperial College London, London, United Kingdom; Division of Neurogeriatrics, Department of Neurobiology, Care Sciences and Society, Center for Alzheimer Research, Karolinska Institutet, Stockholm, Sweden
| | - Miia Kivipelto
- Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Center for Alzheimer Research, Karolinska Institutet, Stockholm, Sweden; Neuroepidemiology and Ageing Research Unit, School of Public Health, Imperial College London, London, United Kingdom; Theme Inflammation and Aging, Medical Unit Aging, Karolinska University Hospital, Stockholm, Sweden; Stockholms Sjukhem, Research and Development Unit, Stockholm, Sweden
| | - Ingemar Kåreholt
- Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Center for Alzheimer Research, Karolinska Institutet, Stockholm, Sweden; Institute of Gerontology, School of Health and Welfare, Jönköping University, Jönköping, Sweden; Department of Neurobiology, Care Sciences and Society, Aging Research Center, Karolinska Institutet and Stockholm University, Stockholm, Sweden
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12
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Lee EH, Kim GH, Park HK, Kang HJ, Park YK, Lee HA, Hong CH, Moon SY, Kang W, Oh HS, Yoon HJ, Choi SH, Jeong JH. Effects of the multidomain intervention with nutritional supplements on cognition and gut microbiome in early symptomatic Alzheimer's disease: a randomized controlled trial. Front Aging Neurosci 2023; 15:1266955. [PMID: 38020771 PMCID: PMC10652389 DOI: 10.3389/fnagi.2023.1266955] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Accepted: 09/27/2023] [Indexed: 12/01/2023] Open
Abstract
Background The SoUth Korean study to PrEvent cognitive impaiRment and protect BRAIN health through lifestyle intervention in at-risk elderly people (SUPERBRAIN) is a part of the World-Wide Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (WW-FINGERS) network. This study aimed to demonstrate the effects of the SUPERBRAIN-based multidomain intervention with nutritional supplements in amyloid positive emission tomography (PET) proven early symptomatic Alzheimer's disease patients. Methods Forty-six participants who were diagnosed with mild cognitive impairment or mild dementia and were positive in the amyloid PET study randomized into three groups: group A, the multidomain intervention with nutritional supplements; group B, nutritional supplements only; and a control group. The primary outcome was a change in the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) total scale index score after an 8-week intervention. Secondary outcomes, including gut microbiome data, were also analyzed. Results The RBANS total scale index score improved significantly in group A compared with group B (p < 0.032) and compared with the control group (p < 0.001). After intervention, beta diversity of the gut microbiome between group A and the control group increased, and patients in group A were more enriched with Bifidobacterium. Conclusion SUPERBRAIN-based multidomain intervention with nutritional supplements improves cognition and gut microbiota in patients with early symptomatic Alzheimer's disease who were amyloid-positive by PET.
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Affiliation(s)
- Eun Hye Lee
- Department of Neurology, Ewha Womans University School of Medicine, Seoul, Republic of Korea
- Department of Neurology, Ewha Womans University Seoul Hospital, Seoul, Republic of Korea
| | - Geon Ha Kim
- Department of Neurology, Ewha Womans University School of Medicine, Seoul, Republic of Korea
- Department of Neurology, Ewha Womans University Mokdong Hospital, Seoul, Republic of Korea
| | - Hee Kyung Park
- Division of Psychiatry, Department of Mental Health Care of Older People, University College London, London, United Kingdom
| | - Hae Jin Kang
- Department of Medical Nutrition (AgeTech-Service Convergence Major), Kyung Hee University, Yongin, Republic of Korea
| | - Yoo Kyoung Park
- Department of Medical Nutrition (AgeTech-Service Convergence Major), Kyung Hee University, Yongin, Republic of Korea
| | - Hye Ah Lee
- Clinical Trial Center, Ewha Womans University Mokdong Hospital, Seoul, Republic of Korea
| | - Chang Hyung Hong
- Department of Psychiatry, Ajou University School of Medicine, Suwon, Republic of Korea
| | - So Young Moon
- Department of Neurology, Ajou University School of Medicine, Suwon, Republic of Korea
| | - Woorim Kang
- CJ Bioscience Inc., Seoul, Republic of Korea
| | | | - Hai-Jeon Yoon
- Department of Nuclear Medicine, Ewha Womans University School of Medicine, Seoul, Republic of Korea
| | - Seong Hye Choi
- Department of Neurology, Inha University College of Medicine, Incheon, Republic of Korea
| | - Jee Hyang Jeong
- Department of Neurology, Ewha Womans University School of Medicine, Seoul, Republic of Korea
- Department of Neurology, Ewha Womans University Seoul Hospital, Seoul, Republic of Korea
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13
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Zupo R, Castellana F, Piscitelli P, Crupi P, Desantis A, Greco E, Severino FP, Pulimeno M, Guazzini A, Kyriakides TC, Vasiliou V, Trichopoulou A, Soldati L, La Vecchia C, De Gaetano G, Donati MB, Colao A, Miani A, Corbo F, Clodoveo ML. Scientific evidence supporting the newly developed one-health labeling tool "Med-Index": an umbrella systematic review on health benefits of mediterranean diet principles and adherence in a planeterranean perspective. J Transl Med 2023; 21:755. [PMID: 37885010 PMCID: PMC10601192 DOI: 10.1186/s12967-023-04618-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Accepted: 10/12/2023] [Indexed: 10/28/2023] Open
Abstract
BACKGROUND Med-Index is a one-health front-of-pack (FOP) label, based on Mediterranean diet (MedDiet) principles, developed to summarize information about the nutritional properties and related-health benefits of any food as well as its sustainable production processes, and the associated food company's social responsibility parameters in a new "Planeterranean" perspective. Thus, Med-Index can be adopted in and by any European region and authority as well as worldwide; this is achieved by consumption and cooking of locally available and sourced foods that respect MedDiet principles, both in terms of healthy nutrition and sustainable production. The huge body of scientific evidence about the health benefits of the MedDiet model and principles requires a comprehensive framework to encompass the scientific reliability and robustness of this tool. A systematic review was carried out to examine the association between human health and adherence to MedDiet patterns upon which the "Med-Index" tool was subsequently developed. METHODS MEDLINE and PubMed databases were searched for eligible publications from 1990 to April 2023. Systematic literature reviews, with or without meta-analysis, of clinical trials and observational studies were screened by two independent investigators for eligibility, data extraction, and quality assessment. English language and the time interval 1990-2023 were applied. A registry code CRD42023464807 was generated on PROSPERO and approved for this search protocol. The corrected covered area (CCA), calculated to quantify the degree of overlap between reviews, gave a slight overlap (CCA = 4%). RESULTS A total of 84 systematic reviews out of 6681 screened records were selected. Eligible reviews included studies with predominantly observational designs (61/84, 72.6%%), of which 26/61 referenced studies of mixed observational and RCT designs, while 23/84 (27.4%) were RCT-only systematic reviews. Seventy-nine different entries were identified for health outcomes, clustered into 10 macro-categories, each reporting a statistically significant association with exposure to the MedDiet. Adherence to MedDiet was found to strongly benefit age-related chronic diseases (21.5%), neurological disorders (19%), and obesity-related metabolic features (12.65), followed by CVDs (11.4%), cancer (10.1%), diabetes (7.5%), liver health (6.3%), inflammation (5%), mortality (5%), and renal health (1.2%). The quality of the studies was moderate to high. CONCLUSION In the context of a "Planeterranean" framework and perspective that can be adopted in any European region and worldwide, MedDiet represents a healthy and sustainable lifestyle model, able to prevent several diseases and reduce premature mortality. In addition, the availability of a FOP, such as Med-Index, might foster more conscious food choices among consumers, paying attention both to human and planetary health.
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Affiliation(s)
- Roberta Zupo
- Department of Interdisciplinary Medicine (DIM), University "Aldo Moro", Piazza Giulio Cesare 11, 70100, Bari, Italy
| | - Fabio Castellana
- Department of Interdisciplinary Medicine (DIM), University "Aldo Moro", Piazza Giulio Cesare 11, 70100, Bari, Italy
| | - Prisco Piscitelli
- Italian Society of Environmental Medicine (SIMA), 20123, Milan, Italy.
- UNESCO Chair on Health Education and Sustainable Development, Federico II University, 80138, Naples, Italy.
| | - Pasquale Crupi
- Department of Interdisciplinary Medicine (DIM), University "Aldo Moro", Piazza Giulio Cesare 11, 70100, Bari, Italy
| | - Addolorata Desantis
- Department of Interdisciplinary Medicine (DIM), University "Aldo Moro", Piazza Giulio Cesare 11, 70100, Bari, Italy
| | - Enrico Greco
- Italian Society of Environmental Medicine (SIMA), 20123, Milan, Italy
| | - Franca Paola Severino
- Department of Education, Literatures, Intercultural Studies, Languages and Psychology, University of Florence, 50121, Florence, Italy
| | - Manuela Pulimeno
- Italian Society of Environmental Medicine (SIMA), 20123, Milan, Italy
| | - Andrea Guazzini
- Department of Education, Literatures, Intercultural Studies, Languages and Psychology, University of Florence, 50121, Florence, Italy
| | | | | | | | - Laura Soldati
- Department of Health Sciences, University of Milan, 20122, Milan, Italy
| | - Carlo La Vecchia
- Department of Clinical Sciences and Community Health, Università Degli Studi di Milano, Milan, Italy
| | - Giovanni De Gaetano
- Department of Epidemiology and Prevention, IRCCS NEUROMED, 86077, Pozzilli, Italy
| | | | - Annamaria Colao
- UNESCO Chair on Health Education and Sustainable Development, Federico II University, 80138, Naples, Italy
| | - Alessandro Miani
- Italian Society of Environmental Medicine (SIMA), 20123, Milan, Italy.
| | - Filomena Corbo
- Department of Pharmacy-Drug Sciences, University of Bari "Aldo Moro", 70125, Bari, Italy
| | - Maria Lisa Clodoveo
- Department of Interdisciplinary Medicine (DIM), University "Aldo Moro", Piazza Giulio Cesare 11, 70100, Bari, Italy
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Andrews V, Zammit G, O’Leary F. Dietary pattern, food, and nutritional supplement effects on cognitive outcomes in mild cognitive impairment: a systematic review of previous reviews. Nutr Rev 2023; 81:1462-1489. [PMID: 37027832 PMCID: PMC10563860 DOI: 10.1093/nutrit/nuad013] [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] [Indexed: 04/09/2023] Open
Abstract
CONTEXT Nutritional interventions may benefit cognition in people with mild cognitive impairment (MCI). However, evidence is yet to be synthesized in a way that can inform recommendations for clinical and public health settings. OBJECTIVE To systematically review evidence on the effect of dietary patterns, foods, and nutritional supplements on cognitive decline in individuals with MCI. DATA SOURCES Guided by the Preferred Reporting items for Systematic Review and Meta-Analysis Protocols 2015 statement, the Medline, EMBASE, and CINAHL databases, the JBI Database of Systematic Reviews and Implementation Reports, Cochrane Database of Systematic Reviews, and Database of Abstracts of Reviews of Effects were searched (publication years 2005 to 2020). Included studies were English-language systematic reviews and meta-analyses of randomized controlled trials and cohort studies reporting on the effectiveness of nutritional interventions on cognition of individuals with MCI. DATA EXTRACTION Two reviewers independently selected studies and extracted data on cognitive outcomes and adverse events. Review quality was assessed using AMSTAR 2 (A Measurement Tool to Assess Systematic Reviews-2). Primary study overlap was managed following Cochrane Handbook guidelines. DATA ANALYSIS Of the 6677 records retrieved, 20 reviews were included, which, in turn, reported on 43 randomized controlled trials and 1 cohort study that, together, addressed 18 nutritional interventions. Most reviews were limited by quality and the small number of primary studies with small sample sizes. Reviews were mostly positive for B vitamins, omega-3 fatty acids, and probiotics (including 12, 11 and 4 primary studies, respectively). Souvenaid and the Mediterranean diet reduced cognitive decline or Alzheimer's disease progression in single trials with <500 participants. Findings from studies with a small number of participants suggest vitamin D, a low-carbohydrate diet, medium-chain triglycerides, blueberries, grape juice, cocoa flavanols, and Brazil nuts may improve individual cognitive subdomains, but more studies are needed. CONCLUSIONS Few nutritional interventions were found to convincingly improve cognition of individuals with MCI. More high-quality research in MCI populations is required to determine if nutritional treatments improve cognition and/or reduce progression to dementia. SYSTEMATIC REVIEW REGISTRATION Open Science Framework protocol identifier DOI:10.17605/OSF.IO/BEP2S.
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Affiliation(s)
- Victoria Andrews
- are with the Discipline of Nutrition and Dietetics, Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, and The Charles Perkins Centre, The University of Sydney, Camperdown, New South Wales, Australia
| | - Gabrielle Zammit
- are with the Discipline of Nutrition and Dietetics, Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, and The Charles Perkins Centre, The University of Sydney, Camperdown, New South Wales, Australia
| | - Fiona O’Leary
- are with the Discipline of Nutrition and Dietetics, Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, and The Charles Perkins Centre, The University of Sydney, Camperdown, New South Wales, Australia
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15
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Ribeiro FJ, Teixeira R, Poínhos R. Dietary Habits and Gaming Behaviors of Portuguese and Brazilian Esports Players. Nutrients 2023; 15:4200. [PMID: 37836483 PMCID: PMC10574580 DOI: 10.3390/nu15194200] [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: 08/18/2023] [Revised: 09/24/2023] [Accepted: 09/26/2023] [Indexed: 10/15/2023] Open
Abstract
As the esports industry grows, marketing campaigns for fast food, soft drinks, alcoholic and energy drinks, and dietary supplements at related events intensify. Portuguese and Brazilian esports players' dietary patterns remain unexplored. This study aimed to characterize the dietary and gaming habits of esports players. We applied an anonymous, open online survey to a convenience sample of esports players that included the PREDIMED and the Internet Gaming Disorder Scale. The survey was shared through email and social media platforms, including Facebook, Twitter, Instagram, Discord, WhatsApp, and Twitch. The sample (n = 579) was predominantly male (91.4%), averaged 26.1 (SD = 7.0) years, and 25.9 (SD = 5.5) kg/m2. Most reported a weak (53.7%) adherence to the Mediterranean diet. Almost a third (32.3%) consumed dietary supplements. Our sample presented a low adhesion to the Mediterranean dietary pattern, low consumption of fruit and vegetables, and high consumption of fast food, red and processed meat, soft drinks, and dietary supplements, including caffeine-based supplements. Dietary supplement consumption was related to a higher adhesion to the Mediterranean diet, and a higher level of professionalization and internet gaming disorder correlated with a lower adhesion. In conclusion, we infer that Portuguese and Brazilian esports players follow an unbalanced diet.
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Affiliation(s)
- Fernando J. Ribeiro
- Faculty of Nutrition and Food Science, University of Porto (FCNAUP), Rua do Campo Alegre, 823, 4150-180 Porto, Portugal; (R.T.); (R.P.)
- Faculty of Sciences, University of Porto (FCUP), Rua do Campo Alegre, 1021, 4169-007 Porto, Portugal
| | - Raquel Teixeira
- Faculty of Nutrition and Food Science, University of Porto (FCNAUP), Rua do Campo Alegre, 823, 4150-180 Porto, Portugal; (R.T.); (R.P.)
| | - Rui Poínhos
- Faculty of Nutrition and Food Science, University of Porto (FCNAUP), Rua do Campo Alegre, 823, 4150-180 Porto, Portugal; (R.T.); (R.P.)
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16
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Ben-Porat T, Alberga A, Audet MC, Belleville S, Cohen TR, Garneau PY, Lavoie KL, Marion P, Mellah S, Pescarus R, Rahme E, Santosa S, Studer AS, Vuckovic D, Woods R, Yousefi R, Bacon SL. Understanding the impact of radical changes in diet and the gut microbiota on brain function and structure: rationale and design of the EMBRACE study. Surg Obes Relat Dis 2023; 19:1000-1012. [PMID: 37088645 DOI: 10.1016/j.soard.2023.02.022] [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: 08/07/2022] [Revised: 01/18/2023] [Accepted: 02/24/2023] [Indexed: 03/19/2023]
Abstract
BACKGROUND Bariatric surgery leads to profound changes in gut microbiota and dietary patterns, both of which may interact to impact gut-brain communication. Though cognitive function improves postsurgery, there is a large variability in outcomes. How bariatric surgery-induced modifications in the gut microbiota and dietary patterns influence the variability in cognitive function is still unclear. OBJECTIVES To elucidate the associations between bariatric surgery-induced changes in dietary and gut microbiota patterns with cognition and brain structure. SETTING University hospital. METHODS A total of 120 adult patients (≥30 years) scheduled to undergo a primary bariatric surgery along with 60 age-, sex-, and body mass index-matched patients on the surgery waitlist will undergo assessments 3-months presurgery and 6- and 12-month postsurgery (or an equivalent time for the waitlist group). Additionally, 60 age-and sex-matched nonbariatric surgery eligible individuals will complete the presurgical assessments only. Evaluations will include sociodemographic and health behavior questionnaires, physiological assessments (anthropometrics, blood-, urine-, and fecal-based measures), neuropsychological cognitive tests, and structural magnetic resonance imaging. Cluster analyses of the dietary and gut microbiota changes will define the various dietary patterns and microbiota profiles, then using repeated measures mixed models, their associations with global cognitive and structural brain alterations will be explored. RESULTS The coordinating study site (Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, QC, Canada), provided the primary ethical approval (Research Ethics Board#: MP-32-2022-2412). CONCLUSIONS The insights generated from this study can be used to develop individually-targeted neurodegenerative disease prevention strategies, as well as providing critical mechanistic information.
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Affiliation(s)
- Tair Ben-Porat
- Department of Health, Kinesiology, and Applied Physiology, Concordia University, Montreal, Quebec, Canada; Montreal Behavioural Medicine Centre (MBMC), Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal (CIUSSS-NIM), Quebec, Canada
| | - Angela Alberga
- Department of Health, Kinesiology, and Applied Physiology, Concordia University, Montreal, Quebec, Canada
| | - Marie-Claude Audet
- School of Nutrition Sciences, University of Ottawa, Ontario, Canada; The Royal's Institute of Mental Health Research, Ottawa, Ontario, Canada
| | - Sylvie Belleville
- Research centre of the Institut Universitaire de Gériatrie de Montréal (CRIUGM), Centre intégré universitaire de santé et de services sociaux du Centre-Sud-de-l'Île-de-Montréal (CIUSSS-CSMTL), Montreal, Quebec, Canada; Department of Psychology, University of Montreal, Montreal, Quebec, Canada
| | - Tamara R Cohen
- Faculty of Land and Food Systems, University of British Columbia (UBC), Vancouver, British Columbia, Canada
| | - Pierre Y Garneau
- Division of Bariatric Surgery, CIUSSS-NIM, Montreal, Canada; Department of Surgery, Université de Montréal, Montréal, Canada
| | - Kim L Lavoie
- Montreal Behavioural Medicine Centre (MBMC), Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal (CIUSSS-NIM), Quebec, Canada; Department of Psychology, Université du Québec a Montréal (UQAM), Montreal, Quebec, Canada
| | - Patrick Marion
- Montreal Behavioural Medicine Centre (MBMC), Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal (CIUSSS-NIM), Quebec, Canada
| | - Samira Mellah
- Research centre of the Institut Universitaire de Gériatrie de Montréal (CRIUGM), Centre intégré universitaire de santé et de services sociaux du Centre-Sud-de-l'Île-de-Montréal (CIUSSS-CSMTL), Montreal, Quebec, Canada
| | - Radu Pescarus
- Division of Bariatric Surgery, CIUSSS-NIM, Montreal, Canada; Department of Surgery, Université de Montréal, Montréal, Canada
| | - Elham Rahme
- Department of Medicine, Faculty of Medicine and Health Sciences, McGill University, Montreal, Quebec, Canada; Center for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre (MUHC), Montreal, Quebec, Canada
| | - Sylvia Santosa
- Department of Health, Kinesiology, and Applied Physiology, Concordia University, Montreal, Quebec, Canada; Metabolism, Obesity and Nutrition Lab, PERFORM Centre, Concordia University, Montreal, Quebec, Canada; Research Centre, Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal (CIUSSS-NIM), Quebec, Canada
| | - Anne-Sophie Studer
- Division of Bariatric Surgery, CIUSSS-NIM, Montreal, Canada; Department of Surgery, Université de Montréal, Montréal, Canada
| | - Dajana Vuckovic
- Department of Chemistry and Biochemistry, Concordia University, Montreal, Quebec, Canada
| | - Robbie Woods
- Montreal Behavioural Medicine Centre (MBMC), Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal (CIUSSS-NIM), Quebec, Canada; Department of Psychology, Concordia University, Montreal, Quebec, Canada
| | - Reyhaneh Yousefi
- Department of Health, Kinesiology, and Applied Physiology, Concordia University, Montreal, Quebec, Canada; Montreal Behavioural Medicine Centre (MBMC), Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal (CIUSSS-NIM), Quebec, Canada
| | - Simon L Bacon
- Department of Health, Kinesiology, and Applied Physiology, Concordia University, Montreal, Quebec, Canada; Montreal Behavioural Medicine Centre (MBMC), Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal (CIUSSS-NIM), Quebec, Canada.
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17
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Barnes LL, Dhana K, Liu X, Carey VJ, Ventrelle J, Johnson K, Hollings CS, Bishop L, Laranjo N, Stubbs BJ, Reilly X, Agarwal P, Zhang S, Grodstein F, Tangney CC, Holland TM, Aggarwal NT, Arfanakis K, Morris MC, Sacks FM. Trial of the MIND Diet for Prevention of Cognitive Decline in Older Persons. N Engl J Med 2023; 389:602-611. [PMID: 37466280 PMCID: PMC10513737 DOI: 10.1056/nejmoa2302368] [Citation(s) in RCA: 60] [Impact Index Per Article: 60.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/20/2023]
Abstract
BACKGROUND Findings from observational studies suggest that dietary patterns may offer protective benefits against cognitive decline, but data from clinical trials are limited. The Mediterranean-DASH Intervention for Neurodegenerative Delay, known as the MIND diet, is a hybrid of the Mediterranean diet and the DASH (Dietary Approaches to Stop Hypertension) diet, with modifications to include foods that have been putatively associated with a decreased risk of dementia. METHODS We performed a two-site, randomized, controlled trial involving older adults without cognitive impairment but with a family history of dementia, a body-mass index (the weight in kilograms divided by the square of the height in meters) greater than 25, and a suboptimal diet, as determined by means of a 14-item questionnaire, to test the cognitive effects of the MIND diet with mild caloric restriction as compared with a control diet with mild caloric restriction. We assigned the participants in a 1:1 ratio to follow the intervention or the control diet for 3 years. All the participants received counseling regarding adherence to their assigned diet plus support to promote weight loss. The primary end point was the change from baseline in a global cognition score and four cognitive domain scores, all of which were derived from a 12-test battery. The raw scores from each test were converted to z scores, which were averaged across all tests to create the global cognition score and across component tests to create the four domain scores; higher scores indicate better cognitive performance. The secondary outcome was the change from baseline in magnetic resonance imaging (MRI)-derived measures of brain characteristics in a nonrandom sample of participants. RESULTS A total of 1929 persons underwent screening, and 604 were enrolled; 301 were assigned to the MIND-diet group and 303 to the control-diet group. The trial was completed by 93.4% of the participants. From baseline to year 3, improvements in global cognition scores were observed in both groups, with increases of 0.205 standardized units in the MIND-diet group and 0.170 standardized units in the control-diet group (mean difference, 0.035 standardized units; 95% confidence interval, -0.022 to 0.092; P = 0.23). Changes in white-matter hyperintensities, hippocampal volumes, and total gray- and white-matter volumes on MRI were similar in the two groups. CONCLUSIONS Among cognitively unimpaired participants with a family history of dementia, changes in cognition and brain MRI outcomes from baseline to year 3 did not differ significantly between those who followed the MIND diet and those who followed the control diet with mild caloric restriction. (Funded by the National Institute on Aging; ClinicalTrials.gov number, NCT02817074.).
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Affiliation(s)
- Lisa L Barnes
- From Rush Alzheimer's Disease Center (L.L.B., P.A., S.Z., F.G., N.T.A., K.A.), the Department of Neurology (L.L.B., N.T.A.), Rush Institute for Healthy Aging (K.D., X.L., C.S.H., T.M.H.), and the Departments of Internal Medicine (K.D., X.L., C.S.H., P.A., F.G., T.M.H., M.C.M.), Clinical Nutrition (J.V., P.A., C.C.T.), Preventive Medicine (J.V., C.C.T.), and Diagnostic Radiology and Nuclear Medicine (K.A.), Rush University Medical Center, and the Department of Biomedical Engineering, Illinois Institute of Technology (K.A.) - all in Chicago; and Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital (V.J.C., N.L., B.J.S., X.R.), Harvard Medical School (V.J.C., N.L., B.J.S., X.R.), and the Department of Nutrition, Harvard T.H. Chan School of Public Health (K.J., L.B., F.M.S.) - all in Boston
| | - Klodian Dhana
- From Rush Alzheimer's Disease Center (L.L.B., P.A., S.Z., F.G., N.T.A., K.A.), the Department of Neurology (L.L.B., N.T.A.), Rush Institute for Healthy Aging (K.D., X.L., C.S.H., T.M.H.), and the Departments of Internal Medicine (K.D., X.L., C.S.H., P.A., F.G., T.M.H., M.C.M.), Clinical Nutrition (J.V., P.A., C.C.T.), Preventive Medicine (J.V., C.C.T.), and Diagnostic Radiology and Nuclear Medicine (K.A.), Rush University Medical Center, and the Department of Biomedical Engineering, Illinois Institute of Technology (K.A.) - all in Chicago; and Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital (V.J.C., N.L., B.J.S., X.R.), Harvard Medical School (V.J.C., N.L., B.J.S., X.R.), and the Department of Nutrition, Harvard T.H. Chan School of Public Health (K.J., L.B., F.M.S.) - all in Boston
| | - Xiaoran Liu
- From Rush Alzheimer's Disease Center (L.L.B., P.A., S.Z., F.G., N.T.A., K.A.), the Department of Neurology (L.L.B., N.T.A.), Rush Institute for Healthy Aging (K.D., X.L., C.S.H., T.M.H.), and the Departments of Internal Medicine (K.D., X.L., C.S.H., P.A., F.G., T.M.H., M.C.M.), Clinical Nutrition (J.V., P.A., C.C.T.), Preventive Medicine (J.V., C.C.T.), and Diagnostic Radiology and Nuclear Medicine (K.A.), Rush University Medical Center, and the Department of Biomedical Engineering, Illinois Institute of Technology (K.A.) - all in Chicago; and Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital (V.J.C., N.L., B.J.S., X.R.), Harvard Medical School (V.J.C., N.L., B.J.S., X.R.), and the Department of Nutrition, Harvard T.H. Chan School of Public Health (K.J., L.B., F.M.S.) - all in Boston
| | - Vincent J Carey
- From Rush Alzheimer's Disease Center (L.L.B., P.A., S.Z., F.G., N.T.A., K.A.), the Department of Neurology (L.L.B., N.T.A.), Rush Institute for Healthy Aging (K.D., X.L., C.S.H., T.M.H.), and the Departments of Internal Medicine (K.D., X.L., C.S.H., P.A., F.G., T.M.H., M.C.M.), Clinical Nutrition (J.V., P.A., C.C.T.), Preventive Medicine (J.V., C.C.T.), and Diagnostic Radiology and Nuclear Medicine (K.A.), Rush University Medical Center, and the Department of Biomedical Engineering, Illinois Institute of Technology (K.A.) - all in Chicago; and Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital (V.J.C., N.L., B.J.S., X.R.), Harvard Medical School (V.J.C., N.L., B.J.S., X.R.), and the Department of Nutrition, Harvard T.H. Chan School of Public Health (K.J., L.B., F.M.S.) - all in Boston
| | - Jennifer Ventrelle
- From Rush Alzheimer's Disease Center (L.L.B., P.A., S.Z., F.G., N.T.A., K.A.), the Department of Neurology (L.L.B., N.T.A.), Rush Institute for Healthy Aging (K.D., X.L., C.S.H., T.M.H.), and the Departments of Internal Medicine (K.D., X.L., C.S.H., P.A., F.G., T.M.H., M.C.M.), Clinical Nutrition (J.V., P.A., C.C.T.), Preventive Medicine (J.V., C.C.T.), and Diagnostic Radiology and Nuclear Medicine (K.A.), Rush University Medical Center, and the Department of Biomedical Engineering, Illinois Institute of Technology (K.A.) - all in Chicago; and Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital (V.J.C., N.L., B.J.S., X.R.), Harvard Medical School (V.J.C., N.L., B.J.S., X.R.), and the Department of Nutrition, Harvard T.H. Chan School of Public Health (K.J., L.B., F.M.S.) - all in Boston
| | - Kathleen Johnson
- From Rush Alzheimer's Disease Center (L.L.B., P.A., S.Z., F.G., N.T.A., K.A.), the Department of Neurology (L.L.B., N.T.A.), Rush Institute for Healthy Aging (K.D., X.L., C.S.H., T.M.H.), and the Departments of Internal Medicine (K.D., X.L., C.S.H., P.A., F.G., T.M.H., M.C.M.), Clinical Nutrition (J.V., P.A., C.C.T.), Preventive Medicine (J.V., C.C.T.), and Diagnostic Radiology and Nuclear Medicine (K.A.), Rush University Medical Center, and the Department of Biomedical Engineering, Illinois Institute of Technology (K.A.) - all in Chicago; and Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital (V.J.C., N.L., B.J.S., X.R.), Harvard Medical School (V.J.C., N.L., B.J.S., X.R.), and the Department of Nutrition, Harvard T.H. Chan School of Public Health (K.J., L.B., F.M.S.) - all in Boston
| | - Chiquia S Hollings
- From Rush Alzheimer's Disease Center (L.L.B., P.A., S.Z., F.G., N.T.A., K.A.), the Department of Neurology (L.L.B., N.T.A.), Rush Institute for Healthy Aging (K.D., X.L., C.S.H., T.M.H.), and the Departments of Internal Medicine (K.D., X.L., C.S.H., P.A., F.G., T.M.H., M.C.M.), Clinical Nutrition (J.V., P.A., C.C.T.), Preventive Medicine (J.V., C.C.T.), and Diagnostic Radiology and Nuclear Medicine (K.A.), Rush University Medical Center, and the Department of Biomedical Engineering, Illinois Institute of Technology (K.A.) - all in Chicago; and Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital (V.J.C., N.L., B.J.S., X.R.), Harvard Medical School (V.J.C., N.L., B.J.S., X.R.), and the Department of Nutrition, Harvard T.H. Chan School of Public Health (K.J., L.B., F.M.S.) - all in Boston
| | - Louise Bishop
- From Rush Alzheimer's Disease Center (L.L.B., P.A., S.Z., F.G., N.T.A., K.A.), the Department of Neurology (L.L.B., N.T.A.), Rush Institute for Healthy Aging (K.D., X.L., C.S.H., T.M.H.), and the Departments of Internal Medicine (K.D., X.L., C.S.H., P.A., F.G., T.M.H., M.C.M.), Clinical Nutrition (J.V., P.A., C.C.T.), Preventive Medicine (J.V., C.C.T.), and Diagnostic Radiology and Nuclear Medicine (K.A.), Rush University Medical Center, and the Department of Biomedical Engineering, Illinois Institute of Technology (K.A.) - all in Chicago; and Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital (V.J.C., N.L., B.J.S., X.R.), Harvard Medical School (V.J.C., N.L., B.J.S., X.R.), and the Department of Nutrition, Harvard T.H. Chan School of Public Health (K.J., L.B., F.M.S.) - all in Boston
| | - Nancy Laranjo
- From Rush Alzheimer's Disease Center (L.L.B., P.A., S.Z., F.G., N.T.A., K.A.), the Department of Neurology (L.L.B., N.T.A.), Rush Institute for Healthy Aging (K.D., X.L., C.S.H., T.M.H.), and the Departments of Internal Medicine (K.D., X.L., C.S.H., P.A., F.G., T.M.H., M.C.M.), Clinical Nutrition (J.V., P.A., C.C.T.), Preventive Medicine (J.V., C.C.T.), and Diagnostic Radiology and Nuclear Medicine (K.A.), Rush University Medical Center, and the Department of Biomedical Engineering, Illinois Institute of Technology (K.A.) - all in Chicago; and Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital (V.J.C., N.L., B.J.S., X.R.), Harvard Medical School (V.J.C., N.L., B.J.S., X.R.), and the Department of Nutrition, Harvard T.H. Chan School of Public Health (K.J., L.B., F.M.S.) - all in Boston
| | - Benjamin J Stubbs
- From Rush Alzheimer's Disease Center (L.L.B., P.A., S.Z., F.G., N.T.A., K.A.), the Department of Neurology (L.L.B., N.T.A.), Rush Institute for Healthy Aging (K.D., X.L., C.S.H., T.M.H.), and the Departments of Internal Medicine (K.D., X.L., C.S.H., P.A., F.G., T.M.H., M.C.M.), Clinical Nutrition (J.V., P.A., C.C.T.), Preventive Medicine (J.V., C.C.T.), and Diagnostic Radiology and Nuclear Medicine (K.A.), Rush University Medical Center, and the Department of Biomedical Engineering, Illinois Institute of Technology (K.A.) - all in Chicago; and Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital (V.J.C., N.L., B.J.S., X.R.), Harvard Medical School (V.J.C., N.L., B.J.S., X.R.), and the Department of Nutrition, Harvard T.H. Chan School of Public Health (K.J., L.B., F.M.S.) - all in Boston
| | - Xavier Reilly
- From Rush Alzheimer's Disease Center (L.L.B., P.A., S.Z., F.G., N.T.A., K.A.), the Department of Neurology (L.L.B., N.T.A.), Rush Institute for Healthy Aging (K.D., X.L., C.S.H., T.M.H.), and the Departments of Internal Medicine (K.D., X.L., C.S.H., P.A., F.G., T.M.H., M.C.M.), Clinical Nutrition (J.V., P.A., C.C.T.), Preventive Medicine (J.V., C.C.T.), and Diagnostic Radiology and Nuclear Medicine (K.A.), Rush University Medical Center, and the Department of Biomedical Engineering, Illinois Institute of Technology (K.A.) - all in Chicago; and Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital (V.J.C., N.L., B.J.S., X.R.), Harvard Medical School (V.J.C., N.L., B.J.S., X.R.), and the Department of Nutrition, Harvard T.H. Chan School of Public Health (K.J., L.B., F.M.S.) - all in Boston
| | - Puja Agarwal
- From Rush Alzheimer's Disease Center (L.L.B., P.A., S.Z., F.G., N.T.A., K.A.), the Department of Neurology (L.L.B., N.T.A.), Rush Institute for Healthy Aging (K.D., X.L., C.S.H., T.M.H.), and the Departments of Internal Medicine (K.D., X.L., C.S.H., P.A., F.G., T.M.H., M.C.M.), Clinical Nutrition (J.V., P.A., C.C.T.), Preventive Medicine (J.V., C.C.T.), and Diagnostic Radiology and Nuclear Medicine (K.A.), Rush University Medical Center, and the Department of Biomedical Engineering, Illinois Institute of Technology (K.A.) - all in Chicago; and Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital (V.J.C., N.L., B.J.S., X.R.), Harvard Medical School (V.J.C., N.L., B.J.S., X.R.), and the Department of Nutrition, Harvard T.H. Chan School of Public Health (K.J., L.B., F.M.S.) - all in Boston
| | - Shengwei Zhang
- From Rush Alzheimer's Disease Center (L.L.B., P.A., S.Z., F.G., N.T.A., K.A.), the Department of Neurology (L.L.B., N.T.A.), Rush Institute for Healthy Aging (K.D., X.L., C.S.H., T.M.H.), and the Departments of Internal Medicine (K.D., X.L., C.S.H., P.A., F.G., T.M.H., M.C.M.), Clinical Nutrition (J.V., P.A., C.C.T.), Preventive Medicine (J.V., C.C.T.), and Diagnostic Radiology and Nuclear Medicine (K.A.), Rush University Medical Center, and the Department of Biomedical Engineering, Illinois Institute of Technology (K.A.) - all in Chicago; and Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital (V.J.C., N.L., B.J.S., X.R.), Harvard Medical School (V.J.C., N.L., B.J.S., X.R.), and the Department of Nutrition, Harvard T.H. Chan School of Public Health (K.J., L.B., F.M.S.) - all in Boston
| | - Francine Grodstein
- From Rush Alzheimer's Disease Center (L.L.B., P.A., S.Z., F.G., N.T.A., K.A.), the Department of Neurology (L.L.B., N.T.A.), Rush Institute for Healthy Aging (K.D., X.L., C.S.H., T.M.H.), and the Departments of Internal Medicine (K.D., X.L., C.S.H., P.A., F.G., T.M.H., M.C.M.), Clinical Nutrition (J.V., P.A., C.C.T.), Preventive Medicine (J.V., C.C.T.), and Diagnostic Radiology and Nuclear Medicine (K.A.), Rush University Medical Center, and the Department of Biomedical Engineering, Illinois Institute of Technology (K.A.) - all in Chicago; and Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital (V.J.C., N.L., B.J.S., X.R.), Harvard Medical School (V.J.C., N.L., B.J.S., X.R.), and the Department of Nutrition, Harvard T.H. Chan School of Public Health (K.J., L.B., F.M.S.) - all in Boston
| | - Christy C Tangney
- From Rush Alzheimer's Disease Center (L.L.B., P.A., S.Z., F.G., N.T.A., K.A.), the Department of Neurology (L.L.B., N.T.A.), Rush Institute for Healthy Aging (K.D., X.L., C.S.H., T.M.H.), and the Departments of Internal Medicine (K.D., X.L., C.S.H., P.A., F.G., T.M.H., M.C.M.), Clinical Nutrition (J.V., P.A., C.C.T.), Preventive Medicine (J.V., C.C.T.), and Diagnostic Radiology and Nuclear Medicine (K.A.), Rush University Medical Center, and the Department of Biomedical Engineering, Illinois Institute of Technology (K.A.) - all in Chicago; and Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital (V.J.C., N.L., B.J.S., X.R.), Harvard Medical School (V.J.C., N.L., B.J.S., X.R.), and the Department of Nutrition, Harvard T.H. Chan School of Public Health (K.J., L.B., F.M.S.) - all in Boston
| | - Thomas M Holland
- From Rush Alzheimer's Disease Center (L.L.B., P.A., S.Z., F.G., N.T.A., K.A.), the Department of Neurology (L.L.B., N.T.A.), Rush Institute for Healthy Aging (K.D., X.L., C.S.H., T.M.H.), and the Departments of Internal Medicine (K.D., X.L., C.S.H., P.A., F.G., T.M.H., M.C.M.), Clinical Nutrition (J.V., P.A., C.C.T.), Preventive Medicine (J.V., C.C.T.), and Diagnostic Radiology and Nuclear Medicine (K.A.), Rush University Medical Center, and the Department of Biomedical Engineering, Illinois Institute of Technology (K.A.) - all in Chicago; and Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital (V.J.C., N.L., B.J.S., X.R.), Harvard Medical School (V.J.C., N.L., B.J.S., X.R.), and the Department of Nutrition, Harvard T.H. Chan School of Public Health (K.J., L.B., F.M.S.) - all in Boston
| | - Neelum T Aggarwal
- From Rush Alzheimer's Disease Center (L.L.B., P.A., S.Z., F.G., N.T.A., K.A.), the Department of Neurology (L.L.B., N.T.A.), Rush Institute for Healthy Aging (K.D., X.L., C.S.H., T.M.H.), and the Departments of Internal Medicine (K.D., X.L., C.S.H., P.A., F.G., T.M.H., M.C.M.), Clinical Nutrition (J.V., P.A., C.C.T.), Preventive Medicine (J.V., C.C.T.), and Diagnostic Radiology and Nuclear Medicine (K.A.), Rush University Medical Center, and the Department of Biomedical Engineering, Illinois Institute of Technology (K.A.) - all in Chicago; and Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital (V.J.C., N.L., B.J.S., X.R.), Harvard Medical School (V.J.C., N.L., B.J.S., X.R.), and the Department of Nutrition, Harvard T.H. Chan School of Public Health (K.J., L.B., F.M.S.) - all in Boston
| | - Konstantinos Arfanakis
- From Rush Alzheimer's Disease Center (L.L.B., P.A., S.Z., F.G., N.T.A., K.A.), the Department of Neurology (L.L.B., N.T.A.), Rush Institute for Healthy Aging (K.D., X.L., C.S.H., T.M.H.), and the Departments of Internal Medicine (K.D., X.L., C.S.H., P.A., F.G., T.M.H., M.C.M.), Clinical Nutrition (J.V., P.A., C.C.T.), Preventive Medicine (J.V., C.C.T.), and Diagnostic Radiology and Nuclear Medicine (K.A.), Rush University Medical Center, and the Department of Biomedical Engineering, Illinois Institute of Technology (K.A.) - all in Chicago; and Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital (V.J.C., N.L., B.J.S., X.R.), Harvard Medical School (V.J.C., N.L., B.J.S., X.R.), and the Department of Nutrition, Harvard T.H. Chan School of Public Health (K.J., L.B., F.M.S.) - all in Boston
| | - Martha Clare Morris
- From Rush Alzheimer's Disease Center (L.L.B., P.A., S.Z., F.G., N.T.A., K.A.), the Department of Neurology (L.L.B., N.T.A.), Rush Institute for Healthy Aging (K.D., X.L., C.S.H., T.M.H.), and the Departments of Internal Medicine (K.D., X.L., C.S.H., P.A., F.G., T.M.H., M.C.M.), Clinical Nutrition (J.V., P.A., C.C.T.), Preventive Medicine (J.V., C.C.T.), and Diagnostic Radiology and Nuclear Medicine (K.A.), Rush University Medical Center, and the Department of Biomedical Engineering, Illinois Institute of Technology (K.A.) - all in Chicago; and Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital (V.J.C., N.L., B.J.S., X.R.), Harvard Medical School (V.J.C., N.L., B.J.S., X.R.), and the Department of Nutrition, Harvard T.H. Chan School of Public Health (K.J., L.B., F.M.S.) - all in Boston
| | - Frank M Sacks
- From Rush Alzheimer's Disease Center (L.L.B., P.A., S.Z., F.G., N.T.A., K.A.), the Department of Neurology (L.L.B., N.T.A.), Rush Institute for Healthy Aging (K.D., X.L., C.S.H., T.M.H.), and the Departments of Internal Medicine (K.D., X.L., C.S.H., P.A., F.G., T.M.H., M.C.M.), Clinical Nutrition (J.V., P.A., C.C.T.), Preventive Medicine (J.V., C.C.T.), and Diagnostic Radiology and Nuclear Medicine (K.A.), Rush University Medical Center, and the Department of Biomedical Engineering, Illinois Institute of Technology (K.A.) - all in Chicago; and Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital (V.J.C., N.L., B.J.S., X.R.), Harvard Medical School (V.J.C., N.L., B.J.S., X.R.), and the Department of Nutrition, Harvard T.H. Chan School of Public Health (K.J., L.B., F.M.S.) - all in Boston
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Shiraseb F, Mirzababaei A, Daneshzad E, Khosravinia D, Clark CCT, Mirzaei K. The association of dietary approaches to stop hypertension (DASH) and Mediterranean diet with mental health, sleep quality and chronotype in women with overweight and obesity: a cross-sectional study. Eat Weight Disord 2023; 28:57. [PMID: 37395824 DOI: 10.1007/s40519-023-01581-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Accepted: 06/13/2023] [Indexed: 07/04/2023] Open
Abstract
PURPOSE Mental and sleep disorders are global public health problems, especially in Middle Eastern countries, and are significantly associated with circadian rhythm. This study sought to investigate the association between the dietary approaches to stop hypertension (DASH) and Mediterranean diet scores and mental health, sleep quality, and circadian rhythm. METHODS We enrolled 266 overweight and obese women, and depression, anxiety, and stress scale (DASS) score, Pittsburgh Sleep Quality Index (PSQI), and Morning-Evening Questionnaire (MEQ), were assessed. The Mediterranean and DASH diet score was measured using a validated semi-quantitative Food Frequency Questionnaire (FFQ). The physical activity was evaluated using the International Physical Activity Questionnaire (IPAQ). Analysis of variance and analysis of covariance, chi-square, and multinomial logistic regression tests were used as appropriate. RESULTS Our results showed that there was a significant inverse association between adherence to the Mediterranean diet and mild and moderate anxiety scores (p < 0.05). In addition, there was an inverse association between adherence to the DASH diet and the risk of severe depression and extremely severe stress scores (p < 0.05). Moreover, higher adherence to both dietary scores was associated with good sleep quality (p < 0.05). There was a significant relationship between circadian rhythm and the DASH diet (p < 0.05). CONCLUSION A significant association exists between a DASH and Mediterranean diet with sleep status, mental health, and chronotype in women of childbearing age with obesity and overweight. LEVEL OF EVIDENCE Level V, Cross-sectional observational study.
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Affiliation(s)
- Farideh Shiraseb
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), P.O. Box: 14155-6117, Tehran, Iran
| | - Atieh Mirzababaei
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), P.O. Box: 14155-6117, Tehran, Iran
| | - Elnaz Daneshzad
- Non-Communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran
| | - Darya Khosravinia
- Department of Nutrition, Science and Research Branch, Islamic Azad University, Tehran, Iran
| | - Cain C T Clark
- Centre for Intelligent Healthcare, Coventry University, Coventry, CV1 5FB, UK
| | - Khadijeh Mirzaei
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), P.O. Box: 14155-6117, Tehran, Iran.
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19
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Arora S, Santiago JA, Bernstein M, Potashkin JA. Diet and lifestyle impact the development and progression of Alzheimer's dementia. Front Nutr 2023; 10:1213223. [PMID: 37457976 PMCID: PMC10344607 DOI: 10.3389/fnut.2023.1213223] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Accepted: 06/08/2023] [Indexed: 07/18/2023] Open
Abstract
Dementia is a growing public health concern, with an estimated prevalence of 57 million adults worldwide. Alzheimer's disease (AD) accounts for 60-80% of the cases. Clinical trials testing potential drugs and neuroprotective agents have proven futile, and currently approved drugs only provide symptomatic benefits. Emerging epidemiological and clinical studies suggest that lifestyle changes, including diet and physical activity, offer an alternative therapeutic route for slowing and preventing cognitive decline and dementia. Age is the single most common risk factor for dementia, and it is associated with slowing cellular bioenergetics and metabolic processes. Therefore, a nutrient-rich diet is critical for optimal brain health. Furthermore, type 2 diabetes (T2D) is a risk factor for AD, and diets that reduce the risk of T2D may confer neuroprotection. Foods predominant in Mediterranean, MIND, and DASH diets, including fruits, leafy green vegetables, fish, nuts, and olive oil, may prevent or slow cognitive decline. The mechanisms by which these nutrients promote brain health, however, are not yet completely understood. Other dietary approaches and eating regimes, including ketogenic and intermittent fasting, are also emerging as beneficial for brain health. This review summarizes the pathophysiology, associated risk factors, and the potential neuroprotective pathways activated by several diets and eating regimes that have shown promising results in promoting brain health and preventing dementia.
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Affiliation(s)
- Sarah Arora
- Center for Neurodegenerative Diseases and Therapeutics, Cellular and Molecular Pharmacology Discipline, The Chicago Medical School, Rosalind Franklin University of Medicine and Science, North Chicago, IL, United States
| | | | - Melissa Bernstein
- Department of Nutrition, College of Health Professions, The Chicago Medical School, Rosalind Franklin University of Medicine and Science, North Chicago, IL, United States
| | - Judith A. Potashkin
- Center for Neurodegenerative Diseases and Therapeutics, Cellular and Molecular Pharmacology Discipline, The Chicago Medical School, Rosalind Franklin University of Medicine and Science, North Chicago, IL, United States
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20
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Impact of Nut Consumption on Cognition across the Lifespan. Nutrients 2023; 15:nu15041000. [PMID: 36839359 PMCID: PMC9965316 DOI: 10.3390/nu15041000] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Revised: 02/13/2023] [Accepted: 02/14/2023] [Indexed: 02/19/2023] Open
Abstract
Cognitive health is a life-long concern affected by modifiable risk factors, including lifestyle choices, such as dietary intake, with serious implications for quality of life, morbidity, and mortality worldwide. In addition, nuts are a nutrient-dense food that contain a number of potentially neuroprotective components, including monounsaturated and polyunsaturated fatty acids, fiber, B-vitamins, non-sodium minerals, and highly bioactive polyphenols. However, increased nut consumption relates to a lower cardiovascular risk and a lower burden of cardiovascular risk factors that are shared with neurodegenerative disorders, which is why nuts have been hypothesized to be beneficial for brain health. The present narrative review discusses up-to-date epidemiological, clinical trial, and mechanistic evidence of the effect of exposure to nuts on cognitive performance. While limited and inconclusive, available evidence suggests a possible role for nuts in the maintenance of cognitive health and prevention of cognitive decline in individuals across the lifespan, particularly in older adults and those at higher risk. Walnuts, as a rich source of the plant-based polyunsaturated omega-3 fatty acid alpha-linolenic acid, are the nut type most promising for cognitive health. Given the limited definitive evidence available to date, especially regarding cognitive health biomarkers and hard outcomes, future studies are needed to better elucidate the impact of nuts on the maintenance of cognitive health, as well as the prevention and management of cognitive decline and dementia, including Alzheimer disease.
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21
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Mahinrad S, Sorond F, Gorelick PB. The Role of Vascular Risk Factors in Cognitive Impairment and Dementia and Prospects for Prevention. Clin Geriatr Med 2023; 39:123-134. [PMID: 36404025 DOI: 10.1016/j.cger.2022.07.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
One of the most challenging clinical expressions of population aging is cognitive impairment and dementia. Among risk factors for the development of dementia, modifiable vascular risk factors have emerged as contributors to both vascular and nonvascular types of dementia. Epidemiologic studies have been particularly informative in understanding the link between vascular risks and dementia across the life course. We discuss vascular risks for dementia and cognitive impairment and practical management recommendations.
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Affiliation(s)
- Simin Mahinrad
- Department of Neurology, Northwestern University, Feinberg School of Medicine, 625 N. Michigan Avenue, 11th Floor, Suite 1150, Chicago, IL 60611, USA.
| | - Farzaneh Sorond
- Department of Neurology, Northwestern University, Feinberg School of Medicine, 625 N. Michigan Avenue, 11th Floor, Suite 1150, Chicago, IL 60611, USA
| | - Philip B Gorelick
- Department of Neurology, Northwestern University, Feinberg School of Medicine, 625 N. Michigan Avenue, 11th Floor, Suite 1150, Chicago, IL 60611, USA
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22
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Mediterranean diet related metabolite profiles and cognitive performance. Clin Nutr 2023; 42:173-181. [PMID: 36599272 DOI: 10.1016/j.clnu.2022.12.012] [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: 10/05/2022] [Revised: 12/13/2022] [Accepted: 12/16/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND & AIMS Evidence suggests that adherence to the Mediterranean diet (MedDiet) affects human metabolism and may contribute to better cognitive performance. However, the underlying mechanisms are not clear. OBJECTIVE We generated a metabolite profile for adherence to MedDiet and evaluated its cross-sectional association with aspects of cognitive performance. METHODS A total of 1250 healthy Greek middle-aged adults from the Epirus Health Study cohort were included in the analysis. Adherence to the MedDiet was assessed using the 14-point Mediterranean Diet Adherence Screener (MEDAS); cognition was measured using the Trail Making Test, the Verbal Fluency test and the Logical Memory test. A targeted metabolite profiling (n = 250 metabolites) approach was applied, using a high-throughput nuclear magnetic resonance platform. We used elastic net regularized regressions, with a 10-fold cross-validation procedure, to identify a metabolite profile for MEDAS. We evaluated the associations of the identified metabolite profile and MEDAS with cognitive tests, using multivariable linear regression models. RESULTS We identified a metabolite profile composed of 42 metabolites, mainly lipoprotein subclasses and fatty acids, significantly correlated with MedDiet adherence (Pearson r = 0.35, P-value = 5.5 × 10-37). After adjusting for known risk factors and accounting for multiple testing, the metabolite profile and MEDAS were not associated with the cognitive tests. CONCLUSIONS A plasma metabolite profile related to better adherence to the MedDiet was not associated with the tested aspects of cognitive performance, in a middle-aged Mediterranean population.
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23
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Schulz CA, Weinhold L, Schmid M, Nöthen MM, Nöthlings U. Analysis of associations between dietary patterns, genetic disposition, and cognitive function in data from UK Biobank. Eur J Nutr 2023; 62:511-521. [PMID: 36152054 PMCID: PMC9899759 DOI: 10.1007/s00394-022-02976-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Accepted: 07/29/2022] [Indexed: 02/07/2023]
Abstract
PURPOSE Research suggests that diet influences cognitive function and the risk for neurodegenerative disease. The present study aimed to determine whether a recently developed diet score, based on recommendations for dietary priorities for cardio metabolic health, was associated with fluid intelligence, and whether these associations were modified by individual genetic disposition. METHODS This research has been conducted using the UK Biobank Resource. Analyses were performed using self-report data on diet and the results for the verbal-numerical reasoning test of fluid intelligence of 104,895 individuals (46% male: mean age at recruitment 57.1 years (range 40-70)). For each participant, a diet score and a polygenic score (PGS) were constructed, which evaluated predefined cut-offs for the intake of fruit, vegetables, fish, processed meat, unprocessed meat, whole grain, and refined grain, and ranged from 0 (unfavorable) to 7 (favorable). To investigate whether the diet score was associated with fluid intelligence, and whether the association was modified by PGS, linear regression analyses were performed. RESULTS The average diet score was 3.9 (SD 1.4). After adjustment for selected confounders, a positive association was found between baseline fluid intelligence and PGS (P < 0.001). No association was found between baseline fluid intelligence and diet score (P = 0.601), even after stratification for PGS, or in participants with longitudinal data available (n = 9,482). CONCLUSION In this middle-aged cohort, no evidence was found for an association between the investigated diet score and either baseline or longitudinal fluid intelligence. However, as in previous reports, fluid intelligence was strongly associated with a PGS for general cognitive function.
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Affiliation(s)
| | - Leonie Weinhold
- Department of Medical Biometry, Informatics and Epidemiology, University Hospital Bonn, University of Bonn, Bonn, Germany
| | - Matthias Schmid
- Department of Medical Biometry, Informatics and Epidemiology, University Hospital Bonn, University of Bonn, Bonn, Germany
| | - Markus M Nöthen
- Institute of Human Genetics, University of Bonn, School of Medicine and University Hospital Bonn, Bonn, Germany
| | - Ute Nöthlings
- Institute of Nutrition and Food Sciences, Nutritional Epidemiology, University of Bonn, Bonn, Germany
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24
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Plini ERG, Melnychuk MC, Harkin A, Dahl MJ, McAuslan M, Kühn S, Boyle RT, Whelan R, Andrews R, Düzel S, Drewelies J, Wagner GG, Lindenberger U, Norman K, Robertson IH, Dockree PM. Dietary Tyrosine Intake (FFQ) Is Associated with Locus Coeruleus, Attention and Grey Matter Maintenance: An MRI Structural Study on 398 Healthy Individuals of the Berlin Aging Study-II. J Nutr Health Aging 2023; 27:1174-1187. [PMID: 38151868 DOI: 10.1007/s12603-023-2005-y] [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: 07/13/2023] [Accepted: 09/19/2023] [Indexed: 12/29/2023]
Abstract
BACKGROUND AND OBJECTIVE It is documented that low protein and amino-acid dietary intake is related to poorer cognitive health and increased risk of dementia. Degradation of the neuromodulatory pathways, (comprising the cholinergic, dopaminergic, serotoninergic and noradrenergic systems) is observed in neurodegenerative diseases and impairs the proper biosynthesis of key neuromodulators from micro-nutrients and amino acids. How these micro-nutrients are linked to neuromodulatory pathways in healthy adults is less studied. The Locus Coeruleus-Noradrenergic System (LC-NA) is the earliest subcortical structure affected in Alzheimer's disease, showing marked neurodegeneration, but is also sensitive for age-related changes. The LC-NA system is critical for supporting attention and cognitive control, functions that are enhanced both by tyrosine administration and chronic tyrosine intake. The purpose of this study was to 1) investigate whether the dietary intake of tyrosine, the key precursor for noradrenaline (NA), is related to LC signal intensity 2) whether LC mediates the reported association between tyrosine intake and higher cognitive performance (measured with Trail Making Test - TMT), and 3) whether LC signal intensity relates to an objective measure of brain maintenance (BrainPAD). METHODS The analyses included 398 3T MRIs of healthy participants from the Berlin Aging Study II to investigate the relationship between LC signal intensity and habitual dietary tyrosine intake-daily average (HD-Tyr-IDA - measured with Food Frequency Questionnaire - FFQ). As a control procedure, the same analyses were repeated on other main seeds of the neuromodulators' subcortical system (Dorsal and Medial Raphe, Ventral Tegmental Area and Nucleus Basalis of Meynert). In the same way, the relationships between the five nuclei and BrainPAD were tested. RESULTS Results show that HD-Tyr-IDA is positively associated with LC signal intensity. Similarly, LC disproportionally relates to better brain maintenance (BrainPAD). Mediation analyses reveal that only LC, relative to the other nuclei tested, mediates the relationship between HD-Tyr-IDA I and performance in the TMT and between HD-Tyr-IDA and BrainPAD. CONCLUSIONS These findings provide the first evidence linking tyrosine intake with LC-NA system signal intensity and its correlation with neuropsychological performance. This study strengthens the role of diet for maintaining brain and cognitive health and supports the noradrenergic theory of cognitive reserve. Within this framework, adequate tyrosine intake might increase the resilience of LC-NA system functioning, by preventing degeneration and supporting noradrenergic metabolism required for LC function and neuropsychological performance.
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Affiliation(s)
- E R G Plini
- Emanuele RG Plini, Department of Psychology, Trinity College Institute of Neuroscience, Trinity College Dublin, Lloyd Building, 42A Pearse St, 8PVX+GJ Dublin, Ireland,
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25
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Fu J, Tan LJ, Lee JE, Shin S. Association between the mediterranean diet and cognitive health among healthy adults: A systematic review and meta-analysis. Front Nutr 2022; 9:946361. [PMID: 35967772 PMCID: PMC9372716 DOI: 10.3389/fnut.2022.946361] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Accepted: 07/12/2022] [Indexed: 11/13/2022] Open
Abstract
Background An increasing prevalence of cognitive disorders warrants comprehensive systematic reviews on the effect of diet on cognitive health. Studies have suggested that the Mediterranean (MeDi) diet has protective effects against metabolic diseases. However, comprehensive systematic reviews on the effect of the MeDi diet on the cognitive decline are limited. We investigated whether adherence to the MeDi diet could lower the risk of the cognitive disorder or improve cognitive function in older adults. Methods In this systematic review and meta-analysis, PubMed, Web of Science, PsycINFO, Scopus, and Cochrane databases were searched from inception to June 2021. Cohort studies and randomized controlled trials (RCTs) were included. The effect sizes were estimated as log risk ratios and standard mean differences (SMDs) with 95% confidence intervals (CIs). The Newcastle–Ottawa score and Cochrane Collaboration’s tool were used to assess the risk of bias in cohort studies and RCTs, respectively. Results Of the 1,687 screened studies, 31 cohort studies and five RCTs met the eligibility criteria for qualitative analysis; 26 cohort studies and two RCTs were included in the meta-analysis. In the cohort studies, high adherence to the MeDi diet was associated with lower risk of mild cognitive impairment (MCI) [risk ratio (RR) = 0.75 (0.66–0.86)], and Alzheimer’s disease (AD) [RR = 0.71 (0.56–0.89)]. In the RCTs, high adherence to the MeDi diet was associated with better episodic [SMD = 0.20 (0.09–0.30)] and working memories [SMD = 0.17 (0.01–0.32)] than lowest group. Conclusion Adherence to the MeDi diet may reduce the risk of MCI and AD. However, other associations with cognitive outcomes (global cognition, working memory, and episodic memory) remain open to interpretation. Overall, the MeDi diet is recommended to prevent or delay cognitive disorders and improve cognitive function. Further, long-term RCTs are warranted to strengthen the evidence. Systematic review registration [https://www.crd.york.ac.uk], identifier [CRD42021276801].
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Affiliation(s)
- Jialei Fu
- Department of Food and Nutrition, Chung-Ang University, Seoul, South Korea
| | - Li-Juan Tan
- Department of Food and Nutrition, Chung-Ang University, Seoul, South Korea
| | - Jung Eun Lee
- Department of Food and Nutrition, College of Human Ecology, Seoul National University, Seoul, South Korea
| | - Sangah Shin
- Department of Food and Nutrition, Chung-Ang University, Seoul, South Korea
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Hsiao FY, Peng LN, Lee WJ, Chen LK. Higher dietary diversity and better healthy aging: A 4-year study of community-dwelling middle-aged and older adults from the Taiwan Longitudinal Study of Aging. Exp Gerontol 2022; 168:111929. [PMID: 35977645 DOI: 10.1016/j.exger.2022.111929] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2022] [Revised: 08/06/2022] [Accepted: 08/11/2022] [Indexed: 11/04/2022]
Abstract
OBJECTIVES To investigate the relationship between dietary diversity and healthy aging (in terms of mobility performance, physical functions, cognitive functions, and depressive symptoms) among community-dwelling middle-aged and older adults by using a nationally representative population-based cohort study. METHODS Data from 3213 study participants in the Taiwan Longitudinal Study on Aging (TLSA) were retrieved for analysis, and all participants were divided into five groups according to the quintile of dietary variety scores (DVSs). In the 4-year follow-up study, multivariate logistic regression models were applied to investigate the associations between DVS subgroups and declines in mobility performance, physical function (activities of daily living (ADLs) and instrumental activities of daily living (IADLs)), cognitive function and depressive symptoms. RESULTS In this study, the DVS quintile identified people who were significantly vulnerable in diet quality. Among those in the lowest DVS quintile, the proportions consuming seafood, eggs, and beans/legumes per week were 0.3 %, 7.8 % and 12.6 %, respectively, while among those in the highest DVS quintile, the proportions were 40.2 %, 83.1 %, and 82.7 %, respectively. "Inverse" dose-response associations were observed between the DVS and the risks of decline in mobility performance, physical function (ADLs and IADLs), cognitive function, and depressive symptoms. These risks decreased with the higher DVS quintile group as compared to the lowest DVS quintile group. Even after adjustments for demographics, health behaviors (e.g., physical activity) and comorbidities, participants in the highest DVS quintile group were still associated with the lowest risk of decline in ADLs (adjusted odds ratio (aOR) 0.59 [95 % confidence interval (CI) 0.37-0.94], p < 0.05) and IADLs (aOR 0.53 [0.39-0.73], p < 0.01). However, no such association was observed in the risk of worsened mobility performance, cognitive function and depressive symptoms. CONCLUSIONS In conclusion, higher dietary diversity has protective effects in declines in multidimensional outcomes associated with healthy aging, particularly physical (ADL and IADL) functions, among community-dwelling middle-aged and older adults. Intervention studies are needed to confirm the causal relationships between dietary diversity and healthy aging.
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Affiliation(s)
- Fei-Yuan Hsiao
- Graduate Institute of Clinical Pharmacy, College of Medicine, National Taiwan University, Taipei, Taiwan; School of Pharmacy, College of Medicine, National Taiwan University, Taipei, Taiwan; Department of Pharmacy, National Taiwan University Hospital, Taipei, Taiwan.
| | - Li-Ning Peng
- Center for Geriatrics and Gerontology, Taipei Veterans General Hospital, Taipei, Taiwan; Center for Healthy Longevity and Aging Sciences, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Wei-Ju Lee
- Center for Healthy Longevity and Aging Sciences, National Yang Ming Chiao Tung University, Taipei, Taiwan; Department of Family Medicine, Taipei Veterans General Hospital Yuanshan Branch, Yi-Lan, Taiwan
| | - Liang-Kung Chen
- Center for Geriatrics and Gerontology, Taipei Veterans General Hospital, Taipei, Taiwan; Center for Healthy Longevity and Aging Sciences, National Yang Ming Chiao Tung University, Taipei, Taiwan; Taipei Municipal Gan-Dau Hospital (Managed by Taipei Veterans General Hospital), Taipei, Taiwan.
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McBean L, O'Reilly S. Diet quality interventions to prevent neurocognitive decline: a systematic review and meta-analysis. Eur J Clin Nutr 2022; 76:1060-1072. [PMID: 34732834 DOI: 10.1038/s41430-021-01032-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 10/05/2021] [Accepted: 10/11/2021] [Indexed: 11/09/2022]
Abstract
OBJECTIVE To determine the impact of diet quality interventions on neurocognitive decline in older adults. DESIGN Four databases were searched (Medline, EMBASE, CENTRAL and PsycINFO) for randomised controlled trials involving diet quality interventions and cognitive outcomes in older adults. Study quality was assessed using the Cochrane Risk of Bias tool. Outcomes selected for meta-analysis were memory and executive function, for which standardised mean differences (SMD) were calculated. Subgroup and sensitivity analyses were undertaken to explore causes of heterogeneity. Additional outcomes of global cognitive function, incident dementia, attention, language/verbal fluency, and processing speed were narratively synthesised. RESULTS Twelve studies were included, investigating the Mediterranean, Dietary Approaches to Stop Hypertension and Nordic diets. Risk of bias varied across studies. Dietary intervention had a significant effect on memory (SMD: 0.98; 95% CI: 0.39, 1.57; p = 0.001) and executive function (SMD: 2.02; 95% CI: 1.04, 3.01; p < 0.00001), although neither outcome was significant in sensitivity analyses. Heterogeneity was high (I2 = 99%) prior to sensitivity analyses and low (I2 = 0%) after. Results for narratively synthesised cognitive measures were inconsistent with no clear direction of effect. CONCLUSION The current body of evidence would suggest the effect of dietary intervention on neurocognitive decline in older adults is unclear given the considerable heterogeneity and bias present across studies. These findings should be interpreted with consideration to the limited number of studies that could be included and the large variation in study designs. Further randomised controlled trials with harmonised cognitive outcomes and assessments are needed to clarify direction of effect.
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Affiliation(s)
- Laura McBean
- School of Agriculture and Food Science, UCD, Belfield, Dublin, 4, Ireland
| | - Sharleen O'Reilly
- School of Agriculture and Food Science, UCD, Belfield, Dublin, 4, Ireland. .,UCD Institute of Food and Health, UCD, Belfield, Dublin, 4, Ireland.
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Gwizdala KL, Brouillete R, Beyl R, Johnson W, Hebert C, Carter L, Harris M, Newton RL, Carmichael OT. Exercise Effects on Cognition in Older African Americans: A Pilot Randomized Trial. Front Aging Neurosci 2022; 14:921978. [PMID: 35936770 PMCID: PMC9354972 DOI: 10.3389/fnagi.2022.921978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2022] [Accepted: 06/20/2022] [Indexed: 11/13/2022] Open
Abstract
Introduction Regular physical activity lowers risk for cognitive decline and neurodegenerative disorders. Older African Americans (AAs) have been underrepresented in trials that increased physical activity to improve cognitive outcomes. Methods 56 sedentary, older, cognitively healthy AAs (avg. 69.2 ± 3.4 yrs. old) were randomized in 1:1 ratio into either a 12-week successful aging group (SAG) or a 12-week physical activity group (PAG). Participants in SAG attended weekly 60-min educational sessions in which healthy aging topics were discussed. Participants in PAG attended supervised physical activity sessions twice per week at local YMCAs (90-120 min/week) and were prescribed 2-3 days per week of home-based activity. The Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) assessed cognitive function. ANCOVA models compared mean 12-week change in global cognition and subdomain scores between groups with secondary analyses for sex differences. Effect sizes for RBANS were calculated. Results The RBANS global cognition score (SAG Est. 5.6 ± 1.8, effect size = 0.37, p = 0.003) and several subdomain scores (one-sample T tests, all p < 0.05) increased significantly within the SAG. Scores for global cognition increased more in SAG than in PAG (Change Estimate, PAG minus SAG: -4.6 ± 2.5 points, effect size = 0.31) at a trend level (p = 0.072). SAG females increased their global cognition score more than PAG females and more than males in either PAG or SAG (all p < 0.035). Discussion A 12-week physical activity intervention (PAG) did not improve cognitive functioning among older AAs but a comparator healthy aging education program did. Inadequate physical activity dosage or duration, SAG members acting on health-related information from educational sessions, and/or social stimulation within the SAG may have contributed to these results. Future studies should combine socially engaging activities with vigorous physical activity for cognitive enhancement among cognitively healthy older African Americans. Clinical Trial Registration www.ClinicalTrials.gov, identifier NCT03474302.
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Liu D, Zhou L, Yang M, McIntyre RS, Cao B. Oxidative Stress Mediates the Association Between Dietary Fat Intake and Cognition in US Older Adults. Am J Geriatr Psychiatry 2022; 30:761-773. [PMID: 35151552 DOI: 10.1016/j.jagp.2022.01.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Revised: 01/06/2022] [Accepted: 01/07/2022] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Dietary fat intake was considered as a modifiable factor influencing cognitive performance. The objective was to 1) examine the associations between different types of dietary fat intakes and cognitive outcomes among elder adults (≥60 years old); 2) assess whether peripheral oxidative stress and antioxidant biomarkers are potential mediators of dietary fat intake and cognitive impairment relationship. METHODS Using data from National Health and Nutrition Examination Survey 2011-2014, total fat, saturated fatty acid (SFAT), monounsaturated fatty acid (MUFA), polyunsaturated fatty acid (PUFA), cholesterol, ω-3 and ω-6 fatty acids were used to evaluate dietary fat intakes. Cognitive outcomes were assessed by word learning and recall modules from the consortium to establish a registry for Alzheimer's Disease (CERAD), animal fluency test, and digit symbol substitution test (DSST). Antioxidant biomarkers were assessed by gamma glutamyl transpeptidase (GGT), bilirubin, uric acid, and vitamin D levels. Linear regression models and causal mediation analysis were applied to quantify the associations. RESULTS A total of 2,253 elder adults were included in the data analyses. Dietary intake of PUFA and ω-6 fatty acid were positively associated with DSST [β (95% CI): 0.06 (0.01,0.10), t statistic = 2.39, df= 2238, p = 0.02; β (95% CI): 0.06 (0.01,0.11), t statistic = 2.54, df= 2238, p = 0.01, respectively]. GGT was negatively associated with DSST [β (95% CI): -0.04 (-0.07, -0.01), t statistic = -2.73, df= 2239, p = 0.01], whereas uric acid was positively associated with CERAD total score [β (95% CI): 0.04 (0.00,0.08), t statistic = 2.03, df= 2233, p = 0.04]. The association between dietary intake of PUFA/ω -3/ω -6 and DSST performance was partially mediated by GGT level. CONCLUSION Our findings support that PUFAs in dietary sources were associated with lower risks for cognitive impairment partially via lowering oxidative stress. Dietary PUFA supplementation may potentially reduce risk of cognitive impairment via antioxidative mechanism.
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Affiliation(s)
- Dan Liu
- Population Health Sciences (DL), German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
| | - Long Zhou
- Department of Cardiology (LZ), Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China
| | - Ming Yang
- The Center of Gerontology and Geriatrics (MY), West China Hospital, Sichuan University, Chengdu, Sichuan, China; Precision Medicine Research Center (MY), West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Roger S McIntyre
- Mood Disorders Psychopharmacology Unit (RSM), University of Toronto, Toronto, Canada
| | - Bing Cao
- School of Psychology and Key Laboratory of Cognition and Personality (Ministry of Education) (BC), Southwest University, Chongqing, P. R. China.
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Costello MM, Mc Carthy CE, Bosch J, Robinson S, McDermott C, Canavan MD, O'Donnell MJ. Are clinical trials randomising households to lifestyle interventions to delay cognitive decline feasible? A pilot study to determine the beliefs, preferences, and deterrents for households impacted by dementia based on semi-structured interviews. BMC Geriatr 2022; 22:322. [PMID: 35418013 PMCID: PMC9005908 DOI: 10.1186/s12877-022-02941-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Accepted: 02/28/2022] [Indexed: 11/23/2022] Open
Abstract
Introduction While lifestyle risk factors are implicated in the development and progression of cognitive impairment, interventional trials of individual participants have yielded unconvincing evidence. We sought to explore the development of lifestyle interventions targeting the household-unit. Methods Semi-structured interviews were carried out among eight households affected by cognitive impairment (i.e. member of the household had cognitive impairment). Interviews took place online using a secure, web-based video platform recommended for patient clinician interaction. Interview content was analysed, and important themes identified. Results Eighteen participants were interviewed within households, of which eight (one per household) had cognitive impairment and others were spouses or first-degree relatives living in the same home. Several themes emerged; 1) household members without cognitive impairment were more likely to report poor sleep habits, and sleep was perceived to be the hardest behaviour to change; 2) diet generated most interest as a potential lifestyle intervention target as most participants believed there is a strong link with nutrition and cognition; 3) physical activity is challenging to adapt due to lack of motivation and focus when individuals are cognitively impaired. Barriers to study participation, including risk of harm, complexity of intervention and deviation from routine emerged during discussions. Conclusions This study identified beliefs and preferences of households towards lifestyle intervention trials. Findings from this study may be used to inform future clinical trial protocols and future qualitative studies should explore acceptability and feasibility of digital intervention applications.
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Affiliation(s)
- Maria M Costello
- HRB-Clinical Research Facility, National University of Ireland Galway, Galway, H91YR71, Ireland. .,University Hospital Galway, Newcastle Road, Galway, Ireland.
| | - Christine E Mc Carthy
- HRB-Clinical Research Facility, National University of Ireland Galway, Galway, H91YR71, Ireland.,University Hospital Galway, Newcastle Road, Galway, Ireland
| | - Jackie Bosch
- School of Rehabilitation Science, McMaster University, Hamilton, Canada
| | - Stephanie Robinson
- HRB-Clinical Research Facility, National University of Ireland Galway, Galway, H91YR71, Ireland.,University Hospital Galway, Newcastle Road, Galway, Ireland
| | - Clodagh McDermott
- HRB-Clinical Research Facility, National University of Ireland Galway, Galway, H91YR71, Ireland.,University Hospital Galway, Newcastle Road, Galway, Ireland
| | - Michelle D Canavan
- HRB-Clinical Research Facility, National University of Ireland Galway, Galway, H91YR71, Ireland.,University Hospital Galway, Newcastle Road, Galway, Ireland
| | - Martin J O'Donnell
- HRB-Clinical Research Facility, National University of Ireland Galway, Galway, H91YR71, Ireland.,University Hospital Galway, Newcastle Road, Galway, Ireland
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Wei J, Wang L, Kulshreshtha A, Xu H. Adherence to Life's Simple 7 and Cognitive Function Among Older Adults: The National Health and Nutrition Examination Survey 2011 to 2014. J Am Heart Assoc 2022; 11:e022959. [PMID: 35243896 PMCID: PMC9075323 DOI: 10.1161/jaha.121.022959] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background The American Heart Association proposed the Life’s Simple 7 (LS7; including diet, physical activity, smoking, body mass index, blood pressure, plasma fasting glucose, total cholesterol) to promote cardiovascular health. Adherence to LS7 has been found to be associated with better cognitive health as well, but the generalizability of previous studies is limited. We aimed to examine the associations of adherence to LS7 and cognitive function among older adults in a nationally representative sample of population. Methods and Results A total of 2585 older adults (≥60 years, 54% female, 80% non‐Hispanic White) in the National Health and Nutrition Examination Survey 2011 to 2014 were included for analysis. Components of LS7 were measured, and adherence to LS7 was calculated on the basis of established cutoff points of individual components. Cognitive function was examined using the Consortium to Establish a Registry for Alzheimer’s Disease Word List Memory Task (immediate and delayed memory), Digit Symbol Substitution Test (DSST), and Animal Fluency Test. Test‐specific and global cognition Z scores were created. Multivariable linear regression models were conducted on the associations of adherence to LS7 with domain‐specific and global cognition Z scores. Each incremental point in adherence to LS7 was associated with higher Z scores for global cognition (β=0.05; 95% CI, 0.02–0.07), Digit Symbol Substitution Test (β=0.05; 95% CI, 0.03–0.07), Consortium to Establish a Registry for Alzheimer’s Disease Word Learning subtest immediate memory (β=0.03; 95% CI, 0.004–0.05), and animal fluency test (β=0.05; 95% CI, 0.02–0.07). Conclusions Greater adherence to LS7 metrics is associated with better cognitive function among older US adults in a nationally representative sample of population.
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Affiliation(s)
- Jingkai Wei
- Department of Epidemiology and Biostatistics Arnold School of Public Health University of South Carolina Columbia SC
| | - Liang Wang
- Department of Public Health Robbins College of Health and Human SciencesBaylor University Waco TX
| | - Ambar Kulshreshtha
- Department of Family and Preventive Medicine School of Medicine Emory University Atlanta GA.,Department of Epidemiology Rollins School of Public Health Atlanta GA
| | - Hanzhang Xu
- School of Nursing Duke University Durham NC.,Department of Family Medicine and Community Health Duke University Medical Center Durham NC
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Can dietary patterns prevent cognitive impairment and reduce Alzheimer's disease risk: exploring the underlying mechanisms of effects. Neurosci Biobehav Rev 2022; 135:104556. [PMID: 35122783 DOI: 10.1016/j.neubiorev.2022.104556] [Citation(s) in RCA: 30] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 01/29/2022] [Accepted: 01/30/2022] [Indexed: 02/07/2023]
Abstract
Alzheimer's disease (AD) is one of the fastest growing cognitive decline-related neurological diseases. To date, effective curative strategies have remained elusive. A growing body of evidence indicates that dietary patterns have significant effects on cognitive function and the risk of developing AD. Previous studies on the association between diet and AD risk have mainly focused on individual food components and specific nutrients, and the mechanisms responsible for the beneficial effects of dietary patterns on AD are not well understood. This article provides a comprehensive overview of the effects of dietary patterns, including the Mediterranean diet (MedDiet), dietary approaches to stop hypertension (DASH) diet, Mediterranean-DASH diet intervention for neurological delay (MIND), ketogenic diet, caloric restriction, intermittent fasting, methionine restriction, and low-protein and high-carbohydrate diet, on cognitive impairment and summarizes the underlying mechanisms by which dietary patterns attenuate cognitive impairment, especially highlighting the modulation of dietary patterns on cognitive impairment through gut microbiota. Furthermore, considering the variability in individual metabolic responses to dietary intake, we put forward a framework to develop personalized dietary patterns for people with cognitive disorders or AD based on individual gut microbiome compositions.
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Metabolic Syndrome, Cognitive Impairment and the Role of Diet: A Narrative Review. Nutrients 2022; 14:nu14020333. [PMID: 35057514 PMCID: PMC8780484 DOI: 10.3390/nu14020333] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 01/04/2022] [Accepted: 01/10/2022] [Indexed: 01/27/2023] Open
Abstract
Background: This narrative review presents the association between metabolic syndrome (MetS), along with its components, and cognition-related disorders, as well as the potential reversal role of diet against cognitive impairment by modulating MetS. Methods: An electronic research in Medline (Pubmed) and Scopus was conducted. Results: MetS and cognitive decline share common cardiometabolic pathways as MetS components can trigger cognitive impairment. On the other side, the risk factors for both MetS and cognitive impairment can be reduced by optimizing the nutritional intake. Clinical manifestations such as dyslipidemia, hypertension, diabetes and increased central body adiposity are nutrition-related risk factors present during the prodromal period before cognitive impairment. The Mediterranean dietary pattern stands among the most discussed predominantly plant-based diets in relation to cardiometabolic disorders that may prevent dementia, Alzheimer’s disease and other cognition-related disorders. In addition, accumulating evidence suggests that the consumption of specific dietary food groups as a part of the overall diet can improve cognitive outcomes, maybe due to their involvement in cardiometabolic paths. Conclusions: Early MetS detection may be helpful to prevent or delay cognitive decline. Moreover, this review highlights the importance of healthy nutritional habits to reverse such conditions and the urgency of early lifestyle interventions.
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Kaplan A, Zelicha H, Yaskolka Meir A, Rinott E, Tsaban G, Levakov G, Prager O, Salti M, Yovell Y, Ofer J, Huhn S, Beyer F, Witte V, Villringer A, Meiran N, B Emesh T, Kovacs P, von Bergen M, Ceglarek U, Blüher M, Stumvoll M, Hu FB, Stampfer MJ, Friedman A, Shelef I, Avidan G, Shai I. The effect of a high-polyphenol Mediterranean diet (Green-MED) combined with physical activity on age-related brain atrophy: the Dietary Intervention Randomized Controlled Trial Polyphenols Unprocessed Study (DIRECT PLUS). Am J Clin Nutr 2022; 115:1270-1281. [PMID: 35021194 PMCID: PMC9071484 DOI: 10.1093/ajcn/nqac001] [Citation(s) in RCA: 27] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Accepted: 01/08/2022] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND The effect of diet on age-related brain atrophy is largely unproven. OBJECTIVES We aimed to explore the effect of a Mediterranean diet (MED) higher in polyphenols and lower in red/processed meat (Green-MED diet) on age-related brain atrophy. METHODS This 18-mo clinical trial longitudinally measured brain structure volumes by MRI using hippocampal occupancy score (HOC) and lateral ventricle volume (LVV) expansion score as neurodegeneration markers. Abdominally obese/dyslipidemic participants were randomly assigned to follow 1) healthy dietary guidelines (HDG), 2) MED, or 3) Green-MED diet. All subjects received free gym memberships and physical activity guidance. Both MED groups consumed 28 g walnuts/d (+440 mg/d polyphenols). The Green-MED group consumed green tea (3-4 cups/d) and Mankai (Wolffia-globosa strain, 100 g frozen cubes/d) green shake (+800 mg/d polyphenols). RESULTS Among 284 participants (88% men; mean age: 51 y; BMI: 31.2 kg/m2; APOE-ε4 genotype = 15.7%), 224 (79%) completed the trial with eligible whole-brain MRIs. The pallidum (-4.2%), third ventricle (+3.9%), and LVV (+2.2%) disclosed the largest volume changes. Compared with younger participants, atrophy was accelerated among those ≥50 y old (HOC change: -1.0% ± 1.4% compared with -0.06% ± 1.1%; 95% CI: 0.6%, 1.3%; P < 0.001; LVV change: 3.2% ± 4.5% compared with 1.3% ± 4.1%; 95% CI: -3.1%, -0.8%; P = 0.001). In subjects ≥ 50 y old, HOC decline and LVV expansion were attenuated in both MED groups, with the best outcomes among Green-MED diet participants, as compared with HDG (HOC: -0.8% ± 1.6% compared with -1.3% ± 1.4%; 95% CI: -1.5%, -0.02%; P = 0.042; LVV: 2.3% ± 4.7% compared with 4.3% ± 4.5%; 95% CI: 0.3%, 5.2%; P = 0.021). Similar patterns were observed among younger subjects. Improved insulin sensitivity over the trial was the parameter most strongly associated with brain atrophy attenuation (P < 0.05). Greater Mankai, green tea, and walnut intake and less red and processed meat were significantly and independently associated with reduced HOC decline (P < 0.05). Elevated urinary concentrations of the polyphenols urolithin-A (r = 0.24; P = 0.013) and tyrosol (r = 0.26; P = 0.007) were significantly associated with lower HOC decline. CONCLUSIONS A Green-MED (high-polyphenol) diet, rich in Mankai, green tea, and walnuts and low in red/processed meat, is potentially neuroprotective for age-related brain atrophy.This trial was registered at clinicaltrials.gov as NCT03020186.
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Affiliation(s)
- Alon Kaplan
- The Health & Nutrition Innovative International Research Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Hila Zelicha
- The Health & Nutrition Innovative International Research Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Anat Yaskolka Meir
- The Health & Nutrition Innovative International Research Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Ehud Rinott
- The Health & Nutrition Innovative International Research Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Gal Tsaban
- The Health & Nutrition Innovative International Research Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel,Soroka University Medical Center, Beer-Sheva, Israel
| | - Gidon Levakov
- Department of Cognitive and Brain Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel,Zlotowski Center for Neuroscience, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Ofer Prager
- Zlotowski Center for Neuroscience, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Moti Salti
- Zlotowski Center for Neuroscience, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Yoram Yovell
- Department of Medical Neurobiology, The Hebrew University-Hadassah School of Medicine, Jerusalem, Israel
| | - Jonathan Ofer
- Zlotowski Center for Neuroscience, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Sebastian Huhn
- Helmholtz Centre for Environmental Research (UFZ), Leipzig, Germany
| | - Frauke Beyer
- Department of Neurology, Max-Planck-Institute for Human Cognitive and Brain Sciences, and Cognitive Neurology, University of Leipzig Medical Center, Leipzig, Germany
| | - Veronica Witte
- Department of Neurology, Max-Planck-Institute for Human Cognitive and Brain Sciences, and Cognitive Neurology, University of Leipzig Medical Center, Leipzig, Germany
| | - Arno Villringer
- Department of Neurology, Max-Planck-Institute for Human Cognitive and Brain Sciences, and Cognitive Neurology, University of Leipzig Medical Center, Leipzig, Germany
| | - Nachshon Meiran
- Department of Cognitive and Brain Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Tamar B Emesh
- Department of Cognitive and Brain Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Peter Kovacs
- Integrated Research and Treatment Center (IFB) Adiposity Diseases, Leipzig University Medical Center, Leipzig, Germany
| | - Martin von Bergen
- Department of Molecular Systems Biology, Helmholtz Centre for Environmental Research (UFZ), Leipzig, Germany
| | - Uta Ceglarek
- Institute of Laboratory Medicine, Clinical Chemistry and Molecular Diagnostics, University Hospital Leipzig, Leipzig, Germany
| | - Matthias Blüher
- Department of Medicine, Leipzig University, Leipzig, Germany
| | | | - Frank B Hu
- Department of Nutrition, Harvard TH Chan School of Public Health, Boston, MA, USA,Department of Medicine, Harvard Channing Division of Network Medicine, Brigham and Women's Hospital, Boston, MA, USA
| | - Meir J Stampfer
- Department of Nutrition, Harvard TH Chan School of Public Health, Boston, MA, USA,Department of Medicine, Harvard Channing Division of Network Medicine, Brigham and Women's Hospital, Boston, MA, USA
| | - Alon Friedman
- Zlotowski Center for Neuroscience, Ben-Gurion University of the Negev, Beer-Sheva, Israel,Department of Medical Neuroscience, Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Ilan Shelef
- The Health & Nutrition Innovative International Research Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel,Soroka University Medical Center, Beer-Sheva, Israel
| | - Galia Avidan
- Department of Cognitive and Brain Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel,Zlotowski Center for Neuroscience, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Iris Shai
- Address correspondence to I Shai (e-mail: )
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Abstract
Although a relationship between traditional cardiovascular risk factors and stroke has long been recognized, these risk factors likely play a role in other aspects of brain health. Clinical stroke is only the tip of the iceberg of vascular brain injury that includes covert infarcts, white matter hyperintensities, and microbleeds. Furthermore, an individual's risk for not only stroke but poor brain health includes not only these traditional vascular risk factors but also lifestyle and genetic factors. The purpose of this narrative review is to summarize the state of the evidence on traditional and nontraditional vascular risk factors and their contributions to brain health. Additionally, we will review important modifiers that interact with these risk factors to increase, or, in some cases, reduce risk of adverse brain health outcomes, with an emphasis on genes and biomarkers associated with Alzheimer disease. Finally, we will consider the importance of social determinants of health in brain health outcomes.
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Affiliation(s)
- Rebecca F Gottesman
- Stroke Branch, National Institute of Neurological Disorders and Stroke Intramural Research Program, Bethesda, MD (R.F.G.)
| | - Sudha Seshadri
- Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases, UTHSA, San Antonio, TX (S.S.).,Department of Neurology, Boston University School of Medicine, Boston, MA (S.S.)
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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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Kirvalidze M, Hodkinson A, Storman D, Fairchild TJ, Bała M, Beridze G, Zuriaga A, Brudasc NI, Brini S. The role of glucose on cognition, risk of dementia, and related biomarkers in individuals without type 2 diabetes mellitus or the metabolic syndrome: a systematic review of observational studies. Neurosci Biobehav Rev 2022; 135:104551. [DOI: 10.1016/j.neubiorev.2022.104551] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Revised: 01/24/2022] [Accepted: 01/24/2022] [Indexed: 01/14/2023]
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Nishi SK, Babio N, Gómez-Martínez C, Martínez-González MÁ, Ros E, Corella D, Castañer O, Martínez JA, Alonso-Gómez ÁM, Wärnberg J, Vioque J, Romaguera D, López-Miranda J, Estruch R, Tinahones FJ, Lapetra J, Serra-Majem JL, Bueno-Cavanillas A, Tur JA, Martín Sánchez V, Pintó X, Delgado-Rodríguez M, Matía-Martín P, Vidal J, Vázquez C, Daimiel L, Razquin C, Coltell O, Becerra-Tomás N, De La Torre Fornell R, Abete I, Sorto-Sanchez C, Barón-López FJ, Signes-Pastor AJ, Konieczna J, Garcia-Rios A, Casas R, Gomez-Perez AM, Santos-Lozano JM, García-Arellano A, Guillem-Saiz P, Ni J, Trinidad Soria-Florido M, Zulet MÁ, Vaquero-Luna J, Toledo E, Fitó M, Salas-Salvadó J. Mediterranean, DASH, and MIND Dietary Patterns and Cognitive Function: The 2-Year Longitudinal Changes in an Older Spanish Cohort. Front Aging Neurosci 2021; 13:782067. [PMID: 34966270 PMCID: PMC8710807 DOI: 10.3389/fnagi.2021.782067] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Accepted: 11/08/2021] [Indexed: 01/10/2023] Open
Abstract
Background and Aims: Plant-forward dietary patterns have been associated with cardiometabolic health benefits, which, in turn, have been related to cognitive performance with inconsistent findings. The objective of this study was to examine the relationship between baseline adherence to three a priori dietary patterns (Mediterranean, DASH, and MIND diets) with 2-year changes in cognitive performance in older adults with overweight or obesity and high cardiovascular disease risk. Methods: A prospective cohort analysis was conducted within the PREDIMED-Plus trial, involving 6,647 men and women aged 55-75 years with overweight or obesity and metabolic syndrome. Using a validated, semiquantitative 143-item food frequency questionnaire completed at baseline, the dietary pattern adherence scores were calculated. An extensive neuropsychological test battery was administered at baseline and 2-year follow-up. Multivariable-adjusted linear regression models were used to assess associations between 2-year changes in cognitive function z-scores across tertiles of baseline adherence to the a priori dietary patterns. Results: Adherence to the Mediterranean diet at baseline was associated with 2-year changes in the general cognitive screening Mini-Mental State Examination (MMSE, β: 0.070; 95% CI: 0.014, 0.175, P-trend = 0.011), and two executive function-related assessments: the Trail Making Tests Part A (TMT-A, β: -0.054; 95% CI: -0.110, - 0.002, P-trend = 0.047) and Part B (TMT-B, β: -0.079; 95% CI: -0.134, -0.024, P-trend = 0.004). Adherence to the MIND diet was associated with the backward recall Digit Span Test assessment of working memory (DST-B, β: 0.058; 95% CI: 0.002, 0.114, P-trend = 0.045). However, higher adherence to the DASH dietary pattern was not associated with better cognitive function over a period of 2 years. Conclusion: In older Spanish individuals with overweight or obesity and at high cardiovascular disease risk, higher baseline adherence to the Mediterranean dietary pattern may be associated with better cognitive performance than lower adherence over a period of 2 years.
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Affiliation(s)
- Stephanie K. Nishi
- Universitat Rovira i Virgili, Departament de Bioquímica i Biotecnologia, and Hospital Universitari San Joan de Reus, Unitat de Nutrició Humana, Reus, Spain
- Institut d’Investigació Sanitária Pere Virgili (IISPV), Reus, Spain
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Toronto 3D (Diet, Digestive Tract and Disease) Knowledge Synthesis and Clinical Trials Unit, Toronto, ON, Canada
- Clinical Nutrition and Risk Factor Modification Centre, St. Michael’s Hospital, Unity Health Toronto, Toronto, ON, Canada
| | - Nancy Babio
- Universitat Rovira i Virgili, Departament de Bioquímica i Biotecnologia, and Hospital Universitari San Joan de Reus, Unitat de Nutrició Humana, Reus, Spain
- Institut d’Investigació Sanitária Pere Virgili (IISPV), Reus, Spain
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Nutrition Unit, University Hospital of Sant Joan de Reus, Reus, Spain
| | - Carlos Gómez-Martínez
- Universitat Rovira i Virgili, Departament de Bioquímica i Biotecnologia, and Hospital Universitari San Joan de Reus, Unitat de Nutrició Humana, Reus, Spain
- Institut d’Investigació Sanitária Pere Virgili (IISPV), Reus, Spain
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Miguel Ángel Martínez-González
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Department of Preventive Medicine and Public Health, University of Navarra, IdiSNA, Pamplona, Spain
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, United States
| | - Emilio Ros
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Department of Endocrinology and Nutrition, Lipid Clinic, Institut d’Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), Hospital Clínic, Barcelona, Spain
| | - Dolores Corella
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Department of Preventive Medicine, University of Valencia, Valencia, Spain
| | - Olga Castañer
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Unit of Cardiovascular Risk and Nutrition, Institut Hospital del Mar de Investigaciones Médicas Municipal d’Investigació Médica (IMIM), Barcelona, Spain
| | - J. Alfredo Martínez
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Department of Nutrition, Food Sciences, and Physiology, Center for Nutrition Research, University of Navarra, IdiSNA, Pamplona, Spain
- Precision Nutrition and Cardiometabolic Health Program, IMDEA Food, CEI UAM + CSIC, Madrid, Spain
| | - Ángel M. Alonso-Gómez
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Bioaraba Health Research Institute, Cardiovascular, Respiratory and Metabolic Area, Osakidetza Basque Health Service, Araba University Hospital, University of the Basque Country UPV/EHU, Vitoria-Gasteiz, Spain
| | - Julia Wärnberg
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- EpiPHAAN Research Group, School of Health Sciences, Instituto de Investigación Biomédica de Málaga (IBIMA), University of Málaga, Málaga, Spain
| | - Jesús Vioque
- CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
- Instituto de Investigación Sanitaria y Biomédica de Alicante, Universidad Miguel Hernández (ISABIAL-UMH), Alicante, Spain
| | - Dora Romaguera
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Health Research Institute of the Balearic Islands (IdISBa), Palma de Mallorca, Spain
| | - José López-Miranda
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Department of Internal Medicine, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, Cordoba, Spain
| | - Ramon Estruch
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Department of Internal Medicine, Institut d’Investigacions Biomédiques August Pi Sunyer (IDIBAPS), Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - Francisco J. Tinahones
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Department of Endocrinology, Virgen de la Victoria Hospital, Instituto de Investigación Biomédica de Málaga (IBIMA), University of Málaga, Málaga, Spain
| | - José Lapetra
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Department of Family Medicine, Research Unit, Distrito Sanitario Atención Primaria Sevilla, Seville, Spain
| | - J. Luís Serra-Majem
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Research Institute of Biomedical and Health Sciences (IUIBS), University of Las Palmas de Gran Canaria and Centro Hospitalario Universitario Insular Materno Infantil (CHUIMI), Canarian Health Service, Las Palmas de Gran Canaria, Spain
| | - Aurora Bueno-Cavanillas
- CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
- Department of Preventive Medicine and Public Health, University of Granada, Granada, Spain
- Instituto de Investigación Biosanitaria ibs, GRANADA, Granada, Spain
| | - Josep A. Tur
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Research Group on Community Nutrition and Oxidative Stress, University of Balearic Islands, Palma de Mallorca, Spain
| | - Vicente Martín Sánchez
- CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
- Institute of Biomedicine (IBIOMED), University of León, León, Spain
| | - Xavier Pintó
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Lipids and Vascular Risk Unit, Internal Medicine, Hospital Universitario de Bellvitge, Hospitalet de Llobregat, Barcelona, Spain
| | - Miguel Delgado-Rodríguez
- CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
- Division of Preventive Medicine, Faculty of Medicine, University of Jaén, Jaén, Spain
| | - Pilar Matía-Martín
- Department of Endocrinology and Nutrition, Instituto de Investigación Sanitaria Hospital Clínico San Carlos (IdISSC), Madrid, Spain
| | - Josep Vidal
- CIBER Diabetes y Enfermedades Metabólicas (CIBERDEM), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Department of Endocrinology, Institut d’ Investigacions Biomédiques August Pi Sunyer (IDIBAPS), Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - Clotilde Vázquez
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Department of Endocrinology and Nutrition, Hospital Fundación Jimenez Díaz, Instituto de Investigaciones Biomédicas IISFJD, University Autonoma, Madrid, Spain
| | - Lidia Daimiel
- Nutritional Control of the Epigenome Group, Precision Nutrition and Obesity Program, IMDEA Food, CEI UAM + CSIC, Madrid, Spain
| | - Cristina Razquin
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Department of Preventive Medicine and Public Health, University of Navarra, IdiSNA, Pamplona, Spain
| | - Oscar Coltell
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Department of Computer Languages and Systems, Universitat Jaume I, Castellon, Spain
| | - Nerea Becerra-Tomás
- Universitat Rovira i Virgili, Departament de Bioquímica i Biotecnologia, and Hospital Universitari San Joan de Reus, Unitat de Nutrició Humana, Reus, Spain
- Institut d’Investigació Sanitária Pere Virgili (IISPV), Reus, Spain
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Rafael De La Torre Fornell
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Integrative Pharmacology and Systems Neurosciences, Instituto Hospital del Mar de Investigaciones Médicas (IMIM), Barcelona, Spain
| | - Itziar Abete
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Department of Nutrition, Food Sciences, and Physiology, Center for Nutrition Research, University of Navarra, IdiSNA, Pamplona, Spain
| | - Carolina Sorto-Sanchez
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Bioaraba Health Research Institute, Cardiovascular, Respiratory and Metabolic Area, Osakidetza Basque Health Service, Araba University Hospital, University of the Basque Country UPV/EHU, Vitoria-Gasteiz, Spain
| | - Francisco Javier Barón-López
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- EpiPHAAN Research Group, School of Health Sciences, Instituto de Investigación Biomédica de Málaga (IBIMA), University of Málaga, Málaga, Spain
| | - Antonio José Signes-Pastor
- CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
- Instituto de Investigación Sanitaria y Biomédica de Alicante, Universidad Miguel Hernández (ISABIAL-UMH), Alicante, Spain
| | - Jadwiga Konieczna
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Health Research Institute of the Balearic Islands (IdISBa), Palma de Mallorca, Spain
| | - Antonio Garcia-Rios
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Department of Internal Medicine, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, Cordoba, Spain
| | - Rosa Casas
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Department of Internal Medicine, Institut d’Investigacions Biomédiques August Pi Sunyer (IDIBAPS), Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - Ana Maria Gomez-Perez
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Department of Endocrinology, Virgen de la Victoria Hospital, Instituto de Investigación Biomédica de Málaga (IBIMA), University of Málaga, Málaga, Spain
| | - José Manuel Santos-Lozano
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Department of Family Medicine, Research Unit, Distrito Sanitario Atención Primaria Sevilla, Seville, Spain
| | - Ana García-Arellano
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Department of Endocrinology, Virgen de la Victoria Hospital, Instituto de Investigación Biomédica de Málaga (IBIMA), University of Málaga, Málaga, Spain
| | - Patricia Guillem-Saiz
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Department of Preventive Medicine, University of Valencia, Valencia, Spain
| | - Jiaqi Ni
- Universitat Rovira i Virgili, Departament de Bioquímica i Biotecnologia, and Hospital Universitari San Joan de Reus, Unitat de Nutrició Humana, Reus, Spain
- Institut d’Investigació Sanitária Pere Virgili (IISPV), Reus, Spain
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | | | - M. Ángeles Zulet
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Department of Nutrition, Food Sciences, and Physiology, Center for Nutrition Research, University of Navarra, IdiSNA, Pamplona, Spain
| | - Jessica Vaquero-Luna
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Bioaraba Health Research Institute, Cardiovascular, Respiratory and Metabolic Area, Osakidetza Basque Health Service, Araba University Hospital, University of the Basque Country UPV/EHU, Vitoria-Gasteiz, Spain
| | - Estefanía Toledo
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Department of Preventive Medicine and Public Health, University of Navarra, IdiSNA, Pamplona, Spain
| | - Montserrat Fitó
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Unit of Cardiovascular Risk and Nutrition, Institut Hospital del Mar de Investigaciones Médicas Municipal d’Investigació Médica (IMIM), Barcelona, Spain
| | - Jordi Salas-Salvadó
- Universitat Rovira i Virgili, Departament de Bioquímica i Biotecnologia, and Hospital Universitari San Joan de Reus, Unitat de Nutrició Humana, Reus, Spain
- Institut d’Investigació Sanitária Pere Virgili (IISPV), Reus, Spain
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Nutrition Unit, University Hospital of Sant Joan de Reus, Reus, Spain
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Polverino A, Sorrentino P, Pesoli M, Mandolesi L. Nutrition and cognition across the lifetime: an overview on epigenetic mechanisms. AIMS Neurosci 2021; 8:448-476. [PMID: 34877399 PMCID: PMC8611190 DOI: 10.3934/neuroscience.2021024] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Accepted: 07/12/2021] [Indexed: 12/28/2022] Open
Abstract
The functioning of our brain depends on both genes and their interactions with environmental factors. The close link between genetics and environmental factors produces structural and functional cerebral changes early on in life. Understanding the weight of environmental factors in modulating neuroplasticity phenomena and cognitive functioning is relevant for potential interventions. Among these, nutrition plays a key role. In fact, the link between gut and brain (the gut-brain axis) is very close and begins in utero, since the Central Nervous System (CNS) and the Enteric Nervous System (ENS) originate from the same germ layer during the embryogenesis. Here, we investigate the epigenetic mechanisms induced by some nutrients on the cognitive functioning, which affect the cellular and molecular processes governing our cognitive functions. Furthermore, epigenetic phenomena can be positively affected by specific healthy nutrients from diet, with the possibility of preventing or modulating cognitive impairments. Specifically, we described the effects of several nutrients on diet-dependent epigenetic processes, in particular DNA methylation and histones post-translational modifications, and their potential role as therapeutic target, to describe how some forms of cognitive decline could be prevented or modulated from the early stages of life.
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Affiliation(s)
- Arianna Polverino
- Institute of Diagnosis and Treatment Hermitage Capodimonte, Naples, Italy.,Department of Motor and Wellness Sciences, University of Naples "Parthenope", Naples, Italy
| | - Pierpaolo Sorrentino
- Institut de Neurosciences des Systèmes, Aix-Marseille University, Marseille, France.,Institute of Applied Sciences and Intelligent Systems, National Research Council, Pozzuoli, Italy
| | - Matteo Pesoli
- Department of Motor and Wellness Sciences, University of Naples "Parthenope", Naples, Italy
| | - Laura Mandolesi
- Department of Humanities Studies, University of Naples Federico II, Naples, Italy
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Yeung SSY, Kwan M, Woo J. Healthy Diet for Healthy Aging. Nutrients 2021; 13:nu13124310. [PMID: 34959862 PMCID: PMC8707325 DOI: 10.3390/nu13124310] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Revised: 11/26/2021] [Accepted: 11/28/2021] [Indexed: 12/31/2022] Open
Abstract
Extending healthspan is a major public health challenge. Diet is one of the modifiable factors for preventing age-related diseases and preserving overall good health status during aging. Optimizing individuals’ intrinsic capacity, including domains in cognition, psychological, sensory function, vitality, and locomotion, has been proposed as a model of healthy aging by the World Health Organization. To better understand the relationships between a healthy diet and healthy aging, this review summarizes the recent epidemiologic and clinical data for dietary patterns that have been shown to play a role in (domains of) healthy aging. Regardless of priori or posteriori dietary patterns, it appears that dietary patterns centered on plant-based foods have a beneficial role in (domains of) healthy aging. Our review identified a knowledge gap in dietary patterns and multidimensional concepts of healthy aging. More epidemiological studies should consider intrinsic capacity as an outcome measure to further our understanding of a healthy diet and multidimensional concepts of healthy aging. When a sufficient number of epidemiological studies is available, evidence can be synthesized and clinical trials can be designed to evaluate a healthy diet as a strategy for healthy aging to further our progress in translating evidence to practice and promoting healthy aging.
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Affiliation(s)
- Suey S. Y. Yeung
- Department of Medicine and Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China;
| | - Michelle Kwan
- Jockey Club Institute of Ageing, The Chinese University of Hong Kong, Hong Kong, China;
| | - Jean Woo
- Department of Medicine and Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China;
- Centre for Nutritional Studies, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
- Correspondence: ; Tel.: +852-3505-3493
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Siervo M, Shannon OM, Llewellyn DJ, Stephan BC, Fontana L. Mediterranean diet and cognitive function: From methodology to mechanisms of action. Free Radic Biol Med 2021; 176:105-117. [PMID: 34562607 DOI: 10.1016/j.freeradbiomed.2021.09.018] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Revised: 09/16/2021] [Accepted: 09/20/2021] [Indexed: 12/12/2022]
Abstract
The traditional Mediterranean diet (MedDiet), rich in minimally processed plant foods and fish, has been widely recognized to be one of the healthiest diets. Data from multiple randomized clinical trials have demonstrated its powerful effect against oxidative stress, inflammation and the development and progression of cardiovascular disease, type 2 diabetes, and other metabolic conditions that play a crucial role in the pathogenesis of neurodegenerative diseases. The protecting effects of the MedDiet against cognitive decline have been investigated in several observational and experimental studies. Data from observational studies suggest that the MedDiet may represent an effective dietary strategy for the early prevention of dementia, although these findings require further substantiation in clinical trials which have so far produced inconclusive results. Moreover, as we discuss in this review, accumulating data emphasizes the importance of: 1) maintaining an optimal nutritional and metabolic status for the promotion of healthy cognitive aging, and 2) implementing cognition-sparing dietary and lifestyle interventions during early time-sensitive windows before the pathological cascades turn into an irreversible state. In summary, components of the MedDiet pattern, such as essential fatty acids, polyphenols and vitamins, have been associated with reduced oxidative stress and the current evidence from observational studies seems to assign to the MedDiet a beneficial role in promoting brain health; however, results from clinical trials have been inconsistent. While we advocate for longitudinal analyses and for larger and longer clinical trials to be conducted, we assert our interim support to the use of the MedDiet as a protective dietary intervention for cognitive function based on its proven cardiovascular and metabolic benefits.
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Affiliation(s)
- Mario Siervo
- School of Life Sciences, The University of Nottingham Medical School, Queen's Medical Centre, Nottingham, UK.
| | - Oliver M Shannon
- Human Nutrition Research Centre, Population Health Sciences Institute, Newcastle University, Newcastle Upon Tyne, UK
| | - David J Llewellyn
- University of Exeter Medical School, Exeter, UK; Alan Turing Institute, London, UK
| | - Blossom Cm Stephan
- Institute of Mental Health, The University of Nottingham Medical School, Nottingham, UK
| | - Luigi Fontana
- Charles Perkins Center, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia; Department of Endocrinology, Royal Prince Alfred Hospital, Sydney, NSW, Australia; Department of Clinical and Experimental Sciences, Brescia University School of Medicine, Brescia, Italy
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Dominguez LJ, Veronese N, Vernuccio L, Catanese G, Inzerillo F, Salemi G, Barbagallo M. Nutrition, Physical Activity, and Other Lifestyle Factors in the Prevention of Cognitive Decline and Dementia. Nutrients 2021; 13:nu13114080. [PMID: 34836334 PMCID: PMC8624903 DOI: 10.3390/nu13114080] [Citation(s) in RCA: 123] [Impact Index Per Article: 41.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Revised: 10/25/2021] [Accepted: 10/27/2021] [Indexed: 02/07/2023] Open
Abstract
Multiple factors combined are currently recognized as contributors to cognitive decline. The main independent risk factor for cognitive impairment and dementia is advanced age followed by other determinants such as genetic, socioeconomic, and environmental factors, including nutrition and physical activity. In the next decades, a rise in dementia cases is expected due largely to the aging of the world population. There are no hitherto effective pharmaceutical therapies to treat age-associated cognitive impairment and dementia, which underscores the crucial role of prevention. A relationship among diet, physical activity, and other lifestyle factors with cognitive function has been intensively studied with mounting evidence supporting the role of these determinants in the development of cognitive decline and dementia, which is a chief cause of disability globally. Several dietary patterns, foods, and nutrients have been investigated in this regard, with some encouraging and other disappointing results. This review presents the current evidence for the effects of dietary patterns, dietary components, some supplements, physical activity, sleep patterns, and social engagement on the prevention or delay of the onset of age-related cognitive decline and dementia.
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Affiliation(s)
- Ligia J. Dominguez
- Geriatric Unit, Department of Medicine, University of Palermo, 90100 Palermo, Italy; (N.V.); (L.V.); (G.C.); (F.I.); (M.B.)
- Faculty of Medicine and Surgery, University of Enna “Kore”, 94100 Enna, Italy
- Correspondence: ; +39-0916554828
| | - Nicola Veronese
- Geriatric Unit, Department of Medicine, University of Palermo, 90100 Palermo, Italy; (N.V.); (L.V.); (G.C.); (F.I.); (M.B.)
| | - Laura Vernuccio
- Geriatric Unit, Department of Medicine, University of Palermo, 90100 Palermo, Italy; (N.V.); (L.V.); (G.C.); (F.I.); (M.B.)
| | - Giuseppina Catanese
- Geriatric Unit, Department of Medicine, University of Palermo, 90100 Palermo, Italy; (N.V.); (L.V.); (G.C.); (F.I.); (M.B.)
| | - Flora Inzerillo
- Geriatric Unit, Department of Medicine, University of Palermo, 90100 Palermo, Italy; (N.V.); (L.V.); (G.C.); (F.I.); (M.B.)
| | - Giuseppe Salemi
- Department of Biomedicine, Neuroscience, and Advanced Diagnostics, University of Palermo, 90100 Palermo, Italy;
- UOC of Neurology, University Hospital “Paolo Giaccone”, 90100 Palermo, Italy
| | - Mario Barbagallo
- Geriatric Unit, Department of Medicine, University of Palermo, 90100 Palermo, Italy; (N.V.); (L.V.); (G.C.); (F.I.); (M.B.)
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Stephen R, Barbera M, Peters R, Ee N, Zheng L, Lehtisalo J, Kulmala J, Håkansson K, Chowdhary N, Dua T, Solomon A, Anstey KJ, Kivipelto M. Development of the First WHO Guidelines for Risk Reduction of Cognitive Decline and Dementia: Lessons Learned and Future Directions. Front Neurol 2021; 12:763573. [PMID: 34764935 PMCID: PMC8577650 DOI: 10.3389/fneur.2021.763573] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Accepted: 09/27/2021] [Indexed: 11/13/2022] Open
Abstract
The first WHO guidelines for risk reduction of cognitive decline and dementia marked an important milestone in the field of dementia prevention. In this paper, we discuss the evidence reviewed as part of the guidelines development and present the main themes emerged from its synthesis, to inform future research and policies on dementia risk reduction. The role of intervention effect-size; the mismatch between observational and intervention-based evidence; the heterogeneity of evidence among intervention trials; the importance of intervention duration; the role of timing of exposure to a certain risk factor and interventions; the relationship between intervention intensity and response; the link between individual risk factors and specific dementia pathologies; and the need for tailored interventions emerged as the main themes. The interaction and clustering of individual risk factors, including genetics, was identified as the overarching theme. The evidence collected indicates that multidomain approaches targeting simultaneously multiple risk factors and tailored at both individual and population level, are likely to be most effective and feasible in dementia risk reduction. The current status of multidomain intervention trials aimed to cognitive impairment/dementia prevention was also briefly reviewed. Primary results were presented focusing on methodological differences and the potential of design harmonization for improving evidence quality. Since multidomain intervention trials address a condition with slow clinical manifestation—like dementia—in a relatively short time frame, the need for surrogate outcomes was also discussed, with a specific focus on the potential utility of dementia risk scores. Finally, we considered how multidomain intervention could be most effectively implemented in a public health context and the implications world-wide for other non-communicable diseases targeting common risk factors, taking into account the limited evidence in low-middle income countries. In conclusion, the evidence from the first WHO guidelines for risk reduction of cognitive decline and dementia indicated that “one size does not fit all,” and multidomain approaches adaptable to different populations and individuals are likely to be the most effective. Harmonization in trial design, the use of appropriate outcome measures, and sustainability in large at-risk populations in the context of other chronic disorders also emerged as key elements.
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Affiliation(s)
- Ruth Stephen
- Department of Neurology, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland
| | - Mariagnese Barbera
- Department of Neurology, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland.,The Ageing Epidemiology Research Unit, Faculty of Medicine, School of Public Health, Imperial College London, London, United Kingdom
| | - Ruth Peters
- School of Psychology, University of New South Wales, Sydney, NSW, Australia.,Neuroscience Research Australia, Randwick, NSW, Australia
| | - Nicole Ee
- School of Psychology, University of New South Wales, Sydney, NSW, Australia.,Neuroscience Research Australia, Randwick, NSW, Australia
| | - Lidan Zheng
- School of Psychology, University of New South Wales, Sydney, NSW, Australia.,Neuroscience Research Australia, Randwick, NSW, Australia
| | - Jenni Lehtisalo
- Department of Neurology, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland.,Population Health Unit, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Jenni Kulmala
- Population Health Unit, Finnish Institute for Health and Welfare, Helsinki, Finland.,Faculty of Social Sciences (Health Sciences) and Gerontology Research Centre (GEREC), Tampere University, Tampere, Finland.,Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Krister Håkansson
- Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.,Theme Inflammation and Aging, Karolinska University Hospital, Stockholm, Sweden
| | - Neerja Chowdhary
- Department of Mental Health and Substance Use, World Health Organization, Geneva, Switzerland
| | - Tarun Dua
- Department of Mental Health and Substance Use, World Health Organization, Geneva, Switzerland
| | - Alina Solomon
- Department of Neurology, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland.,The Ageing Epidemiology Research Unit, Faculty of Medicine, School of Public Health, Imperial College London, London, United Kingdom.,Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Kaarin J Anstey
- School of Psychology, University of New South Wales, Sydney, NSW, Australia.,Neuroscience Research Australia, Randwick, NSW, Australia
| | - Miia Kivipelto
- The Ageing Epidemiology Research Unit, Faculty of Medicine, School of Public Health, Imperial College London, London, United Kingdom.,Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.,Theme Inflammation and Aging, Karolinska University Hospital, Stockholm, Sweden.,Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
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de Melo Reis RA, Isaac AR, Freitas HR, de Almeida MM, Schuck PF, Ferreira GC, Andrade-da-Costa BLDS, Trevenzoli IH. Quality of Life and a Surveillant Endocannabinoid System. Front Neurosci 2021; 15:747229. [PMID: 34776851 PMCID: PMC8581450 DOI: 10.3389/fnins.2021.747229] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Accepted: 10/01/2021] [Indexed: 12/11/2022] Open
Abstract
The endocannabinoid system (ECS) is an important brain modulatory network. ECS regulates brain homeostasis throughout development, from progenitor fate decision to neuro- and gliogenesis, synaptogenesis, brain plasticity and circuit repair, up to learning, memory, fear, protection, and death. It is a major player in the hypothalamic-peripheral system-adipose tissue in the regulation of food intake, energy storage, nutritional status, and adipose tissue mass, consequently affecting obesity. Loss of ECS control might affect mood disorders (anxiety, hyperactivity, psychosis, and depression), lead to drug abuse, and impact neurodegenerative (Alzheimer's, Parkinson, Huntington, Multiple, and Amyotrophic Lateral Sclerosis) and neurodevelopmental (autism spectrum) disorders. Practice of regular physical and/or mind-body mindfulness and meditative activities have been shown to modulate endocannabinoid (eCB) levels, in addition to other players as brain-derived neurotrophic factor (BDNF). ECS is involved in pain, inflammation, metabolic and cardiovascular dysfunctions, general immune responses (asthma, allergy, and arthritis) and tumor expansion, both/either in the brain and/or in the periphery. The reason for such a vast impact is the fact that arachidonic acid, a precursor of eCBs, is present in every membrane cell of the body and on demand eCBs synthesis is regulated by electrical activity and calcium shifts. Novel lipid (lipoxins and resolvins) or peptide (hemopressin) players of the ECS also operate as regulators of physiological allostasis. Indeed, the presence of cannabinoid receptors in intracellular organelles as mitochondria or lysosomes, or in nuclear targets as PPARγ might impact energy consumption, metabolism and cell death. To live a better life implies in a vigilant ECS, through healthy diet selection (based on a balanced omega-3 and -6 polyunsaturated fatty acids), weekly exercises and meditation therapy, all of which regulating eCBs levels, surrounded by a constructive social network. Cannabidiol, a diet supplement has been a major player with anti-inflammatory, anxiolytic, antidepressant, and antioxidant activities. Cognitive challenges and emotional intelligence might strengthen the ECS, which is built on a variety of synapses that modify human behavior. As therapeutically concerned, the ECS is essential for maintaining homeostasis and cannabinoids are promising tools to control innumerous targets.
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Affiliation(s)
- Ricardo Augusto de Melo Reis
- Laboratory of Neurochemistry, Institute of Biophysics Carlos Chagas Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Alinny Rosendo Isaac
- Laboratory of Neurochemistry, Institute of Biophysics Carlos Chagas Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Hércules Rezende Freitas
- Laboratory of Neuroenergetics and Inborn Errors of Metabolism, Institute of Medical Biochemistry Leopoldo de Meis, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Mariana Macedo de Almeida
- Laboratory of Molecular Endocrinology, Institute of Biophysics Carlos Chagas Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Patricia Fernanda Schuck
- Laboratory of Neuroenergetics and Inborn Errors of Metabolism, Institute of Medical Biochemistry Leopoldo de Meis, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Gustavo Costa Ferreira
- Laboratory of Neuroenergetics and Inborn Errors of Metabolism, Institute of Medical Biochemistry Leopoldo de Meis, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | | | - Isis Hara Trevenzoli
- Laboratory of Molecular Endocrinology, Institute of Biophysics Carlos Chagas Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
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Álvarez-Álvarez L, Vitelli-Storelli F, Rubín-García M, Aragonés N, Ardanaz E, Castaño-Vinyals G, Obón-Santacana M, Dierssen-Sotos T, Salas-Trejo D, Tardón A, Moleón JJJ, Alguacil J, Chirlaque MD, Pérez-Gómez B, Pollán M, Kogevinas M, Martín V. Relationship between the Risk of Gastric Cancer and Adherence to the Mediterranean Diet According to Different Estimators. MCC-Spain Study. Cancers (Basel) 2021; 13:cancers13215281. [PMID: 34771444 PMCID: PMC8582518 DOI: 10.3390/cancers13215281] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 10/18/2021] [Accepted: 10/19/2021] [Indexed: 01/22/2023] Open
Abstract
Simple Summary Dietary habits are one of the factors that influence the development of gastric cancer and, although it has been seen that the Mediterranean diet has a protective effect on this type of cancer, there are different indexes to assess the degree of adherence to this dietary pattern; this implies differences in the results obtained in the reduction of risk. The aim of this work was to assess the effect of adherence to the Mediterranean diet, measured with five different indexes, on the risk of gastric cancer. Abstract The aim was to assess the effect of adherence to the Mediterranean Diet, measured with five different indexes, on the risk of gastric cancer. Data come from the multicase-control study MCC—Spain, which included 354 gastric cancer cases and 3040 controls with data on diet. We used five indexes to evaluate adherence to the Mediterranean diet and assess the association between each pattern with the risk of gastric cancer, using multivariate logistic regression. The analyses were performed for the whole set of gastric cancer cases, by anatomical location (cardia and non-cardia) and by histological type (intestinal and diffuse). According to the used index, a high adherence protects one from gastric cancer (between 48% (aOR = 0.52; CI 95% = 0.28–0.94) and 75% (aOR = 0.25; CI 95% = 0.12–0.52)), from non-cardia (between 48% (aOR = 0.52; CI 95% = 0.36–0.75) and 65% (aOR = 0.35; CI 95% = 0.23–0.52)), and from the intestinal type (between 41% (aOR = 0.59; CI 95% = 0.36–0.95) and 72% (aOR = 0.28; CI 95% = 0.16–0.50)), but not from the diffuse type. In conclusion, high adherence to a Mediterranean diet pattern is a protective factor for the risk of gastric cancer, with greater adherence leading to greater protection.
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Affiliation(s)
- Laura Álvarez-Álvarez
- Group of Investigation in Interactions Gene-Environment and Health (GIIGAS), Institute of Biomedicine (IBIOMED), University of León, 24071 León, Spain; (L.Á.-Á.); (F.V.-S.); (V.M.)
| | - Facundo Vitelli-Storelli
- Group of Investigation in Interactions Gene-Environment and Health (GIIGAS), Institute of Biomedicine (IBIOMED), University of León, 24071 León, Spain; (L.Á.-Á.); (F.V.-S.); (V.M.)
| | - María Rubín-García
- Group of Investigation in Interactions Gene-Environment and Health (GIIGAS), Institute of Biomedicine (IBIOMED), University of León, 24071 León, Spain; (L.Á.-Á.); (F.V.-S.); (V.M.)
- Correspondence: ; Tel.: +34-653252471
| | - Nuria Aragonés
- Consortium for Biomedical Research in Epidemiology & Public Health, CIBERESP, 28029 Madrid, Spain; (N.A.); (E.A.); (G.C.-V.); (T.D.-S.); (D.S.-T.); (A.T.); (J.J.J.M.); (J.A.); (M.D.C.); (B.P.-G.); (M.P.); (M.K.)
- Cancer Epidemiology Section, Public Health Division, Department of Health of Madrid, 28035 Madrid, Spain
| | - Eva Ardanaz
- Consortium for Biomedical Research in Epidemiology & Public Health, CIBERESP, 28029 Madrid, Spain; (N.A.); (E.A.); (G.C.-V.); (T.D.-S.); (D.S.-T.); (A.T.); (J.J.J.M.); (J.A.); (M.D.C.); (B.P.-G.); (M.P.); (M.K.)
- Navarra Institute for Health Research (IdiSNA) Navarra Public Health Institute, 31008 Pamplona, Spain
| | - Gemma Castaño-Vinyals
- Consortium for Biomedical Research in Epidemiology & Public Health, CIBERESP, 28029 Madrid, Spain; (N.A.); (E.A.); (G.C.-V.); (T.D.-S.); (D.S.-T.); (A.T.); (J.J.J.M.); (J.A.); (M.D.C.); (B.P.-G.); (M.P.); (M.K.)
- ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), 08036 Barcelona, Spain
| | - Mireia Obón-Santacana
- Oncology Data Analytics Program (ODAP), Catalan Institute of Oncology (ICO), L’Hospitalet Del Llobregat, 08908 Barcelona, Spain;
| | - Trinidad Dierssen-Sotos
- Consortium for Biomedical Research in Epidemiology & Public Health, CIBERESP, 28029 Madrid, Spain; (N.A.); (E.A.); (G.C.-V.); (T.D.-S.); (D.S.-T.); (A.T.); (J.J.J.M.); (J.A.); (M.D.C.); (B.P.-G.); (M.P.); (M.K.)
- Universidad de Cantabria—IDIVAL, 39005 Santander, Spain
| | - Dolores Salas-Trejo
- Consortium for Biomedical Research in Epidemiology & Public Health, CIBERESP, 28029 Madrid, Spain; (N.A.); (E.A.); (G.C.-V.); (T.D.-S.); (D.S.-T.); (A.T.); (J.J.J.M.); (J.A.); (M.D.C.); (B.P.-G.); (M.P.); (M.K.)
- Valencian Breast Cancer Screening Program, General Directorate of Public Health, 46020 València, Spain
| | - Adonina Tardón
- Consortium for Biomedical Research in Epidemiology & Public Health, CIBERESP, 28029 Madrid, Spain; (N.A.); (E.A.); (G.C.-V.); (T.D.-S.); (D.S.-T.); (A.T.); (J.J.J.M.); (J.A.); (M.D.C.); (B.P.-G.); (M.P.); (M.K.)
- Department of Medicine, University of Oviedo, 33003 Oviedo, Spain
| | - José Juan Jiménez Moleón
- Consortium for Biomedical Research in Epidemiology & Public Health, CIBERESP, 28029 Madrid, Spain; (N.A.); (E.A.); (G.C.-V.); (T.D.-S.); (D.S.-T.); (A.T.); (J.J.J.M.); (J.A.); (M.D.C.); (B.P.-G.); (M.P.); (M.K.)
- Instituto de Investigación Biosanitaria de Granada (ibs.GRANADA), Hospitales Universitarios de Granada, Universidad de Granada, 18012 Granada, Spain
| | - Juan Alguacil
- Consortium for Biomedical Research in Epidemiology & Public Health, CIBERESP, 28029 Madrid, Spain; (N.A.); (E.A.); (G.C.-V.); (T.D.-S.); (D.S.-T.); (A.T.); (J.J.J.M.); (J.A.); (M.D.C.); (B.P.-G.); (M.P.); (M.K.)
- Centro de Investigación en Recursos Naturales, Salud y Medio Ambiente (RENSMA), Universidad de Huelva, Campus Universitario de El Carmen, 21004 Huelva, Spain
| | - María Dolores Chirlaque
- Consortium for Biomedical Research in Epidemiology & Public Health, CIBERESP, 28029 Madrid, Spain; (N.A.); (E.A.); (G.C.-V.); (T.D.-S.); (D.S.-T.); (A.T.); (J.J.J.M.); (J.A.); (M.D.C.); (B.P.-G.); (M.P.); (M.K.)
- Department of Epidemiology, Regional Health Council, IMIB-Arrixaca, Murcia University, 30008 Murcia, Spain
| | - Beatriz Pérez-Gómez
- Consortium for Biomedical Research in Epidemiology & Public Health, CIBERESP, 28029 Madrid, Spain; (N.A.); (E.A.); (G.C.-V.); (T.D.-S.); (D.S.-T.); (A.T.); (J.J.J.M.); (J.A.); (M.D.C.); (B.P.-G.); (M.P.); (M.K.)
- Cancer and Environmental Epidemiology Unit, National Center for Epidemiology, Carlos III Institute of Health, 28029 Madrid, Spain
| | - Marina Pollán
- Consortium for Biomedical Research in Epidemiology & Public Health, CIBERESP, 28029 Madrid, Spain; (N.A.); (E.A.); (G.C.-V.); (T.D.-S.); (D.S.-T.); (A.T.); (J.J.J.M.); (J.A.); (M.D.C.); (B.P.-G.); (M.P.); (M.K.)
- Cancer and Environmental Epidemiology Unit, Department of Epidemiology and Chronic Diseases, National Center for Epidemiology, Carlos III Institute of Health, 28029 Madrid, Spain
| | - Manolis Kogevinas
- Consortium for Biomedical Research in Epidemiology & Public Health, CIBERESP, 28029 Madrid, Spain; (N.A.); (E.A.); (G.C.-V.); (T.D.-S.); (D.S.-T.); (A.T.); (J.J.J.M.); (J.A.); (M.D.C.); (B.P.-G.); (M.P.); (M.K.)
- Institute of Global Health (ISGlobal), 08036 Barcelona, Spain
| | - Vicente Martín
- Group of Investigation in Interactions Gene-Environment and Health (GIIGAS), Institute of Biomedicine (IBIOMED), University of León, 24071 León, Spain; (L.Á.-Á.); (F.V.-S.); (V.M.)
- Consortium for Biomedical Research in Epidemiology & Public Health, CIBERESP, 28029 Madrid, Spain; (N.A.); (E.A.); (G.C.-V.); (T.D.-S.); (D.S.-T.); (A.T.); (J.J.J.M.); (J.A.); (M.D.C.); (B.P.-G.); (M.P.); (M.K.)
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Adherence to Mediterranean Diet and Cognitive Abilities in the Greek Cohort of Epirus Health Study. Nutrients 2021; 13:nu13103363. [PMID: 34684367 PMCID: PMC8541267 DOI: 10.3390/nu13103363] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Revised: 09/20/2021] [Accepted: 09/22/2021] [Indexed: 01/27/2023] Open
Abstract
The Mediterranean diet is commonly proposed as a major modifiable protective factor that may delay cognitive impairment in the elderly. The aim of the study was to investigate the cross-sectional association of adherence to the Mediterranean diet with cognitive abilities in a younger Greek population. A total of 1201 healthy adults aged 21-77 years (mean: 47.8) from the Epirus Health Study cohort were included in the analysis. Adherence to the Mediterranean diet was measured using the 14-point Mediterranean Diet Adherence Screener (MEDAS) and cognition was measured using the Trail Making Test, the Verbal Fluency test and the Logical Memory test. Statistical analysis was performed using multiple linear regression models adjusted for age, sex, education, body mass index, smoking status, alcohol consumption and physical activity. Overall, no association was found between the MEDAS score and cognitive tests, which could be explained by the young mean age and high level of education of the participants. Future studies should target young and middle-aged individuals to gain further understanding of the association between Mediterranean diet and cognition in this age group.
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Abstract
The rapid changes that societies have gone through in the last few decades have led to the increase in the prevalence of malnutrition in all its forms and to the degradation of natural resources and the environment. The change in the dietary habits and production systems are responsible for much of this change. Some territorial diets have been shown as potentially capable of reversing these trends by positively contributing to the health of people and the environment such as the Mediterranean Diet and the New Nordic Diet. In this paper, we review the contribution of these 2 diets to health and nutrition and to environmental, sociocultural, and economic sustainability proposing pertinent indicators. Learning from a culturally established diet and a constructed one, tradeoff could be reached to ensure better health and sustainability outcomes. Strong factors for achieving this goal lie in building on the sociocultural appropriation of diets, having the proper tools and indicators, investing in cross-sector collaboration and policy coherence, and having the necessary political support to push the agenda of sustainability forward.
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Affiliation(s)
- Fatima Hachem
- 17107Food and Agriculture Organization of the United Nations, Rome, Italy
| | - Davy Vanham
- 99013European Commission, Joint Research Centre (JRC), Ispra, Italy
| | - Luis A Moreno
- 16765Universidad de Zaragoza, Zaragoza, Spain.,Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain
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Soldevila-Domenech N, Forcano L, Vintró-Alcaraz C, Cuenca-Royo A, Pintó X, Jiménez-Murcia S, García-Gavilán JF, Nishi SK, Babio N, Gomis-González M, Corella D, Sorlí JV, Fernandez-Carrión R, Martínez-González MÁ, Marti A, Salas-Salvadó J, Castañer O, Fernández-Aranda F, Torre RDL. Interplay between cognition and weight reduction in individuals following a Mediterranean Diet: Three-year follow-up of the PREDIMED-Plus trial. Clin Nutr 2021; 40:5221-5237. [PMID: 34474192 DOI: 10.1016/j.clnu.2021.07.020] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Revised: 07/13/2021] [Accepted: 07/16/2021] [Indexed: 12/13/2022]
Abstract
BACKGROUND & AIMS Some cognitive profiles might facilitate successful weight loss and its maintenance. Also, weight reductions may result in cognitive benefits. However, little work to date has examined the interactions between cognition and weight changes in the context of interventions with the Mediterranean diet (MedDiet). We studied the within-subject longitudinal relationships between cognition, body mass index (BMI), physical activity (PA), and quality of life (QoL), in older adults following a MedDiet. METHODS The PREDIMED-Plus is a primary prevention trial testing the effect of a lifestyle intervention program with an energy-restricted MedDiet (er-MedDiet), weight-loss goals and PA promotion on cardiovascular disease. The PREDIMED-Plus-Cognition sub-study included 487 participants (50% women, mean age 65.2 ± 4.7 years), with overweight/obesity, metabolic syndrome and normal cognitive performance at baseline. A comprehensive neurocognitive test battery was administered at baseline and after 1 and 3 years. RESULTS Baseline higher performance in verbal memory (OR = 1.5; 95%CI 1.0, 2.1), visuoconstructive praxis and attention (OR = 1.5; 95%CI 0.9, 2.3), and inhibition (OR = 1.3; 95%CI 0.9, 1.9) were associated with a higher odd of achieving at least 8% weight loss after 3 years follow-up in participants randomized to the intervention group. There were moderate improvements in specific tests of memory and executive functions during follow-up. Higher adherence to the er-MedDiet was associated with greater improvements in memory. Women exhibited lower rates of change in global cognition, PA and QoL. Moreover, improvements in memory correlated with reductions in BMI after 1 year (βSTD = -0.14) and with improvements in PA after 3 years (βSTD = 0.13). Finally, participants who experienced greater improvements in executive functions and global cognition also experienced greater improvements in their QoL. CONCLUSIONS This study refines the understanding of the determinants and mutual interrelationships between longitudinally-assessed cognitive performance and weight loss, adding further evidence to the cognitive benefits associated with better adherence to a MedDiet. Our results also suggest that weight loss interventions tailored to the cognitive profile and gender of participants are promising avenues for future studies.
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Affiliation(s)
- Natalia Soldevila-Domenech
- Integrative Pharmacology and Systems Neurosciences Research Group, Neurosciences Research Program, Hospital Del Mar Medical Research Institute (IMIM), 08003, Barcelona, Spain; Department of Experimental and Health Sciences, Universitat Pompeu Fabra, 08003, Barcelona, Spain.
| | - Laura Forcano
- Integrative Pharmacology and Systems Neurosciences Research Group, Neurosciences Research Program, Hospital Del Mar Medical Research Institute (IMIM), 08003, Barcelona, Spain; CIBER Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, 28029, Madrid, Spain.
| | - Cristina Vintró-Alcaraz
- CIBER Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, 28029, Madrid, Spain; Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain; Psychiatry and Mental Health Group, Neuroscience Program, Institut D'Investigació Biomèdica de Bellvitge-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain.
| | - Aida Cuenca-Royo
- Integrative Pharmacology and Systems Neurosciences Research Group, Neurosciences Research Program, Hospital Del Mar Medical Research Institute (IMIM), 08003, Barcelona, Spain.
| | - Xavier Pintó
- CIBER Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, 28029, Madrid, Spain; Lipid Unit, Department of Internal Medicine, Bellvitge Biomedical Research Institute (IDIBELL)-Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, 08908, Barcelona, Spain.
| | - Susana Jiménez-Murcia
- CIBER Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, 28029, Madrid, Spain; Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain; Psychiatry and Mental Health Group, Neuroscience Program, Institut D'Investigació Biomèdica de Bellvitge-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain; Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain.
| | - Jesús F García-Gavilán
- CIBER Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, 28029, Madrid, Spain; Universitat Rovira I Virgili, Departament de Bioquímica I Biotecnologia, Unitat de Nutrició Humana, Reus, Spain; Institut D'Investigació Sanitària Pere Virgili (IISPV). Hospital Universitari San Joan de Reus, Reus, Spain.
| | - Stephanie K Nishi
- CIBER Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, 28029, Madrid, Spain; Universitat Rovira I Virgili, Departament de Bioquímica I Biotecnologia, Unitat de Nutrició Humana, Reus, Spain; Institut D'Investigació Sanitària Pere Virgili (IISPV). Hospital Universitari San Joan de Reus, Reus, Spain.
| | - Nancy Babio
- CIBER Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, 28029, Madrid, Spain; Universitat Rovira I Virgili, Departament de Bioquímica I Biotecnologia, Unitat de Nutrició Humana, Reus, Spain; Institut D'Investigació Sanitària Pere Virgili (IISPV). Hospital Universitari San Joan de Reus, Reus, Spain.
| | - Maria Gomis-González
- Integrative Pharmacology and Systems Neurosciences Research Group, Neurosciences Research Program, Hospital Del Mar Medical Research Institute (IMIM), 08003, Barcelona, Spain.
| | - Dolores Corella
- CIBER Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, 28029, Madrid, Spain; Department of Preventive Medicine and Public Health, School of Medicine, University of Valencia, 46010, Valencia, Spain.
| | - Jose V Sorlí
- CIBER Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, 28029, Madrid, Spain; Department of Preventive Medicine and Public Health, School of Medicine, University of Valencia, 46010, Valencia, Spain.
| | - Rebeca Fernandez-Carrión
- CIBER Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, 28029, Madrid, Spain; Department of Preventive Medicine and Public Health, School of Medicine, University of Valencia, 46010, Valencia, Spain.
| | - Miguel Ángel Martínez-González
- CIBER Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, 28029, Madrid, Spain; University of Navarra, Department of Preventive Medicine and Public Health, Pamplona, Spain; Navarra's Health Research Institute (IdiSNA), Pamplona, Spain; Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
| | - Amelia Marti
- CIBER Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, 28029, Madrid, Spain; Navarra's Health Research Institute (IdiSNA), Pamplona, Spain; University of Navarra, Department of Nutrition, Food Sciences and Physiology, Pamplona, Spain.
| | - Jordi Salas-Salvadó
- CIBER Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, 28029, Madrid, Spain; Universitat Rovira I Virgili, Departament de Bioquímica I Biotecnologia, Unitat de Nutrició Humana, Reus, Spain; Institut D'Investigació Sanitària Pere Virgili (IISPV). Hospital Universitari San Joan de Reus, Reus, Spain.
| | - Olga Castañer
- CIBER Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, 28029, Madrid, Spain; Cardiovascular Risk and Nutrition Research Group, Hospital Del Mar Medical Research Institute (IMIM), 08003, Barcelona, Spain; Endocrinology Service. Institut Hospital Del Mar D'Investigacions Mèdiques (IMIM), 08003, Barcelona, Spain.
| | - Fernando Fernández-Aranda
- CIBER Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, 28029, Madrid, Spain; Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain; Psychiatry and Mental Health Group, Neuroscience Program, Institut D'Investigació Biomèdica de Bellvitge-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain; Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain.
| | - Rafael de la Torre
- Integrative Pharmacology and Systems Neurosciences Research Group, Neurosciences Research Program, Hospital Del Mar Medical Research Institute (IMIM), 08003, Barcelona, Spain; Department of Experimental and Health Sciences, Universitat Pompeu Fabra, 08003, Barcelona, Spain; CIBER Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, 28029, Madrid, Spain.
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Dickinson DL, Garbuio C. The influence of dietary patterns on outcomes in a Bayesian choice task. Health Sci Rep 2021; 4:e369. [PMID: 34541333 PMCID: PMC8439430 DOI: 10.1002/hsr2.369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Revised: 07/06/2021] [Accepted: 08/08/2021] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND AND AIMS Previous research has investigated the impact of diet on cognition, but the focus has often been on general cognition. This paper reports on a preregistered cross-sectional study aimed at testing for specific executive function differences across individuals who self-reported one of four distinct dietary patterns: No Diet, No Sugar, Vegetarian, or Mediterranean Diet pattern. Our hypotheses were aimed at testing whether adherence to a specialty diet improved decision making relative to those who reported following No Diet. METHODS We administered an incentivized Bayesian choice task to all participants. The task involved multiple components of information-existing information (base rate odds) as well as new information (sample draw evidence)-to allow a test of how these information components were used in making probability assessments, and how this may differ by self-reported dietary pattern. Sample size, hypotheses, and analysis plans were all determined ex ante and registered on the Open Science Framework. Multi-variate linear and non-linear estimation methods were used to analyze the data. RESULTS Our data failed to support our pre-registered hypotheses. In fact, we found some evidence that self-reported adherence to a specialty No Sugar Diet was associated with a reduced decision accuracy and was connected to an increased imbalance in how the participant weighted the two available sources of information when making choices. CONCLUSION Our results suggest that decision making is nuanced among dietary groups, but that short-term incentivized decisions in an ecologically valid field setting are likely not improved solely by following promoted dietary patterns such as the Mediterranean or Vegetarian diets.
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Affiliation(s)
- David L Dickinson
- Department of Economics and CERPAAppalachian State UniversityBooneNorth CarolinaUSA
- Institute of Labor Economics (IZA)BonnGermany
- Economic Science Institute (ESI), Chapman UniversityOrangeCaliforniaUSA
| | - Caleb Garbuio
- Department of EconomicsAppalachian State UniversityBooneNorth CarolinaUSA
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50
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Markovic SJ, Fitzgerald M, Peiffer JJ, Scott BR, Rainey-Smith SR, Sohrabi HR, Brown BM. The impact of exercise, sleep, and diet on neurocognitive recovery from mild traumatic brain injury in older adults: A narrative review. Ageing Res Rev 2021; 68:101322. [PMID: 33737117 DOI: 10.1016/j.arr.2021.101322] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Revised: 03/06/2021] [Accepted: 03/11/2021] [Indexed: 02/06/2023]
Abstract
Mild traumatic brain injury (mTBI) accounts for a large majority of traumatic brain injuries sustained globally each year. Older adults, who are already susceptible to age-related declines to neurocognitive health, appear to be at an increased risk of both sustaining an mTBI and experiencing slower or impaired recovery. There is also growing evidence that mTBI is a potential risk factor for accelerated cognitive decline and neurodegeneration. Lifestyle-based interventions are gaining prominence as a cost-effective means of maintaining cognition and brain health with age. Consequently, inter-individual variations in exercise, sleep, and dietary patterns could influence the trajectory of post-mTBI neurocognitive recovery, particularly in older adults. This review synthesises the current animal and human literature centred on the mechanisms through which lifestyle-related habits and behaviours could influence acute and longer-term neurocognitive functioning following mTBI. Numerous neuroprotective processes which are impacted by lifestyle factors have been established in animal models of TBI. However, the literature is characterised by a lack of translation to human samples and limited appraisal of the interaction between ageing and brain injury. Further research is needed to better establish the therapeutic utility of applying lifestyle-based modifications to improve post-mTBI neurocognitive outcomes in older adults.
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Affiliation(s)
- Shaun J Markovic
- Discipline of Exercise Science, College of Science, Health, Engineering and Education, Murdoch University, 90 South St, Murdoch, Western Australia, Australia; Australian Alzheimer's Research Foundation, Sarich Neuroscience Research Institute Building, 8 Verdun St, Nedlands, Western Australia, Australia.
| | - Melinda Fitzgerald
- Curtin Health Innovation Research Institute, Sarich Neuroscience Research Institute Building, 8 Verdun St, Nedlands, Western Australia, Australia; Perron Institute for Neurological and Translational Science, Sarich Neuroscience Research Institute Building, 8 Verdun St, Nedlands, Western Australia, Australia; School of Biological Sciences, The University of Western Australia, 35 Stirling Hwy, Crawley, Western Australia, Australia
| | - Jeremiah J Peiffer
- Discipline of Exercise Science, College of Science, Health, Engineering and Education, Murdoch University, 90 South St, Murdoch, Western Australia, Australia; Centre for Healthy Ageing, Murdoch University, 90 South St, Murdoch, Western Australia, Australia; Murdoch Applied Sports Science Laboratory, Murdoch University, 90 South St, Murdoch, Western Australia, Australia
| | - Brendan R Scott
- Discipline of Exercise Science, College of Science, Health, Engineering and Education, Murdoch University, 90 South St, Murdoch, Western Australia, Australia; Centre for Healthy Ageing, Murdoch University, 90 South St, Murdoch, Western Australia, Australia; Murdoch Applied Sports Science Laboratory, Murdoch University, 90 South St, Murdoch, Western Australia, Australia
| | - Stephanie R Rainey-Smith
- Australian Alzheimer's Research Foundation, Sarich Neuroscience Research Institute Building, 8 Verdun St, Nedlands, Western Australia, Australia; Centre for Healthy Ageing, Murdoch University, 90 South St, Murdoch, Western Australia, Australia; School of Medical and Health Sciences, Edith Cowan University, 270 Joondalup Dr, Joondalup, Western Australia, Australia; School of Psychological Science, University of Western Australia, 35 Stirling Hwy, Crawley, Western Australia, Australia
| | - Hamid R Sohrabi
- Australian Alzheimer's Research Foundation, Sarich Neuroscience Research Institute Building, 8 Verdun St, Nedlands, Western Australia, Australia; Centre for Healthy Ageing, Murdoch University, 90 South St, Murdoch, Western Australia, Australia; School of Medical and Health Sciences, Edith Cowan University, 270 Joondalup Dr, Joondalup, Western Australia, Australia; Department of Biomedical Sciences, Macquarie University, Balaclava Rd, Macquarie Park, New South Wales, Australia
| | - Belinda M Brown
- Discipline of Exercise Science, College of Science, Health, Engineering and Education, Murdoch University, 90 South St, Murdoch, Western Australia, Australia; Australian Alzheimer's Research Foundation, Sarich Neuroscience Research Institute Building, 8 Verdun St, Nedlands, Western Australia, Australia; Centre for Healthy Ageing, Murdoch University, 90 South St, Murdoch, Western Australia, Australia
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