MeDi Adherence Research Articles

Mediterranean diet related to 3-year incidence of cognitive decline: results from a cohort study in Chinese rural elders

ABSTRACT Objective This study aims to examine the effect of the Mediterranean diet (MeDi) on cognitive decline among the Chinese elderly with a 3-year follow-up. Methods This study is divided into two waves: wave-1 January 2019 to June 2019 (n = 2313); wave-2 January 2022 to March 2022 (n = 1648). MeDi scores were calculated from the Mediterranean Diet Adherence Screener (MEDAS), with the scoring of low compliance (0–6 points) and high compliance (7–14 points). The Mini-Mental State Examination (MMSE) was used to assess cognitive function. An MMSE score dropping ≥ 2 points from baseline was defined as cognitive decline. The relationships between MeDi score and cognitive decline were analyzed by linear regression models or Binary logistic regression. Results During the 3-year follow-up, 23.8% of patients exhibited cognitive decline. The study revealed a significant difference in MMSE score changes between low and high MeDi adherence groups (p < 0.001). MeDi score was negatively correlated with cognitive deterioration (β = −0.020, p = 0.026). MeDi score was only negatively associated with cognitive decline in the female subgroup aged ≥65 years (β = −0.034, p = 0.033). The food beans (OR = 0.65, 95%CI:0.51, 0.84), fish (OR = 0.72, 95%CI:0.54, 0.97), and cooked vegetables (OR = 0.68, 95%CI:0.53, 0.84) were protective factors for cognitive decline. Conclusions This study suggests that greater adherence to the MeDi is linked to a reduced risk of cognitive decline in elderly people. However, this is found only in women who are 65 years old or older. It also found long-term adherence to beans, fish, and vegetables are more effective in improving cognitive function.

Abstract WMP24: Association of the Mediterranean Diet With White Matter Integrity Among Hispanics/Latinos. Results From the Study of Latinos-Investigation of Neurocognitive Aging-MRI Ancillary Study

Objective: Investigate the association between adherence to the Mediterranean Diet (MeDi) and white matter (WM) integrity among Hispanic/Latino adults. Background: High adherence to a MeDi was associated with better cognitive performance and decreased memory decline among Hispanic or Latino adults. Methods: We included 2,342 participants from the Study of Latinos-Investigation of Neurocognitive Aging-MRI Ancillary Study. Participants completed 24-hour dietary recalls at baseline (2008-2011) which were used to calculate a MeDi score (MeDiS). Brain MRI and diffusion tensor images were collected between 2018 and 2022 on a 3T MRI scanner using a standardized protocol. WM integrity was ascertained using WM hyperintensity (WMH) volume, fractional anisotropy (FA), and peak skeletonized mean diffusivity (PSMD). WMH volumes were residualized for total cranial volume and Ln-transformed prior to analysis. The association of MRI outcomes with MeDiS was investigated using weighted linear regression analysis with complex survey design adjusting for age, sex, sociodemographic characteristics, and Framingham Risk Score. Results: Mean age (95% CI) at MRI scan was 64.03 (63.1 - 64.9) and 44% were males. Mean MeDiS was 5.05 (4.92 - 5.17). In our fully adjusted model, increasing MeDiS was associated with decreased LnWMH volume (β=-0.07, 95% CI -0.10 to -0.03) and PSMD (β=-0.004, 95% CI -0.006 to -0.002), and increasing FA (β=0.002, 95% CI 0.001 to 0.003). When participants were grouped by background, the results were retained for all the groups except for Puerto Ricans and Mexicans. Conclusions: Among diverse Hispanic/Latino adults, high MeDi adherence was associated with preserved WM integrity. Since our preliminary results were retained after adjustment for Framingham Risk Score, this suggests that vascular mechanisms do not fully account for the observed associations. In addition, our results highlight that the results obtained in selected cohorts may not be generalizable to other Hispanic/Latino heritages. A culturally tailored MeDi may preserve brain health among Hispanic/Latino adults.

A 6-items Questionnaire (6-QMD) captures a Mediterranean like dietary pattern and is associated with memory performance and hippocampal volume in elderly and persons at risk for Alzheimer’s disease

BACKGROUND: There is evidence that adherence to Mediterranean-like diet reduces cognitive decline and brain atrophy in Alzheimer's disease (AD). However, lengthy dietary assessments, such as food frequency questionnaires (FFQs), discourage more frequent use. OBJECTIVE: Here we aimed to validate a 6-items short questionnaire for a Mediterranean-like diet (6-QMD) and explore its associations with memory performance and hippocampal atrophy in healthy elders and individuals at risk for AD. METHODS: We analyzed 938 participants (N = 234 healthy controls and N = 704 participants with an increased AD risk) from the DZNE-Longitudinal Cognitive Impairment and Dementia Study (DELCODE). The 6-QMD was validated against the Mediterranean Diet (MeDi) score and the Mediterranean-DASH Diet Intervention for Neurodegenerative Delay (MIND) score, both derived from a detailed FFQ. Furthermore, associations between the 6-QMD and memory function as well as hippocampal atrophy were evaluated using linear regressions. RESULTS: The 6-QMD was moderately associated with the FFQ-derived MeDi adherence score (ρ = 0.25, p &lt; 0.001) and the MIND score (ρ = 0.37, p= &lt; 0.001). Higher fish and olive oil consumption and lower meat and sausage consumption showed significant associations in a linear regression, adjusted for diagnosis, age, sex and education, with memory function (β = 0.1, p = 0.008) and bilateral hippocampal volumes (left: β = 0.15, p &lt; 0.001); (right: β = 0.18, p &lt; 0.001)). CONCLUSIONS: The 6-QMD is a useful and valid brief tool to assess the adherence to MeDi and MIND diets, capturing associations with memory function and brain atrophy in healthy elders and individuals at increased AD dementia risk, making it a valid alternative in settings with time constraints.

ASSOCIATIONS BETWEEN ADHERENCE TO THE MEDITERRANEAN DIET AND 24-HOUR PULSE WAVE VELOCITY IN HYPERTENSIVE PATIENTS

Objective: A Mediterranean diet (MeDi) is characterized by high consumption of plant-based food and fish, moderate consumption of red wine, and low intake of red and processed meat, and is associated with improvement in cardiometabolic risk factors. Arterial stiffness measured by pulse wave velocity (PWV) is considered a predictor of cardiovascular events, but the association between dietary intake according to MeDi and arterial stiffness is not yet clear. The aim of this study was to determine possible associations between MeDi adherence and PWV in patients with arterial hypertension (AH). Design and method: This study included 420 participants with AH of which 50.2% were women, with an overall median age of 63.5 years (IQR = 17.3). To assess 24-hour PWV parameter, a 24-hour ambulatory blood pressure monitor IEM Mobil-O-Graph based on the oscillometry was used. In order to determine adherence to the MeDi, a validated Mediterranean Diet Serving Score (MDSS) questionnaire was used. For every participant, data about comorbidities was collected from their medical records combined with their self reports. Results: Adherence to the MeDi defined as MDSS score &gt;14 was found in 6.4% of participants. The mean value of 24-hour PWV was 9.08±1.88 m/s. Significant differences in PWV value were not found among high adherence, medium adherence and low adherence to MeDi. Positive predictors of 24-hour PWV were older age (beta = 0.128, p&lt;0.001), presence of chronic kidney disease (beta = 0.312, p&lt;0.001) and adherence to the legumes intake recommendation (beta = 0.169, p = 0.037), while the negative predictor was adherence to the dairy intake recommendation (beta = -0.174, p = 0.024). Conclusions: Exceptionally low adherence to the principles of the MeDi was noticed in hypertensive patients, with dairy and legumes suggested as predictors of 24-hour PWV. This suggests a need for structural nutritional intervention to increase adherence to the MeDi in order to decrease and reduce cardiovascular risk in this population of patients.

Mediterranean diet is associated with a lower probability of prodromal Parkinson's disease and risk for Parkinson's disease/dementia with Lewy bodies: A longitudinal study.

Lifestyle factors have been implicated in the long-lasting neurodegenerative process in prodromal Parkinson's disease (pPD). The aim was to investigate the associations between adherence to a Mediterranean diet (MeDi) and longitudinal changes of pPD probability and the development of Parkinson's disease (PD) or pPD in a Mediterranean older population. Data from the Hellenic Longitudinal Investigation of Aging and Diet cohort (community-dwelling individuals, aged ≥ 65 years) were used. A detailed food frequency questionnaire was used to evaluate dietary intake and calculate MeDi adherence score, ranging from 0 to 55, with higher scores indicating higher adherence. The probability of pPD was calculated according to the updated Movement Disorder Society research criteria. In all, 1047 non-PD/dementia with Lewy bodies (DLB) participants were followed for 3± 1 years. MeDi adherence was associated with lower increase in pPD probability over time (b= -0.003, 95% confidence interval -0.006 to -0.001, p= 0.010). Forty-nine participants had incident possible/probable pPD (i.e., pPD probability ≥ 30%). Compared to the participants in the lowest quartile of MeDi adherence, those in the higher quartiles had an approximately 60%-70% lower risk for possible/probable pPD (p for trend0.003). MeDi-pPD associations were driven by both motor and non-motor pPD markers and not from risk markers. Also, 21 participants were diagnosed with PD/DLB at follow-up. For each unit increase in the MeDi score, there was a 9%-10% lower risk for PD/DLB (hazard ratio 0.906 [95% confidence interval 0.823-0.997], p= 0.044). Mediterranean diet adherence is associated with lower increase in pPD probability over time and lower possible/probable pPD and PD/DLB incidence in older Mediterranean people. More studies are needed to confirm our results in other populations.

Association of Dietary Patterns with Parkinson’s Disease: A Cross-Sectional Study Based on the United States National Health and Nutritional Examination Survey Database

Introduction: Although studies have explored some dietary patterns for Parkinson’s disease (PD), more other dietary patterns and food item under the dietary pattern are needed to investigate. This study aimed to identify more categories of dietary patterns for PD and further explore the association of single food item with PD. Methods: The 2015–2018 US National Health and Nutritional Examination Survey (NHANES) database was used for data extraction. The data on demographics and nutrient intake were collected. Dietary patterns were derived from food categories by factor analysis. The association between dietary patterns or single food item and PD was explored using logistic regression analysis in the overall and only in secure PD cases, and results were expressed as odds ratio (OR) with 95% confidence intervals (CIs). Sensitivity analysis was performed by excluding participants using unsecure PD medication. Results: Among 5,824 participants aged over 50 years, 91 were diagnosed as PD. Factor analysis identified 5 major dietary pattern factors. We observed that the increased adherence to Mediterranean diet (MeDi) was associated with the reduced odds of PD (OR = 0.78, 95% CI: 0.65–0.93). The higher adherence to Western pattern was associated with the increased odds of PD (OR = 2.19, 95% CI: 1.16–4.14). In addition, high intake of sweets under Western pattern was found to be associated with the higher odds of PD (OR = 2.01, 95% CI: 1.08–3.71). Conclusions: The odds of PD decreased by higher MeDi adherence and increased by higher Western pattern adherence, especially sweets intake in this pattern, suggesting population ≥50 years should adhere to MeDi pattern and decrease the adherence to Western pattern, reducing the intake of sweets.

Mediterranean Diet Adherence and Risk of Depressive Symptomatology in a French Population-Based Cohort of Older Adults.

Several foods from the Mediterranean Diet (MeDi) have already been characterized as beneficial for depression risk, while studies focusing on adherence to the overall MeDi are lacking among older adults at higher risk of depression. The aim of this study was to assess the association between MeDi adherence and the risk of depressive symptomatology (DS) in an older French cohort followed for 15 years. Participants from the Three-City Bordeaux cohort answered a food frequency questionnaire used to assess their MeDi adherence. The Center for Epidemiologic Studies Depression (CES-D) scale score of 16 or greater and/or use of antidepressant treatment ascertained at each visit defined incident DS. Random-effect logistic regression models were adjusted for potential confounders. Among 1018 participants, aged 75.6 years (SD 4.8 years) on average at baseline, 400 incident cases of DS were identified during the follow-up. Only when restricting the definition of DS to a CES-D score ≥ 16 was a borderline-significant trend towards a benefit of greater adherence to the MeDi with reduced odds of DS found (p-value = 0.053). In this large sample of older French adults, a potential benefit of greater adherence to the MeDi regarding the risk of DS would depend on the definition of DS.

Diet moderates the effect of resting state functional connectivity on cognitive function

Past research suggests modifiable lifestyle factors impact structural and functional measures of brain health, as well as cognitive performance, but no study to date has tested the effect of diet on resting state functional connectivity (rsFC), and its relationship with cognition. The current study tested whether Mediterranean diet (MeDi) moderates the associations between internetwork rsFC and cognitive function. 201 cognitively intact adults 20–80 years old underwent resting state fMRI to measure rsFC among 10 networks, and completed 12 cognitive tasks assessing perceptual speed, fluid reasoning, episodic memory, and vocabulary. Food frequency questionnaires were used to categorize participants into low, moderate, and high MeDi adherence groups. Multivariable linear regressions were used to test associations between MeDi group, task performance, and internetwork rsFC. MeDi group moderated the relationship between rsFC and fluid reasoning for nine of the 10 functional networks’ connectivity to all others: higher internetwork rsFC predicted lower fluid reasoning performance in the low MeDi adherence group, but not in moderate and high MeDi groups. Results suggest healthy diet may support cognitive ability despite differences in large-scale network connectivity at rest. Further research is warranted to understand how diet impacts neural processes underlying cognitive function over time.

Mediterranean Diet and White Matter Hyperintensity Change over Time in Cognitively Intact Adults.

Current evidence on the impact of Mediterranean diet (MeDi) on white matter hyperintensity (WMH) trajectory is scarce. This study aims to examine whether greater adherence to MeDi is associated with less accumulation of WMH. This population-based longitudinal study included 183 cognitively intact adults aged 20–80 years. The MeDi score was obtained from a self-reported food frequency questionnaire; WMH was assessed by 3T MRI. Multivariable linear regression was used to estimate the effect of MeDi on WMH change. Covariates included socio-demographic factors and brain markers. Moderation effects by age, gender, and race/ethnicity were examined, followed by stratification analyses. Among all participants, WMH increased from baseline to follow-up (mean difference [follow-up-baseline] [standard deviation] = 0.31 [0.48], p < 0.001). MeDi adherence was negatively associated with the increase in WMH (β = −0.014, 95% CI = −0.026–−0.001, p = 0.034), adjusting for all covariates. The association between MeDi and WMH change was moderated by age (young group = reference, p-interaction[middle-aged × MeDi] = 0.075, p-interaction[older × MeDi] = 0.037). The association between MeDi and WMH change was observed among the young group (β = −0.035, 95% CI = −0.058–−0.013, p = 0.003), but not among other age groups. Moderation effects by gender and race/ethnicity did not reach significance. Greater adherence to MeDi was associated with a lesser increase in WMH over time. Following a healthy diet, especially at younger age, may help to maintain a healthy brain.

Interconnectedness between periodontitis stage, oral hygiene habits, adherence to the Mediterranean diet and nutritional status in Dalmatian kidney transplant recipients: a cross-sectional study

The aim of this cross-sectional study was to determine the associations between the Mediterranean diet (MeDi), nutritional status parameters, muscle strength, and periodontal status in Dalmatian kidney transplant recipients (KTRs). 89 KTRs were included in this analysis, 40 (45%) women, with a mean age of 61 years (IQR = 13) and a mean time since kidney transplantation of 5 years (IQR = 6.6). An OHIP-14 questionnaire and questionnaire-based periodontal history were obtained from all participants, a comprehensive periodontal examination was performed. Body composition data, anthropometric and clinical parameters were collected for each study participant. The Mediterranean Diet Serving Score (MDSS) was used to assess MeDi adherence, and handgrip strength was measured with a hand dynamometer. Our results showed low adherence to MeDi in KTRs (28%) and almost 50% of KTRs suffer from severe forms of periodontitis. We also found a low OHIP-14 score and poor oral hygiene habits. KTRs with a less severe form of periodontitis had higher muscle mass and handgrip strength. MDSS score was associated with a higher number of teeth, and everyday cereal intake was inversely associated with the periodontitis stage. Our results demonstrate the associations between nutritional status, muscle strength, dietary habits, and periodontal health in Dalmatian KTRs.

Anthropometric Parameters and Mediterranean Diet Adherence in Preschool Children in Split-Dalmatia County, Croatia-Are They Related?

Obesity is a rapidly growing problem in European countries, Croatia being among them. According to the latest CroCOSI data, every third child in Croatia aged 8.0–8.9 years is overweight or obese. The Mediterranean diet (MeDi) and its impact on nutritional status and health has been the focus of recent research. Therefore, the aim of this cross-sectional, observational study was to determine the nutritional status and adherence to the MeDi of preschool children in Split, Croatia. We included 598 preschool children aged 3 to 7 years and, for each child, parents completed a lifestyle questionnaire and the Mediterranean Diet Quality Index (KIDMED) in order to assess adherence to the MeDi. The anthropometric assessment included the measurement of weight, height, mid-upper arm circumference (MUAC), waist circumference (WC) and the z-score was calculated. According to the z-score, 420 (70.2%) children had a healthy body weight with 54 (9%) underweight and 124 (20.8%) overweight or obese children. Almost half (49%) of the study participants had a low KIDMED index score, indicating a low MeDi adherence, 37% had an average score, while only 14% had high MeDi compliance. Statistically significant negative correlations between MUAC and WC and the consumption of a second daily serving of fruit (p = 0.04) as well as a daily serving of vegetables (p = 0.03) were found. In conclusion, low compliance to the MeDi principles in preschool children is concerning. Considering the beneficial effects of the MeDi on overall health, further education, and the adoption of healthy eating habits in preschool children in this Mediterranean region are required.

Mediterranean Diet Adherence and Nutritional Status in Dalmatian Kidney Transplant Recipients-Are They Related?

The aim of this study was to evaluate adherence to Mediterranean diet (MeDi) and possible correlation of MeDi adherence and nutritional status parameters in Dalmatian kidney transplant recipients (KTRs). One hundred and sixteen KTRs were included in this study. Data about Mediterranean Diet Serving Score (MDSS), body mass composition, anthropometric parameters, clinical and laboratory parameters were collected for each study participant. The results showed 25% adherence to the MeDi in Dalmatian KTRs. MDSS showed association with higher serum albumin and phosphorus level and higher skeletal muscle mass. Also, significant association between diabetic status and MDSS was found. Adherence to olive oil intake suggested by the MeDi showed significant association with lower level of triglycerides and adherence to nuts suggestions was associated with lower level of fat mass. Following MeDi recommendations for consumption of other foods (cereals, potato, eggs, vegetables, fruits and dairy) were also associated with body mass composition parameters and laboratory findings. In conclusion, low adherence to the MeDi in Dalmatian KTRs raises high concerns. The results showed that MeDi can have favorable effects on nutritional status in KTRs. A structured nutritional approach is needed to enhance adherence to the MeDi and prevent possible adverse effects in this patient population.

Mediterranean Diet, Alzheimer Disease Biomarkers and Brain Atrophy in Old Age.

To determine whether following a Mediterranean-like diet (MeDi) relates to cognitive functions and in vivo biomarkers for Alzheimer disease (AD), we analyzed cross-sectional data from the German DZNE-Longitudinal Cognitive Impairment and Dementia Study. METHOD: The sample (n=512, mean age: 69.5±5.9 years) included 169 cognitively normal participants and subjects at higher AD risk (53 with relatives with AD, 209 with subjective cognitive decline, and 81 with mild cognitive impairment). We defined MeDi adherence based on the Food Frequency Questionnaire. Brain volume outcomes were generated via voxel-based morphometry on T1-MRI and cognitive performance with an extensive neuropsychological battery. AD-related biomarkers (Aβ42/40 ratio, pTau181) in cerebrospinal fluid were assessed in n=226 individuals. We analyzed the associations between MeDi and the outcomes with linear regression models controlling for several covariates. Additionally, we applied hypothesis-driven mediation and moderation analysis. Higher MeDi adherence related to larger mediotemporal gray matter volume (p<0.05 FWE corrected), better memory (β±SE = 0.03 ± 0.02; p=0.038), and less amyloid (Aβ42/40 ratio, β±SE = 0.003 ± 0.001; p=0.008) and pTau181 pathology (β±SE = -1.96±0.68; p=0.004). Mediotemporal volume mediated the association between MeDi and memory (40% indirect mediation). Finally, MeDi favorably moderated the associations between Aβ42/40 ratio, pTau181 and mediotemporal atrophy. Results were consistent correcting for ApoE-ε4 status. Our findings corroborate the view of MeDi as a protective factor against memory decline and mediotemporal atrophy. Importantly, they suggest that these associations might be explained by a decrease of amyloidosis and tau-pathology. Longitudinal and dietary intervention studies should further examine this conjecture and its treatment implications.

Mediterranean diet and risk for dementia and cognitive decline in a Mediterranean population.

Current evidence suggests that nutrition in general and specific dietary patterns in particular, such as the Mediterranean type diet (MeDi), can be employed as potential preventive strategies against the development of dementia and cognitive decline. However, longitudinal data exploring the applicability of these findings in populations of Mediterranean origin are limited. The aim of the present study was to explore the potential relationships of MeDi adherence with dementia incidence rates and cognitive change over time in a traditional Mediterranean population, characterized by a lifelong exposure to Mediterranean eating habits and lifestyle. The sample consisted of 1046 non-demented individuals over the age of 64 (mean age=73.1; SD=5.0), with available baseline dietary information and longitudinal follow-up. Diagnosis of dementia was made by a full clinical and neuropsychological evaluation, while cognitive performance was assessed according to five cognitive domains (memory, language, attention-speed, executive functioning, visuospatial perception) and a global cognitive score. Adherence to MeDi was evaluated by an a priori score (range 0-55), derived from a detailed food frequency questionnaire. A total of 62 incident dementia cases occurred during a mean (SD) of 3.1 (0.9) years of follow-up. Individuals in the highest MeDi quartile (highest adherence to MeDi) had a 72% lower risk for development of dementia, compared to those in the lowest one (p= 0.013). In addition, analysis of cognitive performance as a function of MeDi score revealed that the biennial cognitive benefit of a 10-unit increase in MeDi score offsets the cognitive decline associated with 1year of cognitive aging. In the present study, higher adherence to MeDi was associated with a reduced risk for dementia and cognitive decline in a traditional Mediterranean population.

Abstract MP26: Mediterranean Diet And Brain Magnetic Resonance Imaging Measures In Young And Older Adults

Introduction: Accumulative evidence has suggested that higher adherence to a healthy dietary pattern, such as Mediterranean diet (MeDi), is associated with preservation of brain structure and less cerebrovascular events. Little is known for these associations across lifespan. Hypothesis: We hypothesized that MeDi was associated with brain atrophy or small vessel pathology measured using magnetic resonance imaging (MRI) in a cohort of healthy adults aged 20-80. Methods: This cross-sectional study included 375 healthy, non-demented adults recruited from market mailing within a 50-mile radius of Columbia University Medical Center in New York City. The participants age ranged 20-80 years old (mean 55, SD=16); had on average 16 (SD=2.3) years of education; 210 (56%) were females; 67% were Whites, 20% African-Americans, and 13% others. MeDi score (range 0-9) was calculated based on food consumption information collected through food-frequency questionnaire. Total brain volume (TBV) and white matter hyperintensity (WMH) were derived from high-resolution structural MRI scans. We examined the association of MeDi with TBV (milliliter, adjusted for intracranial volume) and WMH (milliliter, log transformed) using regression models adjusted for age, gender, race, education, and total caloric intake. Stratified analyses were performed among young (20-45), mid-age (46-65), and older (65-80) adults. Results: In multivariable-adjusted linear regression models, one unit increase in MeDi score, indicating consumption of one more food meeting the desirable level, was associated with larger TBV (β=2.79, p=0.027) and of less WMH (β= -0.058, p=0.041), corresponding to roughly 1.8 years and 1.3 years of less aging (β=-1.54 for age on TBV and 0.044 for age on WMH), respectively. Furthermore, we found the association between MeDi and TBV was similar across age groups, while the association between MeDi and WMH was only significant in the young adults (b=-0.189, p=0.002). Conclusions: Higher MeDi adherence was associated with healthier brain, indicated by larger brain volumes and less white matter lesion burden. These findings suggest that following a healthy diet may help maintain brain health across life span. To our knowledge, this is the first study to examine the relation of MeDi adherence to brain measures in healthy adults of all ages. The novel findings, especially the finding of MeDi and WMH in young adults, are worth of further confirmation in larger and longitudinal studies.

Mediterranean diet adherence and rate of cerebral A\u03b2-amyloid accumulation: Data from the Australian Imaging, Biomarkers and Lifestyle Study of Ageing

ABSTRACTAccumulating research has linked Mediterranean diet (MeDi) adherence with slower cognitive decline and reduced Alzheimer’s disease (AD) risk. However, no study to-date has examined the relationship between MeDi adherence and accumulation of cerebral Aβ-amyloid (Aβ; a pathological hallmark of AD) in older adults. Cognitively normal healthy control participants of the Australian Imaging, Biomarkers and Lifestyle (AIBL) Study of Ageing completed the Cancer Council of Victoria Food Frequency Questionnaire at baseline, which was used to construct a MeDi score for each participant (score range 0–9; higher score indicating higher adherence). Cerebral Aβ load was quantified by Pittsburgh Compound B positron emission tomography at baseline, 18 and 36 months: Only individuals categorised as “Aβ accumulators”, and thus considered to be on the AD pathway, were included in the analysis (N = 77). The relationship between MeDi adherence, MeDi components, and change in cerebral Aβ load (baseline to 36 months) was evaluated using Generalised Linear Modelling, accounting for age, gender, education, Apolipoprotein E ε4 allele status, body mass index and total energy intake. Higher MeDi score was associated with less Aβ accumulation in our cohort (β = −0.01 ± 0.004, p = 0.0070). Of the individual MeDi score components, a high intake of fruit was associated with less accumulation of Aβ (β = −0.04 ± 0.01, p = 0.00036). Our results suggest MeDi adherence is associated with reduced cerebral AD pathology accumulation over time. When our results are considered collectively with previous data linking the MeDi to slower cognitive decline, it is apparent that MeDi adherence warrants further investigation in the quest to delay AD onset.

Associations between the mediterranean diet and sleep in older adults: Results from the hellenic longitudinal investigation of aging and diet study.

Although there is some evidence of the relationships between sleep duration/quality and nutrient and/or food intake, the associations between sleep and dietary patterns have been poorly explored. The aim of the present study was to evaluate sleep duration and quality in relation to adherence to the Mediterranean diet (MeDi), and to investigate the sex- and age-specific associations in a population-representative cohort of older adults. Participants from the Hellenic Longitudinal Investigation of Aging and Diet were included. The sample consisted of 1639 adults aged ≥65 years. Sleep duration and quality were assessed through a self-report questionnaire, whereas adherence to the MeDi was evaluated by an a priori score. Sleep quality was positively associated with the MeDi in the unadjusted and the adjusted model (age, sex, depression, years of education, body mass index, level of physical activity and total energy intake were added as covariates). In contrast, sleep duration was not associated with MeDi adherence either in the unadjusted or the adjusted models. In relation to the age-related associations, sleep quality was positively associated with MeDi adherence in those aged ≤75 years, and not in those aged >75 years. Associations between sleep and MeDi did not differ between men and women. The present results suggest that sleep quality is associated with MeDi adherence in older adults; there are also age-specific associations between sleep quality and the MeDi. Although additional studies are required, improvements in diet quality should be considered in the context of sleep management interventions in older individuals. Geriatr Gerontol Int 2018; 18: 1543-1548.

Mediterranean diet and 3-year Alzheimer brain biomarker changes in middle-aged adults

To examine in a 3-year brain imaging study the effects of higher vs lower adherence to a Mediterranean-style diet (MeDi) on Alzheimer disease (AD) biomarker changes (brain β-amyloid load via 11C-Pittsburgh compound B [PiB] PET and neurodegeneration via 18F-fluorodeoxyglucose [FDG] PET and structural MRI) in midlife. Seventy 30- to 60-year-old cognitively normal participants with clinical, neuropsychological, and dietary examinations and imaging biomarkers at least 2 years apart were examined. These included 34 participants with higher (MeDi+) and 36 with lower (MeDi-) MeDi adherence. Statistical parametric mapping and volumes of interest were used to compare AD biomarkers between groups at cross section and longitudinally. MeDi groups were comparable for clinical and neuropsychological measures. At baseline, compared to the MeDi+ group, the MeDi- group showed reduced FDG-PET glucose metabolism (CMRglc) and higher PiB-PET deposition in AD-affected regions (p < 0.001). Longitudinally, the MeDi--group showed CMRglc declines and PiB increases in these regions, which were greater than those in the MeDi+ group (pinteraction < 0.001). No effects were observed on MRI. Higher MeDi adherence was estimated to provide 1.5 to 3.5 years of protection against AD. Lower MeDi adherence was associated with progressive AD biomarker abnormalities in middle-aged adults. These data support further investigation of dietary interventions for protection against brain aging and AD.

Adherence to a Mediterranean diet is associated with the presence and extension of atherosclerotic plaques in middle-aged asymptomatic adults: The Aragon Workers' Health Study

The Mediterranean diet (MeDi) is known to prevent cardiovascular events but the mechanisms mediating this association are not fully understood. The objective of the study was to examine the association between MeDi adherence and the presence and extent of atherosclerotic plaques in carotid, femoral, and aorta territories and its relationship with risk factors in asymptomatic middle-aged adults. Cross-sectional analysis of the Aragon Workers' Health Study, a cohort of 2588 subjects (94.9% men aged 51.3±3.89years) without previous cardiovascular history. Participants underwent carotid, femoral, and aorta ultrasound for the quantification of number and thickness of plaques and intima-media thickness. To estimate the participant's adherence to MeDi, we computed the Alternative MEDiterranean index (aMED). The overall aMED score was 4.19±1.70, representing a moderate adherence to MeDi. aMED score was associated with the presence of plaque in femoral arteries (odds ratio highest vs lowest aMED score quartile: 0.63; 95% confidence interval: 0.48-0.83; P trend=.045) independently of risk factors and mediators. The strongest association between aMED quartiles and presence of plaque was found among smokers, both in femoral (0.39 [0.22-0.69]; P trend=.001) and in any territory (0.33 [0.14-0.79], P trend=.008). aMED was inversely associated with the number of plaques in all territories except for carotids. MeDi adherence showed a dose-dependent protective association with the presence, number, and thickness of plaques independent of other risk factors. The association was strongest for femoral arteries and among smokers.

High adherence to a Mediterranean diet and lower risk of frailty among French older adults community-dwellers: Results from the Three-City-Bordeaux Study

Mediterranean diet (MeDi) is considered as a key component for healthy aging, including prevention of age-related disability, while its association with frailty, independent of disability has never been assessed. Our objective was to investigate the relation between MeDi adherence and frailty incidence among persons aged ≥75 years participating at the prospective population-based French Three-City Study. The study sample consisted of 560 initially non-frail participants of the Three-City-Bordeaux center, seen at the 2009-2010 follow-up, and re-examined two years later. Adherence to MeDi was computed from a food frequency questionnaire (scored as 0-9). Frailty was defined as having at least three out of the following five slightly modified Fried frailty criteria: involuntary weight loss, exhaustion, slowness, weakness and low physical activity. Logistic regression models adjusted for sociodemographic and clinical covariates, including cognitive performance and depressive symptomatology, were used to assess the association between MeDi score and subsequent frailty risk. Over the 2-year follow-up, 79 participants (14%) became frail. Older adults with the highest MeDi adherence (score 6-9) had a significantly 68% frailty risk reduction (95% CI: 28-86%, p=0.006) compared to those in the lowest MeDi category (score 0-3). Regarding the frailty criterion separately, the highest MeDi adherence was associated with a significantly reduced risk of incident slowness (OR=0.45; 95% CI: 0.20-0.99, p=0.04), poor muscle strength (OR=0.44; 95% CI: 0.20-0.98, p=0.04) and low physical activity (OR=0.39; 95% CI: 0.18-0.82, p=0.01), compared to the lowest MeDi adherence. In addition to its well-documented beneficial effects on health, adherence to MeDi might contribute to prevent the onset of frailty, even at late stages of life.