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Mediterranean diet habits in older individuals: Associations with cognitive functioning and brain volumes
Authors:Olga E Titova  Erika Ax  Samantha J Brooks  Per Sjögren  Tommy Cederholm  Lena Kilander  Joel Kullberg  Elna-Marie Larsson  Lars Johansson  Håkan Åhlström  Lars Lind  Helgi B Schiöth  Christian Benedict
Institution:1. Department of Neuroscience, Uppsala University, Sweden;2. Department of Public Health and Caring Sciences, Section of Clinical Nutrition and Metabolism, Uppsala University, Sweden;3. Department of Public Health and Caring Sciences/Geriatric, Uppsala University, Sweden;4. Department of Radiology, Uppsala University, Sweden;5. Department of Medical Sciences Neurology, Uppsala University, Sweden;6. Department of Psychiatry and Mental Health, University of Cape Town, South Africa
Abstract:To examine the association between dietary habits, cognitive functioning and brain volumes in older individuals, data from 194 cognitively healthy individuals who participated in the Prospective Investigation of the Vasculature in Uppsala Seniors cohort were used. At age 70, participants kept diaries of their food intake for 1 week. These records were used to calculate a Mediterranean diet (MeDi) score (comprising dietary habits traditionally found in Mediterranean countries, e.g. high intake of fruits and low intake of meat), with higher scores indicating more pronounced MeDi-like dietary habits. Five years later, participants' cognitive capabilities were examined by the seven minute screening (7MS) (a cognitive test battery used by clinicians to screen for dementia), and their brain volumes were measured by volumetric magnetic resonance imaging. Multivariate linear regression analyses were constructed to examine the association between the total MeDi score and cognitive functioning and brain volumes. In addition, possible associations between MeDi's eight dietary features and cognitive functioning and brain volumes were investigated. From the eight dietary features included in the MeDi score, pertaining to a low consumption of meat and meat products was linked to a better performance on the 7MS test (P = 0.001) and greater total brain volume (i.e. the sum of white and gray matter, P = 0.03) when controlling for potential confounders (e.g. BMI) in the analysis. Integrating all dietary features into the total MeDi score explained less variance in cognitive functioning and brain volumes than its single dietary component meat intake. These observational findings suggest that keeping to a low meat intake could prove to be an impact-driven public health policy to support healthy cognitive aging, when confirmed by longitudinal studies. Further, they suggest that the MeDi score is a construct that may mask possible associations of single MeDi features with brain health domains in elderly populations.
Keywords:AD  Alzheimer's Disease  CI  Confidence interval  EPN  Ethics Committee of Uppsala  FWE  Family Wise Error  MRI  Magnetic resonance imaging  MeDi  Mediterranean diet  MCI  Mild cognitive impairment  MMSE  Mini-mental state examination  PIVUS  Prospective Investigation of the Vasculature in Uppsala Seniors  7MS  Seven minute screening  SEM  Standard error of mean  SPM  Statistical parametric mapping  TFE  Turbo Field Echo  VBM  Voxel Based Morphometry
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