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J Alzheimers Dis. 2010;19(4):1123-39. doi: 10.3233/JAD-2010-1312.
Neuronutrition and Alzheimer's disease.
Ramesh BN1, Rao TS, Prakasam A, Sambamurti K, Rao KS.
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Abstract
Alzheimer's disease (AD) is a complex neurological disorder resulting from both genetic and environmental factors with the latter being particularly important for the sporadic form of the disease. As such, diets rich in saturated fatty acids and alcohol, and deficient in antioxidants and vitamins appear to promote the onset of the disease, while diets rich in unsaturated fatty acids, vitamins, antioxidants, and wine likely suppress its onset. In addition, evidence suggests that diets rich in polyphenols and some spices suppress the onset of AD by scavenging free radicals and preventing oxidative damage. Metal ions are known to catalyze the production of free radicals and induce mental retardation or dementia, and several studies have also identified metals such as Pb, Fe, Al, Cu, and Zn in AD pathogenesis. While specific metal chelators have been tested for therapy, they have not been very successful, probably due to their late administration, i.e., after brain damage has been triggered. Since several dietary polyphenols are known to chelate metals, their routine use may also be protective against the onset of AD. In this review, we summarize beneficial dietary techniques in the fight against AD.
PMID: 20308778 PMCID: PMC2931824 DOI: 10.3233/JAD-2010-1312
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JAMA Intern Med. 2015 Jul;175(7):1094-103. doi: 10.1001/jamainternmed.2015.1668.
Mediterranean Diet and Age-Related Cognitive Decline: A Randomized Clinical Trial.
Valls-Pedret C1, Sala-Vila A1, Serra-Mir M1, Corella D2, de la Torre R3, Martínez-González MÁ4, Martínez-Lapiscina EH4, Fitó M3, Pérez-Heras A1, Salas-Salvadó J5, Estruch R6, Ros E1.
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Abstract
IMPORTANCE:
Oxidative stress and vascular impairment are believed to partly mediate age-related cognitive decline, a strong risk factor for development of dementia. Epidemiologic studies suggest that a Mediterranean diet, an antioxidant-rich cardioprotective dietary pattern, delays cognitive decline, but clinical trial evidence is lacking.
OBJECTIVE:
To investigate whether a Mediterranean diet supplemented with antioxidant-rich foods influences cognitive function compared with a control diet.
DESIGN, SETTING, AND PARTICIPANTS:
Parallel-group randomized clinical trial of 447 cognitively healthy volunteers from Barcelona, Spain (233 women [52.1%]; mean age, 66.9 years), at high cardiovascular risk were enrolled into the Prevención con Dieta Mediterránea nutrition intervention trial from October 1, 2003, through December 31, 2009. All patients underwent neuropsychological assessment at inclusion and were offered retesting at the end of the study.
INTERVENTIONS:
Participants were randomly assigned to a Mediterranean diet supplemented with extravirgin olive oil (1 L/wk), a Mediterranean diet supplemented with mixed nuts (30 g/d), or a control diet (advice to reduce dietary fat).
MAIN OUTCOMES AND MEASURES:
Rates of cognitive change over time based on a neuropsychological test battery: Mini-Mental State Examination, Rey Auditory Verbal Learning Test (RAVLT), Animals Semantic Fluency, Digit Span subtest from the Wechsler Adult Intelligence Scale, Verbal Paired Associates from the Wechsler Memory Scale, and the Color Trail Test. We used mean z scores of change in each test to construct 3 cognitive composites: memory, frontal (attention and executive function), and global.
RESULTS:
Follow-up cognitive tests were available in 334 participants after intervention (median, 4.1 years). In multivariate analyses adjusted for confounders, participants allocated to a Mediterranean diet plus olive oil scored better on the RAVLT (P = .049) and Color Trail Test part 2 (P = .04) compared with controls; no between-group differences were observed for the other cognitive tests. Similarly adjusted cognitive composites (mean z scores with 95% CIs) for changes above baseline of the memory composite were 0.04 (-0.09 to 0.18) for the Mediterranean diet plus olive oil, 0.09 (-0.05 to 0.23; P = .04 vs controls) for the Mediterranean diet plus nuts, and -0.17 (-0.32 to -0.01) for the control diet. Respective changes from baseline of the frontal cognition composite were 0.23 (0.03 to 0.43; P = .003 vs controls), 0.03 (-0.25 to 0.31), and -0.33 (-0.57 to -0.09). Changes from baseline of the global cognition composite were 0.05 (-0.11 to 0.21; P = .005 vs controls) for the Mediterranean diet plus olive oil, -0.05 (-0.27 to 0.18) for the Mediterranean diet plus nuts, and -0.38 (-0.57 to -0.18) for the control diet. All cognitive composites significantly (P < .05) decreased from baseline in controls.
CONCLUSIONS AND RELEVANCE:
In an older population, a Mediterranean diet supplemented with olive oil or nuts is associated with improved cognitive function.
TRIAL REGISTRATION:
isrctn.org Identifier: ISRCTN35739639.
Comment in
PMID: 25961184 DOI: 10.1001/jamainternmed.2015.1668
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  • Am J Prev Med. 2014 Oct;47(4):444-51. doi: 10.1016/j.amepre.2014.05.037. Epub 2014 Jul 29.
  • Regular fish consumption and age-related brain gray matter loss.
  • Raji CA1, Erickson KI2, Lopez OL3, Kuller LH4, Gach HM2, Thompson PM5, Riverol M6, Becker JT7.
  • Author information
  • Abstract
  • BACKGROUND:
  • Brain health may be affected by modifiable lifestyle factors; consuming fish and antioxidative omega-3 fatty acids may reduce brain structural abnormality risk.
  • PURPOSE:
  • To determine whether dietary fish consumption is related to brain structural integrity among cognitively normal elders.
  • METHODS:
  • Data were analyzed from 260 cognitively normal individuals from the Cardiovascular Health Study with information on fish consumption from the National Cancer Institute Food Frequency Questionnaire and brain magnetic resonance imaging (MRI). The relationship between fish consumption data collected in 1989-1990 and brain structural MRI obtained in 1998-1999 was assessed using voxel-based morphometry in multiple regression analyses in 2012. Covariates were age, gender, race, education, white matter lesions, MRI-identified infarcts, waist-hip ratio, and physical activity as assessed by the number of city blocks walked in 1 week. Volumetric changes were further modeled with omega-3 fatty acid estimates to better understand the mechanistic link between fish consumption, brain health, and Alzheimer disease.
  • RESULTS:
  • Weekly consumption of baked or broiled fish was positively associated with gray matter volumes in the hippocampus, precuneus, posterior cingulate, and orbital frontal cortex even after adjusting for covariates. These results did not change when including omega-3 fatty acid estimates in the analysis.
  • CONCLUSIONS:
  • Dietary consumption of baked or broiled fish is related to larger gray matter volumes independent of omega-3 fatty acid content. These findings suggest that a confluence of lifestyle factors influence brain health, adding to the growing body of evidence that prevention strategies for late-life brain health need to begin decades earlier.
  • Copyright © 2014 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.
  • PMID: 25084680 PMCID: PMC4171345 DOI: 10.1016/j.amepre.2014.05.037
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  • Nat Neurosci. 2014 Dec;17(12):1798-803. doi: 10.1038/nn.3850. Epub 2014 Oct 26.
  • Enhancing dentate gyrus function with dietary flavanols improves cognition in older adults.
  • Brickman AM1, Khan UA1, Provenzano FA1, Yeung LK1, Suzuki W2, Schroeter H3, Wall M4, Sloan RP4, Small SA5.
  • Author information
  • Abstract
  • The dentate gyrus (DG) is a region in the hippocampal formation whose function declines in association with human aging and is therefore considered to be a possible source of age-related memory decline. Causal evidence is needed, however, to show that DG-associated memory decline in otherwise healthy elders can be improved by interventions that enhance DG function. We addressed this issue by first using a high-resolution variant of functional magnetic resonance imaging (fMRI) to map the precise site of age-related DG dysfunction and to develop a cognitive task whose function localized to this anatomical site. Then, in a controlled randomized trial, we applied these tools to study healthy 50-69-year-old subjects who consumed either a high or low cocoa flavanol-containing diet for 3 months. A high-flavanol intervention was found to enhance DG function, as measured by fMRI and by cognitive testing. Our findings establish that DG dysfunction is a driver of age-related cognitive decline and suggest non-pharmacological means for its amelioration.
  • Comment in
  • PMID: 25344629 PMCID: PMC4940121 DOI: 10.1038/nn.3850
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  • Ann Neurol. 2012 Jul;72(1):135-43. doi: 10.1002/ana.23594. Epub 2012 Apr 26.
  • Dietary intakes of berries and flavonoids in relation to cognitive decline.
  • Devore EE1, Kang JH, Breteler MM, Grodstein F.
  • Author information
  • Abstract
  • OBJECTIVE:
  • Berries are high in flavonoids, especially anthocyanidins, and improve cognition in experimental studies. We prospectively evaluated whether greater long-term intakes of berries and flavonoids are associated with slower rates of cognitive decline in older women.
  • METHODS:
  • Beginning in 1980, a semiquantitative food frequency questionnaire was administered every 4 years to Nurses' Health Study participants. In 1995-2001, we began measuring cognitive function in 16,010 participants, aged ≥70 years; follow-up assessments were conducted twice, at 2-year intervals. To ascertain long-term diet, we averaged dietary variables from 1980 through the initial cognitive interview. Using multivariate-adjusted, mixed linear regression, we estimated mean differences in slopes of cognitive decline by long-term berry and flavonoid intakes.
  • RESULTS:
  • Greater intakes of blueberries and strawberries were associated with slower rates of cognitive decline (eg, for a global score averaging all 6 cognitive tests, for blueberries: p-trend = 0.014 and mean difference = 0.04, 95% confidence interval [CI] = 0.01-0.07, comparing extreme categories of intake; for strawberries: p-trend = 0.022 and mean difference = 0.03, 95% CI = 0.00-0.06, comparing extreme categories of intake), after adjusting for multiple potential confounders. These effect estimates were equivalent to those we found for approximately 1.5 to 2.5 years of age in our cohort, indicating that berry intake appears to delay cognitive aging by up to 2.5 years. Additionally, in further supporting evidence, greater intakes of anthocyanidins and total flavonoids were associated with slower rates of cognitive decline (p-trends = 0.015 and 0.053, respectively, for the global score).
  • INTERPRETATION:
  • Higher intake of flavonoids, particularly from berries, appears to reduce rates of cognitive decline in older adults.
  • Copyright © 2012 American Neurological Association.
  • PMID: 22535616 PMCID: PMC3582325 DOI: 10.1002/ana.23594
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