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Potential benefits of adherence to the Mediterranean diet on cognitive health

  • Catherine Féart (a1), Cecilia Samieri (a1), Benjamin Allès (a1) and Pascale Barberger-Gateau (a1)
Abstract

The purpose of this review was to update available knowledge on the relationship between adherence to the Mediterranean diet (MeDi) and cognitive decline, risk of dementia or Alzheimer's Disease (AD), and to analyse the reasons for some inconsistent results across studies. The traditional MeDi has been recognised by the United Nations Educational Scientific and Cultural Organisation as an Intangible Cultural Heritage of Humanity. This dietary pattern is characterised by a high consumption of plant foods (i.e. vegetables, fruits, legumes and cereals), a high intake of olive oil as the main source of fat, a moderate intake of fish, low-to-moderate intake of dairy products and low consumption of meat and poultry, with wine consumed in low-to-moderate amounts during meals. Beyond the well-known association between higher adherence to the MeDi and lower risk of mortality, in particular from CVD and cancer, new data from large epidemiological studies suggest a relationship between MeDi adherence and cognitive decline or risk of dementia. However, some inconsistent results have been found as well, even in Mediterranean countries. In this review, we analyse the reasons likely to explain these discrepancies, and propose that most of these differences are due to variations in the methodology used to assess MeDi adherence. We also discuss the possibility of residual confounding by lifestyle, that is, greater adherents to the MeDi also have a healthier lifestyle in general, which can favourably affect cognition. In conclusion, large-scale studies in various populations with common methodology are required before considering the MeDi as an optimal dietary strategy to prevent cognitive decline or dementia.

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Corresponding author
* Corresponding author: Dr Catherine Féart, fax +33 5 5757 1486, email Catherine.Feart@isped.u-bordeaux2.fr
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This list contains references from the content that can be linked to their source. For a full set of references and notes please see the PDF or HTML where available.

1. A Keys , A Menotti , MJ Karvonen (1986) The diet and 15-year death rate in the seven countries study. Am J Epidemiol 124, 903915.

3. F Sofi , F Cesari , R Abbate (2008) Adherence to Mediterranean diet and health status: meta-analysis. Br Med J 337, a1344.

4. F Sofi , R Abbate , GF Gensini (2010) Accruing evidence on benefits of adherence to the Mediterranean diet on health: an updated systematic review and meta-analysis. Am J Clin Nutr 92, 11891196.

5. B Alles , C Samieri , C Feart (2012) Dietary patterns: a novel approach to examine the link between nutrition and cognitive function in older individuals. Nutr Res Rev, 25, 207222.

7. C Brayne (2007) The elephant in the room – healthy brains in later life, epidemiology and public health. Nature Rev 8, 233239.

8. C Reitz , C Brayne & R Mayeux (2011) Epidemiology of Alzheimer disease. Nat Rev Neurol 7, 137152.

9. JC Lambert , S Heath , G Even (2009) Genome-wide association study identifies variants at CLU and CR1 associated with Alzheimer's disease. Nat Genet 41, 10941099.

10. D Harold , R Abraham , P Hollingworth (2009) Genome-wide association study identifies variants at CLU and PICALM associated with Alzheimer's disease. Nat Genet 41, 10881093.

11. K Sleegers , JC Lambert , L Bertram (2010) The pursuit of susceptibility genes for Alzheimer's disease: progress and prospects. Trends Genet 26, 8493.

12. RC Petersen (2004) Mild cognitive impairment as a diagnostic entity. J Intern Med 256, 183194.

13. M Fotuhi , V Hachinski & PJ Whitehouse (2009) Changing perspectives regarding late-life dementia. Nat Rev Neurol 5, 649658.

14. ML Daviglus , CC Bell , W Berrettini (2010) National Institutes of Health State-of-the-Science Conference statement: preventing alzheimer disease and cognitive decline. Ann Intern Med 153, 176181.

15. ML Daviglus , BL Plassman , A Pirzada (2011) Risk factors and preventive interventions for Alzheimer disease: state of the science. Archiv Neurol 68, 11851190.

16. CR Jack Jr, DS Knopman , WJ Jagust (2010) Hypothetical model of dynamic biomarkers of the Alzheimer's pathological cascade. Lancet Neurol 9, 119128.

17. BL Plassman , JW Williams Jr, JR Burke (2010) Systematic review: factors associated with risk for and possible prevention of cognitive decline in later life. Ann Intern Med 153, 182193.

18. CM Filley & CA Anderson (2011) Dementia: five new things. Neurology 76, S26S30.

20. JA Luchsinger , JM Noble & N Scarmeas (2007) Diet and Alzheimer's disease. Curr Neurol Neurosci Rep 7, 366372.

21. V Solfrizzi , C Capurso , A D'Introno (2008) Lifestyle-related factors in predementia and dementia syndromes. Expert Rev Neurother 8, 133158.

22. F Gomez-Pinilla (2008) Brain foods: the effects of nutrients on brain function. Nature Rev 9, 568578.

24. MC Morris (2012) Nutritional determinants of cognitive aging and dementia. Proc Nutr Soc 71, 113.

26. E Reynolds (2006) Vitamin B12, folic acid, and the nervous system. Lancet Neurol 5, 949960.

27. V Solfrizzi , AM Colacicco , A D'Introno (2006) Dietary intake of unsaturated fatty acids and age-related cognitive decline: a 8·5-year follow-up of the Italian Longitudinal Study on Aging. Neurobiol Aging 27, 16941704.

28. JA Luchsinger & R Mayeux (2004) Dietary factors and Alzheimer's disease. Lancet Neurol 3, 579587.

29. MJ Engelhart , MI Geerlings , A Ruitenberg (2002) Dietary intake of antioxidants and risk of Alzheimer disease. J Am Med Assoc 287, 32233229.

30. L Letenneur , C Proust-Lima , A Le Gouge (2007) Flavonoid intake and cognitive decline over a 10-year period. Am J Epidemiol 165, 13641371.

31. C Berr , F Portet , I Carriere (2009) Olive oil and cognition: results from the three-city study. Dementia Geriatr Cogn Disorders 28, 357364.

34. SC Cunnane , M Plourde , F Pifferi (2009) Fish, docosahexaenoic acid and Alzheimer's disease. Prog Lipid Res 48, 239256.

35. V Solfrizzi , V Frisardi , D Seripa (2011) Mediterranean diet in predementia and dementia syndromes. Curr Alzheimer Res 8, 520542.

36. CA von Arnim , U Gola & HK Biesalski (2010) More than the sum of its parts? Nutrition in Alzheimer's disease. Nutrition 26, 694700.

37. C Feart & P Barberger-Gateau (2011) Epidemiological studies on cognition and the omega-6/omega-3 balance. World Rev Nutr Diet 102, 9297.

41. DR Jacobs Jr, MD Gross & LC Tapsell (2009) Food synergy: an operational concept for understanding nutrition. Am J Clin Nutr 89, 1543S1548S.

42. KR Daffner (2010) Promoting successful cognitive aging: a comprehensive review. J Alzheimers Dis 19, 11011122.

43. AK Kant (2004) Dietary patterns and health outcomes. J Am Diet Assoc 104, 615635.

44. KL Tucker (2010) Dietary patterns, approaches, and multicultural perspective. Appl Physiol Nutr Metab 35, 211218.

45. P Barberger-Gateau , C Raffaitin , L Letenneur (2007) Dietary patterns and risk of dementia: the Three-City cohort study. Neurology 69, 19211930.

46. Y Gu & N Scarmeas (2011) Dietary patterns in Alzheimer's disease and cognitive aging. Curr Alzheimer Res 8, 510519.

49. F Sofi (2009) The Mediterranean diet revisited: evidence of its effectiveness grows. Curr Opin Cardiol 24, 442446.

50. E Bere & J Brug (2010) Is the term ‘Mediterranean diet’ a misnomer? Public Health Nutr 13, 21272129.

51. A Bach-Faig , EM Berry , D Lairon (2011) Mediterranean diet pyramid today. Science and cultural updates. Public Health Nutr 14, 22742284.

52. G Kourlaba & DB Panagiotakos (2009) Dietary quality indices and human health: a review. Maturitas 62, 18.

53. ME Rumawas , JT Dwyer , NM McKeown (2009) The development of the Mediterranean-style dietary pattern score and its application to the American diet in the Framingham Offspring Cohort. J Nutr 139, 11501156.

54. R Mila-Villarroel , A Bach-Faig , J Puig (2011) Comparison and evaluation of the reliability of indexes of adherence to the Mediterranean diet. Public Health Nutr 14, 23382345.

55. A Trichopoulou , A Kouris-Blazos , ML Wahlqvist (1995) Diet and overall survival in elderly people. Br Med J 311, 14571460.

56. A Trichopoulou , T Costacou , C Bamia (2003) Adherence to a Mediterranean diet and survival in a Greek population. N Engl J Med 348, 25992608.

57. C Feart , C Samieri & P Barberger-Gateau (2010) Mediterranean diet and cognitive function in older adults. Curr Opin Clin Nutr Metab Care 13, 1418.

58. CC Tangney , MJ Kwasny , H Li (2011) Adherence to a Mediterranean-type dietary pattern and cognitive decline in a community population. Am J Clin Nutr 93, 601607.

59. DB Panagiotakos , C Pitsavos & C Stefanadis (2006) Dietary patterns: a Mediterranean diet score and its relation to clinical and biological markers of cardiovascular disease risk. Nutr Metab Cardiovasc Dis 16, 559568.

60. L Serra-Majem , B Roman & R Estruch (2006) Scientific evidence of interventions using the Mediterranean diet: a systematic review. Nutr Rev 64, S27S47.

61. M Steele , G Stuchbury & G Munch (2007) The molecular basis of the prevention of Alzheimer's disease through healthy nutrition. Exp Gerontol 42, 2836.

62. V Frisardi , F Panza , D Seripa (2010) Nutraceutical properties of Mediterranean diet and cognitive decline: possible underlying mechanisms. J Alzheimers Dis 22, 715740.

63. A Viswanathan , WA Rocca & C Tzourio (2009) Vascular risk factors and dementia: how to move forward? Neurology 72, 368374.

64. C Raffaitin , C Feart , M Le Goff (2011) Metabolic syndrome and cognitive decline in French elders: the Three-City Study. Neurology 76, 518525.

65. C Raffaitin , H Gin , JP Empana (2009) Metabolic syndrome and risk for incident Alzheimer's disease or vascular dementia: the Three-City Study. Diabetes Care 32, 169174.

66. LA Profenno , AP Porsteinsson & SV Faraone (2010) Meta-analysis of Alzheimer's disease risk with obesity, diabetes, and related disorders. Biol Psychiatry 67, 505512.

67. CM Kastorini , HJ Milionis , K Esposito (2011) The effect of Mediterranean diet on metabolic syndrome and its components: a meta-analysis of 50 studies and 534 906 individuals. J Am Coll Cardiol 57, 12991313.

68. R Estruch , MA Martinez-Gonzalez , D Corella (2006) Effects of a Mediterranean-style diet on cardiovascular risk factors: a randomized trial. Ann Intern Med 145, 111.

71. AJ Gaskins , AJ Rovner , SL Mumford (2010) Adherence to a Mediterranean diet and plasma concentrations of lipid peroxidation in premenopausal women. Am J Clin Nutr 92, 14611467.

72. V Konstantinidou , MI Covas , D Munoz-Aguayo (2010) In vivo nutrigenomic effects of virgin olive oil polyphenols within the frame of the Mediterranean diet: a randomized controlled trial. FASEB J 24, 25462557.

74. DB Panagiotakos , K Dimakopoulou , K Katsouyanni (2009) Mediterranean diet and inflammatory response in myocardial infarction survivors. Int J Epidemiol 38, 856866.

75. Y Gu , JA Luchsinger , Y Stern (2010) Mediterranean diet, inflammatory and metabolic biomarkers, and risk of Alzheimer's disease. J Alzheimers Dis 22, 483492.

76. AJ Nordmann , K Suter-Zimmermann , HC Bucher (2011) Meta-analysis comparing Mediterranean to low-fat diets for modification of cardiovascular risk factors. Am J Med 124, 841851, e842.

77. DB Panagiotakos , CM Kastorini , C Pitsavos (2011) The current Greek diet and the omega-6/omega-3 balance: the Mediterranean diet score is inversely associated with the omega-6/omega-3 ratio. World Rev Nutr Diet 102, 5356.

78. C Feart , MJ Torres , C Samieri (2011) Adherence to a Mediterranean diet and plasma fatty acids: data from the Bordeaux sample of the Three-City study. Br J Nutr 106, 149158.

79. N Scarmeas , Y Stern , MX Tang (2006) Mediterranean diet and risk for Alzheimer's disease. Ann Neurol 59, 912921.

80. N Scarmeas , Y Stern , R Mayeux (2009) Mediterranean diet and mild cognitive impairment. Arch Neurol 66, 216225.

81. N Scarmeas , JA Luchsinger , N Schupf (2009) Physical activity, diet, and risk of Alzheimer disease. J Am Med Assoc 302, 627637.

82. N Scarmeas , JA Luchsinger , R Mayeux (2007) Mediterranean diet and Alzheimer disease mortality. Neurology 69, 10841093.

83. C Feart , C Samieri , V Rondeau (2009) Adherence to a Mediterranean diet, cognitive decline, and risk of dementia. J Am Med Assoc 302, 638648.

84. RO Roberts , YE Geda , JR Cerhan (2010) Vegetables, unsaturated fats, moderate alcohol intake, and mild cognitive impairment. Dementia Geriatric Cogn Disorders 29, 413423.

85. N Cherbuin & KJ Anstey (2012) The Mediterranean diet is not related to cognitive change in a large prospective investigation: the PATH Through Life study. Am J Geriatr Psychiatry 20, 635639.

86. N Scarmeas , Y Stern , R Mayeux (2006) Mediterranean diet, Alzheimer disease, and vascular mediation. Arch Neurol 63, 17091717.

87. N Scarmeas , JA Luchsinger , Y Stern (2011) Mediterranean diet and magnetic resonance imaging assessed cerebrovascular disease. Ann Neurol 69, 257268.

88. Three-City Study Group (2003) Vascular factors and risk of dementia: design of the Three-City Study and baseline characteristics of the study population. Neuroepidemiology 22, 316325.

89. H Amieva , M Le Goff , X Millet (2008) Prodromal Alzheimer's disease: successive emergence of the clinical symptoms. Ann Neurol 64, 492498.

91. C Feart , K Peres , C Samieri (2011) Adherence to a Mediterranean diet and onset of disability in older persons. Eur J Epidemiol 26, 747756.

92. ET Kennedy , J Ohls , S Carlson (1995) The Healthy Eating Index: design and applications. J Am Diet Assoc 95, 11031108.

93. MN Vercambre , F Grodstein , C Berr (2012) Mediterranean diet and cognitive decline in women with cardiovascular disease or risk factors. J Acad Nutr Diet 112, 816823.

94. T Psaltopoulou , A Kyrozis , P Stathopoulos (2008) Diet, physical activity and cognitive impairment among elders: the EPIC-Greece cohort (European Prospective Investigation into Cancer and Nutrition). Public Health Nutr 11, 10541062.

96. A Bach , L Serra-Majem , JL Carrasco (2006) The use of indexes evaluating the adherence to the Mediterranean diet in epidemiological studies: a review. Public Health Nutr 9, 132146.

97. DS Knopman (2009) Mediterranean diet and late-life cognitive impairment: a taste of benefit. J Am Med Assoc 302, 686687.

98. DE Barnes (2011) The mediterranean diet: good for the heart = good for the brain? Ann Neurol 69, 226228.

99. M Maillot , C Issa , F Vieux (2011) The shortest way to reach nutritional goals is to adopt Mediterranean food choices: evidence from computer-generated personalized diets. Am J Clin Nutr 94, 11271137.

100. MA Martinez-Gonzalez & A Gea (2012) Mediterranean diet: the whole is more than the sum of its parts. Br J Nutr 108, 577578.

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