Adherence to Mediterranean diet and subjective cognitive function in men
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Benefits of a Mediterranean diet for cognition have been suggested, but epidemiologic studies have been relatively small and of limited duration. To prospectively assess the association between long-term adherence to a Mediterranean dietary pattern and self-reported subjective cognitive function (SCF). Prospective observational study. The Health Professionals’ Follow-up Study, a prospective cohort of 51,529 men, 40–75 years of age when enrolled in 1986, of whom 27,842 were included in the primary analysis. Mediterranean diet (MD) score, computed from the mean of five food frequency questionnaires, assessed every 4 years from 1986 to 2002. Self-reported SCF assessed by a 6-item questionnaire in 2008 and 2012, and validated by association with genetic variants in apolipoprotein-4. Using the average of 2008 and 2012 SCF scores, 38.0% of men were considered to have moderate memory scores and 7.3% were considered to have poor scores. In a multivariate model, compared with men having a MD score in the lowest quintile, those in the highest quintile had a 36% lower odds of a poor SCF score (odds ratio 0.64, 95% CI 0.55–0.75; P, trend < 0.001) and a 24% lower odds of a moderate SCF score (OR 0.76, 95% CI 0.70–0.83; P, trend < 0.001). Both remote and more recent diet contributed to this relation. Associations were only slightly weaker using baseline dietary data and a lag of 22 years. Long-term adherence to the Mediterranean diet pattern was strongly related to lower subjective cognitive function. These findings provide further evidence that a healthy dietary pattern may prevent or delay cognitive decline.
KeywordsMediterranean diet Subjective cognitive function Mild cognitive impairment Subjective cognitive decline Alzheimer’s disease
This work was supported by a grant from the National Institutes of Health (UM1CA167552) and an anonymous gift to the Harvard T H Chan School of Public Health. The funding agencies had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
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Conflict of interest
The authors whose names are listed on the title page of this manuscript certify that they have no affiliations with or involvement in any organization or entity with any financial interest.
- 2.American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 5th ed. (DSM-5), American Psychiatric Association, Arlington, VA; 2013.Google Scholar
- 3.Anand SS, Hawkes C, de Souza RJ, Mente A, Dehghan M, Nugent R, Zulyniak MA, Weis T, Bernstein AM, Krauss RM, Kromhout D, Jenkins DJ, Malik V, Martinez-Gonzalez MA, Mozaffarian D, Yusuf S, Willett WC, Popkin BM. Food consumption and its impact on cardiovascular disease: importance of solutions focused on the globalized food system: a report from the workshop convened by the World Heart Federation. J Am Coll Cardiol. 2015;66(14):1590–614.PubMedPubMedCentralCrossRefGoogle Scholar
- 9.Burgener SC, Buettner L, Coen Buckwalter K, Beattie E, Bossen AL, Fick DM, Fitzsimmons S, Kolanowski A, Richeson NE, Rose K, Schreiner A, Pringle Specht JK, Testad I, Yu F, McKenzie S. Evidence supporting nutritional interventions for persons in early stage Alzheimer’s disease (AD). J Nutr Health Aging. 2008;12(1):18–21.PubMedCrossRefGoogle Scholar
- 13.Claesson MJ, Jeffery IB, Conde S, Power SE, O’Connor EM, Cusack S, Harris HM, Coakley M, Lakshminarayanan B, O’Sullivan O, Fitzgerald GF, Deane J, O’Connor M, Harnedy N, O’Connor K, O’Mahony D, van Sinderen D, Wallace M, Brennan L, Stanton C, Marchesi JR, Fitzgerald AP, Shanahan F, Hill C, Ross RP, O’Toole PW. Gut microbiota composition correlates with diet and health in the elderly. Nature. 2012;488(7410):178–84.PubMedCrossRefGoogle Scholar
- 18.Diano S, Farr SA, Benoit SC, McNay EC, da Silva I, Horvath B, Gaskin FS, Nonaka N, Jaeger LB, Banks WA, Morley JE, Pinto S, Sherwin RS, Xu L, Yamada KA, Sleeman MW, Tschöp MH, Horvath TL. Ghrelin controls hippocampal spine synapse density and memory performance. Nat Neurosci. 2006;9(3):381–8.PubMedCrossRefGoogle Scholar
- 19.Donovan NJ, Amariglio RE, Zoller AS, Rudel RK, Gomez-Isla T, Blacker D, Hyman BT, Locascio JJ, Johnson KA, Sperling RA, Marshall GA, Rentz DM. Subjective cognitive decline and neuropsychiatric predictors of progression to the early clinical stages of Alzheimer disease. Am J Geriatr Psychiatry. 2014;22(12):1642–51.PubMedPubMedCentralCrossRefGoogle Scholar
- 28.Gardener S, Gu Y, Rainey-Smith SR, Keogh JB, Clifton PM, Mathieson SL, Taddei K, Mondal A, Ward VK, Scarmeas N, Barnes M, Ellis KA, Head R, Masters CL, Ames D, Macaulay SL, Rowe CC, Szoeke C, Martins RN. Adherence to a Mediterranean diet and Alzheimer’s disease risk in an Australian population. Transl Psychiatry. 2012;2(2):e164.PubMedPubMedCentralCrossRefGoogle Scholar
- 33.Hardman RJ, Kennedy G, Macpherson H, Scholey AB, Pipingas A. A randomised controlled trial investigating the effects of Mediterranean diet and aerobic exercise on cognition in cognitively healthy older people living independently within aged care facilities: the Lifestyle Intervention in Independent Living Aged Care (LIILAC) study protocol [ACTRN12614001133628]. Nutr J. 2015;24(14):53.CrossRefGoogle Scholar
- 53.Martínez-Lapiscina EH, Clavero P, Toledo E, Estruch R, Salas-Salvadó J, San Julián B, Sanchez-Tainta A, Ros E, Valls-Pedret C, Martinez-Gonzalez MÁ. Mediterranean diet improves cognition: the PREDIMED-NAVARRA randomised trial. J Neurol Neurosurg Psychiatry. 2013;84(12):1318–25.PubMedCrossRefGoogle Scholar
- 64.Psaltopoulou T, Kyrozis A, Stathopoulos P, Trichopoulos D, Vassilopoulos D, Trichopoulou A. Diet, physical activity and cognitive impairment among elders: the EPIC-Greece cohort (European Prospective Investigation into Cancer and Nutrition). Public Health Nutr. 2008;11(10):1054–62.PubMedCrossRefGoogle Scholar
- 67.Roberts RO, Geda YE, Cerhan JR, Knopman DS, Cha RH, Christianson TJ, Pankratz VS, Ivnik RJ, Boeve BF, O’Connor HM, Petersen RC. Vegetables, unsaturated fats, moderate alcohol intake, and mild cognitive impairment. Dement Geriatr Cogn Disord. 2010;29(5):413–23.PubMedPubMedCentralCrossRefGoogle Scholar
- 70.Samieri C, Proust-Lima C, Glymour MM, Okereke OI, Amariglio RE, Sperling RA, Rentz DM, Grodstein F. Subjective cognitive function, episodic memory, and the APOE ε4 allele. Alzheimers Dement. 2014;10(6):752–759.e1.Google Scholar
- 79.Sun Y, Dai Z, Li Y, Sheng C, Li H, Wang X, Chen X, He Y, Han Y. Subjective cognitive function: mapping functional and structural brain changes—a combined resting-state functional and structural MR Imaging Study. Radiology. 2016;22:151771.Google Scholar
- 85.Valls-Pedret C, Sala-Vila A, Serra-Mir M, Corella D, de la Torre R, Martínez-González MÁ, Martínez-Lapiscina EH, Fitó M, Pérez-Heras A, Salas-Salvadó J, Estruch R, Ros E. Mediterranean diet and age-related cognitive decline: a randomized clinical trial. JAMA Int Med. 2015;175(7):1094–103.CrossRefGoogle Scholar
- 91.Wengreen H, Munger RG, Cutler A, Quach A, Bowles A, Corcoran C, Tschanz JT, Norton MC, Welsh-Bohmer KA. Prospective study of Dietary Approaches to Stop Hypertension- and Mediterranean-style dietary patterns and age-related cognitive change: the Cache County Study on Memory, Health and Aging. Am J Clin Nutr. 2013;98(5):1263–71.PubMedPubMedCentralCrossRefGoogle Scholar
- 93.Wu L, Sun D (2017) Adherence to Mediterranean diet and risk of developing cognitive disorders: an updated systematic review and meta-analysis of prospective cohort studies. Sci Rep 2017. Article number: 41317.Google Scholar