Mediterranean diet lowers dementia risk by 23%

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Mediterranean diet lowers dementia risk by 23%

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Mediterranean diet adherence is associated with lower dementia risk, independent of genetic predisposition: findings from the UK Biobank prospective cohort study
BMC Med. 2023 Mar 14;21(1):81.

Background: The identification of effective dementia prevention strategies is a major public health priority, due to the enormous and growing societal cost of this condition. Consumption of a Mediterranean diet (MedDiet) has been proposed to reduce dementia risk. However, current evidence is inconclusive and is typically derived from small cohorts with limited dementia cases. Additionally, few studies have explored the interaction between diet and genetic risk of dementia.

Methods: We used Cox proportional hazard regression models to explore the associations between MedDiet adherence, defined using two different scores (Mediterranean Diet Adherence Screener [MEDAS] continuous and Mediterranean diet Pyramid [PYRAMID] scores), and incident all-cause dementia risk in 60,298 participants from UK Biobank, followed for an average 9.1 years. The interaction between diet and polygenic risk for dementia was also tested.

Results: Higher MedDiet adherence was associated with lower dementia risk (MEDAS continuous: HR = 0.77, 95% CI = 0.65–0.91; PYRAMID: HR = 0.86, 95% CI = 0.73–1.02 for highest versus lowest tertiles). There was no significant interaction between MedDiet adherence defined by the MEDAS continuous and PYRAMID scores and polygenic risk for dementia.

Conclusions: Higher adherence to a MedDiet was associated with lower dementia risk, independent of genetic risk, underlining the importance of diet in dementia prevention interventions.

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Re: Mediterranean diet lowers dementia risk by 23%

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What is a Mediterranean diet? ... -rcna74246

A Mediterranean diet is filled with healthy plant-based foods such as vegetables, nuts and legumes. It's rich in whole grains, fruits and olive oil and fish.

The people in the study were also typically eating less red or processed meat, sweets and pastries and drinking fewer sugar sweetened beverages, Shannon said.

Prior studies have been mixed on whether a Mediterranean diet can help stave off dementia. In fact, a study published in October that looked at medical records from 28,025 Swedes found that the diet did not protect against dementia. In contrast, another study published in May, which included nearly 2,000 older adults, found that diets high in foods associated with inflammation — in contrast to the Mediterranean diet, which appears to be anti-inflammatory — were linked with faster brain aging seen on MRI scans and a greater risk for the development of dementia.

To take a closer look at the impact of a Mediterranean diet on dementia risk, Shannon and his colleagues turned to the U.K. Biobank, which from 2006 to 2010 recruited men and women aged 40 to 69 from across England, Scotland and Wales. The prospective study currently has more than half a million participants.

The recruits filled out a touch-screen questionnaire, participated in a verbal interview and provided biological samples and measures of physical function. Later on, the recruits received scans, were assessed for multiple health outcomes and provided information on their diets, some at multiple times during the study. The Biobank was able to keep track of the participants’ health through linked electronic medical records.

An added dimension to the new study was the inclusion of genetic information in the form of an Alzheimer’s risk score that was devised in earlier research.

“The risk score was constructed using around 250,000 individual genetic variants which have been associated with Alzheimer’s disease, which is the most common form of dementia,” Shannon explained.

For the new study, the researchers focused on 60,298 participants who were in their 60s at recruitment. During an average follow-up of nine years, 882 individuals developed dementia.

When the researchers crunched their data, they found that individuals whose food consumption most closely mirrored the Mediterranean diet were 23% less likely to develop dementia during the years covered by the study.

According to Newcastle's Shannon, to have the perfect Mediterranean diet score, weekly consumption should include:

• Olive oil as the main cooking fat.

• 2 or more servings of vegetables per day.

• 3 or more servings of fruit per day.

• Less than 1 serving of red/processed meat per day.

• Less than 1 serving of butter, margarine or cream per day.

• Less than 1 sugar-sweetened drink per day.

• 3 or more servings of legumes, such as beans, lentils or peanuts, per week.

• 3 or more servings of fish per week.

• Less than 2 servings of sweets or pastries per week.

• 3 or more servings of nuts per week.

• More white meat than red meat in the diet.

• 2 or more servings of a tomato-based sauce per week.

The new research adds to the mounting evidence that diet can impact the risk of dementia even in people who are at a higher risk because of their genes, said Dr. Thomas Wisniewski, a professor of neurology, pathology and psychiatry and director of the Alzheimer’s Disease Research Center and the Center for Cognitive Neurology at NYU Langone.

“This study with really good numbers and a fairly substantial effect size is showing that, indeed, it is brain protective to follow a Mediterranean diet,” Wisniewski said. “It’s positive news and certainly something that everyone can do relatively easily. So it’s good news.”

Reducing the risk of dementia

Diet “is one of the lifestyle things I discuss with all of my patients,” Wisniewski said. “The other thing we typically discuss with patients is the importance of staying physically and mentally active."
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