No abstract

Adherence to a Mediterranean diet (MeD) has recently been shown to protect against cognitive decline and dementia. It remains unclear, however, whether such protection extends to differing ethnic groups and middle-aged individuals, and how it may compare with adherence to the USDA Dietary Guidelines for Americans 2005 (measured with Healthy Eating Index-2005, HEI-2005). This study examined associations between diet quality, as assessed by the MeD and HEI-2005, and cognitive performance in a sample of 1,269 Puerto Rican adults, aged 45–75 years, living in the Greater Boston area, Massachusetts. Dietary intake was assessed with a food-frequency questionnaire specifically designed for and validated with this population. Adherence to the MeD was assessed with a 0 to 9 point scale, and the HEI-2005 score was calculated with a maximum score of 100. Cognitive performance was measured with a battery of seven tests; the Mini Mental State Examination (MMSE) was used for global cognitive function. Greater adherence to the MeD was associated with higher MMSE score (P trend = 0.012) and lower likelihood (OR = 0.87 for each additional point, 95% CI, 0.80–0.94, P <0.001) of cognitive impairment, after adjustment for confounders. Similarly, individuals with higher HEI-2005 score had higher MMSE score (P trend = 0.011) and lower odds of cognitive impairment (OR = 0.86 for each 10 points, 95% CI, 0.74–0.99, P = 0.033). In conclusion, high adherence to either the MeD or the diet recommended by the USDA dietary guidelines may protect cognitive function in middle-aged and older adults.

Similar associations of whole grains and cereal fiber with weight, BMI, waist circumference, plasma cholesterol, and 2-h glucose were observed, suggesting that cereal fiber and its constituents may in part mediate these relations. Refined grains were associated with fasting insulin among women but not men. Additional research should explore potential interaction effects with BMI, sex, age, and genes.