Mediterranean diet and brain structure in a multiethnic elderly cohort

Gu, Yian; Brickman, Adam M.; Stern, Yaakov; Habeck, Christian; Razlighi, Qolamreza R.; Luchsinger, José A.; Manly, Jennifer J.; Schupf, Nicole; Mayeux, Richard; Scarmeas, Nikolaos

doi:10.1212/wnl.0000000000002121

Cited by 208 publications

(174 citation statements)

References 41 publications

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“…In the small subsample of individuals with dietary habits suggesting a sustained trait of iodine consumption, low animal fat intake and, in general, a low calorie-and-salt diet were associated with preserved lateral brain ventricular size, indicative of reduced or absent brain atrophy. This result is confirmatory of those from a study on 674 non-demented older adults from a multi-ethnic cohort in Manhattan, which concluded that higher fish (iodine-rich, but also a source of other nutrients) and lower meat (energy and protein-rich) intake were the key two elements contributing to the association of the Mediterranean diet with less brain atrophy (22). It also confirms results from another study on 52 individuals cognitively normal but at risk for Alzheimer's disease (AD), which also assessed brain atrophy from brain MRI and found that the nutrient combination identified as "AD-protective" (i.e.…”

Section: Discussionsupporting

confidence: 88%

Dietary iodine exposure and brain structures and cognition in older people. Exploratory analysis in the Lothian Birth Cohort 1936

Hernández

Kyle

Allan

et al. 2017

The Journal of nutrition, health and aging

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Background: Iodine deficiency is one of the three key micronutrient deficiencies highlighted as major public health issues by the World Health Organisation. Iodine deficiency is known to cause brain structural alterations likely to affect cognition. However, it is not known whether or how different (lifelong) levels of exposure to dietary iodine influences brain health and cognitive functions. Methods:From 1091 participants initially enrolled in The Lothian Birth Cohort Study 1936, we obtained whole diet data from 882. Three years later, from 866 participants (mean age 72 yrs, SD ±0.8), we obtained cognitive information and ventricular, hippocampal and normal and abnormal tissue volumes from brain structural magnetic resonance imaging scans (n=700). We studied the brain structure and cognitive abilities of iodine-rich food avoiders/low consumers versus those with a high intake in iodine-rich foods (namely dairy and fish). Results:We identified individuals (n=189) with contrasting diets, i) belonging to the lowest quintiles for dairy and fish consumption, ii) milk avoiders, iii) belonging to the middle quintiles for dairy and fish consumption, and iv) belonging to the middle quintiles for dairy and fish consumption. Iodine intake was secured mostly though the diet (n=10 supplement users) and was sufficient for most (75.1%, median 193 µg/day). In individuals from these groups, brain lateral ventricular volume was positively associated with fat, energy and protein intake. The associations between iodine intake and brain ventricular volume and between consumption of fish products (including fish cakes and fishcontaining pasties) and white matter hyperintensities (p=0.03) the latest being compounded by sodium, proteins and saturated fats, disappeared after type 1 error correction. Conclusion:In this large Scottish older cohort, the proportion of individuals reporting extreme (low vs. high)/medium iodine consumption is small. In these individuals, low iodine-rich food intake was associated with increased brain volume shrinkage, raising an important hypothesis worth being explored for designing appropriate guidelines.

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Section: Discussionsupporting

confidence: 88%

Dietary iodine exposure and brain structures and cognition in older people. Exploratory analysis in the Lothian Birth Cohort 1936

Hernández

Kyle

Allan

et al. 2017

The Journal of nutrition, health and aging

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“…We used multivariate analysis of variance (MANOVA) to see whether the linear combination of the 12 cortical and subcortical regional volumes (see supplementary data)(63) was associated with inflammatory biomarkers. We then examined univariate F tests for individual ROIs.…”

Section: Methodsmentioning

confidence: 99%

“…We then examined univariate F tests for individual ROIs. A similar analysis was conducted for 12 thickness ROIs that have been shown to reflect AD-associated neurodegeneration (63, 64) (see supplementary data), and for 26 white matter tracts (61). Because individual ROI analyses were guided by the MANOVA results, and were essentially exploratory, no correction for multiple comparisons has been performed.…”

Section: Methodsmentioning

confidence: 99%

Circulating inflammatory biomarkers in relation to brain structural measurements in a non-demented elderly population

Vorburger

Scarmeas

et al. 2017

Brain, Behavior, and Immunity

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Objective The aim of this investigation was to determine whether circulating inflammatory biomarkers c-reactive protein (CRP), interleukin-6 (IL6), and alpha 1-antichymotrypsin (ACT) were related to structural brain measures assessed by magnetic resonance imaging (MRI). Methods High-resolution structural MRI was collected on 680 non-demented elderly (mean age 80.1 years) participants of a community-based, multiethnic cohort. Approximately three quarters of these participants also had peripheral inflammatory biomarkers (CRP, IL6, and ACT) measured using ELISA. Structural measures including brain volumes and cortical thickness (with both global and regional measures) were derived from MRI scans, and repeated MRI measures were obtained after 4.5 years. Mean fractional anisotropy was used as the indicator of white matter integrity assessed with diffusion tensor imaging. We examined the association of inflammatory biomarkers with brain volume, cortical thickness, and white matter integrity using regression models adjusted for age, gender, ethnicity, education, APOE genotype, intracranial volume. Results A doubling in CRP (b= -2.48, p=0.002) was associated with a smaller total gray matter volume, equivalent to approximately 1.5 years of aging. A doubling in IL6 was associated with smaller total brain volume (b= -14.96, p<0.0001), equivalent to approximately 9 years of aging. Higher IL6 was also associated with smaller gray matter (b=-6.52, p=0.002) and white matter volumes (b=-7.47, p=0.004). The volumes of most cortical regions including frontal, occipital, parietal, temporal, as well as subcortical regions including pallidum and thalamus were associated with IL6. In a model additionally adjusted for depression, vascular factors, BMI, and smoking status, the association between IL6 and brain volumes remained, and a doubling in ACT was marginally associated with 0.054 (p=0.004) millimeter thinner mean cortical thickness, equivalent to that of approximately 2.7 years of aging. None of the biomarkers was associated with mean fractional anisotropy or longitudinal change of brain volumes and thickness. Conclusions Among older adults, increased circulating inflammatory biomarkers were associated with smaller brain volume and cortical thickness but not the white matter tract integrity. Our preliminary findings suggest that peripheral inflammatory processes may be involved in the brain atrophy in the elderly.

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“…The few published studies on diet and imaging biomarkers suggest that higher adherence to a MeDi dietary pattern is associated with a reduced odds ratio for infarctions [15], larger cortical thickness, and larger brain volumes [16, 17]. However, further studies are needed to better understand the associations of the MeDi pattern and components of the MeDi with MRI biomarkers for specific brain regions that are involved in ageing or AD-related neurodegeneration and atrophy.…”

Section: Introductionmentioning

confidence: 99%

Mediterranean diet, micronutrients and macronutrients, and MRI measures of cortical thickness

Staubo

Aakre

Vemuri

et al. 2016

Alzheimer's & Dementia

119

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INTRODUCTION The Mediterranean diet (MeDi) is associated with reduced risk of cognitive impairment, but it’s unclear whether it’s associated with better brain imaging biomarkers. METHODS Among 672 cognitively normal participants (mean age: 79.8 years, 52.5% men), we investigated associations of MeDi score and MeDi components with magnetic resonance imaging measures of cortical thickness for the 4 lobes separately and averaged (average lobar). RESULTS Higher MeDi score was associated with larger frontal, parietal, occipital, and average lobar cortical thickness. Higher legume and fish intakes were associated with larger cortical thickness: legumes with larger superior parietal, inferior parietal, precuneus, parietal, occipital, lingual, and fish with larger precuneus, superior parietal, posterior cingulate, parietal, inferior parietal. Higher carbohydrate and sugar intakes were associated with lower entorhinal cortical thickness. DISCUSSION In this sample of elderly persons, higher adherence to MeDi was associated with larger cortical thickness. These cross-sectional findings require validation in prospective studies.

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Mediterranean diet and brain structure in a multiethnic elderly cohort

Abstract: Among older adults, MeDi adherence was associated with less brain atrophy, with an effect similar to 5 years of aging. Higher fish and lower meat intake might be the 2 key food elements that contribute to the benefits of MeDi on brain structure.

Cited by 208 publications

References 41 publications

Dietary iodine exposure and brain structures and cognition in older people. Exploratory analysis in the Lothian Birth Cohort 1936

Dietary iodine exposure and brain structures and cognition in older people. Exploratory analysis in the Lothian Birth Cohort 1936

Circulating inflammatory biomarkers in relation to brain structural measurements in a non-demented elderly population

Mediterranean diet, micronutrients and macronutrients, and MRI measures of cortical thickness

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