Nutritional Strategies in the Management of Alzheimer Disease: Systematic Review With Network Meta-Analysis

Fernández, Shirley Steffany Muñoz; Ivanauskas, Terry Macedo; Ribeiro, Sandra Maria Lima

doi:10.1016/j.jamda.2017.06.015

Cited by 25 publications

(15 citation statements)

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“…Diet and nutritional status are recognized as important considerations in healthy brain aging and dementia [4]; however, clinical trial evidence for the effectiveness of single nutritional interventions in MCI remains limited [5]. Randomized clinical trials of Souvenaid have provided evidence for improvement in memory performance in subjects with early Alzheimer’s disease (AD) [6, 7], but not in those with more advanced stages of AD [8].…”

Section: Introductionmentioning

confidence: 99%

Souvenaid in the management of mild cognitive impairment: an expert consensus opinion

et al. 2019

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Background Mild cognitive impairment (MCI) among an aging global population is a growing challenge for healthcare providers and payers. In many cases, MCI is an ominous portent for dementia. Early and accurate diagnosis of MCI provides a window of opportunity to improve the outcomes using a personalized care plan including lifestyle modifications to reduce the impact of modifiable risk factors (for example, blood pressure control and increased physical activity), cognitive training, dietary advice, and nutritional support. Souvenaid is a once-daily drink containing a mixture of precursors and cofactors (long-chain omega-3 fatty acids, uridine, choline, B vitamins, vitamin C, vitamin E, and selenium), which was developed to support the formation and function of neuronal membranes and synapses. Healthcare providers, patients, and carers require expert advice about the use of Souvenaid. Methods An international panel of experts was convened to review the evidence and to make recommendations about the diagnosis and management of MCI, identification of candidates for Souvenaid, and use of Souvenaid in real-world practice. This article provides a summary of the expert opinions and makes recommendations for clinical practice and future research. Summary of opinion Early diagnosis of MCI requires the use of suitable neuropsychological tests combined with a careful clinical history. A multimodal approach is recommended; dietary and nutritional interventions should be considered alongside individualized lifestyle modifications. Although single-agent nutritional supplements have failed to produce cognitive benefits for patients with MCI, a broader nutritional approach warrants consideration. Evidence from randomized controlled trials suggests that Souvenaid should be considered as an option for some patients with early Alzheimer’s disease (AD), including those with MCI due to AD (prodromal AD). Conclusion Early and accurate diagnosis of MCI provides a window of opportunity to improve the outcomes using a multimodal management approach including lifestyle risk factor modification and consideration of the multinutrient Souvenaid. Electronic supplementary material The online version of this article (10.1186/s13195-019-0528-6) contains supplementary material, which is available to authorized users.

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Section: Introductionmentioning

confidence: 99%

Souvenaid in the management of mild cognitive impairment: an expert consensus opinion

et al. 2019

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“…Despite the need for this kind of research that addresses the mechanisms by which nutrients may modulate AD, it is inarguable that their potential utility is limited, at best. Nutrients are not consumed in isolation, and the effect of supplementation with specific nutrients on AD is unclear and may be overlooking synergistic or antagonistic actions between different nutrients contained in a certain food [40,41,42]. In fact, a recent network meta-analysis points out that nutrient-based interventions have a limited impact and do not accomplish significant effects [41].…”

Section: Relevance Of Dietary Patternsmentioning

confidence: 99%

“…Nutrients are not consumed in isolation, and the effect of supplementation with specific nutrients on AD is unclear and may be overlooking synergistic or antagonistic actions between different nutrients contained in a certain food [40,41,42]. In fact, a recent network meta-analysis points out that nutrient-based interventions have a limited impact and do not accomplish significant effects [41]. Even single foods seem not to be able to correlate with an improvement of cognitive function or memory decline [40].…”

Section: Relevance Of Dietary Patternsmentioning

confidence: 99%

“…Although these effects are a reflection of studies using single nutrients, the trend towards their potential benefits together with the evidence of improved cognitive function linked to higher adherence to the MD constitutes a compelling argument to address the need of specific dietary interventions in patients suffering cognitive decline and AD [41,45]. In this regard, it is important to highlight the results from a very recent study by Berti and co-workers assessing the effects of the MD on AD biomarker changes on a 3-year follow-up [48].…”

Section: Relevance Of Dietary Patternsmentioning

confidence: 99%

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Modulating Effect of Diet on Alzheimer’s Disease

2019

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As life expectancy is growing, neurodegenerative disorders, such as Alzheimer’s disease, are increasing. This disease is characterised by the accumulation of intracellular neurofibrillary tangles formed by hyperphosphorylated tau protein, senile plaques composed of an extracellular deposit of β-amyloid peptide (Aβ), and neuronal loss. This is accompanied by deficient mitochondrial function, increased oxidative stress, altered inflammatory response, and autophagy process impairment. The present study gathers scientific evidence that demonstrates that specific nutrients exert a direct effect on both Aβ production and Tau processing and their elimination by autophagy activation. Likewise, certain nutrients can modulate the inflammatory response and the oxidative stress related to the disease. However, the extent to which these effects come with beneficial clinical outcomes remains unclear. Even so, several studies have shown the benefits of the Mediterranean diet on Alzheimer’s disease, due to its richness in many of these compounds, to which can be attributed their neuroprotective properties due to the pleiotropic effect they show on the aforementioned processes. These indications highlight the potential role of adequate dietary recommendations for clinical management of both Alzheimer’s diagnosed patients and those in risk of developing it, emphasising once again the importance of diet on health.

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“…De ja, pro gre sa vi mas á de men ci jà ne su lë të jo, kog ni ty vi niø tes tø at li ki mas ne pa ge rë jo, nors struk tû ri niai po ky èiai sme geny se bu vo ma þiau ið reikð ti -reikð min gai ma þiau su ma þë jo hi po kam po tû ris, ma þiau pa di dë jo skil ve liai [56]. 2017 m. sis te mi nës ap þval gos, skir tos mi ty bos áta kai ávai rioms AL sta di joms, duo me ni mis, pa vie niai mais to pa pil dai (an ti oksi dan tai, B gru pës vi ta mi nai, vi ta mi nas D, ino zi to lis, vi duti nës gran di nës rie ba lø rûgð tys, ome ga-3 rie ba lø rûgð tys, spe ci fi niai po li pep ti dai ir po li me rai) ne pa si þy më jo tei giamu po vei kiu nei kli ni ki nei li gos ið raið kai, nei neu ro pa to logi jai [57].…”

Section: Mityba Ir Alzheimerio Ligaunclassified

In search of Alzheimer’s disease treatment methods: trends of clinical trials

Pakulaitė

Regelskytė

Audronytė

et al. 2018

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Vilniaus universiteto Medicinos fakulteto Klinikinës medicinos instituto Neurologijos ir neurochirurgijos klinika ÁVADASAlz hei me rio li ga (AL) -lë ti në pro gre suo jan ti, ne gráþ ta mø po ky èiø sme ge ny se su ke lian ti li ga [1]. Tai daþ niau sia demen ci jos prie þas tis, su da ran ti 60-70 % vi sø de men ci jø, o jos pa pli ti mas itin di dë ja il gë jant gy ve ni mo truk mei [2,3]. AL su ke lia di de lae eko no mi nae nað tà, taip pat tam pa vis daþ -nes ne mir ties prie þas ti mi [3]. Stu di jø duo me ni mis, mir tingu mas nuo in sul to ir ðir dies li gø ma þë ja, ta èiau AL, kaip mir ties prie þas tis tarp vy res niø nei 75 me tø am þiaus pa cientø, mi n i ma jau ne ðeð to je, o tre èio je vie to je pa gal daþ ná po kar dio vas ku li niø ir ce reb ro vas ku li niø li gø bei vë þio [3,4]. AL gy dy mo kli ni ki niø ty ri mø pra dþia lai ko mi 1980-1990 m., kai pra dë ti nau do ti cho li nes te ra zës in hi bito riai [5]. 1974 m. Drach man ir Le a vitt su sie jo cen tri niø cho li ner gi niø neu ro nø pa þei di mà su at min ties blo gë ji mu ir am þiu mi, o vë les në se stu di jo se Da vis ir Ma lo ney ap ra ðë cho li ner gi nio Mei ner to bran duo lio (angl. nu cleus basalis of Meynert) pa þei di mà pa cien tams, ser gan tiems AL [6,7]. Ma ny ta, kad cho li ner gi nës sis te mos pa þei di mas, ser gant AL, pa na ðus á do pa mi ner gi nës sis te mos pa þei di mà, sergant Par kin so no li ga [8]. Pir mà já cho li nes te ra zës in hi bi toriø tak ri nà leng vai ir vi du ti nio sun ku mo Alz hei me rio ti po de men ci jai gy dy ti 1993 m. áre gist ra vo JAV Mais to ir vaistø ad mi nist ra ci ja (angl. Food and Drug Ad min is tra tion, FDA), ta èiau jis ne be nau do ja mas dël ne pa gei dau ja mø reið ki niø (virð ki na mo jo trak to simp to mø) ir ma þo efek tyvu mo [9,10]. Nuo to lai ko bu vo at lik ta ir ðiuo me tu vyks ta dau gy bë kli ni ki niø ty ri mø, ta èiau tik 3 cho li nes te ra zës inhi bi to riai (do ne pe zi lis, ri vas tig mi nas (jo pe ro ra li në ir trans der ma li në for mos), ga lan ta mi nas) ir glu ta ma ter gi nae sis te mà vei kian tis me man ti nas ty ri muo se pa ro dë pa kan kamà efek ty vu mà bei sau gu mà ir bu vo áre gist ruo ti gy dy ti AL [10]. Ðie vais tai, skir ti simp to mi niam AL gy dy mui, ðiek tiek pa leng vi na li gos kli ni ki nae ið raið kà, ta èiau jø efek ty vumas në ra di de lis, jie ne vei kia li gos prie þas ties ir ne su stabdo li gos pro gre sa vi mo [10,11]. Pas ku ti nis vais tas AL gydy ti -me man ti nas -Eu ro po je bu vo áre gist ruo tas 2002 m., o JAV -2003 m. [10]. Vais tø, skir tø AL gy dy ti, kli ni ki niai ty ri mai vyks ta jau ke lis de ðimt me èius, ta èiau 15 me tø neran da ma nau jø efek ty viø ir sau giø vais tø.Pas ta rà já de ðimt me tá dau giau sia kli ni ki niø ty ri mø at lieka ma su vais tais, po ten cia liai ga lin èiais mo di fi kuo ti AL ei - Adresas: Gy të Pa ku lai të Vil niaus uni ver si te to li go ni nës San ta ros kli ni kos, Neurologijos cen tras San ta rið kiø g. 2, LT-08661 Vil nius El. pa ðtas gyte.pakulaite@gmail.comSan tra...

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Nutritional Strategies in the Management of Alzheimer Disease: Systematic Review With Network Meta-Analysis

Cited by 25 publications

References 78 publications

Souvenaid in the management of mild cognitive impairment: an expert consensus opinion

Souvenaid in the management of mild cognitive impairment: an expert consensus opinion

Modulating Effect of Diet on Alzheimer’s Disease

In search of Alzheimer’s disease treatment methods: trends of clinical trials

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