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November 17, 2015; 85 (20) Article

Mediterranean diet and brain structure in a multiethnic elderly cohort

Yian Gu, Adam M. Brickman, Yaakov Stern, Christian G. Habeck, Qolamreza R. Razlighi, José A. Luchsinger, Jennifer J. Manly, Nicole Schupf, Richard Mayeux and Nikolaos Scarmeas
First published October 21, 2015, DOI: https://doi.org/10.1212/WNL.0000000000002121
Yian Gu
From The Taub Institute for Research in Alzheimer's Disease and the Aging Brain (Y.G., A.M.B., Y.S., C.G.H., O.R.R., J.A.L., J.J.M., N. Schupf, R.M., N. Scarmeas), The Gertrude H. Sergievsky Center (A.M.B., Y.S., C.G.H., J.A.L., J.J.M., N. Schupf, R.M., N. Scarmeas), the Department of Neurology (Y.G., A.M.B., Y.S., C.G.H., J.J.M., R.M.), the Department of Medicine (J.A.L.), and the Division of Epidemiology, Joseph P. Mailman School of Public Health (J.A.L., N. Schupf), Columbia University, New York, NY; and the National and Kapodistrian University of Athens Medical School (N. Scarmeas), Greece.
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Adam M. Brickman
From The Taub Institute for Research in Alzheimer's Disease and the Aging Brain (Y.G., A.M.B., Y.S., C.G.H., O.R.R., J.A.L., J.J.M., N. Schupf, R.M., N. Scarmeas), The Gertrude H. Sergievsky Center (A.M.B., Y.S., C.G.H., J.A.L., J.J.M., N. Schupf, R.M., N. Scarmeas), the Department of Neurology (Y.G., A.M.B., Y.S., C.G.H., J.J.M., R.M.), the Department of Medicine (J.A.L.), and the Division of Epidemiology, Joseph P. Mailman School of Public Health (J.A.L., N. Schupf), Columbia University, New York, NY; and the National and Kapodistrian University of Athens Medical School (N. Scarmeas), Greece.
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Yaakov Stern
From The Taub Institute for Research in Alzheimer's Disease and the Aging Brain (Y.G., A.M.B., Y.S., C.G.H., O.R.R., J.A.L., J.J.M., N. Schupf, R.M., N. Scarmeas), The Gertrude H. Sergievsky Center (A.M.B., Y.S., C.G.H., J.A.L., J.J.M., N. Schupf, R.M., N. Scarmeas), the Department of Neurology (Y.G., A.M.B., Y.S., C.G.H., J.J.M., R.M.), the Department of Medicine (J.A.L.), and the Division of Epidemiology, Joseph P. Mailman School of Public Health (J.A.L., N. Schupf), Columbia University, New York, NY; and the National and Kapodistrian University of Athens Medical School (N. Scarmeas), Greece.
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Christian G. Habeck
From The Taub Institute for Research in Alzheimer's Disease and the Aging Brain (Y.G., A.M.B., Y.S., C.G.H., O.R.R., J.A.L., J.J.M., N. Schupf, R.M., N. Scarmeas), The Gertrude H. Sergievsky Center (A.M.B., Y.S., C.G.H., J.A.L., J.J.M., N. Schupf, R.M., N. Scarmeas), the Department of Neurology (Y.G., A.M.B., Y.S., C.G.H., J.J.M., R.M.), the Department of Medicine (J.A.L.), and the Division of Epidemiology, Joseph P. Mailman School of Public Health (J.A.L., N. Schupf), Columbia University, New York, NY; and the National and Kapodistrian University of Athens Medical School (N. Scarmeas), Greece.
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Qolamreza R. Razlighi
From The Taub Institute for Research in Alzheimer's Disease and the Aging Brain (Y.G., A.M.B., Y.S., C.G.H., O.R.R., J.A.L., J.J.M., N. Schupf, R.M., N. Scarmeas), The Gertrude H. Sergievsky Center (A.M.B., Y.S., C.G.H., J.A.L., J.J.M., N. Schupf, R.M., N. Scarmeas), the Department of Neurology (Y.G., A.M.B., Y.S., C.G.H., J.J.M., R.M.), the Department of Medicine (J.A.L.), and the Division of Epidemiology, Joseph P. Mailman School of Public Health (J.A.L., N. Schupf), Columbia University, New York, NY; and the National and Kapodistrian University of Athens Medical School (N. Scarmeas), Greece.
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José A. Luchsinger
From The Taub Institute for Research in Alzheimer's Disease and the Aging Brain (Y.G., A.M.B., Y.S., C.G.H., O.R.R., J.A.L., J.J.M., N. Schupf, R.M., N. Scarmeas), The Gertrude H. Sergievsky Center (A.M.B., Y.S., C.G.H., J.A.L., J.J.M., N. Schupf, R.M., N. Scarmeas), the Department of Neurology (Y.G., A.M.B., Y.S., C.G.H., J.J.M., R.M.), the Department of Medicine (J.A.L.), and the Division of Epidemiology, Joseph P. Mailman School of Public Health (J.A.L., N. Schupf), Columbia University, New York, NY; and the National and Kapodistrian University of Athens Medical School (N. Scarmeas), Greece.
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Jennifer J. Manly
From The Taub Institute for Research in Alzheimer's Disease and the Aging Brain (Y.G., A.M.B., Y.S., C.G.H., O.R.R., J.A.L., J.J.M., N. Schupf, R.M., N. Scarmeas), The Gertrude H. Sergievsky Center (A.M.B., Y.S., C.G.H., J.A.L., J.J.M., N. Schupf, R.M., N. Scarmeas), the Department of Neurology (Y.G., A.M.B., Y.S., C.G.H., J.J.M., R.M.), the Department of Medicine (J.A.L.), and the Division of Epidemiology, Joseph P. Mailman School of Public Health (J.A.L., N. Schupf), Columbia University, New York, NY; and the National and Kapodistrian University of Athens Medical School (N. Scarmeas), Greece.
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Nicole Schupf
From The Taub Institute for Research in Alzheimer's Disease and the Aging Brain (Y.G., A.M.B., Y.S., C.G.H., O.R.R., J.A.L., J.J.M., N. Schupf, R.M., N. Scarmeas), The Gertrude H. Sergievsky Center (A.M.B., Y.S., C.G.H., J.A.L., J.J.M., N. Schupf, R.M., N. Scarmeas), the Department of Neurology (Y.G., A.M.B., Y.S., C.G.H., J.J.M., R.M.), the Department of Medicine (J.A.L.), and the Division of Epidemiology, Joseph P. Mailman School of Public Health (J.A.L., N. Schupf), Columbia University, New York, NY; and the National and Kapodistrian University of Athens Medical School (N. Scarmeas), Greece.
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Richard Mayeux
From The Taub Institute for Research in Alzheimer's Disease and the Aging Brain (Y.G., A.M.B., Y.S., C.G.H., O.R.R., J.A.L., J.J.M., N. Schupf, R.M., N. Scarmeas), The Gertrude H. Sergievsky Center (A.M.B., Y.S., C.G.H., J.A.L., J.J.M., N. Schupf, R.M., N. Scarmeas), the Department of Neurology (Y.G., A.M.B., Y.S., C.G.H., J.J.M., R.M.), the Department of Medicine (J.A.L.), and the Division of Epidemiology, Joseph P. Mailman School of Public Health (J.A.L., N. Schupf), Columbia University, New York, NY; and the National and Kapodistrian University of Athens Medical School (N. Scarmeas), Greece.
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Nikolaos Scarmeas
From The Taub Institute for Research in Alzheimer's Disease and the Aging Brain (Y.G., A.M.B., Y.S., C.G.H., O.R.R., J.A.L., J.J.M., N. Schupf, R.M., N. Scarmeas), The Gertrude H. Sergievsky Center (A.M.B., Y.S., C.G.H., J.A.L., J.J.M., N. Schupf, R.M., N. Scarmeas), the Department of Neurology (Y.G., A.M.B., Y.S., C.G.H., J.J.M., R.M.), the Department of Medicine (J.A.L.), and the Division of Epidemiology, Joseph P. Mailman School of Public Health (J.A.L., N. Schupf), Columbia University, New York, NY; and the National and Kapodistrian University of Athens Medical School (N. Scarmeas), Greece.
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Citation
Mediterranean diet and brain structure in a multiethnic elderly cohort
Yian Gu, Adam M. Brickman, Yaakov Stern, Christian G. Habeck, Qolamreza R. Razlighi, José A. Luchsinger, Jennifer J. Manly, Nicole Schupf, Richard Mayeux, Nikolaos Scarmeas
Neurology Nov 2015, 85 (20) 1744-1751; DOI: 10.1212/WNL.0000000000002121

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Abstract

Objective: To determine whether higher adherence to a Mediterranean-type diet (MeDi) is related with larger MRI-measured brain volume or cortical thickness.

Methods: In this cross-sectional study, high-resolution structural MRI was collected on 674 elderly (mean age 80.1 years) adults without dementia who participated in a community-based, multiethnic cohort. Dietary information was collected via a food frequency questionnaire. Total brain volume (TBV), total gray matter volume (TGMV), total white matter volume (TWMV), mean cortical thickness (mCT), and regional volume or CT were derived from MRI scans using FreeSurfer program. We examined the association of MeDi (scored as 0–9) and individual food groups with brain volume and thickness using regression models adjusted for age, sex, ethnicity, education, body mass index, diabetes, and cognition.

Results: Compared to lower MeDi adherence (0–4), higher adherence (5–9) was associated with 13.11 (p = 0.007), 5.00 (p = 0.05), and 6.41 (p = 0.05) milliliter larger TBV, TGMV, and TWMV, respectively. Higher fish (b = 7.06, p = 0.006) and lower meat (b = 8.42, p = 0.002) intakes were associated with larger TGMV. Lower meat intake was also associated with larger TBV (b = 12.20, p = 0.02). Higher fish intake was associated with 0.019 mm (p = 0.03) larger mCT. Volumes of cingulate cortex, parietal lobe, temporal lobe, and hippocampus and CT of the superior-frontal region were associated with the dietary factors.

Conclusions: 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.

GLOSSARY

AD=
Alzheimer disease;
AGE=
advanced glycation end products;
BMI=
body mass index;
CDR=
Clinical Dementia Rating;
DSM-III-R=
Diagnostic and Statistical Manual of Mental Disorders, 3rd edition, revised;
FFQ=
food frequency questionnaire;
GLM=
generalized linear model;
GM=
gray matter;
ICV=
intracranial volume;
MANOVA=
multivariate analysis of variance;
MCI=
mild cognitive impairment;
mCT=
mean cortical thickness;
MeDi=
Mediterranean diet;
PUFA=
polyunsaturated fatty acids;
ROI=
region of interest;
SFA=
saturated fats;
TBV=
total brain volume;
TGMV=
total gray matter volume;
TWMV=
total white matter volume;
WHICAP=
Washington Heights/Hamilton Heights Inwood Columbia Aging Project;
WM=
white matter

Footnotes

  • Go to Neurology.org for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.

  • Supplemental data at Neurology.org

  • Received February 27, 2015.
  • Accepted in final form July 16, 2015.
  • © 2015 American Academy of Neurology
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