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May 15, 2018; 90 (20) Article

Mediterranean diet and 3-year Alzheimer brain biomarker changes in middle-aged adults

Valentina Berti, Michelle Walters, Joanna Sterling, Crystal G. Quinn, Michelle Logue, Randolph Andrews, Dawn C. Matthews, Ricardo S. Osorio, Alberto Pupi, Shankar Vallabhajosula, Richard S. Isaacson, Mony J. de Leon, Lisa Mosconi
First published April 13, 2018, DOI: https://doi.org/10.1212/WNL.0000000000005527
Valentina Berti
From the Department of Clinical Pathophysiology (V.B., A.P.), Nuclear Medicine Unit, University of Florence, Italy; Department of Nutrition and Food Studies (M.W., L.M.), New York University Steinhardt School of Culture, Education, and Human Development, NY; Woodrow Wilson School of Public and International Affairs (J.S.), Department of Psychology, Princeton University, NJ; Department of Psychiatry (C.G.Q., M.L., R.S.O., L.M.), New York University School of Medicine, NY; ADM Diagnostics (R.A., D.C.M., M.J.d.L.), Chicago, IL; and Departments of Radiology (S.V.) and Neurology (R.S.I., L.M.), Weill Cornell Medical Center/NewYork–Presbyterian, NY.
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Michelle Walters
From the Department of Clinical Pathophysiology (V.B., A.P.), Nuclear Medicine Unit, University of Florence, Italy; Department of Nutrition and Food Studies (M.W., L.M.), New York University Steinhardt School of Culture, Education, and Human Development, NY; Woodrow Wilson School of Public and International Affairs (J.S.), Department of Psychology, Princeton University, NJ; Department of Psychiatry (C.G.Q., M.L., R.S.O., L.M.), New York University School of Medicine, NY; ADM Diagnostics (R.A., D.C.M., M.J.d.L.), Chicago, IL; and Departments of Radiology (S.V.) and Neurology (R.S.I., L.M.), Weill Cornell Medical Center/NewYork–Presbyterian, NY.
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Joanna Sterling
From the Department of Clinical Pathophysiology (V.B., A.P.), Nuclear Medicine Unit, University of Florence, Italy; Department of Nutrition and Food Studies (M.W., L.M.), New York University Steinhardt School of Culture, Education, and Human Development, NY; Woodrow Wilson School of Public and International Affairs (J.S.), Department of Psychology, Princeton University, NJ; Department of Psychiatry (C.G.Q., M.L., R.S.O., L.M.), New York University School of Medicine, NY; ADM Diagnostics (R.A., D.C.M., M.J.d.L.), Chicago, IL; and Departments of Radiology (S.V.) and Neurology (R.S.I., L.M.), Weill Cornell Medical Center/NewYork–Presbyterian, NY.
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Crystal G. Quinn
From the Department of Clinical Pathophysiology (V.B., A.P.), Nuclear Medicine Unit, University of Florence, Italy; Department of Nutrition and Food Studies (M.W., L.M.), New York University Steinhardt School of Culture, Education, and Human Development, NY; Woodrow Wilson School of Public and International Affairs (J.S.), Department of Psychology, Princeton University, NJ; Department of Psychiatry (C.G.Q., M.L., R.S.O., L.M.), New York University School of Medicine, NY; ADM Diagnostics (R.A., D.C.M., M.J.d.L.), Chicago, IL; and Departments of Radiology (S.V.) and Neurology (R.S.I., L.M.), Weill Cornell Medical Center/NewYork–Presbyterian, NY.
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Michelle Logue
From the Department of Clinical Pathophysiology (V.B., A.P.), Nuclear Medicine Unit, University of Florence, Italy; Department of Nutrition and Food Studies (M.W., L.M.), New York University Steinhardt School of Culture, Education, and Human Development, NY; Woodrow Wilson School of Public and International Affairs (J.S.), Department of Psychology, Princeton University, NJ; Department of Psychiatry (C.G.Q., M.L., R.S.O., L.M.), New York University School of Medicine, NY; ADM Diagnostics (R.A., D.C.M., M.J.d.L.), Chicago, IL; and Departments of Radiology (S.V.) and Neurology (R.S.I., L.M.), Weill Cornell Medical Center/NewYork–Presbyterian, NY.
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Randolph Andrews
From the Department of Clinical Pathophysiology (V.B., A.P.), Nuclear Medicine Unit, University of Florence, Italy; Department of Nutrition and Food Studies (M.W., L.M.), New York University Steinhardt School of Culture, Education, and Human Development, NY; Woodrow Wilson School of Public and International Affairs (J.S.), Department of Psychology, Princeton University, NJ; Department of Psychiatry (C.G.Q., M.L., R.S.O., L.M.), New York University School of Medicine, NY; ADM Diagnostics (R.A., D.C.M., M.J.d.L.), Chicago, IL; and Departments of Radiology (S.V.) and Neurology (R.S.I., L.M.), Weill Cornell Medical Center/NewYork–Presbyterian, NY.
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Dawn C. Matthews
From the Department of Clinical Pathophysiology (V.B., A.P.), Nuclear Medicine Unit, University of Florence, Italy; Department of Nutrition and Food Studies (M.W., L.M.), New York University Steinhardt School of Culture, Education, and Human Development, NY; Woodrow Wilson School of Public and International Affairs (J.S.), Department of Psychology, Princeton University, NJ; Department of Psychiatry (C.G.Q., M.L., R.S.O., L.M.), New York University School of Medicine, NY; ADM Diagnostics (R.A., D.C.M., M.J.d.L.), Chicago, IL; and Departments of Radiology (S.V.) and Neurology (R.S.I., L.M.), Weill Cornell Medical Center/NewYork–Presbyterian, NY.
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Ricardo S. Osorio
From the Department of Clinical Pathophysiology (V.B., A.P.), Nuclear Medicine Unit, University of Florence, Italy; Department of Nutrition and Food Studies (M.W., L.M.), New York University Steinhardt School of Culture, Education, and Human Development, NY; Woodrow Wilson School of Public and International Affairs (J.S.), Department of Psychology, Princeton University, NJ; Department of Psychiatry (C.G.Q., M.L., R.S.O., L.M.), New York University School of Medicine, NY; ADM Diagnostics (R.A., D.C.M., M.J.d.L.), Chicago, IL; and Departments of Radiology (S.V.) and Neurology (R.S.I., L.M.), Weill Cornell Medical Center/NewYork–Presbyterian, NY.
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Alberto Pupi
From the Department of Clinical Pathophysiology (V.B., A.P.), Nuclear Medicine Unit, University of Florence, Italy; Department of Nutrition and Food Studies (M.W., L.M.), New York University Steinhardt School of Culture, Education, and Human Development, NY; Woodrow Wilson School of Public and International Affairs (J.S.), Department of Psychology, Princeton University, NJ; Department of Psychiatry (C.G.Q., M.L., R.S.O., L.M.), New York University School of Medicine, NY; ADM Diagnostics (R.A., D.C.M., M.J.d.L.), Chicago, IL; and Departments of Radiology (S.V.) and Neurology (R.S.I., L.M.), Weill Cornell Medical Center/NewYork–Presbyterian, NY.
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Shankar Vallabhajosula
From the Department of Clinical Pathophysiology (V.B., A.P.), Nuclear Medicine Unit, University of Florence, Italy; Department of Nutrition and Food Studies (M.W., L.M.), New York University Steinhardt School of Culture, Education, and Human Development, NY; Woodrow Wilson School of Public and International Affairs (J.S.), Department of Psychology, Princeton University, NJ; Department of Psychiatry (C.G.Q., M.L., R.S.O., L.M.), New York University School of Medicine, NY; ADM Diagnostics (R.A., D.C.M., M.J.d.L.), Chicago, IL; and Departments of Radiology (S.V.) and Neurology (R.S.I., L.M.), Weill Cornell Medical Center/NewYork–Presbyterian, NY.
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Richard S. Isaacson
From the Department of Clinical Pathophysiology (V.B., A.P.), Nuclear Medicine Unit, University of Florence, Italy; Department of Nutrition and Food Studies (M.W., L.M.), New York University Steinhardt School of Culture, Education, and Human Development, NY; Woodrow Wilson School of Public and International Affairs (J.S.), Department of Psychology, Princeton University, NJ; Department of Psychiatry (C.G.Q., M.L., R.S.O., L.M.), New York University School of Medicine, NY; ADM Diagnostics (R.A., D.C.M., M.J.d.L.), Chicago, IL; and Departments of Radiology (S.V.) and Neurology (R.S.I., L.M.), Weill Cornell Medical Center/NewYork–Presbyterian, NY.
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Mony J. de Leon
From the Department of Clinical Pathophysiology (V.B., A.P.), Nuclear Medicine Unit, University of Florence, Italy; Department of Nutrition and Food Studies (M.W., L.M.), New York University Steinhardt School of Culture, Education, and Human Development, NY; Woodrow Wilson School of Public and International Affairs (J.S.), Department of Psychology, Princeton University, NJ; Department of Psychiatry (C.G.Q., M.L., R.S.O., L.M.), New York University School of Medicine, NY; ADM Diagnostics (R.A., D.C.M., M.J.d.L.), Chicago, IL; and Departments of Radiology (S.V.) and Neurology (R.S.I., L.M.), Weill Cornell Medical Center/NewYork–Presbyterian, NY.
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Lisa Mosconi
From the Department of Clinical Pathophysiology (V.B., A.P.), Nuclear Medicine Unit, University of Florence, Italy; Department of Nutrition and Food Studies (M.W., L.M.), New York University Steinhardt School of Culture, Education, and Human Development, NY; Woodrow Wilson School of Public and International Affairs (J.S.), Department of Psychology, Princeton University, NJ; Department of Psychiatry (C.G.Q., M.L., R.S.O., L.M.), New York University School of Medicine, NY; ADM Diagnostics (R.A., D.C.M., M.J.d.L.), Chicago, IL; and Departments of Radiology (S.V.) and Neurology (R.S.I., L.M.), Weill Cornell Medical Center/NewYork–Presbyterian, NY.
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Citation
Mediterranean diet and 3-year Alzheimer brain biomarker changes in middle-aged adults
Valentina Berti, Michelle Walters, Joanna Sterling, Crystal G. Quinn, Michelle Logue, Randolph Andrews, Dawn C. Matthews, Ricardo S. Osorio, Alberto Pupi, Shankar Vallabhajosula, Richard S. Isaacson, Mony J. de Leon, Lisa Mosconi
Neurology May 2018, 90 (20) e1789-e1798; DOI: 10.1212/WNL.0000000000005527

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Abstract

Objective To examine in a 3-year brain imaging study the effects of higher vs lower adherence to a Mediterranean-style diet (MeDi) on Alzheimer disease (AD) biomarker changes (brain β-amyloid load via 11C-Pittsburgh compound B [PiB] PET and neurodegeneration via 18F-fluorodeoxyglucose [FDG] PET and structural MRI) in midlife.

Methods Seventy 30- to 60-year-old cognitively normal participants with clinical, neuropsychological, and dietary examinations and imaging biomarkers at least 2 years apart were examined. These included 34 participants with higher (MeDi+) and 36 with lower (MeDi−) MeDi adherence. Statistical parametric mapping and volumes of interest were used to compare AD biomarkers between groups at cross section and longitudinally.

Results MeDi groups were comparable for clinical and neuropsychological measures. At baseline, compared to the MeDi+ group, the MeDi− group showed reduced FDG-PET glucose metabolism (CMRglc) and higher PiB-PET deposition in AD-affected regions (p < 0.001). Longitudinally, the MeDi−-group showed CMRglc declines and PiB increases in these regions, which were greater than those in the MeDi+ group (pinteraction < 0.001). No effects were observed on MRI. Higher MeDi adherence was estimated to provide 1.5 to 3.5 years of protection against AD.

Conclusion Lower MeDi adherence was associated with progressive AD biomarker abnormalities in middle-aged adults. These data support further investigation of dietary interventions for protection against brain aging and AD.

GLOSSARY

Aβ=
β-amyloid;
AD=
Alzheimer disease;
BMI=
body mass index;
CMRglc=
cerebral metabolic rate of glucose;
FDG=
18F-fluorodeoxyglucose;
GMV=
gray matter volume;
MeDi=
Mediterranean-style diet;
PiB=
Pittsburgh compound B;
QUICKI=
Quantitative Insulin Sensitivity Check Index;
SUVR=
standardized uptake value ratio

Footnotes

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

  • CME Course: NPub.org/cmelist

  • Received October 10, 2017.
  • Accepted in final form February 26, 2018.
  • © 2018 American Academy of Neurology
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