Effect of the Mediterranean diet on cognition and brain morphology and function: a systematic review of randomized controlled trials

Radd‐Vagenas, Sue; Duffy, Shantel L.; Naismith, Sharon L.; Brew, Bruce J.; Flood, Victoria M; Singh, Maria A. Fiatarone

doi:10.1093/ajcn/nqx070

Cited by 125 publications

(93 citation statements)

References 84 publications

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“…Several randomized controlled trials (RCTs) have examined the association between MedDi and cognitive function [33][34][35]. The Spanish PREDIMED (Prevención con Dieta Mediterranea) study was the cornerstone trial showing that patients at high cardiovascular risk consuming MedDi (supplemented with either extra-virgin olive oil or nuts) had a reduced incidence of cardiovascular events compared to those following a low-fat diet after a follow-up period of five years [36,37].…”

Section: Mediterranean Dietmentioning

confidence: 99%

Influence of the Mediterranean and Ketogenic Diets on Cognitive Status and Decline: A Narrative Review

et al. 2020

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Alzheimer’s disease (AD) is the most common form of senile dementia, accounting for up to 70% of dementia cases. AD is a slowly progressive disease, which causes global mental deterioration by affecting various cognitive areas. A growing body of evidence has demonstrated that lifestyle habits and nutritional patterns could delay the natural course of the neurodegeneration process. There is no single dietary pattern unequivocally proven to prevent AD. Nevertheless, epidemiological data suggest that by adopting several dietary habits, especially if accompanied with a healthy lifestyle, the negative consequences of AD could potentially be delayed. Alongside with others, two specific eating patterns have been well investigated concerning their potential beneficial effect on cognitive status: the Mediterranean diet (MedDi) and the Ketogenic Diet (KD). Despite the different underlying mechanisms, both of them have demonstrated a fairly profitable role in reducing or delaying cognitive impairment. The aim of the present narrative review is to overview the existing research on the efficacy of MedDi and KD against AD-related cognitive decline, focusing on the proposed protective mechanisms of action. Although the current knowledge on this complex topic does not allow us, at this point, to make exhaustive conclusions, this information could be of help in order to better characterize the possible role of MedDi and KD as nonpharmacological therapies in the treatment of AD and, more generically, of neurodegenerative disorders.

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Section: Mediterranean Dietmentioning

confidence: 99%

Influence of the Mediterranean and Ketogenic Diets on Cognitive Status and Decline: A Narrative Review

et al. 2020

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“…As an indicator of therapeutic validity, the quality of the intervention utilised in the studies was also assessed. The areas of interest were informed by an earlier review (38) and included whether (i) a dietitian was involved in the design of the dietary intervention; (ii) the dietary intervention was a partial or full simulation of the low-inflammatory diet; (iii) there was the monitoring of adherence to the dietary intervention and (iv) a validated tool was utilised to measure dietary adherence.…”

Section: Risk Of Bias In Individual Studiesmentioning

confidence: 99%

Health effects of a low-inflammatory diet in adults with arthritis: a systematic review and meta-analysis

et al. 2020

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The aim is to systematically assess the health impact of a low-inflammatory diet intervention (full-diet or supplement), compared to usual diet or other dietary interventions, on weight change, inflammatory biomarkers, joint symptoms, and quality of life in adults with osteoarthritis, rheumatoid arthritis or seronegative arthropathy (psoriatic, reactive, ankylosing spondylitis or IBD-related), on outcomes assessed in prospective studies within 6 months of intervention commencement (PROSPERO CRD42019136567). Search of multiple electronic library databases from inception to July 2019, supplemented by grey literature searches, for randomised and prospective trials assessing the above objective. After exclusion of 446 ineligible studies, five randomised and two prospective trials involving 468 participants with either osteoarthritis or rheumatoid arthritis were included. GRADE assessment for all outcomes was very low. Meta-analyses produced the following standardised mean differences (SMD) and 95 % confidence interval (CI) 2–4 months following commencement of the diets favouring the low-inflammatory diet: weight SMD −0⋅45 (CI −0⋅71, −0⋅18); inflammatory biomarkers SMD −2⋅33 (CI −3⋅82, −0⋅84). No significant effects were found for physical function (SMD −0⋅62; CI −1⋅39, 0⋅14), general health (SMD 0⋅89; CI −0⋅39, 2⋅16) and joint pain (SMD −0⋅98; CI −2⋅90, 0⋅93). In most studies, the quality of dietary intervention (dietitian input, use of validated dietary compliance tool) could not be gauged. In conclusion, very low-level evidence suggests that low-inflammatory diets or supplements compared to usual diets are associated with greater weight loss and improvement in inflammatory biomarkers. More high-quality trials are needed to assess the health effects of a low-inflammatory diet more comprehensively and conclusively in arthritic conditions.

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“…For example, the PREDIMED programme provided both individual (with a dietitian) and group support for participants approximately every 3 months, meaning between 12 and 26 sessions of each depending on the overall study length, and this robust design may have contributed in part to the success of the programme (Radd‐Vagenas et al . ).…”

Section: Future Directions and Medex‐ukmentioning

confidence: 97%

“…A recent systematic review, however, identified five separate RCTs on the effects of a MDP on cognition, including five specific sub-studies from PREDIMED RCT (only two of which were reported by SACN; Radd-Vagenas et al 2018). The authors note that only eight of the 66 cognitive outcomes measured within these studies indicated that Mediterranean diet was associated with better cognitive performance, with effect sizes ranging from small (0.32) to large (1.66).…”

Section: Heart Health and Cognitive Healthmentioning

confidence: 99%

Diet, exercise and dementia: The potential impact of a Mediterranean diet pattern and physical activity on cognitive health in a UK population

Bundy

Minihane

2018

Nutrition Bulletin

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Diet and physical activity play key roles in maintaining health and preventing or delaying disease. The global prevalence of dementia, an umbrella term describing a set of symptoms which affect cognitive function, is set to rise dramatically by 2050, with current drug treatments inadequate. Diet and physical activity are modifiable factors in dementia, influencing both disease risk and pathophysiology. It has been known since the 1950s that a Mediterranean diet has positive health benefits. Over the past 25 years, a causal link has been shown between consumption of a Mediterranean diet and decreased risk of cardiovascular disease, particularly in Mediterranean countries. There have also been indications that a Mediterranean diet and increased physical activity can improve cognitive health and delay the onset of dementia. However, causative demonstrations of these effects, as well as the feasibility of implementing such lifestyle changes in a non‐Mediterranean population, are lacking. The new MedEx‐UK programme will attempt to address both these points.

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Effect of the Mediterranean diet on cognition and brain morphology and function: a systematic review of randomized controlled trials

Abstract: Five RCTs of the Mediterranean diet and cognition have been published to date. The data are mostly nonsignificant, with small ESs. However, the significant improvements in cognitive domain composites in the most robustly designed study warrant additional research.

Cited by 125 publications

References 84 publications

Influence of the Mediterranean and Ketogenic Diets on Cognitive Status and Decline: A Narrative Review

Influence of the Mediterranean and Ketogenic Diets on Cognitive Status and Decline: A Narrative Review

Health effects of a low-inflammatory diet in adults with arthritis: a systematic review and meta-analysis

Diet, exercise and dementia: The potential impact of a Mediterranean diet pattern and physical activity on cognitive health in a UK population

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