Mediterranean diet and magnetic resonance imaging–assessed cerebrovascular disease

Abstract

Objective Cerebrovascular disease is 1 of the possible mechanisms of the previously reported relationship between Mediterranean-type diet (MeDi) and Alzheimer’s disease (AD). We sought to investigate the association between MeDi and MRI infarcts. Methods High-resolution structural MRI was collected on 707 elderly 65 years or older community residents of New York with available dietary assessments administered an average of 5.8 years (3.22 standard deviations [SDs]) before the MRI. Participants were divided into 3 groups of adherence to MeDi (low, middle, and high tertiles). We examined the association of increasing adherence to MeDi with presence of infarcts on MRI. Models were run without adjustment, adjusted for basic demographic and clinical factors, and adjusted for vascular risk factors. Results A total of 222 participants had at least 1 infarct. In the unadjusted model, compared to the low adherence group, those in the moderate MeDi adherence group had a 22% reduced odds of having an infarct (odds ratio [OR], 0.78; 95% confidence interval [CI], 0.55–1.14), while participants in the highest MeDi adherence group had a 36% reduced odds (OR, 0.64; 95% CI, 0.42–0.97; p for trend = 0.04). In adjusted models, the association between MeDi adherence and MRI infarcts remained essentially unchanged. The association of high MeDi adherence with infarcts was comparable to that of hypertension (40% reduced probability), did not vary by infarct size or after excluding patients with dementia (n = 46) or clinical strokes (n = 86). There was no association between MeDi and white matter hyperintensities. Interpretation Higher adherence to the MeDi is associated with reduced cerebrovascular disease burden.

Mediterranean Diet, Cognitive Function, and Dementia: A Systematic Review of the Evidence

“…Moreover, factors such as sex, presence or history of relevant comorbidities such as diabetes and CVD, and use of dietary supplementation should be considered and adjusted for. The effects of the MD on brain volume and function also should be examined with the use of physiologic tests and neuroimaging, such as with those used by Scarmeas et al (84). This could give better insight into which neurologic systems are affected by diet.…”

Mediterranean Diet and Cardiovascular Risk

“…A recent study analyzed the impact of Mediterranean Diet on magnetic resonance imaging-assessed cerebrovascular disease. In a random sample of 700 elderly subjects, medium and high adherence to Mediterranean Diet elicited a 22 and 36% lower odds ratio for presenting evidence of infarcts on magnetic resonance imaging with respect to poor adherers (Scarmeas et al, 2011). In fact, adhering to nutritional features of Mediterranean Diet is more effective to act as secondary prevention for stroke than any single medication (Spence, 2010), even provoking the reversion of carotid atherosclerosis (Shai et al, 2010) …”

Dietary Patterns Associated with Alzheimer?s Disease and Related Chronic Disease Risk: A Review

“…Scarmeas et al [74] demonstrated an association between MeDi and cerebrovascular disease, specifically infarcts demonstrated by magnetic resonance imaging; subjects within the highest MeDi adherence tertile had approximately 40% reduction in the likelihood of a brain infarct (Odds Ratio (OR): 0.64; 95% CI: 0.42 -0.97; p for trend=0.04). This cohort of 707 elderly individuals was multiethnic, including Caucasians, Hispanics, and African American participants, which increases the translational nature of these results.…”

“…Mendez et al used an extensive computerized diet-history instrument with over 600 items to capture intake over the previous year. The number of items included is greatly increased compared to other studies [48,74,77,78,91], and participant fatigue when completing a questionnaire of this length may have impaired response accuracy.…”