A 5-Year Systematic Review (2018 to 2022) on The Effectiveness of Mediterranean Diet in Preventing Alzheimer’s Disease
Nur Khairina Binte Azan1,2, Ariel SY Ng1,2, Farij Bin Samsudi1,2, Muhammad Rusydi Bin Mazlan1,2, Yuan Kai Loh1,2 and Maurice HT Ling1,2,3,4*
1School of Life Sciences, Management Development Institute of Singapore, Singapore
2Department of Life Sciences, University of Roehampton, United Kingdom
3School of Data Sciences, Perdana University, Malaysia
4HOHY PTE LTD, Singapore
*Corresponding Author: Maurice HT Ling, School of Life Sciences, Management Development Institute of Singapore, Singapore.
January 02, 2023; Published: January 19, 2023
Alzheimer’s disease (AD) is an age-related neuronal disorder characterized by abnormal levels of proteins, beta amyloid (Aβ) and tau, resulting in gradual loss of cognitive functions due to impaired network of neurons in the brain. Past literature has proposed dietary interventions through administration of Mediterranean Diet (MD) as a solution to prevent AD development. A systematic review on the effectiveness of MD in preventing AD is executed up to July 3, 2022, using PubMed as source database within the last 5 years between 2018 to 2022. 131 articles were identified, and 26 articles were included in this review. After analysing the articles, 5 themes were identified to examine the effectiveness of MD: namely, (a) MD adherence and AD risk (b) MD and AD pathological development, (c) MD and cognitive health (d) Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) diet, and (e) Diet-microbe interaction. MD adherence is a vital factor in achieving successful dietary intervention. Various covariates and demographics affect adherence level. Differing evidence from literature discuss MD’s efficacy in preventing AD. MD is concluded to be effective to a certain extent in preventing Alzheimer’s disease due to various factors such as adherence levels, demographics etc and further longitudinal and randomised control trials (RCT) are warranted.
Keywords: Randomised Control Trials (RCT); Alzheimer’s Disease (AD); Mediterranean Diet
- Carrillo JÁ., et al. “Cognitive Function and Consumption of Fruit and Vegetable Polyphenols in a Young Population: Is There a Relationship?” Foods10 (2019): 507.
- Nagpal R., et al. “Modified Mediterranean-Ketogenic Diet Modulates Gut Microbiome and Short-Chain Fatty Acids in Association with Alzheimer’s Disease Markers in Subjects with Mild Cognitive Impairment”. EBioMedicine 47 (2019): 529-542.
- Dhana K., et al. “Healthy Lifestyle and Life Expectancy With and Without Alzheimer’s Dementia: Population Based Cohort Study”. BMJ 377 (2022): e068390.
- Liu X., et al. “Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) study: Rationale, design and baseline characteristics of a randomized control trial of the MIND diet on cognitive decline”. Contemporary Clinical Trials 102 (2021): 106270.
- Nagpal R., et al. “Gut Mycobiome and Its Interaction With Diet, Gut Bacteria and Alzheimer’s Disease Markers in Subjects with Mild Cognitive Impairment: A Pilot Study”. EBioMedicine 59 (2020): 102950.
- Mosconi L., et al. “Lifestyle and Vascular Risk Effects on MRI-Based Biomarkers of Alzheimer’s Disease: A Cross-Sectional Study of Middle-Aged Adults from the Broader New York City Area”. BMJ open3 (2018): e019362.
- Margara-Escudero HJ., et al. “Association Between Egg Consumption and Dementia Risk in the EPIC-Spain Dementia Cohort”. Frontiers in Nutrition 9 (2022): 827307.
- Rocaspana-García M., et al. “Study of Community-Living Alzheimer’s Patients’ Adherence to the Mediterranean Diet and Risks of Malnutrition at Different Disease Stages”. Peer Journal 6 (2018): e5150.
- Sanchez-Flack JC., et al. “Building Research in Diet and Cognition (BRIDGE): Baseline Characteristics of Older Obese African American Adults in a Randomized Controlled Trial to Examine the Effect of the Mediterranean Diet With and Without Weight Loss on Cognitive Functioning”. Preventive Medicine Reports 22 (2021): 101302.
- Wesselman LMP., et al. “Dietary Patterns are Related to Cognitive Functioning in Elderly Enriched with Individuals at Increased Risk for Alzheimer’s Disease”. European Journal of Nutrition2 (2021): 849-860.
- Andreu-Reinón ME., et al. “Mediterranean Diet and Risk of Dementia and Alzheimer’s Disease in the EPIC-Spain Dementia Cohort Study”. Nutrients2 (2021): 700.
- Tsolaki M., et al. “A Randomized Clinical Trial of Greek High Phenolic Early Harvest Extra Virgin Olive Oil in Mild Cognitive Impairment: The MICOIL Pilot Study”. Journal of Alzheimer’s Disease2 (2020): 801-817.
- Bhushan A., et al. “Adherence to Mediterranean Diet and Subjective Cognitive Function in Men”. European Journal of Epidemiology2 (2018): 223-234.
- Karstens AJ., et al. “Associations of the Mediterranean Diet with Cognitive and Neuroimaging Phenotypes of Dementia in Healthy Older Adults”. The American Journal of Clinical Nutrition2 (2019): 361-368.
- Berti V., et al. “Mediterranean Diet and 3-Year Alzheimer Brain Biomarker Changes in Middle-Aged Adults”. Neurology20 (2018): e1789-e1798.
- Martín ISM., et al. “Body Composition, Dietary, and Gustatory Function Assessment in People With Alzheimer’s Disease”. American Journal of Alzheimer’s Disease and Other Dementias8 (2018): 508-515.
- Taylor MK., et al. “NHANES 2011-2014 Reveals Cognition of US Older Adults may Benefit from Better Adaptation to the Mediterranean Diet”. Nutrients7 (2020): 1929.
- Dhana K., et al. “MIND Diet, Common Brain Pathologies, and Cognition in Community-Dwelling Older Adults”. Journal of Alzheimer’s Disease2 (2021): 683-692.
- Ballarini T., et al. “Mediterranean Diet, Alzheimer Disease Biomarkers and Brain Atrophy in Old Age”. Neurology24 (2021): e2920-2932.
- Hill E., et al. “Adherence to the Mediterranean Diet Is not Related to Beta-Amyloid Deposition: Data from the Women’s Healthy Ageing Project”. The Journal of Prevention of Alzheimer’s Disease2 (2018): 137-141.
- McMaster M., et al. “Body, Brain, Life for Cognitive Decline (BBL-CD): Protocol for a Multidomain Dementia Risk Reduction Randomized Controlled Trial for Subjective Cognitive Decline and Mild Cognitive Impairment”. Clinical Interventions in Aging 13 (2018): 2397-2406.
- Rainey-Smith SR., et al. “Mediterranean Diet Adherence and Rate of Cerebral Aβ-Amyloid Accumulation: Data from the Australian Imaging, Biomarkers and Lifestyle Study of Ageing”. Translational Psychiatry1 (2018): 238.
- Walters MJ., et al. “Associations of Lifestyle and Vascular Risk Factors with Alzheimer’s Brain Biomarker Changes During Middle Age: A 3-Year Longitudinal Study in the Broader New York City Area”. BMJ Open11 (2018): e023664.
- Schwarz C., et al. “Spermidine Intake is Associated with Cortical Thickness and Hippocampal Volume in Older Adults”. NeuroImage 221 (2020): 117132.
- Liu X., et al. “Higher Circulating α-Carotene was Associated with Better Cognitive Function: An Evaluation Among the MIND Trial Participants”. Journal of Nutritional Science 10 (2021): e64.
- Rodrigue KM., et al. “β-Amyloid Burden in Healthy Aging: Regional Distribution and Cognitive Consequences”. Neurology6 (2012): 387-395.
- Huang L-K., et al. “Clinical Trials of New Drugs for Alzheimer Disease”. Journal of Biomedical Science1 (2020): 18.
- Fandos N., et al. “Plasma Amyloid β 42/40 Ratios as Biomarkers for Amyloid β Cerebral Deposition in Cognitively Normal Individuals”. Alzheimer’s and Dementia 8 (2017): 179-187.
- Karas GB., et al. “Global and Local Grey Matter Loss in Mild Cognitive Impairment and Alzheimer’s Disease”. NeuroImage2 (2004): 708-716.
- Pelletier A., et al. “Mediterranean Diet and Preserved Brain Structural Connectivity in Older Subjects”. Alzheimer’s and Dementia9 (2015): 1023-1031.
- Gao L., et al. “Brain-Derived Neurotrophic Factor in Alzheimer’s Disease and Its Pharmaceutical Potential”. Translational Neurodegeneration1 (2022): 4.
- Klimova B., et al. “Effect Of An Extra-Virgin Olive Oil Intake On The Delay Of Cognitive Decline: Role Of Secoiridoid Oleuropein?” Neuropsychiatric Disease and Treatment 15 (2019): 3033-3040.
- Charisis S., et al. “Mediterranean Diet and Risk for Dementia and Cognitive Decline in a Mediterranean Population”. Journal of the American Geriatrics Society6 (2021): 1548-1559.
- Sporn MB and Liby KT. “NRF2 and Cancer: The Good, The Bad and The Importance of Context”. Nature Reviews Cancer8 (2012): 564-571.
- Askarova S., et al. “The Links Between the Gut Microbiome, Aging, Modern Lifestyle and Alzheimer’s Disease”. Frontiers in Cellular and Infection Microbiology 10 (2020): 104.
- Romanenko M., et al. “Nutrition, Gut Microbiota, and Alzheimer’s Disease”. Frontiers in Psychiatry 12 (2021): 712673.
- Hasan N and Yang H. “Factors Affecting the Composition of the Gut Microbiota, and Its Modulation”. Peer Journal 7 (2019): e7502.
- Broom GM., et al. “The Ketogenic Diet as a Potential Treatment and Prevention Strategy for Alzheimer’s Disease”. Nutrition 60 (2019): 118-121.