Mediterranean diet improves cognition: the PREDIMED-NAVARRA randomised trial
Mediterranean diet improves cognition: the PREDIMED-NAVARRA randomised trial
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DOI：
10.1136/jnnp-2012-304792
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发表时间：
2013-12-01
影响因子：
11
通讯作者：
Martinez-Gonzalez, Miguel A.
中科院分区：
文献类型：
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作者：
Martinez-Lapiscina, Elena H.;Clavero, Pedro;Martinez-Gonzalez, Miguel A.
目的以往的观察性研究报道了地中海饮食（MedDiet）对认知功能的有益作用，但结果不一致。我们评估了使用MedDiets与低脂对照饮食进行营养干预对认知的影响。方法我们评估了522名高血管风险的参与者（44.6%男性，认知评估时年龄74.6 ± 5.7岁）入组一项多中心、随机、一级预防试验（PREDIMED），在营养干预后比较两种MedDiets（补充特级初榨橄榄油（EVOO）或混合坚果）与低脂对照饮食。在营养干预6.5年后，采用简易精神状态检查量表（MMSE）和画钟测验（CDT）检查总体认知能力。评估结果的研究人员对分组不知情。结果在调整性别、年龄、教育程度、载脂蛋白E基因型、认知功能障碍/痴呆家族史、吸烟、体力活动、体重指数、高血压、血脂异常、糖尿病、酒精和总能量摄入等因素后，MedDiet+EVOO组的平均MMSE和CDT评分高于对照组，差异有统计学意义（校正差异：MMSE为+0.62 95% CI +0.18至+1.05，p=0.005，CDT为+0.51 95% CI +0.20至+0.82，p=0.001）。与对照组相比，MedDiet+Nuts组受试者的MMSE和CDT评分的调整平均值也更高（MMSE的调整差异：+0.57（95%CI +0.11至+1.03），p=0.015; CDT的调整差异：+0.33（95%CI +0.003至+0.67），p=0.048）。这些结果并没有显着差异后控制事件depression.Conclusions与MedDiets增强EVOO或坚果的干预似乎改善认知与低脂饮食相比。
Objective Previous observational studies reported beneficial effects of the Mediterranean diet (MedDiet) on cognitive function, but results were inconsistent. We assessed the effect on cognition of a nutritional intervention using MedDiets in comparison with a low-fat control diet.Methods We assessed 522 participants at high vascular risk (44.6% men, age 74.6 +/- 5.7 years at cognitive evaluation) enrolled in a multicentre, randomised, primary prevention trial (PREDIMED), after a nutritional intervention comparing two MedDiets (supplemented with either extra-virgin olive oil (EVOO) or mixed nuts) versus a low-fat control diet. Global cognitive performance was examined by Mini-Mental State Examination (MMSE) and Clock Drawing Test (CDT) after 6.5 years of nutritional intervention. Researchers who assessed the outcome were blinded to group assignment. We used general linear models to control for potential confounding.Results After adjustment for sex, age, education, Apolipoprotein E genotype, family history of cognitive impairment/dementia, smoking, physical activity, body mass index, hypertension, dyslipidaemia, diabetes, alcohol and total energy intake, participants allocated to the MedDiet+EVOO showed higher mean MMSE and CDT scores with significant differences versus control (adjusted differences: +0.62 95% CI +0.18 to +1.05, p=0.005 for MMSE, and +0.51 95% CI +0.20 to +0.82, p=0.001 for CDT). The adjusted means of MMSE and CDT scores were also higher for participants allocated to the MedDiet+Nuts versus control (adjusted differences: +0.57 (95% CI +0.11 to +1.03), p=0.015 for MMSE and +0.33 (95% CI +0.003 to +0.67), p=0.048 for CDT). These results did not differ after controlling for incident depression.Conclusions An intervention with MedDiets enhanced with either EVOO or nuts appears to improve cognition compared with a low-fat diet.