Mediterranean Diet, Weight Loss, and Cognition in Obese Older Adults

地中海饮食、减肥和肥胖老年人的认知

• 批准号: 9921480
• 负责人: Marian L. Fitzgibbon
• 金额: $ 73.53万
• 依托单位: UNIVERSITY OF ILLINOIS AT CHICAGO
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-07-01 至 2022-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9921480
• 关键词: Activities of Daily Living; Adherence; Adult; Affect; African American; Age; Aging; Alcohol consumption; Alzheimer' s Disease; American; Attention; Behavioral; Biological; Blood Pressure; Body Composition; Body Weight; Body Weight decreased; Body mass index; Caloric Restriction; Cardiovascular Diseases; Cause of Death; Cognition; Cognitive deficits; Dementia; Development; Diabetes Mellitus; Diet; Diet Habits; Diet Modification; Dietary Factors; Dietary Fats; Dietary Fiber; Dietary Intervention; Dietary Practices; Dyslipidemias; Elderly; Energy Intake; Ethnic Origin; Exhibits; Fabaceae; Fasting; Fibrinogen; Food; Fruit; Glucose; High Prevalence; Hispanics; Hyperlipidemia; Hypertension; Impaired cognition; Impairment; Individual; Inflammation; Insulin; Insulin Resistance; Intake; Intervention; Life Style; Link; Lipids; Maintenance; Mediating; Mediator of activation protein; Mediterranean Diet; Memory; Metabolic; Metabolic Diseases; Neurocognition; Not Hispanic or Latino; Nuts; Obesity; Observational Study; Oxidative Stress; Participant; Pattern; Pharmacological Treatment; Physical activity; Population; Prevalence; Quality of life; Race; Randomized; Randomized Clinical Trials; Reporting; Risk; Risk Factors; Sampling; Saturated Fatty Acids; Self Efficacy; Social support; Socioeconomic Status; Symptoms; Testing; United States; Unsaturated Fatty Acids; Vegetables; Weight; Weight maintenance regimen; Work; adiponectin; adult obesity; aged; arm; blood lipid; blood pressure reduction; cardiovascular disorder risk; cognitive function; dementia risk; dietary antioxidant; dietary restriction; disability; epidemiology study; ethnic diversity; executive function; follow-up; food consumption; glucose metabolism; human old age (65+); improved; innovation; intrinsic motivation; lifestyle intervention; low socioeconomic status; physical inactivity; polyphenol; post intervention; prevent; psychosocial; public health priorities; public health relevance; randomized trial; weight loss intervention

 DESCRIPTION (provided by applicant): Obesity is a leading cause of death and disability in the United States (US), affecting as many as 80 million Americans. It is well-established that obesity contributes to a number of risk factors for metabolic abnormalities and cardiovascular disease (CVD), including hypertension, diabetes, and hyperlipidemia. In addition, there is growing evidence that obesity is associated with cognitive deficits in multiple domains, even in otherwise healthy older adults. With the rapidly aging US population and the high prevalence of obesity among older adults, innovative strategies to prevent cognitive decline in this population are needed. Dietary patterns are central to the development and maintenance of obesity and evidence suggests that dietary factors also may affect cognition. Epidemiologic studies have shown that adherence to a Mediterranean Diet (MedDiet) is associated with less cognitive decline and reduced risk for dementia. Weight loss through caloric restriction also has been shown to improve cognitive function in obese adults. The identification of effective lifestyle interventions for diet/weight management to improve cognition among obese older adults is a public health priority. However, to our knowledge, no randomized clinical trials (RCTs) have examined the effect of the MedDiet, with and without caloric restriction, to promote weight loss on cognitive functioning in obese older adults. We propose a three-arm RCT in which 180 obese (body mass index [BMI] >30 and < 50 kg/m2) older adults, aged 55 years and older, will be randomized to an 8-month intervention consisting of: 1) MedDiet Alone, without caloric restriction/weight loss (MedDiet-A); 2) MedDiet lifestyle intervention with caloric restriction/weight loss (MedDiet-WL); or 3) typical diet control (TDC) without caloric restriction/weight loss. We will test the following hypotheses: 1) participants randomized to MedDiet-A and MedDiet-WL will achieve greater improvements in cognition compared to participants randomized to TDC; 2) participants randomized to MedDiet-WL will exhibit greater improvements in cognition compared to participants randomized to MedDiet-A; 3) participants randomized to MedDiet-A and MedDiet-WL will show greater improvements in CVD/metabolic risk factors, systemic inflammation, oxidative stress (OxStress), and body weight/composition compared to participants in TDC; 4) participants randomized to MedDiet-WL will exhibit greater improvements in CVD/metabolic risk factors, systemic inflammation, OxStress, and body weight/composition compared to MedDiet-A. We also we examine potential moderators of treatment (e.g., ethnicity and baseline cognitive function) and explore mediators by which neurocognition is improved by diet, including changes in CVD/metabolic risk factors, physical activity, systemic inflammation, and OxStress. We also will determine the extent to which changes in dietary habits, weight, and cognitive functioning are maintained over a 6-month follow-up period.

 描述（由申请人提供）：肥胖是美国 (US) 死亡和残疾的主要原因，影响着多达 8000 万美国人。众所周知，肥胖会导致代谢异常和心血管疾病 (CVD) 的许多危险因素，包括高血压、糖尿病和高脂血症。此外，越来越多的证据表明，肥胖与多个领域的认知缺陷有关，即使对于其他方面健康的老年人也是如此。随着美国人口迅速老龄化以及老年人肥胖率较高，需要创新策略来防止该人群认知能力下降。饮食模式对于肥胖的发生和维持至关重要，有证据表明饮食因素也可能影响认知。流行病学研究表明，坚持地中海饮食 (MedDiet) 可以减少认知能力下降并降低痴呆风险。通过热量限制来减肥也被证明可以改善肥胖成年人的认知功能。确定有效的生活方式干预措施以进行饮食/体重管理，以改善肥胖老年人的认知能力是公共卫生的首要任务。然而，据我们所知，尚无随机临床试验 (RCT) 检验过地中海饮食（无论有无热量限制）对于促进肥胖老年人减肥对认知功能的影响。我们提出了一项三臂随机对照试验，其中 180 名年龄在 55 岁及以上的肥胖（体重指数 [BMI] > 30 且 < 50 kg/m2）老年人将被随机分配接受为期 8 个月的干预措施，其中包括： 1) 仅采用 MedDiet，不限制热量/体重减轻 (MedDiet-A)； 2) 限制热量/减肥的 MedDiet 生活方式干预 (MedDiet-WL)；或 3) 典型的饮食控制 (TDC)，不限制热量/体重减轻。我们将测试以下假设：1）与随机分配到 TDC 的参与者相比，随机分配到 MedDiet-A 和 MedDiet-WL 的参与者将在认知方面取得更大的改善； 2) 与随机接受 MedDiet-A 的参与者相比，随机接受 MedDiet-WL 的参与者将在认知方面表现出更大的改善； 3) 与 TDC 组的参与者相比，随机接受 MedDiet-A 和 MedDiet-WL 组的参与者在 CVD/代谢危险因素、全身炎症、氧化应激 (OxStress) 和体重/成分方面表现出更大的改善； 4) 与 MedDiet-A 相比，随机接受 MedDiet-WL 的参与者将在 CVD/代谢危险因素、全身炎症、OxStress 和体重/成分方面表现出更大的改善。我们还检查了治疗的潜在调节因素（例如种族和基线认知功能），并探索通过饮食改善神经认知的调节因素，包括 CVD/代谢危险因素、体力活动、全身炎症和 OxStress 的变化。我们还将确定在 6 个月的随访期内饮食习惯、体重和认知功能的变化维持的程度。

项目成果

Adapting to the impact of the COVID-19 pandemic on a randomized controlled trial examining lifestyle behaviors on cognitive functioning in obese African American adults: Building Research in Diet and Cognition (BRIDGE).

适应 COVID-19 大流行对一项随机对照试验的影响，该试验检查生活方式行为对肥胖非裔美国成年人认知功能的影响：建立饮食和认知研究 (BRIDGE)。

• DOI: 10.21203/rs.3.rs-290482/v1
• 发表时间: 2021
• 期刊: Research square
• 作者: Fitzgibbon,Marian;Blumstein,Lara;Schiffer,Linda;Antonic,MirjanaA;McLeod,Andrew;Dakers,Roxanne;Restrepo,Leo;Boots,ElizabethA;Sanchez-Flack,JenniferC;Tussing-Humphreys,Lisa;Lamar,Melissa
• 通讯作者: Lamar,Melissa