The Mediterranean diet is not associated with neuroimaging or cognition in middle-aged adults : a cross-sectional analysis of the PREVENT Dementia Programme

Gregory, Sarah and Buller-Peralta, Ingrid and Bridgeman, Katie and De La Cruz Góngora, Vanessa and Dounavi, Maria-Eleni and Low, Audrey and Ntailianis, Georgios and O'Brien, John and Parra, Mario A. and Ritchie, Craig W. and Ritchie, Karen and Shannon, Oliver M. and Stevenson, Emma J. and Muniz-Terrera, Graciela (2024) The Mediterranean diet is not associated with neuroimaging or cognition in middle-aged adults : a cross-sectional analysis of the PREVENT Dementia Programme. European Journal of Neurology. e16345. ISSN 1468-1331 (https://doi.org/10.1111/ene.16345)

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Abstract

Background and purpose The Mediterranean diet (MedDiet) has been associated with reduced dementia incidence in several studies. It is important to understand if diet is associated with brain health in midlife, when Alzheimer's disease and related dementias are known to begin. Methods This study used data from the PREVENT dementia programme. Three MedDiet scores were created (the Pyramid, Mediterranean Diet Adherence Screener [MEDAS] and MEDAS continuous) from a self-reported food frequency questionnaire. Primary outcomes were hippocampal volume and cube-transformed white matter hyperintensity volume. Secondary outcomes included cornu ammonis 1 and subiculum hippocampal subfield volumes, cortical thickness and measures of cognition. Sex-stratified analyses were run to explore differential associations between diet and brain health by sex. An exploratory path analysis was conducted to study if any associations between diet and brain health were mediated by cardiovascular risk factors for dementia. Results In all, 504 participants were included in this analysis, with a mean Pyramid score of 8.10 (SD 1.56). There were no significant associations between any MedDiet scoring method and any of the primary or secondary outcomes. There were no differences by sex in any analyses and no significant mediation between the Pyramid score and global cognition by cardiovascular risk factors. Conclusions Overall, this study did not find evidence for an association between the MedDiet and either neuroimaging or cognition in a midlife population study. Future work should investigate associations between the MedDiet and Alzheimer's disease and related dementias biomarkers as well as functional neuroimaging in a midlife population.