Glycemic Control Contributes to the Neuroprotective Effects of Mediterranean and Green-Mediterranean Diets on Brain Age; The DIRECT PLUS Brain-MRI Randomized Controlled Trial.

BACKGROUND

We recently reported that Mediterranean (MED) and green-MED diets significantly attenuated age-related brain atrophy by ∼50% within 18 months.

OBJECTIVE

To explore the contribution of specific diet-induced parameters to brain volume deviation from chronological age.

METHODS

A post-hoc analysis of the 18-month DIRECT-PLUS trial, where participants were randomly assigned to: (1)-healthy-dietary-guidelines (HDG); (2)-MED diet; or (3)-green-MED diet, high in polyphenols and low in red meat. Both MED groups consumed 28g walnuts/day (+440mg/day polyphenols). The green-MED group further consumed green-tea (3-4 cups/day) and Mankai green shake (Wolffia-globosa aquatic plant) (+800mg/day polyphenols). We collected blood samples through the intervention and followed brain structure volumes by magnetic-resonance-imaging (MRI). We used hippocampal-occupancy (HOC) score (hippocampal and inferior-lateral-ventricle volumes ratio) as a neurodegeneration marker and brain age proxy. We applied multivariate-linear-regression models.

RESULTS

Of 284 participants (88% male; age=51.1years; BMI=31.2kg/m

CONCLUSIONS

Glycemic control contributes to the neuroprotective effects of the MED and green-MED diets on brain age. Polyphenols-rich diet components as Mankai and green-tea may contribute to a more youthful brain age.

TRIAL-REGISTRATION-CLINICAL-TRIALS-IDENTIFIER

NCT03020186 URL OF REGISTRATION: https://clinicaltrials.gov/study/NCT03020186.

Informations de copyright

Copyright © 2024. Published by Elsevier Inc.

Déclaration de conflit d'intérêts

Declaration of Competing Interest ☐ The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. ☒ The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Iris Shai reports financial support was provided by German Research Foundation (DFG). Iris Shai reports financial support was provided by The Israel Ministry of Health grant. Iris Shai reports financial support was provided by The Israel Ministry of Science and Technology grant. Iris Shai reports equipment, drugs, or supplies was provided by California Walnut Commission. MB received honoraria for lectures and consultancy from Amgen, Astra Zeneca, Bayer, Boehringer-Ingelheim, Lilly, Novartis, Novo Nordisk, and Sanofi. All other authors report no conflicts of interest. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.