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. 2024 Aug;31(8):e16345.
doi: 10.1111/ene.16345. Epub 2024 May 25.

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

Sarah Gregory  1   2 , Ingrid Buller-Peralta  1 , Katie Bridgeman  1 , Vanessa De La Cruz Góngora  3   4 , Maria-Eleni Dounavi  5 , Audrey Low  5 , Georgios Ntailianis  1 , John O'Brien  5 , Mario A Parra  6 , Craig W Ritchie  1   2   7 , Karen Ritchie  8 , Oliver M Shannon  9 , Emma J Stevenson  9 , Graciela Muniz-Terrera  1   10
Affiliations

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

Sarah Gregory et al. Eur J Neurol. 2024 Aug.

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.

Keywords: cognition; diet; midlife; neuroimaging.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. SG is funded by the MRC UK Nutrition Research Partnership (NRP) Collaboration Award (MR/T001852/1). SG additionally received salary from Scottish Brain Sciences. GN and KW are funded by the PREVENT study funders (Alzheimer's Society, grant numbers 178, 264 and 329; Alzheimer's Association, grant number TriBEKa‐17‐519,007; and philanthropic donations). John O'Brien has no conflicts related to this work. Outside of this work he has acted as a consultant for TauRx, Novo Nordisk, Biogen, Roche, Lilly and GE Healthcare and received grant or academic support from Avid/Lilly, Merck and Alliance Medical. CWR is the CEO and founder of Scottish Brain Sciences and has previously received consulting fees from Biogen, Eisai, MSD, Actinogen, Roche and Eli Lilly, as well as receiving speaker fees from Roche and Eisai. CWR sits on an NIHR data safety monitoring board and is on an advisory board for Roche Diagnostics. CWR is an unpaid chair of the Brain Health Clinic Consortium (sponsored by Biogen). No other conflicts of interest are declared by other authors.

Figures

FIGURE 1
FIGURE 1
Scatterplot of Pyramid score with ACE‐III total score. (a) The data in the cohort as a whole. (b) Sex‐stratified information. ACE‐III: Addenbrookes Cognitive Examination III.
See this image and copyright information in PMC

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