Relationships of Dietary Patterns, Foods, and Micro- and Macronutrients with Alzheimer’s Disease and Late-Life Cognitive Disorders: A Systematic Review

Article type: Research Article

Authors: Solfrizzi, Vincenzo^{a; 1; *} | Custodero, Carlo^a | Lozupone, Madia^b | Imbimbo, Bruno P.^c | Valiani, Vincenzo^a | Agosti, Pasquale^a | Schilardi, Andrea^a | D’Introno, Alessia^a | La Montagna, Maddalena^d | Calvani, Mariapaola^b | Guerra, Vito^e | Sardone, Rodolfo^e | Abbrescia, Daniela I.^e | Bellomo, Antonello^d | Greco, Antonio^f | Daniele, Antonio^g | Seripa, Davide^f | Logroscino, Giancarlo^{b; h} | Sabbá, Carlo^a | Panza, Francesco^{b; f; h; 1; *}

Affiliations: [a] Geriatric Medicine-Memory Unit and Rare Disease Centre, University of Bari Aldo Moro, Bari, Italy | [b] Neurodegenerative Disease Unit, Department of Basic Medicine, Neuroscience, and Sense Organs, University of Bari Aldo Moro, Bari, Italy | [c] Department of Research and Development, Chiesi Farmaceutici, Parma, Italy | [d] Department of Clinical and Experimental Medicine, Psychiatric Unit, University of Foggia, Foggia, Italy | [e] National Institute for Digestive Diseases, IRCCS “Saverio de Bellis”, Castellana, Bari, Italy | [f] Geriatric Unit and Laboratory of Gerontology and Geriatrics, Department of Medical Sciences, IRCCS “Casa Sollievo della Sofferenza”, San Giovanni Rotondo, Foggia, Italy | [g] Institute of Neurology, Catholic University of Sacred Heart, Rome, Italy | [h] Department of Clinical Research in Neurology, University of Bari Aldo Moro, “Pia Fondazione Cardinale G. Panico”, Tricase, Lecce, Italy

Correspondence: [*] Correspondence to: Vincenzo Solfrizzi, MD, PhD, Department of Geriatric Medicine, Memory Unit and Rare Disease Center, University of Bari Aldo Moro - Policlinico, Piazza Giulio Cesare, 11, 70124 Bari, Italy. Tel.: +39 080 5473685; Fax: +39 080 5478633; E-mails: [email protected] and Francesco Panza, MD, PhD, Geriatric Unit and Laboratory of Gerontology and Geriatrics, Department of Medical Sciences, IRCCS “Casa Sollievo della Sofferenza”, San Giovanni Rotondo, Foggia, Italy, and Neurodegenerative Disease Unit, Department of Basic Medicine, Neuroscience, and Sense Organs, University of Bari “Aldo Moro”, Bari, Italy. Tel./Fax: +39 0882 410271; E-mails: [email protected], [email protected].

Note: [1] These authors contributed equally to this work.

Abstract: In the last decade, the association between diet and cognitive function or dementia has been largely investigated. In the present article, we systematically reviewed observational studies published in the last three years (2014–2016) on the relationship among dietary factors and late-life cognitive disorders at different levels of investigation (i.e., dietary patterns, foods and food-groups, and dietary micro- and macronutrients), and possible underlying mechanisms of the proposed associations. From the reviewed evidence, the National Institute on Aging–Alzheimer’s Association guidelines for Alzheimer’s disease (AD) and cognitive decline due to AD pathology introduced some evidence suggesting a direct relation between diet and changes in the brain structure and activity. There was also accumulating evidence that combinations of foods and nutrients into certain patterns may act synergistically to provide stronger health effects than those conferred by their individual dietary components. In particular, higher adherence to a Mediterranean-type diet was associated with decreased cognitive decline. Moreover, also other emerging healthy dietary patterns such as the Dietary Approach to Stop Hypertension (DASH) and the Mediterranean-DASH diet Intervention for Neurodegenerative Delay (MIND) diets were associated with slower rates of cognitive decline and significant reduction of AD rate. Furthermore, some foods or food groups traditionally considered harmful such as eggs and red meat have been partially rehabilitated, while there is still a negative correlation of cognitive functions with saturated fatty acids and a protective effect against cognitive decline of elevated fish consumption, high intake of monounsaturated fatty acids and polyunsaturated fatty acids (PUFA), particularly n-3 PUFA.

Keywords: Alzheimer’s disease, dementia, dietary pattern, food groups, foods, healthy diet, Mediterranean diet, macronutrients, micronutrients, mild cognitive impairment

DOI: 10.3233/JAD-170248

Journal: Journal of Alzheimer's Disease, vol. 59, no. 3, pp. 815-849, 2017