Publication Details

Reference Category Journals
DOI / URL link
Title (Primary) The effect of a high-polyphenol Mediterranean diet (Green-MED) combined with physical activity on age-related brain atrophy: the Dietary Intervention Randomized Controlled Trial Polyphenols Unprocessed Study (DIRECT PLUS)
Author Kaplan, A.; Zelicha, H.; Meir, A.Y.; Rinott, E.; Tsaban, G.; Levakov, G.; Prager, O.; Salti, M.; Yovell, Y.; Ofer, J.; Huhn, S.; Beyer, F.; Witte, V.; Villringer, A.; Meiran, N.; Emesh, T.B.; Kovacs, P.; von Bergen, M.; Ceglarek, U.; Blüher, M.; Stumvoll, M.; Hu, F.B.; Stampfer, M.J.; Friedman, A.; Shelef, I.; Avidan, G.; Shai, I.
Journal American Journal of Clinical Nutrition
Year 2022
Department BIOTOX; MOLSYB
Volume 115
Issue 5
Page From 1270
Page To 1281
Language englisch
Topic T9 Healthy Planet
Supplements https://oup.silverchair-cdn.com/oup/backfile/Content_public/Journal/ajcn/115/5/10.1093_ajcn_nqac001/1/nqac001_supplemental_file.docx?Expires=1656322031&Signature=RkCOMTbYi43zD9x99keQtLDZT~6LFsHJ~SRXmIQiBVbYashjC-lbMDfHwPnLBJ1UGN4C~N0AwJl2PxtGswZQQvw4qRbYPjtXt634a14XNT-0eOC16lzQKCLvTSsDfZ~7LWUuwtJDNqo9v68-jC6qOS4jGqNLsTD1PAsLzbjIYZbWSFovRLlbw-UvgnI9iWXfLJtOnWDwHcL3wz24Zi8b6ba35zaZ-ElwOW7GokCYepE8m6-u~pBYLGSUNmF9ZfHcxjjEoKxV~DTGqCmIkM0maQNnI0K2sF2sYfTFifevpn8i7KCsCO77GpDPmaQ0hCxEn1mXV4HI0xRVR2x7Fhqwig__&Key-Pair-Id=APKAIE5G5CRDK6RD3PGA
Keywords polyphenols; dietary intervention; Green Mediterranean diet; aging; age-related atrophy; neurodegeneration; hippocampal occupancy score
Abstract

Background

The effect of diet on age-related brain atrophy is largely unproven.

Objectives

We aimed to explore the effect of a Mediterranean diet (MED) higher in polyphenols and lower in red/processed meat (Green-MED diet) on age-related brain atrophy.

Methods

This 18-mo clinical trial longitudinally measured brain structure volumes by MRI using hippocampal occupancy score (HOC) and lateral ventricle volume (LVV) expansion score as neurodegeneration markers. Abdominally obese/dyslipidemic participants were randomly assigned to follow 1) healthy dietary guidelines (HDG), 2) MED, or 3) Green-MED diet. All subjects received free gym memberships and physical activity guidance. Both MED groups consumed 28 g walnuts/d (+440 mg/d polyphenols). The Green-MED group consumed green tea (3–4 cups/d) and Mankai (Wolffia-globosa strain, 100 g frozen cubes/d) green shake (+800 mg/d polyphenols).

Results

Among 284 participants (88% men; mean age: 51 y; BMI: 31.2 kg/m2; APOE‐ε4 genotype = 15.7%), 224 (79%) completed the trial with eligible whole-brain MRIs. The pallidum (−4.2%), third ventricle (+3.9%), and LVV (+2.2%) disclosed the largest volume changes. Compared with younger participants, atrophy was accelerated among those ≥50 y old (HOC change: −1.0% ± 1.4% compared with −0.06% ± 1.1%; 95% CI: 0.6%, 1.3%; P < 0.001; LVV change: 3.2% ± 4.5% compared with 1.3% ± 4.1%; 95% CI: −3.1%, −0.8%; P = 0.001). In subjects ≥ 50 y old, HOC decline and LVV expansion were attenuated in both MED groups, with the best outcomes among Green-MED diet participants, as compared with HDG (HOC: −0.8% ± 1.6% compared with −1.3% ± 1.4%; 95% CI: −1.5%, −0.02%; P = 0.042; LVV: 2.3% ± 4.7% compared with 4.3% ± 4.5%; 95% CI: 0.3%, 5.2%; P = 0.021). Similar patterns were observed among younger subjects. Improved insulin sensitivity over the trial was the parameter most strongly associated with brain atrophy attenuation (P < 0.05). Greater Mankai, green tea, and walnut intake and less red and processed meat were significantly and independently associated with reduced HOC decline (P < 0.05). Elevated urinary concentrations of the polyphenols urolithin-A (r = 0.24; P = 0.013) and tyrosol (r = 0.26; P = 0.007) were significantly associated with lower HOC decline.

Conclusions

A Green-MED (high-polyphenol) diet, rich in Mankai, green tea, and walnuts and low in red/processed meat, is potentially neuroprotective for age-related brain atrophy.

Persistent UFZ Identifier https://www.ufz.de/index.php?en=20939&ufzPublicationIdentifier=26172
Kaplan, A., Zelicha, H., Meir, A.Y., Rinott, E., Tsaban, G., Levakov, G., Prager, O., Salti, M., Yovell, Y., Ofer, J., Huhn, S., Beyer, F., Witte, V., Villringer, A., Meiran, N., Emesh, T.B., Kovacs, P., von Bergen, M., Ceglarek, U., Blüher, M., Stumvoll, M., Hu, F.B., Stampfer, M.J., Friedman, A., Shelef, I., Avidan, G., Shai, I. (2022):
The effect of a high-polyphenol Mediterranean diet (Green-MED) combined with physical activity on age-related brain atrophy: the Dietary Intervention Randomized Controlled Trial Polyphenols Unprocessed Study (DIRECT PLUS)
Am. J. Clin. Nutr. 115 (5), 1270 - 1281