|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|
|Topic||T9 Healthy Planet|
|Keywords||polyphenols; dietary intervention; Green Mediterranean diet; aging; age-related atrophy; neurodegeneration; hippocampal occupancy score|
The effect of diet on age-related brain atrophy is largely unproven.
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.
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).
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.
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