title: Nutrition and neurodegeneration: epidemiological evidence and challenges for future research.
abstract: The prevention of dementias, such as Alzheimer's disease (AD), is a growing public health concern, due to a lack of effective curative treatment options and a rising global prevalence. Various potential risk or preventive factors have been suggested by epidemiological research, including modifiable lifestyle factors such as diet. Current epidemiological data are in favour of a protective role of certain micronutrients (B vitamins related to homocysteine metabolism, the anti-oxidant vitamins C and E, flavonoids, polyunsatured omega-3 fatty acids, vitamin D) and macronutrients (fish) in the prevention of cognitive decline and dementia/AD. Some factors have been targeted by interventions tested in randomized controlled trials (RCTs), but many of the results are conflicting with observational evidence. Epidemiological analysis of the relations between nutrient consumption and cognitive decline is complex and it is highly unlikely that a single component plays a major role. In addition, since multiple factors across the life course influence brain function in late life, multidomain interventions might be more promising in the prevention of cognitive decline and dementia/AD. Designing such trials remains very challenging for researchers. The main objective of this paper is to review the epidemiologic data linking potential protective factors to cognitive decline or dementia/AD, focusing particularly on the roles of adiposity, caloric restriction, micro (group B vitamins related to homocysteine metabolism, the anti-oxidant vitamins C and E, flavonoids, polyunsatured omega-3 fatty acids, vitamin D) and macronutrients (fish). Limitations of the current data, divergence with results of interventional prevention studies and challenges for future research are discussed.
authors: Gerontopole, Toulouse University Hospital, Department of Internal Medicine and Geriatrics, Purpan University Hospital, Toulouse F-31059, France. gillette.s@chu-toulouse.fr
authors: Sophie
authors: S
authors: Gillette-Guyonnet
authors: Marion
authors: M
authors: Secher
authors: Bruno
authors: B
authors: Vellas
mesh_terms: D000544:Alzheimer Disease / Q000453:epidemiology / Q000517:prevention & control*; D000975:Antioxidants / Q000627:therapeutic use; D003072:Cognition Disorders / Q000453:epidemiology / Q000517:prevention & control*; D004032:Diet; D016021:Epidemiologic Studies; D015525:Fatty Acids, Omega-3 / Q000627:therapeutic use*; D006801:Humans; D018977:Micronutrients / Q000627:therapeutic use; D009752:Nutritional Status; D016032:Randomized Controlled Trials as Topic; D012307:Risk Factors; D014815:Vitamins / Q000627:therapeutic use*
chemical_list: D000975:Antioxidants; D015525:Fatty Acids, Omega-3; D018977:Micronutrients; D014815:Vitamins
references: Alzheimers Dement. 2009 Mar;5(2):114-21
references: 19328438
references: Lancet Neurol. 2005 Nov;4(11):705-11
references: 16239176
references: Curr Alzheimer Res. 2011 Aug;8(5):479-91
references: 21605054
references: Arch Neurol. 2010 Jul;67(7):819-25
references: 20625087
references: Alzheimers Dement. 2012 Jul;8(4):278-87
references: 21967845
references: J Am Diet Assoc. 2007 Sep;107(9):1541-51
references: 17761231
references: Neurology. 2012 Sep 25;79(13):1397-405
references: 23008220
references: Clin Rehabil. 2012 May;26(5):442-50
references: 22116953
references: Neurology. 2004 Jan 27;62(2):275-80
references: 14745067
references: Neurology. 2008 Jan 29;70(5):360-7
references: 17881716
references: JAMA. 2004 Sep 22;292(12):1454-61
references: 15383516
references: Arch Neurol. 2007 Jan;64(1):86-92
references: 17210813
references: Neurology. 2009 Nov 10;73(19):1559-66
references: 19901247
references: JAMA. 2008 Sep 3;300(9):1027-37
references: 18768414
references: Ann Neurol. 2010 Sep;68(3):311-8
references: 20818789
references: JAMA. 2004 Sep 22;292(12):1447-53
references: 15383515
references: Physiol Behav. 2007 Sep 10;92(1-2):98-104
references: 17588621
references: JAMA. 2002 Jun 26;287(24):3223-9
references: 12076218
references: Arch Neurol. 2005 Oct;62(10):1556-60
references: 16216938
references: Arch Neurol. 2009 Feb;66(2):216-25
references: 19204158
references: Neurology. 2011 May 3;76(18):1568-74
references: 21536637
references: Neurology. 2005 Sep 27;65(6):892-7
references: 16186530
references: Am J Clin Nutr. 2007 Nov;86(5):1384-91
references: 17991650
references: Neurology. 2002 Dec 24;59(12):1915-21
references: 12499483
references: Lancet Neurol. 2007 Aug;6(8):734-46
references: 17616482
references: Int J Geriatr Psychiatry. 2012 Jun;27(6):592-600
references: 21780182
references: JAMA. 2010 Apr 21;303(15):1477; author reply 1477-8
references: 20407051
references: Alzheimers Dement. 2010 Nov;6(6):456-64
references: 20434961
references: Am J Clin Nutr. 2011 Sep;94(3):892-9
references: 21775560
references: Arch Neurol. 2010 Jan;67(1):71-9
references: 20065132
references: Am J Clin Nutr. 2010 Jun;91(6):1725-32
references: 20410089
references: Nutr J. 2011 Mar 11;10:22
references: 21396086
references: Neurology. 2010 Oct 26;75(17):1540-7
references: 20861451
references: Arch Intern Med. 2010 Jul 12;170(13):1135-41
references: 20625021
references: Arch Neurol. 2006 Nov;63(11):1545-50
references: 17101822
references: Neurology. 2007 Feb 27;68(9):670-6
references: 17325274
references: Arch Neurol. 2010 Jun;67(6):699-706
references: 20385883
references: J Nutr Health Aging. 2011 Aug;15(8):720-4
references: 21968871
references: J Alzheimers Dis. 2010;19(2):429-39
references: 20110592
references: JAMA. 2002 Jun 26;287(24):3261-3
references: 12076225
references: Neurology. 2009 Sep 15;73(11):854-61
references: 19752452
references: Ann Intern Med. 2006 Jan 17;144(2):73-81
references: 16418406
references: Neurology. 2006 Dec 12;67(11):1949-54
references: 17159099
references: Alzheimers Dement. 2007 Jul;3(3):186-91
references: 19595937
references: Neurology. 2005 Nov 8;65(9):1409-14
references: 16275829
references: J Alzheimers Dis. 2010;22(3):715-40
references: 20858954
references: Rejuvenation Res. 2007 Jun;10(2):179-90
references: 17518698
references: JAMA. 2007 Feb 28;297(8):842-57
references: 17327526
references: Neurology. 2007 Nov 13;69(20):1921-30
references: 17998483
references: Neurology. 2008 May 6;70(19 Pt 2):1786-94
references: 18094335
references: Clin Nutr. 2011 Jun;30(3):297-302
references: 21216507
references: Lancet Neurol. 2012 Oct;11(10):851-9
references: 22959217
references: Dement Geriatr Cogn Disord. 2010;29(2):109-14
references: 20150731
references: Arch Intern Med. 2011 Jul 25;171(14):1251-7
references: 21771893
references: JAMA. 2002 Jun 26;287(24):3230-7
references: 12076219
references: JAMA. 2008 Oct 15;300(15):1774-83
references: 18854539
references: CMAJ. 2004 Oct 12;171(8):897-904
references: 15477631
references: PLoS One. 2010 Sep 08;5(9):e12244
references: 20838622
references: J Nutr Health Aging. 2007 Mar-Apr;11(2):132-52
references: 17435956
references: Proc Natl Acad Sci U S A. 2009 Jan 27;106(4):1255-60
references: 19171901
references: Am J Clin Nutr. 2008 Dec;88(6):1602-10
references: 19064521
references: Curr Opin Clin Nutr Metab Care. 2008 Nov;11(6):686-92
references: 18827571
references: JAMA. 2009 Aug 12;302(6):627-37
references: 19671904
references: J Am Geriatr Soc. 2012 Jan;60(1):118-23
references: 22211390
references: Am J Clin Nutr. 2007 Apr;85(4):1103-11
references: 17413112
references: Am J Clin Nutr. 2007 Feb;85(2):511-7
references: 17284751
references: Arch Intern Med. 2006 Dec 11-25;166(22):2462-8
references: 17159011
references: Lancet. 2007 Jan 20;369(9557):208-16
references: 17240287
references: Neurology. 2004 May 11;62(9):1573-9
references: 15136684
references: Trials. 2011 Oct 20;12:230
references: 22014101
references: Neurology. 2008 Jul 15;71(3):210-6
references: 18625967
references: J Neurol Neurosurg Psychiatry. 2009 Jul;80(7):802-4
references: 19531688
references: Ann Neurol. 2006 Jun;59(6):912-21
references: 16622828
references: Am J Med. 2005 Feb;118(2):161-7
references: 15694902
references: BMC Geriatr. 2010 Mar 17;10:14
references: 20236541
references: Arch Neurol. 2006 Oct;63(10):1402-8
references: 17030655
references: Neurology. 2009 May 19;72(20):1741-6
references: 19451529
references: Neurology. 2006 Oct 10;67(7):1208-14
references: 17030754
references: Arch Neurol. 2003 Feb;60(2):203-8
references: 12580704
references: JAMA. 2009 Dec 23;302(24):2663-70
references: 20040554
references: Neurology. 2008 May 6;70(19 Pt 2):1809-17
references: 18305231
references: JAMA. 2008 Nov 19;300(19):2253-62
references: 19017911
references: Cochrane Database Syst Rev. 2009 Jan 21;(1):CD003120
references: 19160216
references: Neurology. 2007 Aug 21;69(8):739-46
references: 17709705
references: Hypertension. 2010 Jun;55(6):1331-8
references: 20305128
references: CNS Drugs. 2011 Aug;25(8):629-39
references: 21790207
references: JAMA. 2010 Nov 3;304(17):1903-11
references: 21045096
references: Ann Neurol. 2008 May;63(5):652-7
references: 18409192
references: Arch Neurol. 2006 Sep;63(9):1312-7
references: 16966511
references: Am J Alzheimers Dis Other Demen. 2011 Nov;26(7):511-20
references: 22202127
references: Neurology. 2010 Oct 19;75(16):1408-14
references: 20956786
references: Int J Geriatr Psychiatry. 2011 Jul;26(7):733-40
references: 21495078
references: Lancet Neurol. 2004 Jun;3(6):343-53
references: 15157849
references: Oxid Med Cell Longev. 2012;2012:472932
references: 22888398
references: Neurology. 2004 Nov 9;63(9):1705-7
references: 15534261
references: N Engl J Med. 2000 Aug 24;343(8):530-7
references: 10954760
references: Arch Intern Med. 2011 Jul 25;171(14):1244-50
references: 21771894
references: J Nutr Health Aging. 2011 Jan;15(1):25-31
references: 21267518
references: Neurology. 2006 Mar 28;66(6):821-7
references: 16467493
references: Curr Opin Clin Nutr Metab Care. 2009 Jan;12(1):15-21
references: 19057182
references: Dement Geriatr Cogn Disord. 2011;32(4):273-8
references: 22261995
references: J Alzheimers Dis. 2010;19(4):1101-22
references: 20308777
references: BMJ. 2005 Jun 11;330(7504):1360
references: 15863436
references: Cochrane Database Syst Rev. 2012 Jun 13;(6):CD005379
references: 22696350
references: Am J Clin Nutr. 2011 Jul;94(1):278-86
references: 21593490
references: N Engl J Med. 2006 Jun 29;354(26):2764-72
references: 16807413
references: Alzheimers Dement. 2010 Jan;6(1):1-10.e1
references: 20129316
references: Arch Neurol. 2005 Dec;62(12):1849-53
references: 16216930
references: Arch Neurol. 2004 Jan;61(1):82-8
references: 14732624
references: Stat Med. 2000 Jun 15-30;19(11-12):1481-93
references: 10844713
references: Neurology. 2007 Sep 11;69(11):1084-93
references: 17846408
references: Neurology. 2006 Oct 10;67(7):1195-200
references: 17030752
references: Arch Intern Med. 2007 Nov 12;167(20):2184-90
references: 17998490
references: JAMA. 2009 Aug 12;302(6):638-48
references: 19671905
references: J Am Geriatr Soc. 2011 Jan;59(1):107-12
references: 21226681
references: Am J Clin Nutr. 2012 Jan;95(1):194-203
references: 22170358
references: Arch Neurol. 2009 Mar;66(3):336-42
references: 19273752
references: Neurology. 2003 Jan 14;60(1):117-9
references: 12525731
references: Circulation. 2009 Jun 2;119(21):2772-80
references: 19451353
references: Neurology. 2008 Aug 5;71(6):439-46
references: 18678827
references: Arch Neurol. 2007 Mar;64(3):392-8
references: 17353383
references: Epidemiol Rev. 2008;30:35-66
references: 18779228
references: Neurology. 2008 Aug 5;71(6):430-8
references: 18678826
references: Neurology. 2010 Jan 5;74(1):33-41
references: 19940271
references: Arch Neurol. 2005 Jan;62(1):55-60
references: 15642850
references: Neurology. 2008 Sep 30;71(14):1057-64
references: 18367704