title: Mediterranean Diet and Magnetic Resonance Imaging-Assessed Brain Atrophy in Cognitively Normal Individuals at Risk for Alzheimer's Disease.
abstract: OBJECTIVE
  Epidemiological evidence linking diet, one of the most important modifiable environmental factors, and risk of Alzheimer's disease (AD) is rapidly increasing. Several studies have shown that higher adherence to a Mediterranean diet (MeDi) is associated with reduced risk of AD. This study examines the associations between high vs. lower adherence to a MeDi and structural MRI-based brain atrophy in key regions for AD in cognitively normal (NL) individuals with and without risk factors for AD.
  
  
  METHODS
  Cross-sectional study.
  
  
  METHODS
  Manhattan (broader area).
  
  
  METHODS
  Fifty-two NL individuals (age 54+12 y, 70% women) with complete dietary information and cross-sectional, 3D T1-weighted MRI scans were examined.
  
  
  METHODS
  Subjects were dichotomized into those showing higher vs. lower adherences to the MeDi using published protocols. Estimates of cortical thickness for entorhinal cortex (EC), inferior parietal lobe, middle temporal gyrus, orbitofrontal cortex (OFC) and posterior cingulate cortex (PCC) were obtained by use of automated segmentation tools (FreeSurfer). Multivariate general linear models and linear regressions assessed the associations of MeDi with MRI measures.
  
  
  RESULTS
  Of the 52 participants, 20 (39%) showed higher MeDi adherence (MeDi+) and 32 (61%) showed lower adherence (MeDi-). Groups were comparable for clinical, neuropsychological measures, presence of a family history of AD (FH), and frequency of Apolipoprotein E (APOE) ε4 genotype. With and without controlling for age and total intracranial volume, MeDi+ subjects showed greater thickness of AD-vulnerable ROIs as compared to MeDi- subjects (Wilk's Lambda p=0.026). Group differences were most pronounced in OFC (p=0.001), EC (p=0.03) and PCC (p=0.04) of the left hemisphere. Adjusting for gender, education, FH, APOE status, BMI, insulin resistance scores and presence of hypertension did not attenuate the relationship.
  
  
  CONCLUSIONS
  NL individuals showing lower adherence to the MeDi had cortical thinning in the same brain regions as clinical AD patients compared to those showing higher adherence. These data indicate that the MeDi may have a protective effect against tissue loss, and suggest that dietary interventions may play a role in the prevention of AD.
authors.affiliation: New York University School of Medicine, New York, NY 10016.
authors.forename: L
authors.initials: L
authors.lastname: Mosconi
authors.affiliation: New York University School of Medicine, New York, NY 10016.
authors.forename: J
authors.initials: J
authors.lastname: Murray
authors.affiliation: New York University School of Medicine, New York, NY 10016.
authors.forename: W H
authors.initials: WH
authors.lastname: Tsui
authors.affiliation: New York University School of Medicine, New York, NY 10016.
authors.forename: Y
authors.initials: Y
authors.lastname: Li
authors.affiliation: New York University School of Medicine, New York, NY 10016.
authors.forename: M
authors.initials: M
authors.lastname: Davies
authors.affiliation: New York University School of Medicine, New York, NY 10016.
authors.forename: S
authors.initials: S
authors.lastname: Williams
authors.affiliation: New York University School of Medicine, New York, NY 10016.
authors.forename: E
authors.initials: E
authors.lastname: Pirraglia
authors.affiliation: New York University School of Medicine, New York, NY 10016.
authors.forename: N
authors.initials: N
authors.lastname: Spector
authors.affiliation: New York University School of Medicine, New York, NY 10016.
authors.forename: R S
authors.initials: RS
authors.lastname: Osorio
authors.affiliation: New York University School of Medicine, New York, NY 10016.
authors.forename: L
authors.initials: L
authors.lastname: Glodzik
authors.affiliation: New York University School of Medicine, New York, NY 10016.
authors.forename: P
authors.initials: P
authors.lastname: McHugh
authors.affiliation: New York University School of Medicine, New York, NY 10016.
authors.forename: M J
authors.initials: MJ
authors.lastname: de Leon
keywords: Alzheimer's disease; Mediterranean diet; brain imaging; diet; early detection; magnetic resonance imaging (MRI)