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Article

Mediterranean Diet and Risk of Dementia and Alzheimer’s Disease in the EPIC-Spain Dementia Cohort Study

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Section of Neurology, Department of Internal Medicine, Rafael Méndez Hospital, Murcia Health Service, 30813 Lorca, Murcia, Spain
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Murcia Biomedical Research Institute (IMIB-Arrixaca), 30120 Murcia, Spain
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Department of Epidemiology, Murcia Regional Health Council, 30008 Murcia, Spain
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CIBER Epidemiología y Salud Pública (CIBERESP), 28029 Madrid, Spain
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Department of Health and Social Sciences, University of Murcia, 30100 Murcia, Spain
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Murcia Health Service, 30100 Murcia, Spain
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Public Health Division of Gipuzkoa, Basque Government, 20013 Donostia-San Sebastián, Spain
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Biodonostia Health Research Institute, 20014 San Sebastián, Spain
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Clinical Management Unit, OSI Alto Deba, 20500 Arrasate-Mondragón, Spain
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AP-OSIs Gipuzkoa Research Unit, OSI Alto Deba, 20500 Arrasate-Mondragón, Spain
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Health Services Research Network on Chronic Patients (REDISSEC), 48902 Bilbao, Spain
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CITA Alzheimer Foundation, 20019 Donostia-San Sebastián, Spain
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Neurology Service, OSI Goierri-Alto Urola, 20700 Zumárraga, Spain
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Public Health Institute of Navarra, IdiSNA, 31008 Pamplona, Spain
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Neuroepigenetics Laboratory, Navarrabiomed, Public University of Navarre (UPNA), 31008 Pamplona, Spain
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Department of Neurology, Complejo Hospitalario de Navarra, 31008 Pamplona, Spain
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Research Group on Demography and Health, National Faculty of Public Health, University of Antioquia, Medellín 050010, Colombia
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Unidad de Docencia, Investigación y Formación en Salud Mental (UDIF-SM), Servicio Murciano de Salud, 30120 Murcia, Spain
*
Author to whom correspondence should be addressed.
Academic Editor: Martina Barchitta
Nutrients 2021, 13(2), 700; https://doi.org/10.3390/nu13020700
Received: 11 January 2021 / Revised: 12 February 2021 / Accepted: 18 February 2021 / Published: 22 February 2021
(This article belongs to the Special Issue Effect of Diet on Vascular Function and Hormones)
The Mediterranean diet (MD) has shown to reduce the occurrence of several chronic diseases. To evaluate its potential protective role on dementia incidence we studied 16,160 healthy participants from the European Prospective Investigation into Cancer and Nutrition (EPIC)-Spain Dementia Cohort study recruited between 1992–1996 and followed up for a mean (±SD) of 21.6 (±3.4) years. A total of 459 incident cases of dementia were ascertained through expert revision of medical records. Data on habitual diet was collected through a validated diet history method to assess adherence to the relative Mediterranean Diet (rMED) score. Hazard ratios (HR) of dementia by rMED levels (low, medium and high adherence levels: ≤6, 7–10 and ≥11 points, respectively) were estimated using multivariable Cox models, whereas time-dependent effects were evaluated using flexible parametric Royston-Parmar (RP) models. Results of the fully adjusted model showed that high versus low adherence to the categorical rMED score was associated with a 20% (HR = 0.80, 95%CI: 0.60–1.06) lower risk of dementia overall and HR of dementia was 8% (HR = 0.92, 0.85–0.99, p = 0.021) lower for each 2-point increment of the continuous rMED score. By sub-types, a favorable association was also found in women for non-AD (HR per 2-points = 0.74, 95%CI: 0.62–0.89), while not statistically significant in men for AD (HR per 2-points = 0.88, 0.76–1.01). The association was stronger in participants with lower education. In conclusion, in this large prospective cohort study MD was inversely associated with dementia incidence after accounting for major cardiovascular risk factors. The results differed by dementia sub-type, sex, and education but there was no significant evidence of effect modification. View Full-Text
Keywords: Mediterranean diet; dementia; Alzheimer’s disease; cohort study; prospective analysis; EPIC-Spain Mediterranean diet; dementia; Alzheimer’s disease; cohort study; prospective analysis; EPIC-Spain
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MDPI and ACS Style

Andreu-Reinón, M.E.; Chirlaque, M.D.; Gavrila, D.; Amiano, P.; Mar, J.; Tainta, M.; Ardanaz, E.; Larumbe, R.; Colorado-Yohar, S.M.; Navarro-Mateu, F.; Navarro, C.; Huerta, J.M. Mediterranean Diet and Risk of Dementia and Alzheimer’s Disease in the EPIC-Spain Dementia Cohort Study. Nutrients 2021, 13, 700. https://doi.org/10.3390/nu13020700

AMA Style

Andreu-Reinón ME, Chirlaque MD, Gavrila D, Amiano P, Mar J, Tainta M, Ardanaz E, Larumbe R, Colorado-Yohar SM, Navarro-Mateu F, Navarro C, Huerta JM. Mediterranean Diet and Risk of Dementia and Alzheimer’s Disease in the EPIC-Spain Dementia Cohort Study. Nutrients. 2021; 13(2):700. https://doi.org/10.3390/nu13020700

Chicago/Turabian Style

Andreu-Reinón, María Encarnación, María Dolores Chirlaque, Diana Gavrila, Pilar Amiano, Javier Mar, Mikel Tainta, Eva Ardanaz, Rosa Larumbe, Sandra M. Colorado-Yohar, Fernando Navarro-Mateu, Carmen Navarro, and José María Huerta. 2021. "Mediterranean Diet and Risk of Dementia and Alzheimer’s Disease in the EPIC-Spain Dementia Cohort Study" Nutrients 13, no. 2: 700. https://doi.org/10.3390/nu13020700

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