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This is an early access version, the complete PDF, HTML, and XML versions will be available soon.
Article

MIND Pattern Nutritional Intervention Modulates Mediterranean Diet Adherence and Gut Microbiota in Alzheimer’s Disease: An Observational Case–Control Study

by
Laura Di Renzo
1,†,
Glauco Raffaelli
2,3,†,
Barbara Pala
2,4,*,
Rossella Cianci
5,*,
Daniele Peluso
2,
Giovanni Gambassi
5,
Vincenzo Giambra
6,
Antonio Greco
7,
David Della Morte Canosci
1,
Antonino De Lorenzo
1,‡ and
Paola Gualtieri
1,‡
1
Section of Clinical Nutrition and Nutrigenomics, Department of Biomedicine and Prevention, Tor Vergata University of Rome, Via Montpellier 1, 00133 Rome, Italy
2
PhD School of Applied Medical-Surgical Sciences, Tor Vergata University of Rome, Via Montpellier 1, 00133 Rome, Italy
3
School of Specialization in Food Science, Tor Vergata University of Rome, Via Montpellier 1, 00133 Rome, Italy
4
Unit of Cardiology, Istituto Dermopatico dell’Immacolata—IRCCS, 00167 Rome, Italy
5
Department of Translational Medicine and Surgery, Catholic University of the Sacred Heart, Fondazione Policlinico Universitario A. Gemelli, IRCCS, 00168 Rome, Italy
6
Hematopathology Unit, Institute for Stem Cell Biology, Regenerative Medicine and Innovative Therapeutics (ISBReMIT), Fondazione IRCCS Casa Sollievo della Sofferenza, 71013 San Giovanni Rotondo, Italy
7
Complex Unit of Geriatrics, Department of Medical Sciences, Fondazione IRCCS Casa Sollievo della Sofferenza, 71013 San Giovanni Rotondo, Italy
*
Authors to whom correspondence should be addressed.
†
These authors contributed equally to this work.
‡
These authors contributed equally to this work.
Nutrients 2026, 18(2), 193; https://doi.org/10.3390/nu18020193
Submission received: 22 November 2025 / Revised: 29 December 2025 / Accepted: 3 January 2026 / Published: 7 January 2026
(This article belongs to the Special Issue Nutrient-Driven Modulation of the Gut Virome and Bacteriome: Implications for Brain Aging and Neurodegeneration)
Review Reports Versions Notes

Abstract

Background: Evidence on non-restrictive MIND pattern interventions in Alzheimer’s (ALZ) disease remains limited. Methods: In an observational case–control study, 60 participants (ALZ, n = 30; cognitively healthy controls, n = 30) completed baseline (T0) and follow-up (T1) after structured MIND counseling. Adherence was assessed via the MEDAS questionnaire. Stool samples (16S rRNA profiling) were taken and anthropometry and cognitive/functional measures were recorded at T0/T1. Results: In the ALZ group, MEDAS improved as adherence to the Mediterranean diet increased (increasing the use of vegetables ≥ 2/day, p < 0.01; and lowering butter adoption ≤ 1/day, p = 0.02), with a shift from low to moderate/high adherence; in controls, baseline Mediterranean diet adherence was already high, and changes in MEDAS categories were modest (low adherence from 13.8% to 3.6%, high adherence from 37.9% to 50.0%), with no statistically significant overall change (p = 0.39). Regarding gut microbiota (GM), in the ALZ group, alpha diversity increased significantly and Bray–Curtis PCoA separated T0 from T1. Species-level analysis showed increases in SCFA-linked taxa (e.g., Anaerobutyricum hallii, Blautia luti, Eubacterium coprostanoligenes) and reductions in dysbiosis/mucin-degrading taxa (e.g., Mediterraneibacter torques, M. gnavus, Agathobacter rectalis). Between-group Δ(T1 − T0) comparisons at the genus level indicated larger positive shifts in ALZ for Anaerobutyricum, Oscillibacter, Faecalicatena, Romboutsia, Mediterraneibacter, and Blautia, and more negative Δ for Gemmiger, Subdoligranulum, Bifidobacterium, Clostridium, and Collinsella. sPLS-DA showed partial separation (first two components ≈ 9% variance). Conclusions: A structured, non-restrictive MIND intervention was feasible, improved dietary adherence, and accompanied higher diversity and compositional remodeling of the GM in ALZ’s disease. Larger randomized mechanistic studies are warranted.
Keywords: Alzheimer’s disease; MEDAS questionnaire; gut microbiota Alzheimer’s disease; MEDAS questionnaire; gut microbiota

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MDPI and ACS Style

Di Renzo, L.; Raffaelli, G.; Pala, B.; Cianci, R.; Peluso, D.; Gambassi, G.; Giambra, V.; Greco, A.; Canosci, D.D.M.; De Lorenzo, A.; et al. MIND Pattern Nutritional Intervention Modulates Mediterranean Diet Adherence and Gut Microbiota in Alzheimer’s Disease: An Observational Case–Control Study. Nutrients 2026, 18, 193. https://doi.org/10.3390/nu18020193

AMA Style

Di Renzo L, Raffaelli G, Pala B, Cianci R, Peluso D, Gambassi G, Giambra V, Greco A, Canosci DDM, De Lorenzo A, et al. MIND Pattern Nutritional Intervention Modulates Mediterranean Diet Adherence and Gut Microbiota in Alzheimer’s Disease: An Observational Case–Control Study. Nutrients. 2026; 18(2):193. https://doi.org/10.3390/nu18020193

Chicago/Turabian Style

Di Renzo, Laura, Glauco Raffaelli, Barbara Pala, Rossella Cianci, Daniele Peluso, Giovanni Gambassi, Vincenzo Giambra, Antonio Greco, David Della Morte Canosci, Antonino De Lorenzo, and et al. 2026. "MIND Pattern Nutritional Intervention Modulates Mediterranean Diet Adherence and Gut Microbiota in Alzheimer’s Disease: An Observational Case–Control Study" Nutrients 18, no. 2: 193. https://doi.org/10.3390/nu18020193

APA Style

Di Renzo, L., Raffaelli, G., Pala, B., Cianci, R., Peluso, D., Gambassi, G., Giambra, V., Greco, A., Canosci, D. D. M., De Lorenzo, A., & Gualtieri, P. (2026). MIND Pattern Nutritional Intervention Modulates Mediterranean Diet Adherence and Gut Microbiota in Alzheimer’s Disease: An Observational Case–Control Study. Nutrients, 18(2), 193. https://doi.org/10.3390/nu18020193

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