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Pachter, D.* ; Kaplan, A.* ; Tsaban, G.* ; Zelicha, H.* ; Meir, A.Y.* ; Rinott, E.* ; Levakov, G.* ; Salti, M.* ; Yovell, Y.* ; Huhn, S.* ; Beyer, F.* ; Witte, V.* ; 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.

Glycemic control contributes to the neuroprotective effects of mediterranean and green-mediterranean diets on brain age; the DIRECT PLUS brain-MRI randomized controlled trial.

Am. J. Clin. Nutr. 120, 1029-1036 (2024)
Verlagsversion DOI PMC
Open Access Gold (Paid Option)
Creative Commons Lizenzvertrag
BACKGROUND: We recently reported that Mediterranean (MED) and green-MED diets significantly attenuated age-related brain atrophy by ∼50% within 18 months. OBJECTIVE: To explore the contribution of specific diet-induced parameters to brain volume deviation from chronological age. METHODS: A post-hoc analysis of the 18-month DIRECT-PLUS trial, where participants were randomly assigned to: (1)-healthy-dietary-guidelines (HDG); (2)-MED diet; or (3)-green-MED diet, high in polyphenols and low in red meat. Both MED groups consumed 28g walnuts/day (+440mg/day polyphenols). The green-MED group further consumed green-tea (3-4 cups/day) and Mankai green shake (Wolffia-globosa aquatic plant) (+800mg/day polyphenols). We collected blood samples through the intervention and followed brain structure volumes by magnetic-resonance-imaging (MRI). We used hippocampal-occupancy (HOC) score (hippocampal and inferior-lateral-ventricle volumes ratio) as a neurodegeneration marker and brain age proxy. We applied multivariate-linear-regression models. RESULTS: Of 284 participants (88% male; age=51.1years; BMI=31.2kg/m2; HbA1c=5.48%; APOE-ε4 genotype=15.7%), 224 completed the trial with eligible whole-brain MRIs. Individuals with higher HOC-deviations (i.e., younger brain age) presented lower body weight (r=-0.204;95%CI[-0.298,-0.101]), waist-circumference (r=-0.207;95%CI[-0.310,-0.103]), diastolic (r=-0.186;95%CI[-0.304,-0.072]), and systolic blood pressure (r=-0.189;95%CI[-0.308,-0.061]), insulin (r=-0.099;95%CI[-0.194,-0.004]) and HbA1c (r=-0.164;95%CI[-0.337,-0.006]) levels. After 18 months, greater changes in HOC-deviations (i.e., brain-age decline attenuation) were independently associated with improved HbA1c (β=-0.254;95%CI[-0.392,-0.117]), HOMA-IR (β=-0.200;95%CI[-0.346,-0.055]) fasting glucose (β=-0.155;95%[CI -0.293,-0.016]), and s-CRP (β=-0.153;95%[CI -0.296,-0.010]). Improvement in diabetes status was associated with greater HOC-deviation changes compared to either no change in diabetes status (0.010;95%CI]0.002,0.019[) or with an unfavorable change (0.012;95%CI]0.002,0.023]). A decline in HbA1c is further associated with greater deviation changes in the Thalamus, Caudate nucleus, and Cerebellum (p<0.05). Greater consumption of Mankai and green-tea (green-MED diet components) were associated with greater HOC-deviation changes beyond weight loss. CONCLUSIONS: Glycemic control contributes to the neuroprotective effects of the MED and green-MED diets on brain age. Polyphenols-rich diet components as Mankai and green-tea may contribute to a more youthful brain age. TRIAL-REGISTRATION-CLINICAL-TRIALS-IDENTIFIER: NCT03020186 URL OF REGISTRATION: https://clinicaltrials.gov/study/NCT03020186.
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Publikationstyp Artikel: Journalartikel
Dokumenttyp Wissenschaftlicher Artikel
Korrespondenzautor
Schlagwörter Aging ; Brain Age ; Dietary Intervention ; Glycemic Control ; Green-mediterranean ; Hippocampal Occupancy Score ; Polyphenols; Cognitive Decline; Atrophy; Risk; Association; Intervention; Dementia; Japanese; Volumes; Mri
ISSN (print) / ISBN 0002-9165
e-ISSN 1938-3207
Zeitschrift American Journal of Clinical Nutrition
Quellenangaben Band: 120, Heft: 5, Seiten: 1029-1036 Artikelnummer: , Supplement: ,
Verlag American Society for Nutrition
Verlagsort Ste 800, 230 Park Ave, New York, Ny 10169 Usa
Nichtpatentliteratur Publikationen
Begutachtungsstatus Peer reviewed
Institut(e) Helmholtz Institute for Metabolism, Obesity and Vascular Research (HI-MAG)
Förderungen Kreitman Doctoral Fellowship at the Ben-Gurion University of the Negev
California Walnut Commission
Israel Ministry of Science and Technology
Israel Ministry of Health
German Research Foundation (DFG)