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Nasab MG, Heidari A, Sedighi M, Shakerian N, Mirbeyk M, Saghazadeh A, Rezaei N. Dietary inflammatory index and neuropsychiatric disorders. Rev Neurosci 2024; 35:21-33. [PMID: 37459114 DOI: 10.1515/revneuro-2023-0047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Accepted: 06/24/2023] [Indexed: 01/10/2024]
Abstract
Neuropsychiatric disorders (NPDs) are considered a potential threat to mental health. Inflammation predominantly plays a role in the pathophysiology of NPDs. Dietary patterns are widely postulated to be involved in the physiological response to inflammation. This review aims to discuss the literature on how dietary inflammatory index (DII) is related to inflammation and, consequently, NPDs. After comprehensive scrutiny in different databases, the articles that investigated the relation of DII score and various NPDs and psychological circumstances were included. The association between dietary patterns and mental disorders comprising depression, anxiety, and stress proved the role of a proinflammatory diet in these conditions' exacerbation. Aging is another condition closely associated with DII. The impact of proinflammatory and anti-inflammatory diet on sleep quality indicated related disorders like sleep latency and day dysfunctions among the different populations are in relation with the high DII score. The potential effects of genetic backgrounds, dietary patterns, and the gut microbiome on DII are discussed as well. To plan preventive or therapeutic interventions considering the DII, these factors, especially genetic variations, should be considered as there is a growing body of literature indicating the role of personalized medicine in different NPDs. To the best of our knowledge, there is a limited number of RCTs on this subject, so future research should evaluate the causality via RCTs and look for therapeutic interventions with an eye on personalized medicine using information about DII in NPDs.
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Affiliation(s)
- Mahsa Golshani Nasab
- Faculty of Veterinary Medicine, University of Tabriz, Tabriz, Iran
- Systematic Review and Meta-Analysis Expert Group (SRMEG), Universal Scientific Education and Research Network (USERN), Tabriz, Iran
| | - Arash Heidari
- Research Center for Immunodeficiencies, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
- Systematic Review and Meta-Analysis Expert Group (SRMEG), Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | - Mohammadreza Sedighi
- Systematic Review and Meta-Analysis Expert Group (SRMEG), Universal Scientific Education and Research Network (USERN), Tehran, Iran
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Narges Shakerian
- Student Research Committee, School of Rehabilitation, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
- Musculoskeletal Rehabilitation Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
- Systematic Review and Meta-Analysis Expert Group (SRMEG), Universal Scientific Education and Research Network (USERN), Ahvaz, Iran
| | - Mona Mirbeyk
- Research Center for Immunodeficiencies, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
- Systematic Review and Meta-Analysis Expert Group (SRMEG), Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | - Amene Saghazadeh
- Research Center for Immunodeficiencies, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
- Meta Cognition Interest Group (MCIG), Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | - Nima Rezaei
- Research Center for Immunodeficiencies, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
- Department of Immunology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
- Network of Immunity in Infection, Malignancy and Autoimmunity, Universal Scientific Education and Research Network (USERN), Tehran, Iran
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Chen L, Liu J, Li X, Hou Z, Wei Y, Chen M, Wang B, Cao H, Qiu R, Zhang Y, Ji X, Zhang P, Xue M, Qiu L, Wang L, Li H. Energy-adjusted dietary inflammatory index and cognitive function in Chinese older adults: a population-based cross-sectional study. Nutr Neurosci 2023:1-11. [PMID: 37992128 DOI: 10.1080/1028415x.2023.2285537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2023]
Abstract
Diet can regulate systemic inflammation, which may play an important role in the development and progression of cognitive impairment and dementia. To explore the relationship between the dietary inflammatory potential and cognitive ability. A total of 2307 adults aged 60 years or older were recruited from the Fujian Provincial Hospital (Fujian, China). Dietary inflammatory properties were analyzed using the energy-adjusted dietary inflammatory index (E-DII). The Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) were used to assess cognitive function. Logistic regression and restricted cubic spline (RCS) were fit to assess the associations between variables. The MCI subjects with the highest E-DII scores had a higher risk of AD compared to subjects with the lowest E-DII scores (OR = 1.98, 95%CI = 1.49-2.64, P for trend < 0.001). Subjects with the highest E-DII levels were at increased risk of cognitive impairment compared to those with the lowest E-DII levels (OR = 1.56, 95%CI = 1.25-1.93, P for trend < 0.001). The link between E-DII and cognitive impairment was significant in a nonlinear dose response analysis (P for nonlinear = 0.001). Higher E-DII scores were associated with an increased risk of developing AD or cognitive impairment. These findings may contribute to the effective prevention of cognitive impairment by constructing a multidisciplinary synergistic prevention strategy and controlling dietary inflammation levels.
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Affiliation(s)
- Lili Chen
- Shengli Clinical Medical College of Fujian Medical University, Fujian Provincial Hospital, Fuzhou, People's Republic of China
- Department of Nursing, Fujian Provincial Hospital, Fuzhou, People's Republic of China
| | - Jinxiu Liu
- The School of Nursing, Fujian Medical University, Fuzhou, People's Republic of China
| | - Xiuli Li
- The School of Nursing, Fujian Medical University, Fuzhou, People's Republic of China
| | - Zhaoyi Hou
- The School of Nursing, Fujian Medical University, Fuzhou, People's Republic of China
| | - Yongbao Wei
- Shengli Clinical Medical College of Fujian Medical University, Fujian Provincial Hospital, Fuzhou, People's Republic of China
- Department of Urology, Fujian Provincial Hospital, Fuzhou, People's Republic of China
| | - Mingfeng Chen
- Shengli Clinical Medical College of Fujian Medical University, Fujian Provincial Hospital, Fuzhou, People's Republic of China
- Department of Neurology, Fujian Provincial Hospital, Fuzhou, People's Republic of China
| | - Bixia Wang
- The School of Nursing, Fujian Medical University, Fuzhou, People's Republic of China
| | - Huizhen Cao
- Shengli Clinical Medical College of Fujian Medical University, Fujian Provincial Hospital, Fuzhou, People's Republic of China
| | - Rongyan Qiu
- Fujian Provincial Governmental Hospital, Fuzhou, People's Republic of China
| | - Yuping Zhang
- The School of Nursing, Fujian Medical University, Fuzhou, People's Republic of China
| | - Xinli Ji
- The School of Nursing, Fujian Medical University, Fuzhou, People's Republic of China
| | - Ping Zhang
- The School of Nursing, Fujian Medical University, Fuzhou, People's Republic of China
| | - Mianxiang Xue
- The School of Nursing, Fujian Medical University, Fuzhou, People's Republic of China
| | - Linlin Qiu
- The School of Nursing, Fujian Medical University, Fuzhou, People's Republic of China
| | - Linlin Wang
- The School of Nursing, Fujian Medical University, Fuzhou, People's Republic of China
| | - Hong Li
- The School of Nursing, Fujian Medical University, Fuzhou, People's Republic of China
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Shi Y, Lin F, Li Y, Wang Y, Chen X, Meng F, Ye Q, Cai G. Association of pro-inflammatory diet with increased risk of all-cause dementia and Alzheimer's dementia: a prospective study of 166,377 UK Biobank participants. BMC Med 2023; 21:266. [PMID: 37480061 PMCID: PMC10362711 DOI: 10.1186/s12916-023-02940-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Accepted: 06/13/2023] [Indexed: 07/23/2023] Open
Abstract
BACKGROUND Increasing evidence suggests an association between pro-inflammatory diets and cognitive function. However, only a few studies based on small sample sizes have explored the association between pro-inflammatory diets and dementia using the dietary inflammatory index (DII). Additionally, the relationship between DII and different subtypes of dementia, such as Alzheimer's dementia and vascular dementia, remains largely unexplored. Given the changes in brain structure already observed in patients with dementia, we also investigated the association between DII and magnetic resonance imaging (MRI) measures of brain structure to provide some hints to elucidate the potential mechanisms between pro-inflammatory diet and cognitive decline. METHODS A total of 166,377 UK Biobank participants without dementia at baseline were analyzed. DII calculations were based on the information collected by the 24-h recall questionnaire. Brain structural anatomy and tissue-specific volumes were measured using brain MRI. Cox proportional hazards models, competing risk models, and restricted cubic spline were applied to assess the longitudinal associations. The generalized linear model was used to assess the association between DII and MRI measurements. RESULTS During a median follow-up time of 9.46 years, a total of 1372 participants developed dementia. The incidence of all-cause dementia increased by 4.6% for each additional unit of DII [hazard ratio (HR): 1.046]. Besides, DII displayed a "J-shaped" non-linear association with Alzheimer's dementia (Pnonlinear = 0.003). When DII was above 1.30, an increase in DII was significantly associated with an increased risk of Alzheimer's dementia (HR: 1.391, 95%CI: 1.085-1.784, P = 0.009). For brain MRI, the total volume of white matter hyperintensities increased with an increase in DII, whereas the volume of gray matter in the hippocampus decreased. CONCLUSIONS In this cohort study, higher DII was associated with a higher risk of all-cause dementia and Alzheimer's dementia. However, our findings suggested that the association with DII and vascular and frontotemporal dementia was not significant.
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Affiliation(s)
- Yisen Shi
- Department of Neurology, Center for Cognitive Neurology, Institute of Clinical Neurology, Fujian Medical University Union Hospital, 29 Xinquan Road, Fuzhou, 350001, China
- Fujian Institute of Geriatrics, Fujian Medical University Union Hospital, 29 Xinquan Road, Fuzhou, 350001, China
- Fujian Key Laboratory of Molecular Neurology, Fujian Medical University, 88 Jiaotong Road, Fuzhou, 350001, China
| | - Fabin Lin
- Department of Neurology, Center for Cognitive Neurology, Institute of Clinical Neurology, Fujian Medical University Union Hospital, 29 Xinquan Road, Fuzhou, 350001, China
- Fujian Institute of Geriatrics, Fujian Medical University Union Hospital, 29 Xinquan Road, Fuzhou, 350001, China
- Fujian Key Laboratory of Molecular Neurology, Fujian Medical University, 88 Jiaotong Road, Fuzhou, 350001, China
- Department of Neurosurgery, Fujian Medical University Union Hospital, Fuzhou, 350001, China
| | - Yueping Li
- Department of Neurology, Center for Cognitive Neurology, Institute of Clinical Neurology, Fujian Medical University Union Hospital, 29 Xinquan Road, Fuzhou, 350001, China
- Fujian Institute of Geriatrics, Fujian Medical University Union Hospital, 29 Xinquan Road, Fuzhou, 350001, China
- Fujian Key Laboratory of Molecular Neurology, Fujian Medical University, 88 Jiaotong Road, Fuzhou, 350001, China
| | - Yingqing Wang
- Department of Neurology, Center for Cognitive Neurology, Institute of Clinical Neurology, Fujian Medical University Union Hospital, 29 Xinquan Road, Fuzhou, 350001, China
- Fujian Institute of Geriatrics, Fujian Medical University Union Hospital, 29 Xinquan Road, Fuzhou, 350001, China
- Fujian Key Laboratory of Molecular Neurology, Fujian Medical University, 88 Jiaotong Road, Fuzhou, 350001, China
| | - Xiaochun Chen
- Department of Neurology, Center for Cognitive Neurology, Institute of Clinical Neurology, Fujian Medical University Union Hospital, 29 Xinquan Road, Fuzhou, 350001, China
- Fujian Institute of Geriatrics, Fujian Medical University Union Hospital, 29 Xinquan Road, Fuzhou, 350001, China
- Fujian Key Laboratory of Molecular Neurology, Fujian Medical University, 88 Jiaotong Road, Fuzhou, 350001, China
| | - Fangang Meng
- Beijing Neurosurgical Institute, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100050, China.
| | - Qinyong Ye
- Department of Neurology, Center for Cognitive Neurology, Institute of Clinical Neurology, Fujian Medical University Union Hospital, 29 Xinquan Road, Fuzhou, 350001, China.
- Fujian Institute of Geriatrics, Fujian Medical University Union Hospital, 29 Xinquan Road, Fuzhou, 350001, China.
- Fujian Key Laboratory of Molecular Neurology, Fujian Medical University, 88 Jiaotong Road, Fuzhou, 350001, China.
| | - Guoen Cai
- Department of Neurology, Center for Cognitive Neurology, Institute of Clinical Neurology, Fujian Medical University Union Hospital, 29 Xinquan Road, Fuzhou, 350001, China.
- Fujian Institute of Geriatrics, Fujian Medical University Union Hospital, 29 Xinquan Road, Fuzhou, 350001, China.
- Fujian Key Laboratory of Molecular Neurology, Fujian Medical University, 88 Jiaotong Road, Fuzhou, 350001, China.
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Duggan MR, Butler L, Peng Z, Daya GN, Moghekar A, An Y, Rapp SR, Hayden KM, Shadyab AH, Natale G, Liu L, Snetselaar L, Moaddel R, Rebholz CM, Sullivan K, Ballantyne CM, Resnick SM, Ferrucci L, Walker KA. Plasma proteins related to inflammatory diet predict future cognitive impairment. Mol Psychiatry 2023; 28:1599-1609. [PMID: 36737481 PMCID: PMC10208977 DOI: 10.1038/s41380-023-01975-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Revised: 01/17/2023] [Accepted: 01/19/2023] [Indexed: 02/05/2023]
Abstract
Dysregulation of the immune system and dietary patterns that increase inflammation can increase the risk for cognitive decline, but the mechanisms by which inflammatory nutritional habits may affect the development of cognitive impairment in aging are not well understood. To determine whether plasma proteins linked to inflammatory diet predict future cognitive impairment, we applied high-throughput proteomic assays to plasma samples from a subset (n = 1528) of Women's Health Initiative Memory Study (WHIMS) participants (mean [SD] baseline age, 71.3 [SD 3.8] years). Results provide insights into how inflammatory nutritional patterns are associated with an immune-related proteome and identify a group of proteins (CXCL10, CCL3, HGF, OPG, CDCP1, NFATC3, ITGA11) related to future cognitive impairment over a 14-year follow-up period. Several of these inflammatory diet proteins were also associated with dementia risk across two external cohorts (ARIC, ESTHER), correlated with plasma biomarkers of Alzheimer's disease (AD) pathology (Aβ42/40) and/or neurodegeneration (NfL), and related to an MRI-defined index of neurodegenerative brain atrophy in a separate cohort (BLSA). In addition to evaluating their biological relevance, assessing their potential role in AD, and characterizing their immune-tissue/cell-specific expression, we leveraged published RNA-seq results to examine how the in vitro regulation of genes encoding these candidate proteins might be altered in response to an immune challenge. Our findings indicate how dietary patterns with higher inflammatory potential relate to plasma levels of immunologically relevant proteins and highlight the molecular mediators which predict subsequent risk for age-related cognitive impairment.
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Affiliation(s)
- Michael R Duggan
- Laboratory of Behavioral Neuroscience, National Institute on Aging, Baltimore, MD, USA
| | - Lauren Butler
- Laboratory of Behavioral Neuroscience, National Institute on Aging, Baltimore, MD, USA
| | - Zhongsheng Peng
- Laboratory of Behavioral Neuroscience, National Institute on Aging, Baltimore, MD, USA
| | - Gulzar N Daya
- Laboratory of Behavioral Neuroscience, National Institute on Aging, Baltimore, MD, USA
| | - Abhay Moghekar
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Yang An
- Laboratory of Behavioral Neuroscience, National Institute on Aging, Baltimore, MD, USA
| | - Stephen R Rapp
- Department of Social Sciences and Health Policy, Wake Forest University School of Medicine, Winston-Salem, NC, USA
- Department of Psychiatry & Behavioral Medicine, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Kathleen M Hayden
- Department of Psychiatry & Behavioral Medicine, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Aladdin H Shadyab
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, La Jolla, CA, USA
| | - Ginny Natale
- Program in Public Health, Stony Brook University School of Medicine, Stony Brook, NY, USA
| | - Longjian Liu
- Department of Epidemiology and Biostatistics, Drexel University Dornsife School of Public Health, Philadelphia, PA, USA
| | - Linda Snetselaar
- Department of Epidemiology, University of Iowa, Iowa City, IA, USA
| | - Ruin Moaddel
- Laboratory of Clinical Investigation, National Institute on Aging, Baltimore, MD, USA
| | - Casey M Rebholz
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Kevin Sullivan
- Department of Medicine, University of Mississippi Medical Center, Jackson, MS, USA
| | - Christie M Ballantyne
- Section of Cardiovascular Research, Department of Medicine, Baylor College of Medicine, Houston, TX, USA
| | - Susan M Resnick
- Laboratory of Behavioral Neuroscience, National Institute on Aging, Baltimore, MD, USA
| | - Luigi Ferrucci
- Translational Gerontology Branch, National Institute on Aging, Baltimore, MD, USA
| | - Keenan A Walker
- Laboratory of Behavioral Neuroscience, National Institute on Aging, Baltimore, MD, USA.
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Melo Van Lent D, Gokingco H, Short MI, Yuan C, Jacques PF, Romero JR, DeCarli CS, Beiser AS, Seshadri S, Himali JJ, Jacob ME. Higher Dietary Inflammatory Index scores are associated with brain MRI markers of brain aging: Results from the Framingham Heart Study Offspring cohort. Alzheimers Dement 2023; 19:621-631. [PMID: 35522830 PMCID: PMC9637238 DOI: 10.1002/alz.12685] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Revised: 03/25/2022] [Accepted: 03/28/2022] [Indexed: 12/12/2022]
Abstract
INTRODUCTION We investigated cross-sectional associations between the Dietary Inflammatory Index (DII) and measures of brain volume and cerebral small vessel disease among participants of the Framingham Heart Study Offspring cohort. METHODS A total of 1897 participants (mean ± standard deviation, age 62±9) completed Food Frequency Questionnaires and brain magnetic resonance imaging (MRI). RESULTS Higher (pro-inflammatory) DII scores, averaged across a maximum of three time points, were associated with smaller total brain volume (beta ± standard error: -0.16 ± 0.03; P < .0001) after adjustment for demographic, clinical, and lifestyle covariates. In addition, higher DII scores were associated with smaller total gray matter volume (-0.08 ± 0.03; P = .003) and larger lateral ventricular volume (0.04 ± 0.02; P = .03). No associations were observed with other brain MRI measures. DISCUSSION Our findings showed associations between higher DII scores and global brain MRI measures. As we are one of the first groups to report on the associations between higher DII scores and brain volume, replication is needed to confirm our findings.
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Affiliation(s)
- Debora Melo Van Lent
- Glenn Biggs Institute for Alzheimer's & Neurodegenerative Diseases, UT Health San Antonio, San Antonio, Texas, USA
- Department of Neurology, Boston University School of Medicine, Boston, Massachusetts, USA
- The Framingham Heart Study, Framingham, Massachusetts, USA
| | - Hannah Gokingco
- Glenn Biggs Institute for Alzheimer's & Neurodegenerative Diseases, UT Health San Antonio, San Antonio, Texas, USA
| | - Meghan I Short
- Glenn Biggs Institute for Alzheimer's & Neurodegenerative Diseases, UT Health San Antonio, San Antonio, Texas, USA
- The Framingham Heart Study, Framingham, Massachusetts, USA
| | - Changzheng Yuan
- School of Public Health, Zhejiang University Medical School, Hangzhou, China
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Paul F Jacques
- The Framingham Heart Study, Framingham, Massachusetts, USA
- Jean Mayer US Department of Agriculture Human Nutrition Research Center on Aging, Tufts University, Boston, Massachusetts, USA
| | - José R Romero
- Department of Neurology, Boston University School of Medicine, Boston, Massachusetts, USA
- The Framingham Heart Study, Framingham, Massachusetts, USA
| | - Charles S DeCarli
- Department of Neurology, School of Medicine & Imaging of Dementia and Aging Laboratory, Center for Neuroscience, University of California Davis, Davis, California, USA
| | - Alexa S Beiser
- Department of Neurology, Boston University School of Medicine, Boston, Massachusetts, USA
- The Framingham Heart Study, Framingham, Massachusetts, USA
- Department of Biostatistics, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Sudha Seshadri
- Glenn Biggs Institute for Alzheimer's & Neurodegenerative Diseases, UT Health San Antonio, San Antonio, Texas, USA
- Department of Neurology, Boston University School of Medicine, Boston, Massachusetts, USA
- The Framingham Heart Study, Framingham, Massachusetts, USA
| | - Jayandra J Himali
- Glenn Biggs Institute for Alzheimer's & Neurodegenerative Diseases, UT Health San Antonio, San Antonio, Texas, USA
- Department of Neurology, Boston University School of Medicine, Boston, Massachusetts, USA
- The Framingham Heart Study, Framingham, Massachusetts, USA
- Department of Biostatistics, Boston University School of Public Health, Boston, Massachusetts, USA
- Department of Population Health Sciences, UT Health San Antonio, San Antonio, Texas, USA
| | - Mini E Jacob
- Glenn Biggs Institute for Alzheimer's & Neurodegenerative Diseases, UT Health San Antonio, San Antonio, Texas, USA
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Sun Y, Liang Z, Xia X, Wang MH, Zhu C, Pan Y, Sun R. Extra cup of tea intake associated with increased risk of Alzheimer's disease: Genetic insights from Mendelian randomization. Front Nutr 2023; 10:1052281. [PMID: 36761219 PMCID: PMC9905237 DOI: 10.3389/fnut.2023.1052281] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Accepted: 01/09/2023] [Indexed: 01/27/2023] Open
Abstract
Background Observational studies report inconclusive effects of tea consumption on the risk of Alzheimer's disease (AD), and the mechanisms are unclear. This study aims to investigate the effects of genetically predicted tea intake (cups of tea consumed per day) on AD, brain volume, and cerebral small vessel disease (CSVD) using the two-sample Mendelian randomization (MR) method. Methods Summary statistics of tea intake were obtained from UK Biobank (N = 447,485), and AD was from the International Genomics of Alzheimer's Project (N = 54,162). Genetic instruments were retrieved from UK Biobank using brain imaging-derived phenotypes for brain volume outcomes (N > 33,224) and genome-wide association studies for CSVD (N: 17,663-48,454). Results In the primary MR analysis, tea intake significantly increased the risk of AD using two different methods (ORIVW = 1.48, 95% CI: [1.14, 1.93]; ORWM = 2.00, 95% CI: [1.26, 3.18]) and reached a weak significant level using MR-Egger regression (p < 0.1). The result passed all the sensitivity analyses, including heterogeneity, pleiotropy, and outlier tests. In the secondary MR analysis, per extra cup of tea significantly decreased gray matter (βWM = -1.63, 95% CI: [-2.41, -0.85]) and right hippocampus volume (βWM = -1.78, 95% CI: [-2.76, -0.79]). We found a nonlinear association between tea intake and AD in association analysis, which suggested that over-drinking with more than 13 cups per day might be a risk factor for AD. Association analysis results were consistent with MR results. Conclusion This study revealed a potential causal association between per extra cup of tea and an increased risk of AD. Genetically predicted tea intake was associated with a decreased brain volume of gray matter and the right hippocampus, which indicates that over-drinking tea might lead to a decline in language and memory functions. Our results shed light on a novel possible mechanism of tea intake to increase the risk of AD by reducing brain volume.
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Affiliation(s)
- Yuxuan Sun
- Scientific Research Center, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, China
- Clinical Big Data Research Center, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, China
| | - Zixin Liang
- Scientific Research Center, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, China
| | - Xiaoxuan Xia
- Department of Statistics, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Maggie Haitian Wang
- The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Chengming Zhu
- Scientific Research Center, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, China
| | - Yihang Pan
- Scientific Research Center, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, China
- Clinical Big Data Research Center, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, China
| | - Rui Sun
- Scientific Research Center, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, China
- Clinical Big Data Research Center, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, China
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Jia Y, Yan S, Sun M, Yang Y, Wang L, Wu C, Li P. Association between dietary inflammatory index and cognitive impairment: A meta-analysis. Front Aging Neurosci 2023; 14:1007629. [PMID: 36688153 PMCID: PMC9845281 DOI: 10.3389/fnagi.2022.1007629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2022] [Accepted: 11/18/2022] [Indexed: 01/05/2023] Open
Abstract
Aims Cognitive impairment is an increasingly urgent global public health challenge. Dietary Inflammatory Index (DII) is a literature-derived score that links diet to inflammation. The relationship between DII and cognitive impairment remains controversial. Therefore, our study aimed to analysis the role of DII on the risk of cognitive impairment by meta-analysis. Methods PubMed, Cochrane Library, MEDLINE, Web of Science and EMBASE databases were searched up to July 2022. Newcastle-Ottawa scale (NOS) and Joanna Briggs Institute (JBI) Checklist were performed to estimate the quality of studies. Results Nine observational studies with 19,379 subjects were included. Our study found that higher DII could elevate the risk of cognitive impairment (OR = 1.46, 95%CI = 1.26, 1.69). Meanwhile, the OR of cognitive impairment was 1.49 (95%CI = 1.21, 1.83) for cross-sectional studies and 1.42 (95%CI = 1.12, 1.79) for cohort studies, respectively. Conclusion Our meta-analysis indicated that higher DII (indicating a more pro-inflammatory diet) is related to increased risk of cognitive impairment.
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Affiliation(s)
- Yuxi Jia
- Application Demonstration Center of Precision Medicine Molecular Diagnosis, The Second Hospital of Jilin University, Changchun, China,Department of Orthopedics, The Second Hospital of Jilin University, Changchun, China
| | - Shoumeng Yan
- Department of Nursing Humanities, School of Nursing, Jilin University, Changchun, China
| | - Mengzi Sun
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, China
| | - Yixue Yang
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, China
| | - Ling Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, China
| | - Caihong Wu
- Department of Nutrition and Food Hygiene, School of Public Health, Jilin University, Changchun, China
| | - Ping Li
- Department of Developmental Pediatrics, The Second Hospital of Jilin University, Changchun, China,*Correspondence: Ping Li
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Li W, Li S, Shang Y, Zhuang W, Yan G, Chen Z, Lyu J. Associations between dietary and blood inflammatory indices and their effects on cognitive function in elderly Americans. Front Neurosci 2023; 17:1117056. [PMID: 36895419 PMCID: PMC9989299 DOI: 10.3389/fnins.2023.1117056] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Accepted: 02/07/2023] [Indexed: 02/25/2023] Open
Abstract
Objective To determine the correlations between dietary and blood inflammation indices in elderly Americans and their effects on cognitive function. Methods This research extracted data from the 2011-2014 National Health and Nutrition Examination Survey for 2,479 patients who were ≥60 years old. Cognitive function was assessed as a composite cognitive function score (Z-score) calculated from the results of the Consortium to Establish a Registry for Alzheimer's Disease Word Learning and Delayed Recall tests, the Animal Fluency test, and the Digit Symbol Substitution Test. We used a dietary inflammatory index (DII) calculated from 28 food components to represent the dietary inflammation profile. Blood inflammation indicators included the white blood cell count (WBC), neutrophil count (NE), lymphocyte count (Lym), neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), neutrophil-albumin ratio (NAR), systemic immune-inflammation index [SII, calculated as (peripheral platelet count) × NE/Lym], and systemic inflammatory response index [SIRI, calculated as (monocyte count) × NE/Lym]. WBC, NE, Lym, NLR, PLR, NAR, SII, SIRI, and DII were initially treated as continuous variables. For logistic regression, WBC, NE, Lym, NLR, PLR, NAR, SII, and SIRI were divided into quartile groups, and DII was divided into tertile groups. Results After adjusting for covariates, WBC, NE, NLR, NAR, SII, SIRI, and DII scores were markedly higher in the cognitively impaired group than in the normal group (p < 0.05). DII was negatively correlated with the Z-score when combined with WBC, NE, and NAR (p < 0.05). After adjusting for all covariates, DII was positively correlated with SII in people with cognitive impairment (p < 0.05). Higher DII with NLR, NAR, SII, and SIRI all increased the risk of cognitive impairment (p < 0.05). Conclusion DII was positively correlated with blood inflammation indicators, and higher DII and blood inflammation indicators increased the risk of developing cognitive impairment.
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Affiliation(s)
- Wanyue Li
- Department of Rehabilitation, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong, China
| | - Shuna Li
- Department of Clinical Research, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong, China
| | - Yaru Shang
- Department of Rehabilitation, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong, China
| | - Weisheng Zhuang
- Department of Rehabilitation, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Guoqiang Yan
- Department of Rehabilitation, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong, China
| | - Zhuoming Chen
- Department of Rehabilitation, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong, China
| | - Jun Lyu
- Department of Clinical Research, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong, China.,Guangdong Provincial Key Laboratory of Traditional Chinese Medicine Informatization, Guangzhou, Guangdong, China
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9
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Ding T, Aimaiti M, Cui S, Shen J, Lu M, Wang L, Bian D. Meta-analysis of the association between dietary inflammatory index and cognitive health. Front Nutr 2023; 10:1104255. [PMID: 37081917 PMCID: PMC10111053 DOI: 10.3389/fnut.2023.1104255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Accepted: 03/20/2023] [Indexed: 04/22/2023] Open
Abstract
Background Some studies have shown that a pro-inflammatory diet may be associated with cognitive function, but their conclusions have varied considerably. We here present a meta-analysis of the current published literature on DII score and its association with cognitive health. Methods In this meta-analysis, the PubMed, Embase, Web of Science, and Cochrane databases were searched in September 2022. The reported indexes, specifically OR, RR, and β, were extracted and analyzed using R version 3.1.0. Results A total of 636 studies in databases were identified, and 12 were included in the meta-analysis. Higher DII was associated with an increased risk of AD and MCI (OR = 1.34; 95% CI = 1.21-1.49). Meanwhile, it may also cause global function impairment (categorical: OR = 1.63; 95% CI = 1.36-1.96) and verbal fluency impairment (continuous: OR = 0.18; 95% IC = 0.08-0.42). But there was no significant association between DII and executive function (categorical: OR = 1.12; 95% IC = 0.84-1.49; continuous: OR = 0.48; 95% IC = 0.19-1.21) or episodic memory (continuous: OR = 0.56; 95% IC = 0.30-1.03). Conclusion A pro-inflammatory diet is related to AD, MCI, and the functions of some cognitive domains (specifically global function and verbal fluency). However, the current evidence on the role of diet-induced inflammation in different cognitive domains should be supported by further studies in the future.
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Affiliation(s)
- Tianze Ding
- Department of Geriatrics, Medical Center on Aging of Shanghai Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Department of Nutrition, College of Health Science and Technology, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Maimaitiyusupu Aimaiti
- Department of Geriatrics, Medical Center on Aging of Shanghai Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Department of Nutrition, College of Health Science and Technology, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Shishuang Cui
- Department of Geriatrics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Junhao Shen
- Department of Nutrition, College of Health Science and Technology, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Mengjie Lu
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Lei Wang
- Department of Geriatrics, Medical Center on Aging of Shanghai Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- *Correspondence: Dongsheng Bian, ; Lei Wang,
| | - Dongsheng Bian
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Department of Clinical Nutrition, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- *Correspondence: Dongsheng Bian, ; Lei Wang,
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10
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Association of Dietary Inflammatory Potential with Blood Inflammation: The Prospective Markers on Mild Cognitive Impairment. Nutrients 2022; 14:nu14122417. [PMID: 35745147 PMCID: PMC9229190 DOI: 10.3390/nu14122417] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Revised: 05/26/2022] [Accepted: 06/07/2022] [Indexed: 12/15/2022] Open
Abstract
Inflammation is known as an important mechanism of cognitive dysfunction. Systemic immune inflammation index (SII) and system inflammation response index (SIRI) are two blood inflammatory markers, which are related to many chronic diseases including cognitive impairment. It is recognized that dietary inflammatory index (DII), which is used to estimate the overall inflammatory potential of diet, may be related to mild cognitive impairment (MCI) as well. This study aimed to explore the relationship between SII, SIRI and DII, as well as the role of these inflammatory indexes on MCI in elderly people. A total of 1050 participants from Beijing were included. Neuropsychological tests were used for cognitive evaluation. Energy-adjusted DII scores were calculated based on semi-quantitative food frequency questionnaire. Blood samples were tested for calculating SII and SIRI. Log-binomial regression models were used to estimate the correlation of indexes. After adjusting demographic characteristics, SII and SIRI in MCI individuals were higher than controls (p ≤ 0.001). DII, SII and SIRI had positive relationship with MoCA scores (p < 0.005). DII also correlated with SIRI in MCI (β = 0.11, p = 0.031). Higher DII and SIRI could definitely increase the risk of MCI, as well as DII and SII (p < 0.005). In conclusion, DII was positively correlated with blood inflammation. The elderly with higher level of DII and SIRI, or DII and SII could be considered as people with higher risk of developing MCI.
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11
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Sun M, Wang L, Guo Y, Yan S, Li J, Wang X, Li X, Li B. The Association Among Inflammatory Diet, Glycohemoglobin, and Cognitive Function Impairment in the Elderly: Based on the NHANES 2011–2014. J Alzheimers Dis 2022; 87:1713-1723. [DOI: 10.3233/jad-215688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background: Dietary inflammatory index (DII) was associated with Type 2 diabetes mellitus and cognitive function impairment (CFI). Objective: The aim of this study was to explore whether the associations among DII, glycohemoglobin (HbA1c), and CFI were similar in the participants with or without diabetes. Methods: A total of 1,198 participants aged 60 and over from the National Health and Nutrition Examination Survey (NHANES) in 2011–2014 were involved in this study, dividing into subgroups as diabetes and non-diabetes for further analysis. Results: We found that participants with pro-inflammatory diet had higher proportion of CFI patients (p < 0.05). Pro-inflammatory diet and HbA1c were positively associated with the risk of CFI; participants with pro-inflammatory diet was 1.479 times on occurrence of CFI compared with anti-inflammatory diet group. The interaction between inflammatory diet and HbA1c was positive on the risk of CFI and was negative on the CERAD-immediate and CERAD-delayed, respectively. Among the participants without diabetes, the associations of Energy-adjusted DII (E-DII) with Animal Fluency test and Digit Symbol Substitution Test (DSST) were partially mediated by HbA1c, and the mediated proportion was 5.8% and 6.6%, respectively. However, there was no such mediation effect in the diabetes patients. Conclusion: In elderly participants without diabetes, there was an interaction between inflammatory diet and HbA1c on the association with CFI, especially for the dimension of CERAD-immediate and CERAD-delayed. Besides, the associations of E-DII with Animal Fluency test and DSST were partially mediated by HbA1c. For diabetic patients, HbA1c, rather than the inflammatory diet has a positive effect on the CFI risk.
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Affiliation(s)
- Mengzi Sun
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, P. R. China
| | - Ling Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, P. R. China
| | - Yinpei Guo
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, P. R. China
| | - Shoumeng Yan
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, P. R. China
| | - Jing Li
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, P. R. China
| | - Xuhan Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, P. R. China
| | - Xiaotong Li
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, P. R. China
| | - Bo Li
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, P. R. China
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12
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Motamedi A, Askari M, Mozaffari H, Homayounfrar R, Nikparast A, Ghazi ML, Nejad MM, Alizadeh S. Dietary Inflammatory Index in relation to Type 2 Diabetes: A Meta-Analysis. Int J Clin Pract 2022; 2022:9953115. [PMID: 35685508 PMCID: PMC9159166 DOI: 10.1155/2022/9953115] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 01/16/2022] [Accepted: 01/27/2022] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND AND AIMS Epidemiologic studies show a strong association between chronic inflammation and type 2 diabetes (T2D). Diet may also affect the risk of T2D by modulating inflammation. This meta-analysis aimed to assess the relation of dietary inflammatory index (DII) and risk of T2D. METHODS PubMed and Scopus were systematically searched from their inception to September 2020 to identify relevant studies. Relative risks, hazard ratios, or odds ratios (OR), with their corresponding 95% confidence intervals (95% CI), were calculated and pooled using a random-effects model. RESULTS A total of 48 different studies, with a total sample size of 1,687,424 participants, were eligible to be included in this meta-analysis. In the overall analysis, no significant association was observed between DII and risk of T2D (OR = 1.03, 95% CI: 0.91 to 1.15), with significant evidence for heterogeneity (I 2 = 96.5%, P < 0.001); however, higher DII was identified as being significantly related to increased risk of T2D in high quality studies (OR = 1.58, 95% CI: 1.15 to 2.17). In the stratified analysis by the dietary assessment tool, background disease, and sex of participants, DII showed no significant association with T2D. CONCLUSIONS Higher DII might be associated with an increased risk of T2D. Additional well-designed studies are required to confirm this finding.
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Affiliation(s)
- Amir Motamedi
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammadreza Askari
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Hadis Mozaffari
- Faculty of Land and Food Systems, University of British Columbia, Vancouver, Canada
| | - Reza Homayounfrar
- Noncommunicable Diseases Research Center, Fasa University of Medical Sciences, Fasa, Iran
- National Nutrition and Food Technology Research Institute, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ali Nikparast
- National Nutrition and Food Technology Research Institute, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Maryam Lafzi Ghazi
- Department of Exercise Physiology, Central Tehran Branch, Islamic Azad University, Tehran, Iran
| | - Maryam Mofidi Nejad
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Shahab Alizadeh
- Department of Cellular and Molecular Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran
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13
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Charisis S, Ntanasi E, Yannakoulia M, Anastasiou CA, Kosmidis MH, Dardiotis E, Gargalionis AN, Patas K, Chatzipanagiotou S, Mourtzinos I, Tzima K, Hadjigeorgiou G, Sakka P, Kapogiannis D, Scarmeas N. Diet Inflammatory Index and Dementia Incidence: A Population-Based Study. Neurology 2021; 97:e2381-e2391. [PMID: 34759053 PMCID: PMC8673721 DOI: 10.1212/wnl.0000000000012973] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Accepted: 09/29/2021] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Aging is characterized by a functional shift of the immune system toward a proinflammatory phenotype. This derangement has been associated with cognitive decline and has been implicated in the pathogenesis of dementia. Diet can modulate systemic inflammation; thus, it may be a valuable tool to counteract the associated risk for cognitive impairment and dementia. The present study aimed to explore the associations between the inflammatory potential of diet, assessed with an easily applicable, population-based, biomarker-validated diet inflammatory index (DII), and the risk for dementia in community-dwelling older adults. METHODS Individuals from the Hellenic Longitudinal Investigation of Aging and Diet (HELIAD) were included in the present cohort study. Participants were recruited through random population sampling and were followed up for a mean of 3.05 (standard deviation 0.85) years. Dementia diagnosis was based on standard clinical criteria. Those with baseline dementia or missing cognitive follow-up data were excluded from the analyses. The inflammatory potential of diet was assessed through a DII score that considers literature-derived associations of 45 food parameters with levels of proinflammatory and anti-inflammatory cytokines in the blood; higher values indicated a more proinflammatory diet. Consumption frequencies were derived from a detailed food frequency questionnaire and were standardized to representative dietary intake normative data from 11 different countries. Analysis of dementia incidence as a function of baseline DII scores was performed by Cox proportional hazards models. RESULTS Analyses included 1,059 individuals (mean age 73.1 years, 40.3% male, mean education 8.2 years), 62 of whom developed incident dementia. Each additional unit of DII score was associated with a 21% increase in the risk for dementia incidence (hazard ratio 1.21 [95% confidence interval 1.03-1.42]; p = 0.023). Compared to participants in the lowest DII score tertile, participants in the highest one (maximal proinflammatory diet potential) were 3 (95% confidence interval 1.2-7.3; p = 0.014) times more likely to develop incident dementia. The test for trend was also significant, indicating a potential dose-response relationship (p = 0.014). DISCUSSION In the present study, higher DII scores (indicating greater proinflammatory diet potential) were associated with an increased risk for incident dementia. These findings might avail the development of primary dementia preventive strategies through tailored and precise dietary interventions.
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Affiliation(s)
- Sokratis Charisis
- From the 1st Department of Neurology (S.C., E.N., N.S.) and Department of Medical Biopathology and Clinical Microbiology (A.N.G., K.P., S.C.), Aiginition Hospital, National and Kapodistrian University of Athens Medical School, Greece; Department of Neurology (S.C.), University of Texas Health Science Center at San Antonio; Department of Nutrition and Dietetics (E.N., M.Y., C.A.A.), Harokopio University, Athens; Lab of Cognitive Neuroscience (M.H.K.), School of Psychology, and Department of Food Science and Technology (I.M.), Faculty of Agriculture, Aristotle University of Thessaloniki; School of Medicine (E.D.), University of Thessaly, Larissa, Greece; Department of Food BioSciences (K.T.), Teagasc Food Research Centre Ashtown, Dublin, Ireland; Department of Neurology (G.H.), Medical School, University of Cyprus; Athens Association of Alzheimer's Disease and Related Disorders (P.S.), Greece; National Institute on Aging/NIH (D.K.), Baltimore, MD; and Taub Institute for Research in Alzheimer's Disease and the Aging Brain (N.S.), Gertrude H. Sergievsky Center, Department of Neurology, Columbia University, New York, NY
| | - Eva Ntanasi
- From the 1st Department of Neurology (S.C., E.N., N.S.) and Department of Medical Biopathology and Clinical Microbiology (A.N.G., K.P., S.C.), Aiginition Hospital, National and Kapodistrian University of Athens Medical School, Greece; Department of Neurology (S.C.), University of Texas Health Science Center at San Antonio; Department of Nutrition and Dietetics (E.N., M.Y., C.A.A.), Harokopio University, Athens; Lab of Cognitive Neuroscience (M.H.K.), School of Psychology, and Department of Food Science and Technology (I.M.), Faculty of Agriculture, Aristotle University of Thessaloniki; School of Medicine (E.D.), University of Thessaly, Larissa, Greece; Department of Food BioSciences (K.T.), Teagasc Food Research Centre Ashtown, Dublin, Ireland; Department of Neurology (G.H.), Medical School, University of Cyprus; Athens Association of Alzheimer's Disease and Related Disorders (P.S.), Greece; National Institute on Aging/NIH (D.K.), Baltimore, MD; and Taub Institute for Research in Alzheimer's Disease and the Aging Brain (N.S.), Gertrude H. Sergievsky Center, Department of Neurology, Columbia University, New York, NY
| | - Mary Yannakoulia
- From the 1st Department of Neurology (S.C., E.N., N.S.) and Department of Medical Biopathology and Clinical Microbiology (A.N.G., K.P., S.C.), Aiginition Hospital, National and Kapodistrian University of Athens Medical School, Greece; Department of Neurology (S.C.), University of Texas Health Science Center at San Antonio; Department of Nutrition and Dietetics (E.N., M.Y., C.A.A.), Harokopio University, Athens; Lab of Cognitive Neuroscience (M.H.K.), School of Psychology, and Department of Food Science and Technology (I.M.), Faculty of Agriculture, Aristotle University of Thessaloniki; School of Medicine (E.D.), University of Thessaly, Larissa, Greece; Department of Food BioSciences (K.T.), Teagasc Food Research Centre Ashtown, Dublin, Ireland; Department of Neurology (G.H.), Medical School, University of Cyprus; Athens Association of Alzheimer's Disease and Related Disorders (P.S.), Greece; National Institute on Aging/NIH (D.K.), Baltimore, MD; and Taub Institute for Research in Alzheimer's Disease and the Aging Brain (N.S.), Gertrude H. Sergievsky Center, Department of Neurology, Columbia University, New York, NY
| | - Costas A Anastasiou
- From the 1st Department of Neurology (S.C., E.N., N.S.) and Department of Medical Biopathology and Clinical Microbiology (A.N.G., K.P., S.C.), Aiginition Hospital, National and Kapodistrian University of Athens Medical School, Greece; Department of Neurology (S.C.), University of Texas Health Science Center at San Antonio; Department of Nutrition and Dietetics (E.N., M.Y., C.A.A.), Harokopio University, Athens; Lab of Cognitive Neuroscience (M.H.K.), School of Psychology, and Department of Food Science and Technology (I.M.), Faculty of Agriculture, Aristotle University of Thessaloniki; School of Medicine (E.D.), University of Thessaly, Larissa, Greece; Department of Food BioSciences (K.T.), Teagasc Food Research Centre Ashtown, Dublin, Ireland; Department of Neurology (G.H.), Medical School, University of Cyprus; Athens Association of Alzheimer's Disease and Related Disorders (P.S.), Greece; National Institute on Aging/NIH (D.K.), Baltimore, MD; and Taub Institute for Research in Alzheimer's Disease and the Aging Brain (N.S.), Gertrude H. Sergievsky Center, Department of Neurology, Columbia University, New York, NY
| | - Mary H Kosmidis
- From the 1st Department of Neurology (S.C., E.N., N.S.) and Department of Medical Biopathology and Clinical Microbiology (A.N.G., K.P., S.C.), Aiginition Hospital, National and Kapodistrian University of Athens Medical School, Greece; Department of Neurology (S.C.), University of Texas Health Science Center at San Antonio; Department of Nutrition and Dietetics (E.N., M.Y., C.A.A.), Harokopio University, Athens; Lab of Cognitive Neuroscience (M.H.K.), School of Psychology, and Department of Food Science and Technology (I.M.), Faculty of Agriculture, Aristotle University of Thessaloniki; School of Medicine (E.D.), University of Thessaly, Larissa, Greece; Department of Food BioSciences (K.T.), Teagasc Food Research Centre Ashtown, Dublin, Ireland; Department of Neurology (G.H.), Medical School, University of Cyprus; Athens Association of Alzheimer's Disease and Related Disorders (P.S.), Greece; National Institute on Aging/NIH (D.K.), Baltimore, MD; and Taub Institute for Research in Alzheimer's Disease and the Aging Brain (N.S.), Gertrude H. Sergievsky Center, Department of Neurology, Columbia University, New York, NY
| | - Efthimios Dardiotis
- From the 1st Department of Neurology (S.C., E.N., N.S.) and Department of Medical Biopathology and Clinical Microbiology (A.N.G., K.P., S.C.), Aiginition Hospital, National and Kapodistrian University of Athens Medical School, Greece; Department of Neurology (S.C.), University of Texas Health Science Center at San Antonio; Department of Nutrition and Dietetics (E.N., M.Y., C.A.A.), Harokopio University, Athens; Lab of Cognitive Neuroscience (M.H.K.), School of Psychology, and Department of Food Science and Technology (I.M.), Faculty of Agriculture, Aristotle University of Thessaloniki; School of Medicine (E.D.), University of Thessaly, Larissa, Greece; Department of Food BioSciences (K.T.), Teagasc Food Research Centre Ashtown, Dublin, Ireland; Department of Neurology (G.H.), Medical School, University of Cyprus; Athens Association of Alzheimer's Disease and Related Disorders (P.S.), Greece; National Institute on Aging/NIH (D.K.), Baltimore, MD; and Taub Institute for Research in Alzheimer's Disease and the Aging Brain (N.S.), Gertrude H. Sergievsky Center, Department of Neurology, Columbia University, New York, NY
| | - Antonios N Gargalionis
- From the 1st Department of Neurology (S.C., E.N., N.S.) and Department of Medical Biopathology and Clinical Microbiology (A.N.G., K.P., S.C.), Aiginition Hospital, National and Kapodistrian University of Athens Medical School, Greece; Department of Neurology (S.C.), University of Texas Health Science Center at San Antonio; Department of Nutrition and Dietetics (E.N., M.Y., C.A.A.), Harokopio University, Athens; Lab of Cognitive Neuroscience (M.H.K.), School of Psychology, and Department of Food Science and Technology (I.M.), Faculty of Agriculture, Aristotle University of Thessaloniki; School of Medicine (E.D.), University of Thessaly, Larissa, Greece; Department of Food BioSciences (K.T.), Teagasc Food Research Centre Ashtown, Dublin, Ireland; Department of Neurology (G.H.), Medical School, University of Cyprus; Athens Association of Alzheimer's Disease and Related Disorders (P.S.), Greece; National Institute on Aging/NIH (D.K.), Baltimore, MD; and Taub Institute for Research in Alzheimer's Disease and the Aging Brain (N.S.), Gertrude H. Sergievsky Center, Department of Neurology, Columbia University, New York, NY
| | - Kostas Patas
- From the 1st Department of Neurology (S.C., E.N., N.S.) and Department of Medical Biopathology and Clinical Microbiology (A.N.G., K.P., S.C.), Aiginition Hospital, National and Kapodistrian University of Athens Medical School, Greece; Department of Neurology (S.C.), University of Texas Health Science Center at San Antonio; Department of Nutrition and Dietetics (E.N., M.Y., C.A.A.), Harokopio University, Athens; Lab of Cognitive Neuroscience (M.H.K.), School of Psychology, and Department of Food Science and Technology (I.M.), Faculty of Agriculture, Aristotle University of Thessaloniki; School of Medicine (E.D.), University of Thessaly, Larissa, Greece; Department of Food BioSciences (K.T.), Teagasc Food Research Centre Ashtown, Dublin, Ireland; Department of Neurology (G.H.), Medical School, University of Cyprus; Athens Association of Alzheimer's Disease and Related Disorders (P.S.), Greece; National Institute on Aging/NIH (D.K.), Baltimore, MD; and Taub Institute for Research in Alzheimer's Disease and the Aging Brain (N.S.), Gertrude H. Sergievsky Center, Department of Neurology, Columbia University, New York, NY
| | - Stylianos Chatzipanagiotou
- From the 1st Department of Neurology (S.C., E.N., N.S.) and Department of Medical Biopathology and Clinical Microbiology (A.N.G., K.P., S.C.), Aiginition Hospital, National and Kapodistrian University of Athens Medical School, Greece; Department of Neurology (S.C.), University of Texas Health Science Center at San Antonio; Department of Nutrition and Dietetics (E.N., M.Y., C.A.A.), Harokopio University, Athens; Lab of Cognitive Neuroscience (M.H.K.), School of Psychology, and Department of Food Science and Technology (I.M.), Faculty of Agriculture, Aristotle University of Thessaloniki; School of Medicine (E.D.), University of Thessaly, Larissa, Greece; Department of Food BioSciences (K.T.), Teagasc Food Research Centre Ashtown, Dublin, Ireland; Department of Neurology (G.H.), Medical School, University of Cyprus; Athens Association of Alzheimer's Disease and Related Disorders (P.S.), Greece; National Institute on Aging/NIH (D.K.), Baltimore, MD; and Taub Institute for Research in Alzheimer's Disease and the Aging Brain (N.S.), Gertrude H. Sergievsky Center, Department of Neurology, Columbia University, New York, NY
| | - Ioannis Mourtzinos
- From the 1st Department of Neurology (S.C., E.N., N.S.) and Department of Medical Biopathology and Clinical Microbiology (A.N.G., K.P., S.C.), Aiginition Hospital, National and Kapodistrian University of Athens Medical School, Greece; Department of Neurology (S.C.), University of Texas Health Science Center at San Antonio; Department of Nutrition and Dietetics (E.N., M.Y., C.A.A.), Harokopio University, Athens; Lab of Cognitive Neuroscience (M.H.K.), School of Psychology, and Department of Food Science and Technology (I.M.), Faculty of Agriculture, Aristotle University of Thessaloniki; School of Medicine (E.D.), University of Thessaly, Larissa, Greece; Department of Food BioSciences (K.T.), Teagasc Food Research Centre Ashtown, Dublin, Ireland; Department of Neurology (G.H.), Medical School, University of Cyprus; Athens Association of Alzheimer's Disease and Related Disorders (P.S.), Greece; National Institute on Aging/NIH (D.K.), Baltimore, MD; and Taub Institute for Research in Alzheimer's Disease and the Aging Brain (N.S.), Gertrude H. Sergievsky Center, Department of Neurology, Columbia University, New York, NY
| | - Katerina Tzima
- From the 1st Department of Neurology (S.C., E.N., N.S.) and Department of Medical Biopathology and Clinical Microbiology (A.N.G., K.P., S.C.), Aiginition Hospital, National and Kapodistrian University of Athens Medical School, Greece; Department of Neurology (S.C.), University of Texas Health Science Center at San Antonio; Department of Nutrition and Dietetics (E.N., M.Y., C.A.A.), Harokopio University, Athens; Lab of Cognitive Neuroscience (M.H.K.), School of Psychology, and Department of Food Science and Technology (I.M.), Faculty of Agriculture, Aristotle University of Thessaloniki; School of Medicine (E.D.), University of Thessaly, Larissa, Greece; Department of Food BioSciences (K.T.), Teagasc Food Research Centre Ashtown, Dublin, Ireland; Department of Neurology (G.H.), Medical School, University of Cyprus; Athens Association of Alzheimer's Disease and Related Disorders (P.S.), Greece; National Institute on Aging/NIH (D.K.), Baltimore, MD; and Taub Institute for Research in Alzheimer's Disease and the Aging Brain (N.S.), Gertrude H. Sergievsky Center, Department of Neurology, Columbia University, New York, NY
| | - Georgios Hadjigeorgiou
- From the 1st Department of Neurology (S.C., E.N., N.S.) and Department of Medical Biopathology and Clinical Microbiology (A.N.G., K.P., S.C.), Aiginition Hospital, National and Kapodistrian University of Athens Medical School, Greece; Department of Neurology (S.C.), University of Texas Health Science Center at San Antonio; Department of Nutrition and Dietetics (E.N., M.Y., C.A.A.), Harokopio University, Athens; Lab of Cognitive Neuroscience (M.H.K.), School of Psychology, and Department of Food Science and Technology (I.M.), Faculty of Agriculture, Aristotle University of Thessaloniki; School of Medicine (E.D.), University of Thessaly, Larissa, Greece; Department of Food BioSciences (K.T.), Teagasc Food Research Centre Ashtown, Dublin, Ireland; Department of Neurology (G.H.), Medical School, University of Cyprus; Athens Association of Alzheimer's Disease and Related Disorders (P.S.), Greece; National Institute on Aging/NIH (D.K.), Baltimore, MD; and Taub Institute for Research in Alzheimer's Disease and the Aging Brain (N.S.), Gertrude H. Sergievsky Center, Department of Neurology, Columbia University, New York, NY
| | - Paraskevi Sakka
- From the 1st Department of Neurology (S.C., E.N., N.S.) and Department of Medical Biopathology and Clinical Microbiology (A.N.G., K.P., S.C.), Aiginition Hospital, National and Kapodistrian University of Athens Medical School, Greece; Department of Neurology (S.C.), University of Texas Health Science Center at San Antonio; Department of Nutrition and Dietetics (E.N., M.Y., C.A.A.), Harokopio University, Athens; Lab of Cognitive Neuroscience (M.H.K.), School of Psychology, and Department of Food Science and Technology (I.M.), Faculty of Agriculture, Aristotle University of Thessaloniki; School of Medicine (E.D.), University of Thessaly, Larissa, Greece; Department of Food BioSciences (K.T.), Teagasc Food Research Centre Ashtown, Dublin, Ireland; Department of Neurology (G.H.), Medical School, University of Cyprus; Athens Association of Alzheimer's Disease and Related Disorders (P.S.), Greece; National Institute on Aging/NIH (D.K.), Baltimore, MD; and Taub Institute for Research in Alzheimer's Disease and the Aging Brain (N.S.), Gertrude H. Sergievsky Center, Department of Neurology, Columbia University, New York, NY
| | - Dimitrios Kapogiannis
- From the 1st Department of Neurology (S.C., E.N., N.S.) and Department of Medical Biopathology and Clinical Microbiology (A.N.G., K.P., S.C.), Aiginition Hospital, National and Kapodistrian University of Athens Medical School, Greece; Department of Neurology (S.C.), University of Texas Health Science Center at San Antonio; Department of Nutrition and Dietetics (E.N., M.Y., C.A.A.), Harokopio University, Athens; Lab of Cognitive Neuroscience (M.H.K.), School of Psychology, and Department of Food Science and Technology (I.M.), Faculty of Agriculture, Aristotle University of Thessaloniki; School of Medicine (E.D.), University of Thessaly, Larissa, Greece; Department of Food BioSciences (K.T.), Teagasc Food Research Centre Ashtown, Dublin, Ireland; Department of Neurology (G.H.), Medical School, University of Cyprus; Athens Association of Alzheimer's Disease and Related Disorders (P.S.), Greece; National Institute on Aging/NIH (D.K.), Baltimore, MD; and Taub Institute for Research in Alzheimer's Disease and the Aging Brain (N.S.), Gertrude H. Sergievsky Center, Department of Neurology, Columbia University, New York, NY
| | - Nikolaos Scarmeas
- From the 1st Department of Neurology (S.C., E.N., N.S.) and Department of Medical Biopathology and Clinical Microbiology (A.N.G., K.P., S.C.), Aiginition Hospital, National and Kapodistrian University of Athens Medical School, Greece; Department of Neurology (S.C.), University of Texas Health Science Center at San Antonio; Department of Nutrition and Dietetics (E.N., M.Y., C.A.A.), Harokopio University, Athens; Lab of Cognitive Neuroscience (M.H.K.), School of Psychology, and Department of Food Science and Technology (I.M.), Faculty of Agriculture, Aristotle University of Thessaloniki; School of Medicine (E.D.), University of Thessaly, Larissa, Greece; Department of Food BioSciences (K.T.), Teagasc Food Research Centre Ashtown, Dublin, Ireland; Department of Neurology (G.H.), Medical School, University of Cyprus; Athens Association of Alzheimer's Disease and Related Disorders (P.S.), Greece; National Institute on Aging/NIH (D.K.), Baltimore, MD; and Taub Institute for Research in Alzheimer's Disease and the Aging Brain (N.S.), Gertrude H. Sergievsky Center, Department of Neurology, Columbia University, New York, NY.
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