Mediterranean Diet, Alzheimer Disease Biomarkers, and Brain Atrophy in Old Age
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- Cuicui Li,
- Honghong Ren,
- Hongzhu Liu,
- Tong Li,
- Yigang Liu,
- Baolin Wu,
- Ke Han,
- Shuqi Zang,
- Guoqing Zhao,
- Ximing Wang,
- Alexandra L. Clark,
- Abbey M. Hamlin,
- Nazareth Ortega,
- Jordana Breton,
- Qilin Yuan,
- Ying Han,
- Shuangfang Fang,
- Hanhan Lei,
- Huapin Huang,
- Huiying Lin,
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- Ronghua Chen,
- Zhiting Chen,
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- Nan Liu,
- Houwei Du,
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- Д.Р. Турсуметова,
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- Sara Llamas-Velasco,
- Alberto Villarejo-Galende,
- Julián Benito-León,
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- Adolfo Toledano,
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- Clara Andrezza Crisóstomo Bezerra Costa,
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We thank Dr. Brenner for the insightful comment on our article.1 We agree that in the context of a Mediterranean diet, several bioactive compounds—including spermidine—are highly interesting for preventing neurodegeneration and dementia. For example, this hypothesis could be further clarified in intervention studies with spermidine supplementation.2 Notable results have been recently provided by the LipiDiDiet clinical trial showing how an early and prolonged multi-nutrient intervention slowed the decline on cognitive and brain outcomes in the prodromal Alzheimer stages.3
However, as of yet the majority of intervention studies based on nutrient supplementation showed insufficient efficacy for preventing cognitive decline and dementia.4 For the moment, we believe that dietary recommendations for public health purposes should not focus on specific nutrients but rather on dietary patterns that better summarize the dynamic interplay between foods and their constituents. This might rapidly change due to forthcoming studies and the availability of novel technologies or analytical techniques that will allow mapping of the complexity of food. This topic has been elegantly exposed by Barabasi et al., who assert that our diet comprises several thousand biochemical compounds with potential, but still largely unknown effects on health and disease.5
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I read the study by Ballarini et al. with interest, which details the Mediterranean diet (MD) as being protective against memory decline and mediotemporal atrophy, especially with reference to the decrease of amyloidosis and tau pathology.1
A similar dietary study of older adults with subjective cognitive decline (SCD) and healthy controls (HC) indicated higher dietary spermidine content of food mediated the effects of adherence to a MD. The study revealed MRI-measured larger hippocampal volume, greater mean cortical thickness, and greater cortical thickness in regions vulnerable to Alzheimer Disease (AD)—including parietal and temporal regions—irrespective of SCD and HC.2
Age-related Amyloid Beta (A-Beta) and Phosphorylated tau (P-tau) lead to dysfunctional autophagy (AP) and mitophagy (MP), which are important for continuous removal of cellular debris and damaged mitochondria.3 Enhancing AP and MP may be achieved through bioactive food compounds common in the MD and other cultural diets, which are rich in fish, vegetables, fruit, whole grains, and extra-virgin olive oil, including curcumin, astaxanthin, oleuropein, hydroxytyrosol, resveratrol and spermidine.4
A spermidine supplementation trial resulted in improved cognitive function in patients with mild or moderate loss of cognition symptoms.5 As such, bioactive food compounds in the MD may enhance cognitive function and prevent brain atrophy.
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The authors report no relevant disclosures. Contact [email protected] for full disclosures.
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