Department of Hygiene, Epidemiology and Medical Statistics University of Athens School of Medicine, Athens, Greece.
Ann Neurol. 2013 Oct;74(4):580-91. doi: 10.1002/ana.23944. Epub 2013 Sep 16.
This meta-analysis aims to quantitatively synthesize all studies that examine the association between adherence to a Mediterranean diet and risk of stroke, depression, cognitive impairment, and Parkinson disease.
Potentially eligible publications were those providing effect estimates of relative risk (RR) for the association between Mediterranean diet and the aforementioned outcomes. Studies were sought in PubMed up to October 31, 2012. Maximally adjusted effect estimates were extracted; separate analyses were performed for high and moderate adherence.
Twenty-two eligible studies were included (11 covered stroke, 9 covered depression, and 8 covered cognitive impairment; only 1 pertained to Parkinson's disease). High adherence to Mediterranean diet was consistently associated with reduced risk for stroke (RR = 0.71, 95% confidence interval [CI] = 0.57-0.89), depression (RR = 0.68, 95% CI = 0.54-0.86), and cognitive impairment (RR = 0.60, 95% CI = 0.43-0.83). Moderate adherence was similarly associated with reduced risk for depression and cognitive impairment, whereas the protective trend concerning stroke was only marginal. Subgroup analyses highlighted the protective actions of high adherence in terms of reduced risk for ischemic stroke, mild cognitive impairment, dementia, and particularly Alzheimer disease. Meta-regression analysis indicated that the protective effects of Mediterranean diet in stroke prevention seemed more sizeable among males. Concerning depression, the protective effects of high adherence seemed independent of age, whereas the favorable actions of moderate adherence seemed to fade away with more advanced age.
Adherence to a Mediterranean diet may contribute to the prevention of a series of brain diseases; this may be of special value given the aging of Western societies.
本荟萃分析旨在定量综合所有研究，以考察地中海饮食与中风、抑郁、认知障碍和帕金森病风险之间的关联。
潜在的合格文献是那些提供地中海饮食与上述结果之间关联的相对风险（RR）的效应估计值的文献。在 PubMed 中搜索截至 2012 年 10 月 31 日的文献。提取最大调整的效应估计值；分别对高和中地中海饮食依从性进行分析。
共纳入 22 项合格研究（11 项涉及中风，9 项涉及抑郁，8 项涉及认知障碍；仅 1 项涉及帕金森病）。高地中海饮食依从性与中风风险降低（RR = 0.71，95%置信区间 [CI] = 0.57-0.89）、抑郁（RR = 0.68，95% CI = 0.54-0.86）和认知障碍（RR = 0.60，95% CI = 0.43-0.83）呈一致性相关。中地中海饮食依从性与抑郁和认知障碍风险降低也呈相似相关，而中风保护趋势仅具有边缘意义。亚组分析突出了高地中海饮食依从性在降低缺血性中风、轻度认知障碍、痴呆症和特别是阿尔茨海默病风险方面的保护作用。元回归分析表明，地中海饮食在预防中风方面的保护作用在男性中似乎更为显著。至于抑郁，高地中海饮食依从性的保护作用似乎与年龄无关，而中地中海饮食依从性的有利作用随着年龄的增长而逐渐减弱。
地中海饮食的依从性可能有助于预防一系列脑部疾病；考虑到西方社会的老龄化，这可能具有特殊价值。
