Pistollato Francesca, Sumalla Cano Sandra, Elio Iñaki, Masias Vergara Manuel, Giampieri Francesca, Battino Maurizio
Center for Nutrition and Health, European University of the Atlantic (UEA), Santander, Spain;
Center for Nutrition and Health, European University of the Atlantic (UEA), Santander, Spain; International Ibero-American University (UNINI), Campeche, Mexico; Ibero-American University Foundation (FUNIBER), Barcelona, Spain;
Adv Nutr. 2016 Jul 15;7(4):679-89. doi: 10.3945/an.115.011775. Print 2016 Jul.
Accumulation of proteinaceous amyloid β plaques and tau oligomers may occur several years before the onset of Alzheimer disease (AD). Under normal circumstances, misfolded proteins get cleared by proteasome degradation, autophagy, and the recently discovered brain glymphatic system, an astroglial-mediated interstitial fluid bulk flow. It has been shown that the activity of the glymphatic system is higher during sleep and disengaged or low during wakefulness. As a consequence, poor sleep quality, which is associated with dementia, might negatively affect glymphatic system activity, thus contributing to amyloid accumulation. The diet is another important factor to consider in the regulation of this complex network. Diets characterized by high intakes of refined sugars, salt, animal-derived proteins and fats and by low intakes of fruit and vegetables are associated with a higher risk of AD and can perturb the circadian modulation of cortisol secretion, which is associated with poor sleep quality. For this reason, diets and nutritional interventions aimed at restoring cortisol concentrations may ease sleep disorders and may facilitate brain clearance, consequentially reducing the risk of cognitive impairment and dementia. Here, we describe the associations that exist between sleep, cortisol regulation, and diet and their possible implications for the risk of cognitive impairment and AD.
蛋白质类淀粉样β斑块和tau寡聚体的积累可能在阿尔茨海默病（AD）发病前数年就已出现。在正常情况下，错误折叠的蛋白质会通过蛋白酶体降解、自噬以及最近发现的脑类淋巴系统（一种由星形胶质细胞介导的间质液大量流动）被清除。研究表明，类淋巴系统的活性在睡眠期间较高，而在清醒时则减弱或较低。因此，与痴呆症相关的睡眠质量差可能会对类淋巴系统的活性产生负面影响，从而导致淀粉样蛋白的积累。饮食是调节这个复杂网络时需要考虑的另一个重要因素。以高糖、高盐、动物源性蛋白质和脂肪的高摄入量以及水果和蔬菜的低摄入量为特征的饮食与患AD的风险较高相关，并且会扰乱与睡眠质量差相关的皮质醇分泌的昼夜调节。因此，旨在恢复皮质醇浓度的饮食和营养干预措施可能会缓解睡眠障碍，并可能促进大脑清除，从而降低认知障碍和痴呆症的风险。在此，我们描述了睡眠、皮质醇调节和饮食之间存在的关联及其对认知障碍和AD风险的可能影响。
