Harvard Medical School, 25 Shattuck Street, Boston, MA, 02115, USA.
Department of Epidemiology, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA, 02115, USA.
Eur J Epidemiol. 2018 Feb;33(2):223-234. doi: 10.1007/s10654-017-0330-3. Epub 2017 Nov 17.
Benefits of a Mediterranean diet for cognition have been suggested, but epidemiologic studies have been relatively small and of limited duration. To prospectively assess the association between long-term adherence to a Mediterranean dietary pattern and self-reported subjective cognitive function (SCF). Prospective observational study. The Health Professionals' Follow-up Study, a prospective cohort of 51,529 men, 40-75 years of age when enrolled in 1986, of whom 27,842 were included in the primary analysis. Mediterranean diet (MD) score, computed from the mean of five food frequency questionnaires, assessed every 4 years from 1986 to 2002. Self-reported SCF assessed by a 6-item questionnaire in 2008 and 2012, and validated by association with genetic variants in apolipoprotein-4. Using the average of 2008 and 2012 SCF scores, 38.0% of men were considered to have moderate memory scores and 7.3% were considered to have poor scores. In a multivariate model, compared with men having a MD score in the lowest quintile, those in the highest quintile had a 36% lower odds of a poor SCF score (odds ratio 0.64, 95% CI 0.55-0.75; P, trend < 0.001) and a 24% lower odds of a moderate SCF score (OR 0.76, 95% CI 0.70-0.83; P, trend < 0.001). Both remote and more recent diet contributed to this relation. Associations were only slightly weaker using baseline dietary data and a lag of 22 years. Long-term adherence to the Mediterranean diet pattern was strongly related to lower subjective cognitive function. These findings provide further evidence that a healthy dietary pattern may prevent or delay cognitive decline.
地中海饮食对认知功能有益，这一说法已得到证实，但相关的流行病学研究规模相对较小且持续时间有限。本研究旨在前瞻性评估长期遵循地中海饮食模式与自我报告的主观认知功能（SCF）之间的关联。
这是一项前瞻性观察研究。该研究纳入了 51529 名年龄在 40-75 岁的男性（1986 年入组时），随访至 2014 年。这些男性在入组时完成了 5 次食物频率问卷，以评估其地中海饮食（MD）评分。2008 年和 2012 年采用 6 项问卷评估了自我报告的 SCF，并通过与载脂蛋白-4 基因变异的关联进行了验证。采用 2008 年和 2012 年 SCF 评分的平均值，38.0%的男性被认为有中度记忆评分，7.3%的男性被认为有较差的评分。在多变量模型中，与 MD 评分最低五分位数的男性相比，评分最高五分位数的男性发生较差 SCF 评分的可能性低 36%（比值比 0.64，95%置信区间 0.55-0.75；P，趋势<0.001），发生中等 SCF 评分的可能性低 24%（比值比 0.76，95%置信区间 0.70-0.83；P，趋势<0.001）。这两种饮食都与这种关联有关。即使使用基线饮食数据和 22 年的滞后时间，相关性也只有轻微减弱。长期遵循地中海饮食模式与较低的主观认知功能密切相关。这些发现为健康的饮食模式可能预防或延缓认知能力下降提供了进一步的证据。
