Equipe de Recherche en Epidémiologie Nutritionnelle (EREN), Centre d'Epidémiologie et Statistiques Sorbonne Paris Cité, Université Paris 13, Inserm (U1153), Cnam, Inra (U1125), COMUE Sorbonne Paris Cité, 74 rue Marcel Cachin, 93017, Bobigny, France.
Département de Santé Publique, Hôpital Avicenne, Bobigny, France.
J Neurol. 2019 Apr;266(4):942-952. doi: 10.1007/s00415-019-09218-y. Epub 2019 Jan 31.
Our objective was to examine whether adherence to the Mediterranean-DASH diet intervention for neurodegenerative delay (MIND) was associated with SMC (as measured by the cognitive difficulties scale; CDS) in the NutriNet-Santé cohort.
The study sample consisted of 6011 participants aged ≥ 60 years at baseline, without SMC at the beginning. SMC were defined by a CDS score ≥ 43 (corresponding to the 4th CDS quartile) and SMC cases were participants with SMC at least once during follow-up. The MIND diet score (0-15 points) is a hybrid of the Mediterranean Diet and the Dietary Approaches to Stop Hypertension (DASH) scores, which includes ten brain healthy food groups and five unhealthy food groups. We used Cox proportional hazards models to estimate Hazard Ratios (HR) and 95% confidence intervals (95% CI).
Over a mean follow-up of 6 years, approximately 15% and 30% cases of SMC were identified among participants aged 60-69 and ≥ 70 years, respectively. The MIND diet score was not significantly associated with SMC in the full sample and among participants aged 60-69 years. Among participants aged ≥ 70 years, a significant inverse association was observed between adherence to the MIND diet and SMC (HR = 0.69, 95% CI = 0.47-0.99). This relationship was strengthened after exclusion of participants with depressive symptoms (HR = 0.69, 95% CI = 0.49-0.97; HR = 0.62, 95% CI = 0.41-0.93).
These findings suggest that the MIND diet could help to prevent or delay SMC among older adults without depressive symptoms.
本研究旨在探讨针对神经退行性疾病的地中海-得舒饮食干预（MIND）依从性与 NutriNet-Santé 队列中大脑小血管疾病（SMC）之间的关系。
研究样本包括 6011 名年龄≥60 岁的基线参与者，且在研究开始时无 SMC。SMC 定义为认知困难量表（CDS）评分≥43 分（对应 CDS 四分位数的第 4 个四分位数），且至少在随访期间出现过一次 SMC 的参与者为 SMC 病例。MIND 饮食评分（0-15 分）是地中海饮食和停止高血压的饮食方法（DASH）评分的混合体，包括 10 种有益大脑健康的食物组和 5 种不健康的食物组。我们使用 Cox 比例风险模型来估计风险比（HR）和 95%置信区间（95%CI）。
在平均 6 年的随访期间，年龄在 60-69 岁和≥70 岁的参与者中，约有 15%和 30%分别被诊断为 SMC 病例。在全样本和年龄在 60-69 岁的参与者中，MIND 饮食评分与 SMC 无显著相关性。在年龄≥70 岁的参与者中，MIND 饮食与 SMC 之间存在显著的负相关关系（HR=0.69，95%CI=0.47-0.99）。排除有抑郁症状的参与者后，这种关系更为显著（HR=0.69，95%CI=0.49-0.97；HR=0.62，95%CI=0.41-0.93）。
这些发现表明，MIND 饮食可能有助于预防或延缓无抑郁症状的老年人大脑小血管疾病的发生。
