Aubertin-Leheudre Mylene, Département des Sciences de l'activité physique, Faculté des Sciences, UQAM, Pavillon Sciences Biologiques, SB-4615, 141, Avenue du Président Kennedy, Montréal, Québec, Canada, H2X 1Y4. Email:
J Prev Alzheimers Dis. 2021;8(1):110-116. doi: 10.14283/jpad.2020.40.
Aging is associated with cognitive declines leading to mild cognitive impairments or Alzheimer disease. Nutrition appear to protect from aging. Some dietary factors could either increase or protect against cognitive declines. This article aimed to provide GRADE recommendations related to nutrition aspects able to prevent or to treat cognitive impairments. A comprehensive literature review was performed using Medline database. The GRADE approach was used to classify quality of the existing evidence (systematic review or meta-analysis).The GRADE process led us to formulate seven key nutritional recommendations to manage cognitive declines, but did not allow us to do it for protein, vitamin B or antioxidants. Thus, 1) adherence to a Mediterranean diet (GRADE 1B); 2) high-level of consumption of mono- or poly- unsaturated fatty acids combined to a low consumption of saturated fatty acids (GRADE 1B); 3) high consumption of fruits and vegetables (GRADE 1B); 4) higher vitamin D intake (GRADE 1C) than the recommended daily allowance. In addition, a ketogenic diet, a low consumption of whole-fat dairy products or a caloric restriction are promising nutritional habits although the evidence does not yet support widespread uptake (GRADE 2C). In conclusion, nutrition is an important modifiable factor to prevent or protect against cognitive decline. Nevertheless, more studies are required to determine specific guidelines such as duration and amounts of nutrients to help older adult to maintain a healthy cognitive life.
衰老是认知能力下降的主要原因，进而导致轻度认知障碍或阿尔茨海默病。营养似乎可以起到保护作用。一些饮食因素可能会导致认知能力下降或起到保护作用。本文旨在提供与营养方面相关的 GRADE 推荐意见，这些推荐意见可以预防或治疗认知障碍。使用 Medline 数据库进行了全面的文献综述。使用 GRADE 方法对现有证据（系统评价或荟萃分析）的质量进行分类。GRADE 过程使我们能够制定 7 条关键的营养建议来管理认知能力下降，但不能对蛋白质、维生素 B 或抗氧化剂进行相关推荐。因此，1）坚持地中海饮食（GRADE 1B）；2）高水平摄入单不饱和或多不饱和脂肪酸，同时低水平摄入饱和脂肪酸（GRADE 1B）；3）高水果和蔬菜摄入量（GRADE 1B）；4）摄入比建议的每日允许量更多的维生素 D（GRADE 1C）。此外，生酮饮食、低全脂乳制品摄入或热量限制是有前途的饮食习惯，尽管证据尚不能支持广泛采用（GRADE 2C）。总之，营养是预防或保护认知能力下降的一个重要的可改变因素。然而，还需要更多的研究来确定特定的指导方针，例如营养素的持续时间和数量，以帮助老年人保持健康的认知生活。
