多元文化健康饮食对认知衰退和阿尔茨海默病风险的影响：一项针对中年成年人的II期随机对照试验。
The effects of the Multicultural Healthy Diet on cognitive decline and Alzheimer's disease risk: a phase II randomized controlled trial in middle-aged adults.
作者信息
Mossavar-Rahmani Yasmin, Hyun Noorie, Hakun Jonathan G, Katz Mindy J, Pavlovic Jelena M, Zetterberg Henrik, Wang Zheng, Yang Jasper B, Wylie-Rosett Judith, Hebert James R, Sliwinski Martin J, Shaw Pamela A
机构信息
Division of Health Behavior Research & Implementation Science, Department of Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx, NY, United States.
Division of Biostatistics, Kaiser Permanente Washington Health Research Institute, Seattle, WA, United States; Department of Biostatistics, University of Washington, Seattle, WA, United States.
出版信息
Am J Clin Nutr. 2025 Jul;122(1):48-59. doi: 10.1016/j.ajcnut.2025.05.011. Epub 2025 May 22.
BACKGROUND
Anti-inflammatory dietary patterns are associated with slower cognitive decline in older adults; however, little is known about the effects of an anti-inflammatory dietary pattern in middle age.
OBJECTIVES
This study aims to adapt an anti-inflammatory diet to a multicultural setting and assess its impact on cognitive decline and Alzheimer's disease risk and related dementias in healthy middle-aged adults.
METHODS
We performed a phase II pilot randomized clinical trial in adults (40-65 y old; n = 290) in Bronx, New York. Participants were assigned to follow either the Multicultural Healthy Diet (MHD), an anti-inflammatory diet, or usual diet (Comparison). Diet was evaluated using the National Cancer Institute's Automated Self-Administered 24-h food records. The primary cognitive outcome was assessed at 9 mo after randomization using a global composite score derived from 3 ambulatory cognitive assessments of visuospatial memory (Grid Memory), processing speed (Symbol Search) and short-term associative memory binding (Color Shapes). Secondary outcomes included performance on individual tests and association of dietary components with cognitive performance.
RESULTS
At 9-mo follow-up, the MHD arm had a lower Dietary Inflammatory Index (DII) score based on self-reported diet, with an adjusted MHD minus Comparison difference of -0.64 [95% confidence interval (CI): -1.02, -0.27] and -0.94 (95% CI: -1.34, -0.54) for the DII and energy-adjusted DII scores, respectively, indicating intervention participants had adhered to an anti-inflammatory dietary pattern. Group session and telephone contact completion averaged 93% and 72%, respectively, for the MHD arm. No statistically significant difference between arms was found in the primary outcome-cognitive global score change-from baseline: -0.06 (95% CI: -0.15, 0.04), P = .259.
CONCLUSIONS
The MHD is feasible and acceptable in this multicultural United States cohort. Although the influence of MHD at 9 mo is nonsignificant based on the global composite cognitive score, additional research using other measures such as day-to-day variability in cognitive function and peak performance is warranted. This study was registered at clinicaltrials.gov as NCT03240406 (https://clinicaltrials.gov/study/NCT03240406?term=Diet%20%26%20Cognition&page=3&rank=30).
背景
抗炎饮食模式与老年人认知能力下降速度较慢有关；然而，关于抗炎饮食模式在中年人群中的影响知之甚少。
目的
本研究旨在使抗炎饮食适用于多元文化背景，并评估其对健康中年成年人认知能力下降、患阿尔茨海默病风险及相关痴呆症的影响。
方法
我们在纽约布朗克斯区对成年人（40 - 65岁；n = 290）进行了一项II期试点随机临床试验。参与者被分配遵循多元文化健康饮食（MHD，一种抗炎饮食）或常规饮食（对照组）。饮食情况通过美国国立癌症研究所的自动化24小时自我管理食物记录进行评估。主要认知结局在随机分组后9个月时使用由视觉空间记忆（网格记忆）、处理速度（符号搜索）和短期联想记忆绑定（颜色形状）这三项动态认知评估得出的综合全球评分进行评估。次要结局包括各项测试的表现以及饮食成分与认知表现的关联。
结果
在9个月的随访中，基于自我报告的饮食，MHD组的饮食炎症指数（DII）得分较低，DII得分的MHD组与对照组调整后的差值为 -0.64 [95%置信区间（CI）：-1.02，-0.27]，能量调整后的DII得分差值为 -0.94（95% CI：-1.34，-0.54），这表明干预组参与者坚持了抗炎饮食模式。MHD组的小组会议和电话联系完成率分别平均为93%和72%。在主要结局——认知综合全球评分从基线的变化方面，两组之间未发现统计学上的显著差异：-0.06（95% CI：-0.15，0.04），P = 0.259。
结论
MHD在这个多元文化的美国队列中是可行且可接受的。尽管基于综合全球认知评分，MHD在9个月时的影响不显著，但有必要使用其他测量方法进行进一步研究，如认知功能的日常变异性和最佳表现。本研究已在clinicaltrials.gov上注册，注册号为NCT03240406（https://clinicaltrials.gov/study/NCT03240406?term=Diet%20%26%20Cognition&page=3&rank=30）。
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