Mediterranean Diet's Effectiveness in Dementia Risk Reduction

This literature review evaluates the effectiveness of adhering to the Mediterranean diet for reducing or delaying the onset of dementia. The review includes 12 articles selected from electronic databases like Medline, Embase, and PsycINFO, focusing on studies that assessed the relationship between adherence to the Mediterranean diet and cognitive function. The results indicate a positive association between adherence to the diet and reduced cognitive decline, particularly in individuals aged 75 and older. The underlying mechanisms may involve improved insulin sensitivity, glucose metabolism, and the antioxidant properties of the diet's components. The review concludes that the Mediterranean diet can be effective in reducing the global burden of dementia by enhancing cognitive functioning.

Running head : MEDITERRANEAN DIET IN REDUCTION OF DEMENTIA
Mediterranean diet in reduction of dementia
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MEDITERRANEAN DIET IN REDUCTION OF DEMENTIA
Introduction:
The focus of these studies is to highlight the importance of the Mediterranean diet (MeDi) in
lowering the risk of age-related cognitive disease, namely Alzheimers and dementia (Lourida et
al., 2013). These cognitive diseases give rise to high economic and social burden thereby
hindering the provisions of proper care to the patient. Therefore, effectively reducing the
prevalence of age-related cognitive disease is crucial. Although the current accumulated
evidence is not able to offer a concrete strategy for reducing the prevalence of age-related
disease thereby achieving symptom benefits, few researchers highlighted that the delay onset of
dementia can be prevented by amending lifestyle factors such as diet (Steffen et al., 2016). The
study suggested that Mediterranean diet associated with reduction of a serious of age-related
disease such as type 2 diabetes, stroke, cardiovascular disease, which further increase the
mortality rate (Lourida et al., 2013). The Mediterranean diet characterized as the multi-nutrient
diets which include high consumption of vegetables, fruits, cereals and legumes and lower
consumption of saturated fat, fish, moderate intake of dairy products which minimizes the risk of
dementia (Hardman et al., 2016). Therefore, adherence to the Mediterranean diet is crucial in
order to delay the onset occurrence of the dementia.
The purpose of the study:
The purpose of the study is to evaluate the effectiveness of adherence to the
Mediterranean diet for reducing or delaying the onset of dementia.
Methods:
The search strategies employed for identifying the articles that would provide the
evidences of effectiveness of Mediterranean diet in enhancing cognitive function for reducing or
delaying onset dementia. Researchers conducted the systematic review by using electronic

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databases such as Medline, Embase, and PsycINFO along with other electronic databases. The
key terms used for the search was “cognition,” “dementia,” “Alzheimer,” “memory,” “mild
cognitive impairment,” and “neuropsychological tests (Lourida et al., 2013). All peer-reviewed
journals were included and were extracted on and after the 2012. All articles were focused on the
adherence to a Mediterranean diet and cognitive function and dementia. All articles were focused
on the human subjects and Articles having the abstracts are included (Lourida et al., 2013).
Moreover, the study also included association of a defined score used for measuring adherence to
the Mediterranean diet and included cognitive function or dementia as outcomes. All non-peer
review journal were excluded . All journal focused on the other models were exclude and study
also excluded the study having any other strategy for dementia. Total 719 articles were extracted
after research.
Results:
Out of 719 papers, 195 Duplicates journal were excluded from the study . after screening of Title
and abstract, further 508 papers were excluded. The remaining 16 papers which had full texts
were obtained for further study (Lourida et al., 2013). After further analysis, total 12 articles
were suitable for further research. The study designed and language of publication had no
restrictions rather all journals with accurate details, which allow appraisal study of quality,
included. All studies used various food frequency questionnaires for assessing the average
dietary intake (Lourida et al., 2013). The study suggested that randomized trial control
considered Mediterranean diet adherence as successful if 80% or more meal reported in the food
dietary was completed by the participants. Moreover, the adherence was assessed quantitative
methods of continuous scores or tertile defined calories. However, few studies also considered
both the measurement for assessing the adherence. Out of 12 papers, 11 papers performed the

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cognitive assessment prospectively. Majority of the study assessed using neuropsychological
batteries that produced a composite cognitive score for each participant. The assessment also
includes memory (short- and long-term), executive function, language, orientation, visual-spatial
skills, construction along with abstract reasoning skills(Lourida et al., 2013). The studies with
cross-sectional data showed that there is positive relationship between cognitive function and
Mediterranean diet. The study suggested the adherence to the diet associated with the reduced
decline of cognitive function (Lourida et al., 2013). The randomized trail control reported that
the participants of treatment group exhibit slower response to numeric working memory and
word recognition task (Lourida et al., 2013). The case control study also reported greater
adherence to the diet associated with declined Alzheimer disease.
Discussion:
Researchers assessed all of the 12 articles which reported the association between
adherence to Mediterranean diet and cognitive impairment (Lourida et al., 2013). the study
suggested that the diet is effective for the older people of 75 years since risk of incident is high
for this age and the difference between Mediterranean and other diets are easily detected
(Lourida et al., 2013). According to Lourida et al. (2013), the component of the diet such as
omega three fatty acid has neuro-protective features. High intake of the vegetables and fruits
reduce the mild cognitive impairment where as the wine consumption associated with reduction
of cognitive declines (Valls-Pedret et al., 2015). Detailed study revealed the reduction of
cognitive declines is true for the olive oil. The potential underlying mechanism behind adherence
is that high adherence improves insulin sensitivity and glucose metabolism (Sofi et al., 2014).
Since oxidative damages increases with the ages, components of the diet are highly antioxidants
in nature such as vitamin E, C and carotinoid. Vitamin C, B enhances the neurotransmitter

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synthesis, synaptic synthesis and cell metabolism (Singh et al., 2014). However, study has
certain limitations such as limited dietary assessment method, recruitment through snowballing.
Moreover, the study was only limited to women with smaller sample size. Moreover, the follow
up was taken for any 10days.
Conclusion:
Thus it can be concluded that adherence to the Mediterranean diet increases the cognitive
functioning which in turn reduces the prevalence of dementia. The study selected 12 papers
according to inclusion criteria and excluded all journals with irrelevant information was
excluded. The finding of the study is that the Mediterranean diet is effective for individuals with
75 years or above since, the difference can be measured easily. The underlying mechanism of the
association is that higher prevalence enhances metabolism process by improving insulin
sensitivity. Since the diet components are oxidative in nature, reduce the oxidative damage.
Therefore, adherence to the diet reduces the global burn of dementia.

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references :
Hardman, R. J., Kennedy, G., Macpherson, H., Scholey, A. B., & Pipingas, A. (2016).
Adherence to a Mediterranean-style diet and effects on cognition in adults: a qualitative
evaluation and systematic review of longitudinal and prospective trials. Frontiers in
nutrition, 3, 22.
Lourida, I., Soni, M., Thompson-Coon, J., Purandare, N., Lang, I. A., Ukoumunne, O. C., &
Llewellyn, D. J. (2013). Mediterranean diet, cognitive function, and dementia: a
systematic review. Epidemiology, 24(4), 479-489.
Singh, B., Parsaik, A. K., Mielke, M. M., Erwin, P. J., Knopman, D. S., Petersen, R. C., &
Roberts, R. O. (2014). Association of mediterranean diet with mild cognitive impairment
and Alzheimer's disease: a systematic review and meta-analysis. Journal of Alzheimer's
disease, 39(2), 271-282.
Sofi, F., Macchi, C., Abbate, R., Gensini, G. F., & Casini, A. (2014). Mediterranean diet and
health status: an updated meta-analysis and a proposal for a literature-based adherence
score. Public health nutrition, 17(12), 2769-2782.
Steffen, L. M., Van Horn, L., Daviglus, M. L., Zhou, X., Reis, J. P., Loria, C. M., ... & Duffey,
K. J. (2016). A modified Mediterranean diet score is associated with a lower risk of
incident metabolic syndrome over 25 years among young adults: The CARDIA
(Coronary Artery Risk Development in Young Adults) study. World Review of Nutrition
and Dietetics, 114, 36-37.

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Valls-Pedret, C., Sala-Vila, A., Serra-Mir, M., Corella, D., De la Torre, R., Martínez-González,
M. Á., ... & Estruch, R. (2015). Mediterranean diet and age-related cognitive decline: a
randomized clinical trial. JAMA internal medicine, 175(7), 1094-1103.