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By Joseph E. Scherger, MD, MPH
Core Faculty, Eisenhower Health Family Medicine Residency Program, Eisenhower Health Center, La Quinta, CA; Clinical Professor, Keck School of Medicine, University of Southern California, Los Angeles
Dr. Scherger reports no financial relationships relevant to this field of study.
SYNOPSIS: Italian seniors who ate a high-quality Mediterranean diet exhibited better cognitive function than those who did not.
SOURCE: De Amicis R, et al. Mediterranean diet and cognitive status in free-living elderly: A cross-sectional study in Northern Italy. J Am Coll Nutr 2018;37:494-500.
A group of Italian investigators from Milan, Pavia, and Brescia, Italy, performed a cross-sectional study that included 279 seniors ≥ 65 years of age. The authors specifically studied subjects’ diet and cognitive function. The Mediterranean diet was assessed using a 14-item questionnaire. Cognitive function was assessed with the Mini-Mental State Examination (MMSE). In sum, 30.1% of subjects met the criteria for a healthy Mediterranean diet. The authors suspected mild cognitive decline or observed signs of such in 13.6% of subjects. Adherence to the Mediterranean diet was associated with a lower risk of cognitive impairment (odds ratio [OR], 0.39). The authors also observed this effect when subjects consumed more than three glasses of wine per week (OR, 0.37). Researchers did not observe any association for other food groups.
These findings are consistent with the work of other researchers who found that adhering to a Mediterranean diet is one of the factors that may lead to better cognitive function.1-3 However, what constitutes a proper and healthy Mediterranean diet is confusing and may mean different things to physicians and the public. Listing the 14 items from the Mediterranean diet questionnaire is instructive:
Importantly, pasta is not mentioned as part of a healthy Mediterranean diet. With its emphasis on olive oil, vegetables (including avocado), nuts, and seafood, the Mediterranean diet includes healthy fats and protein as its main macronutrients and is low carbohydrate. Carbohydrates are obtained only from whole foods such as fruit. A healthy Mediterranean diet has stood the test of time as possibly the healthiest way to eat.5,6 It should be standard medical advice for anyone not adhering to a whole food, plant-based diet.
Financial Disclosure: Internal Medicine Alert’s Physician Editor Stephen Brunton, MD, is a retained consultant for Abbott Diabetes, Acadia, AstraZeneca Avadel, Allergan, Boehringer Ingelheim, GlaxoSmithKline, Janssen, Lilly, Mylan, Novo Nordisk, Salix, and Sanofi; he serves on the speakers bureau of Allergan, AstraZeneca, Boehringer Ingelheim, Janssen, Novo Nordisk, Lilly, Sanofi, and Salix. Peer Reviewer Gerald Roberts, MD; Editor Jonathan Springston; Executive Editor Leslie Coplin; and Editorial Group Manager Terrey L. Hatcher report no financial relationships relevant to this field of study.