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Mediterranean diet, stroke, cognitive impairment, and depression: A meta-analysis.

Abstract

OBJECTIVE

This meta-analysis aims to quantitatively synthesize all studies that examine the association between adherence to a Mediterranean diet and risk of stroke, depression, cognitive impairment, and Parkinson disease.

METHODS

Potentially eligible publications were those providing effect estimates of relative risk (RR) for the association between Mediterranean diet and the aforementioned outcomes. Studies were sought in PubMed up to October 31, 2012. Maximally adjusted effect estimates were extracted; separate analyses were performed for high and moderate adherence.

RESULTS

Twenty-two eligible studies were included (11 covered stroke, 9 covered depression, and 8 covered cognitive impairment; only 1 pertained to Parkinson's disease). High adherence to Mediterranean diet was consistently associated with reduced risk for stroke (RR = 0.71, 95% confidence interval [CI] = 0.57-0.89), depression (RR = 0.68, 95% CI = 0.54-0.86), and cognitive impairment (RR = 0.60, 95% CI = 0.43-0.83). Moderate adherence was similarly associated with reduced risk for depression and cognitive impairment, whereas the protective trend concerning stroke was only marginal. Subgroup analyses highlighted the protective actions of high adherence in terms of reduced risk for ischemic stroke, mild cognitive impairment, dementia, and particularly Alzheimer disease. Meta-regression analysis indicated that the protective effects of Mediterranean diet in stroke prevention seemed more sizeable among males. Concerning depression, the protective effects of high adherence seemed independent of age, whereas the favorable actions of moderate adherence seemed to fade away with more advanced age.

INTERPRETATION

Adherence to a Mediterranean diet may contribute to the prevention of a series of brain diseases; this may be of special value given the aging of Western societies.

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  • Publisher Full Text
  • Authors+Show Affiliations

    ,

    Department of Hygiene, Epidemiology and Medical Statistics University of Athens School of Medicine, Athens, Greece.

    , , , ,

    Source

    Annals of neurology 74:4 2013 Oct pg 580-91

    MeSH

    Cognition Disorders
    Depression
    Diet, Mediterranean
    Humans
    Medication Adherence
    Observation
    Regression Analysis
    Risk
    Stroke

    Pub Type(s)

    Journal Article
    Meta-Analysis

    Language

    eng

    PubMed ID

    23720230

    Citation

    Psaltopoulou, Theodora, et al. "Mediterranean Diet, Stroke, Cognitive Impairment, and Depression: a Meta-analysis." Annals of Neurology, vol. 74, no. 4, 2013, pp. 580-91.
    Psaltopoulou T, Sergentanis TN, Panagiotakos DB, et al. Mediterranean diet, stroke, cognitive impairment, and depression: A meta-analysis. Ann Neurol. 2013;74(4):580-91.
    Psaltopoulou, T., Sergentanis, T. N., Panagiotakos, D. B., Sergentanis, I. N., Kosti, R., & Scarmeas, N. (2013). Mediterranean diet, stroke, cognitive impairment, and depression: A meta-analysis. Annals of Neurology, 74(4), pp. 580-91. doi:10.1002/ana.23944.
    Psaltopoulou T, et al. Mediterranean Diet, Stroke, Cognitive Impairment, and Depression: a Meta-analysis. Ann Neurol. 2013;74(4):580-91. PubMed PMID: 23720230.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Mediterranean diet, stroke, cognitive impairment, and depression: A meta-analysis. AU - Psaltopoulou,Theodora, AU - Sergentanis,Theodoros N, AU - Panagiotakos,Demosthenes B, AU - Sergentanis,Ioannis N, AU - Kosti,Rena, AU - Scarmeas,Nikolaos, Y1 - 2013/09/16/ PY - 2013/03/08/received PY - 2013/05/08/revised PY - 2013/05/17/accepted PY - 2013/5/31/entrez PY - 2013/5/31/pubmed PY - 2014/1/22/medline SP - 580 EP - 91 JF - Annals of neurology JO - Ann. Neurol. VL - 74 IS - 4 N2 - OBJECTIVE: This meta-analysis aims to quantitatively synthesize all studies that examine the association between adherence to a Mediterranean diet and risk of stroke, depression, cognitive impairment, and Parkinson disease. METHODS: Potentially eligible publications were those providing effect estimates of relative risk (RR) for the association between Mediterranean diet and the aforementioned outcomes. Studies were sought in PubMed up to October 31, 2012. Maximally adjusted effect estimates were extracted; separate analyses were performed for high and moderate adherence. RESULTS: Twenty-two eligible studies were included (11 covered stroke, 9 covered depression, and 8 covered cognitive impairment; only 1 pertained to Parkinson's disease). High adherence to Mediterranean diet was consistently associated with reduced risk for stroke (RR = 0.71, 95% confidence interval [CI] = 0.57-0.89), depression (RR = 0.68, 95% CI = 0.54-0.86), and cognitive impairment (RR = 0.60, 95% CI = 0.43-0.83). Moderate adherence was similarly associated with reduced risk for depression and cognitive impairment, whereas the protective trend concerning stroke was only marginal. Subgroup analyses highlighted the protective actions of high adherence in terms of reduced risk for ischemic stroke, mild cognitive impairment, dementia, and particularly Alzheimer disease. Meta-regression analysis indicated that the protective effects of Mediterranean diet in stroke prevention seemed more sizeable among males. Concerning depression, the protective effects of high adherence seemed independent of age, whereas the favorable actions of moderate adherence seemed to fade away with more advanced age. INTERPRETATION: Adherence to a Mediterranean diet may contribute to the prevention of a series of brain diseases; this may be of special value given the aging of Western societies. SN - 1531-8249 UR - https://www.unboundmedicine.com/medline/citation/23720230/Mediterranean_diet_stroke_cognitive_impairment_and_depression:_A_meta_analysis_ L2 - https://doi.org/10.1002/ana.23944 DB - PRIME DP - Unbound Medicine ER -