Premium
Mediterranean diet, stroke, cognitive impairment, and depression: A meta‐analysis
Author(s) -
Psaltopoulou Theodora,
Sergentanis Theodoros N.,
Panagiotakos Demosthenes B.,
Sergentanis Ioannis N.,
Kosti Rena,
Scarmeas Nikolaos
Publication year - 2013
Publication title -
annals of neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 4.764
H-Index - 296
eISSN - 1531-8249
pISSN - 0364-5134
DOI - 10.1002/ana.23944
Subject(s) - depression (economics) , medicine , stroke (engine) , dementia , mediterranean diet , relative risk , meta analysis , confidence interval , disease , cognitive decline , cognition , physical therapy , psychiatry , mechanical engineering , engineering , economics , macroeconomics
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. Ann Neurol 2013;74:580–591