Mediterranean diet is associated with a lower probability of prodromal Parkinson's disease and risk for Parkinson's disease/dementia with Lewy bodies: A longitudinal study.

Maria I Maraki, Mary Yannakoulia, Georgia Xiromerisiou, Leonidas Stefanis, Sokratis Charisis, Nikolaos Giagkou, Mary H Kosmidis, Efthimios Dardiotis, Georgios M Hadjigeorgiou, Paraskevi Sakka, Nikolaos Scarmeas, Maria Stamelou

Journal: European journal of neurology 2023;30(4):934-942

PMID: 36692092

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Abstract

BACKGROUND AND PURPOSE

Lifestyle factors have been implicated in the long-lasting neurodegenerative process in prodromal Parkinson's disease (pPD). The aim was to investigate the associations between adherence to a Mediterranean diet (MeDi) and longitudinal changes of pPD probability and the development of Parkinson's disease (PD) or pPD in a Mediterranean older population.

METHODS

Data from the Hellenic Longitudinal Investigation of Aging and Diet cohort (community-dwelling individuals, aged ≥ 65 years) were used. A detailed food frequency questionnaire was used to evaluate dietary intake and calculate MeDi adherence score, ranging from 0 to 55, with higher scores indicating higher adherence. The probability of pPD was calculated according to the updated Movement Disorder Society research criteria.

RESULTS

In all, 1047 non-PD/dementia with Lewy bodies (DLB) participants were followed for 3 ± 1 years. MeDi adherence was associated with lower increase in pPD probability over time (b = -0.003, 95% confidence interval -0.006 to -0.001, p = 0.010). Forty-nine participants had incident possible/probable pPD (i.e., pPD probability ≥ 30%). Compared to the participants in the lowest quartile of MeDi adherence, those in the higher quartiles had an approximately 60%-70% lower risk for possible/probable pPD (p for trend 0.003). MeDi-pPD associations were driven by both motor and non-motor pPD markers and not from risk markers. Also, 21 participants were diagnosed with PD/DLB at follow-up. For each unit increase in the MeDi score, there was a 9%-10% lower risk for PD/DLB (hazard ratio 0.906 [95% confidence interval 0.823-0.997], p = 0.044).

CONCLUSIONS

Mediterranean diet adherence is associated with lower increase in pPD probability over time and lower possible/probable pPD and PD/DLB incidence in older Mediterranean people. More studies are needed to confirm our results in other populations.

Address: Department of Nutrition and Dietetics, School of Health Sciences, Hellenic Mediterranean University, Crete, Greece.; Section of Sport Medicine and Biology of Exercise, School of Physical Education and Sport Science, National and Kapodistrian University of Athens, Athens, Greece.; Department of Nutrition and Dietetics, Harokopio University, Athens, Greece.; School of Medicine, University of Thessaly, Larissa, Greece.; Center of Clinical, Experimental Surgery and Translational Research, Biomedical Research Foundation of the Academy of Athens, Athens, Greece.; First Department of Neurology, Aiginition Hospital, National and Kapodistrian University of Athens Medical School, Greece.; Department of Neurology, University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA.; Laboratory of Cognitive Neuroscience, School of Psychology, Aristotle University of Thessaloniki, Thessaloniki, Greece.; Department of Neurology, Medical School, University of Cyprus.; Athens Association of Alzheimer's Disease and Related Disorders, Marousi, Greece.; Department of Neurology, Taub Institute for Research in Alzheimer's Disease and the Aging Brain, Gertrude H. Sergievsky Center, Columbia University, New York, USA.; Parkinson's Disease and Movement Disorders Department HYGEIA Hospital, Athens, Greece.

DOI: 10.1111/ene.15698

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MeSH Terms: Humans, Aged, Longitudinal Studies, Parkinson Disease, Lewy Body Disease, Diet, Mediterranean, Probability