Nutrition guidance within a multimodal intervention improves diet quality in prodromal Alzheimer's disease: Multimodal Preventive Trial for Alzheimer's Disease (MIND-ADmini).

IF 7.9 1区 医学 Q1 CLINICAL NEUROLOGY Alzheimer's Research & Therapy Pub Date : 2024-07-03 DOI:10.1186/s13195-024-01522-8
Nicholas Levak, Jenni Lehtisalo, Charlotta Thunborg, Eric Westman, Pia Andersen, Sandrine Andrieu, Laus M Broersen, Nicola Coley, Tobias Hartmann, Gerd Faxén Irving, Francesca Mangialasche, Tiia Ngandu, Johannes Pantel, Anna Rosenberg, Shireen Sindi, Hilkka Soininen, Alina Solomon, Rui Wang, Miia Kivipelto
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Abstract

Background: Multimodal lifestyle interventions can benefit overall health, including cognition, in populations at-risk for dementia. However, little is known about the effect of lifestyle interventions in patients with prodromal Alzheimer's disease (AD). Even less is known about dietary intake and adherence to dietary recommendations within this population making it difficult to design tailored interventions for them.

Method: A 6-month MIND-ADmini pilot randomized controlled trial (RCT) was conducted among 93 participants with prodromal AD in Sweden, Finland, Germany, and France. Three arms were included in the RCT: 1) multimodal lifestyle intervention (nutritional guidance, exercise, cognitive training, vascular/metabolic risk management, and social stimulation); 2) multimodal lifestyle intervention + medical food product; and 3) regular health advice (control group). Adherence to dietary advice was assessed with a brief food intake questionnaire by using the Healthy Diet Index (HDI) and Mediterranean Diet Adherence Screener (MEDAS). The intake of macro- and micronutrients were analyzed on a subsample using 3-day food records.

Results: The dietary quality in the intervention groups, pooled together, improved compared to that of the control group at the end of the study, as measured with by HDI (p = 0.026) and MEDAS (p = 0.008). The lifestyle-only group improved significantly more in MEDAS (p = 0.046) and almost significantly in HDI (p = 0.052) compared to the control group, while the lifestyle + medical food group improved in both HDI (p = 0.042) and MEDAS (p = 0.007) during the study. There were no changes in macro- or micronutrient intake for the intervention groups at follow-up; however, the intakes in the control group declined in several vitamins and minerals when adjusted for energy intake.

Conclusion: These results suggest that dietary intervention as part of multimodal lifestyle interventions is feasible and results in improved dietary quality in a population with prodromal AD. Nutrient intakes remained unchanged in the intervention groups while the control group showed a decreasing nutrient density.

Trial registration: ClinicalTrials.gov NCT03249688, 2017-07-08.

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多模式干预中的营养指导可提高阿尔茨海默病前驱期患者的饮食质量:阿尔茨海默病多模式预防试验(MIND-ADmini)。
背景:多模式生活方式干预可有益于痴呆症高危人群的整体健康,包括认知能力。然而,人们对生活方式干预对阿尔茨海默病(AD)前驱期患者的影响知之甚少。对这一人群的饮食摄入量和对饮食建议的遵守情况更是知之甚少,因此很难为他们设计量身定制的干预措施:方法:在瑞典、芬兰、德国和法国对 93 名患有 AD 前驱期的参与者进行了为期 6 个月的 MIND-ADmini 试验性随机对照试验(RCT)。该试验包括三组:1)多模式生活方式干预(营养指导、运动、认知训练、血管/代谢风险管理和社交刺激);2)多模式生活方式干预+医用食品;3)常规健康建议(对照组)。采用健康饮食指数(HDI)和地中海饮食坚持筛选器(MEDAS),通过简短的食物摄入量问卷对饮食建议的坚持情况进行评估。利用 3 天的食物记录对子样本的宏量和微量营养素摄入量进行了分析:结果:研究结束时,与对照组相比,干预组的膳食质量有所改善(HDI(P = 0.026)和 MEDAS(P = 0.008))。与对照组相比,纯生活方式组在 MEDAS(p = 0.046)和 HDI(p = 0.052)方面的改善幅度更大,而生活方式+医疗食品组在研究期间的 HDI(p = 0.042)和 MEDAS(p = 0.007)方面均有改善。随访期间,干预组的宏量营养素或微量营养素摄入量没有变化;但是,如果对能量摄入量进行调整,对照组的几种维生素和矿物质摄入量有所下降:这些结果表明,将饮食干预作为多模式生活方式干预的一部分是可行的,并能改善AD前驱期人群的饮食质量。干预组的营养素摄入量保持不变,而对照组的营养素密度有所下降:ClinicalTrials.gov NCT03249688,2017-07-08。
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来源期刊
Alzheimer's Research & Therapy
Alzheimer's Research & Therapy 医学-神经病学
CiteScore
13.10
自引率
3.30%
发文量
172
审稿时长
>12 weeks
期刊介绍: Alzheimer's Research & Therapy is an international peer-reviewed journal that focuses on translational research into Alzheimer's disease and other neurodegenerative diseases. It publishes open-access basic research, clinical trials, drug discovery and development studies, and epidemiologic studies. The journal also includes reviews, viewpoints, commentaries, debates, and reports. All articles published in Alzheimer's Research & Therapy are included in several reputable databases such as CAS, Current contents, DOAJ, Embase, Journal Citation Reports/Science Edition, MEDLINE, PubMed, PubMed Central, Science Citation Index Expanded (Web of Science) and Scopus.
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