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Diet Inflammatory Index and Dementia Incidence
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This study assessed the inflammatory potential of diet and its association with cognitive decline and dementia. The inflammatory potential of diet was assessed using a diet inflammatory index (DII) score, with 45 inflammatory food parameters. Higher values of DII indicate a more inflammatory diet. The results showed that, with each additional unit of DII increase, there was a 21% increase in the risk for dementia. Those with higher DII scores were three times more likely to develop incident dementia.
- The authors concluded that tailored and specific dietary interventions may help to attenuate the development of primary dementia.
abstract
This abstract is available on the publisher's site.
Access this abstract nowBACKGROUND AND OBJECTIVES
Aging is characterized by a functional shift of the immune system towards a proinflammatory phenotype. This derangement has been associated with cognitive decline and has been implicated in the pathogenesis of dementia. Diet can modulate systemic inflammation; thus, it may be a valuable tool to counteract the associated risks for cognitive impairment and dementia. The present study aimed to explore the associations between the inflammatory potential of diet, assessed using an easily applicable, population-based, biomarker-validated diet inflammatory index (DII), and the risk for dementia in community-dwelling older adults.
METHODS
Individuals from the Hellenic Longitudinal Investigation of Aging and Diet (HELIAD) were included in the present cohort study. Participants were recruited through random population sampling, and were followed for a mean of 3.05 (SD=0.85) years. Dementia diagnosis was based on standard clinical criteria. Those with baseline dementia and/or missing cognitive follow-up data were excluded from the analyses. The inflammatory potential of diet was assessed through a DII score which considers literature-derived associations of 45 food parameters with levels of pro- and anti-inflammatory cytokines in the blood; higher values indicated a more pro-inflammatory diet. Consumption frequencies were derived from a detailed food frequency questionnaire, and were standardized to representative dietary intake normative data from 11 different countries. Analysis of dementia incidence as a function of baseline DII scores was performed by Cox proportional hazards models.
RESULTS
Analyses included 1059 individuals (mean age=73.1 years; 40.3% males; mean education=8.2 years), 62 of whom developed incident dementia. Each additional unit of DII was associated with a 21% increase in the risk for dementia incidence [HR=1.21 (1.03 - 1.42); p=0.023]. Compared to participants in the lowest DII tertile, participants in the highest one (maximal pro-inflammatory diet potential) were 3 [(1.2 - 7.3); p=0.014] times more likely to develop incident dementia. The test for trend was also significant, indicating a potential dose-response relationship (p=0.014).
CONCLUSIONS
In the present study, higher DII scores (indicating greater pro-inflammatory diet potential) were associated with an increased risk for incident dementia. These findings might avail the development of primary dementia preventive strategies through tailored and precise dietary interventions.
Additional Info
Disclosure statements are available on the authors' profiles:
Diet Inflammatory Index and Dementia Incidence: A Population-Based Study
Neurology 2021 Nov 10;[EPub Ahead of Print], S Charisis, E Ntanasi, M Yannakoulia, CA Anastasiou, MH Kosmidis, E Dardiotis, AN Gargalionis, K Patas, S Chatzipanagiotou, I Mourtzinos, K Tzima, G Hadjigeorgiou, P Sakka, D Kapogiannis, N ScarmeasFrom MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.
Inflammatory diet, immunosenescence, and dementia
As humans age, the immune system gradually deteriorates, creating a pro-inflammatory state that can increase the risk of chronic disease, including dementia. This process is called immunosenescence. The inflammatory cytokines that promote inflammation reduce brain-derived neurotropic growth factor (BDNF) and create more oxidative stress, increasing the risk of dementia.
The Hellenic Longitudinal Investigation of Aging and Diet (HELIAD). set in Greece. evaluated 1059 individuals with a mean age of 71 years for a mean of 3 years. Dieticians categorized a 45-food item dietary inflammatory index score into three tertials (low, intermediate, and high). Those in the high-inflammatory diet category had three times the incidence of dementia compared with those in the low category. For each additional unit rise in the diet inflammatory index score, the incidence of dementia rose by 21%.
Those in the lowest inflammatory diet ate more vegetables, fiber, and fish. The most inflammatory foods included red meat, processed meat, alcohol, and sugar. Previous research has also shown that non-nutritive sweeteners (eg, aspartame) are associated with stroke and dementia risk by breaking down the blood–brain barrier.1
Immunosenescence starts to increase after 40 years of age. Growing evidence suggests that eating an anti-inflammatory diet will help you remember what you had for dinner into your 80s.
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