1. In this study, participants over the age of 50 had more brain atrophy within 18-months compared to younger participants.
2. Furthermore, participants on the Green-Mediterranean diet had reduced brain volume loss compared to participants on a standard Mediterranean diet or healthy diet.
Evidence Rating Level: 1 (Excellent)
Longstanding research has shown that the Mediterranean diet is associated with lower mortality and risk of cancer, cardiovascular, and metabolic diseases. Based on the Mediterranean diet, the green-Mediterranean diet replaces red-meat completely with plant-based proteins and further supplement foods rich in polyphenols, such as Mankai. However, very few clinical trials have evaluated the effectiveness of the green-Mediterranean diet in providing further health benefits.
This randomized control trial looked at the effect of Green-Mediterranean (Green-MED) diet compared to traditional Mediterranean diet (MED) or normal healthy diet (HDG) on degree of age-related brain atrophy. 294 middle-aged patients (mean age 51 years old, 88% men) with abdominal obesity were randomized 1:1:1 to each group. Patients with kidney or liver dysfunction, active cancer, or pregnant were excluded. Change in brain volume, particularly the hippocampus, was assessed using whole-brain MRI 18-months after initiation of diet. The primary outcome was degree of hippocampal volume loss.
Compared to the HDG group (-1.3%), both MED (-0.78%) and green-MED (-0.8%) participants had attenuated atrophy of the hippocampus. Specifically, reduced red-meat consumption and increased consumption of high-polyphenol foods such as walnuts (both MED and green-MED) and Mankai (just green-MED) all individually associated with attenuated hippocampal volume decline. However, this study was limited by its small sample size and male-predominant participants, suggesting that the results may not be generalizable to females, younger people, or people without obesity. Nonetheless, given the environmental impact of animal-based food production, whether this diet can also have health benefits on a more general population would be of interest, and also have far-reaching implications on environmental sustainability.
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