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Diabetes Care. 2019 Aug;42(8):1372-1379. doi: 10.2337/dc19-0130. Epub 2019 May 23.

The Mediterranean Diet and 2-Year Change in Cognitive Function by Status of Type 2 Diabetes and Glycemic Control.

Author information

1
Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA jmattei@hsph.harvard.edu.
2
Department of Agriculture, Nutrition, and Food Systems, University of New Hampshire, Durham, NH.
3
Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA.
4
Division of Food and Nutrition Sciences, and Diabetes Institute, Ohio University, Athens, OH.
5
Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, Madrid, Spain.
6
Neuroscience and Aging Laboratory, Jean Mayer U.S. Department of Agriculture Human Nutrition Research Center on Aging, Boston, MA.
7
Department of Nutritional Sciences, The Pennsylvania State University, University Park, PA.
8
Department of Biomedical and Nutritional Sciences, University of Massachusetts Lowell, Lowell, MA.

Abstract

OBJECTIVE:

To determine associations of a Mediterranean diet score (MeDS) with 2-year change in cognitive function by type 2 diabetes and glycemic control status and contrast it against other diet quality scores.

RESEARCH DESIGN AND METHODS:

We used data from the longitudinal Boston Puerto Rican Health Study (n = 913; 42.6% with type 2 diabetes at 2 years). Glycemic control at baseline was categorized as uncontrolled (hemoglobin A1c ≥7% [53 mmol/mol]) versus controlled. Two-year change in glycemic control was defined as stable/improved versus poor/declined. We defined MeDS, Healthy Eating Index, Alternate Healthy Eating Index, and Dietary Approaches to Stop Hypertension scores. Adjusted mixed linear models assessed 2-year change in global cognitive function z score, executive and memory function, and nine individual cognitive tests.

RESULTS:

Higher MeDS, but no other diet quality score, was associated with higher 2-year change in global cognitive function in adults with type 2 diabetes (β ± SE = 0.027 ± 0.011; P = 0.016) but not in those without (P = 0.80). Similar results were noted for Mini-Mental State Examination, word recognition, digit span, and clock drawing tests. Results remained consistent for individuals under glycemic control at baseline (0.062 ± 0.020; P = 0.004) and stable/improved over 2 years (0.053 ± 0.019; P = 0.007), but not for individuals with uncontrolled or poor/declined glycemic control. All diet quality scores were associated with higher 2-year memory function in adults without type 2 diabetes.

CONCLUSIONS:

Both adhering to a Mediterranean diet and effectively managing type 2 diabetes may support optimal cognitive function. Healthy diets, in general, can help improve memory function among adults without type 2 diabetes.

PMID:
31123154
PMCID:
PMC6647047
[Available on 2020-08-01]
DOI:
10.2337/dc19-0130

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