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Effect of the Mediterranean diet and probiotic supplementation in the management of mild cognitive impairment:
Magdalena P Cardelo1,2, Andreea Corina1,2, Ana Leon-Acuña1,2
1Unidad de Gestión Clinica Medicina Interna, Lipids and Atherosclerosis Unit, Maimonides Institute for Biomedical Research in Córdoba (IMIBIC), Reina Sofía University Hospital, University of Córdoba, Córdoba, Spain.
Introduction:
Mild cognitive impairment (MCI) can progress to Alzheimer's disease (AD). When MCI is not properly controlled, the speed of deterioration can dramatically increase. Reduction of oxidative stress/inflammation and the modulation of the gut-brain axis could be new potential therapeutic targets for the prevention and treatment of AD. Consumption of specific nutrients, diets and probiotic supplementation have been evaluated for neurodegenerative disorders. We focus on a detailed description of the study methods and baseline characteristics of a clinical trial aiming to evaluate the efficacy of a combined nutritional intervention, i.e., a Mediterranean diet with probiotics, on cognitive capacity in a population with MCI.
Methods:
In this randomized, latin-square crossover, double-blind, and controlled dietary intervention trial (clinicaltrials.gov NCT05029765), 47 MCI patients were randomized to consume three dietary interventions for 24-weeks each: (1) A Mediterranean diet supplemented with probiotics (109 colony-forming units of Lactobacillus rhamnosus and Bifidobacterium longum); (2) A Mediterranean diet + placebo; and (3) A Healthy diet according to the World Health Organization (WHO) recommendations. Participants will be evaluated before and after each of the three intervention periods (each 24-weeks, with a total of 72-weeks) for adherence to the assigned diet, blood tests, cognitive performance, gut microbiota analysis and functional neuroimaging studies.
Results:
Fifty patients, ≥60 years-old and diagnosed with MCI, underwent randomization. A total of 47 patients completed follow-up dietary interventions (57.4% males), with a good glycemic control (HbA1c 5.8 ± 0.1%, fasting glucose and insulin 99.7 ± 3.3 mg/dL and 10.4 ± 0.9 mU/L, respectively), elevated systolic blood pressure (136.9 ± 2.1 mmHg) and increased degree of inflammation (high-sensitivity C-reactive protein, 8.8 ± 0.9 mg/dL). Baseline adherence to the Mediterranean diet was medium (7.5 ± 0.3 points on the score that ranged from 0 to 14 points).
Conclusion:
The results of this clinical study would provide more evidence on the need for dietary therapeutic strategies, for clinical and individual practice, in the management of MCI patients to reduce the risk of AD development. Targeting lifestyle modifications in high-risk populations could prevent substantial cases of cognitive decline.
Clinical Trial Registration:
[ClinicalTrials.gov], identifier [NCT05029765].
Insights
This study investigated a Mediterranean diet with probiotics for mild cognitive impairment (MCI). Findings may support dietary strategies to prevent Alzheimer's disease progression.
Area of Science:
- Neuroscience
- Nutritional Science
- Gastroenterology
Background:
- Mild cognitive impairment (MCI) can progress to Alzheimer's disease (AD).
- Oxidative stress, inflammation, and the gut-brain axis are potential therapeutic targets for AD.
- Dietary interventions and probiotics show promise for neurodegenerative disorders.
Purpose of the Study:
- To evaluate the efficacy of a combined Mediterranean diet and probiotic intervention on cognitive function in MCI patients.
- To assess the impact of dietary interventions on cognitive capacity, gut microbiota, and neuroimaging markers.
Main Methods:
- A randomized, crossover, double-blind, controlled dietary intervention trial (NCT05029765) involving 47 MCI patients.
- Participants consumed three 24-week interventions: Mediterranean diet with probiotics, Mediterranean diet with placebo, or WHO-recommended healthy diet.
- Evaluations included adherence, blood tests, cognitive performance, gut microbiota, and functional neuroimaging.
Main Results:
- 47 MCI patients (57.4% male, mean age ≥60) completed the study.
- Baseline characteristics included good glycemic control, elevated systolic blood pressure, and increased inflammation.
- Medium baseline adherence to the Mediterranean diet was observed.
Conclusions:
- Results may provide evidence for dietary therapeutic strategies in MCI management to reduce AD risk.
- Lifestyle modifications, including diet, can help prevent cognitive decline in high-risk populations.
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