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Original Contributions |

Mediterranean Diet and White Matter Hyperintensity Volume in the Northern Manhattan Study

Hannah Gardener, ScD; Nikolaos Scarmeas, MD, MS; Yian Gu, PhD; Bernadette Boden-Albala, MPH, DrPh; Mitchell S. V. Elkind, MD, MS; Ralph L. Sacco, MD, MS; Charles DeCarli, MD; Clinton B. Wright, MD, MS
Arch Neurol. 2012;69(2):251-256. doi:10.1001/archneurol.2011.548.
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Objective To examine the association between a Mediterranean-style diet (MeDi) and brain magnetic resonance imaging white matter hyperintensity volume (WMHV).

Design A cross-sectional analysis within a longitudinal population-based cohort study. A semiquantitative food frequency questionnaire was administered, and a score (range, 0-9) was calculated to reflect increasing similarity to the MeDi pattern.

Setting The Northern Manhattan Study.

Participants A total of 1091 participants, of whom 966 had dietary information (mean age, 72 years; 59.3% women, 64.6% Hispanic, 15.6% white, and 17.5% black).

Main Outcome Measures The WMHV was measured by quantitative brain magnetic resonance imaging. Linear regression models were constructed to examine the association between the MeDi score and the log-transformed WMHV as a proportion of total cranial volume, controlling for sociodemographic and vascular risk factors.

Results On the MeDi scale, 11.6% scored 0 to 2, 15.8% scored 3, 23.0% scored 4, 23.5% scored 5, and 26.1% scored 6 to 9. Each 1-point increase in MeDi score was associated with a lower log WMHV (β = −.04, P = .01). The only MeDi score component that was an independent predictor of WMHV was the ratio of monounsaturated to saturated fat (β = −.20, P = .001).

Conclusions A MeDi was associated with a lower WMHV burden, a marker of small vessel damage in the brain. However, white matter hyperintensities are etiologically heterogenous and can include neurodegeneration. Replication by other population-based studies is needed.

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