Mediterranean Diet, Weight Loss, and Cognition in Obese Older Adults

地中海饮食、减肥和肥胖老年人的认知

基本信息

批准号：
9302828
负责人：
Marian L. Fitzgibbon
金额：
$ 77.12万
依托单位：
UNIVERSITY OF ILLINOIS AT CHICAGO
依托单位国家：
美国
项目类别：
财政年份：
2016
资助国家：
美国
起止时间：
2016-07-01 至 2021-04-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9302828
关键词：
Activities of Daily Living Adherence Adult Affect African American Age Aging Alcohol consumption Alzheimer&apos s Disease American Attention Behavioral Biological Blood Pressure Body Composition Body Weight Body Weight decreased Body mass index Caloric Restriction Cardiovascular Diseases Cause of Death Cognition Cognitive deficits Dementia Development Diabetes Mellitus Diet Diet Habits Diet Modification Dietary Factors Dietary Fats Dietary Fiber Dietary Intervention Dietary Practices Dyslipidemias Elderly Energy Intake Ethnic Origin Exhibits Fabaceae Fasting Fibrinogen Food Fruit Glucose High Prevalence Hispanics Hyperlipidemia Hypertension Impaired cognition Impairment Individual Inflammation Insulin Insulin Resistance Intake Intervention Life Style Link Lipids Maintenance Mediating Mediator of activation protein Mediterranean Diet Memory Metabolic Metabolic Diseases Neurocognition Not Hispanic or Latino Nuts Obesity Observational Study Oxidative Stress Participant Pattern Pharmacological Treatment Physical activity Population Prevalence Quality of life Race Randomized Randomized Clinical Trials Reporting Risk Risk Factors Sampling Saturated Fatty Acids Self Efficacy Social support Socioeconomic Status Symptoms Testing United States Unsaturated Fatty Acids Vegetables Weight Weight maintenance regimen Work adiponectin aged arm blood lipid blood pressure reduction cardiovascular disorder risk cognitive function dietary antioxidant dietary restriction disability epidemiology study ethnic diversity executive function follow-up food consumption glucose metabolism improved innovation intrinsic motivation lifestyle intervention low socioeconomic status physical inactivity polyphenol post intervention prevent psychosocial public health priorities public health relevance randomized trial weight loss intervention

项目摘要

DESCRIPTION (provided by applicant): Obesity is a leading cause of death and disability in the United States (US), affecting as many as 80 million Americans. It is well-established that obesity contributes to a number of risk factors for metabolic abnormalities and cardiovascular disease (CVD), including hypertension, diabetes, and hyperlipidemia. In addition, there is growing evidence that obesity is associated with cognitive deficits in multiple domains, even in otherwise healthy older adults. With the rapidly aging US population and the high prevalence of obesity among older adults, innovative strategies to prevent cognitive decline in this population are needed. Dietary patterns are central to the development and maintenance of obesity and evidence suggests that dietary factors also may affect cognition. Epidemiologic studies have shown that adherence to a Mediterranean Diet (MedDiet) is associated with less cognitive decline and reduced risk for dementia. Weight loss through caloric restriction also has been shown to improve cognitive function in obese adults. The identification of effective lifestyle interventions for diet/weight management to improve cognition among obese older adults is a public health priority. However, to our knowledge, no randomized clinical trials (RCTs) have examined the effect of the MedDiet, with and without caloric restriction, to promote weight loss on cognitive functioning in obese older adults. We propose a three-arm RCT in which 180 obese (body mass index [BMI] >30 and < 50 kg/m2) older adults, aged 55 years and older, will be randomized to an 8-month intervention consisting of: 1) MedDiet Alone, without caloric restriction/weight loss (MedDiet-A); 2) MedDiet lifestyle intervention with caloric restriction/weight loss (MedDiet-WL); or 3) typical diet control (TDC) without caloric restriction/weight loss. We will test the following hypotheses: 1) participants randomized to MedDiet-A and MedDiet-WL will achieve greater improvements in cognition compared to participants randomized to TDC; 2) participants randomized to MedDiet-WL will exhibit greater improvements in cognition compared to participants randomized to MedDiet-A; 3) participants randomized to MedDiet-A and MedDiet-WL will show greater improvements in CVD/metabolic risk factors, systemic inflammation, oxidative stress (OxStress), and body weight/composition compared to participants in TDC; 4) participants randomized to MedDiet-WL will exhibit greater improvements in CVD/metabolic risk factors, systemic inflammation, OxStress, and body weight/composition compared to MedDiet-A. We also we examine potential moderators of treatment (e.g., ethnicity and baseline cognitive function) and explore mediators by which neurocognition is improved by diet, including changes in CVD/metabolic risk factors, physical activity, systemic inflammation, and OxStress. We also will determine the extent to which changes in dietary habits, weight, and cognitive functioning are maintained over a 6-month follow-up period.

描述（由适用提供）：肥胖是美国（美国）的死亡和残疾的主要原因，影响了多达8000万美国人。良好的肥胖症促成了代谢异常和心血管疾病（CVD）的许多危险因素，包括高血压，糖尿病和高脂血症。此外，越来越多的证据表明肥胖与多个领域的认知缺陷有关，即使在其他健康的老年人中也是如此。随着美国人口迅速衰老和老年人肥胖的高度流行，需要创新的策略来预防该人群认知能力下降。饮食模式对于肥胖的发展和维持至关重要，证据表明饮食因素也可能影响认知。流行病学研究表明，遵守地中海饮食（Meddiet）与认知能力下降和痴呆症风险降低有关。通过热量限制减肥也已被证明可以改善肥胖成年人的认知功能。鉴定有效的饮食/体重管理生活方式干预措施以改善肥胖老年人的认知是公共卫生的优先事项。但是，据我们所知，尚无随机临床试验（RCT）检查了Meddiet的效果，也没有热量限制，以促进肥胖老年人认知功能的体重减轻。我们提出了一个三臂RCT，其中180个肥胖（体重指数[BMI]> 30> 30和<50 kg/m2）年龄在55岁以上，年龄在55岁及以上，将被随机分配为8个月的干预措施：1）单独使用Meddiet，而无需热量限制/体重减轻/体重减轻（Meddiet-a）； 2）与热量限制/体重减轻（Meddiet-WL）的Meddiet生活方式干预；或3）典型的饮食控制（TDC），而无需热量限制/体重减轻。我们将检验以下假设：1）与随机与TDC的参与者相比，随机分配给Meddiet-A和Meddiet-WL的参与者将在认知方面取得更大的改善； 2）与随机分配给Meddiet-A相比，随机分配给Meddiet-WL的参与者将显示出更大的认知改善； 3）与TDC的参与者相比，随机分配给MEDDIET-A和MEDDIET-WL将显示出更大的改善，即CVD/代谢危险因素，全身感染，氧化应激（OxSrestress）以及体重/组成与TDC的参与者相比； 4）与MEDDIET-A相比，随机分配给Meddiet-WL的参与者将提取更大的改善CVD/代谢危险因素，全身感染，氧化剂和体重/组成。我们还检查了治疗的潜在调节剂（例如种族和基线认知功能），并探索介质通过饮食改善神经认知的介体，包括CVD/代谢危险因素的变化，体育活动，系统性影响和Oxsress。我们还将在6个月的随访期内保持饮食习惯，体重和认知功能的变化的程度。