Effect of dietary interventions in mild cognitive impairment: a systematic review

British Journal of Nutrition
Q1
Nov 2018
Citations:61
Influential Citations:2
Systematic Reviews / Meta-Analyses
82
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Methods
Systematic review of randomized controlled trials in adults with mild cognitive impairment (MCI). Sixteen RCTs included. Interventions encompassed dietary supplements, single foods, and dietary patterns. Primary outcome: incident dementia/AD. Secondary outcomes: overall cognitive function and domain-specific cognitive performance measured with validated neuropsychological tests. Narrative synthesis due to substantial heterogeneity in interventions and outcomes. Quality assessed using Jadad scale and Cochrane risk-of-bias criteria.
Intervention
Vitamin E: 2000 IU daily for 2 years (memory outcomes); 2000 IU daily for 3 years (progression to dementia/AD). Folic acid 800 mcg/day, vitamin B12 500 mcg/day, vitamin B6 20 mg/day for 2 years. Folic acid alone: 400 mcg/day for 6 months. Fish oil (DHA+EPA): 3 × 430 mg DHA + 150 mg EPA daily for 12 months; 480 mg DHA + 720 mg EPA daily for 6 months. Souvenaid Fortasyn Connect: 125 ml daily for 24 months. Cocoa flavonols: High 990 mg/day, intermediate 520 mg/day, low 45 mg/day for 8 weeks. Concord grape juice: 6–9 ml/kg/day for 12 weeks. Wild blueberry juice: 6–9 ml/kg/day for 12 weeks. Chromium picolinate: 1000 mcg daily for 12 weeks. Nutrition counselling with energy restriction; diet patterns include high-saturated fat/high-GI vs low-saturated fat/low-GI; high carbohydrate vs very-low carbohydrate; one study included 150 min/week physical activity.
Results
Vitamin E, Ginkgo biloba, and Souvenaid Fortasyn Connect did not reduce progression from MCI to dementia/AD. Some regimens improved memory and selective cognitive domains, notably B vitamins (folic acid, B12, B6), DHA/EPA, DHA, cocoa flavonols, concord grape juice, and wild blueberry juice, but results were inconsistent across studies due to heterogeneity and small sample sizes. Overall, dietary factors may have potential cognitive benefits in MCI, but robust, standardized RCTs are needed to confirm effects.
Limitations
English-language searches with no grey literature; small number of randomized trials; substantial heterogeneity in interventions and cognitive outcomes; not meta-analysed; some trials underpowered; short study durations; variability in cognitive measures; risk of bias uncertain in several studies.

Abstract

Abstract Diet has been investigated in relation to its ability to promote cognitive function. However, evidence is currently limited and has rarely been systematically reviewed, particularly in a mild cognitive impairment (MCI) population. This revie...