Mediterranean diet is associated with lower white matter lesion volume in Mediterranean cities and lower cerebrospinal fluid Aβ42 in non-Mediterranean cities in the EPAD LCS cohort

The Mediterranean diet (MedDiet) has been associated with better brain health and reduced incidence of dementia. Few studies have compared the effects of the MedDiet in early Alzheimer’s disease or compared effects of the diet within and outside of the Mediterranean region. The Mediterranean Diet Adherence (MEDAS) and MEDAS continuous scores were calculated at the baseline visit of the European Prevention of Alzheimer’s Dementia Longitudinal Cohort Study (n=1625). The scores were included in linear regression models to test for associations with hippocampal volume, log-transformed white matter lesion volume (WMLV), cerebrospinal fluid pTau181 and Aβ42. Higher MEDAS scores were associated with lower log-transformed WMLV (β: -0.07, SE: 0.02, p<0.001). This association was only seen in the Mediterranean region (β: -0.12, SE: 0.03, p<0.001). In the non-Mediterranean region higher MEDAS continuous scores were associated with lower CSF Aβ42 (β: -68.30, SE: 14.32, p<0.001). More research is needed to understand the differences in the associations seen with the MedDiet and AD biomarkers by different European regions.