PURPOSE: The evidence suggests that adherence to the Mediterranean diet (MD) may be beneficial in preventing cognitive decline. We aimed to explore this association in a Central European population. METHODS: A total of 6,028 men and women from the Czech arm of the HAPIEE study were included in the analysis. Dietary data were collected using a food frequency questionnaire, and MD score (MDS) was calculated based on nine food groups. The MDS (range 0-17 points) was classified into three groups: low (0-7), medium (8-10), high (11-17). Cognitive function was measured using four tests assessing verbal memory and learning, verbal fluency, and attention, mental speed and concentration, and composite score, each of them converted to z-score. The associations between MDS and cognitive function were analyzed using multivariate linear regression in men and women. RESULTS: There were no significant associations in men. By contrast, women with a dietary score of 8-10 points (B = 0.05, 95% CI: -0.002; 0.097), and those with a score of 11-17 points (B = 0.08, 95% CI: 0.016; 0.140) had a higher composite cognitive score than women in lowest adherence group. Regarding specific domains, women in the highest adherence group had significantly better immediate verbal memory (B = 0.12, 95% CI: 0.031; 0.205) and delayed recall (B = 0.12, 95% CI: 0.027; 0.212), respectively, than those in the lowest adherence group. CONCLUSION: Higher adherence to the MDS was associated with better cognitive functioning in verbal memory and composite cognitive score in Czech women. The results suggest that the Mediterranean diet may help to improve cognitive functioning.

• Klíčová slova
• Aging, Cognition, Cognitive decline, Diet, Dietary habits, Mediterranean,
• MeSH
• dieta - přehledy MeSH
• dospělí MeSH
• kognice * MeSH
• kognitivní dysfunkce * prevence a kontrola   epidemiologie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• průřezové studie MeSH
• senioři MeSH
• strava středomořská * statistika a číselné údaje   MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Česká republika epidemiologie   MeSH

To update the European Association for the Study of Diabetes clinical practice guidelines for nutrition therapy, we conducted an umbrella review and updated systematic review and meta-analysis (SRMA) of prospective cohort studies of the association between dietary pulses with or without other legumes and cardiometabolic disease outcomes. We searched the PubMed, MEDLINE, EMBASE, and Cochrane databases through March 2019. We included the most recent SRMAs of prospective cohort studies and new prospective cohort studies published after the census dates of the included SRMAs assessing the relation between dietary pulses with or without other legumes and incidence and mortality of cardiovascular diseases (CVDs) [including coronary heart disease (CHD), myocardial infarction (MI), and stroke], diabetes, hypertension, and/or obesity. Two independent reviewers extracted data and assessed risk of bias. Risk estimates were pooled using the generic inverse variance method and expressed as risk ratios (RRs) with 95% CIs. The overall certainty of the evidence was assessed using the GRADE approach. Six SRMAs were identified and updated to include 28 unique prospective cohort studies with the following number of cases for each outcome: CVD incidence, 10,261; CVD mortality, 16,168; CHD incidence, 7786; CHD mortality, 3331; MI incidence, 2585; stroke incidence, 8570; stroke mortality, 2384; diabetes incidence, 10,457; hypertension incidence, 83,284; obesity incidence, 8125. Comparing the highest with the lowest level of intake, dietary pulses with or without other legumes were associated with significant decreases in CVD (RR: 0.92; 95% CI: 0.85, 0.99), CHD (RR: 0.90; 95% CI: 0.83, 0.99), hypertension (RR: 0.91; 95% CI: 0.86, 0.97), and obesity (RR: 0.87; 95% CI: 0.81, 0.94) incidence. There was no association with MI, stroke, and diabetes incidence or CVD, CHD, and stroke mortality. The overall certainty of the evidence was graded as "low" for CVD incidence and "very low" for all other outcomes. Current evidence shows that dietary pulses with or without other legumes are associated with reduced CVD incidence with low certainty and reduced CHD, hypertension, and obesity incidence with very low certainty. More research is needed to improve our estimates. This trial was registered at clinicaltrials.gov as NCT03555734.

• Klíčová slova
• GRADE, cardiovascular disease, diabetes, hypertension, legumes, meta-analysis, obesity, prospective cohort, pulses, systematic review,
• MeSH
• cévní mozková příhoda epidemiologie   prevence a kontrola   MeSH
• diabetes mellitus epidemiologie   prevence a kontrola   MeSH
• dieta * MeSH
• Fabaceae * MeSH
• hypertenze epidemiologie   prevence a kontrola   MeSH
• infarkt myokardu epidemiologie   prevence a kontrola   MeSH
• kardiovaskulární nemoci epidemiologie   prevence a kontrola   MeSH
• koronární nemoc epidemiologie   prevence a kontrola   MeSH
• lidé MeSH
• metabolické nemoci epidemiologie   prevence a kontrola   MeSH
• obezita epidemiologie   prevence a kontrola   MeSH
• prospektivní studie MeSH
• semena rostlinná * MeSH
• stravovací zvyklosti * MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• metaanalýza MeSH
• práce podpořená grantem MeSH
• systematický přehled MeSH

BACKGROUND: Unhealthy diet may increase the risk of impaired physical functioning in older age. Although poor diet and limited physical functioning both seem to be particularly common in Eastern Europe, no previous study has assessed the relationship between these two factors in this region. The current analysis examined the association between overall diet quality and physical functioning in Eastern European populations. METHODS: We used data on 25,504 persons (aged 45-69 years at baseline) who participated in the Health Alcohol and Psychosocial factors in Eastern Europe (HAPIEE) study. Dietary assessment at baseline used food frequency questionnaire, and the overall diet quality was evaluated by the Mediterranean diet score (MDS). Physical functioning (PF) was measured by the physical functioning subscale (PF-10) of the 36-item Short-Form Health Survey at baseline and three subsequent occasions over a 10-year period. The cross-sectional and longitudinal relationships between the MDS and PF were examined simultaneously using growth curve models. RESULTS: Men and women with higher adherence to the Mediterranean diet had significantly better PF at baseline; after multivariable adjustment, the regression coefficient per 1-unit increase in the MDS was 0.39 (95% CI: 0.25, 0.52) in men and 0.50 (0.36, 0.64) in women. However, we found no statistically significant link between baseline MDS and the subsequent slope of PF decline in neither gender; the coefficients were -0.02 (-0.04, 0.00) in men and -0.01 (-0.03, 0.02) in women. DISCUSSION: Our results do not support the hypothesis that the Mediterranean diet has a substantial impact on the trajectories of physical functioning, although the differences existing at baseline may be related to dietary habits in earlier life.

• MeSH
• lidé středního věku MeSH
• lidé MeSH
• longitudinální studie MeSH
• průřezové studie MeSH
• senioři MeSH
• stárnutí * MeSH
• strava středomořská * MeSH
• stravovací zvyklosti MeSH
• tělesná výkonnost * MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Research Support, N.I.H., Extramural MeSH
• Geografické názvy
• východní Evropa epidemiologie   MeSH