PDF(Pubmed)
Abstract：
(1) Background: Mediterranean ketogenic nutrition (MKN) may directly target multiple neurobiological mechanisms associated with dementia risk in older adults. Despite its promise, this type of nutrition can be challenging to learn and adhere to in a healthy manner. Our team used the National Institutes of Health Obesity Related Behavioral Intervention Trials (NIH ORBIT) model to develop and pilot a program to help older adults with memory concerns use MKN. (2) Methods: Using a two-arm, randomized design, we evaluated an MKN Adherence (MKNA) program compared to an MKN education (MKNE) program (N = 58). The primary difference between study arms involved the use of motivational interviewing (MI) strategies and behavior change techniques (BCT) only in the MKNA arm. Participants were included if they evidenced subjective memory concerns or objective memory impairment on the Montreal Cognitive Assessment (Score 19 ≤ 26). Primary outcomes examined included feasibility, acceptability, adherence, and clinical outcomes associated with the program. (3) Results: Overall, there was relatively high program completion in both groups, with 79% of participants completing the 6-week program. The recruitment protocol required adjustment but was successful in reaching the target sample size. Retention (82%) and session attendance (91%) were higher in the MKNA arm compared to the MKNE (retention = 72%; attendance = 77%). Overall, most participants in both groups rated the program as \"excellent\" using the client satisfaction questionnaire. Participants in the MKNA arm evidenced higher objective and self-reported adherence to MKN during the 6-week program. Further, there was some evidence of clinical benefits of the program, although these effects diminished as adherence decreased in the 3 months follow-up. (4) Discussion: This pilot trial demonstrated that the MKN program incorporating MI and BCT strategies may better engage and retain participants than a nutrition education program alone, although participants in both groups reported high satisfaction.
摘要：
（1）背景：地中海生酮营养（MKN）可能直接针对与老年人痴呆风险相关的多种神经生物学机制。尽管承诺,这种类型的营养可能是具有挑战性的学习和坚持以健康的方式。我们的团队使用美国国立卫生研究院肥胖相关行为干预试验（NIHORBIT）模型来开发和试点一项计划，以帮助有记忆问题的老年人使用MKN。（2）方法：使用双臂，随机设计，与MKN教育(MKNE)计划相比,我们评估了MKN坚持(MKNA)计划(N=58).研究组之间的主要差异涉及仅在MKNA组中使用动机性访谈（MI）策略和行为改变技术（BCT）。如果参与者在蒙特利尔认知评估（得分19≤26）中证明了主观记忆问题或客观记忆障碍，则将其包括在内。检查的主要结果包括可行性，可接受性,坚持,以及与该计划相关的临床结果。（3）结果：总体上，两组的计划完成度都相对较高，79%的参与者完成了为期6周的课程。招募方案需要调整，但成功达到目标样本量。与MKNE相比，MKNA部门的保留率（82％）和会议出勤率（91％）更高（保留率=72％；出勤率=77％）。总的来说,两组中的大多数参与者使用客户满意度问卷将该计划评为“优秀”。在为期6周的计划中，MKNA小组的参与者证明了对MKN的客观和自我报告依从性更高。Further,有一些证据表明该计划的临床益处，尽管在3个月的随访中，这些影响随着依从性的降低而减弱。（4）讨论：这项试点试验表明，结合MI和BCT策略的MKN计划可能比单独的营养教育计划更好地吸引和留住参与者，尽管两组参与者都报告了很高的满意度。
