A 6-month MIND-ADmini pilot randomized controlled trial (RCT) was conducted among 93 participants with prodromal AD in Sweden, Finland, Germany, and France. Three arms were included in the RCT: 1) multimodal lifestyle intervention (nutritional guidance, exercise, cognitive training, vascular/metabolic risk management, and social stimulation); 2) multimodal lifestyle intervention + medical food product; and 3) regular health advice (control group). Adherence to dietary advice was assessed with a brief food intake questionnaire by using the Healthy Diet Index (HDI) and Mediterranean Diet Adherence Screener (MEDAS). The intake of macro- and micronutrients were analyzed on a subsample using 3-day food records.
The dietary quality in the intervention groups, pooled together, improved compared to that of the control group at the end of the study, as measured with by HDI (p = 0.026) and MEDAS (p = 0.008). The lifestyle-only group improved significantly more in MEDAS (p = 0.046) and almost significantly in HDI (p = 0.052) compared to the control group, while the lifestyle + medical food group improved in both HDI (p = 0.042) and MEDAS (p = 0.007) during the study. There were no changes in macro- or micronutrient intake for the intervention groups at follow-up; however, the intakes in the control group declined in several vitamins and minerals when adjusted for energy intake.
These results suggest that dietary intervention as part of multimodal lifestyle interventions is feasible and results in improved dietary quality in a population with prodromal AD. Nutrient intakes remained unchanged in the intervention groups while the control group showed a decreasing nutrient density.
ClinicalTrials.gov NCT03249688, 2017-07-08.
方法:一项为期6个月的MIND-ADmini先导随机对照试验(RCT)在瑞典的93名前驱AD参与者中进行,芬兰,德国,和法国。RCT中包括三组:1)多模式生活方式干预(营养指导,锻炼,认知训练,血管/代谢风险管理,和社会刺激);2)多模式生活方式干预+医疗食品;3)定期健康建议(对照组)。通过使用健康饮食指数(HDI)和地中海饮食依从性筛选器(MEDAS),通过简短的食物摄入问卷评估对饮食建议的依从性。使用3天的食物记录对子样本进行了大量和微量营养素的摄入量分析。
结果:干预组的饮食质量,汇集在一起,在研究结束时,与对照组相比有所改善,用HDI(p=0.026)和MEDAS(p=0.008)测量。与对照组相比,仅生活方式组的MEDAS(p=0.046)显着改善,HDI(p=0.052)几乎显着改善,而在研究期间,生活方式+医疗食物组的HDI(p=0.042)和MEDAS(p=0.007)均有所改善。在随访时,干预组的宏观或微量营养素摄入量没有变化;然而,调整能量摄入后,对照组的几种维生素和矿物质摄入量下降。
结论:这些结果表明,作为多模式生活方式干预的一部分,饮食干预是可行的,并且可以改善前驱AD患者的饮食质量。干预组的营养摄入量保持不变,而对照组的营养密度降低。
背景:ClinicalTrials.govNCT03249688,2017-07-08。