Alzheimer's disease (AD) is an age-related neurodegenerative disease with insidious onset and slow progression. The progression of AD from only brain pathological changes to clinically identifiable cognitive changes is affected by a variety of environmental factors inside and outside the organism and can last for decades. Cognitive impairment is an important clinical feature of AD that impairs the quality of life of the elderly in their later years, and the available drugs for the treatment of AD have failed to cure the disease, indicating the importance of early prevention of AD-related cognitive impairment. Most current research on the relationship between nutrition and AD takes nutritional intervention as a preventive method for AD-related cognitive impairment. The role of dietary supplement or restriction on AD-related cognitive impairment is related to multiple pathways. It is worth noting that the gut microbiome, as an important medium in the effect of dietary on the host, can influence cognitive function through the "microbial-gut-brain axis". The antioxidant and anti-inflammatory properties of some foods are beneficial for improving cognitive function. In this paper, relevant studies in recent years were analyzed to discuss the effects of certain single nutrients (vitamins, polyphenols, and long chain polyunsaturated fatty acids) and overall nutritional patterns (Mediterranean diet, dietary approaches to stop hypertension diet, Mediterranean-DASH intervention for neurodegenerative delay, and ketogenic diet) on cognitive function, so as to provide ideas and reference for the prevention and treatment of AD-related cognitive impairment.
JIANG Xinting, HUANG Gaozhong. Research progress in the effect of nutritional intervention on cognitive impairment related to Alzheimer's disease. Journal of Shanghai Jiao Tong University (Medical Science)[J], 2023, 43(6): 788-794 doi:10.3969/j.issn.1674-8115.2023.06.017
The manuscript was conceived, drafted and revised by JIANG Xinting. HUANG Gaozhong was responsible for defining the topic and guiding the revision of the paper. Both authors have read the last version of paper and consented for submission.
利益冲突声明
所有作者声明不存在利益冲突。
COMPETING INTERESTS
All authors disclose no relevant conflict of interests.
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... 长链多不饱和脂肪酸（long chain polyunsaturated fatty acid，LC-PUFA）由ω-6脂肪酸和ω-3脂肪酸组成.其中，ω-3脂肪酸与认知关系的研究较多.ω-3脂肪酸主要包括二十碳五烯酸（eicosapentaenoic acid，EPA）和二十二碳六烯酸（docosahexaenoic acid，DHA）.存在于大脑神经元膜上的G蛋白偶联受体（G-protein coupled receptors，GPCR）是多巴胺和5-羟色胺的受体［24］.ω-3脂肪酸和GPCR的活性相关，因此ω-3脂肪酸对神经元组织的正常功能至关重要［24］.人体主要从膳食中获得ω-3脂肪酸.膳食ω-3脂肪酸的慢性缺乏会影响大脑的正常功能，导致认知能力下降、记忆缺陷和空间导航受损，并可能与包括情绪障碍和痴呆在内的神经系统疾病有关［24］.世界卫生组织（World Health Organization，WHO）建议每日摄入500 mg EPA和DHA，约50 g三文鱼中即包含上述含量的物质［25］.美国2011—2014年的一项国家健康和营养调查（National Health and Nutrition Examination Survey，NHANES）数据表明，饮食中ω-3和ω-6脂肪酸的摄入量减少可能会导致认知能力低下，而摄入2种脂肪酸的比例变化与认知能力之间没有显著相关性［26］.一项系统评价［27］研究ω-3脂肪酸与基线认知状态不同的老年人群认知能力的关系，结果显示在纳入的14项RCT中有10项提示老年人群认知功能的某些领域（工作记忆、执行功能、言语记忆、短期记忆、知觉速度等）得到改善，提示ω-3脂肪酸补充对老年人群认知能力有积极影响.且ω-3脂肪酸补充对认知能力的影响也可能与老年人群基线认知状态有关［27］.临床试验评估LC-PUFA对认知能力的影响时可能受到脂肪酸的类型和来源、受试者不同的基线认知状态等的影响［28］，因此可能需要更多的研究，以便更准确地了解LC-PUFA对AD相关认知障碍的影响. ...
... ［24］.人体主要从膳食中获得ω-3脂肪酸.膳食ω-3脂肪酸的慢性缺乏会影响大脑的正常功能，导致认知能力下降、记忆缺陷和空间导航受损，并可能与包括情绪障碍和痴呆在内的神经系统疾病有关［24］.世界卫生组织（World Health Organization，WHO）建议每日摄入500 mg EPA和DHA，约50 g三文鱼中即包含上述含量的物质［25］.美国2011—2014年的一项国家健康和营养调查（National Health and Nutrition Examination Survey，NHANES）数据表明，饮食中ω-3和ω-6脂肪酸的摄入量减少可能会导致认知能力低下，而摄入2种脂肪酸的比例变化与认知能力之间没有显著相关性［26］.一项系统评价［27］研究ω-3脂肪酸与基线认知状态不同的老年人群认知能力的关系，结果显示在纳入的14项RCT中有10项提示老年人群认知功能的某些领域（工作记忆、执行功能、言语记忆、短期记忆、知觉速度等）得到改善，提示ω-3脂肪酸补充对老年人群认知能力有积极影响.且ω-3脂肪酸补充对认知能力的影响也可能与老年人群基线认知状态有关［27］.临床试验评估LC-PUFA对认知能力的影响时可能受到脂肪酸的类型和来源、受试者不同的基线认知状态等的影响［28］，因此可能需要更多的研究，以便更准确地了解LC-PUFA对AD相关认知障碍的影响. ...
... ［24］.世界卫生组织（World Health Organization，WHO）建议每日摄入500 mg EPA和DHA，约50 g三文鱼中即包含上述含量的物质［25］.美国2011—2014年的一项国家健康和营养调查（National Health and Nutrition Examination Survey，NHANES）数据表明，饮食中ω-3和ω-6脂肪酸的摄入量减少可能会导致认知能力低下，而摄入2种脂肪酸的比例变化与认知能力之间没有显著相关性［26］.一项系统评价［27］研究ω-3脂肪酸与基线认知状态不同的老年人群认知能力的关系，结果显示在纳入的14项RCT中有10项提示老年人群认知功能的某些领域（工作记忆、执行功能、言语记忆、短期记忆、知觉速度等）得到改善，提示ω-3脂肪酸补充对老年人群认知能力有积极影响.且ω-3脂肪酸补充对认知能力的影响也可能与老年人群基线认知状态有关［27］.临床试验评估LC-PUFA对认知能力的影响时可能受到脂肪酸的类型和来源、受试者不同的基线认知状态等的影响［28］，因此可能需要更多的研究，以便更准确地了解LC-PUFA对AD相关认知障碍的影响. ...
1
... 长链多不饱和脂肪酸（long chain polyunsaturated fatty acid，LC-PUFA）由ω-6脂肪酸和ω-3脂肪酸组成.其中，ω-3脂肪酸与认知关系的研究较多.ω-3脂肪酸主要包括二十碳五烯酸（eicosapentaenoic acid，EPA）和二十二碳六烯酸（docosahexaenoic acid，DHA）.存在于大脑神经元膜上的G蛋白偶联受体（G-protein coupled receptors，GPCR）是多巴胺和5-羟色胺的受体［24］.ω-3脂肪酸和GPCR的活性相关，因此ω-3脂肪酸对神经元组织的正常功能至关重要［24］.人体主要从膳食中获得ω-3脂肪酸.膳食ω-3脂肪酸的慢性缺乏会影响大脑的正常功能，导致认知能力下降、记忆缺陷和空间导航受损，并可能与包括情绪障碍和痴呆在内的神经系统疾病有关［24］.世界卫生组织（World Health Organization，WHO）建议每日摄入500 mg EPA和DHA，约50 g三文鱼中即包含上述含量的物质［25］.美国2011—2014年的一项国家健康和营养调查（National Health and Nutrition Examination Survey，NHANES）数据表明，饮食中ω-3和ω-6脂肪酸的摄入量减少可能会导致认知能力低下，而摄入2种脂肪酸的比例变化与认知能力之间没有显著相关性［26］.一项系统评价［27］研究ω-3脂肪酸与基线认知状态不同的老年人群认知能力的关系，结果显示在纳入的14项RCT中有10项提示老年人群认知功能的某些领域（工作记忆、执行功能、言语记忆、短期记忆、知觉速度等）得到改善，提示ω-3脂肪酸补充对老年人群认知能力有积极影响.且ω-3脂肪酸补充对认知能力的影响也可能与老年人群基线认知状态有关［27］.临床试验评估LC-PUFA对认知能力的影响时可能受到脂肪酸的类型和来源、受试者不同的基线认知状态等的影响［28］，因此可能需要更多的研究，以便更准确地了解LC-PUFA对AD相关认知障碍的影响. ...
1
... 长链多不饱和脂肪酸（long chain polyunsaturated fatty acid，LC-PUFA）由ω-6脂肪酸和ω-3脂肪酸组成.其中，ω-3脂肪酸与认知关系的研究较多.ω-3脂肪酸主要包括二十碳五烯酸（eicosapentaenoic acid，EPA）和二十二碳六烯酸（docosahexaenoic acid，DHA）.存在于大脑神经元膜上的G蛋白偶联受体（G-protein coupled receptors，GPCR）是多巴胺和5-羟色胺的受体［24］.ω-3脂肪酸和GPCR的活性相关，因此ω-3脂肪酸对神经元组织的正常功能至关重要［24］.人体主要从膳食中获得ω-3脂肪酸.膳食ω-3脂肪酸的慢性缺乏会影响大脑的正常功能，导致认知能力下降、记忆缺陷和空间导航受损，并可能与包括情绪障碍和痴呆在内的神经系统疾病有关［24］.世界卫生组织（World Health Organization，WHO）建议每日摄入500 mg EPA和DHA，约50 g三文鱼中即包含上述含量的物质［25］.美国2011—2014年的一项国家健康和营养调查（National Health and Nutrition Examination Survey，NHANES）数据表明，饮食中ω-3和ω-6脂肪酸的摄入量减少可能会导致认知能力低下，而摄入2种脂肪酸的比例变化与认知能力之间没有显著相关性［26］.一项系统评价［27］研究ω-3脂肪酸与基线认知状态不同的老年人群认知能力的关系，结果显示在纳入的14项RCT中有10项提示老年人群认知功能的某些领域（工作记忆、执行功能、言语记忆、短期记忆、知觉速度等）得到改善，提示ω-3脂肪酸补充对老年人群认知能力有积极影响.且ω-3脂肪酸补充对认知能力的影响也可能与老年人群基线认知状态有关［27］.临床试验评估LC-PUFA对认知能力的影响时可能受到脂肪酸的类型和来源、受试者不同的基线认知状态等的影响［28］，因此可能需要更多的研究，以便更准确地了解LC-PUFA对AD相关认知障碍的影响. ...
3
... 长链多不饱和脂肪酸（long chain polyunsaturated fatty acid，LC-PUFA）由ω-6脂肪酸和ω-3脂肪酸组成.其中，ω-3脂肪酸与认知关系的研究较多.ω-3脂肪酸主要包括二十碳五烯酸（eicosapentaenoic acid，EPA）和二十二碳六烯酸（docosahexaenoic acid，DHA）.存在于大脑神经元膜上的G蛋白偶联受体（G-protein coupled receptors，GPCR）是多巴胺和5-羟色胺的受体［24］.ω-3脂肪酸和GPCR的活性相关，因此ω-3脂肪酸对神经元组织的正常功能至关重要［24］.人体主要从膳食中获得ω-3脂肪酸.膳食ω-3脂肪酸的慢性缺乏会影响大脑的正常功能，导致认知能力下降、记忆缺陷和空间导航受损，并可能与包括情绪障碍和痴呆在内的神经系统疾病有关［24］.世界卫生组织（World Health Organization，WHO）建议每日摄入500 mg EPA和DHA，约50 g三文鱼中即包含上述含量的物质［25］.美国2011—2014年的一项国家健康和营养调查（National Health and Nutrition Examination Survey，NHANES）数据表明，饮食中ω-3和ω-6脂肪酸的摄入量减少可能会导致认知能力低下，而摄入2种脂肪酸的比例变化与认知能力之间没有显著相关性［26］.一项系统评价［27］研究ω-3脂肪酸与基线认知状态不同的老年人群认知能力的关系，结果显示在纳入的14项RCT中有10项提示老年人群认知功能的某些领域（工作记忆、执行功能、言语记忆、短期记忆、知觉速度等）得到改善，提示ω-3脂肪酸补充对老年人群认知能力有积极影响.且ω-3脂肪酸补充对认知能力的影响也可能与老年人群基线认知状态有关［27］.临床试验评估LC-PUFA对认知能力的影响时可能受到脂肪酸的类型和来源、受试者不同的基线认知状态等的影响［28］，因此可能需要更多的研究，以便更准确地了解LC-PUFA对AD相关认知障碍的影响. ...
