Mediterranean diet and white matter hyperintensity volume in the Northern Manhattan Study

Arch Neurol. 2012 Feb;69(2):251-6. doi: 10.1001/archneurol.2011.548.


Objective: To examine the association between a Mediterranean-style diet (MeDi) and brain magnetic resonance imaging white matter hyperintensity volume (WMHV).

Design: A cross-sectional analysis within a longitudinal population-based cohort study. A semiquantitative food frequency questionnaire was administered, and a score (range, 0-9) was calculated to reflect increasing similarity to the MeDi pattern.

Setting: The Northern Manhattan Study.

Participants: A total of 1091 participants, of whom 966 had dietary information (mean age, 72 years; 59.3% women, 64.6% Hispanic, 15.6% white, and 17.5% black).

Main outcome measures: The WMHV was measured by quantitative brain magnetic resonance imaging. Linear regression models were constructed to examine the association between the MeDi score and the log-transformed WMHV as a proportion of total cranial volume, controlling for sociodemographic and vascular risk factors.

Results: On the MeDi scale, 11.6% scored 0 to 2, 15.8% scored 3, 23.0% scored 4, 23.5% scored 5, and 26.1% scored 6 to 9. Each 1-point increase in MeDi score was associated with a lower log WMHV (β = -.04, P = .01). The only MeDi score component that was an independent predictor of WMHV was the ratio of monounsaturated to saturated fat (β = -.20, P = .001).

Conclusions: A MeDi was associated with a lower WMHV burden, a marker of small vessel damage in the brain. However, white matter hyperintensities are etiologically heterogenous and can include neurodegeneration. Replication by other population-based studies is needed.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Age Factors
  • Aged
  • Blood Pressure / physiology
  • Body Mass Index
  • Brain / anatomy & histology*
  • Cerebral Small Vessel Diseases / pathology
  • Cohort Studies
  • Cross-Sectional Studies
  • Data Interpretation, Statistical
  • Diabetes Mellitus / epidemiology
  • Diet, Mediterranean*
  • Feeding Behavior
  • Female
  • Humans
  • Life Style
  • Lipids / blood
  • Longitudinal Studies
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Motor Activity / physiology
  • New York City
  • Risk Factors
  • Risk Reduction Behavior
  • Socioeconomic Factors
  • Vascular Diseases / epidemiology


  • Lipids