Mediterranean Diet and White Matter Hyperintensity

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Alvin B. Lin, MD, FAAFP

Associate Professor of Family and Community Medicine, University of Nevada School of Medicine

Adjunct Professor of Family Medicine and Geriatrics, Touro University Nevada College of Medicine

Advisory Medical Director, Infinity Hospice Care

Medical Director, Lions HealthFirst Foundation

Dr. Lin maintains a small private practice in Las Vegas, NV. The posts represent the views of Dr. Lin, and in no way are to be construed as representative of the above listed organizations. Dr. Lin blogs about current medical literature and news at


Follow the leader. Aging and vascular risk factors, such as smoking, diabetes, hypertension, and dyslipidemia, are associated with white matter hyperintensity, which is visible on magnetic resonance imaging (MRI). In turn, these white matter hypertensities are associated with risk of stroke and dementia as well as small vessel damage in other organs. But if we are what we eat as noted in yesterday's post, can our diet be linked to these white matter hyperintensities?

In a cross sectional analysis of a longitudinal population-based cohort published in this month's Archives of Neurology, the authors noted that consumption of a Mediterranean-type diet was associated with lower burden of white matter hyperintensities. The 966 participants in the Northern Manhattan Study consisted of two-thirds Hispanic and essentially equal proportions of whites and blacks, average age 72 years old. Those who reported consuming more fruits, vegetables, monounsaturated fat, fish, whole grains, legumes, and nuts, moderate alcohol, and smaller amounts of red meat, saturated fat, and refined grains had less white matter hyperintensities, regardless of sociodemographic and vascular risk factors. Furthermore, body mass index and a personal history of cardiovascular disease made no impact on the linkage between Mediterranean diet and white matter hyperintensities.

We teach our residents not to make assumptions. After all, we don't want to make an a-- out of you & me (spell it out, in case you've never heard this phrase). So just because A=B and B=C, we can't assume that A=C although we'd like to follow the leader. The good news with this study is that we can now demonstrate an association between our nutritional habits and changes on MRI linked to stroke and dementia. Indeed, we are what we eat. Hopefully that will be enough incentive to put down the junk food.