Japanese, Mediterranean and Argentinean diets and their potential roles in neurodegenerative diseases

Accepted Manuscript Japanese, Mediterranean and Argentinean diets and their potential roles in neurodegenerative diseases

Diana Denise Dohrmann, Predrag Putnik, Danijela Bursać Kovačević, Jesus Simal-Gandara, Jose M. Lorenzo, Francisco J. Barba PII: DOI: Reference:

S0963-9969(18)30881-0 https://doi.org/10.1016/j.foodres.2018.10.090 FRIN 8060

To appear in:

Food Research International

Received date: Revised date: Accepted date:

18 July 2018 18 October 2018 30 October 2018

Please cite this article as: Diana Denise Dohrmann, Predrag Putnik, Danijela Bursać Kovačević, Jesus Simal-Gandara, Jose M. Lorenzo, Francisco J. Barba , Japanese, Mediterranean and Argentinean diets and their potential roles in neurodegenerative diseases. Frin (2018), https://doi.org/10.1016/j.foodres.2018.10.090

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ACCEPTED MANUSCRIPT Japanese, Mediterranean and Argentinean Diets and their potential roles in neurodegenerative diseases Diana Denise Dohrmann1,2 , Predrag Putnik3,* , Danijela Bursać Kovačević3 , Jesus SimalGandara4 , Jose M. Lorenzo5 , Francisco J. Barba1,* Nutrition and Food Science Area, Preventive Medicine and Public Health,

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Food Science, Toxicology and Forensic Medicine Department, Faculty of Pharmacy,

Universidad de la Cuenca del Plata, Facultad de Ingeniería y Tecnología. Lavalle 50,

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Universitat de València, Avda. Vicent Andrés Estellés, Burjassot, València, Spain

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3410, Corrientes, Argentina

Faculty of Food Technology and Biotechnology, University of Zagreb, Pierottijeva 6,

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10000 Zagreb, Croatia Nutrition and Bromatology Group, Analytical and Food Chemistry Department,

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Faculty of Food Science and Technology, University of Vigo, Ourense Campus, E-

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32004 Ourense, Spain

Centro Tecnológico de la Carne de Galicia, rúa Galicia n° 4, Parque Tecnológico de

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Galicia, San Cibrao das Viñas, 32900, Ourense, Spain

* Corresponding author Predrag Putnik, PhD Faculty of Food Technology and Biotechnology, University of Zagreb, Pierottijeva 6, 10000 Zagreb, Croatia Email: [email protected] Phone: +385 (1) 4605279, Fax: +385 (1) 4605072

ACCEPTED MANUSCRIPT Authors’ e-mails: Diana Denise Dohrmann ([email protected]); Predrag Putnik ([email protected]); Danijela Bursać Kovačević ([email protected]); Jesus Simal-Gandara ([email protected]); Jose M. Lorenzo ([email protected]); Francisco

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J. Barba ([email protected])

ACCEPTED MANUSCRIPT Abstract Environmental factors are responsible of cellular senescence and processes found in the development of cognitive disorders. The aim of this paper is to compare benefits of the Japanese, Mediterranean, and Argentinian Diet on the onset or prevention of senile dementia (SD) and Alzheimer’s Disease (AD). Special focus was on the effects of

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specific compounds such as polyunsaturated fatty acids (PUFAs), antioxidants, and

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saturated and trans fatty acids. A high adherence to diets rich in PUFAs,

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monounsaturated fatty acids (MUFAs) and antioxidants may decrease the risk of developing neurodegenerative diseases; while the predominance of saturated and trans

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fatty acids possibly rises it.

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Keywords: Alzheimer’s disease; neuroprotection; Mediterranean diet; Japanese style

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diet; food pattern

ACCEPTED MANUSCRIPT Table of Contents 1.

INTRODUCTION.................................................................................................................................. 5

2.

METHODS ............................................................................................................................................. 7

3.

NEURODEGEN ERATIVE DIS EAS ES , FOOD COMPONENTS AND DIETARY PATT ERNS 7

3.1.

ALZHEIMER'S DIS EAS E, S ENILE D EMENTIA AND FOOD COMPONENTS...... ERROR!

BOOKM ARK NOT DEFINED. 4.

DIETARY PATTERNS IN JAPAN ..................................................................................................... 9 JAPANES E FOOD GUID ES ......................................................................................................... 13

4.2.

TRAD ITIONAL JAPANES E DIET.............................................................................................. 15

4.3.

GROCERIES ................................................................................................................................... 15

4.4.

FOOD PREPARATIONS............................................................................................................... 16

4.5.

NUTRITION.................................................................................................................................... 16

4.6.

JAPANES E DIET AND NEURODEGENERATIVE D IS EAS ES ............................................. 17

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4.1.

EFFECTS OF POLYUNS ATURATED FATS ....................................................................... 17

4.6.2.

EFFECTS OF ANTIOXID ANTS ............................................................................................. 19

5.

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4.6.1.

MED ITERRANEAN DIET ................................................................................................................... 9 FOOD GUIDES ................................................................................................................................. 9

5.2.

MED ITERRANEAN DIET AND NEURODEGEN ERATIVE DIS EAS ES.............................. 10

6.

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5.1.

ARGENTIN EAN DIETARY PATTERNS ........................................................................................ 22 FOOD GUIDES ............................................................................................................................... 24

6.2.

S ATURATED AND TRANS FATS AND ONS ET OF NEURODEGENERATIVE DIS EAS ES

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6.1.

25

DIS CUSS ION ....................................................................................................................................... 27

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CONCLUS IONS .................................................................................................................................. 30

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ACKNOWLEDGEMENTS ......................................................................................................................... 32

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REFERENCES ............................................................................................................................................. 33

ACCEPTED MANUSCRIPT 1. Introduction Alzheimer's disease (AD) is the most common cause of primary dementia, characterized by a progressive process of pathophysiological restructuring of the brain over decades. The hallmark of Alzheimer's disease is the extracellular accumulation and deposition of insoluble amyloid, to be found in the parenchyma in the form of amyloid

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plaques and in meningeal and cerebral vessels as a congophile angiopathy. Equally

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conspicuous is the intraneuronal occurrence of neurofibrillary tangles, consisting mainly

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of hyper-phosphorylated tau-protein. Amyloid plaques and neurofibrillary tangles are characteristic, but not specific to Alzheimer's disease. Similar changes can be found in

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healthy ageing processes and in various other neurodegenerative diseases. It is common to differentiate between an early-onset, familial Alzheimer's disease with an established

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genetic etiology, representing only about 5% of all cases, and the more typical lateonset, sporadic Alzheimer's disease with an age of onset above 65 years and no clear

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pattern of inheritance. Although there seems to be a large heterogeneity in the etiology

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of Alzheimer's disease, the amyloid-cascade-hypothesis has taken a central position as a model for the general etiopathogenesis. The regulation of amyloid plaques underlies a diversity of cellular and molecular factors. In addition to ageing, apolipoprotein E 4 is a

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firmly established risk factor. Disturbance in the cerebral glucose metabolism, especially in the hippocampal regions, is a further proposed factor in the pathogenesis of Alzheimer's disease. The widespread loss of cortical cholinergic neurotransmission associated with the cognitive deficits is of importance to the comprehension of the symptoms and the present pharmacotherapy of Alzheimer's disease (Kratzsc h et al., 2002). The potential impact of bioactive compounds (BAC) of foods on cognitive activity has been highlighted, especially in the elderly (Lanyau & Macías, 2005).

ACCEPTED MANUSCRIPT Different studies showed that the intake of saturated and trans fats is positively associated with a higher risk for developing long-term cognitive disorders, such as senile dementia. The saturated and trans fats are likely to increase total plasma and LDL cholesterol, which is related to Alzheimer's disease (AD) (Barnard, Bunner, & Agarwal, 2014). Instead, the consumption of BACs, such as polyphenols (flavonoids), vitamins

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(e.g. C, E), and other nutrients (e.g. omega 3 fatty acids), seem to reduce the risk of

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having these pathologies (Lanyau & Macías, 2005). Hence, prevention from a

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nutritional perspective should follow consumption of diets rich in fish and foods fruits and vegetables, for instance, the Mediterranean Diet and the Japanese style Diet

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(Lanyau & Macías, 2005; Otsuka, 2016). The preventive function of antioxidants is to act against oxidative stress, which according to various laboratory findings, seems to

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contribute to AD pathogenesis (Engelhart, Geerlings, Ruitenberg, & et al, 2002; Otsuka, 2016).

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It is important to highlight the researches that analyze the preventive effect of

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certain diets on the mentioned neurodegenerative pathologies, as their prevalence can be associated with the traditional dieting in population. It is known that there is a large cultural variety in food consumption, and therefore, the identification of nutrients that

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may increase or decrease the risks for developing senile dementia or AD is essential (Cole, Ma, & Frautschy, 2010; Otsuka, 2016). This will encourage intake of essential nutrients that may delay the onset of symptoms, by raising awareness of the beneficial aspects of diets considered to be preventive, and therefore lead to the improvement of general lifestyle. Nowadays, epidemiological data are useful to determine the presence of risk factors for the abovementioned neurodegenerative diseases. There are new clinical trials that elucidate mechanisms which lead to chronic diseases and nutritional interventions

ACCEPTED MANUSCRIPT have proven the reduction of risks factors (Consulta Mixta FAO/OMS de Expertos en Régimen Alimentario, 2013). The present work aims to compare influence of the Japanese, Mediterranean, and Argentinian Diet on the onset or prevention of senile dementia and AD. Focus will be placed on: (i) describing the mechanisms in which foods cause increase/decrease the

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risks for senile dementia or AD; (ii) identify foods, nutrients, components, and food

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intake patterns in Japanese, Mediterranean, and Argentinian diet, that represent a

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preventive factors to cognitive disorders (senile dementia or AD).

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2. Methods

Reviewed literature originated from official public and private organizations

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dedicated to research and education, which was available in Spanish, English or Japanese. Only data provided by scientific research was accepted. The search co vered

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digital libraries, such as PubMed, Scopus, SciELO, ScienceDirect, etc. selecting those references whose title and description were relevant for objectives of this manuscript.

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3. Neurodegenerative diseases, food components and dietary patterns Mediterranean, Japanese and Argentinean diet are discussed based on their

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incidence on neurodegenerative diseases. Anyway, most attention is given to the Mediterranean diet due to its well-recognized health beneficial effects. The death and degenerative process of nerve cells that normally occurs in aging is known as senile dementia, while Alzheimer's disease is not a normal aging process, but a pathology characterized by the decline of cognitive function, memory and intellectual capacity, leading to irreversible neurodegenerative deterioration (Aquino Fernández & Apaza Paucara, 2012; Yegambaram, Manivannan, Beach, & Halden, 2015).

ACCEPTED MANUSCRIPT The AD’s etiology is unknown as it is hereditary in less than 1% of cases. In 70% of the cases, it is believed to occur due to variety of genetic factors, while remaining percentage is attributed to environmental factors and lifestyle patterns. There are also a series of protective factors (Table 1), such as the intake of various nutrients and practice of stimulating cognitive activities. SD’s origin could also be genetic,

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vascular or caused by several diseases or habits. It is known that the deficiency of both

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vitamin B1 and B12 may cause cell damage related to memory loss (Aquino Fernández

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& Apaza Paucara, 2012; Lanyau & Macías, 2005 ; Reitz, Brayne, & Mayeux, 2011; Yegambaram et al., 2015).

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Diet has both roles, protective and risk inducing, depending on the nutritional patterns. Nutritional public health risk factors include but are not limited to the

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following:

(i) lack of nutritional education that increases the prevalence of obesity, metabolic

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syndrome, insulin resistance, and diabetes all of which pose significant risk

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factors for AD, and present double the risk for dementia; (ii) availability and access to foods as effected by industrialization, urbanization,

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economic development and globalization of markets; (iii) economic factors such as the food price; (iv) food preferences for high energy foods containing mostly saturated fats and unrefined carbohydrates (Lanyau & Macías, 2005; Reitz et al., 2011). Alzheimer's disease is one of the most relevant public health problems of the century and it has become a global health crisis with tremendous social and economic burden influencing entire families of affected people and their caregivers. Hence, the adoption of new approaches and the reinforcement of cost-effective prevention measures are

ACCEPTED MANUSCRIPT necessary in society (Honyashiki, Ferri, Sousa, Albanese, & Ribeiro, 2009; WHO 2018). 4. Mediterranean Diet Unlike with common Western diet, it was identified in the Mediterranean Diet a

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greater contribution of monounsaturated fatty acids (MUFA), fish, fruits, vegetables, and lower consumption of meat. This diet represents the foods that are consumed

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frequently among the populations bordering the Mediterranean sea (Romagnolo &

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Selmin, 2017).

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Observational studies have shown the abundant e lements present in the Mediterranean Diet that associate it with longevity and the prevention of a wide range

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of chronic pathologies. The preventive effects of neurocognitive disorders are attributed especially to the consumption of fish oil, olive oil, and red wine with moderation

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proposed by the diet. Increased consumption of fruits, vegetables, legumes and cereals, with minimizing consumption of red meats, resulted with reduction of cardiovascular

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and cancer mortality, lipid metabolism, blood pressure, e ndothelial dysfunction and a beneficial role on the incidence of Parkinson’s disease and AD (Romagnolo & Selmin,

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2017; Sofi, Cesari, Abbate, Gensini, & Casini, 2008). Due to the diet significant reduction in overall pathologies, its greater adherence has become in a primary prevention of major chronic diseases (Sofi, Cesari, Abbate, Gensini, & Casini, 2008). 4.1. Food Guides The Dietary Guidelines for healthy eating of the Spanish Society of Community Nutrition (SENC) proposes that adherence to the Mediterranean diet will increase HDL and decrease LDL, with significant consumption of antioxidants and dietary fiber. The

ACCEPTED MANUSCRIPT main objective of the Dietary Guidelines is the promotion of healthy eating habits, considering the territory, customs, traditions and characteristic foods of the population (Aranceta Batrina et al., 2016; Dapcich et al., 2004). The Mediterranean diet pyramid (Bach-Faig et al., 2011) place the emphasis on regular physical activity, adequate rest, conviviality, biodiversity and seasonality,

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traditional, local and eco- friendly products, and culinary activities. It presents foods that

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are grouped into categories according to the consumption suggested, which is 'for every

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meal', 'daily', 'weekly'.

As part of daily consumption, the second level of the pyramid shows whole grain

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cereals, subset of their products and other foods rich in complex carbohydrates. Vegetables are recommended with two or more servings per day, together with 1-2

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servings of fruits. Here at the same level is the extra virgin olive oil with a differential aspect of other food graphics. The last blocks in daily consumption are from down to

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top the group of dairy products, (prioritizing those low in fat and added sugars), and the group of lean meats, poultry, fish, eggs, with legumes and other plant proteins (e.g. nuts

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and seeds). Among others, red and processed meats, fat spreads, sugars, industrial bakery, ice cream and confectionery are optional and should be moderately consumed,

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similar to alcoholic beverages (two glasses of wine per day for men and one for women). More details at http://mediterradiet.org/nutrition/mediterranean_diet_pyramid 4.2. Mediterranean Diet and neurodegenerative diseases Through the systematic review and meta-analysis on associations of Mediterranean Diet with AD, Singh et al., 2014 observed that a higher adherence to diet is related to a lowered risk for cognitive impairment, mild cognitive impairment and AD, with lesser chances of progressing from mild cognitive impairment to AD. The neuroprotective effect is attributed to the: (i) vascular properties and the reducing capacity of

ACCEPTED MANUSCRIPT inflammation and oxidative stress; (ii) contribution of vegetables, alcohol, fish and the predominance of MUFA over saturated fatty acids; and (iii) cardiovascular protection, which in turn decreases the risks for comorbidities such as hypertension, dyslipidemia coronary disease, obesity, and metabolic syndrome. Sofi, Cesari, Abbate, Gensini, & Casini, 2008, show that the meta-analysis of 12

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cohort studies with 1.5 million healthy subjects indicate a 13% reduction of Parkinson’s

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disease and AD. Because people consume a complex of nutrients, the beneficial effects

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on human health that this dietary pattern brings were analyzed as a whole, rather than focusing in the evaluation of single nutrients or in isolation.

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The capacity of the Mediterranean- like dietary pattern to decrease incidence of AD due to apparent complexity and interactive effect of the dietary constituents was also

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revised in community-based non-demented individuals in New York. The prospective evaluation was done every 1.5 years, and its outcome showed that the higher adherence

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associated with lower risk of AD (Scarmeas, Stern, Tang, Mayeux & Luchsinger, 2006). According to Romagnolo & Selmin, 2017 and Figueiredo-Gonzalez et al., 2018a,b,

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documents also mention the preventive role against cognitive decline obtained by the content of phenols in Extra Virgin Olive Oil. Similarly, their addition as dietary

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supplementation with oleuropein aglycone in a rodent model has improved learning and synaptic functions. More recently, researchers measured and contrasted changes in brains of individuals who ate a Mediterranean diet and a Western diet over a 3- year period. At the beginning of the study, brain scans of the Western diet group already showed early development of dementia: with more beta-amyloid deposits and lower energy use, which is considered as sign of lowered brain activity. Both situations increased with time, and the research finally estimated that it is possible to delay AD’s

ACCEPTED MANUSCRIPT progression up to 3.5 years for people who extensively follow a Mediterranean- like dieting (Berti et al., 2018). The Mediterranean-DASH Intervention for Neurodegenerative Delay diet, or more commonly, the MIND diet, combines the portions of the DASH diet (Dietary Approaches to Stop Hypertension) and the Mediterranean diet. Both, the DASH and

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Mediterranean diet have been shown to improve cognition; however, neither were

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developed to slow neurodegeneration (e.g. Alzheimer's disease) (Morris, 2016).

5. Dietary patterns in Japan

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There is a growing interest within Japanese population for nutritive roles of their

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diet on the health and wellbeing. For years, the Japanese population has been known for having the longest life expectancy in the world, with food being the key factors associated with longevity of the population. This was documented by Dietary Intake

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Reference Guide (RID) where lower mortality rates were associated with Japanese

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dieting (Htun, Suga, Imai, Shimizu, & Takimoto, 2017; Kurotani et al., 2016). The individuals with closer adherence to the Japanese dietary guidelines had a lower risk of

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death from all causes, mainly cardiovascular disease, and particularly cerebrovascular disease. Their findings suggest that balanced consumption of energy, grains, vegetables, fruits, meat, fish, eggs, soy products, dairy products, confectionaries, and alcoholic beverages can contribute to longevity by decreasing the risk of death, predominantly from cardiovascular disease, in the Japanese population. The Ministry of Health, Labor and Welfare of Japan (MHLW), which is in fact responsible for the developing of the Food Guide of Japan, implemented in the act of Health Promotion No. 430, paragraph 1, the main health promoting goals as:

ACCEPTED MANUSCRIPT "The extension of healthy life expectancy and the reduction of health disparities", and "the approach to the problems associated with the rapid aging of the population."

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Alzheimer's Disease International (2015) provides a broad overview of the situation for populations over 60 years of age and the estimated preliminary prevalence

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of dementia in the World (Alzheimer’s Disease International, 2015). Their official data

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reports that East Asia, including China, Mongolia, North and South Korea, and Japan, has a dementia prevalence of 4.5%, lower comparing to the 6.4% prevalence of the

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Americas (Honyashiki et al., 2009).

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By investigating the relationship between the Annual National Health Survey and the Annual Nutritional Survey, Htun et al. (2017) identified three different patterns

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of dietary intake in the study population: “Traditional Japanese”, “Westernized” and “Meat and Fat”. Traditional Japanese diet consisted ma inly of miso soup, soy sauce,

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fresh vegetables and fruits, legumes and potatoes. Furthermore, with predominance in proteins, omega 3 and 6 fatty acids, dietary fibers, vitamins A, D, B1 , B2 , B6 , B12 , C, and

2017).

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folates. Diet also had minerals such as sodium, potassium, calcium and iron (Htun et al.,

5.1. Japanese Food Guides In 2007, researchers from the National Institute of Health and Nutrition (Tokyo), the University of Nutrition (Saitama) and the MHLW, described the Dietary Guidelines presented in Japan in 2005. The MHLW and the Ministry of Agriculture, Forestry and Fisheries (MAFF) developed the Food Guide of Japan to implement the basic principles of a healthy diet (Yoshiike, Hayashi, Takemi, Mizoguchi, & Seino, 2007). The main

ACCEPTED MANUSCRIPT advantage of this model was stating food quantities for dishes that eased estimate of daily consumption. At the top are predominant foods in diet, i.e. dishes based on cereals (rice, bread, noodles). Vegetable-based dishes (e.g. salads, cooked vegetables, and soups) then fish, eggs, and meat dishes follow them. While in the lower part, are dairy and fruits. The guide also contains recommends for drinking water or tea. Interestingly,

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the model’s central axis implies that equilibrium is achieved only by rotation, which

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promotes physical activity (FAO, 2018). The basic total energy intake is 2100 kcal with

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slight variations that account for sex difference and lifestyle, i.e. boys and girls over 6 years of age, adult women with moderate- high physical activity, and sedentary adult

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men.

Generally, in Western societies fruits and vegetables are grouped into one

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category. In Japan, due to the sporadic consumption of fruits as desserts or snacks they are not considered part of the meals, so they are categorized separately from vegetables.

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Similarly and despite of the protein content, milk is in a different category from fish and

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meat, since it does not accompany meals (Yoshiike et al., 2007). The main purpose of the spinning top is to expose dishes and foods that are

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directly consumed. Hence, fats, oils, sugars, and salt are not included in the illustration, as it is important to ensure the reduction of its use by both, in the kitchen and on the table. As for processed snacks, jams and sugary drinks, it was difficult to set a consumption limit. So to prevent excessive intake it was simply stated to "enjoy snacks, sweets and drinks in moderation" (Yoshiike et al., 2007). The Japanese dishes from the guide were selected out of database of around 100 options, and extracted from the National Nutrition Survey. The classification of the food groups is based on the Standard Tables of Food Composition of Japan. Having a variety of main ingredients, the amount to be consumed per day for each group is expressed

ACCEPTED MANUSCRIPT with the total number of servings. This way it accounts for the fact that the food consumption differs for each person throughout the three daily meals (breakfast, lunch and dinner), which is why the spinning top does not indicate the servings to be consumed per meal (Figure 1a).

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5.2. Traditional Japanese Diet The MAFF proposes the term "Washoku" for traditional Japanese diet to

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acknowledge both, the Japanese-style cuisine and the customs related to Japanese food.

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The basic structure of the Washoku has soup and three plates with rice, accompaniments and pickles. This symbolizes the traditional meals in Japan that are currently undergoing

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a dramatic change due to the influence of the dietary customs of the Western society,

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characterized by a higher consumption of bread, dairy products and fats such as butter and margarine, in addition to jams, and with less rice and miso soup. Additionally, it represents an increasing negligence of the population regarding importance of what they

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consume or consuming homemade meals. There are three main elements in traditional

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Japanese diet (Figure 1b), namely groceries, food preparations, and nutrition (MAFF, 2018; Htun et al., 2017).

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5.3. Groceries

The country's agriculture offers a very wide variety of rice, vegetables, wild edible plants and mushrooms. Around 150 varieties of fruits and vegetables are available, as well as cereals, potatoes, legumes, etc. It is also estimated an annual consumption of fish of 57 kg per person, which places Japan on the high sixth place worldwide, that probably leans to three thousand years old tradition. This also accounts the Japanese Wagyu meat, with a fat distribution among the muscle fibers in marbled form that gives a particular texture and flavor where the main ingredients are vegetables, fish, and seafood (MAFF, 2018; Htun et al., 2017).

ACCEPTED MANUSCRIPT 5.4. Food preparations Commonly, the meals are made up from raw ingredients. These preparations generally are low in fat and characterized by the traditional umami flavor. This flavor is naturally found in tomatoes and fermented cheeses, but can also come from dehydrated ingredients, as fermented miso, soybean paste, and soy sauce (MAFF, 2018; Htun et al.,

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2017).

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5.5. Nutrition

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The traditional Japanese diet is considered low in calories due to the

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predominance of vegetables, fish, meat and rice, but with a high availability of nutrients that ensures an excellent nutritional balance, which is why it is recognized worldwide as

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a healthy diet. Analyzing the total intake of energy and fats, in the Japanese-style diet is significantly lower than in the Western diet, because of the absence of red and

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processed meats, whole milk products, refined grains, sugary and alcoholic drinks, candy or sweets. And all this added to the higher supply of fruits, vegetables, products

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derived from whole grains and fish (MAFF, 2018; Zhang et al., 2016). The traditional Japanese diet has 60% carbohydrates, 15% proteins, and 25%

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fats. The main course usually contains a soup, substantial portion of fish, meat or tofu (as a protein source), and potatoes with other vegetables. Healthier alternatives combine grilled fish, steamed vegetables, raw green leaves with miso soup (MAFF, 2018). The Japanese diet tends to have a higher glycemic index and load than Western diets, mainly due to the consumption of white rice, bread, pasta or jams. However, the intake of integral varieties is prioritized to increase the supply of dietary fiber and slow down digestion, indirectly reducing snacks throughout the day. This is why obesity does not tend to be a common issue with traditional food. Rice contains mainly

ACCEPTED MANUSCRIPT carbohydrates, but also proteins, iron and vitamins B1 and E (MAFF, 2018; Murakami & Satoshi Sasaki, 2018). Another aspect is related to the consumption of green tea after meals, before physical activity, to quench thirst or even before sleep. Tea leaves are used not only for infusions but also as cooking ingredients, providing more nutrients and BACs than the beverage itself, such as proteins, free aminoacids, carbohydrates,

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lipids, vitamins, xantic bases, minerals, phenolic and other compunds (MAFF, 2018;

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Pastoriza, Mesías, Cabrera, & Rufián-Henares, 2017). Health indicators, as increased

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average life expectancy, support recommending Japanese dietary pattern over Western food counterparts regarding their nutritional profile (Sugano & Hirahara, 2000).

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5.6. Japanese diet and neurodegenerative diseases

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5.6.1. Effects of polyunsaturated fats

Nutrients from blue fish, specifically polyunsaturated fatty acids (PUFA), increase the life expectancy and good health enjoyed by the Japanese. Nutritional studies report

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improvements of cognitive function with intake of PUFAs while their food sources

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among other blue fish are salmon, tuna, trout, as well as vegetable oils from soybeans, nuts, sunflower and flax seeds (MAFF, 2018; Wax, 2016).

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Meta-analysis associated increased fish intake and lowered risks for mild to severe cognitive impairments (dementia and AD) likely due to docosahexaenoic acid (DHA) commonly found in sea animals. Marine algae tend to synthesize large amounts of these fatty acids and form the foundation for enrichment of lipids in food chain for other marine organisms. In addition, the antioxidant properties of several seaweed extracts demonstrated anti- inflammatory and neuroprotective effects in numerous studies (Cornish, Critchley, & Mouritsen, 2017; Zhang et al., 2016). DHA is located mainly in the neuronal membrane of the brain and participates in the normal maintenance of cognitive function. The levels of DHA in the hippocampus

ACCEPTED MANUSCRIPT decrease with aging and with AD, which in turn is associated with the reduction of spatial learning memory dependent on the hippocampus (the first region to suffer the greatest damage with the disease) (Su, 2010). It has been proposed that DHA and eicosapentaenoic acid (EPA) exert a mechanism to enhance the development and maintenance of spatial learning memory performance (Su, 2010).

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Moreover, it was demonstrated that supplementation with omega 3 fatty acids in

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mice, reversed the changes related to age and maintained the performance of learning

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memory. This is due to the antioxidant, anti- inflammatory, and antiapoptotic effects of polyunsaturated fatty acids, which translate into neuronal protection in the aged and AD

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damaged brains (Su, 2010).

Other studies on hippocampal neurons suggested that increased levels of certain

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cytoskeletal proteins, because of DHA supplementation, influenced the increased resistance to the neurotoxicity induced in AD. Likely due to acting as a protective

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mechanism for inflammation and apoptosis of neurons. Supplementation with fish oil (600 mg of EPA + 1700 mg of DHA for 6-12 months) in patients with mild AD has

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shown a delay of cognitive deterioration. The n-3 PUFA has important role in cognitive performance, as higher levels of DHA in blood or at higher intake levels, reduced the

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risks for AD and cognitive impairments (Su, 2010). Furthermore, Laitinen et al. (2006) showed that even with the presence of other risk factors and the genetic susceptibility (e.g. E4 allele of ApoE), the moderate intake of PUFA in adulthood decreased the risks for developing dementia. From obtained data in Japan by the National Nutrition Survey (2000), it was calculated that consumption of 26% of total energy daily intake falls to fats; with ratios of polyunsaturated-to-saturated fatty acids of 1.2:1; and omega-6-to-omega-3 fatty acids of 4:1. This high intake of omega 3 fatty acids is justified not only by consumed fish

ACCEPTED MANUSCRIPT and seafood, but also by vegetable oils, as almost exclusively those are rapeseed and soy. This is how Japanese eating habits have introduced an important amount of n-3 PUFA into a low-fat diet (Sugano & Hirahara, 2000). It is known that chronic diseases are multifactorial and multigene, so the preventive dose of n-3 PUFA will depend on the genetic predisposition. Normally, in the brain it

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exists equitable proportions of n-3, n-6 PUFAs, DHA, and arachidonic acid (AA)

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respectively. However, studies indicate that this can be modulated through dietary

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intake, where obtained ratios from diet will influence the vital processes of brain functioning and visual acuity. The lower the omega-6-to-omega-3 ratios, the more the

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risks for having higher prevalence of pathologies common for Western societies, many directly related to the onset of AD. A clear example is the reduction of 70% of mortality

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in cardiovascular diseases with an omega-6-to-omega-3 ratio of 4:1 (Cornish et al., 2017; Simopoulos, 2002).

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To determine that diets could satisfy the nutritional requirements of n-3 PUFA, a study was conducted in the USA. Results were able to demonstrate that the intake for

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Japan (0.37% of the total energy or 750 mg/d) meets the established criteria to protect more than 98% of the risks for world population regarding cardiovascular and

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neurocognitive diseases (Hibbeln, Nieminen, Blasbalg, Riggs, & Lands, 2006). 5.6.2. Effects of antioxidants Antioxidants are additional nutrients that protect from dementia and AD. These are substances with main characteristic to avoid adverse effects of reactive species in normal physiological functions (Cornish et al., 2017; Coronado, Vega, Rey Gutiérrez, Vázquez, & Radilla, 2015; Simopoulos, 2002). Since the 80s, there have been multiple epidemiological evidences that establish relationships between insufficient intake/low biochemical levels of vitamins (considered

ACCEPTED MANUSCRIPT as antioxidants) and the deterioration of neurocognitive functions in older adults. To understand the mechanism of action of antioxidants, Engelhart et al. (2002) explained that the central nervous system in comparison with other tissues is particularly vulnerable to free radical damage due to high oxygen consumption of the brain and abundance of PUFAs with relative scarcity of antioxidative enzymes. At the same time,

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oxidative stress plays important role in the pathogenesis of AD, confirmed by oxidative

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brain damage in AD patients, identified in post- mortem experiments (Lanyau & Macías,

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2005).

Currently, both oxidative stress and inflammatory mechanisms are considered the

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main causes of brain aging. Therefore, the ideal treatment for its prevention and for several neurocognitive pathologies that arise with age is the consumption of

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antioxidants and anti- inflammatory molecules, both naturally present in food. An example is the protective effects of polyphenols from fruits, vegetables, cereals and

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seeds, also related to the modulation of the neuropathological processes in diseases, such as Parkinson's, Alzheimer's, depression, and dementia (Sarubbo, Moranta,

2005).

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Asensio, Miralles, & Esteban, 2017; Zavaleta, Muñoz, Blanco, Alvarado, & Loja,

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Miso (fermented soybean paste) is a traditional ingredient of the Japanese diet obtained from the mixture of soybean seeds with rice, wheat cereals or oats. It provides carbohydrates, polyunsaturated fatty acids, vitamins, microorganisms, salts, minerals, vegetable proteins, peptides and amino acids generated from protein hydrolysis during the fermentation process. It is marketed in different varieties and used as an essential condiment in soups and other typical foods of Japanese cuisine. While some varieties demonstrated high antioxidant activities against peroxyl, hypochlorite and peroxynitrite,

ACCEPTED MANUSCRIPT others prepared with bonito-dashi (with/without vegetables) resulted with greater antioxidant activity than the miso itself (Morikawa et al., 2014; Watanabe, 2013). The astringent bioactive component of green tea is a type of polyphenol known as catechin. Its varieties have ability to reduce blood cholesterol and moderate the absorption of fats in the body (Pastoriza, Mesías, Cabrera, & Rufián-Henares, 2017).

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Some components from tea leaves and tea drinks are presented in Figure 2. Within the

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catechins, the epigallocatechin gallate is the one with the greatest antioxidant power. In

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addition, the vitamin C provided by tea is protected from thermal degradation by the simultaneous intake of the polyphenols, which prevents the destruction of this

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antioxidant. Teas contain other phenolic compounds such as gallic, caffeic, chlorogenic or cinnamic acid, quercetin and proanthocyanidols, caffeine, theophylline, and L-

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theanine. Moreover, they also are an interesting source of minerals, such as fluorine, manganese and chromium (Pastoriza, Mesías, Cabrera, & Rufián-Henares, 2017).

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Because of these compounds, different studies have been carried out with focusing to antioxidant potential of tea and its implications for the prevention and treatment of

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degenerative diseases. Some even showed that the antioxidant capacity of green tea is even higher than in other types of tea or similar vegetables (Table 2), such as garlic,

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spinach and Brussels sprouts, or fruits such as oranges, grapes and tomatoes (MAFF, 2018.; Pastoriza, Mesías, Cabrera, & Rufián-Henares, 2017). To determine the consumption of polyphenols in Japan exclusively from beverages, a survey was conducted in Tokyo and Osaka to estimate the total of non-alcoholic beverages in daily diet. Results showed that 1.11±0.51 L/d non-alcoholic beverages is consumed with total polyphenol consumption of 853±512 mg/d. In the results, coffee constitutes 50% of the total intake of polyphenols, while tea accounts for 34%. This included different varieties of tea (black, green and oolong), and accounted for fruit

ACCEPTED MANUSCRIPT juices (including tomatoes), vegetables, and cocoa drinks. The study concluded that coffee is the main beverage in the Japanese-style diet to which the high intake of polyphenols is attributed as antioxidants (Fukushima et al., 2009). 6. Argentinean dietary patterns

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The dietary profile of the Argentine population is given by a series of particular customs that distinguishes them from the rest of Latin Americans. These habits are characterized

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by the higher consumption of animal proteins and fats, mainly from red meats

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(frequently grilled). Additional to the habitual intake of wine and the typical infusion known as "mate" with little consumption of fish, fruits and vegetables (Pou et al., 2014).

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Currently there is no official information regarding the typical dietary patterns for

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total population or studies about the habitual food consumption in Argentina, however indirectly the foods that make up the national diet can be identified thanks from food balance sheets of the FAO. Meat is the predominant source o f proteins, coinciding with

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the Western diet. Bread, flours, noodles, rice and potatoes are main sources of

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carbohydrates with consumption of fats from milk, cheese, sunflower oil, butter, lard, and leafy vegetables, oranges, apples, bananas, tomatoes, and wine (Pou et al., 2014).

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CESNI, through the Household Surveys, provided more accurate data about the characteristic diet of Argentinians,

and

its association with the onset of

neurodegenerative pathologies. CESNI is a non-profit civil association dedicated to research and education in Child Nutrition in the country, created in 1976 by the pediatrician Alejandro O'Donnell. The CESNI research is titled "The Argentine table in the last two decades: changes in the food and nutrient consumption pat terns 19962013,” (Zapata, Rovirosa, & Carmuega, 2013). The study showed that traditional Argentinian diet consists of fresh, minimally processed or prepared at home food, with steady increase of consumption of highly

ACCEPTED MANUSCRIPT processed foods. This means a deterioration of dietary quality in relation to lower consumption of dietary fibers and vitamins A and C, with increase of saturated fats. According to obtained data, an average caloric intake per individual was 2026 kcal per day, with distribution of macronutrients shown on Figure 3a. From the analyzed surveys, it was found that less than ten foods contribute to the half

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of the daily calories, namely: bread, sunflower oil, beef, sugar, noodles, rice, wheat

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flour, sweet cookies, and sugary drinks. Figure 3b illustrates distribution of the

little contribution to the daily caloric intake.

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different food groups in the total daily consumption, where fruits and vegetables have

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Further, Figure 3c indicates the contribution of the different types of fatty acids in the diet. The intake of saturated fats, as detailed in Figure 3d, slightly exceeds the limit

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recommended by FAO (10% of daily calories), which is attributed mainly to the consumption of foods of animal origin or to their use in processed food products. This

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includes sausages, cold meats, dressings and prepared meals. The apparent consumption of trans fat with <1% of the total energy value comes from the use of the bovine fat

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contained in bakery, pastry and cookies. Additional to the use of partially hydrogenated vegetable oil in industrial food production, despite the implemented initiative in the

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country to avoid its addition. The intake of cholesterol is estimated at 266 mg/day. Regarding carbohydrates, 18% of total kcal comes from sugars, of which 13.4% are free, yet another value that exceeds the recommended WHO limits. The main contributors are sugars, candies, sweets, bakery, and cookies, followed by sweetened drinks and milk, and finally fruits. The intake of dietary fibers from vegetables, fruits and legumes reaches only half of the daily recommendations. In general, with this dietary pattern it is virtually imposable to satisfy the daily needs for vitamins, hence

ACCEPTED MANUSCRIPT fortified drinks act as main contributors of vitamins e.g. for vitamin C (Zapata et al., 2013). Sodium is highly consumed nutrient originated from higher consumption of bakery, cookies, canned meats and sausages. Table salt contributes to the half of the sodium daily intake (estimated 3338 mg/day), while the rest is attributed to the aforementioned

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products. Folate is the only nutrient that doubles the nutritional recommendations that

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originates from enriched wheat flours due to legal requirements for prevention of neural

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tube defects in pregnancy (Zapata et al., 2013). 6.1. Food Guides

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In 2016, The National Ministry of Health coordinated the last update of the Dietary

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Guidelines for the Argentinian Population, with CESNI participation as the External Committee of Experts. The proposed food guide model was used from the Nutrition Institute of Central America and Panama (INCAP). The model consists of 10 messages

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with a graphic image, where general objective is improvement of lifestyle habits,

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physical activity, and food consumption of the population. Adult woman with energy requirement of 2000 kcal/per day, distributed as 55% of carbohydrates, 15% of proteins

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and 30% of fats was taken as a unit of measure for the food plan (Hansen, 2016). The new food guides aim to: (i) encourage the choice of a healthier diet composed of locally produced foods while accounting for the available economic resources and seasonality.; (ii) provides the basis for the planning and evaluation of social, food and nutrition programs; (iii) directs food industry for preparation of foods with a better nutritional profile. The Daily Food Chart represents the proportion of the different food groups within a circle, while the center aims to highlight the importance of "safe" water consumption. The recommended daily amounts are based on proportions with their distribution from

ACCEPTED MANUSCRIPT Table 3. The incorporation of optional foods was stated according to the customs and culture of the Argentine population. However, it is intended to acknowledge cultural differences in nation with moderate consumption, so the red color of the tools tries to discourage their consumption (Hansen, 2016).

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6.2. Saturated and trans fats and onset of neurodegenerative diseases Saturated and trans- fats are responsible for the increase of blood LDL cholesterol, while

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decreasing the HDL. These fatty acids originate from meat (mainly red), milk and milk

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products, such as butter and cream, ice cream, dressings, mayonnaise, bakery, and cookies. Trans- fatty acids also those originated from the hydrogenation of vegetable oils

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that is a common process used for the preservation of fresh foods (Martin, 2018).

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Older data show an important intake of trans-fatty acids from foods consumed by young Argentinians, reaching an average of 7,2 g/day in the year 2000 These foods also include some promoted as “low cholesterol,” such as margarines, shortenings,

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mayonnaises, sweet and salty cookies, “alfajores,” snacks (e.g. chips, corn sticks, and

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cereal bars). Due to the evident influence on genesis of chronic diseases (particularly cardiovascular), the industry replaced up to 70% of the partially hydrogenated oil on t he

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market. The low consumption of omega-3 polyunsaturated fatty acids was also determined, which resulted in an unwanted omega-6-to-omega-3 ratio (Peterson et al., 2006; Tavella, Tavella, Gamboa-Santos, Lamelo, & Mastroianni, 2016). More recently, Common Market of the South (MERCOSUR) initiated food labeling with specific information of the content of saturated and trans- fatty acids on the nutritional label. However, this excluded the bakery products (e.g. cookies) that have tendency to increase (with exception to baguettes) the contents of saturated and transfatty acids in daily diet (Negro et al., 2017). Furthermore, several studies documented relationship between the food consumption and chronic diseases. Here higher intake of

ACCEPTED MANUSCRIPT "snacks", refined grains, starchy vegetables and sodium, with lower intake of yogurt, milk, and whole grains, was positively associated with the pre valence of obesity in the city of Córdoba (Aballay, Osella, De La Quintana, & Diaz, 2016). The genetic predispositions for individuals with AD are found on the E4 allele of ApoE. This lipoprotein carrier is the major cause of genetic susceptibility for AD, and

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the main physiological point for roles that intake of fats has on the brain. ApoE and

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other lipid carriers, indicating that the ApoE genotype may influence β-amyloid pathogenesis, transport the β-amyloid peptide, which is involved in the pathogenesis of

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AD. However, even in the absence of β-amyloid, the E4 allele of ApoE modulates other

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risk factors for the disease. For instance, it influences the response to head injuries and the compensatory process that is generated,

as well as other significant

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pathophysiological mechanisms for AD, such as cholesterol metabolism, oxidative damage, and inflammation (Cole et al., 2010).

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The association between saturated fat consumption and dementia was examined with variable results. Several prospective observational studies reported relationship between

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the intake of saturated fats and the risk of cognitive disorders. The results of the systematic review by Barnard et al. (2014) are shown in Figure 4.

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Laitinen et al. (2006) monitored the intake of dairy products in adulthood with 21 years follow- up. Results showed that the consumption of saturated fats was positively associated with the increased risk of dementia, but only in subjects with E4 allele of ApoE. It was concluded that a moderate intake of saturated fats during adulthood might increase the risk for both dementia and AD, especially in carriers of the E4 allele. Thus, well-targeted dietary interventions could potentially lower this risk, particularly in genetically susceptible individuals.

ACCEPTED MANUSCRIPT The experimental murine models targeting consequences of high fat consumption and cognitive defects resulted with series of cognitive abnormalities, together with impairments in the insulin-signaling pathway in the hippocampus, alterations in the peripheral glucose and insulin metabolism, and memory losses (Petrov et al., 2015). In transgenic animals predisposed for development of AD, there was a significant

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deterioration of the phenotype, both in the periphery and in the hippocampus. The

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results of this study finally associated metabolic syndrome, diabetes and underlying

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comorbidities with a significant deterioration of the AD symptoms. 7. Discussion

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The expansion of the Western diet is spreading worldwide and results with promoting

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intake of total fats (particularly saturated) in the daily intake of people who brace it. This is accompanied by the higher consumption of refined carbohydrates and the lower intake of vegetables, causing diet to become a risk factor for obesity, cardiovascular

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diseases, cancer, diabetes, and neurodegenerative disorders. The nutritional transition of

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the Latin American nations that incorporate unhealthy habits becomes evident. This factor introduces a profound epidemiological problem, since it allows the unleashing the

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series of pathologies that impair health in the short and long term (Freitas, Ferreira, Trevenzoli, Oliveira, & de Melo Reis, 2017). Nutritional epidemiology studies relationship that foods and their components have on the onset of different diseases and other co-morbidities. This requires the research of dietary patterns in communities, accounting for the complexity and synergistic effects of diet with other characteristics useful to determine the positive or negative impacts on the lifestyle of population (Medina-Remón, Kirwan, Lamuela-Raventós, & Estruch, 2018).

ACCEPTED MANUSCRIPT Figure 5 gives summary of the preventive effects from consumption of antioxidants and omega-3 PUFAs regarding the cognitive deterioration. These nutrients cause the increase of certain cytoskeletal proteins in hippocampal neurons, which ultimately potentiates the resistance to the neurotoxicity that is induced in AD (Su, 2010). The process where the consumption of saturated fats and trans-fats would favor the

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appearance of neurodegenerative pathologies is shown on Figure 6. The E4 allele of

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ApoE lipoprotein carrier is the genetic risk factor for AD, which may or may not be

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present for the onset of disease. The environmental or lifestyle risk factors in this case are the higher intakes of saturated and trans- fats through diet. Due to nutrients that can

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directly influence the development of the pathogenesis (through oxidative damage) or to provoke onsets of the other diseases that are indirectly associated with the development

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of AD (Cole et al., 2010).

The identification of foods and their components from different diets that may

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influence increased/decreased risks for development of senile dementia and AD was reported here. This gives foundation for comparison of the benefits and the damages

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derived from various dieting patterns. This also may help implicating the "protective" diets, such as the Mediterranean and the Traditional Japanese, and those with "risky"

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patterns, as it is the food consumption in Argentina. Table 4 reflects some parameters of the Dietary Guidelines of Japan, Spain and Argentina, to find contrasts and similarities in food-nutritional recommendations that may be related to cognitive disorders, as well as verifying the follow-up of them in the case of the Argentine population (Cole et al., 2010; Engelhart et al., 2002; Otsuka, 2016). Frequently consumed foods (or lack of them) reveal the predominance or insufficiency of nutrients in the particular diet. In the Japanese Traditional Diet, consumption of fish and shellfish is responsible for the higher contribution of EPA and

ACCEPTED MANUSCRIPT DHA. Usually consumed raw or steamed vegetables, miso soup and infusions, are responsible for the higher antioxidant intake. Foods rich in saturated fat such as red meat, snacks and fats themselves are not part of the population's usual consumption (Hibbeln et al., 2006; MAFF, 2018; Sugano & Hirahara, 2000). For the Mediterranean Diet, PUFAs, MUFAs, dietary fibers, and antioxidants

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predominate, originate from consumption of whole grains, fish, fresh vegetables, fruits,

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nuts, and moderate intake of red wine. Additionally, red meats, whole milk products,

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refined grains, fats and sugars are consumed in reduced amount (Aranceta Batrina et al., 2016; Romagnolo & Selmin, 2017).

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On the other hand, and despite the recommendations of the Dietary Guidelines, the dietary patterns of Argentines are largely opposite to the previous diets. Argentinian diet

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contains high consumption of red and processed meats, snacks, bakery products, pastry dough, fats spreads, sweets, and sugary drinks, with lower consumption of fish, fruits,

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vegetables that essential foods of the Japanese and Mediterranean Diets (Aballay et al., 2016; Aranceta Batrina et al., 2016; Tavella et al., 2016; Zapata et al., 2013).

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Comparing recommendations from Argentinian Dietary Guidelines (Hansen, 2016)with actual food consumption (Zapata et al., 2013), results showed excessive

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consumption of cereals/bread/starchy vegetables, meats, eggs, and optional foods, e.g. fats, oils, sugars and sweets (Figure 7). At the same time, caloric contributions of fresh vegetables and fruits in their diet are minimal as compared to the daily recommendation of 16% of the total kcal. Similarities of Japanese and Argentinian Dietary Guidelines relate to reduced quantities of milk or yogurt to no more than 200 mL/day, or in its replacement with portion of cheese in Japan. Similarly in Argentina, total of 2-3 servings are proposed, each with 200 mL of milk, 125 g of yogurt or a small slice of cheese, all with

ACCEPTED MANUSCRIPT emphasizing the preference for skimmed alternatives. For meats and eggs, Japan stipulates the ideal consumption of 3-5 servings/day, with mostly fish and other vegetable (e.g. tofu, natto, and soybeans) as a source of proteins, instead of red meat. Argentineans propose eating a serving of meat with the size of the hand palm, with frequency of fish consumption to twice or more times per week. Furthermore, twice per

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week it is recommended to eat white meats, while the red ones should be consumed up

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to three times in a week. The statistical data revealed this consumption is inversed as the

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red meats predominate (Table 5), and the contribution of fish is actually minimal (Hansen, 2016; Yoshiike et al., 2007).

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8. Conclusions

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The mechanisms that influence the development of senile dementia and AD are associated with intake of antioxidants and omega-3 polyunsaturated fatty acids from daily diet. Their consumption potentiates the resistance to the neurotoxicity that is

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induced in AD, improves the performance of learning and memory, increases neuronal

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protection, and decreases the risk of dementia even for genetically susceptible individuals. The neuroprotective effect is attributed to the reducing capacity of

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inflammation and oxidative stress, and to the cardiovascular protection that decreases the comorbidities associated with cognitive disorders. The higher consumption of saturated fats and trans- fats contributes to the oxidative damages and the inflammatory processes that are part of the pathogenesis of AD, in addition to triggering other associated pathologies. Longevity and high quality of life of the Japanese is attributed to the predominance of fish and seafood, vegetables and traditional preparations such as miso soup and tea, in their diet that provides high contribution of antioxidants and omega-3 fatty acids. The Mediterranean diet is recognized for its preventive effects against chronic diseases and

ACCEPTED MANUSCRIPT for the reduction of the incidence of AD, thanks to the important inclusion of fish oil, olive oil, vegetables and fruits, cereals and legumes, as well as red wine in moderation. These dietary patterns ensure the contribution of PUFAs, MUFAs, and antioxidants, while minimizing the contribution of saturated fats from red meat. The diet of Argentines contains risk factors for cognitive disorders and AD, as a result of the higher

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consumption of red and processed meats, snacks, pastries and pastry dough, spreads and

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other products rich with saturated and trans fats. The higher consumption of sweets and

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sugary drinks with insignificant contribution of fish, fruits and vegetables poses risk factors for metabolic diseases or for other diseases. Literature implies that both,

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Japanese and Mediterranean Diets have preventive potential for the development of senile dementia and AD, while the Argentinian diets can foster onsets of such neural

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morbidities.

High consumption of plant foods (fruits, vegetables, pulses, cereals, nuts and seeds);

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moderate consumption of fish, seafood, yogurt, cheese, poultry and eggs; and low consumption of red meat and processed meat products; together with high consumption

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of dietary fiber, low glycemic index and glycemic load, anti- inflammatory effects, and antioxidant compounds, may act together to produce favorable effects on health status.

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Collective evidence suggests that this diet not only increases longevity by lowering cardiovascular disease, inhibiting cancer growth, but also by protecting the body from age-dependent cognitive decline. This diet also suppresses oxidative stress and neuroinflammation in neurodegenerative diseases as well as signal transduction. There are, however, diet-related factors in plant foods that affect bioavailability include: the chemical form of the nutrient in food and/or nature of the food matrix; interactions between nutrients and other organic components (e.g. phytate, polyphenols, dietary fiber, oxalic acid, protein, fat, ascorbic acid); pretreatment of food as a result of

ACCEPTED MANUSCRIPT processing and/or preparation practices. Consequently, household strategies that reduce the content or counteract the inhibiting effects of these factors on micronutrient bioavailability are urgently needed in developing-country settings. Examples of such strategies include germination, microbial fermentation or soaking to reduce the phytate and polyphenol content of unrefined cereal porridges used for young child feeding;

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addition of ascorbic acid-containing fruits to enhance non-haem-Fe absorption; heating

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to destroy heat- labile anti- nutritional factors (e.g. goitrogens, thiaminases) or disrupt

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carotenoid-protein complexes. Such strategies have been employed in both experimental isotope-absorption and community-based studies. Increases in Fe, Zn and Ca absorption

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have been reported in adults fed dephytinized cereals compared with cereals containing their native phytate. In this way, when considering diet neuroprotective effects, food

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processing, bioactives bioavailability and mechanistic interactions with diet matrix are

Acknowledgements

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aspects to be considered.

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2017/18.

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Diana Denise Dohrmann holds an award from ERASMUS+ TRAINEESHIP program

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Murakami, K., & Sasaki, S. (2018). Glycemic index and glycemic load of the diets of Japanese adults: the 2012 National Health and Nutrition Survey, Japan. Nutrition, 46, 53–61. Otsuka, M. (2016). Prevention of Alzheimer´s disease and nutrients. Brain Nerve, 68(7), 809–817. Pastoriza, S., Mesías, M., Cabrera, C., & Rufián-Henares, J. A. (2017). Healthy properties of green and white teas: An update. Food and Function, 8(8), 2650–2662. Peterson, G., Aguilar, D., Espeche, M., Mesa, M., Jáuregui, P., Díaz, H., … Tavella, M. (2006). Trans fatty acids consumption in young people at Argentina. Revista Chilena de Pediatria, 77(1), 92–101. Petrov, D., Pedrós, I., Artiach, G., Sureda, F. X., Barroso, E., Pallàs, M., … Camins, A. (2015). High- fat diet- induced deregulation of hippocampal insulin signaling and mitochondrial homeostasis deficiences contribute to Alzheimer disease pathology in rodents. Biochimica et Biophysica Acta - Molecular Basis of Disease, 1852(9), 1687–1699. Pou, S. A., Niclis, C., Aballay, L. R., Tumas, N., Román, M. D., Muñoz, S. E., … Díaz, M. P. (2014). Cancer and its association with dietary patterns in Cordoba (Argentina). Nutricion Hospitalaria, 29(3), 618–628. Reitz, C., Brayne, C., & Mayeux, R. (2011). Epidemiology of Alzheimer disease. Nature Reviews. Neurology, 7(3), 137–52. Romagnolo, D. F., & Selmin, O. I. (2017). Mediterranean Diet and prevention of chronic diseases. Nutrition Today, 52(5), 208–222. Sarubbo, F., Moranta, D., Asensio, V. J., Miralles, A., & Esteban, S. (2017). Effects of Resveratrol and Other Polyphenols on the Most Common Brain Age-Related Diseases. Current Medicinal Chemistry, 24(38), 4245–4266. Scarmeas, N., Stern, Y., Tang, M., Mayeux, R. & Luchsinger, J. A. (2006). Mediterranean diet and risk of Alzheimer’s Disease. Ann Neurol, 59(6): 912-921. Simopoulos, A. P. (2002). The importance of the ratio of omega-6/omega-3 essential fatty acids. Biomedicine & Pharmacotherapy, 56(8), 365–379. Singh, B., Parsaik, A., Mielke, M., Erwin, P., Knopman, D., Petersen, R., & RO, R. (2014). NIH Public Access, 39(2), 271–282. Sofi, F., Cesari, F., Abbate, R., Gensini, G. F., & Casini, A. (2008). Adherence to Mediterranean diet and health status, 1–7. doi:10.1136/bmj.a1344 Su, H.-M. (2010). Mechanisms of n-3 fatty acid- mediated development and maintenance of learning memory performance. Journal of Nutritional Biochemistry, 21(5), 364–373. Sugano, M., & Hirahara, F. (2000). Polyunsaturated fatty acids in the food chain in Japan. American Journal of Clinical Nutrition, 71(1 SUPPL.), 189S–196S. Tavella, M. V, Tavella, J. M., Gamboa-Santos, J., Lamelo, M. J., & Mastroianni, M. (2016). Towards a trans fat free Argentina. Revista Chilena de Nutricion, 43(4), 408– 415. Watanabe, H. (2013). Beneficial biological effects of miso with reference to radiation injury, cancer and hypertension. Journal of Toxicologic Pathology, 26(2), 91–103. Yegambaram, M., Manivannan, B., Beach, T. G., & Halden, R. U. (2015). Role of environmental contaminants in the etiology of Alzheimer’s disease: A review. Current Alzheimer Research, 12(2), 116–146. Yoshiike, N., Hayashi, F., Takemi, Y., Mizoguchi, K., & Seino, F. (2007). A New Food Guide in Japan: The Japanese food guide spinning top. Nutrition Reviews, 65(4), 149–154.

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Zapata, M. E., Rovirosa, A., & Carmuega, E. (2013). La mesa argentina en las últimas dos décadas: cambios en el patrón de consumo de alimentos y nutrients 1996-2013. CESNI. Internet: http://www.cesni.org.ar/archivos/biblioteca/LA-MESAARGENTINA-EN-LAS-ULTIMAS-DOS-DECADAS.pdf Zavaleta, J., Muñoz, A. M., Blanco, T., Alvarado, C. O., & Loja, B. (2005). Capacidad antioxidante y principales ácidos fenólicos y flavonoides de algunos alimentos. Centro de Investigación En Bioquímica y Nutrición de la Facultad de Medicina Humana, USMP, 5, 12. Zhang, Y., Chen, J., Qiu, J., Li, Y., Wang, J., & Jiao, J. (2016). Intakes of fish and polyunsaturated fatty acids and mild-to-severe cognitive impairment risks: a doseresponse meta-analysis of 21 cohort studies1–3. The American Journal of Clinical Nutrition, 103(2), 330–340.

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Figure captions: Figure 1. A) Intake of nutrients expressed in number of servings. Adapted from Yoshiike et al. (2007). B) Graphic representation of the Japanese Traditional Diet. Adapted from MAFF (2018). Figure 2. Compounds found in white Oolangcha tea infusion vs green Genmaicha tealeaves. Adapted from MAFF (2018).

RI

PT

Figure 3. Percentage distribution of A) macronutrients in average daily intake per capita, period 2012-2013 and B) food groups in average daily intake per capita, period 2012-2013. Percentage of C) fatty acids in the daily diet per capita, period 2012-2013 and D) of food groups that contribute to the saturated fatty acids intake. Adapted from Zapata et al. (2013).

SC

Figure 4. Results of prospective observational studies to determine the association between saturated fat intake and the risk of developing neurodegenerative disorders. Adapted from Barnard et al. (2014).

NU

Figure 5. Mechanism of action of the nutritional components that prevent senile dementia and Alzheimer's disease. Adapted from Sarubbo et al. (2017); Su (2010); Zavaleta et al. (2005)

MA

Figure 6. Possible influence of fats on the appearance of neurocognitive diseases. Adapted from Cole et al. (2010); Petrov et al. (2015)

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Tables legends:

ED

Figure 7. Real intake of food groups in comparison with the actual recommendations of the Dietary Guidelines for the Argentine Population. Adapted from Hansen (2016); Zapata et al. (2013).

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Table 1. Genetic and environmental factors that influence on the development of Alzheimer's disease. Adapted from Lanyau Domínguez & Macías Matos (2005); Reitz et al. (2011); Yegambaram et al. (2015). Table 2. Benefits of the consumption of green and white tea for their content in catechins and other flavonoids, related to the development of dementia and Alzheimer's disease. Adapted from Pastoriza et al. (2017) Table 3. Percentage of calories that food groups should represent, servings and equivalents according with the Dietary Guidelines for the Argentine Population. Adapted from Hansen (2016). Table 4. Recommendations from Dietary Guidelines for Japanese, Spanish and Argentineans populations. Table 5. Food quantities recommended by the Dietary Guidelines for the Argentine Population and the Dietary Guidelines for the Japanese Population. Adapted from Hansen (2016); Yoshiike et al. (2007).

ACCEPTED MANUSCRIPT Table 1. Genetic and environmental factors that influence on the development of Alzheimer's disease. Adapted from Lanyau Do mínguez & Macías Matos (2005); Reitz et al. (2011); Yegamb aram et al. (2015). Conditi ons that favor Potential risk factors

Protective factors development

Age (> 65 years old)

Consumption

Female

of

history

Low educational level

of

antioxidants (Mediterranean Diet

dementia

and Traditional Japanese Diet); Birth order

Carrier of the E4 allele

exposures;

occupational exposure

to

aluminum in water consumption Down’s Syndrome

moderate

alcohol

consumption.

NU

of Apolipoprotein E

Some

to

SC

light

RI

Family

PT

polyunsaturated fatty acids and

Physical

activity,

MA

especially aerobic.

Smoking, alcoholism

ED

Cran ioencephalic

Higher educational level

traumatisms

Stimu lating

Depression,

EP T

activities.

AC C

psychological stress

Cerebrovascular

diseases, hypertension, diabetes mellitus type 2, mo rbid obesity, dyslipidemias, syndrome

and

metabolic

cognitive

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Table 2. Benefits of the consumption of green and white tea for their content in catechins and other flavonoids, related to the development of dementia and Alzheimer's disease. Adapted from Pastoriza et al. (2017) Activity

T P

Benefit effect

↔ transcription factors

↓ oxidative processes

↑ chelating action of iron and copper

↓ cell damage caused by free radicals

↑ antioxidant enzymes activity

↑ total antioxidant capacity of the plasma

↑ expression of genes related to antioxidant capacity

↓ oxidative stress associated with brain damage ↓ cell aging

A M

(Cabrera & Giménez, 2010; Carloni et al., 2013; Chung, Schwart z, Herzog & Yang, 2003; Dai et al., 2017; Hilal & Engelhardt, 2007; Winiarska-Mieczan, 2015).

C S

U N

↓ prooxidant enzymes activity

I R

References

(Almajano, Vila & Gines 2011; Espinosa et al., 2014; Winiarska-Mieczan, 2015).

↓ Alzheimer’s, Parkinson’s and Huntington’s disease

D E

↑ antithrombotic and anti-inflammatory action

↓ cardiovascular risks and strokes

↓ total cholesterol and LDL in blood

↓ arterial hypertension

↓ cholesterol oxidation in blood

↓ atherosclerosis

↑ vasodilation and protection in endothelial diffusion

C A

↓ adipocyte proliferation and differentiation ↑ lipogenesis ↑ body weight loss ↑ leptin release ↑ β oxidation and thermogenesis

T P

E C

↓ micellar solubility of intestinal cholesterol

(Tian et al., 2016; Yarmolinsky, Gon & Edwards, 2015).

↓ intestinal cholesterol absorption ↓ arterial hypertension

(Swen, 2007; Yang & Wang, 2016).

↓ risk of obesity and metabolic syndrome

(Amiot, Riva & Vinet, 2016; Boschmann & Thielecke, 2007; Gon zález-Castejón & Rodríguez-Casado, 2011; Hara, 2011; Nagh ma & Mu khtar, 2007; Su zuki, Perv in, Goto, Isemura & Nakamu ra 2016; Richard et al., 2009; Türközü & Tek 2017).

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↓ enzymatic activities of α amylase y α glucosydase

↔ blood glucose

↑ insulin sensivity

↔ postprandial hyperglycemia

↑ activation of the insulin signaling pathway

↑ glucose tolerance

(Alves et al., 2015; Cabrera & Giménez, 2010; Sabu, Smitha & Ramadasan, 2002; W. Swen, 2007; Yi, Zhu, Fu & Li, 2010; Yilmazer-Musa et al., 2012).

T P

↑ increase / ↓decrease / ↔ regulation

I R

C S

U N

D E

T P

C A

E C

A M

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Table 3. Percentage of calories that food groups should represent, servings and equivalents according with the Dietary Guidelines for the Argentine Population. Adapted fro m Hansen (2016). % of total kcal 16 30.3

15.5

11.2

13.5

13.5

Groups

Daily servings

Vegetables and Fruits

5

Cereals, Legumes, Potato*, Bread and Pasta

4

Milk, Yogurt and Cheese

3

D E

Oil, Nuts and Seeds

T P

E C

Optional foods**

T P

½ plate of vegetables / 1 small fruit

A M

I R

C S

U N

Meats and Eggs

Equivalent of one serving

1

60 g of bread or 125 g of legumes, cereals, potato or cooked pasta 1 cup of milk, 1 pot of yogurt, or 1 small slice of fresh cheese 130 g of meat (raw N. W.) or the size of the hand palm and 25 g or ½ unit of egg

3

1 tbsp. of oil, 1 handful of nuts or 1 tbsp. of seeds

Optional and moderated

-

C A

N.W. (Net Weight) / tbsp (table spoon)

*Potato, sweet potato, corn, and other starchy vegetables were included in the group of cereals, legumes and pasta because of their similar nutritional composition. **They are high in fat (mayonnaise, milk cream, butter, solid fats), free sugars (refined sugar, sweets and jam), and product s such as sweetened beverages and infusions, “alfajores”, sweet cookies, chocolates, candy, snacks, pastries, cakes, sugary desserts, ice cream, cereal bars, and breakfast cereals with added sugar.

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Table 4. Recommendations from Dietary Guidelines for Japanese, Spanish and Argentineans populations. Traditional Japanese

Mediterranean

Argentinean

Illustrative figure

Japanese Food Guide Spinning Top

Pyramid of Healthy Eating

Bases for daily food quantity

Number of total servings, expressed in number

Food groups in proportions to eat a day

I R

C S

of dishes a day Differences recommendations

in on

the

U N

Tea as substitute of water.

Classification in D and O

Vegetables > fruits.

cheese > lean meats, fish, egg, legumes,

Meats and eggs > dairy products x Oils and fats x Sugars and sweets

D E

T P

E C

Healthy plate structure

C A

A M

D: fruits = vegetables. Milk, yogurt and

figures

T P

Daily Food Chart Food groups in proportions to eat a day

↓ salt Fruits = vegetables Milk, yogurt and cheese > meat and egg

nuts and seeds. Olive oil Oils, nuts and seeds O: red and processed meats, fats Fats* spreads, sugars and sweets. Wine and beer**

Grilled fish with steamed vegetables, green

One serving of cereals/legumes/starchy

leaves and miso soup.

vegetables, plus vegetables, one serving of fish/meat/egg, and one piece of bread

Sugars and sweets*

N/D

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and fruit. Water * optional / ** 1 glass a day for women and 2 glasses a day for men / > (more intake than) / = (same intake) / ↑ (higher intake) / ↓ (lesser intake) / x (not included)

T P

/ D (daily) / O (occasional) / PUFA (polyunsaturated fatty acids) / MUFA (monounsaturated fatty acids) / SFA (saturated fatty acids) / N/D (no data)

I R

C S

U N

D E

T P

C A

E C

A M

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Continuation of Table 4. Recommendations from Dietary Guidelines for Japanese, Spanish and Argentineans populations. Recommended

distribution

of macronutrients

Culinary

techniques

predominate

in

that

60% Carbohydrates

55 – 60 % Carbohydrates

55% Carbohydrates

15 % Proteins

10-15% Proteins

25% Fats

25-30% Fats

Uncooked ingredients, steamed and grilled

Boiled, roasted, grilled, sautéed, fried,

T P

I R

C S

15% Proteins 30% Fats Grilled and fried

U N

the

steamed and microwave

population

A M

Contribution of kilocalories

Low

Foods frequently consumed

Rice, fish, seafood, miso soup, vegetables, tea,

Fruits and vegetables, whole grains, fish

Red and canned meats, sausages and

coffee

and lean meats, olive and other oils,

processed meats, baked goods, cookies and

nuts, red wine**

refined grains, starchy vegetables, snacks,

D E

E C

T P

C A

Medium

Medium-High

wine, “mate”, sweetened drinks

* optional / ** 1 glass a day for women and 2 glasses a day for men / > (mor e intake than) / = (same intake) / ↑ (higher intake) / ↓ (lesser intake) / x (not included) / D (daily) / O (occasional) / PUFA (polyunsaturated fatty acids) / MUFA (monounsaturated fatty acids) / SFA (saturated fatty ac ids) / N/D (no data).

ACCEPTED MANUSCRIPT Continuation of Table 4. Recommendations from Dietary Guidelines for Japanese, Spanish and Argentineans populations. Foods not

Fruits, highly processed

Red and fatty meats, whole

Fish,

frequently

foods, snacks, red meat,

dairy

vegetables

consumed

sugars, fats spreads

grains, sugars and sweets,

products,

refined

nuts,

fruits

and

PT

fats spreads, sweetened

in the

↑ n-3 PUFA

↑ n-3 and n-6 PUFAs

Ratio PUFA: SFA of 1,2:1

↑ MUFA (oleic acid)

Ratio omega 6: omega 3

↑ dietary fiber

SC

Nutrient intake

RI

beverages

population in

of 4:1

↑ antioxidants (vitamins, antioxidants

quercetin,

MA

↑

NU

general

(polyphenols, catequins,

flavonoids,

carotenoids,

aglycone,

ED

etc.)

vitamins,

carotenoids, oleuropein

↑ animal origin proteins ↑ SFA and trans fatty acids ↑ refined sugars ↑ Iron, Sodium, Vitamin C ↓ dietary fiber

phytoalexins ↓ antioxidants

resveratrol)

EP T

↓ saturated and trans fat

factor

No

No

Yes

Hibbeln et al., 2006;

Aranceta Batrina et al.,

Aballay

et

al.,

2016;

MAFF, 2018; Sugano &

2016; Romagnolo & Selmin,

Tavella

et

al.,

2016;

Hirahara, 2000

2017

Zapata et al., 2013

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Obesity as a risk

References

* optional / ** 1 glass a day for wo men and 2 g lasses a day for men / > (mo re intake than) / = (same intake) / ↑ (higher intake) / ↓ (lesser intake) / x (not included) / D (daily ) / O (ocassional) / PUFA (polyunsaturated fatty acids) / MUFA (monounsaturated fatty acids) / SFA (saturated fatty acids) / N/D (no data)

ACCEPTED MANUSCRIPT Table 5. Food quantities recommended by the Dietary Guidelines for the Argentine Population and the Dietary Guidelines for the Japanese Population. Adapted from Hansen (2016); Yoshiike et al. (2007). Japan Total

Quantity of 1 serving

servings Cereals

Total servings

5-7

100 g of cooked rice or

4

2

100 g

3-5

5

SC

Meat and eggs

70 g

100 g of fish, 1 egg or 1

1

100 mL of milk or yogurt

3

yogurt

and

MA

soy bean bowl Milk,

2

Fats and sweets

0

EP T

Oils, nuts and seeds

ED

cheese

0

AC C

tbsp (table spoon)

-

½ plate of vegetables or 100 g of fruit

NU

Fruits

5-6

125 g of cooked rice or 60 g of bread

RI

25 g of bread Vegetables

Quantity of 1 serving

PT

Food Groups

Argentina

130 g of meat and ½ unit of egg 200 mL of milk or 125 g of yogurt

3

1 tbsp. of oil/seeds or 1 handful of nuts

-

moderated

-

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Dietary factors as health risks/benefits in the development of cognitive disorders Neuroprotective effect of polyunsaturated fatty acids (PUFA) and antioxidants Comparison of the Japanese, Mediterranean and Argentinean dietary patterns PUFAs, monounsaturated fatty acids, and antioxidants may decrease the risks

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Figure 2

Figure 3

Figure 4

Figure 5

Figure 6

Figure 7