Table 1.
Preclinical and clinical studies on DR in aging and neurodegenerative diseases
ModelReferenceType of DRDR effects on inflammatory or other brain pathology markersDR effects on cognitive or motor functionsDR effects on imaging measures
Aging 
Rodents Morgan et al., 1999; Lee et al., 2000  30–40% DR ↓ Age-related increased of activation markers on microglia (e.g., MHCII) or astrocytes (e.g., GFAP); ↓ inflammatory genes   
 Kaur et al., 2008  IF ↓ Age-related changes in brain expression of NCAM, PSA-NCAM, and GFAP   
 Singh et al., 2012  IF ↓ Protein oxidative damage; ↑ markers of synaptic plasticity in the hippocampus Ameliorates motor coordination, cognitive skills  
Nonhuman primates Qin et al., 2006  30% DR ↓ Aβ deposition   
 Willette et al., 2010  30% DR Attenuates the relation between IL-6 and brain volume loss  Attenuates the relation between IL-6 and brain volume loss 
 Willette et al., 2012  30% DR Attenuates the negative correlation between homocysteine and global gray matter volume  Attenuates the negative correlation between homocysteine and global gray matter volume 
 Colman et al., 2009; Kastman et al., 2012; Sridharan et al., 2012; Sridharan et al., 2013  30% DR (University of Wisconsin study) ↓ Age-related astrogliosis (↓ GFAP in hippocampus and entorhinal cortex) Preserves motor performance No effect on corpus callosum integrity; ↑ FA in several white matter regions; ↓ GM volume loss; ↓ brain iron accumulation 
Humans Leclerc et al., 2020; Witte et al., 2009  25–30% DR  Ameliorates memory performance ↓ C reactive protein and insulin levels 
 Blumenthal et al., 2010; Smith et al., 2010  DASH diet (Appel et al., 1997) and DR  Improves cognitive function  
AD 
Rodents Patel et al., 2005; Wang et al., 2005; Wu et al., 2008; Schafer et al., 2015  30–40% DR ↓ Aβ and phospho-tau deposition; ↓ astrocyte activation Improved performance in cognitive tests  
 Halagappa et al., 2007; Brownlow et al., 2014  Different DR regimens based on individual calorie consumption; 35–40% DR No effects Improved age-related behavioral impairments; rescued associative memory deficits  
Humans Horie et al., 2016  DASH diet + DR 500 kcal/d or 25% DR  Improvement in cognitive functions  
PD 
Rodents Duan and Mattson, 1999  IF ↓ Damage to SN neurons ↓ Motor deficits  
 Maswood et al., 2004  30% DR ↑ Levels of dopamine and dopamine metabolites in the striatal region ↑ Locomotor activity No differences in presynaptic dopaminergic activity in vivo 
 Armentero et al., 2008  IF No effect on nigrostriatal degeneration   
 Griffioen et al., 2013  IF NA Ameliorates autonomic function NA 
Nonhuman primates Maswood et al., 2004  30% DR ↑ Levels of dopamine and dopamine metabolites in the striatal region ↑ Locomotor activity No differences in presynaptic dopaminergic activity in vivo 
ALS 
Rodents Pedersen and Mattson, 1999  IF  Accelerates disease onset and shortens disease duration  
 Hamadeh et al., 2005  40% DR  Accelerates disease onset  
MS 
Rodents Esquifino et al., 2007  66% Alters lymphocytes composition in lymphoid organs, ↓ IFN-γ production Prevents EAE  
 Piccio et al., 2008  40% DR ↑ Corticosterone and adiponectin; ↓ leptin and IL-6 Ameliorates EAE clinical course  
 Kafami et al., 2010  IF  Ameliorates EAE clinical course and reduces incidence of disease  
 Cignarella et al., 2018  IF ↓ Th17 cells, ↑ T regulatory cells in small intestine lamina propria, altered gut microbiota Ameliorates EAE clinical course and reduces incidence of disease  
 Jordan et al., 2019  IF ↓ Monocyte infiltration in the spinal cord, ↓ TNFα, IL-1β, CXCL2, and CXCL10 Ameliorates EAE clinical course and reduces incidence of disease  
Humans Saadatnia et al., 2009  Ramadan fasting  Well tolerated, no differences in relapse rate  
 Etemadifar et al., 2016  Ramadan fasting  Improves physical health and mental health composites of QOL  
 Choi et al., 2016  FMD + Mediterranean or ketogenic diet  Improves QOL  
 Fitzgerald et al., 2018  22% DR or IF  Improves mood  
 Cignarella et al., 2018  IF ↓ Leptin   
ModelReferenceType of DRDR effects on inflammatory or other brain pathology markersDR effects on cognitive or motor functionsDR effects on imaging measures
Aging 
Rodents Morgan et al., 1999; Lee et al., 2000  30–40% DR ↓ Age-related increased of activation markers on microglia (e.g., MHCII) or astrocytes (e.g., GFAP); ↓ inflammatory genes   
 Kaur et al., 2008  IF ↓ Age-related changes in brain expression of NCAM, PSA-NCAM, and GFAP   
 Singh et al., 2012  IF ↓ Protein oxidative damage; ↑ markers of synaptic plasticity in the hippocampus Ameliorates motor coordination, cognitive skills  
Nonhuman primates Qin et al., 2006  30% DR ↓ Aβ deposition   
 Willette et al., 2010  30% DR Attenuates the relation between IL-6 and brain volume loss  Attenuates the relation between IL-6 and brain volume loss 
 Willette et al., 2012  30% DR Attenuates the negative correlation between homocysteine and global gray matter volume  Attenuates the negative correlation between homocysteine and global gray matter volume 
 Colman et al., 2009; Kastman et al., 2012; Sridharan et al., 2012; Sridharan et al., 2013  30% DR (University of Wisconsin study) ↓ Age-related astrogliosis (↓ GFAP in hippocampus and entorhinal cortex) Preserves motor performance No effect on corpus callosum integrity; ↑ FA in several white matter regions; ↓ GM volume loss; ↓ brain iron accumulation 
Humans Leclerc et al., 2020; Witte et al., 2009  25–30% DR  Ameliorates memory performance ↓ C reactive protein and insulin levels 
 Blumenthal et al., 2010; Smith et al., 2010  DASH diet (Appel et al., 1997) and DR  Improves cognitive function  
AD 
Rodents Patel et al., 2005; Wang et al., 2005; Wu et al., 2008; Schafer et al., 2015  30–40% DR ↓ Aβ and phospho-tau deposition; ↓ astrocyte activation Improved performance in cognitive tests  
 Halagappa et al., 2007; Brownlow et al., 2014  Different DR regimens based on individual calorie consumption; 35–40% DR No effects Improved age-related behavioral impairments; rescued associative memory deficits  
Humans Horie et al., 2016  DASH diet + DR 500 kcal/d or 25% DR  Improvement in cognitive functions  
PD 
Rodents Duan and Mattson, 1999  IF ↓ Damage to SN neurons ↓ Motor deficits  
 Maswood et al., 2004  30% DR ↑ Levels of dopamine and dopamine metabolites in the striatal region ↑ Locomotor activity No differences in presynaptic dopaminergic activity in vivo 
 Armentero et al., 2008  IF No effect on nigrostriatal degeneration   
 Griffioen et al., 2013  IF NA Ameliorates autonomic function NA 
Nonhuman primates Maswood et al., 2004  30% DR ↑ Levels of dopamine and dopamine metabolites in the striatal region ↑ Locomotor activity No differences in presynaptic dopaminergic activity in vivo 
ALS 
Rodents Pedersen and Mattson, 1999  IF  Accelerates disease onset and shortens disease duration  
 Hamadeh et al., 2005  40% DR  Accelerates disease onset  
MS 
Rodents Esquifino et al., 2007  66% Alters lymphocytes composition in lymphoid organs, ↓ IFN-γ production Prevents EAE  
 Piccio et al., 2008  40% DR ↑ Corticosterone and adiponectin; ↓ leptin and IL-6 Ameliorates EAE clinical course  
 Kafami et al., 2010  IF  Ameliorates EAE clinical course and reduces incidence of disease  
 Cignarella et al., 2018  IF ↓ Th17 cells, ↑ T regulatory cells in small intestine lamina propria, altered gut microbiota Ameliorates EAE clinical course and reduces incidence of disease  
 Jordan et al., 2019  IF ↓ Monocyte infiltration in the spinal cord, ↓ TNFα, IL-1β, CXCL2, and CXCL10 Ameliorates EAE clinical course and reduces incidence of disease  
Humans Saadatnia et al., 2009  Ramadan fasting  Well tolerated, no differences in relapse rate  
 Etemadifar et al., 2016  Ramadan fasting  Improves physical health and mental health composites of QOL  
 Choi et al., 2016  FMD + Mediterranean or ketogenic diet  Improves QOL  
 Fitzgerald et al., 2018  22% DR or IF  Improves mood  
 Cignarella et al., 2018  IF ↓ Leptin   

Summary of the main studies on the effects of DR on aging and neurodegenerative and neuroinflammatory diseases. FA, fractional anisotropy. GM, gray matter; NA, not applicable; NCAM, neural cell adhesion molecule; PSA, polysialylated; QOL, quality of life; SN, substantia nigra.

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