Associations between dietary patterns and the metabolic syndrome in older adults in New Zealand: the REACH study

Vitamin B and One-Carbon Metabolite Profiles Show Divergent Associations with Cardiometabolic Risk Markers but not Cognitive Function in Older New Zealand Adults: A Secondary Analysis of the REACH Study

BACKGROUND

Vitamin B inadequacies and elevated homocysteine status have been associated with impaired cognitive and cardiometabolic health with aging. There is, however, a scarcity of research investigating integrated profiles of one-carbon (1C) metabolites in this context, including metabolites of interconnected folate, methionine, choline oxidation, and transsulfuration pathways.

OBJECTIVES

The study aimed to examine associations between vitamins B and 1C metabolites with cardiometabolic health and cognitive function in healthy older adults, including the interactive effects of Apolipoprotein E-ε4 status.

METHODS

Three hundred and thirteen healthy participants (65-74 y, 65% female) were analyzed. Vitamins B were estimated according to dietary intake (4-d food records) and biochemical status (serum folate and vitamin B12). Fasting plasma 1C metabolites were quantified by liquid chromatography with tandem mass spectrometry. Measures of cardiometabolic health included biochemical (lipid panel, blood glucose) and anthropometric markers. Cognitive function was assessed by the Computerized Mental Performance Assessment System (COMPASS) and Montreal Cognitive Assessment (MoCA). Associations were analyzed using multivariate linear (COMPASS, cardiometabolic health) and Poisson (MoCA) regression modeling.

RESULTS

Over 90% of participants met dietary recommendations for riboflavin and vitamins B6 and B12, but only 78% of males and 67% of females achieved adequate folate intakes. Higher serum folate and plasma betaine and glycine concentrations were associated with favorable cardiometabolic markers, whereas higher plasma choline and homocysteine concentrations were associated with greater cardiometabolic risk based on body mass index and serum lipids concentration values (P< 0.05). Vitamins B and homocysteine were not associated with cognitive performance in this cohort, though higher glycine concentrations were associated with better global cognitive performance (P = 0.017), episodic memory (P = 0.016), and spatial memory (P = 0.027) scores. Apolipoprotein E-ε4 status did not modify the relationship between vitamins B or 1C metabolites with cognitive function in linear regression analyses.

CONCLUSIONS

Vitamin B and 1C metabolite profiles showed divergent associations with cardiometabolic risk markers and limited associations with cognitive performance in this cohort of healthy older adults.

Habitual Dietary Patterns, Nutrient Intakes, and Adherence to the Mediterranean Diet among New Zealand Adults: The NZ MED Cross-Sectional Study

There is increasing evidence that adherence to a Mediterranean dietary pattern reduces the incidence of diet-related diseases. To date, the habitual dietary intake of New Zealand (NZ) adults has not been examined in relation to its alignment with a Mediterranean-style dietary pattern. This study aimed to define the habitual dietary patterns, nutrient intakes, and adherence to the Mediterranean Diet in a sample of 1012 NZ adults (86% female, mean age 48 ± 16 years) who had their diabetes risk defined by the Australian Type 2 Diabetes Risk Assessment Tool (AUSDRISK). Dietary intakes were collected using a validated semi-quantitative NZ food frequency questionnaire, and dietary patterns were identified using principal component analysis. Reported intakes from the FFQ were used in conjunction with the Mediterranean-Style Dietary Pattern Score (MSDPS) to determine adherence to a Mediterranean dietary pattern. Mixed linear models were used to analyze the association between dietary patterns and MSDPS with demographics, health factors, and nutrient intakes. Two distinct dietary patterns were identified: Discretionary (positive loadings on processed meat, meat/poultry, fast food, sweet drinks, and sugar, sweets, and baked good) and Guideline (positive loadings on vegetables, eggs/beans, and fruits). Adherence to dietary patterns and diet quality was associated with age and ethnicity. Dietary patterns were also associated with sex. Adherence to a Mediterranean dietary pattern defined by the MSDPS was low, indicating that a significant shift in food choices will be required if the Mediterranean Diet is to be adopted in the NZ population.

MetS Prevalence and Its Association with Dietary Patterns among Chinese Middle-Aged and Elderly Population: Results from a National Cross-Sectional Study

The prevalence of metabolic syndrome (MetS) increased dramatically over the past years among adults in a separate province in China; little is known about newly diagnosed MetS in middle-aged and above residents nationwide. We investigated the prevalence of MetS and its components, the dietary patterns, and their relationship among the middle-aged and above population of China by using data from a national cross-sectional survey. General information involving lifestyles and health stations was collected, and dietary intake using a 3-day 24 h dietary recall and weighing method for edible oil and condiments was conducted. Height, weight, waist circumference, and blood pressure were measured, and fasting serum lipids and glucose were tested by trained clinical staff. Dietary patterns were derived from 23 food categories by using cluster analysis, and a multivariate logistic regression model was used to evaluate the odd ratio of MetS and its component across obtained dietary patterns. The estimated prevalence of MetS was 37.1% among 40,909 middle-aged and older participants in the study. Participants were classified into diversity pattern, northern pattern, and southern pattern that, respectively, accounted for 9.8%, 47.2%, and 43.0% of the total. Compared with those inclined to the northern pattern, participants prone to the southern pattern decreased the risk of MetS (OR = 0.81, 95%CI: 0.75- 0.87; p < 0.001), central obesity (OR = 0.70, 95%CI: 0.65−0.76; p < 0.001), and HDL-C (OR = 0.82, 95%CI: 0.76−0.89; p < 0.001), and elevated BP (OR = 0.86, 95%CI: 0.79−0.93; p < 0.001) respectively. However, participants of the southern pattern tended to have a higher risk of elevated glucose; the OR (95%CI) was 1.13 (1.05, 1.22; p = 0.002) after adjusting for potential confounding factors. Greater adherence to diverse dietary patterns was negatively related to the risk of central obesity and elevated blood pressure with an OR (95%CI) of 0.82 (0.71, 0.94; p = 0.005) and 0.77 (0.67, 0.88; p < 0.001), respectively. We concluded that dietary improvement and health promotion for MetS should be based on the district-specific nutritional status of the Chinese middle-aged and elderly population.