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Ou YN, Zhang YB, Li YZ, Huang SY, Zhang W, Deng YT, Wu BS, Tan L, Dong Q, Pan A, Chen RJ, Feng JF, Smith AD, Cheng W, Yu JT. Socioeconomic status, lifestyle and risk of incident dementia: a prospective cohort study of 276730 participants. GeroScience 2024; 46:2265-2279. [PMID: 37926784 PMCID: PMC10828350 DOI: 10.1007/s11357-023-00994-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Accepted: 10/17/2023] [Indexed: 11/07/2023] Open
Abstract
Healthy lifestyle might alleviate the socioeconomic inequities in health, but the extent of the joint and interactive effects of these two factors on dementia are unclear. This study aimed to detect the joint and interactive associations of socioeconomic status (SES) and lifestyle factors with incident dementia risk, and the underlying brain imaging alterations. Cox proportional hazards analysis was performed to test the joint and interactive associations. Partial correlation analysis was performed to reflect the brain imaging alterations. A total of 276,730 participants with a mean age of 55.9 (±8.0) years old from UK biobank were included. Over 8.5 (±2.6) years of follow-up, 3013 participants were diagnosed with dementia. Participants with high SES and most healthy lifestyle had a significantly lower risk of incident dementia (HR=0.19, 95% CI=0.14 to 0.26, P<2×10-16), Alzheimer's disease (AD, HR=0.19, 95% CI=0.13 to 0.29, P=8.94×10-15), and vascular dementia (HR=0.24, 95% CI=0.12 to 0.48, P=7.57×10-05) compared with participants with low SES and an unhealthy lifestyle. Significant interactions were found between SES and lifestyle on dementia (P=0.002) and AD (P=0.001) risks; the association between lifestyle and dementia was stronger among those of high SES. The combination of high SES and healthy lifestyle was positively associated with higher volumes in brain regions vulnerable to dementia-related atrophy. These findings suggest that SES and lifestyle significantly interact and influence dementia with its related brain structure phenotypes.
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Affiliation(s)
- Ya-Nan Ou
- Department of Neurology, Qingdao Municipal Hospital, Qingdao University, Qingdao, 266071, China
- Department of Neurology and National Center for Neurological Disorders, Huashan Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Shanghai Medical College, Fudan University, Shanghai, 200040, China
| | - Yan-Bo Zhang
- Department of Epidemiology and Biostatistics, Ministry of Education Key Laboratory of Environment and Health, State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430000, China
| | - Yu-Zhu Li
- Institute of Science and Technology for Brain-inspired Intelligence, Fudan University, Shanghai, 200433, China
| | - Shu-Yi Huang
- Department of Neurology and National Center for Neurological Disorders, Huashan Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Shanghai Medical College, Fudan University, Shanghai, 200040, China
| | - Wei Zhang
- Institute of Science and Technology for Brain-inspired Intelligence, Fudan University, Shanghai, 200433, China
| | - Yue-Ting Deng
- Department of Neurology and National Center for Neurological Disorders, Huashan Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Shanghai Medical College, Fudan University, Shanghai, 200040, China
| | - Bang-Sheng Wu
- Department of Neurology and National Center for Neurological Disorders, Huashan Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Shanghai Medical College, Fudan University, Shanghai, 200040, China
| | - Lan Tan
- Department of Neurology, Qingdao Municipal Hospital, Qingdao University, Qingdao, 266071, China.
| | - Qiang Dong
- Department of Neurology and National Center for Neurological Disorders, Huashan Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Shanghai Medical College, Fudan University, Shanghai, 200040, China
| | - An Pan
- Department of Epidemiology and Biostatistics, Ministry of Education Key Laboratory of Environment and Health, State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430000, China
| | - Ren-Jie Chen
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, 200040, China
| | - Jian-Feng Feng
- Institute of Science and Technology for Brain-inspired Intelligence, Fudan University, Shanghai, 200433, China
| | - A David Smith
- Department of Pharmacology, University of Oxford, Oxford, OX1 3QT, UK
| | - Wei Cheng
- Department of Neurology and National Center for Neurological Disorders, Huashan Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Shanghai Medical College, Fudan University, Shanghai, 200040, China
- Institute of Science and Technology for Brain-inspired Intelligence, Fudan University, Shanghai, 200433, China
| | - Jin-Tai Yu
- Department of Neurology and National Center for Neurological Disorders, Huashan Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Shanghai Medical College, Fudan University, Shanghai, 200040, China.
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Bernini S, Conti S, Perdixi E, Jesuthasan N, Costa A, Severgnini M, Ramusino MC, Prinelli F. Investigating the individual and joint effects of socioeconomic status and lifestyle factors on mild cognitive impairment in older Italians living independently in the community: results from the NutBrain study. J Nutr Health Aging 2024; 28:100040. [PMID: 38280834 DOI: 10.1016/j.jnha.2024.100040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Revised: 01/05/2024] [Accepted: 01/05/2024] [Indexed: 01/29/2024]
Abstract
OBJECTIVES Despite extensive research, a clear understanding of the role of the interaction between lifestyle and socioeconomic status (SES) on cognitive health is still lacking. We investigated the joint association of socioeconomic factors in early to midlife and lifestyle in later life and Mild Cognitive Impairment (MCI). DESIGN Observational cross-sectional study. SETTING NutBrain study in northern Italy. PARTICIPANTS 773 community-dwelling adults aged 65 years and older (73.2 ± 6.0 SD, 58.6% females) participating in the NutBrain study (2019-2023). MEASUREMENTS Three SES indicators (home ownership, educational level, occupation) and five lifestyle factors (adherence to Mediterranean diet, physical activity, smoking habits, social network, leisure activities) were selected. Each factor was scored and summed to calculate SES and healthy lifestyle scores; their joint effect was also examined. The association with MCI was assessed by logistic regression controlling for potential confounders. Sex-stratified analysis was performed. RESULTS In total, 24% of the subjects had MCI. The multivariable logistic model showed that a high SES and a high lifestyle score were associated with 81.8% (OR0.182; 95%CI 0.095-0.351), and 44.1% (OR0.559; 95%CI 0.323-0.968) lower odds of having MCI, respectively. When examining the joint effect of SES and lifestyle factors, the cognitive benefits of a healthy lifestyle were most pronounced in participants with low SES. A healthier lifestyle score was found to be significantly associated with lower odds of MCI, only in females. CONCLUSIONS According to our findings, SES was positively associated with preserved cognitive function, highlighting the importance of active lifestyles in reducing socioeconomic health inequalities, particularly among those with a relatively low SES. TRIAL REGISTRATION Trial registration number NCT04461951, date of registration July 7, 2020 (retrospectively registered, ClinicalTrials.gov).
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Affiliation(s)
- Sara Bernini
- Clinical Neuroscience Unit of Dementia, Dementia Research Center, IRCCS Mondino Foundation, Via Mondino 2, 27100 Pavia, Italy; Neuropsychology Lab/Center for Cognitive Disorders and Dementia IRCCS Mondino Foundation, Via Mondino 2, 27100 Pavia, Italy
| | - Silvia Conti
- Neuropsychology Lab/Center for Cognitive Disorders and Dementia IRCCS Mondino Foundation, Via Mondino 2, 27100 Pavia, Italy; Institute of Biomedical Technologies - National Research Council, Via Fratelli Cervi 93, 20054 Segrate, MI, Italy
| | - Elena Perdixi
- Neuropsychology Lab/Center for Cognitive Disorders and Dementia IRCCS Mondino Foundation, Via Mondino 2, 27100 Pavia, Italy; Department of Neurology, IRCCS Humanitas Clinical and Research Center, Via Alessandro Manzoni, 56, 20089 Rozzano, MI, Italy
| | - Nithiya Jesuthasan
- Institute of Biomedical Technologies - National Research Council, Via Fratelli Cervi 93, 20054 Segrate, MI, Italy
| | - Alfredo Costa
- Clinical Neuroscience Unit of Dementia, Dementia Research Center, IRCCS Mondino Foundation, Via Mondino 2, 27100 Pavia, Italy; Unit of Behavioral Neurology IRCCS Mondino Foundation, Via Mondino 2, 27100 Pavia, Italy
| | - Marco Severgnini
- Institute of Biomedical Technologies - National Research Council, Via Fratelli Cervi 93, 20054 Segrate, MI, Italy
| | - Matteo Cotta Ramusino
- Clinical Neuroscience Unit of Dementia, Dementia Research Center, IRCCS Mondino Foundation, Via Mondino 2, 27100 Pavia, Italy; Unit of Behavioral Neurology IRCCS Mondino Foundation, Via Mondino 2, 27100 Pavia, Italy
| | - Federica Prinelli
- Neuropsychology Lab/Center for Cognitive Disorders and Dementia IRCCS Mondino Foundation, Via Mondino 2, 27100 Pavia, Italy; Institute of Biomedical Technologies - National Research Council, Via Fratelli Cervi 93, 20054 Segrate, MI, Italy.
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Gillies NA, Milan AM, Cameron-Smith D, Mumme KD, Conlon CA, von Hurst PR, Haskell-Ramsay CF, Jones B, Roy NC, Coad J, Wall CR, Beck KL. 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. J Nutr 2023; 153:3529-3542. [PMID: 37863266 DOI: 10.1016/j.tjnut.2023.10.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 10/05/2023] [Accepted: 10/16/2023] [Indexed: 10/22/2023] Open
Abstract
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.
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Affiliation(s)
- Nicola A Gillies
- The Liggins Institute, The University of Auckland, New Zealand; The Riddet Institute, New Zealand
| | - Amber M Milan
- The Liggins Institute, The University of Auckland, New Zealand; The High-Value Nutrition National Science Challenge, New Zealand; AgResearch Ltd, Grasslands Research Centre, New Zealand
| | - David Cameron-Smith
- The Liggins Institute, The University of Auckland, New Zealand; The Riddet Institute, New Zealand; School of Agriculture, Food and Ecosystem Sciences, The University of Melbourne, Australia
| | - Karen D Mumme
- School of Sport Exercise and Nutrition, Massey University, New Zealand
| | - Cathryn A Conlon
- School of Sport Exercise and Nutrition, Massey University, New Zealand
| | | | | | - Beatrix Jones
- Department of Statistics, University of Auckland, New Zealand; The High-Value Nutrition National Science Challenge, New Zealand
| | - Nicole C Roy
- The Riddet Institute, New Zealand; The High-Value Nutrition National Science Challenge, New Zealand; Department of Human Nutrition, University of Otago, New Zealand
| | - Jane Coad
- College of Sciences, Massey University, New Zealand
| | - Clare R Wall
- Discipline of Nutrition and Dietetics, University of Auckland, Auckland, New Zealand
| | - Kathryn L Beck
- School of Sport Exercise and Nutrition, Massey University, New Zealand.
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Liu X, Beck T, Dhana K, Desai P, Krueger KR, Tangney CC, Holland TM, Agarwal P, Evans DA, Rajan KB. Association of Whole Grain Consumption and Cognitive Decline: An Investigation From a Community-Based Biracial Cohort of Older Adults. Neurology 2023; 101:e2277-e2287. [PMID: 37993270 PMCID: PMC10727204 DOI: 10.1212/wnl.0000000000207938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Accepted: 09/13/2023] [Indexed: 11/24/2023] Open
Abstract
BACKGROUND AND OBJECTIVES To examine the association of whole grain consumption and longitudinal change in global cognition, perceptual speed, and episodic memory by different race/ethnicity. METHODS We included 3,326 participants from the Chicago Health and Aging Project who responded to a Food Frequency Questionnaire (FFQ), with 2 or more cognitive assessments. Global cognition was assessed using a composite score of episodic memory, perceptual speed, and the Mini Mental State Examination (MMSE). Diet was assessed by a 144-item FFQ. Linear mixed-effects models were used to estimate the association of intakes of whole grains and cognitive decline. RESULTS This study involved 3,326 participants (60.1% African American [AA], 63.7% female) with a mean age of 75 years at baseline and a mean follow-up of 6.1 years. Higher consumption of whole grains was associated with a slower rate of global cognitive decline. Among AA participants, those in the highest quintile of whole grain consumption had a slower rate of decline in global cognition (β = 0.024, 95% CI [0.008-0.039], p = 0.004), perceptual speed (β = 0.023, 95% CI [0.007-0.040], p = 0.005), and episodic memory (β = 0.028, 95% CI [0.005-0.050], p = 0.01) compared with those on the lowest quintile. Regarding the amount consumed, in AA participants, those who consumed >3 servings/d vs those who consumed <1 serving/d had a slower rate of decline in global cognition (β = 0.021, 95% CI [0.005-0.036], p = 0.0093). In White participants, with >3 servings/d, we found a suggestive association of whole grains with global cognitive decline when compared with those who consumed <1 serving/d (β = 0.025, 95% CI [-0.003 to 0.053], p = 0.08). DISCUSSION Among AA participants, individuals with higher consumption of whole grains and more frequent consumption of whole grain had slower decline in global cognition, perceptual speed, and episodic memory. We did not see a similar trend in White adults.
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Affiliation(s)
- Xiaoran Liu
- From the Rush Institute for Healthy Aging (X.L., T.B., K.D., P.D., K.R.K., T.M.H., D.A.E., K.B.R.), Rush University Medical Center; Department of Internal Medicine (X.L., T.B., K.D., P.D., K.R.K., T.M.H., P.A., D.A.E., K.B.R.), Rush University Medical Center; Department of Clinical Nutrition & Preventive Medicine (C.C.T.), Rush University Medical Center; and Rush Alzheimer's Disease Center (P.A.), Rush University Medical Center, Chicago, IL.
| | - Todd Beck
- From the Rush Institute for Healthy Aging (X.L., T.B., K.D., P.D., K.R.K., T.M.H., D.A.E., K.B.R.), Rush University Medical Center; Department of Internal Medicine (X.L., T.B., K.D., P.D., K.R.K., T.M.H., P.A., D.A.E., K.B.R.), Rush University Medical Center; Department of Clinical Nutrition & Preventive Medicine (C.C.T.), Rush University Medical Center; and Rush Alzheimer's Disease Center (P.A.), Rush University Medical Center, Chicago, IL
| | - Klodian Dhana
- From the Rush Institute for Healthy Aging (X.L., T.B., K.D., P.D., K.R.K., T.M.H., D.A.E., K.B.R.), Rush University Medical Center; Department of Internal Medicine (X.L., T.B., K.D., P.D., K.R.K., T.M.H., P.A., D.A.E., K.B.R.), Rush University Medical Center; Department of Clinical Nutrition & Preventive Medicine (C.C.T.), Rush University Medical Center; and Rush Alzheimer's Disease Center (P.A.), Rush University Medical Center, Chicago, IL
| | - Pankaja Desai
- From the Rush Institute for Healthy Aging (X.L., T.B., K.D., P.D., K.R.K., T.M.H., D.A.E., K.B.R.), Rush University Medical Center; Department of Internal Medicine (X.L., T.B., K.D., P.D., K.R.K., T.M.H., P.A., D.A.E., K.B.R.), Rush University Medical Center; Department of Clinical Nutrition & Preventive Medicine (C.C.T.), Rush University Medical Center; and Rush Alzheimer's Disease Center (P.A.), Rush University Medical Center, Chicago, IL
| | - Kristin R Krueger
- From the Rush Institute for Healthy Aging (X.L., T.B., K.D., P.D., K.R.K., T.M.H., D.A.E., K.B.R.), Rush University Medical Center; Department of Internal Medicine (X.L., T.B., K.D., P.D., K.R.K., T.M.H., P.A., D.A.E., K.B.R.), Rush University Medical Center; Department of Clinical Nutrition & Preventive Medicine (C.C.T.), Rush University Medical Center; and Rush Alzheimer's Disease Center (P.A.), Rush University Medical Center, Chicago, IL
| | - Christy C Tangney
- From the Rush Institute for Healthy Aging (X.L., T.B., K.D., P.D., K.R.K., T.M.H., D.A.E., K.B.R.), Rush University Medical Center; Department of Internal Medicine (X.L., T.B., K.D., P.D., K.R.K., T.M.H., P.A., D.A.E., K.B.R.), Rush University Medical Center; Department of Clinical Nutrition & Preventive Medicine (C.C.T.), Rush University Medical Center; and Rush Alzheimer's Disease Center (P.A.), Rush University Medical Center, Chicago, IL
| | - Thomas M Holland
- From the Rush Institute for Healthy Aging (X.L., T.B., K.D., P.D., K.R.K., T.M.H., D.A.E., K.B.R.), Rush University Medical Center; Department of Internal Medicine (X.L., T.B., K.D., P.D., K.R.K., T.M.H., P.A., D.A.E., K.B.R.), Rush University Medical Center; Department of Clinical Nutrition & Preventive Medicine (C.C.T.), Rush University Medical Center; and Rush Alzheimer's Disease Center (P.A.), Rush University Medical Center, Chicago, IL
| | - Puja Agarwal
- From the Rush Institute for Healthy Aging (X.L., T.B., K.D., P.D., K.R.K., T.M.H., D.A.E., K.B.R.), Rush University Medical Center; Department of Internal Medicine (X.L., T.B., K.D., P.D., K.R.K., T.M.H., P.A., D.A.E., K.B.R.), Rush University Medical Center; Department of Clinical Nutrition & Preventive Medicine (C.C.T.), Rush University Medical Center; and Rush Alzheimer's Disease Center (P.A.), Rush University Medical Center, Chicago, IL
| | - Denis A Evans
- From the Rush Institute for Healthy Aging (X.L., T.B., K.D., P.D., K.R.K., T.M.H., D.A.E., K.B.R.), Rush University Medical Center; Department of Internal Medicine (X.L., T.B., K.D., P.D., K.R.K., T.M.H., P.A., D.A.E., K.B.R.), Rush University Medical Center; Department of Clinical Nutrition & Preventive Medicine (C.C.T.), Rush University Medical Center; and Rush Alzheimer's Disease Center (P.A.), Rush University Medical Center, Chicago, IL
| | - Kumar B Rajan
- From the Rush Institute for Healthy Aging (X.L., T.B., K.D., P.D., K.R.K., T.M.H., D.A.E., K.B.R.), Rush University Medical Center; Department of Internal Medicine (X.L., T.B., K.D., P.D., K.R.K., T.M.H., P.A., D.A.E., K.B.R.), Rush University Medical Center; Department of Clinical Nutrition & Preventive Medicine (C.C.T.), Rush University Medical Center; and Rush Alzheimer's Disease Center (P.A.), Rush University Medical Center, Chicago, IL
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Heger I, van Boxtel M, Deckers K, Bosma H, Verhey F, Köhler S. Socioeconomic position, modifiable dementia risk and cognitive decline: results of 12-year Maastricht Aging Study. Int Psychogeriatr 2023:1-13. [PMID: 37905417 DOI: 10.1017/s1041610223000819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/02/2023]
Abstract
OBJECTIVES This study investigated whether the association between modifiable dementia risk and rate of cognitive decline differs across socioeconomic status (SES) strata. DESIGN, SETTING AND PARTICIPANTS Data were used from Maastricht Aging Study, a prospective cohort study with a 12-year follow-up. The baseline sample consisted of 1023 adults over 40 years old. MEASUREMENTS The "LIfestyle for BRAin health" (LIBRA) index was used to assess modifiable dementia risk. Cognitive performance was assessed at baseline, 6 and 12 years, and measured in the domains of information processing speed, executive functioning and verbal memory function. An SES score was calculated from equivalent income and educational level (tertiles). Linear mixed models were used to study the association between LIBRA, SES and their interaction on the rate of cognitive decline. RESULTS Participants in the lowest SES tertile displayed more decline in information processing speed (vs. middle SES: X2 = 7.08, P = 0.029; vs. high SES: X2 = 9.49, P = 0.009) and verbal memory (vs. middle SES: X2 = 9.28, P < 0.001; vs. high SES: X2 = 16.68, P < 0.001) over 6 years compared to their middle- and high-SES counterparts. Higher (unhealthier) LIBRA scores were associated with more decline in information processing speed (X2 = 12.66, P = 0.002) over 12 years and verbal memory (X2 = 4.63, P = 0.032) over 6 years. No consistent effect modification by SES on the association between LIBRA and cognition was found. CONCLUSIONS Results suggest that lifestyle is an important determinant of cognitive decline across SES groups. Yet, people with low SES had a more unfavorable modifiable risk score suggesting more potential for lifestyle-based interventions.
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Affiliation(s)
- Irene Heger
- School for Mental Health and Neuroscience, Department of Psychiatry and Neuropsychology, Maastricht University, Maastricht, The Netherlands
| | - Martin van Boxtel
- School for Mental Health and Neuroscience, Department of Psychiatry and Neuropsychology, Maastricht University, Maastricht, The Netherlands
| | - Kay Deckers
- School for Mental Health and Neuroscience, Department of Psychiatry and Neuropsychology, Maastricht University, Maastricht, The Netherlands
| | - Hans Bosma
- Care and Public Health Research Institute (CAPHRI), Department of Social Medicine, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Frans Verhey
- School for Mental Health and Neuroscience, Department of Psychiatry and Neuropsychology, Maastricht University, Maastricht, The Netherlands
| | - Sebastian Köhler
- School for Mental Health and Neuroscience, Department of Psychiatry and Neuropsychology, Maastricht University, Maastricht, The Netherlands
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Ellouze I, Sheffler J, Nagpal R, Arjmandi B. Dietary Patterns and Alzheimer's Disease: An Updated Review Linking Nutrition to Neuroscience. Nutrients 2023; 15:3204. [PMID: 37513622 PMCID: PMC10384681 DOI: 10.3390/nu15143204] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 07/15/2023] [Accepted: 07/17/2023] [Indexed: 07/30/2023] Open
Abstract
Alzheimer's disease (AD) is a growing concern for the aging population worldwide. With no current cure or reliable treatments available for AD, prevention is an important and growing area of research. A range of lifestyle and dietary patterns have been studied to identify the most effective preventive lifestyle changes against AD and related dementia (ADRD) pathology. Of these, the most studied dietary patterns are the Mediterranean, DASH, MIND, ketogenic, and modified Mediterranean-ketogenic diets. However, there are discrepancies in the reported benefits among studies examining these dietary patterns. We herein compile a narrative/literature review of existing clinical evidence on the association of these patterns with ADRD symptomology and contemplate their preventive/ameliorative effects on ADRD neuropathology in various clinical milieus. By and large, plant-based dietary patterns have been found to be relatively consistently and positively correlated with preventing and reducing the odds of ADRD. These impacts stem not only from the direct impact of specific dietary components within these patterns on the brain but also from indirect effects through decreasing the deleterious effects of ADRD risk factors, such as diabetes, obesity, and cardiovascular diseases. Importantly, other psychosocial factors influence dietary intake, such as the social connection, which may directly influence diet and lifestyle, thereby also impacting ADRD risk. To this end, prospective research on ADRD should include a holistic approach, including psychosocial considerations.
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Affiliation(s)
- Ines Ellouze
- Department of Plant Biotechnology, Higher Institute of Biotechnology of Beja, University of Jendouba, Beja 382, Tunisia;
- Department of Nutrition and Integrative Physiology, Florida State University, Tallahassee, FL 32306, USA
| | - Julia Sheffler
- Center for Translational Behavioral Science, Florida State University College of Medicine, Tallahassee, FL 32304, USA;
| | - Ravinder Nagpal
- Department of Nutrition and Integrative Physiology, Florida State University, Tallahassee, FL 32306, USA
- Center for Advancing Exercise and Nutrition Research on Aging, Florida State University, Tallahassee, FL 32306, USA
| | - Bahram Arjmandi
- Department of Nutrition and Integrative Physiology, Florida State University, Tallahassee, FL 32306, USA
- Center for Advancing Exercise and Nutrition Research on Aging, Florida State University, Tallahassee, FL 32306, USA
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7
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Townsend RF, Logan D, O’Neill RF, Prinelli F, Woodside JV, McEvoy CT. Whole Dietary Patterns, Cognitive Decline and Cognitive Disorders: A Systematic Review of Prospective and Intervention Studies. Nutrients 2023; 15:nu15020333. [PMID: 36678204 PMCID: PMC9865080 DOI: 10.3390/nu15020333] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 12/17/2022] [Accepted: 12/21/2022] [Indexed: 01/12/2023] Open
Abstract
Dementia prevalence is a global public health concern. Adherence towards a healthy dietary pattern (DP) may reduce the risk of cognitive decline and dementia. This narrative systematic review aimed to synthesise prospective and intervention study data to evaluate the impact of a-posteriori and a-priori derived DPs on cognitive ageing, from cognitive decline to incident dementia. Ninety-three studies were included: 83 prospective studies and 10 randomised controlled trials (RCT). Most prospective studies (77%) examined a-priori DPs, with the Mediterranean diet examined most frequently. A total of 52% of prospective and 50% of RCTs reported a protective relationship between 'healthy' DPs and global cognitive decline. Overall, 59% of prospective studies reported positive associations between healthy DPs and risk of cognitive disorder. Incident cognitive disorder was examined by only one intervention study (subgroup analysis) which reported a beneficial effect of a low-fat diet on risk of probable dementia in women. Unhealthy DPs were examined less frequently (n = 17; 21%), with 41% of these studies reporting associations between adherence and poorer cognitive outcomes. Overall, there were mixed results for healthy and unhealthy DPs on cognition, likely due to between-study heterogeneity. Standardisation of diet exposure and cognitive outcome measurement would help to reduce this. Future research would benefit from investigating effects of culturally appropriate DPs on individual cognitive domains and incident cognitive disorders in diverse and high-risk populations.
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Affiliation(s)
| | - Danielle Logan
- Centre for Public Health, Queen’s University Belfast, Belfast BT12 6BA, UK
| | - Roisin F. O’Neill
- Centre for Public Health, Queen’s University Belfast, Belfast BT12 6BA, UK
| | - Federica Prinelli
- Epidemiology Unit, Institute of Biomedical Technologies, National Research Council, 93 20054 Milan, Italy
| | - Jayne V. Woodside
- Centre for Public Health, Queen’s University Belfast, Belfast BT12 6BA, UK
- Institute for Global Food Security, Queen’s University Belfast, Belfast BT9 5DL, UK
| | - Claire T. McEvoy
- Centre for Public Health, Queen’s University Belfast, Belfast BT12 6BA, UK
- Institute for Global Food Security, Queen’s University Belfast, Belfast BT9 5DL, UK
- Correspondence:
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8
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Nutrition Patterns of Polish Esports Players. Nutrients 2022; 15:nu15010149. [PMID: 36615806 PMCID: PMC9824454 DOI: 10.3390/nu15010149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 12/22/2022] [Accepted: 12/24/2022] [Indexed: 12/31/2022] Open
Abstract
The aim of this study was to quantify the dietary patterns (DPs) of Polish esports players aged 18-26 years. Data were obtained via questionnaires that assessed dietary habits and frequency of food consumption. Dietary patterns were derived using Principal Component Analysis (PCA) and Factor Analysis (FA). In total, nine distinct DPs were identified. Eight DPs were considered unhealthy; 'fast food', 'High-processed food, meat and confectionery', 'Sweet', 'Fat-diary products', 'Vegetable-fruit', 'Spices and additives', 'Fats' and 'Cereal'; and only one was deemed healthy. E-athletes presented mostly poor dietary habits, which included: irregular eating of meals, frequent snacking, at least three meals a day and composition of snacks, frying of meat dishes and sweetening of hot drinks. Healthy dietary habits included proper hydration during the day and consumption of mainly non-sparkling water. The unbalanced and largely unhealthy dietary habits of esports players raise health concerns for these e-athletes, particularly when combined with a sedentary lifestyle. Future research could assess the nutritional knowledge of this group as it relates to national guidelines, investigate interventions designed to introduce healthier eating options into their lifestyle and examine the relationship between DPs and health or cognitive performance.
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9
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Cornelis MC, Agarwal P, Holland TM, van Dam RM. MIND Dietary Pattern and Its Association with Cognition and Incident Dementia in the UK Biobank. Nutrients 2022; 15:nu15010032. [PMID: 36615690 PMCID: PMC9823700 DOI: 10.3390/nu15010032] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 12/13/2022] [Accepted: 12/19/2022] [Indexed: 12/24/2022] Open
Abstract
A high adherence to the Mediterranean-Dietary Approaches to Stop Hypertension Diet Intervention for Neurodegenerative Delay (MIND) has been associated with better cognition and a lower risk of dementia in some but not all studies. We measured adherence to MIND and its association with cognitive health in the UK Biobank (UKB). A MIND score was derived from 24 h diet recall questionnaires for 120,661 participants who completed at least one of seven self-administered cognitive function tests. In a subset of 78,663 participants aged 55+, diagnosis of dementia was determined by linked hospital and death records. Multivariable regression and Cox proportional hazard ratio (HR) models were used to examine associations of MIND with cognitive ability and incident dementia. Higher adherence to MIND was associated with a small but significant worsening in performance on five of seven cognitive tests (p < 0.002). Associations were strongest among highly educated participants (p < 0.002 for MIND × education interaction). After a mean follow-up time of 10.5 years, 842 participants developed dementia. Overall, MIND adherence was not associated with incident dementia. An inverse association was observed among females (HR = 0.87 per score standard deviation (SD), p = 0.008) but not males (HR = 1.09, p = 0.11) (p = 0.008 for MIND × sex interaction). Similar associations with cognitive ability and dementia were observed for the Alternative Healthy Eating Index-2010 (AHEI-2010) dietary pattern. Associations were not modified by genetic susceptibility. In UKB, the MIND diet was not associated with better cognitive test scores and only with lower dementia risk in women.
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Affiliation(s)
- Marilyn C. Cornelis
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA
- Correspondence:
| | - Puja Agarwal
- Department of Internal Medicine, Rush University Medical Center, Chicago, IL 60612, USA
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, IL 60612, USA
| | - Thomas M. Holland
- Department of Internal Medicine, Rush University Medical Center, Chicago, IL 60612, USA
- Rush Institute for Healthy Aging, Rush University Medical Center, Chicago, IL 60612, USA
| | - Rob M. van Dam
- Department of Exercise and Nutrition Sciences, Milken Institute School of Public Health, The George Washington University, Washington, DC 20052, USA
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10
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Liu X, Dhana K, Barnes LL, Tangney CC, Agarwal P, Aggarwal N, Holland TM, Beck T, Evans DA, Rajan KB. A healthy plant-based diet was associated with slower cognitive decline in African American older adults: a biracial community-based cohort. Am J Clin Nutr 2022; 116:875-886. [PMID: 35906190 PMCID: PMC9535523 DOI: 10.1093/ajcn/nqac204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 04/21/2022] [Accepted: 07/22/2022] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND African American (AA) adults have about twice the risk of developing dementia compared with white adults. However, evidence on dietary modification in preventing cognitive decline from diverse populations focusing on AA adults is minimal. OBJECTIVES We aimed to evaluate the association between a plant-based diet and the rate of cognitive decline in a population-based sample of AA and white adults. METHODS This study consisted of 3337 participants from the Chicago Health and Aging Project (60% AA participants, 64% female). Plant-based diet quality was evaluated by the overall plant-based diet index (PDI), the healthful PDI (hPDI), and the unhealthful PDI (uPDI). Global cognition was assessed using a composite score of 4 individual tests of cognition. We used mixed models to examine the associations of PDI, hPDI, and uPDI with the rates of decline in global cognition, perceptual speed, and episodic memory. Models were adjusted for age, sex, presence of apoE e4 allele, lifestyle factors including education, cognitive activities, smoking status, calorie intake, risk factors for cardiovascular disease, time, and the interaction terms of time × each covariate. RESULTS AA and white participants had various dietary patterns. Higher hPDI was associated with a slower rate of decline in global cognition, perceptual speed, and episodic memory in AA participants but not white participants. AA study participants in the highest quintile of hPDI had significantly slower rates of global cognitive decline (β: 0.0183 ± 0.0086; P = 0.032), perceptual speed (β: 0.0179 ± 0.0088; P = 0.04), and episodic memory (β: 0.0163 ± 0.0118; P = 0.04) than individuals in the lowest quintile of hPDI. There were no associations of either PDI or uPDI with the rate of cognitive decline in either racial group. CONCLUSIONS A healthy plant-based diet was associated with a slower rate of decline in global cognition, perceptual speed, and episodic memory in AA adults.
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Affiliation(s)
| | - Klodian Dhana
- Rush Institute for Healthy Aging, Rush University Medical Center, Chicago, IL, USA,Department of Internal Medicine, Rush University Medical Center, Chicago, IL, USA
| | - Lisa L Barnes
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA,Department of Neurology, Rush University Medical Center, Chicago, IL, USA
| | - Christy C Tangney
- Department of Clinical Nutrition & Preventive Medicine, Rush University Medical Center, Chicago, IL, USA
| | - Puja Agarwal
- Department of Internal Medicine, Rush University Medical Center, Chicago, IL, USA,Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA
| | - Neelum Aggarwal
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA,Department of Neurology, Rush University Medical Center, Chicago, IL, USA
| | - Thomas M Holland
- Rush Institute for Healthy Aging, Rush University Medical Center, Chicago, IL, USA,Department of Internal Medicine, Rush University Medical Center, Chicago, IL, USA
| | - Todd Beck
- Rush Institute for Healthy Aging, Rush University Medical Center, Chicago, IL, USA,Department of Internal Medicine, Rush University Medical Center, Chicago, IL, USA
| | - Denis A Evans
- Rush Institute for Healthy Aging, Rush University Medical Center, Chicago, IL, USA,Department of Internal Medicine, Rush University Medical Center, Chicago, IL, USA
| | - Kumar B Rajan
- Rush Institute for Healthy Aging, Rush University Medical Center, Chicago, IL, USA,Department of Internal Medicine, Rush University Medical Center, Chicago, IL, USA
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11
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The Effects of “Diet–Smoking–Gender” Three-Way Interactions on Cognitive Impairment among Chinese Older Adults. Nutrients 2022; 14:nu14102144. [PMID: 35631285 PMCID: PMC9147822 DOI: 10.3390/nu14102144] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 05/04/2022] [Accepted: 05/12/2022] [Indexed: 02/06/2023] Open
Abstract
Investigations on gender variations in the risk factors of cognitive impairment are required to promote future precision medicine among older adults, as well as to contribute to a better understanding of the “male–female health-survival paradox”. With this study, we aimed to investigate the effects of “diet–smoking–gender” three-way interactions on cognitive impairments among Chinese older adults. We conducted a 16-year prospective cohort study among 15,953, 15,555, 16,849, 9716, 7116, and 13,165 older adults from the 2002, 2005, 2008–2009, 2011–2012, 2014, and 2017–2018 waves of the Chinese Longitudinal Healthy Longevity Survey (CLHLS), respectively. Cognitive impairment was measured by the Mini-Mental State Examination (MMSE). The dietary diversity score (DDS) was calculated using the CLHLS food frequency questionnaire. Generalized estimating equations (GEE) were used to assess the “diet–smoking–gender” three-way interaction effects on cognitive impairment across the six waves of CLHLS. We found that higher dietary diversity was associated with lower probability of cognitive impairment among older adults (OR = 0.92; 95%CI = 0.90, 0.98). However, smoking behavior may negatively influence the protective effect of higher dietary diversity on cognitive function among females (OR = 1.26; 95%CI = 1.07, 1.49). Our findings imply that we should take gender differences and lifestyle behaviors into consideration in implementing dietary interventions to improve cognitive function among older adults.
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12
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Townsend RF, Woodside JV, Prinelli F, O'Neill RF, McEvoy CT. Associations Between Dietary Patterns and Neuroimaging Markers: A Systematic Review. Front Nutr 2022; 9:806006. [PMID: 35571887 PMCID: PMC9097077 DOI: 10.3389/fnut.2022.806006] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Accepted: 03/16/2022] [Indexed: 12/13/2022] Open
Abstract
Dementia is a complex, growing challenge for population health worldwide. Dietary patterns (DPs) may offer an opportunity to beneficially influence cognitive ageing and potentially reduce an individuals’ risk of dementia through diet-related mechanisms. However, previous studies within this area have shown mixed results, which may be partly explained by the lack of sensitivity and accuracy within cognitive testing methods. Novel neuroimaging techniques provide a sensitive method to analyse brain changes preceding cognitive impairment which may have previously remained undetected. The purpose of this systematic review was to elucidate the role of DPs in relation to brain ageing processes, by summarising current prospective and intervention studies. Nine prospective studies met the inclusion criteria for the review, seven evaluated the Mediterranean diet (MeDi), one evaluated the Alternative Healthy Eating Index-2010, and one evaluated a posteriori derived DPs. No intervention studies were eligible for inclusion in this review. There was some evidence of an association between healthy DPs and neuroimaging markers including changes within these markers over time. Consequently, it is plausible that better adherence to such DPs may positively influence brain ageing and neurodegeneration. Future studies may benefit from the use of multi-modal neuroimaging techniques, to further investigate how adherence to a DP influences brain health. The review also highlights the crucial need for further intervention studies within this research area.
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Affiliation(s)
- Rebecca F Townsend
- Centre for Public Health, Queen's University Belfast, Belfast, United Kingdom
| | - Jayne V Woodside
- Centre for Public Health, Queen's University Belfast, Belfast, United Kingdom.,Institute for Global Food Security, Queen's University Belfast, Belfast, United Kingdom
| | - Federica Prinelli
- Institute of Biomedical Technologies, National Research Council, Milan, Italy
| | - Roisin F O'Neill
- Centre for Public Health, Queen's University Belfast, Belfast, United Kingdom
| | - Claire T McEvoy
- Centre for Public Health, Queen's University Belfast, Belfast, United Kingdom.,Institute for Global Food Security, Queen's University Belfast, Belfast, United Kingdom
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13
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Lindberg MH, Chen G, Olsen JA, Abelsen B. Combining education and income into a socioeconomic position score for use in studies of health inequalities. BMC Public Health 2022; 22:969. [PMID: 35562797 PMCID: PMC9107133 DOI: 10.1186/s12889-022-13366-8] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Accepted: 05/03/2022] [Indexed: 12/05/2022] Open
Abstract
Background In studies of social inequalities in health, there is no consensus on the best measure of socioeconomic position (SEP). Moreover, subjective indicators are increasingly used to measure SEP. The aim of this paper was to develop a composite score for SEP based on weighted combinations of education and income in estimating subjective SEP, and examine how this score performs in predicting inequalities in health-related quality of life (HRQoL). Methods We used data from a comprehensive health survey from Northern Norway, conducted in 2015/16 (N = 21,083). A composite SEP score was developed using adjacent-category logistic regression of subjective SEP as a function of four education and four household income levels. Weights were derived based on these indicators’ coefficients in explaining variations in respondents’ subjective SEP. The composite SEP score was further applied to predict inequalities in HRQoL, measured by the EQ-5D and a visual analogue scale. Results Education seemed to influence SEP the most, while income added weight primarily for the highest income category. The weights demonstrated clear non-linearities, with large jumps from the middle to the higher SEP score levels. Analyses of the composite SEP score indicated a clear social gradient in both HRQoL measures. Conclusions We provide new insights into the relative contribution of education and income as sources of SEP, both separately and in combination. Combining education and income into a composite SEP score produces more comprehensive estimates of the social gradient in health. A similar approach can be applied in any cohort study that includes education and income data.
Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-13366-8.
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Affiliation(s)
- Marie Hella Lindberg
- Department of Community Medicine, UiT - The Arctic University of Norway, 9037, Tromsø, Norway.
| | - Gang Chen
- Centre for Health Economics, Monash University, Melbourne, Australia
| | - Jan Abel Olsen
- Department of Community Medicine, UiT - The Arctic University of Norway, 9037, Tromsø, Norway.,Centre for Health Economics, Monash University, Melbourne, Australia.,Division of Health Services, Norwegian Institute of Public Health, Oslo, Norway
| | - Birgit Abelsen
- Department of Community Medicine, UiT - The Arctic University of Norway, 9037, Tromsø, Norway
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14
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Harriden B, D'Cunha NM, Kellett J, Isbel S, Panagiotakos DB, Naumovski N. Are dietary patterns becoming more processed? The effects of different dietary patterns on cognition: A review. Nutr Health 2022; 28:341-356. [PMID: 35450490 DOI: 10.1177/02601060221094129] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Background: Identifying dietary patterns that promote healthy aging has become increasingly important due to changes in food processing and consumption of processed foods. Recently, the effects of these foods and unhealthy dietary patterns on cognitive function have become more widely recognized. Aim: The aim of this review is to discuss the association between various dietary patterns and cognition in older age, while also highlighting growing evidence that ultra processed food (UPF) may negatively impact healthy aging. Methods: We have performed a non-systematic literature review searches in Google Scholar electronic database with pre-defined terms relating to UPF, diet, dietary patterns, cognition and ageing. Results: The most prevalent diets in the literature include the Western, Mediterranean, Dietary Approach to Stop Hypertension (DASH), Mediterranean-DASH Intervention for Neurogenerative Delay (MIND), Japanese, Nordic, and plant-based diets. Based on the findings, higher intakes of fresh fruit and vegetables, wholegrains and oily fish are common components of dietary patterns that are positively associated with better cognitive function. In contrast, the characteristics of a Western style dietary pattern, consisting of high amounts of UPF's, are increasing in many countries even where the staple dietary pattern was identified as healthy (i.e. Japan). Conclusion: The consumption of UPF, classified by the NOVA food classification system as industrially manufactured foods containing high levels of starches, vegetable oils, sugar, emulsifiers, and foods additives, has a negative impact on the overall nutritional quality of individual diets.
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Affiliation(s)
- Brittany Harriden
- Faculty of Health, 110446University of Canberra, Canberra, ACT, Australia.,Functional Foods and Nutrition Research (FFNR) Laboratory, University of Canberra, Bruce, Ngunnawal Country, ACT, Australia
| | - Nathan M D'Cunha
- Faculty of Health, 110446University of Canberra, Canberra, ACT, Australia.,Functional Foods and Nutrition Research (FFNR) Laboratory, University of Canberra, Bruce, Ngunnawal Country, ACT, Australia
| | - Jane Kellett
- Faculty of Health, 110446University of Canberra, Canberra, ACT, Australia.,Functional Foods and Nutrition Research (FFNR) Laboratory, University of Canberra, Bruce, Ngunnawal Country, ACT, Australia.,Department of Nutrition-Dietetics, School of Health and Education, 68996Harokopio University, Athens, Greece
| | - Stephen Isbel
- Faculty of Health, 110446University of Canberra, Canberra, ACT, Australia.,Functional Foods and Nutrition Research (FFNR) Laboratory, University of Canberra, Bruce, Ngunnawal Country, ACT, Australia
| | - Demosthenes B Panagiotakos
- Faculty of Health, 110446University of Canberra, Canberra, ACT, Australia.,Functional Foods and Nutrition Research (FFNR) Laboratory, University of Canberra, Bruce, Ngunnawal Country, ACT, Australia.,Department of Nutrition-Dietetics, School of Health and Education, 68996Harokopio University, Athens, Greece
| | - Nenad Naumovski
- Faculty of Health, 110446University of Canberra, Canberra, ACT, Australia.,Functional Foods and Nutrition Research (FFNR) Laboratory, University of Canberra, Bruce, Ngunnawal Country, ACT, Australia.,Department of Nutrition-Dietetics, School of Health and Education, 68996Harokopio University, Athens, Greece
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15
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Ferreira NV, Lotufo PA, Marchioni DML, Barreto SM, Viana MC, Caramelli P, Bensenor IJM, Suemoto CK. Association Between Adherence to the MIND Diet and Cognitive Performance is Affected by Income: The ELSA-Brasil Study. Alzheimer Dis Assoc Disord 2022; 36:133-139. [PMID: 35090161 DOI: 10.1097/wad.0000000000000491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Accepted: 12/06/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND The relationship between the Mediterranean-DASH Diet Intervention for Neurodegenerative Delay (MIND) diet and cognition has not been widely investigated in low- to middle-income countries. We investigated the relationship between MIND diet and cognition in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) baseline data. METHODS We included 11,788 participants. MIND diet adherence was based on the intake of 15 components according to a food frequency questionnaire. We analyzed the association between MIND diet adherence and global cognition, memory, and executive function using adjusted linear regression. We examined the interaction between income and MIND diet adherence on cognition and presented income stratified analyses. RESULTS MIND diet adherence was not associated with cognition in the whole sample. Income was an effect modifier of MIND adherence on global cognition (P=0.03) and executive function (P<0.001). For participants with high income, greater adherence was associated with better executive function [β=0.015, 95% confidence interval (CI)=0.002; 0.028, P=0.025]; while for participants with low income, greater adherence was associated with lower global cognition (β=-0.020, 95% CI=-0.036; -0.005, P=0.010) and executive function (β=-0.023, 95% CI=-0.039; -0.007, P=0.004). Adherence to the MIND diet was higher among participants with high income (P<0.001). CONCLUSION For high-income participants, greater adherence was associated with better cognitive performance; for low-income participants, greater adherence was associated with lower cognitive performance.
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Affiliation(s)
- Naomi V Ferreira
- Center for Clinical and Epidemiological Research, Hospital Universitário
- Adventist University of São Paulo, Engenheiro Coelho, SP
| | - Paulo A Lotufo
- Center for Clinical and Epidemiological Research, Hospital Universitário
- Department of Internal Medicine, Faculdade de Medicina
| | - Dirce M L Marchioni
- Nutrition Department, University of Sao Paulo Medical School, School of Public Health
| | | | - Maria C Viana
- Section of Psychiatric Epidemiology (CEPEP), Department of Social Medicine, Postgraduate Program in Public Health, Federal University of Espírito Santo, Vitória, Brazil
| | - Paulo Caramelli
- Behavioral and Cognitive Research Group, Medical Clinics Department, Medical School, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil
| | - Isabela J M Bensenor
- Center for Clinical and Epidemiological Research, Hospital Universitário
- Department of Internal Medicine, Faculdade de Medicina
| | - Claudia K Suemoto
- Division of Geriatrics, University of Sao Paulo Medical School, Sao Paulo
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16
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Chen C, Lu Z, Zhang D, Li S. The Mediation Role of the Risk of Non-Alcoholic Fatty Liver Disease in Relationship between Lutein and Zeaxanthin and Cognitive Functions among Older Adults in the United States. Nutrients 2022; 14:nu14030578. [PMID: 35276937 PMCID: PMC8840044 DOI: 10.3390/nu14030578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2021] [Revised: 01/25/2022] [Accepted: 01/26/2022] [Indexed: 11/23/2022] Open
Abstract
Background: Previous studies showed lutein and zeaxanthin (L and Z) may influence cognitive function by different mechanisms. Our study aimed to be the first to examine whether the risk of non-alcoholic fatty liver disease (NAFLD) mediated the possible association between the dietary intake of L and Z and cognitive function. Methods: We conducted a cross-sectional analysis of participants aged 60 years or over in the National Health and Nutrition Examination Survey (NHANES) 2011–2014. Multivariable linear regression was used to investigate the association between the dietary intake of L and Z and cognitive function, and structural equation modeling tested the mediation effect. Results: The fatty liver index for the United States population (US FLI) acted as a mediator in the association between the higher intake of L and Z and the Animal Fluency Test, the Digit Symbol Substitution Test (DSST), and composite score and mediated 13.89%, 17.87%, and 13.79% of the total association in dietary L and Z intake (14.29%, 13.68%, and 10.34% of the total association in total L and Z intake), respectively. Conclusion: Our study indicated the potential role of the risk of NAFLD as a mediator of associations between the dietary intake of L and Z and cognitive function in the geriatric American population.
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Affiliation(s)
| | | | | | - Suyun Li
- Correspondence: ; Tel.: +86-0532-8299-1712
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17
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Mumme KD, Conlon CA, von Hurst PR, Jones B, Haskell-Ramsay CF, de Seymour JV, Stonehouse W, Heath ALM, Coad J, Mugridge O, Slade C, Gammon CS, Beck KL. Dietary patterns and cognitive function in older New Zealand adults: the REACH study. Eur J Nutr 2022; 61:1943-1956. [DOI: 10.1007/s00394-021-02775-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Accepted: 12/06/2021] [Indexed: 12/25/2022]
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18
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Samieri C, Yassine HN, Melo van Lent D, Lefèvre-Arbogast S, van de Rest O, Bowman GL, Scarmeas N. Personalized nutrition for dementia prevention. Alzheimers Dement 2021; 18:1424-1437. [PMID: 34757699 DOI: 10.1002/alz.12486] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2021] [Revised: 08/26/2021] [Accepted: 08/30/2021] [Indexed: 12/17/2022]
Abstract
The role of nutrition has been investigated for decades under the assumption of one-size-fits-all. Yet there is heterogeneity in metabolic and neurobiological responses to diet. Thus a more personalized approach may better fit biological reality and have increased efficacy to prevent dementia. Personalized nutrition builds on the food exposome, defined as the history of diet-related exposures over the lifetime, and on its interactions with the genome and other biological characteristics (eg, metabolism, the microbiome) to shape health. We review current advances of personalized nutrition in dementia research. We discuss key questions, success milestones, and future roadmap from observational epidemiology to clinical studies through basic science. A personalized nutrition approach based on the best prescription for the most appropriate target population in the most relevant time-window has the potential to strengthen dementia-prevention efforts.
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Affiliation(s)
- Cécilia Samieri
- Univ. Bordeaux, ISPED, Inserm, Bordeaux Population Health Research Center, Bordeaux, France
| | - Hussein N Yassine
- Department of Medicine, Keck School of Medicine USC, Los Angeles, California, USA.,Department of Neurology, Keck School of Medicine USC, Los Angeles, California, USA
| | - Debora Melo van Lent
- Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases, UT Health San Antonio, San Antonio, Texas, USA.,Department of Neurology, Boston University School of Medicine, Boston, Massachusetts, USA
| | | | - Ondine van de Rest
- Division of Human Nutrition and Health, Wageningen University and Research, Wageningen, the Netherlands
| | - Gene L Bowman
- Department of Neurology and Layton Aging and Alzheimer's Disease Center, Oregon Health and Science University, Portland, Oregon, USA.,Helfgott Research Institute, National University of Natural Medicine, Portland, Oregon, USA
| | - Nikolaos Scarmeas
- 1st Department of Neurology, Aiginition Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece.,Taub Institute for Research in Alzheimer's Disease and the Aging Brain, The Gertrude H. Sergievsky Center, Department of Neurology, Columbia University, New York, New York, USA
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19
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Gajda R, Jeżewska-Zychowicz M, Raczkowska E. Differences in Dietary Patterns among the Polish Elderly: A Challenge for Public Health. Nutrients 2021; 13:nu13113966. [PMID: 34836221 PMCID: PMC8622733 DOI: 10.3390/nu13113966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2021] [Revised: 11/03/2021] [Accepted: 11/05/2021] [Indexed: 11/16/2022] Open
Abstract
The aim of the study was to assess the diversity of dietary patterns within the elderly, in relation to the region of residence, household structure, and socioeconomic status. The questionnaire was conducted in a group of 427 Polish adults aged 60 and older from June to September 2019. The sample was selected by means of the snowball method in two regions. Principal component analysis (PCA) was used to extract and identify three dietary patterns (factors) from the frequency of eating 32 groups of foods. Logistic regression analysis was used to determine the relationship between the identified dietary patterns (DPs), region, household status, and socioeconomic index (SES). Adherence to the identified DPs, i.e., traditional, prudent, and adverse, was associated with socioeconomic status (SES) and living environment, i.e., living alone, with partner, or with family, while the region did not differentiate them. Less people living with their family were characterized by the frequent consumption of traditional food (the upper tertile of this DP), while more of them often consumed food that was typical for both prudent and adverse DPs (the upper tertiles of these DPs). The presence of a partner when living with family did not differentiate the adherence to DPs. A high SES decreased the chances of adhering to the upper tertiles of the “prudent” and “traditional” DPs, while living with family increased the chances of adhering to both the upper and middle tertiles of the “prudent” DP. Identifying the dietary patterns of the elderly contributes to a better understanding of the food intake of the senior citizens living in different social situations, in order to support public policies and nutritional counseling among this age group.
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Affiliation(s)
- Robert Gajda
- Department of Human Nutrition, Faculty of Biotechnology and Food Sciences, Wrocław University of Environmental and Life Science, Norwida 25, 50-375 Wroclaw, Poland;
- Correspondence: ; Tel.: +48-507120428
| | - Marzena Jeżewska-Zychowicz
- Department of Food Market and Consumer Research, Institute of Human Nutrition Sciences, Warsaw University of Life Sciences (SGGW-WULS), Nowoursynowska 159C, 02-776 Warsaw, Poland;
| | - Ewa Raczkowska
- Department of Human Nutrition, Faculty of Biotechnology and Food Sciences, Wrocław University of Environmental and Life Science, Norwida 25, 50-375 Wroclaw, Poland;
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20
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Tessier AJ, Presse N, Rahme E, Ferland G, Bherer L, Chevalier S. Milk, yogurt and cheese intake is positively associated with cognitive executive functions in older adults of the Canadian Longitudinal Study on Aging. J Gerontol A Biol Sci Med Sci 2021; 76:2223-2231. [PMID: 34115853 DOI: 10.1093/gerona/glab165] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Dairy products provide essential nutrients such as calcium, vitamins B12 and D, and include bioactive peptides and fermented products, which may be beneficial for cognition, especially in older adults. Yet, few studies of large contemporary cohorts have investigated this relationship using sensitive domain-specific cognitive tests. METHODS In community-dwelling older adults of the Canadian Longitudinal Study on Aging (2011-2015), we examined cross-sectional associations between total and specific dairy product intake and performance in three cognitive domains (executive functions, memory, psychomotor speed). Cheese, milk, yogurt, regular-fat, low-fat and fermented dairy product intake frequencies were estimated using a food frequency questionnaire; participants were classified into quartiles. MANCOVA models were applied to estimate differences. RESULTS In 7,945 participants (65-86 y, 49% women, 97% Caucasian), the mean dairy product intake was 1.9 (1.1) times/d. Total dairy product, cheese and low-fat dairy product intake were positively associated with the executive function domain and yogurt intake with the memory domain (all p<0.05), independently of important covariates including age, gender, education and diet quality. Intakes of total dairy product, cheese and low-fat dairy were associated with verbal fluency specifically (all p<0.05). Participants with a dairy product intake > 2.5 times/d had a higher score compared to those consuming less. No associations were found with psychomotor speed. CONCLUSIONS This large cohort study suggests a specific role for dairy components in executive function phonemic verbal fluency and memory. Dairy product intake, a modifiable factor, may be targeted in cognitive health-promoting interventions.
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Affiliation(s)
- Anne-Julie Tessier
- School of Human Nutrition, McGill University, 21111 Lakeshore Dr, Sainte-Anne-de-Bellevue, H9X 3L9, QC, Canada.,Research Institute of the McGill University Health Centre, 1001 Decarie Blvd, Montreal, H4A 3J1, QC, Canada
| | - Nancy Presse
- Faculté de médecine et des sciences de la santé, Université de Sherbrooke, 3001 12 Ave N Immeuble X1, Sherbrooke, J1H 5N4, QC, Canada.,Centre de recherche sur le vieillissement, CIUSSS-de-l'Estrie-CHUS, 300 Rue King E, Sherbrooke, J1G 1B1, QC, Canada.,Centre de recherche de l'Institut universitaire de gériatrie de Montréal, CIUSSS-du-Centre-sud-de-l'Île-de-Montréal, 4565 Queen Mary Rd, Montreal, H3W 1W5, QC, Canada
| | - Elham Rahme
- Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, 5252 de Maisonneuve Blvd, Montréal, H4A 3S5, QC, Canada.,Department of Medicine, McGill University, 845 Sherbrooke St W, Montreal, H3A 0G4, QC, Canada
| | - Guylaine Ferland
- Département de Nutrition, Université de Montréal, 2405 chemin de la Côte-Sainte-Catherine Montréal, H3T 1A8, QC, Canada.,Research Centre, Montreal Heart Institute, 5000 Rue Bélanger, Montréal, H1T 1C8, QC, Canada
| | - Louis Bherer
- Centre de recherche de l'Institut universitaire de gériatrie de Montréal, CIUSSS-du-Centre-sud-de-l'Île-de-Montréal, 4565 Queen Mary Rd, Montreal, H3W 1W5, QC, Canada.,Research Centre, Montreal Heart Institute, 5000 Rue Bélanger, Montréal, H1T 1C8, QC, Canada.,Département de Médecine, Faculté de Médecine, Université de Montréal, 2900 boulevard Édouard-Montpetit, Montréal, H3T 1J4, QC, Canada
| | - Stéphanie Chevalier
- School of Human Nutrition, McGill University, 21111 Lakeshore Dr, Sainte-Anne-de-Bellevue, H9X 3L9, QC, Canada.,Research Institute of the McGill University Health Centre, 1001 Decarie Blvd, Montreal, H4A 3J1, QC, Canada.,Department of Medicine, McGill University, 845 Sherbrooke St W, Montreal, H3A 0G4, QC, Canada
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21
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Parrott MD, Carmichael PH, Laurin D, Greenwood CE, Anderson ND, Ferland G, Gaudreau P, Belleville S, Morais JA, Kergoat MJ, Fiocco AJ. The Association Between Dietary Pattern Adherence, Cognitive Stimulating Lifestyle, and Cognitive Function Among Older Adults From the Quebec Longitudinal Study on Nutrition and Successful Aging. J Gerontol B Psychol Sci Soc Sci 2021; 76:444-450. [PMID: 33063101 DOI: 10.1093/geronb/gbaa178] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVES This study examined the effect of dietary patterns and engagement in cognitive stimulating lifestyle (CSL) behaviors on the trajectory of global cognition, executive function (EF), and verbal episodic memory (VEM). METHODS Western and prudent dietary patterns were empirically derived using food frequency questionnaire responses from 350 community-dwelling older adults (mean age: 73.7 years) participating in the Quebec Longitudinal Study on Nutrition and Successful Aging. CSL was represented by a binary composite indicator based on education, occupational complexity, and social engagement. Global cognition, EF, and VEM were assessed prospectively. RESULTS Primary effect models revealed an association between higher Western dietary pattern score and a greater rate of decline in global cognition and EF. Higher Western dietary pattern adherence was also associated with poorer baseline VEM. Primary effect models also revealed that CSL was independently associated with baseline global cognition and EF. Effect modification models suggested an interactive effect between Western dietary pattern and CLS on global cognition only. No associations were found for prudent dietary pattern score. DISCUSSION Contributing to existing research supporting the negative impact of consuming an unhealthy diet on cognitive function, the current study suggests increased vulnerability among older adults who do not engage in a CSL. These findings can inform the development of lifestyle intervention programs that target brain health in later adulthood.
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Affiliation(s)
| | - Pierre-Hugues Carmichael
- Centre d'excellence sur le vieillissement de Québec, Centre de recherche du CHU de Québec, Canada.,Centre de recherche sur les soins et les services de première ligne de l'Université Laval, Canada
| | - Danielle Laurin
- Centre d'excellence sur le vieillissement de Québec, Centre de recherche du CHU de Québec, Canada.,Centre de recherche sur les soins et les services de première ligne de l'Université Laval, Canada
| | - Carol E Greenwood
- Rotman Research Institute, Baycrest Health Sciences, Toronto, Ontario, Canada.,Department of Nutritional Sciences, University of Toronto, Ontario, Canada
| | - Nicole D Anderson
- Rotman Research Institute, Baycrest Health Sciences, Toronto, Ontario, Canada.,Departments of Psychiatry and Psychology, University of Toronto, Ontario, Canada
| | - Guylaine Ferland
- Département de nutrition, Université de Montréal, Quebec, Canada.,Research Center, Montreal Heart Institute, Quebec, Canada
| | - Pierrette Gaudreau
- Centre de recherche du Centre hospitalier de l'Université de Montréal, Quebec, Canada.,Département de médecine, Université de Montréal, Quebec, Canada
| | - Sylvie Belleville
- Centre de recherche, Institut universitaire de gériatrie de Montréal, CIUSSS du Centre-sud-de-l'Île-de-Montréal, Quebec, Canada
| | - José A Morais
- School of Dietetics and Human Nutrition, McGill University, Montréal, Quebec, Canada.,Division of Geriatric Medicine, McGill University, Montréal, Quebec, Canada
| | - Marie-Jeanne Kergoat
- Département de médecine, Université de Montréal, Quebec, Canada.,Centre de recherche, Institut universitaire de gériatrie de Montréal, CIUSSS du Centre-sud-de-l'Île-de-Montréal, Quebec, Canada
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22
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Bermejo-Pareja F, Ciudad-Cabañas MJ, Llamas-Velasco S, Tapias-Merino E, Hernández Gallego J, Hernández-Cabria M, Collado-Yurrita L, López-Arrieta JM. Is milk and dairy intake a preventive factor for elderly cognition (dementia and Alzheimer's)? A quality review of cohort surveys. Nutr Rev 2020; 79:743-757. [PMID: 33316068 DOI: 10.1093/nutrit/nuaa045] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Milk and dairy (M&D) is a longstanding human food with widespread use. Many studies showed the preventive capacity of M&D in several human health disorders, but its utility in others is under discussion. Aging has been associated to elderly cognitive decline including dementia-Alzheimer syndrome (Dem-AD). The absence of a therapy to impede or postpone Dem-AD determines the need for its prevention, including nutritional factors. To evaluate the preventive capacity of M&D consumption in elderly Dem-AD we performed a systematic review in the main biomedical databases and information resources, but we present this study as a narrative review to discuss better the complexity of this subject. The elderly Dem-AD has a long pre-symptomatic period and the M&D intake has a widespread use. These determinants and the quality flaws of published studies impeach us to answer whether M&D consumption is preventive for Dem-AD. Moreover, two long Japanese cohorts suggest that M&D intake could prevent Dem-AD. Prospective cohorts beginning in midlife (or early life) could answer this question in the future.
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Affiliation(s)
- Félix Bermejo-Pareja
- Research Unit, University Hospital "12 de Octubre", Madrid. Chair "Alzheimer disease", Department of Medicine, Faculty of Medicine, Complutense University of Madrid, Spain
| | | | - Sara Llamas-Velasco
- Research Institute (Imas12), University Hospital "12 de Octubre," Madrid, Spain
| | - Ester Tapias-Merino
- Research Institute (Imas12), University Hospital "12 de Octubre," Madrid, Spain
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23
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Self-Reported Diet Quality Differentiates Nutrient Intake, Blood Nutrient Status, Mood, and Cognition: Implications for Identifying Nutritional Neurocognitive Risk Factors in Middle Age. Nutrients 2020; 12:nu12102964. [PMID: 32998296 PMCID: PMC7599651 DOI: 10.3390/nu12102964] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Revised: 09/22/2020] [Accepted: 09/24/2020] [Indexed: 12/19/2022] Open
Abstract
Evidence for diet quality representing a modifiable risk factor for age-related cognitive decline and mood disturbances has typically come from retrospective, cross-sectional analyses. Here a diet screening tool (DST) was used to categorize healthy middle-aged volunteers (n = 141, 40–65 years) into “optimal” or “sub-optimal” diet groups to investigate cross-sectional associations between diet quality, cognitive function, and mood. The DST distinguished levels of nutrient intake as assessed by Automated Self-Administered 24-h dietary recall and nutrient status, as assessed by blood biomarker measures. Compared with the “sub-optimal” group, the “optimal” diet group showed significantly higher intake of vitamin E (p = 0.007), magnesium (p = 0.001), zinc (p = 0.043) and fiber (p = 0.015), higher circulating levels of vitamin B6 (p = 0.030) and red blood cell folate (p = 0.026) and lower saturated fatty acids (p = 0.012). Regarding psychological outcomes, the “optimal” diet group had significantly better Stroop processing than those with a “sub-optimal” diet (p = 0.013). Regression analysis revealed that higher DST scores were associated with fewer mood disturbances (p = 0.002) and lower perceived stress (p = 0.031), although these differences were not significant when comparing “optimal” versus “sub-optimal” as discrete groups. This study demonstrates the potential of a 20-item diet screen to identify both nutritional and psychological status in an Australian setting.
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Kheirouri S, Alizadeh M. Dietary Inflammatory Potential and the Risk of Neurodegenerative Diseases in Adults. Epidemiol Rev 2020; 41:109-120. [PMID: 31565731 DOI: 10.1093/epirev/mxz005] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Revised: 02/17/2019] [Accepted: 02/26/2019] [Indexed: 01/12/2023] Open
Abstract
Nutrition and diet have been suggested to enhance or inhibit cognitive performance and the risk of several neurodegenerative diseases. We conducted a systematic review to elucidate the relationship between the inflammatory capacity of a person's diet and the risk of incident neurodegenerative diseases. We searched major medical databases for articles published through June 30, 2018. Original, full-text, English-language articles on studies with human participants which investigated the link between dietary inflammatory potential and risk of developing neurodegenerative diseases were included. Duplicate and irrelevant studies were removed, and data were compiled through critical analysis. Initially, 457 articles were collected via the searching method, of which 196 studies remained after removal of duplicates. Fourteen articles were screened and found to be relevant to the scope of the review. After critical analysis, 10 were included in the final review. In all studies but one, a higher dietary inflammatory index (DII) was related to higher risk of developing neurodegenerative disease symptoms, including memory and cognition decline and multiple sclerosis. Of 3 studies that assessed the association of DII with levels of circulating inflammation markers, 2 indicated that DII was positively correlated with inflammatory marker levels. Low literacy, an unhealthy lifestyle, and individual nutritional status were the factors involved in a diet with inflammatory potential. These findings enhance confidence that DII is an appropriate tool for measurement of dietary inflammatory potential and validate the role of diets with inflammatory potential in the pathophysiology of neurodegenerative diseases. DII may be correlated with levels of circulating inflammatory markers.
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Affiliation(s)
- Sorayya Kheirouri
- Department of Community Nutrition, School of Health and Nutrition, Faculty of Nutrition and Food Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mohammad Alizadeh
- Nutrition Research Center, School of Health and Nutrition, Faculty of Nutrition and Food Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
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25
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D'Amico D, Parrott MD, Greenwood CE, Ferland G, Gaudreau P, Belleville S, Laurin D, Anderson ND, Kergoat MJ, Morais JA, Presse N, Fiocco AJ. Sex differences in the relationship between dietary pattern adherence and cognitive function among older adults: findings from the NuAge study. Nutr J 2020; 19:58. [PMID: 32563260 PMCID: PMC7306140 DOI: 10.1186/s12937-020-00575-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Accepted: 06/14/2020] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Consumption of a prudent dietary pattern rich in healthy nutrients is associated with enhanced cognitive performance in older adulthood, while a Western dietary pattern low in healthy nutrients is associated with poor age-related cognitive function. Sex differences exist in dietary intake among older adults; however, there is a paucity of research examining the relationship between sex-specific dietary patterns and cognitive function in later life. METHODS The current study aimed to investigate sex differences in the relationship between sex-specific dietary pattern adherence and global cognitive function at baseline and over a 3-year follow-up in 1268 community-dwelling older adults (Mage = 74 years, n = 664 women, n = 612 men) from the Quebec Longitudinal Study on Nutrition and Successful Aging (NuAge). A 78-item Food Frequency Questionnaire was used to estimate dietary intake over the previous year. Sex-specific dietary pattern scores were derived using principal component analysis. Global cognition was assessed using the Modified Mini-Mental State Examination (3MS). RESULTS Adjusted linear mixed effects models indicated that a healthy, prudent dietary pattern was not associated with baseline cognitive performance in men or women. No relationship was found between Western dietary pattern adherence and baseline cognitive function in women. Among men, adherence to an unhealthy, Western dietary pattern was associated with poorer baseline cognitive function (β = - 0.652, p = 0.02, 95% CI [- 1.22, - 0.65]). No association was found between prudent or Western dietary patterns and cognitive change over time in men or women. CONCLUSIONS These findings highlight the importance of conducting sex-based analyses in aging research and suggest that the relationship between dietary pattern adherence and cognitive function in late life may be sex-dependent.
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Affiliation(s)
- Danielle D'Amico
- Department of Psychology, Ryerson University, Toronto, ON, Canada
| | | | - Carol E Greenwood
- Rotman Research Institute, Baycrest Health Sciences, North York, ON, Canada.,Department of Nutritional Sciences, University of Toronto, Toronto, ON, Canada
| | - Guylaine Ferland
- Department of Nutrition, Université de Montréal, Montréal, QC, Canada
| | - Pierrette Gaudreau
- Department of Medicine and Centre hospitalier de l'Université de Montréal (CHUM), Université de Montréal, Montréal, QC, Canada
| | - Sylvie Belleville
- Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal (CRIUGM), Montréal, QC, Canada
| | - Danielle Laurin
- Centre d'excellence sur le vieillissement de Québec, Université Laval, Québec, QC, Canada
| | - Nicole D Anderson
- Rotman Research Institute, Baycrest Health Sciences, North York, ON, Canada.,Department of Psychology, University of Toronto, Toronto, ON, Canada.,Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Marie-Jeanne Kergoat
- Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal (CRIUGM), Montréal, QC, Canada
| | - Jose A Morais
- Division of Geriatric Medicine, McGill University, Montréal, QC, Canada
| | - Nancy Presse
- Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal (CRIUGM), Montréal, QC, Canada.,Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, QC, Canada.,Research Center on Aging, CIUSSS-de-l'Estrie-CHUS, Sherbrooke, QC, Canada
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26
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Estrella ML, Durazo-Arvizu RA, Mattei J, Mossavar-Rahmani Y, Perreira KM, Siega-Riz AM, Sotres-Alvarez D, González HM, Gallo LC, Daviglus ML, Lamar M. Alternate Healthy Eating Index is Positively Associated with Cognitive Function Among Middle-Aged and Older Hispanics/Latinos in the HCHS/SOL. J Nutr 2020; 150:1478-1487. [PMID: 32091597 PMCID: PMC7269746 DOI: 10.1093/jn/nxaa023] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2019] [Revised: 11/04/2019] [Accepted: 01/27/2020] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Diet quality may be an important area of focus for promoting cognitive health; however, the association between diet quality and cognitive function among Hispanics/Latinos remains largely unexamined. We hypothesized that a healthier diet quality will be associated with better cognitive function in middle-aged and older Hispanics/Latinos. OBJECTIVE The objective of this study was to examine associations between the Alternate Healthy Eating Index (AHEI-2010), a measure of diet quality, and cognitive function in middle-aged and older Hispanics/Latinos. METHODS Data from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL) Visit 1 (2008-2011) were used (n = 8461; ages 45-74 y). Cognitive function was assessed with tests of verbal learning and memory, verbal fluency, and processing speed; a global cognition score was derived by summing the z scores of individual tests. Dietary intake was assessed via two 24-h recalls. Total AHEI-2010 score was categorized into quintiles (higher quintiles indicating healthier diet). Linear regression models were used to examine associations between AHEI-2010 quintiles and cognitive function adjusting for sociodemographic characteristics, daily energy intake, type 2 diabetes, smoking, and depressive symptoms. RESULTS Compared with the lowest quintile, in the second to fourth AHEI-2010 quintiles, global cognition scores were significantly higher by 0.28, 0.52, and 0.48 units (P-trend = 0.042). In the second to fifth AHEI-2010 quintiles, verbal learning scores were significantly higher by 0.60, 0.62, 0.92, and 0.88 units, and verbal memory scores were higher by 0.33, 0.40, 0.52, and 0.46 units (P-trend = 0.020 and 0.007, respectively). No associations were observed between the AHEI-2010 and verbal fluency or processing speed (P-trend = 0.49 and 0.84, respectively). Among AHEI-2010 components, adequate consumption of vegetables, alcohol, and whole fruits were each associated with better cognitive function. CONCLUSIONS An overall healthier diet quality was associated with better global cognition, verbal learning, and verbal memory in middle-aged and older Hispanics/Latinos.
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Affiliation(s)
- Mayra L Estrella
- Institute for Minority Health Research, University of Illinois at Chicago, Chicago, IL 60612, USA
| | | | - Josiemer Mattei
- Department of Nutrition, Harvard University TH Chan School of Public Health, Boston, MA 02115, USA
| | - Yasmin Mossavar-Rahmani
- Departments of Medicine and Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY 10461, USA
| | - Krista M Perreira
- Department of Social Medicine, School of Medicine, University of North Carolina at Chapel Hill, NC 27599, USA
| | - Anna Maria Siega-Riz
- School of Public Health and Health Sciences, University of Massachusetts Amherst, Amherst, MA 01003, USA
| | - Daniela Sotres-Alvarez
- Collaborative Studies Coordinating Center, Department of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill, NC 27516, USA
| | - Hector M González
- Department of Neuroscience, Shiley-Marcos Alzheimer's Disease Research Center, University of California San Diego, San Diego, CA 92093, USA
| | - Linda C Gallo
- Department of Psychology, San Diego State University, San Diego, CA 92182, USA
| | - Martha L Daviglus
- Institute for Minority Health Research, University of Illinois at Chicago, Chicago, IL 60612, USA
| | - Melissa Lamar
- Rush Alzheimer's Disease Center and Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, IL 60612, USA
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27
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Hogervorst E. Vegetable, Fruit, and Low to Moderate Alcohol Intakes Are Associated with Better Cognition in Middle-Aged and Older Hispanics/Latinos. J Nutr 2020; 150:1352-1353. [PMID: 32321170 DOI: 10.1093/jn/nxaa110] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Revised: 03/05/2020] [Accepted: 03/31/2020] [Indexed: 12/29/2022] Open
Affiliation(s)
- Eef Hogervorst
- School of Sport, Exercise, and Health Sciences, Loughborough University, Loughborough, United Kingdom
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28
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Wu J, Song X, Chen GC, Neelakantan N, van Dam RM, Feng L, Yuan JM, Pan A, Koh WP. Dietary pattern in midlife and cognitive impairment in late life: a prospective study in Chinese adults. Am J Clin Nutr 2019; 110:912-920. [PMID: 31374567 PMCID: PMC6766457 DOI: 10.1093/ajcn/nqz150] [Citation(s) in RCA: 68] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2019] [Accepted: 06/24/2019] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Prospective studies linking dietary pattern and cognitive function in the elderly are limited in Asian populations. OBJECTIVE We examined the associations between various healthful dietary patterns and risk of cognitive impairment in Chinese adults. METHODS We used data from the Singapore Chinese Health Study of 16,948 men and women who were aged 45-74 y at baseline (1993-1998) and reinterviewed at the third follow-up visit (2014-2016), ∼20 y later. Diet quality at baseline was assessed according to the alternate Mediterranean diet (aMED), the Dietary Approaches to Stop Hypertension (DASH) diet, the alternative Healthy Eating Index (AHEI)-2010, overall plant-based diet index (PDI), and healthful plant-based diet index (hPDI). Cognitive function was evaluated using a Singapore-modified Mini-Mental State Examination during the third follow-up visit when subjects were aged 61-96 y. Multivariable logistic regression models were used to compute ORs and 95% CIs associated with the risk of cognitive impairment defined using education-specific cut-offs. RESULTS Cognitive impairment was present in 2443 (14.4%) participants. The OR (95% CI) for cognitive impairment comparing the highest with the lowest quartile of diet quality scores was 0.67 (0.59, 0.77) for aMED, 0.71 (0.62, 0.81) for DASH, 0.75 (0.66, 0.85) for AHEI-2010, 0.82 (0.71, 0.94) for PDI, and 0.78 (0.68, 0.90) for hPDI (all P values for trend <0.001). Each SD increment in different diet quality scores was associated with 7-16% lower risk of cognitive impairment. CONCLUSIONS These results provide evidence that adherence to healthy dietary patterns in midlife is associated with a lower risk of cognitive impairment in late life in Chinese adults.
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Affiliation(s)
- Jing Wu
- Department of Epidemiology and Biostatistics, and Ministry of Education Key Laboratory of Environment and Health, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China
| | - Xingyue Song
- Department of Epidemiology and Biostatistics, and Ministry of Education Key Laboratory of Environment and Health, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China
| | - Guo-Chong Chen
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore
- Department of Nutrition and Food Hygiene, School of Public Health, Soochow University, Suzhou, Jiangsu Province, China
| | - Nithya Neelakantan
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore
| | - Rob M van Dam
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Lei Feng
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Jian-Min Yuan
- UPMC Hillman Cancer Center, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
| | - An Pan
- Department of Epidemiology and Biostatistics, and Ministry of Education Key Laboratory of Environment and Health, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China
| | - Woon-Puay Koh
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore
- Health Services and Systems Research, Duke-NUS Medical School Singapore, Singapore
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29
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The Interplay of Diet Quality and Alzheimer's Disease Genetic Risk Score in Relation to Cognitive Performance Among Urban African Americans. Nutrients 2019; 11:nu11092181. [PMID: 31514322 PMCID: PMC6769979 DOI: 10.3390/nu11092181] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2019] [Revised: 09/06/2019] [Accepted: 09/08/2019] [Indexed: 12/23/2022] Open
Abstract
We examined the interactive associations of poor diet quality and Alzheimer’s Disease (AD) genetic risk with cognitive performance among 304 African American adults (mean age~57 years) from the Healthy Aging in Neighborhoods of Diversity across the Life Span (HANDLS) study. In this cross-sectional study, selected participants had complete predictors and covariate data with 13 cognitive test scores as outcomes. Healthy Eating Index-2010 (HEI-2010), Dietary Approaches to Stop Hypertension (DASH), and mean adequacy ratio (MAR) were measured. A genetic risk score for AD in HANDLS (hAlzScore) was computed from 12 selected single nucleotide polymorphisms (SNPs). Our key hypotheses were tested using linear regression models. The hAlzScore was directly associated with poor performance in verbal memory (−0.4 ± 0.2, 0.01) and immediate visual memory (0.4 ± 0.2, 0.03) measured in seconds, in women only. The hAlzScore interacted synergistically with poorer diet quality to determine lower cognitive performance on a test of verbal fluency. Among numerous SNP × diet quality interactions for models of cognitive performance as outcomes, only one passed correction for multiple testing, namely verbal fluency. Our results suggest that improved diet quality can potentially modify performance on cognitive tests of verbal fluency among individuals with higher AD genetic risk.
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Mumme KD, von Hurst PR, Conlon CA, Jones B, Haskell-Ramsay CF, Stonehouse W, Heath ALM, Coad J, Beck KL. Study protocol: associations between dietary patterns, cognitive function and metabolic syndrome in older adults - a cross-sectional study. BMC Public Health 2019; 19:535. [PMID: 31077187 PMCID: PMC6509830 DOI: 10.1186/s12889-019-6900-4] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2019] [Accepted: 04/25/2019] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Loss of cognitive function is a significant issue as the world's population ages. Preserving cognitive function maintains independence in older adults bringing major societal and financial benefits. Lifestyle factors such as diet are modifiable risk factors, which may help preserve cognitive function. Most nutrition research aimed at preserving cognitive function and metabolic health has focussed on individual nutrients and foods, not allowing for food combinations and interactions. A dietary pattern approach considers the entire diet including its complexity. Previous research investigating dietary patterns and cognitive function has not always considered relevant covariates such as physical activity and the Apolipoprotein E genotype, which are known to have associations with cognitive function. The aim of the REACH (Researching Eating, Activity and Cognitive Health) study is to investigate associations between dietary patterns, cognitive function and metabolic syndrome, accounting for a range of covariates. METHODS This cross-sectional study design will recruit older, community-living adults (65-74 years) from Auckland, New Zealand. Dietary data will be collected via a 109-item food frequency questionnaire validated using a 4-day food record. Cognitive function will be assessed using the Montreal Cognitive Assessment (paper based) and the Computerised Mental Performance Assessment System (COMPASS) - a testing suite covering six domains. Additional data will include genetic (Apolipoprotein E ε4) and biochemical markers (fasting glucose, HbA1c, lipids profile), anthropometric measurements (weight, height, waist and hip circumference, body composition using dual X-ray absorptiometry), blood pressure, physical activity (International Physical Activity Questionnaire - short form) and health and demographics (questionnaire). Dietary patterns will be derived by principal component analysis. Associations between cognitive function and dietary patterns will be examined using multiple regression analysis. Covariates and interaction factors will include age, education, socio-economic status, physical activity, Apolipoprotein E ε4 genotype, family history of dementia or cognitive impairment, and lifestyle factors. Differences between participants with and without metabolic syndrome will also be examined. DISCUSSION This study will bring new knowledge regarding associations between dietary patterns and cognitive function and metabolic health in older adults living in New Zealand. This is important for developing nutrition related recommendations to help older adults maintain cognitive function.
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Affiliation(s)
- Karen D. Mumme
- College of Health, Massey University, Private Bag 102904, Auckland, 0745 New Zealand
| | - Pamela R. von Hurst
- College of Health, Massey University, Private Bag 102904, Auckland, 0745 New Zealand
| | - Cathryn A. Conlon
- College of Health, Massey University, Private Bag 102904, Auckland, 0745 New Zealand
| | - Beatrix Jones
- Department of Statistics, University of Auckland, Private Bag 92019, Auckland, 1142 New Zealand
| | | | - Welma Stonehouse
- Health and Biosecurity Business Unit, Commonwealth Scientific Industrial Research Organisation, PO Box 11060, Adelaide, SA 5001 Australia
| | - Anne-Louise M. Heath
- Department of Human Nutrition, University of Otago, PO Box 56, Dunedin, 9054 New Zealand
| | - Jane Coad
- College of Sciences, Massey University, Private Bag 11222, Palmerston North, 4442 New Zealand
| | - Kathryn L. Beck
- College of Health, Massey University, Private Bag 102904, Auckland, 0745 New Zealand
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Christensen K, Gleason CE, Mares JA. Dietary carotenoids and cognitive function among US adults, NHANES 2011-2014. Nutr Neurosci 2018; 23:554-562. [PMID: 30326796 DOI: 10.1080/1028415x.2018.1533199] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Objectives: Dietary carotenoids may limit neuronal damage from free radicals, potentially serving as a modifiable risk factor for cognitive decline. We examined intake of lutein and zeaxanthin (L and Z) in relation to cognitive performance among 2011-2014 National Health and Nutrition Examination Survey participants aged ≥60 years. Methods: L and Z intake from foods and supplements was estimated from two non-consecutive 24-hour diet recalls. Outcomes included the CERAD Word Learning sub-test score, Animal Fluency test score, and Digit Symbol Substitution test score. Regression models were adjusted for survey design variables, year, sex, age, race/ethnicity, body mass index, family income, education, alcohol, and smoking. Results: Among the 2796 participants, higher dietary intake of L and Z was associated with higher score on each test. For example, the highest quartile of L and Z intake was associated with a 2.52 point increase (SE=0.86 points, P=0.01) on the digit symbol score test, compared with the lowest quartile. There were differences by race/ethnicity, with positive associations generally stronger for Black compared to white participants. Discussion: Further research from longitudinal studies is needed, but increasing L and Z intake may help to prevent or slow cognitive decline.
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Affiliation(s)
- Krista Christensen
- Department of Ophthalmology and Visual Sciences, University of Wisconsin, 610 N. Walnut Street, 1069 WARF Building, Madison, WI 53726, USA
| | - Carey E Gleason
- Division of Geriatrics and Gerontology, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.,Geriatric Research, Education and Clinical Center (11G), William S. Middleton Memorial Veterans Hospital, Madison, WI, USA.,Wisconsin Alzheimer's Disease Research Center, Madison, WI, USA
| | - Julie A Mares
- Department of Ophthalmology and Visual Sciences, University of Wisconsin, 610 N. Walnut Street, 1069 WARF Building, Madison, WI 53726, USA
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de Haas SCM, de Jonge EAL, Voortman T, Graaff JSD, Franco OH, Ikram MA, Rivadeneira F, Kiefte-de Jong JC, Schoufour JD. Dietary patterns and changes in frailty status: the Rotterdam study. Eur J Nutr 2018; 57:2365-2375. [PMID: 28744573 PMCID: PMC6182690 DOI: 10.1007/s00394-017-1509-9] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2017] [Accepted: 07/11/2017] [Indexed: 10/27/2022]
Abstract
PURPOSE To determine the associations between a priori and a posteriori derived dietary patterns and a general state of health, measured as the accumulation of deficits in a frailty index. METHODS Cross-sectional and longitudinal analysis embedded in the population-based Rotterdam Study (n = 2632) aged 45 years. Diet was assessed at baseline (year 2006) using food frequency questionnaires. Dietary patterns were defined a priori using an existing index reflecting adherence to national dietary guidelines and a posteriori using principal component analysis. A frailty index was composed of 38 health deficits and measured at baseline and follow-up (4 years later). Linear regression analyses were performed using adherence to each of the dietary patterns as exposure and the frailty index as outcome (all in Z-scores). RESULTS Adherence to the national dietary guidelines was associated with lower frailty at baseline (β -0.05, 95% CI -0.08, -0.02). Additionally, high adherence was associated with lower frailty scores over time (β -0.08, 95% CI -0.12, -0.04). The PCA revealed three dietary patterns that we named a "Traditional" pattern, high in legumes, eggs and savory snacks; a "Carnivore" pattern, high in meat and poultry; and a "Health Conscious" pattern, high in whole grain products, vegetables and fruit. In the cross-sectional analyses adherence to these patterns was not associated with frailty. However, adherence to the "Traditional" pattern was associated with less frailty over time (β -0.09, 95% CI -0.14, -0.05). CONCLUSION No associations were found for adherence to a "healthy" pattern or "Carnivore" pattern. However, Even in a population that is relatively young and healthy, adherence to dietary guidelines or adherence to the Traditional pattern could help to prevent, delay or reverse frailty levels.
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Affiliation(s)
- Sandra C M de Haas
- Department of Epidemiology, University Medical Centre, Erasmus MC, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands
- VU University Amsterdam, Amsterdam, The Netherlands
| | - Ester A L de Jonge
- Department of Epidemiology, University Medical Centre, Erasmus MC, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands
- Department of Internal Medicine, University Medical Centre, Erasmus MC, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - Trudy Voortman
- Department of Epidemiology, University Medical Centre, Erasmus MC, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - Jolien Steenweg-de Graaff
- Department of Epidemiology, University Medical Centre, Erasmus MC, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - Oscar H Franco
- Department of Epidemiology, University Medical Centre, Erasmus MC, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - M Arfan Ikram
- Department of Epidemiology, University Medical Centre, Erasmus MC, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - Fernando Rivadeneira
- Department of Epidemiology, University Medical Centre, Erasmus MC, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands
- Department of Internal Medicine, University Medical Centre, Erasmus MC, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - Jessica C Kiefte-de Jong
- Department of Epidemiology, University Medical Centre, Erasmus MC, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands
- Department of Global Public Health, Leiden University College The Hague, P.O. Box 13228, 2501 EE, The Hague, The Netherlands
| | - Josje D Schoufour
- Department of Epidemiology, University Medical Centre, Erasmus MC, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands.
- Department of Internal Medicine, University Medical Centre, Erasmus MC, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands.
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Weng PH, Chen JH, Chiou JM, Tu YK, Chen TF, Chiu MJ, Tang SC, Yeh SJ, Chen YC. The effect of lifestyle on late-life cognitive change under different socioeconomic status. PLoS One 2018; 13:e0197676. [PMID: 29897986 PMCID: PMC5999076 DOI: 10.1371/journal.pone.0197676] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2017] [Accepted: 05/07/2018] [Indexed: 12/20/2022] Open
Abstract
This study aimed to identify lifestyle factors associated with cognitive change and to explore whether the effect of lifestyle varies by socioeconomic status (SES). Participants aged 65 years and older were recruited from elderly health checkup programs from 2011 to 2013 in Taiwan. Neuropsychological tests, including tests of global cognition, logical memory, executive function, verbal fluency and attention, were administered at baseline (N = 603) and 2 years later (N = 509). After literature review, 9 lifestyle factors and 3 SES indicators were chosen and their effects on cognitive change were evaluated using linear regression adjusting for age, sex, education, APOE ε4 status, and baseline cognitive score. Five lifestyle factors (high vegetable and fish intake, regular exercise, not smoking, and light to moderate alcohol consumption) and 3 SES indicators [annual household income (> 33,333 USD vs. less), occupational complexity (high vs. low mental demanding job), and years of education (> 12 years vs. less)] were found to be protective against cognitive decline (P < 0.1 in any cognitive domains, ß ranging from 0.06 to 0.38). After further adjusting for all the lifestyle and SES factors, fish intake, higher income and occupational complexity remained protective. Significant interactions were found between a healthful lifestyle (defined as having ≥ 3 healthful lifestyle factors) and income on changes of global cognition and verbal fluency (Pinteraction = 0.02 and 0.04). The protective effect of a healthful lifestyle was observed only among participants with lower income in global cognition and logical memory [ß = 0.17, 95% confidence interval (CI) = 0.07–0.26; ß = 0.30, 95% CI = 0.14–0.46]. To the best of our knowledge, this study for the first time explored how the interactions of lifestyle and SES affect cognitive change. Our findings will aid in developing dementia prevention programs and reduce health inequalities.
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Affiliation(s)
- Pei-Hsuan Weng
- Department of Family Medicine, Taiwan Adventist Hospital, Taipei, Taiwan
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Jen-Hau Chen
- Department of Geriatrics and Gerontology, National Taiwan University Hospital, Taipei, Taiwan
| | - Jeng-Min Chiou
- Institute of Statistical Science, Academia Sinica, Taipei, Taiwan
| | - Yu-Kang Tu
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Ta-Fu Chen
- Department of Neurology, National Taiwan University Hospital, Taipei, Taiwan
| | - Ming-Jang Chiu
- Department of Neurology, National Taiwan University Hospital, Taipei, Taiwan
| | - Sung-Chun Tang
- Department of Neurology, National Taiwan University Hospital, Taipei, Taiwan
| | - Shin-Joe Yeh
- Department of Neurology, National Taiwan University Hospital, Taipei, Taiwan
| | - Yen-Ching Chen
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
- Department of Public Health, College of Public Health, National Taiwan University, Taipei, Taiwan
- Research Center for Genes, Environment and Human Health, College of Public Health, National Taiwan University, Taipei, Taiwan
- * E-mail:
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Dietary Patterns Associated with Cognitive Function among the Older People in Underdeveloped Regions: Finding from the NCDFaC Study. Nutrients 2018; 10:nu10040464. [PMID: 29642510 PMCID: PMC5946249 DOI: 10.3390/nu10040464] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2018] [Revised: 03/30/2018] [Accepted: 03/30/2018] [Indexed: 01/08/2023] Open
Abstract
Although dietary patterns are crucial to cognitive function, associations of dietary patterns with cognitive function have not yet been fully understood. This cross-sectional study explored dietary patterns associated with cognitive function among the older adults in underdeveloped regions, using 1504 community-dwelling older adults aged 60 and over. Diet was assessed using a food frequency questionnaire and 24-h dietary recall. Factor analysis was used to extract dietary patterns. Global cognitive function was assessed using the Mini-Mental State Examination (MMSE). Two dietary patterns, a “mushroom, vegetable, and fruits” (MVF) pattern and a “meat and soybean products” (MS) pattern, were identified. The MVF pattern, characterized by high consumption of mushrooms, vegetables, and fruits was significantly positively associated with cognitive function (p < 0.05), with an odds ratio of (95% CIs) 0.60 (0.38, 0.94) for cognitive impairment and β (95% CIs) 0.15 (0.02, 0.29) for –log (31-MMSE score). The MS pattern, characterized by high consumption of soybean products and meat, was also associated with better cognitive function, with an odds ratio of 0.47 (95% CIs 0.30, 0.74) for cognitive impairment and β (95% CIs) 0.34 (0.21, 0.47) for –log (31-MMSE score). Our results suggested that both the MVF and MS patterns were positively associated with better cognitive function among older adults in underdeveloped regions.
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Mazza E, Fava A, Ferro Y, Moraca M, Rotundo S, Colica C, Provenzano F, Terracciano R, Greco M, Foti D, Gulletta E, Russo D, Bosco D, Pujia A, Montalcini T. Impact of legumes and plant proteins consumption on cognitive performances in the elderly. J Transl Med 2017; 15:109. [PMID: 28532453 PMCID: PMC5440936 DOI: 10.1186/s12967-017-1209-5] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2017] [Accepted: 05/12/2017] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Numerous studies have investigated the role of the dietary factors in the prevention of cognitive decline but the short-term effects of foods choice on cognitive performances in the elderly are poorly explored. Our aim was to investigate the choice of foods among elderly Italian individuals and the association with cognitive function. METHODS In this longitudinal study, the participants were 214 individuals aged ≥65 years with a score >20 at the Mini Mental State Examination. The cognitive sub-test of ADAScale was used to detect cognitive decline progression over 12 months. Food choices was measured by a combination of a 24-h recall and a seven-day diet record and Principal Components Analysis. RESULTS The Principal Components Analysis identified four food and four nutrient patterns. MMSE and ADAS-cog score after 1 year were found to be associated with legumes pattern (B = 0.25, p = 0.007; 95% CI 0.07/0.44; and B = -0.10, p = 0.006; CI -0.79/-0.30, respectively). A dietary pattern including plant proteins was independently associated with an improved ADAS-cog after 1 year (B = 0.584, p = 0.04; OR 1.79, CI 0.04-0.42). CONCLUSIONS The Principal Components Analysis is useful to investigate the choice of foods and nutrients in the elderly. We demonstrated an association between legumes pattern with cognitive performances.
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Affiliation(s)
- Elisa Mazza
- Department of Clinical and Experimental Medicine, Nutrition Unit, University Magna Grecia, Viale S. Venuta, 88100, Catanzaro, Italy
| | - Antonietta Fava
- Department of Medical and Surgical Science, Nutrition Unit, University Magna Grecia, Catanzaro, Italy
| | - Yvelise Ferro
- Department of Medical and Surgical Science, Nutrition Unit, University Magna Grecia, Catanzaro, Italy
| | - Marta Moraca
- Department of Medical and Surgical Science, Nutrition Unit, University Magna Grecia, Catanzaro, Italy
| | - Stefania Rotundo
- Department of Medical and Surgical Science, Nutrition Unit, University Magna Grecia, Catanzaro, Italy
| | - Carmela Colica
- Department of Pharmacology, CNR, ISN, University Magna Graecia, Catanzaro, Italy
| | - Francesco Provenzano
- Department of Clinical and Experimental Medicine, Nutrition Unit, University Magna Grecia, Viale S. Venuta, 88100, Catanzaro, Italy
| | - Rosa Terracciano
- Department of Health Science, Laboratory Unit, University Magna Grecia, Catanzaro, Italy
| | - Marta Greco
- Department of Health Science, Laboratory Unit, University Magna Grecia, Catanzaro, Italy
| | - Daniela Foti
- Department of Health Science, Laboratory Unit, University Magna Grecia, Catanzaro, Italy
| | - Elio Gulletta
- Department of Health Science, Laboratory Unit, University Magna Grecia, Catanzaro, Italy
| | - Diego Russo
- Department of Health Science, Laboratory Unit, University Magna Grecia, Catanzaro, Italy
| | - Domenico Bosco
- Neurology Unit, S. Giovanni di Dio Hospital, Crotone, Italy
| | - Arturo Pujia
- Department of Medical and Surgical Science, Nutrition Unit, University Magna Grecia, Catanzaro, Italy
| | - Tiziana Montalcini
- Department of Clinical and Experimental Medicine, Nutrition Unit, University Magna Grecia, Viale S. Venuta, 88100, Catanzaro, Italy.
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Kirkpatrick SI, Vanderlee L, Raffoul A, Stapleton J, Csizmadi I, Boucher BA, Massarelli I, Rondeau I, Robson PJ. Self-Report Dietary Assessment Tools Used in Canadian Research: A Scoping Review. Adv Nutr 2017; 8:276-289. [PMID: 28298272 PMCID: PMC5347105 DOI: 10.3945/an.116.014027] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Choosing the most appropriate dietary assessment tool for a study can be a challenge. Through a scoping review, we characterized self-report tools used to assess diet in Canada to identify patterns in tool use and to inform strategies to strengthen nutrition research. The research databases Medline, PubMed, PsycINFO, and CINAHL were used to identify Canadian studies published from 2009 to 2014 that included a self-report assessment of dietary intake. The search elicited 2358 records that were screened to identify those that reported on self-report dietary intake among nonclinical, non-Aboriginal adult populations. A pool of 189 articles (reflecting 92 studies) was examined in-depth to assess the dietary assessment tools used. Food-frequency questionnaires (FFQs) and screeners were used in 64% of studies, whereas food records and 24-h recalls were used in 18% and 14% of studies, respectively. Three studies (3%) used a single question to assess diet, and for 3 studies the tool used was not clear. A variety of distinct FFQs and screeners, including those developed and/or adapted for use in Canada and those developed elsewhere, were used. Some tools were reported to have been evaluated previously in terms of validity or reliability, but details of psychometric testing were often lacking. Energy and fat were the most commonly studied, reported by 42% and 39% of studies, respectively. For ∼20% of studies, dietary data were used to assess dietary quality or patterns, whereas close to half assessed ≤5 dietary components. A variety of dietary assessment tools are used in Canadian research. Strategies to improve the application of current evidence on best practices in dietary assessment have the potential to support a stronger and more cohesive literature on diet and health. Such strategies could benefit from national and global collaboration.
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Affiliation(s)
- Sharon I Kirkpatrick
- School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada;
| | - Lana Vanderlee
- Department of Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada;
| | - Amanda Raffoul
- School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada
| | | | - Ilona Csizmadi
- Departments of Oncology and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Beatrice A Boucher
- Department of Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada;,Prevention and Cancer Control, Cancer Care Ontario, Toronto, Ontario, Canada
| | | | | | - Paula J Robson
- Cancer Measurement, Outcomes, Research, and Evaluation (C-MORE), Alberta Health Services Cancer Control, Edmonton, Alberta, Canada
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Abstract
A significant body of evidence suggests that poor dietary intake is associated with reduced cognitive function. However, few studies have examined this relation in poor urban settings. Our brief review suggests that (a) higher overall diet quality may play a particularly important role in cognitive function among the poorest; and (b) greater vitamin E intake is related to better cognitive performance, at least in part, via fewer depressive symptoms. The broader recent literature strongly suggests the beneficial role of diet for learning and memory, and potentially synergistic influences on other cognitive domains. However, adherence to healthful diet among urban poor may be limited by factors such as cost and access. Here, we propose several potential moderators and mediators of diet-cognition relations among urban poor. Future studies should focus on the complex interplay among factors that influence the role of diet in cognitive function among poor, urban-dwelling persons.
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Greenwood CE, Parrott MD. Nutrition as a component of dementia risk reduction strategies. Healthc Manage Forum 2017; 30:40-45. [PMID: 28929899 DOI: 10.1177/0840470416662885] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
According to the Alzheimer Society of Canada, within the next generation, Canada will experience a more than doubling of individuals living with dementia and a potentially economically crippling 10-fold increase in costs to Canadians. Up to 50% of cases with dementia can be attributed to seven modifiable, predominantly vascular and/or lifestyle-associated, risk factors. Multi-modal dementia risk reduction strategies, targeting diet, exercise, mental stimulation, and vascular risk monitoring, are likely to be the most successful. Diet-related strategies need to focus on overall diet quality and not on individual foods or nutrients. High-quality diets that are associated with better cognitive function and lower dementia risk with aging are high in vegetables, fruits, nuts, whole grains, and fish and low in red meat, high-fat dairy products, sweets, and highly processed foods. It is the time to embed risk reduction strategies into our public health and healthcare infrastructure to proactively address the challenges posed by population aging.
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Affiliation(s)
- Carol E Greenwood
- 1 Rotman Research Institute, Baycrest Health Sciences, Toronto, Ontario, Canada
- 2 Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
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Dietary patterns are associated with cognitive function in the REasons for Geographic And Racial Differences in Stroke (REGARDS) cohort. J Nutr Sci 2016; 5:e38. [PMID: 27752305 PMCID: PMC5048188 DOI: 10.1017/jns.2016.27] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2016] [Revised: 06/10/2016] [Accepted: 07/06/2016] [Indexed: 12/18/2022] Open
Abstract
Identifying factors that contribute to the preservation of cognitive function is imperative to maintaining quality of life in advanced years. Of modifiable risk factors, diet quality has emerged as a promising candidate to make an impact on cognition. The objective of this study was to evaluate associations between empirically derived dietary patterns and cognitive function. This study included 18 080 black and white participants aged 45 years and older from the REasons for Geographic And Racial Differences in Stroke (REGARDS) cohort. Principal component analysis on data from the Block98 FFQ yielded five dietary patterns: convenience, plant-based, sweets/fats, Southern, and alcohol/salads. Incident cognitive impairment was defined as shifting from intact cognitive status (score >4) at first assessment to impaired cognitive status (score ≤4) at latest assessment, measured by the Six-Item Screener. Learning, memory and executive function were evaluated with the Word List Learning, Word List Delayed Recall, and animal fluency assessments. In fully adjusted models, greater consumption of the alcohol/salads pattern was associated with lower odds of incident cognitive impairment (highest quintile (Q5) v. lowest quintile (Q1): OR 0·68; 95 % CI 0·56, 0·84; P for trend 0·0005). Greater consumption of the alcohol/salads pattern was associated with higher scores on all domain-specific assessments and greater consumption of the plant-based pattern was associated with higher scores in learning and memory. Greater consumption of the Southern pattern was associated with lower scores on each domain-specific assessment (all P < 0·05). In conclusion, dietary patterns including plant-based foods and alcohol intake were associated with higher cognitive scores, and a pattern including fried food and processed meat typical of a Southern diet was associated with lower scores.
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Allès B, Samieri C, Lorrain S, Jutand MA, Carmichael PH, Shatenstein B, Gaudreau P, Payette H, Laurin D, Barberger-Gateau P. Nutrient Patterns and Their Food Sources in Older Persons from France and Quebec: Dietary and Lifestyle Characteristics. Nutrients 2016; 8:225. [PMID: 27104557 PMCID: PMC4848693 DOI: 10.3390/nu8040225] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2015] [Revised: 03/24/2016] [Accepted: 03/31/2016] [Indexed: 12/21/2022] Open
Abstract
Background: Dietary and nutrient patterns have been linked to health outcomes related to aging. Food intake is influenced by environmental and genetic factors. The aim of the present study was to compare nutrient patterns across two elderly populations sharing a common ancestral cultural background, but living in different environments. Methods: The diet quality, lifestyle and socioeconomic characteristics of participants from the Three-City Study (3C, France, n = 1712) and the Québec Longitudinal Study on Nutrition and Successful Aging (NuAge, Quebec, Canada, n = 1596) were analyzed. Nutrient patterns and their food sources were identified in the two samples using principal component analysis. Diet quality was compared across sample-specific patterns by describing weekly food intake and associations with the Canadian Healthy Eating Index (C-HEI). Results: Three nutrient patterns were retained in each study: a healthy, a Western and a more traditional pattern. These patterns accounted for 50.1% and 53.5% of the total variance in 3C and NuAge, respectively. Higher education and non-physical occupations over lifetime were associated with healthy patterns in both studies. Other characteristics such as living alone, having a body mass index lower than 25 and being an ex-smoker were associated with the healthy pattern in NuAge. No association between these characteristics and the nutrient patterns was noted in 3C. The healthy and Western patterns from each sample also showed an inverse association with C-HEI. Conclusion: The two healthy patterns showed important similarities: adequate food variety, consumption of healthy foods and associations with common sociodemographic factors. This work highlights that nutrient patterns derived using a posteriori methods may be useful to compare the nutritional quality of the diet of distinct populations.
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Affiliation(s)
- Benjamin Allès
- Centre INSERM U897-Epidemiologie-Biostatistique, University of Bordeaux, ISPED, Bordeaux, F-33000, France.
- Centre INSERM U897-Epidemiologie-Biostatistique, INSERM, ISPED, Bordeaux, F-33000, France.
- Québec Center of Excellence on Aging, CHU de Québec Research Center, Quebec City, QC G1S 4L8, Canada.
- Faculty of Pharmacy, Laval University, Quebec City, QC G1V 0A6, Canada.
| | - Cécilia Samieri
- Centre INSERM U897-Epidemiologie-Biostatistique, University of Bordeaux, ISPED, Bordeaux, F-33000, France.
- Centre INSERM U897-Epidemiologie-Biostatistique, INSERM, ISPED, Bordeaux, F-33000, France.
| | - Simon Lorrain
- Centre INSERM U897-Epidemiologie-Biostatistique, University of Bordeaux, ISPED, Bordeaux, F-33000, France.
- Centre INSERM U897-Epidemiologie-Biostatistique, INSERM, ISPED, Bordeaux, F-33000, France.
| | - Marthe-Aline Jutand
- Centre INSERM U897-Epidemiologie-Biostatistique, University of Bordeaux, ISPED, Bordeaux, F-33000, France.
- Centre INSERM U897-Epidemiologie-Biostatistique, INSERM, ISPED, Bordeaux, F-33000, France.
| | - Pierre-Hugues Carmichael
- Québec Center of Excellence on Aging, CHU de Québec Research Center, Quebec City, QC G1S 4L8, Canada.
| | - Bryna Shatenstein
- Département de Nutrition, Université de Montréal, Montréal, QC H3T 1A8, Canada.
- Centre de Recherche, Institut Universitaire de Gériatrie de Montréal, CIUSSS du Centre-est-de-l'Île-de-Montréal, Montréal, QC H3W 1W5, Canada.
| | - Pierrette Gaudreau
- Department of Medicine, University of Montreal, Montreal, QC H3C 3J7, Canada.
- Centre Hospitalier de l'Université de Montréal Research Center (CRCHUM), Montréal, QC H2X 0A9, Canada.
| | - Hélène Payette
- Research Center on Aging-Centre Intégré Universitaire de Santé et des Services Sociaux de l'Estrie-Centre Hospitalier Universitaire de Sherbrooke (CIUSS de l'Estrie-CHUS), Sherbrooke, QC J1H 4C4, Canada.
- Faculty of Medicine and Health Sciences, University of Sherbrooke, Sherbrooke, QC J1K 2R1, Canada.
| | - Danielle Laurin
- Québec Center of Excellence on Aging, CHU de Québec Research Center, Quebec City, QC G1S 4L8, Canada.
- Faculty of Pharmacy, Laval University, Quebec City, QC G1V 0A6, Canada.
| | - Pascale Barberger-Gateau
- Centre INSERM U897-Epidemiologie-Biostatistique, University of Bordeaux, ISPED, Bordeaux, F-33000, France.
- Centre INSERM U897-Epidemiologie-Biostatistique, INSERM, ISPED, Bordeaux, F-33000, France.
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França VF, Barbosa AR, D’Orsi E. Cognition and Indicators of Dietary Habits in Older Adults from Southern Brazil. PLoS One 2016; 11:e0147820. [PMID: 26894259 PMCID: PMC4764505 DOI: 10.1371/journal.pone.0147820] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2015] [Accepted: 01/09/2016] [Indexed: 12/22/2022] Open
Abstract
OBJECTIVE To assess the association between unhealthy dietary habits and cognition in older adults from Southern Brazil. METHODS This cross-sectional study analyzed data from the second wave of a population- and household-based epidemiological survey (2013-2014) conducted in the city of Florianópolis. A total of 1,197 older adults (778 women) over 60 years old participated in the study. Cognition, the dependent variable, was measured by the Mini-Mental State Examination (MMSE). The independent variables were the following indicators of unhealthy dietary habits: low intake of fruits and vegetables (≤ 4 servings/day); fish (< 1 serving/week); and habitual fatty meat intake (yes/no). Adjustments were made for age, education level, income, smoking status, alcohol intake, leisure-time physical activity, depression symptoms, chronic diseases, and body mass index. Simple and multiple linear regression analyses were performed, considering sampling weights and stratification by gender. RESULTS The mean MMSE scores for men and women were 25.15 ± 5.56 and 24.26 ± 5.68, respectively (p = 0.009). After adjustments, in women low fruit and vegetable intake (≤ 4 servings/day) was independently associated with the lowest MMSE scores. No associations were found in men. Additionally, women's mean MMSE scores increased as their daily frequency of fruit and vegetable intake increased (p = 0.001). CONCLUSION Women with low fruit and vegetable intake according to the World Health Organization (WHO) have lower cognition scores. Regular intake of fruits, vegetables, and fish in exchange of fatty meats may be a viable public policy strategy to preserve cognition in aging.
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Affiliation(s)
- Vivian Francielle França
- Doutoranda, Universidade Federal de Santa Catarina, Programa de Pós Graduação em Nutrição, Florianópolis, Brasil
| | - Aline Rodrigues Barbosa
- Doutora, Departamento de Nutrição, Centro de Desportos, Universidade Federal de Santa Catarina, Programa de Pós Graduação em Nutrição, Florianópolis, Brasil
| | - Eleonora D’Orsi
- Doutora, Departamento de Saúde Pública, Universidade Federal de Santa Catarina, Programa de Pós Graduação em Saúde Coletiva, Florianópolis, Brasil
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Milte CM, McNaughton SA. Dietary patterns and successful ageing: a systematic review. Eur J Nutr 2015; 55:423-450. [PMID: 26695408 PMCID: PMC4767865 DOI: 10.1007/s00394-015-1123-7] [Citation(s) in RCA: 105] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2015] [Accepted: 11/29/2015] [Indexed: 10/25/2022]
Abstract
PURPOSE Nutrition is a key determinant of chronic disease in later life. A systematic review was conducted of studies examining dietary patterns and quality of life, physical function, cognitive function and mental health among older adults. METHODS Literature searches in MEDLINE complete, Academic Search Complete, CINAHL Complete, Ageline, Global health, PsycINFO, SCOPUS and EMBASE and hand searching from 1980 up to December 2014 yielded 1236 results. Inclusion criteria included dietary pattern assessment via dietary indices or statistical approaches, a sample of community-dwelling adults aged 45 years and over at baseline and a cross-sectional or longitudinal study design. Exclusion criteria included a single 24-h recall of diet, evaluation of single foods or nutrients, clinical or institutionalised samples and intervention studies. Risk of bias was assessed using the six-item Effective Public Health Practice Project's Quality Assessment Tool for Quantitative Studies. RESULTS There were 34 articles (11 cross-sectional and 23 longitudinal) included with 23 studies examining dietary indices and 13 studies using empirical analysis. Most studies examined mental health (n = 10) or cognitive function (n = 18), with fewer studies examining quality of life (n = 6) and physical function (n = 8). Although dietary pattern and outcome assessment methods varied, most studies reported positive associations between a healthier diet and better health outcomes. CONCLUSION Overall, the number of studies using dietary patterns to investigate diet and successful ageing is small, and further investigation in longitudinal studies is needed, particularly for quality-of-life outcomes. This review provides support for the importance of a healthy diet for the ageing population globally.
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Affiliation(s)
- Catherine M Milte
- Centre for Physical Activity and Nutrition Research, School of Exercise and Nutrition Sciences, Deakin University, 221 Burwood Highway, Burwood, Melbourne, VIC, 3125, Australia.
| | - Sarah A McNaughton
- Centre for Physical Activity and Nutrition Research, School of Exercise and Nutrition Sciences, Deakin University, 221 Burwood Highway, Burwood, Melbourne, VIC, 3125, Australia
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Temple N. The possible importance of income and education as covariates in cohort studies that investigate the relationship between diet and disease. F1000Res 2015; 4:690. [PMID: 27303622 PMCID: PMC4897756 DOI: 10.12688/f1000research.6929.1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/12/2016] [Indexed: 01/01/2024] Open
Abstract
BACKGROUND Many cohort studies have been carried out that have provided information on the relationship between diet and health-related outcomes. Omission of important covariates during multivariate analysis may give rise to error due to residual confounding. A possibly important covariate is socioeconomic status (SES) as this is related to both diet and health. OBJECTIVE To determine the frequency with which different measures of SES are included as covariates during multivariate analysis of cohort studies that investigated the relationship between diet and health. METHODOLOGY An analysis was carried out of 76 randomly selected papers from 66 cohort studies. The papers covered many dietary variables and a wide variety of diseases/health-related outcomes. The cohort studies were carried out in many different locations and the subjects varied widely in age. RESULTS Approximately two-thirds of the papers (65.8%) used at least one measure of SES as a covariate. Education was used most often (60.5% of papers), followed by income (14.4%) and social class (2.6%). More than one measure of SES was used in 11.8% of papers. CONCLUSIONS Failure to include income (or another measure of present SES, such as occupation) may be a common source of error in cohort studies. Over-reliance on education may be particularly important as it is likely to be a weaker measure of present SES than is income. There is a need for more research on this question. SES in childhood is almost never included in multivariate analysis in cohort studies carried out on adults. This could also play a significant role in disease risk in middle age or later. Very little is known regarding whether this is also a source of residual confounding.
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Affiliation(s)
- Norman Temple
- Centre for Science, Athabasca University, Alberta, Canada
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Shakersain B, Santoni G, Larsson SC, Faxén-Irving G, Fastbom J, Fratiglioni L, Xu W. Prudent diet may attenuate the adverse effects of Western diet on cognitive decline. Alzheimers Dement 2015; 12:100-109. [PMID: 26342761 DOI: 10.1016/j.jalz.2015.08.002] [Citation(s) in RCA: 96] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2015] [Revised: 07/17/2015] [Accepted: 08/02/2015] [Indexed: 12/24/2022]
Abstract
INTRODUCTION The influence of mixed dietary patterns on cognitive changes is unknown. METHODS A total of 2223 dementia-free participants aged ≥60 were followed up for 6 years to examine the impact of dietary patterns on cognitive decline. Mini-mental state examination (MMSE) was administered. Diet was assessed by a food frequency questionnaire. By factor analysis, Western and prudent dietary patterns emerged. Mixed-effect models for longitudinal data with repeated measurements were used. RESULTS Compared with the lowest adherence to each pattern, the highest adherence to prudent pattern was related to less MMSE decline (β = 0.106, P = .011), whereas the highest adherence to Western pattern was associated with more MMSE decline (β = -0.156, P < .001). The decline associated with Western diet was attenuated when accompanied by high adherence to prudent pattern. DISCUSSION High adherence to prudent diet may diminish the adverse effects of high adherence to Western diet on cognitive decline.
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Affiliation(s)
- Behnaz Shakersain
- Aging Research Center, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden.
| | - Giola Santoni
- Aging Research Center, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
| | - Susanna C Larsson
- Unit of Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Gerd Faxén-Irving
- Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden
| | - Johan Fastbom
- Aging Research Center, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
| | - Laura Fratiglioni
- Aging Research Center, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden; Stockholm Gerontology Research Center, Stockholm, Sweden
| | - Weili Xu
- Aging Research Center, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden; Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China.
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Individual and collective factors predicting change in diet quality over 3 years in a subset of older men and women from the NuAge cohort. Eur J Nutr 2015; 55:1671-81. [PMID: 26169872 DOI: 10.1007/s00394-015-0986-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2015] [Accepted: 07/01/2015] [Indexed: 10/23/2022]
Abstract
PURPOSE This study examined individual and collective factors as predictors of change in global diet quality (DQ). METHODS Subjects were 373 older adults (57 % female) aged 68-82 years at recruitment (T1) into the NuAge Cohort Study, and followed for three years. Data were collected by questionnaires, physical performance tests and anthropometric measurements. Diet was assessed at T1 and T4 using three non-consecutive 24-h diet recalls (24HR) and DQ (Canadian Healthy Eating Index), and was computed on the means of the 24HR. DQ change over three years was determined as "DQT4-DQT1". Baseline (T1) measures significantly correlated with DQ at T1 were entered into backward stepwise linear regression analyses along with selected theoretical constructs and controlled for baseline DQ to determine predictors of change in DQ over 3 years. RESULTS Among men, education (p = .009) and sensations of hunger (p = .01) were positive predictors of DQ change over time, while DQ at T1 (p < .0001), cognition (p = .003) and social network (p = .019) were negative predictors (adjusted R (2) = 30.4 %). Finally, among women, diet knowledge (p = .044) was a positive predictor of DQ change, while DQ at T1 (p < .0001) and social network (p = .033) were negative predictors of DQ change over 3 years (adjusted R (2) = 24.1 %). CONCLUSIONS These results can inform dietary intervention programmes targeting gender-specific determinants of diet quality in older adults.
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Davey DA. Alzheimer's disease and vascular dementia: one potentially preventable and modifiable disease? Part II: Management, prevention and future perspective. Neurodegener Dis Manag 2015; 4:261-70. [PMID: 25095820 DOI: 10.2217/nmt.14.14] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
The management of dementia and mild cognitive impairment (MCI) includes pharmacological, nonpharmacological and caregiver interventions. Acetyl-cholinesterase inhibitors and memantine have a small beneficial effect in mild-to-moderate dementia. Attention is increasingly focused on long-term measures that may prevent, delay or minimize MCI and dementia, including Mediterranean diet, exercise, early active treatment of hypercholesterolaemia hypertension, and diabetes starting in midlife and earlier. High cognitive activity and a high cognitive reserve may prevent or delay the onset of aging-related MCI and dementia. Although the numbers of the elderly with dementia are rapidly increasing worldwide, the incidence of dementia in some countries is decreasing attributable to higher educational levels, decreased vascular risk factors and healthier lifestyles. Prevention of dementia is feasible and reasonable.
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Brodziak A, Wolińska A, Kołat E, Różyk-Myrta A. Guidelines for prevention and treatment of cognitive impairment in the elderly. Med Sci Monit 2015; 21:585-97. [PMID: 25708246 PMCID: PMC4349161 DOI: 10.12659/msm.892542] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
The aim of this study is to present the available and verified methods of prevention of cognitive decline in healthy older adults and to review clinical trials of therapies to improve impaired cognitive performance. We discuss data about the actual possibility of pharmacological treatment, usefulness of physical exercises, and effectiveness of different cognitive training methods. In a separate chapter we discuss why older people cope much better in life challenges then it would appear from the measurements made by use of neuro-psychological tests. We also discuss the so-called issue of transfers, ie, the question of how certain cognitive characteristics, improved through cognitive training, are transferred to other mental skills. We distinguish between simple and sophisticated (usually computerized) forms of cognitive training and pay particular attention to methods that are simple and easy to use. In particular, we discuss the so-called “learning therapy”, which amounts to “reading aloud and simple arithmetic calculations”, the method based on “switching between words and imagination”, and also the method consisting of personal counseling, support, and assistance in learning, especially in the form of home visits. In the final chapter we formulate practical advice, not only for individuals who want to undertake the preventing or correction activities alone with eventual help of medical professionals, but also for the members of health institutions that wish to implement preventive and therapeutic actions directed to a chosen population. We also discuss the indications and rationale for further research and clinical trials.
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Affiliation(s)
- Andrzej Brodziak
- Independent Researcher, Institute of Occupational Medicine and Environmental Health, Sosnowiec, Poland
| | | | - Estera Kołat
- Institute of Nursing, University of Applied Sciences, Nysa, Poland
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Temple N. The possible importance of income and education as covariates in cohort studies that investigate the relationship between diet and disease. F1000Res 2015; 4:690. [PMID: 27303622 PMCID: PMC4897756 DOI: 10.12688/f1000research.6929.2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/12/2016] [Indexed: 11/25/2022] Open
Abstract
Background: Many cohort studies have been carried out that have provided information on the relationship between diet and health-related outcomes. Omission of important covariates during multivariate analysis may give rise to error due to residual confounding. A possibly important covariate is socioeconomic status (SES) as this is related to both diet and health. Objective: To determine the frequency with which different measures of SES are included as covariates during multivariate analysis of cohort studies that investigated the relationship between diet and health. Methodology: An analysis was carried out of 76 randomly selected papers from 66 cohort studies. The papers covered many dietary variables and a wide variety of diseases/health-related outcomes. The cohort studies were carried out in many different locations and the subjects varied widely in age. Results: Approximately two-thirds of the papers (65.8%) used at least one measure of SES as a covariate. Education was used most often (60.5% of papers), followed by income (14.4%) and social class (2.6%). More than one measure of SES was used in 11.8% of papers. Conclusions: Failure to include income (or another measure of present SES, such as occupation) may be a common source of error in cohort studies. Over-reliance on education may be particularly important as it is likely to be a weaker measure of
present SES than is income. There is a need for more research on this question. SES in childhood is almost never included in multivariate analysis in cohort studies carried out on adults. This could also play a significant role in disease risk in middle age or later. Very little is known regarding whether this is also a source of residual confounding.
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Affiliation(s)
- Norman Temple
- Centre for Science, Athabasca University, Alberta, Canada
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49
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Crews DC, Kuczmarski MF, Miller ER, Zonderman AB, Evans MK, Powe NR. Dietary habits, poverty, and chronic kidney disease in an urban population. J Ren Nutr 2014; 25:103-10. [PMID: 25238697 DOI: 10.1053/j.jrn.2014.07.008] [Citation(s) in RCA: 76] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2014] [Revised: 07/20/2014] [Accepted: 07/22/2014] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Poverty is associated with chronic kidney disease (CKD) in the United States and worldwide. Poor dietary habits may contribute to this disparity. STUDY DESIGN Cross-sectional study. SETTING AND PARTICIPANTS A total of 2,058 community-dwelling adults aged 30 to 64 years residing in Baltimore City, Maryland. PREDICTORS Adherence to the Dietary Approaches to Stop Hypertension (DASH) diet. DASH scoring based on 9 target nutrients (total fat, saturated fat, protein, fiber, cholesterol, calcium, magnesium, sodium, and potassium); adherence defined as score ≥4.5 of maximum possible score of 9. Poverty (self-reported household income <125% of 2004 Department of Health and Human Services guideline) and nonpoverty (≥125% of guideline). OUTCOMES AND MEASUREMENTS CKD defined as estimated glomerular filtration rate <60 mL/minute/1.73 m(2) (CKD epidemiology collaboration equation). Multivariable logistic regression was used to calculate adjusted odds ratios (AORs) for relation of DASH score tertile and CKD, stratified by poverty status. RESULTS Among 2,058 participants (mean age 48 years; 57% black; 44% male; 42% with poverty), median DASH score was low, 1.5 (interquartile range, 1-2.5). Only 5.4% were adherent. Poverty, male sex, black race, and smoking were more prevalent among the lower DASH score tertiles, whereas higher education and regular health care were more prevalent among the highest DASH score tertile (P < .05 for all). Fiber, calcium, magnesium, and potassium intake were lower, and cholesterol higher, among the poverty compared with nonpoverty group (P < .05 for all), with no difference in sodium intake. A total of 5.6% of the poverty and 3.8% of the nonpoverty group had CKD (P = .05). The lowest DASH tertile (compared with the highest) was associated with more CKD among the poverty (AOR 3.15, 95% confidence interval 1.51-6.56), but not among the nonpoverty group (AOR 0.73, 95% confidence interval 0.37-1.43; P interaction = .001). CONCLUSIONS Poor dietary habits are strongly associated with CKD among the urban poor and may represent a target for interventions aimed at reducing disparities in CKD.
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Affiliation(s)
- Deidra C Crews
- Division of Nephrology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland; Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins Medical Institutions, Baltimore, Maryland.
| | | | - Edgar R Miller
- Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins Medical Institutions, Baltimore, Maryland; Division of General Internal Medicine, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Alan B Zonderman
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, National Institutes of Health, Baltimore, Maryland
| | - Michele K Evans
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, National Institutes of Health, Baltimore, Maryland
| | - Neil R Powe
- Department of Medicine, San Francisco General Hospital, University of California at San Francisco, San Francisco, California
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Schwenke DC. Nutrient-rich fruits and vegetables: key for preventing cardiovascular and all-cause mortality in those with pre-existing cardiovascular disease? Curr Opin Lipidol 2014; 25:317-8. [PMID: 25003739 DOI: 10.1097/mol.0000000000000102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Dawn C Schwenke
- aResearch Health Scientist, Research Service, Phoenix VA Healthcare System, Phoenix, Arizona bResearch Professor, College of Nursing and Health Innovation, Arizona State University, Phoenix, Arizona, USA
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