Education Attenuates the Association between Dietary Patterns and Cognition

Department of Epidemiology and Public Health, University College London, London, UK.
Dementia and Geriatric Cognitive Disorders (Impact Factor: 3.55). 03/2009; 27(2):147-54. DOI: 10.1159/000199235
Source: PubMed


Various foods have been shown to be associated with cognitive outcomes. As individual food items are not consumed in isolation, we examined the association between dietary patterns and cognitive function, with special attention to the role of education in this association.
Analyses were carried out on 4,693 stroke-free white European participants of the Whitehall II study. Two dietary patterns were determined using principal component analysis: a 'whole food' and a 'processed food' pattern. Cognitive function was assessed using a battery of 5 tests.
After adjustment for demographic, behavioral and health measures, higher intake of 'whole food' diet was associated with lower and high consumption of 'processed food' with higher odds of cognitive deficit. However, adjustment for education significantly attenuated most of these associations.
Education, through its role as a powerful confounder, shapes the relationship between dietary patterns and cognitive deficit in a healthy middle-aged UK cohort.

Download full-text


Available from: Archana Singh-Manoux,
  • Source
    • "These factors indicate the presence of cognitive reserve [21] [22]. The cognitive reserve is being analyzed in recent years and is usually assessed considering scholarity, socioeconomic status, occupations that the person has or had during life, leisure activities, IQ (intelligence quotient) and the level of literacy [23]. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Research on cognitive aging is becoming increasingly common because aging is a global phenome-non and brings with it many challenges, for example, the increased incidence of dementias such as Alzheimer's Disease (AD). Even if the cognitive decline in AD is apparently linear, impairment of autonomy in activities of daily living does not follow the same pattern. Objectives: To monitor and evaluate the cognitive aspects of elderly diagnosed with Alzheimer's disease. Methodological pro-cedures: This research was conducted from January 2006 to July 2013 at the Clinic of Geriatrics and Gerontology. Longitudinal study of 51 elderly patients aged 60 years, of both sexes who recei-ved a diagnosis of Alzheimer's disease by DSM-IV (APA, 1994) and NINDS-ADRDA (McKhann et al., 2011). Results: From the results obtained in the present study, we observed that the participants had a decline in cognitive function from the first to the second assessment, even with drug treat-ment.
    Advances in Aging Research 05/2014; 3(3):172-176. DOI:10.4236/aar.2014.32025
  • Source
    • "In an English cohort, with a mean age of 56 years at baseline, two distinct patterns of food consumption, " whole food " and " processed food, " were found using principal components analysis (Akbaraly et al., 2009). Risk of depression 5 years later was higher in the lowest tertile of wholefood consumption but did not change substantially over the other two tertiles, whereas for processed food, the risk of depression increased consistently with increased consumption (Akbaraly et al., 2009). "
    [Show abstract] [Hide abstract]
    ABSTRACT: Background: Anxiety and depression contribute to morbidity in elderly adults and may be associated with diet. We investigated the association between diet and psychological distress as a marker for depression. Methods: Dietary patterns were defined by factor analysis or the Mediterranean Diet Score (MDS); depression and anxiety were assessed 12 years later. A total of 8,660 generally healthy men and women born in Australia and aged 50-69 years from the Melbourne Collaborative Cohort Study were included. At baseline (1990-1994), diet (food frequency questionnaire), education, Socio-Economic Indexes for Areas (SEIFA) - Index of Relative Socio-economic Disadvantage, medication use, social engagement, physical activity, smoking status, alcohol use, and health conditions were assessed; at follow-up (2003-2007), psychological distress was assessed using the Kessler Psychological Distress Scale (K10). Logistic regression was used to identify associations between diet and a K10 score ≥20, indicative of psychological distress. Results: The MDS was inversely associated with psychological distress, with the odds ratio in the top-scoring group relative to the lowest scoring group being 0.72 (95% confidence interval = 0.54-0.95). Stronger adherence to a traditional Australian-style eating pattern was also associated with a lower K10 score at follow-up, with the odds ratio for having a K10 score indicative of psychological distress for the top 20% of adherence to this pattern relative to the lowest being 0.61 (95% confidence interval = 0.40-0.91). Conclusions: A Mediterranean-style diet was associated with less psychological distress, possibly through provision of a healthy nutrient profile. The Australian dietary pattern, which included some foods high in fat and sugar content along with whole foods, also showed a weak inverse association. Adherence to this pattern may reflect a feeling of belonging to the community associated with less psychological distress.
    International Psychogeriatrics 12/2012; 25(3):1-11. DOI:10.1017/S1041610212001986 · 1.93 Impact Factor
  • Source
    • "rs of schooling . Education was also a correlate of DQ and of cognition at baseline in both sexes and a predictor of cognitive de - cline . Our results thus partly resemble those from the 3C study ( Larrieu et al . , 2004 ) , but run counter to findings from the Whitehall study , where education was shown to be a powerful confounder of cognition ( Akbaraly et al . , 2009 ) suggesting that other factors may in - teract with education to protect cognition ."
    [Show abstract] [Hide abstract]
    ABSTRACT: A healthy diet may prevent cognitive decline either directly, or by decreasing risk of nutrition-related chronic diseases associated with cognitive decline. This study examined the relationships between diet quality (DQ) and cognition for over 3 years among 1488 older adults (52.6% female) from the NuAge study, aged 67 to 84 years at recruitment. Cognition was assessed at four annual visits using the modified mini-mental status examination (3MS); rate of cognitive decline was computed for each participant over the 3 years of follow-up using mixed model analyses and the individual-specific number of months between 3MS assessments. Dietary data were collected at recruitment using a validated 78-item, semi-quantitative food frequency questionnaire (FFQ). DQ was characterized as the Canadian Healthy Eating Index (C-HEI), a 9-component global DQ index (maximum score=100) computed from the FFQ output. Other variables were collected by questionnaire or direct measurement. Multivariate analyses were carried out to assess the association of DQ controlled for confounders on cognition. Total C-HEI was better in females (78.7±9.1 vs 75.7±9.4, p<.0001) as were C-HEI component subscores. Males, the less educated, smokers, those with poor social engagement, symptoms of depression, a higher waist:hip ratio and who reported financial insecurity had a poor quality diet that could contribute to chronic diseases associated with cognition. Along with functional autonomy, most of these variables emerged as covariates of baseline 3MS and predictors of cognitive decline. While certain C-HEI subscores and total C-HEI were positive univariate correlates of 3MS at recruitment, total DQ was not associated with cognition in multivariate analyses, either at baseline or over 3 years of follow-up. DQ was not independently associated with cognition. However, the study demonstrates relationships between diet quality and risk factors for chronic diseases associated with cognition. Consequently, older adults might benefit from a healthy diet to decrease risk of nutrition-related chronic diseases established as risk factors for cognitive decline. Further work in diverse older populations, use of dietary data collected earlier in life, finer cognitive measures and longer follow-up are necessary to better elucidate relationships between diet quality, chronic diseases and cognition.
    Experimental gerontology 02/2012; 47(5):353-60. DOI:10.1016/j.exger.2012.02.002 · 3.49 Impact Factor
Show more