Adherence to nutritional recommendations and subsequent cognitive performance: findings from the prospective Supplementation with Antioxidant Vitamins and Minerals 2 (SU.VI.MAX 2) study.
ABSTRACT Few studies have investigated the long-term effect of overall nutritional recommendations on cognition.
In a French cohort of middle-aged adults, we evaluated the association between the French National Nutrition and Health Program (Program National Nutrition Santé) Guideline Score (PNNS-GS) assessed at baseline and cognitive performance evaluated 13 y later.
The PNNS-GS was estimated at baseline (1994-1996) (maximum score: 15 points) in 2135 subjects in the SU.VI.MAX (Supplementation with Antioxidant Vitamins and Minerals) study. We assessed cognitive performance of subjects in 2007-2009 via a battery of 4 neuropsychologic tests that included phonemic and semantic fluency, the RI-48 (rappel indicé-48 item) cued-recall test, the trail-making test, and forward and backward digit spans. A principal components analysis was performed to account for correlations in test scores. Multivariate linear regression models or analyses of covariance were also performed.
In a multivariate model, we observed a positive association between the PNNS-GS and the cued-recall test and semantic and phonemic fluency tasks, whereas no association was observed with digit spans. The principal components analysis revealed 2 factors interpreted as reflecting verbal memory and executive functioning. Better adherence to nutritional recommendations was significantly associated with the verbal memory factor (β = 0.41; 95% CI: 0.17, 0.64), whereas no association was shown with the executive functioning factor. Removing specific components from the PNNS-GS did not modify the findings.
This study suggests that strong compliance with nutritional recommendations in midlife is associated in elderly individuals with better verbal memory, which is a cognitive domain that is particularly vulnerable to pathologic aging and Alzheimer disease. This trial was registered at clinicaltrials.gov as NCT00272428.
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ABSTRACT: Dietary intake is a modifiable exposure that may have an impact on cognitive outcomes in older age. The long-term aetiology of cognitive decline and dementia, however, suggests that the relevance of dietary intake extends across the lifetime. In the present study, we tested whether retrospective dietary patterns from the life periods of childhood, early adulthood, adulthood and middle age predicted cognitive performance in a cognitively healthy sample of 352 older Australian adults >65 years. Participants completed the Lifetime Diet Questionnaire and a battery of cognitive tests designed to comprehensively assess multiple cognitive domains. In separate regression models, lifetime dietary patterns were the predictors of cognitive factor scores representing ten constructs derived by confirmatory factor analysis of the cognitive test battery. All regression models were progressively adjusted for the potential confounders of current diet, age, sex, years of education, English as native language, smoking history, income level, apoE ɛ4 status, physical activity, other past dietary patterns and health-related variables. In the adjusted models, lifetime dietary patterns predicted cognitive performance in this sample of older adults. In models additionally adjusted for intake from the other life periods and mechanistic health-related variables, dietary patterns from the childhood period alone reached significance. Higher consumption of the 'coffee and high-sugar, high-fat extras' pattern predicted poorer performance on simple/choice reaction time, working memory, retrieval fluency, short-term memory and reasoning. The 'vegetable and non-processed' pattern negatively predicted simple/choice reaction time, and the 'traditional Australian' pattern positively predicted perceptual speed and retrieval fluency. Identifying early-life dietary antecedents of older-age cognitive performance contributes to formulating strategies for delaying or preventing cognitive decline.The British journal of nutrition 04/2014; · 3.45 Impact Factor
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ABSTRACT: Introduction The prevention of Alzheimer’s disease (AD) has become a real challenge due to its rising prevalence and the lack of an effective cure. Diet and nutrients have gained significant interest as potentially modifiable protective factors. Purpose The aim of this review is to provide an updated summary of evidence related to the effect of diet and nutritional factors on the risk of AD and cognitive aging, and discuss the potential mechanisms and confounding factors involved. Methods A search was conducted in Medline and Web of Knowledge for epidemiological and clinical studies in the international literature from January 2000 to February 2013 using combinations of the following keywords: “Alzheimer’s disease”, “mild cognitive impairment”, “cognitive function”, “dietary factors”, “omega-3”, “antioxidants”, “B vitamins”, “dietary patterns”, and “Mediterranean diet”. Results and conclusion Data from observational studies point to a protective role for certain nutrients, such as omega-3 fatty acids, antioxidants or B vitamins, and dietary patterns (Mediterranean diet). However, data from randomized controlled trials do not show a consistent effect. Whether confounding factors such as age, disease stage, other dietary components, cooking processes, and other methodological issues explain the divergent results remains to be established. Moreover, if certain nutrients protect against dementia, it is as yet unknown whether they may have a general effect on brain vascular health or directly interfere with the etiopathogenesis of AD.European Journal of Nutrition 07/2013; · 3.13 Impact Factor
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ABSTRACT: Background: Dietary patterns can be identified using a priori and a posterior approaches. Few studies have related dietary patterns with cognitive impairment in Chinese population. This study examined the risk of cognitive impairment associated with dietary patterns identified by both approaches. Methods: Baseline data on 1,926 Chinese men and 1,744 Chinese women aged > 65 years participating in a cohort study examining the risk factors for osteoporosis in Hong Kong were analyzed. Dietary data were collected using a validated food frequency questionnaire. Adherence to a priori dietary patterns, namely the Mediterranean Diet Score (MDS) was assessed. Factor analysis (FA) identified three a posterior dietary patterns: "vegetables-fruits" pattern which was rich in vegetables, fruits, soy products and legumes, "snacks-drinks-milk products" pattern which was a mixture of healthy and unhealthy food groups including fast food, sweets and desserts, nuts, milk products and whole grains, and "meat-fish" pattern which included frequent intake of meat, fish and seafood. Cognitive function was assessed by the Community Screening Instrument for Dementia (CSI-D). Multivariate logistic regression examined the risk of cognitive impairment with adjustment for potential confounders. Results: A total of 221 men and 656 women was classified as cognitive impaired. Neither the MDS nor the dietary patterns identified by FA were associated with risk of cognitive impairment in men. In women, higher "vegetables-fruits" pattern score was associated with reduced risk of cognitive impairment [Adjusted OR=0.73 (95% CI: 0.54-1.00) of the highest quartile of "vegetables-fruits" pattern score compared with the lowest quartile, ptrend=0.018]. Similar inverse trend was observed for "snacks-drinks-milk products" pattern score [Adjusted OR=0.65 (95% CI: 0.47-0.90) of the highest quartile of "snacks-drinks-milk products" pattern score compared with the lowest quartile, ptrend=0.003]. There was no association of "meat-fish" pattern or the MDS with risk of cognitive impairment in women. Conclusion: Higher "vegetables-fruits" and "snacks-drinks-milk products" pattern scores were associated with reduced risk of cognitive impairment in Chinese older women in Hong Kong.The Journal of Nutrition Health and Aging 01/2013; 17(9):757-65. · 2.39 Impact Factor