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: Interventions are crucial as they offer simple and inexpensive public health solutions that will be useful over the long term use. A Task Force on designing trials of nutritional interventions to slow cognitive decline in older adults was held in Toulouse in September 2012. The aim of the Task Force was to bring together leading experts from academia, the food industry and regulatory agencies to determine the best trial designs that would enable us to reach our goal of maintaining or improving cognitive function in apparently healthy aging people. An associated challenge for this Task Force was to determine the type of trials required by the Public Food Agencies for assessing the impact of nutritional compounds in comparison to well established requirements for drug trials. Although the required quality of the study design, rationale and statistical analysis remains the same, the studies designed to show reduction of cognitive decline require a long duration and the objectives of this task force was to determine best design for these trials. Two specific needs were identified to support trials of nutritional interventions: 1- Risk- reduction strategies are needed to tackle the growing burden of cognitive decline that may lead to dementia, 2- Innovative study designs are needed to improve the quality of these studies.The Journal of Nutrition Health and Aging 01/2013; 17(7):619-23. · 2.39 Impact Factor
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ABSTRACT: Background: Evidence on the association between Mediterranean diet (MedDiet) adherence and cognition is presently inconsistent.Objectives: The aims of this study were to investigate the association between midlife MedDiet adherence and cognitive performance assessed 13 y later among participants in the SU.VI.MAX (Supplementation with Vitamins and Mineral Antioxidants) study and to test the hypothesis of effect modification by occupation and education as cognitive reserve markers.Design: A Mediterranean Diet Score (MDS) and a Mediterranean-Style Dietary Pattern Score (MSDPS) were estimated by using repeated 24-h dietary records (1994-1996) from 3083 middle-aged subjects. Cognitive performance was assessed in 2007-2009 by using 6 neuropsychological tests, and a composite score was built. Subgroup analyses were performed according to occupational and educational status. Mean differences and 95% CIs were estimated through covariance analyses.Results: After potential confounders were accounted for, no association between MDS or MSDPS and cognitive scores was detected except for a lower phonemic fluency score with decreasing MSDPS (P = 0.048) and a lower backward digit span score with decreasing MDS (P = 0.03). In turn, a low MDS was related to a lower composite cognitive score in the small subsample of manual workers (n = 178, P-interaction = 0.04) who could be hypothesized to have low cognitive reserve. MedDiet adherence did not interact with educational level in relation to cognitive function.Conclusion: This study did not find support for a beneficial effect of MedDiet adherence on cognitive function, irrespective of educational level, which is the strongest indicator of cognitive reserve. This trial was registered at clinicaltrials.gov as NCT00272428.American Journal of Clinical Nutrition 01/2013; · 6.50 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