ArticleLiterature Review

A Comprehensive Review of Eggs, Choline, and Lutein on Cognition Across the Life-span

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Abstract

In 2030, one in five Americans will be older than 65 years, and with that an increase in the number of individuals who experience loss in cognitive capacity is to be expected. At the same time, nutrition within the first 1000 days postconception has been suggested to strongly influence cognitive outcomes across the life-span in humans. Eggs are a primary source of both choline and the xanthophyll carotenoid lutein in the western diet, and both have been suggested to influence cognitive function in humans. This comprehensive review critically examines the effects of eggs, choline, and lutein on cognition across the life-span. There seems to be clear scientific evidence to suggest that both choline and lutein play a vital role in brain and neurological development during the first 1000 days postconception. The extent to which higher intakes of choline have the potential to enhance or influence cognition during childhood, adulthood, and/or age-related cognitive decline needs further investigation. Emerging but consistent research suggests that lutein has the potential to influence cognition across the life-span and that sufficient intakes during mid to late adulthood may help to ward off age-related cognitive decline. Macular pigment optical density (MPOD) seems to be a reliable and consistent biomarker of brain lutein concentrations across the life-span and potentially one for clinically assessing cognitive status. This review summarizes the current peer-reviewed literature and existing gaps in research.

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... Adolescents are in a rapid and final stage of growth and development that will set the trajectory for their adult health [1,2]. Certain nutrients, such as protein, the B vitamins, vitamins C and D, choline, calcium, magnesium, potassium, selenium, iron, zinc, iodine, and omega-3 fatty acids such as docosahexaenoic acid and α-linolenic acid, are critical to healthy growth during this time, especially bone and brain health [3][4][5][6][7]. For example, bone formation in adolescence depends on protein, vitamins C and D, calcium, magnesium, potassium, and others to accumulate peak bone mineral content [3][4][5], while brain development and executive function (e.g., neurocognitive process such as attention sources, eggs can be part of a high-quality diet, implemented through exemplary menus that may be used to address nutrient gaps [6]. ...
... Certain nutrients, such as protein, the B vitamins, vitamins C and D, choline, calcium, magnesium, potassium, selenium, iron, zinc, iodine, and omega-3 fatty acids such as docosahexaenoic acid and α-linolenic acid, are critical to healthy growth during this time, especially bone and brain health [3][4][5][6][7]. For example, bone formation in adolescence depends on protein, vitamins C and D, calcium, magnesium, potassium, and others to accumulate peak bone mineral content [3][4][5], while brain development and executive function (e.g., neurocognitive process such as attention sources, eggs can be part of a high-quality diet, implemented through exemplary menus that may be used to address nutrient gaps [6]. ...
... Eight nutrients that are underconsumed among adolescents were considered in the daily total and mean menu nutrient models used to calculate the FNI score [2,[8][9][10][11]26]. Vitamins C and D, calcium, magnesium, and potassium are essential for bone health as bone growth reaches its peak before the growth plates close [3][4][5]. Folate, choline, and zinc play important roles in brain development, encompassing cognitive, emotional, and neurological changes [6,7]. Therefore, the daily totals of these eight underconsumed micronutrients were summed for each menu, then the mean daily amounts of each micronutrient were estimated across all seven menu days for each menu as given and with the egg substitution. ...
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Background/Objectives: Eggs, a nutritious and affordable food, are not widely consumed by adolescents, who show many nutrient inadequacies. Modeling dietary substitutions with eggs and their costs can provide dietary insights while considering economic constraints. This study theoretically modeled the impact of substituting an egg for another protein source, considering nutrient quality and cost, using exemplary menus with application to adolescents. Methods: The substitution was modeled in four different seven-day exemplary menus: (1) the Healthy U.S.-Style Dietary Pattern (HUSS), (2) Harvard Medical School’s Heathy Eating Guide, (3) the National Heart, Lung, and Blood Institute’s Dietary Approaches to Stop Hypertension (DASH) diet and (4) the Healthy U.S.-Style Vegetarian Dietary Pattern (HVEG). One egg replaced the gram amount and nutrient profile of a protein source food in each menu. Micronutrient quality was assessed using the Food Nutrient Index (FNI), scored 0–100. The Center for Nutrition Policy and Promotion Food Price Database informed the food prices. Pairwise t-tests compared the effects of egg substitution on micronutrient scores and daily costs. Results: The daily egg substitution increased FNI scores for choline and vitamin D in the HUSS (83 to 95 and 69 to 75, respectively), DASH (80 to 91 and 55 to 59, respectively), and HVEG (91 to 100 and 44 to 51, respectively), and choline alone (89 to 98) in the Harvard menu. Daily menu prices were not significantly different after the egg substitution (p > 0.01). Conclusions: Substituting one egg for another protein source food increased the micronutrient quality of choline and vitamin D in exemplary menus without increasing the cost; however, factors such as food preferences and the economic accessibility of eggs in different contexts should also be considered.
... A growing body of evidence suggests that adequate choline intake plays a critical role in neurodevelopment and lifelong brain function during the first 1000 days of life. However, the potential for higher choline intake to influence cognition during childhood, adulthood and age-related cognitive decline remains inconclusive [34,35]. As the global population ages, the number of individuals experiencing cognitive decline is expected to increase, raising concerns about risk factors and potential interventions for age-related neurodegenerative diseases. ...
... These complex cognitive functions are carried out in the brain. Since 1998, choline has been recognized as an essential nutrient with its metabolites playing both structural and regulatory roles in the body [35]. It is well established that choline is acetylated to form acetylcholine, which is a neurotransmitter involved in learning, memory and attention. ...
... The loss of cholinergic neurons is linked to cognitive impairment, particularly memory loss and AD. Choline may also influence brain function through its metabolite betaine, which is involved in epigenetic regulation [35,37]. Diet is the primary source of choline, and inadequate intake can lead to deficiency. ...
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Background/Objectives: The neuroprotective role of dietary choline during adulthood has not yet been conclusively proven. This study aims to investigate the influence of long-term choline and its constituent intakes on cognitive decline in the Chinese population. Methods: A total of 4502 subjects (≥55 years) with at least two waves of completed data and without cognitive decline at baseline were selected from the China Health and Nutrition Survey 1997–2018. Three consecutive 24 h dietary recalls were performed to collect dietary intake information for choline, phosphatidylcholine (PC), and glycerophosphocholine (GPC) measures. Several items from the Telephone Interview for Cognitive Status (Modified) were employed to perform a cognitive assessment. Cox frailty models were used to estimate hazard ratios (HRs) and 95% CIs. Results: A total of 783 participants developed cognitive decline during 26,080 person-years of follow-up. Cumulative average intakes of choline, PC, and GPC were 188.0, 126.7, and 17.1 mg/d, respectively. In the total population, after full adjustment, subjects in the lower (Q2), medium (Q3), higher (Q4), and highest (Q5) quintiles of dietary choline showed 27.8% (95% CI: 0.584, 0.894), 33.9% (95% CI: 0.522, 0.836), 23.0% (95% CI: 0.599, 0.990), and 29.3% (95% CI: 0.526, 0.949) decreases in the risk of cognitive decline compared to the lowest (Q1), respectively. Similar results were observed in PC but not GPC measures. Both higher choline and PC intakes induced a lower risk of cognitive decline for subjects ≥ 65 years at baseline (Q3 and Q4) and females (Q2–Q5). A marginally significant association of GPC was found for subjects ≥ 65 years (Q5) and males (Q4). Conclusions: These findings identify age and gender disparities relating to the protective associations of dietary choline, PC, and GPC with incident cognitive decline in middle-aged and older Chinese populations.
... Pre-clinical and clinical investigations have shown that GPC and other forms of choline supplementation have beneficial effects, especially in terms of improved cognitive performance [10,11]. There are many studies on the association between dietary total choline intake or blood choline concentration and cognition in the whole population, while longitudinal studies are mostly aimed at early life or children, and studies on adults and the elderly are mostly clinical trials [12]. Longitudinal research focusing on the older Chinese population must still be supplemented. ...
... They are considered to be neuroprotective agents, regulating the expression of key genes related to memory, learning, and cognitive function through epigenetic mechanisms [34]. This is not only critical for normal growth and function of the early brain, but also has good effects in enhancing brain function, delaying or alleviating cognitive decline with age, and neurodegenerative diseases such as AD [12]. ...
... For Chinese people, especially the elderly, daily micronutrient intake is still a major problem. Choline and its derivatives are widely distributed in eggs, fish, and milk, as well as cruciferous vegetables, soybeans, etc. [12,27]. People should choose more of these foods to intake each kind of choline and other essential micronutrients. ...
Article
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Background: With the aging process in China showing an accelerated trend, cognitive decline and impairment have become a major issue in older people. Dietary choline supplement may be a changeable lifestyle to improve this situation. Method: We analyzed 7659 adults aged over 55 in the China Health and Nutrition Survey (CHNS), evaluated cognitive function by the global cognition score, and found the association between cognitive function and dietary intake of total choline or L-alpha-glycerylphosphorylcholine (GPC). Linear and logistic mixed models with three levels were applied to analyze the association between dietary total choline/GPC intake and global cognition score, and the risk of poor cognition. Results: The average dietary intake at baseline was 178.8 mg/d for total choline, and 16.3 mg/d for GPC. After an average follow up of 6.8 years, we found that higher intake of total choline (β = 0.083, 95%CI: 0.046,0.119, p < 0.001) and GPC (β = 0.073, 95%CI: 0.034–0.111, p < 0.001) had positively associated with global cognitive scores. Additionally, higher intake of total choline had a better effect on improving the cognitive function of women (β = 0.092, 95%CI: 0.042–0.142, p < 0.01) and individuals between 55–65 years old (β = 0.089, 95%CI: 0.046–0.132, p < 0.01). However, higher GPC intake had a better effect on the cognitive function of men (β = 0.080, 95%CI: 0.020–0.141, p < 0.05). Higher total choline intake had a protective factor against poor cognition (OR = 0.762, 95%CI: 0.676,0.860, p < 0.001); the protective effect was more pronounced for women (OR = 0.750, 95%CI: 0.639,0.879, p < 0.001) and individuals aged 55–65 (OR = 0.734, 95%CI: 0.636–0.848, p < 0.001). Conclusions: higher dietary choline and GPC intake were beneficial for cognitive function, although we found that higher dietary choline was more effective in improving global cognitive scores at older ages; dietary choline should be supplemented as early as possible in old age to prevent poor cognition.
... Previous work has also demonstrated long-term beneficial effects of DHA on cognition as assessed by a response inhibition task at 5.5 years of age [3]. While studies examining the effects of maternal supplementation with egg yolk components on cognition have yielded varied results, those that assessed reaction speed generally report better performance (reviewed in [4]). Egg supplementation during pregnancy has also been associated with better fetal autonomic health as assessed by the RMSSD and brain maturation as assessed by fABAS [5]. ...
... This could be assessed by future studies in pigs with a rootingbehavior task, or in humans with a standardized motor test such as the PDMS-3 (Peabody Developmental Motor Scales -3rd Edition). This may explain improved reaction speed in infants receiving prolonged egg supplementation and suggests that DHA may also facilitate this in a non-synergistic manner [4]. Findings concerning heightened MHPG levels and a trending increase in MHPG/NE ratio in the cerebellum complements this idea, since the β-adrenergic receptors found in the region facilitate maturation of Purkinje cells and neuronal wiring at this neurodevelopmental window [25]. ...
... * signifies a P-value less than 0.05. choline, tryptophan, lutein, zeaxanthin and are a substantial source of vitamin D [4,41]. Choline supplementation in rats increased brain dopamine and 5-HT levels [42]. ...
Article
Objectives: Reports indicate that children of mothers who received docosahexaenoic acid (DHA) or egg yolk supplements during pregnancy have improved performance on cognitive tasks and brain growth; their combination has recently been demonstrated to modulate functional neuronal network connectivity in the human-relevant piglet brain. To expand upon this functional connectivity analysis, neurochemical evaluation to determine how dietary supplementation with one or both of these nutrients during the last trimester of pregnancy alters monoamine homeostasis in selected brain regions of piglets was done. Methods: Beginning gestation days 60-69 through weaning, pregnant sows were fed either control diet or diets supplemented with egg yolk powder, DHA, or both. Brains were then collected, and monoamine neurotransmitters and their metabolites were quantified from various brain regions with HPLC-ECD. Results: Relative to controls, egg yolk supplementation increased serotonin metabolite (5-HIAA) levels in the cerebellum, while DHA supplementation decreased serotonin (5-HT) levels in the prefrontal cortex; combined supplementation increased norepinephrine metabolite (MHPG) levels in the prefrontal cortex and cerebellum, but decreased 5-HT levels in the posterior hippocampus. Notably, all diets increased serotonin, dopamine, and their respective metabolite levels in the substantia nigra. Disscussion: This suggests both overlapping and specific effects of DHA and components of egg yolk in the context of maternal supplementation during pregnancy and lactation that might facilitate optimal neurodevelopment, with the nigrostriatal pathway being particularly sensitive. Such supplementations might impact brain function and facilitate development later in life through modulating monoamine homeostasis.
... Specifically, whole eggs are a bioavailable source of choline, lutein, zeaxanthin, omega-3 fatty acids, essential amino acids, and fat-soluble vitamins, which are crucial for sustaining physical and cognitive health (Rehault-Godbert et al., 2019). Adequate lutein intake in mid-to-late adulthood was documented to prevent age-related cognitive decline (Wallace, 2018). Supplementation with lutein and zeaxanthin was found to improve cognitive function in community-dwelling older adults (Hammond et al., 2017). ...
... Existing literature predominantly examines the impact of specific nutrients, such as lutein, zeaxanthin, choline, and omega-3 fatty acids, on cognitive function (Hammond et al., 2017;Wallace, 2018). In contrast, the influence of whole egg consumption on cognition among older adults has been less examined with mixed conclusions. ...
... One potential biological mechanism that may explain the link between whole egg consumption and cognitive function is the presence of bioavailable nutrients in eggs, such as lutein, zeaxanthin, choline, and omega-3 fatty acids. These nutrients have been reported to be associated with improved cognitive function (Hammond et al., 2017;Rehault-Godbert et al., 2019;Wallace, 2018;Ylilauri et al., 2019). The inconsistent findings regarding the relationship between whole egg consumption and cognition in various studies could be attributed to variations in methodologies, such as study designs, sample populations, age ranges, sample sizes, and neurocognitive assessment tools. ...
Article
Background: Given China's fast-growing aging population, cognitive decline is a leading public health concern. Eggs are an affordable food rich in several shortfall nutrients that may benefit cognitive health. Aim: This study assessed the longitudinal relationship between whole egg consumption and cognition among older adults in China. Methods: Individual-level data of 4737 Chinese adults 55+ years came from the China Health and Nutrition Survey (CHNS) 1997-2006 waves. Daily egg consumption was measured using 3-day 24-h dietary recalls. Cognitive functioning was assessed with immediate and delayed recall of a 10-word list, counting backward from 20, and serial 7 subtraction. Multivariate mixed-effects regressions were performed to estimate the longitudinal associations between daily whole egg consumption and cognitive functioning in older Chinese adults. Results: Approximately 46% of CHNS participants were whole egg consumers, and their daily intake averaged 47.4 g. The overall cognitive functioning test scores, separate scores for cognitive functioning subdomains, and the prevalence of cognitive impairment at the baseline were modestly higher among whole egg consumers than nonconsumers. However, after adjusting for individual characteristics, multivariate mixed-effects regressions did not find daily whole egg consumption to be associated with cognitive functioning among CHNS participants. By contrast, several demographic and socioeconomic factors, such as age, education attainment, and health insurance coverage, were found to correlate with older Chinese adults' cognition. Conclusion: This study has measurement and design limitations. Future research should investigate the causal impact of habitual egg intake on different domains of cognition using experimental designs with an extended follow-up period.
... This poses the question whether these nutrients that are classified as methyl donors could improve cognitive functions with aging and in some neurodegenerative diseases like Alzheimer's disease. Identification and implementation of effective nutritional strategies early in life may then optimize cognitive functions and mental health throughout life [12]. ...
... AI varies from one individual to another and this variation is influenced by several factors such as age, sex, genetic and environmental factors [33][34][35]. For example, an elevated intake of choline is required for pregnant women to support fetal growth and development and improve neurocognitive functions of offspring later in life [12,32]. Premenopausal women require less intake of choline compared to postmenopausal women. ...
... These effects were manifested as improvement in memory, attention and problem solving and lasted till children school age years [85][86][87]. Other studies reported inconclusive results of the effects of maternal choline intake at several stages of childhood on neurodevelopmental outcomes [12]. Wallace 2018 summarized in an excellent review the effects of choline intake in humans on cognitive functions throughout life [12]. ...
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Recent evidence suggests that physical and mental health are influenced by an intricate interaction between genes and environment. Environmental factors have been shown to modulate neuronal gene expression and function by epigenetic mechanisms. Exposure to these factors including nutrients during sensitive periods of life could program brain development and have long-lasting effects on mental health. Studies have shown that early nutritional intervention that includes methyl-donors improves cognitive functions throughout life. Choline is a micronutrient and a methyl donor that is required for normal brain growth and development. It plays a pivotal role in maintaining structural and functional integrity of cellular membranes. It also regulates cholinergic signaling in the brain via the synthesis of acetylcholine. Via its metabolites, it participates in pathways that regulate methylation of genes related to memory and cognitive functions at different stages of development. Choline-related functions have been dysregulated in some neurodegenerative diseases suggesting choline role in influencing mental health across the lifespan.
... We are unaware of prior studies investigating the association of dietary choline intake with 250 the risk of developing dementia. Nevertheless, several studies have inspected the association 251 of choline compounds with cognition (29). Few have evaluated dietary choline intake during 252 adulthood, however. ...
... Other studies of choline compounds and cognitive performance have inconsistent findings 258 (29). In these studies, choline status has been measured from blood, choline intake has come 259 from supplements, or studies have investigated maternal choline intake (29,31). ...
... Other studies of choline compounds and cognitive performance have inconsistent findings 258 (29). In these studies, choline status has been measured from blood, choline intake has come 259 from supplements, or studies have investigated maternal choline intake (29,31). A few issues 260 in those studies make comparisons difficult: firstly, choline intake does not correlate well with 261 plasma choline level (30,32); thus, circulating choline is not a good marker for choline 262 intake. ...
Article
Background: Moderate egg intake has been associated with better cognitive performance in observational studies. This association may be due to the rich content of choline, especially phosphatidylcholine, in eggs because choline has been suggested to have a role in the prevention of cognitive decline. Objectives: We investigated the associations of dietary choline intake with the risk of incident dementia and with cognitive performance in middle-aged and older men in the prospective, population-based Kuopio Ischaemic Heart Disease Risk Factor Study. Methods: A population-based sample of 2497 dementia-free men aged 42-60 y was examined in 1984-1989. A subset of 482 men completed 5 different cognitive performance tests 4 y later. Dementia and Alzheimer disease diagnoses were retrieved from Finnish health registers. Dietary intakes were assessed with the use of 4-d food records at baseline. Cox regression and ANCOVA were used for the analyses. All analyses were also stratified by the apolipoprotein E phenotype (APOE-ε4 compared with other phenotypes). These data were available for 1259 men. Results: The mean ± SD total choline intake was 431 ± 88 mg/d, of which 188 ± 63 mg/d was phosphatidylcholine. During a 21.9-y follow-up, 337 men were diagnosed with dementia. Those in the highest compared with the lowest phosphatidylcholine intake quartile had 28% (95% CI: 1%, 48%; P-trend = 0.02 across quartiles) lower multivariable-adjusted risk of incident dementia. Total choline intake had no association with the risk of incident dementia. However, both total choline and phosphatidylcholine intakes were associated with better performance in cognitive tests assessing frontal and temporal lobe functioning. For example, higher intakes were associated with better performance in verbal fluency and memory functions. The APOE phenotype had little or no impact on the associations. Conclusion: Higher phosphatidylcholine intake was associated with lower risk of incident dementia and better cognitive performance in men in eastern Finland. This trial was registered at clinicaltrials.gov as NCT03221127.
... More detailed reviews of the health effects of choline across the lifespan have been published elsewhere. 2,3,44 The following is an overview of new research that was presented at the 2018 Choline Science Summit. ...
... The mechanisms and clinical evidence with regard to the neurodevelopmental and neuroprotective actions of choline have recently been extensively reviewed by Blusztajn and others 57 and Wallace. 3 High choline intakes during gestation and early childhood have been shown to enhance cognition across the lifespan in multiple animal models, 2,3,57 but this has yet to be confirmed in human studies. Several challenge studies in both younger and older adults provide mixed results. ...
... Several challenge studies in both younger and older adults provide mixed results. 3 The most compelling short-duration challenge study showed supplementation with choline bitartrate to decrease pupil size, a widely accepted biomarker of cholinergic function, within 70 minutes. Healthy younger adults treated with choline bitartrate in this study had greater precision at rapidly hitting centers of targets as compared with those on the placebo (note: participant baseline choline intake or blood status not assessed). ...
Article
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Choline has been recognized as an essential nutrient by the Food and Nutrition Board of the National Academies of Medicine since 1998. Its metabolites have structural, metabolic, and regulatory roles within the body. Humans can endogenously produce small amounts of choline via the hepatic phosphatidylethanolamine N-methyltransferase pathway. However, the nutrient must be consumed exogenously to prevent signs of deficiency. The Adequate Intake (AI) for choline was calculated at a time when dietary intakes across the populationwere unknown for the nutrient. Unlike the traditional National Academy of Medicine approach of calculating an AI based on observed or experimentally determined approximations or estimates of intake by a group (or groups) of healthy individuals, calculation of the AI for choline was informed in part by a depletionrepletion study in adultmen who, upon becoming deficient, developed signs of liver damage. The AI for other gender and life-stage groups was calculated based on standard reference weights, except for infants 0 to 6 months, whose AI reflects the observedmean intake from consuming human breast milk. Recent analyses indicate that large portions of the population (ie, approximately 90% of Americans), including most pregnant and lactating women, are well below the AI for choline. Moreover, the food patterns recommended by the 2015-2020 Dietary Guidelines for Americans are currently insufficient to meet the AI for choline in most age-sex groups. An individual's requirement for choline is dependent on common genetic variants in genes required for choline, folate, and 1-carbon metabolism, potentially increasing more than one-third of the population's susceptibly to organ dysfunction. The American Medical Association and American Academy of Pediatrics have both recently reaffirmed the importance of choline during pregnancy and lactation. Newand emerging evidence suggests that maternal choline intake during pregnancy, and possibly lactation, has lasting beneficial neurocognitive effects on the offspring. Because choline is found predominantly in animal-derived foods, vegetarians and vegans may have a greater risk for inadequacy. With the 2020-2025 Dietary Guidelines for Americans recommending expansion of dietary information for pregnant women, and the inclusion of recommendations for infants and toddlers 0 to 2 years, better communication of the role that choline plays, particularly in the area of neurocognitive development, is critical. This narrative review summarizes the peer-reviewed literature and discussions from the 2018 Choline Science Summit, held in Washington, DC, in February 2018.
... With 7 g of protein, 5 g of fat, and 1.6 g of saturated fat per egg, they provide a balanced and nutritious option. Additionally, the presence of lutein and zeaxanthin in eggs reduces the risk of age-related macular degeneration, a common cause of blindness in the elderly [28,31]. ...
... Among dietary sources, hard-boiled eggs are the second most abundant source of choline, following beef liver [43]. Furthermore, they represent the primary source of choline in the American diet [31]. Choline can be found in food in both water-soluble forms (such as free choline, phosphocholine, and glycerophosphocholine) and lipid-soluble forms (such as phosphatidylcholine and sphingomyelin) and plays a vital role in the cellular maintenance, growth, and development throughout all life stages. ...
Article
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Eggs are a rich food source of proteins, fats, vitamins, minerals, and other nutrients. However, the egg industry faces some challenges such as microbial invasion due to environmental factors, leading to damage and reduced usability. Therefore, detecting the freshness of raw eggs using various technologies, including traditional and non-destructive methods, can overcome these challenges. As the traditional methods of assessing egg freshness are often subjective and time-consuming, modern non-destructive technologies, including near-infrared (NIR) spectroscopy, Raman spectroscopy, fluorescence spectroscopy, computer vision (color imaging), hyperspectral imaging, electronic noses, and nuclear magnetic resonance, have offered objective and rapid results to address these limitations. The current review summarizes and discusses the recent advances and developments in applying non-destructive technologies for detecting raw egg freshness. Some of these technologies such as NIR spectroscopy, computer vision, and hyperspectral imaging have achieved an accuracy of more than 96% in detecting egg freshness. Therefore, this review provides an overview of the current trends in the state-of-the-art non-destructive technologies recently utilized in detecting the freshness of raw eggs. This review can contribute significantly to the field of emerging technologies in this research track and pique the interests of both food scientists and industry professionals.
... 10 Sufficient intakes of lutein during mid-to-late adulthood may help prevent age-related cognitive decline. 11 A randomised controlled trial (RCT) found that supplementation with lutein and zeaxanthin significantly improved cognitive function in community-dwelling older adults. 12 In a prospective, population-based study, higher dietary choline intake was associated with reduced dementia incidence and enhanced cognitive performance in men. ...
... The vast majority of the relevant literature focuses on the role of specific nutrients (e.g., lutein, zeaxanthin, choline and omega-3 fatty acids) in cognition. [11][12][13] Relatively few have investigated the effect of whole egg consumption on cognitive functioning among older adults. A US-based study using data from the Health and Retirement Study and the Health Care and Nutrition Study (HCNS) did not identify a relationship between egg consumption and cognitive function. ...
Article
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Background Eggs are an affordable food providing many shortfall nutrients with the potential to improve cognitive health. We assessed the relationship between whole egg consumption and cognitive functioning among a US nationally representative sample of older adults. Methods Individual‐level data (2816 adults, aged ≥ 60 years) were obtained from the National Health and Nutrition Examination Survey (NHANES) 2011–2012 and 2013–2014 waves. Cognitive assessments included the Consortium to Establish a Registry for Alzheimer's Disease Word List Learning Test (CERAD‐WL), Word List Recall Test (CERAD‐DR), Animal Fluency Test (AF) and Digit Symbol Substitution Test (DSST). A composite cognitive z‐score was constructed based on the individual tests to represent one's overall cognitive functioning. Multiple linear and logistic regressions were performed to examine the effect of whole egg consumption on cognitive functioning, adjusting for individual characteristics and survey design. Results Approximately 57% of older adults consumed whole eggs, with an average daily intake of 34 g of whole egg equivalent among consumers. The average z‐scores of the CERAD‐WL, CERAD‐DR, AF and DSST tests were −0.08, 0.23, 0.37 and 0.42, respectively, and the overall composite cognitive z‐score was 0.24 among older adults. Regression analyses found that neither whole egg consumption status, nor daily intake quantity was associated with cognitive test scores. Conclusions No association was found between whole egg consumption and cognitive functioning among US older adults. Study limitations included cross‐sectional study design and measurement errors. Future studies with longitudinal or experimental design are warranted to examine the possible link between egg consumption and cognition in older adults.
... Ch serves as a methyl donor for many metabolic processes and is necessary for the synthesis of phosphatidylcholine and sphingomyelin, as well as the production of acetylcholine (ACh) (Jope and Jenden, 1980), a neurotransmitter critical for attention, learning and memory (Drachman and Leavitt, 1974;Bartus and Johnson, 1976;Baxter and Chiba, 1999;Schliebs and Arendt, 2006;Pepeu and Giovannini, 2010;Everitt and Robbins, 1997). Although Ch can be synthesized by the body, the amount is insufficient to meet the functional demand for this nutrient, and thus, Ch must also be obtained from dietary sources Wallace, 2018). ...
... Additionally, studies indicate that small to moderate reductions in Ch availability may negatively impact cognition in adults (Poly et al., 2011;Nurk et al., 2013). The average daily intake of Ch by adults (19-70 y) in the US ranges from 271 -280 mg/day for females, and 391 -421 mg/day for males (Wallace et al., 2018), yielding plasma Ch concentrations from 7 -20 umol/L in healthy adults. Lower than average dietary choline intake is associated with deficits of verbal and visual memory in adults (36-83 y) and low plasma Ch concentrations (<8.36 umol/l) in the elderly (70-74 y) are associated with reduced perceptual processing speed, executive function and global measures of cognition (Poly et al., 2011;Nurk et al., 2013). ...
Article
Background Choline supplementation (+Ch) improves cognitive function in impaired animals and humans. Chemotherapy-related cognitive deficits (CRCDs) occur in cancer patients, and these deficits persist following treatment, adversely impacting quality of life. To date, there are no approved treatments for this condition. Aim Because +Ch improves impaired memory, it was of interest to determine whether +Ch can attenuate spatial memory deficits induced by the chemotherapeutic agents doxorubicin (DOX) and cyclophosphamide (CYP). Methods Female BALB/C mice, 64 days of age, were trained in the Morris water maze and baseline performance determined on day 15. Following baseline assessment, mice were placed on +Ch diet (2.0% Ch) or remained on standard diet (0.12% Ch). Mice received intravenous injections of DOX (2.5 mg/kg) and CYP (25 mg/kg), or equivalent volumes of saline (0.9% NaCl), on days 16, 23, 30, and 37, and spatial memory was assessed weekly from day 22 to 71. Results DOX and CYP produced a prolonged impairment in spatial memory as indicated by an increased latency to the correct zone ( p < 0.05), and a decrease in time in the correct zone ( p < 0.05), % of total swim distance in the correct zone ( p < 0.05) and % entries to the correct zone ( p < 0.05). These effects were attenuated by +Ch. Conclusion Although it remains to be determined whether this effect extends to other cognitive domains and whether +Ch is prophylactic or therapeutic, these findings suggest that +Ch may be an effective intervention for CRCDs.
... Moreover, signals of choline and tartrate were also observed. Choline's role in human health begins prenatally and extends into adulthood and old age [47,48]. Choline is an essential nutrient needed for human health, because of its importance for proper liver, muscle, and brain functions. ...
... Choline is an essential nutrient needed for human health, because of its importance for proper liver, muscle, and brain functions. It is also implicated in cellular membrane composition and lipid metabolism [48][49][50][51]. Humans can produce only small amounts of choline; therefore, this endogenously produced nutrient must be integrated through the diet to prevent deficiency. ...
Article
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Background: Plants of genus Cichorium are known for their therapeutic and nutraceutical properties determined by a wealth of phytochemical substances contained in the whole plant. The aim of this paper was to characterize the metabolic profiles of local Salento chicory (Cichorium intybus L.) varieties ("Bianca", "Galatina", "Leccese", and "Otranto") in order to describe their metabolites composition together with possible bioactivity and health beneficial properties. Methods: The investigation was performed by 1H-NMR spectroscopy and Multivariate Analysis (MVA), by which the metabolic profiles of the samples were easily obtained and compared. Results: The supervised Partial Least Squares Discriminant Analysis (PLS-DA) analysis showed as "Bianca" and "Galatina" samples grouped together separated by "Leccese" and "Otranto" varieties. A different content of free amino acids and organic acids was observed among the varieties. In particular a high content of cichoric and monocaffeoyl tartaric acid was observed for the "Leccese" variety. The presence of secondary metabolites adds significant interest in the investigation of Cichorium inthybus, as this vegetable may benefit human health when incorporated into the diet. Conclusions: The 1H-NMR (Nuclear Magnetic Resonance Spectroscopy) based characterization of Salento chicory varieties allowed us to determine the potential usefulness and nutraceutical properties of the product, also providing a method to guarantee its authenticity on a molecular scale.
... The mechanisms and clinical evidence in regard to neurodevelopmental and neuroprotective actions of choline were recently extensively reviewed by Blusztajn et al. (2017) and Wallace and Fulgoni (2017). High choline intakes during gestation and early childhood have been shown to enhance cognition across the lifespan in multiple animal models (Blusztajn et al. 2017;Wallace 2018;Zeisel and Caudill 2010) and some shortterm longitudinal human studies (Wallace and Fulgoni 2017). The maternal choline supply in rats during pregnancy modifies fetal DNA methylation (Kovacheva et al. 2007) and histone methylation ), suggesting a possible epigenetic mechanism for the long-term effects of choline intake seen in animal models and in longitudinal human studies. ...
... An older RCT found null effects of 750 mg/d choline supplementation (as phosphatidylcholine) from 18 weeks of gestation to 90 days postpartum on infant cognitive function (Cheatham et al. 2012). It is unclear why this study did not observe similar cognitive effects as the study by Caudill et al. (2018); however, poor participant adherence and/or uncontrolled variations in intake of choline and other nutrients have been suggested to play a role Wallace 2018). Data from observational studies are somewhat mixed but tend to also support that higher choline intakes during pregnancy enhance cognitive outcomes of the offspring (Boeke et al. 2013;Signore et al. 2008;Villamor et al. 2012;Wu et al. 2012). ...
Article
Choline is an essential nutrient for proper liver, muscle, and brain functions as well as for lipid metabolism and cellular membrane composition and repair. Humans can produce small amounts of choline via the hepatic phosphatidylethanolamine N-methyltransferase pathway; however, most individuals must consume this vitamin through the diet to prevent deficiency. An individual’s dietary requirement for choline is dependent on common genetic variants in genes required for choline, folate, and one-carbon metabolism. Both the American Academy of Pediatrics and American Medical Association have recently reinforced the importance of maternal choline intake during pregnancy and lactation and recognize that failure to provide choline and other key essential nutrients during the first 1,000 days postconception may result in lifelong deficits in brain function despite subsequent nutrient repletion. Given that dietary intake for the majority of the US population, including subpopulations such as pregnant women, women of childbearing age, and vegetarians, falls well below the current adequate intake, there is a need to develop better policies and improve consumer education around the importance of this essential nutrient for human health. This comprehensive expert review summarizes the current scientific evidence on choline and health in relation to interests of obstetricians and gynecologists.
... The stress comes probably from oxygen in the air because WC, CC and CM are exposed to the air while the mycelia of WI and CI are restricted in the insect bodies during the fungus growth. High levels of choline in WC, CC and CM supported the hypothesis that they had suffered oxidative stress, because reports have shown that oxidative stresses can result in high levels of choline (Peel, Mickelbart, & Rhodes, 2010;Wallace, 2018). Apart from the essential nutrients of choline, α-tocotrienol and phospholipids, WC, CC and CM also contained high levels of nutrients such as carnitine, acetylcarnitine, nicotinic acid and GABA (Lee, Lin, Lin, & Lin, 2016;Li<<Query: AUTHOR: "Li et al., 2016" is cited in text but not provided in the reference list. ...
... Ans: Delete it please. Peel et al., 2010;Si et al., 2018;Wallace, 2018). Higher concentrations of nutritious metabolites and much less NRP content in WC, CC and CM than in WI and CI imply that the former are more nutritious and safer. ...
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Isaria cicadae is one of the fungi used earliest in traditional Chinese medicine. Currently, it is used not only as an herbal medicine but also as a health food in Asia, together with cultured cordyceps and mycelia of the fungus being used as substitute. However, their metabolite differences are unknown. By using a high‐performance liquid chromatography‐mass spectrometry (HPLC‐MS)‐based metabolomic method, we found that the fungus varies its metabolism during growth on wild insect, artificially raised insect and artificial medium. There were 109 discriminatory metabolites detected in the samples by OPLS‐DA and one‐way ANOVA. High level of non‐ribosomal peptides (NRPs) only existed in insect portions of the wild cordyceps (WI) and cultured cordyceps (CI) revealed that immunostimulation of the host insects enhanced the synthesis of NRPs in the fungus. Finding a significantly higher level of sphingolipids in both the insect portions (WI, CI) and coremia of the wild cordyceps (WC) and cultured cordyceps (CC) but not in cultured mycelia (CM) of I. cicadae implies that immunostimulation of the live insects can induce the fungus to produce more sphingolipids, and this enhanced ability is probably heritable. Apart from NRPs and sphingolipids, the insect portions also contained higher levels of bioactive compounds such as lateritin, anisomycin, streptimidone and ustiloxins. In contrast, coremium groups (WC, CC) and CM contained ten times less NRP content but much higher level of sanative metabolites such as tocotrienol, 3'‐deoxy‐hanasanagin, gamma aminobutyric acid and phospholipids than the insect portions. The significant higher content of antioxidants in WC, CC and CM than in WI, CI suggests that environmental oxygen has a significant effect on the metabolites. The temperature stress which the wild cordyceps encountered during growth is responsible for the relative high content of trehalose. These findings indicate that the immunity of the host insect and growth environment have a strong impact on the metabolomic variation in Isaria cicadae. The variation in metabolites suggests differential utilization value for the insect portions, coremia and mycelia of the fungus.
... One egg has, on average, only 75 calories but 7 g of high-quality protein, 5 g of fat, and 1.6 g of saturated fat, along with vitamins, minerals, and carotenoids. The egg is also high in disease-fighting dietary bioactive compounds such as lutein and zeaxanthin, which may reduce the risk of age-related macular degeneration, the leading cause of blindness in older adults (Wallace, 2018). Animal models show lutein and zeaxanthin also help to protect against oxidative stress (Bian et al., 2012). ...
... The evolutionary history of eggs and brain growth may contribute to the rationale for ensuring eggs in the diets of mothers and children. Although we have focused on maternal and young child nutrition, eggs also have the potential to improve brain development and functioning throughout the lifecycle (Wallace, 2018). ...
... One egg has, on average, only 75 calories but 7 g of high-quality protein, 5 g of fat, and 1.6 g of saturated fat, along with vitamins, minerals, and carotenoids. The egg is also high in disease-fighting dietary bioactive compounds such as lutein and zeaxanthin, which may reduce the risk of age-related macular degeneration, the leading cause of blindness in older adults (Wallace, 2018). Animal models show lutein and zeaxanthin also help to protect against oxidative stress (Bian et al., 2012). ...
... The evolutionary history of eggs and brain growth may contribute to the rationale for ensuring eggs in the diets of mothers and children. Although we have focused on maternal and young child nutrition, eggs also have the potential to improve brain development and functioning throughout the lifecycle (Wallace, 2018). ...
... Lutein memiliki peran memberi warna kuning-oranye pada bahan makanan seperti buah dan sayuran. Selain itu, lutein dan zeaxanthin berperan dalam mendukung kesehatan tubuh terutama pada mata dan otak yang ditemukan selama perkembangan di masa prenatal dan pertumbuhan saraf awal [2, [4][5][6]. ...
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Cognitive function is related to the brain's ability to obtain, retain, and understand the information obtained. Decreased cognitive function can have an impact on a person's activities. Impaired cognitive function generally occurs with increasing age. Several studies show the effect of giving lutein as an antioxidant that can maintain brain health. Several studies have stated that there is a link between the body's plasma lutein levels and better cognitive function. This study was carried out with the aim of analyzing research results related to intervention of lutein and its isomers on cognitive function in adulthood. The literature analyzed is publications in the last 10 years with research designs in the form of RCTs and double blinds. Literature search using keywords (lutein or carotenoids) and (brain or cognition or cognitive function). Supplementation is considered to be able to help concentration in answering questions. However, supplementation is also considered to have no significant effect on cognitive function. Through analysis of all literature, it was found that lutein is able to maintain cognitive function in adults, especially memory. Further research is needed regarding lutein supplementation with other substance activators.
... Therefore, it is anticipated that the nutritional intake of L+Z will be less than the current suggested intake of 6 mg per day (Eisenhauer et al., 2017). Once a recommended dietary reference intake has been defined for L+Z, it is likely that shell eggs, both regular and functional eggs, will play a greater role in human nutrition by offering a highly bioavailable, nutritious and appetizing source of L+Z to all ages of consumers (Ranard et al., 2017;Wallace, 2018). ...
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As one of the few foods produced and consumed with no geographical or religious restrictions, shell eggs have always played a key role in the human diet. The consistency in the composition of shell eggs along with their versatility have made them a food of choice for consumers of all ages. The high digestibility of egg proteins along with their content in indispensable amino acids are just one of the nutritional benefits of shell eggs. The eggs are also rich in a wide range of vitamins and minerals, choline, lutein and zeaxanthin, all playing an important role in human nutrition. With the dietary intake of cholesterol no longer seen as a health risk factor in the general population, shell eggs are now widely recommended by governments and health professionals as an essential component of a healthy diet. The ease of production of shell eggs enriched in various nutrients, also called functional eggs, further boost their potential to alleviate the growing incidence of nutrient deficiencies in human diets. There is however a need to further boost the production and consumption of shell eggs in various parts of the world, where they could contribute more to food security and human health.
... In our analysis, duck eggs showed the highest concentration of vitamin A expressed in retinol equivalents (Table 1). Eggs are recognized for containing carotenoids such as lutein and zeaxanthin, which play a crucial role in anti-inflammatory pathways [191,192]. Vitamin A, a fat-soluble vitamin, is important for normal vision, the immune system, reproduction, and growth and development. In TASFs, it is found in preformed vitamin A, which is more bioavailable than in some plant-sourced foods in which it is found in provitamin A carotenoids [193]. ...
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Background. It is well-established that a range of macronutrients, micronutrients and bioactive compounds found in animal-source foods play unique and important roles in human health as part of a healthy diet. Methods. This narrative review focuses on terrestrial animal source foods (TASFs). It particularly analyzes five groups: poultry eggs, milk, unprocessed meat, foods from hunting and wildlife farming, and insects. The objectives were as follows: (1) examine the nutrient composition of TASFs within and across livestock species, drawing on the country and regional food composition databases; (2) analyze the influence of intrinsic animal characteristics and production practices on TASF nutritional quality. Results. TASFs are rich in high-quality proteins and fats, as well as micronutrients such as vitamin B12, iron or zinc. This study found differences in the nutritional quality of TASFs by livestock species and animal products, as well as by characteristics of livestock production systems. Our findings suggest that there may be public health opportunities by diversifying TASF consumption across species and improving certain aspects of the production systems to provide products that are both more sustainable and of higher quality. Conclusions. Future research should adopt a more holistic approach to examining the food matrix and the dietary patterns that influence TASF digestibility. It is necessary to include meat from hunting and wildlife farming and insects in global food composition databases, as limited literature was found. In addition, scarce research focuses on low- and middle-income countries, highlighting the need for further exploration of TASF food composition analysis and how intrinsic animal characteristics and livestock production system characteristics impact their nutritional value.
... Choline's importance is emphasized during the first 1000 days post-conception, impacting cognitive outcomes (Schoen et al., 2023;Smolders et al., 2019;Yamashita et al., 2023;Zeisel, 2006). Adequate choline intake during pregnancy and lactation is also recommended to support fetal brain development and prevent cognitive deficits (Wallace, 2018;Schoen et al., 2023). ...
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This review investigates the potential link between egg consumption and Alzheimer's disease (AD) through a nutritional lens, focusing on key nutrients found in eggs such as choline, docosahexaenoic acid (DHA), and tryptophan (TRP). Eggs are recognized for their high-quality protein content and are rich in nutrients essential for brain health. Notably, national health guidelines have shifted away from considering eggs as a risk factor for hypercholesterolemia and cardiovascular disease, largely due to the complex relationship between dietary cholesterol and blood cholesterol levels. Although eggs are a significant source of dietary cholesterol, recent studies suggest that the cholesterol in eggs does not substantially raise blood cholesterol levels or increase the risk of heart disease. This review also explores how nutrients like choline, DHA, and TRP in eggs contribute to cognitive health and may help reduce the risk of age-related cognitive decline, including AD. While the direct connection between egg consumption and AD is not fully established, the neuroprotective roles of these nutrients highlight the importance of further research. Additionally, this review addresses common misconceptions about egg cholesterol, emphasizing the importance of eggs as part of a balanced diet for maintaining brain health and potentially mitigating the risk of neurodegenerative diseases.
... As an essential nutrient, choline plays a pivotal role in brain development and genomic epigenetic modi cations. It modulates neuronal gene expression, methylation, and activity, preserving the structural and functional integrity of cell membranes [29]. Furthermore, choline governs cholinergic neurotransmission by facilitating acetylcholine synthesis, thereby impacting neural signaling [30]. ...
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Objective: This study aims to elucidate the metabolite profiles in the serum of adolescents engaging in non-suicidal self-injury (NSSI) by employing high-resolution, non-targeted metabolomics. The objectives include differentiating metabolites between the NSSI group and a normal control group, identifying biomarkers of clinical diagnostic value, and utilising these differential metabolites to pinpoint key metabolic pathways implicated in the pathogenesis of NSSI through bioinformatics analyses. Methods: The sample consisted of 39 NSSI patients, aged 13-22 years, presenting at the outpatient clinic of the Department of Psychiatry, Second Affiliated Hospital of Shandong First Medical University from January 2022 to December 2023, with initial, untreated NSSI. Additionally, 24 healthy adolescents were conscripted from the community. Participants were matched for age, gender, and BMI. Ultra-high performance liquid chromatography mass spectrometry (UPLC-MS) facilitated non-target metabolomic analysis. Multivariate statistical analyses, amalgamating univariate and multivariate approaches, enabled the discrimination of differential metabolites and the extraction of biomarkers. Concurrently, bioinformatics evaluation of these metabolites was undertaken to annotate pertinent metabolic pathways. Results: In cationic mode, 235 differential metabolites were discerned, with 133 upregulated and 102 downregulated in the NSSI cohort. Anionic mode identified 66 differential metabolites; among these, 14 were upregulated and 52 were downregulated. KEGG pathway annotations yielded 311 pathways, encompassing 158 cationic and 153 anionic pathways. Significantly enriched and high-degree KEGG pathways included aromatase deficiency, 17-β hydroxysteroid dehydrogenase III deficiency, nadolol's mechanism of action, timosartan's mechanism of action, androgen and estrogen metabolism, α-linolenic and linoleic acid metabolism in the cationic mode, and nicotinic acid and nicotinamide metabolism in the anionic mode. Substances such as phenylalanine, glycine, aspartic acid, asparagine, threonine, histidine, tyrosine, arginine, isoleucine, proline, N-acetylthreonine, glutamine, organic acids and their derivatives, cyclopropene, glycerophospholipids, fatty acylcarnitines, geldanamycin, and cycloprostenol were paramount in distinguishing NSSI patients from healthy controls and exhibited the highest predictive power. Conclusion: Metabolic perturbations characterise NSSI patients, with elevated or diminished levels of substances like phenylalanine, glycine, aspartic acid, asparagine, threonine, histidine, tyrosine, arginine, isoleucine, proline, N-acetylthreonine, glutamine, and others significantly contributing to this distinction. These findings underscore the potential of metabolic biomarkers in understanding and predicting NSSI.
... Although many studies performed on rats found strong evidence that supports the role of choline in achieving better cognition among the offspring, there is no strong evidence from human studies that supports the causal-and-effect relationship between maternal intake of choline and the better cognitive abilities of their children. The results of the studies are inconsistent, and more extensive research is warranted to confirm if there is a causal relationship between maternal choline intake and the cognition of the offspring (Wallace 2018). ...
Chapter
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The burden of cognitive impairment and mental illnesses is increasing daily because of modern lifestyles. Many studies have been conducted to understand the pathology of cognitive impairment and mental illness. Based on a good understanding of that pathology, many studies were conducted to determine if nutrition can play a role in hastening the progression of cognitive impairment and mental illness. Some studies were conducted to determine whether some cognitive impairment conditions or mental illnesses can be prevented from the start, especially when it comes to certain diseases that represent a real burden on society, such as AD, dementia, and major depressive disorders. Other studies have shown the possibility of attaining better cognitive abilities and improving individuals’ cognition and mental health. This will be reflected in the productivity of each individual in society, regardless of their age. Although observational studies that examine the role of nutrition in mental health and cognition are diverse and the correlation between diet and brain development is obviously significant; unfortunately, there are few high-yielding RCTS. Consequently, the causal relationship between nutrition and brain function has not yet been concluded. In this chapter, we will discuss the harmony between the food we have daily and our brains.
... Finally, several observational studies have suggested that moderate egg intake may have a neutral or an inverse association with the risk of cognitive decline or mortality from neurodegenerative diseases, including Alzheimer's disease (75)(76)(77)(78)(79)(80). One possible explanation is the high choline and lutein content in eggs (81,82). There are no systematic reviews or meta-analyses of this topic, so this outcome was not included in this scoping review. ...
Article
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Cardiovascular diseases (CVD), type 2 diabetes (T2D), and cancer are a significant public health burden in the Nordic and Baltic countries. High intake of eggs, mainly due to its high cholesterol content, has been suggested to have adverse health effects. The purpose of this scoping review is to describe the evidence related to the impact of egg intake on health. A literature search identified 38 systematic reviews and meta-analyses on egg consumption in relation to health outcomes published between 2011 and 30 April 2022. Overall, current evidence from systematic reviews of randomized clinical trials indicates that higher egg intake may increase serum total cholesterol concentration and the ratio of low-density lipoprotein to high-density lipoprotein cholesterol, but with substantial heterogeneity in the response. However, recent evidence from observational studies does not provide strong support for a detrimental role of moderate egg consumption (up to one egg/day) on the risk of CVD, especially in the European studies. The overall evidence from observational studies indicates that egg consumption is not associated with increased risk of mortality or T2D in European study populations. There is also little support for a role of egg consumption in cancer development, although a weak association with higher risk of certain cancers has been found in some studies, mainly case–control studies. Again, no associations with cancer risk have been observed in European studies. Systematic reviews and meta-analyses of egg consumption in relation to other health-related outcomes are scarce. There are also limited data available on the associations between the consumption of more than one egg/day and risk of diseases. Based on the available evidence, one egg/day is unlikely to adversely affect overall disease risk.
... Choline is an essential nutrient with defined Dietary Reference Intake values in the United States and Canada since 1998 [1]. It is essential for proper liver, muscle, and brain functions, lipid metabolism, and cellular membrane composition and repair [1][2][3][4]. Choline depletion/repletion studies have linked choline deficiency with liver dysfunction and muscle damage [5,6]. Choline intake and adequate fetal choline supply are particularly critical during development, influencing the risk of neural tube defects [7][8][9], modifying septo-hippocampal circuitry and brain function [10], as well as postnatal cognition and chronic disease risk factors [11]. ...
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Choline is essential for proper liver, muscle, brain, lipid metabolism, cellular membrane composition, and repair. Understanding genetic determinants of circulating choline metabolites can help identify new determinants of choline metabolism, requirements, and their link to disease endpoints. We conducted a scoping review to identify studies assessing the association of genetic polymorphisms on circulating choline and choline-related metabolite concentrations and subsequent associations with health outcomes. This study follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement scoping review extension. Literature was searched to September 28, 2022, in 4 databases: Embase, MEDLINE, Web of Science, and the Biological Science Index. Studies of any duration in humans were considered. Any genome-wide association study (GWAS) investigating genetic variant associations with circulating choline and/or choline-related metabolites and any Mendelian randomization (MR) study investigating the association of genetically predicted circulating choline and/or choline-related metabolites with any health outcome were considered. Qualitative evidence is presented in summary tables. From 1248 total reviewed articles, 53 were included (GWAS = 27; MR = 26). Forty-two circulating choline-related metabolites were tested in association with genetic variants in GWAS studies, primarily trimethylamine N-oxide, betaine, sphingomyelins, lysophosphatidylcholines, and phosphatidylcholines. MR studies investigated associations between 52 total unique choline metabolites and 66 unique health outcomes. Of these, 47 significant associations were reported between 16 metabolites (primarily choline, lysophosphatidylcholines, phosphatidylcholines, betaine, and sphingomyelins) and 27 health outcomes including cancer, cardiovascular, metabolic, bone, and brain-related outcomes. Some articles reported significant associations between multiple choline types and the same health outcome. Genetically predicted circulating choline and choline-related metabolite concentrations are associated with a wide variety of health outcomes. Further research is needed to assess how genetic variability influences choline metabolism and whether individuals with lower genetically predicted circulating choline and choline-related metabolite concentrations would benefit from a dietary intervention or supplementation.
... It is recently reported that maternal intake of egg and/or its nutrients may improve neurodevelopment in human fetal [33]. Egg yolks contain bioactive components proven to have an influence on cognition such as choline and lutein [34]. Thus, supplementation with DHA [28], EGG yolk, or DHA + EGG may lead to a novel nutraceutical approach to improve cognition in humans and animals. ...
Article
Background Functional connectivity (FC) measures statistical dependence between cortical brain regions. Studies of FC facilitate understanding of the brain’s function and architecture that underpin normal cognition, behavior, and changes associated with various factors (e.g. nutritional supplements) at a large scale. Objective We aimed to identify modifications in FC patterns and targeted brain anatomies in piglets following perinatal intake of different nutritional diets using a graph theory based approach. Methods Forty-four piglets from four groups of pregnant sows, who were treated with nutritional supplements, including control diet, docosahexaenoic acid (DHA), egg yolk (EGG), and DHA + EGG, went through resting-state functional magnetic resonance imaging (rs-fMRI). We introduced the use of differential degree test (DDT) to identify differentially connected edges (DCEs). Simulation studies were first conducted to compare the DDT with permutation test, using three network structures at different noise levels. DDT was then applied to rs-fMRI data acquired from piglets. Results In simulations, the DDT showed a greater accuracy in detecting DCEs when compared with the permutation test. For empirical data, we found that the strength of internodal connectivity is significantly increased for more than 6% of edges in the EGG group and more than 8% of edges in the DHA and DHA + EGG groups, all compared to the control group. Moreover, differential wiring diagrams between group comparisons provided means to pinpoint brain hubs affected by nutritional supplements. Conclusion DDT showed a greater accuracy of detection of DCEs and demonstrated EGG, DHA, and DHA + EGG supplemented diets lead to an improved internodal connectivity in the developing piglet brain.
... Taking together the major relevance of a sufficient choline intake for the fetal neuronal development, the elevated choline requirements during pregnancy, and the poor choline content of plant-based foods, it can be supposed that pregnant women following a vegetarian or vegan diet have a high risk of not achieving the recommended AI for choline. Moreover, choline is absent in most dietary supplements marketed for pregnant women, with a median daily choline dose of only 25 mg [41,42]. ...
Article
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Choline is an essential nutrient that is involved in various developmental processes during pregnancy. While the general adequate choline intake (AI) for adults has been set at 400 mg/day by the European Food Safety Authority (EFSA), an AI of 480 mg/day has been derived for pregnant women. To date, the choline intake of pregnant women in Germany has not been investigated yet. Therefore, in this survey, the total choline intake from dietary and supplementary sources in pregnant women was estimated using an online questionnaire. A total of 516 pregnant women participated in the survey, of which 283 met the inclusion criteria (13 to 41 weeks of gestational age, 19–45 years). 224 (79%) of the participants followed an omnivorous diet, 59 (21%) were vegetarian or vegan. Median choline intake was 260.4 (±141.4) mg/day, and only 19 women (7%) achieved the adequate choline intake. The median choline intake of omnivores was significantly higher than that of vegetarians/vegans (269.5 ± 141.5 mg/day vs. 205.2 ± 101.2 mg/day; p < 0.0001). 5% (13/283) of pregnant women took choline-containing dietary supplements. In these women, dietary supplements provided 19% of the total choline intake. Due to the importance of choline for the developmental processes during pregnancy, the study results prove the urgent need for an improved choline supply for pregnant women.
... plants, algae, cyanobacteria), as well as some nonphotosynthetic bacteria, yeast and fungi. Carotenoids such as lutein, zeaxanthin or astaxanthin are important additives in food and feed industry as pigmenting substances and precursors of vitamin A derivatives [1][2][3][4]. In addition, carotenoids have health-promoting effects such as enhancing the immune response and, due to their antioxidant properties, anticancer activity, which makes them of interest as nutraceuticals [1,5]. ...
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Background The bifunctional enzyme β-carotene hydroxylase (CrtZ) catalyzes the hydroxylation of carotenoid β-ionone rings at the 3, 3’ position regardless of the presence of keto group at 4, 4’ position, which is an important step in the synthesis of astaxanthin. The level and substrate preference of CrtZ may have great effect on the amount of astaxanthin and the accumulation of intermediates. Results In this study, the substrate preference of PC crtZ from Paracoccus sp. PC1 and PA crtZ from Pantoea Agglomerans were certified and were combined utilization for increase astaxanthin production. Firstly, PC crtZ from Paracoccus sp. PC1 and PA crtZ from P. Agglomerans were expressed in platform strains CAR032 (β-carotene producing strain) and Can004 (canthaxanthin producing strain) separately to identify their substrate preference for carotenoids with keto groups at 4,4’ position or not. The results showed that PC crtZ led to a lower zeaxanthin yield in CAR032 compared to that of PA crtZ . On the contrary, higher astaxanthin production was obtained in Can004 by PCcrtZ than that of PA crtZ . This demonstrated that PCCrtZ has higher canthaxanthin to astaxanthin conversion ability than PACrtZ, while PACrtZ prefer using β-carotene as substrate. Finally, Ast010, which has two copies of PA crtZ and one copy of PC crtZ produced 1.82 g/L of astaxanthin after 70 h of fed-batch fermentation. Conclusions Combined utilization of crtZ genes, which have β-carotene and canthaxanthin substrate preference respectively, can greatly enhance the production of astaxanthin and increase the ratio of astaxanthin among total carotenoids.
... Eggs provide bioactive compounds, such as lutein, choline, zeaxanthin, and high-value proteins, that may have a protective role against dementia due to their beneficial effects on inflammation (22,23). It has been suggested that lutein may help to protect brain tissues from the accumulated effects of oxidative and inflammatory stress (24). ...
Article
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Background Current evidence suggests that egg composition might have potential neuroprotective effects. Our aim was to determine the association between egg consumption and the risk of dementia in a Mediterranean population. Methods This study was carried out in 3 centers from the European Prospective Investigation into Cancer and Nutrition (EPIC)-Spain Dementia Cohort, i.e., 25,015 participants aged 30–70 years, recruited in 1992–1996, and followed up for a mean of 21.5 years. Results A total of 774 incident dementia cases were diagnosed and validated, of which 518 were Alzheimer's disease (AD). Data on egg consumption were estimated using a validated dietary history questionnaire at recruitment. Cox proportional hazards models, adjusted for confounders, were used in the analyses. No association was observed between egg consumption and either total dementia [hazard ratio between extreme quartiles (HRQ4vs.Q1: 1.05; 95% CI 0.85–1.31; p-trend = 0.93)] or AD (HRQ4vs.Q1 0.93; 95% CI 0.72–1.21; p-trend = 0.50) risks. After dividing the population by adherence to the relative Mediterranean diet (rMED) score, a borderline inverse association was found between egg intake and both total dementia (HRQ4vs.Q1: 0.52; 95% CI 0.30–0.90; p-trend = 0.10) and AD (HRQ4vs.Q1: 0.52; 95% CI 0.27–1.01; p-trend = 0.13) risks within participants with low adherence to rMED score. However, no association was observed in participants with medium and high adherence to rMED score. Conclusion This prospective study suggests that egg consumption is associated with a reduced risk of dementia, and specifically of AD, in the adult population with low adherence to rMED score; whereas it has no impact in subjects with moderate and high MD adherence.
... Eggs have the potential to contribute significant levels of lutein and zeaxanthin, and several essential vitamins and micronutrients in the Western diet (Wallace, 2018). Eggs are an essential part of the American diet with a high per capita consumption and approximately 22% of the US population consuming whole eggs on a given day (Conrad et al., 2017). ...
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Consumers associate nutritional quality and potential health benefits with yolks showing deeper colors produced by healthy layers fed a well-balanced, nutrient-rich diet. However, cereals and oilseed meals generally used in poultry feed do not provide sufficient carotenoids to achieve deeper yolk colors, thus carotenoid additives may be supplemented. High carotenoid corn genotypes have been developed, and when included in poultry diets increase carotenoid concentrations in yolks. Seven different diets were fed to 210 Novogen White laying hens over 21 days. Each diet had five replicates of six hens housed in conventional cages. The only difference in diet treatments was percent inclusion rate of orange corn or inclusion of a carotenoid additive (Oro Glo®). Yolk color was assessed by colorimeter and DSM YolkFan. Yolk carotenoid concentrations were determined by high performance liquid chromatography. Yolks from hens fed diets with a 100% orange corn inclusion rate had the highest YolkFan scores and total xanthophyll levels at the end of the study. Orange corn inclusion rate showed a linear relationship with colorimeter a* values (r = 0.96) and YolkFan scores (r = 0.90) for egg yolks. Orange corn inclusion of 50% and 75% produced yolks with a* axis color value equivalent to that found in yolks from hens fed 100% yellow corn plus 35 g/kg of Oro Glo®. Data indicates that orange corn can be a suitable replacement for carotenoid additives. A 50-75% orange corn inclusion could be sufficient to achieve yolk colors similar to diets that involve supplementation with a carotenoid additive.
... Lutein and its isomers, zeaxanthin and meso-zeaxanthin, are xanthophyll carotenoids found commonly in green leafy vegetables, avocados and eggs which play significant roles in human health, particularly the health of eyes and brain, due to their antioxidant attributes [1][2][3][4]. Although lutein, unlike β-carotene, does not have vitamin A activity, it is exclusively accumulated in the retina and forms macular pigment [5][6][7][8][9]. ...
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Emerging literature suggests that dietary lutein may have important functions in cognitive health, but there is not enough data to substantiate its effects in human cognition. The current study was intended to determine the overall effect of lutein on the main domains of cognition in the adult population based on available placebo randomized-controlled trials. Literature searches were conducted in PubMed, AGRICOLA, Scopus, MEDLINE, and EMBASE on 14 November 2020. The effect of lutein on complex attention, executive function and memory domains of cognition were assessed by using an inverse-variance meta-analysis of standardized mean differences (SMD) (Hedge’s g method). Dietary lutein was associated with slight improvements in cognitive performance in complex attention (SMD 0.02, 95% CI −0.27 to 0.31), executive function (SMD 0.13, 95% CI −0.26 to 0.51) and memory (SMD 0.03, 95% CI −0.26 to 0.32), but its effect was not significant. Change-from-baseline analysis revealed that lutein consumption could have a role in maintaining cognitive performance in memory and executive function. Although dietary lutein did not significantly improve cognitive performance, the evidence across multiple studies suggests that lutein may nonetheless prevent cognitive decline, especially executive function. More intervention studies are needed to validate the role of lutein in preventing cognitive decline and in promoting brain health.
... 19 Several reviews have focused on either choline or DHA, presenting evidence from predominantly high-income countries. [20][21][22][23] This review presents the evidence relating choline, DHA, and a combination of the 2 nutrients during the first 1000 days of life to children's neurodevelopment, birth outcomes, growth, morbidity, and inflammation in the context of LMICs. ...
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Choline and DHA are nutrients that, when provided during the first 1000 days from conception to age 2 years, may have beneficial effects on child neurodevelopment as well as related health factors, including birth outcomes and child growth, morbidity, and inflammation. Because these nutrients are found mainly in animal-source foods, they may be lacking in the diets of pregnant and lactating women and young children in low- and middle-income countries, potentially putting children at risk for suboptimal development and health. Prior reviews of these nutrients have mainly focused on studies from high-income countries. Here, a narrative review is presented of studies describing the pre- and postnatal roles of choline, docosahexaenoic acid, and a combination of the 2 nutrients on child neurodevelopment, birth outcomes, growth, morbidity, and inflammation in low- and middle-income countries. More studies are needed to understand the specific, long-term effects of perinatal choline and docosahexaenoic acid intake in various contexts.
... 37 The nutritional composition and potential of eggs to improve young child nutrition has been reviewed by experts in the field. 38,39 The objective of this individually randomized, partially blinded, controlled comparative effectiveness trial titled Saqmolo' (ie, "egg" in the Mayan language, Kaqchiquel), is to evaluate the influence of adding delivery of a single whole egg per day to a package of local standard nutrition care interventions, compared with the local standard nutrition care alone, on child development, growth, and diet quality measures in rural indigenous Mayan infants, aged 6 to 9 months at baseline. The study is adequately powered to detect changes in both its primary and secondary specified outcomes. ...
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Adequate nutrition during the complementary feeding period is critical for optimal child growth and development and for promoting long-term educational attainment and economic potential. To prioritize limited public health resources, there is a need for studies that rigorously assess the influence of multicomponent integrated nutrition interventions in children younger than age 2 years in different contexts.
... Department of Agriculture, 2021). Eggs have the potential to contribute significant levels of lutein and zeaxanthin, and several essential vitamins and micronutrients in the western diet (Wallace, 2018). The yellow-orange yolk color comes from lutein and zeaxanthin (Schweiggert and Carle, 2017;Titcomb et al., 2019), natural pigments present in laying hens diets. ...
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Plant breeding has developed corn genotypes with grain higher in levels of carotenoids. Dietary consumption of specific carotenoids by humans has been associated with improved eye health, notably with some protection against age-related macular degeneration. Increasing dietary sources of macular carotenoids in the standard American diet might be accomplished by using high carotenoid orange corn in poultry diets to increase macular carotenoid concentrations in egg yolks. Three hundred sixty laying hens (Novogen White) were fed three different diets over 31 days. Each diet had six replicates of 20 hens housed in enrichable colony cages. The only difference was the type of corn included - white, yellow, and orange, in order to assess the impact of each type of corn on egg production, yolk pigmentation, and carotenoid deposition. This study assessed yolk color and carotenoid densities using a portable colorimeter and the DSM YolkFan, and by high performance liquid chromatography (HPLC) on eggs from the feeding study and on 43 cartons of 12 eggs commercially available and produced in various production settings: conventional cage, cage-free, cage-free organic, free-range/pasture, and free-range/pasture organic. Yolks from hens fed with the orange corn diet produced eggs with higher (P < 0.01) DMS yolk color (6 to 10) and total xanthophylls (23.5 to 35.3 μg/g of egg yolk) compared to the yellow diet (5 to 6 DMS and 12.3 to 17.7 μg/g xanthophylls) and white diet (1 to 2 DMS and 2.5 to 3.0 μg/g xanthophylls). Egg yolks reached a maximum xanthophyll accumulation with the orange corn diet (35.3 μg/g of egg yolk) after twelve days of treatment and maintained steady levels at subsequent time points. In general, xanthophyll levels in yolks from the orange corn diet were superior (30-61% higher) to any of the commercial egg brands, suggesting that feeding high carotenoid orange corn increases xanthophyll density in eggs.
... There is evidence that the carotenoids lutein and zeaxanthin may reduce the risk of age-related macular degeneration (Kelly et al. 2017) as well as emerging research to suggest that higher blood levels of these carotenoids are associated with improved cognition (Wallace 2018). Mean levels of total carotenoids were 25% higher among female egg consumers compared with non-consumers (P = 0.008); lutein levels were also higher. ...
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Dietary habits are constantly evolving with changes in culture, economics and the food supply. In the UK, red meat intakes have been declining for more than a decade, while egg consumption has increased in tandem with interest in healthy, sustainable diets. To explore current dietary habits of egg consumers and non‐consumers and potential implications for nutrition and health, we analysed dietary records from 647 adults participating in Year 9 (2017) of the UK National Diet and Nutrition Survey (NDNS). Mean consumption of eggs and egg dishes was 29 g/day (3.5 eggs/week). Female egg consumers (n = 224; mean 46 g/day, 5 eggs/week) ate more fruit, vegetables and fish and had significantly higher dietary intakes of protein, monounsaturated fatty acids, n‐3 polyunsaturated fatty acids and most micronutrients, notably vitamin D, most B vitamins, vitamin C, iron, zinc and selenium, compared with non‐consumers (n = 150). They also had higher plasma levels of 25‐hydroxyvitamin D, total carotenoids, selenium and ferritin and were less likely to be anaemic. Female egg consumers had a lower mean body mass index and waist circumference, despite reporting a higher mean energy intake than non‐consumers. Male egg consumers (n = 159; mean 54 g/day, 6 eggs/week) had higher dietary intakes of vitamin D, biotin, iodine and selenium but similar micronutrient status and bodyweight to non‐consumers (n = 114). There were no significant differences in cardiometabolic risk factors for either sex. Egg consumption appears to be associated with signs of higher dietary quality, better nutritional status, and slightly lower body mass index among women participating in the latest NDNS.
... Carotenoids are proposed to be important for cognitive health [5,6]. Growing evidence supports the role of lutein and zeaxanthin in early neurocognitive development [7,8]. This includes detection of high lutein and zeaxanthin concentrations across a number of infant brain regions [9], as well as associations of a higher macular lutein and zeaxanthin density in children or higher lutein concentrations in breastmilk, with better neurocognitive functioning in infants/ children [10][11][12]. ...
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PurposeCurrent literature on the roles of α-, β-carotene and β-cryptoxanthin in neurocognitive function has largely focused on preventing cognitive decline in older people, and less on neuro-development in children. We examined the relations of maternal plasma carotenoids concentrations with offspring cognitive development up to age 4.5 years in the Growing Up in Singapore Towards healthy Outcomes mother–offspring cohort study.Methods Maternal plasma α-, β-carotene and β-cryptoxanthin concentrations at delivery were determined by ultra-performance liquid chromatography. Children’s cognition was assessed at ages 2 (Bayley Scales of Infant and Toddler Development) and 4.5 (Kaufman Brief Intelligence Test) years. Associations were examined in 419 mother–offspring pairs using linear regressions adjusting for key confounders.ResultsMedian and interquartile range of maternal plasma concentrations (mg/L) were: α-carotene 0.052 (0.032, 0.081), β-carotene 0.189 (0.134, 0.286), and β-cryptoxanthin 0.199 (0.123, 0.304). In 2 years old children, higher maternal carotenoids [per standard deviation (SD) log-concentration] were positively associated with neurocognitive functions: β-cryptoxanthin with higher scores in cognitive [β = 0.18, (0.08, 0.28) SD], receptive language [β = 0.17 (0.07, 0.27) SD], fine motor [β = 0.16 (0.05, 0.26) SD], and gross motor [β = 0.16 (0.06, 0.27) SD] scales; β-carotene with higher cognitive score [β = 0.17 (0.05, 0.29) SD]. No significant associations were observed with neurocognitive functions at age 4.5 years.Conclusion Our study provides novel data suggesting a potential role of prenatal carotenoids, particularly β-cryptoxanthin, on early offspring cognitive and motor development. Whether the prenatal influences sustain beyond early childhood requires further investigation in longer term studies.
... Lutein shows antioxidant and anti-inflammatory activities by targeting reactive oxygen species, and downregulating inflammatory proteins and pro-inflammatory cytokines [2]. Lutein is one of the three xanthophyll carotenoids that can cross the blood-brain barrier and selectively accumulate in the retina and brain tissues [1,3,4]. The xanthophyll lutein is often co-ingested with other plant phytochemicals such as carotenoids and/or flavonoids in a normal human diet containing plant-based foods. ...
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The interactive effects on anti-oxidation and anti-inflammation of lutein combined with each of the six common anthocyanidin glucosides were studied in both chemical and cellular systems. The combined phytochemicals showed an antagonism in the inhibition of lipid oxidation in a liposomal membrane, but showed an additive effect on cellular antioxidant activity in Caco-2 cells. Lutein was an active lipoxygenase inhibitor at 2–12 μM while anthocyanins were inactive. The concentration of lutein when it was used in combination with anthocyanins was 25–54% higher than when lutein was used alone (i.e., IC50 = 1.2 μM) to induce 50% of lipoxygenase inhibition. Only the combination of lutein with malvidin-3-glucoside showed anti-inflammatory synergy in the suppression of interleukin-8, and the synergy was seen at all three ratios tested. Some mixtures, however, showed anti-inflammatory antagonism. The presence of anthocyanins (5–7.5 μM) did not affect lutein uptake (2.5–5 μM) by Caco-2 cells.
... A Finish cohort found no association between both dietary cholesterol and egg intakes and dementia or Alzheimer's disease risks; although moderate egg consumption was associated with better performance on several neuropsycological tests [26]. Eggs are a rich source of choline [27] and an interesting source of lutein and zeaxanthin [28], which may have protective effects on cognition across the lifespan [29]. Low plasma free choline levels were associated with poor cognitive performance, especially in addition to low vitamin B 12 or high methylmalonic acid concentrations in a Norwegian cross-sectional study [30]. ...
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Purpose: Dietary guidelines for egg consumption for general population differ among public health agencies. Our aim was to investigate the association between egg intake and both all-cause and specific-cause of mortality in a Mediterranean population. Methods: The European Prospective Investigation into Cancer and Nutrition (EPIC)-Spain cohort included 40,621 men and women aged 29-69 years old in the nineties from 5 Spanish regions. After a mean of 18 years of follow-up, 3,561 deaths were recorded, of which 1,694 were from cancer, 761 from CVD, and 870 from other causes. Data on egg consumption was collected using a validated diet history at recruitment. Cox proportional hazards models, adjusted for confounders, were used in the analyses. Results: The mean (standard deviation) egg consumption was 22.0 g/day (15.8) and 30.9 g/day (23.1) in women and men, respectively. No association was observed between egg consumption and all-cause mortality for the highest vs the lowest quartile (HR 1.01; 95% CI 0.91-1.11; P trend = 0.96). Likewise, no association was observed with cancer and cardiovascular diseases mortality. However, an inverse association was found between egg consumption and deaths for other causes (HR 0.76; 95% CI 0.63-0.93; P trend = 0.003), particularly for deaths from the nervous system (HR 0.59; 95% CI 0.35-1.00; P trend = 0.036). No interaction was detected with the adherence to Mediterranean diet. Conclusions: This study shows no association between moderate egg consumption, up to 1 egg per day, and main causes of mortality in a large free-living Mediterranean population.
Article
Objective Egg consumption could reduce the chance of cognitive decline. We aimed to assess this possible protective effect using data from the Birjand longitudinal aging study (BLAS). Methods In this cross-sectional study, the association between number of whole eggs consumed per week and cognitive impairment was assessed on 1352 participants in the context of the first wave of BLAS conducted on September 2018 to April 2019. Six Item Cognitive Impairment Test (6-CIT), Mini-Mental State Examination (MMSE), Verbal Fluency Test (VFT) and abbreviated mental test (AMT) questionnaires were used to assess the cognitive function. Analyses have been conducted using multiple logistic regression. Results Participants ate an average of 2.4 eggs per week. Older adults with moderate and high egg consumption (2–3 eggs/week and ≥4 eggs/week, respectively) performed better at 6-CIT (OR: 0.61, 95% CI: 0.46; 0.80; and 0.58, 95% CI: 0.41; 0.82), AMT (0.67, 95% CI: 0.52; 0.87; and 0.56, 95% CI: 0.39; 0.80) and all 4 cognitive tests combined (0.47, 95% CI: 0.30; 0.73; and 0.44, 95% CI: 0.24; 0.78). VFT was not associated, and MMSE score was only associated with high egg intake (0.53, 95% CI: 0.38; 0.74). High egg intake was more protective of cognitive decline (≥40%) than the moderate intake (30–40%). The significance of most associations disappeared after adjustment for confounders and covariates. Conclusion In summary, the findings of this study suggest a potential inverse relationship, displaying an ascending trend, between weekly egg consumption and cognitive function among elderly Iranians.
Article
Background: It is unclear how changes in plant-based dietary quality are linked to subsequent risk of cognitive impairment. This study aims to evaluate this relationship using data from the Chinese Longitudinal Healthy Longevity Survey (CLHLS). Methods: A total of 6662 participants free of cognitive impairment in 2008 were included and followed up to 2018. Plant-based dietary quality was assessed by three indices: overall plant-based diet index (PDI), healthful plant-based diet index (hPDI), and unhealthful plant-based diet index (uPDI). Changes in plant-based diet quality from 2008 to 2011 were classified into quintiles. We assessed incident cognitive impairment (from 2011 to 2018) by using the Mini-Mental State Examination (MMSE). Cox proportional-hazards models were performed. Results: We recorded 1571 incident cases of cognitive impairment during a median of 10 years of follow-up. Compared with participants whose plant-based diet had no change or was relatively stable over three years, the full-adjusted hazard ratios (HRs) with 95% confidence intervals (CI) for cognitive impairment were 0.77 (0.64, 0.93), 0.72 (0.60, 0.86), and 1.50 (1.27, 1.77) among participants with a large increase in PDI, hPDI, and uPDI, respectively. The HRs with 95% CI were 1.22 (1.02, 1.44), 1.30 (1.11, 1.54), and 0.80 (0.67, 0.96) among participants with a large decrease in PDI, hPDI, and uPDI, respectively. Every 10-point increase in PDI and hPDI was associated with 26% and 30% lower risk of cognitive impairment, while every 10-point increase in uPDI was associated with 36% higher risk. Conclusions: Older adults with increased adherence to an overall plant-based diet and a healthful plant-based diet over three years have a lower risk of cognitive impairment, while those with increased adherence to an unhealthy plant-based diet had a higher risk of cognitive impairment.
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Choline is an essential nutrient affects brain development in early life. However, evidence is lacking regarding its potential neuroprotective effects in later life from community-based cohorts. This study assessed the relationship between choline intake and cognitive functioning in a sample of older adults 60 years + from the National Health and Nutrition Examination Survey 2011–2012 and 2013–2014 waves (n = 2,796). Choline intake was assessed using two nonconsecutive 24-hour dietary recalls. Cognitive assessments included immediate and delayed word recalls, Animal Fluency, and Digit Symbol Substitution Test. The average daily dietary choline intake was 307.5 mg, and the total intake (including intake from dietary supplements) was 330.9 mg, both below the Adequate Intake level. Neither dietary OR = 0.94, 95% CI (0.75, 1.17) nor total choline intake OR = 0.87, 95% CI (0.70, 1.09) was associated with changes in cognitive test scores. Further investigation adopting longitudinal or experimental designs may shed light on the issue.
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The gut microbiome interacts with the brain bidirectionally through the microbiome-gut-brain axis, which plays a key role in regulating various nervous system pathophysiological processes. Trimethylamine N-oxide (TMAO) is produced by choline metabolism through intestinal microorganisms, which can cross the blood-brain barrier to act on the central nervous system. Previous studies have shown that elevated plasma TMAO concentrations increase the risk of major adverse cardiovascular events, but there are few studies on TMAO in cerebrovascular disease and vascular cognitive impairment. This review summarized a decade of research on the impact of TMAO on stroke and related cognitive impairment, with particular attention to the effects on vascular cognitive disorders. We demonstrated that TMAO has a marked impact on the occurrence, development, and prognosis of stroke by regulating cholesterol metabolism, foam cell formation, platelet hyperresponsiveness and thrombosis, and promoting inflammation and oxidative stress. TMAO can also influence the cognitive impairment caused by Alzheimer's disease and Parkinson's disease via inducing abnormal aggregation of key proteins, affecting inflammation and thrombosis. However, although clinical studies have confirmed the association between the microbiome-gut-brain axis and vascular cognitive impairment (cerebral small vessel disease and post-stroke cognitive impairment), the molecular mechanism of TMAO has not been clarified, and TMAO precursors seem to play the opposite role in the process of post-stroke cognitive impairment. In addition, several studies have also reported the possible neuroprotective effects of TMAO. Existing therapies for these diseases targeted to regulate intestinal flora and its metabolites have shown good efficacy. TMAO is probably a new target for early prediction and treatment of stroke and vascular cognitive impairment.
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Foods not only supply energy but also help in growth, development and maintenance of health including cognitive functions. It has also been observed that specific nutrients can affect cognitive abilities at different ages. Diverse nutrients present in the food play a crucial role in the maintenance of cognitive functions and deficiencies of such nutrients might lead to neurodegenerative diseases such as Alzheimer disease, Parkinson’s disease and other neuronal dysfunction including dementia. The purpose of the present study is to determine the existing data available in different science literature regarding food items available in India that have potent action on brain function. Searched in PubMed, Google Search, Google Scholar, Research Gate. Using the keywords “Foods for Brain”,Diet influence on cognition'', “Micronutrients on cognition “, “Diets in Cognition”. The direct connection between nutrition, brain function and behaviour exist in several research. Traditional Indian diet consists of many phytochemicals/phytonutrients which have shown one pivotal role in reducing inflammation. There are hundreds of different spices that are specifically used in traditional Indian food which are rich in many phytonutrients that proves to play an important role in better nerve health like turmeric prevents brain damage due to oxidative stress even saffron has neuroprotective properties that protects the hippocampus against age related damage. Many studies proved that specific nutrients can affect our brain development. Phytonutrients present in the Indian food does improves alertness, concentration and performance of brain by reducing oxidative stress, high inflammation, stress induced neurotoxicity and it also impacted on the nerve functionality,however how much portion of such specific food we need to include in diet for best cognitive performance is yet to get disclosed, further research is still needed in this field. Furthermore, traditional Indian foods are having bright future in improving neurological health of an individual.
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Objectives: To evaluate the longitudinal association of eggs consumption with cognitive function in Chinese elderly. Design: Prospective cohort study. Participants: 9028 participants aged ≥60 years from Zhejiang Ageing and Health Cohort Study without cognitive impairment at baseline survey. Measurements: Cognitive function was assessed through the Mini-Mental State Examination (MMSE) at baseline and three waves of follow-up (2015, 2016, and 2019-2020). Data on eggs consumption was collected in the diet habits section within the questionnaire at baseline. Log-binomial regression models with the Generalized Estimating Equations, controlled for an extensive range of potential confounders, were used to evaluate the association and estimate relative risks (RRs). Results: After 6 years of follow-up, 3266 (36.18%) participants were indicated as cognitive impairment by MMSE at least once. Compared with non-consumers or less-than-weekly consumers, participants consuming 0.1-2.9 eggs/week and 3.0-5.9 eggs/week had 18% (RR=0.82, 95%CI 0.76-0.89) and 9% (RR=0.91, 95%CI 0.84-0.99) lower risks of cognitive impairment respectively, whereas no association was found in those consuming ≥6.0 eggs/week (P=0.32). Moreover, infrequent lower-quantity consumption (1-2 days/week and 0.1-1.9 eggs/day), infrequent higher-quantity consumption (1-2 days/week and ≥2.0 eggs/day), and frequent lower-quantity consumption (≥3 days/week and 0.1-1.9 eggs/day) were associated with better cognitive performance, whereas null association was found among frequent higher-quantity consumers (≥3 days/week and ≥2.0 eggs/day). The sensitivity analyses yielded consistent results to the main analysis. Conclusion: Limited eggs consumption is prospectively related to a lower risk of cognitive impairment in Chinese elderly.
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Background Whether consumption of egg and cholesterol is detrimental to cardiovascular health and longevity is highly debated. Data from large-scale cohort studies are scarce. This study aimed to examine the associations of egg and cholesterol intakes with mortality from all causes, cardiovascular disease (CVD), and other causes in a US population. Methods and findings Overall, 521,120 participants (aged 50–71 years, mean age = 62.2 years, 41.2% women, and 91.8% non-Hispanic white) were recruited from 6 states and 2 additional cities in the US between 1995 and 1996 and prospectively followed up until the end of 2011. Intakes of whole eggs, egg whites/substitutes, and cholesterol were assessed by a validated food frequency questionnaire. Cause-specific hazard models considering competing risks were used, with the lowest quintile of energy-adjusted intake (per 2,000 kcal per day) as the reference. There were 129,328 deaths including 38,747 deaths from CVD during a median follow-up of 16 years. Whole egg and cholesterol intakes were both positively associated with all-cause, CVD, and cancer mortality. In multivariable-adjusted models, the hazard ratios (95% confidence intervals) associated with each intake of an additional half of a whole egg per day were 1.07 (1.06–1.08) for all-cause mortality, 1.07 (1.06–1.09) for CVD mortality, and 1.07 (1.06–1.09) for cancer mortality. Each intake of an additional 300 mg of dietary cholesterol per day was associated with 19%, 16%, and 24% higher all-cause, CVD, and cancer mortality, respectively. Mediation models estimated that cholesterol intake contributed to 63.2% (95% CI 49.6%–75.0%), 62.3% (95% CI 39.5%–80.7%), and 49.6% (95% CI 31.9%–67.4%) of all-cause, CVD, and cancer mortality associated with whole egg consumption, respectively. Egg white/substitute consumers had lower all-cause mortality and mortality from stroke, cancer, respiratory disease, and Alzheimer disease compared with non-consumers. Hypothetically, replacing half a whole egg with equivalent amounts of egg whites/substitutes, poultry, fish, dairy products, or nuts/legumes was related to lower all-cause, CVD, cancer, and respiratory disease mortality. Study limitations include its observational nature, reliance on participant self-report, and residual confounding despite extensive adjustment for acknowledged dietary and lifestyle risk factors. Conclusions In this study, intakes of eggs and cholesterol were associated with higher all-cause, CVD, and cancer mortality. The increased mortality associated with egg consumption was largely influenced by cholesterol intake. Our findings suggest limiting cholesterol intake and replacing whole eggs with egg whites/substitutes or other alternative protein sources for facilitating cardiovascular health and long-term survival. Trial registration ClinicalTrials.gov NCT00340015.
Chapter
Often described as ‘nature’s perfect food’, perceptions of egg consumption and human health have evolved substantially over the past decades, in particular dietary guidelines no longer include a limit for dietary cholesterol and recommend eggs as part of healthy eating patterns. This book presents the opportunities for processing eggs to produce value-added food, nutritional, biomedical, functional food, and nutraceutical applications. It provides new evidence around egg consumption with respect to cardiovascular diseases, metabolic syndrome, weight management, mental development, eye, muscle, and ageing health. It also highlights the new discovery regarding egg bioactives that are relevant to anti-oxidants, anti-inflammation, cardiovascular and bone health, anti-microbial and anti-viral activities. Appealing to food scientists, food chemists, researchers in human nutrition specialising in eggs and dairy nutrition, and those involved in egg production, this book is reflecting the trends and innovations in this area of research.
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Lutein, a yellow xanthophyll carotenoid found in egg yolks and many colorful fruits and vegetables, has gained public health interest for its putative role in visual performance and reducing the risk of age-related macular degeneration. The National Academies of Sciences, Engineering and Medicine’s recommended Dietary Reference Intakes (DRIs) focus on preventing deficiency and toxicity, but there is a budding interest in establishing DRI-like guidelines for non-essential bioactives, like lutein, that promote optimal health and/or prevent chronic diseases. Lupton et al. developed a set of nine criteria to determine whether a bioactive is ready to be considered for DRI-like recommendations. These criteria include: (1) an accepted definition; (2) a reliable analysis method; (3) a food database with known amounts of the bioactive; (4) cohort studies; (5) clinical trials on metabolic processes; (6) clinical trials for dose–response and efficacy; (7) safety data; (8) systematic reviews and/or meta-analyses; (9) a plausible biological rationale. Based on a review of the literature supporting these criteria, lutein is ready to be considered for intake recommendations. Establishing dietary guidance for lutein would encourage the consumption of lutein-containing foods and raise public awareness about its potential health benefits.
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Choline is an essential nutrient with critical roles in several biological processes including neuronal development, cell signaling, nerve impulse transmission, and lipid transport and metabolism. The National Cancer Institute method was used to assess usual intakes of choline from foods according to data for participants enrolled in the National Health and Nutrition Examination Survey 2009–2014 datasets and pregnant women in the 2005–2014 datasets. Suboptimal intakes of choline are present across many gender and life-stage subpopulations, as well as pregnant women in the U.S. Only 8.03 ± 0.56% of adults and 8.51 ± 2.89% pregnant women meet the AI for choline. Children 2–3 years were the most likely to meet their gender and life-stage specific AI, followed by children 4–8 years. Adults 19+ years who consume eggs were more likely to meet their gender and life-stage AI as compared to non-consumers (57.3 ± 1.45% and 2.43 ± 0.28%). Consumers of eggs had almost double the usual intake of choline as compared to non-consumers (525 ± 5.17 mg/d and 294 ± 1.98; p < 0.0001). Protein food (meat, poultry and seafood) consumption also increased usual choline intakes compared to non-consumers (345 ± 2.21 mg/day and 235 ± 8.81; p < 0.0001) to a lesser degree, but did not result in substantial increases in the percent of individuals meeting the AI. No subpopulation exceeded the UL for choline. This research illustrates that it is extremely difficult to achieve the AI for choline without consuming eggs or taking a dietary supplement.
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Nutrient needs, including those of the essential nutrient choline, are a population wide distribution. Adequate Intake (AI) recommendations for dietary choline (put forth by the National Academies of Medicine to aid individuals and groups in dietary assessment and planning) are grouped to account for the recognized unique needs associated with age, biological sex, and reproductive status (i.e., pregnancy or lactation). Established and emerging evidence supports the notion that common genetic variants are additional factors that substantially influence nutrient requirements. This review summarizes the genetic factors that influence choline requirements and metabolism in conditions of nutrient deprivation, as well as conditions of nutrient adequacy, across biological sexes and reproductive states. Overall, consistent and strong associative evidence demonstrates that common genetic variants in choline and folate pathway enzymes impact the metabolic handling of choline and the risk of nutrient inadequacy across varied dietary contexts. The studies characterized in this review also highlight the substantial promise of incorporating common genetic variants into choline intake recommendations to more precisely target the unique nutrient needs of these subgroups within the broader population. Additional studies are warranted to facilitate the translation of this evidence to nutrigenetics-based dietary approaches.
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Objectives: The present study constitutes the first randomized controlled trial to investigate the relation of lutein (L) and zeaxanthin (Z) to brain function using functional magnetic resonance imaging (fMRI). It was hypothesized that L and Z supplementation in older adults would enhance neural efficiency (i.e., reduce activation) and cognitive performance on a verbal learning task relative to placebo. Methods: A total of 44 community-dwelling older adults (mean age=72 years) were randomly assigned to receive either placebo or L+Z supplementation (12 mg/daily) for 1 year. Neurocognitive performance was assessed at baseline and post-intervention on an fMRI-adapted task involving learning and recalling word pairs. Imaging contrasts of blood-oxygen-level-dependent (BOLD) signal were created by subtracting active control trials from learning and recall trials. A flexible factorial model was employed to investigate the expected group (placebo vs. supplement) by time (baseline vs. post-intervention) interaction in pre-specified regions-of-interest. Results: L and Z appeared to buffer cognitive decline on the verbal learning task (Cohen's d=.84). Significant interactions during learning were observed in left dorsolateral prefrontal cortex and anterior cingulate cortex (p < .05, family-wise-error corrected). However, these effects were in the direction of increased rather than decreased BOLD signal. Although the omnibus interaction was not significant during recall, within-group contrasts revealed significant increases in left prefrontal activation in the supplement group only. Conclusions: L and Z supplementation appears to benefit neurocognitive function by enhancing cerebral perfusion, even if consumed for a discrete period of time in late life. (JINS, 2017, 23, 1-14).
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One apparent consequence of aging appears to be loss of some aspects of cognitive control. This loss is measurable as early as mid-adulthood. Since, like many aspects of cognition, there is wide variance among individuals, it is possible that behavior, such as one’s diet, could drive some of these differences. For instance, past data on older humans and non-human primates have suggested that dietary carotenoids could slow cognitive decline. In this study, we tested how early such protection might manifest by examining a sample (n = 60) of 25–45 year olds. Carotenoid status was assessed by directly measuring macular pigment optical density (MPOD) which has shown to be highly correlated with the primary carotenoid in brain, lutein. Cognitive control was measured using event-related potentials during the performance of cognitive control tasks designed to tap into different aspects of attentional (i.e., selective attention, attentional inhibition, and response inhibition) control. Our results showed that, across participants, MPOD was related to both age and the P3 component of participants’ neuroelectric profile (P3 amplitude) for attentional, but not response, inhibition. Although younger adults exhibited larger P3 amplitudes than their older adult counterparts, older subjects with higher MPOD levels displayed P3 indices similar to their younger adult counterparts in amplitude. Furthermore, hierarchical regression analyses showed that age was no longer a significant predictor of P3 amplitude when MPOD was included as a predictor in the model, suggesting that MPOD may partially contribute to the relationship between age and P3 amplitude. In addition, age and MPOD were shown to have independent associations with intraindividual variability of attentional control, such that younger individuals and individuals with higher MPOD showed less intraindividual variability. These results show a relationship between retinal carotenoids and neuroelectric indices underlying cognitive control. The protective role of carotenoids within the CNS may be evident during early and middle adulthood, decades prior to the onset of older age.
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Background: Eggs are a good source of nutrients for growth and development. We hypothesized that introducing eggs early during complementary feeding would improve child nutrition. Methods: A randomized controlled trial was conducted in Cotopaxi Province, Ecuador, from March to December 2015. Children ages 6 to 9 months were randomly assigned to treatment (1 egg per day for 6 months [n = 83]) and control (no intervention [n = 80]) groups. Both arms received social marketing messages to encourage participation in the Lulun Project (lulun meaning "egg" in Kichwa). All households were visited once per week to monitor morbidity symptoms, distribute eggs, and monitor egg intakes (for egg group only). Baseline and end point outcome measures included anthropometry, dietary intake frequencies, and morbidity symptoms. Results: Mothers or other caregivers reported no allergic reactions to the eggs. Generalized linear regression modeling showed the egg intervention increased length-for-age z score by 0.63 (95% confidence interval [CI], 0.38-0.88) and weight-for-age z score by 0.61 (95% CI, 0.45-0.77). Log-binomial models with robust Poisson indicated a reduced prevalence of stunting by 47% (prevalence ratio [PR], 0.53; 95% CI, 0.37-0.77) and underweight by 74% (PR, 0.26; 95% CI, 0.10-0.70). Children in the treatment group had higher dietary intakes of eggs (PR, 1.57; 95% CI, 1.28-1.92) and reduced intake of sugar-sweetened foods (PR, 0.71; 95% CI, 0.51-0.97) compared with control. Conclusions: The findings supported our hypothesis that early introduction of eggs significantly improved growth in young children. Generally accessible to vulnerable groups, eggs have the potential to contribute to global targets to reduce stunting.
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Lutein (L) and zeaxanthin (Z) are dietary carotenoids derived from dark green leafy vegetables, orange and yellow fruits that form the macular pigment of the human eyes. It was hypothesized that they protect against visual disorders and cognition diseases, such as age-related macular degeneration (AMD), age-related cataract (ARC), cognition diseases, ischemic/hypoxia induced retinopathy, light damage of the retina, retinitis pigmentosa, retinal detachment, uveitis and diabetic retinopathy. The mechanism by which they are involved in the prevention of eye diseases may be due their physical blue light filtration properties and local antioxidant activity. In addition to their protective roles against light-induced oxidative damage, there are increasing evidences that L and Z may also improve normal ocular function by enhancing contrast sensitivity and by reducing glare disability. Surveys about L and Z supplementation have indicated that moderate intakes of L and Z are associated with decreased AMD risk and less visual impairment. Furthermore, this review discusses the appropriate consumption quantities, the consumption safety of L, side effects and future research directions.
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Eggs have the potential to contribute essential nutrients to nutritionally vulnerable populations on limited food budgets. Further research is needed to better understand patterns of egg consumption across diverse sociodemographic groups in order to inform clinical practice to improve nutrient adequacy. Data on demographics and egg intake of 29,694 U.S. adults were obtained from the National Health and Nutrition Examination Survey, 2001–2012. The National Cancer Institute’s usual intake methodology was used to estimate the distribution of egg intake. Linear and logistic regression models were used to test for time trends in egg consumption and for differences between sociodemographic groups. The proportion of the U.S. population, overall (21%–22%; p = 0.311) and by sociodemographic group (p > 0.05 for all groups), that reported consuming eggs remained unchanged from 2001 to 2012. Mean egg consumption increased overall from 23.0 (95% CI, 20.8–25.2) g/day in 2001–2002 to 25.5 (22.7–28.4) g/day in 2011–2012 (p = 0.012), but not among food insecure individuals (p = 0.816) and Supplemental Nutrition Assistance Program (SNAP) participants (p = 0.399). No differences in the odds of egg consumption were observed by income level, food security status, or SNAP participation status (p > 0.05 for all groups). Given the nutritional benefits of eggs, as well as their low cost and culinary versatility, the results presented here have important implications for reducing disparities in health outcomes and diet quality, in particular among food insecure individuals and SNAP participants. Further research is needed to examine factors that influence egg consumption and associated nutrient intake, and to identify potential barriers to increasing egg consumption, such as egg price changes, across diverse sociodemographic groups.
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Background Low blood serum or plasma concentrations of the xanthophyll carotenoids lutein and zeaxanthin have been implicated in poorer cognitive health in older adults. However, equivocal results from smaller studies and clinical trials highlight the need for large population-based studies with comprehensive measures of cognitive function and adjustment for multiple confounders to examine such associations in more depth. Methods In the current study, we investigated the association between plasma lutein and zeaxanthin and domain-specific cognitive performance in 4,076 community-dwelling adults aged 50 years or older from The Irish Longitudinal Study on Ageing. Mixed-effects models were fitted with adjustment for demographic and socioeconomic factors, health conditions, and health behaviors. Results Higher plasma lutein and zeaxanthin were independently associated with better composite scores across the domains of global cognition, memory, and executive function. We also found evidence that higher plasma zeaxanthin, but not lutein, was associated with better processing speed. These associations were consistent across domains. Conclusions Further investigation of the prognostic value of carotenoid concentrations, and their changes, on cognition in similar population-based samples longitudinally is warranted.
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Background: Prenatal alcohol exposure results in a broad range of cognitive and behavioral impairments. Because of the long-lasting problems that are associated with fetal alcohol spectrum disorders (FASDs), the development of effective treatment programs is critical. Preclinical animal studies have shown that choline, which is an essential nutrient, can attenuate the severity of alcohol-related cognitive impairments. Objective: We aimed to translate preclinical findings to a clinical population to investigate whether choline supplementation can ameliorate the severity of memory, executive function, and attention deficits in children with FASDs. Design: In the current study, which was a randomized, double-blind, placebo-controlled clinical trial, we explored the effectiveness of a choline intervention for children with FASDs who were aged 5-10 y. Fifty-five children with confirmed histories of heavy prenatal alcohol exposure were randomly assigned to either the choline (n = 29) or placebo (n = 26) treatment arms. Participants in the choline group received 625 mg choline/d for 6 wk, whereas subjects in the placebo group received an equivalent dose of an inactive placebo treatment. Primary outcomes, including the performance on neuropsychological measures of memory, executive function, and attention and hyperactivity, were assessed at baseline and postintervention. Results: Compared with the placebo group, participants in the choline group did not differentially improve in cognitive performance in any domain. Treatment compliance and mean dietary choline intake were not predictive of treatment outcomes. Conclusions: Findings of the current study do not support that choline, administered at a dose of 625 mg/d for 6 wk, is an effective intervention for school-aged (5-10 y old) children with FASDs. This research provides important information about choline's therapeutic window. Combined with other studies of choline and nutritional interventions in this population, this study emphasizes a further need for the continued study of the role of nutritional status and supplementation in children with FASDs and the contributions of nutrition to neurocognition. This trial was registered at clinicaltrials.gov as NCT01911299.
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Objectives: It is well known that the carotenoids lutein (L) and zeaxanthin (Z) improve eye health and an accumulating evidence base suggests cognitive benefits as well. The present study investigated underlying neural mechanisms using functional magnetic resonance imaging (fMRI). It was hypothesized that lower L and Z concentrations would be associated with neurobiological inefficiency (i.e., increased activation) during cognitive performance. Methods: Forty-three community-dwelling older adults (mean age=72 years; 58% female; 100% Caucasian) were asked to learn and recall pairs of unrelated words in an fMRI-adapted paradigm. L and Z levels were measured in retina (macular pigment optical density) and serum using validated procedures. Results: Following first-level contrasts of encoding and retrieval trials minus control trials (p<.05, family-wise error corrected, minimum voxel cluster=8), L and Z were found to significantly and negatively relate to blood-oxygen-level-dependent signal in central and parietal operculum cortex, inferior frontal gyrus, supramarginal gyrus, planum polare, frontal and middle temporal gyrus, superior parietal lobule, postcentral gyrus, precentral gyrus, occipital cortex bilaterally, and cerebellar regions. Conclusions: To the authors' knowledge, the present study represents the first attempt to investigate neural mechanisms underlying the relation of L and Z to cognition using fMRI. The observed results suggest that L and Z promote cognitive functioning in old age by enhancing neural efficiency. (JINS, 2016, 22, 1-12).
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Choline is a dietary component and precursor of acetylcholine, a crucial neurotransmitter for memory-related brain functions. In two double-blind, placebo-controlled cross-over experiments, we investigated whether the food supplement choline bitartrate improved declarative memory and working memory in healthy, young students one to two hours after supplementation. In experiment 1, 28 participants performed a visuospatial working memory task. In experiment 2, 26 participants performed a declarative picture memorization task. In experiment 3, 40 participants performed a verbal working memory task in addition to the visuospatial working memory and declarative picture task. All tasks were conducted approximately 60 minutes after the ingestion of 2.0-2.5g of either choline bitartrate or placebo. We found that choline did not significantly enhance memory performance during any of the tasks. The null hypothesis that choline does not improve memory performance as compared to placebo was strongly supported by Bayesian statistics. These results are in contrast with animal studies suggesting that choline supplementation boosts memory performance and learning. We conclude that choline likely has no acute effects on cholinergic memory functions in healthy human participants.
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Lutein, a dietary carotenoid, selectively accumulates in human retina and brain. While many epidemiological studies show evidence of a relationship between lutein status and cognitive health, lutein’s selective uptake in human brain tissue and its potential function in early neural development and cognitive health have been poorly evaluated at a molecular level. The objective of this study was to evaluate the cross-sectional relationship between concentrations of brain lutein and StARD3 (identified as its binding protein in retinal tissue) among three age groups: infants (1–4 months, n = 10), older adults (55–86 years, n = 8), and centenarians (98–105 years, n = 10). Brain lutein concentrations were analyzed by high-performance liquid chromatography and StARD3 levels were analyzed by Western Blot analysis. The strong relationship in infant brains (r = 0.75, P < 0.001) suggests that lutein has a role in neural development. The relationship remained significant but weaker in older adults (r = 0.51, P < 0.05) and insignificant in centenarians (r = 0.08, P > 0.05), seven of whom had mild cognitive impairment (MCI) or dementia. These exploratory findings suggest an age-related decrease or abnormality of StARD3 activity in human brain. Given that StARD3 is also involved in cholesterol transportation, a process that is aberrant in neurodegenerative diseases, the potential protective function of lutein against these diseases remains to be explored.
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The aim was to explore the relation of human milk lutein; choline; and docosahexaenoic acid (DHA) with recognition memory abilities of six-month-olds. Milk samples obtained three to four months postpartum were analyzed for fatty acids, lutein, and choline. At six months, participants were invited to an electrophysiology session. Recognition memory was tested with a 70-30 oddball paradigm in a high-density 128-lead event-related potential (ERP) paradigm. Complete data were available for 55 participants. Data were averaged at six groupings (Frontal Right; Frontal Central; Frontal Left; Central; Midline; and Parietal) for latency to peak, peak amplitude, and mean amplitude. Difference scores were calculated as familiar minus novel. Final regression models revealed the lutein X free choline interaction was significant for the difference in latency scores at frontal and central areas (p < 0.05 and p < 0.001; respectively). Higher choline levels with higher lutein levels were related to better recognition memory. The DHA X free choline interaction was also significant for the difference in latency scores at frontal, central, and midline areas (p < 0.01; p < 0.001; p < 0.05 respectively). Higher choline with higher DHA was related to better recognition memory. Interactions between human milk nutrients appear important in predicting infant cognition, and there may be a benefit to specific nutrient combinations.
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Although Down syndrome (DS) can be diagnosed prenatally, currently there are no effective treatments to lessen the intellectual disability (ID) which is a hallmark of this disorder. Furthermore, starting as early as the third decade of life, DS individuals exhibit the neuropathological hallmarks of Alzheimer’s disease (AD) with subsequent dementia, adding substantial emotional and financial burden to their families and society at large. A potential therapeutic strategy emerging from the study of trisomic mouse models of DS is to supplement the maternal diet with additional choline during pregnancy and lactation. Studies demonstrate that maternal choline supplementation (MCS) markedly improves spatial cognition and attentional function, as well as normalizes adult hippocampal neurogenesis and offers protection to basal forebrain cholinergic neurons (BFCNs) in the Ts65Dn mouse model of DS. These effects on neurogenesis and BFCNs correlate significantly with spatial cognition, suggesting functional relationships. In this review, we highlight some of these provocative findings, which suggest that supplementing the maternal diet with additional choline may serve as an effective and safe prenatal strategy for improving cognitive, affective, and neural functioning in DS. In light of growing evidence that all pregnancies would benefit from increased maternal choline intake, this type of recommendation could be given to all pregnant women, thereby providing a very early intervention for individuals with DS, and include babies born to mothers unaware that they are carrying a fetus with DS.
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Background: Macular pigment (MP) levels correlate with brain concentrations of lutein (L) and zeaxanthin (Z), and have also been shown to correlate with cognitive performance in the young and elderly. Objective: To investigate the relationship between MP, serum concentrations of L and Z, and cognitive function in subjects free of retinal disease with low MP (Group 1, n = 105) and in subjects with AMD (Group 2, n = 121). Methods: MP was measured using customized heterochromatic flicker photometry and dual-wavelength autofluorescence; cognitive function was assessed using a battery of validated cognition tests; serum L and Z concentrations were determined by HPLC. Results: Significant correlations were evident between MP and various measures of cognitive function in both groups (r = –0.273 to 0.261, p≤0.05, for all). Both serum L and Z concentrations correlated significantly (r = 0.187, p≤0.05 and r = 0.197, p≤0.05, respectively) with semantic (animal) fluency cognitive scores in Group 2 (the AMD study group), while serum L concentrations also correlated significantly with Verbal Recognition Memory learning slope scores in the AMD study group (r = 0.200, p = 0.031). Most of the correlations with MP, but not serum L or Z, remained significant after controlling for age, gender, diet, and education level. Conclusion: MP offers potential as a non-invasive clinical biomarker of cognitive health, and appears more successful in this role than serum concentrations of L or Z.
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Lutein is a dietary carotenoid well known for its role as an antioxidant in the macula, and recent reports implicate a role for lutein in cognitive function. Lutein is the dominant carotenoid in both pediatric and geriatric brain tissue. In addition, cognitive function in older adults correlated with macular and postmortem brain lutein concentrations. Furthermore, lutein was found to preferentially accumulate in the infant brain in comparison to other carotenoids that are predominant in diet. While lutein is consistently related to cognitive function, the mechanisms by which lutein may influence cognition are not clear. In an effort to identify potential mechanisms through which lutein might influence neurodevelopment, an exploratory study relating metabolite signatures and lutein was completed. Post-mortem metabolomic analyses were performed on human infant brain tissues in three regions important for learning and memory: the frontal cortex, hippocampus, and occipital cortex. Metabolomic profiles were compared to lutein concentration, and correlations were identified and reported here. A total of 1276 correlations were carried out across all brain regions. Of 427 metabolites analyzed, 257 were metabolites of known identity. Unidentified metabolite correlations (510) were excluded. In addition, moderate correlations with xenobiotic relationships (2) or those driven by single outliers (3) were excluded from further study. Lutein concentrations correlated with lipid pathway metabolites, energy pathway metabolites, brain osmolytes, amino acid neurotransmitters, and the antioxidant homocarnosine. These correlations were often brain region-specific. Revealing relationships between lutein and metabolic pathways may help identify potential candidates on which to complete further analyses and may shed light on important roles of lutein in the human brain during development.
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Although intake of fruits and vegetables has been associated with a decreased risk of dementia, studies focusing on nutrients underlying this association are lacking. Our objective was to analyze the relation between plasma carotenoids and the risk of dementia and Alzheimer's disease (AD) in French elderly community dwellers. The study population consisted of 1,092 nondemented older participants, from the Three-City-Bordeaux cohort followed for up to 10 years (range: 1.8-10.8 years, median: 9.5 years). Dementia and AD were diagnosed by a committee of neurologists. The concentration of plasma carotenoids (beta-carotene, alpha-carotene, lycopene, lutein, zeaxanthin, and beta-cryptoxanthin) was determined at baseline. Longitudinal analyses of the association between each plasma carotenoid, either crude or expressed as a ratio to plasma lipids (total cholesterol + triglycerides), and the risk of dementia or AD were performed by multivariate Cox models. During follow-up, 199 dementia cases, including 132 AD, occurred. After adjustment for sociodemographic data, diet quality, and clinical variables, including baseline cognitive performances, only higher lutein concentration, considered as a function of plasma lipids, was consistently significantly associated with a decreased risk of all-cause dementia and AD (hazard ratio = 0.808, 95% confidence interval = 0.671-0.973, p = .024 and hazard ratio = 0.759, 95% confidence interval = 0.600-0.960, p = .021, respectively for +1 SD). This large cohort of older participants suggests that maintaining higher concentrations of lutein in respect to plasma lipids may moderately decrease the risk of dementia and AD. © The Author 2015. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.
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Only few nutrients are known to enhance cognition. Here we explore whether visuomotor performance can be improved through the intake of the nutrient choline, an essential chemical compound in a vertebrate's diet. Choline is abundant in for example eggs and shrimps and many animal studies suggest that it serves as a cognitive enhancer. As choline is important for the communication between motor neurons and the control of skeletal muscles, we assumed that choline supplementation may have positive effects on action coordination in humans. A group of twenty-eight individuals ingested two grams of choline bitartrate or a placebo in two separate sessions. Seventy minutes post ingestion, participants performed a visuomotor aiming task in which they had to rapidly hit the centers of targets. Results showed that participants hit targets more centrally after choline supplementation. Pupil size (a cognition-sensitive biomarker) also significantly decreased after choline intake and correlated positively with the hit distance to the targets and the number of target misses, and negatively with reaction times. These findings point to a choline-induced bias towards action precision in the trade-off between speed and accuracy. The changes in pupil size suggest that choline uptake alters cholinergic functions in the nervous system.
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Objectives: Lutein and zeaxanthin are dietary carotenoids that preferentially accumulate in the macular region of the retina. Together with meso-zeaxanthin, a conversion product of lutein in the macula, they form the macular pigment. Lutein is also the predominant carotenoid in human brain tissue and lutein status is associated with cognitive function in adults. The study objective was to evaluate the relationship between retinal and brain lutein and zeaxanthin in humans. Methods: Donated brain tissue (occipital cortex and hippocampus) and matched retina were obtained from the National Disease Research Interchange, a national human tissue resource center which adheres to strict consent and confidentiality procedures. Decedents were men and women aged >50 years who either had normal cognitive function or Alzheimer's disease. Tissues were analyzed using standard lipid extractions followed by analysis on reverse-phase high performance liquid chromatography (HPLC) and normal-phase HPLC (for meso-zeaxanthin). Results: Macular pigment carotenoids (lutein, meso-zeaxanthin, and zeaxanthin combined) in the retina were significantly related to the combined concentrations of lutein and zeaxanthin in the occipital cortex. When analyzed separately, only retinal lutein (plus meso-zeaxanthin), not zeaxanthin, was significantly related to lutein in the occipital cortex. No correlations were observed with lutein and zeaxanthin in the hippocampus. Discussion: Total macular pigment density measured via non-invasive, psychophysical techniques can be used as a biomarker to ascertain brain lutein and zeaxanthin status in clinical studies.
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Previous studies have not demonstrated a consistent relationship between precursors to acetylcholine (ACh) and memory function in normal human subjects. This experiment (N = 80, college students) employed a double-blind mixed design to test the effect of phosphatidylcholine (PCh) on explicit memory. Dose of placebo and PCh was compared at two levels (10 and 25 g) as was time of testing postingestion (60 and 90 min). With 25 g of PCh, which supplies 3.75 g of choline, significant improvement in explicit memory, as measured by a serial learning task, was observed at 90 min postingestion and slight improvement was observed at 60 min postingestion. Further analyses indicated that this improvement may have been due to the responses of slow learners. This is the first study to test the relationship between a single dose of PCh and explicit memory on normal human subjects.
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Background Patients with Alzheimer's disease (AD) exhibit significantly less macular pigment (MP) and poorer vision when compared to control subjects. Objective To investigate supplementation with the macular carotenoids on MP, vision, and cognitive function in patients with AD versus controls. Methods A randomized, double-blind clinical trial with placebo and active arms. 31 AD patients and 31 age-similar control subjects were supplemented for six months with either Macushield (10 mg meso-zeaxanthin [MZ]; 10 mg lutein [L]; 2 mg zeaxanthin [Z]) or placebo (sunflower oil). MP was measured using dual-wavelength autofluorescence (Heidelberg Spectralis®). Serum L, Z, and MZ were quantified by high performance liquid chromatography. Visual function was assessed by best corrected visual acuity and contrast sensitivity (CS). Cognitive function was assessed using a battery of cognition tests, including the Cambridge Neuropsychological Test Automated Battery (CANTAB)). Results Subjects on the active supplement (for both AD and non-AD controls) exhibited statistically significant improvement in serum concentrations of L, Z, MZ, and MP (p < 0.001, for all) and also CS at (p = 0.039). Also, for subjects on the active supplement, paired samples t-tests exhibited four significant results (from five spatial frequencies tested) in the AD group, and two for the non-AD group, and all indicating improvements in CS. We found no significant changes in any of the cognitive function outcome variables measured (p > 0.05, for all). Conclusion Supplementation with the macular carotenoids (MZ, Z, and L) benefits patients with AD, in terms of clinically meaningful improvements in visual function and in terms of MP augmentation.
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Background: Low maternal choline intake and blood concentration may be risk factors for having a child with a neural tube defect (NTD); however, the data are inconsistent. This is an important question to resolve because choline, if taken periconceptionally, might add to the protective effect currently being achieved by folic acid. Objective: We examined the relation between NTDs, choline status, and genetic polymorphisms reported to influence de novo choline synthesis to investigate claims that taking choline periconceptionally could reduce NTD rates. Design: Two study groups of pregnant women were investigated: women who had a current NTD-affected pregnancy (AP; n = 71) and unaffected controls (n = 214) and women who had an NTD in another pregnancy but not in the current pregnancy [nonaffected pregnancy (NAP); n = 98] and unaffected controls (n = 386). Blood samples to measure betaine and total choline concentrations and single nucleotide polymorphisms related to choline metabolism were collected at their first prenatal visit. Results: Mean (±SD) plasma total choline concentrations in the AP (2.8 ± 1.0 mmol/L) and control (2.9 ± 0.9 mmol/L) groups did not differ significantly. Betaine concentrations were not significantly different between the 2 groups. Total choline and betaine in the NAP group did not differ from controls. Cases were significantly more likely to have the G allele of phosphatidylethanolamine-N-methyltransferase (PEMT; V175M, +5465 G>A) rs7946 (P = 0.02). Conclusions: Our results indicate that maternal betaine and choline concentrations are not strongly associated with NTD risk. The association between PEMT rs7946 and NTDs requires confirmation. The addition of choline to folic acid supplements may not further reduce NTD risk.
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Lutein and zeaxanthin are xanthophyll carotenoids present in highly pigmented vegetables and fruits. Lutein is selectively accumulated in the brain relative to other carotenoids. Recent evidence has linked lutein to cognition in older adults, but little is known about lutein in young children, despite structural brain development. We determined lutein intake using FFQ, one 24 h recall and three 24 h recalls, plasma lutein concentrations and their association with cognition in 160 children 5·6-5·9 years of age, at low risk for neurodevelopmental delay. Plasma lutein was skewed, with a median of 0·23 (2·5th to 95th percentile range 0·11-0·53) µmol/l. Plasma lutein showed a higher correlation with lutein intake estimated as the average of three 24 h recalls (r 0·479; P = 0·001), rather than one 24 h recall (r 0·242; P = 0·003) or FFQ (r 0·316; P = 0·001). The median lutein intake was 697 (2·5th to 95th percentile range 178-5287) µg/d based on three 24 h recalls. Lutein intake was inversely associated with SFA intake, but dietary fat or SFA intakes were not associated with plasma lutein. No associations were found between plasma lutein or lutein intake and any measure of cognition. While subtle independent effects of lutein on child cognition are possible, separating these effects from covariates making an impact on both child diet and cognition may be difficult.
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Objective: Previous research suggests higher levels of the nutrients lutein and zeaxanthin, naturally occurring carotenoids found in food, are associated with cognitive health due to their role as antioxidants and anti-inflammatory agents. As these nutrients are preferentially taken up into neural tissue, we investigated the association between lutein level and brain activation in response to learning and memory processes. Method: Thirty-five community dwelling older adults ages 65–94 engaged in an fMRI adapted verbal paired associates (VPA) task learning novel word pairings, viewing a distractor, and later recalling the second word of the novel word-pair following exposure to the first word. Tasks were repeated to facilitate learning and recall of the word-pairs. The distractor task was used as the imaging contrast for the learning and recall tasks. Lutein/zeaxanthin levels were measured using a standard Macular Pigment Ocular Density (MPOD) procedure (Hammond, et al, 2005) and used as a covariate in the fMRI analyses. Data were processed using SPM12. Results: Increased BOLD activation during learning and recall was seen in the left middle frontal and inferior frontal gyri, left middle temporal gyrus, and other areas associated with verbal memory (p < 0.01, family-wise error corrected). Covariate analyses indicated higher MPOD was associated with higher BOLD signal in the postcentral gyrus bilaterally (p < 0.001, uncorrected). Lower MPOD levels were associated with increased activation in the left superior frontal gyrus, left precentral gyrus, and right insula (p < 0.001, uncorrected). Conclusion(s): These results suggest that individuals with less lutein may have compensatory neural mechanisms to help them engage in learning and recall processes.
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Alzheimer's disease causes a progressive dementia that currently affects over 35 million individuals worldwide and is expected to affect 115 million by 2050 (ref. 1). There are no cures or disease-modifying therapies, and this may be due to our inability to detect the disease before it has progressed to produce evident memory loss and functional decline. Biomarkers of preclinical disease will be critical to the development of disease-modifying or even preventative therapies. Unfortunately, current biomarkers for early disease, including cerebrospinal fluid tau and amyloid-β levels, structural and functional magnetic resonance imaging and the recent use of brain amyloid imaging or inflammaging, are limited because they are either invasive, time-consuming or expensive. Blood-based biomarkers may be a more attractive option, but none can currently detect preclinical Alzheimer's disease with the required sensitivity and specificity. Herein, we describe our lipidomic approach to detecting preclinical Alzheimer's disease in a group of cognitively normal older adults. We discovered and validated a set of ten lipids from peripheral blood that predicted phenoconversion to either amnestic mild cognitive impairment or Alzheimer's disease within a 2-3 year timeframe with over 90% accuracy. This biomarker panel, reflecting cell membrane integrity, may be sensitive to early neurodegeneration of preclinical Alzheimer's disease.
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Elevated serum cholesterol concentrations in mid-life increase risk for Alzheimer's disease (AD) in later life. However, lower concentrations of cholesterol-carrying high density lipoprotein (HDL) and its principal apolipoprotein A1 (ApoA1) correlate with increased risk for AD. As HDL transports oxocarotenoids, which are scavengers of peroxynitrite, we have investigated the hypothesis that lower HDL and oxocarotenoid concentrations during AD may render HDL susceptible to nitration and oxidation and in turn reduce the efficiency of reverse cholesterol transport (RCT) from lipid-laden cells. Fasting blood samples were obtained from subjects with 1) AD without cardiovascular comorbidities and risk factors (AD); 2) AD with cardiovascular comorbidities and risk factors (AD Plus); 3) normal cognitive function; for carotenoid determination by HPLC, analysis of HDL nitration and oxidation by ELISA, and ³H-cholesterol export to isolated HDL. HDL concentration in the plasma from AD Plus patients was significantly lower compared to AD or control subject HDL levels. Similarly, lutein, lycopene, and zeaxanthin concentrations were significantly lower in AD Plus patients compared to those in control subjects or AD patients, and oxocarotenoid concentrations correlated with Mini-Mental State Examination scores. At equivalent concentrations of ApoA1, HDL isolated from all subjects irrespective of diagnosis was equally effective at mediating RCT. HDL concentration is lower in AD Plus patients' plasma and thus capacity for RCT is compromised. In contrast, HDL from patients with AD-only was not different in concentration, modifications, or function from HDL of healthy age-matched donors. The relative importance of elevating HDL alone compared with elevating carotenoids alone or elevating both to reduce risk for dementia should be investigated in patients with early signs of dementia.
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the xanthophylls lutein (L) and zeaxanthin (Z) exist in relatively high concentration in multiple central nervous tissues (e.g. cortex and neural retina). L + Z in macula (i.e. macular pigment, MP) are thought to serve multiple functions, including protection and improvement of visual performance. Also, L + Z in the macula are related to L + Z in the cortex. to determine whether macular pigment optical density (MPOD, L + Z in the macula) is related to cognitive function in older adults. participants were older adults (n = 108, 77.6 ± 2.7 years) sampled from the age-related maculopathy ancillary study of the Health Aging and Body Composition Study (Memphis, TN, USA). Serum carotenoids were measured using high performance liquid chromatography. MPOD was assessed using heterochromatic flicker chromatography. Eight cognitive tests designed to evaluate several cognitive domains including memory and processing speed were administered. Partial correlation coefficients were computed to determine whether cognitive measures were related to serum L + Z and MPOD. MPOD levels were significantly associated with better global cognition, verbal learning and fluency, recall, processing speed and perceptual speed, whereas serum L + Z was significantly related to only verbal fluency. MPOD is related to cognitive function in older people. Its role as a potential biomarker of cognitive function deserves further study.
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Lutein (L), zeaxanthin (Z), and meso-zeaxanthin are the dominant carotenoids within the central retina (there, termed macular pigment, MP). L is also the dominant carotenoid in the brain. The presence of L and Z in both motor and visual areas of the central nervous system is consistent with a role of these carotenoids in visual-motor behavior. The purpose of this study was to provide a first test of this hypothesis. Balance ability (measured via the Standing Leg Test) and simple reaction time (measured via a stimulus appearing in one of four quadrants of a computer monitor) were measured in 49 subjects (mean age = 54.8 years). Fixed and variable reaction time, and coincidence anticipation ability (estimating the arrival of the stimulus at a target location moving at four velocities) were assessed in 106 younger subjects (mean age = 23 years) using a customized device. MP optical density was measured in all subjects via customized heterochromatic flicker photometry. MP optical density was significantly (P < 0.05) related to reaction time and to balance ability for the older subjects. Even for the younger group, MP optical density was significantly (P < 0.05) related to fixed and variable position reaction time, as well as coincidence anticipation errors, at high speed. L and Z status has been linked to benefits in cognitive function in past research. The present results, and the selective presence of L and Z in visual and motor areas in the brain, are consistent with these carotenoids having a role in visual and motor integration.
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Carotenoids may help to prevent the ageing of the brain. Previous findings regarding β-carotene alone are not consistent. In the present study, we evaluated the cross-time association between a carotenoid-rich dietary pattern (CDP) and subsequent cognitive performance using a sample of 2983 middle-aged adults participating in the SU.VI.MAX (Supplémentation en Vitamines et Minéraux Antioxydants) study. Cognitive performance was assessed in 2007-9 using six neuropsychological tests, and a composite cognitive score was computed. The cognitive data were related to dietary data obtained by repeated 24 h dietary records (1994-6) and to measurements of baseline plasma concentrations of carotenoids (lutein, zeaxanthin, β-cryptoxanthin, lycopene, α-carotene, trans-β-carotene and cis-β-carotene). DP were extracted using the reduced rank regression method for 381 participants and then extrapolated to the whole sample using plasma carotenoid concentrations as response variables. Associations between a CDP and cognitive function measured 13 years later were estimated with ANCOVA providing mean difference values and 95 % CI across the tertiles of CDP. A correlation between CDP and consumption of orange- and green-coloured fruits and vegetables, vegetable oils and soup was observed. CDP was found to be associated with a higher composite cognitive score (mean difference 1·04, 95 % CI 0·20, 1·87, P for trend 0·02), after adjustment for sociodemographic, lifestyle and health factors. Similar findings were obtained for scores obtained in the cued recall task, backward digit span task, trail making test and semantic fluency task (all P for trend < 0·05). Further studies ought to confirm whether a diet providing sufficient quantity and variety of coloured fruits and vegetables may contribute to the preservation of cognitive function during ageing.
Article
Lutein may be protective against diseases such as age-related macular degeneration (ARMD). At present, data regarding bioavailability of lutein from various sources are insufficient. Healthy men (n = 10) participated in an intervention study with a crossover design. After a 2-wk washout period during which they consumed a low-carotenoid diet, the men were administered 1 of 4 lutein doses (lutein supplement, lutein ester supplement, spinach, and lutein-enriched egg) for 9 d. All lutein doses provided 6 mg lutein except for the lutein ester dose, which provided 5.5 mg lutein equivalents. Serum samples were collected from fasting subjects on d –14, 1 (baseline), 2, 3, and 10 and analyzed for changes in lutein concentration. Triacylglycerol-rich lipoproteins (TRL) were separated from postprandial blood samples (0–24 h) after the first lutein dose and analyzed for lutein concentration. Subjects completed all 4 treatments of the study in random order. Results from repeated-measures 1-way ANOVA showed that the baseline and dose-adjusted lutein response in serum was significantly higher after egg consumption than after lutein, lutein ester, and spinach consumption on d 10. There was no significant difference in TRL response. In conclusion, the lutein bioavailability from egg is higher than that from other sources such as lutein, lutein ester supplements, and spinach. The lutein bioavailability from lutein, lutein ester supplements, and spinach did not differ. This finding may have implications for dietary recommendations that may decrease the risk of certain diseases, e.g., ARMD.
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Rodent studies demonstrate that supplementing the maternal diet with choline during pregnancy produces life-long cognitive benefits for the offspring. In contrast, the two experimental studies examining cognitive effects of maternal choline supplementation in humans produced inconsistent results, perhaps because of poor participant adherence and/or uncontrolled variation in intake of choline or other nutrients. We examined the effects of maternal choline supplementation during pregnancy on infant cognition, with intake of choline and other nutrients tightly controlled. Women entering their third trimester were randomized to consume, until delivery, either 480 mg choline/d (n = 13) or 930 mg choline/d (n = 13). Infant information processing speed and visuospatial memory were tested at 4, 7, 10, and 13 mo of age (n = 24). Mean reaction time (RT) averaged across the four ages was significantly faster for infants born to mothers in the 930 (vs. 480) mg choline/d group. This result indicates that maternal consumption of approximately twice the recommended amount of choline during the last trimester improves infant information processing speed. Furthermore, for the 480-mg choline/d group, there was a significant linear effect of exposure duration (infants exposed longer showed faster RTs), suggesting that even modest increases in maternal choline intake during pregnancy may produce cognitive benefits for offspring.-Caudill, M. A., Strupp, B. J., Muscalu, L., Nevins, J. E. H., Canfield, R. L. Maternal choline supplementation during the third trimester of pregnancy improves infant information processing speed: a randomized, double-blind, controlled feeding study.
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Objective: Macular pigment optical density (MPOD) – a non-invasive indicator of retinal xanthophylls and correlate of brain lutein – has been associated with superior cognitive function among adult populations. Given that lutein accumulation in the brain occurs in early life, it is possible that the cognitive implications of greater MPOD may be evident in childhood. Methods: Participants aged 8–9 years (n = 56) completed MPOD measurements via heterochromatic flicker photometry. Academic performance was assessed using the Kaufman Test of Academic and Educational Achievement II (KTEA). Habitual dietary intake of L and Z was measured among a subsample of participants (n = 35) using averaged 3-day food records. Stepwise hierarchical regression models were developed to determine the relationship between MPOD and academic achievement tests, following the adjustment of key covariates including sex, aerobic fitness, body composition, and intelligence quotient (IQ). Results: The regression analyses revealed that MPOD improved the model, beyond the covariates, for overall academic achievement (ΔR² = 0.10, P < 0.01), mathematics (ΔR² = 0.07, P = 0.02), and written language composite standard scores (ΔR² = 0.15, P < 0.01). Discussion: This is the first study to demonstrate that retinal L and Z, measured as MPOD, is positively related to academic achievement in children, even after accounting for the robust effects of IQ and other demographic factors. These findings extend the positive associations observed between MPOD and cognitive abilities to a pediatric population. Trail registration: The Fitness Improves Thinking in Kids 2 (FITKids2) trial was registered at www.clinicaltrials.gov as NCT01619826.
Article
Lutein and zeaxanthin are plant pigments known to preferentially accumulate in neural tissue. Macular Pigment Optical Density (MPOD), a non-invasive measure of retinal carotenoids and surrogate measure of brain carotenoid concentration, has been associated with disease prevention and cognitive health. Superior MPOD status in later adulthood has been shown to provide neuroprotective effects on cognition. Given that childhood signifies a critical period for carotenoid accumulation in brain, it is likely that the beneficial impact would be evident during development, though this relationship has not been directly investigated. The present study investigated the relationship between MPOD and the behavioral and neuroelectric indices elicited during a cognitive control task in preadolescent children. 49 participants completed a modified flanker task while event-related potentials (ERPs) were recorded to assess the P3 component of the ERP waveform. MPOD was associated with both behavioral performance and P3 amplitude such that children with higher MPOD had more accurate performance and lower P3 amplitudes. These relationships were more pronounced for trials requiring greater amounts of cognitive control. These results indicate that children with higher MPOD may respond to cognitive tasks more efficiently, maintaining high performance while displaying neural indices indicative of lower cognitive load. These findings provide novel support for the neuroprotective influence of retinal carotenoids during preadolescence.
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Background: There is little information about the associations of intakes of cholesterol and eggs, a major source of dietary cholesterol, with the risk of cognitive decline in general populations or in carriers of apolipoprotein E ɛ4 (APO-E4), a major risk factor for dementia. Objective: We investigated the associations of cholesterol and egg intakes with incident dementia, Alzheimer disease (AD), and cognitive performance in middle-aged and older men from Eastern Finland. Design: A total of 2497 dementia-free men, aged 42-60 y in 1984-1989 at the baseline examinations of the prospective, population-based Kuopio Ischaemic Heart Disease Risk Factor Study, were included in the study. Information on the apolipoprotein E (Apo-E) phenotype was available for 1259 men. Data on cognitive performance tests at the 4-y re-examinations were available for 480 men. Dietary intakes were assessed with the use of 4-d food records at baseline. Dementia and AD diagnoses were based on Finnish health registers. Cox regression and ANCOVA were used for the analyses. Results: During the 21.9-y follow-up, 337 men were diagnosed with dementia, and 266 men were diagnosed with AD. Neither cholesterol nor egg intake was associated with a higher risk of incident dementia or AD. For example, when evaluated continuously, each intake of 100 mg cholesterol/d was associated with a multivariable-adjusted HR of 0.90 (95% CI: 0.79, 1.02) for incident dementia, and each additional 0.5 egg (27 g)/d was associated with an HR of 0.89 (95% CI: 0.78, 1.01). However, egg intake was associated with better performance on neuropsychological tests of the frontal lobe and executive functioning, the Trail Making Test, and the Verbal Fluency Test. The Apo-E4 phenotype did not modify the associations of cholesterol or egg intake (P-interactions > 0.11). Conclusions: Neither cholesterol nor egg intake is associated with an increased risk of incident dementia or AD in Eastern Finnish men. Instead, moderate egg intake may have a beneficial association with certain areas of cognitive performance.
Article
Introduction: Although diet has a substantial influence on the aging brain, the relationship between dietary nutrients and aspects of brain health remains unclear. This study examines the neural mechanisms that mediate the relationship between a carotenoid important for brain health across the lifespan, lutein, and crystallized intelligence in cognitively intact older adults. We hypothesized that higher serum levels of lutein are associated with better performance on a task of crystallized intelligence, and that this relationship is mediated by gray matter structure of regions within the temporal cortex. This investigation aims to contribute to a growing line of evidence, which suggests that particular nutrients may slow or prevent aspects of cognitive decline by targeting specific features of brain aging. Methods: We examined 75 cognitively intact adults between the ages of 65 and 75 to investigate the relationship between serum lutein, tests of crystallized intelligence (measured by the Wechsler Abbreviated Scale of Intelligence), and gray matter volume of regions within the temporal cortex. A three-step mediation analysis was implemented using multivariate linear regressions to control for age, sex, education, income, depression status, and body mass index. Results: The mediation analysis revealed that gray matter thickness of one region within the temporal cortex, the right parahippocampal cortex (Brodmann’s Area 34), partially mediates the relationship between serum lutein and crystallized intelligence. Conclusion: These results suggest that the parahippocampal cortex acts as a mediator of the relationship between serum lutein and crystallized intelligence in cognitively intact older adults. Prior findings substantiate the individual relationships reported within the mediation, specifically the links between (i) serum lutein and temporal cortex structure, (ii) serum lutein and crystallized intelligence, and (iii) parahippocampal cortex structure and crystallized intelligence. This report is the first to demonstrate a specific structural mediation between lutein status and crystallized intelligence, and therefore provides further evidence that specific nutrients may slow or prevent features of cognitive decline by hindering particular aspects of brain aging. Future work should examine the potential mechanisms underlying this mediation, including the antioxidant, anti-inflammatory, and membrane modulating properties of lutein.
Article
Although epidemiological studies suggest that populations are not meeting daily recommendations for total choline, they fail to consider the forms of choline in the diet. Aqueous and lipid-soluble choline forms differ in absorption, metabolism and functions, suggesting that the form matters. It has been demonstrated that the relative amount of these forms of choline can be altered through consuming different foods and using different preparation methods. Evidence suggests that the forms of choline may differentially impact growth, immune function, plasma and serum cholesterol levels and brain development, therefore in addition to estimating the amount total choline in the diet, researchers should also consider what forms of choline are consumed in the diet.
Article
Observational data have suggested that high dietary intake of saturated fat and low intake of vegetables may be associated with increased risk of Alzheimer disease. To test the effects of oral supplementation with nutrients on cognitive function. In a double-masked randomized clinical trial (the Age-Related Eye Disease Study 2 [AREDS2]), retinal specialists in 82 US academic and community medical centers enrolled and observed participants who were at risk for developing late age-related macular degeneration (AMD) from October 2006 to December 2012. In addition to annual eye examinations, several validated cognitive function tests were administered via telephone by trained personnel at baseline and every 2 years during the 5-year study. Long-chain polyunsaturated fatty acids (LCPUFAs) (1 g) and/or lutein (10 mg)/zeaxanthin (2 mg) vs placebo were tested in a factorial design. All participants were also given varying combinations of vitamins C, E, beta carotene, and zinc. The main outcome was the yearly change in composite scores determined from a battery of cognitive function tests from baseline. The analyses, which were adjusted for baseline age, sex, race, history of hypertension, education, cognitive score, and depression score, evaluated the differences in the composite score between the treated vs untreated groups. The composite score provided an overall score for the battery, ranging from -22 to 17, with higher scores representing better function. A total of 89% (3741/4203) of AREDS2 participants consented to the ancillary cognitive function study and 93.6% (3501/3741) underwent cognitive function testing. The mean (SD) age of the participants was 72.7 (7.7) years and 57.5% were women. There were no statistically significant differences in change of scores for participants randomized to receive supplements vs those who were not. The yearly change in the composite cognitive function score was -0.19 (99% CI, -0.25 to -0.13) for participants randomized to receive LCPUFAs vs -0.18 (99% CI, -0.24 to -0.12) for those randomized to no LCPUFAs (difference in yearly change, -0.03 [99% CI, -0.20 to 0.13]; P = .63). Similarly, the yearly change in the composite cognitive function score was -0.18 (99% CI, -0.24 to -0.11) for participants randomized to receive lutein/zeaxanthin vs -0.19 (99% CI, -0.25 to -0.13) for those randomized to not receive lutein/zeaxanthin (difference in yearly change, 0.03 [99% CI, -0.14 to 0.19]; P = .66). Analyses were also conducted to assess for potential interactions between LCPUFAs and lutein/zeaxanthin and none were found to be significant. Among older persons with AMD, oral supplementation with LCPUFAs or lutein/zeaxanthin had no statistically significant effect on cognitive function. clinicaltrials.gov Identifier: NCT00345176.
Article
purpose. To develop a standardized protocol for measuring macular pigment optical density (MPOD) of experimentally naïve subjects by heterochromatic flicker photometry (HFP). methods. MPOD in eyes of 54 women, age 50 and 79 years (mean, 66), was studied. The spatial profile of MPOD was measured in the right eye, and two spatial points were also measured in the left eye. Forty-eight of these inexperienced subjects completed the protocol on two separate visits. For a subset of the group, the MPOD at two different wavelengths was measured. results. The test–retest correlation at 0.5° eccentricity in the right eye was 0.9. On the second visit, more than 90% of the subjects were able to perform the HFP test with results that were consistent with the absorption spectrum of macular pigment. On the first visit, data from the inexperienced subjects deviated more from the expected relationships between the two wavelengths, presumably because they had less skill in performing the task. However, subjects with high or low macular pigment density were distinguished clearly. conclusions. Reliable and meaningful measurements of macular pigment density in older subjects can be made using HFP, with a standardized protocol in the limited time available in large epidemiologic studies. This protocol will be made freely available to other researchers on request.
Article
To assess the relationship between dietary intake of antioxidants (vitamin C, vitamin E, β-carotene, lutein, flavonoids and lignans) and cognitive decline at middle age, analyses were performed on data from the population based Doetinchem Cohort Study. Habitual diet and cognitive function were assessed twice with a 5-year interval in 2613 persons aged 43-70 year at baseline (1995-2002). Diet was assessed with a validated 178-item semi-quantitative FFQ. Cognitive function was assessed with a neuropsychological test battery, consisting of the 15 Words Learning Test, the Stroop Test, the Word Fluency test, and the Letter Digit Substitution Test. Scores on global cognitive function, memory, processing speed, and cognitive flexibility were calculated. In regression analyses, quintiles of antioxidant intake were associated with change in cognitive domain scores. Results showed that higher lignan intake was linearly associated with less decline in global cognitive function (P= 0·01), memory (P< 0·01) and processing speed (P= 0·04), with about two times less declines in the highest v. the lowest quintile. In the lowest quintile of vitamin E intake, decline in memory was twice as fast as in all higher quintiles (P< 0·01). Global cognitive decline in the highest lutein intake group was greater than in the lowest intake group (P< 0·05). Higher flavonoid intake was associated with greater decline in cognitive flexibility (P for trend = 0·04). Intakes of other antioxidants were not associated with cognitive decline. We conclude that within the range of a habitual dietary intake, higher intake of lignans is associated with less cognitive decline at middle age.
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• Young normal subjects received 16 g of choline chloride in a double-blind A-B-A design. Short- and long-term memory function was evaluated. Comparison of group means indicated that choline chloride did not significantly affect shortterm memory or long-term memory. However, individual subjects may have had some aspects of long-term memory affected by choline chloride treatments. The results suggest that the effect of lower doses of choline on long-term memory should be evaluated.
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CDP-choline (cytidine-5'-diphosphocholine) is a phospholipid used to treat cognitive disorders, presumably repairing and maintaining brain cell membranes. Additional mechanisms may include enhanced cholinergic neurotransmission as the α7 nicotinic receptor actions of choline and increased acetylcholine synthesis accompanying CDP-choline administration may modulate brain oscillations underlying cognitive processes. This study utilizes electroencephalographic (EEG) recordings in healthy volunteers to evaluate CDP-choline induction of an oscillatory response profile associated with nicotinic stimulation. Resting state EEG was acquired in 24 male volunteers administered low (500mg) and moderate (1000mg) doses of CDP-choline in a randomized placebo-controlled, crossover trial. Consistent with nicotinic agonist treatment, spectral analysis showed dose-dependent reductions in delta and increases in alpha oscillations, which were also accompanied by decreases in beta and gamma oscillatory activity. These findings support the posit that CDP-choline cognitive enhancement involves multiple mechanisms including facilitated nicotinic cholinergic action. Copyright © 2015. Published by Elsevier Ireland Ltd.
Article
Novel pharmacological treatments targeting alpha 7 nicotinic acetylcholine receptor (α7 nAChR) hypofunction in schizophrenia have shown mixed success in ameliorating cognitive impairments associated with this disorder. Choline, a selective agonist at α7 receptors is increased with oral administration of cytidine 5'-diphosphocholine (CDP-choline), the cognitive effects of which were assessed in healthy volunteers. Using the CogState test battery, behavioural performance in schizophrenia-relevant cognitive domains were assessed in 24 male participants following a single low (500mg) and moderate (1000mg) dose of CDP-choline. Relative to placebo, CDP-choline improved processing speed, working memory, verbal learning, verbal memory, and executive function in low baseline performers, while exerting no effects in medium baseline performers, and diminishing cognition in high baseline performers. Dose effects varied with cognitive domain but were evident with both the 500mg and 1000mg doses. These preliminary findings of cognitive enhancement in relatively impaired performers are consistent with the α7 receptor mechanism and support further trials with CDP-choline as a potential pro-cognitive strategy for cognitive impairment in schizophrenia. Copyright © 2015. Published by Elsevier Inc.
Article
Specific diets or lifestyles have an impact on cognitive function in previous studies. However, the association of the complex action of Chinese daily diets and lifestyle patterns with mild cognitive impairment (MCI) among elderly people had not been studied exactly. The aim of this study was to explore the association of dietary and lifestyle patterns with MCI among elderly people in Beijing. Population-based and case-control design. The physical examination center in Xuanwu Hospital, Capital Medical University in Beijing. A total of 404 subjects, aged 60 years old or above, with or without MCI. The Montreal cognitive assessment (MoCA) was used to screen the subjects with MCI. All subjects were required to complete a questionnaire which was comprised of their demographic information, health status, lifestyles, and food frequency questionnaire (FFQ). Binary multivariable logistic regression was used to evaluate the potential association between MCI and these factors. With adjustment for some factors,higher daily intake of eggs (OR, 0.975,95% CI, 0.959-0.992, P=.003) and marine products (OR, 0.96, 95% CI, 0.943-0.979, P=.000), longer time of watching TV (OR, 0.763, 95% CI, 0.628-0.928, P=.007), reading (OR, 0.540, 95% CI, 0.379-0.769, P=.001) and physical exercise (OR, 0.382, 95% CI, 0.185-0.789) had significantly decreased odds of suffering from MCI compared with the control group. Our findings suggested that daily higher intake of eggs and marine products,watching TV, reading and physical exercise were associated with preventing the development of MCI in this population-based samples.
Article
Objective. —To test the hypothesis that uptake of circulating choline into the brain decreases with age, because alterations in metabolism of choline may be a factor contributing to age-related degenerative changes in the brain.Design. —Cohort comparison in younger and older adults.Participants. —Subjects were chosen consecutively from lists of healthy volunteers screened by medical and psychiatric interviews and laboratory tests. Younger adults (n=12) were between the ages of 20 and 40 years (mean age, 32 years), and older adults (n=16) were between the ages of 60 and 85 years (mean age, 73 years).Interventions. —After fasting overnight, subjects received choline, as the bitartrate, to yield free choline equal to 50 mg/kg of body weight. Blood was drawn for determination of plasma choline concentration by high-performance liquid chromatography, and proton magnetic resonance spectroscopy (1H-MRS) was performed to determine the relative concentration of cytosolic choline—containing compounds in the brain at baseline and after ingestion of choline.Main Outcome Measures. —Plasma choline and cytosolic choline—containing compounds in the brain, estimated as the ratio of the choline resonance to the creatine resonance on1H-MRS scans of the basal ganglia, were compared following blinded analyses of data from subject cohorts studied at baseline and 3 hours after choline ingestion.Results. —Levels of plasma choline and cytosolic choline—containing compounds in brain were similar at baseline in younger and older subjects. Following ingestion of choline, plasma choline concentration increased by similar proportions (76% and 80%) in both younger and older subjects. Brain cytosolic choline— containing compounds increased substantially in younger subjects (mean increase, 60%; P<.001 vs baseline). Older subjects showed a much smaller increase in brain choline—containing compounds (mean, 16%; P<.001 vs the increase in younger subjects).Conclusion. —Uptake of circulating choline into the brain decreases with age. Given the key role of choline in neuronal structure and function, this change may be a contributing factor in onset in late life of neurodegenerative, particularly dementing, illnesses in which cholinergic neurons show particular susceptibility to loss.(JAMA. 1995;274:902-907)
Article
Diminished auditory sensory gating and associated neurocognitive deficits in schizophrenia have been linked to altered expression and function of the alpha-7 nicotinic acetycholinergic receptor (α7 nAChR), the targeting of which may have treatment potential. Choline is a selective α7 nAChR agonist and the aim of this study was to determine whether cytidine 5'-diphosphocholine (CDP-choline), or citicoline, a dietary source of choline, increases sensory gating and cognition in healthy volunteers stratified for gating level. In a randomized, placebo-controlled, double-blind design involving acute administration of low, moderate doses (500 mg, 1000 mg) of CDP-choline, 24 healthy volunteers were assessed for auditory gating as indexed by suppression of the P50 event-related potential (ERP) in a paired-stimulus (S1, S2) paradigm, and for executive function as measured by the Groton Maze Learning Task (GMLT) of the CogState Schizophrenia Battery. CDP-choline improved gating (1000 mg) and suppression of the S2 P50 response (500 mg, 1000 mg), with the effects being selective for individuals with low gating (suppression) levels. Tentative support was also shown for increased GMLT performance (500 mg) in low suppressors. These preliminary findings with CDP-choline in a healthy, schizophrenia-like surrogate sample are consistent with a α7 nAChR mechanism and support further trials with choline as a pro-cognitive strategy.
Article
The relationship between lutein and zeaxanthin and visual and cognitive health throughout the lifespan is compelling. There is a variety of evidence to support a role for lutein and zeaxanthin in vision. Lutein's role in cognition has only recently been considered. Lutein and its isomer, zeaxanthin, are taken up selectively into eye tissue. Lutein is the predominant carotenoid in human brain tissue. Lutein and zeaxanthin in neural tissue may have biological effects that include antioxidation, anti-inflammation, and structural actions. In addition, lutein and zeaxanthin may be protective against eye disease because they absorb damaging blue light that enters the eye. In pediatric brains, the relative contribution of lutein to the total carotenoids is twice that found in adults, accounting for more than half the concentration of total carotenoids. The greater proportion of lutein in the pediatric brain suggests a need for lutein during neural development as well. In adults, higher lutein status is related to better cognitive performance, and lutein supplementation improves cognition. The evidence to date warrants further investigation into the role of lutein and zeaxanthin in visual and cognitive health throughout the lifespan.
Article
Lutein and zeaxanthin are dietary carotenoids that may influence visual and cognitive development. The objective of this study was to provide the first data on distribution of carotenoids in the infant brain and compare concentrations in preterm and term infants. Voluntarily donated brain tissues from 30 infants who died during the first 1.5 years of life were obtained from the NICHD Brain and Tissue Bank. Tissues (hippocampus and prefrontal, frontal, auditory and occipital cortices) were extracted using standard lipid extraction procedures and analyzed using reverse phase HPLC. Lutein, zeaxanthin, cryptoxanthin and β-carotene were the major carotenoids found in the infant brain tissues. Lutein was the predominant carotenoid accounting for 59% of total carotenoids. Preterm infants (n = 8) had significantly lower concentrations of lutein, zeaxanthin and cryptoxanthin in their brain compared to term infants (n = 22) despite similarity in postmenstrual age. Among formula-fed infants, preterm infants (n = 3) had lower concentrations of lutein and zeaxanthin compared to term infants (n = 5). Brain lutein concentrations were not different between breast milk-fed (n = 3) and formula-fed (n = 5) term decedents. In contrast, term decedents with measurable brain cryptoxanthin, a carotenoid that is inherently low in formula, had higher brain lutein suggesting that type of feeding is an important determinant of brain lutein concentrations. These data reveal preferential accumulation and maintenance of lutein in the infant brain despite under representation in the typical infant diet. Further investigation on the impact of lutein on neural development in preterm infants is warranted.