Abstract
In postmenopausal women (PW), estrogen depletion may predispose to cognitive decline through an increased risk of chronic inflammation. Unhealthy diets also appear to have an impact on the cognitive health of these women. The aim of this study was to investigate the association between inflammatory potential of the diet, levels of inflammatory biomarkers, and cognitive function in PW. In a population of 222 PW, energy intake-adjusted Dietary Inflammatory Index (E-DII) was used to assess the dietary inflammatory potential. Cognitive function was estimated using the Polish version of Mini-Mental State Examination (MMSE), corrected by age and educational level. Selected biochemical inflammatory markers (C-reactive protein, CRP; interleukin-6, IL-6; and tumor necrosis factor alpha, TNF-α) were measured by ELISA tests. PW with an anti-inflammatory diet (first tercile) had significantly higher MMSE, while BMI, percentage fat mass and TNFα concentration were significantly lower compared to those with the most proinflammatory diets (third tercile). Women with cognitive impairment had significantly higher IL-6 concentrations (4.1 (0.8) pg/mL vs. 2.5 (0.2) pg/mL, p = 0.004), and were less educated (12.7 (0.7) years vs. 14.1 (0.2) years, p = 0.03) and less physically active compared to cognitively normal women. PW with the most proinflammatory diets had increased odds of cognitive impairment compared to those with the most anti-inflammatory diets, even after adjustment (OR = 11.10, 95% confidence level; 95%CI: 2.22; 55.56; p = 0.002). Each one-point increase in E-DII (as a continuous value) was also associated with 1.55-times greater odds of cognitive impairment (95%Cl: 1.19; 2.02 p = 0.003) in this population. Dietary inflammation may increase the risk of cognitive impairment in PW, but future studies should include a more sensitive battery of tests to assess cognitive function in this population. Implementation of an anti-inflammatory dietary pattern in PW may help prevent cognitive decline.
Highlights
The first tertile characterized women with the highest anti-inflammatory diet, and the third tertile was the group of women with the highest proinflammatory diet
Saturated fatty acid (SFA) intake was significantly higher, while polyunsaturated fatty acids (PUFA) and dietary fiber intake significantly decreased across the energy intake-adjusted Dietary Inflammatory Index (E-dietary inflammatory index (DII)) score-based tertiles
These women were less educated and less physically active. These findings indicate that, apart from the hormonal changes associated with menopause, dietary nutrients with proinflammatory potential may contribute greatly to worsened cognitive functioning by increasing systemic inflammation
Summary
Cognitive impairment is an increasingly pressing public health problem worldwide, with more than one hundred million adults projected to develop dementia by 2050 [1]. Cognitive impairment does not always reflect incipient dementia, even mild declines in cognitive abilities can cause frustration among people affected by it [1,2]. Accumulating evidence has linked systemic inflammation, as indicated by increased blood levels of circulating proinflammatory cytokines, to decreasing cognitive health and risk of dementia, especially in the later part of life [1]. Systemic inflammation can lead to cognitive decline and dementia by leading the proinflammatory environment in the central nervous system to induce reactive, proinflammatory microglia and astrocytic phenotypes, leading to tau hyperphosphorylation, β-amyloid oligomerization, complement activation, and the breakdown of neurotransmitters into potentially harmful bioactive metabolites [3]
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