Rural‐urban disparities in the consumption of fruits and vegetables and cognitive performance in Brazil

Abstract

AbstractBackgroundAdherence to a healthy diet has been associated with lower risk of dementia and cognitive decline. Furthermore, low consumption of fruits and vegetables has been associated with lower cognitive performance. Rural Brazilians have several factors related to poor diet quality, such as low education and income.Additionally, rural residents of Latin America face a higher burden of dementia compared to urban residents. However, differences in the association of fruit and vegetable consumption with cognitive performance in urban and rural areas have not been explored. The aim of this study was to investigate the association of fruit and vegetable consumption with cognitive performance in urban and rural areas in a nationally representative sample of Brazilian older adults.MethodThe sample included 9,412 adults 50 years or older from the 2015 wave of the Brazilian Longitudinal Study of Aging. Consumption of fruits and vegetables was measured using a food frequency questionnaire. Cognitive performance was evaluated using the immediate recall, late recall, semantic verbal fluency, prospective memory, semantic memory, and temporal orientation. A global composite z‐score was derived from these tests. Association of consumption of fruits and vegetables with cognitive performance was evaluated using linear regression, adjusted for sociodemographic, lifestyle, and clinical variables.ResultIn 6,743 participants (mean age 61.3±8.9 y, 53% women, 43% White, and 15% from rural areas), the mean intake of fruits and vegetables was 2.0±1.3 portions a day (Table 1). Higher consumption of fruits and vegetables was associated with better episodic (β = 0.021, 95% CI = 0.004;0.037, p = 0.013) and semantic memory (β = 0.037, 95% CI = 0.019;0.055, p<0.001), verbal fluency (β = 0.035, 95% CI = 0.018;0.053, p<0.001), and global cognition (β = 0.032, 95% CI = 0.016;0.048, p<0.001) performances (Table 2). There was a modifying effect of urban/rural area of residency (p for interaction <0.001). Stratified analysis showed that consumption of fruits and vegetables was associated with better episodic and semantic memory, verbal fluency, and global cognition performances in participants who resided in urban, but not rural areas (Table 3).ConclusionConsumption of fruits and vegetables was associated with cognitive performance in urban, but not in rural areas in Brazil, possibly due to socioeconomic disadvantages and lower access to healthcare.