Shellfish-based dietary patterns and cognition in the Chinese senior population: A cross-sectional study in Qingdao, China.

Dietary patterns for healthier cognitive ageing

BackgroundLoss of cognitive function is a significant issue as the world’s population ages. Preserving cognitive function maintains independence in older adults bringing major societal and financial benefits. Lifestyle factors such as diet are modifiable risk factors, which may help preserve cognitive function.Most nutrition research aimed at preserving cognitive function and metabolic health has focussed on individual nutrients and foods, not allowing for food combinations and interactions. A dietary pattern approach considers the entire diet including its complexity. Previous research investigating dietary patterns and cognitive function has not always considered relevant covariates such as physical activity and the Apolipoprotein E genotype, which are known to have associations with cognitive function.The aim of the REACH (Researching Eating, Activity and Cognitive Health) study is to investigate associations between dietary patterns, cognitive function and metabolic syndrome, accounting for a range of covariates.MethodsThis cross-sectional study design will recruit older, community-living adults (65–74 years) from Auckland, New Zealand. Dietary data will be collected via a 109-item food frequency questionnaire validated using a 4-day food record. Cognitive function will be assessed using the Montreal Cognitive Assessment (paper based) and the Computerised Mental Performance Assessment System (COMPASS) - a testing suite covering six domains. Additional data will include genetic (Apolipoprotein E ε4) and biochemical markers (fasting glucose, HbA1c, lipids profile), anthropometric measurements (weight, height, waist and hip circumference, body composition using dual X-ray absorptiometry), blood pressure, physical activity (International Physical Activity Questionnaire – short form) and health and demographics (questionnaire).Dietary patterns will be derived by principal component analysis. Associations between cognitive function and dietary patterns will be examined using multiple regression analysis. Covariates and interaction factors will include age, education, socio-economic status, physical activity, Apolipoprotein E ε4 genotype, family history of dementia or cognitive impairment, and lifestyle factors. Differences between participants with and without metabolic syndrome will also be examined.DiscussionThis study will bring new knowledge regarding associations between dietary patterns and cognitive function and metabolic health in older adults living in New Zealand. This is important for developing nutrition related recommendations to help older adults maintain cognitive function.

Since daily dietary habits can affect cognitive function, dietary patterns such as the Mediterranean-DASH Intervention for Neurodegenerative Delay diet have been proposed as interventions to slow cognitive decline. However, because dietary habits vary widely among different food cultures, it is necessary to establish dietary pattern intervention methods that are appropriate for each population. Therefore, in this study, the dietary patterns of elderly Japanese individuals were classified using cluster analysis, and their relationship with cognitive function was investigated. We then modeled the dietary patterns and applied them to another cohort of elderly Japanese individuals to determine whether differences in dietary patterns could predict cognitive decline. One hundred and fifty older adults ≥ 65 years of age in the community were recruited. Their daily food intake and cognitive function were measured using the brief-type self-administered diet history questionnaire and Montreal Cognitive Assessment, respectively. K-means cluster analysis identified a high-carbohydrate (HC) dietary pattern with high cereal intake and a protein-balanced (PB) dietary pattern with high intake of legumes, vegetables, seafood, meat, and eggs. Cognitive function was significantly higher in the PB group than in the HC group. Furthermore, to classify the new data into HC and PB patterns, a classification model was created by discriminant analysis using food groups with significantly different intakes among dietary patterns. Next, we recruited 267 new older adults ≥ 65 years of age and measured food intake and cognitive function assessed using the memory performance index score. Individuals with cognitive decline were identified and their detailed cognitive functions were assessed using the neurocognitive index score. Cognitive function was significantly impaired in the HC pattern in both the general elderly and cognitively impaired cohorts. These findings suggest that a dietary pattern of low carbohydrate and high protein intake is associated with good cognitive function in elderly Japanese individuals. Classification by these dietary patterns can predict cognitive reservation in community-dwelling older adults.

Research has produced inconsistent findings on the association between dietary patterns and cognitive function. In the present study, we examined the association between dietary patterns and cognitive function among rural China's older adults and aimed to identify major dietary patterns. This cross-sectional study included 1176 individuals aged 65-85 years. Dietary intake was assessed using a food frequency questionnaire. Factor analysis and the Chinese Dietary Balance Index were respectively employed to determine dietary patterns and assess dietary quality. Cognitive function was evaluated using the Mini-Mental State Examination, and logistic regression analysis was performed to examine the relationship between dietary patterns and cognitive decline. Three main dietary patterns were identified and named on the basis of foods with high content: a "healthy dietary pattern," a "multigrain dietary pattern," and a "snack dietary pattern." With the increase in the score of the healthy dietary pattern, the Mini-Mental State Examination total score exhibited a significant downward trend (p<0.001). Moreover, we observed a prominent negative association between the healthy dietary pattern and mild cognitive impairment (4th to 1st quartile, OR=0.36; 95%CI, 0.24-0.54; p<0.001). After we adjusted for potential covariates, the negative correlation remained (4th to 1st quartile, OR=0.48; 95%CI, 0.28-0.81; p=0.006). However, no relation was observed between mild cognitive impairment and either the multigrain or snack dietary patterns. The healthy dietary pattern, which is based on the consumption of rice and flour, red meat, chicken, vegetables, seafood, and fruits, protects against cognitive dysfunction.

BackgroundConsumption of a prudent dietary pattern rich in healthy nutrients is associated with enhanced cognitive performance in older adulthood, while a Western dietary pattern low in healthy nutrients is associated with poor age-related cognitive function. Sex differences exist in dietary intake among older adults; however, there is a paucity of research examining the relationship between sex-specific dietary patterns and cognitive function in later life.MethodsThe current study aimed to investigate sex differences in the relationship between sex-specific dietary pattern adherence and global cognitive function at baseline and over a 3-year follow-up in 1268 community-dwelling older adults (Mage = 74 years, n = 664 women, n = 612 men) from the Quebec Longitudinal Study on Nutrition and Successful Aging (NuAge). A 78-item Food Frequency Questionnaire was used to estimate dietary intake over the previous year. Sex-specific dietary pattern scores were derived using principal component analysis. Global cognition was assessed using the Modified Mini-Mental State Examination (3MS).ResultsAdjusted linear mixed effects models indicated that a healthy, prudent dietary pattern was not associated with baseline cognitive performance in men or women. No relationship was found between Western dietary pattern adherence and baseline cognitive function in women. Among men, adherence to an unhealthy, Western dietary pattern was associated with poorer baseline cognitive function (β = − 0.652, p = 0.02, 95% CI [− 1.22, − 0.65]). No association was found between prudent or Western dietary patterns and cognitive change over time in men or women.ConclusionsThese findings highlight the importance of conducting sex-based analyses in aging research and suggest that the relationship between dietary pattern adherence and cognitive function in late life may be sex-dependent.

Dietary intake plays a pivotal role in sustaining optimal melatonin levels, while the relationship between dietary patterns and circulating melatonin levels remains unclear. This study aims to investigate the associations between dietary patterns, nutrient intake, and serum melatonin levels in the Chinese population. This cross-sectional study included 6,521 Chinese adults. Three dietary patterns were identified through principal component analysis. Multivariable linear regression was used to assess the associations between dietary patterns and serum melatonin levels. The covariance analysis and partial least squares regression was used to evaluate the association between micronutrient intake and serum melatonin concentrations. The Dietary pattern 2 (DP2), characterized by high intake of fatty foods and red meat with the lowest Dietary Variety Score (DVS), and DP3 featuring high consumption of red meat, fruits, and vegetables but low intake of white meat and aquatic products with low DVS, were significantly associated with lower serum melatonin levels (DP2: β = - 0.12, P-trend < 0.001; DP3: β = - 0.13, P-trend < 0.001). Insufficient nutrient and quality intake of dietary fiber, potassium, vitamin B2, calcium, and magnesium was found in DP2, whereas DP3 showed inadequate intake of protein, cholesterol, vitamin B2, niacin, calcium, phosphorus, magnesium, selenium, and iron. Specific dietary patterns, low dietary diversity and nutrient deficiencies are associated to reduced melatonin levels. These findings reveal distinct mechanisms linking overall dietary patterns to serum melatonin concentrations, underscoring the importance of appropriate dietary patterns and nutrients intake in sustaining optimal circulating melatonin homeostasis in humans.

&lt;p&gt;Background: Consumption of a prudent dietary pattern rich in healthy nutrients is associated with enhanced cognitive performance in older adulthood, while a Western dietary pattern low in healthy nutrients is associated with poor age-related cognitive function. Sex differences exist in dietary intake among older adults; however, there is a paucity of research examining the relationship between sex-specific dietary patterns and cognitive function in later life.&lt;/p&gt; &lt;p&gt;Methods: The current study aimed to investigate sex differences in the relationship between sex-specific dietary pattern adherence and global cognitive function at baseline and over a 3-year follow-up in 1268 community-dwelling older adults (Mage = 74 years, n = 664 women, n = 612 men) from the Quebec Longitudinal Study on Nutrition and Successful Aging (NuAge). A 78-item Food Frequency Questionnaire was used to estimate dietary intake over the previous year. Sex-specific dietary pattern scores were derived using principal component analysis. Global cognition was assessed using the Modified Mini-Mental State Examination (3MS).&lt;/p&gt; &lt;p&gt;Results: Adjusted linear mixed effects models indicated that a healthy, prudent dietary pattern was not associated with baseline cognitive performance in men or women. No relationship was found between Western dietary pattern adherence and baseline cognitive function in women. Among men, adherence to an unhealthy, Western dietary pattern was associated with poorer baseline cognitive function (β = − 0.652, p = 0.02, 95% CI [− 1.22, − 0.65]). No association was found between prudent or Western dietary patterns and cognitive change over time in men or women.&lt;/p&gt; &lt;p&gt;Conclusions: These findings highlight the importance of conducting sex-based analyses in aging research and suggest that the relationship between dietary pattern adherence and cognitive function in late life may be sex-dependent.&lt;/p&gt;

&lt;p&gt;Background: Consumption of a prudent dietary pattern rich in healthy nutrients is associated with enhanced cognitive performance in older adulthood, while a Western dietary pattern low in healthy nutrients is associated with poor age-related cognitive function. Sex differences exist in dietary intake among older adults; however, there is a paucity of research examining the relationship between sex-specific dietary patterns and cognitive function in later life.&lt;/p&gt; &lt;p&gt;Methods: The current study aimed to investigate sex differences in the relationship between sex-specific dietary pattern adherence and global cognitive function at baseline and over a 3-year follow-up in 1268 community-dwelling older adults (Mage = 74 years, n = 664 women, n = 612 men) from the Quebec Longitudinal Study on Nutrition and Successful Aging (NuAge). A 78-item Food Frequency Questionnaire was used to estimate dietary intake over the previous year. Sex-specific dietary pattern scores were derived using principal component analysis. Global cognition was assessed using the Modified Mini-Mental State Examination (3MS).&lt;/p&gt; &lt;p&gt;Results: Adjusted linear mixed effects models indicated that a healthy, prudent dietary pattern was not associated with baseline cognitive performance in men or women. No relationship was found between Western dietary pattern adherence and baseline cognitive function in women. Among men, adherence to an unhealthy, Western dietary pattern was associated with poorer baseline cognitive function (β = − 0.652, p = 0.02, 95% CI [− 1.22, − 0.65]). No association was found between prudent or Western dietary patterns and cognitive change over time in men or women.&lt;/p&gt; &lt;p&gt;Conclusions: These findings highlight the importance of conducting sex-based analyses in aging research and suggest that the relationship between dietary pattern adherence and cognitive function in late life may be sex-dependent.&lt;/p&gt;

BackgroundDespite increased use of dietary pattern methods in nutritional epidemiology, there have been few direct comparisons of methods. Older adults are a particularly understudied population in the dietary pattern literature. This study aimed to compare dietary patterns derived by principal component analysis (PCA) and cluster analysis (CA) in older adults and to examine their associations with socio-demographic and health behaviours.MethodsMen (n = 1888) and women (n = 2071) aged 55–65 years completed a 111-item food frequency questionnaire in 2010. Food items were collapsed into 52 food groups and dietary patterns were determined by PCA and CA. Associations between dietary patterns and participant characteristics were examined using Chi-square analysis. The standardised PCA-derived dietary patterns were compared across the clusters using one-way ANOVA.ResultsPCA identified four dietary patterns in men and two dietary patterns in women. CA identified three dietary patterns in both men and women. Men in cluster 1 (fruit, vegetables, wholegrains, fish and poultry) scored higher on PCA factor 1 (vegetable dishes, fruit, fish and poultry) and factor 4 (vegetables) compared to factor 2 (spreads, biscuits, cakes and confectionery) and factor 3 (red meat, processed meat, white-bread and hot chips) (mean, 95 % CI; 0.92, 0.82–1.02 vs. 0.74, 0.63–0.84 vs. −0.43, −0.50– −0.35 vs. 0.60 0.46–0.74, respectively). Women in cluster 1 (fruit, vegetables and fish) scored highest on PCA factor 1 (fruit, vegetables and fish) compared to factor 2 (processed meat, hot chips cakes and confectionery) (1.05, 0.97–1.14 vs. −0.14, −0.21– −0.07, respectively). Cluster 3 (small eaters) in both men and women had negative factor scores for all the identified PCA dietary patterns. Those with dietary patterns characterised by higher consumption of red and processed meat and refined grains were more likely to be Australian-born, have a lower level of education, a higher BMI, smoke and did not meet physical activity recommendations (all P < 0.05).ConclusionsPCA and CA identified comparable dietary patterns within older Australians. However, PCA may provide some advantages compared to CA with respect to interpretability of the resulting dietary patterns. Older adults with poor dietary patterns also displayed other negative lifestyle behaviours. Food-based dietary pattern methods may inform dietary advice that is understood by the community.Electronic supplementary materialThe online version of this article (doi:10.1186/s12966-016-0353-2) contains supplementary material, which is available to authorized users.

Mental health: New horizons in nutrition research and dietetic practice

In “Dietary patterns during adulthood and cognitive performance in midlife,” McEvoy et al. assessed the relationship between dietary patterns and cognitive function over a 30-year period and found that greater adherence to the Mediterranean diet (MedDiet) and A Priori Diet Quality Score (APDQS) in early adulthood was associated with better midlife cognitive performance. Muñoz-Garcia et al. complimented the authors on their use of multiple dietary questionnaires, long-term follow-up, and serial cognitive evaluations and recommended ongoing follow-up to assess cognitive function beyond middle age. However, they question the use of a cutoff of 20 on the Montreal Cognitive Assessment (MoCA), given that the literature describes a cutoff of 24/25/26. McEvoy responded that 21 was selected as the MoCA cutoff because it is one standard deviation below the sample mean MoCA of 24. The author further notes that 45% of the study cohort was black and that previous studies found the mean MoCA in black middle-aged adults in the United States to be between 19.8 and 22. In an editor's comment on behalf of the Equity, Diversity, and Inclusion Committee, Hamilton emphasizes that performance on tests such as the MoCA may relate to a number of social factors, such as quality of education, rather than to a biological difference among persons of different racial or ethnic backgrounds. In “Dietary patterns during adulthood and cognitive performance in midlife,” McEvoy et al. assessed the relationship between dietary patterns and cognitive function over a 30-year period and found that greater adherence to the Mediterranean diet (MedDiet) and A Priori Diet Quality Score (APDQS) in early adulthood was associated with better midlife cognitive performance. Muñoz-Garcia et al. complimented the authors on their use of multiple dietary questionnaires, long-term follow-up, and serial cognitive evaluations and recommended ongoing follow-up to assess cognitive function beyond middle age. However, they question the use of a cutoff of 20 on the Montreal Cognitive Assessment (MoCA), given that the literature describes a cutoff of 24/25/26. McEvoy responded that 21 was selected as the MoCA cutoff because it is one standard deviation below the sample mean MoCA of 24. The author further notes that 45% of the study cohort was black and that previous studies found the mean MoCA in black middle-aged adults in the United States to be between 19.8 and 22. In an editor's comment on behalf of the Equity, Diversity, and Inclusion Committee, Hamilton emphasizes that performance on tests such as the MoCA may relate to a number of social factors, such as quality of education, rather than to a biological difference among persons of different racial or ethnic backgrounds.

DIETARY PATTERNS, BODY COMPOSITION, AND COGNITIVE PERFORMANCE IN COMMUNITY-DWELLING HEALTHY ELDERS (NUTRDEM PROJECT)

The global population is ageing. Evidence show dietary patterns may be associated with cognitive status in older adults. This cross-sectional study investigated associations between dietary patterns and cognitive function in older adults in New Zealand. The REACH study (Researching Eating, Activity, and Cognitive Health) included 371 participants (65-74years, 36% male) living independently in Auckland, New Zealand. Valid and reproducible dietary patterns were derived, using principal component analysis, from dietary data collected by a 109-item validated food frequency questionnaire. Six cognitive domains (global cognition, attention and vigilance, executive function, episodic memory, working memory, and spatial memory) were tested using COMPASS (Computerised Mental Performance Assessment System). Associations between dietary patterns and cognitive scores, adjusted for age, sex, education, physical activity, energy, and Apolipoprotein E-ε4 status were analysed using multiple linear regression analysis. Three dietary patterns explained 18% of dietary intake variation-'Mediterranean style' (comprising: salad vegetables, leafy cruciferous vegetables, other vegetables, avocados and olives, alliums, nuts and seeds, white fish and shellfish, oily fish, and berries); 'Western' (comprising: processed meats, sauces and condiments, cakes, biscuits and puddings, meat pies and chips, and processed fish); and 'Prudent' (comprising: dried legumes, soy-based foods, fresh and frozen legumes, whole grains, and carrots). No associations between any cognitive domain and dietary pattern scores were observed. Global cognitive function was associated with being younger and having a university education. In this cohort of community-dwelling, older adults in New Zealand, current dietary patterns were not associated with cognitive function.

Dietary intake in health and disease, challenges in measuring and reporting diet-disease relationships.

Aging decreases cognitive and physical fitness (PF). Though evidence links PF to cognitive function, few studies focus on this association in older adults with dementia. The aim of this study is to investigate the association between cognitive function and PF in institutionalized older adults with cognitive impairment. This is a cross-sectional study encompassing 75 older adults with suggestive major neurocognitive disorder (76% women, 78.00 ± 8.13years) residing in nursing homes. Cognition was assessed with Montreal Cognitive Assessment (MoCA), and the eligible participants (MoCA < 17 points) were categorized as having high or low cognition function according to the 50th percentile of the MoCA score. PF was measured with the Senior Fitness Test, and a global physical fitness score (GPF), computed as the average obtained from the six tests of the Senior Fitness Test, was thereafter classified based on the 25th percentile. Linear regression and binary logistic regression were applied. GPF was significantly associated with MoCA (B = 0.078; 95% confidence interval [0.016, 0.139]; R2 = .300). GPF > 25th percentile (odds ratio = 7.8; 95% confidence interval [2.1, 30.4]; p = .003) and years of education (odds ratio = 1.5; 95% confidence interval [1.0, 2.1]; p = .016) were associated with a higher likelihood of having high MoCA, independently of age, medication use, and clinical conditions. A higher GPF was associated with better cognitive function in institutionalized older adults with dementia. Significance/Implications: It is crucial to understand the relationships between cognitive decline and PF in older adults with dementia. Once both are correlated, we might suggest that improving fitness may help slow cognitive decline and vice versa, which must be ascertained through longitudinal and experimental studies.