M. Ferry

Mediterranean diet and cognitive function: a French study

BACKGROUNDnEvidence on the association between Mediterranean diet (MedDiet) adherence and cognition is presently inconsistent.nnnOBJECTIVESnThe aims of this study were to investigate the association between midlife MedDiet adherence and cognitive performance assessed 13 y later among participants in the SU.VI.MAX (Supplementation with Vitamins and Mineral Antioxidants) study and to test the hypothesis of effect modification by occupation and education as cognitive reserve markers.nnnDESIGNnA Mediterranean Diet Score (MDS) and a Mediterranean-Style Dietary Pattern Score (MSDPS) were estimated by using repeated 24-h dietary records (1994-1996) from 3083 middle-aged subjects. Cognitive performance was assessed in 2007-2009 by using 6 neuropsychological tests, and a composite score was built. Subgroup analyses were performed according to occupational and educational status. Mean differences and 95% CIs were estimated through covariance analyses.nnnRESULTSnAfter potential confounders were accounted for, no association between MDS or MSDPS and cognitive scores was detected except for a lower phonemic fluency score with decreasing MSDPS (P = 0.048) and a lower backward digit span score with decreasing MDS (P = 0.03). In turn, a low MDS was related to a lower composite cognitive score in the small subsample of manual workers (n = 178, P-interaction = 0.04) who could be hypothesized to have low cognitive reserve. MedDiet adherence did not interact with educational level in relation to cognitive function.nnnCONCLUSIONnThis study did not find support for a beneficial effect of MedDiet adherence on cognitive function, irrespective of educational level, which is the strongest indicator of cognitive reserve.

Adherence to nutritional recommendations and subsequent cognitive performance: findings from the prospective Supplementation with Antioxidant Vitamins and Minerals 2 (SU.VI.MAX 2) study

BACKGROUNDnFew studies have investigated the long-term effect of overall nutritional recommendations on cognition.nnnOBJECTIVEnIn a French cohort of middle-aged adults, we evaluated the association between the French National Nutrition and Health Program (Program National Nutrition Santé) Guideline Score (PNNS-GS) assessed at baseline and cognitive performance evaluated 13 y later.nnnDESIGNnThe PNNS-GS was estimated at baseline (1994-1996) (maximum score: 15 points) in 2135 subjects in the SU.VI.MAX (Supplementation with Antioxidant Vitamins and Minerals) study. We assessed cognitive performance of subjects in 2007-2009 via a battery of 4 neuropsychologic tests that included phonemic and semantic fluency, the RI-48 (rappel indicé-48 item) cued-recall test, the trail-making test, and forward and backward digit spans. A principal components analysis was performed to account for correlations in test scores. Multivariate linear regression models or analyses of covariance were also performed.nnnRESULTSnIn a multivariate model, we observed a positive association between the PNNS-GS and the cued-recall test and semantic and phonemic fluency tasks, whereas no association was observed with digit spans. The principal components analysis revealed 2 factors interpreted as reflecting verbal memory and executive functioning. Better adherence to nutritional recommendations was significantly associated with the verbal memory factor (β = 0.41; 95% CI: 0.17, 0.64), whereas no association was shown with the executive functioning factor. Removing specific components from the PNNS-GS did not modify the findings.nnnCONCLUSIONnThis study suggests that strong compliance with nutritional recommendations in midlife is associated in elderly individuals with better verbal memory, which is a cognitive domain that is particularly vulnerable to pathologic aging and Alzheimer disease. This trial was registered at clinicaltrials.gov as NCT00272428.

FRAILTY AND NUTRITION: SEARCHING FOR EVIDENCE

Frailty is a geriatric syndrome that predicts disability, morbidity and mortality in the elderly. Poor nutritional status is one of the main risk factors for frailty. Macronutrients and micronutrients deficiencies are associated with frailty. Recent studies suggest that improving nutritional status for macronutrients and micronutrients may reduce the risk of frailty. Specific diets such as the Mediterranean diet rich in anti-oxidants, is currently investigated in the prevention of frailty. The aim of this paper is to summarize the current body of knowledge on the relations between nutrition and frailty, and provide recommendations for future nutritional research on the field of frailty.

Fruit and vegetable intake and cognitive function in the SU.VI.MAX 2 prospective study

BACKGROUNDnCurrent hypotheses suggest that intake of fruit and vegetables (FVs) protects against age-related cognitive impairment.nnnOBJECTIVEnWe examined the 13-y association between FV intake and cognitive performance in a sample of French adults.nnnDESIGNnA total of 2533 subjects aged 45-60 y at baseline, who were part of the Supplementation with Antioxidant Vitamins and Minerals 2 (SU.VI.MAX 2) cohort, were selected. FV intake was estimated at baseline in participants who had completed at least six 24-h dietary records. Cognitive performance was assessed 13 y after baseline and included an evaluation of verbal memory (RI-48 cued recall, semantic, and phonemic fluency tests) and executive function (trail-making and forward and backward digit span tests). Principal components analysis was performed to account for correlations in test scores. The relation between cognitive performance and quartiles of FV intake was assessed by multivariate linear regression analyses.nnnRESULTSnIntakes of FVs (P-trend = 0.02), fruit alone (P-trend = 0.04), vitamin C-rich FVs (P-trend = 0.03), vitamin C (P-trend = 0.005), and vitamin E (P-trend = 0.04) were positively associated with verbal memory scores. In contrast, intakes of FVs (P-trend = 0.006), vegetables alone (P-trend = 0.03), and β-carotene-rich FVs (P-trend = 0.02) were negatively associated with executive functioning scores.nnnCONCLUSIONSnFVs might have a differential effect on cognition according to groups of FVs and type of cognitive function. Further research using sensitive and reliable measures of various types of cognitive function is needed to clarify the effect of individual FV groups and nutrients. This trial is registered at clinicaltrials.gov as NCT00272428.

Thirteen-year prospective study between fish consumption, long-chain n-3 fatty acids intakes and cognitive function

OBJECTIVESnBecause of their structural, anti-inflammatory and antithrombic properties, long-chain n-3 fatty acids may be key factors in the aging process. We sought to elucidate the association between intake of long-chain n-3 fatty acids and/or fish and cognitive function evaluated 13 years after dietary assessment.nnnDESIGNnProspective population-based study.nnnPARTICIPANTS/SETTINGn3,294 adults from the SU.VI.MAX study (Supplementation with Antioxidant Vitamins and Minerals study). MEASUREMENTS/STATISTICAL ANALYSIS: Subjects underwent a standardized clinical examination which included cognitive tests and self-reported cognitive difficulties scale (2007-2009). Poor scores were defined using percentiles as cut-off. Dietary data were assessed through repeated 24-h dietary records. Odd ratio (OR), comparing the fourth (Q4) to the first quartile (Q1), of having a poor score were calculated using adjusted logistic regression.nnnRESULTSnSelf-reported cognitive difficulties were less frequent among subjects with higher intakes of total n-3 long chain fatty acids (OR = 0.72, CI 95%=0.56-0.92) and eicosapentaenoic acid (OR Q4 versus Q1 = 0.74, CI 95%=0.58-0.95), even after adjustment for depressive symptoms. A borderline significant association was also found with high fish consumption (OR Q4 versus Q1 = 0.80, CI 95%=0.63-1.01).nnnCONCLUSIONnCognitive complaints, which may be an early indicator of cognitive decline, are less frequent among the elderly who have a high long-chain n-3 acids intake, as assessed 13 years earlier.