Higher fruit and vegetable variety associated with lower risk of cognitive impairment in Chinese community-dwelling older men: a 4-year cohort study

Uncovering a New Concept of Foodnality in Diet Recommendations for Chinese Aging Populations Based on Systematic and Bibliometric Review

China is grappling with significant aging challenge, and food patterns play an important role in the health of aging populations. A comprehensive bibliometric analysis with regard to systematically examined population-based studies published between 1 June 2014 and 31 May 2024, and 83 eligible studies, including 43 cross-sectional, 34 longitudinal, and 6 case-control studies, was conducted to investigate the correlations among foods, dietary patterns, and healthy aging concepts. An interesting conclusion from cohort studies was that foods recommended for intake in certain diets might not be recommended in other diets, i.e., food items in various diets showed different contributions. This dual character of foods exhibited in the diet is termed foodnality, a new concept proposed in this study. Foodnality was partially related to the origins, quality, and processing of foods, as well as individual physical status. Therefore, recommended foods with positive foodnality and unrecommended foods with negative foodnality were summarized, and four-dimensional diet recommendations were further proposed, including choosing a suitable dietary pattern, evaluating positive foodnality, upgrading foodnality to a premium diet, and cultivating healthier dietary concepts. This review plays a pivotal role in evaluating the guidelines on food intake and dietary patterns among elderly residents in China.

Correlation between Vegetable and Fruit Intake and Cognitive Function in Older Adults: A Cross-Sectional Study in Chongqing, China

OBJECTIVE

To explore the correlation between different types of vegetable and fruit intake and cognitive function among the older adults in Chongqing, China, and to provide a scientific basis for developing efficient lifestyle interventions for the prevention of Mild Cognitive Impairment (MCI).

METHOD

Approximately 728 older adults in urban and rural areas of Chongqing were surveyed using face-to-face questionnaires. Cognitive function was assessed with the Montreal Cognitive Assessment-Basic (MoCA-B) scale, and the vegetable and fruit intake groups were investigated with the Simple Food Frequency Counting Survey Scale. Binary logistic regression was used to explore the effect of the vegetable and fruit intake group on cognitive function. Subgroup analysis was used to demonstrate the robustness of the results.

RESULT

Of the 728 participants in the study, 36.40% were likely to have MCI, which is higher than the national average for this condition. After adjusting for confounders, compared to the Q1 group, fruit and root vegetable intake was a protective factor for MCI, showing a dose-response relationship (p < 0.05). Only lower intake (Q2) of total vegetables, medium intake (Q2, Q3) of solanaceous vegetables, and medium-high intake (Q2, Q4) of fungi and algae was protective against MCI, whereas the leafy vegetables showed no relation to MCI. Apart from this, participants who were older, female, unmarried, non-smoking, and engaged in physical labor, and who had an average monthly income of less than 3000 RMB were more likely to suffer from cognitive impairment.

CONCLUSION

This suggested that the fruit-intake groups and some vegetable-intake groups showed a protective effect on cognitive function, and might behave differently depending on their different intake and demographic characteristics. A sensible, healthy diet can help prevent MCI.

Composition of healthy diets for older persons

PURPOSE OF REVIEW

This study aims to review recent evidence (2022-2023) on the role of diet in promoting healthy aging in older adults.

RECENT FINDINGS

Current evidence of diet and healthy aging is limited to epidemiological studies. A healthy diet is beneficial for individual domains of intrinsic capacity, that is, cognition, locomotion, vitality, psychological, and/or sensory functions, with sex-specific differences reported. Only a few studies used the multidimensional concept of intrinsic capacity as an outcome. This review supports that a healthy diet for older adults consists of plenty of plant-based foods, adequate protein-rich foods, and healthy fats. Next to quantity, improving the quality and variety within food groups play a role in optimizing health. Data on the associations between adherence to national food-based dietary guidelines and intrinsic capacity are scarce.

SUMMARY

A healthy diet, centered on plant-based foods, adequate protein-rich foods and healthy fats, potentially promotes healthy aging. Future studies may evaluate the association between adherence to healthy dietary patterns (particularly national food-based dietary guidelines) and the multidimensional concept of intrinsic capacity, with consideration of sex-specific differences. Clinical trials are warranted to inform the causal effects of diet and outcomes related to intrinsic capacity.

Nutrition risk and cognitive performance in community-living older adults without cognitive impairment: a cross-sectional analysis of the Canadian Longitudinal Study on Aging

Malnutrition is correlated with poor cognition; however, an understanding of the association between nutrition risk, which precedes malnutrition, and cognition is lacking. This study aimed to determine if nutrition risk measured with the SCREEN-8 tool is associated with cognitive performance among cognitively healthy adults aged 55+, after adjusting for demographic and lifestyle covariates. Sex- and age-stratified analyses were also explored. Baseline data from the Canadian Longitudinal Study on Aging was used. Cognition was determined using a 6-measure composite score based on four executive functions and two memory tasks, taking into account age, sex, and education. Multivariable linear regression was performed while adjusting for body mass index (BMI), lifestyle, and health covariates in the entire sample (n = 11 378) and then stratified by sex and age. Approximately half of participants were female (54.5%) aged 65+ (54.1%). Greater nutrition risk was associated with poorer cognitive performance in the entire sample (F[1, 11 368] = 5.36, p = 0.021) and among participants aged 55-64 (n = 5227; F[1, 5217] = 5.45, p = 0.020). Sex differences in lifestyle and health factors associated with cognition were apparent, but nutrition risk was not associated with cognition in sex-stratified models. Based on this analysis, there may be an association between nutrition risk and cognitive performance in older adults. When screening for either cognitive impairment or nutrition risk, complementary assessments for these conditions is warranted, as early intervention may provide benefit.

Quantity and Variety of Fruit and Vegetable Intake with Changes in Measures of Adiposity among Community-Dwelling Chinese Older Adults

BACKGROUND

The association between fruit and vegetable intake, considering both quantity and variety, and weight change among older adults remains controversial. We aimed to investigate the association between fruit and vegetable intake, variety, and changes in adiposity measures among community-dwelling Chinese older adults.

METHODS

A total of 2944 participants aged ≥65 years from Hong Kong communities were included. Fruit and vegetable intake was estimated by a locally validated food frequency questionnaire. Adiposity measures (weight, body mass index (BMI), waist circumference, fat and lean mass) were assessed at baseline and the year four follow-up. Restricted cubic spline and logistic models were performed to estimate the associations between fruit and vegetable intake, variety, and changes in adiposity measures.

RESULTS

A nonlinear association between vegetable intake and weight change was found, following a J-shape curve. Increased vegetable intake was associated with less increases in weight, BMI, and fat mass among those below median intakes. However, these associations became insignificant at higher intakes (all P-nonlinearity < 0.05). The ORs (95% CIs) for weight gain across the quartiles of vegetable intake were as follows: 1.00 (reference), 0.81 (0.56, 1.17), 0.55 (0.36, 0.83), and 0.88 (0.58, 1.33). Similar patterns were observed in overweight and normal weight participants, but not in those with low body weight. No associations with weight change were found for fruit intake or fruit and vegetable variety.

CONCLUSIONS

Moderate vegetable intake was associated with less weight gain among community-dwelling Chinese older adults, but not in those with low body weight. No association was observed between fruit intake or variety with weight change.

Nutrition and Healthy Ageing in Asia: A Systematic Review

BACKGROUND

Nutrition plays a key role in modulating the likelihood of healthy ageing. In the present study, we aimed to conduct a systematic review to assess the impact of nutrition on healthy ageing in Asia.

METHODS

The systematic review was registered in the International Prospective Register of Systematic Reviews database (CRD42023408936) and conducted based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The PubMed, Web of Science, and Embase databases were searched up to February 2023 without language restrictions. We included prospective cohort studies that evaluated the associations of intake of a single food or consumption of a single nutrient at midlife; adherence to various dietary patterns at midlife; and improved adherence to dietary patterns from mid- to late life with the likelihood of healthy ageing and its components.

RESULTS

Out of 16,373 records, we included 71 papers comprising 24 cohorts from Singapore, China, Japan, and Thailand. The healthy ageing components included cognitive function, physical function, and depression. The majority of studies supported the observation that the likelihood of healthy ageing and its components in late life was positively increased by a higher consumption of healthy foods, such as vegetables, fruits, fish, nuts, legumes, tea, milk, and dairy, at midlife, and also by greater adherence to dietary patterns with high diversity scores or high total antioxidant capacities. Furthermore, improved adherence to healthy dietary patterns from mid- to late life also increased the likelihood of healthy ageing in late life.

CONCLUSION

Consuming healthy foods and adhering to healthy dietary patterns at midlife can promote the likelihood of healthy ageing. Moreover, improving diet quality from mid- to late life can still be beneficial.

Food Hardness Modulates Behavior, Cognition, and Brain Activation: A Systematic Review of Animal and Human Studies

Food hardness is one of the dietary features that may impact brain functions. We performed a systematic review to evaluate the effect of food hardness (hard food versus soft food diet) on behavior, cognition, and brain activation in animals and humans (PROSPERO ID: CRD42021254204). The search was conducted on 29 June 2022 using Medline (Ovid), Embase, and Web of Science databases. Data were extracted, tabulated by food hardness as an intervention, and summarized by qualitative synthesis. The SYRCLE and JBI tools were used to assess the risk of bias (RoB) of individual studies. Of the 5427 studies identified, 18 animal studies and 6 human studies met the inclusion criteria and were included. The RoB assessment indicated that 61% of animal studies had unclear risks, 11% had moderate risks, and 28% had low risks. All human studies were deemed to have a low risk of bias. The majority (48%) of the animal studies showed that a hard food diet improved behavioral task performance compared to soft food diets (8%). However, 44% of studies also showed no differential effects of food hardness on behavioral tests. It was also evident that certain regions of the brain were activated in response to changes in food hardness in humans, with a positive association between chewing hard food, cognition performance, and brain function. However, variations in the methodologies of the included studies hindered the meta-analysis execution. In conclusion, our findings highlight the beneficial effects of dietary food hardness on behavior, cognition, and brain function in both animals and humans, however, this effect may depend on several factors that require further understanding of the causality.

Should We 'Eat a Rainbow'? An Umbrella Review of the Health Effects of Colorful Bioactive Pigments in Fruits and Vegetables

Health promotion campaigns have advocated for individuals to 'eat a rainbow' of fruits and vegetables (FV). However, the literature has only focused on individual color pigments or individual health outcomes. This umbrella review synthesized the evidence on the health effects of a variety of color-associated bioactive pigments found in FV (carotenoids, flavonoids, betalains and chlorophylls), compared to placebo or low intakes. A systematic search of PubMed, EMBASE, CINAHL and CENTRAL was conducted on 20 October 2021, without date limits. Meta-analyzed outcomes were evaluated for certainty via the GRADE system. Risk of bias was assessed using the Centre for Evidence-Based Medicine critical appraisal tools. A total of 86 studies were included, 449 meta-analyzed health outcomes, and data from over 37 million participants were identified. A total of 42% of health outcomes were improved by color-associated pigments (91% GRADE rating very low to low). Unique health effects were identified: n = 6 red, n = 10 orange, n = 3 yellow, n = 6 pale yellow, n = 3 white, n = 8 purple/blue and n = 1 green. Health outcomes associated with multiple color pigments were body weight, lipid profile, inflammation, cardiovascular disease, mortality, type 2 diabetes and cancer. Findings show that color-associated FV variety may confer additional benefits to population health beyond total FV intake.