Dietary Patterns Derived by Hybrid Clustering Method in Older People: Association with Cognition, Mood, and Self-Rated Health

Development and validation of dietary depression index in Chinese adults

OBJECTIVE

Previous studies have suggested diet was associated with depressive symptoms. We aimed to develop and validate Dietary Depression Index (DDI) based on dietary prediction of depression in a large Chinese cancer screening cohort.

METHODS

In the training set (n = 2729), we developed DDI by using intake of 20 food groups derived from a food frequency questionnaire to predict depression as assessed by Patient Health Questionnaire-9 based on the reduced rank regression method. Sensitivity, specificity, positive predictive value, and negative predictive value were used to assess the performance of DDI in evaluating depression in the validation dataset (n = 1176).

RESULTS

Receiver operating characteristic analysis was constructed to determine the best cut-off value of DDI in predicting depression. In the study population, the DDI ranged from -3.126 to 1.810. The discriminative ability of DDI in predicting depression was good with the AUC of 0.799 overall, 0.794 in males and 0.808 in females. The best cut-off values of DDI for depression prediction were 0.204 overall, 0.330 in males and 0.034 in females. DDI was a validated method to assess the effects of diet on depression.

CONCLUSION

Among individual food components in DDI, fermented vegetables, fresh vegetables, whole grains and onions were inversely associated, whereas legumes, pickled vegetables and rice were positively associated with depressive symptoms.

Diet quality indicators and organic food consumption in mothers of young children

BACKGROUND

The health benefits of organic food provide one reason for consuming it. Various studies have shown that regular organic food consumers (REG eco-con) follow a healthier diet. However, this topic has not been explored in Poland. This study aimed to evaluate the diet quality of mothers with children under 6 years old, residing in three provinces of Poland, who consumed organic food at varying frequencies. Data were collected using validated questionnaires.

RESULTS

Among the mothers surveyed (N = 667), 84% achieved an average Diet Quality Index (DQI) score, indicating a neutral impact of their diet on health. Meanwhile, 15% of respondents exhibited diets with a high intensity of health-promoting characteristics. Women with a higher frequency of organic food consumption displayed more health-promoting dietary behavior. Regular organic food consumers demonstrated significantly higher DQI and Pro-Healthy Diet Index (pHDI) scores than those with lower organic food consumption frequency. The REG eco-con mothers also reported significantly more frequent consumption of vegetables, fruit, whole-grain bread and cereals, fermented dairy products, legumes, and fish. Respondents who rated their state of health as better than that of their peers were characterized by more frequent consumption of organic food.

CONCLUSION

An organic diet may play a significant role in an individual's quality of life and well-being. The results of this study could be relevant for the organic food sector and policymakers in developing nutritional transformation towards sustainability. © 2025 Society of Chemical Industry.

Association of dietary diversity and weight change with cognitive impairment among Chinese elderly: A prospective national cohort study

BACKGROUND

Dietary diversity is reported to be beneficial for cognitive function, while the effect may be offset by weight change status. We aimed to examine the association of dietary diversity and weight change with cognitive impairment among older adults.

METHODS

We used three waves from 2008 to 2014 of the Chinese Longitudinal Survey of Health and Longevity, which included 16,954 participants for the subsequent screening and analysis. Dietary diversity information was collected from the food frequency questionnaire. Cognitive function was assessed using the Mini Mental State Examination. The relation of dietary diversity and weight change with cognitive impairment was investigated using Cox proportional hazards models and cubic spline regression.

RESULTS

Compared with those reported poor dietary diversity at baseline, participants with good dietary diversity had a 16 % (hazard ratio [HR] = 0.84, 95 % confidence interval [CI]: 0.71-0.99) lower risk of cognitive impairment. The HR and 95 % CI of participants with consistently good dietary diversity from 2008 to 2011 was 0.71 (0.57-0.89) for cognitive impairment compared to those with consistently poor dietary diversity. Compared with the weight stable group, the HRs and 95 % CI for cognitive impairment were 1.34 (1.10-1.64) in weight loss group, and 1.08 (0.88-1.33) in weight gain group. Restricted cubic splines showed the risk of cognitive impairment decreased with higher dietary diversity score or less weight change, though no significant interaction between dietary diversity and weight change was found.

LIMITATION

Given the observational nature of this study, there might be a reverse causation for the observed association.

CONCLUSION

Establishing and maintaining good dietary diversity were associated with a lower risk of cognitive impairment regardless of weight change status, whereas weight loss was associated with increased cognitive impairment risk independently among older Chinese adults.

Mediating effects of physical activities and cognitive function on the relationship between dietary diversity and all-cause mortality in community-dwelling older adults

Background

Although dietary diversity (DD) has been confirmed to be associated with multiple health outcomes and longevity in older people, the related mechanisms have not been elucidated. In this study, we explored the mediating roles of physical activities and cognitive function in the relationship between DD and all-cause mortality.

Methods

We recruited 34 068 community-dwelling older adults aged ≥60 years from the Chinese Longitudinal Healthy Longevity Study and followed them up until 2018. Dietary diversity score (DDS) was assessed by the intake frequency of nine food sources. We evaluated physical activities and cognitive function using the Katz index and Mini-Mental State Examination. We explored the mediating roles of physical activities and cognitive function between DDS and all-cause mortality using mediated analyses in Cox proportional risk regression models.

Results

A total of 25 362 deaths were recorded during 148 188.03 person-years of follow-up. Participants with physical disability and cognitive impairment had lower DDS than the normal group (P < 0.001). After controlling for all covariates, DDS, physical activities, and cognitive functioning were negatively associated with all-cause mortality. Physical activities and cognitive function mediated 18.29% (95% confidence interval (CI) = 12.90-23.10) and 27.84% (95% CI = 17.52-37.56) of the total effect of DDS on mortality, respectively.

Conclusions

Physical activities and cognitive function mediated the association between DDS and all-cause mortality. Maintaining DD may benefit early death prevention by reducing physical disability and cognitive impairment in community-dwelling older people.

Factors of food choice and nutritional intake of Brazilian older adults according sociodemographic and health characteristics

The rapid demographic transition in developing countries has always posed a challenge for the social and economic policies of these nations. The increase in longevity poses new challenges for understanding dietary consumption among different age groups at the old age population. The aim of this study was to evaluate the reasons for food choice and the composition of nutritional intake of older adults and its relationship to individual characteristics. Community-living older adults aged 60 and older were interviewed in their homes at the southeastern region of Brazil, between December 2021 and February 2022. The Food Choice Questionnaire and a Food Frequency Questionnaire were administered to obtain data on the reasons for food choice and nutritional intake. A structured interview was employed to gather information on individual characteristics. 168 older adults (mean age of 72.6 ± 8.9; 69.6% women) participated. The reasons for food choice differed significantly, with weight control being one of the least important and health being one of the most important. But older adults aged 80 and over valued the health criterion less than younger participants (60-69 years old). The intake of macronutrients and energy were below nutritional recommendations. Carbohydrate consumption was positively correlated with the mood motive. There was a relationship between the reasons for choosing food and/or the components of nutritional intake with: gender, age, living with a partner, self-report of depression/anxiety, self-perception of health and nutritional status anthropometric. The results are important to be considered in prevention policies and clinical-nutritional management, with special attention to the oldest-old.

A Mediterranean Diet-Based Metabolomic Score and Cognitive Decline in Older Adults: A Case-Control Analysis Nested within the Three-City Cohort Study

SCOPE

Evidence on the Mediterranean diet (MD) and age-related cognitive decline (CD) is still inconclusive partly due to self-reported dietary assessment. The aim of the current study is to develop an MD- metabolomic score (MDMS) and investigate its association with CD in community-dwelling older adults.

METHODS AND RESULTS

This study includes participants from the Three-City Study from the Bordeaux (n = 418) and Dijon (n = 422) cohorts who are free of dementia at baseline. Repeated measures of cognition over 12 years are collected. An MDMS is designed based on serum biomarkers related to MD key food groups and using a targeted metabolomics platform. Associations with CD are investigated through conditional logistic regression (matched on age, sex, and education level) in both sample sets. The MDMS is found to be inversely associated with CD (odds ratio [OR] [95% confidence interval (CI)] = 0.90 [0.80-1.00]; p = 0.048) in the Bordeaux (discovery) cohort. Results are comparable in the Dijon (validation) cohort, with a trend toward significance (OR [95% CI] = 0.91 [0.83-1.01]; p = 0.084).

CONCLUSIONS

A greater adherence to the MD, here assessed by a serum MDMS, is associated with lower odds of CD in older adults.

Dairy products and brain structure in French older adults

Among food groups with putative benefits for brain structures, dairy products (DP) have been poorly studied. The sample included participants without dementia from the ancillary brain imaging study of the Three-City cohort who were aged 65+ years, had their DP intake assessed with a FFQ at baseline and underwent an anatomical scan 3 years (n 343) or 9 years (n 195) after completing the dietary survey. The frequencies of consumption of total DP, milk and cheese were not associated with brain structure. Compared with the lowest frequency, the highest frequency of fresh DP (F-DP) consumption (< 0·5 v. > 1·5 times/d) was significantly associated with a lower medial temporal lobe volume (MTLV) (β = -1·09 cm3, 95 % CI - 1·83, -0·36) 9 years later. In this population-based study of older adults, the consumption of F-DP more than 1·5 times/d was associated with a lower MTLV, which is considered an early biomarker of Alzheimer's disease, 9 years later. This original study should be replicated in different settings before conclusions are drawn.

Impact of food-based fortification on nutritional outcomes and acceptability in older adults: systematic literature review

Background

"Do it yourself" (DIY) food-based fortification involves adding fortificants into everyday foods. It is a flexible solution that allows older people with reduced appetite to meet their nutritional needs.

Objectives

The aims of the systematic review are (a) to describe DIY fortified recipes, (b) to evaluate their acceptability, and (c) to evaluate whether they are effective levers to improve nutritional outcomes in older people.

Methods

A systematic search of 3 databases (Web of Science, PubMed, Scopus, last searched on January 2022) was undertaken. Main eligibility criteria include older adults aged ≥60 years living at home, in an institution or in hospital. Studies carried out for a specific medical condition or targeting only micronutrient fortification were excluded. After reviewing all titles/abstracts then full-text papers, key data were extracted and synthesized narratively. The quality of included studies was assessed using Kmet et al.

Results

Of 21,493 papers extracted, 44 original studies were included (3,384 participants), with 31 reporting nutritional outcomes, 3 reporting acceptability outcomes and 10 reporting both nutritional and acceptability outcomes. The review highlighted a wide variety of DIY fortified recipes, with additional energy ranging from 23 to 850 kcal/d (M = 403; SE = 62) and/or protein ranging from 4 to 40 g/d (M = 19; SE = 2). Compared to a standard diet, DIY fortification seems to be a valuable strategy for increasing energy and protein intake in older people. However, no strong evidence was observed on the nutritional status.

Implication for future

Further acceptability studies are crucial to ensure that DIY fortified foods are palatable and thus have a significant impact on the nutritional status. In addition, it would be useful for studies to better describe DIY recipes. This information would result in a better understanding of the factors that maximize the impact of DIY fortification on nutritional outcomes. Study registration: PROSPERO no. CRD42021244689.Systematic review registration: PROSPERO: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021244689.

Effect of Mediterranean Dietary Pattern on Cognitive Status in Community-Dwelling Older Adults

Modifiable factors associated with cognitive decline (CD) require more attention, particularly dietary patterns. This study aimed to investigate the link between cognitive decline and associated factors, particularly dietary patterns (DPs), in community-dwelling older Lebanese of modest economic status. Our cross-sectional national study included 352 participants above 60 years old, from the medico-social centers of the ministry of social affairs all over the country. CD was screened based on literacy. Nutritional and dietary data were collected through a validated food frequency questionnaire. DPs were extracted by the K-mean cluster analysis. CD was found in 32.7% and 61.5% of literate and illiterate groups, respectively. Identified DPs included a Westernized type and Mediterranean type, with high and moderate food intakes. In the context of literacy, independent factors associated with CD were age above 80 years, living in Beirut, frailty, and adopting a Westernized (OR = 3.08, 95% CI: 1.22-7.8) and a high-intake Mediterranean DP (OR = 2.11, 95% CI: 1.05-4.22). In the context of illiteracy, the same factors were associated with CD, but not DP nor frailty, with an age cut-off at 78 years. In a Lebanese sample of older adults, factors associated with CD depend on the level of literacy, with DP only associated with CD in the context of literacy.

Relationship between dietary pattern and depressive symptoms: an international multicohort study

BACKGROUND

Several previous studies have shown that dietary patterns are associated with the incidence of depressive symptoms. However, the results have been inconsistent. This study aimed to prospectively investigate the association between dietary patterns and the risk of depressive symptoms in two large cohort studies.

METHODS

The Tianjin Chronic Low-grade Systemic Inflammation and Health (TCLSIH) cohort study included a total of 7,094 participants living in Tianjin, China from 2013 to 2019, and the UK Biobank cohort study includes 96,810 participants who were recruited from 22 assessment centers across the UK taken between 2006 and 2010. All participants were free of a history of cardiovascular disease (CVD), cancer, and depressive symptoms at baseline. Dietary patterns at baseline were identified with factor analysis based on responses to a validated food frequency questionnaire in TCLSIH or Oxford WebQ in UK Biobank. Depressive symptoms were evaluated using the Chinese version of the Zung Self-Rating Depression Scale (SDS) in TCLSIH or hospital inpatient records in UK Biobank. Cox proportional hazards regression models were used to estimate the association between dietary patterns and depressive symptoms.

RESULTS

A total of 989, and 1,303 participants developed depressive symptoms during 17,410 and 709,931 person-years of follow-up. After adjusting for several potential confounders, the multivariable HRs (95% CIs) of the depressive symptoms were 0.71 (0.57, 0.88) for traditional Chinese dietary pattern, 1.29 (1.07, 1.55) for processed animal offal included animal food dietary pattern, and 1.22 (1.02, 1.46) for sugar rich dietary pattern in TCLSIH (all Q4 vs Q1). In the UK Biobank, the HRs (95% CIs) of depressive symptoms were 1.39 (1.16, 1.68) for processed food dietary pattern (Q4 vs Q1), 0.90 (0.77, 1.00) for healthy dietary pattern (Q3 vs Q1), and 0.89 (0.75, 1.05) for meat dietary pattern (Q4 vs Q1) in the final adjusted model.

CONCLUSION

Dietary patterns rich in processed foods were associated with a higher risk of depressive symptoms, and following a traditional Chinese dietary pattern or healthy dietary pattern was associated with a lower risk of depressive symptoms, whereas meat dietary pattern was not associated.

Demographic and Socioeconomic Factors Associated to Fruits and Vegetables Consumption in Elderly Europeans: A Systematic Review

Several epidemiological studies stress the association between a diet based on high fruits and vegetables intake and a better health condition. However, elderly Europeans cannot manage the recommended fruits and vegetables consumption. This systematic review aims to explore the main factors related to fruits and vegetables consumption in elderly Europeans. We conducted literature searches on Medline, Scopus, and Web of Science from inception to May 2022. Published articles including data related to certain fruits and vegetables consumption among elderly Europeans were selected. The New Castle-Ottawa Scale and National Heart, Lung, and Blood Institute tools were used for methodological quality assessment by two authors independently. A total of 60 articles were retrieved, and data from twenty-one high-quality cross-sectional studies and five moderate-to-high-quality cohort studies, including a total of 109,516 participants, were synthesized. Associated factors mostly analyzed were those relating to demographic and socioeconomic status, such as sex, age, marital status, educational level, and income. However, the findings show a high discrepancy. Some evidence suggests a possible positive association, while other evidence shows an inverse or no association at all. The relationship between demographic and socioeconomic factors with fruits and vegetables consumption is not at all clear. More epidemiological studies with an appropriate design and corresponding statistical methods are required.

Association between Micronutrient-Related Dietary Pattern and Cognitive Function among Persons 55 Years and Older in China: A Longitudinal Study

Appropriate dietary patterns for preserving cognitive function in China remains unknown. This study explored the association between dietary pattern and cognitive function in the Chinese population. A total of 6308 adults aged 55 and above who participated in the China Health and Nutrition Survey at least two waves from 1997 to 2018 were selected. The dietary pattern was determined using the reduced rank regression method with responses regarding vitamin C, vitamin E, zinc, iron, copper, and selenium intakes. We used a three-level random coefficient model to evaluate the association. A "vegetable-pork" dietary pattern characterized by high intakes of Legume products, vegetables, fruits, nuts, pork, fish, and plant oil was identified. Compared to the first quartile (Q1) of dietary scores, the regression coefficients (p value) for the global cognitive score across Q2, Q3, and Q4 were 0.27 (p = 0.030), 0.45 (p < 0.001), and 0.50 (p < 0.001), respectively. The adjusted odds ratios (ORs) and the 95% confidence intervals (CIs) for poor cognition across Q2, Q3, and Q4 were 0.82 (0.73 to 0.93), 0.79 (0.69 to 0.91), and 0.74 (0.63 to 0.86), respectively. The relationship appeared to be stronger among people who were 65 years and older, women, people from the south, and smokers. Higher adherence to the "vegetable-pork" diet is associated with better cognitive function among Chinese elders.

Futurization of Aging: Subjective Beliefs and Effects

Aging in the face of an increasing population and growing life expectancy is considered one of the major demographic challenges in modern society. Previous research has revealed that quality of life in aging could significantly differ depending on the resources one possesses. However, little attention has been given to the mechanisms of formation of these resources and the role of intentionality. In the present study, we identified 22 strategies that favor a better life quality in aging and analyzed them from the perspective of subjective beliefs and reported performance. Our sample was adults (n = 72) aged 57-65, living in St. Petersburg, Russia. The results showed that although participants were aware of the strategies that favor aging, their reported performance ranged on a scale from average to infrequent use of these strategies. We found that subjective beliefs about the role of psychological resources for better aging predicted higher scores on subjective beliefs about the role of lifestyle resources and the reported performance of psychological resources. Our results suggest that there is a gap between subjective beliefs about the controllability of aging processes and the transformation of these beliefs into real performance.

The Effects of “Diet–Smoking–Gender” Three-Way Interactions on Cognitive Impairment among Chinese Older Adults

Investigations on gender variations in the risk factors of cognitive impairment are required to promote future precision medicine among older adults, as well as to contribute to a better understanding of the “male–female health-survival paradox”. With this study, we aimed to investigate the effects of “diet–smoking–gender” three-way interactions on cognitive impairments among Chinese older adults. We conducted a 16-year prospective cohort study among 15,953, 15,555, 16,849, 9716, 7116, and 13,165 older adults from the 2002, 2005, 2008–2009, 2011–2012, 2014, and 2017–2018 waves of the Chinese Longitudinal Healthy Longevity Survey (CLHLS), respectively. Cognitive impairment was measured by the Mini-Mental State Examination (MMSE). The dietary diversity score (DDS) was calculated using the CLHLS food frequency questionnaire. Generalized estimating equations (GEE) were used to assess the “diet–smoking–gender” three-way interaction effects on cognitive impairment across the six waves of CLHLS. We found that higher dietary diversity was associated with lower probability of cognitive impairment among older adults (OR = 0.92; 95%CI = 0.90, 0.98). However, smoking behavior may negatively influence the protective effect of higher dietary diversity on cognitive function among females (OR = 1.26; 95%CI = 1.07, 1.49). Our findings imply that we should take gender differences and lifestyle behaviors into consideration in implementing dietary interventions to improve cognitive function among older adults.

Dietary patterns, breakfast consumption, meals with family and associations with common mental disorders in adolescents: a school-based cross-sectional study

BACKGROUND

Adolescence is a period of transition and vulnerabilities, in which mental illnesses can develop more easily. The objective of this work is to analyze the association of dietary patterns, breakfast consumption, and the practice of having meals accompanied by the family with the presence of Common Mental Disorders in Brazilian adolescents.

METHODS

This is a cross-sectional study which analyzed data from 71,553 Brazilian adolescents aged 12-17 years, from the Study of Cardiovascular Risk in Adolescents (Portuguese acronym, "ERICA"). Principal Component Analysis was performed to identify dietary patterns, and Logistic Regression Models were performed to identify the associations between Common Mental Disorders, dietary patterns, and eating practices that are breakfast consumption and practice of having meals accompanied by family.

RESULTS

Two patterns were found, a Healthy Dietary Pattern and an Unhealthy Dietary Pattern. Adolescents classified in the second (OR: 0.79; 95% CI 0.70-0.89) or third (OR: 0.86; 95% CI 0.77-0.96) tercile of the Healthy Dietary Pattern had a lower chance of having Common Mental Disorders. Eating breakfast sometimes (OR: 0.71; 95% CI 0.61-0.83) or almost every day/every day (OR: 0.54; 95% CI 0.47-0.62), and the practice of having the main meals with the family sometimes (OR: 0.69; 95% CI 0.57-0.84) or almost every day/every day (OR: 0.50; 95% CI 0.44-0.58), decreased the chance for Common Mental Disorders.

CONCLUSION

This study observed that healthy dietary patterns are associated with better mental health in adolescents, thus should be encouraged and promoted.

Psychosocial factors influencing the eating behaviours of older adults: A systematic review

Our understanding of how eating behaviours change in later life have been dominated by the studies of physiological and biological influences on malnutrition. Insights from these studies were consequently used to develop interventions, which are predominantly aimed at rectifying nutritional deficiencies, as opposed to interventions that may enable older adults to eat well and enjoy their food-related life well into older age. The objective of the present review is to summarise the existing knowledge base on psychosocial influences on eating behaviours in later life. Following comprehensive searches, review, and appraisal, 53 articles were included (22 qualitative and 31 quantitative) to provide a greater understanding of the mechanisms underpinning the psychosocial factors influencing eating behaviours. Our analysis identified eight underpinning psychosocial factors that influences eating behaviours in later life; (1) health awareness & attitudes, (2) food decision making, (3) perceived dietary control, (4) mental health & mood, (5) food emotions & enjoyment, (6) eating arrangements, (7) social facilitation, and (8) social support. The importance and lasting influence of early food experiences were also identified as contributing to eating behaviours in later life. The review concludes with the call for further investigation into specific psychosocial factors that influence eating behaviour, calls for improvements in methodologies, and a summary of psychosocial barriers and enablers to eating well in later life.

Mediterranean diet and prudent diet are both associated with low circulating esterified 3-hydroxy fatty acids, a proxy of LPS burden, among older adults

BACKGROUND

LPS-type endotoxins, naturally found in the gut microbiota, are recognized as triggers of inflammation and emerge as detrimental factors of healthy aging. Nutrition represents a promising strategy to reduce LPS burden, yet little is known about the relation of diet to circulating LPS concentrations.

OBJECTIVE

The aim was to evaluate the associations between food groups, dietary patterns, and circulating 3-hydroxy fatty acids (3-OH FAs), a proxy of LPS burden.

METHODS

In a cross-sectional study of 698 French older community-dwelling individuals, 3-OH FA concentrations were measured by LC-tandem MS. Dietary patterns were determined using food-frequency questionnaires. Adherence to a Mediterranean-type diet was computed according to the consumption of 8 food groups (fruits, vegetables, legumes, cereals, fish, olive oil, meat, and dairy products) and alcohol intake (range: 0, low adherence, to 18, high adherence). Three a posteriori dietary patterns were derived from factor analysis: complex carbohydrate (rich in rice, pasta, eggs, poultry, and potatoes), traditional (rich in alcohol, meat, processed meats-cold cuts, and legumes), and prudent (rich in vegetables and fruits and low in cookies) diets. Linear regression models were applied.

RESULTS

The frequency of consumption of each food group was not associated with 3-OH FA concentrations. Greater adherence to both the Mediterranean diet and the prudent diet were associated with lower circulating 3-OH FAs (β [95% CI] for each additional point of score: -0.12 [-0.22, -0.01] and -0.27 [-0.48, -0.07], respectively). In contrast, greater adherence to the traditional diet was associated with higher concentration of 3-OH FAs (β [95% CI] 0.22 [0.001, 0.46]). The adherence to the complex-carbohydrate diet was not associated with 3-OH FA concentrations.

CONCLUSIONS

Based on 2 complementary approaches, the identified plant-based dietary patterns were associated with lower 3-OH FA concentrations, and thus a lower LPS burden, which is considered a potent trigger of inflammatory response.

Simple carbohydrate intake and higher risk for physical frailty over 15 years in community-dwelling older adults

Insulin resistance is a major mechanism involved in the onset of physical frailty (PF). Although rich carbohydrate diets may promote insulin resistance, few studies have examined their association with PF risk. This study aimed to investigate the spectrum of carbohydrate exposure, including carbohydrate intake (simple, complex, and total), glycemic load (measure of the diet-related insulin-demand), and adherence to a low-carbohydrate diet with the incident risk of PF in community-dwelling older adults. Baseline carbohydrate exposure was assessed in non-frail participants of the Three-City-Bordeaux cohort using a 24H dietary recall. Over 15 years of follow-up, participants were screened for PF, defined by the FRAIL scale (≥3 criteria out of Fatigue, Resistance, Ambulation, Illnesses, and weight Loss). Associations were estimated using mixed-effects logistic models adjusted for sex, age, education, smoking status, alcohol consumption, depressive symptomatology, global cognitive performances, and protein and energy intakes. The sample included 1,210 participants (62% females, mean age 76 years). Over the follow-up, 295 (24%) incident cases of PF were documented (28% in females, 18% in males). Higher intake of simple carbohydrates was significantly associated with greater odds of incident PF (per 1-SD increased: OR = 1.29; 95% CI = 1.02-1.62), specifically among males (OR = 1.52; 95% CI = 1.04-2.22). No association was observed with complex or total carbohydrate intake, glycemic load, or low-carbohydrate diet. Among the whole carbohydrate exposure, only higher consumption of simple carbohydrates in older age was associated with a higher risk of developing PF. Further studies are required to explore underlying mechanisms.

The Onset of Depression in Middle-Aged Presumed Healthy Slovenian Family Practice Attendees and Its Associations with Genetic Risk Assessment, Quality of Life and Health Status: A Contribution for Family Medicine Practitioners' Early Detection

Despite depression being a major driver of morbidity and mortality, the majority of primary care patients remain undiagnosed, so this study aimed to assess the prevalence of depression and the association with demographic and clinical variables, genetic risk, and quality of life. The participants were presumably healthy model family medicine practice (MFMP) attendees between 30 and 65 years of age and recruited during a preventive check-up in 2019. Each of the 40 pre-selected MFMP pragmatically invited 30 attendees to voluntarily participate. They completed a questionnaire of demographic, clinical, and social determinants, as well as a three-generational family history. The results were analyzed using multivariable modelling to calculate the associations with signs of depression. A modified Scheuner method was used to calculate the level genetic risk level using family history. Of 968 participants, aged 42.8 ± 8.6 years, 627 (64.8%) were women. The prevalence of depression was 4.1%. Signs of depression were negatively associated with health-related quality of life score, in particular in the domains of self-care (p = 0.001) and anxiety/depression (p < 0.001). Depression was also associated with predicted high risk for comorbidities given the family history (p = 0.030). Primary care directed at improving patients’ quality of life should implement more widespread screening for mental health disorders. Family history for disease even beyond depression can be used by physicians as an important primary prevention tool.

Carotenoid-Rich Brain Nutrient Pattern Is Positively Correlated With Higher Cognition and Lower Depression in the Oldest Old With No Dementia

Background: Healthy dietary patterns are related to better cognitive health in aging populations. While levels of individual nutrients in neural tissues are individually associated with cognitive function, the investigation of nutrient patterns in human brain tissue has not been conducted. Methods: Brain tissues were acquired from frontal and temporal cortices of 47 centenarians from the Georgia Centenarian Study. Fat-soluble nutrients (carotenoids, vitamins A, E, K, and fatty acids [FA]) were measured and averaged from the two brain regions. Nutrient patterns were constructed using principal component analysis. Cognitive composite scores were constructed from cognitive assessment from the time point closest to death. Dementia status was rated by Global Deterioration Scale (GDS). Pearson's correlation coefficients between NP scores and cognitive composite scores were calculated controlling for sex, education, hypertension, diabetes, and APOE ε4 allele. Result: Among non-demented subjects (GDS = 1-3, n = 23), a nutrient pattern higher in carotenoids was consistently associated with better performance on global cognition (r = 0.38, p = 0.070), memory (r = 0.38, p = 0.073), language (r = 0.42, p = 0.046), and lower depression (r = -0.40, p = 0.090). The findings were confirmed with univariate analysis. Conclusion: Both multivariate and univariate analyses demonstrate that brain nutrient pattern explained mainly by carotenoid concentrations is correlated with cognitive function among subjects who had no dementia. Investigation of their synergistic roles on the prevention of age-related cognitive impairment remains to be performed.

Dairy Product Intake and Long-Term Risk for Frailty among French Elderly Community Dwellers

Dairy products (DP) are part of a food group that may contribute to the prevention of physical frailty. We aimed to investigate DP exposure, including total DP, milk, fresh DP and cheese, and their cross-sectional and prospective associations with physical frailty in community-dwelling older adults. The cross-sectional analysis was carried out on 1490 participants from the Three-City Bordeaux cohort. The 10-year frailty risk was examined in 823 initially non-frail participants. A food frequency questionnaire was used to assess DP exposure. Physical frailty was defined as the presence of at least 3 out of 5 criteria of the frailty phenotype: weight loss, exhaustion, slowness, weakness, and low physical activity. Among others, diet quality and protein intake were considered as confounders. The baseline mean age of participants was 74.1 y and 61% were females. Frailty prevalence and incidence were 4.2% and 18.2%, respectively. No significant associations were observed between consumption of total DP or DP sub-types and frailty prevalence or incidence (OR = 1.40, 95%CI 0.65–3.01 and OR = 1.75, 95%CI 0.42–1.32, for a total DP consumption >4 times/d, respectively). Despite the absence of beneficial associations of higher DP consumption on frailty, older adults are encouraged to follow the national recommendations regarding DP.

Fruit and Vegetable Dietary Patterns and Mental Health in Women: A Systematic Review

CONTEXT

Mental health may be influenced by some dietary patterns. Among common elements of beneficial patterns is high fruit and vegetable intake. However, no systematic review has been conducted to date, to our knowledge, that has assessed the influence of fruit and vegetable dietary patterns on a broad spectrum of mental health.

OBJECTIVE

We conducted a systematic review, using the PRISMA guidelines, of the observational studies analyzing the association between the dietary pattern of fruit and vegetables and the broad aspects of mental health in adult women.

DATA SOURCES

The databases PubMed and Web of Science were searched, and additional manual search for observational peer-reviewed studies was conducted for studies published until June 2019.

DATA EXTRACTION

A total of 5911 studies were extracted and verified based on title and abstract for the inclusion criteria. All procedures were conducted independently by 2 researchers. The final number of included studies was 30. The review was structured around the type of observed outcome.

DATA ANALYSIS

The included studies had defined habitual intake associated with dietary patterns with the intake of specific fruit and/or vegetables, and/or fruit or vegetable products (eg, juices), as well as any aspect of the broad spectrum of general mental health. The Newcastle-Ottawa Scale was used to assess bias. The observed association was not stated in all the included studies; some of them revealed a reverse relationship, but only for the vegetarian/vegan diet. A vegetarian diet may be characterized by high consumption of fruits and vegetables, but it sometimes may not be properly balanced, due to excluded products. This may be the reason of observed situation.

CONCLUSIONS

A general positive influence was observed for the dietary patterns characterized by high consumption of fruit and vegetables and of fruit or vegetable products by women.

SYSTEMATIC REVIEW REGISTRATION

PROSPERO registration no. CRD42019138148.

Association of a Single-Item Self-Rated Diet Construct With Diet Quality Measured With the Alternate Healthy Eating Index

Background: A single-item self-rated diet measure (SRD) may provide a quick, low-burden screener. However, assessment of its validity is limited. This study aimed to evaluate the association of an SRD construct with measured diet quality among adults in Puerto Rico (PR). Methodology: Participants (30-75 years old; n = 247) of the PR Assessment of Diet, Lifestyle, and Diseases (PRADLAD) cross-sectional study reported SRD with a single question ("How would you describe your current dietary habits and diet quality?") with a five-point scale: excellent to poor. More complete diet quality was calculated using the Alternate Healthy Eating Index-2010 (AHEI), with 11 food and nutrient components assessed by the food frequency questionnaire. Multivariable general linear models were used to test associations between SRD with AHEI and its components. Associations were also tested between recall SRD in youth and current AHEI. Results: Most participants (35.2%) self-rated diet as "good," 13.8% as "excellent," and 4.1% as "poor," with the remainder split between middle scale points. SRD was not significantly associated with AHEI, although participants with "excellent" vs. "poor" SRD had marginally higher AHEI (P = 0.07). SRD was significantly associated with higher fruit intake (P = 0.02) and marginally associated with intakes of vegetables (P = 0.07) and long-chain fatty acids (P = 0.07). Unexpectedly, AHEI was significantly higher among those reporting "poor" SRD in young adulthood (P = 0.01) or childhood (P = 0.05). Conclusions: SRD may capture current diet quality at extreme intakes. Larger studies should confirm these findings and replicate them in other underrepresented populations. Further research should clarify the inverse associations between adult AHEI and earlier reported SRD.

Dietary fiber deficiency as a component of malnutrition associated with psychological alterations in alcohol use disorder

BACKGROUND & AIMS

Chronic alcohol consumption can cause malnutrition that may contribute to alcohol-induced organ injury and psychological disorders. We evaluated the link between nutrient intake, especially dietary fibers (DF) and different parameters reflecting mental health and well being, namely anxiety, depression, alcohol craving, sociability, fatigue and intestinal comfort in alcohol use disorder (AUD) patients.

METHODS

Cross-sectional data from 50 AUD patients, hospitalized for a 3-week detoxification program were used. Three 24-h recalls allowed to calculate dietary habits and nutrient intakes, that was also assessed in healthy subjects (HS). Diet quality was measured using the NOVA score. Psychological factors and intestinal discomfort were evaluated using validated self-administered questionnaires.

RESULTS

Energy intake (excluding alcoholic beverage), total fat, monounsaturated and polyunsaturated fatty acids, protein and DF intakes were lower in AUD subjects compared to HS. Ninety percent of patients had a DF intake below the recommendation. AUD patients consumed more than twice as much ultra-processed food than HS. Fructan intake was negatively associated with anxiety (p = 0.04) adjusted for main confounders. Total DF, insoluble, soluble DF and galacto-oligosaccharide intakes were associated with higher sociability score. Soluble DF intake was associated with better satisfaction of bowel function (p = 0.02) and a lower intestinal discomfort (p = 0.04).

CONCLUSIONS

This study reveals that insufficient DF intake is part of AUD-related malnutrition syndrome, and is associated with higher anxiety, lower sociability score and intestinal discomfort. Our results suggest that an adequate intake of DF might be beneficial for recovery from AUD.

TRIAL REGISTRATION

NCT03803709, https://clinicaltrials.gov/ct2/show/NCT03803709.

Association between dietary diversity and cognitive impairment among the oldest-old: Findings from a nationwide cohort study

BACKGROUND & AIMS

Dietary diversity is widely recommended in national and international guidelines; however, whether the beneficial effects on cognitive function still apply in the oldest-old (80+) has rarely been studied. This study aimed to evaluate the associations of dietary diversity with cognitive function among the oldest-old in a large prospective cohort in China.

METHODS

We conducted a long-term prospective analysis on 11,970 participants aged 80+ (6581 octogenarians, 3730 nonagenarians, and 1659 centenarians). We constructed the baseline dietary diversity score (DDS) based on eight food items of a food frequency questionnaire. Mini-mental state examination (MMSE) was used to classify the participants as having cognitive impairment or not and was also used as a continuous metric. Non-linear associations of DDS with cognitive impairment was evaluated by cox models with penalized splines. We used mixed-effect models for longitudinal data with repeated measurements of MMSE (for up to seven time during the follow-up between 1998 and 2014).

RESULTS

We documented 4778 cognitive impairment during 46,738 person-years of follow-up. Each one unit increase in DDS was associated with a 4% lower risk of cognitive impairment (adjusted hazard ratio (HR): 0.96; 95% confidential interval (CI): 0.94-0.98). Compared to participants with DDS of 0 score, those with a DDS of 1-2, 3-4, and higher than 5 scores had a lower cognitive impairment risk, the HRs were 0.86 (0.79-0.95), 0.82 (0.74-0.91), and 0.72 (0.64-0.82) respectively, and a significant trend emerged (p < 0.001). Compared with DDS of zero score, a DDS of 1-2,3-4, ≥5 was related to slower MMSE decline (β = 0.128, 0.162, 0.301, respectively, p < 0.01).

CONCLUSIONS

Even after the age of 80, dietary diversity may offer a simple and straightforward mean of identifying and screening individuals at high risk for cognitive impairment. Recommendation of dietary diversity may be advocated to attenuate cognitive decline and decrease the risk of cognitive impairment in the oldest-old, especially in a low income or middle-income countries.

Dietary patterns and trajectories of global- and domain-specific cognitive decline in the Lothian Birth Cohort 1936

Healthy dietary patterns may protect against age-related cognitive decline, but results of studies have been inconsistent and few have had extensive longitudinal follow-up with comprehensive cognitive testing. The aim of the present study was to determine associations of dietary patterns with trajectories of global- and domain-specific cognitive change over a 12-year period. Data from 863 community-dwelling, dementia-free participants from the Lothian Birth Cohort 1936 study of ageing completed a FFQ at baseline (aged 70 years) and underwent cognitive testing at baseline, and at the ages of 73, 76, 79 and 82 years. Composite cognitive scores were constructed for four cognitive domains (visuospatial ability, processing speed, memory and verbal ability) and global cognitive function. A Mediterranean-style pattern and a traditional pattern were derived using principal component analysis of self-reported dietary intakes. In fully adjusted latent growth curve models, higher baseline adherence to the Mediterranean-style dietary pattern (β = 0·056, P = 0·009) and lower baseline adherence to the traditional dietary pattern (β  =  −0·087, P < 0·001) were cross-sectionally associated with better verbal ability. A slightly steeper decline in verbal ability over 12 years was observed in those with higher Mediterranean-style diet scores at baseline (β = −0·003, P = 0·008). All other associations were non-significant. Our findings in this well-characterised Scottish cohort indicate that adherence to a healthy Mediterranean-style diet is associated cross-sectionally with better verbal (crystallised) ability, with the converse being true for the traditional diet. A healthier baseline diet did not predict a reduced risk of global- or domain-specific cognitive decline.

Dietary patterns and depression risk in older adults: systematic review and meta-analysis

CONTEXT

Diet may be one of the modifiable environmental factors that could reduce depressive symptoms or abate the development of depression without side effects. However, previous reviews mainly focused on general adult populations.

OBJECTIVE

The aim of this systematic review and meta-analysis was to explore the association between healthy dietary patterns and depression risk in older adults.

DATA SOURCES

Eight databases were searched up to September 2019. The inclusion criteria were older adults aged ≥ 65 years, healthy dietary patterns, depression assessed by a physician or by validated screening tools, and quantitative study design.

DATA EXTRACTION

Data were extracted independently by 2 researchers, and the Preferred Reporting Items for Systematic Reviews and Meta-analyses guideline was followed.

DATA ANALYSIS

Meta-analysis was conducted by calculating the pooled odds ratio (OR) and 95% CIs. A total of 18 eligible studies were meta-analyzed. Results showed that a healthy dietary pattern is associated with a reduced risk of depression in older adults (OR, 0.85; 95%CI, 0.78-0.92; P < 0.001). There was high heterogeneity (I2 = 64.9%; P < 0.001) among the studies. Subgroup analyses indicated that sample size and depression screening tools were the main sources of study heterogeneity.

CONCLUSIONS

An inverse association between healthy dietary patterns and depression risk in older adults was found. However, the high heterogeneity among the studies should be considered.

SYSTEMATIC REVIEW REGISTRATION

PROSPERO registration no. CRD 42020169195.

Socio-Demographic Characteristics, Dietary, and Nutritional Intakes of French Elderly Community Dwellers According to Their Dairy Product Consumption: Data from the Three-City Cohort

Few data are available regarding dietary habits of the elderly, especially about dairy products (DPs) (total DP and milk, fresh DP, and cheese), whereas these are part of healthy habits. The aim was to describe the socio-demographic characteristics, food, and nutritional intakes of elderly DP consumers. The sample consisted of 1584 participants from the Three-City-Bordeaux cohort (France), who answered a food frequency questionnaire and a 24-h dietary recall. Socio-demographic characteristics, practice of physical activity, Body Mass Index, and polymedication were registered. The sample was 76.2 years (SD 5.0 years) on average, 35% were in line with the French dietary guidelines for DP (3 or 4 servings of DP/day), while 49% were below, and 16% above. Women were significantly more likely to declare the highest total DP (≥4 times/day), milk (>1 time/day), and fresh DP (>1.5 times/day) frequency consumption. The highest cheese frequency consumers (>1.5 times/day) were more likely men, married, and ex-smokers. The highest frequency of fresh DP intake was significantly associated with the lowest energy and lipid intakes, and that of cheese with the highest consumption of charcuteries, meat, and alcohol. This cross-sectional analysis confirmed that the socio-demographics and dietary characteristics varied across DP sub-types consumed, which encourages individual consideration of these confounders in further analyses.

Sex differences in the relationship between dietary pattern adherence and cognitive function among older adults: findings from the NuAge study

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.

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 (M_age = 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).

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.

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.

Positive, but Not Negative, Self-Perceptions of Aging Predict Cognitive Function Among Older Adults

Self-perceptions of aging (SPA) refer to attitudes about one’s aging process and are linked to physical health and longevity. How SPA correlates with cognitive function in older adulthood is less well known. 136 older adults were administered a multifaceted SPA measure, The Brief Ageing Perceptions Questionnaire (B-APQ), in addition to a demographic form and a comprehensive neuropsychological battery. Positive and negative subscales of the B-APQ were correlated with aspects of cognitive function. Regression analyses revealed that only the positive B-APQ subscales predicted mental status ( β = .19, p < .05), short-delay memory ( β = .16, p < .05), processing speed ( β = −.21, p < .05), and two measures of executive function ( β = −.21, p < .01; β = .18, p < .05). This is the first study to demonstrate that positive dimensions of SPA relate to cognitive function in older adulthood.

Dietary Patterns and Cognitive Decline: key features for prevention

The decline in cognitive function is generally the result of the complex interaction of several factors. First of all, age, but also demographic, educational, genetic, socio-economic, and environmental determinants, including nutrition. Cognitive decline and dementia prevalence are increasing, and they are projected to continue increasing in the next decades due to the aging of the world population. Currently, there are no effective pharmacological treatments for these devastating and disabling conditions, which emphasize the key role of preventive strategies. There is compelling evidence of the role of diet and lifestyle on cognitive function. Therefore, dietary/ nutritional approaches that contribute to prevent, or slow cognitive decline may have a remarkable public health impact. Numerous studies have explored the role of dietary components and patterns on age-associated cognitive decline, with accruing evidence that combinations of foods and nutrients can have synergistic effects beyond those attributable to individual foods or nutrients. Dietary patterns show the strongest evidence for slowing the development of cognitive decline, Alzheimer's disease and other dementias including the Mediterranean diet, the Dietary Approaches to Stop Hypertension diet, and their combination (the MedDiet-DASH Intervention for Neurodegenerative Delay - MIND), among others with few positive results. There are also dietary patterns with no evidence of such effects. This review examines the evidence for the effects of some dietary patterns as neuroprotective with a potential to delay cognitive decline and the onset of dementia.

The relationship between dietary patterns and depression mediated by serum levels of Folate and vitamin B12

BACKGROUND

Major depressive disorder is among main worldwide causes of disability. The low medication compliance rates in depressed patients as well as the high recurrence rate of the disease can bring up the nutrition-related factors as a potential preventive or treatment agent for depression. The aim of this study was to investigate the association between dietary patterns and depression via the intermediary role of the serum folate and vitamin B12, total homocysteine, tryptophan, and tryptophan/competing amino acids ratio.

METHODS

This was an individually matched case-control study in which 110 patients with depression and 220 healthy individuals, who completed a semi-quantitative food frequency questionnaire were recruited. We selected the depressed patients from three districts in Tehran through non-probable convenience sampling from which healthy individuals were selected, as well. The samples selection and data collection were performed during October 2012 to June 2013. In addition, to measure the serum biomarkers 43 patients with depression and 43 healthy people were randomly selected from the study population. To diagnose depression the criteria of Diagnostic and Statistical Manual of Mental Disorders, fourth edition, were utilized.

RESULTS

The findings suggest that the healthy dietary pattern was significantly associated with a reduced odds of depression (OR: 0.75; 95% CI: 0.61-0.93) whereas the unhealthy dietary pattern increased it (OR: 1.382, CI: 1.116-1.71). The mediation analysis showed that the healthy dietary pattern was associated with a reduced risk of depression via increased serum levels of the folate and vitamin B12; however, the unhealthy dietary pattern was associated with increased risk of depression via decreased serum levels of folate and vitamin B12, based on tree adjusted logistic regression models.

CONCLUSION

Dietary patterns may be associated with depression by changing the serum levels of folate and vitamin B12. Further studies are required to confirm the mechanism.

Association between dietary patterns and adult depression symptoms based on principal component analysis, reduced-rank regression and partial least-squares

BACKGROUND & AIMS

There have been inconsistent findings on the association between dietary patterns and depressive symptoms (DepS). In addition, studies have used single analysis methods to identify dietary patterns. In the current study, we aimed to determine the association between dietary patterns, derived by principal component analysis (PCA), reduced-rank regressions (RRR) and partial least-squares (PLS), and DepS among adults using a cohort study in Australia.

METHODS

We examined a total of 1743 study participants (≥24 years, 48.9% males) using cross-sectional and longitudinal data from the North West Adelaide Health Study (NWAHS). The Center for Epidemiological Studies-Depression (CES-D) scale was used to assess DepS and a score ≥16 was considered as having depression. Dietary data were collected using a food frequency questionnaire. Eicosapentaenoic acid (EPA)/Docosahexaenoic acid (DHA), folate, magnesium (Mg) and zinc (Zn) densities were chosen as the response variables for RRR and PLS analyses. Dietary patterns were identified by PCA, RRR and PLS. Odds ratios (OR) and 95% confidence intervals (95% CI) were estimated across quartiles (Q) using log-binomial logistic regression to assess the association between dietary patterns and DepS. Sensitivity analyses, including a longitudinal association between dietary patterns and DepS among 859 participants, were performed. Multiple imputation was performed to investigate the effect of missing data on the estimates.

RESULTS

In this study, 16.9% (14.2% in men and 20.8% in women) of the participants had DepS. We retained two, four and four dietary patterns captured by PCA, RRR and PLS respectively. The 'prudent' pattern determined by PCA [OR_Q4VsQ1 = 0.57; 95% CI: 0.35, 0.92] and PLS [OR_Q4VsQ1 = 0.66; 95% CI: 0.43, 1.00] together with the 'typical Australian' pattern determined by RRR [OR_Q4VsQ1 = 0.60; 95% CI: 0.40, 0.90] were inversely associated with DepS whereas the 'western' pattern derived by PCA [OR_Q4VsQ1 = 2.04; 95% CI: 1.12, 3.68] and PLS [OR_Q4VsQ1 = 1.62; 95% CI: 1.05, 2.50] was positively associated with DepS. In the longitudinal analysis, the 'prudent' pattern determined by PCA [OR_Q4VsQ1 = 0.52; 95% CI: 0.25, 1.09] tended to be inversely associated with DepS whereas 'western' patterns determined by PCA [OR_Q4VsQ1 = 3.47; 95% CI: 1.37, 8.78] and PLS [OR_Q4VsQ1 = 2.47; 95% CI: 1.24, 4.91] were positively associated with DepS. We found that a dietary pattern characterized by high intakes of fruits, vegetables, medium fat dairy, nuts, legumes, and fish was inversely associated with DepS in this population-based study. Contrary to this, a dietary pattern characterized by high intakes of processed and red meat, fast foods (snacks and takeaway foods), soft drinks, white bread and high-fat dairy products were significantly associated with DepS. Multiple imputation and sensitivity analysis identified similar patterns of association between dietary pattern and DepS.

CONCLUSIONS

The findings indicate that the 'western' pattern was consistently associated with an increased risk, and the 'prudent' pattern tended to be associated with a reduced risk of DepS. This suggests that dietary interventions may assist with the treatment of DepS. However, current evidence on the impact of diet on DepS should be supported using further longitudinal studies with extended follow up, larger sample sizes and repeated measures.

Associations of Plasma 3-Methylhistidine with Frailty Status in French Cohorts of the FRAILOMIC Initiative

Frailty and sarcopenia are characterized by a loss of muscle mass and functionality and are diagnosed mainly by functional tests and imaging parameters. However, more muscle specific biomarkers are needed to improve frailty diagnosis. Plasma 3-methylhistidine (3-MH), as well as the 3-MH-to-creatinine (3-MH/Crea) and 3-MH-to-estimated glomerular filtration rate (3-MH/eGFR) ratios might support the diagnosis of frailty. Therefore, we investigated the cross-sectional associations between plasma 3-MH, 3-MH/Crea and 3-MH/eGFR with the frailty status of community-dwelling individuals (>65 years). 360 participants from two French cohorts of the FRAILOMIC initiative were classified into robust, pre-frail and frail according to Fried's frailty criteria. General linear models as well as bivariate and multiple linear and logistic regression models, which were adjusted for several confounders, were applied to determine associations between biomarkers and frailty status. The present study consisted of 37.8% robust, 43.1% pre-frail and 19.2% frail participants. Frail participants had significantly higher plasma 3-MH, 3-MH/Crea and 3-MH/eGFR ratios than robust individuals, and these biomarkers were positively associated with frailty status. Additionally, the likelihood to be frail was significantly higher for every increase in 3-MH (1.31-fold) and 3-MH/GFR (1.35-fold) quintile after adjusting for confounders. We conclude that 3-MH, 3-MH/Crea and 3-MH/eGFR in plasma might be potential biomarkers to identify frail individuals or those at higher risk to be frail, and we assume that there might be biomarker thresholds to identify these individuals. However, further, especially longitudinal studies are needed.

Ready-meal consumption in older people: association with obesity and dietary intake

OBJECTIVE

To investigate ready-meal consumption trends in older French people, its association with overall diet quality and obesity.

DESIGN

Cross-sectional analysis SETTING: Multidomain Alzheimer Preventive Trial (MAPT), France SUBJECTS: 421 MAPT participants (mean age 76.8 years) who filled a food frequency questionnaire.

RESULTS

The frequency of ready-meal consumption was low, with nearly 90% of participants declaring consuming ≤ 1 ready-meal per week. Compared to non- and low-consumers (≤ 1 ready-meal/week), regular consumers (≥ 2 ready-meals/week) were older (p < 0.01), more often frail and pre-frail (p 0.04), with impaired cognition (p = 0.02) and functional status (p = 0.02), with more depressive symptoms (p = 0.03) and more difficulties with preparing meals (p = 0.01). Results from multivariate analyses showed that regular ready-meal consumption was not associated with obesity (p = 0.26) and diet quality (p = 0.37).

CONCLUSIONS

In our sample, few older people declared consumption of 2 or more ready-meals per week, this consumption was not associated with a higher prevalence of obesity or a lower diet quality, despite the fact that these subject were older, with a lower physical and cognitive status. These findings suggest that, for these people with difficulties in meal preparation, convenience foods consumed occasionally could help to maintain diet quality and weight status.

Study protocol: associations between dietary patterns, cognitive function and metabolic syndrome in older adults - a cross-sectional study

BACKGROUND

Loss 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.

METHODS

This 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.

DISCUSSION

This 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.

Effects of sustained cognitive activity on white matter microstructure and cognitive outcomes in healthy middle-aged adults: A systematic review

Adults who remain cognitively active may be protected from age-associated changes in white matter (WM) and cognitive decline. To determine if cognitive activity is a precursor for WM plasticity, the available literature was systematically searched for Region of Interest (ROI) and whole-brain studies assessing the efficacy of cognitive training (CT) on WM microstructure using Diffusion Tensor Imaging (DTI) in healthy adults (> 40 years). Seven studies were identified and included in this review. Results suggest there are beneficial effects to WM microstructure after CT in frontal and medial brain regions, with some studies showing improved performance in cognitive outcomes. Benefits of CT were shown to be protective against age-related WM microstructure decline by either maintaining or improving WM after training. These results have implications for determining the capacity for training-dependent WM plasticity in older adults and whether CT can be utilised to prevent age-associated cognitive decline. Additional studies with standardised training and imaging protocols are needed to confirm these outcomes.

Psychological disorders and dietary patterns by reduced-rank regression

OBJECTIVE

To determine the relationship between dietary patterns identified by reduced-rank regression method and psychological disorders in a large group of Iranian adults.

METHODS

A cross-sectional study was performed on 3363 Iranian adults between 20 and 55 years. Dietary intakes were assessed using a validated dish-based semi-quantitative food frequency questionnaire. Psychological health was examined through validated Iranian version of Hospital Anxiety and Depression Scale and General Health Questionnaires. Reduced-rank regression was applied to identify dietary patterns based on the ratio of omega-3/omega-6, zinc, magnesium, vitamin B6, and folic acid intake. Logistic regression was used to assess the relationship between dietary patterns and psychological disorders.

RESULTS

Three major dietary patterns were derived: "healthy," "fish and poultry," and "transitional." After adjustment for potential confounders, "healthy" was associated with reduced depression (odds ratio (OR) for the highest vs. lowest quintile: 0.35; 95% confidence interval (CI): 0.25-0.50), anxiety (OR: 0.47; CI: 0.30-0.74), and psychological distress (OR: 0.52; CI: 0.36-0.75). Greater adherence to the "fish and poultry" was related with lower odds of depression (OR: 0.64; CI: 0.47-0.87). Participant in the third quintile of "fish and poultry" dietary pattern were less likely to be anxious (OR: 0.61; CI: 0.41-0.91). Additionally, we found an inverse significant correlation between adherence to the "transitional" dietary pattern and odds of depression (OR: 0.36; CI: 0.21-0.62), anxiety (OR: 0.43; CI: 0.21-0.88), and psychological distress (OR: 0.41; CI: 0.23-0.72).

CONCLUSION

We found that "healthy," "fish and poultry," and "transitional" dietary patterns have inverse significant relationship with odds of psychological disorders, but prospective studies are needed for causal conclusion.

The impact of nutrient-based dietary patterns on cognitive decline in older adults

BACKGROUND & AIMS

The impact of nutrient patterns on cognitive decline is complex and findings are still inconclusive. We aimed to identify major nutrient patterns and to explore their association with cognitive decline over time among older adults.

METHODS

In a population-based cohort, 2250 cognitively healthy people aged ≥60 years were identified at baseline (2001-2004), and followed-up to 9 years. Global cognitive function was tested with the Mini-Mental State Examination (MMSE) at baseline and follow-ups. Nutrients intake was assessed on the basis of food intake using a 98-semi-quantitative food frequency questionnaire at baseline, and nutrient-based patterns were identified by principal components analysis based on 30 nutrients. Mixed-effects linear regression models were used to determine their association with change in cognitive function taking into account potential confounders.

RESULTS

Four major patterns (the plant-, animal-, dairy-derived nutrients and animal/plants-derived fats) were identified. Over the follow-up time, each one unit increment in plant- (β = 0.081, P = 0.002) and animal-derived nutrients pattern scores (β = 0.098, P < 0.001) was associated with slower decline in MMSE score. On the other hand, one-unit higher in dairy-derived nutrients pattern was related to a faster decline in global cognitive function (β = -0.064, P = 0.014). No significant association between animal/plants fats pattern and cognitive decline was observed. In stratified analyses, the association of high scores of plants- and animal-derived nutrient pattern with slower cognitive decline was stronger in APOE ε4 carriers than in ε4 non-carriers.

CONCLUSIONS

Plant- and animal -derived nutrients are associated with preserved cognitive function, especially among the APOE ε4 carriers, whereas nutrients derived from dairy products may accelerate cognitive decline in older adults.

The Role of Physical Exercise and Omega-3 Fatty Acids in Depressive Illness in the Elderly

Background:

In adulthood, depression is the most common type of mental illness and will be the second leading cause of disease by 2020. Major depression dramatically affects the function of the central nervous system and degrades the quality of life, especially in old age.

Several mechanisms underlie the pathophysiology of depressive illness, since it has a multifactorial etiology. Human and an-imal studies have demonstrated that depression is mainly associated with imbalances in neurotransmitters and neurotrophins, hypothalamic-pituitary-adrenal axis alterations, brain volume changes, neurogenesis dysfunction, and dysregulation of in-flammatory pathways. Also the gut microbiota may influence mental health outcomes.

Although depression is not a consequence of normal aging, depressive disorders are common in later life, even if often undi-agnosed or mis-diagnosed in old age. When untreated, depression reduces life expectancy, worsens medical illnesses, en-hances health care costs and is the primary cause of suicide among older people. To date, the underpinnings of depression in the elderly are still to be understood, and the pharmacological treatment is the most commonly used therapy.

Objective:

Since a sedentary lifestyle and poor eating habits have recently emerged as crucial contributors to the genesis and course of depression, in the present review, we have focused on the effects of physical activity and omega-3 fatty acids on depressive illness in the elderly.

Results:

A growing literature indicates that both exercise and dietary interventions can promote mental health throughout one’s lifespan.

Conclusion:

There thus emerges the awareness that an active lifestyle and a balanced diet may constitute valid low-cost pre-vention strategies to counteract depressive illness in the elderly.

Mediterranean Diet and Incidence of Advanced Age-Related Macular Degeneration: The EYE-RISK Consortium

PURPOSE

To investigate associations of adherence to the Mediterranean diet (MeDi) with incidence of advanced age-related macular degeneration (AMD; the symptomatic form of AMD) in 2 European population-based prospective cohorts.

DESIGN

Prospective cohort study of the Rotterdam Study I (RS-I) and the Antioxydants, Lipides Essentiels, Nutrition et Maladies Oculaires (Alienor) Study populations.

PARTICIPANTS

Four thousand four hundred forty-six participants 55 years of age or older from the RS-I (The Netherlands) and 550 French adults 73 years of age or older from the Alienor Study with complete ophthalmologic and dietary data were included in the present study.

METHODS

Examinations were performed approximately every 5 years over a 21-year period (1990-2011) in RS-I and every 2 years over a 4-year period (2006-2012) in the Alienor Study. Adherence to the MeDi was evaluated using a 9-component score based on intake of vegetables, fruits, legumes, cereals, fish, meat, dairy products, alcohol, and the monounsaturated-to-saturated fatty acids ratio. Associations of incidence of AMD with MeDi were estimated using multivariate Cox proportional hazard models.

MAIN OUTCOMES MEASURES

Incidence of advanced AMD based on retinal fundus photographs.

RESULTS

Among the 4996 included participants, 155 demonstrated advanced incident AMD (117 from the RS-I and 38 from the Alienor Study). The mean follow-up time was 9.9 years (range, 0.6-21.7 years) in the RS-I and 4.1 years (range, 2.5-5.0 years) in the Alienor Study. Pooling data for both the RS-I and Alienor Study, participants with a high (range, 6-9) MeDi score showed a significantly reduced risk for incident advanced AMD compared with participants with a low (range, 0-3) MeDi score in the fully adjusted Cox model (hazard ratio, 0.59; 95% confidence interval, 0.37-0.95; P = 0.04 for trend).

CONCLUSIONS

Pooling data from the RS-I and Alienor Study, higher adherence to the MeDi was associated with a 41% reduced risk of incident advanced AMD. These findings support the role of a diet rich in healthful nutrient-rich foods such as fruits, vegetables, legumes, and fish in the prevention of AMD.

Dietary Patterns and Quality of Life in Older Adults: A Systematic Review

Dietary patterns may be related to quality of life (QoL) of older adults, although evidence from literature is conflicting. The demographic shifts toward ageing populations in many countries increases the importance of understanding the relationship between diet and QoL in older adults. This review was designed to investigate associations between dietary patterns and QoL in older adults. The systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Eight electronic databases were searched to identify articles published in English from January 1975 to March 2018 that investigated associations between dietary patterns and QoL in older adults. Relevant studies were identified based on set inclusion and exclusion criteria, data were extracted and analysed to examine the relationships and possible implications for public health recommendations. The systematic review included 15 articles (One randomized control trial, six prospective cohorts and eight cross sectional). The studies looked at correlations between different dietary patterns and/or adherence to particular dietary patterns and self-reported QoL or self-rated health status. Excluding two studies which showed no significant association, healthy dietary patterns were associated with better self-rated health and QoL in one or more domains, and adherence to healthy dietary patterns like the Mediterranean diet were significantly associated with improvement in at least one of the QoL domains.

Dietary patterns and risk of self-reported activity limitation in older adults from the Three-City Bordeaux Study

Few studies have been interested in the relationship between dietary patterns and activity limitation in older adults yet. We analysed the association between dietary patterns and the risk of self-reported activity limitation - that is mobility restriction, limitation in instrumental activities in daily living (IADL) and in activities in daily living (ADL) - in community-dwellers aged 67+ years initially free of activity limitation in 2001-2002 and re-examined at least once over 10 years - that is 583 participants for mobility restriction, 1114 for IADL limitation and 1267 for ADL limitation. At baseline, five sex-specific dietary clusters were derived by hybrid clustering method from weekly frequency of intake of twenty food and beverage items. Self-reported mobility restriction, limitations in IADL and in ADL were assessed using the Rosow-Breslau, the Lawton-Brody and the Katz scales, respectively. Associations between dietary clusters and the risk of each activity limitation were assessed using Cox proportional hazard models. In models adjusted for socio-demographic and health-related covariates, compared with the 'Healthy' cluster the 'Biscuits and snacking' cluster was associated with a higher risk of mobility restriction (hazard ratio (HR)=3·0; 95 % CI 1·6, 5·8) and limitation in IADL (HR=2·1; 95 % CI 1·1, 4·2) in men and limitation in ADL in women (HR=2·3; 95 % CI 1·3, 4·0). In this French cohort of community-dwellers aged 67+ years, some unhealthy dietary patterns may increase the risk of activity limitation all along the disablement process in older adults.

Association between cognitive function and supplementation with omega-3 PUFAs and other nutrients in ≥ 75 years old patients: A randomized multicenter study

A few studies have assessed the association between omega-3 polyunsaturated fatty acids (n-3 PUFA) and cognitive impairment (CI) in very old adults. The aim of this study was to evaluate the effect of a multinutrient supplementation rich in n-3 PUFA on the cognitive function in an institutionalized ≥75-year-old population without CI or with mild cognitive impairment (MCI). A multicenter placebo-controlled double-blind randomized trial was conducted between 2012 and 2013. Cognitive function was assessed at baseline and after one year using 4 neuropsychological tests. Nutritional status was assessed using Mini Nutritional Assessment (MNA). Interaction between Mini-Mental State Examination (MMSE) score and nutritional status were analyzed using linear regression models. A total of 99 participants were randomized to receive placebo or pills rich in n-3 PUFA. After 1-year follow-up, both groups decreased their MMSE score (-1.18, SD:0. 53 and -0.82, SD:0. 63, p = 0.67 for the control and the intervention group respectively). The memory subscale of the MMSE showed an improvement (+0.26, SD:0.18) in the intervention group against a worsening in the control group (-0.11, SD: 0.14; p = 0.09 for differences between groups). Patients at intervention group with normal nutritional status (MNA ≥24) showed an improvement in the MMSE (+1.03, p = 0.025 for differences between 1-y and baseline measurements) against a worsening in the group with malnutrition (MNA<24) (-0.4, p = 0.886 for differences between 1-y and baseline; p of interaction p = 0.05). Supplementation with n-3 PUFA did not show an improvement in the global cognitive function in institutionalized elderly people without CI or with MCI. They only suggest an apparent improvement in memory loss if previously they were well nourished.

Dietary Intake is Positively Associated with Cognitive Function of a Chinese Older Adults Sample

OBJECTIVE

The relationship between cognitive function and dietary intake in older adults was under-studied in China. This study examined this relationship in a Chinese sample while controlling for the effects of sleep quality and socio demographic confounders.

METHODS

The sample consisted of 340 Chinese older adults (age > 60) who were randomly selected from Wuhan city in central China. Cognitive function was assessed by the Mini-mental State Examination [MMSE], sleep quality by the Pittsburgh Sleep Quality Index [PSQI], and dietary intake by frequencies of intake of meat products, fruits, fish/seafood/aquatic products, nuts and mushroom/algae over the past year. First, confirmatory factor analysis (CFA) was conducted to evaluate the measurement properties of cognitive function, dietary intake, and sleep quality. Second, structural equation modeling (SEM) was conducted to examine the relations of cognitive function, dietary intake, and sleep quality.

RESULTS

Dietary intake was found to be positively related to cognitive function. Older age, lower education status, monthly income, and living alone or without a spouse were significantly associated with poorer cognitive function. SES status had an indirect effect on cognitive function via dietary intake.

CONCLUSION

Dietary intake may be critical to maintain normal cognitive function of older adults in China.

Dietary patterns in french home-living older adults: Results from the PRAUSE study

The aim of the present study was to provide descriptive dietary patterns of home-living older adults, and to examine their association with sociodemographic and 'diet-related' variables, and health and psychological factors. Dietary patterns were analyzed using separately cluster analysis for men (N=151,M_age=72.72, SD=8.80, range=56-97) and women (N=251, M_age=76.74, SD=9.95, range=55-97) in 402 older adults aged 55 years and over. Cluster analyses showed four distinct dietary profiles for each gender. In older men, the four distinct dietary clusters were associated with any differences in sociodemographic and 'diet-related' variables, cognitive function, and health and psychological factors. Likewise, in older women, the four distinct dietary clusters were associated with any differences in sociodemographic and 'diet-related' variables'. However in older women, results showed that the cluster 1 "high fish-fruit-vegetable" was associated with a better cognitive function, a better self-rated health and no depressive symptoms, whereas cluster 3 "moderate ready meals" was associated with cognitive decline, slight depression, and poor perceived health. Results emphasize the interest to take into consideration health and psychological factors associated with dietary patterns to better target the vulnerability of individuals and enable an effective prevention.