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Mameno T, Tsujioka Y, Fukutake M, Murotani Y, Takahashi T, Hatta K, Gondo Y, Kamide K, Ishizaki T, Masui Y, Mihara Y, Nishimura Y, Hagino H, Higashi K, Akema S, Maeda Y, Kabayama M, Akasaka H, Rakugi H, Sugimoto K, Okubo H, Sasaki S, Ikebe K. Relationship between the number of teeth, occlusal force, occlusal contact area, and dietary hardness in older Japanese adults: The SONIC study. J Prosthodont Res 2024; 68:400-406. [PMID: 37648481 DOI: 10.2186/jpr.jpr_d_23_00050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
Abstract
PURPOSE Individuals with impaired masticatory function tend to prefer soft foods, which results in decreased masticatory muscle activity. This study examined the association between the oral condition (number of teeth, occlusal force, and occlusal contact area) and dietary hardness using a daily dietary questionnaire. METHODS This cross-sectional study evaluated 1841 participants aged 69-71 and 79-81 years. Registered dentists examined the number of teeth, occlusal force, and occlusal contact area. Dietary hardness was defined as the estimated masticatory muscle activity required for a habitual diet. Habitual diet during the preceding month was assessed using a brief self-administered diet history questionnaire. Confounding factors, such as age, sex, socioeconomic status, smoking habits, history of chronic diseases (hypertension, hyperlipidemia, and diabetes), and cognitive function were also evaluated. Multivariate linear regression analyses were performed to assess the association between dietary hardness and each oral condition. RESULTS Occlusal force (standardized regression coefficients [β]=0.08, P < 0.01) and occlusal contact area (β=0.06, P < 0.01) were significantly associated with dietary hardness after adjusting for the confounding factors. Number of teeth was not significantly associated with dietary hardness. In addition, the associations between dietary hardness, sex, and a history of diabetes were stronger than those between dietary hardness and oral factors. CONCLUSIONS Occlusal force and contact area were significantly associated with dietary hardness as estimated from the masticatory muscle activity using a daily diet questionnaire.
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Affiliation(s)
- Tomoaki Mameno
- Department of Removable Prosthodontics and Gerodontology, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Yoshitaka Tsujioka
- Department of Removable Prosthodontics and Gerodontology, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Motoyoshi Fukutake
- Department of Removable Prosthodontics and Gerodontology, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Yuki Murotani
- Department of Removable Prosthodontics and Gerodontology, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Toshihito Takahashi
- Department of Removable Prosthodontics and Gerodontology, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Kodai Hatta
- Department of Removable Prosthodontics and Gerodontology, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Yasuyuki Gondo
- Department of Clinical Thanatology and Geriatric Behavioral Science, Osaka University Graduate School of Human Sciences, Osaka, Japan
| | - Kei Kamide
- Department of Health Science, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Tatsuro Ishizaki
- Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology, Tokyo, Japan
| | - Yukie Masui
- Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology, Tokyo, Japan
| | - Yusuke Mihara
- Department of Removable Prosthodontics and Gerodontology, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Yuichi Nishimura
- Department of Removable Prosthodontics and Gerodontology, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Hiromasa Hagino
- Department of Removable Prosthodontics and Gerodontology, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Kotaro Higashi
- Department of Removable Prosthodontics and Gerodontology, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Suzuna Akema
- Department of Removable Prosthodontics and Gerodontology, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Yoshinobu Maeda
- Department of Removable Prosthodontics and Gerodontology, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Mai Kabayama
- Department of Health Science, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Hiroshi Akasaka
- Department of Geriatric and General Medicine, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Hiromi Rakugi
- Department of Geriatric and General Medicine, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Ken Sugimoto
- Department of General Geriatric Medicine, Kawasaki Medical School, Okayama, Japan
| | - Hitomi Okubo
- Japan Environment and Children's Study Programme Office, National Institute for Environmental Studies, Tsukuba, Japan
- Research Fellow of the Japan Society for the Promotion of Science, Tokyo, Japan
| | - Satoshi Sasaki
- Department of Social and Preventive Epidemiology, School of Public Health, University of Tokyo, Tokyo, Japan
| | - Kazunori Ikebe
- Department of Removable Prosthodontics and Gerodontology, Osaka University Graduate School of Dentistry, Osaka, Japan
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Fujiwara A, Fukunaga A, Murakami K, Inoue Y, Nakagawa T, Yamamoto S, Konishi M, Mizoue T. Cross-Sectional Association between Estimated Hardness of the Habitual Diet and Depressive Symptoms in Older Japanese Men. Nutrients 2023; 15:3034. [PMID: 37447360 DOI: 10.3390/nu15133034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 06/18/2023] [Accepted: 07/03/2023] [Indexed: 07/15/2023] Open
Abstract
This cross-sectional study aimed to investigate the association between dietary hardness and depressive symptoms in older Japanese men. Participants were 1487 men aged 60-69 years enrolled in the baseline survey of the Hitachi Health Study II (2017-2020). Habitual dietary intake was estimated by a brief-type, self-administered diet history questionnaire. Dietary hardness was defined as the magnitude of masticatory muscle activity necessary to consume solid foods. The participants who scored ≥ 9 points on a short version of the Center for Epidemiologic Studies Depression Scale were considered to have depressive symptoms. The prevalence of depressive symptoms was 12.7%. The ORs (95% CIs) for depressive symptoms in the third tertile of dietary hardness were significantly lower after adjustment for sociodemographic and lifestyle-related variables and mood-modulating nutrients (ORs [95% CIs]: 0.93 [0.63, 1.36] and 0.58 [0.35, 0.97] for the second and third tertile, respectively [p-value for trend = 0.04]). Dietary hardness was inversely associated with the prevalence of depressive symptoms in older Japanese men. Future studies should confirm these findings and clarify the role of consuming a hard diet in preventing depressive disorders.
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Affiliation(s)
- Aya Fujiwara
- Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo 162-8655, Japan
- Department of Nutritional Epidemiology and Shokuiku, National Institutes of Biomedical Innovation, Health and Nutrition, 3-17 Senriokashinmachi, Settsu-shi 566-0002, Osaka, Japan
| | - Ami Fukunaga
- Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo 162-8655, Japan
- Department of Public Health and Health Policy, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8553, Japan
| | - Kentaro Murakami
- Department of Nutritional Epidemiology and Behavioural Nutrition, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan
| | - Yosuke Inoue
- Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo 162-8655, Japan
| | - Tohru Nakagawa
- Hitachi Health Care Center, Hitachi, Ltd., 4-3-16 Osecho, Hitachi-shi 317-0076, Ibaraki, Japan
| | - Shuichiro Yamamoto
- Department of Nutritional Epidemiology and Behavioural Nutrition, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan
| | - Maki Konishi
- Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo 162-8655, Japan
| | - Tetsuya Mizoue
- Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo 162-8655, Japan
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Fujiwara A, Fukunaga A, Murakami K, Inoue Y, Nakagawa T, Yamamoto S, Konishi M, Mizoue T. Association between Dietary Hardness and Cognitive Dysfunction among Japanese Men in Their 60s: A Cross-Sectional Study. Nutrients 2023; 15:nu15112485. [PMID: 37299449 DOI: 10.3390/nu15112485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 05/06/2023] [Accepted: 05/23/2023] [Indexed: 06/12/2023] Open
Abstract
We aimed to examine the cross-sectional association between dietary hardness and cognitive dysfunction among Japanese men in their 60s. Participants were 1494 men aged 60-69 years from the baseline survey of Hitachi Health Study II (2017-2020). Dietary hardness was defined as an estimate of masticatory muscle activity involved in consuming solid foods. Habitual intake of these foods was assessed using a brief-type, self-administered diet history questionnaire. Cognitive dysfunction was defined as a score ≤ 13 points on the test battery for screening for Alzheimer's disease (MSP-1100). The mean (SD) age of participants was 63.5 (3.5) years. The prevalence of cognitive dysfunction was 7.5%. The ORs (95% CIs) for cognitive dysfunction in the second and third tertiles were: 0.77 (0.47, 1.26) and 0.87 (0.54, 1.41), respectively, after adjustment for socio-demographic factors (p for trend = 0.73). After further adjustment for protective nutrient intake against cognitive dysfunction, the corresponding figures were 0.72 (0.43, 1.21) and 0.79 (0.43, 1.46), respectively (p for trend = 0.57). Dietary hardness was not associated with the prevalence of cognitive dysfunction among Japanese men in their 60s. Future prospective studies are necessary to investigate the association between dietary hardness estimated by a validated questionnaire and cognitive dysfunctions.
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Affiliation(s)
- Aya Fujiwara
- Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo 162-8655, Japan
- Department of Social and Preventive Epidemiology, School of Public Health, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan
- Department of Nutritional Epidemiology and Shokuiku, National Institutes of Biomedical Innovation, Health and Nutrition, 1-23-1 Toyama, Shinjuku-ku, Tokyo 162-8636, Japan
| | - Ami Fukunaga
- Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo 162-8655, Japan
| | - Kentaro Murakami
- Department of Social and Preventive Epidemiology, School of Public Health, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan
| | - Yosuke Inoue
- Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo 162-8655, Japan
| | - Tohru Nakagawa
- Hitachi Health Care Center, Hitachi, Ltd., 4-3-16 Osecho, Hitachi-shi 317-0076, Ibaraki, Japan
| | - Shuichiro Yamamoto
- Hitachi Health Care Center, Hitachi, Ltd., 4-3-16 Osecho, Hitachi-shi 317-0076, Ibaraki, Japan
| | - Maki Konishi
- Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo 162-8655, Japan
| | - Tetsuya Mizoue
- Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo 162-8655, Japan
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Al-Manei K, Jia L, Al-Manei KK, Ndanshau EL, Grigoriadis A, Kumar A. Food Hardness Modulates Behavior, Cognition, and Brain Activation: A Systematic Review of Animal and Human Studies. Nutrients 2023; 15:nu15051168. [PMID: 36904167 PMCID: PMC10005610 DOI: 10.3390/nu15051168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 02/22/2023] [Accepted: 02/23/2023] [Indexed: 03/02/2023] Open
Abstract
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.
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Affiliation(s)
- Khaled Al-Manei
- Division of Oral Diagnostics and Rehabilitation, Department of Dental Medicine, Karolinska Institutet, 141 04 Huddinge, Sweden
- Division of Endodontics, Department of Restorative Dental Science, College of Dentistry, King Saud University, Riyadh 11545, Saudi Arabia
| | - Leming Jia
- Division of Oral Diagnostics and Rehabilitation, Department of Dental Medicine, Karolinska Institutet, 141 04 Huddinge, Sweden
| | - Kholod Khalil Al-Manei
- Division of Endodontics, Department of Restorative Dental Science, College of Dentistry, King Saud University, Riyadh 11545, Saudi Arabia
| | | | - Anastasios Grigoriadis
- Division of Oral Diagnostics and Rehabilitation, Department of Dental Medicine, Karolinska Institutet, 141 04 Huddinge, Sweden
| | - Abhishek Kumar
- Division of Oral Diagnostics and Rehabilitation, Department of Dental Medicine, Karolinska Institutet, 141 04 Huddinge, Sweden
- Academic Center for Geriatric Dentistry, 112 19 Stockholm, Sweden
- Correspondence:
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Sheng Z, Xia B, Wu J, Zhao X, He X, Wen X, Yuan C, Pang T, Xu X. Associations Between Abdominal Obesity, Chewing Difficulty and Cognitive Impairment in Dementia-Free Chinese Elderly. Am J Alzheimers Dis Other Demen 2023; 38:15333175231167118. [PMID: 37186941 PMCID: PMC10578445 DOI: 10.1177/15333175231167118] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
OBJECTIVE To investigate the independent and synergistic associations between abdominal obesity, chewing difficulty and cognitive impairment in a community-dwelling older adults sample in China. METHODS Cognitive function was measured by the 5 min- Montreal Cognitive Assessment (5 min-MoCA) and abdominal obesity was measured by A Body Shape Index (ABSI) in 572 participants recruited from local communities. Chewing difficulty was assessed via a self-report questionnaire. Linear regression and general logistic regression were performed to investigate the association of chewing difficulty and abdominal obesity with cognition. RESULTS Chewing difficulty score [β (95% CI) = -.30 (-.49, -.11)] and ABSI [β (95%CI) = -.30 (-.55, -.05)] were independently associated with worse performance on the 5 min-MoCA. Whilst ABSI was not associated with cognitive impairment, the co-existence of chewing difficulty and abdominal obesity [OR (95% CI) = 2.22 (1.18, 4.17)] was found associated with the presence of cognitive impairment. CONCLUSION Chewing difficulty and abdominal obesity were independently associated with cognition. Abdominal obesity and chewing may have an additive effect on cognitive function.
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Affiliation(s)
| | - Binte Xia
- Zhejiang University, Hangzhou, China
| | - Jing Wu
- Zhejiang University, Hangzhou, China
| | - Xuhao Zhao
- Zhejiang University School of Public Health, Hangzhou, China
- Zhejiang University School of Medicine Second Affiliated Hospital, Hangzhou, China
| | - Xindi He
- Zhejiang University School of Public Health, Hangzhou, China
- Zhejiang University School of Medicine Second Affiliated Hospital, Hangzhou, China
| | - Xu Wen
- Department of Sport Science, College of Education, Zhejiang University, Hangzhou, China
| | - Changzheng Yuan
- Zhejiang University School of Public Health, Hangzhou, China
- Zhejiang University School of Medicine Second Affiliated Hospital, Hangzhou, China
- The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Hangzhou, China
| | - Ting Pang
- Zhejiang University School of Public Health, Hangzhou, China
- Zhejiang University School of Medicine Second Affiliated Hospital, Hangzhou, China
| | - Xin Xu
- Zhejiang University School of Public Health, Hangzhou, China
- Zhejiang University School of Medicine Second Affiliated Hospital, Hangzhou, China
- The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Hangzhou, China
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Iribarren C, Chandra M, Molloi S, Sanchez G, Azamian-Bidgoli F, Cho HM, Ding H, Yaffe K. Breast Arterial Calcification Is Not Associated with Mild Cognitive Impairment or Incident All-Cause Dementia Among Postmenopausal Women: The MINERVA Study. J Womens Health (Larchmt) 2020; 30:848-856. [PMID: 33290145 DOI: 10.1089/jwh.2020.8372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background: Since vascular risk factors are implicated in cognitive decline, and breast arterial calcification (BAC) is related to vascular risk, we postulated that BAC may be associated with cognitive impairment and dementia. Methods: We used a multiethnic cohort of 3,913 asymptomatic women 60-79 years of age recruited after mammography screening at a large health plan in 2012-2015. A BAC mass score (mg) was derived from digital mammograms. Cognitive function was measured at baseline using the Montreal Cognitive Assessment (MoCA) and incident all-cause dementia (n = 49 events; median follow-up = 5.6 years) were ascertained with validated ICD-9 and ICD-10 codes. We used cross-sectional linear regression of MoCA scores on BAC, then multinomial logistic regression predicting mild cognitive impairment not progressing to dementia and incident all-cause dementia and, finally, Cox regression of incident all-cause dementia. Results: No association by linear regression was found between MoCA scores and BAC presence in unadjusted or adjusted analysis. Women with severe (upper tertile) BAC had a MoCA score lower by 0.58 points (standard error [SE] = 0.18) relative to women with no BAC. However, this difference disappeared after multivariate adjustment. No significant associations were found in multinomial logistic regression for either BAC presence or gradation in unadjusted or adjusted analysis. No significant associations were found between BAC presence with incident all-cause dementia (fully adjusted hazard ratio = 0.74; 95% confidence interval: 0.39-1.39). Likewise, no significant association with incident all-cause dementia was noted for BAC gradation. Conclusions: Our results do not support the hypothesis that BAC presence or gradation may contribute to cognitive impairment or development of all-cause dementia.
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Affiliation(s)
- Carlos Iribarren
- Kaiser Permanente Division of Research, Oakland, California, USA
| | - Malini Chandra
- Kaiser Permanente Division of Research, Oakland, California, USA
| | - Sabee Molloi
- Department of Radiological Sciences, University of California Irvine School of Medicine, Irvine, California, USA
| | - Gabriela Sanchez
- Kaiser Permanente Division of Research, Oakland, California, USA
| | - Fatemeh Azamian-Bidgoli
- Department of Radiological Sciences, University of California Irvine School of Medicine, Irvine, California, USA
| | - Hyo-Min Cho
- Safety Measurement Institute, Korea Research Institute of Standards and Science (KRISS), Daejeon, Republic of Korea
| | - Huanjun Ding
- Department of Radiological Sciences, University of California Irvine School of Medicine, Irvine, California, USA
| | - Kristine Yaffe
- Departments of Psychiatry and Neurology and Epidemiology and Biostatistics, University of California San Francisco, San Francisco, California, USA
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Impact of Beef and Beef Product Intake on Cognition in Children and Young Adults: A Systematic Review. Nutrients 2019; 11:nu11081797. [PMID: 31382632 PMCID: PMC6722791 DOI: 10.3390/nu11081797] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2019] [Revised: 07/30/2019] [Accepted: 08/01/2019] [Indexed: 12/31/2022] Open
Abstract
(1) Background: Undernutrition and micronutrient deficiency have been consistently linked to cognitive impairment among children and young adults. As a primary source of dietary animal protein, beef consumption holds the potential to improve diet quality and positively influence cognitive function. This study systematically reviewed evidence linking beef intake to cognition among children and young adults. (2) Methods: A literature search was conducted in seven electronic bibliographic databases for studies assessing the impact of beef consumption on cognition. (3) Results: We identified eight studies reporting results from five unique interventions. Two interventions were conducted in Kenya, two in the U.S. and one in four countries including Guatemala, Pakistan, Democratic Republic of the Congo and Zambia. Only one intervention employed a non-feeding control arm and found beef consumption to improve cognitive abilities compared to the control. However, the other interventions comparing beef consumption to other food types found no consistent result. (4) Conclusions: Evidence pertaining to the impact of beef consumption on cognition remains limited due to the small and heterogeneous set of studies. Future research should adopt a population representative sample and longer follow-up period, employ a non-feeding control arm and comprehensively measure nutrient intakes among study participants.
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Aging, Mastication, and Malnutrition and Their Associations with Cognitive Disorder: Evidence from Epidemiological Data. ACTA ACUST UNITED AC 2019. [DOI: 10.1007/s40496-019-0220-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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