Serum Magnesium and Cognitive Function Among Qatari Adults

Mitigating Traumatic Brain Injury: A Narrative Review of Supplementation and Dietary Protocols

Traumatic brain injuries (TBIs) constitute a significant public health issue and a major source of disability and death in the United States and worldwide. TBIs are strongly associated with high morbidity and mortality rates, resulting in a host of negative health outcomes and long-term complications and placing a heavy financial burden on healthcare systems. One promising avenue for the prevention and treatment of brain injuries is the design of TBI-specific supplementation and dietary protocols centred around nutraceuticals and biochemical compounds whose mechanisms of action have been shown to interfere with, and potentially alleviate, some of the neurophysiological processes triggered by TBI. For example, evidence suggests that creatine monohydrate and omega-3 fatty acids (DHA and EPA) help decrease inflammation, reduce neural damage and maintain adequate energy supply to the brain following injury. Similarly, melatonin supplementation may improve some of the sleep disturbances often experienced post-TBI. The scope of this narrative review is to summarise the available literature on the neuroprotective effects of selected nutrients in the context of TBI-related outcomes and provide an evidence-based overview of supplementation and dietary protocols that may be considered in individuals affected by-or at high risk for-concussion and more severe head traumas. Prophylactic and/or therapeutic compounds under investigation include creatine monohydrate, omega-3 fatty acids, BCAAs, riboflavin, choline, magnesium, berry anthocyanins, Boswellia serrata, enzogenol, N-Acetylcysteine and melatonin. Results from this analysis are also placed in the context of assessing and addressing important health-related and physiological parameters in the peri-impact period such as premorbid nutrient and metabolic health status, blood glucose regulation and thermoregulation following injury, caffeine consumption and sleep behaviours. As clinical evidence in this research field is rapidly emerging, a comprehensive approach including appropriate nutritional interventions has the potential to mitigate some of the physical, neurological, and emotional damage inflicted by TBIs, promote timely and effective recovery, and inform policymakers in the development of prevention strategies.

Association between Dietary Patterns and Cognitive Function among Qatari Adults: A Cross-Sectional Analysis of the Qatar Biobank Study

This study aimed to assess the association between dietary patterns and cognitive function among Qatari adults. In a cross-sectional analysis, data on 1000 Qatari adults attending the Qatar Biobank Study (QBB) aged ≥18 years were obtained. Using factor analysis, dietary patterns were constructed based on habitual dietary intake assessed by food frequency questionnaires (FFQs). The mean reaction time (MRT) derived from self-administered touch screen tests was used as an indicator of cognitive function. The association between dietary patterns and MRT was investigated using linear regression. The mean age of the participants was 35.8 (SD 10.3) years, and the mean MRT was 715.3 (SD 204.1) milliseconds. Three dietary patterns were identified. The "traditional" dietary pattern, characterized by high intakes of white rice, mixed dishes and soups/starters possibly high in saturated fat and sodium, was positively associated with MRT. In the multivariable model, comparing the highest to lowest quartiles of the traditional pattern, the regression coefficient for MRT was 50.0 (95% CI 16.9, 83.1; p for trend 0.001). There was an effect modification of diabetes and age on the association between the "modern" dietary pattern and MRT. The "convenient" dietary pattern was not associated with cognition. In conclusion, the traditional rice-based dietary pattern may be associated with poor cognitive function.

Relationship between Whole-Blood Magnesium and Cognitive Performance among Chinese Adults

OBJECTIVE

To explore the association between magnesium levels and the odds of mild cognitive impairment (MCI).

METHOD

In this cross-sectional study of 1006 participants (≥55 years) from China, whole-blood magnesium concentration was measured using inductively coupled plasma mass spectrometry. MCI was diagnosed according to Petersen criteria using self-reported cognitive decline and a neuropsychological test battery, including the trail-making test-part B (TMT-B), auditory verbal learning test (AVLT), digit symbol substitution test (DSST), and verbal fluency test (VFT), which measured the assessment of executive, memory, attention, and language functioning, respectively. A logistic regression was used to assess the relationship between magnesium levels and MCI, and linear regression analyses were performed for the association between magnesium and cognitive function score.

RESULTS

The MCI group had a significantly lower concentration of magnesium compared to the Non-MCI group (34.7 ± 9.8 vs. 36.7 ± 9.7, p = 0.017). After adjusting for covariates, a negative association was observed between magnesium levels and MCI. Compared with the lowest quartile (median: 25.4 mg/L), the odds ratio for MCI was 0.53 (95%CI 0.32-0.90) for the highest quartile (median: 48.4 mg/L), and there was an inverse dose-response relationship (p for trend = 0.009). In addition, higher levels of magnesium were positively correlated with VFT scores (β = 0.37, 95%CI = 0.11-0.62) and DSST scores (β = 0.50, 95%CI = 0.01~0.98) and negatively correlated with TMT scores (β = -1.73, 95%CI = -3.40--0.07) in the middle-aged and older adults.

CONCLUSIONS

Whole-blood magnesium was inversely associated with the occurrence of MCI and positively associated with performance in neuropsychological tests assessing attention, executive, and language ability in middle-aged and older adults.

Dietary magnesium intake is related to larger brain volumes and lower white matter lesions with notable sex differences

PURPOSE

To examine the association between dietary magnesium (Mg) intake and brain volumes and white matter lesions (WMLs) in middle to early old age.

METHODS

Participants (aged 40-73 years) from UK Biobank (n = 6001) were included and stratified by sex. Dietary Mg was measured using an online computerised 24 h recall questionnaire to estimate daily Mg intake. Latent class analysis and hierarchical linear regression models were performed to investigate the association between baseline dietary Mg, Mg trajectories, and brain volumes and WMLs. Associations between baseline Mg, and baseline blood pressure (BP) measures, and baseline Mg, Mg trajectories and BP changes (between baseline and wave 2) were also investigated to assess whether BP mediates the link between Mg intake and brain health. All analyses controlled for health and socio-demographic covariates. Possible interactions between menopausal status and Mg trajectories in predicting brain volumes and WMLs were also investigated.

RESULTS

On average, higher baseline dietary Mg intake was associated with larger brain volumes (gray matter [GM]: 0.001% [SE = 0.0003]; left hippocampus [LHC]: 0.0013% [SE = 0.0006]; and right hippocampus [RHC]: 0.0023% [SE = 0.0006]) in both men and women. Latent class analysis of Mg intake revealed three classes: "high-decreasing" (men = 3.2%, women = 1.9%), "low-increasing" (men = 1.09%, women = 1.62%), and "stable normal" (men = 95.71%, women = 96.51%). In women, only the "high-decreasing" trajectory was significantly associated with larger brain volumes (GM: 1.17%, [SE = 0.58]; and RHC: 2.79% [SE = 1.11]) compared to the "normal-stable", the "low-increasing" trajectory was associated with smaller brain volumes (GM: - 1.67%, [SE = 0.30]; white matter [WM]: - 0.85% [SE = 0.42]; LHC: - 2.43% [SE = 0.59]; and RHC: - 1.50% [SE = 0.57]) and larger WMLs (1.6% [SE = 0.53]). Associations between Mg and BP measures were mostly non-significant. Furthermore, the observed neuroprotective effect of higher dietary Mg intake in the "high-decreasing" trajectory appears to be greater in post-menopausal than pre-menopausal women.

CONCLUSIONS

Higher dietary Mg intake is related to better brain health in the general population, and particularly in women.

Rice Intake Is Associated with Longer Reaction Time and Interacts with Blood Lipids and Hypertension among Qatari Adults

We aimed to assess the association between rice intake and cognitive function among Qatari adults and test the interactions with health conditions. Data from 1000 adults aged ≥18 years old who attended the Qatar Biobank (QBB) study were used. Rice dietary intake was measured by a food frequency questionnaire (FFQ), and mean reaction time (MRT) was used as an indicator of cognitive function. Linear regression and structure equation models were used. The mean rice consumption was 7.6 times/week (SD 2.0). The sample had a mean MRT of 717 milliseconds (SD 205). Rice consumption was positively associated with MRT. Across the quartiles of rice intake, the regression coefficients (95% CI) for MRT were 0.0 (reference), 22.4 (-7.8, 52.6), 36.3 (5.1, 67.5), and 34.5 (2.6, 66.4). There was a significant interaction between rice intake and hypertension, BMI, and blood lipids in relation to MRT. The association between rice intake and MRT was only observed among those with hypertension, overweight/obesity, low LDL, and low total cholesterol levels. Serum magnesium did not mediate the association. High rice consumption was associated with a higher MRT, especially among those with hypertension, overweight/obesity, low LDL, and or low total cholesterol levels. Further longitudinal studies are needed to confirm the findings.

Low serum magnesium is associated with poor functional outcome in acute ischemic stroke or transient ischemic attack patients

AIM

The association between magnesium and outcomes after stroke is uncertain. We aimed to investigate the association of serum magnesium with all-cause mortality and poor functional outcome.

METHODS

We included patients with acute ischemic stroke (AIS) or transient ischemic attack (TIA) from the China National Stroke Registry III. We used Cox proportional hazards model for all-cause mortality and logistic regression model for poor functional outcome (modified Rankin Scale [mRS] 2-6/3-6) to examine the relationships.

RESULTS

Among the 6483 patients, the median (interquartile range) magnesium was 0.87 (0.80-0.93) mmol/L. Patients in the first quartile had a higher risk of mRS score 3-6/2-6 at 3 months (adjusted odds ratio [OR]: 1.30; 95% confidence interval [CI]: 1.02, 1.64; adjusted OR: 1.29; 95% CI: 1.04-1.59) compared with those in the fourth quartile. Similar results were found for mRS score 26 at 1 year. The age- and sex-adjusted hazard ratio (HR) with 95% CI in first quartile magnesium was 1.40 (1.02-1.93) for all-cause mortality within 1 year, but became insignificant (HR: 1.03; 95% CI: 0.71-1.50) after adjusting for potential variables.

CONCLUSIONS

Low serum magnesium was associated with a high risk of poor functional outcome in patients with AIS or TIA.

Brain dysfunction in tubular and tubulointerstitial kidney diseases

Kidney function has two important elements: glomerular filtration and tubular function (secretion and reabsorption). A persistent decrease in glomerular filtration rate (GFR), with or without proteinuria, is diagnostic of chronic kidney disease (CKD). While glomerular injury or disease is a major cause of CKD and usually associated with proteinuria, predominant tubular injury, with or without tubulointerstitial disease, is typically non-proteinuric. CKD has been linked with cognitive impairment, but it is unclear how much this depends on a reduced GFR, altered tubular function or the presence of proteinuria. Since CKD is often accompanied by tubular and interstitial dysfunction, we explore here for the first time the potential role of the tubular and tubulointerstitial compartments in cognitive dysfunction. To help address this issue, we have selected a group of primary tubular diseases with preserved GFR, in which to review the evidence for any association with brain dysfunction. Cognition, mood, neurosensory, and motor disturbances are not well characterized in tubular diseases, possibly because they are subclinical and less prominent than other clinical manifestations. The available literature suggests that brain dysfunction in tubular and tubulointerstitial diseases is usually mild and is more often seen in disorders of water handling. Brain dysfunction may occur when severe electrolyte and water disorders in young children persist over a long period of time before the diagnosis is made. We have chosen as examples to highlight this topic, Bartter and Gitelman syndromes and nephrogenic diabetes insipidus. We discuss current published findings, some unanswered questions, and propose topics for future research.

Higher Habitual Nuts Consumption Is Associated with Better Cognitive Function among Qatari Adults

The association between nuts intake and cognitive function is inconclusive. We aimed to investigate the association between habitual nuts consumption and cognition among Qatari adults. Data from 1000 participants aged >20 years who attended Qatar Biobank (QBB) were used. Nuts consumption was assessed by a food frequency questionnaire (FFQ). Blood samples were measured for magnesium, lipids and glucose. Mean reaction time (MRT) was used as an indicator of cognitive function. Linear regression was used to assess the association. A total of 21.1% of the participants reported consuming nuts ≥4-6 times/week (high consumption) while 40.2% reported consuming ≤1 time/month (low consumption). The mean MRT was 715.6 milliseconds (SD 204.1). An inverse association was found between nuts consumption and MRT. Compared to those with a low consumption, high consumption of nuts had a regression coefficient of -36.9 (95% CI -68.1 to -5.8) after adjusting for sociodemographic and lifestyle factors. The inverse association between nuts and MRT was mainly seen among those >50 years. There was an interaction between nuts consumption and hypertension. The association between nuts consumption and MRT was not mediated by hypertension, diabetes, or serum magnesium. Habitual higher consumption of nuts is positively associated with cognitive function, especially among old adults.

Habitual Tea and Coffee Consumption and Mean Reaction Time Among Qatari Adults

BACKGROUND

Tea and coffee consumption is associated with cognitive function in some studies.

OBJECTIVE

We aimed to identify tea and coffee drinking patterns and their association with mean reaction time among Qatari adults.

METHOD

The study included 1,000 adults aged 20 years and above attending the Qatar Biobank Study (QBB). Habitual tea and coffee consumption during the previous year was assessed by questionnaire. Tea and coffee drinking patterns were identified using factor analysis. In a computer-based self-administered touch screens test, mean reaction time (MRT) was used as an indicator of cognitive function.

RESULTS

The mean age of the participants was 35.8 (SD 10.3) years. Herbal tea and regular coffee consumption was inversely associated with MRT. In the multivariable model, compared with non-consumers, the regression coefficients for MRT were -34.3 (-65.4, -3.3) and -37.9 (-71.0, -4.7) for daily consumers of herbal tea and regular coffee, respectively. Of the two tea and coffee drinking patterns identified, pattern 1 (high consumption of tea, Arabic coffee, and herbal tea) was not associated with MRT but pattern 2 (high loadings of instant coffee, regular coffee, and Karak) was inversely associated with MRT in the unadjusted model. There was a significant interaction between pattern 2 and low-density lipoprotein (LDL) in relation to MRT. Pattern 2 was inversely associated with MRT among those with a low LDL.

CONCLUSION

There was an inverse association between regular coffee and herbal tea consumption with mean reaction time. There was an interaction between Western coffee pattern and LDL.