Healthy Diet 'Promising Target' to Prevent Cognitive Decline

Megan Brooks

July 23, 2015

WASHINGTON ― A new study provides more evidence that eating right may help keep the brain healthy.

A healthy diet pattern assessed using a brief validated questionnaire was associated with a reduced risk for problems with executive function in the Einstein Aging Study (EAS) cohort. The study was presented here at the Alzheimer's Association International Conference (AAIC) 2015.

Diet is one "promising target" for prevention of cognitive decline, study leader Carol A. Derby, PhD, of the Albert Einstein College of Medicine, New York City, told Medscape Medical News. Assessing diet regularly may help spot older individuals who may benefit from nutritional counseling or other intervention to reduce their risk for executive impairment later in life, she said.

In a cross-sectional study, Dr Derby and colleagues assessed overall diet quality in relation to cognitive function using the Rapid Eating and Activity Assessment for Patients (REAP) questionnaire in 549 nondemented participants in the EAS cohort. The sample was 60% female, 70% white, and 24% black. On average, they were 80 years old and had 14 years of education.

Overall, a healthy diet pattern was associated with lower odds of impairment in executive function after adjusting for age, sex, body mass index, cardiovascular illness, and years of education (odds ratio [OR], 0.65; 95% confidence interval [CI], 0.39 - 1.08; P = .09). Diet was not related to episodic memory or global verbal cognition.

However, race modified the association. "When we looked separately in whites and blacks, the association was seen only in whites," Dr Derby said.

In the race-stratified analyses, among whites, a healthy diet remained associated with reduced odds of impaired executive function (OR, 0.47; 95% CI, 0.22 - 0.98, P = .04), as did more healthy scores on subscales for consumption of total fat (OR = 0.48; 95% CI, 0.24 - 0.99; P = .05) and saturated fat (OR, 0.34; 95% CI, 0.16 - 0.70; P = .003). Among blacks, however, REAP scores were not associated with any cognitive domains.

The observed race differences could be related to increased vascular burden among blacks or to differences in generalizability of the REAP questionnaire, the researchers say. "Also, only about 25% of our population was black, so it could be that we just didn't have enough observation in that subgroup," Dr Derby told Medscape Medical News.

"There is an increasing awareness of the importance of diet, especially diet quality as a whole, for brain health," she noted.

Study coauthor Richard B. Lipton, MD, of the Albert Einstein College of Medicine, told Medscape Medical News that "good diet studies show that following a Mediterranean diet is what's key, and this study is in general agreement with that. The nice thing about this study is that we used a dietary screen (REAP) that is quick and simple and cheap and could be used to help people improve their diets in relatively simple ways by focusing on healthy fats and so forth."

Key Indicator of Brain Health

In an interview with Medscape Medical News, James A. Hendrix, PhD, director of global science initiatives, Alzheimer's Association, said, "Evidence is mounting that diet and exercise are both good for brain health."

"We are learning that to stay sharp, to keep your cognitive health good, exercise and a healthy diet are important. What we don't know is how long you have to be on a particular diet before you start to see a benefit. Most of the Mediterranean diet studies were conducted in Mediterranean populations. In other places, if you change your diet at age 50, 60, or 70, when do you start to see a benefit?"

Dr Hendrix said this study also "speaks to what we've been taught for a long time about our heart health. We're finding that a lot of the same strategies that apply to the heart apply to the brain. That is, it isn't one thing, it's a combination of healthy living. When you're in mid-life, it's really critical to start to take these habits seriously ― obviously, the younger the better."

The study had no commercial funding. The authors report no relevant financial relationships.

Alzheimer's Association International Conference (AAIC) 2015. Poster P3-259. Presented July 21, 2015.

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