Balanced diet associated with better cognitive function

September 20, 2022

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Maintaining a balanced energy intake through diet was associated with significantly better cognitive function compared to unequal intake patterns, researchers reported in life metabolism.

Hui Chen, PhDvice dean of the department of psychology and behavioral sciences at Zhejiang University in China, and colleagues conducted a community-based cohort study to assess whether or not meal timing has an effect on cognitive function.


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Chen and colleagues used data from the China Health and Nutrition Survey from 1997 to 2006 and included participants aged 55 and older who completed at least one diet assessment and cognitive test. Participants were excluded if they had severe cognitive impairment at baseline; had extreme energy intake; or had a stroke, ischemic attack, hypertension, diabetes, or cancer at baseline.

A total of 3,342 subjects were included for analysis (mean age 62.2 years). Of these, 61.2% lived in rural areas and 13.6% had a secondary education or higher.

The authors assessed nutritional intake using a combination of weighing methods and a 3-day, 24-hour diet reminder with each wave. The mean daily energy intakes of breakfast, morning snack, lunch, afternoon snack, dinner and evening snack were calculated using the Chinese food composition table.

The authors identified six transient patterns of energy intake (TPEIs) – participants with a “breakfast-dominant” pattern had an average of 49.5% total energy intake (TEI) per day from breakfast. Those with a “lunch-dominant” pattern had an average of 64.3% TEI from lunch. Participants with a “dinner-dominant” pattern had 64.5 TEI. The “snack rich” pattern was 36.8% TEI and the “skip breakfast” pattern was 5.9% TEI.

Finally, those with an “evenly distributed” pattern characterized by TEI were evenly distributed over three main meals (28.5%, 36.3%, and 33.8% of breakfast, lunch, and dinner, respectively). Overall, 33% of all participants maintained their patterns from baseline to the end of the study.

The authors assessed cognitive function through the modified telephone interview for cognitive status, consisting of immediate and delayed word memories, backward counting, and the serial 7 subtraction test. Total cognitive scores ranged from 0 to 27, with a higher score representing higher cognitive function.

The authors assessed the correlation of TPEIs with cognitive function using linear mixed models and adjusted for age, sex, residence, total energy, physical activity, smoking status, alcohol consumption, household income, education level, and body mass index.

Excluding the evenly distributed TPEIs, all other five patterns were associated with poorer cognitive function – breakfast dominant, -0.94; 95% CI, –1.37 to –0.51; lunch dominant, -1.18; 95% CI, –1.67 to –0.69; dinner dominant, -0.97; 95% CI, –1.43 to –0.51; snack rich, -1.05; 95% CI, –1.70 to –0.40; and skip breakfast, -1.32; 95% CI, -1.66 to -0.99.

In addition, compared to the evenly distributed pattern, the pattern of skipping breakfast was associated with a significantly faster cognitive decline by 0.14 points per year (95% CI, -0.24 to -0.04). This was only significant for those under 65 years of age.

“We found that maintaining a balanced energy intake at three large meals was associated with significantly better cognitive function than the other five unevenly distributed patterns,” the authors wrote.

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