Nijholt W, Jager-Wittenaar H, Visser M, van der Schans C P, Hobbelen J S M
Willemke Nijholt, MSc. Hanze University of Applied Sciences, School of Health Care Studies, Eyssoniusplein 18, 9714 CE Groningen, The Netherlands, E-mail:
J Nutr Health Aging. 2016;20(5):525-32. doi: 10.1007/s12603-015-0610-0.
Previous research has demonstrated that being both physically active and adhering a healthy diet is associated with improved cognitive functioning; however, it remains unclear whether these factors act synergistically. We investigated the synergistic association of a healthy diet and being physically active with cognitive functioning.
Cross-sectional study.
Data from the Longitudinal Aging Study Amsterdam (LASA) were used. We analyzed data from 2,165 community dwelling adults who were aged 55-85 years, 56% of whom were female. Cognitive functioning was assessed by the Mini-Mental State Examination (MMSE), an MMSE score of >26 indicates good cognitive functioning. Physical activity was assessed by the LASA Physical Activity Questionnaire and was considered sufficient if the person engaged in moderately intense physical activity ≥ 20 min/day. A healthy diet score was based on the intake of fruit, vegetables and fish. Each of the food groups was assigned a score that ranged from 1 (well below the Dutch guideline for a healthy diet) to 4 (well above the Dutch guideline for a healthy diet), and the scores were aggregated to determine a healthy diet (healthy ≥ 9 points). Multiple logistic and linear regression analyses were used to examine the (synergistic) association among physical activity, a healthy diet and cognitive functioning. All analyses were adjusted for potential chronic diseases and lifestyle confounders.
Of all of the participants, 25% were diagnosed with a cognitive impairment (MMSE ≤26), 80% were physically active and 41% had a healthy diet. Sixty three percent of the participants both adhered to a healthy diet and were physically active. Sufficient daily physical activity (OR=2.545 p<.001) and adherence to a healthy diet (OR=1.766 p=.002) were associated with good cognitive functioning. After adjusting for confounding factors, sufficient physical activity was not significantly related to cognitive functioning (p=.163); however adherence to a healthy diet remained significantly associated with good cognitive functioning (p=.017). No interaction among sufficient physical activity, healthy diet adherence and good cognitive functioning was observed (crude: p=.401, adjusted: p=.216).
The results of this cross-sectional study indicate that adherence to a healthy diet is inde-pendently related to cognitive functioning. Being physically active does not modify this association. Furthermore, these two lifestyle factors do not synergistically relate to cognitive functioning.
先前的研究表明，保持身体活跃和坚持健康饮食都与认知功能改善有关；然而，尚不清楚这些因素是否具有协同作用。我们调查了健康饮食和身体活动与认知功能之间的协同关联。
横断面研究。
使用来自阿姆斯特丹纵向衰老研究（LASA）的数据。我们分析了2165名年龄在55 - 85岁之间的社区居住成年人的数据，其中56%为女性。认知功能通过简易精神状态检查表（MMSE）进行评估，MMSE得分>26表明认知功能良好。身体活动通过LASA身体活动问卷进行评估，如果一个人每天进行中等强度身体活动≥20分钟，则认为身体活动充足。健康饮食得分基于水果、蔬菜和鱼类的摄入量。每个食物组被赋予一个分数，范围从1（远低于荷兰健康饮食指南）到4（远高于荷兰健康饮食指南），这些分数汇总以确定健康饮食（健康≥9分）。使用多元逻辑回归和线性回归分析来检验身体活动、健康饮食和认知功能之间的（协同）关联。所有分析都对潜在的慢性疾病和生活方式混杂因素进行了调整。
在所有参与者中，25%被诊断为认知障碍（MMSE≤26），80%身体活跃，41%有健康饮食。63%的参与者既坚持健康饮食又身体活跃。每日充足的身体活动（OR = 2.545，p <.001）和坚持健康饮食（OR = 1.766，p =.002）与良好的认知功能相关。在调整混杂因素后，充足的身体活动与认知功能无显著相关性（p =.163）；然而，坚持健康饮食与良好的认知功能仍显著相关（p =.017）。未观察到充足的身体活动、健康饮食坚持与良好的认知功能之间存在相互作用（粗数据：p =.401，调整后：p =.216）。
这项横断面研究的结果表明，坚持健康饮食与认知功能独立相关。身体活跃并不会改变这种关联。此外，这两个生活方式因素与认知功能不存在协同关系。
