Department of Epidemiology, Harvard T. H. Chan School of Public Health, Harvard University, Boston, MA, USA.
Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.
Eur J Epidemiol. 2022 Feb;37(2):133-146. doi: 10.1007/s10654-021-00814-9. Epub 2021 Nov 8.
Diet is one of the modifiable risk factors for cognitive decline. However, human studies on total energy intake and cognitive function have remained limited and studies on fat intake and cognitive decline have been inconclusive. We aimed to examine prospectively the associations between long-term intakes of total energy and fat with subsequent subjective cognitive decline (SCD). A total of 49,493 women from the Nurses' Health Study and 27,842 men from the Health Professionals Follow-up Study were followed for over 20 years. Average dietary intake was calculated based on repeated food frequency questionnaires (SFFQs), and Poisson regression was used to evaluate associations. Higher total energy intake was significantly associated with greater odds of SCD in both cohorts. Comparing the highest with lowest quintiles of total energy intake, the pooled multivariable-adjusted ORs (95% CIs) for a 3-unit increment in SCD, corresponding to poor versus normal SCD, was 2.77 (2.53, 2.94). Each 500 kcal/day greater intake of total energy was associated with 48% higher odds of SCD. Intakes of both total fat and total carbohydrate appeared to contribute to the positive association between total energy intake and SCD although for the same percent of energy, the association was stronger for total fat. In conclusion, higher intakes of total energy, total fat, and total carbohydrate were adversely associated with SCD. Whether these associations are causal is unclear and deserves further investigation.
饮食是认知能力下降的可改变风险因素之一。然而，关于总能量摄入与认知功能的人体研究仍然有限，关于脂肪摄入与认知能力下降的研究也尚无定论。我们旨在前瞻性地研究总能量和脂肪的长期摄入与随后的主观认知下降（SCD）之间的关系。共有来自护士健康研究的 49493 名女性和来自健康专业人员随访研究的 27842 名男性进行了超过 20 年的随访。平均饮食摄入量是根据重复的食物频率问卷（SFFQs）计算的，并使用泊松回归来评估相关性。在两个队列中，较高的总能量摄入与 SCD 的发生几率显著相关。比较总能量摄入最高和最低五分位数的多变量调整比值比（95%置信区间），对应于 SCD 较差与正常，为 2.77（2.53，2.94）。SCD 每增加 3 个单位，即从较差变为正常，总能量摄入增加 3 个单位，相应的 OR 值为 2.77（2.53，2.94）。总能量摄入每增加 500 千卡/天，SCD 的几率就会增加 48%。总脂肪和总碳水化合物的摄入量似乎都促成了总能量摄入与 SCD 之间的正相关，尽管对于相同比例的能量，总脂肪的相关性更强。总之，较高的总能量、总脂肪和总碳水化合物摄入量与 SCD 呈负相关。这些关联是否具有因果关系尚不清楚，值得进一步研究。
