Kühn L, MacIntyre U E, Kotzé C, Becker P J, Wenhold F A M
Lizette Kühn, University of Pretoria Faculty of Health Sciences, Pretoria, Gauteng, South Africa,
J Nutr Health Aging. 2022;26(2):119-126. doi: 10.1007/s12603-021-1723-2.
Dietary omega 3 polyunsaturated fatty acids (PUFA) may reduce the risk of dementia. Many studies have investigated PUFA supplementation in high-income countries, yet food-based randomized control trials using omega 3 PUFA rich fish in lower to middle income countries, are lacking.
To determine the effect on cognition of adding either fish or non-fish foods for twelve weeks to an enhanced diet of cognitively intact, independently living, resource-limited elderly people.
Randomized control trial (National Health Trial register: DOH-27-061-6026).
Retirement center in urban South Africa.
Fifty-seven (74% female, mean age: 72±7 years) elderly participants with cognitive function exceeding 22 on the Mini Mental State Examination were randomized into an intervention (n=31) and control (n=26) group.
The usual diets of both groups were enhanced with context-appropriate foods to mimic elements of the Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) diet. The intervention group additionally received canned pilchards and fish spread every week amounting to an additional (theoretical) intake of 2.2g omega 3 PUFA daily. The control group received canned meatballs and texturized soya every week.
Cognition was measured twice before and once after the intervention phase using the Cognitive Abilities Screening Instrument (CASI). Adherence was assessed by a study-specific food frequency questionnaire and red blood cell (RBC) PUFA biomarkers. Data were analyzed using a non-parametric analysis of covariance (ANCOVA) with, and without, bootstrap imputation.
Participants in the intervention group had a significantly higher post intervention (P=0.036) CASI score than the control group, when the model was fitted with imputation and controlled for baseline scores. Participants in the intervention group also had a significantly higher intake of calculated dietary omega 3 PUFA and higher levels of RBC eicosapentaenoic acid and docosapentaenoic acid content than the control group (P < 0.05).
Twelve weeks of fish intake in the context of a modified MIND diet may improve the cognition of cognitively intact, resource-limited elderly people.
膳食中的ω-3多不饱和脂肪酸（PUFA）可能会降低患痴呆症的风险。许多研究在高收入国家对补充PUFA进行了调查，但在中低收入国家，缺乏使用富含ω-3 PUFA的鱼类进行基于食物的随机对照试验。
确定在认知功能正常、独立生活、资源有限的老年人强化饮食基础上，添加鱼类或非鱼类食物12周对认知的影响。
随机对照试验（国家卫生试验注册：DOH-27-061-6026）。
南非城市的退休中心。
57名（74%为女性，平均年龄：72±7岁）在简易精神状态检查中认知功能超过22分的老年参与者被随机分为干预组（n=31）和对照组（n=26）。
两组的常规饮食都通过添加适合当地情况的食物进行强化，以模拟地中海-DASH神经退行性延迟干预（MIND）饮食的元素。干预组每周额外接受罐装沙丁鱼和鱼酱，相当于每天额外（理论）摄入2.2克ω-3 PUFA。对照组每周接受罐装肉丸和组织化大豆。
在干预阶段前后分别使用认知能力筛查工具（CASI）对认知进行两次测量。通过特定研究的食物频率问卷和红细胞（RBC）PUFA生物标志物评估依从性。数据使用非参数协方差分析（ANCOVA）进行分析，有无自抽样插补。
当模型进行插补并控制基线分数时，干预组参与者干预后的CASI得分显著高于对照组（P=0.036）。干预组参与者计算得出的膳食ω-3 PUFA摄入量也显著高于对照组，红细胞二十碳五烯酸和二十二碳五烯酸含量也更高（P<0.05）。
在改良的MIND饮食中摄入12周鱼类可能会改善认知功能正常、资源有限的老年人的认知。
