Otsuka Rei, Zhang Shu, Ihira Hikaru, Sawada Norie, Inoue Manami, Yamagishi Kazumasa, Yasuda Nobufumi, Tsugane Shoichiro
Department of Epidemiology of Aging, Research Institute, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan.
Division of Cohort Research, National Cancer Center Institute for Cancer Control, Chuo-ku, Tokyo, Japan.
Clin Nutr. 2023 Apr;42(4):541-549. doi: 10.1016/j.clnu.2023.02.002. Epub 2023 Feb 9.
BACKGROUND & AIMS: A balanced diet integrating several foods and nutrients may promote the maintenance of brain function. Previous studies have substantiated the above hypothesis in the regional population in Japan. This study aimed to investigate the potential effect of dietary diversity on the risk of disabling dementia in a nationwide large-scale cohort of the Japanese population.
A total of 38,797 participants (17,708 men and 21,089 women) aged 45-74 years were followed up for a median of 11.0 years. The daily frequencies of the consumption of each of the 133 food and beverage items listed on a food frequency questionnaire (excluding five alcoholic beverages) were measured. The dietary diversity score was calculated as the number of food items consumed per day. Multivariable adjusted Cox proportional hazards regression models were used to calculate hazard ratios (HRs) and corresponding 95% confidence intervals (CIs) of the dietary diversity score quintile groups.
We documented 4302 participants with disabling dementia (11.1%) during the follow-up period. Among women, the dietary diversity score was inversely associated with disabling dementia (highest quintile HR [with the lowest quintile as the reference]: 0.67; 95% CI: 0.56-0.78; Q1-Q5 p for trend <0.001), but this was not true among men (highest quintile HR: 1.06; 95% CI: 0.87-1.29; Q1-Q5 p for trend = 0.415). These results did not change substantially when using disabling dementia with stroke as the outcome; the association remained significant among women but was absent among men.
Our findings indicate that eating a variety of foods may prevent disabling dementia only among women. Thus, the habit of consuming a variety of food items has important public health implications for women.
包含多种食物和营养素的均衡饮食可能有助于维持大脑功能。此前的研究已在日本的地区人群中证实了上述假设。本研究旨在调查在日本全国大规模队列人群中，饮食多样性对失能性痴呆风险的潜在影响。
对总共38797名年龄在45 - 74岁之间的参与者（17708名男性和21089名女性）进行了为期中位数为11.0年的随访。测量了食物频率问卷中列出的133种食品和饮料项目（不包括五种酒精饮料）的每日食用频率。饮食多样性得分通过每天食用的食物种类数量来计算。使用多变量调整的Cox比例风险回归模型计算饮食多样性得分五分位数组的风险比（HR）和相应的95%置信区间（CI）。
在随访期间，我们记录了4302名患有失能性痴呆的参与者（11.1%）。在女性中，饮食多样性得分与失能性痴呆呈负相关（最高五分位数HR[以最低五分位数为参照]：0.67；95%CI：0.56 - 0.78；趋势检验Q1 - Q5 p<0.001），但在男性中并非如此（最高五分位数HR：1.06；95%CI：0.87 - 1.29；趋势检验Q1 - Q5 p = 0.415）。当以失能性痴呆合并中风作为结局时，这些结果没有实质性变化；该关联在女性中仍然显著，但在男性中不存在。
我们的研究结果表明，食用多种食物可能仅对女性预防失能性痴呆有作用。因此，食用多种食物的习惯对女性具有重要的公共卫生意义。
