From the Institute for Advancing Health Through Agriculture, Texas A&M University System, College Station, TX.
Department of Nutritional Sciences and Toxicology, University of California Berkeley, Berkeley, CA.
Menopause. 2024 Oct 1;31(10):853-861. doi: 10.1097/GME.0000000000002408. Epub 2024 Jul 30.
Dietary choline is associated with lower risk of dementia in older adults, yet this association during mid-life remains unknown. Given that menopause reflects a nutrition-sensitive time point where prevention strategies may mitigate cognitive deficits, we examined the relationship of choline, betaine, and egg intakes (ie, dietary exposures) with cognitive performance in the Study of Women's Health Across the Nation (SWAN) cohort ( N = 1,006).
SWAN is a longitudinal study of women across the menopause transition. Diet was assessed via modified Block food frequency questionnaire, and cognitive function was examined using the Symbol Digit Modalities Test, Digits Backward Test, and East Boston Memory Test (EBMT). Annualized rate of cognitive scores and quartiles of diet were computed using linear mixed models overall (all diet exposures) and by baseline menopausal status (choline, betaine only).
Among all women, higher choline ( P -for-trend = 0.006) and betaine ( P -for-trend = 0.005) intakes, independently and combined (ie, choline + betaine; P -for-trend = 0.001), were significantly associated with reduced rate of change on the EBMT-Delayed Recall (DR), but egg intake did not consistently impact cognitive function. By menopausal status, higher betaine, but not choline, was associated with a lower annualized rate of change in cognitive performance on the EBMT-DR (mean difference [95% confidence interval]; Q1: referent vs Q4: -0.071 [-0.17, 0.03]; P -for-trend = 0.006) for early perimenopausal women; nevertheless, choline and betaine were not associated with cognitive function among premenopausal women.
Higher dietary betaine intake among early perimenopausal women and higher dietary intakes of betaine and choline, independently and combined, among all women, were minimally associated with the trajectory of verbal episodic memory, yet no associations between diet and cognition were observed among premenopausal women. Future research should address the relationship between dietary intake and cognition during menopause in other research settings and cohorts.
膳食胆碱与老年人痴呆风险降低相关，但中年时期的这种关联尚不清楚。鉴于绝经反映了一个营养敏感的时间点，在此期间预防策略可能减轻认知缺陷，我们研究了胆碱、甜菜碱和鸡蛋摄入量（即饮食暴露）与全国妇女健康研究（SWAN）队列中认知表现的关系（N=1006）。
SWAN 是一项针对绝经过渡期间女性的纵向研究。饮食通过改良的 Block 食物频率问卷进行评估，认知功能通过符号数字模态测试、数字倒背测试和东波士顿记忆测试（EBMT）进行检查。使用线性混合模型总体（所有饮食暴露）和基于基线绝经状态（胆碱、甜菜碱仅）计算认知评分的年化率和饮食四分位数。
在所有女性中，较高的胆碱（P 趋势=0.006）和甜菜碱（P 趋势=0.005）摄入量，独立和联合（即胆碱+甜菜碱；P 趋势=0.001）与 EBMT-延迟回忆（DR）的变化率降低显著相关，但鸡蛋摄入量并未一致影响认知功能。按绝经状态，较高的甜菜碱，但不是胆碱，与 EBMT-DR 的认知表现年化变化率较低相关（平均差异[95%置信区间]；Q1：参照 vs Q4：-0.071[-0.17，0.03]；P 趋势=0.006），适用于早期围绝经期女性；然而，胆碱和甜菜碱与绝经前女性的认知功能无关。
在早期围绝经期女性中，较高的膳食甜菜碱摄入量以及所有女性中独立和联合的较高膳食甜菜碱和胆碱摄入量与口头情景记忆轨迹最小相关，但在绝经前女性中，饮食与认知之间没有关联。未来的研究应该在其他研究环境和队列中研究绝经期间饮食摄入与认知之间的关系。
