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To explore the meanings that newly arrived refugee adolescents residing in the Southeastern USA attribute to foods.
Design:
We used methods from cognitive anthropology to assess whether adolescents from different countries share a cultural model of eating behaviours.
Setting:
A school-based study in a community in the Southeastern USA.
Participants:
Adolescents (10–17 years) who arrived in the USA on a refugee visa in the previous year.
Results:
Adolescents showed consensus in grouping items and in identifying some foods as associated with adults and others with children. There was evidence of a shared model of eating practices across age, gender and number of siblings. Adolescents who had lived in a refugee camp were significantly different in how they grouped items.
Conclusions:
Adolescents from nine countries shared a model of eating behaviours; these patterns are consistent with rapid dietary acculturation within 1 year of arrival or with shared models held from pre-arrival. Our finding that adolescents who recently arrived in the USA generally agree about how foods relate to one another holds promise for generalised nutrition and dietary interventions across diverse adolescent groups.
To identify patterns of food taxes acceptability among French adults and to investigate population characteristics associated with them.
Design:
Cross-sectional data from the NutriNet-Santé e-cohort. Participants completed an ad hoc web-based questionnaire to test patterns of hypothetical food taxes acceptability (i.e. overall perception combined with reasons for supporting or not) on eight food types: fatty foods, salty foods, sugary foods, fatty and salty foods, fatty and sugary products, meat products, foods/beverages with unfavourable front-of-pack nutrition label and ‘ultra-processed foods’. Sociodemographic and anthropometric characteristics and dietary intakes (24-h records) were self-reported. Latent class analysis was used to identify patterns of food taxes acceptability.
Setting:
NutriNet-Santé prospective cohort study.
Participants:
Adults (n 27 900) engaged in the French NutriNet-Santé e-cohort.
Results:
The percentage of participants in favour of taxes ranged from 11·5 % for fatty products to 78·0 % for ultra-processed foods. Identified patterns were (1) ‘Support all food taxes’ (16·9 %), (2) ‘Support all but meat and fatty products taxes’ (28·9 %), (3) ‘Against all but UPF, Nutri-Score and salty products taxes’ (26·5 %), (4) ‘Against all food taxes’ (8·6 %) and (5) ‘No opinion’ (19·1 %). Pattern 4 had higher proportions of participants with low socio-economic status, BMI above 30 kg/m2 and who had consumption of foods targeted by the tax above the median.
Conclusions:
Results provide strategic information for policymakers responsible for designing food taxes and may help identify determinants of support for or opposition to food taxes in relation to individual or social characteristics or products taxed.
In response to increasing hypertension rates, South Africa implemented a regulation which set a maximum total sodium content for certain packaged food categories. We assess changes in reported sodium intake among 18-39 year old adults living in one township in the Western Cape as a result of the implementation of the regulation in 2016.
Design:
By linking one set of 24 hour dietary recall data to two versions of the South Africa Food Composition Database which reflect the pre-regulation and post-regulation periods, we calculated changes in sodium intake due to reformulation of food products, not behavior change. We statistically tested differences in mean consumption in this sample with paired t-tests.
Setting:
Langa, Western Cape, South Africa
Participants:
Surveyed participants were residents of Langa between 18-39 years old (n=2,148)
Results:
Before and after the implementation of the regulation there was a statistically significant decrease in the estimated sodium intake among adults of 189.4 mg (137.5, 241.4; p=0.00). Reported sodium from cured meat (such as Russians) and certain types of soup powder, cereals, and salted peanuts had a 9 to 33 percent lower calculated sodium consumption.
Conclusions:
Our conclusions show that independent of any behavioral changes on the part of consumers, it is possible to lower sodium intake by using regulations to induce food manufacturers to lower the sodium levels in their products. As countries explore similar regulatory strategies, this work can add to that body of evidence to inform policies to improve the food system.
In this study, nine isonitrogenous experimental diets containing graded levels of carbohydrates (40 g/kg, 80 g/kg and 120 g/kg) and crude lipids (80 g/kg, 120 g/kg and 160 g/kg) were formulated in a two-factor (3 × 3) orthogonal design. A total of 945 mandarin fish with similar body weights were randomly assigned to twenty-seven tanks, and the experiment diets were fed to triplicate tanks twice daily for 10 weeks. Results showed that different dietary treatments did not significantly affect the survival rate and growth performance of mandarin fish. However, high dietary lipid and carbohydrate levels significantly decreased the protein content of the whole body and muscle of cultured fish. The lipid content of the whole body, liver and muscle all significantly increased with increasing levels of dietary lipid, while only liver lipid level was significantly affected by dietary carbohydrate level. Hepatic glycogen content increased significantly with increasing dietary carbohydrate levels. As to liver antioxidant capacity, malondialdehyde content increased significantly with increasing dietary lipid or carbohydrate content, and catalase activity showed an opposite trend. Superoxide dismutase activity increased significantly with increasing levels of dietary lipid but decreased first and then increased with increasing dietary carbohydrate levels. Additionally, the increase in both dietary lipid and carbohydrate levels resulted in a significant reduction in muscle hardness. Muscle chewiness, gumminess and shear force were only affected by dietary lipid levels and decreased significantly with increasing dietary lipid levels. In conclusion, considering all the results, the appropriate dietary lipids and carbohydrate levels for mandarin fish were 120 g/kg and 80 g/kg, respectively.
Ultra-processed foods (UPF), defined using the Nova classification system, are associated with increased chronic disease risk. More recently, evidence suggests the UPF subgroup of whole-grain breads and cereals is in fact linked with reduced chronic disease risk. This study aimed to explore associations of cardiometabolic risk measures with Nova UPF intake v. when foods with ≥ 25 or ≥ 50 % whole grains are excluded from the definition. We considered dietary data from the Australian National Nutrition and Physical Activity Survey 2011–2012. Impacts on associations of UPF intake (quintiles) and cardiometabolic risk measures were analysed using regression models. The median proportion of UPF intake from high whole-grain foods was zero for all quintiles. Participants in the highest Nova UPF intake quintile had significantly higher weight (78·1 kg (0·6)), BMI (27·2 kg/m2 (0·2)), waist circumference (92·7 cm (0·5)) and weight-to-height ratio (0·55 (0·003)) compared with the lowest quintile (P< 0·05). Associations were the same when foods with ≥ 25 and ≥ 50 % whole grains were excluded. Adjusted R-squared values remained similar across all approaches for all outcomes. In Australia, high whole-grain foods considered UPF may not significantly contribute to deleterious cardiometabolic risk associations. Until conclusive evidence on Nova UPF is available, prioritisation should be given to the nutrient density of high whole-grain foods and their potential contribution to improving whole-grain intakes and healthful dietary patterns in Australia.
This study examines public support – and its drivers – for comprehensive policy packages (i.e. bundles of coherent policy measures introduced together) aimed at improving food environments.
Design:
Participants completed an online survey with a choice-based conjoint experiment, where they evaluated pairs of policy packages comprising up to seven distinct food environment measures. After choosing a preferred package or opting for a single policy, participants designed their ideal policy package. Based on their choices, respondents were categorised as resistant, inclined or supportive towards policy packaging according to their frequency of opting out for single measures and the number of policies they included in their ideal package.
Setting:
The study was conducted in Germany via an online survey.
Participants:
The sample included 1200 eligible German voters, recruited based on age, gender and income quotas.
Results:
Based on both opt-out frequency (44·7 %) and ideal policy packaging (72·8 %) outcomes, most respondents were inclined towards policy packages. The inclusion of fiscal incentives and school-based measures in packages enhanced support, while fiscal disincentives reduced it. Key drivers of support included beliefs about the importance of diet-related issues and the role of government in regulation, while socio-demographic factors, political leaning and personal experience with diet-related disease had minimal impact.
Conclusions:
The results reveal public appetite for policy packages to address unhealthy food environments, contingent on package design and beliefs about the issue’s severity and legitimacy of intervention. Public health advocates should design and promote policy packages aligned with public preferences, especially given anticipated opposition from commercial interests.
To describe the economic, lifestyle and nutritional impact of the COVID-19 pandemic on parents, guardians and children in Malaysia, Indonesia, Thailand and Vietnam.
Design:
Data from the SEANUTS II cohort were used. Questionnaires, including a COVID-19 questionnaire, were used to study the impact of the pandemic on parents/guardians and their children with respect to work status, household expenditures and children’s dietary intake and lifestyle behaviours.
Setting:
Data were collected in Malaysia, Indonesia, Thailand and Vietnam between May 2019 and April 2021.
Participants:
In total, 9203 children, aged 0·5–12·9 years, including their parents/guardians.
Results:
Children and their families were significantly affected by the pandemic. Although the impact of lockdown measures on children’s food intake has been relatively mild in all countries, food security was negatively impacted, especially in Indonesia. Surprisingly, in Malaysia, lockdown resulted in overall healthier dietary patterns with more basic food groups and less discretionary foods. Consumption of milk/dairy products, however, decreased. In the other countries, intake of most food groups did not change much during lockdown for households based on self-reporting. Only in rural Thailand, some marginal decreases in food intakes during lockdown persisted after lockdown. Physical activity of children, monthly household income and job security of the parents/guardians were negatively affected in all countries due to the pandemic.
Conclusion:
The COVID-19 pandemic has significantly impacted societies in South-East Asia. To counteract negative effects, economic measures should be combined with strategies to promote physical activity and eating nutrient-adequate diets to increase resilience of the population.
To assess the effectiveness of the ‘Weet wat je eet’ (‘Know what you eat’) school-based nutrition education programme on behavioural determinants and behaviour among students aged 12–15 years. A quasi-experimental study design was used, collecting data at baseline and after implementing the programme in both an intervention and control group (in total 611 students) across the Netherlands. Students from eighteen Dutch secondary education schools completed two consecutive questionnaires, assessing knowledge, self-efficacy, attitude, subjective norm, intention, and behaviours related to healthy, safe, and sustainable nutrition. Multilevel regression analyses were conducted corrected for gender, grade, education level, and school location. The intervention group showed a significant higher increase in self-efficacy, attitude, intention to drink water (all three P < 0.01), and a significant higher decrease in the consumption of sugary drinks, snacks, and meat (all P < 0.05) than the control group. Both the groups scored significantly higher on knowledge during the post-test (both P < 0.05), although the intervention group not significantly higher than the control group (P = 0.14). No significant effects were observed for subjective norm, intention, and fruit, vegetable, and whole grain bread consumption. The results of this study showed positive effects of the ‘Weet wat je eet’ school-based nutrition education programme on self-efficacy and attitude towards healthy, safe and sustainable nutrition, intention to drink more water, and various healthy eating behaviours among secondary school students. Further research is necessary to assess the long-term sustainability of these results.
To investigate the co-existence of single and multiple anthropometric failures among children using an extended composite index of anthropometric failure (ECIAF). This study aims to elucidate the complex interplay between child-specific and maternal factors, highlighting the multifaceted nature of childhood malnutrition.
Design:
A multicentre cross-sectional study as part of the BESLEN project
Setting:
Mother-Child Education Centre in the Pendik district of Istanbul, Türkiye
Participants:
1283 children (preschool children, n 822, school-aged children, n 462) and 1044 mothers
Results:
Almost 1/3 of the children included in the study had an anthropometric failure as determined by ECIAF. Weight excess was the leading cause of the total anthropometric failures, most of which were observed to be slightly higher in boys, except for stunting only and co-occurrence of stunting and underweight. Among the mother-related factors, including higher BMI and waist circumference, low maternal age at delivery, low number of children in the household and being a single parent may be considered predisposing factors to any phenomenon of childhood malnutrition. Among child-related factors, birth weight being ≥ 3500 g had a higher risk for ECIAF failure, and children aged ≥ 60 months were more likely to experience stunting and underweight, while those < 60 months had a higher prevalence of weight excess.
Conclusions:
The co-existence of stunting and overweight, the occurrence of weight excess in one in three stunted children and the high risk of central obesity are public health concerns. Also, ECIAF can better assess all aspects of childhood malnutrition than conventional measures.
The COVID-19 pandemic has presented multifaceted challenges globally, impacting adolescent health. Among these, food security and nutrition are intertwined closely with mental health outcomes. In Indonesia, with its diverse socio-economic landscape, these interconnections may have been exacerbated by the pandemic. This study investigated the relationship between food security, nutrition and adolescent mental health in Indonesia during COVID-19. Longitudinal data were collected from 511 adolescent boys and girls in 2021–2022 in Gunungkidul district, Yogyakarta. Food security was measured using the Household Food Insecurity Access Scale (HFIAS), and the validated Kessler-10 Psychological Distress Scale (K10) was used to measure adolescent depression. Multivariate linear regression and linear mixed-effects regression were employed to explore associations between these variables, while adjusting for sex, age, pubertal status and household income. Overall, food insecurity score was positively associated with depressive symptoms (β: 0·72, 95 % CI 0·52, 0·92), while BMI z-score was inversely associated (β: −0·31, 95 % CI 0·68, −0·03). We found an increase in strength of association between food insecurity and depressive symptoms over time (moderately food-insecure: β: 1·36 (95 % CI −0·10, 2·83) to 4·63 (95 % CI 2·17, 7·09); severely food-insecure: β: 1·89 (95 % CI 0·36, 3·41) to 3·30 (95 % CI 1·50, 5·10). Enhancing food access, improving nutritional status and providing mental health support are crucial components of adolescent health.
Reduced exposure to sweet taste has been proposed to reduce sweet food preferences and intakes, but the evidence to support these associations is limited. This randomised controlled trial investigated the effects of a whole-diet sweet taste intervention for 6 d, on subsequent pleasantness, desire for and sweet food intakes. Participants (n 104) were randomised to increase (n 40), decrease (n 43) or make no change to (n 21) their consumption of sweet-tasting foods and beverages for 6 consecutive days. Pleasantness, desire to eat, sweet taste intensity and sweet food and beverage intakes were assessed on days 0 and 7. One hundred and two (98 %) participants completed the study, and self-reported adherence with the dietary interventions was moderate to good (M = 66–72/100 mm), with instructions to decrease sweet food consumption reported as more difficult than the other diets (smallest (t(81) = 2·45, P = 0·02, Mdiff = 14/100 mm, se = 2 mm). In intention-to-treat analyses, participants in the decreased sweet food consumption group reported higher sweet taste intensity perceptions at day 7 compared with day 0 (F(2101) = 4·10, P = 0·02, Mdiff = 6/100 mm, se = 2 mm). No effects were found for pleasantness (F(2101) = 2·04, P = 0·14), desire to eat (F(2101) = 1·49, P = 0·23) or any of the measures of sweet food intake (largest F(2101) = 2·53, P = 0·09). These results were confirmed in regression analyses that took self-reported adherence to the diets into account. Our findings suggest that exposure to sweet taste does not affect pleasantness, desire for or intakes of sweet-tasting foods and beverages. Public health recommendations to limit the consumption of sweet-tasting foods and beverages to reduce sweet food preferences may require revision.
Mounting evidence suggests that the Mediterranean diet has a beneficial effect on mental health. It has been hypothesised that this effect is mediated by a variety of foods, nutrients and constituents; however, there is a need for research elucidating which of these components contribute to the therapeutic effect. This scoping review sought to systematically search for and synthesise the research on olive oil and its constituents and their impact on mental health, including the presence or absence of a mental illness or the severity or progression of symptoms. PubMed and OVID MEDLINE databases were searched. The following article types were eligible for inclusion: human experimental and observational studies, animal and preclinical studies. Abstracts were screened in duplicate, and data were extracted using a piloted template. Data were analysed qualitatively to assess trends and gaps for further study. The PubMed and OVID MEDLINE search yielded 544 and 152 results, respectively. After full-text screening, forty-nine studies were eligible for inclusion, including seventeen human experimental, eighteen observational and fourteen animal studies. Of these, thirteen human and four animal studies used olive oil as a comparator. Observational studies reported inconsistent results, specifically five reporting higher rates of mental illness, eight reporting lower and five reporting no association with higher olive oil intake. All human experimental studies and nine of ten animal studies that assess olive oil as an intervention reported an improvement of anxiety or depression symptoms. Olive oil may benefit mental health outcomes. However, more experimental research is needed.
Despite bold commitments to reduce anaemia, little change in prevalence was observed over the past decade. We aimed to generate subnational maps of anaemia among women of reproductive age (WRA), malaria transmission and hemoglobinopathies to identify priority areas but also explore their geographical overlap.
Design:
Using the most recent Demographic and Health Surveys (DHS), we first mapped anaemia clusters across sub-Saharan Africa and identified the West and Central Africa (WCA) as a major cluster. Geographic clusters with high anaemia and related aetiologic factors were identified using spatial statistics. Multilevel regression models were run to identify factors associated with any, moderate and severe anaemia.
Settings:
West and Central African countries (n 17).
Participants:
WRA (n 112 024) residing in seventeen WCA countries.
Results:
There was a significant overlap in geographical clusters of anaemia, malaria and hemoglobinopathies, particularly in the coastal areas of the WCA region. Low birth interval (0·86 (0·77, 0·97)), number of childbirth (1·12 (1·02, 1·23)) and being in the 15–19 age range (1·47 (1·09, 1·98)) were associated with increased odds of any anaemia. Unimproved toilet facility and open defecation were associated with any anaemia, whereas the use of unclean cooking fuel was associated with moderate/severe anaemia (P < 0·05). Access to healthcare facility, living in malaria-prone areas and hemoglobinopathies (HbC and HbS) were all associated with any, moderate or severe anaemia.
Conclusion:
Interlinkages between infection, hemoglobinopathies and nutritional deficiencies complicate the aetiology of anaemia in the WCA region. Without renewed efforts to integrate activities and align various sectors in the prevention of anaemia, progress is likely to remain elusive.
Although the energy stored in the lean tissue (LT) and adipose tissue (AT) is well known, the energy required to synthesise these tissues is obscure. Theoretically, the energy at the point at which ΔLT/Δ body weight (BW) reaches 100 % on a regression line, which indicates the relationship between ΔLT/ΔBW and the energy required for BW gain, is considered to be the energy expended to synthesise LT. Therefore, we investigated this relationship in rats. Rats were fed diets with different ratios of protein, fat and carbohydrates because their ΔLT/ΔBW values were expected to be different. Six-week-old male Sprague-Dawley rats had ad libitum access to normal (N, n 6), high-fat (HF, n 7) or high-protein (HP, n 8) diets for 4 weeks. The ΔLT/ΔBW was 0·77 in the N, 0·70 in the HF and 0·87 in the HP groups, respectively. The average energy required to gain BW was 8·8 kJ/g in the N group, 7·0 kJ/g in the HF group and 11·3 kJ/g in the HP group. We observed a positive correlation between ΔLT/ΔBW and energy required for BW gain. The regression line demonstrated that the energy expended to synthesise LT was 13·9 kJ/g and AT was −7·9 kJ/g. Therefore, combined with the energy stored in LT, the energy required to accumulate LT is approximately 19 kJ/g, whereas the energy to accumulate AT could not be elucidated.
Although dietary factors have been examined as potential risk factors for liver cancer, the evidence is still inconclusive. Using a diet-wide association analysis, our research evaluated the associations of 126 foods and nutrients on the risk of liver cancer in a Chinese population. We obtained the diet consumption of 72,680 women in the Shanghai Women’s Health Study using baseline dietary questionnaires. The association between each food and nutrient and liver cancer risk was quantified by Cox regression model. A false discovery rate of 0.05 was used to determine the foods and nutrients which need to be verified. Totally 256 incident liver cancer cases were identified in 1,267,391 person-years during the follow-up duration. At the statistical significance level (P ≤ 0.05), higher intakes of cooked wheaten foods, pear, grape and copper were inversely associated with liver cancer risk, while spinach, leafy vegetables, eggplant and carrots showed the positive associations. After considering multiple comparisons, no dietary variable was associated with liver cancer risk. Similar findings were seen in the stratification, secondary and sensitivity analyses. Our findings observed no significant association between dietary factors and liver cancer risk after considering multiple comparisons in Chinese women. More evidence is needed to explore the associations between diet and female liver cancer occurrence.
Optimal vitamin D status is important for growth and development during childhood(1). Children with a circulating concentration of 25-hydroxyvitamin D [25(OH)D] below 25 nmol/L are at increased risk of rickets. In order to maintain 25(OH)D > 25nmol/L, a dietary intake of 10µg/d vitamin D is recommended for children aged 4 years and above(2,3). The aim of this study was to determine vitamin D status in healthy children and to investigate associations between 25(OH)D concentrations and muscle health, cognitive function, and parental knowledge of vitamin D, vitamin D habits, perceptions, and practices.
A cross-sectional study of healthy children aged 4 – 11 years conducted between 2019 – 2023 examined vitamin D status by measuring plasma 25(OH)D via the gold standard liquid chromatography tandem mass spectrometry and parathyroid hormone concentrations. Muscle strength (hand grip and balance) was determined by dynamometer, single and tandem stance balancing whilst cognitive function was assessed using the Cambridge Neuropsychological Test Automated Battery. Parents completed questionnaires to assess vitamin D knowledge, and perceptions, habits, and attitude towards vitamin D.
A total of 192 children (91 boys; 101 girls) with an average age of 8.2 years were recruited. Plasma 25(OH)D concentrations were 61.10±18.75 nmol/L (n = 190), with 68.4% of children defined as vitamin D sufficient (25(OH)D>50nmol/L). When stratified by winter months, only 58% of children were vitamin D sufficient. In single linear regression, plasma 25(OH)D concentrations were positively associated with dominant hand grip strength, single leg balance and the cognitive test ‘5choice movement time’ (p<0.05). Overall, there was a reported mean score of 41.9% for parental vitamin D knowledge and 68% of parents thought there was no harm in giving their child vitamin D fortified foods.
Approximately 70% of this sample of children were vitamin D sufficient, however insufficiency was prevalent in almost half of the cohort during the winter months. Benefits of optimal vitamin D for muscle and cognitive function were evident. These results support the promotion of the existing vitamin D dietary recommendations during the winter months for optimal child growth and development.
Vegan and vegetarian diets, lacking animal-based foods, increase the risk of vitamin B12 deficiency(1). Yet, there is limited current data on its prevalence among European ancestry individuals in Western Europe or the USA. This study aimed to provide a consensus on the prevalence of B12 deficiency among vegans and vegetarians of European ancestry residing in Western Europe or the USA.
We identified studies from our systematic review of “Functional Vitamin B12 Status Among Adult Vegans” to develop a narrative review of the prevalence of B12 deficiency based on biomarkers of B12 status among vegan and vegetarians. We then used pooled data from National Diet and Nutrition Survey (NDNS)(2) to calculate UK-specific prevalence information on B12 deficiency and insufficiency using the new NICE(3) criteria among vegan/vegetarian women of child-bearing age (WCBA) (age 18-45) compared with older women.
A total of six studies (2013-2022) with data on the prevalence of B12 deficiency were identified.
These studies were conducted on participants from UK, Norway, Spain, Czech Republic and US. Nearly all used different cut-offs to define B12 deficiency. Among vegans and vegetarians, the reported prevalence of deficiency ranged from 5-52% and 6-14%, respectively. Studies from Norway(4) and Finland(5) highlight low prevalence (5%) and no difference between dietary groups, possibly due to widespread supplement usage. The USA(6), indicated a higher prevalence of inadequate B12 intake among vegans and vegetarians compared to omnivours, with 8% of vegans and 6% of vegetarians exhibiting serum B12 levels < 148pmol/l. Similarly, results from Spain(7) noted subclinical deficiencies in 11% of participants, in both vegans and vegetarians. In the Czech Republic(8), cobalamin deficiency was noted in 15% of vegans, with 17% exhibiting deficiency (Serum B12< 100 ng/L). Notably, regular supplementation significantly reduced deficiency rates, emphasising its role in maintaining normal B12 levels. In the UK(9), only one publication reported B12 deficiency rates (SerumB12 <118pmol/L) among male vegans (52%) and vegetarians (7%). Using data from the NDNS and NICE guidelines, the prevalence of B12 deficiency was (defined as serum B12 < 133pmol/L and Holo-TC <25pmol/L) at 5-8% among vegetarian WCBA (Age 18-45); appropriate data on vegans was not available. B12 insufficiency (potential deficiency), defined by NICE as serum B12 < 258 pmol/L and Holo-TC < 70 pmol/L, translated to 75% of vegetarians within the WCBA cohort being defined as insufficient compared to 39% among older vegetarian women. A similar but more pronounced trend emerges for Holo-TC insufficiency, with 90% of vegetarians exhibiting inadequate Holo-TC < 70 pmol/L, compared to 58% of older women vegetarians and 65% of omnivores.
Few studies report B12 deficiency among Western European vegans and vegetarians, particularly for vegan WCBA. Existing data suggest a high risk can be mitigated with appropriate supplementation or adequately fortified foods.
While adherence to a healthy diet is known to reduce dementia risk, the impact varies by diet type. This study examines the association between six dietary scores and dementia incidence.
In this prospective analysis, 210,269 participants aged 60 and above (mean age 64.1 years, 52.7% women) from the UK Biobank were included. Dietary adherence was assessed using six scores: Mediterranean Diet Adherence Index (MEDAS-14), Recommended Food Score (RFS), Healthy Diet Indicator (HDI), Mediterranean Diet Score (MDS), Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND), and a meat consumption index (MCI). Dementia incidence (allcause, Alzheimer’s, vascular, and non-vascular) was the primary outcome, analyzed using Cox proportional hazards models. The lowest quintile (low adherence) was used as reference group. Analyses were conducted using a 2-years landmark and adjusted for sociodemographic (age, sex, ethnicity and deprivation), lifestyle (physical activity, alcohol and smoking) and health-related factors (multimorbidity and BMI).
Among the participants, 4,151 developed dementia during the 8.9 years follow up. Those with the highest adherence to dietary patterns (Quintile 5) showed a reduced risk of all-cause dementia: 49% with MDS (HR: 0.51, CI: 0.42−0.62), 38% with MIND (HR: 0.77, CI: 0.60−0.99), and 19% with MEDAS-14 (HR: 0.81, CI: 0.64-1.00). No significant associations were found with HDI. Individuals reporting low meat consumption (<5 times a week) exhibited a 15% lower dementia risk compared to high meat eaters (≥5 times a week, HR: 0.85, CI: 0.77−0.94). No associations were observed with pescatarian or vegetarian diets. These patterns were consistent across both vascular dementia and Alzheimer’s disease.
Our findings suggest that higher adherence to certain healthy dietary patterns, particularly the Mediterranean and MIND diets, is associated with substantially lower risk of dementia. These findings emphasise the potential for achieving better brain health among older people by improving overall dietary pattern.