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Association of long-term dietary fat intake, exercise, and weight with later cognitive function in the Finnish Diabetes Prevention Study

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The journal of nutrition, health & aging

Abstract

Objectives

To investigate associations of long-term nutrient intake, physical activity and obesity with later cognitive function among the participants in the Finnish Diabetes Prevention Study, in which a lifestyle intervention was successful in diabetes prevention.

Design

An active lifestyle intervention phase during middle age (mean duration 4 years) and extended follow-up (additional 9 years) with annual lifestyle measurements, followed by an ancillary cognition assessment.

Setting

5 research centers in Finland.

Participants

Of the 522 middle-aged, overweight participants with impaired glucose tolerance recruited to the study, 364 (70%) participated in the cognition assessment (mean age 68 years).

Measurements

A cognitive assessment was executed with the CERAD test battery and the Trail Making Test A on average 13 years after baseline. Lifestyle measurements included annual clinical measurements, food records, and exercise questionnaires during both the intervention and follow-up phase.

Results

Lower intake of total fat (p=0.021) and saturated fatty acids (p=0.010), and frequent physical activity (p=0.040) during the whole study period were associated with better cognitive performance. Higher BMI (p=0.012) and waist circumference (p=0.012) were also associated with worse performance, but weight reduction prior to the cognition assessment predicted worse performance as well (decrease vs. increase, p=0.008 for BMI and p=0.002 for waist).

Conclusions

Long-term dietary fat intake, BMI, and waist circumference have an inverse association with cognitive function in later life among people with IGT. However, decreases in BMI and waist prior to cognitive assessment are associated with worse cognitive performance, which could be explained by reverse causality.

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References

  1. McCrimmon RJ, Ryan CM, Frier BM. Diabetes and cognitive dysfunction. Lancet 2012;379:2291–2299. doi: 10.1016/S0140-6736(12)60360-2.

    Article  PubMed  Google Scholar 

  2. Singh B, Parsaik AK, Mielke MM, Erwin PJ, Knopman DS, Petersen RC, Roberts RO. Association of mediterranean diet with mild cognitive impairment and Alzheimer’s disease: a systematic review and meta-analysis. J Alzheimers Dis 2014;39:271–282. doi: 10.3233/JAD-130830.

    PubMed Central  PubMed  Google Scholar 

  3. Sofi F, Valecchi D, Bacci D, Abbate R, Gensini GF, Casini A, Macchi C. Physical activity and risk of cognitive decline: a meta-analysis of prospective studies. J Intern Med 2011;269:107–117. doi: 10.1111/j.1365-2796.2010.02281.x.

    Article  CAS  PubMed  Google Scholar 

  4. Loef M & Walach H. Midlife obesity and dementia: meta-analysis and adjusted forecast of dementia prevalence in the United States and China. Obesity (Silver Spring) 2013;21:E51–55. doi: 10.1002/oby.20037.

    Article  Google Scholar 

  5. Martinez-Lapiscina EH, Clavero P, Toledo E, Estruch R, Salas-Salvado J, San Julian B, Sanchez-Tainta A, Ros E, Valls-Pedret C, Martinez-Gonzalez MA. Mediterranean diet improves cognition: the PREDIMED-NAVARRA randomised trial. J Neurol Neurosurg Psychiatry 2013;84:1318–1325. doi: 10.1136/jnnp-2012-304792.

    Article  PubMed  Google Scholar 

  6. Tuomilehto J, Lindström J, Eriksson JG, Valle TT, Hämäläinen H, Ilanne-Parikka P, Keinänen-Kiukaanniemi S, Laakso M, Louheranta A, Rastas M, Salminen V, Uusitupa M. Prevention of type 2 diabetes mellitus by changes in lifestyle among subjects with impaired glucose tolerance. N Engl J Med 2001;344:1343–1350.

    Article  CAS  PubMed  Google Scholar 

  7. Luchsinger JA, Lehtisalo J, Lindström J, Ngandu T, Kivipelto M, Ahtiluoto S, Ilanne-Parikka P, Keinänen-Kiukaanniemi S, Eriksson JG, Uusitupa M, Tuomilehto J, Finnish Diabetes Prevention Study (DPS). Cognition in the finnish diabetes prevention study. Diabetes Res Clin Pract. 2015 Jun;108(3):e63–6.

    Article  Google Scholar 

  8. Lindström J, Louheranta A, Mannelin M, Rastas M, Salminen V, Eriksson J, Uusitupa M, Tuomilehto J. The Finnish Diabetes Prevention Study (DPS): Lifestyle intervention and 3-year results on diet and physical activity. Diabetes Care 2003;26:3230–3236.

    Article  PubMed  Google Scholar 

  9. Lehtovirta M, Soininen H, Helisalmi S, Mannermaa A, Helkala EL, Hartikainen P, Hanninen T, Ryynanen M, Riekkinen PJ. Clinical and neuropsychological characteristics in familial and sporadic Alzheimer’s disease: relation to apolipoprotein E polymorphism. Neurology 1996;46:413–419.

    Article  CAS  PubMed  Google Scholar 

  10. Ovaskainen M, Valsta L, Lauronen J. The compilation of food analysis values as database for dietary studies: The finnish experience. Food Chemistry 1996;57:133–136.

    Article  CAS  Google Scholar 

  11. Lakka TA & Salonen JT. Intra-person variability of various physical activity assessments in the Kuopio Ischaemic Heart Disease Risk Factor Study. Int J Epidemiol 1992;21:467–472.

    Article  CAS  PubMed  Google Scholar 

  12. Morris JC, Heyman A, Mohs RC, Hughes JP, van Belle G, Fillenbaum G, Mellits ED, Clark C. The Consortium to Establish a Registry for Alzheimer’s Disease (CERAD). Part I. Clinical and neuropsychological assessment of Alzheimer’s disease. Neurology 1989;39:1159–1165.

    Article  CAS  PubMed  Google Scholar 

  13. Reitan RM. The relation of the trail making test to organic brain damage. J Consult Psychol 1955;19:393–394.

    Article  CAS  PubMed  Google Scholar 

  14. Chandler MJ, Lacritz LH, Hynan LS, Barnard HD, Allen G, Deschner M, Weiner MF, Cullum CM. A total score for the CERAD neuropsychological battery. Neurology 2005;65:102–106. doi: 10.1212/01.wnl.0000167607.63000.38.

    Article  CAS  PubMed  Google Scholar 

  15. Box GEP & Cox DR. An analysis of transformations. Journal of the Royal Statistical Society 1964;26:211–252.

    Google Scholar 

  16. Smith PJ, Blumenthal JA, Babyak MA, Craighead L, Welsh-Bohmer KA, Browndyke JN, Strauman TA, Sherwood A. Effects of the dietary approaches to stop hypertension diet, exercise, and caloric restriction on neurocognition in overweight adults with high blood pressure. Hypertension 2010;55:1331–1338. doi: 10.1161/HYPERTENSIONAHA.109.146795.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  17. Eskelinen MH, Ngandu T, Helkala EL, Tuomilehto J, Nissinen A, Soininen H, Kivipelto M. Fat intake at midlife and cognitive impairment later in life: a population-based CAIDE study. Int J Geriatr Psychiatry 2008;23:741–747. doi: 10.1002/gps.1969.

    Article  PubMed  Google Scholar 

  18. Devore EE, Stampfer MJ, Breteler MM, Rosner B, Hee Kang J, Okereke O, Hu FB, Grodstein F. Dietary fat intake and cognitive decline in women with type 2 diabetes. Diabetes Care 2009;32:635–640. doi: 10.2337/dc08-1741.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  19. Okereke OI, Rosner BA, Kim DH, Kang JH, Cook NR, Manson JE, Buring JE, Willett WC, Grodstein F. Dietary fat types and 4-year cognitive change in community-dwelling older women. Ann Neurol 2012;72:124–134. doi: 10.1002/ana.23593;10.1002/ana.23593.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  20. Vercambre MN, Grodstein F, Kang JH. Dietary fat intake in relation to cognitive change in high-risk women with cardiovascular disease or vascular factors. Eur J Clin Nutr 2010;64:1134–1140. doi: 10.1038/ejcn.2010.113.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  21. Luchsinger JA, Tang MX, Shea S, Mayeux R. Caloric intake and the risk of Alzheimer disease. Arch Neurol 59:1258–1263.

  22. Laitinen MH, Ngandu T, Rovio S, Helkala EL, Uusitalo U, Viitanen M, Nissinen A, Tuomilehto J, Soininen H, Kivipelto M. Fat intake at midlife and risk of dementia and Alzheimer’s disease: a population-based study. Dement Geriatr Cogn Disord 2006;22:99–107.

    Article  CAS  PubMed  Google Scholar 

  23. Vercambre MN, Boutron-Ruault MC, Ritchie K, Clavel-Chapelon F, Berr C. Longterm association of food and nutrient intakes with cognitive and functional decline: a 13-year follow-up study of elderly French women. Br J Nutr 2009;102:419–427. doi: 10.1017/S0007114508201959.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  24. Ortega RM, Requejo AM, Andres P, Lopez-Sobaler AM, Quintas ME, Redondo MR, Navia B, Rivas T. Dietary intake and cognitive function in a group of elderly people. Am J Clin Nutr 1997;66:803–809.

    CAS  PubMed  Google Scholar 

  25. Buchman AS, Boyle PA, Yu L, Shah RC, Wilson RS, Bennett DA. Total daily physical activity and the risk of AD and cognitive decline in older adults. Neurology 2012;78:1323–1329. doi: 10.1212/WNL.0b013e3182535d35.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  26. Geda YE, Roberts RO, Knopman DS, Christianson TJ, Pankratz VS, Ivnik RJ, Boeve BF, Tangalos EG, Petersen RC, Rocca WA. Physical exercise, aging, and mild cognitive impairment: a population-based study. Arch Neurol 2010;67:80–86. doi: 10.1001/archneurol.2009.297.

    PubMed Central  PubMed  Google Scholar 

  27. Devore EE, Kang JH, Okereke O, Grodstein F. Physical activity levels and cognition in women with type 2 diabetes. Am J Epidemiol 2009;170:1040–1047. doi: 10.1093/aje/kwp224.

    Article  PubMed Central  PubMed  Google Scholar 

  28. Tolppanen AM, Solomon A, Kulmala J, Kareholt I, Ngandu T, Rusanen M, Laatikainen T, Soininen H, Kivipelto M. Leisure-time physical activity from midto late life, body mass index, and risk of dementia. Alzheimers Dement 2014;doi: 10.1016/j.jalz.2014.01.008. [Epub ahead of print]

    Google Scholar 

  29. Foubert-Samier A, Le Goff M, Helmer C, Peres K, Orgogozo JM, Barberger-Gateau P, Amieva H, Dartigues JF. Change in leisure and social activities and risk of dementia in elderly cohort. J Nutr Health Aging 2014;18:876–882. doi: 10.1007/s12603-014-0475-7 [doi].

    Article  CAS  PubMed  Google Scholar 

  30. Baker LD, Frank LL, Foster-Schubert K, Green PS, Wilkinson CW, McTiernan A, Plymate SR, Fishel MA, Watson GS, Cholerton BA, Duncan GE, Mehta PD, Craft S. Effects of aerobic exercise on mild cognitive impairment: a controlled trial. Arch Neurol 2010;67:71–79. doi: 10.1001/archneurol.2009.307.

    PubMed Central  PubMed  Google Scholar 

  31. Suzuki T, Shimada H, Makizako H, Doi T, Yoshida D, Ito K, Shimokata H, Washimi Y, Endo H, Kato T. A randomized controlled trial of multicomponent exercise in older adults with mild cognitive impairment. PLoS One 2013;8:e61483. doi: 10.1371/journal.pone.0061483.

    Article  Google Scholar 

  32. Baker LD, Frank LL, Foster-Schubert K, Green PS, Wilkinson CW, McTiernan A, Cholerton BA, Plymate SR, Fishel MA, Watson GS, Duncan GE, Mehta PD, Craft S. Aerobic exercise improves cognition for older adults with glucose intolerance, a risk factor for Alzheimer’s disease. J Alzheimers Dis 2010;22:569–579. doi: 10.3233/JAD-2010-100768.

    PubMed Central  CAS  PubMed  Google Scholar 

  33. Dahl AK, Hassing LB, Fransson EI, Gatz M, Reynolds CA, Pedersen NL. Body mass index across midlife and cognitive change in late life. Int J Obes (Lond) 2013;37:296–302. doi: 10.1038/ijo.2012.37.

    Article  CAS  Google Scholar 

  34. Reijmer YD, van den Berg E, Dekker JM, Nijpels G, Stehouwer CD, Kappelle LJ, Biessels GJ. Development of Vascular Risk Factors over 15 Years in Relation to Cognition: The Hoorn Study. J Am Geriatr Soc 2012;60:1426–1433. doi: 10.1111/j.1532-5415.2012.04081.x.

    Article  PubMed  Google Scholar 

  35. Lo AH, Pachana NA, Byrne GJ, Sachdev PS, Woodman RJ. Relationship between changes in body weight and cognitive function in middle-aged and older women. Int J Geriatr Psychiatry 2012;27:863–872. doi: 10.1002/gps.2797.

    Article  PubMed  Google Scholar 

  36. Driscoll I, Espeland MA, Wassertheil-Smoller S, Gaussoin SA, Ding J, Granek IA, Ockene JK, Phillips LS, Yaffe K, Resnick SM, Women’s Health Initiative Study of Cognitive Aging. Weight change and cognitive function: findings from the Women’s Health Initiative Study of Cognitive Aging. Obesity (Silver Spring) 2011;19:1595–1600. doi: 10.1038/oby.2011.23.

    Google Scholar 

  37. Sergi G, De Rui M, Coin A, Inelmen EM, Manzato E. Weight loss and Alzheimer’s disease: temporal and aetiologic connections. Proc Nutr Soc 2013;72:160–165. doi: 10.1017/S0029665112002753.

    Article  PubMed  Google Scholar 

  38. Siervo M, Nasti G, Stephan BC, Papa A, Muscariello E, Wells JC, Prado CM, Colantuoni A. Effects of intentional weight loss on physical and cognitive function in middle-aged and older obese participants: a pilot study. J Am Coll Nutr 2012;31:79–86.

    Article  PubMed  Google Scholar 

  39. Espeland MA, Rapp SR, Bray GA, Houston DK, Johnson KC, Kitabchi AE, Hergenroeder AL, Williamson J, Jakicic JM, van Dorsten B, Kritchevsky SB, for the Action for Health In Diabetes (Look AHEAD) Movement and Memory Subgroup and the Look AHEAD Research Group. Long-term Impact of Behavioral Weight Loss Intervention on Cognitive Function. J Gerontol A Biol Sci Med Sci 2014;69:1101–1108. doi: 10.1093/gerona/glu031.

    PubMed  Google Scholar 

  40. Tolppanen AM, Solomon A, Soininen H, Kivipelto M. Midlife vascular risk factors and Alzheimer’s disease: evidence from epidemiological studies. J Alzheimers Dis 2012;32:531–540. doi: 10.3233/JAD-2012-120802 [doi].

    PubMed  Google Scholar 

  41. Liu CL, Lin MH, Peng LN, Chen LK, Su CT, Liu LK, Chen LY. Late-life metabolic syndrome prevents cognitive decline among older men aged 75 years and over: oneyear prospective cohort study. J Nutr Health Aging 2013;17:523–526. doi: 10.1007/s12603-013-0010-2 [doi].

    Article  PubMed  Google Scholar 

  42. Schneider N & Yvon C. A review of multidomain interventions to support healthy cognitive ageing. J Nutr Health Aging 2013;17:252–257. doi: 10.1007/s12603-012-0402-8;10.1007/s12603-012-0402-8.

    Article  CAS  PubMed  Google Scholar 

  43. Lindström J, Peltonen M, Eriksson JG, Ilanne-Parikka P, Aunola S, Keinänen-Kiukaanniemi S, Uusitupa M, Tuomilehto J, Finnish Diabetes Prevention Study (DPS). Improved lifestyle and decreased diabetes risk over 13 years: long-term follow-up of the randomised Finnish Diabetes Prevention Study (DPS). Diabetologia 2013;56:284–293. doi: 10.1007/s00125-012-2752-5.

    Article  PubMed  Google Scholar 

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Author information

Authors and Affiliations

  1. Chronic Disease Prevention Unit, Department of Health, National Institute for Health and Welfare (THL), P.O.Box 30, FI-00271, Helsinki, Finland

    Jenni Lehtisalo, J. Lindström, T. Ngandu, M. Kivipelto, S. Ahtiluoto & J. G. Eriksson

  2. Department of Public Health, University of Helsinki, Helsinki, Finland

    Jenni Lehtisalo

  3. Aging Research Center, Karolinska Institutet, Stockholm, Sweden

    M. Kivipelto

  4. Department of Neurology, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland

    M. Kivipelto

  5. Espoo City Hospital, Espoo, Finland

    S. Ahtiluoto

  6. Science Center, Tampere University Hospital, Tampere, Finland

    P. Ilanne-Parikka

  7. The Diabetes Center, Finnish Diabetes Association, Tampere, Finland

    P. Ilanne-Parikka

  8. Institute of Health Sciences (General Practice), University of Oulu, Oulu, Finland

    S. Keinänen-Kiukaanniemi

  9. Unit of General Practice, Oulu University Hospital and Health Centre of Oulu, Oulu, Finland

    S. Keinänen-Kiukaanniemi

  10. Department of General Practice and Primary Health Care, University of Helsinki, Helsinki, Finland

    J. G. Eriksson

  11. Folkhälsan Research Center, Helsinki, Finland

    J. G. Eriksson

  12. Unit of General Practice, Helsinki University Central Hospital, Helsinki, Finland

    J. G. Eriksson

  13. Institute of Public Health and Clinical Nutrition, Clinical Nutrition, University of Eastern Finland, Kuopio, Finland

    M. Uusitupa

  14. Research Unit, Kuopio University Hospital, Kuopio, Finland

    M. Uusitupa

  15. Center for Vascular Prevention, Danube University Krems, Krems, Austria

    J. Tuomilehto

  16. Instituto de Investigacion Sanitaria del Hospital Universario LaPaz (IdiPAZ), Madrid, Spain

    J. Tuomilehto

  17. Diabetes Research Group, King Abdulaziz University, Jeddah, Saudi Arabia

    J. Tuomilehto

  18. Department of Medicine, Columbia University Medical Center, New York, USA

    J. Luchsinger

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  1. Jenni Lehtisalo
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  2. J. Lindström
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  3. T. Ngandu
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  4. M. Kivipelto
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  5. S. Ahtiluoto
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  6. P. Ilanne-Parikka
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  7. S. Keinänen-Kiukaanniemi
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  8. J. G. Eriksson
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  9. M. Uusitupa
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  10. J. Tuomilehto
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  11. J. Luchsinger
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For The Finnish Diabetes Prevention Study (DPS)

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Correspondence to Jenni Lehtisalo.

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Lehtisalo, J., Lindström, J., Ngandu, T. et al. Association of long-term dietary fat intake, exercise, and weight with later cognitive function in the Finnish Diabetes Prevention Study. J Nutr Health Aging 20, 146–154 (2016). https://doi.org/10.1007/s12603-015-0565-1

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  • DOI: https://doi.org/10.1007/s12603-015-0565-1

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