Diet quality and cognitive function in an urban sample: findings from the Healthy Aging in Neighborhoods of Diversity across the Life Span (HANDLS) study

Abstract

Objective Poor diet quality contributes to morbidity, including poor brain health outcomes such as cognitive decline and dementia. African Americans and individuals living in poverty may be at greater risk for cognitive decrements from poor diet quality. Design Cross-sectional. Setting Baltimore, MD, USA. Subjects Participants were 2090 African Americans and Whites (57 % female, mean age = 47·9 years) who completed two 24 h dietary recalls. We examined cognitive performance and potential interactions of diet quality with race and poverty status using baseline data from the Healthy Aging in Neighborhoods of Diversity across the Life Span (HANDLS) study. Healthy Eating Index-2010 (HEI-2010) scores were calculated and interpreted using federal guidelines. A neurocognitive test battery was administered to evaluate cognitive function over several domains. Results Linear regression analyses showed that lower HEI-2010 scores were associated with poorer verbal learning and memory (P < 0·05) after adjustment for covariates. Diet quality within the sample was poor. Significant interactions of HEI-2010 and poverty status (all P < 0·05) indicated that higher diet quality was associated with higher performance on tests of attention and cognitive flexibility, visuospatial ability and perceptual speed among those below the poverty line. No significant race interactions emerged. Higher diet quality was associated with better performance on two measures of verbal learning and memory, irrespective of race and poverty status. Conclusions Findings suggest that diet quality and cognitive function are likely related at the population level. Future research is needed to determine whether the association is clinically significant.

Dementia as a source of social disadvantage and exclusion

“…According to Winblad et al, many of the risk factors associated with dementia cluster in lower socio‐economic groups. This is due primarily to the association between deprived areas and a higher prevalence of cardiovascular risk factors in dietary intake, obesity, depression, lack of physical activity, smoking, low levels of social participation and lower levels of education . At the same time, factors associated with higher socio‐economic status, such as occupational status and education attainment, correlate with lower levels of prevalence .…”

Dietary Factors and Cognitive Function in Poor Urban Settings

“…Lower diet quality scores using the Healthy Eating Index (HEI)-2010 were associated with lower verbal memory and learning performance [22, 23], while no independent association was found between the Canadian Healthy Eating Index diet quality score and cognitive measures [24]. …”

“…The lack of research in this area may be reflective of the few studies of cognitive function, in general, being conducted in such settings. A recent study by our group examined relations of diet quality to cognitive function among socioeconomically diverse middle age and older adults in Baltimore city using data from the Healthy Aging in Neighborhoods of Diversity across the Life Span (HANDLS) Study [23]. HANDLS is a 20-year epidemiological study of health disparities among African Americans and Whites in Baltimore City.…”

“…Significant interactions of HEI-2010 and poverty status indicated that higher diet quality was associated with better performance on tests of attention and cognitive flexibility, visuospatial ability and perceptual speed among those living below 125% of the federal poverty guideline; in contrast, there was an absence of associations for those living above 125% of the federal poverty guideline. These findings suggested that, particularly among the poor, higher diet quality may play an important role in cognitive function [23]. …”

Assessing malnutrition in pregnant women using the Dietary Diversity Score and the Mid-Upper Arm Circumference: A cross-sectional study, Zambia

“…The DDS is a qualitative measure of food consumption re ecting an individual's access to different food items and therefore is a proxy indicator of the nutritional status (13) . The 24-hour dietary recall is a subjective report method of collecting data (14) where the individual has to recall what they have consumed in the last 24 hours. There are different methods of conducting the survey, but the commonest one is a qualitative aspect where in-depth interviews are conducted by a trained interviewer or by self-reporting.…”