Associations between nut intake, cognitive function and non‐alcoholic fatty liver disease (NAFLD) in older adults in the United States: NHANES 2011-14

Abstract

Background Nuts are nutrient-rich and reported to provide some cognitive and cardiometabolic health benefits, but limited studies have focused on older adults. This study investigated the cross-sectional relationship between habitual nut intake, dietary pattern and quality, cognition and non-alcoholic fatty liver disease (NAFLD) in older adults. Methods Older adults (≥ 60 years) from the NHANES 2011-12 and 2013-14 cohorts, who had complete data on cognitive function (as CERAD total, delayed recall, animal fluency and digit-symbol substitution test) and variables to calculate the Fatty Liver Index (FLI), an indicator of NAFLD, were included (n = 1848). Nut intake and diet quality (Healthy Eating Index 2015) were determined using two 24-hour diet recalls. Participants were categorised into one of four groups based on their habitual nut intake: non-consumers (0 g/d), low intake (0.1–15.0 g/d), moderate intake (15.1–30.0 g/d) or met recommendation (> 30 g/d), with all outcomes compared between these nut intake groups. Results Cognitive scores of older adults were the lowest in non-consumers and significantly highest in the moderate intake group, with no further increase in those who consumed nuts more than 30 g/d (p < 0.007). FLI was the lowest among older adults with moderate nut intake but the associations disappeared after adjusting for covariates (p = 0.329). Moderate nut intake was also associated with better immediate and delayed memory in older adults with high risk of NAFLD (FLI ≥ 60) (B = 1.84 and 1.11, p < 0.05 respectively). Higher nutrient intake and better diet quality (p < 0.001) were seen with higher nut intake but did not influence energy from saturated fat intake. Factor analysis revealed ‘Nuts and oils’ as one of the four major dietary patterns associated with better cognition and lower FLI scores. Conclusions Moderate nut intake (15.1–30.0 g/d) may be sufficient for better cognitive performance, but not NAFLD risk of older adults in the US.

Prediction of MAFLD and NAFLD using different screening indexes: A cross-sectional study in U.S. adults

“…Similar to our findings, Motamed et al. ( 42 ) found that WC presented excellent performance in the diagnosis of NAFLD(AUC: 0.8533, 95%CI: 0.8419-0.8646)and almost the same predictive power as fatty liver index (FLI), a widely used index for the diagnosis and evaluation of fatty liver development in a number of studies ( 43 , 44 ).…”

Perspective: Is it Time to Expand Research on “Nuts” to Include “Seeds”? Justifications and Key Considerations

“…The health benefits of nuts appear to be dose dependent, which is often expressed as benefit per unit increase in the amount of nuts ( 50–52 ) or increasing frequency ( 53 , 54 ) of nut consumption. However, there was also indication that the dose-dependent relation may be curvilinear, where the maximum benefit of nuts is achieved at a certain threshold of nut intake ( 47 ). This is an important consideration as understanding the optimal amount that promotes health benefits will guide the development of specific dietary recommendations.…”

“…In nutrition epidemiology, the associations between nut intake and various health outcomes rely on how nut and seed intake is categorized and compared. In previous studies, nut intake has been categorized in a number of ways: 1 ) binary classification of intake as nonconsumers compared with consumers defined as nut intake of ≥¼ ounce (or 7.1 g/d) ( 61 , 101 ), 2 ) based on per unit increments of half ( 47 ) or a serving (1 ounce or 28.5 g/d) ( 102 ), 3 ) based on current nut recommendations of 30 g/d ( 8 , 9 ), 4 ) per 50 g/d increment ( 53 ), and 5 ) in nut intake quantiles, e.g. tertiles ( 103 ) or quartiles ( 12 ).…”

Nut Consumption and Effects on Chronic Kidney Disease and Mortality in the United States

“…Nuts are nutrient-dense foods containing salutary compounds, including unsaturated fatty acids, vegetable protein, fiber, phytosterols, vitamins, minerals, and phenols [ 7 , 8 ]. They have been found to have beneficial effects on cardiovascular diseases (CVDs), obesity, cancers, and nonalcoholic fatty liver disease in epidemiologic studies and clinical trials [ 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 ]. Emerging evidence suggests that they may work by reducing oxidative stress and inflammation and improving vascular reactivity, insulin resistance, and lipid metabolism disorder [ 17 , 18 , 19 , 20 , 21 ].…”