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Long-term intake of total energy and fat in relation to subjective cognitive decline

  • NEURO-EPIDEMIOLOGY
  • Published:
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Abstract

Diet is one of the modifiable risk factors for cognitive decline. However, human studies on total energy intake and cognitive function have remained limited and studies on fat intake and cognitive decline have been inconclusive. We aimed to examine prospectively the associations between long-term intakes of total energy and fat with subsequent subjective cognitive decline (SCD). A total of 49,493 women from the Nurses’ Health Study and 27,842 men from the Health Professionals Follow-up Study were followed for over 20 years. Average dietary intake was calculated based on repeated food frequency questionnaires (SFFQs), and Poisson regression was used to evaluate associations. Higher total energy intake was significantly associated with greater odds of SCD in both cohorts. Comparing the highest with lowest quintiles of total energy intake, the pooled multivariable-adjusted ORs (95% CIs) for a 3-unit increment in SCD, corresponding to poor versus normal SCD, was 2.77 (2.53, 2.94). Each 500 kcal/day greater intake of total energy was associated with 48% higher odds of SCD. Intakes of both total fat and total carbohydrate appeared to contribute to the positive association between total energy intake and SCD although for the same percent of energy, the association was stronger for total fat. In conclusion, higher intakes of total energy, total fat, and total carbohydrate were adversely associated with SCD. Whether these associations are causal is unclear and deserves further investigation.

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Data availability

Data will be shared at the request of other qualified investigators for purposes of replicating procedures and results. Our NHS and HPFS websites (www.nurseshealthstudy.org and sites.sph.harvard.edu/hpfs/) include guidelines for external users and links to all questionnaires.

Code availability

Analytic code will be made available upon request.

Abbreviations

SCD:

Subjective cognitive decline

OR:

Odds ratio

CI:

Confidence interval

NHS:

Nurses’ Health Study

HPFS:

Health Professionals Follow-up Study

SFFQ:

Food frequency questionnaires

BMI:

Body mass index

CVD:

Cardiovascular disease

FA:

Fatty acids

SFA:

Saturated fatty acid

MUFA:

Monounsaturated fatty acids

PUFA:

Polyunsaturated fatty acids

ALA:

Alpha-linolenic acid

EPA:

Eicosapentaenoic acid

DHA:

Docosahexaenoic acid

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Funding

This work was supported by grants from the National Institutes of Health (UM1 CA186107, U01 167552).

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Authors and Affiliations

  1. Department of Epidemiology, Harvard T. H. Chan School of Public Health, Harvard University, Boston, MA, USA

    Tian-Shin Yeh, Alberto Ascherio, Deborah Blacker & Walter C. Willett

  2. Channing Division of Network Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA

    Tian-Shin Yeh, Changzheng Yuan, Alberto Ascherio, Bernard A. Rosner & Walter C. Willett

  3. Department of Nutrition, Harvard T.H. Chan School of Public Health, Harvard University, 665 Huntington Avenue, Boston, MA, 02115, USA

    Tian-Shin Yeh, Changzheng Yuan, Alberto Ascherio & Walter C. Willett

  4. Nuffield Department of Population Health, Big Data Institute, University of Oxford, Oxford, UK

    Tian-Shin Yeh

  5. Department of Big Data and Health Science, School of Public Health, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China

    Changzheng Yuan

  6. Department of Biostatistics, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, USA

    Bernard A. Rosner

  7. Department of Medicine, Harvard Medical School, Boston, MA, USA

    Bernard A. Rosner

  8. Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA

    Deborah Blacker

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  1. Tian-Shin Yeh
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Contributions

TSY designed and conducted the analysis, interpreted the data, and wrote the manuscript. CY contributed to data analysis and completed the technical review of the results. AA, BAR, DB contributed to the interpretation of the results, provided critical feedback, and revision of the manuscript for important intellectual content. WCW designed the analysis, interpretation of the results, revision of the manuscript for important intellectual content, and supervised the project. All authors read and approved the final manuscript.

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Correspondence to Walter C. Willett.

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Yeh, TS., Yuan, C., Ascherio, A. et al. Long-term intake of total energy and fat in relation to subjective cognitive decline. Eur J Epidemiol 37, 133–146 (2022). https://doi.org/10.1007/s10654-021-00814-9

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