Current Evidence on Dietary Pattern and Cognitive Function

Bernice H.K. Cheung, … Jean Woo, in Advances in Food and Nutrition Research, 2014

5.2 Healthy diet indicator

Healthy diet indicator (HDI) is first reported by Huijbregts et al. (1997). It is based on the World Health Organization recommendations for the prevention of chronic diseases, particularly cancer and cardiovascular diseases. These guidelines are based on a diet low in fats, free of sugars, and high in fruits, vegetables, and complex carbohydrates. There are nine dichotomous variables generated for each participant according to their intake of: SFAs, polyunsaturated fatty acids, protein, complex carbohydrates, dietary fiber, fruits and vegetables, pulses and nuts, mono- and disaccharides, and cholesterol. To date, two cross-sectional studies were identified to assess the association of HDI and cognitive function.

Huijbregts et al. (1998) combined a 5-populations sample in three countries: West Finland, East Finland, Crevalcore in Italy, Montegiorgio in Italy, and Zutphen in The Netherlands. The results were inconsistent among countries. The mean HDI scores varied from 1.9 in East Finland to 4.1 in Montegiorgio, Italy. In all cohorts except East Finland, men with normal cognitive function had a higher HDI score than men with MCI. In West Finland, the HDI scores for normal cognitive individual was 1.8, while it was 1.0 for MCI men (p < 0.05). Again, except East Finland, a healthy diet was inversely associated with MCI after adjustment, with significant found only in Crevalcore (OR 0.75, 95% CI 0.58–0.97).

Correa Leite, Nicolosi, Cristina, Hauser, and Nappi (2001) identified the association of HDI and cognitive impairment in elderly in Pavia, Italy. Better HDI was associated with lower prevalence of cognitive deficit. Per unit increase in HDI score reduced risk of cognitive deficit by 15% (OR 0.85, 95% CI 0.77–0.93) after adjusted for physical activity, age, education, energy intake, gender, cigarette, and alcohol consumption. This study was limited by the cross-sectional nature and could not differentiate between cause and effect. Further research based on longitudinal studies is needed to confirm the association between diet and better cognitive performance in adults (Correa Leite et al., 2001).

Nutrition, public health politics and dietary tools

Francisco J. Martí-Quijal, … Amin Mousavi Khanegah, in Agri-Food Industry Strategies for Healthy Diets and Sustainability, 2020

10.3 Conclusion

Healthy diet constitutes a basic tool in order to obtain a good health and nutrition. Therefore, a growing interest has been regarding the different approaches related to a healthy diet in order to prevent noncommunicable diseases. For instance, some active policies have been implemented by governments related to public health mainly aiming at improving the population’s diet, as well as nutritional education. In addition, the multiple tools available to evaluate both the diet and the nutritional status of patients facilitate their dietary intervention. However, there are still many challenges in this field. For all these reasons, and although much progress has been made in this field, governments and health-related organizations must continue efforts to improve citizen’s diet.

The Balance Between Regulation and Private-Sector Initiative in Securing Healthy and Sustainable Food

Eleanore Alexander, … Adriana Selwyn, in Food and Drug Regulation in an Era of Globalized Markets, 2015

Challenge: Supporting Healthy Diets and Environmental Sustainability

Healthy diets and environmental sustainability are complex and interlinked issues. Food and nutrition policies have thus far had limited success in addressing these challenges. There are numerous reasons for this: health interests alone rarely control or even lead the approach to the issues, the goals of nutrition policy are rarely framed holistically, many countries pass laws without being able to enforce them, industry interests and lobby groups thwart development of coherent policies, governments severely underinvest in research to build broad-based solutions, and the potentially positive role of the private sector has been undermined by historic distrust. Finally, our models of behavior change have ignored advances in behavioral economic theory.

miRNAs as Nutritional Targets in Aging

Robin A. McGregor, Dae Y. Seo, in Molecular Basis of Nutrition and Aging, 2016

miRNA Modulation by Dietary Minerals

Healthy diets contain a range of essential dietary minerals, including calcium, phosphorus, potassium, sulfur, sodium, chlorine, and magnesium. In addition, healthy diets contain a range of dietary trace elements including iron, cobalt, copper, zinc, manganese, molybdenum, iodine, bromine, and selenium. These dietary minerals and trace elements are necessary for biochemical reactions. Deficiency in trace elements can occur during caloric restriction and when dietary food variety is limited. Trace element deficiencies have been reported in some elderly groups and the efficacy of trace element supplementation has been suggested to protect against a variety of age-related conditions including cognitive impairment.

To date there have been very few mechanistic studies of miRNA modulation by trace elements. Selenite treatment of human prostate cancer cells has been reported to upregulate miR-34b and miR-34c expression, which target the cell-cycle regulator p53 [112]. A recent study of rats fed selenium deficient diets revealed cardiac dysfunction was associated with upregulation of miR-374, miR-16, miR-199a-5p, miR-195, and miR-30e, and downregulation of miR-3571, miR-675, and miR-450a* [113]. miR-374 targets multiple genes which code for proteins in the Wnt/beta-catenin signaling pathway [113].

Nutraceutical Egg Products

Reza Tahergorabi, Jacek Jaczynski, in Egg Innovations and Strategies for Improvements, 2017


Healthy diet plays a prominent role in enhancing the quality of human life. Among the different food products delivering essential nutrients to the body, an egg as a staple food in many cultures has a special place. It is a balanced source of highly bioavailable essential amino acids as well as minerals and vitamins. However, egg is poor in omega-3 fatty acids. Dietary cholesterol and saturated fat have also been a concern for consumers. This chapter focuses on development of a novel nutraceutical egg product containing minimal levels of cholesterol and reduced saturated fat, but much greater content of omega-3 fatty acids, such as eicosapentaenoic acid, docosahexaenoic acid, and α-linolenic acid, through processing rather than manipulation of the hen’s diet. Further, the physicochemical, sensory, and potential nutritional benefits of the nutraceutical egg product prototype are discussed.

Food Security, Nutrition and Health

Joelle Singer, in Encyclopedia of Food Security and Sustainability, 2019

What Is a Healthy Lifestyle?

Healthy diet, regular sleep, daily physical activity, and a moderate approach to life’s stressful moments are components of healthy lifestyle as well as avoiding unhealthy habits such as smoking and drinking alcohol. The World Health Organization (WHO) recommends eating lots of fruits and vegetables, reducing fat, sugar and salt intake and exercising as well as checking body mass index to evaluate presence of overweight (A healthy lifestyle). Healthy diet is not a universal diet for everyone and should be adapted to each person according to its age, occupation, culture, food preferences and co-morbidities. Mediterranean diet including fish, monounsaturated fats from olive oil, fruits, vegetableswhole grains, legumes/nuts, and moderate alcohol consumption (Esposito et al., 2009) and dietary approach to stop hypertension (DASH diet) have been extensively studied. The DASH diet was elaborated in the 90s (Appel et al., 1997) and since many studies confirm an association between adherence to DASH diet and favorable outcomes (Sotos-Prieto et al., 2017). These two diets were found to be helpful to prevent cardiovascular events, breast cancer, depression colorectal cancer, diabetes, obesity, asthma, erectile dysfunction and cognitive decline, and control hypertension or diabetes (Sotos-Prieto et al., 2017; Estruch et al., 2013). Adherence to Mediterranean diet has been scored and is correlated with health outcomes in many health issues. In the Finnish Diabetes prevention study the number of healthy changes at goal was correlated to higher rate of diabetes prevention (Tuomilehto et al., 2001).

Physical activity and avoidance of physical inactivity were shown to promote health and to improve survival in many diseases (Roberts et al., 2013). Associations of physical inactivity and metabolic syndrome (A healthy lifestyle) drove clinical research in the field. The China Da Qing Diabetes Prevention Study, the Finnish Diabetes Prevention Study and the Diabetes Prevention Program (DPP) were large interventional studies in patients with metabolic syndrome in different part of the world and confirmed that change in lifestyle induced a sustained reduction in the incidence of type 2 diabetes and weight loss (Li et al., 2008; Lindström et al., 2006; Diabetes Prevention Program Research Group, 2009). The long term beneficial impact of intervention promoting exercise on body mass index (BMI) and obesity has been shown in adolescents as it was in the different long term evaluation of the China Da Qing Diabetes Prevention Study, Finnish Diabetes Prevention Study and the Diabetes Prevention Program in adults (Llauradó et al., 2018). Walking ∼18.2 km a week alone has been effective to prevent diabetes in the DPP despite a relatively modest 2 kg change in body fat mass (Slentz et al., 2016). Physical activity as therapeutic tool, have been studies in different populations. In the Look-AHEAD study lifestyle intervention didn’t show a reduction in cardiovascular outcomes in overweight or obese people with type 2 diabetes even though intensive lifestyle induced an improvement in weight, levels of HbA1c up to 13.5 years of follow up (AHEAD Research Group et al., 2013). Increased physical activity didn’t improve cognitive function in people with mild to moderate dementia in the DAPA RCT (Lamb et al., 2018). Other studies show clinical benefit of exercise in patients with chronic heart failure and cardiac rehabilitation is part of standard of care in people with cardiovascular disease and improves quality of life, readmission rate and morbidity and mortality (Piepoli et al., 2014; Chen et al., 2018).

Other components of lifestyle like smoking cessation, avoidance of alcohol, length and quality of sleep as well as stress management are part of healthy lifestyle. Special program for smoking cessation in adults with airway obstruction decreased all-cause mortality at 14.5 years by 18% compared to the control group in a large randomized clinical trial (Anthonisen et al., 2005).

Nitric Oxide

L.J. Ignarro, in Reference Module in Biomedical Sciences, 2014

Influence of Lifestyle

Healthy diet and adequate aerobic exercise are critical for the body to produce and maintain healthy levels of NO. It is well appreciated today that a diet rich in healthy protein, omega-3 fatty acids and antioxidants but deficient in saturated fats promotes the formation and stabilization of NO. Protein is a source of amino acids including l-arginine, which is the substrate required for the formation of NO. Antioxidants function to prevent the rapid inactivation of NO by reactive oxygen species. NO, being a free radical (contains an unpaired electron) reacts readily with other free radicals in order to form a more stable electron pair. This results in the destruction of NO. Antioxidants inactivate the oxygen radicals and thereby prevent oxidative destruction of NO. A diet rich in antioxidants is essential to maintaining good cardiovascular health. Fortunately, many foods exist with large quantities of a variety of antioxidants. These include fruits and vegetables. The various dark colors that characterize many fruits and vegetables are attributed to specific antioxidants. Some of the richest sources of antioxidants are blueberries, other berries, pomegranate, red grapes, and green leafy vegetables such as spinach. Red wine and certain unprocessed red gape juices are rich in antioxidants. Beets and spinach are rich sources of nitrite and nitrate, which can be converted to NO in the body. Melons contain the amino acid l-citrulline, which can be converted to l-arginine in vascular endothelial cells, thereby providing the precursor for NO. Omega-3 fatty acids derived primarily from fresh fish are essential to good cardiovascular health. Omega-3 fatty acids promote healthy cell membrane function, including the vascular endothelial cells which function to produce NO. Omega-6 fatty acids can interfere with the healthy actions of Omega-3 fatty acids and elevated dietary intake is associated with cardiovascular disease, arthritis, and cancer. Therefore, a diet rich in Omega-6 fatty acids is undesirable. Foods rich in Omega-6 fatty acids include poultry, eggs, nuts, avocados, and most vegetable oils excluding olive oil.

Aerobic exercise is well known to promote the production of NO. Mechanistically, the increased blood flow that accompanies the increased cardiac output during exercise imposes a tangential force on vascular endothelial cells. This force rapidly stimulates the enzymatic conversion of l-arginine to NO, thereby resulting in local vasodilation to promote blood flow to skeletal muscle during exercise. This physiological response is also known as flow-dependent vasodilation and is mediated by NO. Chronic or repetitive aerobic exercise, such as running, swimming, or cycling several days each week, results in increased expression of NO synthase in vascular endothelial cells, thereby causing sustained increases in NO production. This additional physiological response may be the long awaited explanation of why exercise is good for your health. Athletes and individuals who engage in frequent aerobic exercise for many years enjoy a markedly reduced incidence of cardiovascular disease.

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