MIND Dietary Pattern and Its Association with Cognition and Incident Dementia in the UK Biobank
Abstract
:1. Introduction
2. Methods
2.1. Study Population
2.2. Diet Assessment (2009–2012)
2.3. MIND Adherence Score
2.4. AHEI-2010 Adherence Score
2.5. Cognitive Assessments
2.6. Dementia Outcomes
2.7. Genetic Data and Calculation of Genetic Susceptibility Scores (GS)
2.8. Other Covariates
2.9. Statistical Analysis
3. Results
3.1. Baseline Characteristics
3.2. MIND and AHEI Adherence and Cognitive Ability
3.3. MIND and AHEI-2010 Adherence and Incident Dementia
3.4. Individual Diet Pattern Components and Cognitive Health
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Diet Component | Example Oxford WebQ Items | Component Score | ||
---|---|---|---|---|
0 | 0.5 | 1 | ||
Green leafy vegetables | cabbage/kale, lettuce, spinach | ≤2 servings/wk | 2 < 6 servings/wk | 6+ servings/wk |
Other vegetables | green beans, broccoli, butternut squash, carrot, cauliflower, celery, cucumber, leek, mushroom, sweet pepper, sprouts, sweetcorn, sweet potato | <5 servings/wk | 5 < 7 servings/wk | 7+ servings/wk |
Berries | berries | <1 serving/wk | 1 serving/wk | 2+ servings/wk |
Nuts | nuts, peanuts, seeds, peanut butter | <0.5 serving/wk | 0.5–4 servings/wk | >4 servings/wk |
Olive oil | Participant used olive oil in cooking across all diet records that reported using fat/oil in cooking | No | Yes | |
Butter/margarine | butter/margarine on bread/crackers and potatoes | <1 tsp/d | 1–2 tsp/d | >2 tsp/d |
Cheese (not low fat) | hard cheese, soft cheese, cheese spread, cottage cheese, mozzarella, goat’s cheese | 6+ servings/wk | 1 < 6 servings/wk | <1 servings/wk |
Whole grains | porridge, whole-wheat cereal/breads, wholemeal pasta, brown rice | <1 servings/d | 1–2 servings/d | >2 servings/d |
Fish (not fried) | tinned tuna, oily fish, white fish, prawns, lobster/crab, shellfish | <1 servings/m | 1+ servings/m | 1+ servings/wk |
Beans | baked bean, pulses, broad bean, hummus, tofu | <1 serving/wk | 1–3 servings/wk | >3 servings/wk |
Poultry (not fried) | poultry | <1 serving/wk | 1 serving/wk | 2+ servings/wk |
Red meat and products | sausage, beef, pork, lamb, bacon, ham | >6 servings/wk | 4–6 servings/wk | <4 servings/wk |
Fast/fried foods | fried poultry, breaded fish, fried potatoes, crisp/chips | >3 servings/wk | 1–3 servings/wk | <1 serving/wk |
Pastries and sweets | pastry, crumble, pancake, pudding, ice-cream, cake, doughnut, chocolate bar, biscuits, hot chocolate, fizzy drink, added sugars and preserves | 7+ servings/wk | 5–6 servings/wk | <5 servings/wk |
Wine | red wine, rose wine, white wine, fortified wine | <1 serving/m | 1 serving/m to 1 serving/wk | 2–7 servings/wk |
Characteristic | MIND | AHEI-2010 | ||||
---|---|---|---|---|---|---|
T1 0.0–5.5 n = 40,256 | T2 5.5–6.5 n = 35,963 | T3 7.0–14.5 n = 44,442 | T1 11.2–49.9 n = 40,220 | T2 49.9–62.3 n = 40,221 | T3 62.3–108.6 n = 40,220 | |
Age, years | 57.3 ± 8.0 | 57.9 ± 7.9 | 58.3 ± 7.7 | 56.9 ± 8.1 | 58.1 ± 7.8 | 58.6 ± 7.6 |
Female, n (%) | 17,443 (43.3) | 20,414 (56.8) | 30,209 (68.0) | 17,801 (44.3) | 23,098 (57.4) | 27,167 (67.6) |
Race/ethnicity, n (%) White South Asian Black Chinese Other, Unknown | 39,135 (97.2) 295 (0.7) 277 (0.7) 70 (0.2) 479 (1.2) | 34,791 (96.7) 364 (1.0) 249 (0.7) 79 (0.2) 480 (1.3) | 42,692 (96.0) 431 (1.0) 394 (0.9) 166 (0.4) 759 (1.7) | 39,051 (97.1) 270 (0.7) 300 (0.8) 84 (0.2) 515 (1.3) | 38,919 (96.8) 363 (0.9) 292 (0.7) 87 (0.2) 560 (1.4) | 38,648 (96.1) 457 (1.1) 328 (0.8) 144 (0.4) 643 (1.6) |
Townsend | −1.61 ± 2.85 | −1.72 ± 2.80 | −1.64 ± 2.84 | −1.59 ± 2.86 | −1.72 ± 2.80 | −1.65 ± 2.84 |
Household income ₤52,000+, n (%) | 11,009 (27.3) | 10,895 (30.3) | 14,695 (33.0) | 12,451 (31.0) | 12,072 (30.0) | 12,076 (30.0) |
College/university degree, n (%) | 16,012 (39.8) | 16,848 (46.9) | 23,855 (53.7) | 16,860 (41.9) | 18,781 (46.7) | 21,073 (52.4) |
Currently employed, n (%) | 25,171 (62.5) | 21,692 (60.3) | 26,433 (59.5) | 25,657 (63.8) | 24,066 (59.8) | 23,573 (58.6) |
Current smoker, n (%) | 3898 (9.7) | 2348 (6.5) | 2237 (5.0) | 4097 (10.2) | 2628 (6.5) | 1758 (4.4) |
BMI, kg/m2 | 27.4 ± 4.8 | 26.7 ± 4.5 | 26.0 ± 4.3 | 27.6 ± 4.8 | 26.7 ± 4.5 | 25.8 ± 4.3 |
Moderate to vigorous physical activity, hours/week | 68.7 ± 86.0 | 70.8 ± 78.9 | 75.2 ± 79.1 | 67.3 ± 82.7 | 71.3 ± 80.5 | 76.6 ± 80.9 |
Self-reported health, n (%) Excellent Good Fair Poor | 7172 (17.8) 23,733 (59.1) 7824 (19.5) 1456 (3.6) | 7950 (22.1) 21,536 (60.0) 5562 (15.5) 848 (2.4) | 11,015 (24.8) 26,856 (60.5) 5680 (12.8) 812 (1.8) | 7386 (18.4) 23,617 (58.8) 7710 (19.2) 1441 (3.6) | 8725 (21.7) 24,228 (60.4) 6231 (15.5) 964 (2.4) | 10,026 (25.0) 24,280 (60.5) 5125 (12.8) 711 (1.8) |
Family history of dementia, n (%) | 829 (2.1) | 803 (2.2) | 1107 (2.5) | 821 (2.0) | 941 (2.3) | 977 (2.4) |
Diabetes, n (%) | 1339 (3.3) | 898 (2.5) | 841 (1.9) | 1167 (2.9) | 1049 (2.6) | 862 (2.1) |
Heart disease, n (%) | 1820 (4.5) | 1362 (3.8) | 1409 (3.2) | 1725 (4.3) | 1533 (3.8) | 1333 (3.3) |
Hypertension, n (%) | 7329 (18.2) | 5955 (16.6) | 6592 (14.8) | 7340 (18.3) | 6585 (16.4) | 5951 (14.8) |
Stroke, n (%) | 494 (1.2) | 392 (1.1) | 393 (0.9) | 498 (1.2) | 414 (1.0) | 367 (0.9) |
Depression, n (%) | 1836 (4.6) | 1444 (4.0) | 1772 (4.0) | 1752 (4.4) | 1695 (4.2) | 1605 (4.0) |
APOE ε4 carriers, n (%) 2 | 9403 (27.7) | 8578 (28.1) | 10,600 (28.0) | 9344 (27.5) | 9416 (27.6) | 9821 (28.7) |
Genetic Score (GS)AD2 | 26.9 ± 3.0 | 26.9 ± 3.1 | 26.8 ± 3.1 | 26.9 ± 3.1 | 26.9 ± 3.1 | 26.9 ± 3.1 |
Energy, calories/d | 2075 ± 440 | 2009 ± 428 | 1953 ± 425 | 2097 ± 440 | 1990 ± 430 | 1945 ± 418 |
Frequent fast meal consumer, % | 1483 (3.7) | 943 (2.6) | 835 (1.9) | 1601 (4.0) | 1024 (2.6) | 636 (1.6) |
Vitamin/mineral supplement user, % | 16,639 (41.3) | 16,938 (47.1) | 23,759 (53.5) | 16,545 (41.1) | 19,030 (47.3) | 21,761 (54.1) |
Score Tertile | n | Test Score 5 | Model 1 1 | Model 2 2 | ||
---|---|---|---|---|---|---|
β (95% CI) | p | β (95% CI) | p | |||
3 Fluid Intelligence (higher scores reflect better performance) | ||||||
MIND T1 | 18,764 | 6.69 (2.07) | Reference | Reference | ||
MIND T2 | 16,865 | 6.73 (2.05) | 0.11 (0.07, 0.15) | <0.0001 | −0.03 (−0.07, 0.007) | 0.12 |
MIND T3 | 21,003 | 6.69 (2.02) | 0.12 (0.08, 0.16) | <0.0001 | −0.14 (−0.18, −0.10) | <0.0001 |
MIND score (raw), linear trend MIND score (per SD), linear trend | 0.03 (0.02, 0.03) 0.05 (0.03, 0.07) | <0.0001 | −0.04 (−0.05, −0.03) −0.07 (−0.09, −0.06) | <0.0001 | ||
4 Reaction Time (lower scores reflect better performance) | ||||||
MIND T1 | 40,084 | 542 (101) | Reference | Reference | ||
MIND T2 | 35,807 | 544 (99) | −2.35 (−3.72, −0.97) | 0.0008 | −0.47 (−1.85, 0.91) | 0.51 |
MIND T3 | 44,224 | 548 (101) | −2.52 (−3.85, −1.19) | 0.0002 | 0.66 (−0.70, 2.02) | 0.34 |
MIND score (raw), linear trend MIND score (per SD), linear trend | −0.45 (−0.74, −0.16) −0.87 (−1.43, −0.32) | 0.002 | 0.33 (0.03, 0.62) 0.63 (0.06, 1.21) | 0.03 | ||
4 Pairs Matching (lower scores reflect better performance) | ||||||
MIND T1 | 39,941 | 1.38 (0.62) | Reference | Reference | ||
MIND T2 | 35,609 | 1.39 (0.62) | 0.008 (−0.001, 0.02) | 0.09 | 0.01 (0.001, 0.02) | 0.03 |
MIND T3 | 43,999 | 1.42 (0.62) | 0.03 (0.02, 0.03) | <0.0001 | 0.03 (0.02, 0.04) | <0.0001 |
MIND score (raw), linear trend MIND score (per SD), linear trend | 0.007 (0.005, 0.009) 0.01 (0.01, 0.2) | <0.0001 | 0.008 (0.006, 0.01) 0.02 (0.01, 0.02) | <0.0001 | ||
3 Symbol Digit Substitution (higher scores reflect better performance) | ||||||
MIND T1 | 23,075 | 20.2 (5.1) | Reference | Reference | ||
MIND T2 | 21,153 | 20.1 (5.1) | 0.11 (0.03, 0.20) | 0.01 | −0.07 (−0.15, 0.02) | 0.16 |
MIND T3 | 26,404 | 19.9 (5.0) | 0.06 (−0.02, 0.15) | 0.13 | −0.25 (−0.33, −0.16) | <0.0001 |
MIND score (raw), linear trend MIND score (per SD), linear trend | 0.004 (−0.01, 0.02) 0.007 (−0.03, 0.04) | 0.68 | −0.07 (−0.09, −0.05) −0.14 (−0.17, −0.10) | <0.0001 | ||
4 Trail A (lower scores reflect better performance) | ||||||
MIND T1 | 20,603 | 3.58 (0.32) | Reference | Reference | ||
MIND T2 | 18,780 | 3.59 (0.32) | −0.003 (−0.009, 0.003) | 0.34 | 0.005 (−0.001, 0.01) | 0.10 |
MIND T3 | 23,258 | 3.60 (0.31) | −0.002 (−0.007, 0.004) | 0.56 | 0.01 (0.007, 0.02) | <0.0001 |
MIND score (raw), linear trend MIND score (per SD), linear trend | −0.0007 (−0.002, 0.0006) −0.001 (−0.004, 0.001) | 0.31 | 0.003 (0.002, 0.004) 0.006 (0.003, 0.008) | <0.0001 | ||
4 Trail B (lower scores reflect better performance) | ||||||
MIND T1 | 20,603 | 4.10 (0.33) | Reference | Reference | ||
MIND T2 | 18,780 | 4.12 (0.33) | −0.003 (−0.009, 0.003) | 0.35 | 0.01 (0.005, 0.02) | 0.0002 |
MIND T3 | 23,257 | 4.13 (0.33) | −0.001 (−0.007, 0.004) | 0.62 | 0.02 (0.02, 0.03) | <0.0001 |
MIND score (raw), linear trend MIND score (per SD), linear trend | 0.0001 (−0.001, 0.001) 0.0002 (−0.002, 0.003) | 0.87 | 0.006 (0.005, 0.008) 0.012 (0.010, 0.015) | <0.0001 | ||
4 Prospective Memory Test (higher scores reflect better performance) | ||||||
n | % correct | OR (95% CI) | p | OR (95% CI) | p | |
MIND T1 | 18,887 | 86 | Reference | Reference | ||
MIND T2 | 16,978 | 86 | 1.05 (0.99, 1.12) | 0.11 | 1.01 (0.95, 1.07) | 0.78 |
MIND T3 | 21,132 | 85 | 1.03 (0.97, 1.09) | 0.30 | 0.95 (0.90, 1.01) | 0.11 |
MIND score (raw), linear trend MIND score (per SD), linear trend | 1.00 (0.99, 1.01) 1.00 (0.98, 1.03) | 0.96 | 0.98 (0.97, 0.99) 0.96 (0.94, 0.99) | 0.004 |
Score Tertile | n | Test Score 3 | Model 1 1 | Model 2 2 | ||
---|---|---|---|---|---|---|
β (95% CI) | p | β (95% CI) | p | |||
4 Fluid Intelligence (higher scores reflect better performance) | ||||||
AHEI T1 | 18,826 | 6.77 (2.06) | Reference | Reference | ||
AHEI T2 | 18,819 | 6.72 (2.06) | 0.02 (−0.02, 0.07) | 0.25 | −0.05 (−0.09, −0.008) | 0.02 |
AHEI T3 | 18,987 | 6.63 (2.02) | −0.01 (−0.05, 0.03) | 0.60 | −0.17 (−0.21, −0.13) | <0.0001 |
AHEI score (raw), linear trend AHEI score (per SD), linear trend | −0.0002 (−0.001, 0.001) −0.003 (−0.02, 0.01) | 0.72 | −0.006 (−0.007, −0.004) −0.08 (−0.09, −0.06) | <0.0001 | ||
5 Reaction Time (lower scores reflect better performance) | ||||||
AHEI T1 | 40,056 | 538 (99) | Reference | Reference | ||
AHEI T2 | 40,033 | 546 (100) | −0.01 (−1.35, 1.33) | 0.99 | 1.23 (−0.12, 2.57) | 0.07 |
AHEI T3 | 40,025 | 551 (102) | 0.65 (−0.71, 2.01) | 0.35 | 2.77 (1.37, 4.16) | <0.0001 |
AHEI score (raw), linear trend AHEI score (per SD), linear trend | 0.03 (−0.01, 0.07) 0.42 (−0.14, 0.98) | 0.14 | 0.10 (0.06, 0.14) 1.41 (0.83, 1.99) | <0.0001 | ||
5 Pairs Matching (lower scores reflect better performance) | ||||||
AHEI T1 | 39,919 | 1.36 (0.62) | Reference | Reference | ||
AHEI T2 | 39,852 | 1.40 (0.62) | 0.03 (0.02, 0.04) | <0.0001 | 0.03 (0.02, 0.04) | <0.0001 |
AHEI T3 | 39,776 | 1.43 (0.63) | 0.04 (0.03, 0.05) | <0.0001 | 0.04 (0.03, 0.05) | <0.0001 |
AHEI score (raw), linear trend AHEI score (per SD), linear trend | 0.001 (0.0012, 0.002) 0.02 (0.016, 0.023) | <0.0001 | 0.001 (0.0011, 0.0017) 0.019 (0.016, 0.023) | <0.0001 | ||
4 Symbol Digit Substitution (higher scores reflect better performance) | ||||||
AHEI T1 | 23,018 | 20.4 (5.1) | Reference | Reference | ||
AHEI T2 | 23,585 | 20.0 (5.1) | −0.06 (−0.14, 0.03) | 0.18 | −0.19 (−0.27, −0.11) | <0.0001 |
AHEI T3 | 24,029 | 19.7 (5.1) | −0.19 (−0.27, −0.10) | <0.0001 | −0.40 (−0.49, −0.32) | <0.0001 |
AHEI score (raw), linear trend AHEI score (per SD), linear trend | −0.006 (−0.009, −0.004) −0.08 (−0.12, −0.05) | <0.0001 | −0.013 (−0.016, −0.011) −0.18 (−0.22, −0.15) | <0.0001 | ||
5 Trail A (lower scores reflect better performance) | ||||||
AHEI T1 | 20,614 | 3.57 (0.32) | Reference | Reference | ||
AHEI T2 | 20,829 | 3.59 (0.32) | 0.003 (−0.003, 0.009) | 0.29 | 0.009 (0.003, 0.01) | 0.002 |
AHEI T3 | 21,198 | 3.61 (0.31) | 0.01 (0.005, 0.02) | 0.0005 | 0.02 (0.01, 0.03) | <0.0001 |
AHEI score (raw), linear trend AHEI score (per SD), linear trend | 0.0003 (0.0001, 0.0005) 0.004 (0.002, 0.006) | 0.001 | 0.0006 (0.0004, 0.0008) 0.008 (0.006, 0.01) | <0.0001 | ||
5 Trail B (lower scores reflect better performance) | ||||||
AHEI T1 | 20,614 | 4.09 (0.33) | Reference | Reference | ||
AHEI T2 | 20,828 | 4.12 (0.33) | 0.004 (−0.001, 0.01) | 0.14 | 0.015 (0.009, 0.021) | <0.0001 |
AHEI T3 | 21,198 | 4.14 (0.33) | 0.016 (0.01, 0.021) | <0.0001 | 0.034 (0.028, 0.039) | <0.0001 |
AHEI score (raw), linear trend AHEI score (per SD), linear trend | 0.0005 (0.0003, 0.0007) 0.007 (0.004, 0.009) | <0.0001 | 0.0011 (0.0009, 0.0012) 0.015 (0.012, 0.017) | <0.0001 | ||
4 Prospective Memory Test (higher scores reflect better performance) | ||||||
n | % correct | OR (95% CI) | p | OR (95% CI) | p | |
AHEI T1 | 18,927 | 87 | Reference | Reference | ||
AHEI T2 | 18,958 | 85 | 0.91 (0.86, 0.97) | 0.002 | 0.89 (0.84, 0.95) | 0.0003 |
AHEI T3 | 19,098 | 85 | 0.94 (0.88, 1.00) | 0.04 | 0.90 (0.85, 0.96) | 0.002 |
AHEI score (raw), linear trend AHEI score (per SD), linear trend | 1.00 (0.99, 1.00) 0.96 (0.94, 0.99) | 0.003 | 1.00 (0.99, 1.00) 0.95 (0.92, 0.97) | <0.0001 |
Model | Cases/ Person-Years | MIND Score | Cases/ Person-Years | AHEI Score | ||||||
---|---|---|---|---|---|---|---|---|---|---|
Model 1 1 | Model 2 2 | Model 1 1 | Model 2 2 | |||||||
HR (95% CI) | p | HR (95% CI) | p | HR (95% CI) | p | HR (95% CI) | p | |||
All-Cause Dementia | ||||||||||
T1 | 283/259,772 | Ref | Ref | 298/273,476 | Ref | Ref | ||||
T2 | 348/324,304 | 0.98 (0.84, 1.15) | 0.79 | 1.06 (0.90, 1.24) | 0.51 | 282/276,915 | 0.90 (0.77, 1.07) | 0.23 | 0.93 (0.78, 1.10) | 0.38 |
T3 | 211/245,160 | 0.81 (0.68, 0.97) | 0.03 | 0.90 (0.74, 1.09) | 0.27 | 262/278,666 | 0.84 (0.71, 1.00) | 0.04 | 0.89 (0.75, 1.06) | 0.20 |
Diet score (raw), linear trend Diet score (per SD), linear trend | 842/829,236 | 0.96 (0.93, 1.00) 0.93 (0.86, 1.00) | 0.04 | 0.99 (0.95, 1.03) 0.97 (0.90, 1.05) | 0.48 | 842/829,236 | 0.99 (0.99, 1.00) 0.92 (0.85, 0.98) | 0.01 | 1.00 (0.99, 1.00) 0.94 (0.87, 1.01) | 0.10 |
Alzheimer’s Dementia | ||||||||||
T1 | 117/259,807 | Ref | Ref | 117/273,683 | Ref | Ref | ||||
T2 | 139/324,333 | 0.94 (0.74, 1.21) | 0.63 | 1.00 (0.78, 1.30) | 0.98 | 116/276,938 | 0.94 (0.73, 1.22) | 0.65 | 0.94 (0.72, 1.23) | 0.66 |
T3 | 95/245,184 | 0.88 (0.67, 1.16) | 0.35 | 0.96 (0.72, 1.28) | 0.76 | 118/278,703 | 0.96 (0.74, 1.24) | 0.75 | 0.99 (0.75, 1.29) | 0.91 |
Diet score (raw), linear trend Diet score (per SD), linear trend | 351/829,324 | 0.99 (0.93, 1.05) 0.98 (0.88, 1.09) | 0.67 | 1.01 (0.95, 1.07) 1.02 (0.91, 1.14) | 0.76 | 351/829,324 | 1.00 (0.99, 1.01) 1.00 (0.90, 1.12) | 0.97 | 1.00 (0.99, 1.01) 1.01 (0.90, 1.14) | 0.82 |
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Cornelis, M.C.; Agarwal, P.; Holland, T.M.; van Dam, R.M. MIND Dietary Pattern and Its Association with Cognition and Incident Dementia in the UK Biobank. Nutrients 2023, 15, 32. https://doi.org/10.3390/nu15010032
Cornelis MC, Agarwal P, Holland TM, van Dam RM. MIND Dietary Pattern and Its Association with Cognition and Incident Dementia in the UK Biobank. Nutrients. 2023; 15(1):32. https://doi.org/10.3390/nu15010032
Chicago/Turabian StyleCornelis, Marilyn C., Puja Agarwal, Thomas M. Holland, and Rob M. van Dam. 2023. "MIND Dietary Pattern and Its Association with Cognition and Incident Dementia in the UK Biobank" Nutrients 15, no. 1: 32. https://doi.org/10.3390/nu15010032