Energy and macronutrient intakes at breakfast and cognitive declines in community-dwelling older adults: a 9-year follow-up cohort study.
Energy and macronutrient intakes at breakfast and cognitive declines in community-dwelling older adults: a 9-year follow-up cohort study.
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DOI：
10.1093/ajcn/nqaa403
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发表时间：
2021-03
期刊：
影响因子：
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通讯作者：
Xianwen Shang;Edward Hill;Yanping Li;M. He
中科院分区：
文献类型：
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作者：
Xianwen Shang;Edward Hill;Yanping Li;M. He
目前尚不清楚早餐摄入量和早餐成分是否与老年人长期认知变化独立相关。我们的目的是研究早餐时的能量和大量营养素摄入与认知能力下降之间的关系。方法：我们纳入了2935名年龄在55-93岁的参与者，基线来自中国健康与营养调查。认知在1997年，2000年，2004年，2006年和2015年进行了评估。饮食摄入量评估使用称重方法结合24小时的食物记录。结果早餐能量占总能量的25.9%，其中蛋白质、脂肪和碳水化合物的能量摄入分别占12.8%、11.5%和75.7%。在9年的中位随访期间，早餐时摄入蛋白质和脂肪的五分位组5的总体认知z评分变化的β值（以五分位组1为参考）分别为0.13（95% CI：0.01-0.25）和0.17（95% CI：0.04-0.30）。在早餐时，用等量的蛋白质（β，0.06; 95% CI：0.01-0.11）或脂肪（β，0.05; 95% CI：0.02-0.08）替代5%的碳水化合物能量与总体认知Z评分的变化呈正相关。早餐的能量摄入与总体认知Z评分没有显著相关性。对于非文字记忆Z分数也发现了类似的结果。在城市居民中，早餐脂肪摄入量与认知能力下降的正相关性和早餐碳水化合物摄入量与认知能力下降的负相关性更强。结论：早餐时蛋白质和脂肪的摄入量较高，碳水化合物的摄入量较低，与老年人认知能力下降的比率较低有关。在早餐时用蛋白质或脂肪替代碳水化合物的摄入可能有助于延缓或防止认知能力下降。
BACKGROUND It is unclear whether breakfast consumption and breakfast composition are independently associated with changes in cognition over a long-term period in older adults. OBJECTIVES We aimed to examine the associations between energy and macronutrient intakes at breakfast and cognitive declines. METHODS We included 2935 participants aged 55-93 y at baseline from the China Health and Nutrition Survey in our analysis. Cognition was assessed in 1997, 2000, 2004, 2006, and 2015. Dietary intake was assessed using weighing methods in combination with 24-h food records. RESULTS Breakfast contributed to 25.9% of total energy intake of the day and percentages of breakfast energy intake from protein, fat, and carbohydrates were 12.8%, 11.5%, and 75.7%, respectively. During a median follow-up of 9 y, the β values for changes in global cognitive z-scores for Quintile 5 of protein and fat intakes at breakfast, with Quintile 1 as the reference, were 0.13 (95% CI: 0.01-0.25) and 0.17 (95% CI: 0.04-0.30), respectively. Substitution of 5% energy from carbohydrates with equivalent energy from protein (β, 0.06; 95% CI: 0.01-0.11) or fat (β, 0.05; 95% CI: 0.02-0.08) at breakfast was positively associated with the change in the global cognitive z-score. Energy intake at breakfast was not significantly associated with the global cognitive z-score. Similar results were found for the verbal memory z-score. The positive association of breakfast fat intake and the inverse association of breakfast carbohydrate intake with cognitive declines were stronger in urban residents. CONCLUSIONS Higher intakes of protein and fat and lower intake of carbohydrates at breakfast were associated with a lower rate of cognitive decline in older adults. Substitution of carbohydrates with protein or fat intake at breakfast may help to delay or prevent cognitive declines.