Energy and macronutrient intakes at breakfast and cognitive declines in community-dwelling older adults : A 9-year follow-up cohort study

Journal article

Xianwen Shang, Hill, Edward, Li, Yanping and He, Mingguang. (2021). Energy and macronutrient intakes at breakfast and cognitive declines in community-dwelling older adults : A 9-year follow-up cohort study. American Journal of Clinical Nutrition. 113(5), pp. 1093-1103. https://doi.org/10.1093/ajcn/nqaa403
AuthorsXianwen Shang, Hill, Edward, Li, Yanping and He, Mingguang
Abstract

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.

Keywordsdietary protein; dietary fat; dietary carbohydrates; energy; breakfast; cognitive decline
Year2021
JournalAmerican Journal of Clinical Nutrition
Journal citation113 (5), pp. 1093-1103
PublisherOxford University Press
ISSN1938-3207
Digital Object Identifier (DOI)https://doi.org/10.1093/ajcn/nqaa403
Scopus EID2-s2.0-85106222981
Research or scholarlyResearch
Page range1093-1103
Publisher's version
License
All rights reserved
File Access Level
Controlled
Output statusPublished
Publication dates
Online01 Mar 2021
Publication process dates
Accepted01 Dec 2020
Deposited21 Oct 2021
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