scholarly journals Dietary Intakes of Fatty Acids in Midlife and Risk of Cognitive Impairment in Late Life: The Singapore Chinese Health Study (P01-009-19)

2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Yiwen Jiang ◽  
Liting Sheng ◽  
Jian-Min Yuan ◽  
Woon-Puay Koh ◽  
An Pan
Keyword(s):  
Fatty Acids ◽  
Cognitive Impairment ◽  
Lower Risk ◽  
Health Study ◽  
Fat Intake ◽  
Dietary Intakes ◽  
Chinese Adults ◽  
Total Carbohydrate ◽  
Singapore Chinese

Abstract Objectives We aimed to examine the association between dietary intakes of fat and risk of cognitive impairment in Chinese adults, which has rarely been evaluated. Methods The Singapore Chinese Health Study is an ongoing cohort among Chinese adults living in Singapore. Dietary information was assessed by a validated food-frequency questionnaire at baseline (1993–1998) when the participants were aged 45–74 years old. Cognitive impairment was identified using modified Singapore version of Mini-Mental State Examination at the 3rd follow-up interviews (2014–2016). After a mean follow-up of 19.7 years, 16,948 surviving participants was included in the final analysis. Multivariable logistic regression models were used to calculate odds ratio (OR) and 95% confidence interval (CI) with adjustment for potential confounders. Results Cognitive impairment was presented in 2443 participants. Compared to total carbohydrate, dietary fat intake was inversely related to cognitive impairment (OR comparing extreme quartiles = 0.82; 95% CI 0.69–0.97; P-trend = 0.008). The OR (95% CI) comparing extreme quartiles of specific dietary fats was 1.08 (0.89–1.31) for saturated fatty acids (SFAs; P-trend = 0.50), 0.81 (0.65–1.00) for monounsaturated fatty acids (MUFAs; P-trend = 0.03), 0.83 (0.71–0.97) for polyunsaturated fatty acids (PUFAs; P-trend < 0.001), 0.92 (0.77–1.10) for n-3 PUFAs (P-trend = 0.49), and 0.83 (0.71–0.99) for n-6 PUFAs (P-trend = 0.01). Plant-based fat showed an inverse association with cognitive impairment (OR 0.84; 95% CI 0.72–0.98; P-trend = 0.02), whereas no significant association was found for animal fat (P-trend = 0.97). When compared to SFAs, inverse associations remained similar for MUFAs (P-trend = 0.03) and PUFAs (P-trend < 0.001). Conclusions In this large population-based cohort in Chinese adults, we found that substitution of total carbohydrate or SFAs with MUFAs and PUFAs, mainly n-6 PUFAs, was related to a lower risk of cognitive impairment. Furthermore, plant-based fat intake was associated with a lower risk. Our results indicate the importance of considering the quality of fat intake in preventing cognitive impairment. Funding Sources National Medical Research Council, Singapore; National Institutes of Health; National Key Research and Development Program of China. Supporting Tables, Images and/or Graphs

scholarly journals Midlife Dietary Intakes of Monounsaturated Acids, n–6 Polyunsaturated Acids, and Plant-Based Fat Are Inversely Associated with Risk of Cognitive Impairment in Older Singapore Chinese Adults

2019 ◽  
Vol 150 (4) ◽  
pp. 901-909 ◽  
Author(s):  
Yi-Wen Jiang ◽  
Li-Ting Sheng ◽  
Xiong-Fei Pan ◽  
Lei Feng ◽  
Jian-Min Yuan ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Dietary Fat ◽  
Cohort Analysis ◽  
The Elderly ◽  
Health Study ◽  
Inverse Association ◽  
Fat Intake ◽  
Total Carbohydrate ◽  
Dietary Fat Intake ◽  
Singapore Chinese

ABSTRACT Background Previous studies have shown inconsistent results for the relation between dietary fat intake and cognitive function in the elderly. Furthermore, prospective studies on this topic among the Chinese population are scarce. Objectives We aimed to examine the association between midlife dietary fat intake and risk of cognitive impairment in the elderly. Methods Prospective cohort analysis was conducted among 16,736 participants from the Singapore Chinese Health Study. Dietary information was assessed by a validated FFQ at baseline (1993–1998) when participants aged 45–74 y (mean: 53.5; SD: 6.22). Cognitive impairment was identified using the Singapore modified Mini-Mental State Examination at the third follow-up visit (2014–2016) when participants aged 61–96 y (mean: 73.2; SD: 6.41). Multivariable logistic regression models were used to calculate ORs and 95% CIs. Results Cognitive impairment was presented in 2397 participants. When substituted for total carbohydrate, dietary fat intake was inversely related to cognitive impairment (OR comparing extreme quartiles: 0.80; 95% CI: 0.67, 0.94; P-trend = 0.003). The OR (95% CI) comparing extreme quartiles of specific dietary fats was 1.08 (0.89, 1.31; P-trend = 0.51) for SFAs, 0.80 (0.64, 0.99; P-trend = 0.02) for MUFAs, 0.84 (0.72, 0.99; P-trend = 0.02) for PUFAs, 0.92 (0.77, 1.09; P-trend = 0.49) for n–3 PUFAs, and 0.83 (0.70, 0.98; P-trend = 0.01) for n–6 PUFAs. An inverse association was found for plant-based fat (OR: 0.84; 95% CI: 0.72, 0.98; P-trend = 0.02), but not for animal-based fat (OR: 0.96; 95% CI: 0.81, 1.15; P-trend = 0.76). When substituted for SFAs, the OR (95% CI) was 0.77 (0.61, 0.97; P-trend = 0.02) for MUFAs and 0.82 (0.70, 0.95; P-trend = 0.003) for PUFAs. Conclusions We found that substitution of total carbohydrate or SFAs with MUFAs and PUFAs, particularly n–6 PUFAs, was related to a lower risk of cognitive impairment in elderly Chinese participants. In addition, an inverse association with cognitive impairment was found for plant-based fat.

scholarly journals Consumption of dietary nuts in midlife and risk of cognitive impairment in late-life: the Singapore Chinese Health Study

2020 ◽  
Author(s):  
Yi-Wen Jiang ◽  
Li-Ting Sheng ◽  
Lei Feng ◽  
An Pan ◽  
Woon-Puay Koh
Keyword(s):  
Fatty Acids ◽  
Cognitive Impairment ◽  
Lower Risk ◽  
Unsaturated Fatty Acids ◽  
Late Life ◽  
Population Based ◽  
Health Study ◽  
Logistic Regression Models ◽  
Singapore Chinese ◽  
State Examination

Abstract Background evidence from prospective studies investigating the association between consumption of nuts in midlife and risk of cognitive impairment in late life is limited. Methods this study analysed data from 16,737 participants in a population-based cohort, the Singapore Chinese Health Study. Intake of nuts was assessed using a validated food-frequency questionnaire at baseline (1993–1998), when participants were 45–74 years old (mean age = 53.5 years). Cognitive function was tested using the Singapore modified Mini-Mental State Examination during the third follow-up visit (2014–2016), when participants were 61–96 years old (mean age = 73.2 years). Cognitive impairment was defined using education-specific cut-off points. Logistic regression models were used to estimate the odds ratio (OR) and the 95% confidence interval (CI) for the association between intake and risk of cognitive impairment. Results cognitive impairment was identified in 2,397 (14.3%) participants. Compared with those who consumed &lt;1 serving/month of nuts, participants who consumed 1–3 servings/month, 1 serving/week and ≥2 servings/week had 12% (95% CI 2–20%), 19% (95% CI 4–31%) and 21% (2–36%) lower risk of cognitive impairment, respectively (P-trend = 0.01). Further adjustment for intake of unsaturated fatty acids attenuated the association to non-significance. Mediation analysis showed that the 50.8% of the association between nuts and risk of cognitive impairment was mediated by the intake of total unsaturated fatty acids (P &lt; 0.001). Conclusion higher intake of nuts in midlife was related to a lower risk of cognitive impairment in late life, which was partly mediated by unsaturated fatty acids.

scholarly journals Association Between Dietary Intakes of B Vitamins in Midlife and Cognitive Impairment in Late-Life: The Singapore Chinese Health Study

2019 ◽  
Vol 75 (6) ◽  
pp. 1222-1227
Author(s):  
Li-Ting Sheng ◽  
Yi-Wen Jiang ◽  
Xiong-Fei Pan ◽  
Lei Feng ◽  
Jian-Min Yuan ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Cognitive Function ◽  
Chinese Population ◽  
Late Life ◽  
Epidemiological Studies ◽  
B Vitamins ◽  
Health Study ◽  
Dependent Manner ◽  
Dietary Intakes ◽  
Singapore Chinese

Abstract Background Dietary intakes of B vitamins (eg, folate) are related to cognitive function according to epidemiological studies in western countries. But prospective studies in Asian populations are scarce. This study evaluated the relationships of dietary intakes of six B vitamins in midlife with cognitive impairment in old age in a Chinese population living in Singapore. Methods This study included 16,948 participants from the Singapore Chinese Health Study, a population-based prospective cohort. Baseline dietary intakes of B vitamins were assessed using a validated 165-item food frequency questionnaire when the participants were aged 45–74 years (1993–1998). After an average follow-up of 20 years, cognitive function was examined using a Singapore-modified version of Mini-Mental State Examination scale in 2014–2016, and cognitive impairment was defined using education-specific cutoffs. Logistic regression models were applied to estimate the association between B vitamins and cognitive impairment. All the six B vitamins were mutually adjusted in the final model. Results In the 2014–2016 interview, 2,443 participants were defined as cognitive impairment. Riboflavin and folate were significantly and independently associated with cognitive impairment in a dose-dependent manner: the odds ratio (95% confidence interval) comparing the highest with the lowest quartile was 0.82 (0.69, 0.97) for riboflavin and 0.83 (0.70, 0.98) for folate (both p-trend &lt;.05). Dietary intakes of thiamine, niacin, vitamin B-6, and B-12 were not significantly associated with risk of cognitive impairment. Conclusions Higher dietary intakes of riboflavin and folate in midlife were associated with a lower risk of cognitive impairment in late-life in the Chinese population.

scholarly journals Dairy fat intake and risk of type 2 diabetes in 3 cohorts of US men and women

2019 ◽  
Vol 110 (5) ◽  
pp. 1192-1200 ◽  
Author(s):  
Andres V Ardisson Korat ◽  
Yanping Li ◽  
Frank Sacks ◽  
Bernard Rosner ◽  
Walter C Willett ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Dairy Products ◽  
Lower Risk ◽  
Whole Grains ◽  
Health Study ◽  
Fat Intake ◽  
Men And Women ◽  
Dairy Fat

ABSTRACT Background Previous studies have examined dairy products with various fat contents in relation to type 2 diabetes (T2D) risk, although data regarding dairy fat intake per se are sparse. Objectives We aimed to evaluate the association between dairy fat intake and risk of T2D in 3 prospective cohorts. We also examined associations for isocalorically replacing dairy fat with other macronutrients. Methods We prospectively followed 41,808 men in the Health Professionals Follow-Up Study (HPFS; 1986–2012), 65,929 women in the Nurses’ Health Study (NHS; 1984–2012), and 89,565 women in the NHS II (1991–2013). Diet was assessed quadrennially using validated FFQs. Fat intake from dairy products and other relevant sources was expressed as percentage of total energy. Self-reported incident T2D cases were confirmed using validated supplementary questionnaires. Time-dependent Cox proportional hazards regression was used to estimate the HR for dairy fat intake and T2D risk. Results During 4,219,457 person-years of follow-up, we documented 16,511 incident T2D cases. Dairy fat was not associated with risk of T2D when compared with calories from carbohydrates (HR for extreme quintiles: 0.98; 95% CI: 0.95, 1.02). Replacing 5% of calories from dairy fat with other sources of animal fat or carbohydrate from refined grains was associated with a 17% (HR: 1.17; 95% CI: 1.13, 1.21) and a 4% (HR: 1.04; 95% CI: 1.00, 1.08) higher risk of T2D, respectively. Conversely, a 5% calorie replacement with carbohydrate from whole grains was associated with a 7% lower risk of T2D (HR: 0.93; 95% CI: 0.88, 0.98). Conclusions Dairy fat intake was not associated with T2D risk in these cohort studies of US men and women when compared with calories from carbohydrate. Replacing dairy fat with carbohydrates from whole grains was associated with lower risk of T2D. Replacement with other animal fats or refined carbohydrates was associated with higher risk.

scholarly journals Dietary pattern in midlife and cognitive impairment in late life: a prospective study in Chinese adults

2019 ◽  
Vol 110 (4) ◽  
pp. 912-920 ◽  
Author(s):  
Jing Wu ◽  
Xingyue Song ◽  
Guo-Chong Chen ◽  
Nithya Neelakantan ◽  
Rob M van Dam ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Cognitive Function ◽  
Diet Quality ◽  
Dietary Patterns ◽  
Dietary Pattern ◽  
Lower Risk ◽  
Late Life ◽  
Chinese Adults ◽  
The Third

ABSTRACT Background Prospective studies linking dietary pattern and cognitive function in the elderly are limited in Asian populations. Objective We examined the associations between various healthful dietary patterns and risk of cognitive impairment in Chinese adults. Methods We used data from the Singapore Chinese Health Study of 16,948 men and women who were aged 45–74 y at baseline (1993–1998) and reinterviewed at the third follow-up visit (2014–2016), ∼20 y later. Diet quality at baseline was assessed according to the alternate Mediterranean diet (aMED), the Dietary Approaches to Stop Hypertension (DASH) diet, the alternative Healthy Eating Index (AHEI)-2010, overall plant-based diet index (PDI), and healthful plant-based diet index (hPDI). Cognitive function was evaluated using a Singapore-modified Mini-Mental State Examination during the third follow-up visit when subjects were aged 61–96 y. Multivariable logistic regression models were used to compute ORs and 95% CIs associated with the risk of cognitive impairment defined using education-specific cut-offs. Results Cognitive impairment was present in 2443 (14.4%) participants. The OR (95% CI) for cognitive impairment comparing the highest with the lowest quartile of diet quality scores was 0.67 (0.59, 0.77) for aMED, 0.71 (0.62, 0.81) for DASH, 0.75 (0.66, 0.85) for AHEI-2010, 0.82 (0.71, 0.94) for PDI, and 0.78 (0.68, 0.90) for hPDI (all P values for trend &lt;0.001). Each SD increment in different diet quality scores was associated with 7–16% lower risk of cognitive impairment. Conclusions These results provide evidence that adherence to healthy dietary patterns in midlife is associated with a lower risk of cognitive impairment in late life in Chinese adults.

scholarly journals Association Between Combined Lifestyle Factors and Healthy Ageing in Chinese Adults: The Singapore Chinese Health Study

2021 ◽  
Author(s):  
Yan-Feng Zhou ◽  
Xing-Yue Song ◽  
Xiong-Fei Pan ◽  
Lei Feng ◽  
Nan Luo ◽  
...  
Keyword(s):  
Healthy Lifestyle ◽  
Population Attributable Risk ◽  
Lifestyle Factors ◽  
Healthy Eating Index ◽  
Healthy Ageing ◽  
Health Study ◽  
Moderate Activity ◽  
Chinese Adults ◽  
Singapore Chinese

Abstract Background The aim of the study was to examine the relations of individual lifestyle factors and its composite score with healthy ageing among Chinese adults. Method We included 14 159 participants aged 45–74 years at baseline from the Singapore Chinese Health Study, a population-based prospective cohort. A protective lifestyle score (0–5 scale) was calculated at baseline (1993–1998) and updated at the second follow-up visit (2006–2010) on the basis of optimal body mass index (18.5–22.9 kg/m2), healthy diet (upper 40% of the Alternative Healthy Eating Index score), being physically active (≥2 h/wk of moderate activity or ≥0.5 h/wk of strenuous activity), nonsmoking (never smoking), and low-to-moderate alcohol drinking (&gt;0 to ≤14 drinks/wk for men and &gt;0 to ≤7 drinks/wk for women). Healthy ageing was assessed at the third follow-up visit (2014–2016) and was defined as absence of specific chronic diseases, absence of cognitive impairment and limitations in instrumental activities of daily living, good mental and overall self-perceived health, good physical functioning, and no function-limiting pain. Results About 20.0% (2834) of the participants met the criteria of healthy ageing after a median follow-up of 20 years. Each 1-point increase in the protective lifestyle score computed at baseline and second follow-up visits was associated with higher likelihood of healthy ageing by 25% (95% CI: 20%–30%) and 24% (18%–29%), respectively. The population-attributable risk percent of adherence to 4–5 protective lifestyle factors was 34.3% (95% CI: 25.3%–42.3%) at baseline and 31.3% (23.0%–38.7%) at second follow-up visits for healthy ageing. In addition, positive increase in lifestyle scores from baseline to second follow-up visits was also significantly associated with a higher likelihood of healthy ageing with an odds ratio of 1.18 (95% CI: 1.12%–1.24%) for each increment in protective lifestyle score. Conclusions Our findings confirmed that adopting healthy lifestyle factors, even after midlife, was associated with healthy ageing at old age.

Abstract MP40: Associations of Monounsaturated Fatty Acids From Plant and Animal Sources With Total and Cardiovascular Mortality Risk

Circulation ◽  
2018 ◽  
Vol 137 (suppl_1) ◽  
Author(s):  
Marta Guasch ◽  
Geng Zong ◽  
Walter Willett ◽  
Peter Zock ◽  
Anne Wanders ◽  
...  
Keyword(s):  
Fatty Acids ◽  
Mortality Risk ◽  
Cardiovascular Mortality ◽  
Lower Risk ◽  
Saturated Fatty Acids ◽  
Total Mortality ◽  
Food Composition ◽  
Health Study ◽  
Refined Carbohydrates

Background: Studies regarding monounsaturated fatty acid(MUFA) intake and mortality have reported inconsistent findings.Dietary MUFAs can come from both plant and animal sources with divergent nutrient components that potentially obscure the associations for total MUFAs. Hypothesis: We hypothesized that MUFA from plant sources(MUFA-P) is more likely to be inversely associated with mortality than MUFA from animal sources (MUFA-A).Replacing saturated fatty acids(SFA), trans fat,or refined carbohydrates by MUFA-P would be associated with a lower risk. Methods: We included 63,412 women from the Nurses’ Health Study(1990-2012) and 29,966 men from Health Professionals Follow-up Study(1990-2010). MUFA-Ps and MUFA-As were calculated based on validated food frequency questionnaires collected every 4-y and food composition databases that capture changes in composition over time. Results: During 1,896,864 person-years of follow-up, 20,672 total and 4,588 cardiovascular deaths occurred.MUFA-P was inversely associated with total mortality after adjusting for potential confounders [HR:0.84(95%CI:0.79,0.89) P <0.01], whereas MUFA-A was associated with higher risk [1.21(1.07,1.37), P <0.01].Isocalorically replacing SFAs (5% of total energy), refined carbohydrates (5% energy),or trans fat (2% energy) with MUFA-Ps was associated with 15%, 14%, and 10% lower risk of total mortality, respectively. Mortality risk was 24% lower when MUFA-Ps were modelled to replace MUFA-As(5% energy),and 20% lower when the sum of SFAs and MUFA-As(5% energy) was replaced.Similar results were observed for cardiovascular mortality for the same substitutions:HR(95%CI) were 0.74 (0.64, 0.85; P <0.01) for replacing MUFA-A and 0.83 (0.76, 0.92; P <0.01) for replacing SFA+MUFA-A. Conclusions: Higher MUFA-P intake was associated with lower total mortality and MUFA-A was associated with higher mortality.Significantly lower mortality was observed when SFAs, trans fats,or refined carbohydrates were replaced by MUFA-P, but not MUFA-A.

scholarly journals Relation of cigarette smoking and alcohol drinking in midlife with risk of cognitive impairment in late life: the Singapore Chinese Health Study

2018 ◽  
Vol 48 (1) ◽  
pp. 101-107 ◽  
Author(s):  
Jing Wu ◽  
Wenhong Dong ◽  
Xiong-Fei Pan ◽  
Lei Feng ◽  
Jian-Min Yuan ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Cigarette Smoking ◽  
Alcohol Drinking ◽  
Late Life ◽  
Health Study ◽  
Singapore Chinese

Abstract MP26: Sleep duration and risk of stroke mortality among Chinese adults in Singapore: the Singapore Chinese Health Study

Circulation ◽  
2014 ◽  
Vol 129 (suppl_1) ◽  
Author(s):  
An Pan ◽  
Jian-Min Yuan ◽  
Woon-Puay Koh
Keyword(s):  
Sleep Duration ◽  
Reference Group ◽  
Total Mortality ◽  
Health Study ◽  
Stroke Mortality ◽  
Chinese Adults ◽  
Short Sleep Duration ◽  
Increased Risk ◽  
Long Sleep ◽  
Singapore Chinese

Introduction: Short or long sleep hours are associated with adverse health outcomes, including diabetes, hypertension, coronary heart disease (CHD) and total mortality. However, the prospective relation between sleep duration and stroke risk is less studied, particularly in Asians. Thus, we assessed the hypothesis that short (≤5 hours) and long (≥9 hours) sleep durations were related to increased risk of stroke mortality among Chinese adults residing in Singapore. Methods: The Singapore Chinese Health Study is a population-based cohort that recruited 63,257 Chinese adults aged 45-74 years during 1993 and 1998. Sleep duration was assessed at baseline and categorized to five groups: ≤5, 6, 7, 8 or ≥9 hours. Death information was identified via registry linkage up to December 31, 2011, with ICD-9 codes 430-438 for all stroke deaths, 430-432 for hemorrhagic, and 433-438 for ischaemic or non-specified stroke deaths. Cox proportional hazard models were used to calculate hazard ratios (HRs) with adjustment for socio-demographic, lifestyle and comorbidities. Results: We documented 1,381 total stroke deaths (322 hemorrhagic and 1,059 ischaemic or non-specified strokes) during 926,752 person-years of follow-up. Compared to the reference group of sleeping for 7 hours, the multivariate-adjusted HR (95% confidence interval) for total stroke mortality was 1.25 (1.05-1.50) for ≤5 hours, 1.01 (0.87-1.18) for 6 hours, 1.09 (0.95-1.26) for 8 hours, and 1.54 (1.28-1.85) for ≥9 hours. The increased risk was also observed for ischaemic or non-specified stroke deaths with short (1.37; 1.12-1.68) and long (1.68; 1.36-2.06) sleep durations, but not for hemorrhagic stroke deaths (0.92 [0.62-1.36] and 1.14 [0.76-1.72], respectively). We observed significant interaction with baseline hypertension (P-interaction=0.04): positive association was found for short (1.54; 1.16-2.03) and long (1.95; 1.48-2.57) sleep durations among individuals with baseline hypertension, but not among those without baseline hypertension (1.07 [0.85-1.36] and 1.27 [0.98-1.63], respectively). Furthermore, in participants without baseline CHD/stroke, short and long sleep durations were related to an increased risk (HR 1.30 [1.07-1.57] and 1.43 [1.16-1.76], respectively); while in CHD/stroke patients, only long sleep duration was associated with an increased risk (2.34; 1.53-3.57), but not the short sleep duration (0.96; 0.57-1.62). Conclusions: In this large cohort study of Chinese adults, both short and long sleep durations were significantly associated with increased risks of stroke mortality. The associations were significant and stronger in hypertensive participants, but not in those without hypertension. Further studies are needed to confirm the interaction with hypertension and explore the mechanisms linking sleep quantity and stroke mortality.

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