Elderly Individuals Eating a Balanced Diet have Better Mental Health and Cognitive Functioning

  • An analysis of UK Biobank data published in Nature Mental Health revealed that elderly individuals eating a balanced diet tended to have better mental health and cognitive abilities than individuals with other types of dietary preferences.
  • Study authors identified three additional dietary typesvegetarian, starch-free or reduced starch, and high protein-low fiber.
  • The study identified structural differences in specific areas of the brain between individuals eating a balanced diet and those preferring other diet types.

Food preferences are determined by many different factors. In modern societies, individual food choices are primarily defined by food preferences. In other words, people tend to eat the foods they like.

Dietary patterns and health


The link between food and health is very straightforward – if we do not eat, we will eventually die. Our body needs lots of different substances to continue functioning. We need some of them, such as proteins, fats, and carbohydrates, in large quantities. These substances are called macronutrients. Our bodies need many other types of substances in much smaller quantities. These micronutrients include vitamins, minerals, specific essential fatty acids, and many other substances.

 

In modern societies, individual food choices are primarily defined by food preferences. In other words, people tend to eat the foods they like.

 

However, a growing body of evidence indicates that specific patterns of consuming foods that our body needs can also lead to adverse health effects (for example, fats, sugars, and proteins are all substances our body needs, but eating too much or focusing on just one can produce adverse effects). Studies indicate that prolonged consumption of a diet rich in foods abundant both in fats and sugars can dysregulate our food intake control system, make us prone to overeating, and eventually lead to overweight and obesity (Hedrih, 2024; Ikemoto et al., 1996; Thanarajah et al., 2023; Wilding, 2001).

 

Prolonged consumption of a diet rich in foods abundant both in fats and sugars can dysregulate our food intake control system.

 

Studies also link prolonged consumption of foods rich in refined sugars with the development of type 2 diabetes, mental health conditions like depression and anxiety, and various other health issues (Hedrih, 2023; Huang et al., 2023).

The UK Biobank


Until recently, one of the challenges of studying the links between food intake and disease is that the effects of following specific dietary patterns often materialize after longer periods of time, sometimes years or even decades. Studies of diet-health relationships can be done on rodents in much shorter time periods, but the applicability of such findings to humans remains unknown without actual studies on humans. There are more and more experimental studies of the diet-mental health relationship in humans as well. Still, legal and ethical constraints usually make data collection techniques much less comprehensive.

Another issue with studying the diet-health relationship in humans is that human dietary patterns tend to be very diverse (unless experimentally controlled for research purposes). It is very difficult for a single group of researchers to have a large number of participants in a single research study. The UK Biobank helps solve this issue.

The UK Biobank is a large biomedical database containing in-depth genetic and health information from around half a million UK residents. It was established in 2006 with the aim of improving the prevention, diagnosis, and treatment of a wide range of serious and life-threatening illnesses. Data stored in the UK Biobank are available to researchers worldwide.

The current study


Study author Ruohan Zhang and his colleagues wanted to explore the associations between naturally developed dietary patterns and cognitive functions, mental health, blood and metabolic biomarkers, brain characteristics, and genetics (Zhang et al., 2024).

They analyzed data from the UK Biobank from participants who completed a food preference questionnaire. This included 182,990 elderly individuals, the average of whom was 71 years old and 57% female.

The food preference questionnaire consisted of 150 questions that assessed both the sensory qualities of food (e.g., taste) and food preferences. It also asked about health-related behaviors such as physical activity and watching TV. Participants rated how much they liked specific types of foods and beverages.

In addition, the study used data on participants’ mental health, cognitive functioning, blood and metabolic biomarkers, magnetic resonance imaging scans of participants’ brains, and genetic data related to mental disorders (see Figure 1).

 

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Figure 1. Study Procedure (Zhang et al., 2024)

 

The dietary subtypes


The study authors analyzed the structure of associations between participants’ food preference ratings to identify groups of food items that the same people tend to like or dislike. In other words, they looked for sets of food items such that if a person likes one of the items in a set, it is more likely that he/she will also like the other items and vice versa. They also looked for groups of people with similar food preferences.

In this way, they identified 4 dietary subtypes: 1) Starch-free or reduced starch, 2) vegetarian, 3) high protein and lower fiber, and 4) balanced subtype. Individuals in the first subtype showed a higher preference for fruits, vegetables, and protein foods but a lower preference for foods containing starches (e.g., grains, potatoes, cassava, beans, peas, etc.).  The vegetarian subtype showed a higher preference for fruits and vegetables but a lower preference for protein foods. The third subtype had a greater preference for snacks and protein foods but a lower preference for fruits and vegetables. The balanced subtype showed balanced preferences across all food categories (see Figure 2).

 

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Figure 2. Dietary subtypes

 

Individuals preferring a balanced diet had better mental health and cognitive function


Results showed that individuals with the balanced dietary subtype had better mental health results than the other 3 categories. They tended to have lower anxiety and depression symptoms, less mental distress and psychotic experiences, less prone to self-harm, reported fewer trauma experiences, and better well-being.

Participants with the balanced diet and those preferring a high protein-low fiber diet had better cognitive functioning compared to the other two groups. Magnetic resonance imaging scans showed certain differences in brain structures between the subtypes (see Figure 3).

 

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Figure 3. Results (Zhang et al., 2024)

 

Conclusion

 

The study shed light on the links between naturally developed dietary patterns and cognitive functioning in elderly individuals. It showed that a diet with balanced preferences for various food categories is associated with better mental health and cognitive abilities than diets focusing on specific types of food while avoiding others.

While the design of this study does not allow any definitive cause-and-effect inferences to be drawn from these results, it stands to reason that a balanced diet, a diet including many different types of food, would best provide all the nutrients needed for the optimal functioning of the human body, allowing for better cognitive functioning even in advanced age.

The paper “Associations of dietary patterns with brain health from behavioral, neuroimaging, biochemical and genetic analyses” was authored by Ruohan Zhang, Bei Zhang, Chun Shen, Barbara J. Sahakian, Zeyu Li, Wei Zhang, Yujie Zhao, Yuzhu Li, Jianfeng Feng, and Wei Cheng.

 

References

Hedrih, V. (2023, June 6). Health Consequences of High Sugar Consumption. CNP Articles in Nutritional Psychology. https://www.nutritional-psychology.org/health-consequences-of-high-sugar-consumption/

Hedrih, V. (2024, February 19). Consuming Fat and Sugar (At The Same Time) Promotes Overeating, Study Finds. CNP Articles in Nutritional Psychology. https://www.nutritional-psychology.org/16563-2/

Huang, Y., Chen, Z., Chen, B., Li, J., Yuan, X., Li, J., Wang, W., Dai, T., Chen, H., Wang, Y., Wang, R., Wang, P., Guo, J., Dong, Q., Liu, C., Wei, Q., Cao, D., & Liu, L. (2023). Dietary sugar consumption and health: Umbrella review. BMJ (Clinical Research Ed.), 381, e071609. https://doi.org/10.1136/bmj-2022-071609

Ikemoto, S., Takahashi, M., Tsunoda, N., Maruyama, K., Itakura, H., & Ezaki, O. (1996). High-fat diet-induced hyperglycemia and obesity in mice: Differential effects of dietary oils. Metabolism, 45(12), 1539–1546. https://doi.org/10.1016/S0026-0495(96)90185-7

Thanarajah, S. E., Difeliceantonio, A. G., Albus, K., Br, J. C., Tittgemeyer, M., Small, D. M., Thanarajah, S. E., Difeliceantonio, A. G., Albus, K., Kuzmanovic, B., & Rigoux, L. (2023). Habitual daily intake of a sweet and fatty snack modulates reward processing in humans. Cell Metabolism, 35, 1–14. https://doi.org/10.1016/j.cmet.2023.02.015

Wilding, J. P. H. (2001). Causes of obesity. Practical Diabetes International, 18(8), 288–292. https://doi.org/10.1002/PDI.277

Zhang, R., Zhang, B., Shen, C., Sahakian, B. J., Li, Z., Zhang, W., Zhao, Y., Li, Y., Feng, J., & Cheng, W. (2024). Associations of dietary patterns with brain health from behavioral, neuroimaging, biochemical and genetic analyses. Nature Mental Health, 2(5), 535–552. https://doi.org/10.1038/s44220-024-00226-0

Multivitamin-Multimineral Supplements Might Improve Cognitive Functioning in Elderly Adults

Multivitamin-multimineral supplements might improve cognitive functioning in elderly adults

 

  • Results of a large study published in the American Journal of Clinical Nutrition reported that taking multivitamin-multimineral supplements for two years somewhat improved cognitive functioning in elderly adults.
  • The most favorable change compared to placebo was in episodic memory, which corresponds to 4.8 years of fewer aging years.
  • The effect on global cognition was more modest and equivalent to reducing cognitive aging by two years.

We are all aware that people of advanced age can often be forgetful, and their memory is no longer what it used to be. Tasks requiring speed and quick reactions are more difficult. Is there a way to prevent this?

Cognition and age


Cognitive changes occur throughout the entire lifespan, starting from infancy and continuing into old age. In early childhood, our cognitive abilities develop rapidly. Language, memory, and problem-solving skills improve quickly, particularly in the earliest years of life. During adolescence and young adulthood, cognitive functions such as processing speed, working memory, and executive functions reach their peak (e.g., R. Siegler, 2024).

However, from the mid-20s to the 30s, subtle declines in processing speed and memory begin. By the time individuals reach their 60s and beyond, more noticeable declines in cognitive functions, such as short-term memory, attention, and executive functions, are visible (e.g., Williams & Kemper, 2010). Despite this, certain cognitive abilities like emotional regulation and some aspects of long-term memory can remain stable or even improve with age (Isaacowitz, 2022) (see Figure 1).

 

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Figure 1. Cognition and age

 

In the 1960s, the famous psychologist Raymond Cattell proposed a theory that differentiated between cognitive abilities that remain stable or even improve as we age and those that decline with age. He called them crystalized and fluid intelligence. Crystallized intelligence refers to the accumulation of knowledge and skills acquired through experience and education, such as vocabulary and general knowledge. Fluid intelligence, on the other hand, encompasses the ability to reason, think abstractly, and solve problems in novel situations. Later studies confirmed that some abilities do not decline until very advanced age and start visibly declining much earlier (e.g., Murman, 2015) (see Figure 2).

 

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Figure 2. Crystallized intelligence vs. fluid intelligence

 

Raymond Cattell proposed a theory that differentiated between cognitive abilities that remain stable or improve as we age and those that decline

 

What causes cognitive decline?


There are many causes of age-related cognitive decline. Some of them are genetic; others have to do with changes that our brain undergoes as we age. Biochemical processes such as oxidative stress contribute, and changes in neurotransmitter levels have a similar effect (Raz & Rodrigue, 2006; Wilson et al., 2010).

Research also indicates that some factors can reduce the rate of cognitive decline and even prevent it in some aspects. These include education, being cognitively active, healthy lifestyle habits, good physical health, and good nutritional choices (Williams & Kemper, 2010).

The current study


Study author Chirag M. Vyas and his colleagues conducted a large-scale longitudinal study on older adults called COSMOS (COcoa Supplement and Multivitamin Outcomes Study). The study explored the effects of cocoa extract (500 mg flavanols) and multivitamin-multimineral supplements (Haleon; Centrum Silver®) on preventing cardiovascular disease and cancer. It also focused on age-related cognitive decline.

The COSMOS study consisted of three parts: an experiment called COSMOS-clinic, involving 573 participants; COSMOS-Mind, a study involving annual telephone-based cognitive assessments for three years (2158 participants); and COSMOS-Web, involving annual computer-based cognitive assessments for three years (2472 participants). 

In this analysis, the study authors focused on COSMOS-clinic. Around 50% of participants in the COSMOS-clinic study were males, and over 50% had post-college education. Their average body mass index was around 27, meaning they were overweight. Around 32% reported taking alcohol daily.

The study procedure


COSMOS-clinic participants were divided into four groups. One group was taking multivitamin-multimineral supplements and cocoa extracts, another was taking cocoa extracts and a placebo instead of multivitamin-multimineral supplements, the third group was taking placebo instead of cocoa extract and (real) multivitamin-multimineral supplements, and the fourth group was taking placebo instead of both substances. The look of placebo capsules was identical to that of capsules containing cocoa extract or multivitamin-multimineral supplements, with the difference that they contained no active ingredients (i.e., did not contain any cocoa extract,  vitamins, and minerals). Around 90-91% of participants reported adhering to the treatment regimen, i.e., taking the assigned pills as required by the study protocol.

Participants completed cognitive assessments at the study authors’ clinic before and after two years of taking their assigned treatments (depending on the group) (see Figure 3).

 

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Figure 3. Study Procedure (Vyas et al., 2024)

 

Multivitamin-multimineral supplements improved episodic memory


Results showed that participants assigned to the groups taking multivitamin-multimineral treatments had a bit better global cognition after two years compared to groups taking placebo. Effects on episodic memory were much better, showing a higher average difference from the placebo group.

When study authors compared these changes to typical changes caused by age, the improvement in episodic memory was equivalent to 4.8 years less aging compared to placebo groups. Effects on global cognition amounted to 2.4 years less aging. This sample did not affect executive functions or attention (see Figure 4).

 

%learn about nutrition mental health %The Center for Nutritional Psychology

Figure 4. Results

 

Multivitamin-multimineral supplements improved global cognition across all three studies

 

The study authors also conducted a metanalysis of the results of all three COSMOS studies together. In this analysis, multivitamin-multimineral supplements had a clear positive effect on global cognition and episodic memory in particular.

Looking at the difference’s magnitude, global cognition’s effect amounted to around two years less aging. Results were similar across the three studies.

Conclusion


Results of these studies showed that taking multivitamin-multimineral supplements might slow down the cognitive decline that occurs with aging. The effects were the strongest on episodic memory, while executive functioning and attention were unaffected.

The observed effects are small, but taking supplements is easy and practically does not require changes to daily life habits. This is particularly the case when comparing them to other prospective methods of slowing cognitive decline. This means that this kind of supplement could be a useful addition to programs aimed at preventing age-related cognitive decline.

The paper “Effect of multivitamin-mineral supplementation versus placebo on cognitive function: results from the clinic subcohort of the COcoa Supplement and Multivitamin Outcomes Study (COSMOS) randomized clinical trial and meta-analysis of 3 cognitive studies within COSMOS” was authored by Chirag M Vyas, JoAnn E Manson, Howard D Sesso, Nancy R Cook, Pamela M Rist, Alison Weinberg, Vinayaga Moorthy, Laura D Baker, Mark A Espeland, Lok-Kin Yeung, Adam M Brickman, and Olivia I Okereke.

 

References

 

Isaacowitz, D. M. (2022). What do we know about aging and emotion regulation? Perspectives on Psychological Science : A Journal of the Association for Psychological Science, 17(6), 1541–1555. https://doi.org/10.1177/17456916211059819

Murman, D. L. (2015). The Impact of Age on Cognition. Seminars in Hearing, 36(3), 111–121. https://doi.org/10.1055/s-0035-1555115

Siegler. (2024). Cognitive Development in Childhood. In R. Biswas-Diener & E. Diener (Eds). Noba textbook series: Psychology. IL: DEF publishers. http://noba.to/8uv4fn9h

Raz, N., & Rodrigue, K. M. (2006). Differential aging of the brain: Patterns, cognitive correlates and modifiers. Neuroscience & Biobehavioral Reviews, 30(6), 730–748. https://doi.org/10.1016/j.neubiorev.2006.07.001

Williams, K., & Kemper, S. (2010). Exploring Interventions to Reduce Cognitive Decline in Aging. Journal of Psychosocial Nursing and Mental Health Services, 48(5), 42–51. https://doi.org/10.3928/02793695-20100331-03

Wilson, R. S., Leurgans, S. E., Boyle, P. A., Schneider, J. A., & Bennett, D. A. (2010). Neurodegenerative basis of age-related cognitive decline. Neurology, 75(12), 1070–1078. https://doi.org/10.1212/WNL.0b013e3181f39adc

 

 

 

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