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The good, bad, and ugly?: How blood nutrient concentrations may reflect cognitive performance.
MedLine Citation:
PMID:  22205762     Owner:  NLM     Status:  Publisher    
A growing body of evidence is supportive of the influence of nutritional factors on cognitive health. There is evidence relating nutrition to cognitive measures to assess cognitive change over time, but such functional changes may not reflect the neuroanatomic or pathologic alterations that have occurred. Brain imaging may complement clinical assessment of dementia and hence, an understanding of how nutrients alter brain structure, specifically volumes, is key. The scarcity of such information is due in part to costs of brain imaging as well as the reluctance of participants to undergo these tests. Further, the complexity of dietary exposures or behaviors, and how best to characterize or quantify their diversity, are not only demanding of the respondent, but also demand a level of expertise in the investigator that is often overlooked. Most efforts have been directed to examining associations between single nutrients and cognitive status. More recently, nutritional epidemiologists have described dietary pattern-disease associations using a variety of approaches. These include a posteriori methods, such as factor or cluster analyses, that reduce nutrient data into investigator-named dietary patterns based on the intercorrelations between food/nutrient items or for cluster analyses on the differences(1); a comparison of a priori patterns, such as the Mediterranean pattern(2,3); and reduced rank regression, which is a combination of the 2 methods.(4) All of these approaches are highly dependent on the performance characteristics (validity and reliability) of the dietary instruments used in the intended population. Application of one of these analytical approaches is appealing because extraction of dietary patterns can distill the synergistic and sometimes antagonistic metabolic influences of food groups or nutrients (even anti-nutrients) within foods. Additional advantages of such methods include the ability to summarize dietary behavior when examined in the context of other health behaviors, the avoidance of type I (false-positive) error inflation when many nutrients are examined, and an alternative way to account for redundancy in contribution that several nutrients have on the outcomes (here, cognitive performance, brain volumes).(1-4) Moreover, if a dietary pattern is highly predictive of improved health outcomes, it may be easier to translate that pattern into practice, as has been reported for the Dietary Approaches to Stop Hypertension (DASH) diet plan.(5) People eat foods, not nutrients, and they eat them in combination, not in isolation.
Christy C Tangney; Nikolaos Scarmeas
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-12-28
Journal Detail:
Title:  Neurology     Volume:  -     ISSN:  1526-632X     ISO Abbreviation:  -     Publication Date:  2011 Dec 
Date Detail:
Created Date:  2011-12-29     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0401060     Medline TA:  Neurology     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
From the Department of Clinical Nutrition (C.C.T.), Rush University Medical Center, Chicago, IL; and Department of Neurology (N.S.), Columbia University, New York, NY.
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