Association of Fruit and Vegetable Consumption With Mild Cognitive Impairment in Low- and Middle-Income Countries.
Lee Smith, Guillermo F López Sánchez, Nicola Veronese, Pinar Soysal, Hans Oh, Karel Kostev, Masoud Rahmati, Laurie Butler, Poppy Gibson, Helen Keyes, Yvonne Barnett, Jae Il Shin, Ai Koyanagi
Author Information
Lee Smith: Centre for Health Performance and Wellbeing, Anglia Ruskin University, Cambridge, UK.
Guillermo F López Sánchez: Division of Preventive Medicine and Public Health, Department of Public Health Sciences, School of Medicine, University of Murcia, Murcia, Spain. ORCID
Nicola Veronese: Department of Internal Medicine, Geriatrics Section, University of Palermo, Palermo, Italy.
Pinar Soysal: Department of Geriatric Medicine, Faculty of Medicine, Bezmialem Vakif University, Istanbul, Turkey. ORCID
Hans Oh: Suzanne Dworak Peck School of Social Work, University of Southern California, Los Angeles, California, USA.
Karel Kostev: University Clinic of Marburg, Marburg, Germany. ORCID
Masoud Rahmati: Department of Physical Education and Sport Sciences, Faculty of Literature and Human Sciences, Lorestan University, Khoramabad, Iran. ORCID
Laurie Butler: Centre for Health Performance and Wellbeing, Anglia Ruskin University, Cambridge, UK.
Poppy Gibson: Faculty of Education and Social Care, Anglia Ruskin University, Chelmsford, UK.
Helen Keyes: School of Psychology and Sport Science, Anglia Ruskin University, Cambridge, UK.
Yvonne Barnett: Centre for Health Performance and Wellbeing, Anglia Ruskin University, Cambridge, UK.
Jae Il Shin: Department of Pediatrics, Yonsei University College of Medicine, Seoul, South Korea. ORCID
Ai Koyanagi: Research and Development Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, ISCIII, Dr. Antoni Pujadas, Sant Boi de Llobregat, Barcelona, Spain.
BACKGROUND: Inadequate fruit and vegetable intake may be associated with cognitive decline but its association with mild cognitive impairment (MCI; a preclinical stage of dementia) is largely unknown. Therefore, we examined the association of fruit and vegetable consumption with MCI among middle-aged and older adults from low- and middle-income countries (LMICs). METHODS: Cross-sectional, nationally representative data from the WHO Study on global AGEing and adult health were analyzed. MCI was defined using the National Institute on Aging-Alzheimer's Association criteria. Quintiles of vegetable and fruit consumption were created based on the number of servings consumed on a typical day. Multivariable logistic regression analysis was conducted. RESULTS: Data on 32 715 individuals aged ≥50 years were analyzed (mean [standard deviation] age 62.1 [15.6] years; 51.7% females). Greater fruit consumption was dose-dependently associated with lower odds for MCI. For example, the highest quintile (vs lowest) had 47% lower odds for MCI (odds ratio [OR] = 0.53; 95% confidence interval [CI] = 0.43-0.66). For vegetable consumption, compared to the lowest quintile, the second to fourth quintiles had significant 38%-44% lower odds for MCI but there was no significant difference for the highest quintile (OR = 0.82; 95% CI = 0.59-1.15). CONCLUSIONS: Higher fruit and vegetable consumption was associated with lower odds for MCI among middle-aged and older adults from LMICs, but no significant differences were found between the highest and lowest quintiles of vegetable consumption. Future longitudinal studies are required to explore these findings in more depth, and mechanistic studies are required to elucidate on the observed possible U-shaped association between vegetable consumption and MCI.
