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Objectives: Research concerning the link between dairy product intake and cognition is scant while experimental studies suggest links through various biological mechanisms. This study's objective was to examine the cross-time associations of total and specific dairy product consumption with cognitive performance in aging adults. We also explored compliance with dairy intake recommendations in France., Design: The study was based on the «Supplémentation en Vitamines et Minéraux Antioxydants» randomized trial (SU.VI.MAX, 1994-2002) and the SU.VI.MAX 2 observational follow-up study (2007-2009)., Setting: A general-population cohort in France., Participants: N=3,076 participants included in both the SU.VI.MAX and SU.VI.MAX 2 studies., Measurements: Dairy product consumption was estimated using repeated 24h records (1994-1996; mean=10 records, SD=3). Cognitive performance was assessed by neuropsychologists after an average of 13 years post-baseline via a battery of six validated tests. Mean age at the time of the cognitive function evaluation was 65.5 (SD=4.6) years. Principal component analysis revealed factors for verbal memory and working memory. Associations of energy-adjusted dairy product consumption and compliance with the respective dietary guidelines with subsequent cognitive impairment were examined using ANCOVA, providing mean differences (95% confidence intervals, CI) according to tertiles (T), adjusted for confounders including overall dietary patterns., Results: Total dairy product consumption was not associated with cognitive function. However, milk intake was negatively associated with verbal memory performance: mean difference T3 versus T1= -0.99 (-1.83, -0.15). Among women, consuming more than the recommended amount of dairy was negatively associated with working memory performance: excess versus adequate = -1.52 (-2.93, -0.11)., Conclusion: Our results indicate that dairy products consumption and especially compliance with dietary guidelines regarding dairy product intake are differentially associated with performance in specific cognitive domains after a comprehensive adjustment for lifestyle factors, health status markers and dietary patterns. Further longitudinal research is needed given the limited data available.

Objectives: The scientific literature supports a link between midlife adiposity and cognitive function or decline but most studies to-date have investigated only overall adiposity, often omitting important confounders from the analyses. We investigated in a cross-time design the relationships between two different midlife adiposity markers and subsequent cognitive function, testing midlife dietary patterns as a potential confounder of the associations., Design: The study was based on the «Supplémentation en Vitamines et Minéraux Antioxydants» randomized trial (SU.VI.MAX, 1994-2002) and the SU.VI.MAX 2 observational follow-up study (2007-2009)., Setting: A general-population cohort in France., Participants: N=2,817 individuals (1,493 men and 1,324 women) included in both the SU.VI.MAX and SU.VI.MAX 2 studies., Measurements: The cognitive performance of 2,817 middle-aged adults participating in the SU.VI.MAX (Supplémentation en Vitamines et Minéraux Antioxydant) study was assessed in 2007-2009 using 6 neuropsychological tests. Principal component analysis was used to derive specific cognitive scores. A composite cognitive score was also computed. Body mass index (BMI) and waist circumference (WC) were measured 13 years earlier (1994). Associations between midlife adiposity and cognitive functioning were estimated through covariance analyses., Results: After adjustment for obesity-related cardio-metabolic parameters, higher BMI and larger WC at midlife predicted lower executive function. For example, the adjusted mean difference (95% confidence interval) for 1 SD increase in WC was -0.48 (-0.97, 0.00). Obese participants in midlife showed an adjusted mean difference (95% confidence interval) of -1.68 (-3.15, -0.22) compared with non-obese. Further adjustment for midlife dietary patterns slightly attenuated these associations. No relationships were observed with verbal memory or global cognitive function., Conclusion: Midlife overall and abdominal adiposity were similarly associated with lower executive functioning scores. Dietary patterns may partly explain such a relationship, arguing for the importance of controlling for lifestyle confounders in future studies.

Interventions are crucial as they offer simple and inexpensive public health solutions that will be useful over the long term use. A Task Force on designing trials of nutritional interventions to slow cognitive decline in older adults was held in Toulouse in September 2012. The aim of the Task Force was to bring together leading experts from academia, the food industry and regulatory agencies to determine the best trial designs that would enable us to reach our goal of maintaining or improving cognitive function in apparently healthy aging people. An associated challenge for this Task Force was to determine the type of trials required by the Public Food Agencies for assessing the impact of nutritional compounds in comparison to well established requirements for drug trials. Although the required quality of the study design, rationale and statistical analysis remains the same, the studies designed to show reduction of cognitive decline require a long duration and the objectives of this task force was to determine best design for these trials. Two specific needs were identified to support trials of nutritional interventions: 1- Risk- reduction strategies are needed to tackle the growing burden of cognitive decline that may lead to dementia, 2- Innovative study designs are needed to improve the quality of these studies.

Few studies have investigated the long-term impact of overall dietary patterns (DP) on cognition. We evaluated the association between empirically derived DP in midlife and cognitive performance 13 y later. Dietary data were based on 24-h dietary records obtained from a subsample of the Supplémentation en Vitamines et Minéraux Antioxydant Study. Cognitive performance was assessed via a battery of neuropsychological tests that included verbal fluency, the RI-48 cued recall test, the trail-making test, and forward and backward digit span. Three composite variables, for global cognitive function, verbal memory, and executive functioning, were built. The multivariate analyses were adjusted for baseline characteristics (age, gender, intervention group, education, alcohol and energy intake, number of dietary records, physical activity, BMI, tobacco use, self-reported memory troubles, diabetes, hypertension, and, for women, menopausal status and hormone therapy use), follow-up time, history of cardiovascular disease, and depressive symptoms. Adjusted means ± SEM of composite variables across quartiles (Q4 vs. Q1) of DP were estimated using ANCOVA. A healthy and a traditional DP were identified. In the multivariate model, the healthy pattern was associated with better global cognitive function (50.1 ± 0.7 vs. 48.9 ± 0.7; P-trend = 0.001) and verbal memory (49.7 ± 0.4 vs. 48.7 ± 0.4; P-trend = 0.01). These relationships were stronger in participants scoring below the gender-specific median values for energy intake (<2490 kcal for men and <1810 for women) than in those scoring at or above those values. Adherence to a healthy DP in middle life may help preserve global cognitive function, especially verbal memory, when total energy intake is regulated.

Background: Associations between alcohol consumption and cognitive function are discordant and data focusing on midlife exposure are scarce., Objective: To estimate the association between midlife alcohol consumption and cognitive performance assessed 13 y later while accounting for comorbidities and diet., Methods: 3,088 French middle-aged adults included in the SU.VI.MAX (1994) study with available neuropsychological evaluation 13 y later. Data on alcohol consumption were obtained from repeated 24h dietary records collected in 1994-1996. Cognitive performance was assessed in 2007-2009 via a battery of 6 neuropsychological tests. A composite score was built as the mean of the standardized individual test scores (mean=50, SD=10). ANCOVA were performed to estimate mean differences in cognitive performance and 95% confidence intervals (CI)., Results: In women, abstainers displayed lower cognitive scores than did low-to-moderate alcohol drinkers (1 to 2 drinks/day) (mean difference= -1.77; 95% CI: -3.29, -0.25). In men, heavy drinkers (>3 drinks/day) had higher cognitive scores than did low-to-moderate (1 to 3 drinks/day) (mean difference=1.05; 95% CI: 0.10, 1.99). However, a lower composite cognitive score was detected in male drinkers consuming ≥ 90 g/d (≈8 drinks/d). A higher proportion of alcohol intake from beer was also associated with lower cognitive scores. These associations remained significant after adjustment for diet, comorbidities and sociodemographic factors., Conclusion: In men, heavy but not extreme drinking was associated with higher global cognitive scores. Given the known harmful effects of alcohol even in low doses regarding risk of cancer, the study does not provide a basis for modifying current public health messages., Trial Registration: ClinicalTrials.gov NCT00272428.

Background: Antioxidant properties of some vitamins and trace elements may help to prevent cognitive decline., Objective: The aim of the current study was to estimate the long-term effects of antioxidant nutrient supplementation on the cognitive performance of participants in the Supplementation in Vitamins and Mineral Antioxidants (SU.VI.MAX) study 6 y after the end of the trial., Design: This study included 4447 French participants aged 45-60 y who were enrolled in the SU.VI.MAX study (1994-2002), which was a double-blind, placebo-controlled, randomized trial. From 1994 to 2002, participants received daily vitamin C (120 mg), β-carotene (6 mg), vitamin E (30 mg), selenium (100 μg), and zinc (20 mg) in combination or as a placebo. In 2007-2009, the cognitive performance of participants was assessed with 4 neuropsychological tests (6 tasks). Principal components analysis (PCA) was performed to identify cognitive-function summary scores. Associations between antioxidant supplementation and cognitive functions, in the full sample and by subgroups, were estimated through ANOVA and expressed as mean differences and 95% CIs. Subgroup analyses were performed according to baseline characteristics., Results: Subjects receiving active antioxidant supplementation had better episodic memory scores (mean difference: 0.61; 95% CI: 0.02, 1.20). PCA indicated 2 factors that were interpreted as showing verbal memory and executive functioning. Verbal memory was improved by antioxidant supplementation only in subjects who were nonsmokers or who had low serum vitamin C concentrations at baseline., Conclusion: This study supports the role of an adequate antioxidant nutrient status in the preservation of verbal memory under certain conditions. This trial was registered at clinicaltrials.gov as NCT00272428.

Objectives: Because of their structural, anti-inflammatory and antithrombic properties, long-chain n-3 fatty acids may be key factors in the aging process. We sought to elucidate the association between intake of long-chain n-3 fatty acids and/or fish and cognitive function evaluated 13 years after dietary assessment., Design: Prospective population-based study., Participants/setting: 3,294 adults from the SU.VI.MAX study (Supplementation with Antioxidant Vitamins and Minerals study). MEASUREMENTS/STATISTICAL ANALYSIS: Subjects underwent a standardized clinical examination which included cognitive tests and self-reported cognitive difficulties scale (2007-2009). Poor scores were defined using percentiles as cut-off. Dietary data were assessed through repeated 24-h dietary records. Odd ratio (OR), comparing the fourth (Q4) to the first quartile (Q1), of having a poor score were calculated using adjusted logistic regression., Results: Self-reported cognitive difficulties were less frequent among subjects with higher intakes of total n-3 long chain fatty acids (OR = 0.72, CI 95%=0.56-0.92) and eicosapentaenoic acid (OR Q4 versus Q1 = 0.74, CI 95%=0.58-0.95), even after adjustment for depressive symptoms. A borderline significant association was also found with high fish consumption (OR Q4 versus Q1 = 0.80, CI 95%=0.63-1.01)., Conclusion: Cognitive complaints, which may be an early indicator of cognitive decline, are less frequent among the elderly who have a high long-chain n-3 acids intake, as assessed 13 years earlier.

Background: Few studies have investigated the long-term effect of overall nutritional recommendations on cognition., Objective: In a French cohort of middle-aged adults, we evaluated the association between the French National Nutrition and Health Program (Program National Nutrition Santé) Guideline Score (PNNS-GS) assessed at baseline and cognitive performance evaluated 13 y later., Design: The PNNS-GS was estimated at baseline (1994-1996) (maximum score: 15 points) in 2135 subjects in the SU.VI.MAX (Supplementation with Antioxidant Vitamins and Minerals) study. We assessed cognitive performance of subjects in 2007-2009 via a battery of 4 neuropsychologic tests that included phonemic and semantic fluency, the RI-48 (rappel indicé-48 item) cued-recall test, the trail-making test, and forward and backward digit spans. A principal components analysis was performed to account for correlations in test scores. Multivariate linear regression models or analyses of covariance were also performed., Results: In a multivariate model, we observed a positive association between the PNNS-GS and the cued-recall test and semantic and phonemic fluency tasks, whereas no association was observed with digit spans. The principal components analysis revealed 2 factors interpreted as reflecting verbal memory and executive functioning. Better adherence to nutritional recommendations was significantly associated with the verbal memory factor (β = 0.41; 95% CI: 0.17, 0.64), whereas no association was shown with the executive functioning factor. Removing specific components from the PNNS-GS did not modify the findings., Conclusion: This study suggests that strong compliance with nutritional recommendations in midlife is associated in elderly individuals with better verbal memory, which is a cognitive domain that is particularly vulnerable to pathologic aging and Alzheimer disease. This trial was registered at clinicaltrials.gov as NCT00272428.

Cognitive impairment can be influenced by a number of factors. The potential effect of nutrition has become a topic of increasing scientific and public interest. In particular, there are arguments that nutrients (food and/or supplements) such as vitamins, trace minerals, lipids, can affect the risk of cognitive decline and dementia, especially in frail elderly people at risk of deficiencies. Our objective in this paper is to review data relating diet to risk of cognitive decline and dementia, especially Alzheimer's disease (AD). We chose to focus our statements on homocysteine-related vitamins (B-vitamins), antioxidant nutrients (vitamins E and C, carotenoids, flavonoids, enzymatic cofactors) and dietary lipids. Results of epidemiological studies may sometimes appeared conflicting; however, certain associations are frequently found. High intake of saturated and trans-unsaturated (hydrogenated) fats were positively associated with increased risk of AD, whereas intake of polyunsaturated and monounsaturated fats were protective against cognitive decline in the elderly in prospective studies. Fish consumption has been associated with lower risk of AD in longitudinal cohort studies. Moreover, epidemiologic data suggest a protective role of the B-vitamins, especially vitamins B9 and B12, on cognitive decline and dementia. Finally, the results on antioxidant nutrients may suggest the importance of having a balanced combination of several antioxidant nutrients to exert a significant effect on the prevention of cognitive decline and dementia, while taking into account the potential adverse effects of these nutrients. There is no lack of attractive hypotheses to support research on the relationships between nutrition and cognitive decline. It is important to stress the need to develop further prospective studies of sufficiently long duration, including subjects whose diet is monitored at a sufficiently early stage or at least before disease or cognitive decline exist. Meta analyses should be developed, and on the basis of their results the most appropriate interventional studies can be planned. These studies must control for the greatest number of known confounding factors and take into account the impact of the standard social determinants of food habits, such as the regional cultures, social status, and educational level.

Objective: Baseline data are reported from a study of the effects of zinc supplementation on cognitive function in older adults as assessed by the CANTAB computerised test battery., Design: This is a multicentre prospective intervention study employing a randomised double-blind design., Setting: European community-based study., Participants: There are 387 healthy adults aged 55-87 y from centres in France, Italy and Northern Ireland., Interventions: Measures of visual memory, working memory and attention were obtained at baseline (prior to supplementation)., Results: Younger adults (<70 y) performed significantly better than older adults (>70 y) on all tests, with minimal differences between centres. In addition, men outperformed women on tests of spatial span, pattern recognition memory and reaction times, although these gender differences varied somewhat between centres., Conclusions: The results are generally consistent with previous age- and gender-related effects on cognitive functioning.

Abstract: Nutrition appears, with exercise and social activities, as a key element of healthy aging. Numerous epidemiological studies and interventional trials have strongly suggested a link, in aging, between an adequate nutritional status and health. Cognitive functions, which tend to decline with age, may have special benefits from nutrition, and particularly in adequate micronutrients intake. All nutrients are useful for the brain. Glucose is indispensable for brain metabolism, aminoacids for neuro-mediators, and fatty acids for neuronal membranes and, with fatty acids, micronutrients, which are vitamins, minerals and trace-elements are indispensable for function. If we consider that nutritional status and mental health are known to be main factors involved in health and quality of life in elderly people, micronutrients are a main part of this nutritional status and we will discuss those which have a special interest in brain, such as antioxidant vitamins and trace-elements. And we will focus their requirements and the risk of their deficiencies. [Copyright &y& Elsevier]