Diet and cardiorespiratory fitness in older adults with special reference to metabolic syndrome and cognitive function : a population-based study

Metabolic syndrome and cognitive decline are common health problems in Western population. Both of these conditions are related to a larger cluster of different risk factors. Metabolic syndrome increases the risk of type 2 diabetes and cardiovascular diseases, which are known risk factors for dementia. The aim of the present dissertation was to study the associations between diet and cardiorespiratory fitness with the risk of suffering from the metabolic syndrome and experiencing a decline in cognitive function among 57-78 years old men and women in Eastern Finland. This study was part of the population-based DR's EXTRA –intervention study.

Altogether 1410 individuals participated in this study. Based on a four-day food record, the consumption of food items and intake of nutrients as well as the subject’s diet’s similarity to two healthy dietary patterns were calculated. Cardiorespiratory fitness was assessed as maximal oxygen uptake (VO2max, ml/kg/min) by a respiratory gas analysis in a maximal symptom-limited exercise stress test on a cycle ergometer. The metabolic syndrome was defined according to the National Cholesterol Education Program -criteria. Cognitive function was assessed by the Consortium to Establish a Registry for Alzheimer’s Disease (CERAD) and the Mini-Mental State Examination (MMSE) neuropsychological test batteries.

High consumptions of berries, fish, legumes and nuts were associated with a lower risk of having metabolic syndrome in men, whereas in women, a high consumption of sausage was associated with a higher risk. In addition, adherence to a healthy diet in line with Finnish nutrition recommendations and good cardiorespiratory fitness were independently associated with a lower risk of having metabolic syndrome. The risk was lowest among those individuals in the highest tertile of cardiorespiratory fitness and achieving 3-4 dietary goals out of 4. On the other hand, the highest risk of having metabolic syndrome was observed among those individuals in the lowest tertile of cardiorespiratory fitness who did not reach any of the dietary goals.

The baseline Nordic diet score was positively associated with the CERAD total score in women and MMSE in men at four years; both scales assess the global cognitive function. Furthermore, in women, the baseline Nordic diet score was positively associated with two subtests in the CERAD test battery - the Word list learning and Word List Recall, at four years.

These results emphasize that middle-aged and elderly individuals should adopt a healthy diet in line with existing guidelines and strive for good cardiorespiratory fitness as ways of avoiding the metabolic syndrome and maintaining their cognitive function.


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