title: Adherence to nutritional recommendations and subsequent cognitive performance: findings from the prospective Supplementation with Antioxidant Vitamins and Minerals 2 (SU.VI.MAX 2) study.
abstract: 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.
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Unité de Recherche en Epidémiologie Nutritionnelle, U557 INSERM/U1125 Inra/Cnam/Université Paris 13, CRNH IdF, Bobigny, France. e.kesse@uren.smbh.univ-paris13.fr
authors.forename: Emmanuelle
authors.initials: E
authors.lastname: Kesse-Guyot
authors.forename: Hélène
authors.initials: H
authors.lastname: Amieva
authors.forename: Katia
authors.initials: K
authors.lastname: Castetbon
authors.forename: Adina
authors.initials: A
authors.lastname: Henegar
authors.forename: Monique
authors.initials: M
authors.lastname: Ferry
authors.forename: Claude
authors.initials: C
authors.lastname: Jeandel
authors.forename: Serge
authors.initials: S
authors.lastname: Hercberg
authors.forename: Pilar
authors.initials: P
authors.lastname: Galan
mesh_terms: D000368:Aged; D000975:Antioxidants / Q000008:administration & dosage*; D003071:Cognition; D019587:Dietary Supplements; D004311:Double-Blind Method; D005260:Female; D019983:Guideline Adherence; D006801:Humans; D008297:Male; D008875:Middle Aged; D008903:Minerals / Q000008:administration & dosage*; D011446:Prospective Studies
chemical_list: D000975:Antioxidants; D008903:Minerals