title: Association of Long-Term Dietary Fat Intake, Exercise, and Weight with Later Cognitive Function in the Finnish Diabetes Prevention Study.
abstract: OBJECTIVE
  To investigate associations of long-term nutrient intake, physical activity and obesity with later cognitive function among the participants in the Finnish Diabetes Prevention Study, in which a lifestyle intervention was successful in diabetes prevention.
  
  
  METHODS
  An active lifestyle intervention phase during middle age (mean duration 4 years) and extended follow-up (additional 9 years) with annual lifestyle measurements, followed by an ancillary cognition assessment.
  
  
  METHODS
  5 research centers in Finland.
  
  
  METHODS
  Of the 522 middle-aged, overweight participants with impaired glucose tolerance recruited to the study, 364 (70%) participated in the cognition assessment (mean age 68 years).
  
  
  METHODS
  A cognitive assessment was executed with the CERAD test battery and the Trail Making Test A on average 13 years after baseline. Lifestyle measurements included annual clinical measurements, food records, and exercise questionnaires during both the intervention and follow-up phase.
  
  
  RESULTS
  Lower intake of total fat (p=0.021) and saturated fatty acids (p=0.010), and frequent physical activity (p=0.040) during the whole study period were associated with better cognitive performance. Higher BMI (p=0.012) and waist circumference (p=0.012) were also associated with worse performance, but weight reduction prior to the cognition assessment predicted worse performance as well (decrease vs. increase, p=0.008 for BMI and p=0.002 for waist).
  
  
  CONCLUSIONS
  Long-term dietary fat intake, BMI, and waist circumference have an inverse association with cognitive function in later life among people with IGT. However, decreases in BMI and waist prior to cognitive assessment are associated with worse cognitive performance, which could be explained by reverse causality.
authors.affiliation: Jenni Lehtisalo, Chronic Disease Prevention Unit, Department of Health, National Institute for Health and Welfare (THL), P.O.Box 30 FI-00271 Helsinki, Finland, Phone: +358 29 524 8573, email: jenni.lehtisalo@thl.fi.
authors.forename: J
authors.initials: J
authors.lastname: Lehtisalo
authors.forename: J
authors.initials: J
authors.lastname: Lindström
authors.forename: T
authors.initials: T
authors.lastname: Ngandu
authors.forename: M
authors.initials: M
authors.lastname: Kivipelto
authors.forename: S
authors.initials: S
authors.lastname: Ahtiluoto
authors.forename: P
authors.initials: P
authors.lastname: Ilanne-Parikka
authors.forename: S
authors.initials: S
authors.lastname: Keinänen-Kiukaanniemi
authors.forename: J G
authors.initials: JG
authors.lastname: Eriksson
authors.forename: M
authors.initials: M
authors.lastname: Uusitupa
authors.forename: J
authors.initials: J
authors.lastname: Tuomilehto
authors.forename: J
authors.initials: J
authors.lastname: Luchsinger
mesh_terms: D000368:Aged; D015992:Body Mass Index; D001835:Body Weight; D003071:Cognition; D003072:Cognition Disorders / Q000209:etiology; D003704:Dementia / Q000209:etiology; D003920:Diabetes Mellitus / Q000517:prevention & control; D004032:Diet; D004041:Dietary Fats / Q000008:administration & dosage / Q000009:adverse effects*; D002149:Energy Intake; D015444:Exercise; D005247:Feeding Behavior; D005260:Female; D005387:Finland; D018149:Glucose Intolerance / Q000150:complications*; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications*; D055105:Waist Circumference; D015431:Weight Loss
chemical_list: D004041:Dietary Fats
references.citation: J Intern Med. 2011 Jan;269(1):107-17
references.pmid: 20831630
references.citation: Int J Geriatr Psychiatry. 2008 Jul;23 (7):741-7
references.pmid: 18188871
references.citation: J Gerontol A Biol Sci Med Sci. 2014 Sep;69(9):1101-8
references.pmid: 24619151
references.citation: J Am Coll Nutr. 2012 Apr;31(2):79-86
references.pmid: 22855912
references.citation: Int J Epidemiol. 1992 Jun;21(3):467-72
references.pmid: 1634307
references.citation: Int J Obes (Lond). 2013 Feb;37(2):296-302
references.pmid: 22450854
references.citation: Diabetes Care. 2003 Dec;26(12):3230-6
references.pmid: 14633807
references.citation: Br J Nutr. 2009 Aug;102(3):419-27
references.pmid: 19203415
references.citation: Lancet. 2012 Jun 16;379(9833):2291-9
references.pmid: 22683129
references.citation: J Alzheimers Dis. 2014;39(2):271-82
references.pmid: 24164735
references.citation: Ann Neurol. 2012 Jul;72(1):124-34
references.pmid: 22605573
references.citation: Neurology. 1989 Sep;39(9):1159-65
references.pmid: 2771064
references.citation: Int J Geriatr Psychiatry. 2012 Aug;27(8):863-72
references.pmid: 21987451
references.citation: Arch Neurol. 2010 Jan;67(1):80-6
references.pmid: 20065133
references.citation: Neurology. 2005 Jul 12;65(1):102-6
references.pmid: 16009893
references.citation: Am J Epidemiol. 2009 Oct 15;170(8):1040-7
references.pmid: 19729385
references.citation: Eur J Clin Nutr. 2010 Oct;64(10):1134-40
references.pmid: 20648044
references.citation: Diabetologia. 2013 Feb;56(2):284-93
references.pmid: 23093136
references.citation: J Am Geriatr Soc. 2012 Aug;60(8):1426-33
references.pmid: 22861348
references.citation: J Alzheimers Dis. 2010;22(2):569-79
references.pmid: 20847403
references.citation: PLoS One. 2013 Apr 09;8(4):e61483
references.pmid: 23585901
references.citation: Arch Neurol. 2010 Jan;67(1):71-9
references.pmid: 20065132
references.citation: Neurology. 1996 Feb;46(2):413-9
references.pmid: 8614504
references.citation: Neurology. 2012 Apr 24;78(17):1323-9
references.pmid: 22517108
references.citation: Proc Nutr Soc. 2013 Feb;72(1):160-5
references.pmid: 23110988
references.citation: Obesity (Silver Spring). 2013 Jan;21(1):E51-5
references.pmid: 23401370
references.citation: Obesity (Silver Spring). 2011 Aug;19(8):1595-600
references.pmid: 21394095
references.citation: Alzheimers Dement. 2015 Apr;11(4):434-443.e6
references.pmid: 24721528
references.citation: J Nutr Health Aging. 2013;17(6):523-6
references.pmid: 23732548
references.citation: J Nutr Health Aging. 2014 Dec;18(10):876-82
references.pmid: 25470802
references.citation: Am J Clin Nutr. 1997 Oct;66(4):803-9
references.pmid: 9322553
references.citation: J Alzheimers Dis. 2012;32(3):531-40
references.pmid: 22842867
references.citation: J Neurol Neurosurg Psychiatry. 2013 Dec;84(12 ):1318-25
references.pmid: 23670794
references.citation: Diabetes Res Clin Pract. 2015 Jun;108(3):e63-6
references.pmid: 25799080
references.citation: N Engl J Med. 2001 May 3;344(18):1343-50
references.pmid: 11333990
references.citation: Diabetes Care. 2009 Apr;32(4):635-40
references.pmid: 19336640
references.citation: Hypertension. 2010 Jun;55(6):1331-8
references.pmid: 20305128
references.citation: Arch Neurol. 2002 Aug;59(8):1258-63
references.pmid: 12164721
references.citation: J Nutr Health Aging. 2013 Mar;17(3):252-7
references.pmid: 23459978
references.citation: J Consult Psychol. 1955 Oct;19(5):393-4
references.pmid: 13263471
references.citation: Dement Geriatr Cogn Disord. 2006;22(1):99-107
references.pmid: 16710090