title: Dietary pattern, inflammation and cognitive decline: The Whitehall II prospective cohort study.
abstract: Low-grade inflammation appears to play an etiological role in cognitive decline. However the association between an inflammatory dietary pattern and cognitive decline has not been investigated. We aimed to investigate dietary patterns associated with inflammation and whether such diet is associated with cognitive decline.
  
  
  
  We analyzed 5083 participants (28.7% women) from the Whitehall II cohort study. Diet and serum interleukin-6 (IL-6) were assessed in 1991-1993 and 1997-1999. We used reduced rank regression methods to determine a dietary pattern associated with elevated IL-6. Cognitive tests were performed in 1997-1999 and repeated in 2002-2004 and 2007-2009. The association between dietary pattern and cognitive decline between ages 45 and 79 was assessed using linear mixed models.
  
  
  
  We identified an inflammatory dietary pattern characterized by higher intake of red meat, processed meat, peas and legumes, and fried food, and lower intake of whole grains which correlated with elevated IL-6 both in 1991-1993 and 1997-1999. A greater decline in reasoning was seen in participants in the highest tertile of adherence to the inflammatory dietary pattern (-0.37 SD; 95% confidence interval [CI] -0.40, -0.34) compared to those in the lowest tertile (-0.31; 95% CI -0.34, -0.28) after adjustment for age, sex, ethnicity, occupational status, education, and total energy intake (p for interaction across tertiles = 0.01). This association remained significant after multivariable adjustment. Similarly for global cognition, the inflammatory dietary pattern was associated with faster cognitive decline after multivariable adjustment (p for interaction across tertiles = 0.04). Associations were stronger in younger participants (<56 years), reducing the possibility of reverse causation.
  
  
  
  Our study found that a dietary pattern characterized as higher intake of red and processed meat, peas, legumes and fried food, and lower intake of whole grains was associated with higher inflammatory markers and accelerated cognitive decline at older ages. This supports the case for further research.
authors.affiliation: Department of Epidemiology and Public Health, University College London, London, UK. Electronic address: mio.ozawa@ucl.ac.uk.
authors.forename: Mio
authors.initials: M
authors.lastname: Ozawa
authors.affiliation: Department of Epidemiology and Public Health, University College London, London, UK. Electronic address: martin.shipley@ucl.ac.uk.
authors.forename: Martin
authors.initials: M
authors.lastname: Shipley
authors.affiliation: Department of Epidemiology and Public Health, University College London, London, UK. Electronic address: m.kivimaki@ucl.ac.uk.
authors.forename: Mika
authors.initials: M
authors.lastname: Kivimaki
authors.affiliation: Department of Epidemiology and Public Health, University College London, London, UK; INSERM, U1018, Centre for Research in Epidemiology and Population Health, Villejuif, France. Electronic address: a.singh-manoux@ucl.ac.uk.
authors.forename: Archana
authors.initials: A
authors.lastname: Singh-Manoux
authors.affiliation: Department of Epidemiology and Public Health, University College London, London, UK. Electronic address: e.brunner@ucl.ac.uk.
authors.forename: Eric J
authors.initials: EJ
authors.lastname: Brunner
mesh_terms: D000328:Adult; D000368:Aged; D003071:Cognition; D060825:Cognitive Dysfunction / Q000175:diagnosis* / Q000453:epidemiology; D004032:Diet / Q000009:adverse effects*; D007887:Fabaceae; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007249:Inflammation / Q000175:diagnosis* / Q000453:epidemiology; D015850:Interleukin-6 / Q000097:blood; D008297:Male; D008875:Middle Aged; D015596:Nutrition Assessment; D018532:Pisum sativum; D011446:Prospective Studies; D000069466:Red Meat; D000067348:Whole Grains
chemical_list: C508600:IL6 protein, human; D015850:Interleukin-6
keywords: Aging; Cognitive decline; Diet; Inflammation; Longitudinal study