目的 探索膳食宏量营养素供能比与认知功能减退的关系,为指导膳食防治中老年人认知功能减退提供科学依据。方法 依据1997–2006年中国健康与营养调查（CHNS)数据库,通过多阶段分层整群随机抽样方法,纳入55~89岁以上且至少完成一次认知功能测试的中老年人群,并排除了能量摄入异常人群。计算中老年人群的膳食碳水化合物、脂肪、以及蛋白质供能比,分别用多因素Logistic回归模型分析中老年人宏量营养素供能比与认知功能减退的关系,并进一步用限制性立方样条曲线（RCS)将宏量营养素供能比与认知功能减退的关系进行拟合。结果 在CHNS中老年人群中,共纳入了10689个研究对象。校正了协变量后,与碳水化合物供能比较低人群相比,碳水化合物供能比较高人群具有更高的认知功能减退风险（OR=1.41,95% CI:1.03~1.94);脂肪供能比适中人群有最低的认知功能减退风险（OR=0.84,95% CI: 0.71~0.99);与蛋白质供能比较低人群相比,蛋白质供能比较高人群具有较低的认知功能减退风险（OR=0.75,95% CI:0.63~0.89)。RCS曲线表明,碳水化合物和蛋白质供能比与认知功能减退为线性关系（P non-linear>0.05),脂肪供能比与认知功能减退之间为非线性关系（P non-linear<0.05),且当脂肪供能比为34.65%时,中老年人认知功能减退的风险最低。结论 在CHNS中老年人群中,碳水化合物供能与认知功能减退风险增加有关;蛋白质供能比与认知功能减退风险降低有关;34.65%的脂肪供能比的高脂肪膳食具有最低的认知功能减退风险。
Abstract
Objective To explore the relationship between dietary macronutrient energy supply ratio and cognitive decline, so as to provide a scientific basis for dietary guidance for cognitive decline prevention in Chinese middle-aged and elderly adults. Methods Based on the China Health and Nutrition Survey (CHNS) database from 1997 to 2006, adults aged 55-89 years who had completed at least one cognitive function test were included through multistage stratified cluster random sampling method. Individuals with abnormal energy intake were excluded. The dietary energy intake, carbohydrate energy ratio, fat energy ratio, and protein energy ratio were calculated. Multivariate logistic regression model was used to analyze the relationship between the macronutrient energy supply ratio and cognitive decline. Additionally, the relationship between macronutrient energy supply ratio and cognitive decline was further examined using limiting restricted cubic spline (RCS). Results A total of 10,689 participants were included in this study. After adjusting for covariates, those with higher carbohydrates to energy ratios (carbohydrate%E) had a higher risk of cognitive decline than those with lower carbohydrate%E (OR=1.41, 95% CI: 1.03-1.94). The risk of cognitive decline was lowest in the population with moderate fat to energy ratio (fat%E) (OR=0.84, 95% CI: 0.71-0.99). People with higher protein to energy ratios(protein%E) had a lower risk of cognitive decline (OR=0.75, 95% CI: 0.63-0.89). The results in the RCS curves showed that there was a linear relationship between carbohydrate%E or protein%E and cognitive decline (P non-linear>0.05), and a nonlinear relationship between fat%E and cognitive decline (P non-linear <0.05). The risk of cognitive decline was the lowest in the subjects when fat%E was 34.65%. Conclusion In the middle-aged and elderly adults of CHNS, carbohydrate%E is related to higher risk of cognitive decline, and protein%E is related to lower risk of cognitive decline. A high-fat diet with a fat energy ratio of 34.65% is related to the lowest risk of cognitive decline.
关键词
宏量营养素 /
供能比 /
认知功能 /
中老年人
Key words
macronutrients /
energy supply ratio /
cognitive function /
middle-aged and elderly adults
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参考文献
[1] Kleinridders A, Ferris HA, Cai W, et al. Insulin action in brain regulates systemic metabolism and brain function[J].Diabetes,2014,63:2232–2243.
[2] Biskup CS, Gaber T, Helmbold K, et al. Amino acid challenge and depletion techniques in human functional neuroimaging studies: an overview[J]. Amino Acids, 2015, 47: 651–683.
[3] Leigh Gibson E, Green MW.Nutritional influences on cognitive function: mechanisms of susceptibility[J]. Nutr Res Rev, 2002, 15: 169–206.
[4] Lindqvist A, Mohapel P, Bouter B, et al. High-fat diet impairs hippocampal neurogenesis in male rats[J]. Eur J Neurol, 2006, 13: 1385–1388.
[5] Shi D, Han T, Chu X, et al. An isocaloric moderately high-fat diet extends lifespan in male rats and Drosophila[J]. Cell Metab, 2021, 33: 581–597.
[6] Shi Z, El-Obeid T, Li M, et al. Iron-related dietary pattern increases the risk of poor cognition[J]. Nutr J, 2019, 18: 48.
[7] Jia X, Su C, Du W, et al. Association of dietary quality with cognitive function in Chinese adults aged 55 years and above: a longitudinal study[J]. J Nutr Health Aging, 2023, 27: 514–523.
[8] Prince M, Bryce R, Albanese E, et al. The global prevalence of dementia: a systematic review and meta analysis[J]. Alzheimer Dement, 2013, 9：63–75.e2.
[9] Wu YT, Ali GC, Guerchet M, et al. Prevalence of dementia in mainland China, Hong Kong and Taiwan: an updated systematic review and meta-analysis[J]. Int J Epidemiol,2018,47:709–719.
[10] Frisardi V, Panza F, Seripa D, et al. Nutraceutical properties of Mediterranean diet and cognitive decline: possible underlying mechanisms[J]. J Alzheimers Dis, 2010, 22: 715–740.
[11] Meeusen R.Exercise, nutrition and the brain[J]. Sports Med, 2014, 44: S47–S56.
[12] Kanoski SE, Davidson TL.Western diet consumption and cognitive impairment: links to hippocampal dysfunction and obesity[J]. Physiol Behav, 2011, 103: 59–68.
[13] Krikorian R, Shidler MD, Dangelo K, ,et al. Dietary ketosis enhances memory in mild cognitive impairment[J]. Neurobiol Aging. Dietary ketosis enhances memory in mild cognitive impairment[J]. Neurobiol Aging, 2012, 33: 425.e19–425.e27.
[14] Gomez-Pinilla F.The combined effects of exercise and foods in preventing neurological and cognitive disorders[J].Prev Med, 2011, 52: S75–S80.
[15] Robertson SD, Matthies HJG, Owens WA, et al. Insulin reveals Akt signaling as a novel regulator of norepinephrine transporter trafficking and norepinephrine homeostasis[J]. J Neurosci, 2010, 30: 11305–11316.
[16] Cordner ZA, Tamashiro KLK.Effects of high-fat diet exposure on learning & memory[J]. Physiol Behav, 2015, 152: 363–371.
[17] Kurhe Y, Mahesh R, Gupta D.Effect of a selective cyclooxygenase type 2 inhibitor celecoxib on depression associated with obesity in mice: an approach using behavioral tests[J].Neurochem Res, 2014, 39: 1395–1402.
[18] Sivanathan S, Thavartnam K, Arif S, et al. Chronic high fat feeding increases anxiety-like behaviour and reduces transcript abundance of glucocorticoid signalling genes in the hippocampus of female rats[J]. Behav Brain Res, 2015, 286: 265–270.
[19] Unamuno X, Gómez-Ambrosi J, Rodríguez A, et al. Adipokine dysregulation and adipose tissue inflammation in human obesity[J]. Eur J Clin Invest, 2018, 48: e12997.
[20] Kalivarathan J, Chandrasekaran SP, Kalaivanan K, et al. Apigenin attenuates hippocampal oxidative events, inflammation and pathological alterations in rats fed high fat, fructose diet[J]. Biomed Pharmacother, 2017, 89: 323–331.
[21] Elhaik Goldman S, Goez D, Last D, et al. High-fat diet protects the blood-brain barrier in an Alzheimer's disease mouse model[J]. Aging Cell, 2018, 17: e12818.
[22] Keum M, Lee BC, Choe Y M, et al. Protein intake and episodic memory: the moderating role of the apolipoprotein E ε4 status[J]. Alzheimers Res Ther, 2024, 16: 181.
[23] Li W, Kong Q, Guo M, et al. Butyrylated modification of corn starch alleviates autism-like behaviors by modulating 5-hydroxytryptamine metabolism and gut-brain neural activity[J]. Carbohydr Polym, 2025, 351: 123073.
基金
国家自然科学基金（No.82404248）; 国家资助博士后研究人员计划（No.GZC20240350）
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