BACKGROUND:Pistachios are a bioavailable source of the xanthophyll lutein. Along with zeaxanthin, these plant pigments are major components of macular pigment (MP) in the human retina. MP can be non-invasively measured and is referred to as MP optical density (MPOD). MPOD is modifiable with dietary interventions that include lutein and zeaxanthin (L/Z). Higher MPOD protects the eye from light damage and is positively associated with eye health. OBJECTIVES:This dietary intervention study aimed to evaluate the effect of pistachio consumption on MPOD. METHODS:This single-blinded, randomized controlled trial compared a 12-week pistachio intervention (2 oz/d) with usual diet (UD) on MPOD and serum L/Z in middle-aged to older healthy adults (n = 36) in a 1:1 randomization scheme. Participants were selected for habitually low L/Z intake and low baseline MPOD. MPOD was measured using heterochromatic flicker photometry at 4 retinal eccentricities during baseline, week 6, and week 12 study visits. Serum L/Z was analyzed using high-performance liquid chromatography. Primary statistical analysis was conducted on an intent-to-treat basis using repeated-measure analysis of variance. RESULTS:Compared with UD, MPOD of the participants in the pistachio intervention group (PIS) had significantly increased (P < 0.001) at all eccentricities over the initial 6-wk period. This increase was maintained at week 12. MPOD in the UD participants did not change during the 12-week period. Serum lutein concentration followed a similar pattern to MPOD; serum cis-lutein and zeaxanthin did not change in either group over the 12-wk intervention. CONCLUSIONS:The results of our study demonstrate that a dietary intervention with pistachios is efficacious in increasing MPOD in healthy adults selected for habitually low intake of L/Z and low baseline MPOD. This suggests that pistachio consumption could be an effective dietary strategy for preserving eye health. Future studies need to evaluate the generalizability of our findings to other populations. This trial was registered at clinicaltrials.gov as NCT05283941.

This study aimed to assess associations between socioeconomic condition and cognitive function among Puerto Rican adults residing in the greater Boston Area. We assessed the relationship between a score of social condition, encompassing education, income-to-poverty ratio, perceived stress, food security, and psychological acculturation, and cognitive function in a cohort of Puerto Rican Adults residing in the greater Boston area. The score was assessed over more than 12 years of follow-up and ranged from 0 (best social condition) to 15 (poorest social condition). We examined the varying contributions of traditional (education and income) vs. psychosocial (perceived stress, food security, and psychological acculturation) in relation to cognitive function. After adjusting for covariates, poorer 12-year average social condition was associated with poorer cognitive function (β = - 0.52, 95% CI = [- 0.66, - 0.38; P trend = 5.7×10 −14 for highest vs. lowest disparity category). The association was stronger for traditional (β = - 0.53, 95% CI = [- 0.67, - 0.40] P trend = 5.7×10 −14 ) than psychosocial (β = -0.20, 95% CI = [- 0.34, - 0.06] P trend = 0.05) measures, but both were significantly associated with cognitive function. Our findings in US-mainland Puerto Rican adults suggest that socioeconomic condition, both traditional and psychosocial, are associated with cognitive function. This work highlighting the importance of addressing and reducing social disparities to promote better cognitive health outcomes.

BACKGROUND:Nutrition plays a critical role in cognitive health throughout life, especially during the early years of development. OBJECTIVES:This study aimed to evaluate the role of maternal diet during pregnancy and offspring cognitive functioning during early and mid-childhood. METHODS:The study population consisted of 178 mother-child dyads in early childhood (ages 3-5 y) and 174 in mid-childhood (ages 6-11 y) from the Environmental Influences On Child Health Outcomes Cohort. Maternal diet during pregnancy was assessed using a food frequency questionnaire. Diet quality was evaluated using the healthy eating index, alternative healthy eating index (AHEI-P), Mediterranean-Dietary Approaches to Stop Hypertension (DASH) intervention for neurodegenerative delay (MIND-P), and Mediterranean diet (MDS-P) for pregnant women. Offspring cognition was assessed using the National Institutes of Health Toolbox Cognition Battery with age-standardized composite and subscale scores. Multivariable linear mixed models were performed to estimate the associations between maternal diet quality and offspring cognition. RESULTS:Higher AHEI-P [each 10-point increment: β = 2.20; 95% confidence interval (CI): 0.30, 4.00] and MIND-P (each 1-point increment: β = 1.31; 95% CI: 0.04, 2.58) scores were associated with better total cognitive composite scores in mid-childhood. Higher AHEI-P (each 10-point increment: β = 1.60; 95% CI: 0.04, 3.20), MDS-P (each 10-point increment: β = 1.90; 95% CI: 0.50, 3.30), and MIND-P (each 1-point increment: β = 1.29; 95% CI: 0.22, 2.36) were associated with better crystallized scores in mid-childhood. None of the maternal diet scores were associated with fluid scores in mid-childhood or with cognitive scores in early childhood. CONCLUSIONS:Higher maternal diet quality during pregnancy was associated with better composite and crystallized cognitive function in offspring in mid-childhood. However, no associations were observed in early childhood.

Objectives: Cognitive reserve (CR) is the brain's ability to compensate for brain changes, injury, and disease. CR is represented by crystallized intelligence (acquired knowledge/experience) and influenced by genes and environmental factors like education, occupational complexity, and lifestyle. Yet, the role of diet in CR is not clear. This study aimed to investigate the association between adherence to different dietary patterns across the life course and CR. Methods: This cross-sectional study used data from the Medical Research Council's National Survey of Health and Development, 1946 British Birth Cohort. Crystallized intelligence was measured by the National Adult Reading Test (NART) at age 53. We applied the 2020 Healthy Eating Index (HEI) and Plant-Based Diet Indexes (overall PDI, healthful [hPDI], and unhealthful [uPDI]) to diet recalls and food diaries at age 4, 36, 43, and 53. Typical diet over time was measured by energy-adjusted cumulative average index scores. To examine associations between NART and dietary patterns, we ran multiple linear regression models adjusted for factors associated with CR. The proportion of total variance explained (R2) and variability in NART explained by diet was determined by decomposing R2 with the Owen value. Results: Participants with complete data were included (n = 2,514, 48% male). NART was positively associated with HEI, PDI, and hPDI but inversely associated with uPDI in fully adjusted models. Compared to the lowest quintile, those in the highest quintiles for HEI, PDI, and hPDI had significantly higher NART (adjusted mean difference [95% CI]: HEI = 1.53 [0.59, 2.46]; PDI: 0.99 [0.12, 1.85]; hPDI: 0.98 [0.16, 1.79]), while those most adherent to uPDI had lower NART, (-0.95 [-1.85, -0.04]). Among dietary patterns, HEI explained the highest percent of variability in NART (HEI, 2.84%; uPDI, 1.51%; hPDI, 1.05%; PDI, 0.51%). Conclusions: In this study, higher CR was associated with dietary patterns that aligned with dietary guidelines, had high intakes of overall and healthful plant-based food groups, and had low intakes of less healthy plant-based food groups. Diet helped explain variability in CR and should be included among lifestyle factors in future CR research. Longitudinal analyses are needed to confirm this. Funding Sources: This study received no external funding. KCC was supported by a PhD stipend from Tufts University.

Magnesium (Mg) plays a key role in neurological functioning and manifestations. However, the evidence from randomized controlled trials (RCTs) and cohorts on Mg and cognitive health among adults has not been systematically reviewed. We aimed to examine the associations of various Mg forms (supplements, dietary intake, and biomarkers) with cognitive outcomes by summarizing evidence from RCTs and cohorts. PubMed, Embase, PsycINFO, and the Cochrane Central Register of Controlled Trials were searched for relevant peer-reviewed articles published up to May 3, 2024. Three random-effects models were performed, when appropriate, to evaluate the relationship between Mg and cognitive outcomes: 1) linear meta-regression, 2) nonlinear (quadratic) meta-regression, and 3) meta-analysis using Mg variables categorized based on pre-existing recommendations. Three RCTs and 12 cohort studies were included in this systematic review. Evidence from the limited number of RCTs was insufficient to draw conclusions on the effects of Mg supplements. Cohort studies showed inconsistent dose-response relationships between dietary Mg and cognitive disorders, with high heterogeneity across populations. However, consistent U-shape associations of serum Mg with all-cause dementia and cognitive impairment were found in cohorts, suggesting an optimal serum Mg concentration of ∼0.85 mmol/L. This nonlinear association was detected in meta-regression (Pquadratic = 0.003) and in meta-analysis based on the reference interval of serum Mg (0.75-0.95 mmol/L) [<0.75 compared with 0.85 mmol/L: pooled hazard ratio (HR) = 1.43; 95% confidence interval (CI) = 1.05, 1.93; >0.95 compared with 0.85 mmol/L: pooled HR = 1.30; 95% CI = 1.03, 1.64]. More evidence from RCTs and cohorts is warranted. Future cohort studies should evaluate various Mg biomarkers and collect repeated measurements of Mg intake over time, considering different sources (diet or supplements) and factors affecting absorption (for example, calcium-to-Mg intake ratio). This systematic review was preregistered in PROSPERO (CRD42023423663).

Objective:Several studies have examined metabolomic profiles in relation to Alzheimer's disease and related dementia (AD/ADRD) risk; however, few studies have focused on minorities, such as Latinos, or examined Magnetic-Resonance Imaging (MRI)-based outcomes. Methods:We used multiple linear regression, adjusted for covariates, to examine the association between metabolite concentration and MRI-derived brain age deviation. Metabolites were measured at baseline with untargeted metabolomic profiling (Metabolon, Inc). Brain age deviation (BAD) was calculated at wave 4 (~ 9 years from Boston Puerto Rican Health Study (BPRHS) baseline) as chronologic age, minus MRI-estimated brain age, representing the rate of biological brain aging relative to chronologic age. We also examined if metabolites associated with BAD were similarly associated with hippocampal volume and global cognitive function at wave 4 in the BPRHS. Results:Several metabolites, including isobutyrylcarnitine, propionylcarnitine, phenylacetylglutamine, phenylacetylcarnitine (acetylated peptides), p-cresol-glucuronide, phenylacetylglutamate, and trimethylamine N-oxide (TMAO) were inversely associated with brain age deviation. Taurocholate sulfate, a bile salt, was marginally associated with better brain aging. Most metabolites with negative associations with brain age deviation scores also were inversely associations with hippocampal volumes and wave 4 cognitive function. Conclusion:The metabolites identifiedin this study are generally consistent with prior literature and highlight the role of BCAA, TMAO and microbially derived metabolites in cognitive decline.

Abstract Background and Aims Ultra-processed foods (UPF) are formulations of ingredients that are mostly of exclusive industrial use and may contain additives like artificial colors, flavors, or stabilizers. The sale and consumption of these foods has been increasing despite their associations with increased risk for several non-communicable diseases including chronic kidney disease. Ultra-processed foods are widely accessible, more shelf-stable and convenient while tending to be more affordable and lower in nutritional quality. The aim of this study was to evaluate trends in kidney function and UPF intake and temporal effect of income among United States (US) adults. Method We used dietary intake data collected with 24-hour dietary recalls from 35160 US adults across 8 cycles of the National Health and Nutrition Examination Survey (NHANES) (from 2003-2004 to 2017-2018 cycles) to categorize intake using the Nova processed food classification system. Poisson regression models were used to assess the 15-year trends in populations at risk for kidney function decline (measured by estimated glomerular filtration rate [eGFR]) and higher percentage of calories from UPF (PC-UPF) consumed along with the temporal effect of income in select subpopulations and adjusted for age and gender and non-linear effects of income and age). Results Over the past 15 years eGFR, PC-UPF, and self-reported income continue to increase among US adults. However, the associations between eGFR, PC-UPF and income are quite complex, vary by subpopulation and non-linearly depend on age. Specifically, among Black adults adjusted for age (age2) and gender, eGFR was the lowest (85 mL/min/1.73 m2, 95% CI: 84.9, 85.0 mL/min/1.73 m2) among those with the lowest ($2,500) and highest ($125,000) income (p = 0.0000000579 for a quadratic term of income), respectively. Hispanic and Mexican Americans also have similar pattern eGFR with the lowest and highest income though the eGFR is consistently higher than White and Black Americans. Across cycles, White Americans with the lowest income ($2,500) have the highest PC-UPF (range: 57-62%, p <2e-16; mean: 59.4%, 95% CI: 59.3, 59.6%) while Black Americans with the lowest ($2,500) and highest income ($125,000) have the highest PC-UPF (range: 53-58%, p <2e-16; mean: 54.8%, 95% CI: 54.3, 55.4%). Income levels does not predict PC-UPF among Mexican Americans. Overall, the PC-UPF is steadily increasing in all population subgroups. Conclusion Among Non-White US adults, higher eGFR was associated with higher income until reaching a group-specific threshold when the relationship reversed. We observed a similar threshold pattern in the association between PC-UPF and income among Black and Hispanic Americans. These complex non-linear relationships between eGFR, PC-UPF and income are driven in part by age-related association and warrant further exploration.

BACKGROUND:Minorities, including mainland Puerto Ricans, are impacted disproportionally by Alzheimer's disease (AD), dementia, and cognitive decline. Studying blood metabolomics in this population has the potential to probe the biological underpinnings of this health disparity.OBJECTIVE:We performed a comprehensive analysis of circulating plasma metabolites in relation to cognitive function in 736 participants from the Boston Puerto Rican Health Study (BPRHS) who underwent untargeted mass-spectrometry based metabolomics analysis and had undergone a battery of in-person cognitive testing at baseline.METHODS:After relevant exclusions, 621 metabolites were examined. We used multivariable regression, adjusted for age, sex, education, apolipoprotein E genotype, smoking, and Mediterranean dietary pattern, to identify metabolites related to global cognitive function in our cohort. LASSO machine learning was used in a complementary analysis to identify metabolites that could discriminate good from poor extremes of cognition. We also conducted sensitivity analyses: restricted to participants without diabetes, and to participants with good adherence to Mediterranean diet.RESULTS:Of 621 metabolites, FDR corrected (p < 0.05) multivariable linear regression identified 3 metabolites positively, and 10 negatively, associated with cognitive function in the BPRHS. In a combination of FDR-corrected linear regression, logistic regression regularized via LASSO, and sensitivity analyses restricted to participants without diabetes, and with good adherence to the Mediterranean diet, β-cryptoxanthin plasma concentration was consistently associated with better cognitive function and N-acetylisoleucine and tyramine O-sulfate concentrations were consistently associated with worse cognitive function.CONCLUSION:This untargeted metabolomics study identified potential biomarkers for cognitive function in a cohort of Puerto Rican older adults.

[This corrects the article DOI: 10.3389/fnagi.2023.1285333.].

Introduction: Allostatic load (AL), a measure of overall body wear and tear, has been associated with structural and functional alterations of the brain, but the evidence remains scarce. We aimed to evaluate the prospective associations of AL with brain MRI measures in the Boston Puerto Rican Health Study (BPRHS). Research Questions: Whether AL is associated with 1) brain macro-morphology: brain age and volumes, 2) subclinical cerebrovascular disease: white matter hyperintensity (WMH) and brain infarcts, and 3) microstructural integrity of white matter (WM) pathways in Puerto Rican adults. Methods: Adults from the BPRHS cohort who provided blood and urine samples at baseline, 2-y, and 6-y visits and underwent MRI scans at 13-y visit were included in analyses (n=226). AL was evaluated as a composite score (0-11) of 11 physiological parameters in five body systems. An overall AL score was calculated by averaging the scores of the baseline, 2-y, and 6-y visits, with higher scores indicating greater dysregulation. We evaluated brain age and volumes using T1-weighted MRI, WMH and brain infarcts using T2-weighted MRI, and microstructural integrity of WM pathways using diffusion tensor imaging. Multivariable logistic regression models were used to examine the associations between AL and brain infarcts, and linear regression models were used for other MRI outcomes. Results: Mean age at baseline was 54.6 ± 6.6 y, with 79.2% female. Higher AL was associated with higher brain age z scores (β = 0.129, P = 0.031) and lower volumes of total WM, cerebral WM (especially parietal and temporal lobes), cerebellum, and brain stem. Higher AL was also associated with higher grades of WMH (β = 0.207, P = 0.024) and higher odds of small vessel infarcts [OR (95% CI) = 3.50 (1.56-7.87), P = 0.002], but not large vessel infarcts [OR (95% CI) = 1.33 (0.73-2.40), P = 0.348]. Diffusion tensor imaging parameters showed that participants with higher AL had more microstructural deterioration patterns in major WM pathways. Conclusions: Higher AL score was associated with brain macro- and microstructural disruptions and a higher risk of subclinical cerebrovascular disease, suggesting that AL may be a potential indicator of the need for early intervention in preventing neuronal damage in older adults.

BACKGROUND:Higher Mediterranean diet (MeD) adherence has been linked with lower depressive symptomatology, but research examining this association is limited, especially among Latinos, including mainland U.S. Puerto Ricans. Hence, we examined cross-sectional and longitudinal associations between MeD adherence and self-reported depressive symptomatology in Boston area Puerto Rican adults. METHODS:The Center for Epidemiologic Studies Depression Scale (CES-D) was used to evaluate depressive symptoms. Adherence to MeD was assessed at all 3 visits. We used multivariable linear regression for baseline cross-sectional analysis, and linear mixed effects modeling over 3 waves of follow-up for longitudinal analysis. We also assessed whether baseline MeD adherence affected 5y CES-D trajectory. We conducted sensitivity analyses among participants without diabetes, and among participants with complete MeD and CES-D measures at all visits. RESULTS:MeD adherence was significantly associated with CES-D score at baseline (β = -2.0, 95% confidence interval [CI] -4.0, -0.04 for highest vs lowest tertile, p trend = .04) and across 3 waves (β = -1.9, 95% CI = -3.0, -0.8 for highest vs lowest tertile, p trend = .0005). Results were similar in analyses restricted to participants without diabetes, as well as among participants with complete CES-D and MeD scores at all visits. CONCLUSIONS:While CES-D score was consistently lower in those with higher MeD adherence over 5 years of follow up, no relationship between baseline MeD adherence and 5y CES-D trajectory was observed.

Our objective was to quantify the cross-sectional associations between dietary fatty acid (DFA) patterns and cognitive function among Hispanic/Latino adults. This study included data from 8942 participants of the Hispanic Community Health Study/Study of Latinos, a population-based cohort study (weighted age 56·2 years and proportion female 55·2 %). The National Cancer Institute method was used to estimate dietary intake from two 24-h recalls. We derived DFA patterns using principal component analysis with twenty-six fatty acid and total plant and animal MUFA input variables. Global cognitive function was calculated as the average z-score of four neurocognitive tests. Survey linear regression models included multiple potential confounders such as age, sex, education, depressive symptoms, physical activity, energy intake and CVD. DFA patterns were characterised by the consumption of long-chain SFA, animal-based MUFA and trans-fatty acids (factor 1); short to medium-chain SFA (factor 2); very-long-chain n-3 PUFA (factor 3); very-long-chain SFA and plant-based MUFA and PUFA (factor 4). Factor 2 was associated with greater scores for global cognitive function (β = 0·037 (sd 0·012)) and the Digit Symbol Substitution (DSS) (β = 0·56 (sd 0·17)), Brief Spanish English Verbal Learning-Sum (B-SEVLT) (β = 0·23 (sd 0·11)) and B-SEVLT-Recall (β = 0·11 (sd 0·05)) tests (P < 0·05 for all). Factors 1 (β = 0·04 (sd 0·01)) and 4 (β = 0·70 (sd 0·18)) were associated with the DSS test (P < 0·05 for all). The consumption of short to medium-chain SFA may be associated with higher cognitive function among US-residing Hispanic/Latino adults. Prospective studies are necessary to confirm these findings.