Page 57 - Today's Dietitian (March 2020)

of North Carolina in Chapel Hill. “The
new nutrition reality is driven by changes Obesity Associated With Higher Dementia Risk
to the food system, which have increased
availability of ultraprocessed foods that Alarge study that followed more than 1 in the long term, a 21% greater risk of
are linked to increased weight gain, million women for nearly two decades dementia compared with women with
while also adversely affecting infant suggests that obesity in midlife is linked a desirable BMI. Among the obese
and preschooler diets. These changes to a greater risk of dementia later in life women, 2.1%, or 3,948 of 177,991
include disappearing fresh food markets, but poor diet and lack of exercise aren’t. women, were diagnosed with demen-
increasing supermarkets, and the control The study is published in Neurology, the tia. This is compared with 1.6% of
of the food chain by supermarkets, and medical journal of the American Acad- women with a desirable BMI, or 7,248 of
global food, catering, and agriculture emy of Neurology. 434,923 women, who were diagnosed
companies in many countries,” he says. “Some previous studies have sug- with the disease.
Exposure to undernutrition early in gested poor diet or a lack of exercise However, while low calorie intake
life followed by becoming overweight may increase a person’s risk of demen- and inactivity were associated with
from childhood onwards increases the tia,” says study author Sarah Floud, a higher risk of dementia during the
risk of a range of NCDs—making the PhD, a senior epidemiologist in the first 10 years of the study, these asso-
double burden of malnutrition a key Nuffield Department of Population ciations weakened substantially, and,
factor driving the emerging global epi- Health at the University of Oxford in the after 15 years, neither was strongly
demics of type 2 diabetes, high blood United Kingdom. “However, our study linked to dementia risk.
pressure, stroke, and CVD. Negative found these factors are not linked to “Other studies have shown that
effects can also pass across genera- the long-term risk of dementia. Short- people become inactive and lose weight
tions—for example, the effect of mater- term associations between these fac- up to a decade before they are diag-
nal obesity on the likelihood of the child tors and dementia risk are likely to nosed with dementia,” Floud says.
having obesity may be exacerbated if the reflect changes in behavior,
mother was undernourished in early life. such as eating poorly and
Despite physiological links, actions being inactive, due to early
to address all forms of malnutrition his- symptoms of dementia.”
torically haven’t taken account of these The study involved one
or other key factors, including early-life of every four women born in
nutrition, diet quality, socioeconomic the United Kingdom between
factors, and food environments. In addi- 1935 to 1950, or nearly
tion, there’s some evidence that pro- 1,137,000 women. They had
grams addressing undernutrition have an average age of 56 and
unintentionally increased risks of obe- didn’t have dementia at the
sity and diet-related NCDs in low-income start of the study. Participants
and middle-income countries where food were asked about their height,
environments are changing rapidly. weight, diet, and exercise at
While it’s critical to maintain these the start of the study.
programs for undernutrition, they For the study, a BMI
need to be redesigned to do no harm. between 20 and 25 was con-
Existing undernutrition programs sidered desirable, and a BMI of
delivered through health services, social 30 or higher was considered
safety nets, educational settings, and obese. Women who reported exercising “The short-term links between demen-
agriculture and food systems present less than once per week were consid- tia, inactivity, and low calorie intake
opportunities to address obesity and ered inactive. Those who exercised more are likely to be the result of the earliest
diet-related NCDs. often were considered active. Women’s signs of the disease, before symptoms
The report identifies a set of “double- reported usual diet was used to calculate start to show.”
duty actions” that simultaneously pre- their calorie intake. Floud continues, “On the other hand,
vent or reduce the risk of nutritional Researchers then followed the obesity in midlife was linked with demen-
deficiencies leading to underweight, women for an average of 18 years. After tia 15 or more years later. Obesity is a
wasting, stunting, or micronutrient defi- 15 years from the start of the study, well established risk factor for cerebro-
ciencies, and obesity or NCDs, with the 18,695 women were diagnosed with vascular disease. Cerebrovascular dis-
same intervention, program, or policy. dementia. ease contributes to dementia later in life.”
These range from improved antenatal Researchers adjusted for age, edu- A limitation of the study was that it
care and breast-feeding practices, to cation, smoking, and many other fac- looked at women only, so the results
social welfare, and to new agricultural tors. They found that women who were may not be the same for men.
and food system policies with healthful obese at the start of the study had,
diets as their primary goal. SOURCE: AMERICAN ACADEMY OF NEUROLOGY
SOURCE: WORLD HEALTH ORGANIZATION
MARCH 2020 • WWW.TODAYSDIETITIAN.COM 57