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No association was observed in Model 2 and Model 3. The association of dietary carbohydrates consumption with cognitive scores among participants whose daily fasting duration was more than 16 h is shown in Supplementary Table 4.
As shown in the table, no significant association was observed. Figure 1. Figure 2. Figure 3. Figure 4. When excluding participants with sleep disorders, the association was consistent with the results of the total sample Supplementary Tables 5 — 7. Meanwhile, the above association remained robust when additional adjustment was made for the timing of breakfast and dinner Supplementary Tables 8 — Finally, the association was remained robust between dietary carbohydrates and poor cognitive performance defined by total score of CERAD-WL, CERAD-DR, DSST, and AF test Supplementary Tables 14 — In addition, we found that consuming more carbohydrates were associated with cognitive performance among male, Non-Hispanic Black participants, and participants with or without regular exercise Supplementary Tables 17 — This study investigates the association of dietary carbohydrates consumption with cognitive function among participants with different daily fasting duration among U.
S older adults. In this nationally representative data, we found that higher percentage energy from carbohydrates was associated with poor cognitive performance, but not in participants whose daily fasting duration was more than 16 h.
Further, the negative associations between dietary carbohydrates consumption and cognitive score were still significant among total participant and participants with a daily fasting duration of less than 16 h. Whereas, no association was observed among participants with a daily fasting duration of more than 16 h.
To the best of our knowledge, this is the first study to illustrate that daily fasting duration could improve the cognitive impairment caused by dietary carbohydrates consumption.
Previous studies have revealed that dietary carbohydrate consumption has been related to cognitive impairment, which was consistent with the current study among total participants Bachlechner et al.
A growing body of evidence showed that time-restricted feeding TRF; limiting the time of food consumption to 8—10 h throughout a day , a popular form of intermittent fasting, can improve cognitive function, aging, and extend healthy lifespan Anton et al.
Compared with the long-time diet control, there has been increased interest and acceptance of TRF, which may be easier to adhere to and maintain as time goes by Rynders et al. The direct effect of dietary carbohydrates and daily fasting duration on cognitive function has been widely documented respectively in previous studies Benau et al.
In the current study, we found that the association between dietary carbohydrates consumption and cognitive impairment could be improved by daily fasting duration among U.
When participants were stratified by daily fasting duration, the above association remained robust among participants with a daily fasting duration of fewer than 16 h, but not in participants with a daily fasting duration of more than 16 h.
This observation illustrated that participants could attenuate the harmful effect of dietary carbohydrates on cognitive function by extending their daily fasting duration to 16 h. Similar associations were also observed when excluding participants with sleep disorders, which was a traditional risk factor for cognitive function Irwin and Vitiello, Additionally, this study also observed that the percentage energy from carbohydrates was negatively associated with CERAD-WL and DSST scores among total participants and participants with a daily fasting duration of fewer than 16 h, but not in participants with a daily fasting duration of more than 16 h, which further supports our point of view.
The above association could be partially supported by the previous research. It appears that dietary carbohydrates on cognitive function include inflammatory, dysregulation in metabolic, and vascular factors Hawkins et al.
It has been one of the major public health concerns for establishing effective manners to prevent cognitive decline in older adults. To date, intermittent fasting has received increasing interest, which may produce biological changes similar to caloric restriction Anton and Leeuwenburgh, , as a useful manner to slow down the aging process and extend lifespan Weindruch, Human studies showed the benefits of TRF meals on cognitive function and dementia in older adults Anton et al.
Compared with traditional dietary restrictions, participants showed that this manner of eating was more acceptable and they would be willing to maintain this manner of eating pattern, suggesting intermittent fasting is a sustainable and useful strategy for older adults Anton et al.
A previous study suggested that intermittent fasting may counteract aging, which has been considered a major risk factor for cognitive impairment, dementia, and neurological disease Longo and Mattson, Further, intermittent fasting has beneficial effects in increasing circulation, modulation of reactive oxygen species, and inflammation through increasing autophagy and mitochondrial respiratory efficiency Lee and Longo, Animal studies also indicated that intermittent fasting was an effective mechanism for improving cognition impairment and hippocampal function in mice Hamezah et al.
A potential mechanism between intermittent fasting and cognitive function was that intermittent fasting was proved to reduce levels of inflammatory cytokines TNFα, IL-1β, and IL-6 , ROS production, and improve the function of endothelial Arumugam et al.
Moreover, intermittent fasting was reported to modulate the composition of microbial and increase its abundance, which had an influence on metabolism and nutritional status Zeb et al. Therefore, the imbalance of the gut microbiome has been related to a series of immune, inflammatory, and nervous system-related diseases by the microbiome-brain axis Salvucci, , as well as the development and function of the brain Ceppa et al.
In summary, this study illustrates that dietary carbohydrate consumption was associated with poor cognitive performance, while longer daily fasting duration could improve cognitive impairment. This study provides new perspectives and knowledge in the field of nutrition to prevent poor cognitive performance in the US elderly.
This study has several strengths. Firstly, this study firstly demonstrated the association between dietary carbohydrate consumption and cognitive impairment by simultaneously considering daily fasting duration based on the well-designed study NHANES.
Secondly, this study involved quite a large number of US older adults from the nationally representative data in the United States.
Thirdly, a series of potential confounders were included in the current study to better examine the above association. Fourthly, this study also examined the dose-response association between percentage energy from carbohydrates and cognitive impairment among participants with different daily fasting duration.
Finally, both quartiles and continuous forms of percentage energy from carbohydrates were considered in the current study. However, limitations still exist in this study. First of all, dietary information was adopted and measured by two h dietary recalls, which cannot reflect the real consumption as usual.
Secondly, causality could not be established due to the cross-sectional study design. Thirdly, residual confounders may still exist even if a large number of confounders were adjusted. Publicly available datasets were analyzed in this study. Ethical review and approval was not required for the study on human participants in accordance with the local legislation and institutional requirements.
Written informed consent for participation was not required for this study in accordance with the national legislation and the institutional requirements. CS and WH designed the work and were responsible for the overall manuscript. SZ wrote the manuscript.
TH conducted the statistical analysis. XP, YS, YZ, LL, and XW participated in data preparation. All authors made a significant contribution to this study, critically reviewed the manuscript, and approved the final published version. This study was supported by funds from National Natural Science Foundation of China to CS.
We thank the participants and staff of the National Health and Nutrition Examination Survey — for their valuable contributions. The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.
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