Adherence to the Eatwell Guide and cardiometabolic, cognitive and neuroimaging parameters: An analysis from the PREVENT Dementia study

Abstract

Healthy diet behaviours are important in a globally ageing population, particularly in relation to cardiometabolic and brain health. The Eatwell guide (EWG) reflects the UK government's recommendations for a healthy and balanced diet. Data from the PREVENT dementia cohort study baseline visit was used in this analysis. Binary and graded EWG scores (BEWG, GEWG) were created from a self-reported Food Frequency Questionnaire. The CAIDE score was included as the primary outcome measure to represent risk for future AD. Secondary outcome measures included cardiometabolic health measures, and brain health measures. Generalised additive models were run in R. A total of 517 participants were included in the analysis, with a mean BEWG score of 4.39 (+/-1.66) (out of a possible 12 points) and GEWG score of 39.88 (+/-6.19) (out of a possible 60 points). There was no significant association between either EWG score and the CAIDE (BEWG beta: 0.07; p: 0.32; GEWG beta: 0.02, p: 0.36) or any measures of brain health. There was a significant association between higher GEWG score and lower systolic and diastolic blood pressure and body mass index (BMI) (systolic beta: -0.24, p: 0.03; diastolic beta: -0.16, p: 0.01; BMI beta: -0.09, p: 0.02). Although not directly associated with the CAIDE score, the EWG dietary pattern may be beneficial for dementia prevention efforts through modification of hypertension and obesity, which are both known risk factors for dementia. Future work could replicate these findings in other UK-based cohorts as well as further development of EWG scoring methodologies.

Adherence to the Eatwell Guide and population and planetary health: A Rank Prize Forum report

“…A graded scoring method was also developed where points were awarded on a sliding scale to recognise the potential benefit of incremental dietary changes in Eatwell Guide components. An analysis of 517 individuals from the PREVENT Dementia cohort found no association between either the binary or graded scoring method and the CAIDE score, an established midlife risk score for future dementia (Gregory et al, 2023). However, several cardiovascular health measures, which contribute to the CAIDE score, were significantly associated with Eatwell Guide adherence.…”

“…Several individual Eatwell Guide components, such as higher intake of fruits and vegetables (e.g., associated with reduced CVD incidence [Aune et al, 2017]) and fish (e.g., associated with reduced dementia incidence [Bakre et al, 2018]), and lower intake of red/processed meat (e.g., associated with reduced risk of colorectal cancer [Farvid et al, 2021]) have been associated with improved health outcomes. However, only a handful of studies have explored associations between overall adherence to the Eatwell Guide (accounting for the level of adherence to the Eatwell Guide as a whole and appreciating potential cumulative/synergistic effects of different dietary components) and health (Best & Flannery, 2023;Cobiac et al, 2016;Gregory et al, 2023;Scheelbeek et al, 2020). In this session, which included four presentations, we set out to summarise the limited body of evidence on links between Eatwell Guide adherence and risk of mortality, markers of adiposity, cognitive outcomes and risk of falls.…”

“…Dr Sarah Gregory discussed the development of an Eatwell Guide score in a UK midlife cohort designed to understand the risk for dementia (PREVENT Dementia), as well as cross-sectional associations with markers of brain health, including cognition and MRI volumetrics (for preprint see Gregory et al [2023]). The scoring methodology is built on the binary scoring approach described by Dr Papier, with additional components added as available in PREVENT Dementia.…”