Correlation of dietary inflammation index and dietary pattern with mild cognitive impairment in patients with type 2 diabetes

Objective

We aimed to determine the dietary patterns associated with mild cognitive impairment (MCI) in type 2 diabetes (T2DM) and the correlation of dietary inflammatory index (DII) with MCI.

Methods

The Montreal Cognitive Assessment (MoCA) was used to assess cognitive function. A semi-quantitative food frequency questionnaire was used to collect dietary data and calculate DII. Dietary patterns were determined by reduced-rank regression (RRR), grouping dietary pattern scores and DII into quartiles, with logistic regression for correlation analysis. Dose–response relationships between dietary pattern scores, DII and diabetic MCI were explored using restricted cubic splines (RCS). A mediation analysis was performed to investigate whether DII mediates the association between dietary patterns and MCI.

Results

In the “Mediterranean-style dietary pattern”, the multivariable-adjusted odds ratio of having MCI was 0.37 (95% CI: 0.20–0.68; p for trend = 0.002) in the highest versus lowest quartiles of the dietary score. In the “high-meat and low-vegetable pattern”, the multivariable-adjusted odds ratio of having MCI was 6.84 (95% CI: 3.58–13.10; p for trend < 0.001) in the highest versus lowest quartiles of the dietary score. In the “Western-style dietary pattern”, the multivariable-adjusted odds ratio of having MCI was 2.48 (95% CI: 1.38–4.46; p for trend = 0.001). The multivariable-adjusted odds ratio of having MCI was 3.99 (95% CI: 2.14–7.42; p for trend < 0.001) in the highest versus lowest quartiles of DII.

There is a non-linear dose–response relationship between the “high-meat and low-vegetable pattern” score and the prevalence of MCI, as well as the DII and the prevalence of MCI. The DII partially mediated the impact of the “Mediterranean-style dietary pattern” and the “high-meat and low-vegetable pattern” on MCI.

Conclusion

In T2DM patients, greater adherence to the “Mediterranean-style dietary pattern” is associated with a lower probability of having MCI. However, excessive consumption of meat, especially red meat and processed meat, combined with a lack of vegetable intake, is associated with a higher probability of having MCI. Greater adherence to the “Western-style dietary pattern” is associated with a higher probability of having MCI. In addition, a pro-inflammatory diet is associated with a higher probability of having MCI, and DII partially mediates the impact of dietary patterns on MCI.