Important considerations when assessing the effect of essential fatty acids on cognitive performance
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LETTER TO THE EDITOR
Open Access
Important considerations when assessing the effect of essential fatty acids on cognitive performance Aayush Visaria1,2* , David Lo2 and Pranay Maniar2,3 Abstract Over the past decade, there have been many studies determining the effect of dietary ω-3 and ω-6 fatty acids intake on cognitive performance; however, they have largely been inconsistent in their conclusions. In this letter, we provide context to the article by Dong et al., titled “Association of dietary ω-3 and ω-6 fatty acids intake with cognitive performance in older adults: National Health and nutrition examination Survey (NHANES) 2011–2014” and provide methodological considerations with regards to covariate measurement and inclusion that can be generalized to future cross-sectional studies. In particular, delineating 1) the type and source of fatty acid, in context of an individual’s overall dietary patterns, 2) sociobehavioral risk factors and physical & mental comorbidities, 3) and daily cognitive activity are important to adequately control for covariates. Keywords: Fatty acids, Nutrition, Cognitive impairment, Elderly To the Editor: Nutrition is at the forefront of preventive medicine, with ever-increasing evidence of the benefit of different nutrients and their ability to prevent, mitigate the progression of, and even reverse chronic diseases or processes. One such process is cognitive decline. We read with great pleasure the article by Dong et al., titled “Association of dietary ω-3 and ω-6 fatty acids intake with cognitive performance in older adults: National Health and nutrition examination Survey (NHANES) 2011–2014” which found that increased dietary ω-3 and ω-6 fatty acids were inversely associated with low cognitive performance in people aged 60 and older [1]. We applaud the authors’ efforts to comprehensively control for potential confounders such as physical activity and comorbidity burden; however, we would like to reiterate and bring forth key * Correspondence: [email protected] 1 Department of Medicine, Rutgers New Jersey Medical School, 185 South Orange Ave, Newark, NJ 07103, USA 2 North American Disease Intervention, Rutgers University, New Brunswick, NJ, USA Full list of author information is available at the end of the article
covariates and methodological considerations that may be necessary to determine the independent effect of ω-3 and ω-6 fatty acids on cognitive performance. While the authors have appropriately controlled for demographic, socioeconomic, physical activity, and cardiometabolic comorbidity factors, there are several other covariates that need to be accounted for, including 1) vitamin and mineral consumption (as authors have mentioned, vitamin Bs [2], vitamin D [3], folate [4], among others, have all shown protective effects on cognitive function), 2) other dietary consumption (protein intake [5] has been shown to be protective whereas saturated fats and refined sugars [6] have been associated with cognitive decline), 3) source of fatty acid (plant-based vs. animal-bas
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