Nutrients (Oct 2023)
Dietary Iron, Anemia Markers, Cognition, and Quality of Life in Older Community-Dwelling Subjects at High Cardiovascular Risk
- Carolina Donat-Vargas,
- Víctor Mico,
- Rodrigo San-Cristobal,
- Miguel Ángel Martínez-González,
- Jordi Salas-Salvadó,
- Dolores Corella,
- Montserrat Fitó,
- Ángel Maria Alonso-Gómez,
- Julia Wärnberg,
- Jesús Vioque,
- Dora Romaguera,
- José López-Miranda,
- Ramon Estruch,
- Miguel Damas-Fuentes,
- José Lapetra,
- Luís Serra-Majem,
- Aurora Bueno-Cavanillas,
- Josep Antoni Tur,
- Sergio Cinza-Sanjurjo,
- Xavier Pintó,
- Miguel Delgado-Rodríguez,
- Pilar Matía-Martín,
- Josep Vidal,
- Claudia Causso,
- Emilio Ros,
- Estefanía Toledo,
- Josep Maria Manzanares,
- Carolina Ortega-Azorín,
- Olga Castañer,
- Patricia Judith Peña-Orihuela,
- Juan Manuel Zazo,
- Carlos Muñoz Bravo,
- Diego Martinez-Urbistondo,
- Alice Chaplin,
- Rosa Casas,
- Naomi Cano Ibáñez,
- Lucas Tojal-Sierra,
- Ana María Gómez-Perez,
- Elena Pascual Roquet-Jalmar,
- Cristina Mestre,
- Rocío Barragán,
- Helmut Schröder,
- Antonio Garcia-Rios,
- Inmaculada Candela García,
- Miguel Ruiz-Canela,
- Nancy Babio,
- Mireia Malcampo,
- Lidia Daimiel,
- Alfredo Martínez
Affiliations
- Carolina Donat-Vargas
- ISGlobal, Campus Mar, 08036 Barcelona, Spain
- Víctor Mico
- Cardiometabolic Nutrition Group, IMDEA Food, CEI UAM + CSIC, 28049 Madrid, Spain
- Rodrigo San-Cristobal
- Cardiometabolic Nutrition Group, IMDEA Food, CEI UAM + CSIC, 28049 Madrid, Spain
- Miguel Ángel Martínez-González
- Biomedical Research Centre for Obesity Physiopathology and Nutrition Network (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain
- Jordi Salas-Salvadó
- Unitat de Nutrició Humana, Departament de Bioquímica i Biotecnologia, Universitat Rovira i Virgili, 43201 Reus, Spain
- Dolores Corella
- Biomedical Research Centre for Obesity Physiopathology and Nutrition Network (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain
- Montserrat Fitó
- Biomedical Research Centre for Obesity Physiopathology and Nutrition Network (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain
- Ángel Maria Alonso-Gómez
- Biomedical Research Centre for Obesity Physiopathology and Nutrition Network (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain
- Julia Wärnberg
- Biomedical Research Centre for Obesity Physiopathology and Nutrition Network (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain
- Jesús Vioque
- CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Dora Romaguera
- Biomedical Research Centre for Obesity Physiopathology and Nutrition Network (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain
- José López-Miranda
- Biomedical Research Centre for Obesity Physiopathology and Nutrition Network (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain
- Ramon Estruch
- Biomedical Research Centre for Obesity Physiopathology and Nutrition Network (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain
- Miguel Damas-Fuentes
- Biomedical Research Centre for Obesity Physiopathology and Nutrition Network (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain
- José Lapetra
- Biomedical Research Centre for Obesity Physiopathology and Nutrition Network (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain
- Luís Serra-Majem
- Biomedical Research Centre for Obesity Physiopathology and Nutrition Network (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain
- Aurora Bueno-Cavanillas
- CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Josep Antoni Tur
- Biomedical Research Centre for Obesity Physiopathology and Nutrition Network (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain
- Sergio Cinza-Sanjurjo
- CS Milladoiro, Área Sanitaria de Santiago de Compostela, 15706 Santiago de Compostela, Spain
- Xavier Pintó
- Biomedical Research Centre for Obesity Physiopathology and Nutrition Network (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain
- Miguel Delgado-Rodríguez
- Cardiometabolic Nutrition Group, IMDEA Food, CEI UAM + CSIC, 28049 Madrid, Spain
- Pilar Matía-Martín
- Department of Endocrinology and Nutrition, Instituto de Investigación Sanitaria Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain
- Josep Vidal
- Department of Endocrinology, IDIBAPS, Hospital Clinic, University of Barcelona, 08036 Barcelona, Spain
- Claudia Causso
- Servicio de Endocrinologia Hospital General de Villalba, 28400 Madrid, Spain
- Emilio Ros
- Biomedical Research Centre for Obesity Physiopathology and Nutrition Network (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain
- Estefanía Toledo
- Biomedical Research Centre for Obesity Physiopathology and Nutrition Network (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain
- Josep Maria Manzanares
- Unitat de Nutrició Humana, Departament de Bioquímica i Biotecnologia, Universitat Rovira i Virgili, 43201 Reus, Spain
- Carolina Ortega-Azorín
- Biomedical Research Centre for Obesity Physiopathology and Nutrition Network (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain
- Olga Castañer
- Unit of Cardiovascular Risk and Nutrition, Institut Hospital del Mar de Investigaciones Médicas Municipal d’Investigació Médica (IMIM), 08003 Barcelona, Spain
- Patricia Judith Peña-Orihuela
- Biomedical Research Centre for Obesity Physiopathology and Nutrition Network (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain
- Juan Manuel Zazo
- Department of Preventive Medicine and Public Health, School of Medicine, Instituto de Investigación Biomédica de Málaga, University of Málaga, 29590 Málaga, Spain
- Carlos Muñoz Bravo
- Department of Public Health and Psychiatry, University of Malaga-IBIMA (Instituto de Investigación Biomédica de Málaga), 29071 Málaga, Spain
- Diego Martinez-Urbistondo
- Internal Medicine Department, Clínica Universidad de Navarra, 28022 Madrid, Spain
- Alice Chaplin
- Biomedical Research Centre for Obesity Physiopathology and Nutrition Network (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain
- Rosa Casas
- Biomedical Research Centre for Obesity Physiopathology and Nutrition Network (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain
- Naomi Cano Ibáñez
- CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Lucas Tojal-Sierra
- Biomedical Research Centre for Obesity Physiopathology and Nutrition Network (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain
- Ana María Gómez-Perez
- Biomedical Research Centre for Obesity Physiopathology and Nutrition Network (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain
- Elena Pascual Roquet-Jalmar
- Osasunbidea, Servicio Navarro de Salud, 31003 Pamplona, Spain
- Cristina Mestre
- Biomedical Research Centre for Obesity Physiopathology and Nutrition Network (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain
- Rocío Barragán
- Biomedical Research Centre for Obesity Physiopathology and Nutrition Network (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain
- Helmut Schröder
- CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Antonio Garcia-Rios
- Biomedical Research Centre for Obesity Physiopathology and Nutrition Network (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain
- Inmaculada Candela García
- Primary Health Care Center Santa Pola, 03130 Alicante, Spain
- Miguel Ruiz-Canela
- Biomedical Research Centre for Obesity Physiopathology and Nutrition Network (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain
- Nancy Babio
- Biomedical Research Centre for Obesity Physiopathology and Nutrition Network (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain
- Mireia Malcampo
- Unit of Cardiovascular Risk and Nutrition, Institut Hospital del Mar de Investigaciones Médicas Municipal d’Investigació Médica (IMIM), 08003 Barcelona, Spain
- Lidia Daimiel
- Nutritional Control of the Epigenome Group, Precision Nutrition and Obesity Program, IMDEA Food, CEI UAM + CSIC, 28049 Madrid, Spain
- Alfredo Martínez
- Cardiometabolic Nutrition Group, IMDEA Food, CEI UAM + CSIC, 28049 Madrid, Spain
- DOI
- https://doi.org/10.3390/nu15204440
- Journal volume & issue
-
Vol. 15,
no. 20
p. 4440
Abstract
Anemia causes hypo-oxygenation in the brain, which could lead to cognitive disorders. We examined dietary iron intake as well as anemia markers (i.e., hemoglobin, hematocrit, mean corpuscular volume) and diabetes coexistence in relation to neuropsychological function and quality of life. In this study, 6117 community-dwelling adults aged 55–75 years (men) and 60–75 years (women) with overweight/obesity and metabolic syndrome were involved. We performed the Mini-Mental State Examination (MMSE), the Trail Making Test parts A and B (TMT-A/B), Semantic Verbal Fluency of animals (VFT-a), Phonological Verbal Fluency of letter P (VFT-p), Digit Span Test (DST), the Clock Drawing Test (CDT), and the Short Form-36 Health Survey (SF36-HRQL test). Dietary iron intake did not influence neuropsychological function or quality of life. However, anemia and lower levels of anemia markers were associated with worse scores in all neurophysiological and SF36-HRQL tests overall, but were especially clear in the MMSE, TMT-B (cognitive flexibility), and the physical component of the SF36-HRQL test. The relationships between anemia and diminished performance in the TMT-A/B and VFT tasks were notably pronounced and statistically significant solely among participants with diabetes. In brief, anemia and reduced levels of anemia markers were linked to inferior cognitive function, worse scores in different domains of executive function, as well as a poorer physical, but not mental, component of quality of life. It was also suggested that the coexistence of diabetes in anemic patients may exacerbate this negative impact on cognition. Nevertheless, dietary iron intake showed no correlation with any of the outcomes. To make conclusive recommendations for clinical practice, our findings need to be thoroughly tested through methodologically rigorous studies that minimize the risk of reverse causality.
Keywords