La Trobe
1166975_Tan,S_2021.pdf (774.01 kB)

Associations between nut intake, cognitive function and non‐alcoholic fatty liver disease (NAFLD) in older adults in the United States: NHANES 2011-14

Download (774.01 kB)
journal contribution
posted on 2021-07-13, 04:25 authored by SY Tan, EN Georgousopoulou, BR Cardoso, RM Daly, Elena GeorgeElena George
Background: Nuts are nutrient-rich and reported to provide some cognitive and cardiometabolic health benefits, but limited studies have focused on older adults. This study investigated the cross-sectional relationship between habitual nut intake, dietary pattern and quality, cognition and non-alcoholic fatty liver disease (NAFLD) in older adults. Methods: Older adults (≥ 60 years) from the NHANES 2011-12 and 2013-14 cohorts, who had complete data on cognitive function (as CERAD total, delayed recall, animal fluency and digit-symbol substitution test) and variables to calculate the Fatty Liver Index (FLI), an indicator of NAFLD, were included (n = 1848). Nut intake and diet quality (Healthy Eating Index 2015) were determined using two 24-hour diet recalls. Participants were categorised into one of four groups based on their habitual nut intake: non-consumers (0 g/d), low intake (0.1–15.0 g/d), moderate intake (15.1–30.0 g/d) or met recommendation (> 30 g/d), with all outcomes compared between these nut intake groups. Results: Cognitive scores of older adults were the lowest in non-consumers and significantly highest in the moderate intake group, with no further increase in those who consumed nuts more than 30 g/d (p < 0.007). FLI was the lowest among older adults with moderate nut intake but the associations disappeared after adjusting for covariates (p = 0.329). Moderate nut intake was also associated with better immediate and delayed memory in older adults with high risk of NAFLD (FLI ≥ 60) (B = 1.84 and 1.11, p < 0.05 respectively). Higher nutrient intake and better diet quality (p < 0.001) were seen with higher nut intake but did not influence energy from saturated fat intake. Factor analysis revealed ‘Nuts and oils’ as one of the four major dietary patterns associated with better cognition and lower FLI scores. Conclusions: Moderate nut intake (15.1–30.0 g/d) may be sufficient for better cognitive performance, but not NAFLD risk of older adults in the US.


This study was funded by the International Nut and Dried Fruit Council (INC) (Project number 2019-R02). The funder had no role in the design, analysis, interpretation of data, or writing of this article.


Publication Date



BMC Geriatrics





Article Number

ARTN 313







Rights Statement

The Author reserves all moral rights over the deposited text and must be credited if any re-use occurs. Documents deposited in OPAL are the Open Access versions of outputs published elsewhere. Changes resulting from the publishing process may therefore not be reflected in this document. The final published version may be obtained via the publisher’s DOI. Please note that additional copyright and access restrictions may apply to the published version.