Obesity

A small study involving 50 younger adults (18-35; average age 24) has found that those with a higher BMI performed significantly worse on a computerised memory test called the “Treasure Hunt Task”.

The task involved moving food items around complex scenes (e.g., a desert with palm trees), hiding them in various locations, and indicating afterward where and when they had hidden them. The test was designed to disentangle object, location, and temporal order memory, and the ability to integrate those separate bits of information.

Those with higher BMI were poorer at all aspects of this task. There was no difference, however, in reaction times, or time taken at encoding. In other words, they weren't slower, or less careful when they were learning. Analysis of the errors made indicated that the problem was not with spatial memory, but rather with the binding of the various elements into one coherent memory.

The results could suggest that overweight people are less able to vividly relive details of past events. This in turn might make it harder for them to keep track of what they'd eaten, perhaps making overeating more likely.

The 50 participants included 27 with BMI below 25, 24 with BMI 25-30 (overweight), and 8 with BMI over 30 (obese). 72% were female. None were diagnosed diabetics. However, the researchers didn't take other health conditions which often co-occur with obesity, such as hypertension and sleep apnea, into account.

This is a preliminary study only, and further research is needed to validate its findings. However, it's significant in that it adds to growing evidence that the cognitive impairments that accompany obesity are present early in adult life and are not driven by diabetes.

The finding is also consistent with previous research linking obesity with dysfunction of the hippocampus and the frontal lobe.

http://www.eurekalert.org/pub_releases/2016-02/uoc-bol022616.php

https://www.theguardian.com/science/neurophilosophy/2016/mar/03/obesity-linked-to-memory-deficits

[4183] Cheke LG, Simons JS, Clayton NS. Higher body mass index is associated with episodic memory deficits in young adults. The Quarterly Journal of Experimental Psychology [Internet]. 2015 :1 - 12. Available from: http://dx.doi.org/10.1080/17470218.2015.1099163

A mouse study has found that obese mice had high levels of interleukin 1 in both their blood and their brains, and this was associated with:

  • high levels of inflammation,
  • low levels of a biochemical important to synapse function, and
  • impaired cognitive function.

Moreover, when fat was removed from the obese mice, interleukin levels dropped dramatically, and cognitive performance improved.

Putting obese mice on an exercise program had a similar effect, even though they didn’t lose weight — but they gained muscle and lost fat.

http://www.fastcoexist.com/3027307/why-youre-fat/your-fat-is-why-youre-not-as-bright-as-you-could-be

I’ve reported before on the growing evidence that metabolic syndrome in middle and old age is linked to greater risk of cognitive impairment in old age and faster decline. A new study shows at least part of the reason.

The study involved 71 middle-aged people recruited from the Wisconsin Registry for Alzheimer's Prevention (WRAP), of whom 29 met the criteria for metabolic syndrome (multiple cardiovascular and diabetes risk factors including abdominal obesity, high blood pressure, high blood sugar and high cholesterol).

Those with metabolic syndrome averaged 15% less blood flow to the brain than those without the syndrome.

One tried and true method of increasing blood flow to the brain is of course through exercise.

The study was presented at the Alzheimer's Association International Conference in Vancouver, Canada by Barbara Bendlin.

A study involving 130 HIV-positive people has found that memory impairment was associated with a significantly larger waistline.

Some 40% of participants (average age 46) had impaired cognition. This group had an average waist circumference of 39 inches, compared to 35 inches for those without such problems. Memory impairment was also linked to diabetes in those older than 55 (15% of those with memory problems had diabetes compared to only 3% of those without memory problems).

Waistline was more important than BMI. Unfortunately, some anti-HIV drugs cause weight gain in this area.

The finding is consistent with evidence that abdominal weight is more important than overall weight for cognitive impairment and dementia in the general population.

For more about HIV-related cognitive impairment

Obesity has been linked to cognitive decline, but a new study involving 300 post-menopausal women has found that higher BMI was associated with higher cognitive scores.

Of the 300 women (average age 60), 158 were classified as obese (waist circumference of at least 88cm, or BMI of over 30). Cognitive performance was assessed in three tests: The Mini-Mental Statement Examination (MMSE), a clock-drawing test, and the Boston Abbreviated Test.

Both BMI and waist circumference were positively correlated with higher scores on both the MMSE and a composite cognitive score from all three tests. It’s suggested that the estrogen produced in a woman’s fat cells help protect cognitive function.

Interestingly, a previous report from the same researchers challenged the link found between metabolic syndrome and poorer cognitive function. This study, using data from a large Argentinean Cardiovascular Prevention Program, found no association between metabolic syndrome and cognitive decline — but the prevalence of metabolic syndrome and cognitive decline was higher in males than females. However, high inflammatory levels were associated with impairment of executive functions, and higher systolic blood pressure was associated with cognitive decline.

It seems clear that any connection between BMI and cognitive decline is a complex one. For example, two years ago I reported that, among older adults, higher BMI was associated with more brain atrophy (replicated below; for more recent articles relating obesity to cognitive impairment, click on the obesity link at the end of this report). Hypertension, inflammation, and diabetes have all been associated with greater risk of impairment and dementia. It seems likely that the connection between BMI and impairment is mediated through these and other factors. If your fat stores are not associated with such health risk factors, then the fat in itself is not likely to be harmful to your brain function — and may (if you’re a women) even help.

Previous:

Overweight and obese elderly have smaller brains

Analysis of brain scans from 94 people in their 70s who were still "cognitively normal" five years after the scan has revealed that people with higher body mass indexes had smaller brains on average, with the frontal and temporal lobes particularly affected (specifically, in the frontal lobes, anterior cingulate gyrus, hippocampus, and thalamus, in obese people, and in the basal ganglia and corona radiate of the overweight). The brains of the 51 overweight people were, on average, 6% smaller than those of the normal-weight participants, and those of the 14 obese people were 8% smaller. To put it in more comprehensible, and dramatic terms: "The brains of overweight people looked eight years older than the brains of those who were lean, and 16 years older in obese people." However, overall brain volume did not differ between overweight and obese persons. As yet unpublished research by the same researchers indicates that exercise protects these same brain regions: "The most strenuous kind of exercise can save about the same amount of brain tissue that is lost in the obese."

Zilberman, J.M., Del Sueldo, M., Cerezo, G., Castellino, S., Theiler, E. & Vicario, A. 2011. Association Between Menopause, Obesity, and Cognitive Impairment. Presented at the Physiology of Cardiovascular Disease: Gender Disparities conference, October 12, at the University of Mississippi in Jackson.

Vicario, A., Del Sueldo, M., Zilberman, J. & Cerezo, G.H. 2011. The association between metabolic syndrome, inflammation and cognitive decline. Presented at the European Society of Hypertension (ESH) 2011: 21st European Meeting on Hypertension, June 17 - 20, Milan, Italy.

[733] Thompson PM, Raji CA, Ho AJ, Parikshak NN, Becker JT, Lopez OL, Kuller LH, Hua X, Leow AD, Toga AW. Brain structure and obesity. Human Brain Mapping [Internet]. 2010 ;31(3):353 - 364. Available from: http://dx.doi.org/10.1002/hbm.20870

Obesity has been linked to cognitive decline, but a new study involving 300 post-menopausal women has found that higher BMI was associated with higher cognitive scores.

Of the 300 women (average age 60), 158 were classified as obese (waist circumference of at least 88cm, or BMI of over 30). Cognitive performance was assessed in three tests: The Mini-Mental Statement Examination (MMSE), a clock-drawing test, and the Boston Abbreviated Test.

Both BMI and waist circumference were positively correlated with higher scores on both the MMSE and a composite cognitive score from all three tests. It’s suggested that the estrogen produced in a woman’s fat cells help protect cognitive function.

Interestingly, a previous report from the same researchers challenged the link found between metabolic syndrome and poorer cognitive function. This study, using data from a large Argentinean Cardiovascular Prevention Program, found no association between metabolic syndrome and cognitive decline — but the prevalence of metabolic syndrome and cognitive decline was higher in males than females. However, high inflammatory levels were associated with impairment of executive functions, and higher systolic blood pressure was associated with cognitive decline.

It seems clear that any connection between BMI and cognitive decline is a complex one. For example, two years ago I reported that, among older adults, higher BMI was associated with more brain atrophy (replicated below; for more recent articles relating obesity to cognitive impairment, click on the obesity link at the end of this report). Hypertension, inflammation, and diabetes have all been associated with greater risk of impairment and dementia. It seems likely that the connection between BMI and impairment is mediated through these and other factors. If your fat stores are not associated with such health risk factors, then the fat in itself is not likely to be harmful to your brain function — and may (if you’re a women) even help.

Previous:

Overweight and obese elderly have smaller brains

Analysis of brain scans from 94 people in their 70s who were still "cognitively normal" five years after the scan has revealed that people with higher body mass indexes had smaller brains on average, with the frontal and temporal lobes particularly affected (specifically, in the frontal lobes, anterior cingulate gyrus, hippocampus, and thalamus, in obese people, and in the basal ganglia and corona radiate of the overweight). The brains of the 51 overweight people were, on average, 6% smaller than those of the normal-weight participants, and those of the 14 obese people were 8% smaller. To put it in more comprehensible, and dramatic terms: "The brains of overweight people looked eight years older than the brains of those who were lean, and 16 years older in obese people." However, overall brain volume did not differ between overweight and obese persons. As yet unpublished research by the same researchers indicates that exercise protects these same brain regions: "The most strenuous kind of exercise can save about the same amount of brain tissue that is lost in the obese."

Zilberman, J.M., Del Sueldo, M., Cerezo, G., Castellino, S., Theiler, E. & Vicario, A. 2011. Association Between Menopause, Obesity, and Cognitive Impairment. Presented at the Physiology of Cardiovascular Disease: Gender Disparities conference, October 12, at the University of Mississippi in Jackson.

Vicario, A., Del Sueldo, M., Zilberman, J. & Cerezo, G.H. 2011. The association between metabolic syndrome, inflammation and cognitive decline. Presented at the European Society of Hypertension (ESH) 2011: 21st European Meeting on Hypertension, June 17 - 20, Milan, Italy.

[733] Thompson PM, Raji CA, Ho AJ, Parikshak NN, Becker JT, Lopez OL, Kuller LH, Hua X, Leow AD, Toga AW. Brain structure and obesity. Human Brain Mapping [Internet]. 2010 ;31(3):353 - 364. Available from: http://dx.doi.org/10.1002/hbm.20870

Growing evidence links obesity and poorer cognitive performance. Many factors associated with obesity, such as high blood pressure, type 2 diabetes and sleep apnea, damage the brain.

A study involving109 bariatric surgery patients and 41 obese control subjects has found that the bariatric surgery patients demonstrated improved memory and concentration 12 weeks after surgery, improving from the slightly impaired range to the normal range. That of the obese controls actually declined over this period. The improvement of those who had surgery seemed to be particularly related to improved blood pressure.

Study participants will be tested one year and two years after surgery.

The new label of ‘metabolic syndrome’ applies to those having three or more of the following risk factors: high blood pressure, excess belly fat, higher than normal triglycerides, high blood sugar and low high-density lipoprotein (HDL) cholesterol (the "good" cholesterol). Metabolic syndrome has been linked to increased risk of heart attack.

A new French study, involving over 7,000 older adults (65+) has found that those with metabolic syndrome were 20% more likely to show cognitive decline on a memory test (MMSE) over a two or four year interval. They were also 13% more likely to show cognitive decline on a visual working memory test. Specifically, higher triglycerides and low HDL cholesterol were linked to poorer memory scores; diabetes (but not higher fasting blood sugar) was linked to poorer visual working memory and word fluency scores.

The findings point to the importance of managing the symptoms of metabolic syndrome.

High cholesterol and blood pressure in middle age tied to early memory problems

Another study, involving some 4800 middle-aged adults (average age 55), has found that those with higher cardiovascular risk were more likely to have lower cognitive function and a faster rate of cognitive decline over a 10-year period. A 10% higher cardiovascular risk was associated not only with increased rate of overall mental decline, but also poorer cognitive test scores in all areas except reasoning for men and fluency for women.

The cardiovascular risk score is based on age, sex, HDL cholesterol, total cholesterol, systolic blood pressure and whether participants smoked or had diabetes.

Memory problems may be sign of stroke risk

A very large study (part of the REGARDS study) tested people age 45 and older (average age 67) who had never had a stroke. Some 14,842 people took a verbal fluency test, and 17,851 people took a word recall memory test. In the next 4.5 years, 123 participants who had taken the verbal fluency test and 129 participants who had taken the memory test experienced a stroke.

Those who had scored in the bottom 20% for verbal fluency were 3.6 times more likely to develop a stroke than those who scored in the top 20%. For the memory test, those who scored in the bottom 20% were 3.5 times more likely to have a stroke than those in the top quintile.

The effect was greatest at the younger ages. At age 50, those who scored in the bottom quintile of the memory test were 9.4 times more likely to later have a stroke than those in the top quintile.

 

Together, these studies, which are consistent with many previous studies, confirm that cardiovascular problems and diabetes add to the risk of greater cognitive decline (and possible dementia) in old age. And point to the importance of treating these problems as soon as they appear.

[2147] Raffaitin C, Féart C, Le Goff M, Amieva H, Helmer C, Akbaraly TN, Tzourio C, Gin H, Barberger-Gateau P. Metabolic syndrome and cognitive decline in French elders. Neurology [Internet]. 2011 ;76(6):518 - 525. Available from: http://www.neurology.org/content/76/6/518.abstract

The findings of the second and third studies are to be presented at the American Academy of Neurology's 63rd Annual Meeting in Honolulu April 9 to April 16, 2011

The new label of ‘metabolic syndrome’ applies to those having three or more of the following risk factors: high blood pressure, excess belly fat, higher than normal triglycerides, high blood sugar and low high-density lipoprotein (HDL) cholesterol (the "good" cholesterol). Metabolic syndrome has been linked to increased risk of heart attack.

A new French study, involving over 7,000 older adults (65+) has found that those with metabolic syndrome were 20% more likely to show cognitive decline on a memory test (MMSE) over a two or four year interval. They were also 13% more likely to show cognitive decline on a visual working memory test. Specifically, higher triglycerides and low HDL cholesterol were linked to poorer memory scores; diabetes (but not higher fasting blood sugar) was linked to poorer visual working memory and word fluency scores.

The findings point to the importance of managing the symptoms of metabolic syndrome.

High cholesterol and blood pressure in middle age tied to early memory problems

Another study, involving some 4800 middle-aged adults (average age 55), has found that those with higher cardiovascular risk were more likely to have lower cognitive function and a faster rate of cognitive decline over a 10-year period. A 10% higher cardiovascular risk was associated not only with increased rate of overall mental decline, but also poorer cognitive test scores in all areas except reasoning for men and fluency for women.

The cardiovascular risk score is based on age, sex, HDL cholesterol, total cholesterol, systolic blood pressure and whether participants smoked or had diabetes.

Memory problems may be sign of stroke risk

A very large study (part of the REGARDS study) tested people age 45 and older (average age 67) who had never had a stroke. Some 14,842 people took a verbal fluency test, and 17,851 people took a word recall memory test. In the next 4.5 years, 123 participants who had taken the verbal fluency test and 129 participants who had taken the memory test experienced a stroke.

Those who had scored in the bottom 20% for verbal fluency were 3.6 times more likely to develop a stroke than those who scored in the top 20%. For the memory test, those who scored in the bottom 20% were 3.5 times more likely to have a stroke than those in the top quintile.

The effect was greatest at the younger ages. At age 50, those who scored in the bottom quintile of the memory test were 9.4 times more likely to later have a stroke than those in the top quintile.

 

Together, these studies, which are consistent with many previous studies, confirm that cardiovascular problems and diabetes add to the risk of greater cognitive decline (and possible dementia) in old age. And point to the importance of treating these problems as soon as they appear.

[2147] Raffaitin C, Féart C, Le Goff M, Amieva H, Helmer C, Akbaraly TN, Tzourio C, Gin H, Barberger-Gateau P. Metabolic syndrome and cognitive decline in French elders. Neurology [Internet]. 2011 ;76(6):518 - 525. Available from: http://www.neurology.org/content/76/6/518.abstract

The findings of the second and third studies are to be presented at the American Academy of Neurology's 63rd Annual Meeting in Honolulu April 9 to April 16, 2011

Research into the link, if any, between cholesterol and dementia, has been somewhat contradictory. A very long-running Swedish study may explain why. The study, involving 1,462 women aged 38-60 in 1968, has found that cholesterol measured in middle or old age showed no link to dementia, but there was a connection between dementia and the rate of decline in cholesterol level. Those women whose cholesterol levels decreased the most from middle to older age were more than twice as likely to develop dementia as those whose cholesterol levels increased or stayed the same (17.5% compared to 8.9%).After 32 years, 161 women had developed dementia.

Later in life, women with slightly higher body mass index, higher levels of cholesterol and higher blood pressure tend to be healthier overall than those whose weight, cholesterol and blood pressure are too low. But it is unclear whether "too low" cholesterol, BMI and blood pressure are risk factors for dementia or simply signs that dementia is developing, for reasons we do not yet understand.

On the other hand, a recent rat study has found that consuming a high cholesterol diet for five months caused memory impairment, cholinergic dysfunction, inflammation, enhanced cortical beta-amyloid and tau and induced microbleedings — all of which is strikingly similar to Alzheimer's pathology. And this finding is consistent with a number of other studies. So it does seem clear that the story of how exactly cholesterol impacts Alzheimer’s is a complex one that we are just beginning to unravel.

In light of other research indicating that the response of men and women to various substances (eg caffeine) may be different, we should also bear in mind that the results of the Swedish study may apply only to women.

A very large study of older women has found that although there was a small downward trend in cognitive function (as measured by the MMSE) with increasing obesity, this trend was almost entirely driven by those with a waist-hip ratio below 0.78 — that is, for women who carry excess weight around their hips, known as pear shapes (as opposed to carrying it around the waist, called apple shapes). The study of 8,745 post-menopausal women (aged 65-79) found a drop of around 2 points on the 100-point MMSE for those with a BMI over 40 compared to those who were of normal weight, after controlling for such variables as education, diabetes, heart disease and hypertension, all of which were also significantly associated with BMI and MMSE score. Because 86% of the participants were white, and women belonging to other ethnic groups were not equally distributed between BMI categories, only data from white women were used. Some 70% of the participants were overweight (36%) or obese (34%).

Fat around the middle is thought to make more estrogen, which protects cognitive function. However, although depositing fat around the waist may be better for the brain, it is said to increase the risk of cancer, diabetes and heart disease.

A variant of a gene called the fat mass and obesity associated (FTO) gene causes people to gain weight and puts them at risk for obesity. The gene variant is found in nearly half of all people in the U.S. with European ancestry, around one-quarter of U.S. Hispanics, 15 percent of African Americans and 15 percent of Asian Americans. A new study involving 206 healthy elderly subjects from around the U.S. now suggests that this gene variant is also associated with loss of brain tissue. It’s not clear why, but the gene is highly expressed in the brain. Those with the "bad" version of the FTO gene had an average of 8% less tissue in the frontal lobes, and 12% less in the occipital lobes. The brain differences could not be directly attributed to other obesity-related factors (cholesterol levels, hypertension, or the volume of white matter hyperintensities), which didn’t vary between carriers and non-carriers. But if you have this gene variant, your weight is associated with neuron loss, and if you don't, it isn’t. The finding emphasizes the need for those with the gene to fight weight gain (and brain loss) by exercising and eating healthily.

Older news items (pre-2010) brought over from the old website

Overweight and obese elderly have smaller brains

Analysis of brain scans from 94 people in their 70s who were still "cognitively normal" five years after the scan has revealed that people with higher body mass indexes had smaller brains on average, with the frontal and temporal lobes particularly affected (specifically, in the frontal lobes, anterior cingulate gyrus, hippocampus, and thalamus, in obese people, and in the basal ganglia and corona radiate of the overweight). The brains of the 51 overweight people were, on average, 6% smaller than those of the normal-weight participants, and those of the 14 obese people were 8% smaller. To put it in more comprehensible, and dramatic terms: "The brains of overweight people looked eight years older than the brains of those who were lean, and 16 years older in obese people." However, overall brain volume did not differ between overweight and obese persons. As yet unpublished research by the same researchers indicates that exercise protects these same brain regions: "The most strenuous kind of exercise can save about the same amount of brain tissue that is lost in the obese."

[733] Thompson PM, Raji CA, Ho AJ, Parikshak NN, Becker JT, Lopez OL, Kuller LH, Hua X, Leow AD, Toga AW. Brain structure and obesity. Human Brain Mapping [Internet]. 2010 ;31(3):353 - 364. Available from: http://dx.doi.org/10.1002/hbm.20870

http://www.newscientist.com/article/mg20327222.400-expanding-waistlines-may-cause-shrinking-brains.htm

Obesity surgery can lead to memory loss

A review of the literature has found that weight loss surgery such as gastric bypass surgery, can lead to a vitamin deficiency that can cause memory loss and confusion, inability to coordinate movement, and other problems. Wernicke encephalopathy affects the brain and nervous system when the body doesn’t get enough vitamin B1 (thiamine). The study found that the syndrome occurs most often in people who have frequent vomiting after the surgery, and usually occurs within one to three months after the surgery.

Singh, S. & Kumar, A. 2007. Wernicke encephalopathy after obesity surgery: A systematic review. Neurology, 68, 807-811.

http://www.eurekalert.org/pub_releases/2007-03/aaon-osc030607.php

High BMI tied to poorer cognitive function in middle-aged adults

A study of 2,223 healthy French men and women aged 32—62 found that a higher body mass index (BMI) was associated with lower scores on a word-recall task.

[823] Cournot M, Marquie JC, Ansiau D, Martinaud C, Fonds H, Ferrieres J, Ruidavets JB. Relation between body mass index and cognitive function in healthy middle-aged men and women. Neurology [Internet]. 2006 ;67(7):1208 - 1214. Available from: http://www.neurology.org/cgi/content/abstract/67/7/1208

http://www.sciencedaily.com/releases/2006/10/061010023000.htm
http://www.eurekalert.org/pub_releases/2006-10/aaon-hbt100306.php

Morbid obesity in toddlers linked to low IQ

A study of 18 children and adults with early-onset morbid obesity (they weighed at least 150% of their ideal body weight before they were 4), 19 children and adults with Prader-Willi syndrome, and 24 of their normal-weight siblings, has revealed a link between morbid obesity in toddlers and lower IQ scores, cognitive delays and brain lesions similar to those seen in Alzheimer's disease patients. The links between cognitive impairments and Prader-Willi syndrome (a genetic disorder that causes people to eat nonstop and become morbidly obese at a very young age if not supervised) are well-established. But researchers were surprised to find patients with early-onset morbid obesity had an average IQ of 77, compared to an average of 63 for Prader-Willi patients and an average of 106 for the control group of siblings. Scans also revealed white-matter lesions on the brains of many of the Prader-Willi and early-onset morbidly obese patients.

[962] Sahoo T, Beaudet AL, Driscoll DJ, Miller J, Kranzler J, Liu Y, Schmalfuss I, Theriaque DW, Shuster JJ, Hatfield A, et al. Neurocognitive findings in Prader-Willi syndrome and early-onset morbid obesity. The Journal of Pediatrics [Internet]. 2006 ;149(2):192 - 198. Available from: http://www.ncbi.nlm.nih.gov/pubmed/16887432

http://www.eurekalert.org/pub_releases/2006-08/uof-ssl083106.php

Fat hormone linked to learning and memory

A new study reveals why obese patients who have diabetes also may have problems with their long-term memory. Leptin — the so-called ‘fat’ hormone — doesn't cross into the brain to help regulate appetite in obese people. Leptin also acts in the hippocampus, suggesting that leptin plays a role in learning and memory. The new study supports this by demonstrating that mice navigated a maze better after they received leptin. Moreover, mice with elevated levels of amyloid-beta plaques (characteristic of Alzheimer's) were particularly sensitive to leptin.

[2400] Farr SA, Banks WA, Morley JE. Effects of leptin on memory processing. Peptides [Internet]. 2006 ;27(6):1420 - 1425. Available from: http://www.sciencedirect.com/science/article/pii/S0196978105004754

http://www.sciencedaily.com/releases/2006/06/060614090511.htm
http://www.eurekalert.org/pub_releases/2006-06/slu-alb061306.php