NuBrain: UK Consortium for Optimal Nutrition for Healthy Brain Ageing

Cognitive function declines naturally with age and in some individuals, this will progress to differing degrees of cognitive impairment or to dementia Globally the human population is living longer; it is predicted that by 2050, the number of people aged 60 years and over will reach two billion. As a result, it is predicted that dementia prevalence will almost triple during this timeframe.

The health, economic and social burden of dementia and other cognitive disorders is profound and mental health is considered to be one of the greatest global challenges. There is currently a distinct lack of effective medications to prevent or treat dementias. Therefore, there is an urgent need to identify i) which individuals are at greatest risk and ii) which lifestyle factors can modify cognition and therefore target to support better brain health in our ageing population. There is strong and growing evidence from animal and population observational studies that nutrition throughout the life-course has a profound impact on age-associated cognitive decline. However, as yet, there is limited understanding of which dietary patterns, foods and food components influence brain function during ageing and at what intakes and which population subgroups (age, sex, stage of disease progression etc.) are most responsive. As highlighted in a recent UK Department of Health Report (SACN 2018, Statement on Diet, Cognitive Impairment and Dementias) there is a great need to conduct fit-for-purpose intervention studies in humans to meaningfully advance our current understanding of the potential of nutrition strategies in brain health.

Our collaboration will aim to address these knowledge gaps with the long-term aim of improving brain ageing through better understanding of the impact of nutrition on brain health. This requires a new collaboration between scientists from multiple disciplines, many of whom have not collaborated before or who have not previously engaged in nutrition research. The NuBrain consortium will bring together expertise and techniques in human nutrition, translational epidemiology, informatics, brain imaging, neuroscience, behavioural science and public health and policy along with clinical psychiatry expertise to produce a step change in research on nutrition and brain ageing. We will engage with industry and retailers, government, policy makers, charities and the public to ensure that research findings are relevant and to maximise opportunities for translation via e.g. food product innovation and public health policy in an effective and timely manner to improve public health. Initial studies carried out by the consortium will focus on utilising information from several key cohort studies to better understand the potential benefits of dietary interventions for healthy brain ageing in different target populations. We will also carry out feasibility studies to further understand how to support long term dietary behaviour change and the efficacy of different intervention tools and methodologies to help achieve this. Further feasibility studies will be funded as the consortium develops.

We will support early career researchers (ECRs) in relevant fields to develop new skills and expertise and foster innovation in nutrition and brain ageing research. The consortium will expose ECRs to new collaborators, potential industry partners and other important bodies such as Alzheimer's Research UK and Public Health England. This is important to build capacity and develop the next generation of multidisciplinary researchers in this area.

This funding will also act as a catalyst for the consortium to develop future funding bids to continue to develop the research in this area. We will actively seek ways to (i) attract new members and further develop the expertise within the consortium and (ii) seek further funding from funding bodies to strengthen and expand the work of the collaboration.

Whilst some cognitive functions remain stable with age, most people experience age-related decline in cognition which can progress to differing degrees of cognitive impairment or to dementia. Dementia currently affects 47 million people worldwide, and is projected to increase to over 131 million people by 2050, with increased prevalence mainly attributed to ageing population demographics. With the lack of effective curative or preventative pharmacological interventions, there is an urgent need to identify i) at risk individuals and ii) modifiable factors for targeted interventions to support better brain health in our ageing population. Nutrition is emerging as a tractable lifestyle factor to promote healthy brain ageing and reduce dementia risk. Research (mainly observational and often cross-sectional in approach) has identified numerous dietary factors (e.g. DHA, B-vitamins, Vitamin D) that can promote cognitive performance with cell and rodent models providing insights into underlying physiological and molecular mechanisms. However, comprehensive longitudinal or RCT data, using sensitive measures of cognitive function and brain structure, and state-of-the-art detailed nutrition profiling is lacking. Such information is needed in order to gain insight and granularity into which diet derived components are likely to be most effective at a population and population subgroup level.
Our vision is to provide a step change in research in the area by developing novel approaches and techniques to further understand the complex interactions between diet and brain health and how we can support appropriate behaviour change in the population. This will be achieved by bringing together a consortium with multi-disciplinary but complimentary areas of expertise to address this specific challenge. The aim is to build a sustainable internationally field-leading consortium in nutrition and brain ageing who can collectively address the fundamental research challenges in this area.

Worldwide, 47 million people are currently affected by dementia with approximately 8 million newly diagnosed cases annually. Even though the overall care of individuals with dementia has improved, effective interventions to prevent or delay onset are still lacking. In England alone, it is estimated that the economic cost of dementia is £23 billion a year and this is set to triple by 2040. The prevention or delay of significant cognitive decline would have profound health and socio-economic benefits. It is paramount that we act now to develop effective solutions to this serious health issue. The impact of diet and nutrition on age-related cognitive decline is a growing research field but well-designed studies in target populations with sensitive outcome measures have yet to be carried out. The overall aim of the proposed work is to build a multidisciplinary consortium who can collectively begin to address the fundamental research challenges in nutrition and brain ageing, working towards supporting appropriate behaviour change in target populations. This research will have far-reaching impact for multiple beneficiaries:

THE AGEING POPULATION: Preventing or slowing cognitive decline through effective dietary strategies would have major benefits for public health including improved functional years of life and independence and reduced care burden for families and health care professionals. We anticipate that the proposed research will ultimately help to develop useable public health nutritional recommendations for policy makers and clinicians to support healthy brain ageing. We will also better understand the opportunities to support behaviour change in food choice and consumption and how we can work with key stakeholders such as the food industry, retailers, technology companies and health care professionals to achieve this. This will aid the public to adhere to recommendations and make sustainable dietary changes which will help to support better brain health in later life.The health impacts will help to reduce NHS burden of cognitive decline in our ageing population.

PARTNERSHIP WITH INDUSTRY: Partnership with industry is vital to ensure research advances can be translated into better services, products or improved support to facilitate long-term behaviour change. Industry partners have already committed to the NuBrain consortium. The pre-competitive nature of this research means that further collaborations can and will be developed as the consortium grows and develops. Through partnership with Campden BRI we will disseminate our aims and objectives and subsequently main findings to key industry partners maximising our impact. We will also engage with the National Innovation Centre for Ageing to attract other industry partners to the consortium e.g. technology companies to aid the delivery of large scale interventions.

TRAINING OF EARLY CAREER RESEARCHERS: This work takes a novel multidisciplinary approach towards addressing a major nutritional challenge. This project will hence offer experience and training across a range of techniques and discipline areas building the skills and capacity of the next generation of nutritional science researchers. The opportunities to engage with multiple stakeholders will also support future collaborations, knowledge transfer, and raise awareness of potential career opportunities. This will strengthen future expertise at the interface between public health, nutrition and technology and ultimately help to build future capacity in nutrition science, an important issue highlighted by the MRC /NIHR Review of Nutrition and Human Health Research (July 2017). The ECR Sandpit Event (WP1) will be an excellent opportunity for ECRs to engage with stakeholders and co-develop pilot and feasibility studies. ECRs will also be involved in the planning and management of this event led by the ECR representative on the Collaboration Steering Group.