The relationship between nutrient intake and executive function in adults with post-traumatic stress disorder

Background: Executive function (EF) deficits are common in adults with post-traumatic stress disorder (PTSD). Macro- and micronutrient intake are potential modifiable factors that may influence EF in PTSD. Objectives: To explore the relationship between the daily dietary intake of o-3 and o-6 polyunsaturated fatty acids (PUFAs), vitamin C, vitamin E, vitamin D, vitamin B12 and folate, and EF in adults with PTSD. Methods: This was a cross-sectional observational study of adults with PTSD who completed neurocognitive assessments (n = 201). Digit span backwards, spatial span backwards, Stroop test and the Ruff Figural Fluency Task were used to assess EF. FoodFinder nutrient intake based on 24-h dietary recalls was used to calculate average daily nutrient intake. Multivariable linear regression models were used to regress EF on the nutrient variables. Results: Intake of vitamin E, o-3 PUFAs, and o-6 PUFAs were all positively associated with planning and setshifting, with vitamin E (adjusted beta = 0.20, p = 0.004) and o-6 (adjusted beta = 0.17, p = 0.01) remaining significant after adjustment for age; sex; education and body mass index. Vitamin D intake was negatively associated with interference (adjusted beta = -0.21, p = 0.01). Vitamin C, vitamin B12 and folate intake were not associated with EF. Limitations: 24-h dietary recall data is limited by recall bias. Circulating nutrient levels were not measured. Conclusions: Dietary intake of vitamins E, o-3 and o-6 may be important modifiable factors affecting EF in adults with PTSD. Randomised controlled trials are needed to investigate whether micro- and macronutrient interventions can improve EF and other outcomes in PTSD.