Genetic Factors of Alzheimer’s Disease Modulate How Diet is Associated with Long-Term Cognitive Trajectories: A UK Biobank Study

Article type: Research Article

Authors: Klinedinst, Brandon S.^{a; b; 1} | Le, Scott T.^{a; 1} | Larsen, Brittany^{b; c} | Pappas, Colleen^a | Hoth, Nathan J.^a | Pollpeter, Amy^{a; c} | Wang, Qian^a | Wang, Yueying^d | Yu, Shan^e | Wang, Li^d | Allenspach, Karin^f | Mochel, Jonathan P.^c | Bennett, David A.^g | Willette, Auriel A.^{a; b; f; h; *}

Affiliations: [a] Department of Food Science and Human Nutrition, Iowa State University, Ames, IA, USA | [b] Neuroscience Graduate Program, Iowa State University, Ames, IA, USA | [c] Department of Biomedical Sciences, Iowa State University, Ames, IA, USA | [d] Department of Statistics, Iowa State University, Ames, IA, USA | [e] Department of Statistics, University of Virginia, Charlottesville, VA, USA | [f] Department of Veterinary Clinical Sciences, Iowa State University, Ames, IA, USA | [g] Rush Alzheimer’s Disease Center, Rush Medical Center, Rush University, Chicago, IL, USA | [h] Department of Neurology, University of Iowa, Iowa City, IA, USA

Correspondence: [*] Correspondence to: Auriel A. Willette, PhD, MS, 1109 HNSB, 2302 Osborn Drive, Ames, IA 50011-1078, USA. Tel.: +1 515 294 3110; E-mail: Awillett@iastate.edu.

Note: [1] These authors contributed equally to this work.

Abstract: Background:Fluid intelligence (FI) involves abstract problem-solving without prior knowledge. Greater age-related FI decline increases Alzheimer’s disease (AD) risk, and recent studies suggest that certain dietary regimens may influence rates of decline. However, it is uncertain how long-term food consumption affects FI among adults with or without familial history of AD (FH) or APOE4 (ɛ4). Objective:Observe how the total diet is associated with long-term cognition among mid- to late-life populations at-risk and not-at-risk for AD. Methods:Among 1,787 mid-to-late-aged adult UK Biobank participants, 10-year FI trajectories were modeled and regressed onto the total diet based on self-reported intake of 49 whole foods from a Food Frequency Questionnaire (FFQ). Results:Daily cheese intake strongly predicted better FIT scores over time (FH-: β= 0.207, p < 0.001; ɛ4–: β= 0.073, p = 0.008; ɛ4+: β= 0.162, p = 0.001). Alcohol of any type daily also appeared beneficial (ɛ4+: β= 0.101, p = 0.022) and red wine was sometimes additionally protective (FH+: β= 0.100, p = 0.014; ɛ4–: β= 0.59, p = 0.039). Consuming lamb weekly was associated with improved outcomes (FH-: β= 0.066, p = 0.008; ɛ4+: β= 0.097, p = 0.044). Among at risk groups, added salt correlated with decreased performance (FH+: β= –0.114, p = 0.004; ɛ4+: β= –0.121, p = 0.009). Conclusion:Modifying meal plans may help minimize cognitive decline. We observed that added salt may put at-risk individuals at greater risk, but did not observe similar interactions among FH- and AD- individuals. Observations further suggest in risk status-dependent manners that adding cheese and red wine to the diet daily, and lamb on a weekly basis, may also improve long-term cognitive outcomes.

Keywords: Aging, APOE4, cognitive decline, functional food, lamb, Mediterranean diet, nutrition policy, preventive medicine, red wine, salt

DOI: 10.3233/JAD-201058

Journal: Journal of Alzheimer's Disease, vol. 78, no. 3, pp. 1245-1257, 2020