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Researchers at Iowa State University assessing the UK Biobank Study reported recently that modifying meal plans may help minimize cognitive decline associated with Alzheimer’s Disease (AD). Observations suggest that adding cheese and red wine to the diet daily, and lamb on a weekly basis, may improve long-term cognitive outcomes in “risk status-dependent manners.” Cheese in the diet was shown in the study to strongly predict better problem solving ability.
A sample of 1,787 of 1,929 participants in the study completed the Fluid Intelligence Test (FIT) as part of a touchscreen questionnaire at baseline and two follow-up assessments (2006-2010, 2012-2013, and 2015-2016). The FIT score is quantified by how many numeric, logic, and syntactic questions (out of 13 total questions) that participants were able to answer correctly within two minutes. 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).
Apolipoprotein E or APOE (ɛ) is a protein involved in the metabolism of fats in the body of humans and mammals. A subtype (ɛ4) is implicated in Alzheimer’s disease and cardiovascular disease.
AD and APOE
Alzheimer’s disease (AD) is characterized by build-ups of aggregates of the peptide beta-amyloid.
Apolipoprotein E (APOE) enhances proteolytic break-down of this peptide, both within and between cells. The isoform or E4 variant (APOE-ε4) is not as effective as the others at promoting these reactions, resulting in increased vulnerability to AD in individuals with that gene variation.
The E4 variant does not correlate with AD risk in every ethnic population.
A Food Frequency Questionnaire inquired about participants’ intake of fresh fruit, dried fruit, raw vegetables and salad, cooked vegetables, oily fish, lean fish, processed meat, poultry, beef, lamb, pork, cheese, bread, cereal, tea and coffee, beer and cider, red wine, white wine and champagne, and liquor. Bread, cereal, fruit, and vegetable responses were recorded in integer units (slices per week, bowls per week, pieces per day, and tablespoons per day, respectively). Intakes of meat, fish, and cheese responses were recorded as dichotomous variables (“less than once a week”, “once a week”, “two to four times a week”, “five or six times a week”, “once or more daily”, “never”). Alcohol consumption responses were recorded by type as an average weekly intake (in pints for beer and cider, glasses for red and white wine and champagne, and measures for liquor). Frequency of alcohol intake was also recorded as dichotomous variables (“daily or almost daily”, “three or four times a week”, “once or twice a week”, “special occasions only or never”). Tea and coffee intake were recorded in integer units of cups per day, and did not distinguish between caffeinated or decaffeinated coffee, nor black or green tea. Bread and cereal intake categories were combined to estimate total grain intake. Fresh and dried fruit intake categories were combined to estimate total fruit intake. Raw and cooked vegetable intake categories were combined to estimate total vegetable intake.
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). Beta (β) refers to Standardized parameter estimates, which were interpreted as the change in outcome variable per standard deviation change in the predictor -- estimated using maximum likelihood. Genetic Factors - APOE and AD Family History All UK Biobank genome-wide association study (GWAS) data have been processed as previously described. Briefly, APOE haplotype was determined using allele variation on rs429358 and rs7412. APOE was further stratified as whether participant has at least one ε4 allele (ε2/ε4, ε3/ε4, and ε4/ε4) or not at all (ε2/ε2, ε2/ε3, and ε3/ε3). AD family history was classified according to the participants’ self-report responses of the presence or absence of AD in their family history on the touchscreen questionnaire. Specifically, participants were queried about family history via the question, “Has/did your father/mother ever suffer from:”, followed by a list of chronic diseases, including ‘Alzheimer’s disease/dementia.’ The researchers observed that added salt may put at-risk individuals at greater risk, but did not observe similar interactions among FH- and AD-individuals.
Objective: Observe how the total diet is associated with long-term cognition among mid- to late-life populations at-risk and not c -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).
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).
Institution Affiliations included the following …
Department of Food Science and Human Nutrition, Iowa State University, Ames, IA, USA.
Neuroscience Graduate Program, Iowa State University, Ames, IA, USA.
Department of Biomedical Sciences, Iowa State University, Ames, IA, USA.
Department of Statistics, Iowa State University, Ames, IA, USA.
Department of Statistics, University of Virginia, Charlottesville, VA, USA.
Department of Veterinary Clinical Sciences, Iowa State University, Ames, IA, USA.
Rush Alzheimer’s Disease Center, Rush Medical Center, Rush University, Chicago, IL, USA.
Department of Neurology, University of Iowa, Iowa City, IA, USA.
Klinedinst BS, Le ST, Larsen B, Pappas C, Hoth NJ, Pollpeter A, Wang Q, Wang Y, Yu S, Wang L, Allenspach K, Mochel JP, Bennett DA, Willette AA. Genetic Factors of Alzheimer’s Disease Modulate How Diet is Associated with Long-Term Cognitive Trajectories: A UK Biobank Study. J Alzheimers Dis. 2020;78(3):1245-1257. doi: 10.3233/JAD-201058. PMID: 33252089.