Nutrient patterns and brain biomarkers of Alzheimer's disease in cognitively normal individuals

Abstract

Objectives Epidemiological evidence linking diet, one of the most important modifiable lifestyle factors, and risk of Alzheimer’s disease (AD) is rapidly increasing. However, there is little or no evidence for a direct association between dietary nutrients and brain biomarkers of AD. This study identifies nutrient patterns associated with major brain AD biomarkers in a cohort of clinically and cognitively normal (NL) individuals at risk for AD. Design Cross-sectional study. Setting Manhattan (broader area). Participants Fifty-two NL individuals (age 54+12 y, 70% women, Clinical Dementia Rating=0, MMSE>27, neuropsychological test performance within norms by age and education) with complete dietary information and cross-sectional, 3D T1-weighted Magnetic Resonance Imaging (MRI; gray matter volumes, GMV, a marker of brain atrophy), 11C-Pittsburgh compound-B (PiB; a marker of fibrillar amyloid-β, Aβ) and 18F-fluorodeoxyglucose (FDG; a marker of glucose metabolism, METglc) Positron Emission Tomography (PET) scans were examined. Measurements Dietary intake of 35 nutrients associated with cognitive function and AD was assessed using the Harvard/Willet Food Frequency Questionnaire. Principal component analysis was used to generate nutrient patterns (NP) from the full nutrient panel. Statistical parametric mapping and voxel based morphometry were used to assess the associations of the identified NPs with AD biomarkers. Results None of the participants were diabetics, smokers, or met criteria for obesity. Five NPs were identified: NP1 was characterized by most B-vitamins and several minerals [VitB&Minerals]; NP2 by monounsaturated and polyunsaturated fats, including ω-3 and ω-6 PUFA, and vitamin E [VitE&PUFA]; NP3 by vitamin A, vitamin C, carotenoids and dietary fibers [Anti-oxidants&Fibers]; NP4 by vitamin B12, vitamin D and zinc [VitB12&D]; NP5 by saturated, trans-saturated fats, cholesterol and sodium [Fats]. Voxel-based analysis showed that NP4 scores [VitB12&D] were positively associated with METglc and GMV, and negatively associated with PiB retention in AD-vulnerable regions (p<0.001). In addition, both METglc and GMV were positively associated with NP2 scores [VitE&PUFA], and negatively associated with NP5 scores [Fats] (p<0.001), and METglc was positively associated with higher NP3 scores [Anti-oxidants&Fibers] (p<0.001). Adjusting for age, gender, ethnicity, education, caloric intake, BMI, alcohol consumption, family history and Apolipoprotein E (APOE) status did not attenuate these relationships. The identified ‘AD-protective’ nutrient combination was associated with higher intake of fresh fruit and vegetables, whole grains, fish and low-fat dairies, and lower intake of sweets, fried potatoes, high-fat dairies, processed meat and butter. Conclusion Specific dietary NPs are associated with brain biomarkers of AD in NL individuals, suggesting that dietary interventions may play a role in the prevention of AD by modulating AD-risk through its effects on Aβ and associated neuronal impairment.

An exploratory study of dietary intake patterns among adults diagnosed with cardiovascular risk factors

“…Towards this direction, the PCA provided three nutrient factors: the ''plant oil factor'', the ''vegetable/fruit factor'', and the ''animal food factor''. It must be noted that similar trends were observed in previous studies aiming at identifying dietary patterns based on nutrients ( (Bertuccio et al, 2009;Bravi et al, 2010), ''unsaturated fats'' (Bosetti et al, 2013;Edefonti et al, 2008), or ''vitamin E and PUFA'' (Berti et al, 2014). Consistent with our ''vegetable/fruit factor'', the ''vitamins and fiber'' (Bertuccio et al, 2009;Bosetti et al, 2013;Bravi et al, 2010;Edefonti et al, 2008) and ''antioxidants and fiber'' (Berti et al, 2014) factors are reported in the literature.…”

“…It must be noted that similar trends were observed in previous studies aiming at identifying dietary patterns based on nutrients ( (Bertuccio et al, 2009;Bravi et al, 2010), ''unsaturated fats'' (Bosetti et al, 2013;Edefonti et al, 2008), or ''vitamin E and PUFA'' (Berti et al, 2014). Consistent with our ''vegetable/fruit factor'', the ''vitamins and fiber'' (Bertuccio et al, 2009;Bosetti et al, 2013;Bravi et al, 2010;Edefonti et al, 2008) and ''antioxidants and fiber'' (Berti et al, 2014) factors are reported in the literature. Furthermore, in line with our ''animal food factor'', Edefonti et al (2008), Bertuccio et al (2009), Bravi et al (2010, and Bosetti et al (2013) identified the ''animal products'' pattern.…”

Let Food Be Thy Medicine: Diet, Nutrition, and Biomarkers’ Risk of Alzheimer’s Disease

“…Multimodality brain imaging studies tested PCA-derived NPs for associations with Aß deposition on PiB-PET, CMRglc on FDG-PET, and gray matter volumes (GMV) on MRI in 25- to 72-year-old cognitively normal adults [75]. Five distinct NPs were extracted from a panel of 35 nutrients related to AD or cognitive function.…”

“…Additionally, CMRglc and GMV were negatively associated with a second NP characterized by intake of saturated, trans-saturated fats, cholesterol, and sodium. Finally, CMRglc was positively associated with two additional NPs: one characterized by intake of vitamin E, ω-3, and ω-6 PUFA, and the other by intake of vitamin A, vitamin C, several carotenoids (α- and β-carotene, β-cryptoxanthin, lutein, zeaxanthin), and dietary fibers [75]. The identified “brain-protective” NPs were correlated to higher intake of vegetables, fruit, whole grains, fish, low fat dairies, and nuts, and lower intake of sweets, fried potatoes, processed meat, high-fat dairies, and butter [75] (Fig.…”

Dietary iodine exposure and brain structures and cognition in older people. Exploratory analysis in the Lothian Birth Cohort 1936

“…that was associated with reduced brain atrophy) was linked to higher intake of fish and low-fat dairy products and lower intake of high-fat dairies, processed meat and butter (23).…”