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A Protective Diet

Yian Gu, PhD; Jeri W. Nieves, PhD; Yaakov Stern, PhD; Jose A. Luchsinger, MD, MPH; Nikolaos Scarmeas, MD, MS

Arch Neurol. 2010;67(6):699-706. Published online April 12, 2010 (doi:10.1001/archneurol.2010.84).

Objective  To assess the association between food combination and Alzheimer disease (AD) risk. Because foods are not consumed in isolation, dietary pattern (DP) analysis of food combination, taking into account the interactions among food components, may offer methodological advantages.

Design  Prospective cohort study.

Setting  Northern Manhattan, New York, New York.

Patients or Other Participants  Two thousand one hundred forty-eight community-based elderly subjects (aged 65 years) without dementia in New York provided dietary information and were prospectively evaluated with the same standardized neurological and neuropsychological measures approximately every 1.5 years. Using reduced rank regression, we calculated DPs based on their ability to explain variation in 7 potentially AD-related nutrients: saturated fatty acids, monounsaturated fatty acids, -3 polyunsaturated fatty acids, -6 polyunsaturated fatty acids, vitamin E, vitamin B₁₂, and folate. The associations of reduced rank regression–derived DPs with AD risk were then examined using a Cox proportional hazards model.

Main Outcome Measure  Incident AD risk.

Results  Two hundred fifty-three subjects developed AD during a follow-up of 3.9 years. We identified a DP strongly associated with lower AD risk: compared with subjects in the lowest tertile of adherence to this pattern, the AD hazard ratio (95% confidence interval) for subjects in the highest DP tertile was 0.62 (0.43-0.89) after multivariable adjustment (P for trend = .01). This DP was characterized by higher intakes of salad dressing, nuts, fish, tomatoes, poultry, cruciferous vegetables, fruits, and dark and green leafy vegetables and a lower intake of high-fat dairy products, red meat, organ meat, and butter.

Conclusion  Simultaneous consideration of previous knowledge regarding potentially AD-related nutrients and multiple food groups can aid in identifying food combinations that are associated with AD risk.

Author Affiliations: The Taub Institute for Research in Alzheimer's Disease and the Aging Brain (Drs Gu, Stern, Luchsinger, and Scarmeas), The Gertrude H. Sergievsky Center (Drs Stern, Luchsinger, and Scarmeas), and Departments of Neurology (Drs Stern and Scarmeas), Medicine (Dr Luchsinger), and Epidemiology (Drs Luchsinger and Nieves), Columbia University, New York, and Clinical Research Center, Helen Hayes Hospital, West Haverstraw (Dr Nieves), New York.

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