Prospective Associations of Diet and Late-Onset Alzheimer's Disease and Related Dementias Among Five Racial and Ethnic Populations

五个种族和民族人群中饮食与迟发性阿尔茨海默病及相关痴呆症的前瞻性关联

• 批准号: 10809518
• 负责人: Song-Yi Park
• 金额: $ 17.46万
• 依托单位: UNIVERSITY OF HAWAII AT MANOA
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-09-30 至 2025-09-29
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10809518
• 关键词: Address; Adherence; Adult; African American; African American population; Aging; Alzheimer' s disease related dementia; American; Asian Americans; Attenuated; Blood Vessels; Brain; Cognition; Cohort Studies; Consumption; DASH diet; Data; Data Analyses; Diabetes Mellitus; Diet; Dietary Component; Dietary Intervention; Dietary Practices; Disease; Disparate; Disparity; Ethnic Origin; Ethnic Population; Etiology; Evaluation; Fabaceae; Factor Analysis; Fat-Soluble Vitamin; Follow-Up Studies; Food; Frequencies; Future; Genetic Risk; Green tea; Hawaii; Health Benefit; Healthcare; Healthy Eating; Heart Diseases; Individual; Inflammation; Inflammatory; Intake; Intervention; Intervention Studies; Japanese American; Late Onset Alzheimer Disease; Latino; Life Style; Longitudinal Studies; Longterm Follow-up; Los Angeles; Maintenance; Medicare; Medicare claim; Mediterranean Diet; Metabolic; Minority; Native Hawaiian; Nerve Degeneration; Nutrient; Nutritional Study; Obesity; Observational Study; Omega-3 Fatty Acids; Outcome; Oxidative Stress; Participant; Pattern; Pharmacological Treatment; Physical activity; Population; Prevention; Prevention strategy; Questionnaire Designs; Questionnaires; Race; Recommendation; Research; Risk; Risk Factors; Sampling; Scheme; Sleep; Taro Vegetable; Time; Underrepresented Populations; Vegetables; apolipoprotein E-4; cancer epidemiology; cohort; cost; dementia risk; design; dietary; dietary constituent; ethnic disparity; evidence base; follow-up; good diet; healthy weight; high risk; improved; indexing; insight; longitudinal, prospective study; microbial; modifiable risk; multi-ethnic; novel; nutritional epidemiology; polygenic risk score; polyphenol; population based; prevent; prospective; protective effect; protective factors; public health priorities; racial disparity; racial population; risk variant; soy; synergism; uptake

PROJECT SUMMARY / ABSTRACT Diet is a promising modifiable factor for the prevention of late-onset Alzheimer's disease and related dementias (LOADRD). Healthy diet may directly reduce oxidative stress and inflammation in the brain and moderate metabolic risk factors of LOADRD, such as obesity, diabetes, and heart disease. Specific foods and nutrients (e.g., vegetables, fat-soluble vitamins, omega-3 fatty acids, polyphenols) have been suggested as protective. However, considering the complexity of diet and the synergistic effects of constituents, increasingly the research focus is on overall dietary patterns: especially for LOADRD research, the Mediterranean diet (MED), the Dietary Approaches to Stop Hypertension (DASH) and the Mediterranean-DASH intervention for Neurodegenerative Delay (MIND) diet. While some prospective observational studies provide strong support for the protective effect of these dietary patterns, mostly involving White populations and some African Americans, data is lacking for Latino American, Asian American, and Native populations, which limits the understanding of dietary contributions to ADRD disparities. Also, longitudinal studies of dietary change or maintenance are needed to provide evidence for dietary interventions to reduce ADRD risks. To address these gaps, we propose a secondary data analysis in the Multiethnic Cohort (MEC) Study on African American, Japanese American, Latino, Native Hawaiian, and White adults with high-quality dietary data and Medicare linkage-based ADRD outcomes (1999-2019). Based on a validated food frequency questionnaire administered at cohort entry and 10-year follow-up, we have calculated several dietary pattern scores (the alternate MED (aMED), DASH, the Healthy Eating Index 2015 (HEI-2015), and the Dietary Inflammatory Index (DII)) and will compute the MIND score. Our analysis will include ~102,000 participants and ~19,000 ADRD cases. Specifically, we will evaluate the LOADRD risk associated with overall dietary patterns (MIND, aMED, DASH, HEI-2015 and DII scores) (Aim 1) and the individual components of the patterns and two specific nutrients (fat-soluble vitamins and polyphenols) (Aim 2) overall and by race and ethnicity. We will assess these associations (a) based on the baseline intake, (b) for the change over 10 years, and (c) by ADRD subtypes and by genetic risk (APOE e4 status or polygenic risk score). We hypothesize that healthful dietary patterns will be protective against LOADRD across racial and ethnic groups, that improved dietary quality will be associated with a reduced risk, and that the specific bioactive components, the consumption of which vary by race and ethnicity, may have independent protective effects. Lastly, we will develop a novel dietary pattern to capture the unique and diverse dietary features of the multiethnic population, and validate it by examining its association with LOADRD (Aim 3). This project based in a large, long-term, multiethnic cohort, equipped with comprehensive dietary data and extensive expertise in nutritional epidemiology, presents a unique opportunity to provide much needed data and rigorous evaluations for the diet-LOADRD associations to inform future studies on disparities, interventions, and dietary recommendations.

项目摘要 /摘要 饮食是预防晚期阿尔茨海默氏病和相关痴呆症的有希望的改变因素 （LOADRD）。健康饮食可以直接减少大脑的氧化应激和炎症 负载的代谢危险因素，例如肥胖，糖尿病和心脏病。特定的食物和营养 （例如，蔬菜，脂溶性维生素，omega-3脂肪酸，多酚）被认为是保护性的。 但是，考虑到饮食的复杂性和成分的协同作用，越来越多的研究 重点是整体饮食模式：特别是对于Loadrd研究，地中海饮食（MED），饮食 停止高血压（DASH）的方法和用于神经退行性 延迟（思维）饮食。尽管一些前瞻性观察研究为保护效应提供了强有力的支持 在这些饮食模式中，主要涉及白人人群和一些非洲裔美国人，数据缺乏数据 拉丁裔美国人，亚裔美国人和本地人口，限制了对饮食贡献的理解 差异差异。此外，还需要对饮食变化或维持的纵向研究以提供证据 为了减少饮食干预措施以减少ADRD风险。为了解决这些差距，我们提出了二级数据分析 在非裔美国人，日裔美国人，拉丁裔，夏威夷人和夏威夷人和的多民族队列（MEC）中 具有高质量饮食数据的白人成年人和基于Medicare连接的ADRD成果（1999-2019）。基于 在队列进入和10年随访时管理的经过验证的食品频率问卷，我们已经计算了 几个饮食模式分数（替代药物（AMED），DASH，健康饮食指数2015（HEI-2015）， 以及饮食炎症指数（DII）），并将计算思维评分。我们的分析将包括〜102,000 参与者和约19,000例案件。具体来说，我们将评估与总体相关的负载风险 饮食模式（思维，AMED，DASH，HEI-2015和DII分数）（AIM 1）以及单个组成部分 图案和两种特定的营养素（脂溶性维生素和多酚）（AIM 2）总体以及种族和划分 种族。我们将根据基线摄入量进行评估（a），（b）在10年内变化， （c）按ADRD亚型和遗传风险（APOE E4状态或多基因风险评分）。我们假设这一点 健康的饮食模式将对种族和族裔群体的负载有保护，这有所改善 饮食质量将与降低的风险以及特定的生物活性成分，消费有关 其中因种族和种族而异，可能具有独立的保护作用。最后，我们将开发一本小说 饮食模式以捕获多种族人口的独特和多样化的饮食特征，并通过 检查其与Loadrd的关联（AIM 3）。这个项目以大型，长期的多民族队列为基础 配备了全面的饮食数据和营养流行病学方面的广泛专业知识，提出了独特的 提供急需的数据和严格评估的机会，以告知饮食。 关于差异，干预措施和饮食建议的未来研究。