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.

项目总结/摘要 饮食是预防迟发性阿尔茨海默病和相关痴呆症的一个有希望的可改变因素 （LOADRD）.健康的饮食可以直接减少大脑中的氧化应激和炎症， LOADRD的代谢危险因素，如肥胖、糖尿病和心脏病。特定食物和营养素 (e.g.,蔬菜、脂溶性维生素、ω-3脂肪酸、多酚）被认为具有保护作用。 然而，考虑到饮食的复杂性和成分的协同效应，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 停止高血压的方法（DASH）和Mediterranean DASH干预神经退行性疾病 延迟（MIND）饮食。虽然一些前瞻性观察性研究为保护作用提供了强有力的支持， 在这些饮食模式中，大多数涉及白色人群和一些非洲裔美国人， 拉丁裔美国人、亚裔美国人和原住民，这限制了对饮食贡献的理解 ADRD差异。此外，需要对饮食改变或维持进行纵向研究，以提供证据 进行饮食干预以降低ADRD风险。为了解决这些差距，我们提出了二次数据分析 在对非裔美国人、日裔美国人、拉丁美洲人、夏威夷土著人和 白色成年人高质量的饮食数据和医疗保险联系为基础的ADRD结果（1999-2019）。基于 在队列进入和10年随访时进行的一项经验证的食物频率问卷调查中，我们计算出 几种饮食模式评分（替代MED（aMED），DASH，2015年健康饮食指数（HEI-2015）， 和饮食炎症指数（DII）），并将计算MIND评分。我们的分析将包括~ 102，000 参与者和约19，000例ADRD病例。具体而言，我们将评估与总体风险相关的LOADRD风险。 饮食模式（MIND、aMED、DASH、HEI-2015和DII评分）（目标1）和 模式和两种特定的营养素（脂溶性维生素和多酚）（目标2）的总体和种族， 种族我们将评估这些关联（a）基于基线摄入量，（B）10年内的变化， 和（c）ADRD亚型和遗传风险（APOE e4状态或多基因风险评分）。我们假设 健康的饮食模式将在种族和民族群体中保护LOADRD， 饮食质量将与风险降低有关，并且特定的生物活性成分， 其中，因种族和族裔而异，可能具有独立的保护作用。最后，我们将开发一个新的 饮食模式，以捕捉多民族人口的独特和多样化的饮食特点，并验证它， 检查其与LOADRD的关联（目标3）。这个项目基于一个大的，长期的，多种族的群体， 配备了全面的饮食数据和广泛的营养流行病学专业知识，提出了一个独特的 有机会为饮食负荷协会提供急需的数据和严格的评估， 未来的研究差异，干预措施和饮食建议。