Objective:The widely reported associations between various nutrients and cognition may occur through many biologic pathways including those of -amyloid (A). However, little is known about the possible associations of dietary factors with plasma A40 or A42. The aim of the current study was to evaluate the association between nutrient intake and plasma A levels.
Methods:In this cross-sectional study, plasma A40 and A42 and dietary data were obtained from 1,219 cognitively healthy elderly (age Ͼ65 years), who were participants in a communitybased multiethnic cohort. Information on dietary intake was obtained 1.2 years, on average, before A assay. The associations of plasma A40 and A42 levels and dietary intake of 10 nutrients were examined using linear regression models, adjusted for age, gender, ethnicity, education, caloric intake, apolipoprotein E genotype, and recruitment wave. Nutrients examined included saturated fatty acid, monounsaturated fatty acid, -3 polyunsaturated fatty acid (PUFA), -6 PUFA, vitamin E, vitamin C, -carotene, vitamin B 12 , folate, and vitamin D.
Results:In unadjusted models that simultaneously included all nutrients, higher intake of -3 PUFA was associated with lower levels of A40 ( ϭ Ϫ24.7, p Ͻ 0.001) and lower levels of A42 ( ϭ Ϫ12.3, p Ͻ 0.001). In adjusted models, -3 PUFA remained a strong predictor of A42 ( ϭ Ϫ7.31, p ϭ 0.02), whereas its association with A40 was attenuated ( ϭ Ϫ11.96, p ϭ 0.06). Other nutrients were not associated with plasma A levels.
Conclusions:Our data suggest that higher dietary intake of -3 PUFA is associated with lower plasma levels of A42, a profile linked with reduced risk of incident AD and slower cognitive decline in our cohort. Neurology ® 2012;78:1832-1840 GLOSSARY A ϭ -amyloid; AD ϭ Alzheimer disease; DHA ϭ docosahexaenoic acid; MCI ϭ mild cognitive impairment; MUFA ϭ monounsaturated fatty acid; PUFA ϭ polyunsaturated fatty acid; SFA ϭ saturated fatty acid; SFFQ ϭ semiquantitative food frequency questionnaire; WHICAP ϭ Washington Heights/Hamilton Heights Columbia Aging Project.There is increasing evidence to suggest that diet may play an important role in preventing or delaying the onset of Alzheimer disease (AD). 1 We have previously reported that a Mediterranean-type diet and a dietary pattern explaining the maximum variation of 7 ADrelated nutrients were associated with lower risk of prevalent AD, incident AD, incident mild cognitive impairment (MCI), or MCI conversion to AD 2-5 in a New York population. However, the potential biologic mechanisms for the relation between diet and AD have not been well addressed.One important pathologic hallmark of AD is -amyloid (A) peptide (mainly A40 and A42) deposition in the brain, resulting in formation of plaques. Although the brain burden of A has been considered to be the most direct marker of AD pathology and has been well associated with clinical manifestations of AD severity, it is not easy or practical to measure in epidemiologic studies. In contrast, plasma A is r...