scholarly journals MIND diet and the risk of dementia: a population-based study

2022 ◽  
Vol 14 (1) ◽  
Author(s):  
Tosca O. E. de Crom ◽  
Sanne S. Mooldijk ◽  
M. Kamran Ikram ◽  
M. Arfan Ikram ◽  
Trudy Voortman
Keyword(s):  
Lower Risk ◽  
Population Based ◽  
Reverse Causality ◽  
Cox Models ◽  
The Mind ◽  
Residual Confounding ◽  
Diet Score ◽  
Insight Into ◽  
Mind Diet

Abstract Background Adherence to the Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) diet has been linked to a decreased risk of dementia, but reverse causality and residual confounding by lifestyle may partly account for this link. We aimed to address these issues by studying the associations over cumulative time periods, which may provide insight into possible reverse causality, and by using both historical and more contemporary dietary data as this could give insight into confounding since historical data may be less affected by lifestyle factors. Methods In the population-based Rotterdam Study, dietary intake was assessed using validated food frequency questionnaires in 5375 participants between 1989 and 1993 (baseline I) and in a largely non-overlapping sample in 2861 participants between 2009 and 2013 (baseline II). We calculated the MIND diet score and studied its association with the risk of all-cause dementia, using Cox models. Incident all-cause dementia was recorded until 2018. Results During a mean follow-up of 15.6 years from baseline I, 1188 participants developed dementia. A higher MIND diet score at baseline I was associated with a lower risk of dementia over the first 7 years of follow-up (hazard ratio (HR) [95% confidence interval (CI)] per standard deviation (SD) increase, 0.85 [0.74, 0.98]), but associations disappeared over longer follow-up intervals. The mean follow-up from baseline II was 5.9 years during which 248 participants developed dementia. A higher MIND diet score at baseline II was associated with a lower risk of dementia over every follow-up interval, but associations slightly attenuated over time (HR [95% CI] for 7 years follow-up per SD increase, 0.76 [0.66, 0.87]). The MIND diet score at baseline II was more strongly associated with the risk of dementia than the MIND diet score at baseline I. Conclusion Better adherence to the MIND diet is associated with a decreased risk of dementia within the first years of follow-up, but this may in part be explained by reverse causality and residual confounding by lifestyle. Further research is needed to unravel to which extent the MIND diet may affect the risk of dementia.

scholarly journals Adherence to the MIND diet is associated with 12-year all-cause mortality in older adults

2020 ◽  
pp. 1-10
Author(s):  
Janie Corley
Keyword(s):  
Birth Cohort ◽  
Dietary Patterns ◽  
Lower Risk ◽  
Risk Of Death ◽  
Traditional Diet ◽  
All Cause Mortality ◽  
The Mind ◽  
Diet Score ◽  
Mind Diet

Abstract Objective: To prospectively evaluate the association of three dietary patterns: the MIND (Mediterranean-DASH diet intervention for Neurodegenerative Delay) diet; a Mediterranean-type diet and a traditional diet, with all-cause mortality over a 12-year period in an older sample. Design: A longitudinal birth cohort study. We ascertained dietary patterns using FFQ data at baseline (2004–2007) and mortality using linkage data. Cox regression was used to estimate mortality hazard ratios (HR) with adjustment for confounders. Setting: The Lothian Birth Cohort 1936 (LBC1936) study in Edinburgh, Scotland. Participants: Dietary patterns were ascertained in 882 participants, mean age 69·5 (±0·8) years, at baseline. During the 12-year follow-up (to October 2019), 206 deaths occurred. Results: In the basic-adjusted model, all three dietary patterns were significantly associated with mortality, the MIND diet and Mediterranean-type diet with a lower risk and the traditional diet with a higher risk. In fully adjusted models, MIND diet score was inversely related to all-cause mortality (HR 0·88; 95 % CI 0·79, 0·97) such that the risk of death was reduced by 12 % per unit increase in MIND diet score. Participants in the top compared with the bottom third of MIND diet score had a 37 % lower risk of death (HR 0·63; 95 % CI 0·41, 0·96). No significant associations with the Mediterranean-type or traditional dietary patterns were observed in the final multivariate model. Conclusions: Our findings suggest that closer adherence to the MIND diet is associated with a significantly lower risk of all-cause mortality, over 12 years of follow-up, and may constitute a valid public health recommendation for prolonged survival.

scholarly journals Diet quality and risk and severity of COVID-19: a prospective cohort study

2021 ◽  
Author(s):  
Jordi Merino ◽  
Amit D Joshi ◽  
Long Nguyen ◽  
Emily Leeming ◽  
David Alden Drew ◽  
...  
Keyword(s):  
Diet Quality ◽  
Lower Risk ◽  
Socioeconomic Deprivation ◽  
Healthy Plant ◽  
Cox Models ◽  
Plant Foods ◽  
Hazard Ratios ◽  
High Deprivation ◽  
Diet Score

Objective: Poor metabolic health and certain lifestyle factors have been associated with risk and severity of coronavirus disease 2019 (COVID-19), but data for diet are lacking. We aimed to investigate the association of diet quality with risk and severity of COVID-19 and its intersection with socioeconomic deprivation. Design: We used data from 592,571 participants of the smartphone-based COVID Symptom Study. Diet quality was assessed using a healthful plant-based diet score, which emphasizes healthy plant foods such as fruits or vegetables. Multivariable Cox models were fitted to calculate hazard ratios (HR) and 95% confidence intervals (95% CI) for COVID-19 risk and severity defined using a validated symptom-based algorithm or hospitalization with oxygen support, respectively. Results: Over 3,886,274 person-months of follow-up, 31,815 COVID-19 cases were documented. Compared with individuals in the lowest quartile of the diet score, high diet quality was associated with lower risk of COVID-19 (HR, 0.91; 95% CI, 0.88-0.94) and severe COVID-19 (HR, 0.59; 95% CI, 0.47-0.74). The joint association of low diet quality and increased deprivation on COVID-19 risk was higher than the sum of the risk associated with each factor alone (Pinteraction=0.005). The corresponding absolute excess rate for lowest vs highest quartile of diet score was 22.5 (95% CI, 18.8-26.3) and 40.8 (95% CI, 31.7-49.8; 10,000 person-months) among persons living in areas with low and high deprivation, respectively. Conclusions: A dietary pattern characterized by healthy plant-based foods was associated with lower risk and severity of COVID-19. These association may be particularly evident among individuals living in areas with higher socioeconomic deprivation.

scholarly journals Diet quality and risk and severity of COVID-19: a prospective cohort study

Gut ◽  
2021 ◽  
Vol 70 (11) ◽  
pp. 2096-2104 ◽  
Author(s):  
Jordi Merino ◽  
Amit D Joshi ◽  
Long H Nguyen ◽  
Emily R Leeming ◽  
Mohsen Mazidi ◽  
...  
Keyword(s):  
Diet Quality ◽  
Lower Risk ◽  
Socioeconomic Deprivation ◽  
Healthy Plant ◽  
Unhealthy Lifestyle ◽  
Cox Models ◽  
Plant Foods ◽  
High Deprivation ◽  
Diet Score

ObjectivePoor metabolic health and unhealthy lifestyle factors have been associated with risk and severity of COVID-19, but data for diet are lacking. We aimed to investigate the association of diet quality with risk and severity of COVID-19 and its interaction with socioeconomic deprivation.DesignWe used data from 592 571 participants of the smartphone-based COVID-19 Symptom Study. Diet information was collected for the prepandemic period using a short food frequency questionnaire, and diet quality was assessed using a healthful Plant-Based Diet Score, which emphasises healthy plant foods such as fruits or vegetables. Multivariable Cox models were fitted to calculate HRs and 95% CIs for COVID-19 risk and severity defined using a validated symptom-based algorithm or hospitalisation with oxygen support, respectively.ResultsOver 3 886 274 person-months of follow-up, 31 815 COVID-19 cases were documented. Compared with individuals in the lowest quartile of the diet score, high diet quality was associated with lower risk of COVID-19 (HR 0.91; 95% CI 0.88 to 0.94) and severe COVID-19 (HR 0.59; 95% CI 0.47 to 0.74). The joint association of low diet quality and increased deprivation on COVID-19 risk was higher than the sum of the risk associated with each factor alone (Pinteraction=0.005). The corresponding absolute excess rate per 10 000 person/months for lowest vs highest quartile of diet score was 22.5 (95% CI 18.8 to 26.3) among persons living in areas with low deprivation and 40.8 (95% CI 31.7 to 49.8) among persons living in areas with high deprivation.ConclusionsA diet characterised by healthy plant-based foods was associated with lower risk and severity of COVID-19. This association may be particularly evident among individuals living in areas with higher socioeconomic deprivation.

scholarly journals Independent and joint effects of vascular and cardiometabolic risk factor pairs for risk of all-cause dementia: a prospective population-based study

2019 ◽  
Vol 31 (10) ◽  
pp. 1421-1432 ◽  
Author(s):  
C. Elizabeth Shaaban ◽  
Yichen Jia ◽  
Chung-Chou H. Chang ◽  
Mary Ganguli
Keyword(s):  
Cardiometabolic Risk ◽  
Joint Effect ◽  
Population Based ◽  
Cox Models ◽  
Joint Effects ◽  
Synergistic Interactions ◽  
Dementia Risk ◽  
Dementia Prevention ◽  
Adjusted Model

ABSTRACTObjectives:To assess independent and joint effects of pairs of vascular and cardiometabolic risk factors (VCMRFs) in relation to risk of all-cause dementia.Design:Population-based longitudinal cohort study of cognitive impairment. We used an algorithm to select pairs of VCMRFs and tested their joint effects in time-dependent Cox models. We used attributable proportions (AP) to measure the proportion of risk from interactions beyond any additive effect.Setting:Economically depressed small-town population.Participants:Adults age 65+ years with up to 10 yearly study visits (N=1701, median (Q1, Q3) age, 78 (71.0, 83.0), 62.3% female, 94.9% white).Results:Among 1701 participants free from prevalent dementia with at least one follow-up visit, 109 developed incident all-cause dementia. In pairings of APOE*4 with hypertension (HTN) and congestive heart failure (CHF), the variables contributed independently and additively to all-cause dementia risk. In pairings of APOE*4 with stroke and stroke with CHF, the variables demonstrated independent contributions to all-cause dementia risk; their joint effects showed excess detriment demonstrating synergistic interactions (joint HR [95% CI]: 28.33 [6.74, 119.01] and 50.30 [14.57, 173.57] respectively, fully adjusted models). Physical activity (PA) was independently associated with lower all-cause dementia risk when paired with APOE*4, stroke, and CHF in unadjusted models; these associations did not survive covariate adjustment. The joint effect of low PA and APOE*4 was associated with additively increased all-cause dementia risk (joint HR [95% CI]: 4.61 [2.07, 10.23], fully adjusted model).Conclusions:Reduction of VCMRFs, including low PA, could be valuable for dementia prevention, especially among APOE*4 carriers.

scholarly journals SURVIVAL ADVANTAGE OF APOE2

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S621-S621
Author(s):  
Sudha Seshadri
Keyword(s):  
Lower Risk ◽  
Large Population ◽  
Population Based ◽  
European Ancestry ◽  
Aggregated Data ◽  
Risk Of Death ◽  
Apoe Ε4 ◽  
Increased Risk ◽  
Ε4 Allele

Abstract Apolipoprotein E is a glycoprotein mediator and regulator of lipid transport and uptake. The APOE-ε4 allele has been associated with higher risk of Alzheimer’s disease and of mortality, but the effect of the less prevalent APOE-ε2 on survival remains elusive. We aggregated data of 38,537 individuals of European ancestry (mean age 65.5 years; 55.6% women) from six large population-based cohorts to determine the association of APOE-ε2, with survival in the general population. During a mean follow-up of 11.7 years, 17,021 individuals died. Compared with homozygous APOE-ε3 carriers, APOE-ε2 carriers were at lower risk of death (hazard ratio,95% confidence interval: 0.94,0.90-0.99; P=1.1*10-2), whereas APOE-ε4 carriers were at increased risk (HR 1.17,1.12-1.21; P=2.8*10-16). Risk was lowest for homozygous APOE-ε2 (HR 0.89,0.74-1.08), and highest for homozygous APOE-ε4 (HR 1.52,1.37-1.70). Results did not differ by sex. The association was unaltered after adjustment for baseline LDL or cardiovascular disease. Larger, multiethnic collaborations are ongoing.

scholarly journals Ambulatory blood pressure and long-term risk for atrial fibrillation

Heart ◽  
2018 ◽  
Vol 104 (15) ◽  
pp. 1263-1270 ◽  
Author(s):  
Valérie Tikhonoff ◽  
Tatiana Kuznetsova ◽  
Lutgarde Thijs ◽  
Nicholas Cauwenberghs ◽  
Katarzyna Stolarz-Skrzypek ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Blood Pressure ◽  
Ambulatory Blood Pressure ◽  
Population Based ◽  
European Population ◽  
Night Time ◽  
Cox Models ◽  
Increased Risk ◽  
Daytime Blood Pressure

ObjectiveData on the contribution of ambulatory blood pressure (ABP) components to the risk of developing atrial fibrillation (AF) are limited. We prospectively tested the hypothesis that ABP may represent a potentially modifiable risk factor for the development of AF in a European population study.MethodsWe recorded daytime blood pressure (BP) in 3956 subjects randomly recruited from the general population in five European countries. Of these participants, 2776 (70.2%) underwent complete 24-hour ABP monitoring. Median follow-up was 14 years. We defined daytime systolic BP load as the percentage BP readings above 135 mm Hg. The incidence of AF was assessed from ECGs obtained at baseline and follow-up and from records held by general practitioners and/or hospitals.ResultsOverall, during 58 810 person-years of follow-up, 143 participants experienced new-onset AF. In adjusted Cox models, each SD increase in baseline 24 hours, daytime and night-time systolic BP was associated with a 27% (P=0.0056), 22% (P=0.023) and 20% (P=0.029) increase in the risk for incident AF, respectively. Conventional systolic BP was borderline associated with the risk of AF (18%; P=0.06). As compared with the average population risk, participants in the lower quartile of daytime systolic BP load (<3%) had a 51% (P=0.0038) lower hazard for incident AF, whereas in the upper quartile (>38%), the risk was 46% higher (P=0.0094).ConclusionsSystolic ABP is a significant predictor of incident AF in a population-based cohort. We also observed that participants with a daytime systolic BP load >38% had significantly increased risk of incident AF.

scholarly journals Incidence of fractures in middle-aged individuals with early chronic kidney disease: a population-based analysis of CARTaGENE

2020 ◽  
Vol 35 (10) ◽  
pp. 1712-1721 ◽  
Author(s):  
Louis-Charles Desbiens ◽  
Rémi Goupil ◽  
François Madore ◽  
Fabrice Mac-Way
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Population Based ◽  
Fracture Incidence ◽  
Administrative Databases ◽  
Middle Aged ◽  
Cox Models ◽  
Ckd Stage ◽  
Age And Sex

Abstract Background Previous studies evaluating fractures in chronic kidney disease (CKD) have mostly focused on hip or major fractures in aged populations with moderate to advanced CKD. We aimed at evaluating the association between early CKD and fracture incidence at all sites across age and sex in middle-aged individuals. Methods We analyzed CARTaGENE, a prospective population-based survey of 40- to 69-year-old individuals from Quebec (Canada). Estimated glomerular filtration rate (eGFR) at baseline was evaluated categorically or continuously using restricted cubic splines. Fractures at any site (except toes, hand and craniofacial) for up to 7 years of follow-up were identified through administrative databases using a validated algorithm. Adjusted Cox models were used to evaluate the association of CKD with fracture. Interaction terms for age and sex were also added. Results A total of 19 391 individuals (756 CKD Stage 3; 9114 Stage 2; 9521 non-CKD) were included and 829 fractures occurred during a median follow-up of 70 months. Compared with the median eGFR of 90 mL/min/1.73 m2, eGFRs of ≤60 mL/min/1.73 m2 were associated with increased fracture incidence in unadjusted and adjusted models [adjusted hazard ratio (HR) = 1.25 (95% confidence interval 1.05–1.49) for 60 mL/min/1.73 m2; 1.65 (1.14–2.37) for 45 mL/min/1.73 m2]. The eGFR was linearly associated with fracture incidence &lt;75 mL/min/1.73 m2 [HR = 1.18 (1.04–1.34) per 10 mL/min/1.73 m2 decrease] but not above [HR = 0.98 (0.91–1.06) per 10 mL/min/1.73 m2 decrease). The effect of decreased eGFR on fracture incidence was more pronounced in younger individuals [HR = 2.45 (1.28–4.67) at 45 years; 1.11 (0.73–1.67) at 65 years] and in men. Conclusions Even early CKD increases fracture incidence, especially in younger individuals and in men.

Abstract 2118: A Population-based Comparison of the Cardiovascular Protective Effects of Hydrochlorothiazide and Chlorthalidone

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Jeff Nagge ◽  
David N Juurlink
Keyword(s):  
Confidence Interval ◽  
Lower Risk ◽  
Primary Outcome ◽  
Population Based ◽  
Hazard Ratio ◽  
Protective Effects ◽  
Composite Outcome ◽  
Index Event ◽  
Significant Difference

Background Clinical practice guidelines for the treatment of hypertension recommend a thiazide diuretic as initial therapy for the majority of patients. Most clinicians consider chlorthalidone (CHL) and hydrochlorothiazide (HCTZ), the two most commonly prescribed thiazides, to be interchangeable, despite evidence suggesting these drugs are not equivalent. Methods We constructed a population-based retrospective cohort study by linking the health records of 1.4 million residents of Ontario, Canada aged 66 or older between July 1, 1993 and March 1, 2002. The index event for entry into the cohort was a new prescription for either HCTZ or CHL. The primary outcome was the time from the index event to a composite outcome of acute myocardial infarction (AMI), stroke, or all-cause mortality. Secondary analyses explored each outcome individually. Analysis was done using Cox proportional hazards regression with the HCTZ group as the reference. Results During 218,360 person-years of follow-up in the HCTZ group, there were 10 025 events (death, AMI or stroke), compared to 113 events during 4,214 person-years of follow-up in the CHL group. The unadjusted hazard ratio for the primary outcome was 0.73 (95% confidence interval 0.61 to 0.88), suggesting a substantially lower risk of events during CHL therapy. After adjustment for differences in baseline demographic and clinical characteristics, there was no statistically significant difference between the groups for the primary outcome (adjusted hazard ratio 0.85; 95% confidence interval 0.71 to 1.03). The hazard ratios for each component of the primary composite outcome all trended in the direction of a lower risk of events in users of CHL. Conclusion In a large cohort of older patients treated with thiazide diuretics, the use of CHL was not associated with a statistically significant reduction in the risk of AMI, stroke, or death. However, treatment effects favored CHL for every outcome, raising the hypothesis that CHL is superior to HCTZ. Further research is needed to confirm or refute this hypothesis.

Abstract P215: Plasma and Dietary Linoleic Acid and Diabetes Incidence After Myocardial Infarction

Circulation ◽  
2018 ◽  
Vol 137 (suppl_1) ◽  
Author(s):  
Marjolein C Harbers ◽  
Kamalita Pertiwi ◽  
Sabita S Soedamah-Muthu ◽  
Janette de Goede ◽  
Famke J Mölenberg ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Fatty Acids ◽  
Linoleic Acid ◽  
Lower Risk ◽  
Plasma Cholesterol ◽  
Dietary Factors ◽  
Diabetes Incidence ◽  
Cox Models ◽  
Total Fatty Acids

Background: Plasma linoleic acid (C18:2n-6, LA) has been associated with a lower risk of type 2 diabetes mellitus (T2DM) in prospective cohort studies, but associations of dietary LA with T2DM risk are inconsistent. Objective: To study both plasma and dietary LA in relation to incident T2DM in post-myocardial infarction (MI) patients who received state-of-the-art drug treatment. Methods: We included 3,377 patients (80% male) from the Alpha Omega Cohort aged 60-80 y who had an MI <10 y before study enrollment and who were initially free of T2DM. At baseline, LA was measured in plasma cholesterol esters as a proportion of total fatty acids. Dietary LA intake was estimated from a validated 203-item food-frequency questionnaire that had been specifically designed for measuring fatty acid intake. Incident T2DM was ascertained through self-reported physician diagnosis and medication use. HRs for incident T2DM in quintiles of plasma LA and dietary LA were obtained from multivariable Cox models that included age, sex, lifestyle and dietary factors. For dietary LA, we used a substitution model in which LA was iso-calorically replaced with the sum of saturated plus trans fatty acids. Results: From the lowest to the highest quintile, dietary LA ranged from 3.5 to 8.8 percent of energy and the proportion of plasma LA ranged from 43.7 to 56.3%. Plasma and dietary LA were weakly correlated (Spearman r = 0.14, P <.0001). During a median follow-up of 3.4 years, 171 cases of T2DM occurred. Plasma LA was associated with a significantly lower risk of T2DM (HR Q5vsQ1 : 0.45; 95% CI: 0.27 - 0.76; P for trend = 0.002). Dietary LA was not associated with T2DM risk (HR Q5vsQ1: 0.97; 95% CI: 0.53 - 1.76; P for trend = 0.85). Conclusion: Plasma LA but not dietary LA was associated with lower T2DM risk in post-MI patients. The utility of plasma LA as a biomarker of dietary LA warrants further investigation.

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