Dietary and genetic interactions in Alzheimer's disease
R.P. Friedland, F. Traore, S.M. Debanne, T. Fritsch, A.J. Lerner, K.A. Smyth, G.J. Petot
lab of neurogeriatrics,
dept of neurology,
case western reserve university,
university hospitals of cleveland,
10900 euclid avenue,
cleveland ohio 44106-4962
Genetic factors, especially the apolipoprotein E (Apo E) e4 allele, are
important determinants of Alzheimer's disease (AD). However, many
people with the e4 allele do not get the disease and many AD patients
do not have the e4 allele. The role of Apo E as a lipid transport
protein suggests that lipid homeostasis is an important factor in the
disease. In our CWRU case-control study of 121 AD cases and 227
controls we investigated genetic and environmental risk and protective
factors and their interactions. Diet was studied in mid-adult life
using a life history questionnaire adapted from the Block Health Habits
and History instrument. We have found that: 1) controls with Apo E e4
consumed less fat than controls without e4 (p < .01); 2) higher fat
intake was protective in those without e4 [OR = 0.42 (95%CI 0.2-0.89)];
3) a diet pattern identified from factor analysis characterized by low
fat/high antioxidant intake was protective [OR = 0.45 (.21-.96) for
highest tertile); 4) midlife BMI and fish consumption were not related
to disease, and 5) plasma total homocysteine values were also not
related to disease. Other important issues to be considered include
physical and mental exercise, smoking, education and occupational
demands. Lipid levels may influence the crucial process of clearance of
the amyloid Beta protein from brain to blood through competition for
binding sites on Apo E. Genetic factors and diet and their interactions
are important determinants in the causal web of AD.
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