Associations of Midlife Dietary Patterns with Incident Dementia and Brain Structure: Findings from the UK Biobank Study

Jingyun Zhang; Xingqi Cao; Xin Li; Xueqin Li; Meng Hao; Yang Xia; Huiqian Huang; Terese Sara Høj Jørgensen; George O Agogo; Liang Wang; Xuehong Zhang; Xiang Gao; Zuyun Liu

doi:10.1016/j.ajcnut.2023.05.007

Associations of Midlife Dietary Patterns with Incident Dementia and Brain Structure: Findings from the UK Biobank Study

Am J Clin Nutr. 2023 Jul;118(1):218-227. doi: 10.1016/j.ajcnut.2023.05.007. Epub 2023 May 5.

Authors

Jingyun Zhang¹, Xingqi Cao¹, Xin Li², Xueqin Li¹, Meng Hao³, Yang Xia⁴, Huiqian Huang⁵, Terese Sara Høj Jørgensen⁶, George O Agogo⁷, Liang Wang⁸, Xuehong Zhang⁹, Xiang Gao¹⁰, Zuyun Liu¹¹

Affiliations

¹ Center for Clinical Big Data and Analytics of the Second Affiliated Hospital and Department of Big Data in Health Science School of Public Health, The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Zhejiang University School of Medicine, Zhejiang, China.
² Welch Center for Prevention, Epidemiology, and Clinical Research Department of Epidemiology, Johns Hopkins University, Baltimore, MD, United States.
³ State Key Laboratory of Genetic Engineering, Collaborative Innovation Center for Genetics and Development, School of Life Sciences and Human Phenome Institute, Fudan University, Shanghai, China.
⁴ Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China.
⁵ Clinical Research Center, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.
⁶ Section of Social Medicine, Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
⁷ StatsDecide Analytics and Consulting Ltd, Nakuru, Kenya.
⁸ Department of Public Health, Robbins College of Human Health and Sciences, Baylor University, Waco, TX, United States.
⁹ Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, United States.
¹⁰ Department of Nutrition and Food Hygiene, School of Public Health, Fudan University, Shanghai, China.
¹¹ Center for Clinical Big Data and Analytics of the Second Affiliated Hospital and Department of Big Data in Health Science School of Public Health, The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Zhejiang University School of Medicine, Zhejiang, China. Electronic address: Zuyun.liu@outlook.com.

PMID: 37150507
DOI: 10.1016/j.ajcnut.2023.05.007

Abstract

Background: At present, the results on the associations between dietary patterns and risk of dementia are inconsistent, and studies on the associations between dietary patterns and brain structures are limited.

Objectives: We aimed to investigate the associations of midlife dietary patterns with incident dementia and brain structures.

Methods: On the basis of the UK Biobank Study, we investigated the 1) prospective associations of 4 healthy dietary pattern indices [healthy plant-based diet index (hPDI), Mediterranean diet score (MDS), recommended food score (RFS), and Mediterranean-DASH Intervention for Neurodegenerative Delay Diet (MIND)] with incident dementia (identified using linked hospital data; N = 114,684; mean age, 56.8 y; 55.5% females) using Cox proportional-hazards regressions and the 2) cross-sectional associations of these dietary pattern indices with brain structures (estimated using magnetic resonance imaging; N = 18,214; mean age, 55.9 y; 53.1% females) using linear regressions. A series of covariates were adjusted, and several sensitivity analyses were conducted.

Results: A total of 481 (0.42%) participants developed dementia during the average 9.4-y follow-up. Although the associations were not statistically significant, all dietary patterns exerted protective effects against incident dementia (all HRs < 1). Furthermore, higher dietary pattern indices were significantly associated with larger regional brain volumes, including volumes of gray matter in the parietal and temporal cortices and volumes of the hippocampus and thalamus. The main results were confirmed via sensitivity analyses.

Conclusions: Greater adherence to hPDI, MDS, RFS, and MIND was individually associated with larger brain volumes in specific regions. This study shows a comprehensive picture of the consistent associations of midlife dietary patterns with risk of dementia and brain health, underscoring the potential benefits of a healthy diet in the prevention of dementia.

Keywords: dementia; epidemiology; geriatrics; nutritional science; public health.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Biological Specimen Banks
Brain / diagnostic imaging
Cross-Sectional Studies
Dementia* / epidemiology
Dementia* / prevention & control
Diet, Mediterranean*
Female
Humans
Male
Middle Aged
United Kingdom / epidemiology