“Precision” nutrition? Benefits of DHA modified by AD Genetic Risk


In middle-aged adults without cognitive impairment and with a high genetic risk of suffering Alzheimer’s disease (AD), increased intake of dietary docosahexaenoic acid (DHA) was associated with increased resistance to disease-related brain atrophy in neuroimaging.

DHA intake, as measured by a food frequency questionnaire, was found to be significantly related to increased cortical thickness, the AD signature in individuals homozygous for APOE-ε4, that is, with two copies of the risk allele, but not in non-homozygous.

This association was reinforced in a propensity score analysis that matched participants with risk factors.

“What we saw was this in patients with two APOE-ε4 alleles compared with those with one or none, increasing self-administered DHA intake related to a more preserved cortical thickness in these areas associated with the risk and disease progression of the so-called disease (AD), ”he reported. the main author Aleix Sala-Vila, PharmD, doctor, from the BarcelonaBeta Brain Research Center, in Barcelona, ​​Spain.

“So, in other words, people with the highest genetic risk of Alzheimer’s due to the disease APOE allele, these were the patients who benefited from increased fish intake, ”he added.

“This is important because it gives us a clue on how to test whether you can try this simple lifestyle intervention, which is to eat more fatty fish. Maybe we need to try the intervention in this enriched target group,” Sala suggested. -Villa the interview.

Sala-Vila and colleagues they published their findings at the American Journal of Clinical Nutrition.

No significant associations were seen between DHA intake and episodic memory or executive function. There was also no association between DHA intake and evidence of white matter hyperintensities, an indication of small brain vessel disease burden.

In general, in both homozygous and nonhomozygous individuals, a nonsignificant trend toward a lower prevalence of cerebral microbedits (CMB) was observed in the lobar regions of the brain (odds ratio, 0.446; Pg = 0.055), which are mostly related to the accumulation of amyloid proteins in the walls of blood vessels.

Fatty fish is the main dietary source of DHA, a critical fatty acid for brain function. It is still a matter of debate whether dietary DHA prevents or delays cognitive impairment or AD disease.

“We’ve seen that if we look at the brains of Alzheimer’s patients and compare them to those who don’t have Alzheimer’s, we’ll see that in those with AD the amount of DHA is lower, but it’s mostly observational data, so we’ve to be prudent in making any conclusions. “

In a published study last year and reported by Medscape Medical News, Sala-Vila and colleagues shared observational data showing that regular consumers of foods rich in omega-3 fatty acids had an improved prognosis after the ST segment myocardial infarction.

In this study, researchers avoided the dangers of food frequency questionnaires, but assessed tissue levels of EPA and alpha-linolenic acid (ALA) by measuring serum phosphatidylcholine (PC) levels, which reflect intake. diet for the previous 3 or 4 weeks.

He is also currently working on the collection of circulating omega-3 measures in this current study cohort.

Precision nutrition?

“The findings suggest a role for APOE-ε4 as a conditional modulator in antiretroviral disease prevention regimens, strengthening the potential relevance of precision nutrition during the preclinical stages of neurodegenerative disease prevention, ”writes Omar Yaxmehen Bello-Chavolla, MD, PhD, National Autonomous University of Mexico, Mexico City and colleagues in a accompanying editorial.

This “positive step forward for precision nutrition” is consistent with recent evidence supporting the role of nutritional habits in managing both cardiovascular and cardiovascular disease risk, the editorial writers said.

The researchers studied 340 participants from the ALFA study, a project that is being carried out at the new BarcelonaBeta Brain Research Center (BBRC).

BBRC was an idea of ​​Pasqual Maragall, mayor of Barcelona from 1982 to 1997. In 2007 Maragall announced his diagnosis of AD and his plans for the disease. Pasqual Maragall Foundation, a private non-profit foundation dedicated to the study of the disease. BBRC was created in 2012 for this purpose.

The ALFA study is a research platform to identify the early pathophysiological features of Alzheimer’s disease, with the aim of developing prevention strategies.

ALFA was launched in 2013 and has enrolled 2,742 middle-aged adults without cognitive impairment (45-75 years), of whom nearly half (47.5%) have one or more parents diagnosed with AD before age 75.

“I think the most interesting feature of this cohort is the enrichment of the carriers of APOE, said Sala-Vila.

Of the 340 registered, 122 were non-carriers of APOE-ε4, 157 were carriers of one allele and 61 were carriers of two alleles.

“Because nearly half of the ALFA cohort has family members with Alzheimer’s disease, they are a truly committed group,” Sala-Vila said. “When Maragall started the foundation he said,‘ No, where is it written that Alzheimer’s can’t be defeated? And this is the foundation of our research at BarcelonaBeta: to provide high-quality scientific evidence to better understand the disease and find ways to prevent it or slow its progression. “

The study was supported by the “la Caixa” Foundation and the Generalitat de Catalunya. Sala-Vila is the beneficiary of grants from various organizations and foundations.

I’m J Clin Nutr. Published online March 18, 2021. Full text, Editorial

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