title: Food combination and Alzheimer disease risk: a protective diet.
abstract: OBJECTIVE
  To assess the association between food combination and Alzheimer disease (AD) risk. Because foods are not consumed in isolation, dietary pattern (DP) analysis of food combination, taking into account the interactions among food components, may offer methodological advantages.
  
  
  METHODS
  Prospective cohort study.
  
  
  METHODS
  Northern Manhattan, New York, New York.
  
  
  METHODS
  Two thousand one hundred forty-eight community-based elderly subjects (aged > or = 65 years) without dementia in New York provided dietary information and were prospectively evaluated with the same standardized neurological and neuropsychological measures approximately every 1.5 years. Using reduced rank regression, we calculated DPs based on their ability to explain variation in 7 potentially AD-related nutrients: saturated fatty acids, monounsaturated fatty acids, omega-3 polyunsaturated fatty acids, omega-6 polyunsaturated fatty acids, vitamin E, vitamin B(12), and folate. The associations of reduced rank regression-derived DPs with AD risk were then examined using a Cox proportional hazards model. Main Outcome Measure Incident AD risk.
  
  
  RESULTS
  Two hundred fifty-three subjects developed AD during a follow-up of 3.9 years. We identified a DP strongly associated with lower AD risk: compared with subjects in the lowest tertile of adherence to this pattern, the AD hazard ratio (95% confidence interval) for subjects in the highest DP tertile was 0.62 (0.43-0.89) after multivariable adjustment (P for trend = .01). This DP was characterized by higher intakes of salad dressing, nuts, fish, tomatoes, poultry, cruciferous vegetables, fruits, and dark and green leafy vegetables and a lower intake of high-fat dairy products, red meat, organ meat, and butter.
  
  
  CONCLUSIONS
  Simultaneous consideration of previous knowledge regarding potentially AD-related nutrients and multiple food groups can aid in identifying food combinations that are associated with AD risk.
authors.affiliation: The Taub Institute for Research in Alzheimer's Disease and the Aging Brain, Columbia University, New York, NY, USA.
authors.forename: Yian
authors.initials: Y
authors.lastname: Gu
authors.forename: Jeri W
authors.initials: JW
authors.lastname: Nieves
authors.forename: Yaakov
authors.initials: Y
authors.lastname: Stern
authors.forename: Jose A
authors.initials: JA
authors.lastname: Luchsinger
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Scarmeas
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000196:embryology* / Q000523:psychology; D015992:Body Mass Index; D004032:Diet; D004041:Dietary Fats / Q000008:administration & dosage; D004044:Dietary Proteins / Q000008:administration & dosage; D019587:Dietary Supplements / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D009518:New York / Q000453:epidemiology; D015596:Nutrition Assessment; D016016:Proportional Hazards Models; D012111:Residence Characteristics; D018570:Risk Assessment / Q000379:methods; D012307:Risk Factors; D011795:Surveys and Questionnaires; D016019:Survival Analysis
chemical_list: D004041:Dietary Fats; D004044:Dietary Proteins
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