title: Dietary fat intake, pesticide use, and Parkinson's disease.
abstract: BACKGROUND
  Dietary fat intake may modify Parkinson's disease (PD) risk directly or by altering the response to environmental neurotoxicants including pesticides.
  
  
  METHODS
  We conducted a case-control study of PD nested in the Agricultural Health Study (AHS), a cohort of pesticide applicators and spouses. We evaluated diet and pesticide use before diagnosis in 89 PD cases, confirmed by movement disorder specialists, or a corresponding date in 336 frequency-matched controls. Associations were evaluated using multivariate logistic regression to estimate odds ratios (ORs) and 95% confidence intervals (CIs).
  
  
  RESULTS
  In the AHS, PD was inversely associated with N-3 polyunsaturated fatty acids (PUFAs) (OR 0.4, 95% CI 0.2-0.8 for highest vs. lowest tertile) and the N-3 precursor α-linolenic acid (0.4, 0.2-0.8). In a meta-analysis of nine studies, including the present one, PD was inversely associated with α-linolenic acid (0.81, 0.68-0.96). In the AHS, associations of PD with the pesticides paraquat and rotenone were modified by fat intake. The OR for paraquat was 4.2 (1.5-12) in individuals with PUFA intake below the median but 1.2 (0.4-3.4) in those with higher intake (p-interaction = 0.10). The OR for rotenone was 5.8 (2.3-15) in those with saturated fat intake above the median but 1.5 (0.5-4.2) in those with lower intake (p-interaction = 0.02).
  
  
  CONCLUSIONS
  PUFA intake was consistently associated with lower PD risk, and dietary fats modified the association of PD risk with pesticide exposure. If confirmed, these findings suggest that a diet high in PUFAs and low in saturated fats might reduce risk of PD.
authors.affiliation: Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health (NIH), Department of Health and Human Services (DHHS), Research Triangle Park, NC, USA. Electronic address: kamel@niehs.nih.gov.
authors.forename: Freya
authors.initials: F
authors.lastname: Kamel
authors.affiliation: The Parkinson's Institute, Sunnyvale, CA, USA.
authors.forename: Samuel M
authors.initials: SM
authors.lastname: Goldman
authors.affiliation: Biostatistics Branch, National Institute of Environmental Health Sciences, NIH, DHHS, Research Triangle Park, NC, USA.
authors.forename: David M
authors.initials: DM
authors.lastname: Umbach
authors.affiliation: Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health (NIH), Department of Health and Human Services (DHHS), Research Triangle Park, NC, USA.
authors.forename: Honglei
authors.initials: H
authors.lastname: Chen
authors.affiliation: Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health (NIH), Department of Health and Human Services (DHHS), Research Triangle Park, NC, USA.
authors.forename: Gina
authors.initials: G
authors.lastname: Richardson
authors.affiliation: Westat Inc, Durham, NC, USA.
authors.forename: Marie Richards
authors.initials: MR
authors.lastname: Barber
authors.affiliation: The Parkinson's Institute, Sunnyvale, CA, USA.
authors.forename: Cheryl
authors.initials: C
authors.lastname: Meng
authors.affiliation: Toronto Western Hospital, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Connie
authors.initials: C
authors.lastname: Marras
authors.affiliation: The Parkinson's Institute, Sunnyvale, CA, USA.
authors.forename: Monica
authors.initials: M
authors.lastname: Korell
authors.affiliation: Department of Neurology, University of Lübeck, Lübeck, Germany; Department of Clinical and Molecular Neurogenetics, University of Lübeck, Lübeck, Germany.
authors.forename: Meike
authors.initials: M
authors.lastname: Kasten
authors.affiliation: Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health (NIH), Department of Health and Human Services (DHHS), Research Triangle Park, NC, USA.
authors.forename: Jane A
authors.initials: JA
authors.lastname: Hoppin
authors.affiliation: The Parkinson's Institute, Sunnyvale, CA, USA.
authors.forename: Kathleen
authors.initials: K
authors.lastname: Comyns
authors.affiliation: Institute of Cognitive Neurology, Institute of Neuroscience, Favaloro University, Buenos Aires, Argentina.
authors.forename: Anabel
authors.initials: A
authors.lastname: Chade
authors.affiliation: Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Rockville, MD, USA.
authors.forename: Aaron
authors.initials: A
authors.lastname: Blair
authors.affiliation: The Parkinson's Institute, Sunnyvale, CA, USA.
authors.forename: Grace S
authors.initials: GS
authors.lastname: Bhudhikanok
authors.affiliation: Veterans Affairs Pacific Islands Health Care System, Honolulu, HI, USA.
authors.forename: G
authors.initials: G
authors.lastname: Webster Ross
authors.affiliation: The Parkinson's Institute, Sunnyvale, CA, USA.
authors.forename: J
authors.initials: J
authors.lastname: William Langston
authors.affiliation: Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health (NIH), Department of Health and Human Services (DHHS), Research Triangle Park, NC, USA.
authors.forename: Dale P
authors.initials: DP
authors.lastname: Sandler
authors.affiliation: The Parkinson's Institute, Sunnyvale, CA, USA.
authors.forename: Caroline M
authors.initials: CM
authors.lastname: Tanner
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D004032:Diet; D004041:Dietary Fats; D015525:Fatty Acids, Omega-3; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000453:epidemiology*; D010575:Pesticides / Q000009:adverse effects*; D012307:Risk Factors
chemical_list: D004041:Dietary Fats; D015525:Fatty Acids, Omega-3; D010575:Pesticides
keywords: Dietary fat; Parkinson's disease; Pesticides; Polyunsaturated fatty acids