title: Differential Effects of Meal Challenges on Cognition, Metabolism, and Biomarkers for Apolipoprotein E ɛ4 Carriers and Adults with Mild Cognitive Impairment.
abstract: BACKGROUND
  High intake of saturated fat (SF) and glycemic index (GI) foods is a risk factor for sporadic Alzheimer's disease. Meal challenges may elucidate mechanisms that contribute to this risk, enabling development of targeted interventions.
  
  
  OBJECTIVE
  To assess cognitive and metabolic changes after a meal high in SF and GI calories (HIGH) versus a meal low in these macronutrients (LOW) in older adults with and without cognitive impairment, and with and without the apolipoprotein E4 risk factor.
  
  
  METHODS
  46 adults with either cognitive impairment (CI) or normal cognition (NC) ingested a LOW (25% total fat, 7% SF, GI <55) and a HIGH meal (50% total fat, 25% SF, GI >70) in a blinded random fashion. Participants then underwent cognitive testing and blood sampling for metabolic and Alzheimer's disease biomarkers. Data were analyzed using repeated measures ANOVA and Spearman correlations.
  
  
  RESULTS
  E4-adults with NC demonstrated lower delayed memory scores after the HIGH compared to the LOW meal, whereas normal E4+ and CI E4- groups had higher scores after the HIGH meal (ANOVA p = 0.03). These findings were associated with meal-induced changes in glucose (p = 0.05), insulin (p = 0.004), triglycerides (p <  0.01), and plasma Aβ42 (p = 0.05).
  
  
  CONCLUSIONS
  These preliminary data suggest that cognitive performance of adults without CI may worsen following high SF and sugar meals, whereas adults with CI or those at risk for CI due to E4 status may benefit acutely from such meals. Furthermore, plasma Aβ was affected by meal type, suggesting a relationship between metabolic response and amyloid regulation.
authors.affiliation: Department of Medicine, University of Washington Medical Center, Seattle, WA, USA.
authors.forename: Angela J
authors.initials: AJ
authors.lastname: Hanson
authors.affiliation: University of Iowa, Iowa City, IA, USA.
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: Bayer
authors.affiliation: Sticht Center on Aging, Department of Internal Medicine, Wake Forest University School of Medicine, Winston-Salem, NC, USA.
authors.forename: Laura D
authors.initials: LD
authors.lastname: Baker
authors.affiliation: Department of Medicine, University of Washington Medical Center, Seattle, WA, USA.
authors.forename: Brenna
authors.initials: B
authors.lastname: Cholerton
authors.affiliation: VA Puget Sound Healthcare System, Seattle, WA, USA.
authors.forename: Brian
authors.initials: B
authors.lastname: VanFossen
authors.affiliation: VA Puget Sound Healthcare System, Seattle, WA, USA.
authors.forename: Emily
authors.initials: E
authors.lastname: Trittschuh
authors.affiliation: Alzheimer's Disease Cooperative Study, Department of Neurosciences, University of California San Diego, La Jolla, CA, USA.
authors.forename: Robert A
authors.initials: RA
authors.lastname: Rissman
authors.affiliation: Alzheimer's Disease Cooperative Study, Department of Neurosciences, University of California San Diego, La Jolla, CA, USA.
authors.forename: Michael C
authors.initials: MC
authors.lastname: Donohue
authors.affiliation: Alzheimer's Disease Cooperative Study, Department of Neurosciences, University of California San Diego, La Jolla, CA, USA.
authors.forename: Setareh H
authors.initials: SH
authors.lastname: Moghadam
authors.forename: Stephen R
authors.initials: SR
authors.lastname: Plymate
authors.affiliation: Sticht Center on Aging, Department of Internal Medicine, Wake Forest University School of Medicine, Winston-Salem, NC, USA.
authors.forename: Suzanne
authors.initials: S
authors.lastname: Craft
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D016229:Amyloid beta-Peptides / Q000097:blood; D000704:Analysis of Variance; D053327:Apolipoprotein E4 / Q000235:genetics*; D019540:Area Under Curve; D015415:Biomarkers / Q000378:metabolism*; D002784:Cholesterol / Q000097:blood; D060825:Cognitive Dysfunction / Q000178:diet therapy* / Q000235:genetics* / Q000378:metabolism; D004041:Dietary Fats / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D050356:Lipid Metabolism / Q000235:genetics* / Q000502:physiology; D008297:Male; D011939:Mental Recall / Q000502:physiology; D008875:Middle Aged; D009483:Neuropsychological Tests; D013028:Space Perception / Q000502:physiology; D013997:Time Factors
chemical_list: D016229:Amyloid beta-Peptides; D053327:Apolipoprotein E4; D015415:Biomarkers; D004041:Dietary Fats; D002784:Cholesterol
keywords: APOE genotype; Alzheimer’s disease; glycemic index; insulin; plasma amyloid; saturated fat; triglycerides