Evidence map›Paper›PMID 33933737›Full record

ArticleClinical nutrition (Edinburgh, Scotland)2021

Interaction between APOE ε4 and dietary protein intake on cognitive decline: A longitudinal cohort study.

Yun Zhang, Xurui Jin, Michael W Lutz, Sang-Yhun Ju, Keyang Liu, Guang Guo, Yi Zeng, Yao Yao

Open access · greenAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Clinical nutrition (Edinburgh, Scotland), 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
22citing papers in PubMed, 1 pooled it
4.9field-weighted citation impact, top 5% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

22 citing papers in PubMed, 1 synthesis or guideline pooled it, 36 citations in OpenAlex.

  1. Pooled it
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  6. Sex andInternational journal of molecular sciences · 2025
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  14. Socioeconomic Deprivation, Genetic Risk, and Incident Dementia.American journal of preventive medicine · 2023
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 7 institutions in 4 countries.

Yun ZhangSchool of Sociology and Anthropology, Sun Yat-sen University, Guangzhou, Guangdong, 510275, China. Electronic address: zhangy853@sysu.edu.cn.
Xurui JinGlobal Health Research Center, Duke Kunshan University, Kunshan, Jiangsu, 215374, China. Electronic address: xurui.jin@dukekunshan.edu.cn.
Michael W LutzDepartment of Neurology, Duke University of Medicine, Durham, NC, 27710, USA. Electronic address: michael.lutz@duke.edu.
Sang-Yhun JuDepartment of Family Medicine, St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Gyeonggi-do, 11765, Republic of Korea. Electronic address: kolpos@daum.net.
Keyang LiuPublic Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Osaka, 565-0871, Japan. Electronic address: liu@pbhel.med.osaka-u.ac.jp.
Guang GuoDepartment of Sociology, Carolina Population Center, Carolina Center for Genome Sciences, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA. Electronic address: guang_guo@unc.edu.
Yi ZengCenter for Healthy Aging and Development Studies, National School of Development, Peking University, Beijing, 100871, China; Center for the Study of Aging and Human Development and Geriatrics Division, Medical School of Duke University, Durham, NC, 27710, USA. Electronic address: zengyi@nsd.pku.edu.cn.
Yao YaoCenter for Healthy Aging and Development Studies, National School of Development, Peking University, Beijing, 100871, China; Center for the Study of Aging and Human Development and Geriatrics Division, Medical School of Duke University, Durham, NC, 27710, USA. Electronic address: yaoyao@nsd.pku.edu.cn.
Duke University · USCatholic University of Korea · KRDuke Kunshan University · CNOsaka University · JPPeking University · CNSun Yat-sen University · CNUniversity of North Carolina at Chapel Hill · US

Funding

THE RANGE OF MALE-FEMALE MORTALITY DIFFERENCESP01AG031719 · NIA · DUKE UNIVERSITY · PI CHRISTENSEN, KAARE · 2009 to 2020
$10.2M
NIA NIH HHS P01 AG031719
6 · The paper itself

Abstract

objectiveTo exam the association of cognitive decline with APOE ε4 allele carriage and dietary protein intake and investigate whether there is a gene-diet (GxD) interaction of APOE ε4 allele carriage and dietary protein intake on cognitive decline in a nationwide cohort of older adults.

methodsA cohort study of participants from Chinese Longitudinal Healthy Longevity Survey was conducted from 2008 to 2014. A total of 3029 participants (mean age of 77.0 years, SD = 9.0; 49.3% were women) was enrolled. We genotyped APOE ε4 allele for each participant and calculated the diversity of dietary protein intake (DDPI) by summing up the frequency of intake of the 6 protein-rich foods (meats, fish, eggs, nuts, dairy products, and bean products). We assessed cognitive function using the Mini-Mental State Examination (MMSE). We used ordinal regression model to estimate the independent and joint effects of APOE ε4 carrier and dietary protein intake on cognitive decline, adjusting for potential confounders of age, sex, education, socio-economic status, lifestyles, BMI, and cardiometabolic conditions.

resultsThere was significant association between carrying APOE ε4 allele and faster cognitive decline (Odds ratio: 1.19, 95% CI = 1.00-1.42), independent of potential confounders. While the associations of DDPI and the intake of 6 protein-rich foods with cognitive decline did not reach any statistical significance. We observed significant interactions of APOE ε4 with DDPI and fish intake, at multiple correction-adjusted Ps < 0.05. In those who were APOE ε4 carriers rather than non-carriers, both high DDPI (OR = 0.54, 95% CI: 0.34-0.88) and daily fish intake (OR = 0.43, 95% CI: 0.22-0.78) were significantly associated with slower cognitive decline, respectively. We also found that frequent intake of fish benefits women more than men regarding the mitigating of cognitive decline among APOE ε4 allele carriers (P for interaction = 0.016).

conclusionsThe results of this study support the hypothesis that diversified protein food intake in addition to frequent fish intake may reduce the detrimental effect of APOE ε4 on cognitive health.

Indexed as

AgedApolipoprotein E4Cognitive DysfunctionCohort StudiesDietary ProteinsDiet SurveysFemaleHumansLongitudinal StudiesMaleNeuropsychological TestsSex FactorsApolipoprotein E4Dietary ProteinsAPOECognitive declineFish intakeGender differencesGene-diet interactionProtein-rich diet

Identifiers

PMID33933737
PMCPMC10106247
OpenAlexW3137550227

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.