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March 05, 2013; 80 (10) Article

Total antioxidant capacity of the diet and major neurologic outcomes in older adults

Elizabeth E. Devore, Edith Feskens, M. Arfan Ikram, Tom den Heijer, Meike Vernooij, Fedde van der Lijn, Albert Hofman, Wiro J. Niessen, Monique M.B. Breteler
First published February 20, 2013, DOI: https://doi.org/10.1212/WNL.0b013e3182840c84
Elizabeth E. Devore
From the Departments of Epidemiology (E.E.D., M.A.I., T.d.H., M.V., A.H., M.M.B.B.), Radiology (M.A.I., M.V.), Neurology (T.d.H.), and Medical Informatics (F.v.d.L.), Erasmus Medical Center, Rotterdam, the Netherlands; Channing Laboratory (E.E.D.), Department of Medicine, Brigham and Women's Hospital, and Harvard Medical School, Boston, MA; Division of Human Nutrition and Epidemiology (E.F.), Wageningen University, Wageningen; Department of Neurology (T.d.H.), Sint Franciscus Gasthuis, Rotterdam; Biomedical Imaging Group Rotterdam (F.v.d.L., W.J.N.), Departments of Radiology and Medical Informatics, Erasmus Medical Center, Rotterdam; Imaging Science and Technology (W.J.N.), Faculty of Applied Sciences, Delft University of Technology, Delft, the Netherlands; and German Center for Neurodegenerative Diseases (M.M.B.B.), Bonn, Germany.
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Edith Feskens
From the Departments of Epidemiology (E.E.D., M.A.I., T.d.H., M.V., A.H., M.M.B.B.), Radiology (M.A.I., M.V.), Neurology (T.d.H.), and Medical Informatics (F.v.d.L.), Erasmus Medical Center, Rotterdam, the Netherlands; Channing Laboratory (E.E.D.), Department of Medicine, Brigham and Women's Hospital, and Harvard Medical School, Boston, MA; Division of Human Nutrition and Epidemiology (E.F.), Wageningen University, Wageningen; Department of Neurology (T.d.H.), Sint Franciscus Gasthuis, Rotterdam; Biomedical Imaging Group Rotterdam (F.v.d.L., W.J.N.), Departments of Radiology and Medical Informatics, Erasmus Medical Center, Rotterdam; Imaging Science and Technology (W.J.N.), Faculty of Applied Sciences, Delft University of Technology, Delft, the Netherlands; and German Center for Neurodegenerative Diseases (M.M.B.B.), Bonn, Germany.
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M. Arfan Ikram
From the Departments of Epidemiology (E.E.D., M.A.I., T.d.H., M.V., A.H., M.M.B.B.), Radiology (M.A.I., M.V.), Neurology (T.d.H.), and Medical Informatics (F.v.d.L.), Erasmus Medical Center, Rotterdam, the Netherlands; Channing Laboratory (E.E.D.), Department of Medicine, Brigham and Women's Hospital, and Harvard Medical School, Boston, MA; Division of Human Nutrition and Epidemiology (E.F.), Wageningen University, Wageningen; Department of Neurology (T.d.H.), Sint Franciscus Gasthuis, Rotterdam; Biomedical Imaging Group Rotterdam (F.v.d.L., W.J.N.), Departments of Radiology and Medical Informatics, Erasmus Medical Center, Rotterdam; Imaging Science and Technology (W.J.N.), Faculty of Applied Sciences, Delft University of Technology, Delft, the Netherlands; and German Center for Neurodegenerative Diseases (M.M.B.B.), Bonn, Germany.
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Tom den Heijer
From the Departments of Epidemiology (E.E.D., M.A.I., T.d.H., M.V., A.H., M.M.B.B.), Radiology (M.A.I., M.V.), Neurology (T.d.H.), and Medical Informatics (F.v.d.L.), Erasmus Medical Center, Rotterdam, the Netherlands; Channing Laboratory (E.E.D.), Department of Medicine, Brigham and Women's Hospital, and Harvard Medical School, Boston, MA; Division of Human Nutrition and Epidemiology (E.F.), Wageningen University, Wageningen; Department of Neurology (T.d.H.), Sint Franciscus Gasthuis, Rotterdam; Biomedical Imaging Group Rotterdam (F.v.d.L., W.J.N.), Departments of Radiology and Medical Informatics, Erasmus Medical Center, Rotterdam; Imaging Science and Technology (W.J.N.), Faculty of Applied Sciences, Delft University of Technology, Delft, the Netherlands; and German Center for Neurodegenerative Diseases (M.M.B.B.), Bonn, Germany.
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Meike Vernooij
From the Departments of Epidemiology (E.E.D., M.A.I., T.d.H., M.V., A.H., M.M.B.B.), Radiology (M.A.I., M.V.), Neurology (T.d.H.), and Medical Informatics (F.v.d.L.), Erasmus Medical Center, Rotterdam, the Netherlands; Channing Laboratory (E.E.D.), Department of Medicine, Brigham and Women's Hospital, and Harvard Medical School, Boston, MA; Division of Human Nutrition and Epidemiology (E.F.), Wageningen University, Wageningen; Department of Neurology (T.d.H.), Sint Franciscus Gasthuis, Rotterdam; Biomedical Imaging Group Rotterdam (F.v.d.L., W.J.N.), Departments of Radiology and Medical Informatics, Erasmus Medical Center, Rotterdam; Imaging Science and Technology (W.J.N.), Faculty of Applied Sciences, Delft University of Technology, Delft, the Netherlands; and German Center for Neurodegenerative Diseases (M.M.B.B.), Bonn, Germany.
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Fedde van der Lijn
From the Departments of Epidemiology (E.E.D., M.A.I., T.d.H., M.V., A.H., M.M.B.B.), Radiology (M.A.I., M.V.), Neurology (T.d.H.), and Medical Informatics (F.v.d.L.), Erasmus Medical Center, Rotterdam, the Netherlands; Channing Laboratory (E.E.D.), Department of Medicine, Brigham and Women's Hospital, and Harvard Medical School, Boston, MA; Division of Human Nutrition and Epidemiology (E.F.), Wageningen University, Wageningen; Department of Neurology (T.d.H.), Sint Franciscus Gasthuis, Rotterdam; Biomedical Imaging Group Rotterdam (F.v.d.L., W.J.N.), Departments of Radiology and Medical Informatics, Erasmus Medical Center, Rotterdam; Imaging Science and Technology (W.J.N.), Faculty of Applied Sciences, Delft University of Technology, Delft, the Netherlands; and German Center for Neurodegenerative Diseases (M.M.B.B.), Bonn, Germany.
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Albert Hofman
From the Departments of Epidemiology (E.E.D., M.A.I., T.d.H., M.V., A.H., M.M.B.B.), Radiology (M.A.I., M.V.), Neurology (T.d.H.), and Medical Informatics (F.v.d.L.), Erasmus Medical Center, Rotterdam, the Netherlands; Channing Laboratory (E.E.D.), Department of Medicine, Brigham and Women's Hospital, and Harvard Medical School, Boston, MA; Division of Human Nutrition and Epidemiology (E.F.), Wageningen University, Wageningen; Department of Neurology (T.d.H.), Sint Franciscus Gasthuis, Rotterdam; Biomedical Imaging Group Rotterdam (F.v.d.L., W.J.N.), Departments of Radiology and Medical Informatics, Erasmus Medical Center, Rotterdam; Imaging Science and Technology (W.J.N.), Faculty of Applied Sciences, Delft University of Technology, Delft, the Netherlands; and German Center for Neurodegenerative Diseases (M.M.B.B.), Bonn, Germany.
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Wiro J. Niessen
From the Departments of Epidemiology (E.E.D., M.A.I., T.d.H., M.V., A.H., M.M.B.B.), Radiology (M.A.I., M.V.), Neurology (T.d.H.), and Medical Informatics (F.v.d.L.), Erasmus Medical Center, Rotterdam, the Netherlands; Channing Laboratory (E.E.D.), Department of Medicine, Brigham and Women's Hospital, and Harvard Medical School, Boston, MA; Division of Human Nutrition and Epidemiology (E.F.), Wageningen University, Wageningen; Department of Neurology (T.d.H.), Sint Franciscus Gasthuis, Rotterdam; Biomedical Imaging Group Rotterdam (F.v.d.L., W.J.N.), Departments of Radiology and Medical Informatics, Erasmus Medical Center, Rotterdam; Imaging Science and Technology (W.J.N.), Faculty of Applied Sciences, Delft University of Technology, Delft, the Netherlands; and German Center for Neurodegenerative Diseases (M.M.B.B.), Bonn, Germany.
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Monique M.B. Breteler
From the Departments of Epidemiology (E.E.D., M.A.I., T.d.H., M.V., A.H., M.M.B.B.), Radiology (M.A.I., M.V.), Neurology (T.d.H.), and Medical Informatics (F.v.d.L.), Erasmus Medical Center, Rotterdam, the Netherlands; Channing Laboratory (E.E.D.), Department of Medicine, Brigham and Women's Hospital, and Harvard Medical School, Boston, MA; Division of Human Nutrition and Epidemiology (E.F.), Wageningen University, Wageningen; Department of Neurology (T.d.H.), Sint Franciscus Gasthuis, Rotterdam; Biomedical Imaging Group Rotterdam (F.v.d.L., W.J.N.), Departments of Radiology and Medical Informatics, Erasmus Medical Center, Rotterdam; Imaging Science and Technology (W.J.N.), Faculty of Applied Sciences, Delft University of Technology, Delft, the Netherlands; and German Center for Neurodegenerative Diseases (M.M.B.B.), Bonn, Germany.
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Citation
Total antioxidant capacity of the diet and major neurologic outcomes in older adults
Elizabeth E. Devore, Edith Feskens, M. Arfan Ikram, Tom den Heijer, Meike Vernooij, Fedde van der Lijn, Albert Hofman, Wiro J. Niessen, Monique M.B. Breteler
Neurology Mar 2013, 80 (10) 904-910; DOI: 10.1212/WNL.0b013e3182840c84

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Abstract

Objective: To evaluate total antioxidant capacity of the diet, measured by the ferric-reducing antioxidant power (FRAP) assay, in relation to risks of dementia and stroke, as well as key structural brain volumes, in the elderly.

Methods: We prospectively studied 5,395 participants in the Rotterdam Study, aged 55 years and older, who were dementia free and provided dietary information at study baseline; 5,285 individuals were also stroke free at baseline, and 462 were dementia and stroke free at the time of an MRI brain scan 5 years after baseline. Dietary data were ascertained using a semiquantitative food-frequency questionnaire, and combined with food-specific FRAP measurements from published tables; this information was aggregated across the diet to obtain “dietary FRAP scores.” Multivariable-adjusted Cox proportional hazard models were used to estimate relative risks of dementia and stroke, and multivariable-adjusted linear regression was used to estimate mean differences in structural brain volumes, across tertiles of dietary FRAP scores.

Results: During a median 13.8 years of follow-up, we identified approximately 600 cases each of dementia and stroke. In multivariable-adjusted models, we observed no associations between dietary FRAP scores and risk of dementia (p trend = 0.3; relative risk = 1.12, 95% confidence interval = 0.91–1.38, comparing the highest vs lowest FRAP tertiles) or risk of stroke (p trend = 0.3; relative risk = 0.91, 95% confidence interval = 0.75–1.11, comparing extreme FRAP tertiles); results were similar across subtypes of these outcomes. Dietary FRAP scores were unrelated to brain tissue volumes as well.

Conclusions: Total antioxidant capacity of the diet, measured by dietary FRAP scores, does not seem to predict risks of major neurologic diseases.

GLOSSARY

CI=
confidence interval;
DSM-III-R=
Diagnostic and Statistical Manual of Mental Disorders, 3rd edition, revised;
FRAP=
ferric-reducing antioxidant power;
HASTE=
half-Fourier acquisition single-shot turbo spin-echo;
HR=
hazard ratio;
TEAC=
Trolox equivalent antioxidant capacity

Footnotes

  • Go to Neurology.org for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.

  • Supplemental data at www.neurology.org

  • Received July 24, 2012.
  • Accepted November 29, 2012.
  • © 2013 American Academy of Neurology
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