(P19-053-23) Adherence to the EAT-Lancet Diet, Genetic Risks, and Cognitive Impairment in Chinese Adults

Objectives: We aimed to explore the association between adherence to the EAT-Lancet diet and the risk of cognitive impairment among Singapore Chinese adults, and to evaluate whether the APOE ε4 allele can modify this association.

Methods: The cohort study included 16,736 individuals from the Singapore Chinese Health Study. Dietary intake was investigated using a 165-item semiquantitative food frequency questionnaire at baseline (1993–1998). The continuous EAT-Lancet index was developed based on intakes of 14 food components and energy consumption of 2500 kcal/d. Cognitive impairment was ascertained by the Singapore-modified Mini-Mental State Examination (SM-MMSE) at follow-up 3 (2014–2016). Logistic regression models were used to estimate the ORs and 95% CIs, with adjustment of potential confounders. Blood samples from a subset of 9,313 participants were used for APOE genotyping.

Results: We identified 2,397 (14.3%) cases of cognitive impairment among 16,736 participants. Of the 9,313 participants with APOE genotyping data, 1,399 (15.0%) carried the APOE ε4 allele. Compared to participants with the lowest adherence to the EAT-Lancet diet, the multivariable-adjusted OR and 95% CI of cognitive impairment for participants with the highest adherence were 0.68 (0.58, 0.78) (P-trend < 0.001). Each SD increment in the EAT-Lancet index was associated with an increase of 0.18 points (95% CI: 0.13, 0.23; P  < 0.001) in the SM-MMSE score, equivalent to a 1-year reduction in the age in terms of cognitive function. There was a significant interaction between the APOE ε4 allele and the EAT-Lancet index (P = 0.033). Each SD increment in the EAT-Lancet index was associated with a 12% lower risk of cognitive impairment in participants without the APOE ε4 allele (OR: 0.88, 95% CI: 0.84, 0.93); however, such association was not significant in participants with the APOE ε4 allele (OR: 1.04, 95% CI: 0.88, 1.22).

Conclusions: This study found an inverse association between the EAT-Lancet diet and risk of cognitive impairment in Singapore Chinese adults. Additionally, there was a significant interaction between the APOE ε4 allele and the EAT-Lancet diet, and the association between the EAT-Lancet diet and cognitive impairment was not significant in participants carrying the APOE ε4 allele.

Funding Sources: The study was supported by the National Natural Science Foundation of China.