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From INSERM, U593, Univ Victor Segalen (P.B.-G., C.R., L.L., J.F.D.), Bordeaux; INSERM, U888, Univ Montpellier (C.B.); and INSERM, U708 (C.T., A.A.), Paris, France.
Address correspondence and reprint requests to Dr. P. Barberger-Gateau, INSERM, U593, University Victor Segalen Bordeaux 2, case 11, 146 rue Léo-Saignat, F-33076 Bordeaux cedex, France Pascale.Barberger-Gateau{at}isped.u-bordeaux2.fr
Background: Dietary fatty acids and antioxidants may contribute to decrease dementia risk, but epidemiologic data remain controversial. The aim of our study was to analyze the relationship between dietary patterns and risk of dementia or Alzheimer disease (AD), adjusting for sociodemographic and vascular risk factors, and taking into account the ApoE genotype.
Methods: A total of 8,085 nondemented participants aged 65 and over were included in the Three-City cohort study in Bordeaux, Dijon, and Montpellier (France) in 1999–2000 and had at least one re-examination over 4 years (rate of follow-up 89.1%). An independent committee of neurologists validated 281 incident cases of dementia (including 183 AD).
Results: Daily consumption of fruits and vegetables was associated with a decreased risk of all cause dementia (hazard ratio [HR] 0.72, 95% CI 0.53 to 0.97) in fully adjusted models. Weekly consumption of fish was associated with a reduced risk of AD (HR 0.65, 95% CI 0.43 to 0.994) and all cause dementia but only among ApoE 
4 noncarriers (HR 0.60, 95% CI 0.40 to 0.90). Regular use of omega-3 rich oils was associated with a decreased risk of borderline significance for all cause dementia (HR 0.46, 95% CI 0.19 to 1.11). Regular consumption of omega-6 rich oils not compensated by consumption of omega-3 rich oils or fish was associated with an increased risk of dementia (HR 2.12, 95% CI 1.30 to 3.46) among ApoE 4 noncarriers.
Conclusion: Frequent consumption of fruits and vegetables, fish, and omega-3 rich oils may decrease the risk of dementia and Alzheimer disease, especially among ApoE 4 noncarriers.
GLOSSARY: AD = Alzheimer disease; BMI = body mass index; CCPPRB = Consultative Committee for the Protection of Persons participating in Biomedical Research; DHA = docosahexaenoic acid; EI = energy intake; HR = hazard ratio; PUFA = polyunsaturated fatty acids.
*Details of the Three-City Study Group are provided in appendix E-1 on the Neurology® Web site.
Supplemental data at www.neurology.org
The Three-City Study is conducted under a partnership agreement among the Institut National de la Santé et de la Recherche Médicale (INSERM), the Institut de Santé Publique et Développement of the Victor Segalen Bordeaux 2 University, and Sanofi-Aventis. The Fondation pour la Recherche Médicale funded the preparation and initiation of the study. The 3C Study is also supported by the Caisse Nationale Maladie des Travailleurs Salariés, Direction Générale de la Santé, Mutuelle Générale de l’Education Nationale, Institut de la Longévité, Regional Councils of Aquitaine and Bourgogne, Fondation de France, and Ministry of Research-INSERM Programme "Cohortes et collections de données biologiques." The nutritional part of the 3C study is included in the COGINUT (COGnition, anti-oxidants, fatty acids: an interdisciplinary approach of the role of NUTrition in brain aging) research program which benefits from a 3-year grant from the French National Agency for Research since 2007. The Lille Genopole was supported by an unconditional grant from Eisai. C. Raffaitin received funding from the Federation Hospitalière de France for her Master training.
Disclosure: The authors report no conflicts of interest.
Received November 27, 2006. Accepted in final form May 17, 2007.
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