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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.

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Supplementary Material

File (figures_e-1_and_e-2.pdf)
File (total_antioxidant_capacity.pdf)

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Information & Authors

Information

Published In

Neurology®
Volume 80Number 10March 5, 2013
Pages: 904-910
PubMed: 23427318

Publication History

Received: July 24, 2012
Accepted: November 29, 2012
Published online: February 20, 2013
Published in print: March 5, 2013

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Disclosure

The authors report no disclosures relevant to the manuscript. Go to Neurology.org for full disclosures.

Study Funding

The Netherlands Organization for Scientific Research (NOW, 918-46-615) supported this research, and NIH (F32 AG031633) provided salary support for Dr. Devore to conduct this research.

Authors

Affiliations & Disclosures

Elizabeth E. Devore, ScD
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.
Disclosure
Scientific Advisory Boards:
1.
NONE
Gifts:
1.
NONE
Funding for Travel or Speaker Honoraria:
1.
NONE
Editorial Boards:
1.
NONE
Patents:
1.
NONE
Publishing Royalties:
1.
NONE
Employment, Commercial Entity:
1.
NONE
Consultancies:
1.
NONE
Speakers' Bureaus:
1.
NONE
Other Activities:
1.
NONE
Clinical Procedures or Imaging Studies:
1.
NONE
Research Support, Commercial Entities:
1.
NONE
Research Support, Government Entities:
1.
(1) NIH, F32 AG031633, 2008-2010
Research Support, Academic Entities:
1.
NONE
Research Support, Foundations and Societies:
1.
NONE
Stock/stock Options/board of Directors Compensation:
1.
NONE
License Fee Payments, Technology or Inventions:
1.
NONE
Royalty Payments, Technology or Inventions:
1.
NONE
Stock/stock Options, Research Sponsor:
1.
NONE
Stock/stock Options, Medical Equipment & Materials:
1.
NONE
Legal Proceedings:
1.
NONE
Edith Feskens, PhD
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.
Disclosure
Scientific Advisory Boards:
1.
NONE
Gifts:
1.
NONE
Funding for Travel or Speaker Honoraria:
1.
NONE
Editorial Boards:
1.
Diabetes Care, associate editor as of 2011
Patents:
1.
NONE
Publishing Royalties:
1.
NONE
Employment, Commercial Entity:
1.
NONE
Consultancies:
1.
NONE
Speakers' Bureaus:
1.
NONE
Other Activities:
1.
NONE
Clinical Procedures or Imaging Studies:
1.
NONE
Research Support, Commercial Entities:
1.
NONE
Research Support, Government Entities:
1.
NONE
Research Support, Academic Entities:
1.
NONE
Research Support, Foundations and Societies:
1.
NONE
Stock/stock Options/board of Directors Compensation:
1.
NONE
License Fee Payments, Technology or Inventions:
1.
NONE
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1.
NONE
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1.
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1.
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M. Arfan Ikram, MD, PhD
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.
Disclosure
Scientific Advisory Boards:
1.
NONE
Gifts:
1.
NONE
Funding for Travel or Speaker Honoraria:
1.
Barcelona-Pittsburgh Conference 2012, speaker honorarium
Editorial Boards:
1.
Neuroepidemiology, Editorial board member, 2011
Patents:
1.
NONE
Publishing Royalties:
1.
NONE
Employment, Commercial Entity:
1.
NONE
Consultancies:
1.
NONE
Speakers' Bureaus:
1.
NONE
Other Activities:
1.
NONE
Clinical Procedures or Imaging Studies:
1.
NONE
Research Support, Commercial Entities:
1.
NONE
Research Support, Government Entities:
1.
NONE
Research Support, Academic Entities:
1.
(1)Erasmus MC MRACE
Research Support, Foundations and Societies:
1.
(1)Internationaal Parkinson Fonds,(2)Netherlands Heart, Foundation - 2009B102
Stock/stock Options/board of Directors Compensation:
1.
NONE
License Fee Payments, Technology or Inventions:
1.
NONE
Royalty Payments, Technology or Inventions:
1.
NONE
Stock/stock Options, Research Sponsor:
1.
NONE
Stock/stock Options, Medical Equipment & Materials:
1.
NONE
Legal Proceedings:
1.
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Tom den Heijer, MD, PhD
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.
Disclosure
Scientific Advisory Boards:
1.
NONE
Gifts:
1.
NONE
Funding for Travel or Speaker Honoraria:
1.
NONE
Editorial Boards:
1.
NONE
Patents:
1.
NONE
Publishing Royalties:
1.
NONE
Employment, Commercial Entity:
1.
NONE
Consultancies:
1.
NONE
Speakers' Bureaus:
1.
NONE
Other Activities:
1.
NONE
Clinical Procedures or Imaging Studies:
1.
NONE
Research Support, Commercial Entities:
1.
NONE
Research Support, Government Entities:
1.
NONE
Research Support, Academic Entities:
1.
NONE
Research Support, Foundations and Societies:
1.
NONE
Stock/stock Options/board of Directors Compensation:
1.
NONE
License Fee Payments, Technology or Inventions:
1.
NONE
Royalty Payments, Technology or Inventions:
1.
NONE
Stock/stock Options, Research Sponsor:
1.
NONE
Stock/stock Options, Medical Equipment & Materials:
1.
NONE
Legal Proceedings:
1.
NONE
Meike Vernooij, MD, PhD
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.
Disclosure
Scientific Advisory Boards:
1.
NONE
Gifts:
1.
NONE
Funding for Travel or Speaker Honoraria:
1.
NONE
Editorial Boards:
1.
NONE
Patents:
1.
NONE
Publishing Royalties:
1.
NONE
Employment, Commercial Entity:
1.
NONE
Consultancies:
1.
NONE
Speakers' Bureaus:
1.
NONE
Other Activities:
1.
NONE
Clinical Procedures or Imaging Studies:
1.
NONE
Research Support, Commercial Entities:
1.
NONE
Research Support, Government Entities:
1.
Funded as principal investigator by the Alzheimer's Association, New Investigator's Research Grant NIRG-09-131680 entitled 'Microstructural White Matter Changes and Risk of Cognitive Decline' (2009-present)
Research Support, Academic Entities:
1.
NONE
Research Support, Foundations and Societies:
1.
NONE
Stock/stock Options/board of Directors Compensation:
1.
NONE
License Fee Payments, Technology or Inventions:
1.
NONE
Royalty Payments, Technology or Inventions:
1.
NONE
Stock/stock Options, Research Sponsor:
1.
NONE
Stock/stock Options, Medical Equipment & Materials:
1.
NONE
Legal Proceedings:
1.
NONE
Fedde van der Lijn, PhD
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.
Disclosure
Scientific Advisory Boards:
1.
NONE
Gifts:
1.
NONE
Funding for Travel or Speaker Honoraria:
1.
NONE
Editorial Boards:
1.
NONE
Patents:
1.
NONE
Publishing Royalties:
1.
NONE
Employment, Commercial Entity:
1.
NONE
Consultancies:
1.
NONE
Speakers' Bureaus:
1.
NONE
Other Activities:
1.
NONE
Clinical Procedures or Imaging Studies:
1.
NONE
Research Support, Commercial Entities:
1.
NONE
Research Support, Government Entities:
1.
NONE
Research Support, Academic Entities:
1.
NONE
Research Support, Foundations and Societies:
1.
1) NWO Netherlands Organization for Scientific Research, 2) Information Technology for European Advancement Programme
Stock/stock Options/board of Directors Compensation:
1.
NONE
License Fee Payments, Technology or Inventions:
1.
NONE
Royalty Payments, Technology or Inventions:
1.
NONE
Stock/stock Options, Research Sponsor:
1.
NONE
Stock/stock Options, Medical Equipment & Materials:
1.
NONE
Legal Proceedings:
1.
NONE
Albert Hofman, MD, PhD
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.
Disclosure
Scientific Advisory Boards:
1.
NONE
Gifts:
1.
NONE
Funding for Travel or Speaker Honoraria:
1.
Travel to LpPLA2 meeting, GSK 2007
Editorial Boards:
1.
Editor Eur J Epidemiol form 2000 onwards
Patents:
1.
NONE
Publishing Royalties:
1.
Royalties two Dutch books on epidemiology: Grondslagen der Epidemiologie, Elsevier 2008 Klinische Epidemiologie Elsevier 2000, Investigating neurological disease, ambridge University press 1996
Employment, Commercial Entity:
1.
NONE
Consultancies:
1.
NONE
Speakers' Bureaus:
1.
NONE
Other Activities:
1.
NONE
Clinical Procedures or Imaging Studies:
1.
NONE
Research Support, Commercial Entities:
1.
NONE
Research Support, Government Entities:
1.
Grant Netherlands Genomics Initiative for Rotterdam Study, Grant Ministry of health for Generation R study
Research Support, Academic Entities:
1.
NONE
Research Support, Foundations and Societies:
1.
NONE
Stock/stock Options/board of Directors Compensation:
1.
NONE
License Fee Payments, Technology or Inventions:
1.
NONE
Royalty Payments, Technology or Inventions:
1.
NONE
Stock/stock Options, Research Sponsor:
1.
NONE
Stock/stock Options, Medical Equipment & Materials:
1.
NONE
Legal Proceedings:
1.
NONE
Wiro J. Niessen, PhD
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.
Disclosure
Scientific Advisory Boards:
1.
NONE
Gifts:
1.
NONE
Funding for Travel or Speaker Honoraria:
1.
NONE
Editorial Boards:
1.
(1) IEEE Transactions on Medical Imaging, Associate, Editor, 1997-onward, (2) Elsevier's Medical Image Analysis, Associate Editor, 1999-onward
Patents:
1.
NONE
Publishing Royalties:
1.
NONE
Employment, Commercial Entity:
1.
NONE
Consultancies:
1.
NONE
Speakers' Bureaus:
1.
NONE
Other Activities:
1.
NONE
Clinical Procedures or Imaging Studies:
1.
NONE
Research Support, Commercial Entities:
1.
NONE
Research Support, Government Entities:
1.
Netherlands Organization for Scientific Research (NWO), 612.065.412 getiteld 'Multiscale Modeling of Object Shape and Appearance for Analyzing 3D Image Content'
Research Support, Academic Entities:
1.
NONE
Research Support, Foundations and Societies:
1.
NONE
Stock/stock Options/board of Directors Compensation:
1.
I am co-founder and stock-holder of Quantib BV
License Fee Payments, Technology or Inventions:
1.
NONE
Royalty Payments, Technology or Inventions:
1.
NONE
Stock/stock Options, Research Sponsor:
1.
NONE
Stock/stock Options, Medical Equipment & Materials:
1.
NONE
Legal Proceedings:
1.
NONE
Monique M.B. Breteler, MD, PhD
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.
Disclosure
Scientific Advisory Boards:
1.
NONE
Gifts:
1.
NONE
Funding for Travel or Speaker Honoraria:
1.
NONE
Editorial Boards:
1.
(1) Neuroepidemiology, editorial advisory board member, (2)Alzheimer's & Dementie, editorial advisory board member
Patents:
1.
NONE
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NONE
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NONE
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NONE
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NONE
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NONE
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(1) Dutch Cancer Society
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NONE
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Notes

Correspondence to Dr. Devore: [email protected]
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.

Author Contributions

Elizabeth E. Devore contributed to the analysis and interpretation of the data, as well as drafting and revision of the manuscript for intellectual content. Edith Feskens contributed to the analysis and interpretation of the data, and to revisions of the manuscript for intellectual content. M. Arfan Ikram, Tom Den Heijer, Meike Vernooij, and Fedde van der Lijn contributed to revisions of the manuscript for intellectual content. Albert Hofman contributed to the design and conceptualization of the Rotterdam Study and Rotterdam Scan Study, as well as revision of the manuscript for intellectual content. Wiro J. Niessen contributed to revisions of the manuscript for intellectual content. Monique M.B. Breteler contributed to the design and conceptualization of the Rotterdam Study and Rotterdam Scan Study, to the analysis and interpretation of the data, and revision of the manuscript for intellectual content.

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