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Relationship of Mediterranean diet and caloric intake to phenoconversion in Huntington disease.

Abstract

IMPORTANCE

Adherence to Mediterranean-type diet (MeDi) may delay onset of Alzheimer and Parkinson diseases. Whether adherence to MeDi affects time to phenoconversion in Huntington disease (HD), a highly penetrant, single-gene disorder, is unknown.

OBJECTIVES

To determine if MeDi modifies the time to clinical onset of HD (phenoconversion) in premanifest carriers participating in Prospective Huntington at Risk Observational Study (PHAROS), and to examine the effects of body mass index and caloric intake on time to phenoconversion.

DESIGN, SETTING, AND PARTICIPANTS

A prospective cohort study of 41 Huntington study group sites in the United States and Canada involving 1001 participants enrolled in PHAROS between July 1999 and January 2004 who were followed up every 9 months until 2010. A total of 211 participants aged 26 to 57 years had an expanded CAG repeat length (≥ 37).

EXPOSURE

A semiquantitative food frequency questionnaire was administered 33 months after baseline. We calculated daily gram intake for dairy, meat, fruit, vegetables, legumes, cereals, fish, monounsaturated and saturated fatty acids, and alcohol and constructed MeDi scores (0-9); higher scores indicate higher adherence. Demographics, medical history, body mass index, and Unified Huntington's Disease Rating Scale (UHDRS) score were collected.

MAIN OUTCOME AND MEASURE

Cox proportional hazards regression models to determine the association of MeDi and phenoconversion. RESULTS Age, sex, caloric intake, education status, and UHDRS motor scores did not differ among MeDi tertiles (0-3, 4-5, and 6-9). The highest body mass index was associated with the lowest adherence to MeDi. Thirty-one participants phenoconverted. In a model adjusted for age, CAG repeat length, and caloric intake, MeDi was not associated with phenoconversion (P for trend = 0.14 for tertile of MeDi, and P = .22 for continuous MeDi). When individual components of MeDi were analyzed, higher dairy consumption (hazard ratio, 2.36; 95% CI, 1.0-5.57; P = .05) and higher caloric intake (P = .04) were associated with risk of phenoconversion.

CONCLUSIONS AND RELEVANCE

MeDi was not associated with phenoconversion; however, higher consumption of dairy products had a 2-fold increased risk and may be a surrogate for lower urate levels (associated with faster progression in manifest HD). Studies of diet and energy expenditure in premanifest HD may provide data for interventions to modify specific components of diet that may delay the onset of HD.

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  • Authors+Show Affiliations

    ,

    Departments of Neurology and Psychiatry, Columbia University College of Physicians and Surgeons, New York, New York3Gertrude H. Sergievsky Center, Columbia University Medical Center, New York, New York.

    , , , , , ,

    Source

    JAMA neurology 70:11 2013 Nov pg 1382-8

    MeSH

    Adult
    Body Mass Index
    Canada
    Diet, Mediterranean
    Disease Progression
    Energy Intake
    Female
    Humans
    Huntington Disease
    Male
    Medication Adherence
    Middle Aged
    Observation
    Phenotype
    Predictive Value of Tests
    Proportional Hazards Models
    Prospective Studies
    Retrospective Studies
    Severity of Illness Index
    Surveys and Questionnaires
    Time Factors
    Trinucleotide Repeat Expansion
    United States

    Pub Type(s)

    Journal Article
    Research Support, N.I.H., Extramural
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, Non-P.H.S.
    Research Support, U.S. Gov't, P.H.S.

    Language

    eng

    PubMed ID

    24000094

    Citation

    Marder, Karen, et al. "Relationship of Mediterranean Diet and Caloric Intake to Phenoconversion in Huntington Disease." JAMA Neurology, vol. 70, no. 11, 2013, pp. 1382-8.
    Marder K, Gu Y, Eberly S, et al. Relationship of Mediterranean diet and caloric intake to phenoconversion in Huntington disease. JAMA Neurol. 2013;70(11):1382-8.
    Marder, K., Gu, Y., Eberly, S., Tanner, C. M., Scarmeas, N., Oakes, D., & Shoulson, I. (2013). Relationship of Mediterranean diet and caloric intake to phenoconversion in Huntington disease. JAMA Neurology, 70(11), pp. 1382-8. doi:10.1001/jamaneurol.2013.3487.
    Marder K, et al. Relationship of Mediterranean Diet and Caloric Intake to Phenoconversion in Huntington Disease. JAMA Neurol. 2013;70(11):1382-8. PubMed PMID: 24000094.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Relationship of Mediterranean diet and caloric intake to phenoconversion in Huntington disease. AU - Marder,Karen, AU - Gu,Yian, AU - Eberly,Shirley, AU - Tanner,Caroline M, AU - Scarmeas,Nikolaos, AU - Oakes,David, AU - Shoulson,Ira, AU - ,, PY - 2013/9/4/entrez PY - 2013/9/4/pubmed PY - 2014/1/1/medline SP - 1382 EP - 8 JF - JAMA neurology JO - JAMA Neurol VL - 70 IS - 11 N2 - IMPORTANCE: Adherence to Mediterranean-type diet (MeDi) may delay onset of Alzheimer and Parkinson diseases. Whether adherence to MeDi affects time to phenoconversion in Huntington disease (HD), a highly penetrant, single-gene disorder, is unknown. OBJECTIVES: To determine if MeDi modifies the time to clinical onset of HD (phenoconversion) in premanifest carriers participating in Prospective Huntington at Risk Observational Study (PHAROS), and to examine the effects of body mass index and caloric intake on time to phenoconversion. DESIGN, SETTING, AND PARTICIPANTS: A prospective cohort study of 41 Huntington study group sites in the United States and Canada involving 1001 participants enrolled in PHAROS between July 1999 and January 2004 who were followed up every 9 months until 2010. A total of 211 participants aged 26 to 57 years had an expanded CAG repeat length (≥ 37). EXPOSURE: A semiquantitative food frequency questionnaire was administered 33 months after baseline. We calculated daily gram intake for dairy, meat, fruit, vegetables, legumes, cereals, fish, monounsaturated and saturated fatty acids, and alcohol and constructed MeDi scores (0-9); higher scores indicate higher adherence. Demographics, medical history, body mass index, and Unified Huntington's Disease Rating Scale (UHDRS) score were collected. MAIN OUTCOME AND MEASURE: Cox proportional hazards regression models to determine the association of MeDi and phenoconversion. RESULTS Age, sex, caloric intake, education status, and UHDRS motor scores did not differ among MeDi tertiles (0-3, 4-5, and 6-9). The highest body mass index was associated with the lowest adherence to MeDi. Thirty-one participants phenoconverted. In a model adjusted for age, CAG repeat length, and caloric intake, MeDi was not associated with phenoconversion (P for trend = 0.14 for tertile of MeDi, and P = .22 for continuous MeDi). When individual components of MeDi were analyzed, higher dairy consumption (hazard ratio, 2.36; 95% CI, 1.0-5.57; P = .05) and higher caloric intake (P = .04) were associated with risk of phenoconversion. CONCLUSIONS AND RELEVANCE: MeDi was not associated with phenoconversion; however, higher consumption of dairy products had a 2-fold increased risk and may be a surrogate for lower urate levels (associated with faster progression in manifest HD). Studies of diet and energy expenditure in premanifest HD may provide data for interventions to modify specific components of diet that may delay the onset of HD. SN - 2168-6157 UR - https://www.unboundmedicine.com/medline/citation/24000094/Relationship_of_Mediterranean_diet_and_caloric_intake_to_phenoconversion_in_Huntington_disease_ L2 - https://jamanetwork.com/journals/jamaneurology/fullarticle/10.1001/jamaneurol.2013.3487 DB - PRIME DP - Unbound Medicine ER -