Morris Martha Clare, Tangney Christine C
Section of Nutrition and Nutritional Epidemiology, Department of Internal Medicine, Rush University Medical Center, Chicago, IL, USA.
Department of Clinical Nutrition, Rush University Medical Center, Chicago, IL, USA.
Neurobiol Aging. 2014 Sep;35 Suppl 2:S59-64. doi: 10.1016/j.neurobiolaging.2014.03.038. Epub 2014 May 15.
This is a qualitative review of the evidence linking dietary fat composition to the risk of developing dementia. The review considers laboratory and animal studies that identify underlying mechanisms as well as prospective epidemiologic studies linking biochemical or dietary fatty acids to cognitive decline or incident dementia. Several lines of evidence provide support for the hypothesis that high saturated or trans fatty acids increase the risk of dementia and high polyunsaturated or monounsaturated fatty acids decrease risk. Dietary fat composition is an important factor in blood-brain barrier function and the blood cholesterol profile. Cholesterol and blood-brain barrier function are involved in the neuropathology of Alzheimer's disease, and the primary genetic risk factor for Alzheimer's disease, apolipoprotein E-ε4, is involved in cholesterol transport. The epidemiologic literature is seemingly inconsistent on this topic, but many studies are difficult to interpret because of analytical techniques that ignored negative confounding by other fatty acids, which likely resulted in null findings. The studies that appropriately adjust for confounding by other fats support the dietary fat composition hypothesis.
这是一篇关于饮食脂肪成分与患痴呆症风险之间关联的证据的定性综述。该综述考虑了确定潜在机制的实验室和动物研究，以及将生化或膳食脂肪酸与认知衰退或新发痴呆症联系起来的前瞻性流行病学研究。有几条证据支持这样的假设，即高饱和脂肪酸或反式脂肪酸会增加患痴呆症的风险，而高多不饱和脂肪酸或单不饱和脂肪酸会降低风险。饮食脂肪成分是血脑屏障功能和血液胆固醇水平的一个重要因素。胆固醇和血脑屏障功能参与了阿尔茨海默病的神经病理学，而阿尔茨海默病的主要遗传风险因素载脂蛋白E-ε4参与了胆固醇转运。关于这个主题，流行病学文献似乎存在不一致之处，但由于分析技术忽略了其他脂肪酸的负面混杂因素，许多研究难以解释，这可能导致了无显著结果。适当调整其他脂肪混杂因素的研究支持饮食脂肪成分假说。
