Apolipoprotein E Genotype, Meat, Fish, and Egg Intake in Relation to Mortality Among Older Adults: A Longitudinal Analys

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TheresaB
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Apolipoprotein E Genotype, Meat, Fish, and Egg Intake in Relation to Mortality Among Older Adults: A Longitudinal Analys

Post by TheresaB »

This paper was just published 20 July 2021, I thought the results were interesting and yet more reinforcement for eating fish.

Apolipoprotein E Genotype, Meat, Fish, and Egg Intake in Relation to Mortality Among Older Adults: A Longitudinal Analysis in China

From the paper:
In this prospective cohort study of older adults aged 65 or older, we found that higher meat intake and lower fish intake increased the risk of mortality. We found significant interaction between APOE genotype and meat and fish intake. APOE ε4 non-carriers with high meat intake had a higher risk of mortality and APOE ε4 carriers with high fish intake had a lower risk of mortality compared with APOE ε4 non-carriers with low meat or fish intake, separately. Interestingly, such relationship was restricted to the male and was not observed in the female.
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Re: Apolipoprotein E Genotype, Meat, Fish, and Egg Intake in Relation to Mortality Among Older Adults: A Longitudinal An

Post by Julie G »

Fascinating paper. I just took a quick look but from what I could tell ApoE4 carriers had better outcomes, in terms of all-cause mortality, with higher amounts of meat, fish, and eggs. It's worth noting that those in the study are metabolically healthier than Americans and "higher amounts" in China are probably considerably lower than "higher amounts" in the US.
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Re: Apolipoprotein E Genotype, Meat, Fish, and Egg Intake in Relation to Mortality Among Older Adults: A Longitudinal An

Post by NF52 »

TheresaB wrote:This paper was just published 20 July 2021, I thought the results were interesting and yet more reinforcement for eating fish.
Julie G wrote:Fascinating paper. I just took a quick look but from what I could tell ApoE4 carriers had better outcomes, in terms of all-cause mortality, with higher amounts of meat, fish, and eggs. It's worth noting that those in the study are metabolically healthier than Americans and "higher amounts" in China are probably considerably lower than "higher amounts" in the US.
This is a fascinating example of epidemiology research, done in "waves" of people with a mean age of 81 (!) representing 85% of the country's provinces and cities, so probably ethnically and economically diverse for China. I'd love to live in a neighborhood with the healthy centenarians, who began to be studied in 1998, before the researchers branched out to the "younger" seniors:
Based on sex and place of residence (i.e., living in the same street, village, city, or county) for a given centenarian, randomly selected octogenarians and nonagenarians were also sampled...There were no familial/kinship relations among the participants within and across different waves. The analysis was performed in 2020.
Great epidemiological work to make sure people in the study weren't related to each other--no small feat in small towns!
Looks like "high intake" might be similar to rankings here--although no one seems to track use of garlic in the U.S.
The respondents were asked to report the intake frequency for ten different food categories at present (baseline) and at 60 years old, including fresh fruits, vegetables, meat, fish, bean products, tea, garlic, egg, sugar, and salt-preserved vegetables. Each food's frequency of intake was reported as three categories: “almost every day,” “sometimes or occasionally,” or “rarely or never.” ...In the subgroup analysis, for each food type, “almost every day” was defined as “high intake,” while “Sometimes or occasionally” and “rarely or never” was merged into “low intake.”
With thanks to TheresaB for posting this, I thought the Discussion section, which offers a lengthy series of hypotheses on the results in ApoE4 carriers is worth including here at length (with some highlighting added!)
When examining the relationship between meat, fish and egg intake and mortality, stratified by APOE ε4 genotype, we observed that the inverse association between fish intake and mortality was only significant among APOE ε4 carriers, and the increased risk of high meat intake was only observed among non-carriers. We are not aware of any other studies that touched on this relationship in terms of mortality. However, In several observational studies, the APOE ε4 genotype and other modifiable factors have a similar interactive relationship in their impact on cognitive function...The possible explanation is that carrying APOE ε4 may amplify the benefits of modifiable factors, such as high intake of fish and low intake of meat. It is probable that carrying APOE ε4 increases the benefits of favorable modifiable factors such as a high fish and a low meat intake of our study. But, the mechanism of this interaction is not fully understood, and further investigations is needed.

Another plausible explanation for the observed gene-by-diet interaction may be the interaction between APOE genotype and dietary pattern on lipid-related biomarkers and cholesterol (10–12). APOE is a multifunctional protein which transports and delivers cholesterol and other lipids in the plasma via binding to cell surface apoE receptors (28). Carriers of the ε4 allele of the APOE gene have higher total and low-density lipoprotein cholesterol levels than non-carriers (29–33).

In another trial, it was observed that after replacing dietary saturated fats with low glycemic index carbohydrates for 6 months, APOE ε4 carriers showed a higher decrease rate in total cholesterol and apo B than non-carriers, which included 389 participants with 125 APOE ε4 carriers (12)...Thus, it is possible that the APOE genotype may modify the effect of meat and fish intake accompanied with rich lipid on long-term outcomes by varying response of lipid-related biomarkers. Additionally, the interaction between APOE ε4 genotype and fish intake may be also attributable to the higher dietary n-3 fatty acids, plasma eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) with higher fish intake, and APOE ε4 genotype may interact with those biomarkers. ...

We also found that this gene-by-diet interaction was restricted to the male, and this might be explained by the impacts of APOE genotype on some biomarkers. An observational study included 4,410 American found that the relationship between APOE genotype and plasma lipid levels was only significant among females (36) and similarly, the relationship between carbohydrate intake and plasma HDL-C levels was only significant among females APOE ε4 carriers (31). Additionally, in an interventional study of fish oil supplement, the triacylglycerol-lowering responses was found greater in male with APOE ε4 allele (37)... Although it is still unclear for which sex the APOE ε4 allele was more sensitive in response to different dietary pattern, the sex-specific interaction can be partially explained by those prior evidence.

Our findings are important for two reasons. First, the identification of this diet-gene interactions offers an opportunity to study dietary interventions from a genetic perspective. If our findings could be further validated by large-scale interventional studies, meaningful implications could be generated to develop personalized dietary interventions that consider, or maybe even take advantage of, the effects of genetic factors. Second, APOE genotyping was currently widely used in clinical studies and is included in many commercial genetic testing products. Exploration of this specific genotype is thus of high public interests and may contribute to wider public health impact.
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Re: Apolipoprotein E Genotype, Meat, Fish, and Egg Intake in Relation to Mortality Among Older Adults: A Longitudinal An

Post by SusanJ »

As I posted on the Facebook page, here's something in the results section that was easy to skip over:
"For fish intake, in male, the all-cause mortality was substantially lower among APOE ε4 carrier with high fish intake compared with the reference group (HR = 0.56, 95% CI: 0.40, 0.80), but no similar result was found in the female."
And that the meat consumed is most likely pork, unless they specifically say otherwise. It's something like 70% of all meat consumption.
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Re: Apolipoprotein E Genotype, Meat, Fish, and Egg Intake in Relation to Mortality Among Older Adults: A Longitudinal An

Post by Julie G »

As I posted on the Facebook page, here's something in the results section that was easy to skip over
LOL, and as I said on the Facebook page — wonder what mechanism is at play re. the differences between the genders? FWIW, whenever I see epidemiological studies like this, I look for signals vs. strong conclusions. The message I'm getting is that some animal protein is better for E4 carriers than none and fish is likely the most advantageous protein.
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Re: Apolipoprotein E Genotype, Meat, Fish, and Egg Intake in Relation to Mortality Among Older Adults: A Longitudinal An

Post by marty »

This is an association study only. It's a curious finding, for sure.

We don't know the mechanism for the group differences. There could be many possibilities.
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