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. 2024 May 1;7(5):e2410021.
doi: 10.1001/jamanetworkopen.2024.10021.

Consumption of Olive Oil and Diet Quality and Risk of Dementia-Related Death

Anne-Julie Tessier  1 , Marianna Cortese  1 , Changzheng Yuan  1   2 , Kjetil Bjornevik  1   3 , Alberto Ascherio  3   4 , Daniel D Wang  1   3 , Jorge E Chavarro  1   3   4 , Meir J Stampfer  1   3   4 , Frank B Hu  1   3   4 , Walter C Willett  1   3   4 , Marta Guasch-Ferré  1   5
Affiliations

Consumption of Olive Oil and Diet Quality and Risk of Dementia-Related Death

Anne-Julie Tessier et al. JAMA Netw Open. .

Erratum in

  • Errors in Table 1 and Figures.
    [No authors listed] [No authors listed] JAMA Netw Open. 2024 Jun 3;7(6):e2424366. doi: 10.1001/jamanetworkopen.2024.24366. JAMA Netw Open. 2024. PMID: 38916897 Free PMC article. No abstract available.

Abstract

Importance: Age-standardized dementia mortality rates are on the rise. Whether long-term consumption of olive oil and diet quality are associated with dementia-related death is unknown.

Objective: To examine the association of olive oil intake with the subsequent risk of dementia-related death and assess the joint association with diet quality and substitution for other fats.

Design, setting, and participants: This prospective cohort study examined data from the Nurses' Health Study (NHS; 1990-2018) and Health Professionals Follow-Up Study (HPFS; 1990-2018). The population included women from the NHS and men from the HPFS who were free of cardiovascular disease and cancer at baseline. Data were analyzed from May 2022 to July 2023.

Exposures: Olive oil intake was assessed every 4 years using a food frequency questionnaire and categorized as (1) never or less than once per month, (2) greater than 0 to less than or equal to 4.5 g/d, (3) greater than 4.5 g/d to less than or equal to 7 g/d, and (4) greater than 7 g/d. Diet quality was based on the Alternative Healthy Eating Index and Mediterranean Diet score.

Main outcome and measure: Dementia death was ascertained from death records. Multivariable Cox proportional hazards regressions were used to estimate hazard ratios (HRs) and 95% CIs adjusted for confounders including genetic, sociodemographic, and lifestyle factors.

Results: Of 92 383 participants, 60 582 (65.6%) were women and the mean (SD) age was 56.4 (8.0) years. During 28 years of follow-up (2 183 095 person-years), 4751 dementia-related deaths occurred. Individuals who were homozygous for the apolipoprotein ε4 (APOE ε4) allele were 5 to 9 times more likely to die with dementia. Consuming at least 7 g/d of olive oil was associated with a 28% lower risk of dementia-related death (adjusted pooled HR, 0.72 [95% CI, 0.64-0.81]) compared with never or rarely consuming olive oil (P for trend < .001); results were consistent after further adjustment for APOE ε4. No interaction by diet quality scores was found. In modeled substitution analyses, replacing 5 g/d of margarine and mayonnaise with the equivalent amount of olive oil was associated with an 8% (95% CI, 4%-12%) to 14% (95% CI, 7%-20%) lower risk of dementia mortality. Substitutions for other vegetable oils or butter were not significant.

Conclusions and relevance: In US adults, higher olive oil intake was associated with a lower risk of dementia-related mortality, irrespective of diet quality. Beyond heart health, the findings extend the current dietary recommendations of choosing olive oil and other vegetable oils for cognitive-related health.

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Conflict of interest statement

Conflict of Interest Disclosures: Dr Cortese reported a speaker honorarium from Roche outside the submitted work. Dr Ascherio reported receiving speaker honoraria from WebMD, Prada Foundation, Biogen, Moderna, Merck, Roche, and Glaxo-Smith-Kline. No other disclosures were reported.

Figures

Figure 1.
Figure 1.. Joint Associations of Olive Oil Intake and Alternative Mediterranean Diet Index (AMED) and Alternative Healthy Eating Index (AHEI) With Dementia-Related Mortality
Models were stratified by age, cohort (sex), and calendar time, and adjusted for Southern European/Mediterranean ancestry (yes/no), married (yes/no), living alone (yes/no), smoking status (never, former, current smoker 1-14 cigarettes/d, 15-24 cigarettes/d, or ≥25 cigarettes/d), physical activity (<3.0, 3.0-8.9, 9.0-17.9, 18.0-26.9, ≥27.0 metabolic equivalent of task–h/wk), multivitamin use (yes/no), history of hypertension (yes/no), history of hypercholesterolemia (yes/no), history of diabetes (yes/no), in women postmenopausal status and menopausal hormone use (premenopausal, postmenopausal [no, past, or current hormone use]), total energy intake (kcal/d), family history of dementia (yes/no), history of depression (yes/no), census socioeconomic status (9-variable score, in quintiles), and body mass index calculated as weight in kilograms divided by height in meters squared (<23, 23-25, 25-30, 30-35, ≥35). Pooled results were obtained by pooling the datasets of the cohorts. AMED score is without monounsaturated:saturated fats intake ratio component. AHEI score is without polyunsaturated fats intake component. HR indicates hazard ratio. aReference value. bP < .05.
Figure 2.
Figure 2.. Substitution of Olive Oil for Other Fats Associated With Dementia-Related Mortality Risk in Pooled Cohorts, Nurses’ Health Study (NHS), and Health Professionals’ Follow-Up Study (HPFS)
Substitution analysis of 5 g/d intake of olive oil for the equivalent amount of butter, other vegetable oils, mayonnaise, and margarine. All Cox proportional hazards models were stratified by age and calendar time. Models were adjusted for Southern European/Mediterranean ancestry (yes/no), married (yes/no), living alone (yes/no), smoking status (never, former, current smoker 1-14 cigarettes/d, 15-24 cigarettes/d, or ≥25 cigarettes/d), alcohol intake (0, 0.1-4.9, 5.0-9.9, 10.0-14.9, and ≥15.0 g/d), physical activity (<3.0, 3.0-8.9, 9.0-17.9, 18.0-26.9, ≥27.0 metabolic equivalent of task–h/wk), multivitamin use (yes/no), history of hypertension (yes/no), history of hypercholesterolemia (yes/no), in women postmenopausal status and menopausal hormone use (premenopausal, postmenopausal [no, past, or current hormone use]), total energy intake (kcal/d), family history of dementia (yes/no), history of depression (yes/no), census socioeconomic status (9-variable score, in quintiles), body mass index calculated as weight in kilograms divided by height in meters squared (<23, 23-25, 25-30, 30-35, ≥35), red meat, fruits and vegetables, nuts, soda, whole grains intake (in quintiles), and trans-fat. Pooled results were obtained by pooling the data sets of the cohorts and Cox proportional hazards model 3 was further stratified by cohort (sex). HR indicates hazard ratio.
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