Author Identifier
Nicola P. Bondonno: https://orcid.org/0000-0001-5905-444X
Liezhou Zhong: https://orcid.org/0000-0002-6847-4240
Simone Radavelli-Bagatini: https://orcid.org/0000-0001-6821-5217
Stephanie R. Rainey-Smith: https://orcid.org/0000-0001-7328-9624
Samantha Gardener: https://orcid.org/0000-0002-1933-5260
Lauren C. Blekkenhorst: https://orcid.org/0000-0003-1561-9052
Joshua R. Lewis: https://orcid.org/0000-0003-1003-8443
Jonathan M. Hodgson: https://orcid.org/0000-0001-6184-7764
Catherine P. Bondonno: https://orcid.org/0000-0001-8509-439X
Document Type
Journal Article
Publication Title
Frontiers in Nutrition
Volume
11
Publisher
Frontiers
School
Nutrition and Health Innovation Research Institute / School of Medical and Health Sciences / Centre of Excellence for Alzheimer's Disease Research and Care
RAS ID
75836
Funders
National Health and Medical Research Council / Australian Government Department of Health and Ageing / Abbott Australasia Pty Ltd / Alphapharm Pty Ltd / AstraZeneca / Bristol-Myers Squibb / City Health Centre-Diabetes Service-Canberra / Department of Health and Community Services—Northern Territory / Department of Health and Human Services—Tasmania / Department of Health—New South Wales / Department of Health—Western Australia / Department of Health—South Australia / Department of Human Services—Victoria / Diabetes Australia / Diabetes Australia Northern Territory / Eli Lilly Australia / Estate of the Late Edward Wilson / GlaxoSmithKline / Jack Brockhoff Foundation / Janssen-Cilag / Kidney Health Australia / Marian & FH Flack Trust / Menzies Research Institute / Merck Sharp & Dohme / Novartis Pharmaceuticals / Novo Nordisk Pharmaceutical / Pfizer Pty Ltd / Pratt Foundation / Queensland Health / Roche Diagnostics Australia / Royal Prince Alfred Hospital / Sanofi Aventis / Sanofi-Synthelabo / Victorian Government’s OIS Programme / National Heart Foundation of Australia (102498, 102817) / ARC Laureate Fellowship (FL190100011) / Royal Perth Hospital Research Foundation ‘Lawrie Beilin’ Career Advancement Fellowship (CAF 127/2020) / Western Australian Future Health Research and Innovation Fund
Grant Number
NHMRC Numbers : 233200, APP1159914, GNT1197315, 1172987, 2016668, 1173952
Abstract
Introduction: Dietary nitrate is potentially beneficial for cardiovascular, cerebrovascular, and nervous systems due to its role as a nitric oxide (NO) precursor. Increased nitrate intake improves cardiovascular health and therefore could protect against dementia, given the cardiovascular-dementia link. Objective: To investigate the association between source-dependent nitrate intake and dementia-related mortality. As individuals with diabetes are at higher risk of dementia, a secondary aim was to investigate if the associations between nitrate and dementia varied by diabetes mellitus (DM) and pre-diabetes status. Methods: This study involved 9,149 participants aged ≥25 years from the well-characterised Australian Diabetes, Obesity, and Lifestyle (AusDiab) Study followed over a period of 17 years. Intakes of plant-sourced, vegetable-sourced, naturally occurring animal-sourced nitrate, and processed meat (where nitrate is an allowed additive)-sourced nitrate were assessed from a 74-item food frequency questionnaire completed by participants at baseline and nitrate databases were used to estimate nitrate from these different dietary sources. Associations between source-dependent nitrate intake and dementia-related mortality were assessed using multivariable-adjusted Cox proportional hazards models adjusted for demographics, lifestyle, and dietary factors. Results: Over 17 years of follow-up, 93 (1.0%) dementia-related deaths occurred of 1,237 (13.5%) total deaths. In multivariable-adjusted models, participants with the highest intakes of plant-sourced nitrate (median intake 98 mg/day) had a 57% lower risk of dementia-related mortality [HR (95% CI): 0.43 (0.22, 0.87)] compared to participants with lowest intakes of plant-sourced nitrate (median intake 35 mg/day). A 66% lower risk was also seen for higher intakes of vegetable-sourced nitrate [HR (95% CI): 0.34 (0.17, 0.66)]. No association was observed for animal-sourced nitrate, but the risk was two times higher amongst those who consumed the most processed meat-sourced nitrate intake [HR (95%): 2.10 (1.07, 4.12)]. The highest intake of vegetable-sourced nitrate was associated with a lower risk of dementia-related mortality for those with and without DM and pre-diabetes. Conclusion: Encouraging the intake of nitrate-rich vegetables, such as green leafy vegetables and beetroot, may lower the risk of dementia-related mortality, particularly in individuals with (pre-) diabetes who are at a higher dementia risk.
DOI
10.3389/fnut.2024.1327042
Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.
Comments
Rajendra, A., Bondonno, N. P., Zhong, L., Radavelli-Bagatini, S., Murray, K., Rainey-Smith, S. R., ... & Bondonno, C. P. (2024). Plant but not animal sourced nitrate intake is associated with lower dementia-related mortality in the Australian Diabetes, Obesity, and Lifestyle Study. Frontiers in Nutrition, 11. https://doi.org/10.3389/fnut.2024.1327042