Abstract
Background: Dietary nitrate, as a nitric oxide (NO) precursor, may support brain health and protect against dementia. Objective: Our primary aim was to investigate whether dietary nitrate is associated with neuroimaging markers of brain health linked with Alzheimer's disease (AD). Participants: Study participants were cognitively unimpaired individuals from the Australian Imaging, Biomarkers and Lifestyle Study of Ageing (AIBL) who had β-amyloid positron emission tomography (PET) scans (n = 554) and magnetic resonance imaging (MRI) scans (n = 335) and had completed a Food Frequency Questionnaire at baseline. Methods: Source-specific nitrate intakes were estimated using comprehensive nitrate food composition databases. Rates of cerebral β-amyloid (Aβ) deposition, measured using PET, and rates of brain atrophy, measured using MRI, were assessed between baseline and 126-months follow-up, at intervals of 18 months. Multivariable-adjusted linear mixed effect models were used to examine associations between baseline source-specific nitrate intake and rates of (i) cerebral Aβ deposition and (ii) brain atrophy, over the 126 months of follow-up. Analyses were carried out following stratification of the sample by established dementia Alzheimer's disease (AD) risk factors including sex and presence or absence of the apolipoprotein E (APOE) ε4 allele. RESULTS: In women carriers of the APOE ε4 allele, higher plant sourced nitrate intake (median intake 121 mg/day), was associated with a slower rate of cerebral Aβ deposition [β: 4.47 versus 8.99 Centiloid (CL) /18 months, p < 0.05] and right hippocampal atrophy [-0.01 versus -0.03 mm3 /18 months, p < 0.01], after multivariable adjustments. Moderate intake showed protective associations in men carriers and in both men and women non-carriers of APOE ε4. Conclusions: Associations were observed between plant-derived nitrate intake and cerebral Aβ deposition, particularly in high-risk populations (women and APOE ε4 carriers). Associations were also observed for brain volume atrophy, however these exhibited subgroup variability without clear patterns relative to sex and APOE ε4 allele carriage. These findings suggest a potential link between plant-sourced nitrate and AD related neuroimaging markers of brain health improved brain health, but further validation in larger studies is required.
RAS ID
82646
Document Type
Journal Article
Date of Publication
6-1-2025
Volume
12
Issue
6
Funding Information
Alzheimer's Association / Alzheimer's Drug Discovery Foundation / Anonymous Foundation / Science and Industry Endowment Fund / Dementia Collaborative Research Centres / Victorian Government's Operational Infrastructure Support Program / Australian Alzheimer's Research Foundation / National Health, and Medical Research Council / The Yulgilbar Foundation / Research Training Program Scholarship / National Heart Foundation of Australia Post-Doctoral Research Fellowship (102498) / Western Australian Future Health Research and Innovation Fund (WANMA2023/Ideas3, WANMA/EL2023–24/2) / Royal Perth Hospital Research Foundation ‘Lawrie Beilin’ Career Advancement Fellowship (CAF 127/2020)
PubMed ID
40221237
School
Centre of Excellence for Alzheimer's Disease Research and Care / Centre for Precision Health / School of Medical and Health Sciences
Grant Number
NHMRC Number : GNT1197315, 1172987, 2028286, APP2030071
Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.
Publisher
Elsevier
Identifier
Nicola P. Bondonno: https://orcid.org/0000-0001-5905-444X
Liezhou Zhong: https://orcid.org/0000-0002-6847-4240
Stephanie R. Rainey-Smith: https://orcid.org/0000-0001-7328-9624
Samantha L. Gardener: https://orcid.org/0000-0002-1933-5260
Lauren Blekkenhorst: https://orcid.org/0000-0003-1561-9052
Simon M. Laws: https://orcid.org/0000-0002-4355-7082
Belinda M. Brown: https://orcid.org/0000-0001-7927-2540
Kevin Taddei: https://orcid.org/0000-0002-8106-7957
Ralph N. Martins: https://orcid.org/0000-0002-4828-9363
Jonathan M. Hodgson: https://orcid.org/0000-0001-6184-7764
Catherine P. Bondonno: https://orcid.org/0000-0001-8509-439X
Comments
Rajendra, A., Bondonno, N. P., Murray, K., Zhong, L., Rainey-Smith, S. R., Gardener, S. L., Blekkenhorst, L. C., Doré, V., Villemagne, V. L., Laws, S. M., Brown, B. M., Taddei, K., Masters, C. L., Rowe, C. C., Martins, R. N., Hodgson, J. M., & Bondonno, C. P. (2025). Baseline habitual dietary nitrate intake and Alzheimer’s disease related neuroimaging biomarkers in the Australian Imaging, Biomarkers and Lifestyle Study of Ageing. The Journal of Prevention of Alzheimer S Disease, 12(6), 100161. https://doi.org/10.1016/j.tjpad.2025.100161