Science

Galit Weinstein, Daniel Kojis, Ayantika Banerjee, Sudha Seshadri, Maura Walker, Alexa S. Beiser

Background: Ultra-processed food consumption is emerging as a risk factor for various cardiometabolic diseases; however, its association with dementia and Alzheimer’s disease has rarely been explored.

Objectives: We sought to examine whether ultra-processed food consumption is associated with risk of all-cause dementia and Alzheimer’s disease among middle-aged and older adults.

Design: A prospective cohort study.

Setting: The Framingham Heart Study, a single-site, community-based cohort study.

Participants: Off spring cohort participants who attended examination cycles 5(1991-1995) and7(1998-2001) at age ≥60years and who were dementia-free at baseline.

Measurements: Nutritional information was retrieved from food frequency questionnaires, and ultra-processed food was categorized based on the NOVA system. Participants were followed up for all-cause dementia and Alzheimer’s disease. Cox regression models were used to estimate hazard ratios (HRs) and 95 % confidence intervals (CIs), adjusting for potential confounders.

Results: The study sample included 1,375 participants free of dementia and stroke at baseline (mean age 68 ±6y, 54%females). During a mean follow-up of 12.7± 6.0years, 224 and 172 individuals were diagnosed with all-cause dementia and Alzheimer’s disease, respectively. An interaction of ultra-processed food consumption with age was observed with regard to dementia and Alzheimer’s disease (p for interaction = 0.02 and 0.007, respectively). Therefore, all analyses were stratified by the median age of 68years. Among participants who were