Consuming meat at an amount higher than conventionally recommended appears to be associated with favourable cognitive health outcomes and reduced dementia risk in the specific subgroup of individuals carrying the Alzheimer’s disease (AD) genetic risk modifier APOE34/44, as reported in a study.
Analysis of 15 years of follow-up data showed that among APOE34/44 carriers, those in the top vs bottom quintile of total meat consumption had better cognitive trajectories (β, 0.32, 95 percent confidence interval [CI], 0.07–0.56; p=0.01), with the most pronounced effect observed for global cognition (β, 0.10, 95 percent CI, 0.03–0.16; p=0.002) and episodic memory (β, 0.18, 95 percent CI, 0.06–0.31; p=0.006). [JAMA Netw Open 2026;9:e266489]
APOE34/44 carriers in the top quintile of total meat consumption also had a 55-percent lower risk of dementia compared with those in the bottom quintile (subdistribution hazard ratio [sHR], 0.45, 95 percent CI, 0.21–0.95; p=0.04).
None of the associations were seen in carriers of non-APOE34/44 genotypes.
These findings align with patterns reported in two large cohorts, said lead study author Dr Jakob Norgren from Karolinska Institutet, Stockholm, Sweden, and colleagues.
In the UK Biobank, greater consumption of unprocessed red meat had a significant protective association with dementia, driven by APOE4 carriers (per 50-g/d increase: HR, 0.64; p<0.001), with no associations in noncarriers (HR, 0.93; p=0.59). Meanwhile, supplementary analyses of data from the Nurses’ Health Study and Health Professionals Follow-up Study showed an interaction by APOE4 genotype, such that greater unprocessed red meat consumption leaned toward cognitive benefit in carriers and toward adverse cognitive effect in noncarriers. [Am J Clin Nutr 2021;114:175-184; Neurology 2025;104:e210286]
Taken together, the data “point to a consistent gene-diet interaction, with important implications for public health,” according to Norgren and colleagues.
“Given that these APOE34/44 genotypes account for approximately 70 percent of Alzheimer dementia cases in Northern Europe and North America, the absolute number of potentially preventable cases is substantial,” they added. [Alzheimers Dement 2018;14:913-924]
“There is a lack of dietary research into brain health, and our findings suggest that conventional dietary advice may be unfavourable to a genetically defined subgroup of the population,” Norgren said in a press statement. “For those who are aware that they belong to this genetic risk group, the findings offer hope. The risk may be modifiable through lifestyle changes.”
The study included 2,157 participants (mean age 71.2 years, 62 percent female) from the Swedish National Study on Aging and Care–Kungsholmen who were followed for 15 years. Of these, 1,680 participants had longitudinal cognition data and 569 (26.4 percent) were APOE34/44 carriers. During follow-up, 296 participants received a dementia diagnosis, and 690 died without dementia.
Further analysis indicated that a higher ratio of processed to total meat was associated with a 14-percent increased risk of dementia (sHR, 1.14, 95 percent CI, 1.01–1.29; p=0.04), with no APOE interaction and no substantial difference between unprocessed red meat and poultry.
Post hoc data suggested a mortality benefit, such that higher unprocessed meat consumption at baseline was associated with significantly lower mortality among participants with APOE34/44 genotypes (HR, 0.85, 95 percent CI, 0.73–0.99; p=0.04; p=0.03 for interaction). Conversely, unprocessed meat consumption tended to provide a survival disadvantage for people without the APOE34/44 genotypes.
“Clinical trials are now needed to develop dietary recommendations tailored to APOE genotype,” Norgren said.