{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T14:18:06Z","timestamp":1785161886994,"version":"3.55.0"},"reference-count":0,"publisher":"Oxford University Press (OUP)","license":[{"start":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T00:00:00Z","timestamp":1785110400000},"content-version":"am","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Increasing oily fish intake has been proposed as a strategy for Alzheimer\u2019s disease (AD) prevention, but evidence for long-term benefit remains limited. Using observational data from 2012 cognitively healthy adults in the Framingham Heart Study Offspring cohort, we emulated a target trial of seven isocaloric fish intake strategies to estimate 21-year\u00a0AD risk. We modeled repeated measures of diet and adjusted for pre-baseline diet, baseline covariates, and time-varying confounding using the parametric g-formula. The estimated 21-year\u00a0AD risk ranged from 10.33% (95% confidence interval [CI]: 8.41%, 12.92%) under no fish intake to 9.98% (95% CI, 6.64%, 13.31%) under\u00a0\u2265\u00a03 servings\/week. Risk ratios relative to no intervention were close to one and risk differences were close to zero across all strategies. Substituting fish for meat yielded similar results. We observed no clear long-term protective effect of sustained fish intake on AD risk, though exploratory analyses suggested a possible protective effect among older participants during earlier follow-up, warranting further investigation. This study illustrates the use of target trial emulation to estimate long-term dietary effects while accounting for time-varying confounding and competing risks in nutritional epidemiology.<\/jats:p>","DOI":"10.1093\/aje\/kwag140","type":"journal-article","created":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T11:39:52Z","timestamp":1784893192000},"source":"Crossref","is-referenced-by-count":0,"title":["Sustained fish intake and 21-year Alzheimer\u2019s disease risk: a target trial emulation"],"prefix":"10.1093","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1702-1599","authenticated-orcid":false,"given":"Yi","family":"Zhao","sequence":"first","affiliation":[{"name":"Nutrition Epidemiology and Data Science, Friedman School of Nutrition Science and Policy, Tufts University , Boston, MA ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5567-3147","authenticated-orcid":false,"given":"Paul F","family":"Jacques","sequence":"additional","affiliation":[{"name":"Nutritional Epidemiology, Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University , Boston, MA ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8471-4128","authenticated-orcid":false,"given":"Martin","family":"Lajous","sequence":"additional","affiliation":[{"name":"Centro de Investigaci\u00f3n en Salud Poblacional, Instituto Nacional de Salud P\u00fablica, Fray Pedro de Gante 12, Belisario Dom\u00ednguez Secc 16, Tlalpan, 14080, Mexico City ,","place":["Mexico"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paola","family":"Sebastiani","sequence":"additional","affiliation":[{"name":"Institute for Clinical Research and Health Policy Studies , Tufts Medical Center, Boston, MA ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jos\u00e9 M","family":"Ordov\u00e1s","sequence":"additional","affiliation":[{"name":"Precision Nutrition Directive, Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University , Boston, MA ,","place":["United States"]},{"name":"CIBER Physiopathology of Obesity and Nutrition (CIBEROBN) Institute of Health Carlos III \u00a0 Madrid \u00a0","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,7,27]]},"container-title":["American Journal of Epidemiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/aje\/advance-article-pdf\/doi\/10.1093\/aje\/kwag140\/70165122\/kwag140.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/aje\/advance-article-pdf\/doi\/10.1093\/aje\/kwag140\/70165122\/kwag140.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T13:47:38Z","timestamp":1785160058000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/aje\/advance-article\/doi\/10.1093\/aje\/kwag140\/8742354"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,27]]},"references-count":0,"URL":"https:\/\/doi.org\/10.1093\/aje\/kwag140","relation":{},"ISSN":["0002-9262","1476-6256"],"issn-type":[{"value":"0002-9262","type":"print"},{"value":"1476-6256","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,27]]},"article-number":"kwag140"}}