Diet for the mind

A study of dietary patterns in older adults in Australia showed those who followed a diet designed for brain health had a reduced risk of developing cognitive impairment.

Following a diet designed to increase brain health in the long term appears to reduce the odds of cognitive impairment and disorders including Alzheimer’s and dementia, in a study led by researchers from Neuroscience Research Australia (NeuRA), UNSW Sydney and ANU.

Published last week in Alzheimer’s & Dementia, the authors reviewed the potential protective effects of the Mediterranean-DASH Intervention for Neurodegenerative Delay diet, also known as the MIND diet. DASH stands for Dietary Approaches to Stop Hypertension.

The Mediterranean diet is believed to have a protective effect in other health settings, such as cardiovascular diseases.

The composition of the MIND diet is based partially on the Mediterranean diet but incorporates foods specifically relevant to brain health. The MIND diet is characterised by 15 dietary components with a focus on green leafy vegetables, whole grains, olive oil and small amounts of red meat.

The investigation followed 1220 adults aged 60 and older, for a period of 12 years. During this time, a dietary pattern that followed the MIND diet was linked to 19 per cent reduced odds of developing clinically diagnosed mild cognitive impairment or dementia. In contrast, no benefit was found for adhering to the Mediterranean dietary pattern.

Scientia Professor Kaarin Anstey, who led the study team, is Director of the UNSW Ageing Futures Institute. Her research group has a strong interest in identifying ways to reduce risk of dementia and improve healthy ageing.

“This study has shown for the first time, outside of the United States, that the MIND diet reduces the risk of dementia,” says Professor Kaarin Anstey.

Professor Anstey hopes the study will help researchers develop concrete recommendations for reducing the risk of dementia in Australia and around the world.

The findings come from a 12-year longitudinal cohort study, the PATH Through Life project which is based in Canberra and Queanbeyan, NSW. Participants were interviewed about their dietary intake using the CSIRO food frequency questionnaire at the commencement of the study. Their cognitive abilities were monitored over time and they were also assessed for cognitive impairment. Their diets were scored to see whether the participant’s dietary patterns followed the MIND or Mediterranean pattern.

Professor Martha Morris developed the MIND diet in the US. What sets it apart from other diets is the detailed specification of foods thought to be neuroprotective, such as green leafy vegetables and berries. The scoring also has a category for cakes and pastries, which were hallmarks of a westernised diet. This allowed researchers to better capture dietary pattern and behaviour of the participants.

The authors say that the next steps are to evaluate the diet in randomised controlled trials and to conduct studies that reveal the protective mechanisms and pathways associated with the MIND diet.

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The MIND diet, as the name implies, is designed to promote a healthy mind and lower the risk of Alzheimer’s disease. It is a mash-up of the Mediterranean diet and the DASH diet — two diets that have been found to have several health benefits.

Diet information

MIND stands for Mediterranean-DASH Intervention for Neurodegenerative Delay. It was developed by a nutritional epidemiologist, Martha Clare Morris, at Rush University Medical Center through a study that was funded by the National Institute on Aging. Her goal was to lower the risk of Alzheimer’s disease by promoting a diet consisting of brain-healthy foods.

The Mediterranean diet focuses on eating foods that are as natural as possible, while limiting unhealthy fats and red meat. The DASH (Dietary Approaches to Stop Hypertension) diet, as its name suggests, is aimed at helping to ease hypertension. It focuses on helping people to eat foods that can lower their sodium intake and blood pressure.

Morris told Live Science in a 2015 article that the researchers focused on this mix of two-well-known, healthy diets because it would be easy for Americans to follow. The MIND diet recommends eating 10 foods daily and avoiding five types of foods. The healthy-food group contains:

  1. Vegetables
  2. Green leafy vegetables in particular
  3. Berries, especially blueberries
  4. Nuts
  5. Beans
  6. Wine
  7. Whole grains
  8. Fish
  9. Poultry
  10. Olive oil

The five unhealthy foods are:

  1. Fried or fast food
  2. Red meats
  3. Cheeses
  4. Butter and stick margarine
  5. Pastries and sweets

The rules of the diet are:

  • Get at least three servings of whole grains per day
  • Eat a salad each day
  • Eat one other vegetable every day
  • Drink a glass of wine each day
  • Snack almost every day on nuts
  • Eat beans every other day
  • Consume poultry and berries at least twice a week
  • Consume fish at least once a week
  • Unhealthy foods are allowed, but less than one serving per week, with the exception of butter
  • Less than 1 tablespoon a day of butter is allowed per day

Benefits

The researchers’ main goal in creating the MIND diet was to reduce the risk of Alzheimer’s disease (AD). According the Alzheimer’s Foundation of America, it is estimated that about a half-million Americans younger than age 65 have some form of dementia, including Alzheimer’s disease.

Morris and her team conducted studies of the MIND diet for nearly a decade, working with a group of 923 seniors. The results showed that the diet lowered the risk of Alzheimer’s by as much as 53 percent in participants who meticulously adhered to the diet. It also helped 35 percent of the seniors who followed the diet moderately well, according to Rush University Medical Center.

The study also found that the longer a person followed the MIND diet, the better protected the individual was from developing Alzheimer’s. The results of the study were published in March 2015, in the journal Alzheimer’s & Dementia: The Journal of the Alzheimer’s Association.

In another study, Morris’ team conducted a head-to-head comparison of the MIND diet with the DASH and Mediterranean diets. The results that they obtained with the other two diets were similar to those they found with the MIND diet alone. A high adherence to the diets reduced the risk of Alzheimer’s by 39 percent among those who followed the DASH diet and 54 percent among those who followed the Mediterranean diet, according to Rush University Medical Center. However, the participants obtained very little benefit from the two other diets if their adherence to them could be termed moderate rather than strict.

“One of the more exciting things about this is that people who adhered even moderately to the MIND diet had a reduction in their risk for AD,” Morris said in a Rush University press release. “I think that will motivate people.”

In various studies, the Mediterranean diet and the DASH diet have each been found to have health benefits in other areas as well. For example, people in one study who followed the DASH diet experienced a decrease in their blood sugar levels over a three-month period. Researchers in that study thought that the decrease was due to the higher consumption of probiotics than the diet prescribed. According to the Mayo Clinic, the DASH diet may also help reduce blood pressure by a few points in just two weeks, and systolic blood pressure could be reduced eight to 14 points, over time.

Another study, which was published in April 2010, found that the Mediterranean diet helped dieters lose weight and lower cholesterol, triglycerides and blood pressure. And a study of 780 male firefighters that was conducted by the Harvard School of Public Health and Cambridge Health Alliance also found that a Mediterranean-style diet was associated with lower risk factors for cardiovascular disease.

Risks

Live Science asked Dana Hunnes, senior dietitian at Ronald Reagan UCLA Medical Center and an adjunct assistant professor at the UCLA Fielding School of Public Health, to weigh in on the risks that may be associated with the MIND diet. “The Mediterranean and DASH diets are very healthy diets in general,” said Hunnes. “They are extremely high in plant-based foods: fruits, vegetables, plant-based proteins (nuts, seeds, legumes). They are also very high in potassium and magnesium, two electrolytes/minerals we don’t typically get enough of through diet.

“When it comes to eating fish and fish products, which the Mediterranean diet recommends more of, we need to be careful about some of the potential pollutants and toxins that end up in fish, including mercury and plastic residues. More and more, plastic residues, BPA — other persistent pollutants including DDT — and mercury are found in fish, Hunnes said. “So, if you eat fish, it’s a good idea to aim low in the food chain and look for sustainably fished (line and pole caught) products.”

“In general though, these are healthy eating patterns that are high in produce, low in saturated fat and good for human health and even the environment.”

As with any diet, consult with a doctor before starting any new diet plan.

Additional resources

Healthy lifestyle habits may help reduce risk of Alzheimer’s

Doctors have been saying for years that what you eat can affect the health of your heart. Now there’s growing evidence that the same is true for your brain.

A new study by researchers at Rush University Medical Center in Chicago shows a diet plan they developed — appropriately called the MIND diet — may reduce the risk of developing Alzheimer’s disease by as much as 53 percent.

Even those who didn’t stick to the diet perfectly but followed it “moderately well” reduced their risk of Alzheimer’s by about a third.

Diet appears to be just one of “many factors that play into who gets the disease,” said nutritional epidemiologist Martha Clare Morris, PhD, the lead author of the MIND diet study. Genetics and other factors like smoking, exercise and education also play a role. But the MIND diet helped slow the rate of cognitive decline and protect against Alzheimer’s regardless of other risk factors.

The study, published in the journal Alzheimer’s & Dementia, looked at more than 900 people between the ages of 58 and 98 who filled out food questionnaires and underwent repeated neurological testing. It found participants whose diets most closely followed the MIND recommendations had a level of cognitive function the equivalent of a person 7.5 years younger.

The MIND diet breaks its recommendations down into 10 “brain healthy food groups” a person should eat and five “unhealthy food groups” to avoid.

It combines many elements of two other popular nutrition plans which have been proven to benefit heart health: the Mediterranean diet and the DASH (Dietary Approaches to Stop Hypertension) diet. (MIND stands for Mediterranean-DASH Intervention for Neurodegenerative Delay.)

But the MIND diet also differs from those plans in a few significant ways and proved more effective than either of them at reducing the risk of Alzheimer’s.

MIND Diet for Better Brain Aging

Does a healthy eating pattern preserve brain function with aging? An important new study hopes to provide clues.

Some studies suggest that a dietary pattern including berries helps to slow mental decline with aging.

Currently available medical treatments for age-related cognitive decline and Alzheimer’s disease have had limited success. Adopting a healthy diet and lifestyle has been among the most consistent recommendations to maintain brain health over the long term. Some studies have linked an overall healthy dietary pattern to less chance of experiencing age-related decline in memory and other cognitive skills.

The specifics of “brain protective” diets vary, but tend to have certain elements in common. Dietary patterns associated with lower risk of age-related cognitive decline and dementia are higher in non-starchy vegetables, fruits, whole grains, nuts, legumes and seafood while limited in red and/or processed meats, sugar-sweetened foods and drinks, refined grains and added salt.

But there have been few long-term trials testing overall dietary patterns for protecting the aging brain. Researchers at Rush University Medical Center in Chicago and the Harvard T.H. Chan School of Public Health are currently conducting a clinical trial of a diet specifically optimized for brain health and mild weight loss—the Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) diet.

If successful, the result of the MIND trial will provide older adults with more specific nutritional guidance to maintain their cognitive health. “What they’re doing is logical and I predict will have positive benefits for a disease for which we have few interventions,” notes Dennis Steindler, PhD, senior scientist and director of Tufts’ HNRCA Neuroscience and Aging Laboratory. “Past trials were not home runs, but this study could be it if it bears the kind of findings I think it will.”

What is the MIND Diet? The MIND diet is a hybrid of the Mediterranean diet pattern and the Dietary Approaches to Stop Hypertension (DASH) diet, combined with mild caloric restriction. In some studies, these approaches have shown potential to support brain health with aging.

Like the Mediterranean pattern and the DASH diet, MIND emphasizes minimally processed plant-based foods and limited consumption of animal foods relatively high in saturated fat. But the MIND diet also tweaks the Mediterranean/DASH patterns to favor particular foods and food groups shown in previous research to be potentially brain protective. “It’s the first clinical trial designed specifically to establish whether a diet can prevent brain degeneration,” says Martha Clare Morris, PhD, the researcher at Rush leading the trial.

The MIND diet recommends eating certain foods a specific number of times a day or week. The diet specifies targeted servings of 10 healthy foods, namely whole grains, green leafy vegetables, and berries, and maximum allowed servings of 5 unhealthy foods, notably pastries and red meat.

There’s evidence from observational studies that MIND could be brain-protective. For over 20 years, Rush researchers have followed a group of older adults living in retirement communities and senior public housing units in the Chicago area, average age 81. One of many studies based on this epidemiological data, published in 2015 in Alzheimer’s & Dementia, reported that adhering closely to the MIND diet was associated with 53% less risk of Alzheimer’s diesease. Even moderate adherence came with a 35% lower risk.

The Trial Begins: The investigators recently finished recruiting 600 individuals for the trial, ages 65 to 84. The participants have a family history of Alzheimer’s disease but currently no signs of cognitive decline. They were eating a usual diet that was deemed to be not particularly healthy (or brain-protective).

Half have been assigned randomly to either a treatment group, which will attempt to follow the MIND diet plus a mild calorie reduction of 250 calories per day for 3 years, or to a control group asked to continue eating their usual diet plus mild calorie reduction alone. Morris’s team at Rush will follow half of the study participants in the Chicago area. The others, in the Boston area, will be followed by researchers at the Harvard T.H. Chan School of Public Health.

Participants will have weekly to monthly contact with dietitians, who design individualized eating plans to best follow the assigned diet recommendations. Five times over the 3-year study period, the participants will complete a battery of 12 cognitive tests. The study will continue collecting data until 2021, when Morris and her colleagues will start crunching the numbers in hopes of finding out whether the MIND diet prevents cognitive decline.

Multiple Options: Until the results come in, the MIND diet is just one option that could help to maintain brain health.

“There are many ways to configure a daily eating pattern that will support brain health and reduce the risk of chronic diseases,” says Alice H. Lichtenstein, DSc, director of Tufts’ HNRCA Cardiovascular Nutrition Laboratory and executive editor of Tufts Health & Nutrition Letter.

The key factor is sticking with it for the long run. “The way to do that is to adopt a healthy eating pattern made up of foods you enjoy rather than foods you think are good for you,” Lichtenstein says. “Given the general parameters of a healthy eating pattern and the plethora of food choices available in the marketplace today, that should not be difficult.”

7 MIND Diet Holiday Tips

Get a head start on a healthier New Year

‘Tis the season when cheese, butter and pastries are everywhere. But the holidays can be a great time to jump-start your New Year’s resolutions with the MIND diet.

The MIND diet blends two heart-healthy diets — DASH (Dietary Approaches to Stop Hypertension) and Mediterranean — but focuses on foods that aid in brain health. The MIND diet is rich in vegetables, berries, whole grains, fish, olive oil and nuts but low in red meat, cheese, pastries and sweets.

Research conducted by nutritional epidemiologist Martha Clare Morris, PhD, and colleagues at Rush University Medical Center shows that those who strictly followed the MIND diet lowered their risk of Alzheimer’s disease by as much as 53% and delayed cognitive decline by 7.5 years. Even those who followed the guidelines only moderately well lowered their Alzheimer’s risk by 35%.

“MIND is about changing your lifestyle, not following a fad diet,” says Jennifer Ventrelle, MS, RD, CPT, lead dietitian for the MIND Diet Intervention to Prevent Alzheimer’s Disease at Rush. “Because it is a set of guidelines instead of strict rules, the MIND diet allows for special days.”

Here, Ventrelle offers seven holiday tips based on MIND diet principles:

1. Keep actual holidays special …

“I’m a big proponent of saying the actual holidays should be special, and on those days — like Thanksgiving, Christmas, Hanukkah or New Year’s Eve — you do not need to make substitutions,” Ventrelle says. “Go ahead and eat some of your family’s traditional foods.”

2. … but think ahead.

Because the MIND diet calls for limiting— but not eliminating — certain foods, spend your weekly allotments of foods to avoid, like red meat and pastries, on the specific holiday, she says.

For instance, if your brother-in-law always makes prime rib on Christmas day, count that as one of your three portions of red meat for the week. However, that might mean avoiding roast beef sandwiches at the office luncheon the week before.

3. Pace yourself.

If you are at a holiday party with a huge spread, take the time to walk through the entire buffet line without a plate, then weigh your options, Ventrelle suggests.

“Because the MIND diet calls for daily servings of vegetables, make a plate with salad and veggies first,” she adds. “Fill up a bit on that before you go for the casserole or rolls. And pace yourself. It takes your brain about 20 minutes to realize you’ve eaten.”

4. Be the host.

As the host of a holiday gathering, you can make sure there are options that adhere to MIND diet guidelines.

  • Include appetizers like hummus, which can count for weekly bean portions.
  • Add a bowl of deeply-colored berries — like blueberries — at the dessert table. Dark berries are chock full of antioxidants, fiber and vitimans.
  • Since poultry is encouraged twice a week, roast a turkey or game hen as the main course. But instead of basting the bird in butter, brush it with extra-virgin olive oil, a MIND diet staple.
  • Serve fish, like salmon, as either an appetizer or entree. Fish is on the MIND menu at least once a week.

Also, assign guests specific MIND-ful dishes, like a spinach salad with walnuts, dried cranberries and a balsamic and olive oil dressing.

The “eat what you want, it’s a holiday” mindset doesn’t have to extend to the office holiday party or the neighbor’s gathering. Not every party is an actual holiday.

The “eat what you want, it’s a holiday” mindset doesn’t have to extend to the office holiday party or the neighbor’s gathering. “Remember, not every party is an actual holiday,” Ventrelle says.

On those less special occasions, pick the foods the MIND diet encourages over the foods to avoid.

For instance, at the office holiday party, opt for a glass of wine — allowed on the MIND diet — over spiked eggnog. And, as the appetizer plates are passed, choose shrimp cocktail or salmon croquettes — fulfilling the weekly fish requirement — over that cheesy mini quiche.

6. Banish leftovers

With too many leftovers around, foods to avoid can become too available and easy to eat, Ventrelle says.

If you are the host, invest in inexpensive plastic containers to fill with leftovers like stuffing and buttery mashed potatoes to share with your guests as they leave. Or bring the leftover pastries into the office for your colleagues, she adds. “It is important that they are not in your house,” she adds.

As a guest, control what ends up at your house. “When I go to my mother’s for a holiday and she tries to send me home with leftovers, I try to politely say, ‘no thanks.’ Or I bring my own containers so I can control what and how much comes home,” Ventrelle says.

7. Be kind to yourself

Remember, it’s hard to change your behavior. Allow yourself to ease into the MIND lifestyle as you ring in the new year.

“All of this self-control is easier said than done, so be patient. Don’t beat yourself up if you have a bad day,” Ventrelle says. “When your reprimand yourself, that can make you want to give up. Making small changes goes a long way toward helping you achieve your goal.”

MIND Diet May Slow Cognitive Decline in Stroke Survivors

A diet created by researchers at Rush University Medical Center may help substantially slow cognitive decline in stroke survivors, according to preliminary research presented on Jan. 25 at the American Stroke Association’s International Stroke Conference 2018 in Los Angeles. The findings are significant because stroke survivors are twice as likely to develop dementia compared to the general population.

The diet, known as the MIND diet, is short for Mediterranean-DASH Diet Intervention for Neurodegenerative Delay. The diet is a hybrid of the Mediterranean and DASH (Dietary Approaches to Stop Hypertension) diets. Both have been found to reduce the risk of cardiovascular conditions such as hypertension, heart attack and stroke.

“The foods that promote brain health, including vegetables, berries, fish and olive oil, are included in the MIND diet,” said Dr. Laurel J. Cherian, a vascular neurologist and assistant professor in Rush’s Department of Neurological Sciences. “We found that it has the potential to help slow cognitive decline in stroke survivors.”

Cherian is the lead author of the study, which was funded by the National Institute of Aging (grant numbers R01AG054476 and R01AG17917).

Study assessed survivors’ cognitive function, monitored their diets

Study co-author Martha Clare Morris, ScD, a Rush nutritional epidemiologist, and her colleagues developed the MIND diet based on information from years of research about what foods and nutrients have good, and bad, effects on the functioning of the brain. The diet has been associated with reduced Alzheimer’s risk in seniors who adhered to its recommendations. Even people who moderately adhered had reduced risk of AD and cognitive decline.

Rush is currently seeking volunteers to participate in the study, which aims to show whether a specific diet can prevent cognitive decline and brain changes with age. Those interested in participating in the study can call (708) 660-MIND (6463) or email [email protected]

The MIND diet has 15 dietary components, including 10 “brain-healthy food groups” and five unhealthy groups — red meat, butter, cheese, pastries and sweets, and fried or fast food.

To adhere to and benefit from the MIND diet, a person would need to eat at least three servings of whole grains, a green leafy vegetable and one other vegetable every day — along with a glass of wine — snack most days on nuts, have beans every other day or so, eat poultry and berries at least twice a week and fish at least once a week. The diet also specifies limiting intake of the designated unhealthy foods, limiting butter to less than 1 1/2 teaspoons a day and eating less than five servings a week of sweets and pastries, and less than one serving per week of whole fat cheese, and fried or fast food.

“I was really intrigued by the results of a previous MIND study, which showed that the people who were most highly adherent to the MIND diet cognitively functioned as if they were 7.5 years younger than the least adherent group,” Cherian said. “It made me wonder if those findings would hold true for stroke survivors, who are twice as likely to develop dementia compared to the general population.”

From 2004 to 2017, Cherian and colleagues studied 106 participants of the Rush Memory and Aging Project who had a history of stroke for cognitive decline, including decline in one’s ability to think, reason and remember. They assessed people in the study every year until their deaths or the study’s conclusion, for an average of 5.9 years, and monitored patients’ eating habits using food journals.

The researchers grouped participants into those who were highly adherent to the MIND diet, moderately adherent and least adherent. They also looked at additional factors that are known to affect cognitive performance, including age, gender, education level, participation in cognitively stimulating activities, physical activity, smoking and genetics.

Related diets not associated with slower cognitive decline

The study participants whose diets scored highest on the MIND diet score had substantially slower rate of cognitive decline than those who scored lowest. The estimated effect of the diet remained strong even after taking into account participants’ level of education and participation in cognitive and physical activities. In contrast to the results of slower decline with higher MIND diet score, stroke survivors who scored high on the Mediterranean and DASH diets, did not have significant slowing in their cognitive abilities.

“The Mediterranean and DASH diets have been shown to be protective against coronary artery disease and stroke, but it seems the nutrients emphasized in the MIND diet may be better suited to overall brain health and preserving cognition,” Cherian said.

According to Cherian, studies have found that folate, vitamin E, omega-3 fatty acids, carotenoids and flavonoids are associated with slower rates of cognitive decline, while substances such as saturated and hydrogenated fats have been associated with dementia.

The right foods may protect stroke survivors’ cognition

“I like to think of the MIND diet as a way to supercharge the nutritional content of what we eat. The goal is to emphasize foods that will not only lower our risk of heart attacks and stroke, but make our brains as resilient as possible to cognitive decline,” she said.

“Our study suggests that if we choose the right foods, we may be able to protect stroke survivors from cognitive decline.” Cherian cautions, however, that the study was observational, with a relatively small number of participants, and its findings cannot be interpreted in a cause-and-effect relationship.

“This is a preliminary study that will hopefully be confirmed by other studies, including a randomized diet intervention study instroke survivors,” she says. “For now, I think there is enough information to encourage stroke patients to view food as an important tool to optimize their brain health.”

July/August 2015

The MIND Diet — Fighting Dementia With Food
By Judith C. Thalheimer, RD, LDN
Today’s Geriatric Medicine
Vol. 8 No. 4 P. 10

A recent study from Rush University has identified a dietary pattern that can significantly reduce the risk of developing Alzheimer’s disease, even in patients with only moderate compliance.

There is growing scientific evidence that dietary intake can actually reduce the risk of developing Alzheimer’s disease (AD).1 The same eating patterns recommended to support cardiovascular health, such as the Mediterranean diet and the Dietary Approaches to Stop Hypertension (DASH) diet, have also been shown in multiple studies and meta-analyses to slow cognitive decline or reduce the risk of cognitive impairment, including AD.2-5

A recent study led by Martha Clare Morris, ScD, a professor of epidemiology and director of the Section on Nutrition and Nutritional Epidemiology at Rush University, has taken a closer look at the effect of those two diets on cognitive decline and compared them with a new diet plan. Called the MIND (Mediterranean-DASH Intervention for Neurodegenerative Delay) diet, this new dietary pattern uses the Mediterranean and DASH diets as a basis, but modifies them to place more emphasis on foods that have been linked by previous research to improved cognitive function and delayed decline.6

The Research
The MIND trial followed 923 individuals aged 58 to 98 for an average of 4.5 years (in a range of two to 10 years). Diet was assessed using a 154-item guided questionnaire, and cognitive function was measured yearly using 19 cognitive tests. Participants’ diets were scored by how closely they matched up with recommendations for the Mediterranean, DASH, or MIND eating patterns. High adherence to any of these diets was associated with reduced risk of cognitive decline. For the people who followed the diet most closely, the Mediterranean diet had the greatest impact, with the top one-third of adherents realizing a 54% reduction in the risk of developing AD. The MIND diet was a close second at 53% reduction. But the MIND diet was the most effective overall, since the middle one-third of MIND diet followers had a significant reduction in AD (35%) during the study period, even when results were adjusted for AD risk factors.6 “Unlike the other two diets we studied, even moderate adherence to the MIND diet brought about significant reduction in dementia risk,” Morris says.

The MIND Diet
The MIND diet emphasizes foods shown to support a healthy brain and recommends limiting potentially damaging choices.7 The more closely the recommendations are followed, the greater the impact on neurological health is likely to be.

Why It Works
A diet that supports vascular health is certainly protective against vascular dementia, but certain foods and food components have been directly linked to improved neurological function or reduced AD biomarkers in the brain.1,8 “MIND diet foods reflect nutrients shown to slow cognitive decline, lower risk of AD, decrease amyloid in the brain or neuron loss in animal studies, or decrease oxidative stress and inflammation,” Morris says.

MIND-recommended foods are rich in nutrients such as vitamin E and the omega-3 fatty acid docosahexaenoic acid (DHA). “Dietary vitamin E (tocopherol), which is found in nuts, plant oils, seeds, and leafy greens, is a very potent antioxidant associated strongly with brain health,” Morris says, “and fish is an excellent source of omega-3 fatty acids, which, studies show, are important for synaptic proteins in the brain. Omega-3s (DHA in particular) are among the more important lipid structures in the brain. They lead to higher synaptic transmission and less oxidative stress.” The diet also includes plenty of B vitamins such as folate, and vitamins C and D, all of which have been found in multiple analyses and randomized controlled studies to help neurons cope with aging.9

Epidemiologic studies sometimes point to specific foods. “Food studies show that vegetables are important for reducing cognitive decline,” Morris says, “but green leafy vegetables show up in research as particularly protective, so we recommend people eat things like spinach, kale, collards, or romaine at least six times a week.” Fruits, which are stressed in the Mediterranean and DASH diets, are not specifically recommended in the MIND diet, except for berries. “No studies on cognitive decline and AD have found an association with fruits as a general category. But berries like strawberries and blueberries have been shown to decrease neuron loss and improve memory performance in a fairly large body of animal studies and the Nurses Health Study,” she says.

Balance of fats appears to be important to brain health as well. A 2014 Neurobiology of Aging review of evidence linking dietary fat composition to the risk of developing dementia (coauthored by Morris) found support from laboratory, animal, and prospective epidemiologic studies for the hypothesis that high saturated or trans fatty acids increase the risk of dementia and high polyunsaturated or monounsaturated fatty acids decrease the risk.10 Avoiding fried foods, pastries, full-fat dairy, and large amounts of red meat, and eating foods such as fish, nuts, and plant oils such as olive oil, as recommended by the MIND diet, provides this balance of fats.

Putting It Into Practice
“The MIND diet is a fairly simple diet to follow,” says Vandana R. Sheth, RDN, CDE, a spokesperson for the Academy of Nutrition and Dietetics. It eschews specific nutrient recommendations for more general patterns of foods. “Having a green salad and one other vegetable every day and snacking on nuts is pretty simple to do,” Sheth says. “Many people already eat poultry at least twice a week and enjoy a glass of wine with dinner or before bed. Adding fish once a week can be as simple as a can of tuna on that lunch salad.”

Eating three servings of whole grains every day may seem like a challenge, but patients should be reminded that one slice of bread is a serving, so that goal can be met with oatmeal for breakfast and a sandwich on whole grain bread for lunch, or a bowl of whole grain cereal in the morning and a cup of brown rice or barley soup for dinner. Berries can be expensive, particularly out of season, but frozen berries are just as nutritious as fresh berries and are perfect in oatmeal or for smoothies and yogurt parfaits all year round. For patients who prefer not to cook, are on a fixed budget, or have issues with dentition, beans are a perfect choice. Rinsed canned beans can be tossed into salads; stirred into prepared soups, stews, and chilies; or served over brown rice with some simple herbs and spices for a truly brain-boosting meal.

Cutting back on saturated fats presents a big challenge for many Americans. Stepping down from whole milk to 2%, and then to 1% over time is an effective strategy. Avoiding cheese, limiting red and processed meats, and keeping to one tablespoon of butter or less per day may be difficult, and cutting back on pastries, cookies, and other sweet treats is nearly impossible for many. It may help to look at dessert as a special occasion treat rather than a requirement to round out a meal. “It is important to recognize that behavior change is difficult,” Sheth says. “A diet is not a short-term strategy; it’s a permanent lifestyle change. Most people do best by tackling one or two small achievable goals at a time.” Making room for the positive changes discussed above, such as salads, whole grains, fish, and beans, will push some of the less than judicious choices off the plate. Reassure patients that any step toward the ideal eating pattern is a positive step for neurological (and cardiovascular) health. “The beauty of the MIND diet is that you get benefits even if you are not following it to the letter,” Morris says.

Older patients often have additional concerns that make good dietary choices even more difficult, Sheth says. “Good nutrition allows us to prevent, delay, and better manage normal aging as well as chronic conditions,” she says, “but older patients often experience physical, emotional, and social changes that affect their ability to eat right. These include limited ability to shop , prep, and cook meals; financial constraints; lack of motivation to cook; taste and appetite changes related to medications as well as normal aging; and difficulty chewing or swallowing.” Health care professionals working with this population are in the perfect position to screen for these issues when providing other needed care. “Discussing eating habits and the importance of proper nutrition, and making a referral to a registered dietitian, as necessary, can make a big difference,” Sheth says.

As the relatively young science of nutrition and the brain evolves, more specific information is sure to become available. What seems clear even now, however, is that diet-related lifestyle changes can be neuroprotective and are worth encouraging in patients. As Sheth says, “Introducing the MIND diet principles can positively affect not only the geriatric patients’ neurological health but also their overall health and well-being.”

— Judith C. Thalheimer, RD, LDN, is a registered dietitian and principal of JTRD Nutrition Education Services, LLC, outside Philadelphia.

1. Mosconi L, Murray J, Davies M, et al. Nutrient intake and brain biomarkers of Alzheimer’s disease in at-risk cognitively normal individuals: a cross-sectional neuroimaging pilot study. BMJ Open. 2014;4(6):e004850.

3. Singh B, Parsaik AK, Mielke MM, et al. Association of Mediterranean diet with mild cognitive impairment and Alzheimer’s disease: a systematic review and meta-analysis. J Alzheimers Dis. 2014;39(2):271-282.

5. Wengreen H, Munger RG, Cutler A, et al. Prospective study of Dietary Approaches to Stop Hypertension- and Mediterranean-style dietary patterns and age-related cognitive change: the Cache County Study on Memory, Health and Aging. Am J Clin Nutr. 2013;98(5):1263-1271.

9. Mohajeri MH, Troesch B, Weber P. Inadequate supply of vitamins and DHA in the elderly: implications for brain aging and Alzheimer-type dementia. Nutrition. 2015;31(2):261-275.

10. Morris MC, Tangney CC. Dietary fat composition and dementia risk. Neurobiol Aging. 2014;35 Suppl 2:S59-S64.

MIND Diet: Best Foods to Eat to Keep Your Brain Young

The MIND diet is based on the Mediterranean diet and the DASH diet-two healthy eating plans in their own right. The MIND diet focuses specifically on foods that can help your brain and reduce your risk of Alzheimer’s and dementia. Over decades of research, nutritional epidemiologist Martha Clare Morris, Sc.D., and her colleagues at Rush University Medical Center identified 10 key foods associated with better brain function and a lower risk of Alzheimer’s disease. Each of these foods is rich in compounds that have been shown to protect and nourish the brain. Here’s what to eat more of each week on the MIND diet.

Related: Your Anti-Aging Diet

1. Whole Grains

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Pictured recipe: Farro Salad with Cranberries and Persimmons

You should eat: ≥21 servings (3 per day). One serving is ½ cup cooked grains.

Brown rice, oats and other whole grains are high in magnesium, which helps brain cells use energy.

2. Leafy Greens

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Pictured recipe: Sautéed Broccoli & Kale with Toasted Garlic Butter

You should eat: ≥6 servings/week. One serving is 2 cups raw greens or 1 cup cooked greens.

Greens contain antioxidants including beta carotene and folate, and they are also rich in vitamin K, which is used to make brain cell membranes.

3. Berries

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Pictured recipe: Berry-Almond Smoothie Bowl

You should eat: ≥2 servings/week. One serving is 1 cup of berries.

Berries contain flavonoids, which strengthen connections between neurons, making it easier for them to communicate.

4. Nuts

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Pictured recipe: Dark Chocolate Trail Mix

You should eat: ≥5 servings/week. One serving is 1 ounce of nuts or about 24 almonds or 49 pistachios.

Almonds are high in vitamin E, an antioxidant that absorbs damaging free radicals surrounding brain cells, while walnuts contain anti-­inflammatory omega-3 fats.

5. Beans

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Pictured recipe: Composed Bean Salad with Basil Vinaigrette

You should eat: ≥4 servings/week. One serving of beans is ½ cup cooked.

Many beans, including chickpeas, navy beans and pinto beans, are rich in magnesium, which helps brain cells use energy.

6. Vegetables

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Pictured recipe: Rainbow Buddha Bowl with Cashew Tahini Sauce

You should eat: ≥7 servings/week (1 per day). One serving of vegetables is 1 cup or 2 cups of raw greens.

Veggies are full of vitamins, such as folate. In a 2012 study, women with Alzheimer’s plaques and higher folate levels had fewer dementia symptoms.

7. Wine

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Pictured recipe: Classic Sangria

You should drink: ≥7 servings/week (5 oz. a day). One serving of wine is 5 ounces.

It’s still unclear why one serving of wine a day is good for the brain, but take note: more than one glass a day seems to do more damage than good.

8. Fish

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Pictured recipe: One-Skillet Salmon with Fennel & Sun-Dried Tomato Couscous

You should eat: ≥1 serving/week. One serving of fish is 4 ounces cooked.

Oily fish are excellent sources of omega-3 fats, which reduce inflammation and are used to build the brain’s solid matter.

9. Poultry

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Pictured recipe: Roast Chicken and Sweet Potatoes

You should eat: ≥2 servings/week. One serving of chicken or turkey is 3 ounces cooked.

Poultry is rich in choline, a B vitamin that is important for brain development and, according to a 2011 study, could protect against dementia.

10. Olive Oil

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Pictured recipe: Grilled Summer Vegetables with Shallot-Herb Vinaigrette

You should: Use as your primary cooking oil.

Olive oil is rich in oleo­canthol, a compound that calms the inflammatory ­enzymes COX-1 and COX-2.

Mayo Clinic Q and A: MIND diet includes variety of healthy foods, is safe for most

DEAR MAYO CLINIC: What exactly is the MIND diet, and can it really help prevent dementia? Is it a healthy diet for everyone?

ANSWER: The MIND diet is a combination of two other healthy diets, so it is a healthy option. Results from a recent study show that, over time, older adults who followed the MIND diet appeared to have less cognitive decline, such as memory problems. The effect of food on cognitive health has been the subject of research for quite some time. The research has shown that certain foods — particularly plant foods, such as green leafy vegetables, nuts and berries — can help preserve brain function.

The MIND diet includes a variety of brain-friendly foods. MIND stands for Mediterranean-DASH Intervention for Neurodegenerative Delay. It includes aspects of a Mediterranean diet, as well as the Dietary Approaches to Stop Hypertension, or DASH, diet. A Mediterranean diet is rich in fruits, vegetables, olive oil, legumes, whole grains and fish. The DASH diet, often recommended for people who need to lower their blood pressure, emphasizes vegetables, fruit and low-fat dairy foods, along with moderate amounts of whole grains, fish, poultry and nuts.

To evaluate the benefits of the MIND diet, researchers monitored the eating habits of 900 older adults for several years. Specifically, they assessed a pattern of eating that emphasizes foods associated with cognitive benefit and limits foods associated with cognitive decline. This pattern of eating includes relatively high amounts of green leafy vegetables, as well as other vegetables, berries, fish, olive oil, whole grains, beans, nuts and poultry, along with moderate amounts of wine. It also includes low amounts of red meat, cheese, butter, margarine, fried foods, pastries and sweets.

Researchers found that people who regularly followed this pattern of eating showed less cognitive decline over time than people who did not. Based on previous studies, the results of this study are not surprising. But they extend the previous research by looking at an entire pattern of eating, not just specific foods. The results also are consistent with many studies that show benefits from this pattern of eating on other health conditions. It helps lower blood pressure and serum cholesterol, and it follows guidelines to lower the risk of heart disease and cancer.

Following the Mediterranean diet, upon which the MIND diet is partially based, can be a very tasty way of eating that incorporates different types of salads with olive oil, whole-grain pasta or rice with vegetables, and fish, poultry or beans. But making beneficial dietary changes and transitioning to a diet that relies more heavily on plants may seem challenging. There are strategies you can use to make it easier.

For example, plan ahead before you shop or make meals. Try new recipes that incorporate MIND diet foods. Keep different types of berries and mixed nuts on hand to snack on, rather than potato chips or processed crackers. When you eat at a restaurant, try grilled fish or chicken rather than fried. Start off with a salad and include generous amounts of vegetables. Stick to whole-grain bread with a little olive oil rather than white bread with butter. Opt for berries for dessert instead of pastries or other sweets. Eating in this way can be enjoyable, and the benefits on your mind, your overall health and your quality of life can be tremendous.

Because the MIND diet incorporates a wide variety of healthy food choices, it is safe for most people. If you have a chronic medical condition that requires you to eat or avoid certain foods, however, it would be a good idea to talk with your health care provider before you make significant changes to your diet. — Donald Hensrud, M.D., Preventive Medicine, Mayo Clinic, Rochester, Minn.

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