The MIND Diet for Reducing Dementia Risk
It’s not improbable that you may have a family medical history that includes neurodegeneration, seeing that about 1 in 9 people aged 65+ has a common type of dementia called Alzheimer's disease. Pharmacological treatment for dementia is extremely limited, and so there is a need for emphasis on risk reduction through nutrition + lifestyle. There is strong evidence in favor of adopting a particular food-first approach to reducing risk of Alzheimer’s disease: the MIND Diet (which is not a fad diet, but general recommendation for specific foods). And so in this blog post you will learn: briefly about the disease process of Alzheimer’s disease, the connection between cardiovascular + neurological health, how nutrition plays a role, and specific food-based recommendations for better cognitive health.
Dementia broadly describes a progressive cognitive decline which affects a person's ability to carryout normal daily life due to problems with memory, thinking and behavior. The vast majority of dementia diagnoses are Alzheimer's disease (AD), with several other subtypes following. If you have a close relative who has been diagnosed with AD, your risk for development increases significantly. Other risk factors include diabetes, high blood cholesterol and high blood pressure.
You may notice that these other risk factors are cardiovascular in nature. It seems that there is a link between cardiovascular and neurological health- this would make logically make sense seeing that the cardiovascular system supplies nourishment via blood to the brain. And through epidemiological studies (those which observe the occurrence of disease in a population), this broad relationship is clear for various cardiovascular + neurological conditions. AD has been associated with atherosclerosis (think high LDL + VLDL/”bad” cholesterol”), high blood pressure (even in mid-life), and congenital heart disease.
It is unknown specifically what triggers AD- at this point we can’t exactly say why these cardiovascular conditions are associated with AD. What we do know is there are two key processes that contribute to the loss of neurons (brain cells) and their connections with each other (how they communicate):
-Development of amyloid plaques: abnormal deposits of Aβ protein in the spaces between neurons that cause cellular damage and loss of neuron connections
-Tau Tangles: abnormal deposits of Tau protein inside neurons. Normally, Tau is a protein that helps stabilize the structure of neurons. Tangles in these proteins cause the neuron structure to fall apart.
So even though we currently understand this underlying pathology, we do not fully understand what causes the pathology. While epidemiology doesn’t give us that type of answer, it does give us insight into associations (risk factors) like…
What other health conditions are associated with risk AD, like those mentioned above
What foods are associated with risk of AD
And other associations- but we are keeping this blog post narrowed to food
As with many diseases, the cause is probably multifactorial- a combination of age-related changes, genetics, environment, and lifestyle. Lifestyle is a semi-controllable risk factor that includes things like food and physical activity. So let’s move onto associations between food and risk of AD.
At this point it may not be surprising to you that much evidence in support of specific food recommendations for AD originate from research looking at cardiovascular health as the primary outcome. Two very important cardiovascular-related nutrition intervention trials that with subsequent analysis revealed insights into cognitive health are PREDIMED and DASH.
In the PREDIMED (Prevention with Mediterranean Diet) trial, subjects received either extra-virgin olive oil or mixed nuts daily, to be consumed in addition to a Mediterranean-style diet. The amount of oil or nuts administered were very reasonable for a person to consume:
-About 4 Tablespoons of olive oil per day
-30 grams mixed nuts: 15 grams/0.5 oz walnuts + 7.5 grams almonds + 7.5 grams hazelnuts
Subjects were men (55-80 years old) or women (60-80 years old) with no cardiovascular disease at the time of enrollment; but who had either Type 2 diabetes or at least three of the following major risk factors: smoking, hypertension, elevated LDL (“bad cholesterol”), low HDL (“good cholesterol”), higher BMI, or a family history of premature coronary heart disease. The findings in cardiovascular risk reduction were significant for the treatment groups (subjects) compared to the control group, which received no oil or nut supplementation. The treatment groups both saw improvements in cardiovascular + cognitive health.
These findings are complimented by results from the DASH (Dietary Approaches to Stop Hypertension) trial. You may have heard of the DASH Diet before, especially if you have high blood pressure. It is one of the longest standing nutrition interventions that is well-supported by strong scientific evidence. The DASH diet emphasizes foods like olive oil and nuts, while also emphasizing vegetables, fruits and whole grains. For protein choices, it includes fat-free or low-fat dairy products, fish, poultry and legumes. And it minimizes foods that high in saturated fat like fatty meats and butter. Similar to findings from PREDIMED, DASH also consistently shows improvements in both cardiovascular and cognitive health outcomes.
And thus, the MIND Diet was born as a hybridized diet of the two- as the Mediterranean-DASH Intervention for Neurodegenerative Delay. The MIND diet recommends specific types of foods aiming to delay cognitive decline, with evidence pointing towards the possibility of delaying cognitive aging by around 7.5 years. In my experience working and talking with many older adults in hospitals and skilled nursing facilities, so many of them related that they wished to have that amount of time (in good health) back. And so, you reading this can aim to make changes in your diet at any point in your age to support your quality of life in the future!
With that, let’s get into the recommendations of the MIND Diet:
Extra-Virgin Olive Oil
Incorporate olive oil into your cooking + eaten raw (like on a salad).
Olive oil is rich in polyphenols. Polyphenols are a type of phytonutrient (phyto=plant) that are thought to have a positive biological role in the body. Two polyphenols in olive oil are oleuropein and oleocanthal. These are thought to provide brain protection due to their anti-inflammatory and antioxidant properties.
When buying olive oil, look for cold-pressed + extra-virgin. Also, make sure you read the ingredient label. Sometimes manufacturers will cut olive oil with a cheaper oil to reduce their cost. Buy olive oil that is in a dark colored container, and store it away from light and heat.
Oily Fish
Eat an oily fish like salmon, trout, mackerel, tuna, herring or sardines 1-2x/week.
Oily fish provide very beneficial types of fat called omega-3 fatty acids, in particular EPA + DHA. You can purchase fresh, frozen or canned fish- they all are good sources of omega-3 fatty acids. I do highly recommend consuming actual fish versus taking an omega-3 supplement. However, some people really don’t enjoy fish or they may abstain from eating it (ex. vegan). In this case, you may discuss a supplement with your healthcare provider.
Flavonoid-Rich Foods
Regularly consume foods like berries, tea, citrus, high-quality chocolate, and if you do drink alcohol- choose red wine.
Flavonoids are another class of phytonutrients that can confer protective benefits to the brain. Evidence suggests at least a few servings of berries per week along other foods rich in flavonoids. Green tea is a great option, as well as high-cacao content chocolate. While alcohol intake has its pros and cons (decreasing cardiovascular risk but increasing cancer risk), if you do consume alcohol- make some if it red wine.
Vitamin E-Rich Foods
Regularly consume foods high in Vitamin E like nuts, seeds, avocados, dark leafy greens, whole grains + squashes.
Vitamin E is actually a collective term for 8 similar molecules, 4 of which are called tocopherols. Tocopherols are involved in neuronal activity. Reduced plasma levels of Vitamin E has been associated with increased risk of AD.
You can increase how much your body absorbs vitamin E from food by pairing foods with a fat source. This is not necessary for foods rich in both Vitamin E and fat, like nuts or avocados. But you could sauté dark leafy greens or roast butternut squash with olive oil.
Foods Rich in
B Vitamins
Important B Vitamins include folate and vitamins B6 + B12.
Foods rich in various B Vitamins include green leafy vegetables, fish, and fruits. The American Heart Association recommends 4-5 servings each of fruits and vegetables per day which can help you eat enough B Vitamins. Smoothies and salads are great ways to get in multiple servings of fruits and veggies. For example, in a smoothie you could have a serving of berries, a banana and a handful. In a salad you could have greens with other veggies + 1/4 avocado (which is botanically a fruit… interestingly, MyPlate counts it as a veggie).
I personally think that these recommendations are very reasonable to incorporate. They also fall in line with improving overall health and reducing risk of other chronic diseases, so I think that the MIND Diet could be great for most people.
If you want to start eating more along these recommendations, the recipes I have here on my website are a good place to start- so click here to take look at them.
I would love to know your thoughts about this blog post- so click here to let me know what you think!
