Work to improve your MIND and your BODY
Dementia is now the 6th leading cause of death[i] and the prevention of cognitive decline in an already physically aging population is certainly a public health priority. It now appears that dietary measures have the potential to prevent the rate of decline substantially, adding more years to your life AND more life to your years.
Two popular diets have been shown to further these goals: The Mediterranean Diet and the DASH Diet.
They can be summarized as follows:
Eat plenty of fruits and vegetables, beans and nuts.
Allow for whole grains
Protein sources predominantly of fish with small amounts of meat and dairy
Olive oil for cooking and salad dressing (or whole grain dipping)
Red Wine (1 glass for women, 1-2 for men)
Eat plenty of fruits and vegetables
Consume low fat dairy products
More whole grains, fish, poultry, nuts
Decrease the amounts of food with high saturated fat, cholesterol, and trans-fats
Decrease your sodium intake, sweets, sugary drinks (these should be entirely eliminated in my view), and red meat
Because of this a group of researchers got together to devise the MIND Diet which stands for: Mediterranean-DASH diet intervention for neurodegenerative delay. Lengthy, if not catchy. It is styled after the two aforementioned diets but with modification based on recent findings in the diet-dementia field- tailored to both cognitive support and to protection of the brain. So it is a hybrid, taking the best from both diets and synthesizing into something that will hopefully be even better.
The evidence strongly supports increased protection from cognitive decline by consuming vegetables, particularly green leafy vegetables.[iv],[v] Green leafy vegetables are good sources for folate, Vitamin E, carotenoids, and flavonoids – all related to lower risk of dementia and cognitive decline.
Although fruit has a much weaker association, berries have the strongest evidence for neuroprotection.[vi]
In the MIND study[vii], researchers scored the consumption of green leafy veggies and berries and related the MIND diet score to cognitive decline in the pre-existing Memory and Aging Project (MAP). They also compared the estimated effects to those of the Mediterranean and DASH diets.
Nearly 1,000 (960) subjects over the age of 40 and without pre-existing dementia were studied over a period of 9 years. Subjects were formally tested annually in the 5 cognitive domains of episodic memory, working memory, semantic memory, visuospatial ability, and perceptual speed. 52% of participants had multiple tests throughout the year. Avg age was 81 with 75% being female.
Among the MIND diet score components are 10 brain healthy food categories
1) Green Leafy Vegetables such as spinach or kale
2) Other Vegetables (red peppers, squash, carrots, broccoli)
4) Berries (strawberries in this study but I would add blueberries and raspberries)
5) Beans (lentils and soybeans)
6) Whole Grains
7) Seafood (at least once per week)
8) Poultry (chicken and turkey)
9) Olive Oil (add in coconut, avocado, fish oil)
10) Wine (red)
And there are 5 unhealthy food groups scored
1) Red Meat ( I do believe that grass fed or wild – venison – is OK)
2) Butter and Stick Margarine
4) Pastries and Sweets
5) Fried/Fast Food
Results: A higher MIND diet score was associated with less cognitive decline and this was statistically significant (p<.0001). The difference in rate was the equivalent of being 7.5 years younger. The score was also statistically significance for each cognitive domain assessed, particularly episodic memory, semantic memory, and perceptual speed. Visuospatial ability showed the least change. So this won’t help me be a private pilot forever… but I’ll be able to react to sudden death just as fast.
Studies of fish consumption observed a lower risk of dementia with just one fish meal per week with no additional benefit with increased frequency.[viii] Does this mean I’ll only eat sushi once a week – not a chance.
Limitations: This is really a retrospective look into prospectively collected data and thus cannot show causality. Much of the possible confounders such as age, education, physical activity were statistically controlled and cancelled out without affecting the outcome of the study. The study population was also older, less active, with comorbities so the possibility of inference to a younger, healthier, more active population is in question. However, the basic tenants of the diet for brain health seem to be sound as the basic laws of physiology do not change with age, although there parameters on the continuum of life may.
But think about it – if we found a way to decrease the loss of muscle mass as we age, don’t you think many of us would start behaving that way in our 20’s? I’ll be following these recommendations NOW. But I’d also like to integrate two more dietary palns into the MIND diet for strength, conditioning, and overall optimal performance…more to follow.
[i] 2013 Alzheimer’sDisease Fact an Figures. Volume 9, Issue 2. 2013. Alzheimer’s Association, Chicago
[ii] Smith PJ, Blumenthal JA, Babyak MA, et al. Effects of the dietary approaches to stop hypertension diet, exercise, and caloric restriction on neurocognition in overweight adults with high blood pressure. Hypertension. 2010;55:1331-1338.
[iii] Martinez-Lapiscina EH, Clavero P, Toledo E, et al. Mediterranean diet improves cognition: the PREDIMED-NAVARRA randomized trial. J Neurol Neurosurg Psychiatry. 2013;84:1318-1325.
[iv] Morris MC, Evans DA, Tangney CC, et al. Associations of vegetable and fruit consumption with age-related cognitive change. Neurology. 2006;67:1370-1376.
[v] Kang JH, Ascherio A, Grodstein F. Fruit and vegetable consumption and cognitive decline in aging women. Ann Neurol. 2005:57;713-720.
[vi] Devore EE, Kang JH, Breteler MM, et al. Dietary intakes of berries and flavonoids in relation to cognitive decline. Ann Neurol. 2012;72:135-143.
[vii] Morris MC, Tangney CC, Wang Y, et al. MIND Diet slows cognitive decline with aging. Alzheimer’s and Dementia. 2015; June epub ahead of print.
[viii] Morris MC, Evans DA, Tangney CC, et al. Fish consumption and cognitive decline with age in a large community study. Arch Neurol. 2005;62:1849-1853.