Dementia is a growing concern, ranking as the sixth leading cause of death in the United States. This has spurred increased interest in preventative measures, particularly dietary interventions, to combat cognitive decline. Among these, the MIND diet has emerged as a promising approach, specifically targeting the health of the aging brain.
Understanding the MIND Diet
The Mediterranean-DASH Diet Intervention for Neurodegenerative Delay, or MIND diet, is a hybrid approach combining elements of the Mediterranean and DASH (Dietary Approaches to Stop Hypertension) diets. Both the Mediterranean and DASH diets highlight plant-based foods and limit the intake of animal and high saturated fat foods. Developed in 2015 by Dr. Martha Clare Morris and her team at Rush University Medical Center and the Harvard Chan School of Public Health, the MIND diet focuses on specific foods and nutrients believed to protect against dementia and cognitive decline. The purpose of the research was to see if the MIND diet, partially based on the Mediterranean and DASH diets, could directly prevent the onset or slow the progression of dementia.
Research Behind the MIND Diet
Dr. Morris's team followed a group of older adults for up to 10 years as part of the Rush Memory and Aging Project (MAP). Over 1,000 participants, initially free of dementia, completed annual dietary questionnaires for nine years and underwent cognitive assessments. The study identified fifteen dietary components, classifying them as either "brain healthy" or unhealthy.
The results were striking: participants with the highest MIND diet scores experienced a significantly slower rate of cognitive decline compared to those with the lowest scores. Specifically, researchers found a 53% lower rate of Alzheimer’s disease for those with the highest MIND diet scores. Even those participants who had moderate MIND diet scores showed a 35% lower rate compared with those with the lowest MIND scores. Several other large cohort studies have shown that participants with higher MIND diet scores, compared with those with the lowest scores, had better cognitive functioning, larger total brain volume, higher memory scores, lower risk of dementia, and slower cognitive decline, even when including participants with Alzheimer’s disease and history of stroke.
Greater poverty and less education are strongly associated with lower MIND diet scores and lower cognitive function.
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Key Components of the MIND Diet
The MIND diet emphasizes consuming certain "brain-healthy" foods while limiting intake of unhealthy ones. Unlike rigid meal plans, the MIND diet offers flexibility, requiring individuals to create their own meal plans and recipes based on recommended foods. This may be challenging for those who do not cook. Although the diet plan specifies daily and weekly amounts of foods to include and not include, it does not restrict the diet to eating only these foods.
Foods to Embrace
The MIND diet encourages the consumption of the following nine food groups:
- Green Leafy Vegetables: Aim for at least six servings per week of kale, spinach, cooked greens, and salads.
- Other Vegetables: Include at least one serving daily of non-starchy vegetables.
- Berries: Consume berries (strawberries, blueberries, raspberries, blackberries) at least twice a week for their antioxidant benefits.
- Nuts: Aim for five or more servings of nuts each week, varying the types for a wider range of nutrients.
- Olive Oil: Use olive oil as your primary cooking oil.
- Whole Grains: Target at least three servings daily of oatmeal, quinoa, brown rice, whole wheat pasta, and 100% whole wheat bread.
- Fish: Eat fish, especially fatty fish like salmon, sardines, trout, tuna, and mackerel (rich in omega-3 fatty acids), at least once a week.
- Beans: Include beans, lentils, and soybeans in at least four meals per week.
- Poultry: Consume chicken or turkey at least twice a week, avoiding fried versions.
Foods to Limit
The MIND diet recommends limiting the following five food groups:
- Butter and Margarine: Limit intake to less than 1 tablespoon (about 14 grams) daily, opting for olive oil instead.
- Cheese: Eat cheese less than once per week.
- Red Meat: Aim for no more than three servings per week, including beef, pork, lamb, and products made from these meats.
- Fried Food: Highly discouraged, especially from fast-food restaurants; limit consumption to less than once per week.
- Pastries and Sweets: Limit processed snack foods and desserts like ice cream, cookies, brownies, snack cakes, doughnuts, and candy to no more than four times per week.
The MIND diet can be a healthful eating plan that incorporates dietary patterns from the Mediterranean and DASH, both of which have suggested benefits in preventing and improving cardiovascular disease and diabetes, and supporting healthy aging. When used in conjunction with a balanced plate guide, the diet may also promote healthy weight loss if desired.
Potential Benefits and Mechanisms
The MIND diet contains foods rich in certain vitamins, carotenoids, and flavonoids that are believed to protect the brain by reducing oxidative stress and inflammation. The MIND diet is designed to reduce the risk of dementia and loss of brain function as you age.
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Reducing Oxidative Stress and Inflammation
Scientists believe the MIND diet may work by reducing oxidative stress and inflammation, both detrimental to brain health. Oxidative stress occurs when free radicals accumulate in the body, damaging cells. Inflammation, while a natural response, can be harmful if unregulated and contribute to chronic diseases. The foods that make up the MIND diet probably also have antioxidant and anti-inflammatory effects.
Connection to Mediterranean Diet and White Matter Integrity
Emerging evidence supports the beneficial role of MeDi and other dietary factors in maintaining structural brain health, such as brain volume, cortical thickness, and white matter tract integrity [2,12]. White matter is tissue in the brain that helps different regions communicate with each other, playing a key role in memory and learning. It declines naturally with age, but this process can be slowed through healthy diet and lifestyle choices.
A preliminary study suggests that closely following a Mediterranean diet may enhance brain health among Hispanic/Latino adults. More closely following a Mediterranean diet was associated with: lower white matter hyperintensity volume, indicating less damage to the white matter in the brain; increased fractional anisotropy, indicating well-organized and healthy white matter connections. These positive effects were only partially explained by improved cardiovascular health markers, indicating that the diet may directly benefit brain health through other mechanisms.
Sample Meal Plan
Here’s a 7-day meal plan to get you started:
Monday
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- Breakfast: Greek yogurt with raspberries and sliced almonds
- Lunch: Mediterranean salad with olive oil-based dressing, grilled chicken, whole wheat pita
- Dinner: Burrito bowl with brown rice, black beans, fajita vegetables, grilled chicken, salsa, and guacamole
Tuesday
- Breakfast: Whole wheat toast with almond butter, scrambled eggs
- Lunch: Grilled chicken sandwich, blackberries, carrots
- Dinner: Grilled salmon, side salad with olive oil-based dressing, brown rice
Wednesday
- Breakfast: Steel-cut oatmeal with strawberries, hard-boiled eggs
- Lunch: Mexican-style salad with mixed greens, black beans, red onion, corn, grilled chicken, and olive oil-based dressing
- Dinner: Chicken and vegetable stir-fry, brown rice
Thursday
- Breakfast: Greek yogurt with peanut butter and banana
- Lunch: Baked trout, collard greens, black-eyed peas
- Dinner: Whole wheat spaghetti with turkey meatballs and marinara sauce, side salad with olive oil-based dressing
Friday
- Breakfast: Whole wheat toast with avocado, omelet with peppers and onions
- Lunch: Chili made with ground turkey
- Dinner: Greek-seasoned baked chicken, oven-roasted potatoes, side salad, whole wheat dinner roll
Saturday
- Breakfast: Overnight oats with strawberries and almond butter
- Lunch: Fish tacos on whole wheat tortillas, brown rice, coleslaw, and pinto beans
- Dinner: Chicken gyro on whole wheat pita, cucumber and tomato salad
Sunday
- Breakfast: Spinach frittata, sliced apple with peanut butter
- Lunch: Tuna salad sandwich on whole wheat bread, plus carrots and celery with hummus
- Dinner: Curry chicken, brown rice, lentils, and a side salad
Considerations and Potential Drawbacks
While promising, the MIND diet has some considerations:
- Flexibility and Meal Planning: The MIND diet is flexible in that it does not include rigid meal plans. However, this also means that people will need to create their own meal plans and recipes based on the foods recommended on the MIND diet.
- Limited Research: Current research on the MIND diet has not been able to determine exactly how it works. However, scientists think it may work by reducing oxidative stress and inflammation.
- Alcohol Consumption: Wine was included as one of the 15 original dietary components in the MIND diet score, in which a moderate amount was found to be associated with cognitive health. However, in subsequent MIND trials it was omitted for “safety” reasons. The effect of alcohol on an individual is complex, so that blanket recommendations about alcohol are not possible. Based on one’s unique personal and family history, alcohol offers each person a different spectrum of benefits and risks. Whether or not to include alcohol is a personal decision that should be discussed with your healthcare provider.
The Mediterranean Diet and White Matter Hyperintensity
Current evidence on the impact of Mediterranean diet (MeDi) on white matter hyperintensity (WMH) trajectory is scarce. This study aims to examine whether greater adherence to MeDi is associated with less accumulation of WMH.
In this longitudinal study of 183 cognitively intact adults, WMH burden increased within an average of five years from baseline to follow-up. Greater adherence to MeDi was associated with a lesser increase in WMH burden, and this association was moderated by age group and MeDi group. Participants in middle and high MeDi groups, compared to those in low MeDi group, were more likely to be females (p = 0.001) and to report a higher level of total daily energy intake (p = 0.016).
After adjusting for the covariates, the association between MeDi and WMH change was significantly moderated by age (young group as the reference, p-interaction[middle-aged × MeDi] = 0.075, p-interaction[older × MeDi] = 0.037), such that young participants showed less increase in WMH burden for each unit increase in MeDi score, compared to the middle-aged or older participants. In terms of the three MeDi groups, in the fully adjusted model, the significant association between MeDi score and WMH change was observed in the low MeDi group only (β = −0.053, 95% CI = −0.091-−0.015, p = 0.008), indicating that participants with diets less similar to MeDi had less of an increase in WMH burden with each unit increase in MeDi score.
In order to test the moderation effect of age on the associations between individual food categories and WMH change, an interaction term of each individual food category by continuous age was added to the models, adjusting for follow-up interval. The interaction term of age and food category was significant in the models for vegetables (β = 0.003, 95% CI = −0.0002-0.007, p-interaction = 0.068), dairy (β = 0.002, 95% CI = −0.0001-0.004, p-interaction = 0.065), and alcohol (β = 0.003, 95% CI = 0.00005-0.005, p-interaction = 0.046), indicating that increasing age attenuated the associations between vegetable/dairy/alcohol intake and WMH change. In other words, associations between intake of these food types and WMH change were stronger among younger participants than older participants.
Magnesium and Brain Health
Eating foods rich in magnesium, a mineral found in nuts and seeds, leafy greens, whole grains, beans and other foods, may be good for the brain. Scientists in Australia report that adults who tend to get the most magnesium in their diets tend to have less shrinkage in their brains as they age.
The Recommended Dietary Allowance for magnesium is 400 to 420 milligrams a day for men and 310 to 320 milligrams a day for women. Foods high in magnesium include pumpkin seeds (168 mg in a 1-ounce serving), almonds (80 mg in a 1-ounce serving), spinach (78 mg in a half-cup cooked), peanuts (63 mg in a quarter-cup serving), soy milk (61 mg per cup), black beans (60 mg per cup cooked), dark chocolate (50 mg per 1-ounce serving), avocados (44 mg per cup), bananas (32 mg per medium banana), and salmon (26 mg in a 3-ounce portion). If you are worried you may be deficient in magnesium or want to take magnesium supplements, talk to your doctor first. Magnesium can interact poorly with various medications, and taking high-dose supplements can cause stomach cramps, nausea and digestive upset.