Brain Health Diet
Researchers observe that there is a link between healthy eating and healthy living, including benefits extending to healthy brain aging.
To promote healthy brain aging and stave off neurocognitive diseases of aging including dementias, Alzheimer’s disease, Parkinson’s disease, and memory loss, there is good reason to believe that a well-balanced, nutritious diet can provide many benefits.
A brain healthy diet can minimize inflammation and insulin resistance, as well as nourish brain cells (neurons) and connections (synapses).
There are no specific diets that have been shown to reduce progression neurodegenerative disorders. However the MIND diet aims at reducing the risk of developing dementia and neurocognitive decline that can come with aging.
Integrated Approach
Our specialists advocate programs that integrate healthy lifestyle, nutritional guidelines and physical and cognitive exercise. These together aim at delaying or even preventing neurocognitive decline to promote healthy brain aging.
The MIND diet
The MIND diet, which stands for the Mediterranean-DASH Intervention for Neurodegenerative Delay, combines the brain health benefits of the Mediterranean diet and the Dietary Approaches to Stop Hypertension (DASH) diet.
Patients with coronary artery disease, kidney disease, and diabetes should consult their medical doctors and nutritionists prior to beginning a new diet as those conditions have other dietary restrictions or priorities.
The MIND diet has 15 dietary components.
10 brain-healthy food groups
- Green leafy vegetables
- Other vegetables
- Nuts
- Berries (especially blueberries and strawberries)
- Beans
- Whole grains
- Fish (see note below)
- Poultry
- Olive oil
- Red wine
5 unhealthy food groups
- Red meats
- Butter and stick margarine
- Cheese
- Pastries and sweets
- Fried or fast food
The MIND diet includes at least three servings of whole grains, a salad and one other vegetable every day. It also involves snacking most days on nuts and eating beans every other day or so, poultry and berries at least twice a week and fish at least once a week.
The MIND diet recommends limited eating of the designated unhealthy foods, especially butter (less than 1 tablespoon a day), cheese, and fried or fast food (less than a serving a week for any of the three).
However, please note that because this diet has not been studied in Parkinson’s disease, where patients may have balance issues, which could worsen with alcohol, we do not recommend a daily glass of wine for PD patients. The supplement resveratrol may be taken instead.
Our recommendations are more flexible than the strict a limitation of cheese and butter, however we do recommend limiting excess sugars and processed foods.
We believe that the optimal diet would be for the patient to enjoy high-quality food of limited quantity, even on occasion rich foods or pastries, rather than having high quantities of low quality, processed foods such as diet or fat-free versions of food, which typically have higher sugar content or may use more chemicals to substitute for flavor.
For example, dark chocolate is known to have anti-oxidant qualities so a small amount (an ounce for example) of good quality chocolate, enjoyed with thoughtfulness, would be better than abstaining altogether or attempting to abstain and then breaking a diet with binges of low-quality chocolate.
Regarding fish intake, we recommend avoiding high-mercury fish:
- King Mackerel
- Marlin
- Orange Roughy
- Shark
- Swordfish
- Tilefish
- Ahi Tuna (albacore tuna has lower mercury content and can be had once a week).
Mercury content information can be found on the EPA website.
We recommend fatty fish like salmon, sardines, trout, and albacore tuna for their high amounts of omega-3 fatty acids.
The MIND diet is very new being introduced in 2015. Observational research suggests that adhering to food recommendations in the MIND diet even in a moderate way and even if you are unable to stick to the suggested quantities, still correlates to a reduced incidence if Alzheimer’s disease.
How the MIND diet works
Both the Mediterranean and MIND diets are associated with a reduced risk of cognitive decline and Alzheimer’s disease. While it is still unclear how the MIND diet works, scientists believe a few factors may be involved.
Antioxidant effects of the recommended brain healthy food groups are thought to help reduce the build-up of large amounts of toxic proteins (called free radicals) in the body. These tend to accumulate due to oxidative stress, which causes cellular breakdown particularly in the brain.
The anti-inflammatory food groups help minimize inflammation which is a contributing component of several chronic diseases.
Beta-amyloid proteins that occur naturally in the body accumulate over time and can form harmful plaques in the brain. In diseases such as Alzheimer’s disease, it is thought that these plaques disrupt normal brain cell communications causing the symptoms of neurocognitive disease resulting in brain health decline.
Other suggestions for nutritional adjustment include the following:
- Minimize simple carbohydrates
- Minimize processed foods
- Consider a gluten free diet
- Consider a ‘Mediterranean-style’ diet
- Consider a low glycemic index diet
- Consider a low grain diet
We caution against “fad diets” including unregulated diet supplements, extreme caloric restriction, etc. which can lead to electrolyte abnormalities associated with elevated risk of seizures, heart attacks, and death.
Dietary Interventions
Goals
- Abstinence from alcohol (no drinking), with reassessment every 6 months
Methods
- Continuing or initiating abstinence from alcohol, under medical supervision if necessary, with reassessment of the alcohol use risk/benefit ratio every 6 months.
- Consider structured professional or peer programs (e.g., MATRIX, Alcohol Anonymous)
- Consider medications for alcohol use disorders (e.g., naltrexone, acamprosate, disulfiram)
Cautions
- Abrupt discontinuation of regular alcohol use can induce a life-threatening withdrawal with complications including anxiety, insomnia, agitation, tremor, shakiness, disorientation, hallucinations, seizures, instability of blood pressure and pulse, and possible death.
Reasoning
- For healthy, non-symptomatic individuals (no memory changes, normal mood according to self and loved ones), up to two drinks per day for men and one drink per day for women may be low risk (though associated with oral/gut cancers).
- However, for brain health, prolonged or extensive alcohol use damages brain cells and leads to serious memory loss and mood dysregulation.
- Bottom line: Continued alcohol use in the context of mood and memory symptoms is more harmful than good.
Resources
- Alcoholics anonymous
- MATRIX program
- Naltrexone
- Acamprosate
- Disulfiram
References
Chronically high blood sugar damages the brain, just as it damages many ‘end organs’ (kidneys, eyes, feet, etc.). Eliminating processed sugar in the diet helps in minimizing insulin resistance and type II diabetes, a modifiable risk factor for Alzheimer’s disease.
Goals
- Fasting blood sugar (glucose) level 70-90 mg/dL (Diabetes = Fasting blood sugar > 126)
- HgbA1c < 5.6 %
- Fasting insulin < 4.5 microIU/ml
Methods
- For mildly elevated fasting blood sugar, HgbA1c, and insulin resistance, self-care
- For pre-diabetes and diabetes, primary care and/or endocrinology care
Reasoning
- The hormone insulin helps control the amount of sugar in the blood.
- With insulin resistance, the body’s cells don’t respond normally to insulin.
- Glucose can’t enter the cells as easily, so it builds up in the blood which can lead to type 2 diabetes.
- Chronically high blood sugar damages the brain, just as it damages many ‘end organs’ (kidneys, eyes, feet, etc.).
Resources
- Ask your doctor to test the above labs levels and discuss appropriate treatment options
- Exercise – 30 min aerobic exercise daily with strength and conditioning at least 2x weekly
- Diet – low glycemic index foods, eliminate added sugar, focus on fresh ‘whole’ foods
- Cinnamon supplementation – Walgreens Finest Nutrition Cinnamon 1000 mg capsules – can help lower blood sugar
- ConsumerLab.com Cinnamon Review
References
- De la Monte, S. M. (2009). Insulin resistance and Alzheimer’s disease. BMB Reports, 42(8), 475–481.
- Kuusisto J, Koivisto K, Mykkänen L, Helkala EL, Vanhanen M, Hänninen T, Kervinen K, Kesäniemi YA, Riekkinen PJ, Laakso M. Association between features of the insulin resistance syndrome and Alzheimer’s disease independently of apolipoprotein E4 phenotype: cross sectional population based study. BMJ. 1997 Oct 25;315(7115):1045-9. PubMed PMID: 9366728; PubMed Central PMCID: PMC2127678.