Tuesday, May 12, 2015

Alzheimer's Disease and the MIND Diet


Are you worried about Alzheimer's disease? Did you recently hear about the MIND diet? News outlets and magazines grabbed onto the press release from Rush University Medical Center and circulated it. The press-release has been circulating since March 16, 2015.

I can’t share with you the details of the research because I don’t have access to it yet. The research article that explains the research and the results is not available in print yet. I’ve been waiting for a month now to find out if the article will be embargoed or if it will be available to non-journal subscribers once it actually is available in print. As of May 11, 2015 the article remains listed as “in-press” and unavailable to non-journal subscribers. Draft versions of the article have been available to journal subscribers since February or March and now the rest of us finally can purchase 24-hour limited access to the corrected-proof of the article but I’m not willing to do that. In all fairness, corrected-proofs are basically the final version of the article, but I’m opposed to the practice of selling drafts or proofs of journal articles. Only final versions of articles should be available online and in print.

The reality is that the “MIND diet associated with reduced incidence of Alzheimer’s disease” paper has been circulating for a couple of months now and it is time for to write about it. At least as much as I can.


What’s the MIND diet?

MIND stands for Mediterranean-DASH Intervention of Neurodegenerative Delay. It was developed by Martha Clare Morris, ScD, a nutritional epidemiologist, and her research team based at Rush University Medical Center.


"Berries (USDA ARS)" by Scott Bauer, USDA ARS - This image was released by the Agricultural Research Service, the research agency of the United States Department of Agriculture, with the ID K7229-19 http://commons.wikimedia.org/wiki/File:Berries_(USDA_ARS).jpg#/media/File:Berries_(USDA_ARS).jpg


The researched-based eating plan combines parts of the Mediterranean way of eating (Nutrition Tuesday: Mediterranean Diet), the DASH diet (Nutrition Tuesday: Glycemic Index, DASH Diet and Heart Health) and research that suggests certain fruits (berries like blueberries and strawberries) may have properties that help to protect the brain. The researchers spent years working to understand what dietary components may work together to protect the brain from degeneration. They came up with the MIND diet. 

Based on a description of the diet I found at Rush University’s website (Rush University Medical Center News - Diet May Help Prevent Alzheimer's) the MIND diet emphasizes 15 foods – 10 types of foods to eat and 5 types of foods to limit for the promotion of brain health.

Foods included in the MIND Diet
Foods to limit in the MIND diet
Green leafy vegetables
Butter and margarine
Vegetables
Cheese
Nuts
Sweets, pastries
Berries 
Fried food, fast food
Whole grains

Fish

Poultry

Olive oil


Rush University Medical Center News - Diet May Help Prevent Alzheimer's


Does the MIND diet prevent Alzheimer’s disease?

Dr. Morris and colleagues published the results of an observational study. Participants in their study came from people already participating in a bigger study called the Rush Memory and Aging Project (MAP). Dr. Morris' group evaluated the types of foods consumed by 923 people ages 58—98 and the development of Alzheimer’s disease over an average of 4.5 years. Researchers assessed what people ate through a type of survey called a food frequency questionnaire. This allowed them to ask questions about how frequently people consumed different groups or types of foods like berries, nuts, green leafy vegetables, fried foods, cheese, etc. They also assessed how many people developed Alzheimer’s disease during the observational period. According to an article about the study that appeared in a trade magazine, Today's Dietitian,  114 people developed Alzheimer's disease during the course of the study. 

 This was an observational study. This was not an intervention study. This means that the researchers did not change anything about people’s diets or lifestyle. They just watched. Observational studies NEVER determine cause and effect. Observational studies look at how different factors relate to one another. In this case, how adherence to the MIND diet, Mediterranean diet, and DASH diet related to the development of Alzheimer’s disease.

Here is what they found according to the scientific abstract and press releases.
  1. Strictly following the MIND diet, Mediterranean diet, or the DASH diet was associated with a lower incidence of Alzheimer’s disease. All 3 of those diets were associated with lower numbers of people developing Alzheimer’s if they strictly followed the eating plan.
  2. Moderately following the MIND diet was associated with a lower incidence of Alzheimer’s disease. This was the result that the researchers got most excited about because it was unique and potentially most palatable to people. It suggests that even when people only sometimes followed the guidelines they found a possible health benefit.  
Again, this study doesn't show cause and effect. The researchers observed a phenomenon and are working on other studies to try to understand these results. Their current and future work includes younger participants and research about the way the diet impacts blood flow to the brain. More research is needed to understand if the diet really does protect people from developing Alzheimer's and if so how it works.

Should I change my diet?

In the United States, the USDA’s MyPlate, the DASH diet, and the Mediterranean diet are recognized as healthy and balanced dietary approaches. Based on the limited information published online about the MIND diet, it appears to be a hybrid of the Mediterranean and DASH diets but further specifies eating berries and drinking 1 glass of wine per day. In the U.S., if you are of legal age to drink and if you drink alcohol, it is recommended that you do so in moderation. If you don't drink alcohol, it isn't recommended that you start. Moderation means no more than 1 serving of alcohol per day for women and 2 per day for men. At this time, there is not enough evidence to advocate adopting the MIND diet over other diets.


Final thoughts

Alzheimer’s disease is brutal. My mom has it, my uncle had it, and my aunt has it. I’m always looking for ways to avoid this horrific familial curse but I also suspect it is unlikely we'll find a single one-size fits all magic cure in my lifetime. 

The role of nutrition in brain health is exciting, new, and largely unexplored. I look forward to reading this research paper one day. I also look forward to following this line of research throughout, well, the rest of my life. We don’t know much about the impact of nutrients on the adult brain in terms of cognitive decline. I’m particularly interested about the cumulative impact of nutrition and exercise on the aging brain. 

Discuss your concerns about Alzheimer’s disease with your primary healthcare provider whether it is for yourself or on the behalf of a loved one. If you are interested in the MIND diet, talk to a dietitian or your primary healthcare provider and together decide if it is right for you. As I said, this is a new area of research.

References

#alzhiemer'ssucks

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