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The MIND Diet for Improving Brain Health, Part 1

Mar 10, 2024
jazz, how are you, I'm fine, welcome everyone, yeah, so this is an exciting series that we're doing on Alzheimer's disease. Yes, last week we focused on the medical side of the really exciting things happening in terms of Alzheimer's treatment and prevention. that the way therapies are progressing so that we get to a place where one day those who are diagnosed with Alzheimer's, if diagnosed early enough, may never have to experience symptoms this week, we also have an episode very exciting related to alzheimer's disease, so this week our food expert and host leslie back med cans, director of food and nutrition, is exploring a neuroprotective eating pattern called the mental

diet

with two of the researchers who actually helped develop it, Those researchers are Dr.
the mind diet for improving brain health part 1
Neelam Agarwal, she is a cognitive neurologist, and Dr. Christy Tangni, a professor of nutrition, both of whom are from Rush University Medical Center in Chicago and developed this

diet

. I mean, it's really great that we have these guests here today, welcome to eat, move around, I think I'm Christopher Shulkin, executive producer. I'm Jasmine Ratch, I'm a managing producer, so a little explanation, so

mind

is an acronym and it's actually a nested acronym that I always trip over, so I'm going to try this jazz, no, take it, feel free to correct my pronunciation. I totally trust that you have this

mind

that represents the Dash Mediterranean Diet intervention for neurodegenerative retardation and Dash in that sentence means dietary approach to stop hypertension so it's like a clash between the Mediterranean diet and the Dash diet what put the mental diet into operation. the map was a pair of observational studies published in 2015 in the journal alzheimer's and dementia yes, the study looked at the eating patterns of 960 adults, they gave each a score on how closely they were able to adhere to the mental diet and then he grouped those people into thirds and the nice thing about the grouping is that the top third, the third that had the highest mental diet adherence score versus the lowest score, the top third was equivalent to being 7.5 years younger. of age compared to the lowest group.
the mind diet for improving brain health part 1

More Interesting Facts About,

the mind diet for improving brain health part 1...

Thus, the people who consumed the best, most neuroprotective diet were 7.5 years younger in terms of cognitive

health

than the bottom third in terms of neuroprotective diet pattern. It's crazy that something you eat like what you eat every day can actually make you feel better. being younger makes your

brain

younger no, it's remarkable and just as we recite these studies, another study analyzed the diets and cognitive performance of more than 5,900 American seniors and for them the researchers found that those who adhered most closely to either the Mediterranean diet or the mina diet had a 30 to 35 percent lower risk of cognitive decline compared to those who followed the diets less strictly.
the mind diet for improving brain health part 1
That's like a substantial portion. It's crazy. I love these statistics. One more study that we are going to mention. Dr. Agarwal. and dr. antagny are

part

of a group that just concluded a randomized controlled trial designed to establish a causal relationship rather than just an association on whether the mental diet can help prevent Alzheimer's disease and are simply analyzing the data. so the results will be out soon, they say, well, we are going to tell leslie beck in a conversation with doctor christie tangni and doctor neila magerwal hello everyone, it is a real honor to be joined today by cognitive neurologist doctor neelam agarwal and doctor christy tangni, a clinical nutritionist who co-developed the mental diet.
the mind diet for improving brain health part 1
Both women are co-authors of the seminal studies on the mental diet that revealed that the diet could help reduce the risk of developing Alzheimer's disease, so welcome to both of them and thank you very much for your time today. Good thank you. Thank you, I mean here at Medcan, as

part

of our clients' annual

health

assessment, they see a dietitian for half an hour and they can choose from basically a menu of topics that they want to learn about and we. I developed them all in 2018 anyway, the most popular one by far still today is the mental diet for

brain

health so I just wanted to share it with you guys yeah wow that's awesome so Christy, Let's start by telling our listeners what mental diet is, it's not really. a diet in the sense of the word, what does mind mean?, what is mind?, it actually means a Mediterranean diet that has been merged with a dash diet and that is a hybrid between two diet patterns that have been closely associated good with good. cardiovascular health, hypertension and now brain health, so that combination really reflects some unique foods that come from both patterns, plus some unique foods that have been identified as being associated with brain health that are much more specific than either of those patterns. by themselves.
And that's how we came up with this mental diet pattern. I see, yeah, and I'll be excited to learn how to tell our listeners more about what those specific foods are, so tell me, so how did the mental diet actually come about? Dr. Martha Claire Morris was a pioneer in the field of nutrition and making the connection between brain health and diet. Tell us about her and how her mental diet came to be. Yes, Martha Claire was a nutrition epidemiologist and had been trained by Dr. Walt Willett. at Harvard and as you know or as many listeners probably know, the Nurses' Health Study is a very long-term observational study that we call observational cohorts and she was very interested in continuing to work here in Chicago on the relationship between diet and brain health, so he came to chicago to work with dr.
Dennis Evans, who was a famous neurologist and had established and was establishing a cohort here in Chicago known as the Chicago Health and Aging Project and out of that came another cohort study that was eventually led by one of his trainees of Dr. David Bennett and that's called the Memory and Aging Project, so what Martha Claire did was invite me onto her team because my background was that I had a PhD in nutrition and she and I worked together to look at various nutrients and their role in health. of the brain and at some point I started thinking about people don't eat nutrients, people eat food and some other colleagues of mine had started talking about this idea of ​​patterns and the Europeans had recognized that the Mediterranean pattern was the very healthy pattern. for heart health for many different outcomes, so we started looking at the Mediterranean pattern and another pattern that was developed for hypertension known as the Dietary Approach to Stop Hypertension known as script and we looked at both to see if those patterns that we could identify in our cohorts it was associated with better brain health and less Alzheimer's disease.
What we did then was we took these two patterns and then we looked at the most recent science that was available in our studies or some of our colleagues in the United States in Europe was the strongest evidence that we could find and could we come up with a more specific plan that it was not only a hybrid but had some unique properties? In fact, that's what we did and we called it the mental diet pattern and we tested it in the memory and aging project and what we found was basically history from now on because it happened in 2015, but what we found is that it was highly predictive of cognitive impairment, that is, in the reduction of cognitive impairment, in addition to being highly predictive of what we call incident or incident. alzheimer's disease means that new cases of alzheimer's disease are developing, so this pattern seemed to protect people from developing alzheimer's disease, so neelum, I would like to delve a little deeper into the research on mental diet .
I remember hearing about the first studies. published in 2015 and the enthusiasm they generated not only in the media but also in the dietitian community. I wrote about those findings about the Mind Diet in my Globe and Mail column, and as I mentioned earlier, we now teach the Mind Diet to clients who are fascinated by it. So tell us about those early findings and how they changed our understanding of the connection between diet and brain health. Well, I think one of the things you know when before we even talk about how diet changed things, let's talk about brain health and what that's like.
Our concept of brain health has changed enormously over the years and you know that when you think about Alzheimer's, we think about the typical changes in brain plaques and tangles and changes in the volume of your brain and that it can't be done nothing in regards. and we've made progress in looking at how we can prevent Alzheimer's and that's really evolved into this discussion about brain health. We incorporated the diet component and now we ask ourselves: could a diet change the trajectory or what we say? pattern of what might happen as you get older with your thinking and that's how it all came together and now it looks different like dr tangy said right patterns of what we eat so the research you know we've talked about before came from large studies, many people were followed over time, we did memory tests with them and the diagnoses of Alzheimer's disease or changes in thinking, mild cognitive impairment were made with these and from there we could see which are. eating and developing what I thought was fantastic and, uh, Dr.
Tangy can mention this, the score, this mental diet score, and you know, as a neurologist and as a doctor, we like scores, we like scores because helps our patients understand where they are, but we really were. Looking at the score that developed, you know a score of, say, 15. Where are you in this pattern with the score and how do you improve a score if you change your diet? So I think that's really how the investigation has worked. advanced to four and if you're in the top third of a score, the middle third or the bottom third, how does that predict how you're doing?
Yeah, so what you're saying is that with your study participants, you looked at their usual diets and I scored it based on how closely it matched the mental diet. I think it's fantastic and I think it's something that really has a lot of traction and is being used, you know, it's been used quite a bit and, again, it's very attractive to use. Yes, we actually use the mental diet score with our clients as well, so thank you for that. Tell us about the findings of what you found in this initial research, so a couple of things to mention, you know, when we were looking at the mind score. and showed that there was a positive correlation, so when you have a good score it positively correlates with slower cognitive decline and, again, these are people who have been seen multiple times throughout their life, if you start at age 65 and a What stood out and really caught our attention was that the difference in rates of being on the highest mental diet score versus the lowest was equivalent to approximately 7.5 years of age and that really impacted a lot. from people like wow, that really means something and even the people who didn't score, you know, at the top, but scored in the middle, they still had, you know, over a 30 35 reduction in the risk of develop Alzheimer's and again, that was the other surprise of this, it was really Yeah, I remember, so neelam, I want to talk about the randomized controlled trial, the mental diet intervention trial testing the effect of mental diet or cognitive impairment.
This is really exciting. We are now moving from an observational study to a real trial. that can prove causality, can you tell us a little about this trial and what it might tell us? Yes, thank you and you are right, this trial is completed and we are actually at the point where we are analyzing the data. and what the data can reveal about this intervention, you know, this trial enrolled people at two sites in Boston and Chicago and we were looking at people who were not, you know, what we would say are not sick in the sense that They have a lot of medical problems, but we're not exercising very well, we're not really having the best diet, and since we're from the community, and you know a lot of people can relate to that, I should eat better and I should exercise more, but we were Look at the people who are participating in this trial, older adults, to see if we could give them the ingredients, if you will, with the mental diet, and if we could see that taking that diet and adhering to that diet could affect their thinking and not only his thought.
Could it affect your mood? Could it affect your physical functioning? And you knowWe were very careful when designing this study. This was a study where many people worked to provide the best important information possible about what we should do, but essentially that's what the focus of the study was to look at and you know it was a fascinating study because it was my first study in the that we looked at nutrition and actually had people follow a pattern of nutritional intake to see if it would change. Basically, general performance, but really memory, so we're waiting right now to see what this test shows.
It involved a lot of people, you know, 600 people, so it's a large study and it was two and a half years of intervention. looking at how well people are going to respond to the diet and this was something that he was very involved in, you know, also designing how we should look at this intervention because it will lay the foundation for other interventions to show this. If this pattern of intake is followed, guess what might help you with your own brain function over time? And the participants who were in the mental diet group of the study were compared to people who were just following their usual diet, that's right.
And again, it's common in the sense of training and really getting support. Here are some options.there are some things to consider here are some things to consider and incorporate into your diet, so they were also involved with that training element, Christy, did you want to add anything else? Yeah, I just wanted to clarify a point, so it was very clinical. Trials have a big difficulty: you know people want to be part of the test group, so when we designed this trial there was another part: everyone had the opportunity to get information and tools on how to reduce caloric intake. and the goal was to lose weight, so one of the things that Mielem identified was that we were looking at the risk factors that put people at higher risk for poor brain health and the people who came in had to be overweight when they came in first time, and so on independently.
Which arm they were assigned to, they were both going to have diet experts help them figure out the best way to maintain portion sizes to reduce portion sizes of key foods so they could also achieve weight loss. The reason this is so important is because when we design future trials we don't want people to say, "Oh, I didn't get into the good arm." You know they won't necessarily know, but when you start educating people about the components of the mental diet, the participants know that they are on the active component, so what is very important is that both groups and there has been some evidence which suggests that weight loss has a positive impact on brain health, so both arms could have a positive effect.
We don't know the final results at this time, so we're pretty eager to learn more about it. Do you have any idea when this study might be published? Oh that's a good question, I can tell you the short answer is no, we are actively looking. In the data, and as you can imagine, there's a lot of data in any longitudinal study like this, where you do a lot of longitudinal dietary interventions, there's a lot of data coming from so many different sources, so it's continually being analyzed. but hopefully soon we will be, so it will be exciting I'll write about it okay, so now let's talk more specifically about the mental diet Christie, you said it's a hybrid of the Mediterranean diet and the Dash diet, and it includes healthy foods for specific brain foods that have been gleaned from previous studies, so let's talk about foods in the mind diet.
Can you tell our listeners what some of the brain-healthy food groups for diets are? I would say the first one that comes to mind without reading a list is leafy greens, so as I mentioned above, I really hope we had some evidence before when we just looked at leafy greens, not the whole mental diet, and we saw very strong evidence of its role in protecting brain health and therefore vegetables. the leafy ones are one, we're talking about spinach, kale, chard, rapini, exactly, zucchini, arugula, thank you, chime in because you know, I think that's okay, let me continue, but thanks for the details, so we're also talking about another category called other vegetables and that is. assuming that predominantly we're not seeing any type of chips or anything like that, but rather we're seeing almost all other types of vegetables included and we're striving to get people to consume around two servings a day for that and what about leafy greens, leafy greens, one serving a day, okay, so you mentioned the critical piece is having that, you have to eat one leafy vegetable and at least two other vegetables every day, that's for the ideal points for each of them. one for each and how you define a serving size: half a cup, about half a cup, you know, unless you're talking about the leafy green categories, you're taking a whole raw leaf, you know, so it's a full cup. because as you know it's when you cook things, it's half a cup when it's cooked, usually, that's what a serving is, so the other big one is the berries, the berries, um, the hope is that people will consume berries about half a cup five times a week and blueberries, raspberries.
Blackberries Most of the work that has been done with strawberries has been done on individual berries, however, we recognize that there is a whole field of polyphenols associated with berries that are really effective. I just read another article again about modifying berry consumption and its impact on brain health, so but again, this is a whole pattern where we're asking people to put these things together. The other healthy thing, as we talked about, is extra virgin olive oil and the emphasis here is on extra virgin, which is really critical because a lot of salad dressings will talk about having olive oil, but if you look closely, they don't say be extra virgin and there is a unique characteristic in extra virgin olive oils not only in its monounsaturated fat content or in the unique fatty acid composition of the olive, but also in the polyphenols and if an olive oil is highly refined, Many of those polyphenols are removed in processing, which is why extra virgin olive oil is very important, so the light olive oil sold in grocery stores has been refined and will lack many of these protectants. phytochemicals exactly right exactly exactly and let me just uh if you want to have a great resource, Dr.
Morris and her daughter published a book about, I guess about four years ago, maybe three years ago, it's called Diet for the Mind and it's she . author, her authorship and there she has tons of recipes and a lot of background on this for people who really want an easy source for some of this information, but who are more than happy to continue talking about this, I think the other thing is really important and it's a carryover from both Dash and Mediterranean is the impact or inclusion of nuts, so nuts are about an eighth of a cup a day and again, that doesn't mean you have to eat them every day, you can eat them three. times a day and then your portion size would be a little bit larger, so potentially about a handful, which is more like a quarter cup, and you could say you could eat that three times a week, so Most nuts are included, so nuts are really important. an almonds pistachios hazelnuts many of those nuts are the same ones that were used in the European uh Pretty Med trial, which was so effective in reducing heart disease, so walnuts are a very important component.
Another important component is the integration of legumes or beans into your diet. a great source of protein and many different cultural groups do a much better job than most Caucasians. I would say beans are a big part of Hispanic culture, they're a great addition to the mental diet and we're really looking for people to consume about half a cup at least three times a week and that's half a cup cooked, you know, so We could be talking about chickpeas, hummus, cinnamon beans, black beans, pinto beans, any amount of those beans in your diet contribute tremendous fiber to our diet and there is some preliminary data that also directly says that these beans are important not only for the heart disease but also for brain health.
I think one of the things that our clients find almost counterintuitive is that one of the brain-healthy food groups is red wine. and you can have a glass daily and many of our clients really find that strange. Can you explain it? Well, I have to say that we have struggled quite a bit with that and in fact, although the original mental diet had alcohol and particularly red. wine and that is a remnant of some of the great work that has been done with the Mediterranean diet pattern and in one like this we are seeing moderation, that is, there is good evidence that red wine is approximately one drink a day at a time. ounce a day can be protected for brain health, but again, you know there are other scientific groups that are very hesitant to make recommendations for any form of alcohol, so in much of our studies and trials, we actually eliminate that last component , we just do it. we use the 14 components and if people choose to do that, we keep track of that, but we don't, not as part of the scoring, but because it's a personal choice, you know, and whether or not, and hopefully, the mental diet will be the mental diet.
The essay will answer some of those questions because remember that with the original design of the pattern it was based on these cohort studies where we were looking at what people reported and in our map, as well as in the chapter, we have a very low proportion of individuals than consuming alcohol at all, so that was one of the reasons for the hesitation in making that recommendation in the trial because, although we saw some evidence of the mixture, we were never able to define it with the data we had that each individual component was critical and To err on the side of safety and caution we decided to eliminate the alcohol component and you will see that in all the subsequent trials that we have currently worked with with the mental diet, I guess one of the things that I didn't talk about as Something positive about which I would like to go back to and I think that's where commercial cakes and sweets could be balanced and that's whole grains, so I think our food supply is flooded with a lot of refined grains and find a bread. that's made from whole grains, a big problem with 100 whole grains, you mean exactly, yes, exactly, that's very difficult and probably like the USDA has been asking all people to consume whole grains at a level of about three times per day, I mean, we're not close. that and the recommendation here and the mind is also high, we are asking people to consume more than 28 servings per week, but again the idea is that we are substituting those refined products and that takes work and that is one of the best things where Our dietitians chime in to let you know that you know you think about the grains that we put in our diet and the noodles and all that, but we've been unlucky enough to have seen a very receptive food supply, so there are a lot of new grains available.
I mean you can get pastas made with lentils, we have pastas that are extremely rich in whole grains and the problem I've had in mind is easily identifying them in the states where we use something that is not prolific in all products and is a hallmark whole grain, but it is still difficult for the consumer to understand what is best and how I eat cold grains. I'm sure you've come across that too, so you're asking, the mental diet basically recommends to clients. Eat four servings of whole grains per day in exactly the same way as the original diet of mine, you know when you rated the diets of the participants in that 20 in the 2015 research, it seems to me that the serving size is the recommended one, how many times a week. how many times a day has it changed for some things yes, yes, okay, yes, yes, because you remember the original one that we talked about to get a score of 15, like for example with leafy greens, we said six plus that's what that We said now you know when you actually um and I guess that's the difference in some ways between objectives and goals that you know for um for individuals and the way we rate it is different than when we tell people that these are the objectives. , but remember what we published. in our original 2015 article, that was the right experiment and now we're putting it into practice with a group of dietitians who are helping people adopt this pattern in a living situation instead of, you know, where we come frominitially.
I think that's the big issue and we've had constant conversations about that, particularly about dropping the wine piece and I can say historically the wine piece came up as well. I published an article with Neelam and Martha Claire because I was so convinced about the Mediterranean diet and Pretty Med had just come out, so we looked at it and I was also adamant about using a particular tool that, like the mind, would have target amounts for that many other groups assigned a score of zero or one when they looked at the distribution of the population and if you were taller than the median you got a one if you were shorter than the median and these were sex-specific medians.
I didn't think that was like that. I felt that if we really wanted to follow a Mediterranean diet, we should have specific goals, so this group in Greece developed this tool called um the med diet score and it was developed by Dr. Paggy Otakus and we took the data from the chapter and analyzed it and that is. when we first discovered some potential benefit of the Mediterranean diet and that's what started us on this journey of looking at these different patterns and how we wanted to maximize the positive aspects of the Mediterranean diet in our mental diet and again, it was exploratory. period, but once we saw the potential benefit based on this cohort analysis, that's what prompted us to design the mental diet trial, we said now we have to try this and you're absolutely right, those nuances are slightly different than The Original Mental Diet had prescribed, many thanks to both of them.
Well, that's all for the first part. Be sure to join us for part two of this conversation next week just to clarify that Dr. Christie Tangni is discussing the mental diet intervention to prevent Alzheimer's disease and So that's the randomized control trial that just happened. conclude and that aims to establish the causality of the mental diet and that is the different study from the pair of studies from 2015, which were observational studies in those randomized cases of Alzheimer's and dementia that the randomized control trial just ended. completed and the data is being analyzed, hopefully we'll get some more interesting statistics from this, yes, maybe we'll get them back, yes, we should, well that's it for the first part of our interview with two of the creators of the mental diet.
The second part that we will run next week and discuss is the mechanisms by which mental diet is thought to benefit brain health. Other studies that are examining the interaction between diet and brain health, including the Pointers Trial of USA, and Dr. Christie Tangni and Dr. Nilam Agarwal provide their advice on how to follow a more neuroprotective eating pattern. Follow Dr. Agarwal on Twitter at Dr. Adda. d-o-c-t-o or you can follow rush university medical center on rush medical and don't forget to follow leslie also on leslie beck rd that's c k l-e-s-l-i-e-b-e-c-k-r d. We will post featured episodes and links you can visit on our website at Eveningthinkpodcast. .com say hello and send us a tip or suggestion by emailing us at info eatmovethinkpodcast.com and follow medcan on twitter and instagram at medcan live welcome to eat move think is produced by ghost office jasmine eruption managed by social media producers and supporters from chantal goerten strategy emily bozek and andrew imax i am executive producer christopher shoulder we will be back soon with a new episode examining the latest in health and wellness this podcast is intended to provide general health and wellness information only and is not designed or intended To constitute or be used as a substitute for medical advice treatment or diagnosis, you should always speak with your MedCan healthcare provider for individual medical advice diagnosis and treatment, including your specific health and wellness needs.
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