For Mind-Health, Change Lifestyle Patterns

According to the Alzheimer’s Association, over 5 million Americans are living with Alzheimer’s disease, and the number is projected to increase to 16 million in 30 years. In Pennsylvania, an 18.5 percent increase in diagnosis is estimated in people aged 65 and over in the next eight years.

The cost of caring for those with Alzheimer’s and other dementias is estimated to total $259 billion this year, likely increasing to $1.1 trillion (in today’s dollars) by midcentury. Nearly one in every three seniors who dies each year has Alzheimer’s or another dementia.

Why is the rate of Alzheimer’s disease increasing so dramatically? Research shows that several factors contribute to late-onset Alzheimer’s (over age 65, the most common form). These include older age, genetics (especially carrying the APOE4 allele), family history, a history of head trauma, midlife onset high-blood pressure, obesity, diabetes, and high cholesterol. Delving deeper, Americans are living longer, but over 65 percent of adults are overweight or obese, and diabetes rates are climbing (over a third have diabetes or prediabetes). What is good or bad for the heart is the same for the brain.


What are the common lifestyle factors influencing the heart and brain? Diet, exercise, sleep and mental acuity are the most prominent, and fortunately, modifiable factors.

In the past, the majority of diet research focused on individual nutrients. However, it is difficult to show much difference using this approach, since we don’t eat single nutrients. So, past research has shown there is not enough data to support reduction or prevention of Alzheimer’s with omega-3 fatty acids, antioxidants or B-vitamins by themselves, such as in supplement form. Nonetheless, some research has shown that low levels of vitamin D are associated with a higher risk of Alzheimer’s.

However, in the last several years there has been renewed study of eating patterns that support brain health. The Mediterranean diet, first named in 1993, but eaten for over 4,000 years in the 22 countries of the Mediterranean region, has shown great promise in promoting and maintaining brain health. Studies in Spain, which began in the early 2000s and continue today, have demonstrated declines in heart attacks, strokes and improved cognition when participants were following Mediterranean eating patterns. Longer life, less diabetes and some cancers, and lower rates of childhood obesity are also seen. The diet focuses on consumption of more vegetables, fruits, whole grains, beans, nuts, seeds, olive oil, water, fish and shellfish. It also includes small amounts of cheese, yogurt and poultry, and even smaller amounts of red meats and sweets. Moderate amounts of red wine are included.

This eating pattern also includes minimal processed foods, so overall, it is lower in sodium and sugar, as well as saturated and trans fats. It is higher in fiber, potassium, antioxidants and healthy fats compared to the typical Western diet. The research is so compelling about the healthfulness that this eating pattern has now been recognized and recommended in the newest 2010-2015 U.S. Dietary Guidelines.

Published in 2015, research from Rush University in Chicago has combined elements from the Mediterranean diet and the DASH diet (Dietary Approaches to Stop Hypertension developed in the early 1990s by Harvard researchers), called the MIND (Mediterranean-DASH Intervention for Neurodegenerative Delay) diet. The goal is to prevent Alzheimer’s. The researchers tested more than 900 Chicago-area seniors over four and a half years. The longer people had followed the MIND diet patterns, the less risk they appeared to have for Alzheimer’s. The study found that the MIND diet lowered Alzheimer’s risk by about 35 percent for people who followed it moderately well and up to 53 percent for those who adhered to it rigorously.

The MIND diet outlines 15 dietary components to follow. The 10 “brain-healthy food groups” are as follows:

• Green leafy vegetables, daily.
• Other vegetables, daily.
• Nuts, five times per week.
• Berries, 1/2 cup twice per week.
• Beans, 1/2 cup every other day.
• Whole grains, at least three daily.
• Fish, at least weekly.
• Poultry, twice per week.
• Olive oil, use as main cooking oil.
• Wine, daily.

The five “unhealthy food groups” are as follows:

• Red meats, use just four times per week.
• Butter and margarine, use less than

1 tablespoon per day.

• Cheeses, use less than 1 serving per week.
• Pastries and sweets, use less than

five per week

• Fried or fast food, use none.

While the MIND diet research is compelling and promising, more research is needed to replicate the results. With the exclusion of dairy foods, calcium and vitamin D will likely need to be supplemented or replaced by fortified soy products, and iron intake may be low with less red meats. It is unclear why low or nonfat dairy products are not included.

If you consume dairy products and/or eat out frequently, this diet could be a challenge to follow.

Leading neurobiology researchers published a set of recommendations in 2014 summarizing their ideas for lifestyle changes to prevent Alzheimer’s, with the first two strongly diet-related:

• Minimize saturated fats and trans fats.
• Vegetables, legumes, fruits and whole grains should replace meats and dairy products as primary staples of the diet.

Additionally, physical activity, sleep and how you use your brain are included in the recommendations as follows:

• Do aerobic exercise equivalent to 40 minutes of brisk walking, 3 times per week.
• Have a regular sleep routine of 7-8 hours per night.
• Engage in regular mental activity that promotes new learning; for example, 30 minutes per day, 4-5 times per week.

There is little doubt we can decrease the amount of adults diagnosed with Alzheimer’s by making lifestyle changes. The question is, will we?

The costs are too great to society if we do nothing. Families today are under immense financial, emotional, physical and mental stress when a parent or spouse is in cognitive decline from Alzheimer’s.

For more information and support, contact the Alzheimer’s Association at www.alz.org. To learn more about the Mediterranean diet and lifestyle, check out Penn State Extension’s website at www.extension.psu.edu, for our Mediterranean Cuisine Comes to You classes, offered throughout Pennsylvania and upon request. We will also be offering the classes online soon, to take at your own time and pace.