The MIND diet revisited

In 2015, the late Dr. Martha Clare Morris and her colleagues at Rush University published their first paper on the effects of following the MIND diet on risk of getting Alzheimer’s disease. The MIND diet (Mediterranean-DASH Intervention for Neurodegenerative Delay) is a hybrid of the Mediterranean diet and DASH diet (Dietary Approaches to Stop Hypertension), but it differs in the addition of berries and nuts and stricter restrictions on dairy.  It may be easier to follow for some than the Mediterranean diet which requires daily fish consumption. In that 2015 report, the MIND diet lowered the risk of developing Alzheimer’s by as much as 53% in participants who adhered to the diet rigorously, and by about 35% in those who followed it only moderately well. These findings have been confirmed by several studies since then, and in at least one head-to-head study the MIND diet was more more effective than the Mediterranean diet in preventing Alzheimer’s.

The Rush group has found that chemicals called flavonoids, and in particular a subgroup called flavonols, may be one of the keys to the success of the MIND and other Mediterranean-style diets. In a 2020 paper in Neurology, they showed that total flavonol consumption was inversely correlated with chance of getting Alzheimer’s disease.  As seen in the graph below, participants in the top two quintiles of flavonol consumption, i.e., they ate the most flavonol-containing foods, were less likely to get Alzheimer’s as they aged compared to those in the bottom quintile.

I had fun paging through the USDA tables for flavonoid (and flavonol) content of various foods. In general, the foods highest in total flavonols are various herbs, green vegetables (especially the bitter ones), and berries. By far the highest content in a vegetable of normal serving size is kale. Some of the herbs are higher, but the serving size would be much less. Onions are a surprisingly good source of flavonols.  At the bottom of the list, foods with undetectable flavonol levels are avocados and mushrooms. I believe avocado oil is considered healthy, so I will continue to enjoy them. Admittedly, kale may be an acquired taste, but it is part of my daily diet now, and I quite enjoy it both raw and cooked.  Raw of course has higher flavonol levels.

Finally, there is increasing information suggesting that a flavonoid-rich diet can slow other degenerative diseases as well. A recent paper in the journal Movement Disorders found that adherence to either the MIND or Mediterranean diet delayed the onset of Parkinson’s disease, and a paper in Neurology this month found that adherence to the MIND diet decreased mortality in Parkinson’s disease.

I have made this point many times in this blog, and I’ll emphasize it again because it is so important: Life style modifications such as diet, aerobic exercise, staying intellectually and socially active, getting at least seven hours of sleep, and managing cardiovascular risk factors such as heart disease, high blood pressure, high cholesterol, and diabetes are effective in slowing the progression of Alzheimer’s disease and reducing the chance of getting Alzheimer’s dementia.  There is no medication yet that even comes close.