Finding yourself confused by the seemingly endless promotion of weight-loss strategies and diet plans? In this series, we take a look at some popular diets—and review the research behind them.
What Is It?
The Mediterranean-DASH Diet Intervention for Neurodegenerative Delay, or MIND diet, targets the health of the aging brain. Dementia is the sixth leading cause of death in the United States, driving many people to search for ways to prevent cognitive decline. In 2015, Dr. Martha Clare Morris and colleagues at Rush University Medical Center and the Harvard Chan School of Public Health published two papers introducing the MIND diet. [1,2] Both the Mediterranean and DASH diets had already been associated with preservation of cognitive function, presumably through their protective effects against cardiovascular disease, which in turn preserved brain health.
The research team followed a group of older adults for up to 10 years from the Rush Memory and Aging Project (MAP), a study of residents free of dementia at the time of enrollment. They were recruited from more than 40 retirement communities and senior public housing units in the Chicago area. More than 1,000 participants filled out annual dietary questionnaires for nine years and had two cognitive assessments. A MIND diet score was developed to identify foods and nutrients, along with daily serving sizes, related to protection against dementia and cognitive decline. The results of the study produced fifteen dietary components that were classified as either “brain healthy” or as unhealthy. Participants with the highest MIND diet scores had a significantly slower rate of cognitive decline compared with those with the lowest scores. [1] The effects of the MIND diet on cognition showed greater effects than either the Mediterranean or the DASH diet alone.
How It Works
The purpose of the research was to see if the MIND diet, partially based on the Mediterranean and DASH diets, could directly prevent the onset or slow the progression of dementia. All three diets highlight plant-based foods and limit the intake of animal and high saturated fat foods. The MIND diet recommends specific “brain healthy” foods to include, and five unhealthy food items to limit. [1]
The healthy items the MIND diet guidelines* suggest include:
The unhealthy items, which are higher in saturated and trans fat, include:
Less than 5 servings a week of pastries and sweets
Less than 4 servings a week of red meat (including beef, pork, lamb, and products made from these meats)
Less than one serving a week of cheese and fried foods
Less than 1 tablespoon a day of butter/stick margarine
*Note: modest variations in amounts of these foods have been used in subsequent studies. [9,10]
Sample meal plan
This sample meal plan is roughly 2000 calories, the recommended intake for an average person. If you have higher calorie needs, you may add an additional snack or two; if you have lower calorie needs, you may remove a snack. If you have more specific nutritional needs or would like assistance in creating additional meal plans, consult with a registered dietitian.
Breakfast: 1 cup cooked steel-cut oats mixed with 2 tablespoons slivered almonds, ¾ cup fresh or frozen blueberries, sprinkle of cinnamon
Snack: 1 medium orange
Lunch:
Beans and rice – In medium pot, heat 1 tbsp olive oil. Add and sauté ½ chopped onion, 1 tsp cumin, and 1 tsp garlic powder until onion is softened. Mix in 1 cup canned beans, drained and rinsed. Serve bean mixture over 1 cup cooked brown rice.
2 cups salad (e.g., mixed greens, cucumbers, bell peppers) with dressing (mix together 2 tbsp olive oil, 1 tbsp lemon juice or vinegar, ½ teaspoon Dijon mustard, ½ teaspoon garlic powder, ¼ tsp black pepper)
Snack: ¼ cup unsalted mixed nuts
Dinner:
3 ounces baked salmon brushed with same salad dressing used at lunch
1 cup chopped steamed cauliflower
1 whole grain roll dipped in 1 tbsp olive oil
Wine was included as one of the 15 original dietary components in the MIND diet score, in which a moderate amount was found to be associated with cognitive health. [1] However, in subsequent MIND trials it was omitted for “safety” reasons. The effect of alcohol on an individual is complex, so that blanket recommendations about alcohol are not possible. Based on one’s unique personal and family history, alcohol offers each person a different spectrum of benefits and risks. Whether or not to include alcohol is a personal decision that should be discussed with your healthcare provider. For more information, read Alcohol: Balancing Risks and Benefits.
The Research So Far
The MIND diet contains foods rich in certain vitamins, carotenoids, and flavonoids that are believed to protect the brain by reducing oxidative stress and inflammation. Although the aim of the MIND diet is on brain health, it may also benefit heart health, diabetes, and certain cancers because it includes components of the Mediterranean and DASH diets, which have been shown to lower the risk of these diseases.
Cohort studies
Researchers found a 53% lower rate of Alzheimer’s disease for those with the highest MIND diet scores (indicating a higher intake of foods on the MIND diet). Even those participants who had moderate MIND diet scores showed a 35% lower rate compared with those with the lowest MIND scores. [2] The results didn’t change after adjusting for factors associated with dementia including healthy lifestyle behaviors, cardiovascular-related conditions (e.g., high blood pressure, stroke, diabetes), depression, and obesity, supporting the conclusion that the MIND diet was associated with the preservation of cognitive function.
Several other large cohort studies have shown that participants with higher MIND diet scores, compared with those with the lowest scores, had better cognitive functioning, larger total brain volume, higher memory scores, lower risk of dementia, and slower cognitive decline, even when including participants with Alzheimer’s disease and history of stroke. [3-8]
Clinical trials
A 2023 randomized controlled trial followed 604 adults aged 65 and older who at baseline were overweight (BMI greater than 25), ate a suboptimal diet, and did not have cognitive impairment but had a first-degree relative with dementia. [9] The intervention group was taught to follow a MIND diet, and the control group continued to consume their usual diet. Both groups were guided throughout the study by registered dietitians to follow their assigned diet and reduce their intake by 250 calories a day. The authors found that participants in both the MIND and control groups showed improved cognitive performance. Both groups also lost about 11 pounds, but the MIND diet group showed greater improvements in diet quality score. The authors examined changes in the brain using magnetic resonance imaging, but findings did not differ between groups. [10] Nutrition experts commenting on this study noted that both groups lost a similar amount of weight, as intended, but the control group likely improved their diet quality as well (they had been coached to eat their usual foods but were taught goal setting, calorie tracking, and mindful eating techniques), which could have prevented significant changes from being seen between groups. Furthermore, the duration of the study–3 years–may have been too short to show significant improvement in cognitive function.
The results of this study showed that the MIND diet does not slow cognitive aging over a 3-year treatment period. Whether the MIND diet or other diets can slow cognitive aging over longer time periods remains a topic of intense interest.
Other factors
Research has found that greater poverty and less education are strongly associated with lower MIND diet scores and lower cognitive function. [11]
Potential Pitfalls
The MIND diet is flexible in that it does not include rigid meal plans. However, this also means that people will need to create their own meal plans and recipes based on the foods recommended on the MIND diet. This may be challenging for those who do not cook. Those who eat out frequently may need to spend time reviewing restaurant menus.
Although the diet plan specifies daily and weekly amounts of foods to include and not include, it does not restrict the diet to eating only these foods. It also does not provide meal plans or emphasize portion sizes or exercise.
Bottom Line
The MIND diet can be a healthful eating plan that incorporates dietary patterns from the Mediterranean and DASH, both of which have suggested benefits in preventing and improving cardiovascular disease and diabetes, and supporting healthy aging. When used in conjunction with a balanced plate guide, the diet may also promote healthy weight loss if desired. Whether or not following the MIND diet can slow cognitive aging over longer time periods remains an area of interest, and more research needs to be done to extend the MIND studies in other populations.
Related
References
Morris MC, Tangney CC, Wang Y, Sacks FM, Barnes LL, Bennett DA, Aggarwal NT. MIND diet slows cognitive decline with aging. Alzheimer’s & dementia. 2015 Sep 1;11(9):1015-22.
Morris MC, Tangney CC, Wang Y, Sacks FM, Bennett DA, Aggarwal NT. MIND diet associated with reduced incidence of Alzheimer’s disease. Alzheimer’s & Dementia. 2015 Sep 1;11(9):1007-14.
Dhana K, James BD, Agarwal P, Aggarwal NT, Cherian LJ, Leurgans SE, Barnes LL, Bennett DA, Schneider JA. MIND diet, common brain pathologies, and cognition in community-dwelling older adults. Journal of Alzheimer’s Disease. 2021 Jan 1;83(2):683-92.
Cherian L, Wang Y, Fakuda K, Leurgans S, Aggarwal N, Morris M. Mediterranean-Dash Intervention for Neurodegenerative Delay (MIND) diet slows cognitive decline after stroke. The journal of prevention of Alzheimer’s disease. 2019 Oct;6(4):267-73.
Hosking DE, Eramudugolla R, Cherbuin N, Anstey KJ. MIND not Mediterranean diet related to 12-year incidence of cognitive impairment in an Australian longitudinal cohort study. Alzheimer’s & Dementia. 2019 Apr 1;15(4):581-9.
Melo van Lent D, O’Donnell A, Beiser AS, Vasan RS, DeCarli CS, Scarmeas N, Wagner M, Jacques PF, Seshadri S, Himali JJ, Pase MP. Mind diet adherence and cognitive performance in the Framingham heart study. Journal of Alzheimer’s Disease. 2021 Jan 1;82(2):827-39.
Berendsen AM, Kang JH, Feskens EJ, de Groot CP, Grodstein F, van de Rest O. Association of long-term adherence to the mind diet with cognitive function and cognitive decline in American women. The journal of nutrition, health & aging. 2018 Feb;22(2):222-9. Disclosure: Grodstein reports grants from International Nut Council, other from California Walnut Council, outside the submitted work.
Chen H, Dhana K, Huang Y, Huang L, Tao Y, Liu X, van Lent DM, Zheng Y, Ascherio A, Willett W, Yuan C. Association of the Mediterranean Dietary Approaches to Stop Hypertension Intervention for Neurodegenerative Delay (MIND) Diet With the Risk of Dementia. JAMA psychiatry. 2023 May 3.
Liu X, Morris MC, Dhana K, Ventrelle J, Johnson K, Bishop L, Hollings CS, Boulin A, Laranjo N, Stubbs BJ, Reilly X. Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) study: rationale, design and baseline characteristics of a randomized control trial of the MIND diet on cognitive decline. Contemporary clinical trials. 2021 Mar 1;102:106270. Disclosure: several corporations generously donated mixed nuts (International Tree Nut Council Nutrition Research and Education Foundation), peanut butter (The Peanut Institute), extra virgin olive oil (Innoliva-ADM Capital Europe LLP), and blueberries (U.S. Highbush Blueberry Council). These items will be distributed to those participants who are randomized to the MIND diet arm.
Barnes LL, Dhana K, Liu X, Carey VJ, Ventrelle J, Johnson K, Hollings CS, Bishop L, Laranjo N, Stubbs BJ, Reilly X. Trial of the MIND Diet for Prevention of Cognitive Decline in Older Persons. New England Journal of Medicine. 2023 Jul 18.
Boumenna T, Scott TM, Lee JS, Zhang X, Kriebel D, Tucker KL, Palacios N. MIND diet and cognitive function in Puerto Rican older adults. The Journals of Gerontology: Series A. 2022 Mar;77(3):605-13.
Last reviewed August 2023
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