The MIND diet is associated with reduced risk of cognitive decline and Alzheimer's disease. Following the MIND diet was linked to 53% reduced risk of developing Alzheimer's compared to other diets. Even moderate adherence to the MIND diet was associated with slower cognitive decline and neuroprotection. The MIND diet emphasizes berries, green leafy vegetables, nuts, beans, whole grains and fish and appears to be more effective for brain health than the DASH and Mediterranean diets.

1. MIND Diet and Dementia Prevention
Martha Clare Morris, Sc.D.
Director, Section on Nutrition and Nutritional Epidemiology,
Rush University Medical Center
Alzheimer Scotland Annual Conference, June 2, 2017
Edinburgh, Scotland

2. Summary: Nutrition for a Healthy Brain
NUTRIENT FOOD SOURCES
Evidence Strong
Dietary tocopherols – low deleterious Nuts, oils, seeds, green leafy vegetables,
whole grains
DHA – low deleterious Fish – 1 meal /week
Folate – low deleterious Vegetables, whole grains
Saturate Fat –high deleterious
U/S Fats – high beneficial
Commercial products, baked goods, red
meats, high fat dairy
Moderate / Limited Evidence
Carotenoids (β-carotene, luteine,
lycopene)
Green leafy vegetables, bright colored
fruit, vegetables
Flavonoids Berries
Vitamin D Fish, dairy
Trans fats Commercial products, baked goods
Monounsaturated fat Olive oil
Polyphenols Olive oil, red wine, teas, vegs, fruits

3. DASH Mediterranean MIND
Total Grains 42+/wk Nonrefined Grains >32/wk Whole Grains >28/wk
Vegetables 28+/wk
Vegetables >33/wk
Potatoes >18/wk
Green Leafy 7+/wk
Other Vegetables 14+/wk
Fruits 28+/wk
Fruits >22/wk Berries (1/2 c /d)
Dairy ≥14/wk
Full-fat Dairy .≤10/wk
Regular Cheese ≤1/d
Butter <1T/d
Nuts, seeds & legumes ≥4/wk Legumes, nuts & beans >6/wk
Beans 3+/wk
Nuts 1/8 c/d
Lean meat, poultry fish ≤6/wk
Red meat ≤ 1/wk
Fish >6/wk
Poultry ≤3/wk
Lean Red Meats <4/wk
Fish 1+/wk
Poultry 2+/wk
Total Fat ≤ 27% of kcal
Saturated Fat ≤ 6% of kcal
Sweets ≤ 5/wk Commercial Pastries, sweets <5/wk
Sodium ≤ 2400mg/d Olive oil 3-4 T/d Olive Oil>1 T/d
Alcohol < 300mL/d but >0 Alcohol/wine 1/d

4. Mediterranean-DASH Intervention for Neurodegenerative Delay
MIND
Component
0
0.5
1
Green Leafy
Vegetables
≤2 servings/wk > 2 to <6/wk 6+ servings/wk
Other Vegetables <5 serving/wk 5 - <7 wk 7+ servings/wk
Berries <1 serving/wk 1 /wk 2+ servings/wk
Nuts <1/mo 1/mo - <5/wk 5+ servings/wk
Olive Oil Not primary oil Primary oil used
Butter, Cream >2 servings/d 1-2 /d <1 serving/d
Regular Cheese 7+ servings/wk 1-6 /wk < 1 serving/wk
Whole Grains <1 serving/d 1-2 /d 3+ servings/d
Fish (not fried, not
shell)
Rarely 1-3 /mo 1+ meals/wk
Beans <1 meal/wk 1-3/wk >3 meals/wk
Poultry (not fried) <1 meal/wk 1 /wk 2+ meals/wk
Red Meat 7+ meals/wk 4-6 /wk < 4 meals/wk
Fast Foods 4+ times/wk 1-3 /wk <1 time/wk
Pastries & Sweets 7+ servings/wk 5 -6 /wk <5 servings/wk
Wine >1 glass/d or never 1/mo – 6/wk 1 glass/d

5. MAP NUTRITION STUDY
• Food Frequency Questionnaires
– 144 food items
– 2004 to present
– Self-administered at yearly evaluations
– 75 % to 80% response
– Validated in biracial sample of Chicago community
residents 65+ years old

7. Bennett DA, et al. Neuroepidemiology. 2005;25:163–175.
MAP STUDY DESIGN

8. MAP NUTRITION ANALYTIC SAMPLES
• Cognitive Decline:
– 994 with baseline FFQ and 2 cognitive
assessments; mean of 4.5 years follow-up; range
2-10 years
– Mixed effects models
• Incident AD
– 923 with FFQ and free of dementia at baseline
– 114 incident AD cases
– Proportional Hazard Models

9. MIND Diet Score and Cognitive Decline
-0.7
-0.6
-0.5
-0.4
-0.3
-0.2
-0.1
0
0.1
0.2
0.3
0 1 2 3 4 5 6 7 8 9 10
GlobalCognivtiveScore
Years on study
Mindscore_tertile1
Mindscore_tertile2
Mindscore_tertile3
Adjusted for age, sex, education, participation in cognitive activities,
energy intake

10. MIND Diet Score and Global Cognitive Change
MIND
Score
Age-
Adjusted
Basic-
Adjusted*
Basic *+
CVD
Beta
0.0090 0.0095 0.0095
SE (0.0023) (0.0023) (0.0023)
P-value 0.0001 <0.0001 <0.0001
*Age, sex, education, participation in cognitive activities, APOE-ε4,
smoking history, physical activity hours per week, total energy intake

11. Comparison to MedDi and DASH
Standardized Betas For Diet Pattern Effects on Decline
in Global Score
MIND MedDi DASH
β/SE* 4.4 2.44 2.76
P-Value 0.003 0.01 0.02
*Adjusted for age, sex, education, cognitive activities, caloric intake

12. MIND Diet Score and Cognitive Domains
Episodic
Memory
Semantic
Memory
Perceptual
Organization
Perceptual
Speed
Working
Memory
Beta 0.0080 0.0105 0.0077 0.0084 0.0050
P-
value
0.004 0.0001 0.002 0.0003 0.04
† Adjusted for age, sex, education, participation in cognitive activities, APOE-ε4,
smoking history, physical activity hours per week, total energy intake

13. MIND Diet and Incident AD
Tertile 1 Tertile 2 Tertile 3
MIND Score
HR 1.0 0.65* 0.47*
95% CI (referent) (0.44, 0.98) (0.26, 0.76)
DASH
HR 1.0
0.98 0.61*
95% CI (referent)
(0.66, 1.46) (0.38,0.97)
Mediterranean
HR 1.0
0.81 0.46*
95% CI (referent)
(0.54, 1.24) (0.27, 0.79)
Adjusted for age, sex, education, cognitive activities, physical activity, calories

14. MIND Diet and Incident AD with CVD Factors
MODELS HR for Linear
MIND Score
P-value
Basic Model* 0.84 0.004
+ Physical Activity, Smoking 0.85 0.008
+ Stroke, MI, Diabetes, Hypertension 0.85 0.007
+ BMI<20, BMI>30, depressive symptoms 0.86 0.01
Basic Model – deleting cases within 2 years 0.84 0.008
*Adjusted for age, sex, education, cognitive activities, calories

15. MIND Diet, Mortality, Disability & Motor
Decline
MODELS MIND Score
HR
DASH
HR
MedDiet
HR
Death (n=234) 0.92* 0.89* 0.97*
Help with ADL (n=192) 0.90** 0.89* 0.97
Parkinsonism (top 10%) 0.88** 0.88 0.88
Bradykinesia (top 10%) 0.89** 0.88* 0.97
Gait, top 25% (n=152) 0.89** 0.89* 0.96*
Tremor (n=126) 0.83 0.86* 0.98
Rigidity (n=60) 0.85* 0.84 0.94*
Adjusted for age and sex

16. CONCLUSION
• MIND diet associated with 53% reduced risk of
developing Alzheimer’s disease
– Slower decline in cognitive abilities
• Even moderate scores on the MIND diet were
associated with neuroprotection
• MIND diet appears to be more
neuroprotective than DASH and
Mediterranean diets