Rush University Medical Center dates back to March 2, 1837, when Rush Medical College received its charter. The college is named for Benjamin Rush, a signer of the Declaration of Independence and a Pennsylvania physician, who counted George Washington among his patients. He became a medical and humanitarian leader after the Revolutionary War. He was also a social activist, a prominent advocate for the abolition of slavery, for scientific education for the masses— including women—and for public medical clinics to treat the poor.
The Mind Diet, created by researchers at Rush University Medical Center, may help substantially slow cognitive decline in stroke survivors, according to preliminary research presented on Jan. 25 at the American Stroke Association's International Stroke Conference 2018 in Los Angeles. The findings are significant because stroke survivors are twice as likely to develop dementia compared to the general population.
"The foods that promote brain health, including vegetables, berries, fish and olive oil, are included in the MIND diet," said Dr. Laurel J. Cherian, a vascular neurologist and assistant professor in Rush's Department of Neurological Sciences. "We found that it has the potential to help slow cognitive decline in stroke survivors." Cherian is the lead author of the study, which was funded by the National Institute of Aging. "I was really intrigued by the results of a previous MIND study, which showed that the people who were most highly adherent to the MIND diet cognitively functioned as if they were 7.5 years younger than the least adherent group," Cherian said. "It made me wonder if those findings would hold true for stroke survivors, who are twice as likely to develop dementia compared to the general population." "The Mediterranean and DASH diets have been shown to be protective against coronary artery disease and stroke, but it seems the nutrients emphasized in the MIND diet may be better suited to overall brain health and preserving cognition." Cherian said that studies have found that folate, vitamin E, omega-3 fatty acids, carotenoids and flavonoids are associated with slower rates of cognitive decline, while substances such as saturated and hydrogenated fats have been associated with dementia. "I like to think of the MIND diet as a way to supercharge the nutritional content of what we eat. The goal is to emphasize foods that will not only lower our risk of heart attacks and stroke, but make our brains as resilient as possible to cognitive decline.” Cherian cautions, however, that the study was observational, with a relatively small number of participants, and its findings cannot be interpreted in a cause-and-effect relationship.
Study co-author Martha Clare Morris, ScD, a Rush nutritional epidemiologist, and her colleagues developed the MIND diet based on information from years of research about what foods and nutrients have good, and bad, effects on the functioning of the brain. The diet has been associated with reduced Alzheimer's risk in seniors who adhered to its recommendations. Even people who moderately adhered had reduced risk of AD and cognitive decline.
Rush, in Chicago, is currently seeking volunteers to participate in the study, which aims to show whether a specific diet can prevent cognitive decline and brain changes with age. From 2004 to 2017, Cherian and colleagues studied 106 participants of the Rush Memory and Aging Project who had a history of stroke for cognitive decline, including decline in one's ability to think, reason and remember. They assessed people in the study every year until their deaths or the study's conclusion, for an average of 5.9 years, and monitored patients' eating habits using food journals.
The researchers grouped participants into those who were highly adherent to the MIND diet, moderately adherent and least adherent. They also looked at additional factors that are known to affect cognitive performance, including age, gender, education level, participation in cognitively stimulating activities, physical activity, smoking and genetics. The study participants whose diets scored highest on the MIND diet score had substantially slower rate of cognitive decline than those who scored lowest. The estimated effect of the diet remained strong even after taking into account participants' level of education and participation in cognitive and physical activities. In contrast to the results of slower decline with higher MIND diet score, stroke survivors who scored high on the Mediterranean and DASH diets, did not have significant slowing in their cognitive abilities. "This is a preliminary study that will hopefully be confirmed by other studies, including a randomized diet intervention study instroke survivors," say the authors. "For now, I think there is enough information to encourage stroke patients to view food as an important tool to optimize their brain health."
The MIND diet has 15 dietary components, including 10 "brain-healthy food groups" and five unhealthy groups.
Foods to enjoy include
1) green leafy vegetables – 2 cups raw or one cup cooked, daily.
2) Berries – at least 2 cups a week. Bananas count as a berry.
3) Vegetables and fruit – at least one serving daily -2 cups raw vegetables or one cup cooked, one cup fresh fruit or ½ cup dried. An apple equals one cup.
4) Nuts - almonds, pecans, walnuts et al. 1-2 ounces at least 3 times a week
5) Whole grains – 3 servings a day. Oats, quinoa, spelt, rye, brown rice, whole grain pasta, buckwheat, 100% whole grain bread.
6) Seafood – at least one serving a week of salmon, sardines, trout or other seafood you enjoy. 4-6 ounces.
7) Beans – a serving every other day – fresh or cooked. Wash canned beans to eliminate extra salt. Unsweetened non-dairy milk: soy, almond, cashew or rice milk.
8) Poultry – at least 2 four ounce servings a week, skin removed. Poultry provides protein and vitamin B12, iron and zinc, important for cognitive health.
9) Olive Oil – Use as primary oil for cooking and for salads and cooked vegetables. Olive oil has many anti-oxidant and anti-inflammatory properties. Use low to moderate heat when cooking with olive oil. Grapeseed oil is also good for cooking and can be used at higher heat.
10) Wine – one 5 ounce serving of wine – containing alcohol or not. Wine has micronutrients such as resveratrol that help prevent degenerative diseases. Red or purple grape juice may have same effects of wine on health – to be verified.
The diet also specifies limiting intake of the designated unhealthy foods
1) Red meat – beef, lamb, pork and duck – limit intake to 3 ounces less than 4 times per week. Look for lean, organic an/or grass fed options. Avoid all cured and processed meats.
2) Pastries and Sweets – less than 5 servings a week – such as one small cookie. Try to enjoy whole fruit instead.
3) Butter and stick margarine – Avoid any fat that is solid at room temperature, including palm oil, coconut oil and other shortenings. No hydrogenated oil. Limit butter to less than 1 ½ teaspoons daily.
4) Full-fat cheese – limit to 1.5 ounces, less than once a week. Try low or no fat options, or vegan cheese.
5) Fried or fast food – limit to one small serving of fries twice a month at most.
Greenwood’s addenda: 1) Studies from Oxford University and elsewhere have shown that levels of vitamin B12 decrease with age and low levels can affect leaning and memory adversely. B12 is only found in animal food. Supplements are advisable in vegans and older people. 50 micrograms a day should suffice.
2) Alcohol use disorders are the most important preventable risk factors for the onset of all types of dementia, especially early-onset dementia, according to a nationwide observational study of over one million adults diagnosed with dementia in France. Red or purple grape juice my have the same effects as wine on health – to be verified.
3 ) A cookbook based on the Mind Diet by Kristin Diversi is published by Ulysses Press: The Mind Diet Cookbook
Sadja Greenwood, MD, MPH Past issues at sadjascolumns.blogspot.com