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Comparing the MIND and Mediterranean Diets by Christina Badaracco, MPH, RD

As the U.S. is experiencing a rise in cases of dementia and resulting mortality, researchers are increasingly focused on effective means of reducing modifiable risk factors. I first learned about the MIND diet (or "Mediterranean-DASH Intervention for Neurodegenerative Delay") while participating in a journal club meeting during the outpatient rotation of my dietetic internship at Massachusetts General Hospital. We were discussing an article about this newly defined dietary pattern. I was fascinated to learn about and consider the implications of applying this pattern linked so strongly to brain health to our patient care. Over the last several years, dietitians and some physicians have increasingly recommended the diet to improve brain health and reduce the risk of mental decline. Though similar to the Mediterranean diet—the most well-known dietary intervention proven to lead to health benefits—in many ways, it offers more specific guidelines about the foods that should—and should not—be eaten. So how should patients and consumers decide which is best for them?

What is included in the Mediterranean diet?

This dietary pattern is surely not new to our readers. The Mediterranean diet is based on what has traditionally been eaten by populations living around the Mediterranean basin. The diet incorporates several key components:

  • Whole, unprocessed foods

  • Relatively high percentage of calories (up to 40%) coming from healthy fats—especially olive oil

  • Frequent intake of fish, legumes, fruits and vegetables

  • Moderate alcohol intake

  • Minimal red/processed meat, saturated fat and added sugars

  • Positive lifestyle behaviors, such as low stress

Consuming anti-inflammatory foods devoid of preservatives and full of protective polyphenols (such as the anti-inflammatory oleocanthal found in olive oil) and following the diet's general lifestyle recommendations have yielded similar benefits for health in populations around the globe. Further, the Mediterranean diet's principles can be adapted to diverse cultures based on their preferences and food availability.


What is included in the MIND diet?

The MIND diet combines the Mediterranean diet with another prominent dietary pattern, the DASH (or Dietary Approach to Stop Hypertension) diet. DASH is similar in many ways to the Mediterranean diet, but it places more emphasis on fat-free or low-fat dairy and meat products and includes more whole grains. Components of each diet were selected based on their benefits to brain health. The MIND diet focuses closely on 10 groups of foods that ought to be maximized to yield the proven impact on brain health. Key components of the diet include:

  • Ten foods—including berries, leafy green vegetables, other vegetables, olive oil, whole grains, fish, wine, poultry, beans and nuts—that should be consumed daily

  • Seafood intake providing rich sources of omega-3s and zinc (such as sardines and oysters, respectively)

  • Minimal amounts of five pro-inflammatory foods—butter and margarine, cheese, red meat, fried food and sweets

Unlike the Mediterranean diet, the MIND diet doesn't explicitly recommend servings of fruit and potatoes each day, includes no recommendation for dairy and places less priority on poultry and red meat. And it doesn't restrict fat and sodium as the DASH diet does.


Of note, while moderate wine consumption has been shown to benefit the brain, it begins to cause harm in a dose-response manner above about one drink per day. To reduce the risk of conditions such as dementia and liver disease, wine should not be consumed in large volumes. Finally, because the foods included in this pattern are also beneficial for other aspects of the body's physiology, the diet can be expected to improve heart health, blood glucose control, etc., thereby reducing the risk of other chronic diseases.

What evidence exists for the benefits of these diets?

The Mediterranean diet consistently ranks among the healthiest dietary patterns and is ranked #1 in "Best Diets Overall" by US News and World Report. It carries with it extensive evidence for good health, including for both primary and secondary prevention of cardiovascular disease, longevity and other endpoints. In addition, the largest randomized control trial to date, known as PREDIMED (or "Prevención con Dieta Mediterránea"), has shown even more benefits, such as prevention of cognitive decline and breast cancer.


The primary food groups included in the MIND diet are rich in polyphenols (defensive compounds found in plants that yield health benefits when consumed) that reduce oxidative stress and inflammation. Researchers have also recently learned that polyphenols are important for supporting a healthy and diverse microbiota, which is linked to the health of our brains and essentially all other parts of the body. This suggests another pathway for the MIND diet to benefit the brain.


The first publications describing the diet and showing benefits for cognition were published by Morris et al. in 2015. In this paper, the MIND diet score was linearly and statistically significantly associated with a lower risk of developing Alzheimer's disease—independently of other healthy lifestyle behaviors and cardiovascular-related conditions. More specifically, results from a 4.5-year study showed that the risk of Alzheimer's disease fell by up to 53% among participants who followed the MIND diet rigorously and by 35% among those who followed it moderately.

How can I incorporate the MIND diet into my lifestyle?

  • Consider adopting the MIND dietary pattern if you have concerns about your risk for cognitive decline—either based on family history or known genetic risk factors. Fill your refrigerator, freezer and pantry with leafy greens, berries, whole grains and nuts. While you may still include other items in your diet on occasion, try to include these specific items at least once per day.

  • Note that both of these dietary patterns exclude ultra-processed foods, instead prioritizing whole, minimally processed foods and seasonings.

  • Though the MIND diet doesn't explicitly mention stress reduction, sleep quality and regular physical activity, these are all known lifestyle factors that promote good brain health—try to incorporate them into your daily life, as well.

  • Talk with your doctor and/or dietitian about which dietary plan best aligns with your goals. Both of these diets are beneficial and far better than the standard American diet.

Resources


Christina Badaracco, MPH, RD

Christina is a registered dietitian and author who aims to improve access to healthy and sustainable food and educate Americans about the connections between food and health. She loves to experiment with healthy recipes in the kitchen and share her creations to inspire others to cook.


Christina completed her dietetic internship at Massachusetts General Hospital and earned her Master of Public Health degree from the University of California, Berkeley. Previously, she graduated with a degree in Ecology and Evolutionary Biology from Princeton University, after conducting her thesis on sustainable agriculture and energy in Kenya. She has done clinical nutrition research at the National Institutes of Health, menu planning and nutrition education at the Oakland Unified School District and communications at the Environmental Protection Agency’s Office of Water. She has also enjoyed contributing to children’s gardens, farmers’ markets and a number of organic farms.


cbadarac@gmail.com

www.linkedin.com/in/christina-badaracco/

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