October brain health tip: Diet

• There is good evidence that following what is known as the MIND diet (Mediterranean-DASH Intervention for Neurological Delay) may reduce the risk of cognitive impairment and slow cognitive decline.
• This is a combination of two approaches – the well-known term “Mediterranean Diet” and the less well-known DASH diet (Dietary Approaches to Stop Hypertension).
• Brain health diets are also heart-healthy diets and will protect against stroke, diabetes and many cancers as well.
• Brain health diets have also been shown to be helpful when they are embedded in a general programme of healthy living including exercise and cognitive stimulation. An international research collaboration called the FINGERS initiative has shown that a combination of healthy lifestyle changes can reduce the risk of cognitive decline among older people.  You may want to check out our other tips on our March page on healthy weight, our June page on glucose control, and our August page on alcohol 

Some of the key concepts are:

• Consume an abundance fruits (including berry fruit) and vegetables (especially seasonal leafy greens as well as legumes such as beans, chickpeas, and lentils), and try to “eat the rainbow”, paying attention to having as many brightly coloured fruit and vegetables each week as possible. The fresher these ingredients are, with the least cooking (raw is best, steamed, baked or lightly microwaved next best, and boiled last). Overall, the component of each main meal made up of these ingredients can be increased.
• Use whole grains rather than processed grain products, for example barley, brown and wild rice, bulghur wheat, oatmeal, as well as whole-wheat bread, wraps, pasta and crackers (and popcorn!). Another alternative to commonly used refined grains is to use legumes such as chickpeas, lentils, or canned beans. Overall, the component of each main meal made up of “traditional carbs” such as potatoes or refined grain products can be decreased.
• Use olive oil preferentially to other oils or cooking fats, and not sparingly! Use of other fats in our weekly diets can be reduced.
• Incorporate nuts and seeds in your weekly diet, but perhaps not so many peanuts compared with the others. Along with fruit and vegetables, nuts and seeds make great snacks.
• In terms of protein, eat foods such as chicken, fish and eggs a few times each week, with red meat and processed meats being used much less often than would be usual for a traditional New Zealand diet. Overall, the component of each main meal made up of protein can be reduced.
• The addition of herbs and spices such as turmeric is also recommended as they are often rich in antioxidants may help protect brain cells from oxidation. On the other hand, use less salt.
• Reduce the amount of sugars in our diets each week, especially via flavoured drinks and high-energy snacks (unless trying to encourage weight gain).

• Some great meal ideas provided by the Heart Foundation is a good place to start. https://www.heartfoundation.org.nz/about-us/news/blogs/what-is-the-mediterranean-diet
• The trick is not to go on some kind of diet fad, but to think about one or two ways your current diet could be nudged in a better direction that you would enjoy, without costing more money or taking up too much time. Then next year, nudge your diet further along the health eating track. After all, we are what we eat!
• What about these dietary ideas for people already living with dementia? Most of the evidence refers to preventing cognitive impairment from developing, but since all these ideas are good for us for many reasons, and because preventing heart disease and stroke is important whether we have dementia or not, many clinicians recommend this kind of diet for people with dementia as well as a good brain and general health strategy.

• Numerous dietary compounds that can be found in fruits, vegetables, spices, wine, tea, and chocolate (for example) have many anti-inflammatory and antioxidant components that might be helpful for preventing or treating cognitive impairment. Many are also available as supplements such as fish oils, turmeric, Goji berries, vitamins of various kinds, and so on. 
• While the scientific evidence is promising in some respects, it is not currently strong enough to recommend starting any particular food supplement, and a healthy diet gives far greater benefits. 
• Current evidence supports investing in altering your diet to be based on more healthy choices rather than paying for expensive supplements.
• Food as a whole is more than the sum of its constituent nutrients. The matrix of food has a positive influence on digestion and absorption, which may be why the outcomes of clinical trials with different antioxidants have demonstrated no or minimal effects – and very occasionally, harms (such as from some trials of Vitamin E). 
• Most health supplements are not know to cause harm, but the only benefit might be that you make very expensive and exclusive urine!
• Sometimes people may not be able to eat a full range of a healthy diet, and a health professional may recommend a supplement.
• A special topic is the cognitive impairment supplement Souvenaid™. This is available in New Zealand from pharmacies and there are some data to support its use by some people with mild cognitive impairment to prevent them progressing to a dementia diagnosis. This information is still judged to be preliminary by most clinicians and using this treatment option is not currently on any international recommendations for dementia prevention or for people who already live with dementia.