The “Mind Diet” Reduces the Risk Of Alzheimer’s Dementia. Might It Also Help the Brain Fog Found With Fibromyalgia or Chronic Fatigue Syndrome?

By Richard Podell, M.D., MPH
For more decades than I can count an army of dietary fads all claim they can improve our health. But, almost all these claims are based on anecdotes. They lack scientific studies to prove that they really work. Fortunately, that’s changing. Controlled studies of diet and health are starting to be done.

The best research so far has focused on the “Mediterranean Diet” as a preventive treatment for heart disease and stroke. (1)

Researchers recruited more than 7000 Spanish men and women who were at high risk for heart disease or stroke.  Using a random decision tree, each person was assigned to follow either a “Mediterranean” style diet plan (high in unsaturated fats such as olive oil or nuts, high in fruits, vegetables and whole grains, but low in saturated fat) or a “control” diet. The control diet was a standard low fat diet, such as the American Heart Association might advise.
After 5 years, those on the Mediterranean Diet had 30% fewer cardiovascular events (heart attacks, strokes) compared to those on a low fat diet. Statistically, the advantage of the Mediterranean Diet was highly significant.

Two points are especially encouraging. The Mediterranean Diet was practical. Most people stayed on it for more than 5 years.  As importantly, just five years was long enough to reduce the incidence cardiovascular events by 30%.  It did not take a life-time.

The Mediterranean Diet might also delay or prevent the onset of Alzheimer’s dementia.

About six years after beginning the Mediterranean Diet versus Low Fat Diet study, the Spanish researchers selected 522 persons from within the main study and put them through neuro-cognitive testing. (2) Since these persons had been assigned to different diets at random, if formal cognitive tests had been done at the start of the study, in theory the initial scores for the two groups should have been roughly equal. But, after six years in the study the Mediterranean Diet group scored significantly higher on the cognitive tests compared to those in the Low Fat arm of the study.

The differences favoring the Mediterranean Diet group remained after adjusting for risk factors that are believed to affect cognition–including age, sex, education, ApoE genotype, family history of dementia, smoking, physical activity, body mass index, high blood pressure, high cholesterol, and diabetes.

Therefore, the higher cognitive test scores after six years suggests that the Mediterranean Diet, not only prevents heart attacks and stroke, but also helps maintain cognitive skills.

In 2015 Valls-Pedret and a Mediterranean Diet study group provided further support for the cognitive benefit of the Mediterranean Diet. Before assigning 447 healthy 60 + year old Spanish volunteers to a Mediterranean Diet versus a Low Fat Diet, they obtained baseline cognitive test scores. After 4.1 years cognitive test and memory scores were higher for the Mediterranean Diet group (3)

So, what has this to do with the brain fog of fibromyalgia or chronic fatigue syndrome? We can’t answer this question yet. But, I hope readers will be encouraged by the fact that a relatively simple dietary change probably can block a different form of “untreatable” cognitive decay—even if that cause might have nothing in common with FM or CFS.

Martha Morris, Ph.D. and her research team at Chicago’s Rush University Medical Center may be the world’s leading experts studying cognitive decline due to aging and or Alzheimer’s.

Dr.  Morris modified the Mediterranean diet to take into account other research on dementia. She named this the MIND DIET. (4) (See table 1 below.)

Dr. Morris and her colleagues enrolled 923 Chicago men and women, age 58 to 98. None had Alzheimer’s at the start of the study. At baseline dieticians analyzed each person’s current eating pattern to compare it with the key principles of the MIND DIET. These principles are shown below on table 1.

Over the next 4.5 years 144 of 923 (16%) of those in Dr. Morris’ study were diagnosed with Alzheimer’s.  Participants whose Mind DIET scores were initially in the top third were only 47% as likely to develop Alzheimer’s compared to those in the bottom third. This difference was highly significant statistically (P=.0006). Those in the middle third did better than those in the lowest third, but not as well as those in the upper third.

The Mediterranean Diet pattern also predicted a low Alzheimer’s rate, almost but not quite as well as did the MIND DIET adherence score.

A strength of Dr. Morris’ study was that the statistical analysis controlled for life style behaviors, illnesses and genetic risks for Alzheimer’s. The study’s main limitation is that the researchers did not actively assign subjects to each diet. They simply scored how closely each subject’s self-chosen diet compared to the MIND DIET ideal.  So, we can’t be sure whether high adherence to the MIND diet caused the lower rate of Alzheimer’s or whether other factors might have been at work.    

In a separate paper Dr. Morris group calculated that better adherence to a MIND DIET style of eating was associated with slower decline in global cognitive score over-all ( P < .0001). The difference in cognitive skills between the top third on the MIND DIET scores and those in the bottom third was the equivalent of the top third being “7.5 years younger in age” compared to the bottom third—although chronologically in fact their average age was the same. (5)

The MIND diet contains 15 separate elements. These are listed in the table below:

Table 1—MIND DIET SCORING (15=perfect adherence to MIND DIET principles. 0=no adherence at all. Average Score for top third of patients=9.6 (range:8.5-12.5); middle third=7.5 (range: 7-8) bottom third=5.6 (range 2.5-6.5)
MIND DIET COMPONENTS One Point scored for each component
Eat Whole Grain foods 3 times a day 1 point
Eat Green leafy vegetables 6 times each week 1 point
Eat an additional vegetable once a day 1 point
Eat berries twice a week 1 point
Eat red meat products less than 4 times a week 1 point
Eat Fish at least once a week 1 point
Eat poultry twice a week 1 point
Eat beans 3 times a week 1 point
Eat nuts 5 times a week 1 point
Eat fried foods less than once a week 1 point
Eat butter or margarine less than once a day 1 point
Eat cheese less than once a week 1 point
Eat Pastries, or sweets less than 5 times a week 1 point
Drink alcohol or wine one serving per day 1 point
The Bottom Line: This study adds to the growing evidence that relatively simple changes in diet such as eating lots of green leafy vegetables and reducing saturated fat have a fairly prompt, fairly powerful effect on reducing the risk of cognitive decline due to Alzheimer’s Disease.

So, which diet should we follow if our “brain fog” symptoms are due to Fibromyalgia or Chronic Fatigue Syndrome? At this time, we have no easy answer. Ideally, someone would fund a study where several hundred people with CFS or Fibromyalgia would take a cognitive test, then go on either the MIND DIET or their usual way of eating.

But, things being as they are, that kind of funding isn’t likely to appear. Next best: if people who voluntarily adopt the MIND DIET or the Mediterranean Diet on their own would email to report on their progress. Favorable self-reports might create enough wind to shake someone’s money tree.

For those interested in trying the MIND DIET it might be best to aim for a score of 12 on the MIND DIET index. (See table 1.)  For those interested in the Mediterranean Diet, consider a book by Nick Nigro and Bay Ewald, Living the Mediterranean Diet: Proven Principles and Modern Recipes for Staying Healthy.  

Richard Podell, M.D., MPH,
(1) Ramón Estruch, M.D. et. al. for the PREDIMED Study Investigators, Primary Prevention of Cardiovascular Disease with a Mediterranean Diet N Engl J Med 2013; 368:1279-1290 April 4, 2013DOI: 10.1056/NEJMoa1200303. Link to this article here.

(2) Martinez-Lapiseina, et al. Mediterranean diet improves cognition: the PREMIDED_NAVARRA randomized trial. J Neurol Neurosurg Psychiatry 2013:84: 1318-25. Link to abstract here.

(3) Valls-Pedret, C et al. Mediterranean Diet and Age-Related Cognitive Decline: A Randomized Clinical Trial, JAMA Intern Med 2015;175(7): 1094-1-3 Link to abstract here

(4) Morris, M et al. MIND diet associated with reduced incidence of Alzheimer’s disease, Alzheimer’s & Dementia, (2015) 1-
Link to abstract here.

(5) Morris, M, et. al MIND diet slows cognitive decline with aging. Alzheimer’s &Dementia, 2015 Jun 15. pii: S1552-5260(15)00194-6. doi: 10.1016/j.jalz.2015.04.011. [Epub ahead of print]. Link to abstract here

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4 thoughts on “The “Mind Diet” Reduces the Risk Of Alzheimer’s Dementia. Might It Also Help the Brain Fog Found With Fibromyalgia or Chronic Fatigue Syndrome?”

  1. MindDiet says:

    Excellent article. The list of items is very helpful, but you’ve only got 14 items when you say there are 15. Wondering if you can identify the 15th, please? I know olive oil is one of the recommended items, so perhaps that’s it?

  2. GeekyGranny says:

    I’ve been vegan for 20 years and am healthier for it. No triglycerides issues, blood pressure issues, cholesterol all good.

    I think I have less pain because of it too and my mind is a wee bit sharper.

    Our digestive system is herbivore. We cannot process animal flesh and other products from animals. It is not natural. So I totally disagree with his recommendation.

    Plus the “production” of processing animal products harms the environment with waste of water, poisoning of our air and waters, wasting natural resources, and worst is the CHEMICALS they use to process all this crap.

  3. bah125 says:

    I have tried many times to achieve improvement in my CFS symptoms through diet. Several months ago, I figured I would bite the bullet and convert to a Mediterranean diet, but although I ate only whole grains, I had incredible cravings for refined carbs. I also found that I couldn’t think very well, and not connecting it to my diet (since I was supposedly on the healthiest diet), I was concerned that it might be an indicator of early dementia. Tired of the cravings, I converted to a modified Atkins, and I feel so much better — more energy, less confusion. By “modified,” I mean that I eat a lot of fish, a fair amount of lean red meat and poultry, green vegetables every day, blueberries, walnuts, plain Greek yogurt, and a tbsp of psyllium seed. I don’t eat pasta — not even whole wheat or brown rice or quinoa — and I don’t eat bread. Potatoes are not on the menu. I eat turnips, an occasional carrot, squash, peppers, cucumbers, tomatoes, etc. I think eating something like chicken livers or other organ meats might be essential, so I’m going to start doing that too. I don’t eat much of the cheese that most Atkins people seem to depend on. Instead of drinking alcohol, I drink Kombucha every night, and have an Atkins bar for dessert.

  4. Sandy10m says:

    I have ME/CFS, Fibro, migraines, low thyroid, IBS, essentially a bunch of problems. Brain fog was my biggest problem, other than the fatigue. Then I read the book “Grain Brain” by Dr. Perlmutter. What he suggests is that we should eat a high-fat Caveman/Paleo diet. This means eliminate ALL grains and carbs (potatoes included) and replace the calories with as much good fat as your body wants. No dieting, no counting calories, just swap out grains/carbs for fats. I have been eating this way for over 1.5 years, and my brain fog is much better. AND, one big surprise was that I was able to lose the last 30 pounds of weight that the low thyroid had put on me. My normal weight is probably 135 for my age, but I was 198! I tried so many other things to lose the weight, but I was stuck at 168. Now I am 135. I think my body is still trying to lose a little more of the weight, which would be amazing because my high school weight was 130. I am 51 years old, and I’m sure many of us would love to be at our high school weight again. I dare you to try this diet for 2 weeks and see what happens. Eat a normal amount of meat (the typical deck of cards size) once per day. Eat lots of veggies with plenty of fat (butter is okay). Eggs and coconut oil are your best friends. Your brain is made up of roughly 50% cholesterol and fats, so why would you starve your body of these things? Oh, and I know you are thinking, but what is her cholesterol level? It dropped from 220 to 140. My doctor and I are actually worried that my level is TOO LOW now. I am not taking any statins, nor would I EVER take any statins. Because blood cholesterol has almost nothing to do with heart disease and stroke. If we stop eating the grains, our bodies are much happier, and everything starts to return to “normal”. I hope this helps someone.

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