What is the Best Diet for Brain Health?

by Amylee Amos PhD, RDN, IFMCPNutrition
Foods in the shape of a brain

Alzheimer’s disease is the 3rd leading cause of death in the United States (1). Fear over developing Alzheimer’s disease and cognitive decline can feel debilitating. If you have watched a loved one suffer from neurodegenerative disease or have increased genetic risk, this fear is further exacerbated. However the scientific literature now reflects that many neurodegenerative diseases including Alzheimer’s are highly influenced by our environment. Our environment, including our diet and lifestyle, has the greatest impact on our risk of cognitive decline. Nutrition is perhaps our greatest point of leverage when it comes to making a robust impact on our disease risk. So the question becomes, what is the best diet for brain health? Below are the best diets for brain health, depending on your genetic risk and your current health status. 

What are the worst diets for brain health?

Without a doubt, the worst diet for brain health is the standard American, or western diet. The western diet is loaded with saturated fat, sugar, salt, refined carbohydrates, and heavily processed foods. These foods drive the disease process. With regard to the brain, the connection between the western diet and neurodegeneration is well established (2). The western diet contributes to neurodegenerative disease through multiple mechanisms, including by creating an inflammatory internal environment, by encouraging dysbiosis in the gut microbiome, and by resulting in overactivation of the immune system. These and other mechanisms are how consuming a western diet increases the risk of developing neurodegenerative diseases such as Alzheimer’s. 

What are the best diets for brain health?

There are many diets that have been well studied for their effect on brain health and cognition. Which of the diets you choose to implement should depend on several factors, including your current health, your genetic risk, and your ability to implement the nutritional components of each diet. Thus, the question should be ‘what is the best diet for you to optimize brain health?’ Here are the best diets for brain health and some of the considerations when identifying the best diet for you. 

The Mediterranean Diet

The Mediterranean diet is perhaps one of the most well known diets. The Mediterranean diet consists of primarily whole, minimally processed foods. It is rich in extra virgin olive oil, unrefined grains, legumes, vegetables, fish, nuts, and seeds. It includes moderate consumption of unsweetened yogurt, cheese, and wine. Small amounts of meat, meat products, and eggs can be included. Sugar and highly processed foods are consumed rarely, if at all. The Mediterranean diet has been extensively studied for its disease fighting benefits. It has been shown to be protective against cardiovascular disease, cancer, diabetes, metabolic syndrome, and more (3,4). The Mediterranean diet is highly associated with a reduction in inflammatory biomarkers (5), which may be the reason why this diet is so protective of health. The Mediterranean diet has also been well studied for its use to protect brain health and has been shown to reduce the risk of neurodegeneration and cognitive impairment (6,7).  Clinical trials with long term follow up have supported the use of a Mediterranean diet for improved cognitive performance (8,9).

This is the ideal diet for individuals looking to reduce overall disease risk, including neurodegenerative disease, in a flexible and iterative way. The diet is flexible, allowing you to slowly reduce intake of those foods recommended less often, and slowly increase intake of the foods that should make up the majority of the diet. For those currently consuming the western diet, switching to a Mediterranean diet pattern allows for more flexibility. 

The MIND Diet

The MIND diet stands for the Mediterranean-DASH Intervention for Neurodegenerative Delay. It is a combination of the Mediterranean diet and the DASH diet, which is the Dietary Approach to Stop Hypertension. The MIND diet was developed after recognizing that adherence to the DASH and Mediterranean diets were associated with consistently higher levels of cognitive function in elderly men and women (10). Epidemiologic data shows that greater adherence to the MIND diet was independently associated with better cognitive function in older adults. The MIND diet is more specific than the Mediterranean and DASH diets because it focuses on daily and weekly recommendations for specific foods and food groups. Foods encouraged on the MIND diet include berries (2 or more servings per week), green leafy vegetables (1 or more servings per day), all other vegetables (1 or more servings per day), nuts (5 or more servings per week), beans (4 or more servings per week), whole grains (3 or more servings per day), fish (1 or more servings per week), poultry (1 or more servings per week), wine (1 serving per day), and extra virgin olive oil. Foods to limit include red meat (3 or less servings per week), butter and margarine (less than 1 tbsp per day), cheese (1 or less servings per week), fried foods (1 or less servings per week), and sweets (3 or less servings per week). 

The MIND diet is more specific than the Mediterranean diet. This may make it more challenging to implement than the Mediterranean diet, but is advantageous for those who prefer more structure. The MIND diet has been well studied with regard to brain health and is clearly of benefit to those wishing to make general improvements in their brain health. 

The Ketoflex 12/3 Diet

The Ketoflex 12/3 diet is the nutrition plan followed on the Bredesen Protocol (ReCODE protocol), for those wishing to prevent or reverse Alzheimer’s disease and other cognitive decline. It is a nutrition plan designed to help the individual achieve metabolic flexibility, or the ability to transition between a glucose based metabolism and a lipid based metabolism. It is keto-leaning, meaning it allows for a mildly ketogenic state, but does so in a plant based manner. It includes intermittent fasting, specifically time restricted eating, for the well documented metabolic benefits. The diet is composed of non-starchy vegetables, healthy fats, and gut supporting foods. It eliminates processed and sugary foods, gluten containing grains, and dairy products (11). This diet is newer, so data showing its efficacy is limited, but this type of diet has been shown as part of adjunct therapy to aid in the reversal of cognitive decline in 100 patients. More studies are in the works to document the benefit of this nutrition plan. 

The Ketoflex 12/3 diet is the best diet for brain health for those who are fully committed to doing all that they can to optimize their cognition, for those who have cognitive decline, and for those who have genetic risk for cognitive decline, such as the ApoE4 variant. 

What diet should you follow for brain health?

All three of these diets are far superior to the western diet in regards to brain health. The diet you choose should depend on your current health, your genetic risk for neurodegenerative diseases, and your ability to adhere to the nutrition plan. The most robust diet for brain health is the Ketoflex 12/3 diet; however, if the nutritional restrictions on that diet are beyond your abilities at this time, the Mediterranean diet and the MIND diet are excellent options. Most people need a combination of these types of diets and a registered dietitian specializing in a functional approach to optimize brain health to help you decide which factors are most necessary for you to implement and which can be implemented at a later time, or not at all. To make an appointment with a dietitian at the Amos Institute, contact us today. 

References:

  1. ​​James B.D., et al. (2014). DOI: 10.1212/WNL.0000000000000240
  2. Esposito, S. et al. (2018) DOI: 10.1080/1028415X.2017.1303016
  3. Casas R, (2014). doi: 10.2174/1871530314666140922153350. 
  4. Estruch R, et al. 2013 DOI: 10.1056/NEJMoa1200303
  5. Urpi-SardaM, et al. (2012). DOI: 10.3945/jn.111.148726
  6. Lourida I. et al. (2013). doi: 10.1097/EDE.0b013e3182944410. 
  7. Singh B. et al. (2014). doi: 10.3233/JAD-130830.
  8. Valls-Pedret C, et al. (2015), DOI: 10.1001/jamainternmed.2015.1668
  9. Martínez-Lapiscina EH, et al. (2013). doi: 10.1136/jnnp-2012-304792. 
  10. Wengreen, H.,et al. (2013). .https://doi.org/10.3945/ajcn.112.051276
  11. Bredesen, D.E. (2020). The End of Alzheimer’s Program: the First Protocol to Enhance Cognition and Reverse Decline at Any Age. Penguin Random House: New York.