Last Updated on May 15, 2024 by Patricia Carter

My work has focused on three evidence based brain healthy diets. These are Dale Bredesen’s Protocol, the MIND diet, and the Mediterranean diet. All of these diets have been studied in clinical trials. All have been shown to decrease the risk of Alzheimer’s and even improve brain health.

Research has been fast and furious once it was understood that the Western diet shrinks the brain beginning around age 40 years.

The connection between diet – brain health is becoming increasing clear. The need to move in the diet direction is becoming urgent as ultra-processed food is topping food consumption and, it negatively impacts gut microbiome and brain health leading to disease.

It makes total sense that these three brain healthy diets are more similar than not, and they are summarized below.

You may have seen two of these diets, MIND diet and Mediterranean diet, repeatedly make the top healthy diets in the US News and World Report annual diet reviews. For 2024, the Mediterranean diet is #1 while MIND diet is #3. [1]

But make no mistake, brain health is multifactorial. Thus, beyond diet, the lifestyle factors integrated in Dr. Bredesen’s Protocol is spot on for brain health and science continues to publish relevant supporting data.

Brain Healthy Diets: Dr. Bredensen’s Protocol

Dr Bredesen’s Protocol has moved beyond proof of concept to randomized control trial. The protocol was found to decrease mild cognitive impairment and Alzheimer disease. The protocol is multifactorial meaning it addresses dietary nutritional needs AND it addresses 36 lifestyle interventions known to detrimentally affect brain health (such as sleep, exercise, toxins, nutritional assessment, serum and brain lab assessment, and more). The website Apollo Health, [2] discusses all this in more detail.

The 2022 proof of concept study documented twenty-five patients with Alzheimer’s disease or mild cognitive impairment, ages 50–76, recruited to three clinical sites. Many physical and neurological examinations were performed for this cohort (see the paper for details). The patients were treated for nine months with a personalized, precision medicine protocol that addressed each patient’s identified potentially contributory factors, and cognition was assessed at t = 0, 3, 6, and 9 months. [3]

Results: All outcome measures revealed improvement: statistically significant improvement in MoCA scores, CNS Vital Signs Neurocognitive Index, and Alzheimer’s Questionnaire Change score were documented. No serious adverse events were recorded. MRI volumetrics also improved.

Conclusion: Based on the cognitive improvements observed in this study, a larger, randomized, controlled trial of the precision medicine therapeutic approach described herein is warranted (and progressing, see Clinical Trails ID NCT05894954)

Bredesen’s Protocol is the first time a multifactorial approach has been tried for cognition. Below is a general listing of the things addressed:

• Diet used in the study: A plant-rich, high-fiber (soluble and insoluble), mildly ketogenic diet, high in leafy greens and other non-starchy vegetables (raw and cooked), high in unsaturated fats, low in glycemic load, with a fasting period of 12 minimum to 16 hours maximum each night. Organic produce, wild-caught low-mercury fish (salmon, mackerel, anchovies, sardines, and herring), and modest consumption of pastured eggs and meats were encouraged, as well as avoidance of processed food, simple carbohydrates, gluten-containing foods, and dairy. Blood ketone levels were monitored with fingerstick ketone meters, with a goal of 1.0–4.0 mM beta-hydroxybutyrate.
• Aerobic and strength training was encouraged for at least 45 minutes per day, at least six days per week (for aerobic exercise) and at least twice per week (for strength training), and facilitated by the personal trainers. High-intensity interval training (HIIT) was recommended a minimum of twice per week.
• Sleep hygiene was supported to ensure 7-8 hours of quality sleep per night, and all patients without known sleep apnea were tested over several nights using home sleep study devices. In those diagnosed with sleep apnea or upper airway resistance syndrome (UARS) were treated.
• Stress management included biofeedback and heart-rate variability training with a HeartMath Inner Balance for IOS device, for a minimum of 10 minutes per day, chosen because of the ease of patient use and thus high compliance.
• Brain training was carried out using BrainHQ, a HIPAA and SOC-2-compliant platform with empirical validation, for a minimum of 15 minutes daily. Participants trained on 29 cognitive exercises that target the speed and accuracy of information processing.
• Hormone levels, GI function, systemic infections, viruses were treated.
• Toxicity associated with metals were resolved. Metal toxicity included mercury, lead, organic pollutants (e.g., benzene, phthalates, or organophosphate insecticides), and biotoxins (e.g., trichothecenes, ochratoxin A, or gliotoxin). Detox used binding agents (e.g., cholestyramine or bentonite clay), sauna, herbs, sulforaphane, and dietary restriction of seafood if indicated.

The Bredesen Protocol is offered through PreCODE (for prevention) and ReCODE (for reversal). It has opened the door to new approaches to prevent and treat Alzheimer’s disease. See the website, Apollo Health, [2] for much more.

Brain Healthy Diets: The MIND Diet

The MIND diet combines both the Mediterranean diet and DASH diet along with brain based nutrient literature. The acronym MIND stands for Mediterranean-DASH Intervention for Neurodegenerative Delay. MIND diet shows promise in reducing Alzheimer’s risk by 53% for strict adherence and a 35% improvement with partial adoption. With strict adherence, the brain functioned as if 7.5 years younger!

Importantly, the MIND diet BETTERED the Mediterranean and DASH diet for brain health because those had NO significant impact on Alzheimer risk reduction for moderate follow!

Look through the Mind Diet Scorecard below to see how your diet scores! Note, in the studies there was NO perfect score!

A 2023 study [4], and its NIH Review [5], found for 581 participants who had donated their brains at death for dementia research, those having higher MIND diet scores showed fewer signs of Alzheimer’s. This was primarily due to lower levels of amyloid plaques. This trend was not influenced by other lifestyle factors, including physical activity and smoking, or vascular health. There was no correlation between the diet scores and the presence of tangles. This cohort began a first dietary assessment at an average of 84 years. For more than a decade they completed food questionaires. The findings suggest that diet is an important lifestyle factor that needs further research as an Alzheimer’s prevention strategy.

Brain Healthy Diets: Mediterranean Diet

The Mediterranean Diet is high in olive oil (extra virgin olive oil is best), fruits, nuts, abundant use of herbs and spices, vegetables, whole grain, legumes, and fish and tends to be moderate in red meat and sweets.[6] For brevity, I’ll skip health benefit talking points on the Mediterranean Diet since it is the most studied diet and is easily Googled. Despite these uncontroverted health benefits, we focus on the MIND diet (a tweak of the Mediterranean and DASH diets) since MIND diet BETTERED Mediterranean and DASH diet for brain health. Given that, below you’ll be interested to see the similarity of food components for the MIND, Mediterranean, and DASH diets. The red notations explain nuances of the diets that might specifically support the gut – brain health axis.

Similarites of These Diets

Generally, foods that are common in these diets are fruits, vegetables, nuts, olive oil, spices, fish, cocoa, and others. Potential mechansims for brain health are:

• Fatty SMASH fish (salmon, mackerel, anchovies, sardines, herring) and certain nuts like walnuts, are abundant in Omega-3 which has uncontroverted known benefits for brain health.
• Olive oil has anti-inflammatory, antioxidant, and antibacterial benefits. It is also a healthy fat that facilitates fat soluble vitamin absorption. Extra virgin olive oil is known to be best for these properties.
• The other noted foods are abundant in plant chemicals known as Phenolic compounds. Over 8000 naturally occurring phenolic compounds have been reported in the literature. New research finds upon ingestion of phenolic compounds they reach the microbiome with consequent beneficial microbiome changes. Recent research finds that certain phenolic compounds go systemic and are capable of crossing the blood – brain barrier! A great deep dive into all this [6].
• The bottom line, the American Gut data information learned over a decade ago still holds true today – eat 30 different plant foods each week to feed the microbiome and establish a community having the best microbiome diversity so that it can do all that it needs to do for your best health, body AND brain. [7]

Why Your Medical Professional Won’t Be Talking Anytime Soon About Microbiome Based Diets

The nutrient dense diets discussed in this post are loaded with bioactive compounds.

“Bioactive compounds are anti-inflammatory and antioxidative, alter gene expression, and modulate the microbiome.” [6]

Research on bioactive compounds suggests robust prophylactic and therapeutic roles in fighting a spectrum of disease including ones related to the nervous system and brain.

Many diseases are now treated first with pharmaceuticals many of which are not effective and come with side effects.

“Despite this, medical professionals are far from prescribing dietary regimens rich in bioactive compounds for therapeutic purposes as evidence-based guidelines are still lacking, in part due to the underrated remedial effect of nutrient-dense diets. Therefore, as the interest in personalized medicine increases, focused research and funding should be the cornerstone to reach that goal.” [6]

I applaud you for advocating for yourself and learning the diet – lifestyle – health connections!

Conclusion

For brain health, my work focuses on Dale Bredesen’s Protocol, the MIND diet, and the Mediterranean diet.

Additionally, since brain health is multifactorial, beyond diet, sage advise is to consider integrating into your lifestyle, those factors integrated in Dr. Bredesen’s Protocol. Science continues to publish data supporting that they are spot on for brain health.

Best in health

References

1. U.S. News Reveals the 2024 Best Diets
2. Apollo Health
3. [Touts et al 2022] Precision Medicine Approach to Alzheimer’s Disease: Successful Pilot Project
4. [Agarwal et al 2023] Association of Mediterranean-DASH Intervention for Neurodegenerative Delay and Mediterranean Diets With Alzheimer Disease Pathology
5. [NIH Research Highlights 2023] MIND and Mediterranean diets linked to fewer signs of Alzheimer’s brain pathology
6. [Begdache et al 2023] Bioactive Compounds for Customized Brain Health: What Are We and Where Should We Be Heading?
7. [McDonald et al 2018] American Gut: an Open Platform for Citizen Science Microbiome Research