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Fighting Cognitive Decline Part 2: Eating Right = The Mediterranean Diet

If we all face cognitive decline to some degree, why don’t we fight it? And what tools are there to help us fight it? My answer is simple. Fight cognitive decline with The Three E’s...

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1.         Exercising

2.         Eating right

3.         Exploring mindfulness

In the first article on cognitive decline, we looked at exercising to fight against this disease’s attack on the brain.  Specifically, we addressed cardiovascular exercise, like running, teamed with lower impact weight or strength training, and then balanced with yoga.  These are all good exercise practices to fight cognitive decline.  Today, we will add another layer of defense: eating right, specifically focusing on the often talked about, Mediterranean Diet.  Let’s learn about what it is, why it is so beneficial to brain health, and the food swaps that are easy actions to take to start implementing the Mediterranean diet onto your plate.

To recap, the Mayo Clinic defines cognitive decline within the context of a more serious diagnosis. “Mild cognitive impairment (MCI) is the stage between the expected cognitive decline of normal aging and the more serious decline of dementia.  It can involve problems with memory, language, thinking and judgment that are greater than normal age-related changes.”  Symptoms can also include a decreased ability to maintain focus and decreased ability to problem solve.  In some cases, symptoms can progress into more serious conditions, such as dementia or even Alzheimer’s disease.  According to the Alzheimer’s Association, MCI, “causes cognitive changes that are serious enough to be noticed by the individuals experiencing them or to other people, but the changes are not severe enough to interfere with daily life or independent function.”  

To fight against this aggressive disease, eating right is a form of combat.  Lately, the phrase, “food is medicine,” has caught on not only in the medical community, but within daily conversation.  But what does that look like?  The Mediterranean diet is a good place to start to try to use food as medicine.  What is this diet? And why is it regarded even by the medical community as so beneficial?

According to the American Heart Association (AHA), the Mediterranean diet describes the traditional eating habits of the countries bordering the Mediterranean Sea.  With so many different countries included in that region that vary with their religious, cultural and agricultural backgrounds, the commonalities of the diet basically are the following:

  • plenty of fruits, vegetables, bread and other grains, beans, nuts and seeds
  • olive oil as a primary fat source
  • dairy products, eggs, fish and poultry in low to moderate amounts
  • fish and poultry are eaten more often than red meat
  • minimally processed, plant-based foods
  • wine may be consumed, but in low amounts, usually with meals
  • fruit is a common dessert instead of sweets

The AHA officially recommends the Mediterranean diet for several reasons.  The basic outline of the diet can help a person achieve what the AHA considers a health dietary pattern.  This dietary pattern includes eating vegetables, fruits, whole grains, beans and legumes on a daily basis, incorporating fish, poultry, non-tropical vegetable oils and nuts into your eating regimen, and limiting your intake of added sugars, sugary beverages, sodium, highly processed foods, refined carbohydrates, saturated fats, and fatty or processed meats.  The most significant benefit noted by the AHA is the effect on your brain.  Specifically, your brain health can improve because studies have proven that this diet can improve your ability to think, remember and process information as you age.  In one study that looked at Mediterranean diet, “the healthiest eaters at age 50 had a nearly 90% lower risk of dementia compared with those who had the least healthy diets.”[i] 

            The Mediterranean diet is beneficial to brain health according to actually several studies.  In a 2013 study that tracked a diverse group of 6,229 American women and men, ages 44 to 84, for eight years, Johns Hopkins researchers and others found that a Mediterranean-style diet combined with regular exercise, a healthy weight, and not smoking protected against early heart disease, slowed the build-up of plaque in artery walls, and reduced risk for an early death by 80 percent. “Our study shows us that you have the control and power to change the trajectory of your health and life,” says lead study author and Johns Hopkins expert Haitham Ahmed, M.D., M.P.H. “With a healthier diet, exercise, weight maintenance and smoking avoidance, thousands of our participants were able to live longer and free of cardiovascular disease. You can too!”[ii]  Not only does the success of this study show benefits for the heart, but the results show benefits to the brain as well.   

In addition, a study published in the New England Journal of Medicine showed that the Mediterranean diet helped to reduce the risk of heart attack, stroke, and death related to heart problems by 30%.[iii]  Further, a recent article noted that while initial studies found cardiovascular benefits from the Mediterranean diet, “[e]nsuing trials confirmed favorable influences on the risk for metabolic syndrome, obesity, type 2 diabetes mellitus, cancer, and neurodegenerative diseases.”[iv]

Finally, bringing the Mediterranean life piece by piece to your life is easy when you think in terms of food swaps.  One change at a time will benefit your health and increase your arsenal of weapons to fight against cognitive decline.  There are a number of changes that can be made, but start with any of the following week-by-week swapping one at a time:

  • Eat salmon, instead of basic pasta or red meat for dinner
  • Eat low-sugar greek yogurt like Oikos Triple Zero flavored yogurt, instead of cereal for breakfast
  • Order a salad with protein for lunch, instead of a sandwich
  • Eat a seasonal fruit like a clementine in the winter or strawberries in the summer, instead of a cookie for dessert
  • Snack on cucumbers with dip instead of crackers and dip
  • Add olive oil and red wine vinegar with a dash of salt and pepper to your salad, instead of commercially made salad dressing
  • Grab a handful of non-roasted nuts, instead of pretzels for a snack
  • Replace red meat one time per week with any kind of seafood for dinner
  • Use olive oil on bread instead of butter

There are so many recipes and books out there with more elaborate ways to go totally Mediterranean, but starting slowly is the way to success.  One change at a time will allow for the process to be manageable and enjoyable.  The key is to understand the pattern of the diet and the foods needed to implement the diet.  Knowing that scientific studies support your efforts helps, too. 

Next, we will look at mindfulness as another tool in fighting cognitive decline. 

© 2020 Megan Davia Mikhail


[i] See the American Heart Association, What is the Mediterranean Diet? Available at: https://www.heart.org/en/healthy-living/healthy-eating/eat-smart/nutrition-basics/mediterranean-diet

[ii] See Johns Hopkins University, Take Your Diet to the Mediterranean. Available at:  https://www.hopkinsmedicine.org/health/wellness-and-prevention/take-your-diet-to-the-mediterranean

[iii] The Cleveland Clinic.  “Mediterranean Diet.” Available at:  https://my.clevelandclinic.org/health/articles/16037-mediterranean-diet

[iv] The National Center for Biotechnology Information.  Abstract from Int J Environ Res Public Health. 2019 Mar 15;16(6). “The Mediterranean Diet: From an Environment-Driven Food Culture to an Emerging Medical Prescription.  Available at:  https://www.ncbi.nlm.nih.gov/pubmed/30875998

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