Food & Fitness After 50: Unlocking the MIND Diet

While there is no one best diet for those over the age of 50, in Food & Fitness After 50, we highlight four healthy eating plans that can work for just about everyone. And, it happens that these are the top four plans identified as the “Best Diets” by U.S. News & World Report in their 2019 review. The four plans are:

  • The Mediterranean Diet
  • The DASH Eating Plan
  • The Flexitarian Diet
  • The MIND Diet

minddietThe MIND diet stands for the official mouthful name of the Mediterranean-DASH Intervention for Neurodegenerative Delay. A much catchier title is the MIND diet because its premise is that diet can delay cognitive decline.  Researchers at Rush University Medical Center in Chicago studied over 900 older adults from retirement communities for 5 years; those who had the greatest adherence to the MIND diet suffered less cognitive decline than those who did not. This was an observational study, meaning that it shows association with diet and brain health, but it doesn’t prove it. So, the researchers are in the midst of conducting a longer, more rigorous study with adults in both Chicago and Boston. The results will be available in a couple of years.

However, the diet plan is healthy and while it can’t promise to prevent all cognitive decline with aging, it certainly can’t hurt as the plan is comprised of healthy foods that we should all be consuming.

Today, we feature the MIND diet by posing questions to registered dietitian, author, colleague, and friend, Maggie Moon. I met Maggie many moons ago at a CIA meeting…. Culinary Institute of America, not the spy agency, in her role as nutrition communications director for the Wonderful Company. The folks that bring us tasty, healthful foods, like pistachios, almonds, pomegranates and juice, and Halo mandarins. Maggie has written two books: The MIND Diet and the Telomere Diet Cookbook.

Chris and MaggieAs you can see from the photo of the two of us together at the annual meeting of the Academy of Nutrition and Dietetics conference, she is not in my age demographic, so my first question was obvious!

Question: You are a young woman…. how did you get interested in writing about food and nutrition to prevent cognitive decline which is something we think about as a part of aging?

Answer: I’ve been a registered dietitian for more than ten years and while I do still feel youthful, to answer your question, I think about when I was truly young. I grew up in a three-generation household with my parents and my grandmother. They were all immigrants from a war-weary and economically depressed South Korea in the late 1960s, so my immediate family is all I have. I am lucky to have a handful of siblings, but no big extended family. Because of this I feel extremely close to my parents and am ferociously driven to support their wellbeing. And because I was just as close to my grandmother, I’ve been aware of the importance of healthy aging from a young age.

I’ve always had an affinity for the elderly, probably because of my relationship with my grandmother. I love helping them and it is upsetting to my core when I hear about mistreatment of older adults. Truth is, I’m looking forward to being old lady! I’m in no rush, but it is something I think of fondly. I think of aging as a privilege.

This is a long answer to a simple question, but I guess it boils down to my writing what I care about. And I care about helping people thrive as they age and improving their health in longevity. It starts with my own parents, but then extends to my and my husband’s future, and finally to all humans that I can reach with my work, whether they’re worried about their own health or someone else’s.

 Question: Can you describe the MIND diet in your own words. What is it about the diet that would appeal to older adults and when is the best time to adopt the MIND principles? I can image some people in their 60s saying “it’s too late for me.”

Mind diet coverThe MIND diet was born from research led by Dr. Martha Clare Morris at Rush University in Chicago. Its foundation is a blend of two well-studied heart-healthy diets, but what makes it different is that it’s been optimized for brain health based on the available evidence for which specific foods support cognitive health, slow down decline, and reduce the risk of developing dementia. The two landmark studies that came out in late 2015 suggest that following the MIND diet keeps the brain 7.5 years cognitively younger and reduces the risk of Alzheimer’s by 53% compared to those who didn’t follow the principles of the diet.

It’s never too late, especially for someone in their 60s. Most of the research related to the MIND diet is with older adults, so it’s clearly relevant throughout older adulthood. The Alzheimer’s study was conducted with people ages 58-98 and the average age in the cognitive decline study was 81 years old.

That said, the results indicate that the longer someone followed the dietary principles the greater the benefit for brain health, suggesting that more years of healthy eating was more protective. Therefore, I think it’s important for people to eat for brain health at any age, but especially after age 40.

Question: What are the core principles of the diet? How did you develop the recipes for the book?

The core principles of the MIND diet includes ten healthy food groups that make up the foundation of the eating pattern. It also includes five food groups that should be limited.

The MIND diet includes whole grains, vegetables, olive oil, red wine (for those who drink alcohol), leafy greens, nuts, beans, berries, poultry, and seafood. From a culinary and cultural sensitivity perspective, I appreciate that the food groups are so broad that they can be adapted to many different heritage diets and preferences. The foods to limit include processed and red meat, solid fats from butter, margarine and cheese, fried food in general but especially from fast food, and added sugars from pastries and other sweets.

Here is a breakdown of recommended food groups to consume:

Foundation (these are minimums, except for red wine)

  • Whole grains – 3 times a day
  • Vegetables – daily
  • Olive oil – used as main fat
  • Red wine – a glass with a meal (only one; excess here is detrimental, and of course, if you don’t drink you won’t miss the benefits of the diet)
  • Leafy greens – six times/week
  • Nuts – 5 times/week
  • Beans – 4 times/week
  • Berries – 2 times/week
  • Poultry – 2 times/week
  • Seafood – 1 time/week

Limit

  • Processed and red meat – less than 4 times/week (e.g. no more than 3 times/week)
  • Butter/margarine – less than 1 tbsp/day (e.g. no more than 1-2 tsp/day)
  • Cheese – less than 1 time/week (e.g. once every two weeks)
  • Fried food – less than 1 time/week (e.g. once every two weeks)
  • Sweets – less than 5 times/week (e.g. no more than 4 times/week)

The recipes for the book were developed by me and other culinary dietitians. For the guest recipes, I collaborated with trusted colleagues. I provided the recipe parameters and then reviewed submissions to ensure they fit the guidelines and added a good variety of options before selecting them for my book.

Question: Let’s describe your newest book about telomere health….fill us in on how this ties into the MIND diet.

telomere-book-cover-on-amazonMy newest book, The Telomere Diet & Cookbook, came out in fall of 2019. It’s about genetic aging on a cellular level, and how what we eat can slow or accelerate biological aging. Telomeres are protective endcaps to our chromosomes, and they prematurely dwindle when exposed to inflammatory diets, environmental toxins, and poor sleep, to name a few. They protect the DNA in our chromosomes like shoelace tips protect shoelaces from unraveling and growing dysfunctional. Telomere length is a widely-accepted gauge for biological aging in research.

Telomere health is ultimately tied back to fighting inflammation and oxidative stress, which are also systemic issues the MIND diet attacks and improves. Both books are about healthy aging for all. In both books, the evidence-based perspective is that the more years spent eating healthfully the better. That sounds like common sense, and to some degree it is, but it actually signals a shift in thinking about aging: in this paradigm, aging is a continuum that begins at birth, not just once we hit a certain birthday. This is why two 50-year old people can be in completely different stages of biological aging while at the same chronological age – one vibrant, active and thriving; the other sedentary, sluggish and beleaguered with chronic health conditions. Of course, genetics, socio-economic factors, and lifestyle all play a part, but what we eat is something under our control.

Question: What the 3 key takeaways that you want people to know about cognitive health as we age?

  1. It’s never too late to start to eat healthfully.
  2. The earlier you start the better.
  3. Prevention through a healthy diet and lifestyle, not waiting for a miracle medication, is currently the best defense against age-related cognitive decline.

For more information on both diets, check out Maggie’s website by clicking here.

For more tips on eating well, moving well, and being well, check out Food & Fitness After 50 available at Amazon and other booksellers.

Copyright © 2019 [Christine Rosenbloom]. All Rights Reserved.

 

Food & Fitness After 50: Research Roundup

Each day dozens of research studies appear in my inbox, peaking this old college professor’s interest. Last week, there were three studies that made me want to take a closer look: one published in an aging journal, one presented at an annual scientific conference, and one animal study in the journal Brain Structure and Function.  Let’s briefly talk about each one and how it might translates from the page to your plate.

Blueberries for Blood Pressure

1200-136890271-blueberriesThe blue color in blueberries is due to the presence of anthocyanins (pronounced ann-though-sigh-a-nins), a sub-group of plant chemicals knows as polyphenols. Fruits and veggies that are deeply colored red, blue, and purple are especially rich in anthocyanins. The study published in the Journals of Gerontology (gerontology is the study of aging) found that eating about a cup of blueberries twice a day lowered blood pressure similar to the lowering from taking common blood pressure meds. The effect on blood pressure was both acute (happened quickly) and chronic (over time). Researchers found that the anthocyanins relaxed blood vessels and reduced the stiffness that occurs in aging blood vessels. As we age, our blood vessels lose their elasticity making it harder to control blood pressure and increasing our risk for heart disease.

What does in mean for you?

Eat more blueberries! One cup of berries, whether fresh or frozen, has about 60 calories, making it a low-calorie addition to your diet. What it doesn’t mean is taking a blueberry concentrate supplement (yes, they do exist). Researchers note that blueberries are also rich in vitamins, minerals, and fiber and the synergistic action between them and the anthocyanins might also be a reason for their health promoting powers. So, food beats supplements!

Pomegranate: Can it juice your memory?

pom wonderfulPomegranate juice is rich in polyphenols called ellagitannins (pronounced eee-laj-ah-tan-ins). These antioxidant compounds are in plants to protect the plant, but when we eat the plant, their protectors come along for the ride. The research, presented at the 2019 meeting of the American Association for Geriatric Psychiatry, described how a daily serving of pomegranate juice improved visual learning and retention of learning in a year-long study with older adults, average age of 60. The study was a randomized, placebo-controlled, double-blind study; a design that is considered the gold standard in nutrition research. What that means is that study participants were randomly assigned to either drink 8-ounces of pomegranate juice or 8-ounces of drink that looked and tasted like pomegranate juice but contained none of the active polyphenols. Double-blind means that neither the participant nor the researchers knew who was getting the real juice or the placebo. Dr. Gary Small, director of the University of California (UCLA) Longevity Center, presented the current research at the scientific conference, building upon similar work that his group published in 2013 in the Journal of Evidence-Based Complementary and Alternative Medicine. In the 2013 study, a similar design was used but the study was short-term, only lasting one month, but the results were similar. So, the researchers wanted to know if a longer-term study would show memory benefits, and it did.

Researchers are not sure exactly what it is in the pomegranate juice that showed the positive results. One interesting theory is that the pomegranate juice works though the gut microbiome. The healthy bacteria in our gut can breakdown the ellagitannins to a compound that crosses the blood brain barrier, exerting its beneficial effect through the gut-brain axis.

What does it mean for you?

An eight-ounce bottle of pomegranate juice contains 2 whole pomegranates, so drinking the unsweetened juice gives you 650 to 700 milligrams of polyphenols. That’s a lot of good stuff in a little bottle. Pomegranate juice is tart, not sweet, so it might appeal to those of you who don’t like sweet, sugar-added beverages. Considering that most of us don’t eat enough fruit, 8-ounces of pomegranate juice is a good way to get more fruit and healthy polyphenols in our diet.

Vitamin D: Good for the Brain?

Vit DThe third study is on vitamin D deficiency on processing new information and retaining it for future recall. It was conducted with mice and I always cautioned my students to count the legs on the research subjects before considering if it is relevant to those of us on two legs, but this study is interesting in understanding vitamin D deficiency and the brain. Vitamin D is most often thought of as a bone-building nutrient because without enough vitamin D only 10-15% of dietary calcium is absorbed. Yet, vitamin D has many roles in the body, including cognition.

Older adults are considered “at risk” for vitamin D deficiency because our skin doesn’t convert sunlight to vitamin D as readily as it did when we were younger and vitamin D isn’t found naturally in a lot of foods. Some foods, like milk, are fortified with vitamin D, but many yogurts are not. (The only way to know if your favorite yogurt is fortified with vitamin D is to read the nutrition facts panel and ingredient list on the container.)  The recommended dietary allowance for vitamin D is 600 IU for those 51 to 70 years and 800 IU for those over 70. The upper limit is 4000 IU and many older adults take a supplement of 1000 IU to make sure they are getting enough vitamin D. Check with your doctor and ask if a vitamin D blood test is needed to tailor your vitamin D intake to your blood level.

What does it mean for you?

Choose vitamin D-rich foods, either naturally occurring or fortified (for an extensive list of vitamin D in foods click here.)

Bottom Line

Eat more deeply colored fruits and veggies, including blueberries and pomegranate juice, to get healthy plant compounds in your diet. And, choose vitamin D rich foods, like salmon or tuna, and fortified milk, yogurt, and cereals. Here is my breakfast plan:

  • 1 cup of Greek yogurt (choose a brand fortified with Vitamin D)
  • 1 cup of fresh or frozen blueberries and ½ cup of high fiber breakfast cereal mixed into yogurt
  • 8-ounces of pomegranate juice

While the research is promising, this breakfast may or may not improve my brain health, but it gives me a great start to the morning with three servings of fruit and a good dose of fiber in a calcium and vitamin D-rich breakfast bowl. And, did I mention it tastes great?

For more information on how foods and fitness affect brain health check out Food & Fitness After 50.

Copyright © 2019 [Christine Rosenbloom]. All Rights Reserved.

Disclosure, I am on a clinical nutrition advisory board for POM Wonderful, but I was not asked to write about pomegranate juice or compensated to write this post. 

Why this dietitian promotes healthful eating and exercise for those over 50

When talking about food and fitness for those over 50, it is the best of times, and sometimes the worst of times. Everyone want to know the ”best” exercise or food to eat to prevent aging. A quick Google search will provide you with many answers, unfortunately most of them are less than science-based and are usually trying to separate you from your money. Let’s be clear: there is no one superfood or exercise that will prevent aging.

That is why, I am excited to launch Food & Fitness After 50, with co-author, exercise book-front-pagephysiologist, Bob Murray. The book will be published later this year. While there might not be a “best” exercise or food, that doesn’t mean that food and fitness are unimportant as we age. You can be healthier at 65 than you were at 45 by eating well and starting (or increasing) your physical activity. This is important because so many of us are living longer. Baby boomers, those born between 1946 and 1964, began turning 65 in 2011 and by 2029 when all boomers will be 65, more than 20% of the population will be over 65. Why is 65 an important number? Because people reaching age 65 have an average life expectancy of 19.3 years (20.5 years for women and 18 years for men). How do you want to spend those 20 years? Do you want to travel, enjoy your favorite physical activities, and be a vibrant person in the lives of your grandchildren and great grandchildren? I am sure that we all want that, so being active and eating healthfully are steps you can take right now to increase your odds of being healthy into your later years.

Just this week, The Journal of the American College of Cardiology published an article on nutrition controversies in preventing heart and blood vessel disease. The article can be found here  http://www.onlinejacc.org/content/69/9/1172?_ga=1.183783078.1620905078.1488293025 and here is an easy to guide to see their recommendations.

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While their article focused on heart disease, our book covers many healthful eating patterns to keep your heart, bones, joints, blood sugar, blood pressure, and brain healthy. Remember there isn’t one “best” eating plan. So, we feature four plans that we think most older adults will find fit their lifestyle and their enjoyment of foods:

  • The DASH eating plan (DASH stands for Dietary Approaches to Stop Hypertension)
  • The Flexitarian plan
  • The Mediterranean Diet
  • The MIND diet (MIND stands for Mediterranean- ASH Intervention for Neurodegenerative Delay)

We also dive into exercise for endurance, strength, agility, balance, and functional fitness. Keeping our heart and lungs strong, halting muscle loss, and keeping agile all contributes to functional fitness….the ability to do the things you did when you were younger without a second thought. I want to be able to lift my suitcase in the overhead bin when I travel and pick up a 50-pound bag of dog food, all examples of functional fitness. Age-related muscle loss usually starts at about age 40. We can lose 10-15% of muscle mass and muscle strength every decade if we don’t engage in progressive, resistance exercise.

We hope that our book can help those over 50 learn to separate usual aging from the disuse of a sedentary lifestyle and sort out the fact from fiction about foods. Please visit our webpage to learn more about the book and leave us a question that you might see featured in an upcoming blog post. Web page for Food & Fitness After 50

 

 

 

 

Citicoline and Brain Health

My husband is concerned about his brain. He exercises, is lean, and eats right, but increasingly he says he has a hard time remembering the right word or clearly articulating his thoughts. So, when I attended a lecture by Drs. Deborah Yurgelun-Todd and Perry Renshaw from The Brain Institute of the University of Utah on the brain health benefits of the dietary supplement, CognizinÒ citicoline, I was intrigued. (The session was sponsored by Kyowa Hakko, USA (http://kyowa-usa.com/), a global manufacturer of compounds used in dietary supplements and CognizinÒ brand citicoline).

After the conference I did some research by starting with Natural Medicines and then doing a literature search through Pub Med (http://www.ncbi.nlm.nih.gov/pubmed) to learn more about citicoline. I also contacted Dr. Yurgelun-Todd about her research on citicoline, as she has been studying it for over a decade. I found that citicoline was originally used as a treatment for individuals who had a stroke.  It is estimated that 2 million brain cells die every minute after a stroke so early treatment is essential to preserve the brain and maintain normal function. In a recent review of citicoline used in stroke patients, it was found that citicoline was safe to use and had beneficial effects on recovery, especially in older patients (>70 yrs) who had no other treatments. One study found that when citicoline was given to stroke patients within 3 hours, they were more likely to have complete recovery compared to those who got a placebo. Not all studies find such great results, but overall the evidence of a positive improvement in brain function after a stroke is well founded.

Food is not a good source of citicoline; only a small amount is found in organ meats. When citicoline is taken orally (in a pill) it is broken down into a B-vitamin, choline, and cytidine which is further metabolized into a compound called uridine. Both choline and uridine can cross the blood brain barrier and once in the brain, they can be converted back to citicoline, sometimes referred to as CDP-choline. Within the brain citicoline has several actions. First, it helps stimulate the production of cell membranes. Second, citicoline increases the production of the neurotransmitters which have been shown to increase attention, focus and memory.

Research on citicoline for other disorders where cognitive abilities are affected is scant, but promising. Researchers can’t yet say that citicoline will improve memory or cognition in individuals with Alzheimer’s disease, Bipolar disorder, Parkinson’s disease or traumatic brain injury, but stay tuned as more research is conducted in these areas.
I asked Dr. Yurgelun-Todd what she would say about healthy 50+ adults taking citicoline and she said that there is some good evidence to support the use of the supplement on improved focus and sustained attention. Her studies have used doses ranging from 250-4000 mg/day but she says a dose of 250-500 mg/day is effective and well-tolerated.

What about my husband? He has been taking citicoline for a couple of months (250 mg twice a day) and notices an improvement in word finding and clarity in conversations. He said he sometimes had to “think in pictures” when telling a story, but now he thinks he has better mental clarity. Of course, this is anecdotal. As for his memory, well, he still leaves the house without his wallet and phone and can’t find the milk in the refrigerator, but he feels it has helped him and that is a good thing.