Brain arterial health factors in MIND diet’s cognitive benefits

While the MIND* diet has been shown to boost cognitive health, new research suggests that this effect is partially explained by reduced brain arteriosclerosis risk.

In a mediation analysis, cerebral arteriosclerosis accounted for about 6.8 percent of the association between the MIND diet and cognition, reported Dr Puja Agarwal from Rush Alzheimer’s Disease Center in Chicago, Illinois, US.

Agarwal, along with colleagues, performed the analysis using structural equation modelling and found that cerebral arteriosclerosis had a direct (p<0.0001) and an indirect (p=0.051) effect. [Agarwal P, et al, AAIC 2024]

Cerebral arteriosclerosis was determined using ARTS, a fully automated in-vivo classifier that generates a score based on brain MRI data and basic demographic information. The higher the ARTS score, the higher the likelihood of arteriolosclerosis, Argarwal noted. Rapid increases in ARTS scores have been associated with faster rates of global cognitive decline in African American older adults. [Neurobiol Aging 2024;134:21-27]

In the present research, the ARTS score correlated with the MIND diet score (estimated using validated food frequency questionnaires), such that participants with a higher MIND diet score had a lower likelihood of cerebral arteriosclerosis.

“The association was there in our basic model, adjusted for age, sex education, calories, and MRI data,” Argawal said, adding that the association persisted in models that further adjusted for vascular diseases, which included having a history of heart condition, congestive heart failure, stroke and claudication, and the presence of the APOE-ε4 allele.

“We ran the same models for white matter hyperintensities and found similar associations,” she continued.

However, unlike cerebral arteriosclerosis, white matter hyperintensities had no mediating role in the MIND diet–cognition association, according to Agarwal.

The research involved 561 participants (mean age 81.3 years, 76 percent female) from the Rush Memory and Aging Project. All of them had dietary and neuroimaging data available no more than a year apart. The mean MIND diet score was 7.8, and 24 percent were APOE-ε4 allele carriers.

A hybrid between the Mediterranean and the DASH diets, the MIND diet specifically focuses on brain health and, as such, has several unique characteristics. Unlike other dietary patterns, the MIND diet categorizes leafy green vegetables separately from other vegetables and exclusively recognizes berries as fruit. It also emphasizes fish consumption at least once weekly while de-emphasizing dairy products. [Dhana K, et al, AAIC 2024]

Much is known about the benefits of MIND diet, with existing literature showing associations with increased total brain volume, reduced white matter hyperintensity, cognitive resilience, and lower AD pathology, Agarwal pointed out. As such, she and her team sought to explore other potential imaging biomarkers with a goal of deepening the understanding of the underlying mechanisms.

Overall, the findings of the present research suggest that “lifestyle approaches such as adherence to a healthy diet may improve cognition by maintaining cerebrovascular health among older adults,” Agarwal said.

The research was limited by its observational study design and the use of cross-sectional analysis, leading to the inability to define a causal pathway, Agarwal acknowledged. Additionally, the findings cannot be generalized to the younger US adult population.

*Mediterranean-DASH Intervention for Neurodegenerative Delay