Is the Mediterranean diet the secret to avoid dementia?

The Mediterranean diet has been credited with being heart-healthy, helping to maintain a healthy weight and also keeping your brain dementia free. It is easy to follow and there are loads of delicious recipe ideas. Here’s how!

Dietary patterns and the brain protective diet
There are many nutrients and foods that may help protect you against dementia. But while this information is useful to researchers, in our everyday lives we don’t sit down to a plate of vitamin E with a side of folate and an omega-3 sauce. We eat whole foods as part of complete meals and these, together with drinks and snacks, form our overall way of eating or, as nutritional researchers call it, our dietary pattern.

The Mediterranean diet emphasizes eating primarily plant-based foods

Many experts now argue that ‘food synergy’ is likely to be more important than the effects of any single nutrient and that a combination of dietary factors is likely to have the greatest effect on long-term health. This might explain why the results of some studies we have looked at have been unexpected or disappointing and why supplements don’t always seem to be beneficial.

An increasing number of studies have examined the beneficial effects of different dietary patterns on the risk of diseases such as heart disease, type-2 diabetes and, in the past few years, dementia. On the whole, these appear to show stronger links than studies of single nutrients. One of the most studied has been the Mediterranean diet, although recently other dietary patterns, such as the Japanese diet, have come under the spotlight.

What is the Mediterranean diet?
The Mediterranean diet is a way of eating based on foods traditionally consumed in areas that border the Mediterranean Sea, such as Crete, other parts of Greece and southern Italy. Key ingredients, usually consumed as close as possible to their natural state, are olive oil, nuts, oily fish, some poultry, a little meat, plenty of fruit, vegetables and pulses, wholegrains plus a moderate amount of red wine consumed during meals. The pyramid below shows how they fit in to an overall eating pattern.

The show Dr Oz explains the Mediterranean diet

What is the evidence?
Numerous studies have looked at how eating the Mediterranean way may help protect against dementia:

  • A 2010 analysis of 18 studies found a 13 per cent reduction in the risk for neurodegenerative diseases, together with a 10 per cent reduction in the risk for heart disease. The researchers concluded that, followed over a long period, a Mediterranean diet provided ‘significant and consistent protection against major, chronic, degenerative diseases’.
  • A study that analysed the results of 11 clinical trials with a total of over 50,000 participants, looking at the effect of following a Mediterranean diet on the prevention of cardiovascular disease, a key risk factor for dementia, concluded that this type of diet was very likely to help keep the heart and blood vessels healthy.
  • A large analysis of 22 observational studies, published in 2013, found that sticking closely to a Mediterranean way of eating reduced the risk of stroke, another significant risk factor for dementia, by almost 30 per cent, and the risk of cognitive impairment by about 40 per cent.

Extra virgin olive oil is loaded with antioxidants so it's no surprise that it is a super brain food

Few clinical trials have studied the effects of a Mediterranean diet on brain function specifically. However, one that looked at the effects of an ‘enhanced’ Mediterranean diet (with either added olive oil or extra nuts) over a period of six years found that it had beneficial effects on brain function compared to a low-fat diet.

Conflicting conclusions
Not all studies have found a positive link between a Mediterranean diet and health. This may be because people who make healthy dietary choices are more likely to have a healthy lifestyle, which can confuse results. It could also be that people whose brain function is beginning to falter may find it harder to stick to a healthy diet.

In 2013, a Scottish study initially found a link between a Mediterranean dietary pattern and better cognitive performance in old age. The association was lost, however, when they factored in the intelligence of participants. It was suggested that more intelligent people make healthier choices and so are likely to have better brain function as they get older.

A 2012 Australian study, which examined the diets of 1,500 people over four years, found that a Mediterranean-style diet provided no protection against MCI or dementia, but cooking methods (grilled fish and vegetables were more beneficial than deep-fried fish and chips) and perhaps the levels of processed versus freshly prepared foods could have skewed the results.

Using herbs and spices instead of salt to flavor foods are also a more healthier option

Other dietary patterns
The Mediterranean way of eating isn’t the only one to have benefits for brain health:

  • A 2013 study in Japan followed over 1,000 people for 15 years and found a reduced risk of dementia linked to a high intake of soya beans and soya products, vegetables, seaweed, milk and dairy products and low intake of rice.
  • In a multi-ethnic New York community, researchers found an average reduction of AD risk of over 35 per cent in people with higher intakes of salad dressing, nuts, fish, tomatoes, poultry, cruciferous vegetables such as cabbage, broccoli and Brussels sprouts, fruit and green leafy vegetables and low intakes of high-fat dairy, red meat, offal and butter.
  • In recent reviews of the evidence, a set of recommendations aimed at reducing high blood pressure known as the DASH (Dietary Approaches to Stop Hypertension) diet and a pattern of eating called the US Healthy Eating Index, 2005, has also been linked to a lower risk of dementia and AD.

Leek-and-butterbean-pie-wyza-com-auTry delicious recipes inspired by the Mediterranean diet such as this leek and butterbean pie

Adapting your diet
We live in a global economy where foods from all over the world are readily available. However, adopting eating and cooking styles from other parts of the world is not always easy. The good news is that it is possible to adapt your own food likes and dislikes to include the beneficial components of a healthy dietary pattern wherever you live.

In compiling our recipe collection - which include a warming pork and butterbean stew and a hearty lentil and mushroom bake - we have identified common features of apparently beneficial dietary patterns to produce a range of dishes that we hope will provide something to suit all tastes.

Of course, we hope our hints, tips and suggestions for alternatives will inspire you to adapt your own recipes and help you to expand your repertoire of brain-healthy meals, such as this Thai stir-fry with green tea noodles.

Mediterranean Diet Pyramid By George Middleton
Illustration by George Middleton. © 2009 Oldways Preservation and Exchange Trust 

How much should you be eating?
As shown in the Mediterranean Diet pyramid illustration above, wine should be taken in moderation, and water meats and sweets less often. Poultry, eggs, cheese and yogurt should be taken in moderate portions, daily to weekly, and fish and seafood should be consumed more often - at least two times per week.

Fruits, vegetables, grains (mostly whole), olive oil, beans, nuts, legumes and seeds, herbs and spices, all should be the base for every meal.

Consume foods at the bottom of the pyramid freely. Eat those towards the top occasionally or in small amounts. But importantly, be physically active and enjoy meals with others. 

Extract from Healthy Eating to Reduce the Risk of Dementia by Margaret Rayman and Katie Sharpe, published by Kyle Books, RRP $24.99.

Have you ever tried the Mediterranean diet? Did it work for you? Join the conversation below. . .