Doctors Say People With a Higher Risk of Alzheimer’s May Benefit From Following This Diet

The MIND diet—one rich in berries, veggies, legumes, whole grains, and more—is often recommended to support brain health. Now, research shows it may be especially beneficial for people who have a higher risk of developing Alzheimer’s. A new study in the Journal of Alzheimer’s Disease found people with higher levels of Alzheimer’s-related biomarkers who followed the MIND diet showed higher cognitive scores compared with the control group.

The biomarkers measured in the study participants’ blood were beta-amyloid (or amyloid-ß40) and phosphorylated tau (or p-tau181), two key proteins at the center of Alzheimer’s disease. Both can build up in the brain, actively interfering with normal neuron processes, disrupting cell communication and brain function.

“What we found is that higher biomarker levels were associated with lower cognitive scores among people on the control diet, but not among those following the MIND diet,” says Klodian Dhana, M.D., Ph.D., an associate professor in the department of internal medicine at Rush University Medical Center in Chicago and the lead study author.

The Mediterranean-DASH Diet Intervention for Neurodegenerative Delay, otherwise known as the MIND diet, combines aspects of the Mediterranean and DASH (Dietary Approaches to Stop Hypertension) eating plans. Research has shown both of those diets on their own provide significant risk reduction for certain cardiometabolic conditions, including hypertension, type 2 diabetes, and high cholesterol.

In a 2015 landmark Rush University MIND diet study, scientists created the hybrid diet with a focus on foods associated with a decreased risk of dementia. It was officially coined the MIND diet and the researchers did indeed discover the combo slowed age-related cognitive decline.

“The MIND diet is one of the most well-studied eating patterns for brain health because it combines the strongest evidence from the Mediterranean and DASH diets while emphasizing foods that have repeatedly been linked with better cognitive aging,” says Stefani Sassos, M.S., R.D., a registered dietitian and the director of the Good Housekeeping Institute’s Nutrition and Fitness Lab.

Primarily plant-based, the MIND diet suggests routinely eating nutrient-rich whole foods and trying to steer clear, but not completely avoid, unhealthy ones such as processed foods. The beauty of the MIND diet is its flexibility. “Instead of asking people to follow complicated rules, it encourages eating more vegetables, berries, beans, whole grains, nuts, olive oil, and fish, while limiting foods higher in saturated fat, added sugar, and sodium,” explains Sassos.

The goal of the study was to determine if people with higher levels of Alzheimer's-related biomarkers in their blood responded differently to the MIND diet than those who had lower levels. To get an idea, Dr. Dhana and his colleagues looked at data from the MIND randomized clinical trial that he and some other scientists published in 2023. It was a study of 604 adults, aged 65 to 84, who had no cognitive impairment when the research began.

During that three-year study, approximately half of the participants followed the MIND diet and the other half followed a control one; all received support for weight loss. At the start of the study and then again every year, cognitive scores were derived from an assortment of 12 tests that looked at things like episodic memory and executive function, with higher scores signaling better cognitive performance.

The MIND diet followers had a slightly better improvement in cognition,; however, it wasn’t significantly better than the people on the control diet. Over the course of the study, the participants in both groups lost about 11 pounds, which means the improvement in cognition could have occurred because of weight loss.

The research also suggested that the cognitive response to the MIND diet may depend on the subjects’ baseline levels of blood biomarkers, says Dr. Dhana. So he and some colleagues dug into the existing research and found the association between the MIND diet intervention and cognition varied according to participants’ baseline levels of amyloid-ß40 or p-tau181.

While the MIND intervention didn’t improve overall cognitive function amongst the entire study group, the relative advantage of the MIND group over the control one was more pronounced among people with those higher biomarker levels.

One of the reasons researchers think the MIND diet works is that it supports several biological pathways at once, Sassos says. “The antioxidants in these foods help protect brain cells from oxidative stress, healthy fats help maintain the structure and function of brain cells, fiber nourishes the gut microbiome, and nutrients support healthy blood flow to the brain,” she notes. “It's likely the combination of these effects, not one nutrient alone, is what makes the difference.”

People with cardiovascular risk factors like high blood pressure, high cholesterol, or diabetes may have even more to gain because what's good for the heart is often good for the brain, adds Sassos. “Healthy blood vessels are essential for delivering oxygen and nutrients to brain tissue.”

“The general takeaway is that the MIND diet appeared to matter most for people who started the trial with higher levels of Aβ40 and p-tau181,” says Dr. Dhana. “That said, these are group-level findings from a research setting, not medical advice, and anyone with concerns about their brain health or considering a major dietary change should talk with their own health care provider.”

All in all, he hopes these findings may encourage future clinical trials to consider baseline biomarker levels when designing studies and enrolling participants.

Sassos says this current study adds an important layer to the existing evidence. “We’ve known the MIND diet is associated with better cognitive outcomes, and now this research suggests that baseline Alzheimer’s biomarkers may influence how much someone benefits from the intervention.”

While this study highlights the important role nutrition can play in brain health, healthy aging is shaped by a combination of factors, she stresses. “Diet is one piece of the puzzle, alongside movement, sleep, social engagement, and other lifestyle factors that support brain function over time.”