By: Stephanie Searor, MS RD LDN
Edited/Revised by: Elizabeth Kolena

In January 2021, U.S. News & World Report brought together a group of experts to review, assess, and scrutinize 39 diets that exist today. The panel was made up of physicians from top-tier institutions, directors of respected nutrition programs across the United States, psychologists, and wellness experts. Diets were assessed for many qualities including their safety, how easy they were to follow, and their health benefits. The experts found that the MIND (Mediterranean-DASH Intervention for Neurodegenerative Delay), DASH (Dietary Approaches to Stop Hypertension)  and Mediterranean diet were some of the best diets in the world. All three meal plans were ranked in the top five for “Best Diets Overall” and “Easiest Diets to Follow”.(9) There is no denying the benefit to these meal plans, but what is the difference between them? Are they really that easy to follow? And how much do our food choices actually matter?

Food is medicine that you get to choose everyday. This mindset shift helps you remember that food plays important roles in fueling your body, providing you sustenance, building and maintaining muscle, and nourishing your brain (to name just a few). The notion that our food choices directly impact our health is not a new one; data traced back to the 1960s highlights discoveries made by doctors and scientists regarding the link between what people ate and the status of their overall health.  A group of people with similar diets that lived on selected Mediterranean islands was studied over time. It was noted that these populations had longer life expectancies when compared to the rest of the world. From this discovery evolved many of the diets and “food lifestyles” lauded today to optimize our overall health and function. The focus of this article is on exploring the components and benefits of three eating plans: the DASH, the Mediterranean diet and the MIND diet. 

The “DASH Diet”: Dietary Approaches to Stop Hypertension

The “DASH Diet” was developed in the 1990s as a response to growing concern over rising healthcare costs and deaths associated with hypertension (read: high blood pressure) and cardiovascular disease.1 Research studies found that following the DASH diet could help to lower blood pressure, blood glucose levels, triglycerides, and LDL cholesterol (“bad” cholesterol).(1) It is high in heart-healthy vitamins and minerals (potassium, calcium, magnesium) and low in fat, cholesterol, sodium, and added sugars. A secret weapon of the effectiveness of this diet on high blood pressure is its focus on low sodium levels. The DASH calls for consumption of no more than 2300 mg of sodium per day, with improved benefit to blood pressure shown for those who are able to reduce sodium intake to 1500 mg per day.(2) The specific mechanism of how sodium truly lowers blood pressure is complex and still being studied by scientists to this day. Studies have shown that elevated levels of sodium can cause increased blood volume, making the heart work harder to pump blood throughout the body, thus increasing blood pressure within the arteries. In addition, high levels of sodium in our bodies have been shown to affect our kidneys and heart wall function, both of which can play a role in high blood pressure.(3)

The guidelines for the diet are as follows;

• High intake of whole grains daily- like whole grain pasta, bread, oats, and cereal
• Focus on fruits, and vegetables daily (focusing on non-starchy, leafy greens like spinach and kale)
• Moderate consumption of lean meats, proteins, and fish
• Dairy is allowed – in moderation – as long as it is low fat or fat free
• Low consumption of nuts, seeds, legumes, fats, and oils (several times per week or less)
• Little to no consumption of sweets, processed foods, or condiments high in sodium
• No alcohol recommended
• Try salt substitutes or increased use of herbs for seasoning due to salt restrictions

Example day of DASH diet eating: 

Breakfast: Avocado toast on multigrain bread + fried egg + low fat yogurt with fruit

Lunch: Whole wheat pasta, shrimp, + peppers

Dinner: Grilled chicken, brussel sprouts & broccoli

The Mediterranean Diet

The “Mediterranean Diet” is not so much a diet, but a dietary lifestyle.(4) As mentioned earlier, in the 1960s (during the Seven Countries Study), four Mediterranean areas were of particular interest: Crete and Corfu, Greece, Dalmatia, Croatia, and Montegiorgio, Italy. Researchers studied the similarities among the population’s diets, later coined as “The Mediterranean Diet”. The Mediterranean diet is very high in fiber and antioxidants, low in saturated fat, and very low in trans-fat (which should be avoided no matter what your diet). This is important because saturated fats and trans fats are culprits of clogging our arteries and leading to heart disease. The incidence of death related to cardiovascular disease was lowest in the Mediterranean areas studied compared to any other part of the world. Studies show that cardiovascular disease and Alzheimer’s disease have been linked, thanks to genetics and DNA, which means that lowering the risk for cardiovascular disease may also help to reduce the risk for Alzheimer’s disease.(5) 

Traditionally, a Mediterranean style of eating includes:(4)

• High intake of fruits, vegetables, legumes (beans and lentils), and whole grains on a daily basis
• Olive oil as the primary fat source
• Moderate consumption of fish
• Moderate consumption of wine (5 ounces per day)
• Low consumption of dairy and meat (several times per week or less)
• Little to no consumption of processed, high fat, high sugar, or high sodium foods

Example Day of Mediterranean Diet eating: 

Breakfast: Scrambled eggs with tomatoes

Lunch: Mediterranean bowl: arugula, chickpeas, cucumbers, black olives, tomatoes, hummus & olive oil

Dinner:  Salmon salad with an olive oil based dressing

The MIND diet (Mediterranean-DASH Intervention for Neurodegenerative Delay) 

The MIND combines the best of both worlds. It is a hybrid food plan combining the Mediterranean diet and the DASH and is focused on fostering brain health and preventing cognitive decline and dementia. It was first developed in 2015 by a nutritional epidemiologist named Martha Clare Morris. The MIND diet is founded on research sponsored by the National Institute on Aging that was conducted over a span of 10 years by Rush University in Chicago, IL. Findings of this study showed that adherence to the MIND diet reduced the risk for Alzheimer’s development by over 50% of the study participants.(6) 

Can making smarter dietary choices really boost your brainpower? The short answer is yes. Improved diet and lifestyle brings a wealth of short term benefits like improved focus, attention and energy. The main goal of the MIND diet is to slow or completely prevent the natural cognitive decline that inevitably occurs with aging. The MIND diet accomplishes this with a meal plan recommending increased consumption of neuroprotective foods, and decreased consumption of harmful, inflammation driving foods. The MIND diet is rich in omega-3 fatty acids, which are polyunsaturated fats linked to having a neuroprotective effect on our bodies and are known to decrease inflammation and oxidative stress throughout the body.(10) Studies have demonstrated that increased levels of this type of stress and inflammation in our brains have been linked to Alzheimer’s Disease.(7)  It is important to remember that our body systems and organs are all interconnected - and a benefit to one body system inherently yields benefits to others. Because the MIND diet combines the DASH and the Mediterranean diets, an individual following this meal plan will reap heart-healthy benefits of the DASH diet, including decreased blood pressure, decreased cholesterol and improved heart health. Lower blood pressure leads to improved blood flow of oxygen-rich blood to all organs of our body (including the brain). This results in lower risk of  development of vascular dementia and strokes.(8)

Guidelines for this diet include ten food groups, including green leafy vegetables, non-starchy vegetables, berries (especially blueberries), nuts, beans, red wine, whole grains, fish, poultry, and olive oil.(6) This diet favors certain fruits and vegetables (blueberries & leafy greens) over others, which is a difference between this diet and the Mediterranean diet. It even shows benefits even when compliance to this lifestyle is not 100%, so if you have a “cheat day” all efforts do not go to waste.

Specific guidelines are: 

• Try to consume at least three servings of whole grains each day
• Try to eat a salad every day, along with at least one more non-starchy vegetable
• Consume berries (with an emphasis on blueberries) and poultry at least twice per week
• Snack on nuts at least several times per week, if not every day
• Eat beans/legumes every other day
• Have a glass of red wine each day (5 ounces)
• Eat fish at least once per week
• Consume olive oil as your main source of fat, but in very small quantities (not specified)
• Consume less than one tablespoon of butter per day
• Eat no more than one single serving once per week: fried/fast food, red meat, cheese, desserts and “junk foods”

Day of Meals in the MIND diet: 

Breakfast: whole grain Oatmeal with blueberries + blueberry banana smoothie

Lunch: Spinach salad with whole grain grilled chicken sandwich

Dinner: Pan seared salmon salad with 1 cup grilled veggies

See below for the diets side-by-side to compare:

Final Food for Thought

Each respective diet described above has its own mission. The DASH eating plan is based upon the goal of lowering an individual’s blood pressure. The Mediterranean diet is focused on promoting general cardiovascular health, with the intent to lower heart disease. The MIND diet is neuroprotective and is meant to prolong cognitive functioning, slow the natural course of cognitive decline and the onset of dementia. 

It is important to note that just because a diet encourages a certain food, does not mean you should consume it.  For instance, if you are unable to tolerate dairy (lactose intolerance), then choosing dairy-free options makes sense for you. If you take a medication that requires you to avoid alcohol, rather than drinking a glass of wine, you can substitute 100% grape juice (with no added sugar) to get the same benefits from the grapes. Choosing the diet that is best for you and your health goals can be difficult.  However, knowing more about the DASH diet, the Mediterranean diet, and the MIND diet makes you better equipped to make smart diet choices. With increased knowledge of nutrition comes the power to live your best and most healthy life!

This article is not meant to diagnose or treat any medical condition, and we advise that you speak with your doctor before starting any new diet or exercise regimen.

References

1. Challa HJ, Tadi P, Uppaluri KR. DASH diet (dietary approaches to stop hypertension). Treasure Island, Florida. Stat Pearls. 2019. 
2. “DASH Eating Plan”. National Heart Lung and Blood Institute. https://www.nhlbi.nih.gov/health-topics/dash-eating-plan
3. Farquhar, William et. al. “Dietary sodium and health: more than just blood pressure”. Journal of the American College of Cardiology.  2015 Mar 17; 65 (10). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5098396/
4. Mayo Clinic staff. Mayo Clinic. Mediterranean diet; a heart-healthy eating plan. https://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/in-depth/mediterranean-diet/art-20047801. Updated June 21, 2019. Accessed September 27, 2019.
5. Dryden J. Washington University School of Medicine in St. Louis. Cardiovascular disease, Alzheimer’s genetically linked. https://medicine.wustl.edu/news/cardiovascular-disease-alzheimers-genetically-linked/. Updated November 9, 2018. Accessed September 27, 2019.
6. Bradford A. Live Science. What is the MIND diet? https://www.livescience.com/57132-mind-diet.html. Updated December 8, 2016. Accessed September 27, 2019.
7. Kinney, Jefferson et. al. “Inflammation as a central mechanism in Alzhemier’s disease”. Alzhemiers & Dementia, vol 4. 2018. pp 575-590. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6214864/
8. “What do we know about diet & prevention of Alzheimer’s disease?” National Institute on Aging. https://www.nia.nih.gov/health/what-do-we-know-about-diet-and-prevention-alzheimers-disease. Updated: November 27, 2019. Accessed: April 15, 2021
9. “Best Diets’. U.S. News & World Report. Updated: Jan 4, 2021. https://health.usnews.com/best-diet
10. Morris, M. et al. “Mind Diet slows cognitive decline with aging”. Alzheimers Dementia. 2015 Sept; 11(9) 1015-1022. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4581900/