When Dr Annie Fenn’s mother Diana was diagnosed with the early stages of Alzheimer’s in 2015, the brain health expert knew what to do.
“We got rid of the processed food in her diet, replaced frozen dinners and cookies with whole foods, and watered down her wine until she was no longer drinking at all. Diet soft drinks and juice were eliminated,” says Fenn, 58, from Jackson, Wyoming.
“She enjoyed simple meals made by her caregivers such as salmon with brown rice and broccoli, almond butter on wholegrain toast and oatmeal with berries and almond milk.”
This approach is part of the MIND diet, aka the Mediterranean-DASH Intervention for Neurodegenerative Delay, which was devised in 2015 by American researchers from Rush University Medical Centre in Chicago and Harvard School of Public Health in Boston.
It combines the Mediterranean diet with the DASH (Dietary Approaches to Stop Hypertension) eating plan, with an emphasis on the 10 most neuro-protective food groups (see below).
Dairy products, red meat and fried and processed foods are kept to a minimum, and it includes red wine.
The scientists found that among participants who followed the MIND guidelines closely there were 53 per cent fewer cases of Alzheimer’s after four and a half years. Participants who followed the diet closely over time even improved their cognitive function.
And so it proved with Diana, who, at 87, is still living at home. “Her general health is frail but she has caregivers and is still able to do simple things like make toast, walk around at home, and sit outside on the patio in the sun and enjoy the birds,” says Fenn.
It’s also a philosophy that gynaecologist-turned-chef Fenn swears by. She is the founder of the Brain Health Kitchen, the only cooking school that’s focused exclusively on brain health through food and lifestyle, although she has made her own modifications to the MIND diet.
“The BHK food groups reflect a plant-heavy version of the MIND and Mediterranean diets, with more servings of leafy greens and vegetables and fewer servings of food from animals,” she explains. “I based this on the vast amount of data that points to the brain health benefits of eating plants in reducing heart disease, especially stroke.”
She also reduces the prominence of alcohol after 2022 findings from the UK Biobank, that even moderate drinking may be harmful.
None of this was known when Fenn was growing up eating boxed cereal, frozen dinners and sandwiches made with luncheon meat. Fenn only realised how much her diet was based around processed foods when she went to Spain as a 16-year-old exchange student. After returning home, she adopted the Mediterranean diet and started cooking her own meals.
Today Fenn follows a plant-heavy MIND diet and stays active with daily hiking, walking, biking, skiing, yoga or weight training. She also meditates for 12 minutes each day, barely drinks and goes alcohol-free for four months a year.
As it has long been thought that hormones play a role in Alzheimer’s, which could explain why women make up 65 per cent of current cases of dementia in the UK, Fenn took the contraceptive pill until menopause to keep her oestrogen levels stable throughout midlife and then went on HRT, which she plans to continue as long as she can.
Other brain-friendly habits include being sociable and learning new skills, such as speaking Italian.
Her two sons, aged 22 and 25, are following her example. “They cook for themselves and are building solid brain-healthy habits,” she says. “The earlier you begin eating with brain health in mind, the better – you’ll cultivate a brain that is resilient to age-related cognitive decline from all causes, especially Alzheimer’s.”
The 10 Brain Health Kitchen food groups
These 10 food groups provide everything an ageing brain needs to thrive. Think of it as a brain-healthy food pyramid, with the foods to eat most at the top of the list, and the produce to be enjoyed in small amounts at the bottom.
95g a day
Regularly eating berries may slow down brain ageing by two-and-a-half years. Studies showed improved memory in older adults with mild cognitive impairment if berries are enjoyed daily. They have a low glycaemic index score so they’re less likely to elevate blood sugar.
Tip: Choose the most vibrant red, purple, blue, or black berries. The darker the berry, the more anthocyanins. These are important brain-boosting flavonoids that help scrub the brain of inflammatory debris.
2. Leafy greens
80g raw or 200g cooked a day
Leafy greens are the most nutrient-dense of all the vegetables. The darker the leafy green, the more nutrient-dense. Sample the wide variety, from “tender” greens like romaine lettuce, rocket and watercress to hearty greens such as kale, Swiss chard, spinach and chicory.
Tip: Buy root vegetables with their green tops. The dark leafy greens of carrots, beets, turnips, and radishes have big, earthy flavours and a high nutrient density.
3. Other vegetables
480g raw or 240g cooked a day
Vegetables provide many brain-specific nutrients, all in one fibre-rich package. Diversity is key. Aim to eat 30 or more different types of plants – mostly vegetables – each week. One-third of your veg should be cruciferous (broccoli, cauliflower, cabbage, Brussels sprouts, and bok choy). Choose one serving of colourful veg a day such as carrots, sweet potatoes and beetroot. Include alliums (garlic, onions, spring onions and leeks) frequently.
Tip: Cooked tomatoes provide 62 percent more lycopene, a potent antioxidant, than eating the same amount raw.
Eat one or more 85g servings a week
Fish and seafood provide the two types of omega-3 fatty acids – DHA (docosahexaenoic acid) and EPA (eicosapentaenoic acid) – that repair and build brain cells throughout life. Other key brain health nutrients in fish and seafood include selenium, vitamin D and vitamin B12, which is needed to build the myelin sheath that protects nerve cells.
Tip: Cook fish over a low indirect heat, or braise, so that it retains its brain-boosting nutrients.
5. Nuts and seeds
Eat 40g at least four times a week
A handful of nuts most days is proven to reduce your risk of having a heart attack or stroke and also keeps your memory sharp. Regular nut eaters perform better on cognitive tests, and those who eat nuts four times weekly outperform those who eat nuts just a few times a month.
Tip: Buy nuts and seeds raw since they retain more of their healthy fats and antioxidants.
6. Beans and lentils
Eat four or more 30g cooked servings a week
Beans stabilise blood sugar, lower harmful blood cholesterol and provide the type of fibre that health-promoting gut microbiota need to flourish. Bean eaters are slimmer, on average, than people who don’t eat beans, and obesity is a known risk factor for Alzheimer’s.
Tip: Tinned beans can have a high sodium content and too much salt is not part of a brain-healthy diet. Look for “no salt added” on the label or a sodium content of under 1 per cent in the nutrition facts. If you can’t find low-salt beans, rinse well before using.
7. Whole grains
Eat a 100g cooked serving three times a day
A grain is considered whole when its three original parts are intact: bran, germ, and endosperm. Whole grains, including barley, bulgur, freekeh, rye, spelt, wheatberry, oats and brown rice, contain brain-healthy B vitamins, antioxidant vitamin E and fibre.
Tip: Refrigerate a batch of brown rice or barley for up to five days; add to soups, vegetable frittatas or eat toasted as a salad topping.
8. Meat, poultry and eggs
Eat small portions (85g) of chicken or meat up to four times each week; limit eggs based on your personal health factors
Brain-protective diets all have one thing in common: they are mostly plants. If you choose to include animal products the emphasis should be on quality and smaller amounts. If you skip this food group entirely, your brain will still thrive.
Tip: Adopt gentle cooking techniques (braising and slow cooking) to minimise advanced glycation end products (AGEs), the brain-harmful substances created during cooking.
9. Olives and olive oil
Use olive oil as your primary cooking oil and enjoy olives frequently
High-quality olive oil provides polyphenols, potent antioxidants that are part of the reason numerous studies report olive oil consumers suffer fewer heart attacks, strokes, and have lower overall rates of death from any cause. Eating the whole olive provides the same healthy fats and polyphenols as in olive oil.
Tip: Use an everyday bottle of extra-virgin olive oil for cooking and baking and a high-end one for drizzling.
10. Coffee, tea and other drinks
While water is the brain-healthiest drink of all, other choices can be a welcome part of your dietary pattern. A substantial body of science says drinking coffee (up to five cups per day) and tea is advantageous for a healthy brain and for fending off Alzheimer’s and age-related cognitive decline.
Tip: Drink coffee black and unsweetened as dairy products may deactivate the antioxidants in coffee and sugar turns it into a brain-harming beverage. Add turmeric, cinnamon or nutmeg to coffee grounds before brewing to add an anti-inflammatory boost.
Excerpted from The Brain Health Kitchen by Annie Fenn (Artisan Books, £30). Copyright © 2023
Recipes for brain health
Wine-braised chicken with currants, caper berries and cauliflower
You can use raisins, dried blueberries or sultanas and if you can’t find caper berries (the fruit of the caper plant), use capers (the flower buds) instead.
80g dried currants or golden raisins
240 ml boiling water
2 tablespoons extra-virgin olive oil
1 large shallot (140g), thinly sliced
8 small boneless, skinless chicken thighs (910g total)
1 teaspoon kosher salt
1/2 teaspoon freshly ground black pepper
240 ml dry white wine
1 medium head cauliflower (680 g), cut into 5 cm florets
60g caper berries or 30 g capers, rinsed
60 ml white wine vinegar
65g roasted pistachios
30g fresh flat-leaf parsley leaves, finely chopped
1. Place the currants in a small bowl and pour the boiling water over top. Let sit until soft, about 15 minutes.
2. Warm the oil over low heat in a casserole dish. When the oil starts to shimmer, add the shallot and cook, stirring often, until starting to brown, about five minutes.
3. Season the chicken with 1/2 teaspoon of the salt and the pepper. Add the chicken to the shallots and cook over medium heat until the pieces can be easily released from the bottom of the pan, about five minutes.
4. Turn the chicken over and add the wine, then the currants and their soaking water. Adjust the heat so the sauce gently bubbles at a low simmer. Add the cauliflower to the pot, and sprinkle with the remaining 1/2 teaspoon salt.
5. Stir to coat, cover, and cook at a low simmer until you can insert the tip of a knife into the largest piece of cauliflower, 20 to 25 minutes.
6. Stir in the caper berries, vinegar, pistachios, and parsley. Divide between four shallow bowls and serve hot.
Slow-roasted salmon with avocado butter
Slow-roasting salmon is not only a brain-friendlier method than cooking over higher heat, it’s practically foolproof, turning out perfectly cooked salmon every time.
2 small fennel bulbs (230 g), thinly sliced, fronds reserved for garnish
2 cans chickpeas, drained
1 large lemon, thinly sliced, seeds removed
120 ml water
60 ml extra-virgin olive oil, plus more for drizzling
1 teaspoon kosher salt
680g whole salmon fillet, skin-on (preferably wild caught), about 2.5cm thick (or use salmon fillets, 115g-170g portions)
1/4 teaspoon freshly ground black pepper
230g peas (fresh or frozen)
2 large, ripe avocados, mashed
3 tablespoons fresh lemon or lime juice
2 tablespoons unsalted butter, preferably grassfed, at room temperature
2 tablespoons fresh flat leaf parsley
1 medium garlic clove, minced (about 1/2 teaspoon)
1. Set an oven rack in the centre position and preheat the oven to 150°C (130°C fan).
2. Toss the fennel, chickpeas, lemon, water, 2 tablespoons of the oil, and 1/2 teaspoon of the salt on a rimmed baking sheet until evenly coated, then spread into an even layer.
3. Top with the salmon, skin side down, and pour the remaining 2 tablespoons oil over top. Sprinkle the salmon with pepper and ¼ teaspoon of the salt.
4. Bake for 20 to 28 minutes, stirring in the peas after 10 minutes, until the salmon is just turning opaque.
5. Meanwhile, combine the avocados, lemon juice, butter, parsley, garlic, and the remaining 1/4 teaspoon salt in the bowl of a food processor. Process until completely smooth. Keep in the refrigerator until ready to eat.
6. To serve, divide the salmon and vegetables between plates and spoon a tablespoon of pan sauce over top. Top each piece of fish with 2 tablespoons of avocado butter, some of the reserved fennel fronds, and a drizzle of oil.
7. Store extra avocado butter in an airtight container with a piece of parchment paper pressed onto the surface of the butter to prevent browning. It will keep for up to 3 days in the refrigerator or 3 months in the freezer.
Warm lentil, grapefruit and bitter greens salad
Tossing the lentils with the vinaigrette while still warm helps them soak up all the bold flavours going on in this salad.
Serves: 4-6 (as a side dish)
200g puy, green, or brown lentils, rinsed
1 large grapefruit
4 anchovy fillets, finely chopped
1 teaspoon anchovy paste
1 large garlic clove, minced
3 tablespoons extra-virgin olive oil, plus more for drizzling
2 teaspoons Dijon mustard
1/2 teaspoon kosher salt
1/4 teaspoon crushed red pepper flakes
1 small head radicchio (200 g), cored and thinly sliced
1 medium head endive (115 g), thinly sliced lengthwise
80g almonds, toasted and coarsely chopped
Freshly ground black pepper
Flaky salt (optional)
1. Bring a medium pot of salted water to a boil and add the lentils. Reduce the heat to a gentle simmer, cover, and cook until the lentils are soft but still hold their shape, 20 to 25 minutes. Drain in a colander and transfer back to the pot.
2. While the lentils cook, cut off the stem ends of the grapefruit, then cut off the peel. Slice between the white pith and the flesh to remove the segments. Squeeze any juice left from the peels into a small cup. (You should have 1 to 2 tablespoons.) Discard the peels.
3. In a large serving bowl, use a fork to mash together the anchovies and garlic until you have a paste. Whisk in the oil, 1 tablespoon of the grapefruit juice, and the mustard, kosher salt, and red pepper flakes.
4. Add the warm lentils and toss to combine. Fold in the radicchio and endive, then top with the grapefruit segments and almonds. Drizzle with any remaining grapefruit juice and more oil, then season with black pepper and flaky salt (if using).
Coffee, date and oat bars
These fig-packed chewy bars are packed with brain-healthy ingredients.
Makes 12 bars
Extra-virgin olive oil or olive oil cooking spray, for the pan
170g pitted dates (10 to 12 large Medjool dates)
250ml freshly brewed coffee (decaff if you prefer)
1 teaspoon orange oil, flavour, or extract
140g toasted almonds
200g rolled oats
60g almond flour or meal
1 teaspoon kosher salt
200g dried figs, stems removed and coarsely chopped
1. Set an oven rack in the centre position and preheat the oven to 180°C (160°C fan). Line an 8-inch (20cm) square baking pan with parchment paper so that the edges overhang, and coat with olive oil or cooking spray.
2. Place the dates, hot coffee, and orange oil in the bowl of a food processor. Let sit for 5 minutes to soften.
3. Process on low speed until you have a mostly smooth paste, about 30 seconds. Scrape into a bowl. Place the almonds in the food processor and process on low speed until coarsely chopped, about 30 seconds.
4. Add the oats, almond flour, egg, salt, and 150g of the date puree and process until the ingredients start to come together, about 30 seconds. Scrape down the sides of the bowl and process for another 30 seconds.
5. Set aside 215g of the oat mixture to use as a topping and transfer the rest to the prepared pan. Press firmly using your hands to make an even crust with an edge that comes 2.5cm up the sides of the pan. Spread the remaining date puree over top and smooth into an even layer.
6. Sprinkle with the figs and the remaining oat mixture. Press the toppings firmly into the base so they adhere. Bake for 30 to 40 minutes, until the bars are golden brown on the edges and set in the centre.
7. Let cool completely before cutting into bars. To store, wrap tightly and keep in the refrigerator for up to 5 days or in the freezer for up to 3 months.