The association between adherence to the MIND diet and stroke: a case-control study

Associations of the MIND Diet with Cardiometabolic Diseases and Their Risk Factors: A Systematic Review

Purpose

Recent studies have expanded the scope of research on the Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) diet beyond its impact on cognitive performance. These investigations have specifically explored its potential to provide protection against cardiometabolic diseases and associated risk factors, including obesity and dyslipidemia.

Methods

We systematically summarized and evaluated all existing observational and trial evidence for the MIND diet in relation to cardiometabolic diseases and their risk factors in adults. PubMed, Embase, CINAHL and Cochrane Library databases were systematically searched to extract original studies on humans published until September 2023, without date restrictions. A total of 491 studies were initially retrieved, out of which 23 met the eligibility criteria and were included in the final review. Duplicated and irrelevant studies were screened out by five independent reviewers using the Rayyan platform. Quality assessment was ascertained using the Newcastle-Ottawa scale for observational studies and the Cochrane risk-of-bias tool (RoB 2) for randomized trials.

Results

Across the different study designs, the MIND diet was generally associated with an improvement in anthropometric measures and other cardiometabolic outcomes, such as blood pressure, glycemic control, lipid profile, inflammation and stroke. The effects of the MIND eating pattern on some cardiovascular diseases are less conclusive.

Conclusion

The findings of this systematic review support the recommendation of the MIND diet as a strategy to reduce cardiometabolic risk in adults. Further well-designed and long-term studies are warranted.

Association Between MIND Diet Adherence and Mortality: Insights from Diabetic and Non-Diabetic Cohorts

BACKGROUND/OBJECTIVES

To date, evidence regarding the protective roles of the Mediterranean-Dietary Approaches to Stop Hypertension Intervention for Neurodegenerative Delay (MIND) diet in patients with type 2 diabetes mellitus (T2DM) is scarce. This study aims to estimate the impact of adhering to the MIND diet on the mortality in patients with and without T2DM.

SUBJECTS/METHODS

In this cohort study, 6887 participants (1021 patients with T2DM) from the NHANES dataset were analyzed. The exposure is the MIND diet adherence. The primary outcomes are all-cause and cardiovascular (CV) deaths.

RESULTS

We documented 1087 all-cause deaths consisting of 377 CV deaths during the follow-up (median time of 10 years). Among participants with T2DM, those with a high MIND score (> 8.0, range of MIND score: 4.5-13) had a significantly lower risk of all-cause death (hazard ratio [HR] 0.75, 95% confidence interval [CI]: 0.59, 0.96, P = 0.021) and CV death (HR 0.50, 95% CI: 0.29, 0.87, P = 0.014) compared to those with a low MIND score (≤ 8.0). In participants without T2DM, a high MIND score was associated with a significant decrease in the risk of all-cause death (HR = 0.83, 95% CI: 0.70, 0.99, P < 0.001), but the association with CV death risk was not statistically significant.

CONCLUSION

This study uncovered significant associations between the MIND diet and decreased risk of all-cause and CV death in patients with T2DM. The findings highlight the potential benefits of following the MIND diet in managing and enhancing the outcomes of individuals with T2DM.

Adherence to the DASH, MeDi, and MIND diet scores and the incidence of metabolically unhealthy phenotypes

BACKGROUND

A metabolically unhealthy phenotype is associated with the risk of cardiometabolic events and can be prevented by adherence to healthy dietary patterns. The present study was designed to investigate the association between high adherence to the Dietary Approaches to Stop Hypertension (DASH), Mediterranean (MeDi), and Mediterranean-DASH intervention for neurodegenerative delay (MIND) diet scores and the incidence of metabolically unhealthy phenotypes in adults across body mass index (BMI) categories.

METHODS

In this cohort study, 512 subjects with metabolically healthy normal weight (MHNW) at baseline and 787 subjects with metabolically healthy overweight/obesity (MHOW/MHO) at baseline were included. Dietary intake was collected by a validated food frequency questionnaire, and DASH, MeDi, and MIND scores were calculated. The Joint Interim Statement (JIS) criteria were used to define a metabolically unhealthy status.

RESULTS

A total of 137 and 388 subjects with metabolically unhealthy normal weight (MUNW) and metabolically unhealthy overweight/obesity (MUOW/MUO) phenotypes, respectively, were observed, over a mean of 5.91 years of follow-up. The Cox proportional hazard regression indicated participants in the third tertile of the DASH score had a lower risk of the MUNW phenotype (HR: 0.59; 95% CI: 0.37-0.92) than those in the lowest tertile. Similarly, the highest adherence to the MeDi and MIND scores was also linked to a 46% (HR: 0.54; 95% CI: 0.36-0.81) and 47% (HR: 0.53; 95% CI: 0.34-0.83) lower risk of the MUNW phenotype, respectively. As well, there was an inverse relationship between the highest adherence to the DASH (HR: 0.66; 95% CI: 0.50-0.86), MeDi (HR: 0.74; 95% CI: 0.58-0.93), and MIND (HR: 0.57; 95% CI: 0.43-0.74) scores and the risk of MUOW/MUO. There was no interaction between age and the three dietary patterns in relation to a metabolically unhealthy phenotype.

CONCLUSION

High compliance with the DASH, MeDi, and MIND scores was associated with a lower risk of MUNW. An inverse relationship between these three dietary patterns and the incidence of the metabolically unhealthy phenotype was also observed in individuals who had MHOW/MHO at baseline.

The value of the MIND diet in the primary and secondary prevention of hypertension: A cross-sectional and longitudinal cohort study from NHANES analysis

Background

The Mediterranean-Dietary Approaches to Stop Hypertension for neurodegenerative delay (MIND) has been regarded as a novel healthy dietary pattern with huge benefits. However, its value in preventing and treating hypertension has not been investigated. The objective of this study is to investigate the impact of adhering to the MIND diet on the prevalence of hypertension in the entire population and long-term mortality in hypertensive patients.

Methods

In this cross-sectional and longitudinal study, 6,887 participants consisting of 2,984 hypertensive patients in the National Health and Nutritional Examination Surveys were analyzed and divided into 3 groups according to the MIND diet scores (MDS; groups of MDS-low [&lt;7.5], MDS-medium [7.5–8.0] and MDS-high [≥8.5]). In the longitudinal analysis, the primary outcome was all-cause death and the secondary outcome was cardiovascular (CV) death. Hypertensive patients received a follow-up with a mean time of 9.25 years (median time: 111.1 months, range 2 to 120 months). Multivariate logistics regression models and Cox proportional hazards models were applicated to estimate the association between MDS and outcomes. Restricted cubic spline (RCS) was used to estimate the dose–response relationship.

Results

Compared with the MDS-low group, participants in the MDS-high group presented a significantly lower prevalence of hypertension (odds ratio [OR] 0.76, 95% confidence interval [CI] 0.58, 0.97, p = 0.040) and decreased levels of systolic blood pressure (β = −0.41, p = 0.033). Among hypertensive patients, 787 (26.4%) all-cause death consisting of 293 (9.8%) CV deaths were recorded during a 10-year follow-up. Hypertensive patients in the MDS-high group presented a significantly lower prevalence of ASCVD (OR = 0.71, 95% CI, 0.51, 0.97, p = 0.043), and lower risk of all-cause death (hazard ratio [HR] = 0.69, 95% CI, 0.58, 0.81, p &lt; 0.001) and CV death (HR = 0.62, 95% CI, 0.46, 0.85, p for trend = 0.001) when compared with those in the MDS-low group.

Conclusion

For the first time, this study revealed the values of the MIND diet in the primary and secondary prevention of hypertension, suggesting the MIND diet as a novel anti-hypertensive dietary pattern.

Better adherence to the MIND diet is associated with lower risk of all-cause death and cardiovascular death in patients with atherosclerotic cardiovascular disease or stroke: a cohort study from NHANES analysis

The Mediterranean-DASH intervention for neurodegenerative delay (MIND) diet has been evaluated as a brain-protective diet pattern that contributes to better cognitive performance and attenuates dementia. Cardioprotective effects of the MIND diet have been demonstrated in the primary prevention of atherosclerotic cardiovascular disease (ASCVD), however, there is no exploration in patients with ASCVD. In this prospective cohort study, 943 patients with ASCVD or stroke from the National Health and Nutrition Examination Survey (NHANES) from 2003 to 2006 were enrolled and divided into three groups according to the MIND diet scores (≤7.0, 7.5-8.0, and ≥8.5). Compared with patients with low MIND diet scores (≤7.0), patients with better adherence to the MIND diet presented a significantly lower risk of all-cause and CV death, as results showed that the hazard ratio [HR] and 95% confidence interval [CI] were 1.09 (0.78, 1.52) in the group of 7.5-8.0, 0.66 (0.50, 0.87) in the group of ≥8.5 for all-cause mortality (P trend = 0.002); 0.70 (0.42, 1.17) in the group of 7.5-8.0 and 0.52 (0.35, 0.75) in the group of ≥8.5 for CV mortality (P for trend < 0.001). Besides, per one-score increase in the MIND diet score was associated with a 10% (HR = 0.90, 95% CI: 0.82, 0.99) lower risk of all-cause mortality and a 16% (HR = 0.84, 95% CI: 0.73, 0.97) lower risk of CV mortality in these patients. In conclusion, this study, for the first time, revealed that better adherence to the MIND diet was associated with improved outcomes in patients with ASCVD.

Adherence to the MIND diet and the risk of cardiovascular disease in adults: a cohort study

The Mediterranean-DASH intervention for neurodegenerative delay (MIND) and cardiovascular disease (CVD) has yet to be studied. As a result, the objective of this study was to investigate if there was a link between MIND diet adherence and the risk of CVD in adults over a 10.6-year period of time. There were 2863 participants in this research cohort who were free of CVD and were followed-up for 10.6 years. Using a validated food frequency questionnaire (FFQ), the MIND diet score was calculated. Reliable medical data was used to evaluate cardiovascular events, including coronary heart disease (CHD), stroke, and CVD-related mortality. A total of 200 CVD occurrences (159 CHD, 21 stroke, and 20 CVD fatalities) were documented throughout the 10.6-year follow-up period. Our results indicated each increase in MIND diet score reduced the incidence of CVD by 16% (HR: 0.84; 95% CI: 0.74 to 0.96). We also detected an inverse association relationship between the MIND diet and the incidence of CVD after classifying the MIND diet score into tertiles as well (HR: 0.68; 95% CI: 0.47 to 0.97). Among the components of the MIND diet, each increase in whole grains, green leafy vegetables, and beans reduced the risk of CVD by 60%, 45%, and 65%, respectively. Finally, our findings revealed that the higher adherence to the MIND was associated with a lower risk of cardiovascular events. Besides, we found an inverse association between consumption of whole grains, green leafy vegetables, and beans and the number of CVD incidents. However, more well-designed cohort studies are needed before conclusive conclusions can be formed.