Why You Should Consider Serving Fish This Thanksgiving

On September 7, the American Heart Association and American Stroke Association issued a joint presidential advisory entitled, “Defining Optimal Brain Health in Adults” (Gorelick et al., 2017). It was the culmination of a wealth of studies that looked at a variety of health factors, including diet, and recommended the Mediterranean diet as one that has been consistently associated with reduced cognitive decline. In fact, not only did it suggest that the Mediterranean diet is good for the brain, it went to explain that if we can use this diet to help maintain healthy blood pressure and cholesterol, that is even more beneficial than controlling those factors by medications alone. Lastly, the article pointed out that, although one is never too old to change to a healthy diet, the effects are stronger the younger one starts.

One landmark study that provides evidence for the Mediterranean diet looked at cognitive function over about four years in 334 older adults whose average age was 67 years (Vallas-Pedret et al., 2015). Individuals were randomized to their usual diet (with advice to reduce dietary fat), a Mediterranean diet plus olive oil, or a Mediterranean diet plus mixed nuts. They found that those in the Mediterranean diet groups performed better on tests of thinking and memory compared to the control group. (There was no difference between the olive oil and mixed nuts groups.)

In regards to Alzheimer’s disease, dementia, and mild cognitive impairment (MCI) in particular, a systematic review and meta-analysis found that adherence to the Mediterranean diet was associated with a reduced risk of developing either MCI or Alzheimer’s disease dementia (Singh et al., 2014).

What about blueberries, or coconut oil, or turmeric? Blueberries have resveratrol in them, one component of red wine that is thought to be beneficial. But randomized studies of resveratrol have failed to show benefit. (Blueberries are a great fruit, however, and a good source of antioxidants.) Regarding coconut oil and turmeric, there have not been any large-scale randomized studies, and the anecdotal data is not convincing.

In brief, the Mediterranean diet is the only diet proven beneficial for brain health. It includes:

• Fish
• Olive oil
• Avocados
• Fruits
• Vegetables
• Nuts
• Beans
• Whole grains

(It also includes red wine, but that’s a whole topic in itself, so let’s skip the wine for the moment.)

Foods to limit consumption of include: butter, margarine, red meats, fried foods, fast foods, pastries, white flour, white bread, and sweets. Some of these foods have unhealthy fats, and others, like white flour, are very quickly broken down into sugars, so it is almost like eating sugar.

What about poultry? The good news for Thanksgiving is that a variation of the Mediterranean diet (called the “MIND” diet) includes eating poultry twice a week (Morris et al., 2015). It produced a 53% reduction in the risk of developing Alzheimer’s disease!

So how can we use this knowledge to improve our holiday meal?

First, turkey is OK. (Whew!) For appetizers, serve unsalted nuts and fresh vegetables by themselves or with a yogurt-based dip. For stuffing, make it yourself, use 100% whole wheat bread instead of white bread, and use olive oil instead of butter or margarine. Or try a whole grain stuffing such as one based on barley or wild rice. For cranberry sauce, use whole cranberries and natural sweeteners like fresh or dried fruit instead of sugars. (Apples, oranges, raisins, and dates work great.) Sweet potatoes and squashes don’t need added sugar. Try a fruit compote for dessert with a mixture of fresh and dried fruit, perhaps with some pecans, almonds, and other nuts.

If you try it, you’ll find it is easier than you think to have a healthy Thanksgiving dinner. When you skip the added sugar and salt, you’ll enjoy natural flavors of the foods more.

Lastly, eat healthy portions. Don’t overdo it; enjoy having a little bit of everything. And go for a nice walk after dinner.

© Andrew E. Budson, MD, 2017, all rights reserved.