A group consisting of a brain health expert, 2 nutritionists and recipe developers, and even several celebrity chefs have teamed up to create what they call one of the first best-evidence, science-based "cookbooks for the healthy brain."
The goal of Mindfull, according to lead author Carol Greenwood, PhD, senior scientist at the Rotman Research Institute at Baycrest Health Sciences and professor of nutrition and brain health at the University of Toronto, Ontario, Canada, is to provide consumer-friendly information on the science of good nutrition.
The 300-page ebook offers step-by-step recipes along with detailed explanations as to why each one's various ingredients are important, based on past research.
Some of the book's recommended nutrients include omega-3 fatty acids, vitamin E, fiber, folate, polyphenols, and monounsaturated fats. The cookbook also lists several spices and herbs thought to contain brain-protective compounds.
"It really starts with making the right selection of foods during your grocery shopping. No single nutrient is going to be a magic bullet. So we wanted to provide information on nutrients that are important to overall diet quality," Dr. Greenwood told Medscape Medical News.
"Overall, I wanted to convey that the science is reliable and we're not making any unsubstantiated claims. And in many instances, we're drawing on consensus statements," she said.
Captain Joseph R. Hibbeln, MD, acting chief of the Section on Nutritional Neurosciences at the National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, in Bethesda, Maryland, called cookbooks such as this "very important."
"Science has to get translated to the mouth," said Dr. Hibbeln, who was not involved with the cookbook.
Alzheimer's, Lifestyle Link
According to the Alzheimer Society of Canada, 60% of diagnoses of Alzheimer's disease can be attributed to lifestyle choices.
"Poor eating habits and a lack of physical and intellectual stimulation are stronger drivers for dementia than genetics alone," according to a release from Baycrest.
"We know that diet is an important predictor of how well our brain ages and that people who have better-quality diets have greater preservation of their brain function with aging," said Dr. Greenwood in the same release.
After focusing on diet and brain health from a research perspective "for close to 30 years," she told Medscape Medical News that she wanted to "share our body of evidence with the public" in a way that was easily accessible.
She teamed up with professional recipe developer Daphna Rabinovitch and food expert Joanna Gryfe to "put the science into perspective" and to translate the data into a cookbook that would focus on healthy cognitive aging.
Dr. Greenwood reported that the process would start with a meeting between herself and Rabinovitch to discuss the core message of an individual meal, such as body weight regulation during breakfast or need for glucose in terms of cognitive processes.
"Once we decided on that message, I would write about that piece of science and then Daphna and I would sit down together. I would talk about the types of food I would like to see included, and then she had the responsibility of taking that information and developing it into recipes," explained Dr. Greenwood.
That information was also given to several noted Canadian chefs and even the wife of Canada's prime minister, Laureen Harper, when approached about contributing their own recipes.
"We would tell them the specific focus we really wanted them to draw on, whether it was complex carbohydrates, more vegetables, etc," said Dr. Greenwood.
For example, a recipe for whole wheat pancakes from a celebrity chef was created to also include blueberries, to hit the importance of eating more fruit, and used ricotta as a low-fat solution to whipped cream. Each recipe also includes references to related studies.
"I thought it was important to do this in terms of protecting the scientific integrity of the project," said Dr. Greenwood
Nevertheless, the field is becoming crowded with books claiming to focus on eating for a healthy brain, including The Brain Power Cookbook; Change Your Brain, Change Your Body; and even The Alzheimer's Prevention Cookbook. So why should consumers and clinicians look to this new book? What sets it apart?
"Some books make claims that aren't always substantiated, including one out there that promotes veganism for brain health. The reality is it is healthful, but we have no evidence that a vegan diet is better than a regular diet," said Dr. Greenwood.
"So standing back and not trying to promote a personal preference around diet and lifestyle but giving it that real scientific-based evidence is where I think we are unique," she said.
She added that although it is true that some very credible organizations are putting out their own cookbooks, "by definition they are very targeted towards the disorders more to their interests. We're trying to put a broader perspective on it."
Dr. Greenwood laughed, somewhat exasperatedly, when asked: why do you think the public gets so much wrong when it comes to healthy eating?
"That's the question, isn't it? I think there's a lot of confusion out there. Our target is the 40- to 60-year-old age group. And I think the general message we really need to get across is that this is the age where we start going into increased risk for obesity and its associated disorders. And we need to think about what our brain health is going to look like in our senior years," she said.
"Over the last decade, I feel that we've seen an increased medicalization of eating. People have lost touch with just that gentle healthy eating approach, such as with fresh fruits and vegetables. We're just trying to recreate that balance."
Dr. Hibbeln told Medscape Medical News that the general public often has problems understanding "things in the abstract." Instead, they need concrete instructions.
"I felt that this book is not directed towards physicians or scientists. It's directed towards high-end eaters. This is a chef's cookbook and not a 7-11 diet. People need to make these foods, and it's headed towards the right direction," he said.
"I've seen many books before where the writers tried to review the science to excess and push it where it shouldn't go and wind up doing a hackneyed job. And I don't feel that was the case here. The scientific introduction was straightforward, evidence-based, and accessible."
Nevertheless, he added that he would next like to see a book aimed at a slightly less high-end consumer.
"We need cookbooks with recipes for black beans and for sardines!" he laughed, noting that both are very good for cognitive health.
"Sardines have really critical nutrient components. They've got vitamin D, minerals, calcium, omega-3s. They're fabulous."
Dr. Hibbeln was a member of the 2006 treatment recommendation committee for the American Psychiatric Association, which issued recommendations that all psychiatric patients should take at least 1 gram per day of omega-3 fatty acids. He noted that it is actually a good idea for everyone to increase their omega-3 intake.
"I think the best database approach to dietary patterns is something around the definition of a Mediterranean diet. And that means a lot more fruits and vegetables, a lot more omega-3 fatty acids, and I would argue a lot less omega-6 fatty acids."
"Nix the 6"
He noted that "the biggest origin" for the latter component in a United States diet is in soy bean oil, which is often incorporated into processed foods.
Dr. Hibbeln reported that a study that he and his colleagues published earlier this year in Obesity showed that increased intake of linoleic acid (LA), a precursor to omega-6 arachidonic acid, caused significant elevations in levels of the endocannabinoids 2-arachidonoylglycerol and anandamide, resulting in the development of diet-induced obesity in mice.
"It turns out that one of the major functions of the cannabinoids, the marijuanalike molecules in the brain, is to regulate appetite," he explained.
However, the study showed that the detrimental effects from LA can be prevented by consuming diets with sufficient amounts of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA).
"I think this is critically important for many illnesses, including psychiatric illnesses. When it comes to nutrients needed for brain health, I would say people are probably the most deficient in omega-3s. Yet omega-6 fatty acids flood the brain and the body and push out the needed omega-3s," said Dr. Hibbeln.
"Historically, omega-6 was around 1% of all calories. In the last 50 to 75 years, it's increased to 8% or 10%. At this point, we can't link the data on [LA] to an important question: as diet has changed, how strong is the case that this is linked to the increased prevalence of diseases, such as Alzheimer's?"
"But I would say that everyone should 'nix the 6' whenever possible. As good as this current cookbook is, I wish they understood more about omega-6s," he said.
Dr. Hibbeln added that he also believes that psychiatrists should refer all of their patients to dieticians.
"No matter what psychiatric disorder patients have, they're at higher risk for heart disease, etc. Just as you would refer someone with a broken leg to an orthopedist, I believe this is very important.
Mindfull is currently available by download only from iTunes, Amazon, and Kobo. It is scheduled to soon be available from Google Play as well.
The book was supported by the Baycrest Foundation and by Cogniciti Inc. Dr. Greenwood reported that the majority of the proceeds from the book will be used to support programs and services that promote innovations in aging and brain health at Baycrest.
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Cite this: Science-Based 'Cookbook for the Brain' Offers Food for Thought - Medscape - Nov 15, 2012.