Multicultural Healthy Diet to Reduce Cognitive Decline

The Multicultural Healthy Diet (MHD) is a pilot randomized controlled clinical trial designed
to test the effects of an 18 month intervention on cognitive function among 326 middle-aged
individuals (40-65 yr). MHD is an anti-inflammatory diet tailored to a multicultural
population. The emphasis of the intervention is on plant-based foods and limited animal and
high saturated fat foods with focus on anti-inflammatory foods/food components specific to
the cultural context of the participants. The trial will employ a parallel group design
comparing the effects of the dietary intervention (MHD) on cognitive status to those of the
control diet or usual diet plus modules on self-care matters such as dealing with aches and
pains of aging, obtaining a health care proxy ,etc. To show that MHD can be adapted to this
population serum biomarkers indicative of the MHD diet pattern such as fatty acid profile as
well as other key nutrition biomarkers will be evaluated. Other aims include testing whether
the MHD intervention can benefit cognitive function using real-time ambulatory assessments.
The investigators will also assess plasma markers of oxidative stress and inflammation.
Components of the MHD diet that are associated with stable or improved measures of cognition
will also be evaluated. The clinical site for the proposed study is at the Albert Einstein
College of Medicine; the ambulatory cognitive assessment reading center is at Pennsylvania
State University, State College; the statistical core is at the University of Pennsylvania
and the laboratory for biospecimen analysis is at the University of Minnesota.

Inclusion Criteria:

- residency in Co-op City, Bronx, age (between 40-65 yrs)

- willingness to accept assignment to intervention or comparison diet group

- willingness to participate in a study where weight loss is not a primary goal

Exclusion Criteria:

- cognitively impaired

- history of traumatic brain injury

- psychiatric illness

- history of diabetes treated with a medication that may cause hypoglycemia

- renal or liver disease

- uncontrolled hypertension as defined as blood pressure > 140/90 mm Hg

- history of cardiovascular disease

- severe chronic illness

- low literacy

- history of alcohol or drug dependence

- hematologic disease or malignancy not in remission for more than 5 years

- visual, auditory, or motor impairment that precludes cognitive testing.

- chronic kidney disease