Racial differences in the association between Mediterranean-Dietary Approaches to Stop Hypertension Intervention for...

The Mediterranean-DASH (Dietary Approaches to Stop Hypertension) Diet Intervention for Neurodegenerative Delay (MIND) diet has been associated with cognitive performance, but little is known about factors related to the social determinants of health, such as race, influence this association. The aim of this study was to investigate racial differences in the association between MIND diet scores and cognitive performance.

In this cross-sectional analysis of older adults from the National Health and Nutrition Examination Survey (NHANES) 2011-2014, MIND diet scores (0-15) were calculated based on the intake of 15 food groups assessed using a 24-h dietary recall. Cognitive performance was assessed using a word list from the Consortium to Establish a Registry for Alzheimer's Disease, the Animal Fluency, and the Digit Symbol Substitution Test. We conducted linear regression models to assess the association of MIND diet scores with cognition, as well as interaction and stratified analysis using sociodemographic variables.

We included 2354 participants (mean age 68.9 ± 6.6, 54% female). The median MIND diet score was 4.5 (IQR 3.5-6). Higher MIND diet scores were associated with better memory (β = 0.034, 95% CI = 0.010; 0.057, p = 0.008) and global cognitive performances (β = 0.031, 95% CI = 0.004; 0.059, p = 0.023). Race was a modifier in the association between MIND diet scores and cognitive performance (p < 0.001). In stratified analysis, higher MIND diet scores were associated with better global cognitive performance in White participants (β = 0.048, 95% CI = 0.012; 0.083, p = 0.010) and worse global cognitive performance in Black participants (β = -0.046, 95% CI = -0.086; -0.007, p = 0.024). Socioeconomic and MIND diet component intakes differed between Black and White participants.

Higher MIND diet scores were associated with better global and domain-specific cognitive performance, particularly in White participants, but with worse global performance in Black participants. Future studies with multiple dietary assessments focusing on the components of the MIND diet, differences in socioeconomic status (SES), and other risk factors between Black and White individuals, in order to gain a deeper understanding of the racial differences observed in this study.