As we age, many of us will almost certainly struggle with dementia – if not our own, then the cognitive decline of someone we love. This is especially true for women. Not only are women at higher risk of developing Alzheimer’s disease than men, but most caregivers of people with dementia are also women.
The incidence of dementia in the United States has doubled in the past 10 years, as baby boomers swell the ranks of those over 65. By 2022, more than 1 in 9 people over the age of 65 – and 1 in 2 people over the age of 85 – will have Alzheimer’s disease, notes Annie Fenn in her new book, “The Brain Health Kitchen: Preventing Alzheimer’s Through Food”.
“Every time I look at the numbers, I’m in shock,” says Fenn, a doctor-turned-food writer and cooking instructor who lives in Jackson, Wyoming. After practicing for more than two decades as an obstetrician-gynecologist, Fenn has become an expert on menopause. Memory problems were among the main reasons elderly patients came to see her. And yet, to her dismay, she missed the first signs of her own mother’s cognitive decline.
Fenn retired from medicine in 2010, changing course to pursue culinary arts. She has traveled abroad to study the eating habits of other cultures, attended a chef boot camp at the Culinary Institute of America, and started a newsletter called “Jackson Hole Foodie.” In 2015, the year her mother was diagnosed with Alzheimer’s disease, Fenn started Brain Health Kitchen, a cooking school focused on ways to prevent cognitive decline.
His program is based on the MIND diet guidelines, published the same year. A major report that Fenn says didn’t get much media coverage at the time, MIND merges the Mediterranean Diet with DASH (Dietary Approaches to Stop Hypertension). The program has significantly reduced the incidence of Alzheimer’s disease and, when closely adhered to, even improved cognitive function.
The MIND study identified the food groups that provide the most neuroprotection: berries, leafy greens, vegetables, fish and seafood, whole grains, nuts and seeds, poultry, beans and legumes, and olive oil. . These became the framework for Fenn’s classes, as well as his cookbook. Although filled with solid scientific data, the book is not a dense read; it packs data and information into easy-to-digest bites.
As you’d expect, brain-healthy eating is plant-based, but there are plenty of recipes with poultry, eggs, seafood, and even red meat, along with advice on how to to prepare them in a healthier way. Marinating meats, for example, reduces the formation of advanced glycation end products (AGEs), compounds formed in the body when fats and proteins combine with sugar. High levels of AGEs increase the risk of many diseases, including Alzheimer’s disease.
Eating healthy for the brain seems to have benefited Fenn’s mother. As soon as she was diagnosed, the family adapted their meals to closely follow the MIND diet. Today, she still lives at home with one of her sons and a home health aide. The family only recently started talking about a memory care center, something they thought was coming years ago.
The 100 recipes in the book all sound delicious and seem quite doable by the average home cook. They skew the Mediterranean, but Fenn emphasizes that everyone needs to find the right neuroprotective foods for them that fit their tastes, budget, and lifestyle. A successful diet “must have a sense of who you are, how you connect with others, and how it builds on your ancestry,” she says.
This adjustment is one of the “four Fs” that Fenn suggests as a quick tool for identifying brain-healthy foods. The other three are fats (unsaturated, the building blocks of brain cells), fiber (slows the absorption of sugar, binds harmful cholesterol, and provides nutrients that help the blood flow) and flavonoids (nutrients that block stress oxidative in the brain). Any food that has at least two of the four Fs is good for your brain.
She once gave a lecture to a group of medical students in which she presented heritage food pyramids that illustrate the health benefits inherent in the diets of many traditional cultures, including Mediterranean, African, Latin American, Asian and vegetarians/vegans. (They can be found on the Oldways website, a non-profit organization that helped popularize the Mediterranean diet in the 1990s.) Later, a student from Ghana told him that he had never heard of nobody say that his African diet could be healthy.
There’s no one-size-fits-all approach to brain-healthy eating, says Fenn. “My book is about building your own brain health pyramid. Everyone will look different. What’s important is to find the foods you love and keep cooking.
Cranberry Bean and Sausage Stew
For 4 to 6 people
This hearty stew is a derivative of my grandmother’s minestrone. This streamlined version retains the old-school minestrone vibes, but replaces a few pantry staples to speed up cooking time. Use freshly cooked beans if you have them, or choose another large creamy canned bean, such as gigante beans or Great Northern. A good marinara sauce in a jar is a real time saver. Look for lean turkey or high-quality chicken sausages at the best grocery stores or farmers markets.
¼ cup extra virgin olive oil, plus more for drizzling
½ pound bulk turkey or chicken sausage
4 medium stalks celery, finely chopped (about 7 ounces, plus celery leaves, coarsely chopped and reserved for garnish)
3 medium carrots, washed and coarsely chopped (about 1½ cups)
1 medium yellow onion, finely chopped (about 2 cups)
½ small green cabbage, thinly sliced (about 4 cups)
1 teaspoon kosher salt
¼ teaspoon black pepper, plus more for serving
6 cups chicken or vegetable broth or bean broth
3 cups cooked cranberry beans or two 15.5 ounce cans, rinsed
1½ cups marinara sauce, homemade or store-bought
¼ cup small whole-grain pasta, such as fregola sarda or orzo
1 piece of Parmesan rind, 2 inches
Freshly grated parmesan cheese (optional)
1. Heat 1 teaspoon of oil in a large saucepan over medium heat. Add sausage and cook, stirring to break it up, until no pink remains. Transfer with a slotted spoon to a plate. Pour the fat from the pan into a heatproof container and discard when cool. Heat the remaining oil over medium heat. Add celery, carrots, onion, cabbage, ½ teaspoon salt and pepper. Cook, stirring often, until onion is translucent and vegetables begin to soften, 10 to 12 minutes.
2. Add sausage, broth, beans, marinara, pasta, Parmesan crust and remaining ½ teaspoon salt to pot. Bring to a boil over high heat, then reduce heat to a simmer. Cook, stirring often to make sure nothing sticks to the bottom of the pan, until the pasta is tender, 10 to 15 minutes. Discard the parmesan crust.
3. To serve, ladle into bowls, garnish with grated Parmesan (if using), celery leaves and additional pepper, then drizzle with olive oil.
4. To store, store in an airtight container in the refrigerator for up to 2 days or in the freezer for up to 3 months. Soup thickens over time, so dilute with water or stock when reheating.
— Excerpt from “The Brain Health Kitchen” by Annie Fenn (Artisan Books). Copyright 2023.