A physician’s cookbook explores the link between food and Alzheimer’s

AS WE AGE, many of us almost certainly will be dealing with dementia — if not our own, then the cognitive decline of someone we love. That’s especially true for women. Not only are women at greater risk for Alzheimer’s than men, but most caregivers for people with dementia also are women.

Incidences of dementia in the United States have doubled over the past 10 years, as boomers swell the ranks of over-65-year-olds. As of 2022, more than 1 in 9 people over 65 — and 1 out of 2 over 85 — 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 physician turned food writer and cooking instructor who lives in Jackson, Wyoming. After practicing for more than two decades as an OB/GYN, Fenn became an expert on menopause. Memory issues were among the top reasons aging patients came to her. And yet, to her dismay, she missed the early signs of her own mother’s cognitive decline.

Fenn retired from medicine in 2010, changing course to pursue the culinary arts. She traveled abroad to study the food-ways of other cultures, attended a boot camp for chefs 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, Fenn launched Brain Health Kitchen, a cooking school focused on ways to prevent cognitive decline.

Her curriculum is based on the MIND diet guidelines, published that same year. A significant report that Fenn says didn’t get a lot of traction in the media at the time, MIND merges the Mediterranean Diet with DASH (Dietary Approaches to Stop Hypertension). The program significantly reduced incidences of Alzheimer’s disease and, when closely adhered to, even improved cognitive function.

The MIND study identified food groups that offer 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 her cookbook. Though packed with solid science, the book isn’t dense reading; she dishes up the data and information in easily digestible bites.

As you’d expect, a brain-healthy diet is plant-forward, but there are plenty of recipes involving poultry, eggs, seafood and even red meat, as well as tips on how to prepare them in healthier ways. Marinating meats, for example, reduces the formation of advanced glycation end products (AGEs), compounds formed in the body when fat and protein combine with sugar. High levels of AGEs increase the risk of many diseases, including Alzheimer’s.

Brain-healthy eating appears to have benefited Fenn’s mom. As soon as she was diagnosed, the family adapted her meals to closely follow the MIND diet. Today, she is still living at home with one of her sons and home health assistance. The family has only recently started talking about a memory care facility, something they thought would happen years ago.

The book’s 100 recipes all sound delicious and seem very doable by the average home cook. They skew Mediterranean, but Fenn stresses that everyone needs to find the neuroprotective foods that are the right fit — that suit their taste, their budget and their lifestyle. A successful diet plan “has to make sense with who you are, how you connect with other people and how it draws on your ancestry,” she says.

That fit is one of the “Four Fs” 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 absorption of sugar, binds harmful cholesterol and delivers helpful nutrients to the bloodstream) and flavonoids (nutrients that block oxidative stress in the brain). Any food that possesses at least two of the four Fs is good for your brain.

She once gave a talk to a group of medical students in which she displayed heritage food pyramids that illustrate the health benefits inherent in the diets of many traditional cultures, including Mediterranean, African, Latin American, Asian and Vegetarian/Vegan. (They can be found on the website Oldways, a nonprofit that helped popularize the Mediterranean Diet in the 1990s.) Afterward, a student from Ghana told her that he’d never heard anyone say his African diet could be healthful.

There’s no one-size-fits-all approach to brain-healthy eating, Fenn says. “My book is about building your own brain-health pyramid. Everyone’s will look different. What’s important is to find the foods that you love and keep cooking.”

Cranberry Bean and Sausage Stew
Serves 4 to 6
This hearty stew is a spinoff of my grandmother’s minestrone. This streamlined version keeps the old-school minestrone vibes, but swaps in a few pantry staples to speed up the cooking time. Use freshly cooked beans if you have them, or choose another large, creamy bean from a can, such as gigante beans or Great Northerns. Good marinara sauce from a jar is a real timesaver. Look for high-quality lean turkey or chicken sausage at better grocery stores or farmers markets.
— Annie Fenn

¼ cup extra-virgin olive oil, plus more for drizzling
½ pound bulk turkey or chicken sausage
4 medium-size celery stalks, finely chopped (about 7 ounces, plus celery leaves, coarsely chopped and reserved for garnish)
3 medium carrots, scrubbed 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 stock, 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 2-inch piece Parmesan cheese rind
Freshly grated Parmesan cheese (optional)

1. Warm 1 teaspoon of the oil in a large saucepan over medium heat. Add the sausage and cook, stirring to break into crumbles, until no pink remains. Transfer with a slotted spoon to a plate. Pour off any fat from the pan into a heatproof container, and discard once cool. Warm the remaining oil over medium heat. Add the celery, carrots, onion, cabbage, ½ teaspoon of the salt and the pepper. Cook, stirring often, until the onion is translucent, and the vegetables are starting to soften, 10 to 12 minutes.

2. Add the sausage, stock, beans, marinara, pasta, Parmesan rind and the remaining ½ teaspoon salt to the pot. Bring to a boil over high heat, then reduce the heat to a gentle simmer. Cook, stirring often to make sure nothing sticks to the bottom of the pot, until the pasta is tender, 10 to 15 minutes. Discard the Parmesan rind.

3. To serve, ladle into bowls, top with grated Parmesan (if using), celery leaves and more pepper, then drizzle with olive oil.

4. To store, keep in an airtight container in the refrigerator for up to 2 days or in the freezer for up to 3 months. The soup thickens with time, so thin with water or stock when reheating.

— Excerpted from “The Brain Health Kitchen” by Annie Fenn (Artisan Books). Copyright 2023.