Evidence for Improved Cognitive Health with Diet: A Narrative Review.

Background: Despite growing interest in nutrition as a behavioral intervention to improve cognitive health in clinical populations, many providers find it challenging to provide specific nutritional recommendations. We aimed to review and synthesize current empirical research on this topic and provide considerations for healthcare providers working with adults who wish to optimize their cognition via dietary improvements. Methods: We performed a narrative review of research published between January 2009 and May 2021 on 5 popular dietary interventions: the Mediterranean diet, Dietary Approaches to Stop Hypertension (DASH), the Mediterranean-DASH Intervention Diet for Neurodegenerative Delay (MIND), the ketogenic diet and intermittent fasting. Results and Conclusions: Of the 5 dietary interventions, the Mediterranean diet has been the most extensively investigated, and there is evidence supporting its cognitive benefits. However, operationalization of the Mediterranean diet varies across studies, rendering the results inconclusive. The DASH diet and the MIND diet have stronger operationalization and showed evidence of cognitive benefits. More longitudinal studies and/or randomized clinical trials should be conducted on these 2 relatively new interventions. Finally, there is limited research with human participants regarding the ketogenic diet and intermittent fasting, which are found to be cognitively protective within stringent parameters. Definitions for these 5 dietary patterns and practice tips and recommendations are provided.

Acceptability of an adjunct equine-assisted activities and therapies program for veterans with posttraumatic stress disorder and/or traumatic brain injury.

OBJECTIVE: Equine-assisted activities and therapies (EAATs) have been a growing adjunctive integrative health modality, as they allow participants to practice mindfulness, emotional regulation, and self-mastery or self-esteem building skills. Preliminary evidence suggests that these programs may be helpful in reducing posttraumatic stress disorder (PTSD), anxiety, and depressive symptoms. The current study examines the acceptability of integrating an EAAT program as part of a two-week, intensive clinical program for veterans with PTSD and/or traumatic brain injury (TBI). METHODS: A family member or support person could accompany veterans and participate in the program. One hundred and six participants (veteran n = 62, family n = 44) left the urban environment in an intensive outpatient program (IOP) to attend a two-day, weekend EAAT in rural New Hampshire. Satisfaction surveys were conducted on the last day of the program and examined using thematic analysis. RESULTS: The following themes were reported in the surveys: ability of horses to catalyze emotional rehabilitation, effectiveness of immersion in equine-assisted activities, program's ability to foster interpersonal relationships and necessity of education about PTSD for staff. Participants also reported enjoying the program as highlighted by qualitative feedback, a mean score of 9.76 (standard deviation [SD] = 0.61) as reported by veterans and a mean score of 9.91 (SD = 0.29) as reported by family members on a 10-point visual analog scale with higher scores indicating a greater overall experience. CONCLUSION: These data offer preliminary evidence that an adjunct EAAT program is acceptable for veterans with PTSD and/or TBI participating in an IOP.