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Nutrition

Measures of nutrition are based on the Rush Food Frequency Questionnaire (FFQ). The FFQ is a more than 142-item semi-quantitative assessment tool for the usual intake of food and beverages during the past year. This is a modified version of the Harvard-FFQ. This FFQ version includes modifications to capture the foods that have existing scientific evidence for brain health with detailed questions on berries, leafy greens, olive oil, and whole grain. The FFQ also includes questions on vitamin supplement use and other eating behaviors such as consuming whole grain and low-fat food options.

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Food frequency questionnaire (FFQ)

The Rush Food Frequency Questionnaire (FFQ) is a more than 142-item semi-quantitative assessment tool for the usual intake of food and beverages during the past year. This is a modified version of the Harvard-FFQ. This FFQ version includes modifications to capture the foods that have existing scientific evidence for brain health with detailed questions on berries, leafy greens, olive oil, and whole grain. The FFQ also includes questions on vitamin supplement use and other eating behaviors such as consuming whole grain and low-fat food options. Responses on the FFQ are used to compute diet scores, dietary components, total energy/calorie intake, and dietary nutrients.

Selected FFQ response variables on supplement use and beverage intake:

Use of multivitamin supplements or any single nutrient supplement

multvit= use of multivitamin, Yes/ No
supplem = Any vitamin or mineral supplements other than multivitamins, Yes/No

Beverages Intake

oj = Orange juice
aj = Apple juice and other fruit juices
localcaf = Diet soda
coke = Soda- not diet
punch = Hawaiian Punch, lemonade, Koolaide or other non-carbonated fruit drinks
tea = Tea
coff = Coffee
sug = Sugar added to the beverages

Dietary components

This includes different primary food components of a diet. We also use these components to compute our diet scores.

Dietary components/food groups	Included in MIND score	Included in MedDiet score	Description
MIND20221_evoo	X	X	Olive oil consumed as primary oil (Yes/No)
MIND20222_othveg_wk	X		Total servings of vegetables consumed per week (excluding green leafy vegetables)
MIND20223_leafygreen_wk	X		Total servings of green leafy vegetables consumed per week¹
MIND20224_berry_wk	X		Total servings of berries consumed per week (one serving is 1/2 cup of berries as per WWEIA data for older adults)²
MIND20225_bean_wk	X	X*	Total servings beans/legumes/lentils consumed per week³
MIND20226_fish_wk	X	X	Total servings of fish/seafood consumed per week (fried fish not included)⁴
MIND20227_redmeat_wk	X	X	Total servings of red and processed meat consumed per week³
MIND20228_chicken_wk	X	X	Total servings of poultry consumed per week (fried chicken not included)
MIND20229_friedfood_wk	X		Total servings of fried food consumed per week³
MIND202210_nut_wk	X	X*	Total servings of nuts consumed per week
MIND202211_wholegrain_wk	X	X	Total servings of whole grains consumed per week (includes grains, multi/wholegrain bread, pasta, pizza, oats or cereals with carbohydrate/fiber ratio <10)
MIND202212_pastr_wk	X		Total servings of pastries and sweets consumed per week³
MIND202213_butter_wk	X		Total servings of butter and margarine consumed per week
MIND202214_cheese2_wk	X	X	Total servings of full-fat cheese consumed per week
MIND202215_wine_wk	X		Total servings of wine consumed per week
fruit_wk		X	Total servings of any fruit consumed per week

*In MedDiet score, beans/legumes and nuts are combined as one component.

References:

Morris MC, Wang Y, Barnes LL, Bennett DA, Dawson-Hughes B, Booth SL. Nutrients and bioactives in green leafy vegetables and cognitive decline: Prospective study. Neurology 2018;90:e214-e222. PubMed PMID: 29263222 PubMedCentral PMCID: PMC5772164
Agarwal P, Holland TM, James BD, et al. Pelargonidin and Berry Intake Association with Alzheimer's Disease Neuropathology: A Community-Based Study. Journal of Alzheimer's disease : JAD 2022;88:653-661. PubMed PMID: 35694918 PubMedCentral PMCID: PMC10903634
Agarwal P, Leurgans SE, Agrawal S, et al. Association of Mediterranean-DASH Intervention for Neurodegenerative Delay and Mediterranean Diets With Alzheimer Disease Pathology. Neurology 2023;100:e2259-e2268. PubMed PMID: 36889921 PubMedCentral PMCID: PMC10259273
Morris MC, Brockman J, Schneider JA, et al. Association of Seafood Consumption, Brain Mercury Level, and APOE ε4 Status With Brain Neuropathology in Older Adults. Jama 2016;315:489-497. PubMed PMID: 26836731 PubMedCentral PMCID: PMC5460535

Diet scores

The dietary patterns include a combination of various food components. The diet pattern scores prioritized in our data are those with compelling scientific evidence on brain health and related outcomes.

dash_score	Dietary Approach to Stop Hypertension (DASH) diet score
medi_score	Mediterranean diet score (MedDiet score)
minddiet2022_sc	Mediterranean-DASH diet intervention for neurodegenerative delay (MIND) diet score

Dietary nutrients

The per day intake of total calories, macronutrients, and micronutrients, are computed based on the consumption (frequency responses) of food items reported in the RUSH FFQ

Total Energy Intake

calor = Total kilocalories per day

Primary Energy Sources/Macronutrients

Carbohydrates: The carbohydrate intake is approximately equal to the sum of available carbohydrates (starch and sugars) and dietary fiber. Values are expressed in grams (g) per day.

carbo = Carbohydrates (g)

Proteins: The protein intake is a sum of protein from animal products (meats, eggs, and dairy foods); dairy products (milk and milk products); and vegetable products (e.g., beans, legumes, and other protein sources from plants). Values are given in grams (g) per day.

prot_wo = Protein (g)
aprot = Animal protein (g)
vprot = Vegetable protein (g)

Fat and Cholesterol: Total fat intake is the sum of all kinds of fats in the food consumed per day.

tfat = Total fat (g)
satfat = Total saturated fatty acid (g)
poly = Polyunsaturated fat (g)
monfat = Monounsaturated fat (g)

Fiber: Total dietary fiber includes unavailable carbohydrates (cellulose, hemicellulose, pectins, gums, and mucilages) and lignin per day.

aofib = Total dietary fiber (g)

Alcohol: The volume is converted to weight by use of conversion factors based on the specific gravity of alcohol. Amounts are expressed in grams (g) per day.

alco = alcohol (g)

Micronutrients

Micronutrient intake per day is measured separately for intake method (food sources only and supplements only)

Vitamins	From food sources only	From supplements only
Vitamin C (Ascorbic acid)²	vitc_wo (mg)	vitc_s (mg)
Vitamin E (Tocopherols)²	e02mg_wo (mg)	e02_iu_s (International units)
Vitamin B12 (Cobalamin)³	b12_wo (mcg)	b12_s (mcg)
Vitamin D (Calciferol)	vitd_wo (IU)	vitd_s (IU)
Folate (Vitamin B9)³	fol98_wo (mcg)	folic_s (mcg)
Vitamin K¹	vitk_wo (mcg)	vitk_s (mcg)

Carotenoids from food sources²:

acar_wo = α-carotene (mcg)
bcar_wo = β-carotene (mcg)
lyco_wo = Lycopene (mcg)
lut_wo = Lutein and zeaxanthin (mcg)
bcryp_wo = β-cryptoxanthin (mcg)

Carotenoids from supplements:

vita_s = Total vitamin A activity from supplements (IU)
lyco_s = Lycopene from supplements (mcg)
lut_s = Lutein and zeaxanthin from supplements (mcg)

Minerals	From food sources only	From supplements only
Manganese (mg)	mn_wo	mn_s
Copper (mg)⁴	cu_wo	cu_s
Iron (mg)	iron_wo	iron_s
Magnesium (mg)	magn_wo	magn_s
Sodium (mg)	sodium_wo	--
Calcium (mg)	calc_wo	calc_s

Others:

caff_wo = Caffeine from food sources (mg)
choline_wo = Choline from food sources (mg)