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Table 1 Key elements in the Baycrest Brain-healthy Eating Approach

From: Feasibility and preliminary efficacy of the LEAD trial: a cluster randomized controlled lifestyle intervention to improve hippocampal volume in older adults at-risk for dementia

Element

Description

1. Brain Health Food Guide

The guide was based on existing European and American epidemiologic and clinical trial results related to diet and cognitive function or dementia risk. It was designed as a practical, lifelong eating guide that does not eliminate any type of food but emphasizes variety and moderation, and offers maximum flexibility for individual food choices and preferences. Recommendations on daily or weekly servings of foods to include and foods to limit is provided as part of the guide.

2. Didactic Education

Participants selected topics of interest and were provided details about the health benefits of particular foods, suggestions for how these foods might be incorporated into one’s diet, and making healthy food choices. Topics selected were incorporating legumes into one’s diet, the health benefits of various plant foods, healthy fats, and label reading

3. Individual Nutritional Counseling

Each participant was offered a 30-min session with the dietitian to address individual concerns and barriers to change. Participants missed 30-min of group discussion to receive their individual counseling. If participants felt they needed to schedule additional individual sessions, they were accommodated on a case by case basis.

4. Individualized Goal Setting

Each week, participants selected a dietary change to align their diets more closely to the Brain Health Food Guide and put it into a goal statement.

5. Meta-cognitive strategy us

The meta-cognitive strategy, GOAL-PLAN-DO-CHECK, provides the frame for behaviour change.

6. Guided Discovery

This method of instruction is accomplished through having the group leader act as a facilitator rather than instructing participants. The group leader uses a series of questions to help participants identify plans that will achieve their goals in a way that will work for them and encourages participants to focus on “one thing at a time”.

7. Dynamic Performance Analysis

While facilitating the plan development, the group leader encourages the active analysis of whether the proposed plan is feasible and do-able. Thus, the planning is an iterative process.

8. Intervention Format

1-hour facilitated session that included goal setting, education, a brain-healthy snack break and group support.