!1AARP Research © MARCH 2019 ALL RIGHTS RESERVED

RESEARCH BRIEF

Brain Health and Nutrition Behavior in African American/Black Adults Age 40-Plus

Brain Health, Nutrition, and Mental Well-being

Support for nutrition’s impact on brain health continues to increase.1

Previous research has shown positive connections between consumption

of specific foods, such as fruits, vegetables, and fish, and better brain

health.1 Although healthier food choices are better for brain health, studies

have also found race-based differences in diet quality,2 perceptions of

healthy diet,3 and eating patterns.4 Therefore, it is important to investigate

the relationships between brain health and nutrition behaviors in African

American/Black adults compared to other racial groups.

An AARP survey about nutrition behaviors and brain health included an

oversample of African American/Black adults age 40 and older (N=350).

Six in 10 (60%) African American/Black respondents reported their brain

health status as very good or excellent. This is similar to rates among Whites (64%) and Hispanics (56%).

h"ps://doi.org/10.26419/res.00187.003

African American adults with better overall health tended to have better self-reported brain health than their peers with lower overall health.

1 Moore et al., “Current Evidence Linking Nutrition with Brain Health in Ageing.” 2 McCabe-Sellers et al., “Assessment of the Diet Quality of US Adults in the Lower Mississippi Delta.” 3 Lucan et al., “Concepts of Healthy Diet Among Urban, Low-Income, African Americans.” 4 Li et al., “Racial Differences in Eating Patterns and Food Purchasing Behaviors among Urban Older Women.”

Mental well-being was assessed through a series of related questions that

were summed into a composite score, with possible scores ranging from

14 to 70.5 These questions asked respondents to report their frequency of

different feelings such as feeling optimistic, relaxed, and confident, among

others. In general, there is a positive association between better brain

health and higher mental well-being scores. Overall scores for African

American/Black respondents (52.2) were also similar to White (52.3) and

Hispanic (53.3) adults.

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Health and Nutrition Behaviors

Just 41 percent of African American respondents self-reported their overall health to be very good or excellent. This is

noteworthy due to the connection between overall health and brain health: African American adults with better overall

health tended to have better self-reported brain health than their peers with lower overall health. This difference was

substantial, with 93 percent of those reporting excellent/very good overall health also reporting excellent/very good

brain health, compared to only 37 percent of those with lower overall health reporting excellent/very good brain health.

Survey respondents were asked about the frequency of engaging in different activities that contribute to a healthy

lifestyle, including eating nutritious and well-balanced meals; managing stress effectively in their lives; exercising;

socializing with family, friends or others; and feeling well rested. For this analysis, the criteria of a “healthy behavior”

required a frequency of “most or all the time (5-7 days per week).”

Ate nutritious andwell-balanced

meals

Managed stress effectively

Exercised Socialized with family,friends or others

Felt well-rested

56%55%58%54%55%

80%74%80%72%

80%

≥5 Days per Week ≤4 Days per Week

Healthy Behaviors and Better Brain Health Status (% Reporting Excellent/Very Good Brain Health)

5 NHS Health Scotland, University of Warwick, and University of Edinburgh, “Warwick-Edinburgh Mental Well-Being Scale (WEMWBS).”

African American/Black adults who reported eating nutritious and well-balanced meals most or all days of the week were more likely to report better brain health than their peers who did not.

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African American/Black adults who reported eating nutritious and well-

balanced meals most or all days of the week were more likely to report

better brain health than their peers who did not (80% versus 55%). This

was true for the other healthy behaviors as well (see chart above).

Approximately one-third (35%) of African American/Black adults age 40

and older did not engage in any of the noted healthy behaviors five days

a week or more often. African American adults who reported meeting

three or more healthy behaviors were more likely to report excellent/very

good brain health (85%) than their peers reporting one to two healthy

behaviors (55%) or no healthy behaviors (47%) (see chart at right). This

suggests a correlation between engagement in healthy behaviors and

better self-reported brain health.

When compared to other races/ethnicities, African Americans were less

likely to eat nutritious and well-balanced meals most or all days of the

week than White respondents (26% versus 37%). A similar relationship

was found for socializing with family and friends between African

Americans and Whites (36% versus 44%). However, African Americans

were more likely to effectively manage their stress most or all days of the

week than Hispanic respondents (43% versus 32%). Additionally, a

significantly larger proportion of African American adults age 40 and

older did not meet any healthy behaviors (35%) compared to Whites

(26%) but similar to Hispanics (39%).

85%

55%

47%0

1 to 2

3+

Fruit Vegetables Dairy Protein Grains

Number of Healthy Behaviorsand Brain Health

(% Reporting Excellent/Very Good Brain Health)

1%6%

13%39%

45%

# of healthy behaviors

Food Group Recommendations

(% Meeting Recommendation)

MyPlate Recommendations

Fruit: 1.5 - 2 cups per day Vegetables: 2 - 3 cups per day

Dairy: 3 cups per day Protein: 5-6 cups per day Grains: 5-7 cups per day

*From: https://www.choosemyplate.gov (amount varies by age and gender)

Meeting Nutritional Guidelines

Meeting nutritional guidelines was low across all food groups for African

American adults age 40 and older. The US Department of Agriculture first

developed a nutritional tool called MyPlate in 2010 to assist individuals

with understanding dietary guidelines. MyPlate has since been updated

to reflect the 2015-2020 Dietary Guidelines for Americans.6 Fewer than

half of African American adults met MyPlate’s fruit (45%) and vegetable

(39%) guidelines, and even fewer met guidelines for dairy (13%), protein

(6%), and grains (1%). Within the African American sample, those who

met fruit guidelines were more likely to report very good or excellent

brain health than their peers who did not (66% versus 55%). This

suggests that meeting MyPlate nutritional recommendations may

contribute to better brain health among African American respondents.

6 UnitedStatesDepartmentofAgriculture,“ChooseMyPlate.Gov.”

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The overall patterns of meeting nutritional guidelines was similar for all race and ethnic groups with one exception.

Fewer African American/Black respondents met dairy guidelines than White respondents (13% versus 23%) and

Hispanic respondents (18%). Similar to their White and Hispanic counterparts, about 40 percent of African American

adults did not meet the nutritional guidelines in any food group, and only 11 percent met the guidelines in three or

more food groups.

Consumption of Specific Foods

www.aarp.org/research

7 GlobalCouncilonBrainHealth,“Brain-FoodGCBHRecommendaTonsonNourishingYourBrainHealth.”

Specific foods have been identified as healthy (i.e., fish/seafood, beans and legumes, olive oil, raw nuts, berries, etc.)

and less healthy (i.e., red meat, desserts, beverages with sugar, prepared foods, whole-fat dairy, etc.)7 More African

American adults age 40 and older reported eating fish or seafood at least once a week (57%) than reported eating red

meat (53%). Additionally, many consumed beans/legumes and olive oil at least once per week, but few consumed

these foods three or more times per week (see table below).

In a typical week, African Americans tended to consume fewer healthy foods such as beans, legumes, and olive oil

than other racial/ethnic groups, but they also reported lower consumption of red meat, dessert and prepared foods

relative to Whites.

Healthy Foods

% Who Consume at Least Once in a Typical Week

% Who Consume 3+ Days per Week

Less Healthy Foods

Any type of fish/seafood

57% 25%Beans and Legumes

43% 17%Olive Oil

40% 22%Raw Nuts

33% 19%Berries

27%15%

Red Meats

53% 23%Desserts

47% 24%Beverages with Sugar

48% 28%Prepared Foods

23% 8%

13%

15%

16%

19%

20%

22%

29%

30%

37%

38%Eating healthy would be too expensive

It is hard to eat a healthy diet

My family may not like the taste of healthy foods

I am not a “healthy foods types” of person

I do not know what foods are best to eat

I generally don’t have much of an appetite

I do not like the test of healthy foods

Changing my diet will not make that much of a difference

No stores nearby that sell healthy food

Issues, illness, or condition that make it difficult to eat

Barriers to Healthy Nutrition (% Agree)

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Barriers to Healthy Nutrition and Behavior Change

Since healthy nutrition is positively related to brain health, it is important to consider why some people do not meet

nutritional guidelines. The top barriers to healthy nutrition cited by African American adults age 40 and older included

cost, the difficulty associated with healthy eating, the taste of healthy foods, and not being a “healthy foods type”

person (see chart above). The average number of reported barriers was similar between African Americans and other

races/ethnicities; however, frequencies of specific barriers differed. African Americans were more likely to report not

knowing what foods are best to eat and that there are no stores nearby that sell healthy foods as barriers than White

respondents were. There were no differences in specific barriers or total number of barriers reported based on income.

This could indicate that healthy eating is perceived as expensive and inaccessible to all, regardless of income, and

might be a promising point for education interventions.

Sugar-Sweetened Beverages

Almost 50 percent of African American adults age 40+ reported consumption of sugar-sweetened beverages in a typical week, and 28 percent consumed these

beverages three or more days per week. Consumption of beverages with

sugar was much higher in African Americans than Whites and Hispanics.

African American adults who did not consume sugar-sweetened beverages

were more likely to report excellent/very good brain health than those

that did (69% versus 55%).

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Food Insecurity

There are also significant associations between all food insecurity

situations and brain health. Almost 60 percent of African American

respondents reported that they have been unable to afford the healthier

foods they would rather buy, and over 50 percent report they have run out

of money for food before the end of the month. Additionally, almost one in

four were often hungry because they cannot afford to buy food. Those

who have experienced food insecurity were less likely to report very good

or excellent brain health than their more food-secure peers. For example,

only 53 percent of respondents indicated that they have run out of money

for food before the end of the month reported a brain health status of very

good or excellent, compared to 74 percent of their peers who had not.

African American adults reported a higher likelihood for all food insecurity

situations than White adults, similar to Hispanic adults.

24%

30%

34%

42%

56%

58%

I have been unable to afford the healthier foods I would rather buy

Food Insecurity (% Ever Experienced)

African American respondents indicated being very likely to make healthier nutrition choices with awareness of positive health benefits for brain health and other health conditions.

I have run out of money for foodbefore the end of the month

I have had to choose betweenbuying food and paying bills

I have had to skip meals in orderto stretch my food budget

I have had to choose between buying food and buying medication

I am often hungry because Icannot afford to buy food

Nutrition Behavior Change

Since brain health is impacted by nutrition, interventions aimed at

changing eating behaviors may help improve nutrition and therefore brain

health. Fifty-eight percent (58%) of African American adults age 40 and

older reported that they would be more likely to change their diet if their

doctor told them to. Sixty-eight percent (68%) had confidence in their

abilities to eat a healthier, well-balanced diet knowing that it could help

them improve or maintain their brain health; however, only 62 percent

intended to make eating a healthy diet part of their regular routine.

Individuals who were confident in their abilities to eat a healthier, well-

balanced diet (70% versus 53%) and individuals who intended to make a

healthy, well-balanced diet part of their regular routine (69% versus 52%)

were more likely to report better brain health than their peers who were

not confident and did not intend to do this.

African American respondents indicated being very likely to make

healthier nutrition choices with awareness of positive health benefits for

brain health and other health conditions. Approximately 80 to 85 percent

of African American adults age 40 or older were willing to eat more fish/

seafood, limit red meat, and limit whole-fat dairy consumption to improve

or maintain their brain health.

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Additionally, almost all were willing to eat a healthier diet to reduce the risk

of cognitive decline, heart disease, and diabetes (see chart at right).

African Americans were significantly more likely to indicate they would

make these healthier nutrition choices (i.e., eat more fish/seafood, less red

meat, less whole-fat dairy, a healthy diet) than White respondents.

Summary

Overall, the majority of African American adults age 40 and older

indicated very good or excellent brain health status, which was positively

associated with better overall health and mental well-being. Better brain

health was also associated with frequent participation in healthy

behaviors, meeting fruit guidelines, and not consuming sugar-sweetened

beverages. Across all income levels, the most commonly named barrier to

healthy nutrition for African American adults was economic, suggesting

there may be a perception of low value for the money in addition to cost-

prohibitive access. Regarding food security, African American older adults

were much less food secure than White older adults, but similar to

Hispanic older adults. Food insecurity was also associated with brain

health status; those experiencing situations of food insecurity were more

likely to report lower brain health than those who did not. Regardless of

barriers and food security, high levels of willingness for behavior change

were reported among African American adults. With awareness of

benefits for brain health and other health conditions, 80 to 90 percent of

respondents were willing to make positive nutrition behavior changes,

which was significantly higher than willingness in White respondents. This

suggests that educational interventions as well as interventions improving

health food access may improve nutrition and therefore brain health.

Behavior Change by Race/Ethnicity

(% Meeting Recommendation)

Eat more fish/seafood

Limit red meat

Limit whole- fat dairy

Cognitive decline

Heart Disease

Diabetes

African American/Black

Hispanic

White

“. . . to maintain or im

prove brain health”“E

at a healthy diet to reduce risk of . . .”

59%

85%

85%

55%

88%

80%

64%

84%

83%

85%

95%

97%

86%

95%

95%

86%

85%

93%

95%

85%

!8AARP Research © MARCH 2019 ALL RIGHTS RESERVED www.aarp.org/research

Methodology

Survey data presented in this brief were collected through an online, national survey of adults age 40 and older fielded

from October–November 2017. This study was completed as part of a series of surveys on brain health in adults

concerning multiple areas including exercise, mental well-being, sleep, social engagement, and cognitive activities in

addition to nutrition. For more information please see https://www.aarp.org/health/brain-health/global-council-on-brain-

health/resource-library/

This research brief was written by Kerri Vasold and Madeline Eller. The

original report was written by Laura Mehegan (lmehegan@aarp.org),

Chuck Ra inv i l l e (g ra inv i l l e@aarp .o rg) , and Laura Skufca

(lskufca@aarp.org).

Visual Production Credits

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