It's something we've heard since childhood: eat your vegetables. And for good reason! There are so many health benefits that come with a healthy diet. Chief among them: keeping your brain sharp for the long-term and avoiding serious and debilitating cognitive conditions, like Alzheimer's and dementia.

To be fair, there's no "perfect" way to eat right. But adopting eating patterns that emphasize healthy cornerstones—like the Mediterranean diet—is a good place to start. And science agrees.

A new study published in BMC Medicine found that adhering to the Mediterranean diet may just be the key to lowering dementia risk, regardless of genetic predisposition. In fact, participants who adhered most closely to the Mediterranean diet had a 23% lower risk of developing dementia compared to those who did not follow this lifestyle.

The importance of this study can't be understated, according to the authors, who noted, "Preventing dementia is a global public health priority due to the enormous and growing societal cost of this condition." They concluded, "Diet is an important modifiable risk factor for dementia that could be targeted for disease prevention and risk reduction."

The Mediterranean diet and dementia connection

The study included over 60,000 participants between the ages of 40 and 69 years old who were participating in an ongoing UK Biobank cohort study. Researchers analyzed the subjects' self-reported dietary habits, which they recorded using a 24-hour food assessment tool that included the types of food they ate (choosing from a list of 206 foods and 32 drinks) and the number of standard portions for each item they consumed. Surveys and follow-ups were given every three-to-four months, for up to a total of five assessments. These assessments were scored based on their individual adherence to a Mediterranean-style diet, particularly their intake of olive oil and vegetables.

The researchers used two separate scores to quantify overall adherence to the Mediterranean diet (often nicknamed the MedDiet):

• MedDiet Adherence Screener (MEDAS) continuous score
• PYRAMID score

Using these tools, the participants were then ranked by high, medium or low adherence to the Mediterranean diet.

Another tool called a polygenic risk score was also used to measure genetic risk compared to actual incidence of dementia in the participants. During this study, of the 60,298 participants, 882 dementia cases were reported.

The researchers concluded that although genetic risk was associated with a greater risk of dementia, high Mediterranean diet adherence was associated with an overall lower risk of dementia. More significantly, with each one-point increase in the MEDAS score, there was a 4.5% lower dementia risk. And those with the highest adherence to this dietary lifestyle had a whopping 23% lower risk of developing dementia compared to those who had the lowest MedDiet adherence.

Perhaps the most meaningful finding was that those who had a higher MedDiet adherence had an overall lower associated dementia risk—independent of their genetic risk. The authors concluded these results are essential in "underlining the importance of diet in dementia prevention interventions."

How does the Mediterranean diet lower the risk of dementia?

Following a Mediterranean-type pattern of eating truly is a smart way to keep declining cognition at bay. And multiple studies have shown the benefit of this diet for fighting dementia and Alzheimer's, with one study even finding that the healthiest eaters at age 50 had almost a 90% lower dementia risk compared to those with the least healthy diets.

How can an eating plan influence decrease dementia and Alzheimer's risk? It is likely that the heavy emphasis on vegetables and fruits means you're eating foods known for their abilities to fight oxidative stress, plus many of the various foods included in the MedDiet have anti-inflammatory properties. Since the major causes of cognitive decline progression (including the progression found in those with dementia and Alzheimer's) are oxidative stress and inflammation within the brain, all of the healthy produce and good fats that the Mediterranean diet is known for really hit the spot, so to speak!

Mediterranean diet checklist

The Mediterranean diet is notable for being high in the things we want, like polyphenols, mono and polyunsaturated fatty acids, vitamins, minerals and fiber, and low in things we want to limit, like added sugars, saturated fats and trans fats. As its name suggests, this diet mirrors the standard dietary patterns of countries that border the Mediterranean Sea.

Mediterranean diet adherence typically means including specific foods in your diet daily, eating certain foods in moderation, then limiting or totally avoiding other foods. Here's how you can eat like someone who lives in this region of the world:

• Daily staples:
• Olive oil (make sure you're looking for the extra virgin variety to get your healthy fats)
• Vegetables (all kinds, especially leafy greens)
• Fruits
• Whole grains
• Nuts and legumes
• Occasional inclusions (a couple times a week):
• Dairy
• Eggs
• Poultry
• Seafood (this will help ensure your omega-3 intake is high enough)
• Red wine
• Infrequent indulgences:
• Red meat
• Processed foods
• Sweet treats/desserts

To summarize, this dietary lifestyle is less about the restrictions of low-fat or low-carb diets and more about embracing plant-based eating habits while emphasizing whole and unprocessed foods. It also has a stellar overall nutritional profile.

Other benefits of the Mediterranean diet

If the benefits for cognitive function aren't enough to get you to adopt the diet that those living in the Mediterranean swear by, you might want to reconsider. It turns out that this diet has benefits that go well beyond the brain!

In fact, the Mediterranean diet can benefit you from your head to your toes. Not only is it associated with a reduction in all-cause mortality, it also can help fight cardiovascular disease and support a heart-healthy lifestyle with its benefits for blood pressure and healthy cholesterol. A Mediterranean-like diet can also help improve glucose health and lower diabetes risk factors, reduce risk of some types of cancer and even promote healthy longevity.

And remember, a healthy diet is only one part of the equation. Nourish your noggin in other ways—by learning new skills, prioritizing exercise and mindfulness and getting enough sleep—to keep your head in the game for many years to come.

References

• Román, G C, et al. "Mediterranean diet: The role of long-chain ω-3 fatty acids in fish; polyphenols in fruits, vegetables, cereals, coffee, tea, cacao and wine; probiotics and vitamins in prevention of stroke, age-related cognitive decline, and Alzheimer disease." Rev Neurol (Paris). December 2019. https://pubmed.ncbi.nlm.nih.gov/31521398/
• Shannon, Oliver M., et al. "Mediterranean diet adherence is associated with lower dementia risk, independent of genetic predisposition: findings from the UK Biobank prospective cohort study." BMC Medicine. March 2023. https://bmcmedicine.biomedcentral.com/articles/10.1186/s12916-023-02772-3
• Siervo, Mario, et al. "Mediterranean diet and cognitive function: From methodology to mechanisms of action." Free Radic Biol Med. November 2021. https://pubmed.ncbi.nlm.nih.gov/34562607/
• Williamson, Elizabeth J., et al. "Sustained adherence to a Mediterranean diet and physical activity on all-cause mortality in the Melbourne Collaborative Cohort Study: application of the g-formula." BMC Public Health. December 2019. https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-019-7919-2
• "What is Dementia?" Alzheimer's Association. https://www.alz.org/alzheimers-dementia/what-is-dementia
• "What is the Mediterranean Diet?" American Heart Association. https://www.heart.org/en/healthy-living/healthy-eating/eat-smart/nutrition-basics/mediterranean-diet

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