Mediterranean diet reduces risk of cognitive decline and dementia by 11–30%

Age-related cognitive decline, dementia, and Alzheimer’s disease are a global health, social, and economic challenge. In addition to classic risk factors, diet is increasingly recognized as an important modifiable determinant of brain health. A meta-analysis of 23 large studies involving tens of thousands of adults found that strict adherence to the Mediterranean diet was associated with:

• 18% reduction in the risk of age-related cognitive impairment (mild cognitive impairment) (HR = 0.82; 95% CI 0.75–0.89),
• 11% reduction in the risk of any dementia (HR = 0.89; 95% CI 0.83–0.95),
• 30% reduction in the risk of Alzheimer's disease (HR = 0.70; 95% CI 0.60–0.82.

The study is published in the journal GeroScience.

What did scientists study?

• Diet: rich in fruits, vegetables, whole grains, legumes, fish and olive oil; moderate consumption of dairy products and wine; minimizing red meat and saturated fats.
• Data sources: PubMed, Web of Science, Google Scholar; publications from 2000 to 2024.
• Analysis methods: random-effect model, I² = 55% indicated moderate heterogeneity; Egger's test recorded a possible publication bias towards positive results, but TSA (trial sequential analysis) confirmed the sufficiency of the accumulated data.

Why is this important?

1. Vascular-neural connection: Many cognitive disorders and dementias have a vascular component (VCID), as well as classic amyloid pathology. The Mediterranean diet protects both vessels and neurons.
2. Preventive strategy: Shifting diet towards a plant-based diet rich in unsaturated fats and antioxidants is an affordable and effective measure to reduce the burden of cognitive aging.
3. Public health: The findings could inform nutrition programs for older and middle-aged people to slow the dementia epidemic.

“Our meta-analysis combines data from the last 25 years and confirms that the Mediterranean diet is not just a gastronomic trend, but a powerful neuroprotective tool,” said Dr. Monika Fekete, lead author of the study.

Practical recommendations:

• Include fruits and vegetables (at least 5 servings), whole grains, fish 2-3 times a week and olive oil as your main source of fat in your daily diet.
• Limit red meat and processed foods and replace them with legumes and nuts.
• Consider moderate consumption of red wine (unless contraindicated) for its additional antioxidant effects.

Below are the authors' key opinions and recommendations based on the article's findings:

• Mónika Fekete:
  “Our meta-analysis shows that following a Mediterranean dietary pattern provides at least an 11–30% reduction in the risk of cognitive impairment, dementia and Alzheimer’s disease. This proves that nutrition can be considered, along with pharmacotherapy, as a powerful tool for neuroprotection.”

• Péter Varga:
  “The heterogeneity of results between regions highlights the importance of taking into account local characteristics of the ‘Mediterranean diet’. Further prospective studies are needed in countries with different dietary traditions in order to adapt recommendations to different populations.”

• Zoltan Ungvari:
  “The Mediterranean diet acts as both a vascular-protective and neuroprotective factor, affecting key mechanisms of aging - oxidative stress, inflammation, mitochondrial dysfunction. This confirms its role in complex strategies for maintaining healthy brain aging.”

• Giuseppe Grosso:
  “Incorporating Mediterranean-style dietary recommendations into public health programmes could be a low-cost and scalable way to reduce the burden of dementia in ageing populations.”

• Ágnes Szappanos:
  “Our results highlight the need for an integrated approach: in addition to dietary interventions, it is important to encourage physical activity, social engagement and other Mediterranean lifestyle factors to maximize the neuroprotective effect”

These simple dietary changes could be key to fighting cognitive decline, dementia and Alzheimer's disease, keeping your mind sharp for years to come.