Summary: A study finds a clear association between following the Mediterranean diet and better cognitive function.
Source: RUVID
The Mediterranean diet is well known for supporting cardiovascular health, but new evidence shows it can also improve memory and help prevent or delay age-related cognitive decline. These cognitive benefits are not uniform across all people, highlighting the need to adapt dietary and lifestyle recommendations to individual characteristics.
Researchers from the Instituto Hospital del Mar for Medical Research (IMIM-Hospital del Mar), the Biomedical Research Institute of Bellvitge (IDIBELL) and Bellvitge University Hospital—through groups focused on integrated pharmacology, systems neuroscience, cardiovascular risk and nutrition—led a multi-center study published in Clinical Nutrition. The team included collaborators from the University of Valencia, Rovira i Virgili University and the University of Navarre.
The analysis followed 487 volunteers (roughly equal numbers of men and women) with an average age of 65 for three years. Participants were enrolled in the PREDIMED-Plus trial, a Spanish, multi-center lifestyle intervention study testing an energy-restricted Mediterranean diet combined with increased physical activity and behavioral support to promote weight loss and reduce cardiovascular risk.
At baseline, all participants were overweight or obese and met at least three criteria of metabolic syndrome—conditions such as high blood pressure, elevated blood glucose, excess abdominal fat, low HDL cholesterol and high triglycerides. Metabolic syndrome affects about one in four adults worldwide and increases the risk of heart disease, stroke, type 2 diabetes and cognitive decline.
Better adherence to the Mediterranean diet correlates with memory gains
Neuropsychological tests measured participants’ cognitive performance at the start of the study, after one year and after three years. The battery assessed memory and other cognitive domains, including executive functions such as planning, decision-making, attention and impulse control.
Compared with expected declines in untreated individuals with metabolic syndrome—about 0.4 points in global cognition and 0.1 points in memory over three years—the study observed cognitive improvements among participants following the intervention. On average, global cognition improved by more than 0.6 points and memory by nearly 0.9 points using standardized units that allow comparison between different neuropsychological tests.
Adherence to the low-calorie Mediterranean diet was assessed with a 17-item questionnaire covering aspects such as extra-virgin olive oil use and daily servings of fruits and vegetables. Scores above 11 indicate high adherence to the Mediterranean pattern. For each one-point improvement in adherence, memory performance rose by 0.12 standardized points.
The researchers attribute these cognitive gains in part to weight loss and increased physical activity, both of which can improve quality of life. Rafael de la Torre, one of the lead investigators, notes that small cognitive changes may be subtle but become meaningful when combined with better overall well-being.
Fernando Fernández-Aranda, project lead at IDIBELL and Bellvitge Hospital, emphasizes that the study demonstrates benefits of the Mediterranean diet beyond weight loss, specifically gains in verbal memory and attention.
Not all participants gained the same cognitive benefits. Natàlia Soldevila-Domènech, the study’s first author, reports that women, older individuals, those with lower educational attainment and people with type 2 diabetes showed smaller improvements. Still, she stresses that every participant experienced some benefit from following the Mediterranean diet, although the magnitude varied.
Participants who began the study with lower cognitive performance—across memory and executive function tests—tended to have poorer adherence to the Mediterranean diet and were less likely to achieve substantial weight loss. Understanding why some individuals succeed while others do not was a central aim for the research team.
Those with stronger baseline cognitive profiles—better auditory memory, superior planning and decision-making, faster reaction times and lower impulsivity—were 20% to 50% more likely to reach the target of losing at least 8% of their weight over three years. The study suggests that these cognitive strengths supported better adherence to the diet and, consequently, clinically meaningful weight loss.
Based on these findings, the authors recommend identifying groups who face greater challenges in benefiting from lifestyle interventions. Tailoring dietary, behavioral and physical activity strategies to a person’s cognitive profile and sociodemographic background could improve adherence and help prevent cognitive decline.
About this diet and cognition research news
Author: Press Office, RUVID
Source: RUVID
Contact: Press Office – RUVID
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Original Research: Closed access. “Interplay between cognition and weight reduction in individuals following a Mediterranean Diet: Three-year follow-up of the PREDIMED-Plus trial” by Natalia Soldevila-Domenech et al. Clinical Nutrition
Abstract
Interplay between cognition and weight reduction in individuals following a Mediterranean Diet: Three-year follow-up of the PREDIMED-Plus trial
Background & aims
Certain cognitive profiles may support successful weight loss and maintenance, while weight reduction itself can provide cognitive benefits. Despite this, few studies have examined the two-way relationships between cognition and weight change within Mediterranean diet interventions. This study evaluated within-subject, longitudinal links among cognitive performance, body mass index (BMI), physical activity (PA) and quality of life (QoL) in older adults following a Mediterranean diet.
Methods
PREDIMED-Plus is a primary prevention trial testing a lifestyle program that combines an energy-restricted Mediterranean diet (er-MedDiet), weight-loss targets and PA promotion to reduce cardiovascular disease risk. The PREDIMED-Plus-Cognition sub-study included 487 participants (50% women, mean age 65.2 ± 4.7 years) who were overweight or obese, had metabolic syndrome and normal cognitive performance at baseline. A comprehensive neurocognitive test battery was administered at baseline, one year and three years.
Results
Higher baseline performance in verbal memory (OR = 1.5; 95% CI 1.0, 2.1), visuoconstructive praxis and attention (OR = 1.5; 95% CI 0.9, 2.3), and inhibition (OR = 1.3; 95% CI 0.9, 1.9) was associated with greater odds of achieving at least 8% weight loss after three years among participants randomized to the intervention. Moderate improvements were observed in specific memory and executive function tests over time. Greater adherence to the er-MedDiet was linked to larger memory gains. Women showed smaller changes in global cognition, physical activity and quality of life. Memory improvements correlated with BMI reductions after one year (βSTD = −0.14) and with PA improvements after three years (βSTD = 0.13). Participants who improved executive functions and global cognition also tended to report better quality of life.
Conclusions
This study clarifies how cognitive performance and weight loss influence each other over time in the context of a Mediterranean diet intervention. The findings reinforce evidence that better adherence to a Mediterranean diet is associated with cognitive benefits. They also suggest that tailoring weight-loss programs to participants’ cognitive profiles and gender may enhance outcomes and merits further research.