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Mediterranean diet and cognitive function: From methodology to mechanisms of action

Lookup NU author(s): Dr Mario Siervo, Dr Oliver Shannon



This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND).


The traditional Mediterranean diet (MedDiet), rich in minimally processed plant foods and fish, has been widely recognized to be one of the healthiest diets. Data from multiple randomized clinical trials have demonstrated its powerful effect against oxidative stress, inflammation and the development and progression of cardiovascular disease, type 2 diabetes, and other metabolic conditions that play a crucial role in the pathogenesis of neurodegenerative diseases. The protecting effects of the MedDiet against cognitive decline have been investigated in several observational and experimental studies. Data from observational studies suggest that the MedDiet may represent an effective dietary strategy for the early prevention of dementia, although these findings require further substantiation in clinical trials which have so far produced inconclusive results. Moreover, as we discuss in this review, accumulating data emphasizes the importance of: 1) maintaining an optimal nutritional and metabolic status for the promotion of healthy cognitive aging, and 2) implementing cognition-sparing dietary and lifestyle interventions during early time-sensitive windows before the pathological cascades turn into an irreversible state. In summary, components of the MedDiet pattern, such as essential fatty acids, polyphenols and vitamins, have been associated with reduced oxidative stress and the current evidence from observational studies seems to assign to the MedDiet a beneficial role in promoting brain health; however, results from clinical trials have been inconsistent. While we advocate for longitudinal analyses and for larger and longer clinical trials to be conducted, we assert our interim support to the use of the MedDiet as a protective dietary intervention for cognitive function based on its proven cardiovascular and metabolic benefits.

Publication metadata

Author(s): Siervo M, Shannon OM, Llewellyn DJ, Stephan BCM, Fontana L

Publication type: Article

Publication status: Published

Journal: Free Radical Biology and Medicine

Year: 2021

Volume: 176

Pages: 105-117

Print publication date: 20/11/2021

Online publication date: 22/09/2021

Acceptance date: 20/09/2021

Date deposited: 21/09/2021

ISSN (print): 0891-5849

ISSN (electronic): 1873-4596

Publisher: Elsevier


DOI: 10.1016/j.freeradbiomed.2021.09.018


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Funder referenceFunder name
ARUK-PRRF2017-006Alzheimer`s Research UK
MR/T001852/1Medical Research Council (MRC)