Nature’s Bounty: Saving the Brain with Food

In neuronutrition, the whole is greater than the sum of its parts.

By Lisa Mosconi Ph.D., published March 1, 2018 - last reviewed on September 20, 2019

Steamed artichokes drizzled with olive oil. Cremini mushrooms sautéed with garlic and parsley. Braised swiss chard with pine nuts. These are everyday dishes on the Italian table, which is almost invariably colorful, fresh, and vegetable-centered. What’s more, such foods tend to be the stars of the meal. 

Researchers have long praised the Mediterranean diet for promoting brain health as well as overall physical health. In fact, as famously heart-healthy as the diet is, it also benefits the brain. A large body of scientific literature, my own work included, shows that people who closely follow a Mediterranean diet are not only less likely to develop health issues like diabetes, obesity, and cardiovascular disease but also to have a reduced risk of cognitive impairment and Alzheimer’s disease as they age. 

Born and raised in Italy, I have firsthand experience of what this diet is all about. For Italians, it is not so much a diet as it is a way of eating and experiencing food. If you were to travel from Italy to the Greek islands, or from the southwest of France to Barcelona, you’d probably notice a wonderful variation of cuisines—a wide spectrum of specialties and different key ingredients, along with all the local habits that accompany them, each and every one a source of regional pride. However, what all these countries have in common is a healthy respect for fresh, locally grown, sun-baked products.

If you were to create a Mediterranean diet pyramid, as many nutritionists are fond of doing, you’d find a wide range of vegetables, fruits, beans, and nuts at the base, as they are the main focus of the plate. One step up, whole grains like wheat, oats, spelt, and barley are consumed in minimally processed forms to provide the maximum dose of nutrients. Often served along with wild-caught fish, such as trout and dorade,  or sea bream, they are eaten fairly often.

Meat and dairy are occasional indulgences. Herbs and spices are used freely to flavor the food naturally, reducing the use of extra fat and salt in the process. Sweets are consumed in small portions, usually as a Sunday treat or at special celebrations. In addition, they tend to be much healthier than the usual supermarket-bought desserts, since they are typically made using nuts and seeds and often sweetened with honey, molasses, or other natural sugars. As a whole, the Mediterranean diet is a very fresh, very tasty diet, low in calories and fat and rich in all sorts of brain-essential nutrients. 

Olive oil deserves special mention. It is now believed that regular consumption of extra-virgin olive oil is a prime reason for the health effects of the Mediterranean diet. Olive oil that is truly extra virgin has a distinctively bitter, almost pungent taste and owes its reputation as “the world’s healthiest oil” to its high antioxidant content. In fact, the oil contains heart-healthy monounsaturated fat blended with artery-scrubbing phenolic compounds. It is also a good source of vitamin E, another important antioxidant. This particular combination makes olive oil practically magical, as polyphenols also protect and preserve the delicate vitamin E. Even clinical trials show that if we regularly consume extra-virgin olive oil (up to one liter a week), we can actively protect ourselves from cognitive decline.

Red wine is another main staple of the Mediterranean diet and an excellent source of antiaging antioxidants. Wine delivers its benefits when drunk as an accompaniment to meals rather than as a drink had by itself. Another special feature of the diet is its social component. One doesn’t eat or drink alone. Rather, meals are consumed in the company of others and savored over enjoyable conversation—which, funnily enough, often revolves around food.

The Mediterranean diet is not so much a diet as a lifestyle. Vibrant, fresh, and genuine foods are combined with regular exercise (walking, housework, gardening, riding a bike, or taking the stairs instead of the elevator are normal parts of the culture’s daily routine), a rich social life, and a positive outlook, which all contribute to the long lifespan of the Mediterranean people.  

What is really exciting is that the health benefits of the Mediterranean diet even show up on brain scans. The MRI scans shown at left come from a series of brain-imaging studies in which we looked at the effects of the Mediterranean diet in more than 50 participants between 25 and 70-plus years old. The results were astonishing. Regardless of their age, those who followed the diet had overall healthier brains than those on a typical Western diet (or any diet full of red and processed meat, sugary beverages and sweets and low in plant-based foods and fish). In fact, the brains of those on less healthy diets seem to literally age and shrink more rapidly. In some studies, their brains appear to be a good five years older.

Not only were these beleaguered brains shrinking, their activity was also reduced. Worse still, even though none of the participants had yet to demonstrate any outward sign of cognitive impairment, the brains of those on a Western diet were already carrying more amyloid plaques than was normal for their age, indicating a higher risk of developing Alzheimer’s in the future. 

While you probably get the biggest payoff adopting a Mediterranean-type diet early in life, research shows that it is never too late to reap the benefits of a healthy shift toward better lifestyle choices. For example, a study of over 10,000 women showed that those who followed the Mediterranean diet during middle age were much more likely to live past the age of 70 without chronic illness or mental deficiencies than those who did not eat as healthily. 

You don’t have to move to a Mediterranean country to keep your mind sharp—just eat as if you lived there. There are a lot of brain-sustaining nutrients in the Mediterranean diet: B vitamins in greens and legumes, omega fats in fish and nuts, monounsaturated fats in olive oil, fiber in legumes and beans, and varieties of antioxidants and minerals in fresh fruits and vegetables. It may be that they all work in concert.

THE MRI SCAN above left is that of a 52-year-old woman who has been on a Mediterranean-style diet most of her life. Her brain takes up most of the space inside the skull. The ventricles, the butterfly-shaped fissures in the middle of the brain, are small and compact. The hippocampus (the brain’s memory center) is well rounded and in close contact with the surrounding tissues. By comparison, the scan at right shows the brain of a 50-year-old woman who has long eaten a Western-type diet. The red arrows point to brain atrophy, indicating loss of neurons—a sign of accelerated aging and increased risk of dementia. As the brain loses neurons, the space is filled by fluids, seen as black areas on an MRI. There are more black areas in the brain of the person consuming a Western diet than in the brain of the person eating a Mediterranean diet. Overall, among 52 persons scanned, those who adhere to a Mediterranean-type diet show greater thickness in areas of the brain most vulnerable to neuronal loss in Alzheimer’s disease.   Photo courtesy of Dr. Lisa Mosconi, Mosconi Et Al. Journal of Alzheimers Disease 2014

Lisa Mosconi, Ph.D., is associate director of the Alzheimer’s Prevention Clinic at Weill Cornell Medical College in New York. This article is adapted from her book, Brain Food: The Surprising Science of Eating for Cognitive Power.

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