Midlife Strategies for Brain Health

The connection between brain health and nutrition has been making headlines over the last several years, and it’s supported by growing evidence of the correlation between what you eat and cognition. A May 2018 study published in Neurology found that a healthy diet increases total brain volume, potentially offsetting age-related shrinkage.1

The study established that people who eat a diet rich in vegetables, fruits, nuts, and fish may have bigger brains.1 Researchers found that after adjusting for age, sex, education, smoking, and physical activity, a higher diet score was linked to larger total brain volume. Those who consumed a better diet had an average of two milliliters more total brain volume than those who did not. To compare, having a brain volume that is 3.6 milliliters smaller is equivalent to one year of aging.1

“People with greater brain volume have been shown in other studies to have better cognitive abilities, so initiatives that help improve diet quality may be a good strategy to maintain thinking skills in older adults,” said study author Meike W. Vernooij, MD, PhD, of the Erasmus University Medical Center in Rotterdam, the Netherlands. “More research is needed to confirm these results and to examine the pathways through which diet can affect the brain.”1

A 2018 randomized controlled trial, the first of its kind, found that a Mediterranean-like whole-foods diet could slow down age-related cognitive decline, helping to prevent cognitive impairment and dementia.2 Greater adherence to the Mediterranean diet and other emerging healthy diets has been related to decreased risks of several age-related health conditions, including cognitive decline, cognitive impairment, and dementia.2-5 In this regard, healthy dietary patterns characterized by high intake of plant-based foods, probiotics, antioxidants, soy beans, nuts, and omega-3 polyunsaturated fatty acids, and a low intake of saturated fats, animal-derived proteins, and refined sugars, have been shown to decrease the risk of neurocognitive impairments and eventually the onset of Alzheimer’s disease.4,5 Similar results were also observed in the few population-based studies that have used culturally adapted Mediterranean-like dietary patterns such as the MIND diet, the Prudent diet, and the Baltic Sea Diet.2

New research also sheds light on the idea that as you age, who you eat with may be just as important as what you eat. A 2018 study indicates that a socially integrated lifestyle in the later stages of life protects against cognitive decline and dementia.6 Female respondents with compromised nutritional status eating their meals alone exhibited a greater decrease in SPMSQ scores compared with those who had a normal nutritional status and who were eating their meals with others. The study’s authors suggest that nutritional programs for the elderly should focus on what they eat as well as who they eat their meals with to prevent social isolation.6

Implementing early interventions focused on modifiable risk factors like nutrition for cognitive decline at midlife is a strategy used by Functional Medicine practitioners, and one that is backed by research. The clinical understanding of how nutrition and other lifestyle factors impact cognition and brain structure continues to evolve, and some studies have shown that nutrition interventions can prevent or even reverse cognitive decline.

Learn from expert educators, including Dr. Dale Bredesen, who will illuminate current, in-depth research about reversing neurodegeneration in IFM’s online course, Reversing Cognitive Decline. In collaboration with MPI Cognition and Dr. Bredesen, this IFM course translates current research findings into effective therapies for Alzheimer’s disease and its precursors, mild or subjective cognitive impairment. Learn how to differentiate and address mild cognitive impairment and the six subtypes of Alzheimer’s disease.

Learn more or register for IFM’s online course Reversing Cognitive Decline


  1. Croll PH, Voortman T, Ikram MA, et al. Better diet quality relates to larger brain tissue volumes: The Rotterdam Study [published online May 16, 2018]. Neurology. doi:1212/WNL.0000000000005691.
  2. Marseglia A, Xu W, Fratiglioni L, et al. Effect of the NU-AGE diet on cognitive functioning in older adults: a randomized controlled trial. Front Physiol. 2018;9:349. doi:3389/fphys.2018.00349.
  3. Morris MC, Tangney CC, Wang Y, et al. MIND diet slows cognitive decline with aging. Alzheimers Dement. 2015;11(9):1015-1022. doi:1016/j.jalz.2015.04.011.
  4. Pistollato F, Iglesias RC, Ruiz R, et al. Nutritional patterns associated with the maintenance of neurocognitive functions and the risk of dementia and Alzheimer’s disease: a focus on human studies. Pharmacol Res. 2018;131:32-43. doi:1016/j.phrs.2018.03.012.
  5. Nowson CA, Service C, Appleton J, Grieger JA. The impact of dietary factors on indices of chronic disease in older people: a systemic review. J Nutr Health Aging. 2018;22(2):282-296. doi:1007/s12603-017-0920-5.
  6. Li CL, Tung HJ, Yeh MC. Combined effect of eating alone and a poor nutritional status on cognitive decline among older adults in Taiwan. Asia Pac J Clin Nutr. 2018;27(3):686-694. doi:6133/apjcn.092017.05.

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