Background: Observational studies of the Mediterranean diet suggest cognitive benefits, potentially reducing dementia risk. Objective: We performed the first published review to our knowledge of randomized controlled trials RCTs investigating Mediterranean diet effects on cognition or brain morphology and function, with an additional focus on intervention diet quality and its relation to “traditional” Mediterranean dietary patterns. Design: We searched 9 databases from inception final update December for RCTs testing a Mediterranean compared with alternate diet for cognitive or brain morphology and function outcomes. The prescribed Mediterranean diets varied considerably between studies, particularly with regards to quantitative food advice. Data limitations precluded a meta-analysis. A posttest comparison at a second PREDIMED site found that the Mediterranean diet modulates the effect of several genotypes associated with dementia risk for some cognitive outcomes, with mixed results. There was no benefit of the Mediterranean diet for incident cognitive impairment or dementia. The data are mostly nonsignificant, with small ESs. However, the significant improvements in cognitive domain composites in the most robustly designed study warrant additional research. Abstract Background: Observational studies of the Mediterranean diet suggest cognitive benefits, potentially reducing dementia risk.
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