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Published on: January 30, 2026
Mediterranean diet and 3-year Alzheimer brain biomarker changes in middle-aged adults
Valentina Berti1, Michelle Walters1, Joanna Sterling1
1From the Department of Clinical Pathophysiology (V.B., A.P.), Nuclear Medicine Unit, University of Florence, Italy; Department of Nutrition and Food Studies (M.W., L.M.), New York University Steinhardt School of Culture, Education, and Human Development, NY; Woodrow Wilson School of Public and International Affairs (J.S.), Department of Psychology, Princeton University, NJ; Department of Psychiatry (C.G.Q., M.L., R.S.O., L.M.), New York University School of Medicine, NY; ADM Diagnostics (R.A., D.C.M., M.J.d.L.), Chicago, IL; and Departments of Radiology (S.V.) and Neurology (R.S.I., L.M.), Weill Cornell Medical Center/NewYork-Presbyterian, NY.
Objective:
To examine in a 3-year brain imaging study the effects of higher vs lower adherence to a Mediterranean-style diet (MeDi) on Alzheimer disease (AD) biomarker changes (brain β-amyloid load via 11C-Pittsburgh compound B [PiB] PET and neurodegeneration via 18F-fluorodeoxyglucose [FDG] PET and structural MRI) in midlife.
Methods:
Seventy 30- to 60-year-old cognitively normal participants with clinical, neuropsychological, and dietary examinations and imaging biomarkers at least 2 years apart were examined. These included 34 participants with higher (MeDi+) and 36 with lower (MeDi-) MeDi adherence. Statistical parametric mapping and volumes of interest were used to compare AD biomarkers between groups at cross section and longitudinally.
Results:
MeDi groups were comparable for clinical and neuropsychological measures. At baseline, compared to the MeDi+ group, the MeDi- group showed reduced FDG-PET glucose metabolism (CMRglc) and higher PiB-PET deposition in AD-affected regions (p < 0.001). Longitudinally, the MeDi--group showed CMRglc declines and PiB increases in these regions, which were greater than those in the MeDi+ group (pinteraction < 0.001). No effects were observed on MRI. Higher MeDi adherence was estimated to provide 1.5 to 3.5 years of protection against AD.
Conclusion:
Lower MeDi adherence was associated with progressive AD biomarker abnormalities in middle-aged adults. These data support further investigation of dietary interventions for protection against brain aging and AD.
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