Mediterranean diet and cognitive decline. A lesson from the whole-diet approach: what challenges lie ahead?

Higher adherence to a Mediterranean-type diet was associated with decreased cognitive decline, although the Mediterranean diet (MeDi) combines several foods, micronutrients, and macronutrients already separately proposed as potential protective factors against dementia and predementia syndromes. The findings from prospective studies and very recent systematic reviews and meta-analyses suggested that adherence to the MeDi fulfilling the whole-diet approach may affect not only the risk of Alzheimer's disease, but also of predementia syndromes and their progression to overt dementia. However, some concerns exist regarding how these instruments have been developed for measuring adherence to the MeDi, suggesting a better qualitative and quantitative selection of the individual dietary components and/or food groups to improve their reliability.