Cognitive health and Mediterranean Diet: Just diet or lifestyle pattern?

•Mediterranean diet is an eating pattern characterized by abundance of plant foods.•Longitudinal studies show that Mediterranean diet is protective against mild and advanced cognitive impairment, including Alzheimer's disease.•Some lifestyle behaviors, beyond diet, characteristic of the Mediterranean lifestyle, have an evidence-based association with cognitive health.

Mediterranean diet is a term used to describe the traditional eating habits of people in Crete, South Italy and other Mediterranean countries. It is a predominantly plant-based diet, with olive oil being the main type of added fat. There are many observational studies exploring the potential association between adherence to the Mediterranean diet and cognitive decline. The present review focuses on longitudinal studies with repeated cognitive assessments. It also evaluates evidence on behaviors related to the Mediterranean way of living, that have been shown to be associated with cognition, namely social interaction, participation in leisure activities, including physical activities, and sleep quality. The synergistic association-effect of these lifestyle behaviors, including diet, is unknown. Lifestyle patterns may constitute a new research and public health perspective.