Mediterranean Diet Program Linked to Cognitive Scores and Brain Markers, Study Finds
A dietary program, biological markers, and cognitive test scores – what changes were observed over four months in older adults? A new controlled study examines how these variables relate under a structured intervention.
Note: This article is intended for general information and educational purposes. It summarizes scientific research in accessible language for a broad audience and is not an official scientific press release.
A new peer-reviewed study by Olmos, Hernández, Garrido, Salinas, and Díaz-Pérez from the University of Almería (Spain) examines how a structured, Mediterranean diet-based program relates to cognitive performance and a biological marker known as brain-derived neurotrophic factor (BDNF). The study was published on March 27, 2026, in the journal Nutrients.
The researchers conducted a controlled trial to evaluate changes in cognitive test scores and urinary BDNF concentrations following participation in the CESPORT program, a multicomponent intervention combining dietary guidance, food provision, and ongoing support. According to the authors, participants in the intervention group showed higher post-intervention cognitive scores and increased BDNF levels compared to a control group, alongside observed correlations between these variables.
What the Researchers Investigated
The study aimed to examine whether participation in a structured Mediterranean diet-based program was associated with changes in both cognitive performance and a biological marker linked to neural processes.
Specifically, the researchers investigated:
- Whether cognitive test scores changed after the intervention
- Whether urinary BDNF concentrations changed after the intervention
- Whether associations existed between BDNF levels and cognitive performance
The study focused on older adults, a population described by the authors as particularly relevant due to age-related changes in cognitive function. The research was conducted by a multidisciplinary team including experts in sociology, anthropology, and engineering, all affiliated with the University of Almería.
The authors situate their work within existing literature describing BDNF as a protein involved in neurogenesis, synaptic plasticity, and neuronal survival, and highlight previous research linking Mediterranean diet adherence to biological and cognitive variables.
How the Study Was Conducted
Study Design
The study was designed as a non-blinded, non-randomized controlled trial lasting four months. Participants were allocated into two groups:
- Experimental group (n = 58): Participated in the CESPORT program
- Control group (n = 18): Continued usual habits without intervention
The unequal group sizes were planned due to logistical and ethical considerations, and statistical adjustments were applied to account for baseline differences.
Participants
A total of 76 adults over the age of 60 were recruited from a senior university program in southern Spain. Eligibility criteria included:
- No diagnosed neurodegenerative or cardiovascular diseases
- No medications affecting cognition
The mean age was approximately 67–69 years across groups, with a majority of female participants.
Intervention
The CESPORT program included multiple components:
- Weekly provision of fruits and vegetables consistent with Mediterranean diet patterns
- Nutritional education workshops
- A recipe guide
- Continuous support through group communication
The intervention lasted four months, during which participants received structured dietary inputs and guidance. The control group did not receive any of these components.
Measurements
The study used several validated tools:
Cognitive assessments:
- Mini-Mental State Examination (MMSE) for global cognition
- CogniFit® computerized battery assessing:
- Reasoning
- Memory
- Attention
- Coordination
- Perception
Biological measurement:
- Urinary BDNF concentrations measured via ELISA
Additional measures:
- Food Frequency Questionnaire (FFQ)
- Mediterranean Diet Score (MDS)
- Physical activity (IPAQ)
Statistical analyses included ANCOVA models controlling for baseline scores and Spearman correlations to assess relationships between variables.
What Makes This Study New
The authors highlight several aspects that distinguish this study from prior research:
- It evaluates a multicomponent intervention, rather than a single dietary factor
- It examines multiple cognitive domains simultaneously using both MMSE and a computerized battery
- It introduces urinary BDNF as a non-invasive biomarker, which has been less commonly studied compared to blood-based measures
According to the authors, few prior studies have explored the relationship between Mediterranean diet adherence, cognitive performance, and urinary BDNF within the same experimental framework.
The study also examines the relationship between a traditional cognitive screening tool (MMSE) and a computerized cognitive assessment battery, highlighting their alignment across multiple domains.
Key Findings from the Study
Cognitive Outcomes
After adjusting for baseline differences, the study found that the experimental group had higher post-intervention scores than the control group in several domains:
- Reasoning: p < 0.001
- Attention: p < 0.001
- Coordination: p < 0.001
- Perception: p < 0.001
No statistically significant between-group differences were observed for memory (p = 0.509).
For global cognition:
- MMSE scores were higher in the experimental group (p < 0.001)
BDNF Results
The study reported:
- Higher urinary BDNF concentrations in the experimental group compared to the control group (p < 0.001)
Correlations
Post-intervention analyses showed:
- Positive correlations between BDNF and:
- MMSE (r = 0.319; p ≤ 0.001)
- Reasoning (r = 0.233; p ≤ 0.001)
- Coordination (r = 0.203; p ≤ 0.05)
- Perception (r = 0.228; p ≤ 0.001)
The study also reported significant associations between global cognitive scores measured by the MMSE and multiple domains assessed through the CogniFit battery. According to the authors, these relationships indicate consistent patterns across different cognitive measurement approaches, with correlations observed between MMSE scores and domains such as memory and coordination at baseline, and broader associations after the intervention.
Odds Ratio Analysis
The study found:
- A lower probability of BDNF values below the 10th percentile in the experimental group compared to the control group (OR = 0.233; p = 0.029)
Authors’ Conclusions
The authors conclude that participation in the CESPORT program was associated with higher cognitive test scores across several domains and increased urinary BDNF concentrations.
The authors further note that the observed correlations between MMSE scores and CogniFit domains support the use of computerized cognitive assessments as complementary tools for evaluating cognitive performance.
They suggest that:
- The intervention is associated with changes in both cognitive measures and a biological marker linked to neuroplasticity
- Urinary BDNF may function as a non-invasive biomarker associated with cognitive performance
- Observed correlations indicate relationships between biological and cognitive variables
The authors also note several limitations:
- Non-randomized and non-blinded design
- Unequal group sizes
- Potential observer bias
- Short intervention duration (4 months)
- Possible practice effects from repeated cognitive testing
- Lack of creatinine normalization in urinary BDNF measurements
They recommend that future research include randomized designs, larger samples, and longer follow-up periods.
Understanding the Broader Context
These findings contribute to ongoing scientific investigation into how lifestyle-related variables, including diet and behavioral programs, are associated with cognitive measures and biological markers.
The study also adds to research exploring BDNF as a measurable variable in human populations. By using urine samples rather than blood, the authors describe an alternative method that may be more accessible in certain research settings.
Additionally, the use of both traditional cognitive screening (MMSE) and computerized assessment tools provides a multidimensional perspective on cognitive performance.
Conclusion
This controlled trial reports that older adults participating in a structured Mediterranean diet-based program showed higher scores in several cognitive domains and higher urinary BDNF concentrations compared to a control group over a four-month period.
The results highlight associations between dietary program participation, cognitive test outcomes, and a biological marker linked to neural processes. At the same time, the study’s design and limitations indicate that further research is needed to better understand these relationships.
As research continues, future studies may clarify how these variables interact over longer periods and across different populations.
The information in this article is provided for informational purposes only and is not medical advice. For medical advice, please consult your doctor.
References
- Olmos, J. C. C., Hernández, M. M., Garrido, Á. A., Salinas, J. A., & Díaz-Pérez, M. (2026). Effects of a Mediterranean Diet-Based Program on Cognitive Decline: Non-Blinded Non-Randomized Controlled Trial of the CESPORT Program. Nutrients, 18(7), 1073. https://doi.org/10.3390/nu18071073
