Why The Mediterranean Diet Isn’t Good Enough

For years, I have been advocating the Mediterranean diet as the gold standard for brain health. But new research makes it clear that simply adding healthy foods is not enough.

A recent study of over 2,100 adults found that higher intake of ultra-processed foods was linked to poorer cognitive performance and increased dementia risk, even in people who followed a Mediterranean-style diet.

In fact, every 10% increase in ultra-processed food consumption was associated with worse attention and higher dementia risk, independent of overall diet quality. The authors summarize it succinctly:

“Higher UPF consumption is associated with poorer attention and increased modifiable dementia risk, independent of overall diet quality.”

This is a critical shift in how we think about nutrition.

It’s not just about what you add to your diet, it’s about what you remove.

Ultra-processed foods are not simply inferior versions of real food. They are industrial formulations stripped of their natural structure and loaded with additives, refined sugars, and unhealthy fats. In this study, they accounted for roughly 40% of total caloric intake, an astonishing figure that’s actually lower than what’s commonly quoted.

These foods drive inflammation, metabolic dysfunction, microbiome disruption, and vascular injury, all pathways that ultimately affect microglial activation and brain health, as I discuss in Brain Defenders.

Importantly, the study showed that attention, not memory, was most affected. That matters because attention is foundational. When attention declines, it sets the stage for broader cognitive impairment.

The takeaway is simple: you cannot “out-eat” ultra-processed foods with healthy choices. The Mediterranean diet is powerful, but it is not protective if ultra-processed foods remain part of the equation.

The goal is not just to eat better.

It is to eliminate what is harmful.

Top 10 Most Commonly Consumed Ultra-Processed Foods

(Based on the study’s dietary breakdown)

1. Dairy-based desserts and flavored dairy drinks
2. Soft drinks, fruit drinks, and sweetened beverages
3. Packaged salty snacks (chips, crackers)
4. Reconstituted processed meats (hot dogs, deli meats)
5. Ready-to-eat meals
6. Ultra-processed breads
7. Instant and canned soups
8. Sauces, dressings, and spreads
9. Biscuits and cookies
10. 10.Sweet snacks (pastries, cakes, candy)

These are not fringe foods, they are dietary staples for many. And that’s exactly the problem.