It's no secret that a healthy diet may benefit the brain. However, it may not only be what foods you eat, but what foods you eat together that may be associated with your risk of dementia, according to a new study published in the April 22, 2020, online issue of Neurology®, the medical journal of the American Academy of Neurology. The study looked at "food networks" and found that people whose diets consisted mostly of highly processed meats, starchy foods like potatoes, and snacks like cookies and cakes, were more likely to have dementia years later compared to people who ate a wider variety of healthy foods.

"There is a complex inter-connectedness of foods in a person's diet, and it is important to understand how these different connections, or food networks, may affect the brain because diet could be a promising way to prevent dementia," said study author Cécilia Samieri, PhD, of the University of Bordeaux in France. "A number of studies have shown that eating a healthier diet, for example a diet rich in green leafy vegetables, berries, nuts, whole grains and fish, may lower a person's risk of dementia. Many of those studies focused on quantity and frequency of foods. Our study went one step further to look at food networks and found important differences in the ways in which food items were co-consumed in people who went on to develop dementia and those who did not."

The study involved 209 people with an average age of 78 who had dementia and 418 people, matched for age, sex and educational level, who did not have dementia.

Participants had completed a food questionnaire five years previously describing what types of food they ate over the year, and how frequently, from less than once a month to more than four times a day. They also had medical checkups every two to three years. Researchers used the data from the food questionnaire to compare what foods were often eaten together by the patients with and without dementia.

Researchers found while there were few differences in the amount of individual foods that people ate, overall food groups or networks differed substantially between people who had dementia and those who did not have dementia.

"Processed meats were a 'hub' in the food networks of people with dementia," said Samieri. "People who developed dementia were more likely to combine highly processed meats such as sausages, cured meats and patés with starchy foods like potatoes, alcohol, and snacks like cookies and cakes. This may suggest that frequency with which processed meat is combined with other unhealthy foods, rather than average quantity, may be important for dementia risk. For example, people with dementia were more likely, when they ate processed meat, to accompany it with potatoes and people without dementia were more likely to accompany meat with more diverse foods, including fruit and vegetables and seafood."

Overall, people who did not have dementia were more likely to have a lot of diversity in their diet, demonstrated by many small food networks that usually included healthier foods, such as fruit and vegetables, seafood, poultry or meats.

"We found that more diversity in diet, and greater inclusion of a variety of healthy foods, is related to less dementia," said Samieri. "In fact, we found differences in food networks that could be seen years before people with dementia were diagnosed. Our findings suggest that studying diet by looking at food networks may help untangle the complexity of diet and biology in health and disease."

One limitation of the study was that participants completed a food questionnaire that relied on their ability to accurately recall diet rather than having researchers monitor their diets. Another limitation was that diets were only recorded once, years before the onset of dementia, so any changes in diet over time were unknown.

This research was funded by the Alzheimer's Association. The overall study was funded by the INSERM Research Center at the University of Bordeaux, Sanofi-Aventis, and the French Foundation for Medical Research, as well as other French organizations including the French National Research Agency and the Plan Alzheimer Foundation.