Sustainable Food Systems and Cognitive Health

by Annie Lin, MS Candidate, Dietetic InternNutrition
Plate with image of the globe surrounded by grains and vegetables

Today’s food systems are unhealthy, unsustainable, and unjust. Globally, there is an increasing issue of overconsumption and undernourishment contributing to higher rates of chronic disease, devastating effects on our climate, and a disproportionate impact on the most vulnerable marginalized groups. These crises not only affect our physical wellbeing but also our cognitive health. This article will explore the interconnections between current food systems and brain health, and the impact of a food systems transformation (as discussed in the 2025 EAT Lancet report) on cognitive function. Additionally, this article will compare the Planetary Health Diet (PHD), a more sustainable dietary pattern proposed by the EAT Lancet Commission, with the Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) diet, looking at key characteristics of each diet and associated cognitive outcomes. 

Current Food Systems & Cognitive Health 

Cognitive health is influenced by a variety of factors including genetics, our physical environment, and health and social factors like nutrition and stress, to name a few. So, in considering these factors, how are today’s food systems affecting our cognitive health? 

Physical Environment

Current food systems are responsible for ~30% of global greenhouse gas (GHG) emissions, largely due to the production of animal-based foods [1]. This rise in GHG emissions contributes to increased global warming, leading to more extreme weather events, disruptions to ecosystems, and negative impacts on agricultural production and food supply chains [2]. In regards to cognitive health, extreme heat can cause:

  • Increased stress on heat shock proteins that protect cells by regulating protein folding
  • Excitotoxicity (neuron damage/death from overstimulation by excitatory neurotransmitters)
  • Oxidative stress due to imbalances in reactive oxygen species (ROS) vs. antioxidants
  • Chronic neuroinflammation caused by the activation of microglia, which trigger the release of pro-inflammatory compounds like TNF-α and IL-1β

… all of which drive misfolding and aggregation of proteins (e.g. p-tau and Aβ, which are linked to Alzheimer’s Disease (AD)), contributing to neurodegeneration [3]. Children and older adults are the most vulnerable due to less efficient/reduced thermoregulation related to age [3,4]. Individuals with a lower socioeconomic status (SES) and/or who are minorities are equally vulnerable due to increased exposure and limited access to resources [4,5]. For example, one cross-sectional study involving 9-10 year old children found an association between greater exposure to extreme heat and lower cognitive function, with Black families and low SES households or neighborhoods being disproportionally exposed to extreme heat [5]. Extreme cold can also impact cognition - particularly for those who live in traditionally warmer regions - through reducing blood flow to the brain via vasoconstriction and triggering mild shivering to conserve heat [4,6]. Furthermore, it can cause physical discomfort, which may increase distraction and affect functions like processing speed and executive function [4,6]. 

To keep up with increasing demand and to combat these environmental effects on food production and supply, excessive nutrient inputs (e.g. increased fertilizer use) and crop residue burning are utilized [1]. Both of these interfere with soil and plant health, and significantly contribute to air and water pollution [1,2]. Looking specifically at air pollution, pollutants like the ozone precursors (e.g. nitrogen oxides and volatile organic compounds) and fine particulate matter (PM2.5) released in current food systems have been suggested to impact our brains across the lifespan through [2,7,8]:

  • Crossing the blood-brain barrier and damaging nerve cells (direct neurotoxicity)
  • Infiltrating other body systems (e.g. lungs, cardiovascular system, gut), triggering the release and transport of inflammatory compounds to the brain (indirect neurotoxicity)
  • Increasing expression of pro-inflammatory molecules and ROS
  • Interacting with other risk factors like an unhealthy diet, a sedentary lifestyle, comorbidities, and genetic risk factors (e.g. APOE4 gene, which is associated with an increased risk of AD) 
  • Interfering with factors related to gene expression (e.g. DNA methylation, non-coding RNA expression, histone protein modification) through epigenetic modification

This may result in alterations in brain structure including thinning of certain cortical regions, increased white-matter lesions, loss of neurons, and impaired nerve cell growth and function due to altered gene expression [7,8]. Changes in brain structure can then lead to changes in brain function, resulting in issues such as impaired psychomotor and behavioral development in infancy with prenatal exposure, and accelerated development of neurodegenerative diseases [7,8]. These effects may be more prevalent and exacerbated in lower-SES neighborhoods and lower-income countries, as they tend to have higher levels of air pollution and greater exposure to the risk factors mentioned above [7,9]. 

Health and Social Factors

Along with modifying our physical environment, current food systems impact our cognitive health through interacting with various health and social factors.

To begin, due to a rise in the cost of nutritious food in recent years and a strong societal focus on convenience, our diets have become increasingly filled with ultra-processed foods (UPFs) high in calories, saturated fat, sugar, and sodium [10]. These tend to replace foods that are more nutrient-dense such as fruits, vegetables, legumes, nuts and seeds, and whole grains. All of this comes at a cost, particularly in regards to our brain health. Studies have found associations between high UPF consumption and increased risk of dementia, although UPFs may begin to affect our brains even earlier on [11]. For instance, one study involving middle-aged and older adults in the U.S. found that over the course of seven years, there was a 17% and 6.3% increase in risk of cognitive impairment with each additional daily serving of ultraprocessed animal products and beverages, respectively, that participants consumed [12]. Another study found a significant negative association between UPF consumption and cognitive function in youth, with increased consumption suggested to negatively impact attention, executive function, fluid intelligence, language, and visuospatial domains [13]. Potential mechanisms include disrupted signaling in the prefrontal cortex, insufficient amounts of nutrients essential for brain development and function, and increased risk for comorbidities (e.g. obesity, diabetes) linked to later cognitive decline [13]. 

In contrast to rising food prices, wages have remained low, resulting in higher levels of food insecurity, particularly among lower-income and marginalized communities (and, ironically, among many individuals working within food systems like farmers and retail food service workers). Food insecurity can affect brain health through insufficient intake of nutrients, physical and psychological stress, and association with other risk factors. For example, a 2020 study involving 2,915 older Americans found a significant negative association between food insecurity and scores on different cognitive tests (IRT, DRT, DSST) [14]. Food-insecure individuals were also observed to be predominantly racial/ethnic minorities and had lower education levels, higher poverty levels, increased rates of smoking, and a greater prevalence of conditions like diabetes, hypertension, and cardiovascular disease [14]. While food insecurity can impact cognitive health all throughout the lifespan, it can be particularly detrimental early on in life, with studies suggesting it could affect children’s abilities to concentrate on schoolwork, as well as the amount of cognitive stimulation children receive at home and parent-child interactions [15,16]. This can then impact various cognitive skills (e.g. math, reading, vocabulary), school readiness, and overall child development [15,16].

Additionally, food has historically played a large social role within our society, whether that be through preparing and eating meals together or fostering community through engaging with local food systems. Social interaction and community engagement are both important for brain health as they provide the opportunity to encounter new stimuli, strengthening existing neural connections and encouraging the growth of new neurons, and allow individuals to feel supported by and connected to others, acting as a stress buffer [17]. Today’s food systems, however, are rooted in convenience culture, reducing the number of opportunities individuals have to share meals with others and to build strong bonds. High food prices can also make it more difficult for low-income individuals and/or individuals struggling with food insecurity to engage with their community. 

A Food Systems Transformation & Cognitive Health

To transform current food systems and combat these issues, the EAT Lancet Commission proposed 8 priority solutions in their 2025 report, including [1]:

  1. Creating food environments that encourage healthy eating
  2. Promoting healthy traditional diets
  3. Implementing sustainable and ecological intensification (SEI) practices
  4. Halting conversion of intact ecosystems for agricultural use
  5. Reducing food loss and waste at all levels of the food supply chain 
  6. Securing fair working conditions for all food systems workers 
  7. Advocating for democratic participation in food systems governance 
  8. Recognizing and protecting marginalized groups

Aligning with these solutions is the Planetary Health Diet (PHD), a framework that emphasizes whole or minimally-processed foods, whole grains, plant protein sources, unsaturated fats, and traditional/local cultural crops that are nutrient-dense, regenerative, and supportive of local economies [1,18]. Its emphasis on plant-forward eating reduces the demand for animal-based foods which, along with the solutions listed above, can help with:

  • Reducing GHG emissions and extreme weather events
  • Reducing air and water pollution and supporting soil health by reducing excessive bluewater use, nitrogen and phosphorus use from fertilizers, and crop residue burning
  • Reducing need for labor, potentially reducing producer prices and helping to alleviate food insecurity
  • Increasing social interaction and community engagement through connections with local food systems
  • Reducing risk of various health conditions including obesity and Type 2 diabetes, cardiovascular disease, depression, and dementia

… all of which support brain health and protect against cognitive decline [1,19-21].

PHD vs. MIND Diet

Similar to the PHD, the MIND diet - developed in 2015 - has also been suggested to be beneficial for cognitive health. It is a combination of the Mediterranean diet and the Dietary Approaches to Stop Hypertension (DASH) diet, which have both been found to protect against cognitive decline through improving cardiovascular health, with modifications based on findings from various cognitive studies [22]. While the PHD and the MIND diet both focus on eating more plant-based and reducing consumption of saturated fats, added sugars, and UPFs, there are some slight differences in the amounts and specific types of foods that are recommended, as shown here:

MIND Diet [22]

Fruits: 2+ servings/week of berries

Vegetables: 6+ servings/week of green leafy vegetables, 1+ servings/day of other vegetables

Animal protein: 2+ servings/week of poultry, 1+ serving/week of fish, <4 servings/week of red meat

Dairy: <1 serving/week of cheese

Grains: 3+ servings/day of whole grains

Nuts and legumes: 5+ servings/week of nuts, 3+ servings/week of beans

Fat: Primarily olive oil, <1 Tbsp/day of butter or stick margarine

Other: <5 servings/week of pastries and sweets, <1 serving/week of fried foods

PHD [1]

Fruits and vegetables: 5+ servings/day of fruits and vegetables combined

Animal protein: 2 servings/week of poultry, 2 eggs/week, 2 servings/week of fish, 

<1 serving/week of red meat

Dairy: 1 serving/day of milk/milk equivalents

Grains: 3-4 servings/day of whole grains

Nuts and legumes: 3-5 servings/day of legumes, nuts, and seeds (at least 1 serving of nuts)

Fat: Primarily unsaturated plant oils

Is one diet better than the other for cognitive health?

In regards to the MIND diet, several studies have suggested that greater adherence may be associated with better cognition globally and within certain domains (e.g. memory and executive function), as well as a reduced risk of dementia, but there are mixed results on whether it can protect against cognitive decline [23-28]. It is believed that the MIND diet may help improve cognition by emphasizing foods like berries and leafy green vegetables that possess certain properties that are supportive of brain health (e.g. anti-inflammatory and antioxidant compounds). While these foods may not have a significant effect on their own, they may have a large impact when consumed together, helping to reduce the accumulation of proteins like Aβ, target risk factors like stress and insulin resistance, and potentially alter brain structure and function [23,28]. That being said, it is important to keep in mind that most of the studies that have been conducted on the MIND diet and cognition are observational, meaning causation cannot be inferred. Many of these studies also utilize a food-frequency questionnaire to gather data on dietary intake, which can be easier for participants to complete but may be inaccurate as it relies on recall and may not include all food items. Furthermore, there are differences in the way each study assesses cognitive functions, the type of population that is involved, the presence of confounding factors like comorbidities, and the duration of each study, making it difficult to compare studies and determine the actual effect of the MIND diet. 

Studies have also found that greater adherence to the PHD may be linked to improved global and domain-specific cognition and a reduced risk of dementia although, again, most of the studies are observational and there are additional factors that must be taken into account [29-31]. One study in Brazil, for example, found that higher adherence to the PHD was associated with slower decline of memory and global cognition; however, this association was only found in high-income participants [32]. Lower-income participants had poor adherence, suggesting that while cognitive benefits can be achieved with the PHD regardless of SES, they are more likely to be observed in higher-income populations who do not have to worry about barriers like food cost.

Overall, there is not enough evidence to determine whether one diet is better than the other for cognitive health. To date, there are no studies that have directly compared the two diets for cognition, although there has been a similar study conducted on the PHD and the Mediterranean diet. In this study, researchers found that greater adherence to the PHD was significantly associated with higher total average cortical thickness and a thicker cortex in AD-related regions, but only greater adherence to the Mediterranean diet was significantly associated with better cognitive performance [33]. It is important to note, however, that this study was conducted in healthy Swedish 70-year-olds, limiting its generalizability, and it is cross-sectional, meaning causation cannot be inferred and reverse associations are possible (e.g. participants with better cognition may make dietary choices that better align with the Mediterranean diet). 

While it is unclear which diet best supports cognitive health, it is clear that moving towards more sustainable food systems and dietary patterns, like the PHD and the MIND diet, can benefit our brains in a multitude of ways. 

Conclusion

Today’s food systems are damaging our environment, our health, and our communities, highlighting the need for a major food systems transformation, as proposed by the EAT Lancet Commission. The PHD is a diet that is sustainable, healthy, culturally-inclusive, and just, and aligns with the Commission’s efforts to change current food systems for the better. Both the PHD and the MIND diet have been suggested to be associated with improved cognition and a reduced risk of dementia, but it is still unknown if one is more beneficial than the other for brain health. Key differences include an emphasis on berries and leafy greens in the MIND diet, a stricter limit on red meat consumption in the PHD, and a stronger focus on environmental sustainability with the PHD (which, as discussed above, is strongly interconnected with cognitive health). More research needs to be done to understand the long-term effects of these diets, as well as the impact for individuals from different cultural backgrounds and at different stages of cognitive functioning. And most importantly, more action needs to be taken to support a shift towards more sustainable food systems in general, and to assist lower-income individuals who have higher rates of cognitive decline/neurodegenerative diseases but face the most barriers to these kinds of interventions.

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