Eating vegetables, fruits, fish, and plant-based foods helps enhance brain function and lower the risk of cognitive impairment and decline in Chinese populations, including those from mainland China, Hong Kong, Taiwan, and Singapore, according to a systematic review and meta-analysis.
Pooled data from 10 studies showed that adherence to plant-based diets reduced the odds of cognitive impairment by 22 percent (odds ratio, 0.78, 95 percent confidence interval, 0.69–0.87). [Nutr Rev 2026;doi:10.1093/nutrit/nuag026]
The protective association between plant-based diets and cognitive impairment persisted in subgroups defined by geographic region (p=0.275) and remained robust in sensitivity analyses, the authors noted.
“Moreover, no significant publication bias was detected, strengthening the validity of these findings,” they added.
Single foods, food groups
In total, 86 studies—in which specific foods, food groups, dietary patterns, and dietary score indices were evaluated in relation to cognitive outcomes—were identified and included in the systematic review. Evidence across these studies indicated that consumption of vegetables and fruits could mitigate the risk of developing dementia.
Regular consumption of substantial quantities of green, red, and yellow vegetables was associated with a reduced likelihood of cognitive decline, while intake of fresh fruit was linked to a lower risk of cognitive impairment. In one study, reduced consumption of vegetables and beans among older illiterate adults in China appeared detrimental, leading to a decline in cognitive abilities.
Apart from fruits and vegetables, other food groups also influenced cognitive health. Fish, seafood, dairy, and nuts were associated with protective benefits, whereas alcohol and red meat were associated with negative effects.
Additionally, consumption of eggs, mushroom, and tea was shown to have a positive impact on cognitive function.
Dietary patterns, score index
In terms of dietary patterns, adherence to certain patterns was associated with positive cognitive outcomes. These included the Mediterranean diet, the Dietary Approaches to Stop Hypertension (DASH) diet, the Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) diet, the “mushroom, vegetable, and fruits” (MVF) pattern, the protein-rich dietary pattern, the “vegetable-pork” diet, the Alternate Mediterranean Diet (AMED), the Chinese Food Pagoda (CHFP), the plant-based diet, the Planetary Healthy Diet (PHD), the grains-fruits-vegetables pattern, the “plant-preferred” pattern, and the vegetable and mushroom dietary pattern.
Conversely, the iron-related dietary pattern and the animal-based dietary pattern were negatively associated with cognitive function.
Across studies that looked at dietary score indices, higher dietary diversity scores and dietary total antioxidant capacity in the diet were linked to improved cognitive function and a decreased risk of cognitive impairment. On the other hand, a higher energy-adjusted Dietary Inflammatory Index correlated with an elevated risk of cognitive impairment.
Traditional Chinese dietary practices
“Overall, the findings from this review highlight the importance of consuming specific foods and food groups, adhering to balanced dietary patterns, and maintaining a high dietary score for cognitive health. The beneficial effects of a balanced diet that combines plant and animal products suggest that a variety of foods and adequate nutrient intake are essential for cognitive health,” the authors said.
They pointed out that the cognitive benefits of adhering to diets rich in vegetables, fruits, fish, and plant-based foods in Chinese adults are potentially influenced by unique genetic variations, traditional dietary practices, and cultural factors.
“Traditional Chinese dietary practices emphasize high consumption of plant-based foods, including vegetables, legumes, mushrooms, and tea, each containing bioactive compounds with anti-inflammatory and antioxidant properties that may uniquely affect cognitive health in this population,” the authors explained.
“Additionally, dietary practices, such as low dairy intake, limited consumption of processed foods, and distinct cooking methods (eg, stir-frying, steaming), may modulate the diet–cognition relationship uniquely in ethnic Chinese individuals compared with Western populations,” they continued.
The authors also noted that genetic predispositions prevalent among ethnic Chinese populations, including APOE genotypes associated with dementia, may interact differently with dietary factors. [Front Public Health 2024;12:1417499]
The trends and associations between specific dietary components and cognitive outcomes identified in this systematic review and meta-analysis may inform culturally appropriate dietary recommendations to mitigate the risk of Alzheimer’s disease, “and this culturally relevant approach improves the applicability of the findings for public health programs and dietary guidelines targeting Chinese communities,” they said.