Long-term outcomes of a Mediterranean diet with or without calorie restriction on cognition and cardiometabolic health: The building research in diet and cognition trial

Objectives The Building Research in Diet and Cognition Trial tested the short and long-term outcomes of an eight-month Mediterranean Diet lifestyle intervention with (MedWL) or without weight loss (MedA) via calorie restriction and physical activity, compared to a usual diet condition, on executive function, attention, information processing, learning, memory, and recognition. Short-term outcomes were measured shortly after the eight-month intervention and reported previously. The objective of this article is to report the long-term outcomes measured six months after the eight-month intervention. Methods Participants were randomized to either MedWL ( n = 75), MedA ( n = 73), or control group ( n = 37). Data were collected January 2017–October 2020. Results Participants were 91 % African American with mean age of 66 years and mean body mass index of 37.1 kg/m 2 . There were no significant between-group differences in change in cognition from baseline to 14 months or eight to 14 months. However, Mediterranean Diet adherence improved more in the MedWL (+3.2) and MedA (+3.4) groups compared to controls (+0.2) over 14 months ( p < 0.05), and the MedWL group lost more weight (−3.8 kg) than the MedA group (−1.7 kg) and controls (−0.5 kg) over 14 months (p < 0.05). Conclusions An eight-month Mediterranean Diet lifestyle intervention, with or without weight loss, followed by a six-month maintenance period did not change cognition relative to controls; however, the interventions improved Mediterranean Diet adherence and led to weight loss. These findings show that older, primarily African American adults can maintain Mediterranean Diet adherence and weight loss well after the end of a lifestyle intervention.