TL;DR: A multicultural anti-inflammatory diet proved workable in midlife but did not shift overall test scores at nine months

A phase II pilot randomized clinical trial in 290 healthy adults aged 40 to 65 in Bronx, New York found that the Multicultural Healthy Diet was feasible and acceptable in a multicultural United States cohort, lowered Dietary Inflammatory Index scores at 9 months after randomization, and did not produce a statistically significant change in a global composite cognitive score, according to the Albert Einstein College of Medicine research record.

The record describes the intervention as the Multicultural Healthy Diet, abbreviated as MHD, an anti-inflammatory diet adapted to a multicultural setting, compared with a usual-diet Comparison arm. The trial aim was to adapt that pattern and assess its impact on cognitive decline and Alzheimer's disease risk and related dementias in healthy middle-aged adults.

The background stated in the record is that anti-inflammatory dietary patterns are associated with slower cognitive decline in older adults, while little is known about effects of such a pattern in middle age. The investigators therefore focused enrollment on adults 40-65 years old and set the primary cognitive assessment at 9 months after randomization.

The paper appeared in the American Journal of Clinical Nutrition, volume 122, issue number 1, pages 48-59, a 12-page article listed as published in July 2025, with digital identifier https://doi.org/10.1016/j.ajcnut.2025.05.011. The Albert Einstein College of Medicine listing names Yasmin Mossavar-Rahmani as lead author, with co-authors Noorie Hyun, Jonathan G. Hakun, Mindy J. Katz, Jelena M. Pavlovic, Henrik Zetterberg, Zheng Wang, Jasper B. Yang, Judith Wylie-Rosett, James R. Hebert, Martin J. Sliwinski and Pamela A. Shaw. The trial was registered at clinicaltrials.gov as NCT03240406.

Who took part and where the trial happened

The Albert Einstein College of Medicine record states that the study enrolled 290 participants in Bronx, New York. Eligibility centered on healthy middle-aged adults between 40 and 65 years old.

Participants were assigned to follow either the Multicultural Healthy Diet or a usual diet described as the Comparison condition. The MHD arm received the anti-inflammatory diet program, while the Comparison arm continued a usual diet without that program.

The multicultural framing matters for nutrition guidance because the objective called for adapting an anti-inflammatory diet to a multicultural setting rather than testing a menu built for a single food culture. The conclusion later describes the approach as feasible and acceptable in the multicultural United States cohort studied in the Bronx.

The trial is identified as a phase II pilot randomized clinical trial. That design signals an early-stage test of feasibility alongside preliminary cognitive outcomes, not a large definitive prevention trial.

How diet was tracked

Diet was evaluated using the National Cancer Institute's Automated Self-Administered 24-h food records, according to the Albert Einstein College of Medicine record. Those self-reported records provided the basis for Dietary Inflammatory Index calculations.

The record reports two versions of that index: the Dietary Inflammatory Index, abbreviated as DII, and the energy-adjusted DII score. Both were calculated from self-reported diet and compared between arms at follow-up.

Program participation was tracked through group sessions and telephone contacts for the MHD arm. Group session completion and telephone contact completion averaged 93% and 72%, respectively, for participants assigned to the MHD program.

Those completion figures underpin the feasibility finding. High group-session completion alongside lower but substantial telephone-contact completion showed that middle-aged participants continued engagement across nine months of counseling contacts.

How thinking and memory were measured on phones in daily life

The primary cognitive outcome was assessed at 9 months after randomization using a global composite score, according to the Albert Einstein College of Medicine record. The composite was derived from three ambulatory cognitive assessments.

The three components were visuospatial memory measured by Grid Memory, processing speed measured by Symbol Search, and short-term associative memory binding measured by Color Shapes. Ambulatory assessment means testing occurred outside a single clinic visit, capturing performance in daily-life settings.

Secondary outcomes included performance on individual tests and association of dietary components with cognitive performance. The record lists those secondary interests without presenting separate significant effects in the abstract summary.

The choice of a global composite score meant that the main result combined memory and speed tasks into one change-from-baseline measure. Individual-test results were treated as secondary rather than primary for the nine-month comparison.

What changed in inflammation scores after nine months

At 9-month follow-up, the MHD arm had a lower Dietary Inflammatory Index score based on self-reported diet, according to the Albert Einstein College of Medicine record. The adjusted MHD-minus-Comparison difference was -0.64, with a 95% confidence interval of -1.02 to -0.27.

For the energy-adjusted DII score, the adjusted MHD-minus-Comparison difference was -0.94, with a 95% confidence interval of -1.34 to -0.54. The record states that those lower scores indicated intervention participants had adhered to an anti-inflammatory dietary pattern.

In practical terms, the diet arm reported eating patterns that scored as less inflammatory than those reported by the usual-diet arm after nine months. The confidence intervals for both DII measures excluded zero, consistent with a dietary difference between arms.

The finding does not by itself establish a change in blood markers of inflammation. It reflects self-reported intake captured through the National Cancer Institute's Automated Self-Administered 24-h food records and scored with the Dietary Inflammatory Index method.

What happened to memory and processing scores

No statistically significant difference between arms was found in the primary outcome of cognitive global score change from baseline, according to the Albert Einstein College of Medicine record. The estimated difference was -0.06, with a 95% confidence interval of -0.15 to 0.04 and P = .259.

That estimate means the MHD and Comparison arms showed similar change in the combined Grid Memory, Symbol Search and Color Shapes score from baseline to nine months. The confidence interval crossed zero and the P value exceeded the conventional threshold for statistical significance.

The authors' conclusion states that the MHD is feasible and acceptable in this multicultural United States cohort. It adds that although the influence of MHD at 9 months is nonsignificant based on the global composite cognitive score, additional research using other measures such as day-to-day variability in cognitive function and peak performance is warranted.

The call for work on day-to-day variability and peak performance points to ambulatory data beyond an average composite. It suggests future analyses could examine consistency or best performance across repeated phone-based tests rather than only mean change.

How this midlife pilot fits with other diet-and-brain studies

A separate study published in Nutrients on May 27, 2026 examined adherence to DASH and Mediterranean diets and cognitive performance in adults living in Afyonkarahisar, Türkiye, using face-to-face administration of the Mediterranean Diet Adherence Screener, the DASH Diet Quality Scale, the Oktem Verbal Memory Processes Test and the Trail Making Test, with data analyzed using SPSS v27 software.

In that Turkish sample, higher DASH scores were linked with higher Immediate Memory and Spontaneous Recall sub-components of the memory test and with lower Learning Mistake Score, USB Mistake Score and IST-A, IST-B and IST Total scores. Higher MEDAS scores were linked with higher Criteria Achievement, Maximum Learning, Spontaneous Recall, Recognition and Total Recall, and with lower Learning Mistake Score, and the authors concluded that age, educational status, DASH and MEDAS scores are associated with cognitive performance.

The Nutrients report also found that as participant age increased, DASH scores decreased, and that as body mass index and waist-to-hip width increased, DASH and MEDAS scores decreased. As age increased, IST-A, IST-B and IST-Total scores increased, while higher education was associated with lower IST-A, IST-B and IST-Total scores and higher total recall on the Oktem scale.

Those cross-sectional associations differ in design from the Bronx randomized pilot. One reports links between reported diet quality and test performance at one point in time, while the Bronx trial randomized 290 adults to MHD or usual diet and compared change over nine months.

Another feasibility trial described in Nutrition Research tested a remotely administered Mediterranean-DASH Intervention for Neurodegenerative Delay pattern in 40 persons with multiple sclerosis over 12 weeks. Participants were randomized to MIND or control, with 20 in each arm, and both received one meal per day through a delivery service plus dietary guidelines.

In that 12-week multiple sclerosis trial, 31 participants completed the study, for 77.5% overall retention and 87.5% intervention retention, with provided-meal compliance averaging 91.1%, including 89.7% in the MIND condition and 92.6% in control. Both conditions improved diet quality, only the MIND condition improved MIND score by a mean change of 3.97, no significant group-by-time effects were observed for cognition, and MIND improvements correlated with improved attention and spatial memory in the MIND condition.

What readers in midlife can take from a feasibility result

For adults aged 40 to 65, the Bronx pilot shows that an anti-inflammatory eating pattern presented in multicultural form can be followed for nine months with high session completion and a measurable shift in reported Dietary Inflammatory Index scores.

It does not show that nine months of that pattern improves a combined score of visuospatial memory, processing speed and associative memory binding in healthy middle-aged adults. The global-score difference of -0.06 was small and statistically nonsignificant.

The authors position the work as supporting larger or longer studies, specifically mentioning day-to-day variability in cognitive function and peak performance as additional measures. Those approaches would use the same kind of repeated ambulatory tests to look past average change.

Anyone considering a change in eating pattern can discuss personal risk factors, medications and nutritional needs with a clinician or registered dietitian. Trial registration NCT03240406 provides the public identifier for the Bronx study protocol and its listed outcomes.

Sources referenced