Inflammatory Diets and Cognitive Decline: Connecting the Dots Across the Oral-Gut-Brain Axis

In their longitudinal study “Longitudinal association of inflammatory diets on cognition in older adults: insights from the oral-gut-brain axis”, Chou et al. [1] provide evidence linking pro-inflammatory dietary patterns to poorer memory performance in older adults, particularly highlighting stronger associations among individuals with periodontitis or Helicobacter pylori (Hp) seropositivity. Their research, utilizing the Empirical Dietary Inflammatory Index (EDII), involved 511 community-dwelling older adults without dementia, examining the integration of dietary intake data with clinical assessments of oral and gastrointestinal inflammation. This multimodal approach underscores the significance of the oral-gut-brain axis in cognitive aging, as prior research supports emerging hypotheses connecting systemic inflammation to neurodegeneration, characterized notably by chronic low-grade inflammation as a contributing factor in cognitive decline [2, 3].

The role of inflammatory mediators, such as IL-6 and TNF-α, is critical, serving as vital links between oral and gut dysbiosis and neurodegenerative processes. Recent studies explored how inflammatory pathways initiated by oral pathogens could further exacerbate systemic inflammation, subsequently influencing cognitive functions [1]. Moreover, recent studies have also established a communicative framework within the oral-gut-brain axis that implicates systemic dysbiosis in cognitive impairment [3, 4].

The neuroprotective benefits of anti-inflammatory dietary patterns, particularly the Mediterranean and DASH diets, are also well-documented. These dietary patterns are rich in antioxidants and anti-inflammatory agents, including olive oil and omega-3 fatty acids, which are consistently linked to reduced levels of inflammatory markers and lower incidences of neurodegenerative diseases [5-8]. Research demonstrates that these dietary approaches not only promote a healthy body weight but also enhance gut microbiota composition, which is crucial for optimal brain health through the gut-brain axis framework [6, 9].

Together, these findings advocate for advancing research that integrates lifestyle-based prevention strategies for cognitive decline, focusing not just on dietary improvements but also considering oral and gastrointestinal health. A holistic model that incorporates both diet and microbiome health may lead to more effective prevention strategies against cognitive decline in aging populations [10].

Peter M. Abadir was solely responsible for the conception, drafting, and final approval of this editorial.

There was no external sponsor involved in the preparation, review, or approval of this editorial.

The author declares no conflicts of interest.

This publication is linked to a related article by Chou et al. To view this article, visit https://doi.org/10.1111/jgs.19599.