A balanced diet: can wine and cheese be good for your brain?

This piece was written by Reece Thompson (University of Strathclyde) and Dr Fiona Kerr (Edinburgh Napier University).

As part of the RSE Young Academy Scotland (YAS) Robertson Trust mentoring programme, YAS members mentor Robertson Trust Journey to Success Scholars who have talent, but perhaps not the financial means or guidance, to reach their potential through higher education. Often first in family to undertake a degree, scholars are supported by YAS members to develop their communication, learning, and employability skills. During this year’s programme, Reece Thompson, a third-year student in Biochemistry and Pharmacology at the University of Strathclyde, worked with Dr Fiona Kerr, a YAS member from Edinburgh Napier University, to develop his understanding of how research is reported in the media and to communicate the findings of a complex research study to the public through this Research the Headlines post. 

A balanced diet: can wine and cheese be good for your brain?

This article builds on a previous post by undergraduate student Izzy Aitken, from Heriot-Watt University, who assessed the reporting in the Daily Mail of a study from Klinedinst et al. (2020), on the links between food consumption and cognitive (thinking) function as part of the Brain blog showcase 2021. Here we expand on this work by comparing the ways in which this article is reported in traditional tabloids to online media sources. Recent studies suggest that modifying lifestyle factors may reduce dementia risk by up to 40% (2020 report of the Lancet commission) and a plethora of health advice is publicly available. For this reason, it is important to understand the evidence underpinning these potential interventions, to ensure a balanced, rather than a fad, diet that promotes brain health.

What does the study show?

As previously described by Izzy (Brain blog showcase 2021), Klinedinst and colleagues examined the effects of food intake on fluid intelligence, a particular aspect of thinking that reflects our capacity to reason and solve problems. You can read about what the researchers did and found on Izzy’s blog. In summary, data was gathered from 1787 participants, with a Fluid Intelligence Test (FIT) and a food frequency questionnaire performed at three timepoints over the course of ten years. Although patients with a diagnosis of Alzheimer’s disease (AD) were not included in this investigation, and AD pathology was not measured, participants were grouped based on genetic risk factors for AD (APOE4+ or APOE4-), or a family history of developing AD (FH+ or FH-). The association between FIT and certain foods was different depending on what risk group a person was in. 

How well did the media cover the findings?

This article has been widely reported in the mainstream and online media, most likely due to the attractiveness for preventing dementia for cheese and wine lovers! Building on Izzy’s previous account of reporting in the Daily Mail, overall mainstream media articles reported the study in a fair manner, including clear explanations of the ‘think on the fly’ Fluid Intelligence Test (FIT) used to measure thinking abilities and accurate reporting of the study cohort, sample sizes, demographics, and duration. Both the Mirror and Daily Mail, however, have used sensational headlines, “Eating cheese and drinking red wine can reduce your risk of Alzheimer’s…” and “No need to hold back on the cheese and wine this Christmas: Study shows they can REDUCE risk of Alzheimer’s and age-related cognitive decline”, which over-exaggerate the potential implications of the study to prevention of Alzheimer’s disease. This, in turn, encourages those to eat a high-calorie diet – increasing risk of obesity and type 2 diabetes.  “Cheese and wine is good for your brain” from the Independent is more accurate and aligns with the results from the study, since AD patients were not included, or pathology tested, despite grouping into those who carried genetic risk factors or a family history of disease. Although the Daily Mail and Independent provide useful explanations and signposting to the signs of dementia, neither of the reports clearly explain how the FIT test would relate to these symptoms and that it was used as a proxy, rather than a definitive, measure of dementia. Rather these food groups associate with higher levels of one particular type of cognitive ability that is affected in AD, and this is more accurately described in The Independent as ‘age-related cognitive decline’. Moreover, the Mirror and Daily Mail report that cheese was protective against cognitive decline even into later life, but the study did not analyse different age groups separately despite including participants from mid to late life. 

Comparatively, online articles, reported in Science Daily, IFL Science, MY MODERN MET, World Medicine Foundation, and Big Think tended to adopt titles that more accurately reflected the effects of diet on cognitive function rather than dementia per se. Key study findings are accurately reported, and the effects of family history and genetics on associations between cheese or wine and cognition are discussed more clearly in Science Daily, My Modern Met, and IFL Science than in the mainstream articles, This may reflect the scientific focus of the online sources. 

All reports, reassuringly, acknowledge that this is an observational study, requiring further clinical trials to prove cause and effect links between particular food groups and risk of AD and other dementias, and highlight negative associations between salt and cognitive function as well as the positive effects of cheese, wine and lamb. Quotes from the study authors provide overall a balanced approach to reporting of the study including its limitations.

What does it all mean: take this with a pinch of salt?

Perhaps, diet is the “silver bullet” stated by Klinedinst, for cognitive decline, and their results do show that it could be a possibility. But before delving into the ‘red wine and cheese diet’ to prevent dementia, do not forget other risks that may be involved in such a diet and note that much more research is required. Calorie intake, which has been implicated in increased risk of dementia, was not reported in this study, for example in relation to the amount of cheese that was consumed daily. Moreover, obesity and type 2 diabetes, which increase with high fat and calorie consumption, as well as lack of exercise and excessive alcohol consumption, present significant risk for development of dementia (2020 report of the Lancet commission), contrary to the implications of this study that cheese and red wine reduced, and moderate exercise accelerated, cognitive decline. Hence, clinical studies will be important in verifying these findings and to determine whether they actually prevent AD and if so why. Until then, a balanced approach to diet and exercise seems like a safer approach for good health.