Background: Cognitive decline—worsening memory and more frequent memory loss or confusion—affects 10% of all US adults aged 45 and older. Incidence is higher—11.4%—among Hispanic and Latino Americans. In some cases, cognitive decline may be an early sign of dementia.
Close adherence to the Mediterranean diet (MeDi) is associated with a reduced risk of dementia and cognitive decline. The MeDi emphasizes fresh fruits, vegetables, whole grains, beans, legumes, nuts, low to moderate amounts of dairy, eggs, fish, and poultry, and olive oil as the primary fat source.
Researchers have attributed the MeDi’s brain benefits to its cardiovascular effects, such as lower blood pressure, reduced diabetes risk, and improvements in blood vessel function and cholesterol levels. The first large-scale study of the MeDi in Hispanic and Latino Americans investigated whether the MeDi’s brain benefits are independent of its cardiovascular effects.
Preliminary findings from this 10-year study of 2,774 participants (44% men, 56% women; average age 64 at follow-up) were presented at the recent conference of the American Stroke Association, February 5–7, 2025.
Methods: At an initial visit, each participant reported their food intake during the previous 24 hours and received a score (0 to 9), indicating how closely their diet corresponded to the MeDi. Average MeDi score was 5. Ten years after the baseline visit, investigators obtained a brain scan via MRI (magnetic resonance imaging) for each participant.
The main outcome evaluated in the study was white matter integrity (WMI) and volume. The white matter of the brain (as opposed to the gray matter) consists of bundles of nerve fibers that, crucially, communicate information to different parts of the brain. WMI and volume are markers of the strength of those connections in the brain. MRI scans provide clear, detailed cross-sections of the brain, showing white matter and gray matter.
To account for the impact of cardiovascular benefits, the study also asked participants about multiple practices associated with heart health: regular exercise; healthy diet; not smoking; weight maintenance; and maintaining healthy blood pressure, blood sugar, and cholesterol levels.
Results: Participants with higher MeDi scores had stronger connections between regions of the brain (preserved WMI) compared to those with lower MeDi scores. With each point higher in MeDi score, participants’ MRI scans also showed less structural damage to the blood vessels of the brain. After factoring in heart-health practices, the researchers determined that cardiovascular effects alone did not account for all the significant brain benefits of the MeDi.
Conclusion: Eating a Mediterranean-style diet improved brain health and preserved structural integrity in a high-risk population. Even small adjustments in food intake, closer to the MeDi, could help protect against cognitive decline and dementia. The brain benefits of the MeDi extend beyond its well-known cardiovascular effects—more research is needed to identify the brain-protective mechanisms involved.
Olive Oil and Lemon Pancakes Recipe, Spotlight on Lemons, Heating Your Griddle, The Downside of Perfumed Products, and Your Brain on Exercise
If you love fluffy flapjacks, you’ll be over the moon about these olive oil and lemon pancakes, packed with flavors as well as nutrients. Boxed mixes can’t hold a candle to them! Speaking of candles, you’ll want to read about discoveries from researchers at Purdue who found that scented products, including wax melts that are flame-free, are creating indoor toxins that can harm respiratory health. I’m also sharing a study on a brainy benefit from exercise.
Pancakes from scratch take breakfast (or brunch) to a whole new level. These are so tasty that you don’t need any syrup to enhance their flavor. If you want a nutritious garnish, top each serving with mixed berries.
Ingredients
1-1/2 cups all-purpose flour
1/2 cup white whole wheat flour
3 tablespoons sugar or equivalent
2-1/2 teaspoons baking powder
1/2 teaspoon baking soda
1/2 teaspoon fine sea salt
1/4 teaspoon freshly grated nutmeg
1/4 teaspoon cinnamon
4 large or extra-large eggs
4 tablespoons extra virgin olive oil, divided use
1-1/3 cups milk or non-dairy alternative
1 cup ricotta cheese
2 teaspoons vanilla
Zest of one large lemon
4 tablespoons freshly squeezed lemon juice
Directions
Step 1
Mix all the dry ingredients in a large bowl.
Step 2
In a separate bowl, beat the eggs until frothy, then add 3 tablespoons olive oil, the milk, ricotta, vanilla, and lemon zest. Whisk well, then fold in the lemon juice.
Step 3
Using a large spatula, scrape the liquid mixture into the bowl of dry ingredients and blend thoroughly, being sure to incorporate all the flour into the batter.
Step 4
Heat a griddle over medium heat. When ready, brush the griddle with the final tablespoon of olive oil. Use an ice cream scoop to make as many 4-inch pancakes as will fit without crowding. Cook for about 3 minutes, until the edges start to firm, then flip the pancakes and continue cooking for another 3 minutes. Repeat until you’ve used up all the batter.
Yields 20 pancakes
Healthy Ingredient Spotlight
Keeping Lemons Fresh Longer
A squeeze of lemon adds freshness to so many dishes that I always have a few on hand. And to make sure they stay fresh until I use them, I don’t keep them in a bowl on the counter, but rather in the fridge. This can extend their shelf life from about one week to three or four weeks.
When you get home from the store, rinse the lemons under cold water and dry them thoroughly. Then place them in an airtight container in a crisper drawer.
Because citrus fruits more easily release their juices at room temperature, take lemons out of the fridge about an hour before using.
Quick Kitchen Nugget
Heating Your Griddle
Members of the Fresh-Pressed Olive Oil Club know that I’m a stickler when it comes to heating a pan before adding olive oil. This is especially true for a stovetop pancake griddle because this cookware needs a long preheat to create uniform temperature and avoid hot spots that can burn your pancakes.
Place your griddle on the stovetop over medium heat and give it 5 to 10 minutes to heat up. Test it with a drop of water—the water should sizzle and evaporate quickly. Then pour a tablespoon of olive oil on the griddle and use a silicone brush to spread it across the surface.
If you’re unsure whether the pan is hot enough, test with a small spoonful of batter. The bottom should brown evenly within a minute or two. If browning happens too quickly and you see dark spots when you flip it, lower the heat a notch before proceeding. If the tester doesn’t brown nicely, turn the heat up a notch.
For Your Best Health
The Downside of Perfumed Products
Do you find the scent of a pine forest or a rose bush so pleasant that you use products with the fragrance indoors? Problem is, simulating natural aromas with chemicals, like those found in air fresheners, wax melts, floor cleaners, and room deodorants, rapidly fills your inside environment with nanoscale particles, invisible to the naked eye and small enough to penetrate deep into your respiratory system and spread to other organs, according to research done at Purdue University. These nanoparticles form when fragrances interact with ozone, which enters buildings through ventilation systems, triggering chemical transformations that create new airborne pollutants.
“A forest is a pristine environment, but if you’re using cleaning and aromatherapy products full of chemically manufactured scents to re-create a forest in your home, you’re actually creating a tremendous amount of indoor air pollution that you shouldn’t be breathing in,” said Nusrat Jung, DSc, an assistant professor in Purdue’s Lyles School of Civil and Construction Engineering.
Dr. Jung and her colleague Brandon Boor, PhD, Purdue’s Dr. Margery E. Hoffman Associate Professor in civil engineering, have been the first to study nanoscale airborne particle formation indoors and compare it to outdoor atmospheric processes. “To understand how airborne particles form indoors, you need to measure the smallest nanoparticles—down to a single nanometer. At this scale, we can observe the earliest stages of new particle formation, where fragrances react with ozone to form tiny molecular clusters. These clusters then rapidly evolve, growing and transforming in the air around us,” said Dr. Boor.
In a “tiny house lab,” a dedicated residential lab space for indoor air quality research, Drs. Jung and Boor are using the latest industry-developed air quality instruments to track how household products emit volatile chemicals that evaporate easily and generate the tiniest airborne nanoparticles. Called the Purdue zero Energy Design Guidance for Engineers (zEDGE) lab, the tiny house has all the features of a typical home but is equipped with sensors for closely monitoring the impact of everyday activities on a home’s air quality. Dr. Jung led the design of the lab, which was built in 2020 as the first of its kind. With this unprecedented level of detail and accuracy, Drs. Jung and Boor have made discoveries suggesting that many everyday household products used indoors may not be as safe as previously assumed.
Even though it’s yet to be determined how breathing in volatile chemicals from these products impacts your health, newly formed nanoparticles are particularly concerning because they can reach very high concentrations, potentially posing risks to respiratory health. Both professors believe these findings highlight the need for further research into indoor nanoparticle formation triggered by heavily scented chemical products. “Our research shows that fragranced products are not just passive sources of pleasant scents—they actively alter indoor air chemistry, leading to the formation of nanoparticles at concentrations that could have significant health implications,” Dr. Jung said. “These processes should be considered in the design and operation of buildings and their HVAC systems to reduce our exposures.”
The two researchers also specifically found that scented wax melts, typically advertised as nontoxic because they are flame-free, actually pollute indoor air at least as much as candles. Wax melts and other scented products release terpenes, the chemical compounds responsible for their scents. Since wax melts contain a higher concentration of fragrance oils than many candles do, they emit more terpenes into indoor air. These terpenes then rapidly react with ozone, triggering significant nanoparticle formation. In fact, the nanoparticle pollution from wax melts rivals that of candles, despite the absence of combustion. They also found that essential oil diffusers, disinfectants, air fresheners, and other scented sprays generate a significant number of nanoscale particles.
Drs. Jung and Boor use the tiny house lab to study how a range of other everyday household activities, such as hair care routines, could impact a home’s air quality. Dr. Jung and her students have found that several chemicals, particularly cyclic volatile methyl siloxanes, ubiquitous in hair care products, linger in the air in surprising amounts during and after use. In a single hair care session at home, a person can inhale a cumulative mass of 1 to 17 milligrams of these chemicals.
Toxicologists will need to build upon these studies to find out exactly how harmful it could be to inhale complex mixtures of volatile chemicals and nanoscale particles indoors. As their research continues, Drs. Jung and Boor also hope their findings will improve how indoor air quality is monitored, controlled, and regulated. “Indoor air quality is often overlooked in the design and management of the buildings we live and work in, yet it has a direct impact on our health every day,” Dr. Boor said. “With data from the tiny house lab, we aim to bridge that gap, transforming fundamental research into real-world solutions for healthier indoor environments for everyone.”
Fitness Flash
Your Brain on Exercise
A study led by scientists at Rutgers University-New Brunswick has shown that specialized cells involved in how the body responds to insulin are activated in the brain after exercise, suggesting that physical activity may directly improve brain function. The research, published in Aging Cell, a journal focused on the biology of aging, indicates that therapies targeting this insulin action may be developed to offset or even prevent dementia progression.
“We believe this work is important because it suggests exercise may work to improve cognition and memory by improving the abilities of insulin to act on the brain,” said Steven Malin, PhD, an associate professor in the Department of Kinesiology and Health in the Rutgers School of Arts and Sciences and lead author of the study.
Conducted in collaboration with the National Institutes of Health’s National Institute on Aging, the researchers focused on the role of neuronal extracellular vesicles, specialized cells released by the brain. Extracellular vesicles, once dismissed by researchers as “cell dust,” have in the past 15 years grown exponentially in recognition as important players in the microscopic world of the human body, facilitating transport of key molecules such as proteins between cells. For this study, the scientists targeted vesicles produced in the brain that ferry several proteins involved in insulin sensitivity, one of which is called Akt.
Insulin sensitivity is a measure of how well the body responds to insulin, a hormone that controls blood sugar levels. People with high insulin sensitivity can use blood glucose more effectively in the body, such as in the muscles, which reduces blood sugar. People with type 2 diabetes, with its key symptom of low insulin sensitivity or insulin resistance, have brain cells that are less responsive to insulin. This can have negative impacts on cognition.
Researchers were able to study the vesicles by isolating them in the blood of participants in an experimental study. The trial, conducted over two weeks, included a group of 21 volunteers who had an average age of 60 and had prediabetes. Over the course of the study, they engaged in 12 individual, supervised, 60-minute exercise sessions of moderate to high intensity. The participants ingested a glucose drink before and after training, and researchers collected blood samples from them at the start and end of exercise training. The blood samples showed that the number of neuronal vesicles carrying the proteins involved in insulin sensitivity increased after each training, with Akt being most notable.
“We showed for the first time that exercise impacts insulin signaling from neuronal extracellular vesicles in relation to clinical improvements in blood sugar,” Dr. Malin said. “And we use these neuronal extracellular vesicles as an indicator of brain insulin sensitivity.” Exercise, therefore, is potentially able to improve the brain’s capacity to respond to insulin for neuronal function, he said.
Insulin is a hormone increasingly recognized to regulate cognition, the mental process of acquiring knowledge through thought, experience, and the senses. Prediabetes is a serious health condition that occurs when blood sugar levels are higher than normal but not high enough to be diagnosed as type 2 diabetes. Those with prediabetes run the risk of having insufficient levels of insulin in their bodies, particularly the brain, which increases the chances of developing diseases of dementia such as Alzheimer’s, Dr. Malin said.
Insulin also plays a crucial role in memory formation, recall, processing speed, and the functioning of synapses, structures that allow brain cells to communicate with one another. “If insulin is insufficient in the brain, that means not only will brain cells become potentially dysfunctional, but also they may fail to interact with each other properly,” Dr. Malin said. “It’s like playing the game telephone…At some point the message gets lost when the brain becomes insulin resistant.”
Exercise has long been believed to improve cognition, but the mechanisms involved have been unclear. Past studies have uncovered evidence that high blood sugar contributes to a decrease in the brain’s ability to recall information and learn new information. Dr. Malin said that insulin, which is produced by the pancreas and travels to the brain to perform its functions, plays a central role in promoting brain blood flow and neuronal functioning for cognition. “Our work suggests that therapies that target brain insulin action may be able to ward off dementia,” he added.
Future plans are to conduct a long-term exercise training study that assesses brain insulin sensitivity improvements in relation to cognition in older adults.
Pancakes from scratch take breakfast (or brunch) to a whole new level. These are so tasty that you don’t need any syrup to enhance their flavor. If you want a nutritious garnish, top each serving with mixed berries.
Ingredients
1-1/2 cups all-purpose flour
1/2 cup white whole wheat flour
3 tablespoons sugar or equivalent
2-1/2 teaspoons baking powder
1/2 teaspoon baking soda
1/2 teaspoon fine sea salt
1/4 teaspoon freshly grated nutmeg
1/4 teaspoon cinnamon
4 large or extra-large eggs
4 tablespoons extra virgin olive oil, divided use
1-1/3 cups milk or non-dairy alternative
1 cup ricotta cheese
2 teaspoons vanilla
Zest of one large lemon
4 tablespoons freshly squeezed lemon juice
Directions
Step 1
Mix all the dry ingredients in a large bowl.
Step 2
In a separate bowl, beat the eggs until frothy, then add 3 tablespoons olive oil, the milk, ricotta, vanilla, and lemon zest. Whisk well, then fold in the lemon juice.
Step 3
Using a large spatula, scrape the liquid mixture into the bowl of dry ingredients and blend thoroughly, being sure to incorporate all the flour into the batter.
Step 4
Heat a griddle over medium heat. When ready, brush the griddle with the final tablespoon of olive oil. Use an ice cream scoop to make as many 4-inch pancakes as will fit without crowding. Cook for about 3 minutes, until the edges start to firm, then flip the pancakes and continue cooking for another 3 minutes. Repeat until you’ve used up all the batter.
Barley Bowl Recipe, Spotlight on Green Peas (Vegetable or Legume?), Hearing and Your Health, Storing Grains, When Worries About Not Sleeping Keep You Up at Night
Whole grains are an important part of the Mediterranean diet—and should be part of every diet, not only for their nutrients but also for the depth of flavor that is missing in refined products. Barley bowls are a great way to enjoy this nutty-tasting grain, and you can customize it with your favorite seasonal vegetables any time of the year. When it comes to good health, many people aren’t aware of the impact hearing loss can have on their lives, physically and socially—there’s a new app that lets you check on your own. I’m also sharing advice from the American Academy of Sleep Medicine to calm concerns among people who might be going too far in their efforts to get better sleep.
Barley is a nutritious whole grain that retains far more nutrients than pearl barley. It does take longer to cook and tends to require more water, but the taste is more than worth it, and you can make it up to 3 days in advance. I like to enhance this medley with pomegranate molasses. A staple in Mediterranean and Middle Eastern cuisines, it’s a luscious sweet-tart syrup made by boiling down pomegranate juice until it becomes thick. It’s available at spice and gourmet shops, but it’s easy enough to make on your own…with a little patience—expect a couple of cups of juice to take an hour or more to reduce (check the pot often and stand by when it gets close to the syrup stage to avoid burning it).
Ingredients
1 cup uncooked hulled barley
8 cups water, divided use
4 tablespoons extra virgin olive oil, plus more for drizzling
1 large sweet onion, chopped
1 teaspoon coarse sea salt
8 ounces white mushrooms, cleaned and thinly sliced
4 garlic cloves, minced
1 teaspoon freshly ground black pepper
1 tablespoon each chopped fresh flat-leaf parsley and thyme leaves
8 ounces spinach leaves, rinsed, patted dry, and rough-chopped
Optional: 1 tablespoon pomegranate molasses, more to taste
Directions
Step 1
Add the dry barley and 6 cups of water to a wide saucepan. Bring to a boil and then turn down the heat and simmer for an hour, stirring occasionally and checking that the water doesn’t evaporate before the barley is done; if needed, add more water, 1 cup at a time. For the last 10 minutes, stir continuously to prevent scorching as the last of the water gets absorbed.
Step 2
Defrost the peas if frozen. Heat a wok or wide sauté pan over medium heat. When hot, add the olive oil and onions; cook until the onions turn translucent, sprinkling them with salt after 5 minutes. Add the mushrooms, garlic, black pepper, and herbs; continue cooking until the mushrooms give up most of their liquid. Push the other vegetables to the side and add the spinach, a handful at a time, cooking each batch until wilted.
Step 3
When all the vegetables are tender, fold in the peas, cooked barley, and pomegranate molasses, if using. Serve in deep bowls with a drizzle of olive oil.
Yields 4 servings
Healthy Ingredient Spotlight
Green Peas: Vegetable or Legume?
Whether snap peas or green peas (or snow peas for that matter), peas are classified as legumes—plants that make pods with seeds or beans inside. Legumes also include all types of lentils; beans, including soybeans and chickpeas (garbanzo beans); and dried yellow and green split peas.
Confusing the situation, the USDA puts green peas not in the “beans, peas, and lentils group” but rather in with traditional veggies because, the agency says, peas’ nutrients align better with those of vegetables than those of legumes (it also describes them as “starchy” vegetables). The bottom line? No matter what you call them, peas are delicious and packed with nutrients, and they make a great addition to many recipes.
Quick Kitchen Nugget
Storing Grains
Because whole grains include natural oils, it’s important to store them correctly. As with extra virgin olive oil, grains’ natural enemies are heat, light, and moisture! If stored properly in airtight containers, grains like barley, farro, brown rice, and spelt will keep for up to 6 months on a cool, dry pantry shelf or up to a year in the freezer. For amaranth, oats, and quinoa, it’s 4 months on the shelf and 8 in the freezer. Buckwheat and millet are the most perishable—use within 2 months when stored on a shelf, within 4 in the freezer. If you transfer grains to your own container after opening the package, write down the package’s use-by date as a reminder.
For Your Best Health
Can You Hear Me Now?
The Johns Hopkins Bloomberg School of Public Health has released an app, Hearing Number, that makes it free, fast, and easy to test your hearing. It introduces the most widely used clinical measure for hearing as a wellness metric that can be tracked over time. The app is part of a public health campaign to raise awareness about the importance of monitoring, protecting, and optimizing hearing at all ages.
Hearing Number will tell someone, in decibels, the softest speech sound they can hear in each ear. Children and young adults with healthy hearing can have a Hearing Number as low as -10 dB; this number increases as we get older. The higher someone’s Hearing Number is, the harder it is for them to hear and communicate in noisy places.
“The Hearing Number gives everyone a way to easily understand and think about their hearing over their lifetime, beginning as a teenager,” says Frank Lin, MD, PhD, lead creator of the app and director of the Johns Hopkins Cochlear Center for Hearing and Public Health at the Bloomberg School. “Many of us track simple metrics about ourselves like our blood pressure and our step count, but people have never had a way to measure their hearing in the same way. By knowing their Hearing Number, people can understand this important aspect of their health, track the changes to their hearing that occur naturally over time, and know when to use technologies to protect their hearing and hear better.”
Your Hearing Number—known clinically as the 4-frequency pure tone average—is one of many ways that audiologists and other hearing care professionals measure hearing and is the basis of the broad categories that the World Health Organization uses to define hearing loss. WHO estimates that 700 million—or 1 in 10—people worldwide will have hearing loss by 2050, with over 1 billion young people currently at risk of preventable hearing loss due to unsafe listening practices. Risk of hearing loss increases with age, with more than 25% of people over 60 affected by hearing loss globally, according to WHO. In the US, about 1 in 3 people between the ages of 65 and 74 has hearing loss, according to the National Institutes of Health.
Hearing is foundational to social and cognitive health. A 2023 study led by Bloomberg School researchers found that treating hearing loss in older adults at increased risk for cognitive decline slows down loss of thinking and memory abilities. Research has also linked hearing loss to increased risk of depression, falls, fatigue, loss of thinking and memory abilities, and social isolation. “Connecting people with their hearing through a simple metric has the potential to drive a shift in how people think about and prioritize their hearing throughout their lives,” said Dr. Lin.
The Hearing Number app is available for iOS and Android smartphones. The test requires headphones or earbuds and takes about 5 minutes to complete in a quiet setting. The app does not collect user personal data and users can share the app without sharing personal data.
Fitness Flash
When Worries About Not Sleeping Keep You Up at Night
A recent survey from the American Academy of Sleep Medicine highlights a surprising paradox: 81% of Americans report losing sleep due to worries about sleep problems. This illustrates the growing pressure to achieve “perfect sleep,” fueled by social media trends, wellness products, and sleep tracking technology.
“Concerns about getting enough high-quality sleep can create a vicious cycle of stress and sleeplessness for some people,” said Anita Shelgikar, MD, MHPE, a sleep medicine physician and president-elect of the AASM. “Prioritizing sleep is great for overall health and well-being. For some, however, a heavy focus on optimizing sleep can actually lead to a decrease in sleep quality and sleep quantity.”
While many people embrace rigorous sleep optimization routines, from advanced tracking apps to highly structured rituals, often in pursuit of achieving that “perfect” 8 hours of sleep, experts caution that these things can unintentionally fuel sleep anxiety, a condition called orthosomnia.
“Sleep maximization can sometimes turn what should be a restorative process into a high-pressure task,” Dr. Shelgikar noted. “Highly detailed sleep tracking and optimization can cause some individuals to become overly critical of their sleep patterns, leading to heightened stress and potentially worsened sleep over time.”
The AASM recommends the following strategies to ease worries and promote better sleep:
Create a relaxing environment: Make your bedroom a calming space. Keep it dark, quiet, and cool, and invest in comfortable bedding.
Practice relaxation techniques: Engage in activities such as deep breathing, meditation, or journaling to help calm and clear your mind before bedtime.
Understand the role of sleep tracking data: If you’re using sleep technologies, think of them as guides and tools, not rigid scorekeepers.
Seek professional help: If you continue to experience sleep-related stress or sleeplessness, talk with your health care professional or sleep medicine specialist for further evaluation of your sleep.
“Sleep doesn’t have to be perfect every night,” Dr. Shelgikar added. “The key is focusing on sustainable habits and broad trends related to your sleep. The goal is to get the amount of sleep you need to wake up refreshed and well rested on a regular basis.”
