Western Diet and Cognitive Decline: A Hungarian Perspective-Implications for the Design of the Semmelweis Study

BACKGROUND: Accelerated demographic aging in Hungary and across Europe presents significant public health and socioeconomic challenges, particularly in preserving cognitive function and preventing neurodegenerative diseases. Modifiable lifestyle factors-especially dietary habits-play a critical role in brain aging and cognitive decline.

OBJECTIVE: This narrative review explores the mechanisms by which Western dietary patterns contribute to cognitive impairment and neurovascular aging, with specific attention to their relevance in the Hungarian context. It also outlines the rationale and design of the Semmelweis Study and its workplace-based health promotion program targeting lifestyle-related risk factors.

METHODS: A review of peer-reviewed literature was conducted focusing on Western diet, cognitive decline, cerebrovascular health, and dietary interventions. Emphasis was placed on mechanistic pathways involving systemic inflammation, oxidative stress, endothelial dysfunction, and decreased neurotrophic support.

KEY FINDINGS: Western dietary patterns-characterized by high intakes of saturated fats, refined sugars, ultra-processed foods, and linoleic acid-are associated with elevated levels of 4-hydroxynonenal (4-HNE), a lipid peroxidation product linked to neuronal injury and accelerated cognitive aging. In contrast, adherence to Mediterranean dietary patterns-particularly those rich in polyphenols from extra virgin olive oil and moderate red wine consumption-supports neurovascular integrity and promotes brain-derived neurotrophic factor (BDNF) and nerve growth factor (NGF) activity. The concept of “cognitive frailty” is introduced as a modifiable, intermediate state between healthy aging and dementia.

APPLICATION: The Semmelweis Study is a prospective cohort study involving employees of Semmelweis University aged >/=25 years, collecting longitudinal data on dietary, psychosocial, and metabolic determinants of aging. The Semmelweis-EUniWell Workplace Health Promotion Model translates these findings into practical interventions targeting diet, physical activity, and cardiovascular risk factors in the workplace setting.

CONCLUSIONS: Improving our understanding of the diet-brain health relationship through population-specific longitudinal research is crucial for developing culturally tailored preventive strategies. The Semmelweis Study offers a scalable, evidence-based model for reducing cognitive decline and supporting healthy aging across diverse populations.