In other words: reducing visceral fat is good for the brain
You (and the paper) are way too comfortable with claiming causation. The MED score was used specifically to reduce the possibility that there was another cause for both the lowered visceral fat and the cognitive measures and assumes the original interventions caused VAT reduction. If there is a known dietary intervention that works over 5 or 10 years to reduce weight, that alone would be a miracle since I've never seen any study of an intervention that can even guarantee a ten percent loss sustained over two years excepting gastric bypass. Self reported data about ones diet over five or ten years is practically worthless in my eyes. Can you tell me how many ounces of food your lunch was exactly one month ago? Neither could the participants. I bet their levels of physical activity may fluctuate year by year as well, especially at the age many of the participants were at. How many MET hours is also something typical people will not be able to accurately know or give a meaningful answer that covers 5 or 10 years.
Bad data does not lead to a strong conclusion.
Nonetheless, the prospective design, extended follow-up, and clear temporal sequence between MRI analyses support the plausibility of long-term associations. Dietary and lifestyle patterns at follow-up were systematically assessed, and the MED diet adherence score was included in all multivariable models to account for post-trial behaviors.
structured lifestyle questionnaires regarding diet, smoking habits, clinical data, and physical activity (PA) levels (quantified as metabolic equivalent of task (MET)-hours per week)41 were collected at baseline, end of intervention, and follow-up (5–16 years post-RCT), with dietary patterns additionally evaluated using the validated 14-item MED Diet Adherence Screener at follow-up.




An first I thought the ATM had a biometric scanner for their butts.