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sugary beverage intake was associated with poorer cognitive function 231 Confidence of Efficacy: High* Cocoa Polyphenols Food source(s): Dark chocolate Potential Mechanism(s) 237-240 : Increasing brain blood flow and oxygenation, as well as influencing brain electrical signaling after short-term consumption Increasing nerve growth factor levels with daily consumption Suggested Intake (Brain Benefits): 35 grams (about 1 ounce) of dark chocolate in a sitting 10 grams of chocolate with 99% cocoa content daily Scientific Evidence: Study 1 Study Design: RCT Subjects: 98 individuals aged 1824 years Dose: 35 grams (about 1 ounce) of dark chocolate versus 35 grams of low-flavanol white chocolate Results: Improved performance on a test of verbal memory (remembering information presented via written or spoken words) and some tests of verbal learning (learning through reading or listening) two hours later 241 Study 2 Study Design: RCT Subjects: 140 postmenopausal women Dose: 10 grams of chocolate with 99% cocoa content daily versus no chocolate for six months Results: Slightly improved performance on tests of cognitive flexibility and processing speed 242 Study 3 Study Design: RCT (Negative) Subjects: 100 participants over age 65 Dose: 50 grams of high-flavanol dark chocolate (providing 410 mg of cocoa flavanols) versus 50 grams of low-flavanol dark chocolate (providing 86 mg of cocoa flavanols) daily for eight weeks Results: No differences in cognitive performance 243 Study 4 Study Design: Systematic reviews of RCTs Subjects: Young adults Results: Cocoa flavanols can improve neuroplasticity and cognitive function in early adulthood 237 Confidence of Efficacy: Medium* Carotenoids Food source(s): Leafy greens (spinach, kale, et al) Carrots Avocadoes Potential Mechanism(s): Lutein, in particular, accumulates in the retina of the eye and in the brain where it protects against oxidative damage and supports nerve function 244,245 Suggested Intake (Brain Benefits): Estimates of lutein content suggest cup of cooked kale or cup of cooked spinach may provide a meaningful amount of lutein 246 Scientific Evidence: Study 1 Study Design: RCT Subjects: 84 adults, aged 2545 years, with overweight or obesity Dose: One Hass avocado per day versus no avocado for 12 weeks Results: Raised blood lutein levels and improved scores on a cognitive test measuring the ability to control attention

doi: 10.1093/brain/awab102 92 WangYZhangJChangHWangHXuWCongHet al