Abstract
Background/Objectives: Whole grains are increasingly recognized as protective components of dietary patterns linked to healthy aging and reduced risk of chronic disease. Nevertheless, relatively limited research has explored the relationship between whole wheat flour consumption and cognitive health in South Asian populations, where wheat-based foods represent a major dietary staple. This study investigated the association between habitual whole wheat flour intake and cognitive status in a Pakistani population. Methods: A two-phase cross-sectional study was conducted using interviewer-administered dietary questionnaires. In the first phase, dietary habits related to wheat product consumption were assessed in a population sample of 144 adults. In the second phase, dietary profiles were compared between two matched groups: cognitively healthy individuals (HLT, n = 30) and patients with clinically diagnosed dementia (PwD, n = 30). Categorical variables were analyzed using Pearson's chi-square and Fisher's exact tests. Results: Whole wheat flour was the predominant flour type used among respondents. Compared with PwD, HLT reported significantly higher consumption of whole wheat flour and greater adherence to dietary practices associated with whole grain intake. HLT also reported higher consumption of several foods commonly associated with brain-supportive dietary patterns. Conclusions: Although causal relationships cannot be inferred due to the cross-sectional design, the findings suggest that whole wheat flour consumption may be associated with broader dietary patterns linked to cognitive health. Given the central role of wheat-based foods in the Pakistan diet, promoting whole wheat flour as a staple food choice may represent a culturally feasible strategy within dietary approaches aimed at supporting healthy brain aging.