Cognition emerges from biology. Executive functioning (EF) and decision-making (DM), the cognitive processes that underpin human choice behaviour, depend on distributed neurobiological systems operating under metabolic, neurochemical, and physiological constraints⁽¹˒²⁾. As one of the most powerful modifiable biological exposures, diet has the potential to influence these systems through metabolism, neurotransmission, inflammation, and gut–brain signalling⁽³˒⁴⁾. However, the field remains fragmented and limited by challenges in accurately capturing complex dietary exposures.
In this systematic review, we reviewed evidence examining how dietary exposures influence the neurobiological mechanisms underlying EF and DM. Of 12,952 records identified, 26 studies met the inclusion criteria, involving over 2,000 participants. The evidence consistently demonstrated that dietary exposures modulate the biological pathways supporting EF and DM. Collectively, the findings support a multi-level neurobiological framework in which dietary exposures modify the biological pathways supporting EF and DM. Behavioural effects were observed across all dietary domains and in the majority of included studies; however, their expression was highly context-dependent, whereas biological adaptations were detected more consistently.
Current research provides limited understanding of when and how these biological adaptations translate into measurable behavioural change, representing a key barrier to mechanistic understanding. This framework offers a potential explanation for the inconsistent behavioural findings reported across dietary intervention studies. Rather than questioning whether dietary exposures influence cognition, future research should determine when and how dietary modulation of neurobiological pathways translates into changes in EF, DM, and adaptive behaviour through longitudinal, mechanistically integrated study designs.
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