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Background The population age structure in the U.S. is advancing, as to is the prevalence of Alzheimer’s disease and related dementias despite life expectancy stagnating in recent years. Decline in neural parameters like brain volume and lesion density are expected with advanced age, but rate and severity of loss and function vary widely. Here, we examined how 149 variables representing the total diet could predict or explain variation in total brain volume and lesion density. Methods Among 10,938 adults aged 45 to 80 from the UK Biobank, food choices for 149 items were measured using the 24‐hour Dietary Recall questionnaire and collected up to 5 times over the course of a year. Our outcomes of interest were total brain volume and white matter hyperintensity load, which were derived from a structural Magnetic Resonance Imaging scan conducted 10 years after baseline. Structural equation models of correlated outcomes, using a Backwards selection method (p<.05), were used to identify the most significant food choice predictors. Results Over a period of 10 years, more total brain volume was related to consuming more calories in general, water, various coffee preparations, and teas, hard cheeses, whole grain products, pomme fruits like apples and pears, and to some degree various desserts. Conversely, less total brain volume was seen with consuming more red and rose wine, certain vegetables and mushrooms, potatoes, crackers, and beef. For white matter hyperintensities, less lesion load was seen with consuming more mangoes, apiaceae vegetables like carrots and celery, allium vegetables like onions and leeks, spinach, sweet potatoes, and cow’s milk of any fat percentage. Conversely, greater lesion load was seen with consuming refined chocolates, processed meats and shellfish, fried potatoes, beets, eggs, mushrooms, and vitamin B6 or calcium supplements. Conclusion Maintaining brain health was generally related to consuming more water, fruits and vegetables, complex vs. simple carbohydrates, certain sweets, and dairy products while avoiding processed meats, eggs, and mushrooms. Future work will elucidate how whole food choices are related to functional brain imaging outcomes.