Mediterranean diet may also benefit your brain, not just your heart

After last year’s widely reported finding that the Mediterranean Diet (fish, poultry, olive oil, fruits, nuts and whole grains, with little meat and dairy) indeed benefits cardiovascular health, now here’s a new study, published in the April 30, 2013 issue of the journal Neurology, and taken up by our hometown newspaper the New York Times, in their online blog “Well”:

Researchers prospectively followed 17,478 mentally healthy men and women 45 and older, gathering data on diet from food questionnaires, and testing mental function with a well-validated six-item screening tool. They ranked their adherence to the Mediterranean diet on a 10-point scale, dividing the group into low adherence and high adherence. […]
During a four-year follow-up, 1,248 people became cognitively impaired. But those with high adherence to the diet were 19 percent less likely to be among them. This association persisted even after controlling for almost two dozen demographic, environmental and vascular risk factors, and held true for both African-Americans and whites.


On the Importance of B Vitamins

We’ve adapted this piece from the NYBC Info Sheet on Vitamin B12.

We can now update the Info Sheet with recent reports on the importance of the B vitamins for cognitive health, a specific concern for people with HIV, but also a general concern for people as they age:

NYBC members often supplement with B-right B complex and/or with Methylcobalamin, a form of B12 that is better absorbed by the body than other forms of B12.

B-12 may play a very critical role in preventing HIV disease progression: a large Johns Hopkins University study found that people with HIV who are deficient in B-12 have a two-fold increased risk of progression to AIDS. In this study, those who were B-12 deficient progressed to AIDS four years faster than those who were not. The exact mechanism by which adequate B-12 in the body may slow progression is not known, but the finding is not surprising, given all the roles B-12 is known to play in healthy human function.

B12 and another B vitamin, folic acid, are critical to prevent or eliminate the often-overwhelming fatigue that so often accompanies HIV disease, as well as to help prevent some forms of neuropathy and brain and spinal cord changes. Maintaining adequate B12 levels also supports the bone marrow’s production of blood cells (crucial to prevent white and red blood cell decreases), and helps protect the heart.

There are countless anecdotal reports from people with HIV that using B-12 supplementation has dramatically improved their lives by its ability to reverse fatigue, often restoring normal energy to people who had previously been so exhausted that their daily functioning had been greatly affected. Many people have also reported significant improvements in memory and mental functioning, improvements that have made a huge difference in daily life. The possibility that B-12 supplementation might also help prevent or reverse the spinal cord changes that can have such devastating effects on some people is also very encouraging.

B-12 and folic acid should always be given together. Doses of B-12 (1000 mcg given daily via pills, or one to several times weekly via prescribable nasal gel or injections) and folic acid (800 mcg daily via pills) may be useful for restoring energy, treating neuropathy, protecting the heart, increasing overall feelings of well being, and boosting mental function (especially when combined with thiamin, niacin, and folic acid, since all four of these B vitamins are needed for normal neurological function) even when tests don’t indicate obvious deficiencies.

Deficiencies of B-12 can result in deterioration of mental function and neurologic damage that will yield such symptoms as memory loss, decreased reflexes, weakness, fatigue, disorientation, impaired pain perception, tinnitus (chronic ringing in the ears), neuropathy, burning tongue, and various psychiatric disorders. B-12 deficiency can also cause canker sores in the mouth, impaired bone marrow function, loss of appetite, and loss of weight, as well as impaired antibody responses to vaccines.

Folic acid deficiency can also cause fatigue and weakness, along with irritability, cramps, anemia, nausea, loss of appetite, diarrhea, hair loss, mouth and tongue pain, and neurological problems. In addition, folic acid deficiency is believed to play a role in the development of numerous and varied types of human cancers.

A combination of B-12 and folic acid deficiency can allow increases in blood levels of homocysteine, a chemical that can damage artery walls and contribute to heart disease.

One of the known causes of B12 deficiency is chronic viral illness with resulting poor gastrointestinal absorption. AZT use may contribute to deficiencies of both B-12 and folic acid. Many other drugs may worsen folate status in the body including TMP/SMX (Bactrim, Septra), pyrimethamine, and methotrexate (all three of which are folate antagonists), as well as phenytoin (Dilantin), various barbiturates, and alcohol (all of which block folate absorption). B-12 deficiency can also worsen folate levels in the body because B-12 is required to change folate into its active form.

Can this omega-3 fatty acid make you think better?

We don’t often put up such a “believe it or not” / “popular science” sounding headline on this Blog, but here’s a rather neatly done scientific study from 2010 that seems to confirm those old sayings about fish being “brain food.”

University of Pittsburgh researchers recently reported on an interesting study about the connection between omega-3 fatty acids (such as those found in fish oil) and cognitive function. The research study followed 280 healthy adults, aged 35-54, and looked at how they performed on tests of nonverbal reasoning and working memory. Researchers found that those who registered higher blood levels of the omega-3 fatty acid docosahexaenonic acid (DHA) performed significantly better on these tests. They did not find any association between two other omega-3 fatty acids, a-linolenic acid (ALA) and eicosapentaenoic acid (EPA), and mental performance measures. They conclude that “DHA is associated with major aspects of cognitive performance in nonpatient adults [up to 55 years old]. These findings suggest that DHA is related to brain health throughout the lifespan…”

Our comment: in recent years there have been several studies relating dietary intake of fish or omega-3 fatty acids and better early brain development and lowered risk of cognitive disorders in late life. (Also , higher fish oil/omega-3 fatty acids intake has been linked to lower rates of depression.) This 2010 study adds evidence that it is specifically DHA that delivers cognitive benefit such as improved reasoning and working memory.

Reference: Matthew Muldoon et al, Serum Phospholipid Docosahexaenonic Acid Is Associated with Cognitive Functioning during Middle Adulthood. The Journal of Nutrition – J. Nutr. 140: 848–853, 2010

NYBC stocks this supplement, which, as the tradename suggests, focuses on providing a substantial dose of DHA, the omega-3 fatty acid found to be effective in the Univ. of Pittsburgh study:

DHA Max (Jarrow)

Supplements for the Brain (and Nerves)

“For Your Peace of Mind…”

Recent research on supplements for memory, cognition and other neurological functions
You may remember (we hope you remember!) the Scarecrow’s petition to the Wizard of Oz for a brain. Be advised–we at NYBC do not stock new brains, so don’t come to us with that request.

However, we do follow the sometimes startling new research on supplements, brain function and related neurological issues. In this department, there’s special cause for concern for people with HIV. According to a Canadian study released in 2010, in a group of 1615 people receiving treatment for HIV during the decade 1998-2008, one fourth had neurological problems, including memory loss, cognitive impairment and peripheral neuropathy. Of course being worried about brain function–and neurological function in general–is not unique to people with HIV. As people age, they are more likely to experience memory loss or forms of dementia such as Alzheimer’s. And the nerve condition called peripheral neuropathy (pain, tingling in the feet and hands) is found not just in people with HIV, but also among the growing population with Type 2 diabetes.

Now, on to what we see as some of the most valuable recent findings about supplements and brain or neurological function:

B vitamins can be considered a foundation because they are needed in so many processes essential to the brain’s operation, from energy supply and healthy blood flow, to the formation of neurotransmitters (=chemical messengers of neurologic information from one cell to another). Furthermore, there is evidence that several groups of people, including those over 60 and those with HIV, have a greater risk for Vitamin B deficiencies. So supplementing with a B complex vitamin is a sensible start to cognitive health. More specifically, there is good research linking deficiency of vitamins B12 and B6 to mood disorders like depression—and depression earlier in life is associated with higher risk of dementia in later life. Last, there is also some evidence that B vitamins may reduce stroke risk in older people.

Omega-3 fatty acids (fish oil) support cognitive health in a variety of ways. In 2008, UCLA researchers reported on a lab study showing that the omega-3 fatty acid DHA, together with exercise, improved cognitive function. This caught our attention, because there is wide agreement that regular exercise strongly supports brain function as we age, and here the suggestion is that omega-3 fatty acids multiply that known benefit. A diet rich in omega-3 fatty acids/fish oil has also been linked to lower risk of depression—another plus. And still more: recent research found that omega-3 fatty acids block the development of retinopathy, a chief cause of blindness as we age. (The retina of the eye is actually part of the brain–it is full of nerve cells essential for vision.) All in all, the neurological benefits of omega-3 fatty acids seem both wide-ranging and quite convincing, so it’s high on our recommended list.

The amino acid acetylcarnitine has shown benefit for brain function in a number of studies with humans. In the last decade, acetylcarnitine has also been investigated for peripheral neuropathy in people with HIV. (Some recommend using it with evening primrose oil and Vitamin C.) A 2008 study found that acetylcarnitine influences a chemical process in the brain that triggers Alzheimer’s, so researchers are continuing to puzzle out how this supplement produces its neurological benefits.

Antioxidants. There’s much suggestive research about how antioxidants counter destructive oxidative processes in the brain, thus blocking memory loss and cognitive decline. For example, a 2003 report found that the antioxidant combination alpha lipoic acid and NAC reversed memory loss in aged laboratory mice. And there’s also been a lot of attention to the combination acetylcarnitine and alpha lipoic acid for memory impairment. Furthermore, other antioxidants such as curcumin are under study for their potential to fight the processes that lead to declining brain function.

Acetylcholine. The first neurotransmitter to be identified, acetylcholine is closely associated with memory, with lower levels linked to memory loss. NYBC currently stocks two combination supplements that support acetylcholine levels in the brain, while also providing other nutrients for neurological function: Neuro Optimizer (Jarrow), which includes acetylcholine enhancers, acetylcarnitine, and alpha lipoic acid; and Think Clearly (SuperNutrition), which includes B vitamins, as well as acetylcholine enhancers and a botanical traditionally used for cognitive support, ginkgo biloba.

Resveratrol. In the past decade, there has been intense scientific interest in this compound, most famously found in red wine. While some research ventures have hoped to find in resveratrol a life-extending supplement (a capacity demonstrated in animal studies), others have focused on its therapeutic value for conditions like diabetes or cognitive decline. For example, Cornell researchers reported in 2009 that resveratrol reduced the kind of plaque formation in animal brains that causes Alzheimer’s. And a year later another lab investigation, this one at Johns Hopkins, found that a moderate dose of the compound protected animal brains from stroke damage.

Ginkgo biloba, a botanical derived from Earth’s most ancient tree species, has been widely used for cognitive function. In the late 1990s, two reviews of dozens of ginkgo studies concluded that it could improve symptoms of dementia. However, a long-term trial of ginkgo published in the Journal of the American Medical Association in 2008 found that the supplement did not prevent development of dementia in a group of more than 3000 older people who had normal cognitive function at the start of the research. One possible conclusion: ginkgo may help symptoms of cognitive decline, but doesn’t address underlying causes.

NYBC’s RECOMMENDATIONS: A B complex supplement (like Jarrow’s B-right) and fish oil (like Jarrow’s Max DHA) are foundations for maintaining cognitive health, especially important for people with HIV or people over 60. There is some evidence for acetylcarnitine, alpha lipoic and acetylcholine supplementation for memory impairment and possibly for cognitive decline. Acetylcarnitine and other supplements can be used to address peripheral neuropathy. And stay tuned for emerging research on preserving brain function with compounds like resveratrol, NAC and curcumin.

Gingko biloba and omega-3 fatty acids for cognitive health

In its annual bibliography of significant advances in dietary supplement research for 2006, the National Institutes of Health focused on two studies in the category of “cognitive health.” One, involving gingko biloba, found that a component of this botanical may have therapeutic potential for the prevention and treatment of Alzheimer’s disease. This research on gingko provides further background information for of two large randomized controlled investigations that are now underway: the Gingko Evaluation of Memory study, and the GuidAge study.

A second study in the “cognitive health” category was a clinical trial that followed patients with mild to moderate Alzheimer’s disease who took omega-3 fatty acid supplements, as compared to those taking placebo. A significant reduction in cognitive decline was found in those with very moderate dysfunction who took the omega-3.

This investigation also was undertaken in support of a wider investigation on Alzheimer’s and omega-3s, which is being funded by the National Institutes of Health.