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How does our ‘do it at home’ pinprick blood test for omega-3 predict your cognitive ability, dementia risk, brain size and intelligence? 

We are a charity dedicated to researching cognitive function and helping people look after their brain and reduce their risk of dementia and other brain-related health challenges, and TODAY we have launched a new ‘do it at home’ pinprick blood test for omega-3.

Multiple studies, including a new study, by psychologists at the Linda Loma University in California and published in the journal Brain Sciences (1), have found that the higher a person’s omega-3 index was in their blood, the more white matter there was in their brain, and the better they performed on cognitive tests that predict less risk for dementia.

With omega-3 such an important brain-health indicator, we have launched an easy, do it yourself, home pin prick test, so your omega-3 levels can be accurately determined. 

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Research also shows that the test can predict brain size and cognitive function. 

The study in California not only found omega-3 was a clear predictor of cognitive function and dementia risk (the higher the omega-3, the lower the risk), it also found that in older people in good health, levels of omega-3 predicted both their brain volume and their cognitive abilities on tests of memory and speed of thinking (the higher the level the bigger their brain volume and the faster their thinking).

“This confirms previous growing evidence that a person’s omega-3 index, which is a composite score of the two main brain-friendly omega-3 fats found in seafood, called EPA and DHA, predicts both the risk for depression (2) and dementia (3), and poorer reading ability, lower IQ, worse memory, difficulty sleeping, aggression and emotional instability in children – hallmarks of ADHD (4) .” says Patrick Holford, our founder and CEO.

The Omega-3 index, which should be above 8%, also predicts risk for heart disease (5) and developmental problems in babies from measures taken in women both before and during pregnancy. “Pregnant women with a higher omega-3 index have a much lower risk of having a baby with developmental problems, according to research at Imperial College London from the Institute of Brain Chemistry at the Chelsea & Westminster Hospital campus.” adds Holford. “It is wise for a woman considering pregnancy to check their omega-3 index and ensure it is above 8%.”

The home test kit, now available HERE also includes our free Cognitive Function Test and a questionnaire to complete about your diet and lifestyle that then identifies the key changes that lower risk of dementia. 

We have tested over 400,000 people and our goal is now to track people’s blood levels of omega-3 with cognitive function to work out exactly what the optimal intake of omega-3 for brain health actually is – so we need your help!

What about Omega-3 from plants?

While there is a type of omega-3 fat (called linolenic acid) in green leafy vegetables, as well as walnuts, chia and flax seeds, its conversion into EPA and DHA is poor. The ability to convert plant-based omega-3 into EPA, which is associated with better mood, and DHA which is the main brain-building omega-3 fat linked to lower risk of age-related memory decline and dementia, varies from person to person. So we hope to find out whether other factors such as age, sex, alcohol consumption and dietary habits, other than seafood intake, make a difference to the ability to make the brain-friendly types of omega-3 measured in this test.

The intake of marine foods has continued to decline over the past hundred years and countries with the lowest intake have the most risk for depression (6), dementia (7) and suicide (8). Even the rate of homicide is linked to a country’s omega-3 intake according to World Health Organisation data (9). 

Less than 5 per cent of children achieve the basic government guidelines for eating fish and omega-3 (10) however we really don’t know if even these guidelines are optimal for mental health. So the more people who are willing to take this inexpensive test and complete a short questionnaire about their dietary habits, plus take a 10-minute online Cognitive Function Test, the more effectively we can discover what an optimal intake of omega-3 for brain health and the prevention of dementia later in life is.

So will you join us and become citizen scientists in this way and help us advance this much-needed area of research – while also helping improve your own brain health?

The test, which costs £49.95, helps to support this research, so to check your omega-3 status click here.

Thank you for reading!
Food for the Brain is a non-for-profit educational and research charity that offers a free Cognitive Function Test and assesses your Dementia Risk Index to be able to advise you on how to dementia-proof your diet and lifestyle.

By completing the Cognitive Function Test you are joining our grassroots research initiative to find out what really works for preventing cognitive decline. We share our ongoing research results with you to help you make brain-friendly choices.

Please support our research by becoming a Friend of Food for the Brain.

References

¹ Loong, S.; Barnes, S.; Gatto, N.M.; Chowdhury, S.; Lee, G.J. Omega-3 Fatty Acids, Cognition, and Brain Volume in Older Adults. Brain Sci.2023,13,1278. https://doi.org/ 10.3390/brainsci13091278 

² Yonezawa K, Kusumoto Y, Kanchi N, Kinoshita H, Kanegae S, Yamaguchi N, Ozawa H. Recent trends in mental illness and omega-3 fatty acids. J Neural Transm (Vienna). 2020 Nov;127(11):1491-1499. doi: 10.1007/s00702-020-02212-z. Epub 2020 May 25. PMID: 32451632.

³ Wei BZ, Li L, Dong CW, Tan CC; Alzheimer’s Disease Neuroimaging Initiative; Xu W. The Relationship of Omega-3 Fatty Acids with Dementia and Cognitive Decline: Evidence from Prospective Cohort Studies of Supplementation, Dietary Intake, and Blood Markers. Am J Clin Nutr. 2023 Jun;117(6):1096-1109. doi: 10.1016/j.ajcnut.2023.04.001. Epub 2023 Apr 5. PMID: 37028557; PMCID: PMC10447496.

⁴ Montgomery P, Burton JR, Sewell RP, Spreckelsen TF, Richardson AJ. Low blood long chain omega-3 fatty acids in UK children are associated with poor cognitive performance and behavior: a cross-sectional analysis from the DOLAB study. PLoS One. 2013 Jun 24;8(6):e66697. doi: 10.1371/journal.pone.0066697. Erratum in: PLoS One. 2013;8(9).doi:10.1371/annotation/26c6b13f-b83a-4a3f-978a-c09d8ccf1ae2. PMID: 23826114; PMCID: PMC3691187; see also Raine A, Ang RP, Choy O, Hibbeln JR, Ho RM, Lim CG, Lim-Ashworth NSJ, Ling S, Liu JCJ, Ooi YP, Tan YR, Fung DSS. Omega-3 (ω-3) and social skills interventions for reactive aggression and childhood externalizing behavior problems: a randomized, stratified, double-blind, placebo-controlled, factorial trial. Psychol Med. 2019 Jan;49(2):335-344. Doi 10.1007/s11920-018-0894-y. PMID: 29623453. ; see also Liu, J., Cui, Y., Li, L. et al. The mediating role of sleep in the fish consumption – cognitive functioning relationship: a cohort study. Sci Rep 7, 17961 (2017). https://doi.org/10.1038/s41598-017-17520-w

⁵ 1 Elagizi A, Lavie CJ, O’Keefe E, Marshall K, O’Keefe JH, Milani RV. An Update on Omega-3 Polyunsaturated Fatty Acids and Cardiovascular Health. Nutrients. 2021 Jan 12;13(1):204. doi: 10.3390/nu13010204. PMID: 33445534; PMCID: PMC7827286.

⁷ Yonezawa K, Kusumoto Y, Kanchi N, Kinoshita H, Kanegae S, Yamaguchi N, Ozawa H. Recent trends in mental illness and omega-3 fatty acids. J Neural Transm (Vienna). 2020 Nov;127(11):1491-1499. doi: 10.1007/s00702-020-02212-z. Epub 2020 May 25. PMID: 32451632.

⁸ Hibbeln JR. Depression, suicide and deficiencies of omega-3 essential fatty acids in modern diets. World Rev Nutr Diet. 2009;99:17-30. doi: 10.1159/000192992. Epub 2009 Jan 9. PMID: 19136836.

⁹ Hibbeln JR. From homicide to happiness–a commentary on omega-3 fatty acids in human society. Cleave Award Lecture. Nutr Health. 2007;19(1-2):9-19. doi: 10.1177/026010600701900204. PMID: 18309762.

¹⁰ Kranz, S.; Jones, N.R.V.; Monsivais, P. Intake Levels of Fish in the UK Paediatric Population. Nutrients 2017, 9, 392. https://doi.org/10.3390/nu9040392

What is HbA1c?

HbA1c stands for Hemoglobin A1c, which is a specific type of protein that glucose becomes attached to. Glucose is a simple sugar that is absorbed into the bloodstream when your body breaks down carbohydrate foods. When glucose is absorbed, some of it becomes attached to the hemoglobin A1c protein and, over time, the more glucose that is circulating in the blood stream, the more glucose becomes attached to the hemoglobin A1c protein. HbA1c is expressed as a percentage because it is the percent of hemoglobin A1c protein that has glucose attached, so if your HbA1c is 5.5% (36.6 mmol/mol), that means that 5.5% of the hemoglobin A1c proteins have glucose attached to them.

Where does blood sugar (glucose) come from?

The main source of sugar in your blood comes directly from the foods you eat. Some examples of these types of foods include rice, potatoes, pasta and bread, as well as sugary foods such as cookies, cakes, and pastries. When glucose enters the bloodstream after you eat carbohydrates, it goes through the pancreas. The pancreas secretes insulin when you consume carbohydrates and sends excess glucose to the liver as glycogen. The pancreases also produces glucagon, which actually raises blood sugar when necessary. You need both glycogen and glucagon to keep blood sugar levels balanced.

What happens when blood sugar (glucose) levels are too high?

Glucose is the primary sugar found in your blood. It is also your body’s main source of energy. However, when there is too much in your blood over a period of time it can damage blood vessels, tissues and organs and potentially lead to serious health issues like diabetes, heart disease and cognitive disorders, as well as vision and nerve problems.

Some signs of high blood sugar include frequent urination, increased hunger and thirst, fatigue, blurred vision, tingling or numbness in the hands or feet, and unexplained weight loss. If you are experiencing any of these, you should immediately consult a health care provider.

What happens when blood sugar (glucose) levels are too low?

Low blood sugar, also called hypoglycemia, is an issue faced most often by diabetics who have taken too much insulin, causing their blood sugar level to drop. This typically requires quick treatment with sugary drinks like orange juice or honey or candy. In severe cases, someone will require a shot of glucagon to bring the level back up. Some of the signs of low blood sugar are an irregular or fast heartbeat, fatigue, sweating, irritability, and tingling or numbness on the lips, tongue and cheeks. In severe cases, hypoglycemia can also cause confusion, loss of consciousness, seizures and blurred vision. If you are experiencing any of these symptoms, you should immediately consult a health care provider.

Do I need to fast for a HbA1c test?

You do not need to fast for the HbA1c test. Unlike other glucose tests, your HbA1c number reflects glucose levels over time, not a quick, one-time snapshot of a current glucose level.

Why HbA1c vs. a fasting glucose test?

A fasting glucose test will give you a great snapshot of your current glucose level. However, fasting glucose can also be affected acutely by a lot of different factors that don’t necessarily reflect your overall glucose metabolism. On the other hand, HbA1c offers you a window into your glucose levels over a longer period (~3 months).

Is the HbA1c Test NGSP-Certified?

The HbA1c method (reagents/kit) that we purchase from the manufacturer is NGSP-certified. This means our test’s reference values are compatible with NGSP reference values.

NGSP stands for National Glycohemoglobin Standardization Program (NGSP), which was implemented to enable laboratories to report DCCT/UKPDS-traceable GHb/HbA1c results.

How often should you take an HbA1c test?

HbA1c should be tested every 2-3 months if you are making diet and lifestyle changes.

Can HbA1c be too low?

While it is possible for your HbA1c to be too low, it is very rare. HbA1c under 4.0% (20.2 mmol/mol) is considered extremely low and is associated with a significant increase in all-cause mortality. Although it is not well understood why a low HbA1c is associated with an increase in all-cause mortality, it is likely because individuals with other conditions such as iron-deficiency anemia, liver diseases/disorders, or inflammatory conditions have lower circulating glucose or lower hemoglobin levels that can affect their HbA1c. If your HbA1c is extremely low, you need to speak with a health care provider to discuss your results.

Who should get their HbA1c tested?

Anyone can benefit from better understanding their health, specifically their glucose metabolism.

I thought only diabetics needed to check their HbA1c. Is that true?

While it is important for diabetics to monitor and manage their HbA1c, anyone can benefit from checking their levels. Being proactive can help you identify areas of your health/lifestyle that may need adjusting. Or if you’ve recently made a change, checking to see if that change is having the desired metabolic effect. Elevated blood glucose is very common and can escalate quickly, so monitoring your HbA1c regularly can help you get a head of any problems down the road.

I’m active, at a healthy weight, and exercise regularly. Do I need to check my HbA1c?

Absolutely. There are so many factors that can affect blood glucose, including stress, sleep, and genetics. Checking your HbA1c can help you determine if your lifestyle is, in fact, supporting a healthy blood sugar level. And if not, you can re-check in 2-3 months when you adjust in your diet or activity.

I don’t eat a lot of desserts or sugary foods. Why should I bother checking my blood sugar?

The term “blood sugar” can be confusing as it implies that only sugary, dessert-type foods will increase blood glucose. Any carbohydrate, even healthy ones such as whole grains, beans, vegetables, and fruits can be broken down into glucose as well. Your body also can produce its own glucose in the liver when it is stressed or deprived of glucose in your diet, so checking your HbA1c can give you an idea of how well your body is regulating glucose and if you might need to make any changes.

I’m on a low carb diet. Do I still need to test my HbA1c?

It is a common misconception that people on a low-carb diet will always have low blood sugar. Although you won’t be taking in much glucose, your body can and will produce it on its own in your liver through a process called gluconeogenesis. In fact, depriving your body of exogenous carbohydrates (via food) can result in an increase in cortisol production, which then triggers the process of gluconeogenesis in your liver. Your liver will produce glucose to feed your organs, specifically your brain, because you are not taking in enough carbohydrates via your diet. So, while decreasing carbohydrates can be an effective way to manage high blood sugar, going too low in carbohydrates can lead to the opposite effect. Therefore, measuring your HbA1c while making any dietary changes is still very important.

By Patrick Holford

What does any animal, perhaps your dog, do after exercising or going for a walk?

Sleep.

Sleep is how the brain recovers. There is now overwhelming evidence that sleep is a ‘brain essential’ and just like Goldilocks, it seems we need just the right amount. Getting too much, or too little, increases our risk for cognitive decline.

The optimal amount of sleep for brain health appears to be a total of seven hours. This does not necessarily need to be in one uninterrupted stretch – a study found that napping after physical activity can reduce the risk of cognitive impairment (1).

However, those consistently getting less than seven hours of sleep may be doubling their risk of age-related cognitive decline (2). A UK study of Whitehall civil servants, which began in the 1980s, found that persistent short sleep at ages 50, 60, and 70 was associated with a 30% increased risk of dementia (3). Sleep loss does not just increase long-term dementia risk – it also reduces empathy, increases negative emotions, and impairs next-day functioning (4).

Why Sleep Is Essential to Brain Health?

Think of sleep as the brain’s housekeeper. During sleep, circulation of blood and cerebrospinal fluid improves, helping to clear out waste products from brain metabolism (5). These include harmful oxidants and amyloid protein, the latter linked to Alzheimer’s and brain inflammation – which can begin accumulating after just one night of poor sleep (6).

One key agent in this nightly brain cleanse is melatonin. As night falls, our brains convert serotonin into melatonin, primarily in the pineal gland – referred to by Descartes as the seat of the soul, and known in yoga as the ‘third eye’ chakra.

Sensitive to light via receptors behind the eyes, the pineal gland is the only endocrine organ in direct contact with the external world. Darkness triggers melatonin production, while exposure to light – including screen use before bed – suppresses it.

Melatonin helps keep us in sync with the circadian cycle. Some frequent flyers even use melatonin supplements to overcome jet lag and adjust their sleep rhythms more easily (7).

More than just a sleep aid, melatonin acts as a powerful antioxidant – disarming damaging oxidants, restoring mitochondrial energy production, and acting as an anti-inflammatory. It has been used to support recovery in cancer, COVID-19, and cardiovascular conditions (8,9). Reduced brain melatonin levels and circadian disruption are also observed in individuals with cognitive decline.

Why Dreaming Matters?

Sleep isn’t just for rest – it’s a deeply active process. About 30 minutes after falling asleep, we enter deep sleep, marked by slower breathing, a reduced heart rate, and lower blood pressure. This phase restores and repairs bodily tissues. About 90 minutes in, we shift into REM (rapid eye movement) sleep – where most dreaming occurs.

REM sleep is critical for brain health. Each night, we cycle between deep, light, and REM sleep three to five times, with REM ideally making up about 25% of total sleep.

REM and deep sleep phases also see increased production of growth hormone, which supports tissue repair. Meanwhile, melatonin helps clear metabolic waste. However, under stress, cortisol levels rise and suppress REM sleep and growth hormone production, reducing the brain’s ability to recover. Sleep-deprived individuals tend to experience more REM when they finally do sleep, suggesting REM plays a key role in emotional processing.

One theory suggests that dreams help us metabolise suppressed emotions – fear, anger, sadness – stored during our busy days. If you have a vivid, emotional dream, it may be worth tracing it back to unresolved feelings from the previous day.

How Chronic Stress Disrupts Sleep and Brain Function?

Chronic or intense stress – such as bereavement, illness, or financial strain – has been shown to increase the risk of cognitive decline and dementia (10). However, good sleep can help process a stressful day.

The perception of control matters, too. Studies show that high job demands combined with low control are strongly linked to an increased risk of depression and cognitive impairment (11). Examples might include caregiving for a loved one with dementia while navigating health services, or working in a high-stress job without the resources to make meaningful changes.

Your Brain on Cortisol: The Hippocampus Feedback Loop

Two hormones mediate stress: adrenaline (short-acting) and cortisol (longer-acting). Adrenaline prepares you to act quickly – it’s the fight-or-flight hormone. Cortisol helps regulate energy and alertness throughout the day.

In the morning, cortisol naturally rises to get us going. It should fall in the evening to support sleep. But chronic stress disrupts this rhythm. If cortisol stays high at night, sleep is disturbed. If it’s too low in the morning, you may feel foggy and reach for caffeine.

Excess cortisol impairs memory, slows thinking, lowers social functioning, and raises the risk of dementia (12). What’s happening in the brain is that cortisol overstimulates the hippocampus, which is responsible for memory and emotional regulation. With prolonged stress, this feedback loop fails – the hippocampus shrinks, and cortisol levels remain elevated, accelerating brain ageing.

Short-Term Relief, Long-Term Harm: Sugar and Alcohol as Stress Crutches

Oscar Ichazo described how we reach for compensations under stress. Unfortunately, many – like alcohol and sugar – backfire.

Alcohol temporarily boosts GABA, calming the nervous system and reducing adrenaline. But the effect is short-lived. Drinking too much reduces GABA receptor sensitivity the next day, leaving us more anxious. In the long term, alcohol is neurotoxic and increases dementia risk (12). It also disrupts sleep architecture, impairing the brain’s ability to repair itself.

Sugar triggers dopamine and activates the brain’s reward circuits, making us crave more. It also spikes the adrenal system, amplifying stress and cortisol levels (13). Fats and proteins do not have this effect – this is unique to sugar.

So, when we use sugar or alcohol to manage stress, we often wake up feeling more anxious and foggy. This leads us to reach for caffeine and more sugar, which spikes cortisol again, leaving us even more depleted by evening – creating a cycle of stress, poor sleep, and accelerated brain ageing.

Simple Ways to Break the Cycle

The good news? You can reverse this pattern. Start here:

Become a FRIEND and get access to your personalised COGNITION® programme which which includes:
– A whole module dedicated to sleep and calm
– Another focused on helping you reduce sugar
– Plus monthly live group coaching to help you stay focused and on track
Prioritise seven hours of quality sleep each night.
Identify and reduce common stress triggers.
Be mindful of alcohol and sugar intake.
Find positive outlets: yoga, walking, journaling, a good book – like Upgrade Your Brain.

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Thank you for reading!
Food for the Brain is a non-for-profit educational and research charity that offers a free Cognitive Function Test and assesses your Dementia Risk Index to be able to advise you on how to dementia-proof your diet and lifestyle.

By completing the Cognitive Function Test you are joining our grassroots research initiative to find out what really works for preventing cognitive decline. We share our ongoing research results with you to help you make brain-friendly choices.

Please support our research by becoming a Friend of Food for the Brain.

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References:

¹ Qian YX, Ma QH, Sun HP, Xu Y, Pan CW. Combined effect of three common lifestyle factors on cognitive impairment among older Chinese adults: a community-based, cross-sectional survey. Psychogeriatrics. 2020 Nov;20(6):844-849. doi: 10.1111/psyg.12604. Epub 2020 Aug 31. PMID: 32869429.

² Bubu OM, Brannick M, Mortimer J, Umasabor-Bubu O, Sebastião YV, Wen Y, Schwartz S, Borenstein AR, Wu Y, Morgan D, Anderson WM. Sleep, Cognitive impairment, and Alzheimer’s disease: A Systematic Review and Meta-Analysis. Sleep. 2017 Jan 1;40(1). doi: 10.1093/sleep/zsw032. PMID: 28364458.

³ Sabia S, Fayosse A, Dumurgier J, van Hees VT, Paquet C, Sommerlad A, Kivimäki M, Dugravot A, Singh-Manoux A. Association of sleep duration in middle and old age with incidence of dementia. Nat Commun. 2021 Apr 20;12(1):2289. doi: 10.1038/s41467-021-22354-2. PMID: 33879784; PMCID: PMC8058039.

⁴ Krause AJ, Simon EB, Mander BA, Greer SM, Saletin JM, Goldstein-Piekarski AN, Walker MP. The sleep-deprived human brain. Nat Rev Neurosci. 2017 Jul;18(7):404-418. doi: 10.1038/nrn.2017.55. Epub 2017 May 18. PMID: 28515433; PMCID: PMC6143346.

5⁶ Xie L, Kang H, Xu Q, Chen MJ, Liao Y, Thiyagarajan M, O’Donnell J, Christensen DJ, Nicholson C, Iliff JJ, Takano T, Deane R, Nedergaard M. Sleep drives metabolite clearance from the adult brain. Science. 2013 Oct 18;342(6156):373-7. doi: 10.1126/science.1241224. PMID: 24136970; PMCID: PMC3880190.

⁶ Shokri-Kojori E, Wang GJ, Wiers CE, Demiral SB, Guo M, Kim SW, Lindgren E, Ramirez V, Zehra A, Freeman C, Miller G, Manza P, Srivastava T, De Santi S, Tomasi D, Benveniste H, Volkow ND. β-Amyloid accumulation in the human brain after one night of sleep deprivation. Proc Natl Acad Sci U S A. 2018 Apr 24;115(17):4483-4488. doi: 10.1073/pnas.1721694115. Epub 2018 Apr 9. PMID: 29632177; PMCID: PMC5924922.

⁷ Herxheimer A, Petrie KJ. Melatonin for the prevention and treatment of jet lag. Cochrane Database Syst Rev. 2002;(2):CD001520. doi: 10.1002/14651858.CD001520. PMID: 12076414.

⁸ Keithahn C, Lerchl A. 5-hydroxytryptophan is a more potent in vitro hydroxyl radical scavenger than melatonin or vitamin C. J Pineal Res. 2005 Jan;38(1):62-6. doi: 10.1111/j.1600-079X.2004.00177.x. PMID: 15617538.

⁹ Chitimus DM, Popescu MR, Voiculescu SE, Panaitescu AM, Pavel B, Zagrean L, Zagrean AM. Melatonin’s Impact on Antioxidative and Anti-Inflammatory Reprogramming in Homeostasis and Disease. Biomolecules. 2020 Aug 20;10(9):1211. doi: 10.3390/biom10091211. PMID: 32825327; PMCID: PMC7563541; regarding covid see also Tan DX, Reiter RJ. Mechanisms and clinical evidence to support melatonin’s use in severe COVID-19 patients to lower mortality. Life Sci. 2022 Apr 1;294:120368. doi: 10.1016/j.lfs.2022.120368. Epub 2022 Jan 30. PMID: 35108568; PMCID: PMC8800937.; see also Begum R, Mamun-Or-Rashid ANM, Lucy TT, Pramanik MK, Sil BK, Mukerjee N, Tagde P, Yagi M, Yonei Y. Potential Therapeutic Approach of Melatonin against Omicron and Some Other Variants of SARS-CoV-2. Molecules. 2022 Oct 16;27(20):6934. doi: 10.3390/molecules27206934. PMID: 36296527; PMCID: PMC9609612.; regarding cancer see Reiter RJ, Rosales-Corral SA, Tan DX, Acuna-Castroviejo D, Qin L, Yang SF, Xu K. Melatonin, a Full Service Anti-Cancer Agent: Inhibition of Initiation, Progression and Metastasis. Int J Mol Sci. 2017 Apr 17;18(4):843. doi: 10.3390/ijms18040843. PMID: 28420185; PMCID: PMC5412427.

¹0 Franks KH, Bransby L, Saling MM, Pase MP. Association of Stress with Risk of Dementia and Mild Cognitive Impairment: A Systematic Review and Meta-Analysis. J Alzheimers Dis. 2021;82(4):1573-1590. doi: 10.3233/JAD-210094. PMID: 34366334.

¹1 Wang HX, Wahlberg M, Karp A, Winblad B, Fratiglioni L. Psychosocial stress at work is associated with increased dementia risk in late life. Alzheimers Dement. 2012;8(2):114-20. doi: 10.1016/j.jalz.2011.03.001. PMID: 22404853; see also Gonzalez-Mulé, E., & Cockburn, B. S. (2021). This job is (literally) killing me: A moderated-mediated model linking work characteristics to mortality. Journal of Applied Psychology, 106(1), 140–151. https://doi.org/10.1037/apl0000501; see also Gonzalez-Mulé E, Kim MM, Ryu JW. A meta-analytic test of multiplicative and additive models of job demands, resources, and stress. J Appl Psychol. 2021 Sep;106(9):1391-1411. doi: 10.1037/apl0000840. Epub 2020 Sep 21. PMID: 32955269.

¹2 Ouanes S, Popp J. High Cortisol and the Risk of Dementia and Alzheimer’s Disease: A Review of the Literature. Front Aging Neurosci. 2019 Mar 1;11:43. doi: 10.3389/fnagi.2019.00043. PMID: 30881301; PMCID: PMC6405479.¹3 Gonzalez-Bono E, Rohleder N, Hellhammer DH, Salvador A, Kirschbaum C. Glucose but not protein or fat load amplifies the cortisol response to psychosocial stress. Horm Behav. 2002 May;41(3):328-33. doi: 10.1006/hbeh.2002.1766. PMID: 11971667.

Developing dementia is the second biggest health fear, after cancer. But what can you do about it? 

The conventional view is that genes play a big part and that factors under our control, including diet, lifestyle and health status, account for up to 40% of risk and therefore up to 40% of dementia cases could be prevented or delayed. Genes actually account for less than 1% of Alzheimer’s cases. But a new study from the UK BioBank, following 344,000 people over 15 years, estimates that “up to 73% of cases could be prevented” by targeting risk factors largely under our control. 

The authors of the study, published in the Nature Human Behaviour journal (1), investigated 210 modifiable risk factors. They found that increased hand grip strength (a good reflection of physical strength), increasing leisure or social activities or time spent in sports clubs or gyms, spending less time watching TV or on a computer, having better dental health, drinking more water, not dozing off in the day and sleeping between 7 to 9 hours a night, not smoking or being exposed to smoke and having better lung function were all associated with less risk of Alzheimer’s. Being unemployed, having a low income, having diabetes, high blood pressure or having had a stroke or brain injury all increased risk. Inheriting the so-called ‘Alzheimer’s gene’, ApoE4, didn’t make any significant difference to overall risk.

However, even this figure of 73% may be an underestimate as this study excluded blood test measures. “We have under-estimated the power of prevention,” says Professor David Smith from the University of Oxford, one of the study authors. “Even this figure of up to 73% of cases preventable could be higher if a person’s omega-3 and B vitamin status, measured by a blood test for homocysteine that any GP can do, were taken into account.”

While the BioBank study didn’t include blood test measures of either homocysteine or omega-3, scientists at the US National Institutes of Health have attributed 22% of the risk of Alzheimer’s to raised blood homocysteine and 22% to a lack of omega-3 (2). “These have been shown to predict risk but were beyond the scope of this study.” confirmed the study author, Professor Jin-Tai Yu from Shanghai’s Fudan University. “Homocysteine-lowering treatment with B vitamins, especially B12, is one of the most promising interventions for dementia prevention.” 

The Impact of B Vitamins & Omega-3

Professor Smith’s group at Oxford University tested the effects of giving B vitamins (B6, B12, folate) versus placebo to those with pre-dementia and found that the 10p a day supplements halved the rate of brain shrinkage in one year and virtually stopped further memory loss (3). “The greatest effect we found in our trial was in those in the top third of DHA blood levels (an omega-3 found in fish or fish oil supplements). Those with high DHA reduced their rate of brain shrinkage by 73%, down to the level normally seen in older people with loss of cognitive function. They also had virtually no further memory loss and almost a third ended the trial with no clinical dementia rating at all.”

The benefit of omega-3 was also confirmed in a major study this year of over 100,000 people, finding that increased omega-3 cut the risk of dementia or cognitive decline by around 20%. An increase in intake of omega-3 DHA of 200 mg decreased risk by almost a fifth (4). 

And here at Food for the Brain, we take prevention seriously.

Alzheimer’s is preventable, but not curable

We developed the free online Cognitive Function Test,  which includes a Dementia Risk Index questionnaire assessing your diet, omega-3 and B vitamin status, and lifestyle and an optional home-test kit for pinprick blood tests that will be available soon.

“Over 400,000 people have taken our validated Cognitive Function Test, which not only shows a person their cognitive status right now but also their future risk based on our Dementia Risk Index questionnaire, the factors driving future risk and what they can easily do right now to lower it. If all modifiable risk factors are taken into account, including B vitamins and omega-3, it is highly likely a person could reduce risk by over 80%.” says our CEO, Patrick Holford.

“The government has pledged £160 million a year for dementia prevention research but we are not seeing any of this going into easy prevention wins. Most seem to be fueling drug research for an apparent ‘cure’.

Alzheimer’s is preventable, but not curable. You cannot reverse holes in the brain. With over 200,000 people diagnosed every year with dementia, if prevention were taken seriously we could halve the number of people developing this terrible, but preventable disease.”

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Thank you for reading!
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References

¹ Zhang, Y., et al. Nature Human Behaviour. 2023 7, 1185–1195

² Beydoun MA., et al. BMC Public Health. 2014 Jun 24;14:643.

 Jernerén F., et al. Am J Clin Nutr. 2015 Jul;102(1):215-21.

³ Oulhaj A., et al. J Alzheimers Dis. 2016;50(2):547-57.

⁴ Wei B., et al. Am J Clin Nutr 2023 Jun;117(6):1096-1109.