by Patrick Holford and edited by Nuala Mcdermott

Have you ever experienced ‘brain fog’?

Difficulty concentrating, feeling mentally sluggish, forgetful, and unable to focus or think clearly?

Increasingly, the term is used to describe a range of cognitive symptoms that affect clarity and mental sharpness – the good news is that you can do something about it.  

Our brains require a steady supply of energy to function optimally, just as our bodies do. Typically, this energy comes from glucose, but as we age or experience cognitive decline, our brains can become less efficient at using glucose. This leads to energy deficiency, often caused by insulin resistance, which in turn leads to ‘hungry’ brain cells that struggle to function, hence feeling brain ‘fog’ and also sugar cravings.

Mind the gap with C8 oil

This energy deficit can be filled by an alternative fuel – ketones, made from C8 oil, a type of medium-chain triglyceride (MCT). Coconut, palm and, to a lesser extent, olive oil are all sources of MCTs. However, recent research has shown that almost all ketones are made from a sub-fraction of these fats called C8. Unlike other fats, C8 is rapidly converted by the liver into ketones, an alternative energy source that the brain can easily use. 

Research by Dr. Melanie Fortier and Professor Stephen Cunnane from Sherbrooke University [1] [2] has shown that C8 oil can dramatically boost brain energy levels, particularly in those with cognitive decline. In studies involving individuals with Alzheimer’s or pre-dementia, those who consumed C8 oil saw an incredible 230% increase in brain energy derived from ketones, leading to significant improvements in memory, language skills, and overall cognitive function.

“People with cognitive decline have an energy gap,” says Professor Cunnane. “Probably due to insulin resistance, they are not able to make use of glucose. Providing a food source, C8 oil, from which the body can readily make ketones, fills that energy gap, brain cells come back to life and memory and brain function improve as a result. It reminds me of those announcements on the London Underground, ‘Mind the gap.’

By filling the energy gap with ketones, C8 oil not only alleviates brain fog and improves cognitive function but also reduces sugar cravings. When the brain has a steady, reliable source of energy, it no longer sends out urgent signals for quick fixes like sugar, helping to restore balance and mental clarity. In Professor Cunnane’s study participants were given 30 grams or 2 tablespoons of primarily C8 oil. It is tasteless and is often best taken with food although some put it in their morning coffee.

Omega-3 and B vitamins – the dynamic duo

In recent years the discovery that omega-3 and B vitamins are co-dependent, that they work optimally together, led to a study (3) giving people with mild cognitive impairment either the B vitamin folic acid (800mcg) or omega-3 DHA (800mg) or both nutrients for one year and then compared to those given placebos, to test their effects on measures of intelligence. The individual nutrients worked, showing some improvements but the biggest effect was seen in those given both omega-3 DHA and folic acid. The combination produced a significant improvement in all three measures of IQ (full, verbal and performance IQ), more so than the individual nutrients, showing a clear benefit for those experiencing cognitive decline.

The researchers, from Tianjin Medical University and Hebei Medical University in China, also investigated the effects of the nutrients on mitochondria, the energy factories in cells, and found that those on the nutrients had less oxidative damage to mitochondrial DNA. “The cognitive benefits might act via DNA oxidative damage and mitochondrial function”, they report. 

Reduced mitochondrial energy and increased oxidative stress on the mitochondria, may result in brain fog and cognitive fatigue.

They conclude that “Interventions of folic acid (800mcg) combined with DHA (800mg) daily orally for 12 months can improve cognitive function in older adults with Mild Cognitive Impairment, and the combined intervention is superior to either intervention alone.” Folate is found in green leafy vegetables and DHA is marine food although you’d have to eat a lot to achieve the levels used in this study.

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Is food making you feel foggy?

It’s not just a lack of energy or a lack of nutrients that can create brain fog symptoms. Researchers worldwide (4, 5, 6, 7) have identified that food intolerances can also trigger mental health problems like brain fog, anxiety, and depression. 

The reasons for this are a little complex but researchers are increasingly linking our digestive system to our brain health, through a mechanism known as the ‘gut-brain axis’. Our gut contains more immune cells than the rest of our whole body. Inside our 10-metre-long gut live some 100 trillion bacteria, (about 2kg in weight), with a combination of about 130 different species, collectively known as our ‘microbiome’. 

Excessive consumption of inflammatory foods such as gluten, alcohol, refined sugars, unhealthy fats (like trans fats), and processed foods can damage our microbiome, reducing the population of beneficial bacteria (like Lactobacillus and Bifidobacterium) which inhibit inflammation, whilst encouraging the growth of harmful bacteria (such as Firmicutes and Proteobacteria) that promote inflammation and disease. 

Inflammatory foods also increase the production of zonulin, a protein that disrupts the tight junctions between the cells in the intestinal wall, causing the gut to be more permeable. This increased permeability (often referred to as ‘leaky gut’) allows undigested food particles, toxins and microbes to seep from the intestines into the bloodstream, further triggering our immune response and chronic inflammation.

An inflamed gut can negatively impact mental health by influencing the production of neurotransmitters and inflammatory markers affecting mood and cognitive function, which in turn can lead to symptoms such as brain fog, anxiety, and depression.

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Can testing help?

York Test have been pioneers in the field of food allergies and intolerances for decades. Their simple at-home tests for food intolerances are accurate and effective, allowing individuals to make dietary changes to reduce inflammation and improve gut integrity with remarkably rapid positive results. Food intolerances are highly individual, so getting tested is the best way to find out what your individual triggers might be. 

Unlike conventional IgE allergies, which can last for life, IgG antibodies ‘die off’, so theoretically, if you avoid the offending food for at least three months, you may be able to reintroduce the food without reacting. However, it is worth doing this systematically, because some people do continue to react.

In a survey of 436 people who reported brain fatigue and then avoided their IgG intolerant foods, nine out of ten reported improvement in mood, brain fog and lethargy. (8) 

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Other considerations with persistent brain fog:

Vitamin D is an all-rounder as far as your brain and mental health are concerned. It helps neurotransmission and has anti-inflammatory and neuroprotective effects on the brain by reducing both inflammation and the oxidative stress. So it may be worth considering checking levels if brain fog is an issue.

Additionally, we know that depressed patients have much higher homocysteine, indicating worse methylation, and significantly lower B12 and vitamin D levels, with the levels of these specific nutrients predicting the severity of their symptoms. (9) So if brain fog and any other symptoms of cognitive decline persist then testing homocysteine, as well as omega-3 and vitamin D, all of which are included in our 4-in-1 DRIfT test, is a good idea. 
Order your test kit here

Sleep is another important consideration as during this time, important repair processes take place. During sleep, blood and cerebrospinal fluid circulation improves, and waste products of brain metabolism get removed. These waste products include both oxidants and amyloid protein which is associated with Alzheimer’s and brain inflammation and can start to accumulate after just one night of sleep deprivation.  Good quality sleep is vital to brain health! Read more about sleep here

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Steps to reduce brain fog symptoms 

>> Incorporate C8 Oil into Your Diet 

Begin with small doses, such as a teaspoon two or three times a day, and gradually increase to a tablespoon twice daily. 

A great tasting way to get your C8 is to make Patrick’s hybrid ‘latte’, combining carb-free almond milk, almond butter and two tablespoons of C8 oil, plus a teaspoon of unsweetened cacao and half a teaspoon of cinnamon. 

You could also add C8 to smoothies or meals or simply mix with your morning coffee to boost your brain power.

>> Adopt a Low-Carb, Ketogenic Diet 

Consider following a low-carb ketogenic diet to support brain health, especially if you’re already experiencing some cognitive decline. This diet promotes the production of ketones, providing an alternative energy source for the brain and potentially improving memory, focus, and overall cognitive abilities.

>> Test don’t guess 

Make sure you test your vitamin D, omega-3 and homocysteine (B vitamin) levels and supplement if needed.

You might also wish to test for any food intolerances which you can do with York Test.  YorkTest are a supporter of Food for the Brain and offer our Friends £10 off the price of a test in the UK. If you live in the UK go to yorktest.com and enter the discount code FFB10 in the basket.

If you live in the US go to yorktest.com/us and enter FFB10US in the basket for your $10 discount. YorkTest will match your discount with a donation to Food for the Brain to help us help more people regain mental health through optimum nutrition.

>> Take the Cognitive Function Test  

Use this FREE validated assessment to find out what other steps you need to take to upgrade your brain health. Take the test here.

As more vital research in this area continues, these steps can set you in the right direction for a sharper mind, happier mood and better health overall.

>> Learn more in the Upgrade Your Brain Book. Buy it here (UK only)

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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.

References

1 – 96. Croteau E, Castellano CA, Richard MA, Fortier M, Nugent S, Lepage M, Duchesne S, Whittingstall K, Turcotte ÉE, Bocti C, Fülöp T, Cunnane SC. Ketogenic Medium Chain Triglycerides Increase Brain Energy Metabolism in Alzheimer’s Disease. J Alzheimers Dis. 2018;64(2):551-561. doi: 10.3233/JAD-180202. PMID: 29914035.

2 – 98. Danan A, Westman EC, Saslow LR, Ede G. The Ketogenic Diet for Refractory Mental Illness: A Retrospective Analysis of 31 Inpatients. Front Psychiatry. 2022 Jul 6;13:951376. doi: 10.3389/fpsyt.2022.951376. PMID: 35873236; PMCID: PMC9299263.

3. – (1) Reference: Li M et al., Cognitive Benefits of Folic Acid, Docosahexaenoic Acid, and a Combination of Both Nutrients in Mild Cognitive Impairment: Possible Alterations through Mitochondrial Function and DNA Damage. Gerontology. 2024;70(9):940-949. doi: 10.1159/000540021. Epub 2024 Jul 17. PMID: 38952108.

4 -150. Severance E et al (2015) IgG dynamics of dietary antigens point to cerebrospinal fluid barrier or flow dysfunction in first-episode schizophrenia. Brain Behav Immun. 44:148–58  

5 – 151. Tao R et al (2019) Chronic Food Antigen-specific IgG-mediated Hypersensitivity Reaction as A Risk Factor for Adolescent Depressive Disorder. Genomics Proteomics Bioinformatics 17(2):183-189.

6 – 152. Karakuła-Juchnowicz H et al (2017) The role of IgG hypersensitivity in the pathogenesis and therapy of depressive disorders. Nutr Neurosci 20:110-8; see also Karakula-Juchnowicz H et al (2018) The Food-Specific Serum IgG Reactivity in Major Depressive Disorder Patients, Irritable Bowel Syndrome Patients and Healthy Controls. Nutrients 10:548; 

7 – 153. Hart G (2017) Food-specific IgG guided elimination diet; a role in mental health? BAOJ Nutrition 3:3:033 

8 – 154. Hardman G and Hart G, 2007: Dietary advice based on food-specific IgG results. Nutrition and Food Science 37, 16-23; https://www.emerald.com/insight/content/doi/10.1108/00346650710726913/full/html

9 – 34. J. Durga J, et al., ‘Effect of 3-year folic acid supplementation on cognitive function in older adults in the FACIT trial: A randomised, double blind, controlled trial’, Lancet, 2007 Jan 20;369(9557):208–16.

by Patrick Holford

There is a reason why we don’t just talk about the benefits of omega-3, or encourage people to only focus on vitamin D – many of these nutrients work synergistically and are all needed to work together to maximise the reduction in dementia risk.

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A few months ago, a study looked at three blood tests – homocysteine, vitamin D and omega-3 index and assigned a score of 1 = bad or 0 = good to each result. A person scoring 3 (three ‘bad’ results) had 4.6 times the risk of having dementia compared to a score of 0 (three ‘good’ results). This confirms the synergistic effect of two of our four ‘biological horsemen of the mental health apocalypse’ – brain fats (omega-3 and vitamin D) together with homocysteine-lowering B vitamins. 

The researchers, led by Dr Annike van Soest in Holland say: 

“The effect size we observed was substantial; a four-fold increased risk of developing dementia in individuals with combined suboptimal status of omega-3, vitamin D, and homocysteine (three ‘bad’ results). This effect size is large in comparison with other risk factors of dementia. In our sample, being a current smoker or having diabetes doubled the risk, and being a carrier of at least one APOE ε4 allele (gene variant) tripled the risk of dementia (1).”

In this study, which is the third of its kind, if homocysteine was above 8mcmol/l, that was ‘high risk’ (scoring 1) and if below this, ‘low risk’ (scoring 0). Similarly, if vitamin D was below 15 ng/ml (37.5 nmol/l) that was classified as high risk and if the omega-3 index was below 5%, then that was classified as high risk. 

Interestingly, this was based on the research of risk according to blood levels. So, while it is already known that if homocysteine is above 11mcmol/l the brain is shrinking at an accelerated rate, in this study, even levels above 8 are associated with increased risk of dementia! 

At Food for the Brain, we set the optimal level for homocysteine at 7 or less.

According to Professor David Smith from Oxford University whose group carried out the original study of this kind, homocysteine-lowering B vitamins slowed the rate of brain shrinkage by 73%. They also slowed the rate of cognitive decline, arresting it in a third of trial participants.  

He stated: 

“For too long nutrition has been relatively discounted as a factor in the causation of dementia. This study corrects that misconception and lays the foundation for prevention based upon multiple nutrients.”

A study in France (2), which didn’t include homocysteine but did include a measure of carotenoids as an indicator of ‘oxidation’ reported a fourfold increased risk if all blood tests were in the ‘high-risk’ category.

We offer a similar range of tests in our Dementia Risk Index functional Test (DRIfT) but with more sensitivity, plus adding in HbA1c as a measure of blood sugar resilience. We have also recently added a Glutathione Index test as a measure of antioxidant status. 

In other words, we are looking at ‘four horsemen of the mental health apocalypse’, not just two. Additionally, instead of only having a good/bad, 0/1 scale we have a four-point scale, from 0 to 3 for each test. So, our 4 in 1 test can score within a range of 0 to 12.

On a practical level, your goal is to have all blood test levels in ‘the green’ zone, which we have set as:

– homocysteine below 7
– omega-3 index above 8%
– vitamin D above 40 ng/ml or 100 nmol/l
– HBA1c below 5.5%;
– Glutathione Index above 500.

Tracking changes in these markers against changes in cognitive function would provide further evidence for a systems-based approach to preventing age-related cognitive decline. Whilst it might sound technical, when you test with us (and support our charity and research in the process), we help by making it clear and easy to understand.

We hope to have substantial test results soon, and to plug into NHS patient data to import more test results for vitamin D and HbA1c, along with future dementia diagnoses. This will help further develop and research the perfect DRIfT score and enhance our guidance for your future protection against cognitive decline.

Exciting, isn’t it?

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What can you do?

Online test. Find out more about your own brain health and unique risk factors by completing the FREE Cognitive Function Test here
Blood Tests. Order one of your at-home pin-prick blood tests here.
You can find out your homocysteine, vitamin D, HbA1c, Omega-3 and Glutathione index results from your own home worldwide and also contribute to our Citizen Science Research
Become a FRIEND and support our charity and get access to COGNITION – your personalised online program to help you reclaim your brain. Become a FRIEND here
Get the book! Order the latest Upgrade Your Brain book here if you are in the UK 

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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.

References

1.  van Soest APM, de Groot LCPGM, Witkamp RF, van Lent DM, Seshadri S, van de Rest O. Concurrent nutrient deficiencies are associated with dementia incidence. Alzheimers Dement. 2024 Jun 12. doi: 10.1002/alz.13884. Epub ahead of print. PMID: 38865433.

2.  Neuffer J, Gourru M, Thomas A, Lefèvre-Arbogast S, Foubert-Samier A, Helmer C, Delcourt C, Féart C, Samieri C. A Biological Index to Screen Multi-Micronutrient Deficiencies Associated with the Risk to Develop Dementia in Older Persons from the Community. J Alzheimers Dis. 2022;85(1):331-342. doi: 10.3233/JAD-215011. PMID: 34806604.

By Patrick Holford

Your brain consumes more energy than any other organ, burning either glucose or ketones. 

This combustion creates oxidants that age your brain. 

The ability to rapidly extinguish these oxidants, which ultimately age your brain and body, is what helps you live longer with less wrinkles, more flexible joints, healthier blood vessels and organs, especially your brain. Your brain has 400 miles of blood vessels. Keeping oxidants down is perhaps the single most important thing you can do for vascular health. Vascular dementia, for example, is strongly associated with oxidation. It is oxidised cholesterol that predicts heart attacks (along with raised homocysteine).

For those who have been following our ‘four horsemen of the mental health apocalypse’, oxidation is the fourth horseman. Check out this film to understand how key antioxidants work together. Those with diets high in antioxidant foods literally halve their risk for dementia compared to those with low intakes, according to a study last year of 2,716 people aged over 60. (1) 

The key antioxidants are vitamins C, E, glutathione, anthocyanidins (in blue/red foods), lipoic acid and co-enzyme Q10. The most important of these are vitamin C and glutathione.

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Also, critical antioxidants such as vitamin C and vitamin E, if supplemented together, reduced the risk of developing Alzheimer’s by as much as two-thirds. Taking either, cut risk by a quarter in a study of 4,740 elderly residents of Cache County, Utah. (2) 

A review of all studies to date show, that ‘either a high vitamin E or C intake showed a trend of attenuating risk by about 26 per cent’ according to China’s leading prevention expert Professor Jin Tai Yu of Fudan University in Shanghai, making these nutrients ‘grade 1’ top level prevention factor. (3)

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Eating fruit and veg might not be enough…

Now, I’m sure you eat fruit and vegetables and supplement vitamin C but how do you know you’ve optimised your anti-oxidation potential? After all, the variation in antioxidants is 40-fold! Even in organic produce.

There is only one way to do this accurately, due to a breakthrough that we’ve made working with top analytical chemists.

The way in which these harmful oxidants (think of them like mini fires or bursts of heat) are ‘extinguished’ is to effectively ‘cool’ them. Otherwise they bump into things, like arteries, cholesterol, fats and ‘burn’ them setting up a chain reaction of damage. 

That cooling is largely done by either glutathione (GSH) or vitamin C (Ascorbic Acid). They are the firemen. But, when they leave a fire zone they too become hot or oxidised. Oxidised vitamin C is called DiHydroAscorbicAcid, or DHAA. Oxidised glutathione is called GSSG.

Vitamin C helps ‘reload’ glutathione and glutathione helps reload vitamin C as you’ll see in the figures below. This glutathione-vitamin C cycle is one of the hottest discoveries in anti-ageing science. You’ll see that niacin (vitamin B3) and its cousin NAD are involved.

People with cognitive decline and dementia have less glutathione and more oxidised glutathione and an ever decreasing ability to recycle the spent/oxidised glutathione back to functional glutathione. Read the science here. That is why we recommend anyone with concerns about their cognitive health measure their glutathione index.

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Your Glutathione Index – a world first!

By measuring a pin prick of your blood in our new test kit both how much glutathione you have in your cells AND how much is oxidised you will know if you’ve got the ability to extinguish those ageing fires in your brain and body optimally. (Technically, it is the ratio between active glutathione (GSH) and spent glutathione (GSSG) or GSH/GSSG.)

You want your score to be above 500. We could call this your Fortune 500 because fortunately, with this score, you’ve got the power to stay young. 

If your score was 100 that’s really not good. If you smoke, live in a polluted environment, rarely eat fruit, vegetables, herbs and spices, that’s where you’d be. 

The difference between 500 and 100 could literally be a decade less life!

So, rather than guess, why not find out by testing your Glutathione Index? 

These at home test kits are now available internationally! (UK, EU, USA & AUS!)

Knowing your Glutathione Index lets us advise you on what you need to eat and supplement to anti-age your brain. This is all included in your ‘interpretation of results’. Your Glutathione Index will also become part of your DRIfT score (Dementia Risk Index functional Test score) – you are aiming for a DRIfT score for ‘0’ which means, biologically, you have a super-healthy brain (and body).

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Why other Glutathione tests may not be so accurate and are twice the price

So you are fully in the loop, other labs test red cell Glutathione. This is good but not nearly as good as the ratio of GSH/GSSG. It also tends to cost around £150 and requires a blood draw at a lab. 

But we’ve found out something rather disturbing. 

Since glutathione is such a powerful antioxidant the second it leaves your body it starts to oxidise simply from interacting with air. That is why many blood tests, and studies based on them, are not so accurate. We have solved this by adding a super strong ‘fixer’ to the dry blood spot target where you drip your drop of blood. Problem solved!

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Thank you for being a Citizen Scientist

When you order your Glutathione test – which you can buy as a single test here OR as part of the DRIfT 5 in 1 test bundle here you can become a part of our team of Citizen Scientists!

You also need to complete your Cognitive Function Test which is FREE and together with any blood test results you get, give you personalised information on what you need to do to optimise your brain AND it will also contribute to our vital research – thank you.

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 Peng, M., et al. Dietary Total Antioxidant Capacity and Cognitive Function in Older Adults. J Nutr Health Aging (2023).

² Basambombo LL, Carmichael PH, Côté S, Laurin D. Use of Vitamin E and C Supplements for the Prevention of Cognitive Decline. Ann Pharmacother. 2017 Feb;51(2):118-124. doi: 10.1177/1060028016673072. Epub 2016 Oct 5. PMID: 27708183.

³ Yu JT, Xu W, Tan CC, Andrieu S, Suckling J, Evangelou E, Pan A, Zhang C, Jia J, Feng L, Kua EH, Wang YJ, Wang HF, Tan MS, Li JQ, Hou XH, Wan Y, Tan L, Mok V, Tan L, Dong Q, Touchon J, Gauthier S, Aisen PS, Vellas B. Evidence-based prevention of Alzheimer’s disease: systematic review and meta-analysis of 243 observational prospective studies and 153 randomised controlled trials. J Neurol Neurosurg Psychiatry. 2020;91(11):1201-9. Epub 2020/07/22. doi: 10.1136/jnnp-2019-321913. PubMed PMID: 32690803; PMCID: PMC7569385.

The recent Lancet dementia commission has ignored the best nutrition prevention evidence. (See the Lancet Commission Report here)

The Alzheimer’s Prevention Expert Group has accused the Lancet Commission of bad science for knowingly ignoring two highly effective and firmly evidence-based ways to reduce risk factors for dementia – high dose supplements of B vitamins and omega-3 fish oils as well as the impact of a low sugar diet. 

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We support this group of eleven leading scientists and have called on the Lancet to revise their report, which hit the headlines in the past weeks, minimising the effectiveness of nutrition and lifestyle interventions.

(Click here to read the three letters sent to The Lancet asking for a revision in this report.)

The major benefit of B vitamins is their ability to lower levels of the damaging amino acid homocysteine, found in the brain of Alzheimer’s patients. A comprehensive Chinese review of Alzheimer’s prevention research in 2020, described homocysteine lowering as ‘the most promising intervention for Alzheimer’s disease prevention’ (1).

Last month, a review in the Journal of Prevention of Alzheimer’s Disease, listed reducing homocysteine among the top five evidence-based actions (2).  A US National Institutes of Health review attributes almost a quarter (22%) of the risk of Alzheimer’s to raised homocysteine and a further 22% to lack of seafood and omega-3 fish oils (3). 

The combination of high homocysteine, low omega-3 and vitamin D is present in the majority of those over 50 and quadruples dementia risk, according to research in Holland earlier this year, led by Professor Annick van Soest at Wageningen University (4). 

“Remarkably, a suboptimal status of all three nutrients was associated with a four-fold increased risk of dementia,” she says.  These common combined deficiencies, so easily corrected, could have a bigger impact on dementia risk than any of the 14 risk factors listed in the Lancet Commission’s report.

Yet, for the third time since the first Lancet Commission report in 2017, and despite being sent all the evidence, the report’s scientists, headed by Professor Gill Livingston, have ignored it. 

Instead, two far less significant risk factors have been added – cholesterol and cataracts. The report claims cataract surgery would eliminate a very modest 2% of overall risk. In stark contrast, reducing high homocysteine, which affects one in two of over 65 ‘s could potentially eliminate a quarter of all risk, “saving the UK economy approximately £60 million per year,” says Oxford University health economist, Professor Apostolos Tsiachristas.

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Why has important science been missed out?

Asked why she continued to deny any benefit from homocysteine lowering, Professor Gill Livingston commented: “high homocysteine only affects a small number of people and there are no trials that show that lowering it has any benefit.” 

This is simply not true.

Studies in Holland (5), Norway (6), the UK (7) and China (8), have additionally reported a synergistic effect between B vitamins and omega-3, with several times better clinical benefit than any dementia drug. A study at Oxford University showed two thirds less brain shrinkage in those with mild cognitive impairment given B vitamins with sufficient omega-3 compared to placebo and one third of trial participants were clinically dementia-free at the end of one year (9). These studies were sent to Professor Gill Livingston in 2023.

The commission has also ignored studies showing a benefit from improving omega-3 status by eating fish or taking supplements. The Lancet Report cited only one study linking higher blood levels of omega-3 fatty acids with risk for dementia which concluded that this study provided “compelling evidence for a relationship between long-chain omega-3 fatty acids levels and lower risks for dementia and related outcomes .” 

Essentially, the same conclusions were reached by at least eight other similar studies. “Why were these studies ignored?” asked Professor William Harris of the Fatty Acid Research Institute, a leading omega-3 expert in the US. “The vast majority of adults in the western world have suboptimal blood omega-3 fatty acid levels. Increased consumption of marine omega-3 is safe, simple, cheap and effective.”   

By ignoring these well established, easy to change risk factors the Lancet Commission was able to reduce the claimed preventable risk to 45%, something that China’s leading prevention expert Professor Jin-Tai Yu of Fudan University in Shanghai strongly disputes. “It may be possible to prevent up to 80% of dementia cases if all known risk factors, including homocysteine lowering B vitamins and omega-3, found in oily fish, were targeted.” he says. 

He was co-author of a study in the journal Nature, together with Oxford University’s leading prevention expert Professor David Smith, analysing data from the UK BioBank which concluded that ‘up to 73% of dementia cases can be prevented.” However, even this may be an under-estimate as this study excluded blood test measures, says Professor David Smith. “This figure could be higher if a person’s omega-3 and B vitamin status, measured by a blood test for homocysteine, were taken into account.”

Homocysteine, omega-3 and vitamin D blood levels attribute 45% of modifiable risk to a deficiency of B vitamins and brain fats. 

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The Lancet Omission – what can we do?

That is why we offer our free online Cognitive Function Test as well as at home, accurate pin prick blood tests – available internationally so you can use them to assess your future risk of dementia and crucially, how to reduce it. 

We are ‘citizen science’ in action and gathering independent research on the effectiveness of diet, supplements and lifestyle change that anyone can join. 

Simply put – the cultural bias against nutrition, demonstrated by the Lancet Commission’s omissions, isn’t science-based. 

And it certainly isn’t helping those at risk take easy, positive actions to reduce it.

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Action steps

The next steps you need to take to reduce your risk:

Complete the FREE Cognitive Function Test here
Order one of your at-home pin-prick blood tests here
Become a FRIEND and support our charity and get access to COGNITION – your personalised online program to help you reclaim your brain. Become a FRIEND here
Get the book! Order the latest Upgrade Your Brain book here if you are in the UK 

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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.

References:
1 Yu JT, et al. J Neurol Neurosurg Psychiatry. 2020 Nov;91(11):1201-1209
2 He S.-Y, et al. Prev Alzheimers Dis. 2024 Aug;11:917–927
3 Beydoun MA, et al. BMC Public Health. 2014 Jun 24;14:643
4 van Soest APM, et al. Am J Clin Nutr. 2021 Apr 6;113(4):801-809
5 van Soest APM, et al. Eur J Nutr. 2022 Jun;15:61 3731–3739
6 Jernerén F, et al. J Azheimers Dis. 2019;69(1):189-197
7 Oulhaj A, et al. J Alzheimers Dis. 2016;50(2):547-57
8 Li M, et al. Eur J Nutr. 2021 Jun;60(4):1795-1808
9 Jernerén F, et al. Am J Clin Nutr. 2015 Jul;102(1):215-21
10 Zhang Y, et al. Nature Human Behaviour. 2023;7:1185–1195