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Lithium and Brain Health: The Overlooked Mineral That Could Protect Your Mind

Lithium and Brain Health: The Overlooked Mineral That Could Protect Your Mind

by Greg Potter

Lithium and Brain Health: The Overlooked Mineral That Could Protect Your Mind

Lithium and brain health are more connected than many realise. One of the universe’s oldest elements could also be one of the brain’s most powerful protectors.

Long associated with bipolar treatment, lithium is often dismissed as a heavy-duty psychiatric drug – yet new research tells a different story. Trace amounts of lithium appear to influence mood, longevity and even cognitive decline. With dementia rates rising fast, scientists are revisiting this humble mineral to understand whether it could slow or prevent neurodegeneration altogether.

In this article, Dr Greg Potter, member of our Scientific Advisory Board and Sleep Scientist, explores the remarkable – and misunderstood – role of lithium in supporting brain health, from dementia protection to lifespan extension and neural resilience.


Lithium is one of three elements created during the Big Bang event that gave rise to the universe 13.8 billion years ago, and nowadays it’s mostly found in igneous rocks. 

Because lithium predates all life on Earth, it’s perhaps no surprise it plays a role in human biology. While lithium doesn’t seem to be a truly “essential” nutrient  (1) as it isn’t indispensable for any one biological process, lithium’s mood-stabilising actions have long been recognised. Specifically, lithium has primarily been used to help patients with bipolar disorder avert swings into sleepless mania. Despite its clinical utility, lithium has arguably been stigmatised due to its association with mental illness, its side effects at high doses, and perceptions that it’s an outdated drug with superior, more modern alternatives – a perspective that frankly defies reality. Some astute individuals have understood lithium’s greater promise for years; however, lithium was recently thrust back into the spotlight. 

A recent high-profile publication showing promise of lithium in mitigating Alzheimer’s in the prestigious journal Nature (2) means we are finally waking up to just how interesting and helpful lithium can be.

Could lithium help prevent or treat dementia?

Research into lithium effect on brain health goes back longer than many realise. Several studies have associated lithium use with reduced risk of dementia (3), and scientists have also considered lithium as an adjunct treatment for patients who already have dementia. An experiment (4) on Alzheimer’s disease patients found that supplementing just 300 mcg lithium (as carbonate) per day for 15 months prevented deterioration in cognitive function, which continued to decline in people taking a placebo. While not all research has reported such positive effects, the early evidence is encouraging, and discrepancies between studies might be explained by variables such as discrepant lithium forms and doses.

Returning to the 2025 publication that caused such a stir, the researchers undertook a range of experiments to try to decipher lithium’s effects. First, when they looked at levels of metals in the brains of cognitively healthy adults, people with mild cognitive impairment, or individuals with Alzheimer’s, they found higher levels of lithium in a part of the brain key to processes such as planning and decision making in the cognitively healthy. They also explored the effects of adding lithium orotate, a salt of lithium, to the drinking water of mice genetically engineered to develop a condition similar to familial Alzheimer’s, the aggressive, early-onset form of the disease that runs in families. Compared with the lithium-free condition, even very low doses of lithium orotate dramatically reduced the characteristic misfolded brain proteins that occur in Alzheimer’s, also potentially allaying cognitive decline. Promisingly, lithium also exerted similar protective effects in “wild type” mice. These mice lack the genetic changes that cause early-onset Alzheimer’s, making them a better model for most people.

Does Lithium Extend Lifespan? What the Evidence Suggests

My interest in lithium is tentative evidence from the last couple of decades positively associating intakes with lifespan. This link has been shown in the general population, but there’s also the intriguing finding that people medicated with lithium for psychiatric conditions live longer than their peers taking alternative medications (5). Some of lithium’s effects on mood might mediate the relationship between higher lithium intake and longer life. Tragically, suicide is a common driver of deaths in young adults, and studies of large groups of people have linked higher lithium intakes with lower suicidality (6), which by itself would extend lifespan a little. However, the effects of lithium on mood might not be the whole story, and scientists who study the biology of ageing (geroscientists) have started to test whether lithium extends lifespan in non-human animals. 

So far, the jury is out, for while lithium has been found to extend life in yeast, roundworms, and flies (7, 8 ,9), it didn’t do so in mice, although male mice consuming lithium did seem to have better body composition and blood sugar control (10). Again, perhaps lithium form, dose, and age of use matter though. Overall, lithium certainly doesn’t seem to hurt lifespan, and it might prove modestly beneficial for healthspan (let’s define this as days of life free from disease or disability) and lifespan in a subset of people – but more research needs to be done.

How Lithium Supports Brain Cells and Mood Stability

Regarding how lithium supports mood stability and protects the brain against degeneration (11), as usual, we’re not sure. Most of the relevant research has used the equivalent of very high lithium doses, but I’ll mention a few mechanisms that have substantial empirical support.

Lithium can enter cells through sodium channels, and by competing with sodium and magnesium it can reduce activity of enzymes activated by these other minerals. Perhaps the best-accepted instance of this is lithium’s inhibition of glycogen synthase kinase-3β, an enzyme so named because, among other actions, it reduces activity of an enzyme that synthesises the storage form of carbohydrate, glycogen. This, plus inhibition of other key enzymes, such as inositol monophosphate, set in motion changes in the expression of myriad gene networks involved in brain health, including enhancing clearance of dysfunctional cells and hence improving regulation of proteins in the brain, reducing brain inflammatory responses and hence collateral damage, and promoting the neuroplastic processes needed to remodel the brain to thrive in the dynamic environments in which we live. 

Interestingly, the kinds of high lithium doses used to treat bipolar also support body clock function and sleep, which often go awry before mental illness sets in. Lithium has been shown to influence the body clock at several levels of organisation, from individual cells to people’s rest-activity timing (12), shifting the sleep-wake cycle earlier, making the cycle more regular, and increasing its amplitude. High doses also tend to deepen sleep (13), and deep sleep is a key player in mood regulation and brain maintenance processes, such as waste clearance. (Incidentally, a big part of why appropriate exercise is so good for the brain is that it tends to deepen sleep.) Again, we’re talking about large doses here though.

How Much Lithium Do You Need – and Is Supplementation Safe?

Several factors make it difficult to give clear recommendations regarding lithium intakes.

Firstly, none of us really have any idea how much lithium we regularly consume. Lithium intakes vary enormously between populations, based partly on the physical geography of where people live (over half the world’s lithium is concentrated in Argentina and Chile). This affects how much lithium gets into local drinking water and food. Even then, in much of the world people drink water and eat food that doesn’t come from nearby. Next, your lithium intake would ideally map to your bodily lithium status and needs, and we don’t have good proxies for these at present. There’s also the fact that lithium comes in different salts. Lithium carbonate is most widely used in psychiatry, followed by lithium citrate. However, there’s experimental evidence that lithium orotate is more bioavailable than both, and this superiority of orotate was born out by the recent Nature publication, albeit for different reasons (related to reduced lithium uptake by amyloid). Finally, lithium is used as a medication and is quite tightly regulated in some parts of the world. The salt we know most about (carbonate) is therefore off limits for most of us, although given the early promise of lithium orotate, that might be no issue. 

I’m not a medical doctor and recommend running the supplements you take by a qualified medical professional – just bear in mind that most medical doctors know very little about nutrition and supplementation. I would consider a dose of up to 1 mg elemental lithium per day to be reasonable, provided it’s from a reputable manufacturer. People not very familiar with lithium doses might think of some of the adverse effects of high dose lithium intakes, which can include kidney toxicity. To be clear, my suggestion is well below the amount of lithium consumed from diet alone in much of the world, which most people have never thought twice about. 

I have no affiliation with either, but both Swanson and Life Extension sell low- or trace-dose lithium orotate, and the data I’ve seen suggest their products are high quality and contain what they claim they do. (In fact, there’s been research (14) showing the Swanson low-dose lithium orotate product raises brain lithium in adults.) Part of the difficulty here is that, in my opinion, the lithium doses in many supplements might be higher than is ideal. Based on the work on trace dose lithium use in dementia, plus the apparent higher bioavailability of lithium orotate (15), I think 300 to 400 mcg lithium orotate is an excellent starting point. That dose is more than conservative yet should be sufficient to be beneficial, and my approach to supplementation is generally to choose the lowest dose shown to have the effects you’re after. 

Parting words

In summary, while lithium is not an essential micronutrient, the human brain seems to thrive when it has enough lithium. To ensure you’re providing your brain with what it needs, a lithium supplement providing a trace dose (less than 5 mg elemental lithium) each day seems to be a reasonable, safe way to ensure this. If you’re interested in learning more about lithium, in 2024 I interviewed Dr Becci Strawbridge, an expert in low-dose lithium. The conversation is available on all major podcasting platforms. It’s also on YouTube here.

Note: These words are solely the opinions of the author. (He used no large language models to help write this article.)


About Greg Potter

Greg helps individuals and organisations sustainably improve their health and performance. He does this through developing and popularising innovative businesses and products, coaching, public speaking, consulting, and empowering people through educational resources such as e-books, articles, and courses. Among other roles, Greg is a Sleep Coach at the London Psychiatry Clinic and is Chief Science Officer at Coastline Longevity, where he leads the formulation of supplements to extend healthspan. He also hosts the Reason & Wellbeing podcast and YouTube channel.

Greg’s PhD research spanned sleep, circadian rhythms, nutrition, and metabolism. Highlights of Greg’s career include having this research featured in dozens of international news outlets, including the BBC, Reuters, and The Washington Post; having his writing featured in many newspapers and magazines, including The Metro, Stylist, and Newsweek; coaching a sprinter to four gold medals at the European Championships; and helping athletes break multiple World Records in ocean rowing.

Reference:

8 https://pubmed.ncbi.nlm.nih.gov/17959600/

15 https://pubmed.ncbi.nlm.nih.gov/37356352/

Further info

Why Women’s Brains Need Omega-3 Now

Why Women’s Brains Need Omega-3 Now

What if the key to protecting women’s brains from Alzheimer’s isn’t a drug, but a nutrient most of us are not getting enough of?

That’s the conclusion of new research linking low omega-3 status with a higher risk of dementia, particularly in women. It adds to a growing body of evidence that what you eat today directly shapes your brain health tomorrow.

You may have seen headlines this year reporting that women with Alzheimer’s disease tend to have unusually low levels of omega-3 fatty acids in their blood. This new evidence adds weight to what our research has been highlighting for years: your brain needs these essential fats to stay healthy, sharp, and resilient.

What The New Study Shows?

A study led by Wretland and colleagues, published in Alzheimer’s & Dementia, analysed blood lipid profiles and found that those at greater risk of Alzheimer’s disease had lower levels of lipids containing the long-chain omega-3 fats EPA and DHA. Importantly, this association was stronger in women than in men [1].

Professor William Harris, a member of Food for the Brain’s Scientific Advisory Board and one of the world’s leading omega-3 researchers, commented on the study, saying:

“Measurement of blood omega-3 levels may be especially useful in identifying women at increased risk for Alzheimer’s. Why women? Possibly because of the widespread abandonment of hormone replacement therapy after the Women’s Health Initiative study, which may have inadvertently left many women more vulnerable. Oestrogen supports cognitive health and also helps maintain omega-3 status. Without it, low omega-3 levels may pose an even greater risk.

(Want to learn more about how to support women’s brains and hormones? Find out more here.

Learn more about maintaining healthy omega-3 levels from OmegaQuant, founded by Professor William Harris.)

Why Omega-3 Is So Vital For The Brain?

  • The brain is about 60% fat by dry weight, with DHA the dominant structural fat in brain cells [2].
  • Higher omega-3 status is consistently linked to slower brain shrinkage and lower dementia risk [3,4].
  • Just one serving of oily fish a week has been associated with a 60% lower risk of Alzheimer’s disease [5].

But omega-3 rarely works in isolation. Research from the University of Oxford shows that the combination of good omega-3 levels and homocysteine-lowering B vitamins can reduce brain shrinkage by 73% in those at risk of dementia [6,7].

Why Women’s Brains Need Special Attention After Menopause?

After menopause, falling oestrogen increases the risk of memory decline. Following the 2002 Women’s Health Initiative report, HRT prescribing plummeted worldwide due to perceived risks. Although use is now rising again, this shift has raised important questions about how hormones interact with brain health.

While decisions about HRT are individual and should be made with the guidance of a medical professional, supporting brain health through nutrition is relevant for all women. Because oestrogen helps maintain levels of the omega-3 fats EPA and DHA, women with a low intake of these nutrients may be at particular risk of deficiency. Ensuring adequate omega-3 – through oily fish or supplements – remains a practical, evidence-based step for long-term brain protection.

How Do You Know If You’re Protected?

The easy answer is to test, not guess. That is why we offer our at-home pinprick blood tests as part of our research and prevention support.

Our DRIfT 5-in-1 test includes the omega-3 index, homocysteine, vitamin D, blood sugar control (HbA1c), and glutathione – together providing a powerful snapshot of your brain’s future resilience. This allows you to see whether you are eating enough oily fish, supplementing properly, or at greater risk of future disease.

The Bigger Picture Of Brain Health

This new study is another reminder that Alzheimer’s is not an inevitable part of ageing.
It is largely preventable when we address the eight modifiable risk domains – from brain fats and B vitamins to diet, lifestyle, and gut health – which we cover in our COGNITION brain upgrade programme.

Women’s brain health has been historically under-researched, particularly in relation to hormones and cognitive ageing. Studies like this are a vital step towards closing that gap and ensuring prevention strategies work for everyone.

Learn more

  • Join Menopause and the Mind with Dr Ghazala Aziz – find out more here.
  • Are you supplementing correctly? Eating enough fish? The only way to know is to test – order your DRIfT 5-in-1 test today to discover what you need to do to protect your brain.
  • Complete the free, validated Cognitive Function Test today to receive personalised information on how you can protect your brain and your future.

References

  1. Wretland A, et al. Lipid profiling shows reduced long-chain omega-3 lipids in individuals at risk for Alzheimer’s, especially women. Alzheimer’s Dement. 2024. PMID: 40832908.
  2. Crawford MA, et al. The role of essential fatty acids and phospholipids in brain development and health. Prostaglandins Leukot Essent Fatty Acids. 2001;64(2):95-111.
  3. Tan ZS, et al. Red blood cell omega-3 fatty acid levels and markers of accelerated brain aging. Neurology. 2012;78(9):658-664.
  4. Yassine HN, et al. Long-chain omega-3 fatty acids and brain health. Alzheimers Dement. 2016;12(7):759-768.
  5. Morris MC, et al. Fish consumption and the risk of Alzheimer disease. Arch Neurol. 2003;60(7):940-946.
  6. Smith AD, et al. Homocysteine-lowering by B vitamins slows the rate of accelerated brain atrophy in mild cognitive impairment. Proc Natl Acad Sci U S A.
  7. Jernerén F, et al. Homocysteine-lowering B-vitamin treatment modifies the effect of omega-3 fatty acids on brain atrophy in mild cognitive impairment. Am J Clin Nutr. 2015;102(1):215-221.

Further info

Brain-Boosting Cacao with Maca & Cinnamon

healthy cocoa drink recipe -

Everywhere you turn, coffee shops tempt us with seasonal lattes, pumpkin-spiced treats and sugary hot chocolates. They may taste comforting, but many of these drinks deliver more sugar (up to 40 g in a single serving) and stimulants than your brain can’t handle, fuelling blood sugar spikes, jitters and, over time, even memory decline. In fact, higher blood glucose levels, even within the normal range, is linked to an increased risk of dementia (1*), while poor glucose control shrinks the hippocampus, the brain’s memory centre (2*).

Here’s a different kind of comfort drink: a rich, velvety hot cacao that actually supports your brain. Taken from the Upgrade Your Brain Cook App,  and packed with flavonoids, adaptogens and blood-sugar-balancing spices, it’s a recipe you can enjoy at any time of year – whether you’re heading out on autumn walks in the northern hemisphere, or entering spring in the south.

Why is hot cacao brain-friendly?

Raw cacao – flavanols for circulation, memory and mood

Cacao is one of the richest natural sources of flavanols, powerful antioxidants that improve circulation, including blood flow to the brain. Better blood flow means better oxygen and nutrient delivery, supporting attention, memory and overall cognitive function.

In a landmark study at Columbia University, cocoa flavanol supplementation improved memory in older adults by enhancing dentate gyrus function in the hippocampus (3). Large-scale trials confirm this: in the COSMOS study of more than 21,000 people, cocoa extract improved cognition in those with lower diet quality (4).

Cacao also contains theobromine and serotonin-enhancing compounds, which may explain why a simple square of dark chocolate – or a steaming mug of raw cacao – can lift mood and reduce stress.

Maca – an adaptogen for stress resilience and mood

Maca, a root vegetable from the Andes, is classed as an adaptogen – plants that help the body adapt to stress. Adaptogens support the adrenal system, helping to buffer the effects of chronic stress and supporting hormone balance.

In human trials, maca supplementation improved mood and reduced anxiety and depression scores in postmenopausal women (5). While more research is needed on cognition in humans, maca is widely valued for its mood-enhancing and potential stress-buffering properties.

Cinnamon – balancing blood sugar to protect the brain

Cinnamon isn’t just for apple pies, it’s a powerful spice for blood sugar control, which is essential for maintaining brain health and longevity. Stable blood sugar means steadier energy and less “brain fog.” Excess sugar is one of the strongest dietary risk factors for dementia: raised HbA1c (a measure of long-term blood sugar that we test in our at-home blood test, DRIfT) increases the risk of both vascular dementia and Alzheimer’s (1,2).

Human trials show that cinnamon supplementation can improve HbA1c, blood pressure and lipid profiles in people with type 2 diabetes (6). Other studies report improved insulin sensitivity and glucose tolerance, even in healthy adults (7). By helping to stabilise the delivery of glucose to the brain, cinnamon protects against the highs and lows that drive fatigue, irritability and cognitive decline.


Hot Cacao with Maca & Cinnamon

Ingredients:

  • 500 ml (2 cups) milk or unsweetened milk alternative of your choice
  • 2 tbsp raw cacao powder
  • 1 tsp maca powder
  • ½ tsp ground cinnamon
  • 1 tsp xylitol, raw honey or chicory root syrup (use code FFB10 to save 10% on the syrup)

Method:

  1. Gently heat the milk in a saucepan until steaming but not boiling. You can also use a milk frother for this if you prefer.
  2. Whisk in the cacao, maca, cinnamon, and sweetener (if using).
  3. Pour into mugs and serve immediately.

Servings: Serves 2

Cook’s Tips: Always use raw cacao rather than processed cocoa to maximise flavonoids.

Add a pinch of cayenne for extra warmth and circulation.


At Food for the Brain, we’ve long championed the role of antioxidants, blood-sugar balance, and stress resilience in protecting against cognitive decline. A simple daily ritual like this hot cacao brings together three powerful, evidence-based strategies for your brain:

  • Flavanols from cacao improve circulation and memory.
  • Adaptogens from maca (optional) to enhance mood.
  • Spices like cinnamon to steady blood sugar and protect the hippocampus.

Take the next step for your brain

If you enjoyed this recipe, there’s so much more you can do to nourish your mind and memory.

Explore over 120 brain-friendly recipes – from Stewed Cinnamon Apples with Walnuts & Flaxseed, to Roasted Pumpkin & Red Lentil Soup with Turmeric, or even an indulgent Spiced Pear & Almond Crumble. All are available in our Recipe Cook App  – yours for just £30 a year.

 Join our “Forget Sugar” webinar with Patrick Holford  discover the surprising science of how sugar shrinks the brain along the practical steps to cut cravings, balance blood sugar, and protect memory.

(If you are a FRIEND of Food for the Brain log in to your account and access the webinar for free here)

Test your own brain health today – take our free online Cognitive Function Test. It’s a validated way to see how your lifestyle is shaping your future brain health. 

Feeling good now, and ageing well, is within your power.

References

  1. Crane PK, Walker R, Hubbard RA, et al. Glucose levels and risk of dementia. N Engl J Med. 2013;369:540–548. doi:10.1056/NEJMoa1215740
  2. Kerti L, Witte AV, Winkler A, Grittner U, Rujescu D, Flöel A. Higher glucose levels associated with lower memory and reduced hippocampal microstructure. Diabetes Care. 2013;36(10):3289–3296. doi:10.2337/dc13-0306
  3. Brickman AM, Khan UA, Provenzano FA, et al. Enhancing dentate gyrus function with dietary flavanols improves cognition in older adults. Nat Neurosci. 2014;17(12):1798–1803. doi:10.1038/nn.3850
  4. Sesso HD, Wang L, Reynoso J, et al. Effect of cocoa extract supplementation on cognitive function: COSMOS trial. Am J Clin Nutr. 2022;116(3):682–693. doi:10.1093/ajcn/nqac152
  5. Gonzales GF, Córdova A, Vega K, Chung A, Villena A, Góñez C. Effect of Lepidium meyenii (Maca) on mood in postmenopausal women. CNS Neurosci Ther. 2009;15(6):639–650. doi:10.1111/j.1755-5949.2009.00104.x
  6. Akilen R, Tsiami A, Devendra D, Robinson N. Glycated haemoglobin and blood pressure-lowering effect of cinnamon in type 2 diabetes. Diabet Med. 2010;27(10):1159–1167. doi:10.1111/j.1464-5491.2010.03079.x
  7. Solomon TPJ, Blannin AK. Effects of short-term cinnamon ingestion on insulin sensitivity. Eur J Appl Physiol. 2007;99(5):483–488. doi:10.1007/s00421-006-0362-z

★ = references already discussed in Patrick Holford’s books (Upgrade Your Brain 2024; Alzheimer’s: Prevention is the Cure 2025).

Further info

Sugar, Metabolic Syndrome and Early-Onset Dementia: Is This Type 3 Diabetes?

Sugar, Metabolic Syndrome and Early-Onset Dementia: Is This Type 3 Diabetes?

Insulin molecule. Computer model showing the structure of a molecule of the hormone insulin. Insulin plays a key role in blood sugar regulation, released from the pancreas when blood sugar levels rise, for example after a meal. Impaired insulin signalling is not only central to diabetes but is also linked to “Type 3 diabetes,” a term used to describe insulin resistance in the brain that contributes to Alzheimer’s disease and dementia.

Why are more people in their 40s and 50s developing dementia? Most assume the answer lies in the genes. But here’s the reality: fewer than 1% of Alzheimer’s cases are caused by rare genetic mutations. The other 99%? They are driven largely by preventable, lifestyle-related factors – and at the centre of the storm is how we process sugar, , leading many scientists to describe Alzheimer’s as “Type 3 diabetes.”

A major new study of nearly two million people confirms that metabolic syndrome – the cluster of blood sugar imbalance, abdominal obesity, high blood pressure, and poor lipid levels  – significantly increases the risk of early-onset dementia.

This should be front-page news. Dementia is now affecting people in their 40s and 50s, not just the elderly. And at the heart of this early decline? Poor blood sugar control, excess abdominal fat, and the metabolic mayhem caused by high-sugar diets.

The Evidence: 24% Higher Risk of Dementia Before Age 65

The landmark 2024 study published in JAMA Neurology followed more than 1.9 million adults and found that those with metabolic syndrome had a 24% higher risk of developing dementia before the age of 65 compared with those without (1).

The strongest associations were observed with:

  • Hyperglycaemia (high blood sugar)
  • Abdominal obesity (visceral fat around the waist)

These two factors, when present together, were particularly predictive of vascular dementia, although risks were also elevated for Alzheimer’s disease and other forms of dementia.

The authors adjusted for other lifestyle and demographic factors, confirming that metabolic health itself was an independent driver. Men and those in their 40s showed the highest vulnerability.This aligns with decades of research linking insulin resistance and poor glucose control with brain shrinkage, memory loss, and neurodegeneration – all of which are discussed in detail in [here] and [here]. 

The Type 3 Diabetes Hypothesis

Scientists have increasingly referred to Alzheimer’s disease as “Type 3 diabetes” – a term that reflects how brain cells become resistant to insulin and fail to metabolise glucose properly.

Chronically high blood sugar damages blood vessels in the brain, increases inflammation, and accelerates the formation of amyloid plaques, all hallmark features of Alzheimer’s pathology. This new study provides the strongest population-level evidence to date that the same dysfunction is also driving younger-onset dementia.

The Role of Fructose and Processed Sugar

Endocrinologist and paediatric neuroendocrinologist Dr Robert Lustig has long warned of the unique effects of fructose (a sugar found in high-fructose corn syrup and added sugars) on the brain. Unlike glucose, fructose is processed in the liver, promoting visceral fat, insulin resistance, and inflammation – all central to metabolic syndrome (2).

When the brain is chronically exposed to excess sugar and insulin, its ability to generate energy and form new synapses becomes impaired. Over time, it is as if the brain is being starved, even in the midst of plenty.

 This isn’t just a long-term risk – we’re now seeing it play out in middle-aged adults.

Thankfully we know that there is much you can do to prevent this from happening – your future is in your hands – here is what to focus on.

What Can You Do? Five Simple Shifts

  1. Check your blood sugar regulation. The HbA1c test is a key marker of long-term blood glucose control. (Available via our home test kits and in our DRIfT 5 in 1 test kit.)
  2. Prioritise low-GL, whole foods. Swap out refined carbohydrates and processed sugars for whole grains, legumes, nuts, and non-starchy vegetables.
  3. Limit fructose. Reduce or remove sweetened drinks (including fruit juice), syrups, and processed snacks high in high-fructose corn syrup. Read more on high/low fructose foods here.
  4. Assess your waist size. Abdominal fat is a strong dementia risk factor. A healthy waistline helps protect your brain.
  5. Exercise regularly. Just 30 minutes a day improves insulin sensitivity and helps the brain use glucose more efficiently.

Need help taking action on the above? Struggle to know how to ditch your sweet tooth?

Join us in the Forget Sugar Webinar in October with Patrick Holford.

A Wake-Up Call, Not a Life Sentence

This study shows a sobering trend – but Food for the Brain exists to empower you in your prevention path. Early-onset dementia is not inevitable. It is largely preventable if you act now. Sugar, insulin resistance, and metabolic syndrome are right at the centre of the problem.

We need public health messaging that reflects this. Dementia is not just an age-related disease. It’s a lifestyle-driven brain disorder that begins years, even decades, before diagnosis.

Your brain doesn’t have to retire early – start your brain upgrade programme and journey today.Want to assess your brain health? Complete this free validated online Cognitive Function test to receive personalised insights into your brain health, along with guidance on what you can do to reduce your risk and protect your future!


References

  1.  Jang H et al. Association Between Metabolic Syndrome and Early-Onset Dementia in a Nationwide Cohort. JAMA Neurol. 2024. doi:10.1001/jamaneurol.2024.xxxxxx
  2. Lustig RH. Fat Chance: The Hidden Truth About Sugar, Obesity and Disease. Penguin; 2013.https://pubmed.ncbi.nlm.nih.gov/12450889/

Further info

Coffee – Good or Bad for your Brain?

Coffee – Good or Bad for your Brain?

by Patrick Holford

coffee cup in woman hands

Coffee: Friend or Foe for Your Brain?

For many, the day doesn’t truly begin until that first cup of coffee hits the system. It sharpens the mind, lifts the fog, and gives an instant boost of focus – which explains why, in the UK alone, we drink an astonishing 100 million cups every single day, about two per person. But is this daily ritual really fuelling your brain, or quietly robbing it of long-term vitality?

Coffee is more than just a stimulant. Yes, it contains polyphenols – those antioxidant compounds that can protect the brain. But it also delivers caffeine, which fires up your adrenal hormones to give that short-term buzz. The problem is that this instant lift comes with a hidden cost: over time, it can deplete energy reserves and, more worryingly, raise homocysteine – one of the strongest predictors of dementia and Alzheimer’s.

The Hidden Brain Risk – Homocysteine

The homocysteine-raising effect is quite considerable. A group of doctors from University Hospital Nijmegen tested the effects of coffee by assigning volunteers to drink a litre of unfiltered coffee a day – that’s about four cups – for two weeks. At the start of the two weeks, their average homocysteine score was 12.8 µM, slightly above the national average of 10 to 11. At the end of the two weeks, their homocysteine score was 14. (1)

This homocysteine-raising effect was confirmed in another study by Dr Verhoef and colleagues at the Wageningen Centre for Food Sciences in the Netherlands, which showed that two cups of coffee increased homocysteine by 11% after four hours. Interestingly, caffeine tablets without coffee increased it by only 5%, suggesting that other compounds in coffee, such as theophylline and theobromine (also found in chocolate), may play a role. (2)

This means that if your homocysteine is already slightly raised, perhaps above 9 or 10, drinking coffee may be doing more harm than good, since the brain starts shrinking with homocysteine levels above 11. Also, if you do drink a lot of coffee, it’s a good reason to check your homocysteine level. 
(Order your homocysteine test here. An accurate and simple way to check your level via a quick pinprick test.)

How Much Coffee is Too Much?

So, does coffee protect against dementia – or put you at greater risk? The answer depends on quantity.  A UK Biobank study involving 400,000 participants compared those drinking 1-2 cups a day with those drinking six or more cups a day and found both a 53% increased risk of dementia and smaller brain volumes in those drinking 6 or more cups.(3)  The UK Biobank didn’t measure the homocysteine of the participants, but this is the most plausible mechanism.

A new 2025 analysis from the US NHANES database reached a similar conclusion: higher coffee consumption was associated with a greater risk of dementia (4).

Yet the story isn’t entirely one-sided. A review of all studies up to 2020 concluded: “Caffeine effects were more often positive when consumed in moderate quantities (100–400 mg/day), consumed in the form of coffee or green tea, and in women.” (5)  The most recent UK Biobank findings confirmed that moderate coffee or tea drinkers had a lower risk of cognitive decline than abstainers. (6)

A double espresso delivers 200–300 mg of caffeine, so moderation seems to mean no more than two to two and a half cups a day — and only if unsweetened.

Sweetened or Unsweetened – Does it Matter?

It matters a lot. The UK Biobank found a modest reduction in risk in those drinking up to 2.5 cups a day, compared with non-coffee consumers, but only in those drinking unsweetened coffee. Those drinking sweetened coffee had a higher risk. (7)

This is consistent with research at Canada’s University of Guelph. Participants were given a carbohydrate snack – such as a croissant, muffin, or toast – together with either a decaf or regular coffee. Those having the coffee-carb combo had triple the increase in blood sugar levels. In addition, insulin sensitivity, the hormone that controls blood sugar levels, was almost halved. (8)  The lesson? Enjoy your coffee on its own, without sugar or a carb-laden pastry.

Don’t Drink Coffee on Waking

Timing also matters. In the first hour after waking, your body naturally peaks in cortisol, the long-acting adrenal hormone that gets you going. (9)  That is why it is probably better not to have coffee, which further promotes adrenal hormones, for at least an hour after waking. Otherwise, you may stop producing enough of your own cortisol and become dependent on the caffeine hit.

In the evening, it’s the opposite story. Cortisol should be reducing and melatonin rising, but caffeine can affect this for up to 10 hours. The results? Over time, poorer sleep, which can contribute to a whole host of health problems, and greater difficulty waking in the morning, leading to a cycle of dependency on coffee.

One cup of coffee a day, in the morning, ideally not on waking but at least 30 to 60 minutes later, seems optimal. (10) However, the more tea you drink, the better, according to two studies, with green tea being the most beneficial.(11, 12)  This benefit, however, was not found in a UK Biobank study, which reported tea and coffee drinking to be associated with worsening cognition compared with abstainers.(13) 

The Japanese have a tradition of making a pot of green tea and, if they want a second, simply add hot water to the teapot. I do the same with coffee – if I have a second cup I run the coffee through the filter paper again. In this way it is progressively weaker.

But let’s be honest: coffee is an addictive stimulant and, while it may not be as harmful as alcohol, it is ultimately an energy robber. Having used coffee to help me through an intense month of early mornings and book writing, I quit and experienced a severe withdrawal headache that lasted 36 hours!

My Advice for the ‘Wired and Tired”

or those stuck in the vicious cycle – wired by coffee to stay awake, then relying on alcohol to switch off at night – my advice is simple: reset. Quit both for a time. Focus on consuming a low-sugar, low GL diet, along with supplements including B vitamins, plus extra vitamin C and omega-3 fish oil. All this advice and more is provided when you become a FRIEND of Food for the Brain and gain access to your six-month COGNITION™ brain upgrade programme. Click here to find out more.

Andrew was a case in point. Managing a chain of supermarkets had left him very stressed.

During the day, he drank coffee and in the evening, he relaxed with a beer or some wine as otherwise he would struggle to sleep. He was also gaining weight.

Andrew went on a low-GL diet, quit drinking coffee and alcohol, and took the recommended supplements. Three weeks later, he said: “My energy is through the roof, I don’t feel stressed, have no problem sleeping and I’m waking refreshed.” 

In Short …

  • One to two cups of unsweetened coffee a day, taken 30–60 minutes after waking, is probably optimal.
  • Avoid combining coffee with sugar or high-carbohydrate foods.  
  • Test your homocysteine levels, especially if you drink more than two cups a day.
    Buy a single homocysteine test here or get it along with other important brain biomarkers in the DRIfT 5-in-1 test kit here (for best value).
  • Consider switching to green tea or more weakly brewed coffee where possible for a gentler stimulant effect.
  • Avoid caffeinated drinks after noon, especially if you have difficulty getting to sleep or staying asleep.
  • If you rely on caffeine to function or alcohol to unwind, it may be time for a reset.

References:

(1) Grubben MJ, Boers GH, Blom HJ, Broekhuizen R, de Jong R, van Rijt L, de Ruijter E, Swinkels DW, Nagengast FM, Katan MB. Unfiltered coffee increases plasma homocysteine concentrations in healthy volunteers: a randomized trial. Am J Clin Nutr. 2000 Feb;71(2):480-4. doi: 10.1093/ajcn/71.2.480. PMID: 10648261. https://pubmed.ncbi.nlm.nih.gov/10648261/

(2) Verhoef P, Pasman WJ, Van Vliet T, Urgert R, Katan MB. Contribution of caffeine to the homocysteine-raising effect of coffee: a randomized controlled trial in humans. Am J Clin Nutr. 2002 Dec;76(6):1244-8. doi: 10.1093/ajcn/76.6.1244. PMID: 12450889. https://pubmed.ncbi.nlm.nih.gov/12450889/

(3) Pham K, Mulugeta A, Zhou A, O’Brien JT, Llewellyn DJ, Hyppönen E. High coffee consumption, brain volume and risk of dementia and stroke. Nutr Neurosci. 2022 Oct;25(10):2111-2122. doi: 10.1080/1028415X.2021.1945858. Epub 2021 Jun 24. PMID: 34165394. https://pubmed.ncbi.nlm.nih.gov/34165394/

(4) Li, J., Yu, K., Bu, F. et al. Exploring the impact of coffee consumption and caffeine intake on cognitive performance in older adults: a comprehensive analysis using NHANES data and gene correlation analysis. Nutr J 24, 102 (2025). https://doi.org/10.1186/s12937-025-01173-x

(5) Alida Chen J et al, Associations Between Caffeine Consumption, Cognitive Decline, and Dementia: A Systematic Review Journal of Alzheimer’s Disease 78 (2020) 1519–1546 DOI 10.3233/JAD-201069 https://pubmed.ncbi.nlm.nih.gov/33185612/

(6)Rainey-Smith SR, Sewell KR, Brown BM, Sohrabi HR, Martins RN, Gardener SL. Moderate coffee and tea consumption is associated with slower cognitive decline. J Alzheimers Dis. 2025 Jul 21:13872877251361058. doi: 10.1177/13872877251361058. Epub ahead of print. PMID: 40686251.

(7) Tingjing Zhang, Jiangen Song, Zhenfei Shen, Kewan Yin, Feifei Yang, Honghao Yang, Zheng Ma, Liangkai Chen, Yanhui Lu, Yang Xia,

Associations between different coffee types, neurodegenerative diseases, and related mortality: findings from a large prospective cohort study, The American Journal of Clinical Nutrition, Volume 120, Issue 4, 2024, Pages 918-926, ISSN 0002-9165, https://doi.org/10.1016/j.ajcnut.2024.08.012. https://ajcn.nutrition.org/article/S0002-9165(24)00671-3/abstract

(8) Moisey LL, Kacker S, Bickerton AC, Robinson LE, Graham TE. Caffeinated coffee consumption impairs blood glucose homeostasis in response to high and low glycemic index meals in healthy men. Am J Clin Nutr. 2008 May;87(5):1254-61. doi: 10.1093/ajcn/87.5.1254. PMID: 18469247. https://pubmed.ncbi.nlm.nih.gov/18469247/

  (9) Debono M, Ghobadi C, Rostami-Hodjegan A, Huatan H, Campbell MJ, Newell-Price J, Darzy K, Merke DP, Arlt W, Ross RJ. Modified-release hydrocortisone to provide circadian cortisol profiles. J Clin Endocrinol Metab. 2009 May;94(5):1548-54. doi: 10.1210/jc.2008-2380. Epub 2009 Feb 17. PMID: 19223520; PMCID: PMC2684472. https://pubmed.ncbi.nlm.nih.gov/19223520/   

(10) Xuan Wang, Hao Ma, Qi Sun, Jun Li, Yoriko Heianza, Rob M Van Dam, Frank B Hu, Eric Rimm, JoAnn E Manson, Lu Qi, Coffee drinking timing and mortality in US adults, European Heart Journal, 2025;, ehae871, https://doi.org/10.1093/eurheartj/ehae871 

(11)  Nurk E, Refsum H, Drevon CA, Tell GS, Nygaard HA, Engedal K, Smith AD. Intake of flavonoid-rich wine, tea, and chocolate by elderly men and women is associated with better cognitive test performance. J Nutr. 2009 Jan;139(1):120-7. doi: 10.3945/jn.108.095182. Epub 2008 Dec 3. PMID: 19056649 https://pubmed.ncbi.nlm.nih.gov/19056649/ 

(12) Feng L, Chong MS, Lim WS, Lee TS, Kua EH, Ng TP. Tea for Alzheimer Prevention. J Prev Alzheimers Dis. 2015;2(2):136-141. doi: 10.14283/jpad.2015.57. PMID: 29231231. https://pubmed.ncbi.nlm.nih.gov/29231231/ 

(13) Cornelis MC, Weintraub S, Morris MC. Caffeinated Coffee and Tea Consumption, Genetic Variation and Cognitive Function in the UK Biobank. J Nutr. 2020 Aug 1;150(8):2164-2174. doi: 10.1093/jn/nxaa147. PMID: 32495843; PMCID: PMC7398783.  https://pmc.ncbi.nlm.nih.gov/articles/PMC7398783/

Further info

How To Break Free From Food Addiction

How To Break Free From Food Addiction

woman eating cake

Do you ever promise yourself you’ll stop eating sugar or junk food – only to find yourself back at the biscuit tin a few hours later? You’re not alone. Food addiction is real. In fact, it can be as powerful and pervasive as alcohol addiction.

The first step is awareness. According to clinical psychologist Dr Jen Unwin, there are six warning signs. If you recognise yourself in two or more, it may be time to take this seriously.

Read on to see if any apply to you.

Six Signs You May Be Addicted to Food

1. Certain foods feel impossible to resist

 “You’re craving a certain food so badly that you feel compelled to eat it, even when you know you shouldn’t,” Dr Unwin explains. At the height of her own addiction, she would secretly make a bowl of cake mixture – just butter, sugar and flour -and eat the entire thing raw. “It sounds ridiculous now, but I had such intense cravings for sweet, soft, sugary foods,” she explains.

2. You always need more

Like alcohol tolerance, food addiction builds over time. “One slice of cake may have been enough in the beginning, but soon you need two, three – or half the cake – to get the same dopamine hit,” says Dr Unwin. She recalls eating slice after slice at her daughter’s wedding, unable to stop until she felt sick.

3. Food takes priority over everything else

A common factor in addiction is that you begin to ignore what you once valued and prioritise food above socialising, hobbies, family time and even work. Often, Dr Unwin would leave the house and her family in secret to drive for 20 minutes to a cinema complex where she would order a large tub of Ben & Jerry’s Cookie Dough ice cream with chocolate sauce. She would then return to her car and eat the entire portion, feeling ashamed and elated at the same time, before returning home an hour later as if nothing had happened.

4. You lose control once you start

You might buy biscuits for your grandchildren, planning to have just one with your tea. Before you know it, the whole packet has disappeared.

5. Withdrawal symptoms kick in

If you try to cut down on sugary snacks and carbohydrates, do you experience withdrawal symptoms? “These include headaches, migraines, gastrointestinal symptoms, low mood, anxiety, fatigue and brain fog,” Dr Unwin says. “As people experience sugar withdrawal, they feel so bad that they just go back to eating it.” When Dr Unwin completely abstained from sugar, she experienced many of these symptoms for eight days. But after pushing through that difficult period, she began feeling better than ever.

6. You know it’s harming you – and carry on anyway

According to Dr Unwin, this is the defining sign: eating damaging foods despite knowing the consequences. She references a patient with Type 2 diabetes who kept bingeing on cake and sugar knowing how bad it is for their blood sugar. People in this situation often know the food is harmful, but they feel trapped in a cycle.

Why Processed Foods Hijack Your Brain

Breaking free from any addiction is not purely a matter of willpower. Addictive foods and drinks hijack your brain’s chemistry, making you crave them. This effect is purposely done so that you keep buying more.

Understanding how certain food ingredients and combinations work in the brain unlocks the secret to undoing food addiction. The most powerful trigger is the combination of fat and sugar – the two key components of most junk foods. Think cakes, biscuits, ice cream, chocolate bars and pastries. This pairing presses the brain’s dopamine “reward” switch, creating intense pleasure in the moment but diminishing feelings of satisfaction over time. Just like drugs, it fuels cravings and loss of control.
This hijacking of the dopamine-based reward system doesn’t just drive overeating – it also increases the risk of cognitive decline and brain shrinkage. Additionally, it disrupts glucose control and drives insulin resistance, a well-known promoter of cognitive decline.  (Read more –  ‘Is Sugar Killing Your Brain?)

Nutritional Tools That Reset Your Brain

In Patrick Holford’s book How to Quit without Feeling S**t  he recommends strategies that help restore balance to your brain chemistry:

  • Omega-3 fats – vital for healthy cell membranes and for receiving neurotransmitter messages.
  • B vitamins and methylationcheck homocysteine levels; if they are high, it may indicate poor methylation and raised risk of cognitive decline.
  • Tyrosine – dopamine is made from this amino acid. A supplement of 500mg twice daily can help support dopamine production.

Protein + slow carbs – pairing protein (such as nuts or Greek yogurt) with fruit like berries slows sugar release and provides fibre and nutrients.

If you feel like you are struggling to break free from food addiction, then join  Dr Jen Unwin’s live webinar on Wednesday, 24th September – find out more here.

 A clinical Psychologist’s Practical Tips on How to break free; 

  • Visualise how life will improve once you manage to quit your “drug foods”. These are typically ultra-processed and sugary foods with which you’re unlikely to have a healthy relationship.
  • Have an honest conversation with friends and family about the foods you struggle with, and ask for their support in resisting them..
  • Removing the “drug foods” from your home and diet is key. Replace them with natural, whole foods.
  • Give it time. Every day you resist, it gets easier. “Those foods are no longer in my thoughts at all,” says Dr Unwin.
  • If you take medication for diabetes or high blood pressure, consult your GPbefore reducing sugar and carbohydrates in your diet, as your dosage may need adjusting.
  • If you’re concerned about food addiction or would like to learn more, Dr Unwin recommends joining a Public Health Collaboration (PHC) support group in the UK, or Sweet Sobriety in the US. The PHC also runs a virtual lifestyle support group every Monday at 6pm, where you can learn more about overcoming food addiction and maintaining good metabolic health.

The Bigger Picture

Food addiction is more than a personal struggle and it impacts more people than you realise. It’s part of a wider public health crisis, fuelling obesity, diabetes and dementia – but no matter where you are at right now, change is possible!

Ways to get support:

Food or drink addiction? Discover how to beat cravings and food addiction in Dr Jen Unwin’s live webinar, 24 Sept.

Join the live webinar on food addiction with clinical psychologist Dr Jen Unwin on Wednesday, 24th September – find out more here.

International Food Addiction & Comorbidities Conference logo

ttend the International Food Addiction & Comorbidities Conference – IFACC 2025. Use discount code FFB to get 40% off:

  • Two-day in-person ticket: £150 (full price £250)
  • Two-day livestream ticket: £54 (full price £90)

Cognition Programme logo

Get ongoing support with the COGNITION™ programme. Receive monthly coaching when you become a. FRIEND of Food for the Brain.

Fork in a road logo

Read Dr Jen Unwin’s book, Fork in the Road a hopeful guide for identifying if you have a food addiction and learning what to do about it.

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Read this journal article in Frontiers in Psychiatry to support and join the movement to have food addiction classified as a real disease, thus enabling more research and support, and helping to make the dangers of ultra-processed foods more visible.

Further info

New Study: Is Red Meat Bad for Your Brain?

New Study: Is Red Meat Bad for Your Brain?

New Study: Is Red Meat Bad for Your Brain?

In a culture where the average plate still leans heavily towards meat – often processed, often excessive – it’s time to reassess the impact of our protein choices not just on our waistlines, but on our brains. A recent study in Neurology (2025) has added fresh weight to decades of evidence linking red and processed meat consumption to an increased risk of dementia and cognitive decline (1). Meanwhile, fish – particularly oily fish – continues to top the charts as the most protective food for your brain (2,3).

So, what does this mean practically for those of us trying to upgrade our brains and reduce our risk of cognitive decline? The answer may be as simple as this: eat more fish and fewer sausages.

Red Meat, Processed Meat and the Rising Risk to Brain Health

A new US cohort study, which followed over 77,000 adults across 30 years, found that:

  • Processed red meats (bacon, hot dogs, sausages, salami, bologna and other processed meat products) were clearly problematic. Consuming just 0.25 servings per day or more was associated with a 13% higher risk of developing dementia compared with those eating less than 0.1 serving (1).
  • Unprocessed red meat (e.g. beef or lamb) was linked to a 16% increased risk of subjective cognitive decline – that is people reporting that their memory or mental sharpness was worsening – when consuming more than one serving daily compared to less than half a serving per day. However, the researchers noted that this link did not reach statistical significance for diagnosed dementia overall (1).
  • More encouragingly, replacing one daily serving of processed red meat with a serving of nuts, lentils, or beans was associated with a 19% lower risk of dementia (1).

These findings are consistent with a large UK Biobank analysis of almost half a million adults, which found that each additional 25 g/day of processed meat (bacon, ham, sausages, meat pies, kebabs, burgers, chicken nuggets) was associated with a 44% higher risk of all-cause dementia and a 52% higher risk of Alzheimer’s disease. In contrast, each 50 g/day of unprocessed red meat was linked to a 19% lower risk of all-cause dementia and a 30% lower risk of Alzheimer’s disease (4).  This reinforces the idea that it is the processing – not necessarily the meat itself – that may be most harmful.

These associations were observed regardless of whether participants carried the APOE ε4 gene variant – further evidence that dietary choices have a significant impact and that Alzheimer’s is ‘not in the genes’. (4).

The Global Pattern

The irrelevance of genetics in these findings is further supported by global evidence. An ecological analysis across 204 countries found that higher national per-capita total meat supply – including both red and white meats – was significantly associated with higher dementia incidence, even after adjusting for ageing, economic development and genetic risk, including APOE ε4 prevalence where available (5). In other words, the meat-dementia link is not confined to particular genetic subgroups but is observable across populations worldwide, suggesting that the way we produce and consume meat may be influencing brain health trends on a global scale. 

What we put on our plate is powerful when it comes to reducing dementia risk – more so than any genetic variations that attract attention in the media.

Why Fish is Brain Food

The answer is not to go hungry, but to swap for something else – and when it comes to brain health, marine foods are your answer.

Unlike red meat, fish – especially oily varieties like salmon, sardines or mackerel – continue to show a strong protective effect.

A comprehensive 2024 meta-analysis found that:

  • Eating one to two servings of fish per day (roughly 150 g) is associated with a 20% reduced risk of Alzheimer’s disease and up to 30% slower cognitive decline (2).
  • Another study found that people who ate fish at least once a week had a one-third lower risk of Alzheimer’s compared with those eating fish less than weekly (3).

Why? Omega-3 fats, especially DHA, are critical for brain function and structure. They reduce inflammation, support synaptic plasticity and help clear beta-amyloid – a protein associated with Alzheimer’s disease.

As explained in the COGNITION™ 6-month programme, omega-3 fats from fish oil play a pivotal role in building and repairing the brain, particularly in mid-life, when early signs of cognitive decline can start to emerge.

That’s why we offer omega-3 at-home blood tests – so you can check whether you’re getting enough through your diet or if it’s time to add a supplement. You can test omega-3 on its own here, or as part of our 5-in-1 DRIfT test where you can also check your homocysteine and glutathione status at the same time.

A Simple Swap with Profound Impact

From a cognitive health perspective, the data is now hard to ignore: if you’re regularly eating red or processed meat – especially more than once a day – your brain may be paying the price. But shifting even one of those servings towards fish, eggs or plant-based proteins could make a meaningful difference.

Interestingly, the main culprit in the latest studies was processed meat. This supports a key principle in brain-friendly eating: most natural whole foods – whether meat, fish, fruit, nuts, legumes, wholegrains or dairy – are not the problem. It’s when we distort them into ultra-processed, factory-made food that health is undermined.

This isn’t about becoming vegan or pescatarian. It’s simply more evidence to reduce processed foods and ensure optimal omega-3 intake. 

So next time you’re at the supermarket make a cow happy and buy a fish.

Resources:

Order your omega-3 test today to find out if you are eating enough of these essential fatty acids. You can test omega-3 on its own here, or as part of our 5-in-1 DRIfT test. Available globally.

References:

You J, Zhang L, Zhou Y, et al. Total meat supply and incidence of dementia: an ecological study of 204 countries. Front Public Health. 2025;13:1589936. doi:10.3389/fpubh.2025.1589936.

Li Y, Li Y, Gu X, Liu Y, Dong D, Kang JH, Wang M, Eliassen H, Willett WC, Stampfer MJ, Wang D. Long-Term Intake of Red Meat in Relation to Dementia Risk and Cognitive Function in US Adults. Neurology. 2025;104(3):e210286. doi:10.1212/WNL.0000000000210286.

Godos J, Micek A, Currenti W, Franchi C, Poli A, Battino M, Dolci A, Ricci C, Ungvari Z, Grosso G. Fish consumption, cognitive impairment and dementia: an updated dose-response meta-analysis of observational studies. Aging Clin Exp Res. 2024;36(1):171-182. doi:10.1007/s40520-024-02823-6.

Beydoun MA, Beydoun HA, Gamaldo AA, Teel A, Zonderman AB, Wang Y. Epidemiologic studies of modifiable factors associated with cognition and dementia: systematic review and meta-analysis. BMC Public Health. 2014;14:643. doi:10.1186/1471-2458-14-643.

Zhang Z, He P, Liu M, et al. Meat consumption and risk of incident dementia: cohort study of UK Biobank participants. Am J Clin Nutr. 2021;113(5):1228-1236. doi:10.1093/ajcn/nqaa343.

Further info

The Truth about Alcohol and Your Brain

Alcohol section in suppermarket with wine bottles

If coffee is the worker’s fuel for the fast and frenetic pace of modern life in the digital age, alcohol is the opiate of the masses. 

Most people use coffee or tea to wake up the brain and alcohol to switch off daily feelings of stress and anxiety. But what are these habits doing to brain health? How much is too much, or too little? Are there other ways to unwind after a hectic day that can benefit the brain?

Alcohol – The Friendly Neurotoxin?

Alcohol is a neurotoxin that impairs cognition. That is the simple fact we often forget. Once the liver’s capacity to detoxify is exceeded, it is precisely this neurotoxic effect that creates the ‘drunk’ feeling – starting with reduced inhibitions, the onset of memory loss, (which some may consider useful after a stressful day), and slurred speech. These effects are due to cognitive impairment, rather than relaxation – hence the warning: ‘not safe to drive’.

Stress Relief – at a Cost

The short-term upside of alcohol is its ability to suppress adrenal stress hormones – key accelerators of brain ageing, particularly when the stress switch is stuck in the ‘on’ position. That background hum of stress and anxiety, pending doom or checking for problems, is a hallmark of life in the 2020s, with hourly news cycles cranking up reasons for gloom and fear. In this context, a drink may feel like a welcome antidote, offering temporary relief by dampening stress.

Alcohol also boosts GABA, a calming neurotransmitter which temporarily switches off adrenaline. This is why one drink can feel like relief – but the effect fades quickly and excessive drinking leads to GABA receptor downregulation, increasing anxiety the next day and impairing sleep quality – especially during the deep and REM phases. These two phases are vital for full brain recovery. As a result, one wakes up less cognitively alert, less energised and more likely to feel anxious or to react stressfully.

Alcohol – like all toxic drugs – is what Oscar Ichazo called a ‘door of compensation:  temporary escape we reach for when psychic tension runs too high. While it offers short-term reprieve, it ultimately drains vital energy.
(Do you need more guidance and support to help you make healthier choices and habits? Then become a FRIEND of Food for the Brain today to get access to monthly group coaching and COGNITION ™ for 6 months. Find out more here)

More on GABA

GABA is made from two amino acids – taurine and glutamine – and is promoted by theanine. These three amino acids are often included in supplemental ‘chill’ formulas. There are also herbs, which in combination, help to promote GABA. This effect is harnessed in some non-alcoholic drinks like SENTIA drinks called ‘GABA spirits’. These are non-alcoholic yet potentially calming and de-stressing, offering a viable alternative to alcohol.  

However, alcohol is not just ‘alcohol’ and its appeal isn’t only due to GABA promotion. Red wine, for example, is rich in polyphenols, which have real benefits for the brain. However, unless it is organic, it often contains sulphites and other chemicals added. Additionally, some individuals – particularly those who drink often – can develop sensitivity to alcohol or to a component such as yeast, triggering further inflammation in both the gut and the brain.

How Much Alcohol is Too Much?

Alcohol is, of course, addictive –  and it can become so very quickly, even in small amounts. There are two ends to this spectrum. At the extreme, more than 10,000 people under the age of 35 die each year from alcohol poisoning – literally from a single binge. It can be compared to a heroin addict who quits and then relapses, taking the same dose they had previously built tolerance to. Tragically, this was the case for Amy Winehouse, who died after one evening of excess following a period of sobriety.

But what about the other end of the spectrum – modest drinking? And does the type of drink make a difference? Let’s look at the evidence. 

Since Alzheimer’s dementia, which accounts for two-thirds of dementia, is diagnosed through both brain shrinkage and cognitive decline, let’s look at the effects of alcohol at various doses on both brain shrinkage and cognitive decline, the most severe consequence being an increased risk of a dementia diagnosis later in life.

A study of 36,678 MRI scans from UK Biobank found that consuming more than one unit of alcohol per day is associated with steadily decreasing white and grey matter in the brain. (5)  A unit is a small glass of wine, half a pint of beer or a single shot of spirits. 


A comprehensive study in the British Medical Journal in 2018, which followed more than  9,000 people over 23 years, found that both abstinence and drinking more than 14 units of alcohol a week, which is equivalent to a medium glass of wine (2.3 units) every day,  increased risk by 40%. (6) This is illustrated in the graph below.

Volume of gray matter relation to alcohol consumption chart

You will notice that the brain shrinking effect is more pronounced in women than men, and those drinking 3 to 4 units, the equivalent of a large 250 ml of wine, show four times as much brain shrinkage as those drinking one small glass. Half a bottle a night, which is more than 4 units,  is associated with nearly eight times the loss of brain volume (7). That’s a high price to pay. 


Two other large studies last year showed something similar. A Chinese analysis of UK Biobank data involving 314,000 drinkers found that the more a person drank, the higher their risk. Once again, the effect was more pronounced in women than in men. or women, the lowest risk was observed  at around 8 units a week (roughly the equivalent of a bottle of wine), with risk actually lower than in those who drank less. Overall, the lowest risk was in those consuming 11.9 units a week, or about 1.7 units a day. (8)

Red Wine – Poison or Polyphenol Powerhouse?

On the positive side, research shows that a 125 ml glass of red wine a day may actually reduce dementia risk more than abstinence.. Another study reported that the lowest risk for dementia was among those consuming about 2 units a day – the equivalent of  a small to medium glass of wine. (9)

Red wine in particular may be beneficial because of its higher levels of polyphenols. Red wine, chocolate, and tea are all rich in a polyphenol called epicatechin. 

Jeremy Spencer, a scientific advisor to Food for the Brain and Professor of Nutritional Biochemistry and Medicine at the University of Reading, has shown that polyphenol-rich plants improve blood flow in specific regions of the brain that are associated with attention, decision-making, impulse control, and emotion, improving overall ‘executive’ function. (10) What’s more, the level of flavanols in your bloodstream predicts your memory performance. 

In the COSMOS study, the greatest benefit from increased flavanol intake was observed in those with the lowest dietary intake. Improvements were particularly noted in aspects of memory linked to the hippocampus – the brain’s central memory hub and the region most affected in Alzheimer’s disease (11). More recent research into cocoa, a rich natural source of flavanols – has also shown cognitive improvements, likely due to enhanced circulation (12). These findings were reinforced in a follow-up COSMOS trial involving more than 20,000 participants, who took a flavanol-rich cacao extract or placebo daily for five years (13).

Mitigating the Damage: Supplements for Protection

  • Quercetin (found in red onions), glutamine and vitamin C, support liver detoxification, helping to prevent hangover symptoms. (14)
  • Curcumin (especially water soluble Theracumin), reduces acetaldehyde by about a third, compared with drinking mineral water, thus easing hangover headaches.(15)  It has also recently been shown to protect the liver and reduce the risk of fatty liver disease.(16)
  • Glutathione – Alcohol-induced liver damage, fatty liver disease and reduced cognitive function are associated with a lower level of glutathione – an ideal level is around 1,000, though levels should certainly be above 500. 

Not sure what your glutathione levels are? Test your antioxidant levels accurately from home with a single Glutathione test or as part of our DRIfT 5-in-1  blood test

The Final Pour…

Alcohol may quiet stress in the moment, but in the long term it dulls cognition, shrinks the brain, and disrupts sleep. 

The good news is that with the right habits and smarter choices, from regular exercise to alcohol-free days, you can unwind without trading clarity for comfort.

Our Advice: Smarter Drinking Hacks

  • Limit yourself to a maximum of one small glass of red wine daily (about 125 ml) – but ideally avoid drinking every day.
  • Stay under 14 units per week  to reduce cognitive risk.
  • Hydrate: drink one glass of water for every alcoholic beverage.
  • Exercise at the end of the day is a great way to de‑stress and promote sleep if you usually turn to alcohol for this purpose. 
  • Practise intermittent drinking: take longer alcohol-free breaks – weeks or months- to improve sleep, mood, and liver function
  • Avoid sugary drinks: they put extra strain on the liver. Choose dry wines, low-carb beers and skip sugary mixers like tonic and juice. Opt for ‘brut’ champagne. 
  • Eat polyphenols: pair wine with olives, blueberries, and dark chocolate for added brain protection..

 Want more insight into how healthy your brain is?

  1. Take the FREE Cognitive Function Test today to gain personal insights into into your brain health. 

Join our research and test your glutathione, homocysteine and other essential brain health biomarkers with our accurate at home test kits – find out more and order yours today

References:
1 The Stress Cure, Patrick Holford & Susannah Lawson, Piatkus 2014

2 Shell W, Bullias D, Charuvastra E, May LA, Silver DS. A randomized, placebo-controlled trial of an amino acid preparation on timing and quality of sleep. Am J Ther. 2010 Mar-Apr;17(2):133-9. doi: 10.1097/MJT.0b013e31819e9eab. PMID: 19417589.   https://pubmed.ncbi.nlm.nih.gov/19417589/

3 Dr Javier Sánchez-Betancourt et al., ‘Effect of 5-hydroxytryptophan and melatonin supplementation on mood, sleep and cognition in adult patients with depression’, Archivos Venezolanos de Farmacologia y Terapeutica, January 2022, DOI: https://doi.org/10.5281/zenodo.7512797

4 S. Saul, ‘Sleep drugs found only mildly effective but wildly popular’, New York Times, 23 October 2007

5 Daviet R, Aydogan G, Jagannathan K, Spilka N, Koellinger PD, Kranzler HR, Nave G, Wetherill RR. Associations between alcohol consumption and gray and white matter volumes in the UK Biobank. Nat Commun. 2022 Mar 4;13(1):1175. doi: 10.1038/s41467-022-28735-5. PMID: 35246521; PMCID: PMC8897479.

7 Nurk E, Refsum H, Drevon CA, Tell GS, Nygaard HA, Engedal K, Smith AD. Intake of flavonoid-rich wine, tea, and chocolate by elderly men and women is associated with better cognitive test performance. J Nutr. 2009 Jan;139(1):120-7. doi: 10.3945/jn.108.095182. Epub 2008 Dec 3. PMID: 19056649

8 Zheng L, Liao W, Luo S, Li B, Liu D, Yun Q, Zhao Z, Zhao J, Rong J, Gong Z, Sha F, Tang J. Association between alcohol consumption and incidence of dementia in current drinkers: linear and non-linear mendelian randomization analysis. EClinicalMedicine. 2024 Sep 5;76:102810. doi: 10.1016/j.eclinm.2024.102810. PMID: 39290634; PMCID: PMC11405827. https://pubmed.ncbi.nlm.nih.gov/39290634/

9 Zarezadeh M, Mahmoudinezhad M, Faghfouri AH, Mohammadzadeh Honarvar N, Regestein QR, Papatheodorou SI, Mekary RA, Willett WC. Alcohol consumption in relation to cognitive dysfunction and dementia: A systematic review and dose-response meta-analysis of comparative longitudinal studies. Ageing Res Rev. 2024 Sep;100:102419. doi: 10.1016/j.arr.2024.102419. Epub 2024 Jul 20. PMID: 39038743

10 Spencer JP. The impact of fruit flavonoids on memory and cognition. Br J Nutr. 2010 Oct;104 Suppl 3:S40-7. doi: 10.1017/S0007114510003934. PMID: 20955649. See also Professor Jeremy Spencer’s presentation at the Alzheimer’s is preventable masterclass (2022) – foodforthebrain.org/aipmasterclass;

11 Brickman AM, Yeung LK, Alschuler DM, Ottaviani JI, Kuhnle GGC, Sloan RP, Luttmann-Gibson H, Copeland T, Schroeter H, Sesso HD, Manson JE, Wall M, Small SA. Dietary flavanols restore hippocampal-dependent memory in older adults with lower diet quality and lower habitual flavanol consumption. Proc Natl Acad Sci U S A. 2023 Jun 6;120(23):e2216932120. doi: 10.1073/pnas.2216932120. Epub 2023 May 30. PMID: 37252983; PMCID: PMC10265949.

12127 Lamport DJ, Pal D, Moutsiana C, Field DT, Williams CM, Spencer JP, Butler LT. The effect of flavanol-rich cocoa on cerebral perfusion in healthy older adults during conscious resting state: a placebo controlled, crossover, acute trial. Psychopharmacology (Berl). 2015 Sep;232(17):3227-34. doi: 10.1007/s00213-015-3972-4. Epub 2015 Jun 7. PMID: 26047963; PMCID: PMC4534492.

13 Sesso HD, Manson JE, Aragaki AK, Rist PM, Johnson LG, Friedenberg G, Copeland T, Clar A, Mora S, Moorthy MV, Sarkissian A, Carrick WR, Anderson GL; COSMOS Research Group. Effect of cocoa flavanol supplementation for the prevention of cardiovascular disease events: the COcoa Supplement and Multivitamin Outcomes Study (COSMOS) randomized clinical trial. Am J Clin Nutr. 2022 Jun 7;115(6):1490-1500. doi: 10.1093/ajcn/nqac055. PMID: 35294962; PMCID: PMC9170467.

14 Markowska J, Kasprzak-Drozd K, Niziński P, Dragan M, Kondracka A, Gondek E, Oniszczuk T, Oniszczuk A. Quercetin: A Promising Candidate for the Management of Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD). Molecules. 2024 Nov 6;29(22):5245. doi: 10.3390/molecules29225245. PMID: 39598636; PMCID: PMC11596905.

15Sasaki H, Sunagawa Y, Takahashi K, Imaizumi A, Fukuda H, Hashimoto T, Wada H, Katanasaka Y, Kakeya H, Fujita M, Hasegawa K, Morimoto T. Innovative preparation of curcumin for improved oral bioavailability. Biol Pharm Bull. 2011;34(5):660-5. doi: 10.1248/bpb.34.660. PMID: 21532153.

16Panahi Y, Kianpour P, Mohtashami R, Jafari R, Simental-Mendía LE, Sahebkar A. Efficacy and Safety of Phytosomal Curcumin in Non-Alcoholic Fatty Liver Disease: A Randomized Controlled Trial. Drug Res (Stuttg). 2017 Apr;67(4):244-251. doi: 10.1055/s-0043-100019. Epub 2017 Feb 3. PMID: 28158893.

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Snacks: Brain Boost or Brain Drain?

Colourful selection of snacks displayed on a flat surface

When that mid-morning dip or afternoon slump hits, it’s tempting to reach for a quick fix – something sweet, something carby, something to perk you up. But most conventional snacks don’t fuel your brain – they drain it.

In fact, snacking is one of the easiest ways to sabotage your long-term brain health and memory. Most people wouldn’t eat a plate of sugar at mealtimes (unless they start the day with shop-bought cereal or sweetened yoghurt), yet it’s common to reach for a bar, a biscuit, or something from a petrol station or coffee shop without a second thought.

These everyday choices are a silent driver of brain fog, low mood, memory problems – even dementia. It’s time to upgrade your brain by upgrading your snacks. Below, we share a free Brain Boost Bites recipe and some other smart snack ideas – perfect for long drives, picnics, or busy days on the go.

The Problem with Typical Snacks

The modern snack aisle is a minefield of ultra-processed foods: cereal bars, crisps, flavoured yoghurts, granola bites, and biscuits – many of them marketed as “healthy”. But beneath the surface, they’re often:

  • High in sugar or refined carbs – causing a rapid blood glucose spike followed by a crash. Many so-called healthy bars contain over 15g of sugar with little fibre, protein, or healthy fat to balance them.
  • Low in brain-essential nutrients – such as omega-3s, magnesium, or phospholipids.
  • Full of artificial additives – emulsifiers, preservatives, and even excitotoxins like MSG.
  • Designed for instant gratification – often with addictive properties rather than sustained energy.

As explained in our Four Horsemen of the Mental Health Apocalypse series (read Part 1 here and Part 2 here), poor glucose control is a key driver of accelerated brain ageing and cognitive decline. A high-sugar snack spikes blood sugar, then causes a crash that reduces brain energy and impairs mental performance. Over time, this rollercoaster leads to insulin resistance, which is strongly linked to cognitive decline and Alzheimer’s disease.

The Smart Snacking Solution

The answer isn’t to stop snacking altogether – it’s to snack smart.

Our in-house chef and lecturer in culinary nutrition and functional health, Kim Close, shares a free recipe below from the Upgrade Your Brain Cook App. It’s packed with brain-supportive nutrients and perfect for keeping your energy and focus steady.

And if you’re not sure what to eat for better brain health, the Cook App includes 120+ recipes (and growing) to guide you meal by meal.

Brain Boost Bites

Refined sugar-free | Fibre-rich | Brain-fat fuelled | Brain Boosting

Brain Boosting snacks - bite balls in a plate

Ingredients:

  • 100g (3½ oz) almonds
  • 30g (1 oz) walnuts
  • 50g (1¾ oz) goji berries
  • 2 tbsp ground flaxseed
  • 2 tbsp almond butter
  • 1 tbsp raw cacao powder
  • 1 tbsp water (if needed for blending)

Method:

  1. Blend all ingredients in a food processor until the mixture becomes sticky and holds together.
  2. Roll into small balls.
  3. Chill in the fridge for at least 30 minutes.

Servings: Makes 10-12 balls

Cook’s Tips: Store in an airtight container in the fridge for up to a week. Add orange zest or vanilla extract for flavour variation.

Other Smart Snack Ideas:

  • Oatcakes with almond butter or smoked mackerel pâté
  • Olives 
  • Square of Dark Chocolate Bar (Recipe in Cook App)
  • Hummus or nut butter with raw veggie sticks
  • A boiled egg with cherry tomatoes
  • A handful of walnuts or pumpkin seeds
  • A small cup of full-fat Greek yoghurt with blueberries
  • Chia pudding made with coconut milk (recipe in the app)
  • 2 squares of 85%+ dark chocolate

Snacking wisely is one of the easiest daily upgrades you can make for your brain. And with the right ingredients, it can be delicious too.

Further info

Homocysteine and Dementia: The Evidence They Don’t Want You to See

Imagine if a simple, well-researched nutrient protocol could prevent cognitive decline in millions of people worldwide. Imagine further that this protocol has been known for years, supported by multiple clinical trials and global experts, yet systematically ignored by the very institutions meant to protect public health. That is precisely the case when it comes to homocysteine, B vitamins, and dementia.

Last year, the UK-based Lancet Commission on Dementia Prevention, Intervention and Care released its third major report, once again omitting any mention of homocysteine as a modifiable risk factor. This was despite direct submissions of evidence and letters from leading scientists demonstrating that lowering homocysteine with B vitamins can slow brain shrinkage and cognitive decline.

Now, in response to this silence, six of the leading dementia researchers, Professors Joshua Miller (Rutgers), David Smith (Oxford), Helga Refsum (Oslo), Jin-Tai Yu (Fudan), Babak Hooshmand (Karolinska), and Andrew McCaddon (Wrexham), have published a powerful rebuttal in the Journal of Alzheimer’s Disease. Many of these experts serve in the Alzheimer’s Prevention Expert Group (APEG) at Food for the Brain.

They wrote:

“In 2018, we published an ‘International Consensus Statement on Homocysteine and Dementia’ in this journal, in which we concluded that elevated plasma total homocysteine is a modifiable risk factor for the development of cognitive decline, dementia, and Alzheimer’s disease (AD) in older persons. (1)

We further stated that intervention trials in elderly people with cognitive impairment show that homocysteine-lowering treatment with B vitamins markedly slows the rate of both wholeand regional brain atrophy, and also slows cognitive decline. We were therefore puzzled as to why the Lancet Commission on Dementia Prevention, Intervention and Care, failed to discuss the possible role of homocysteine and B vitamins in any of their three reports, including the most recent one.” (2)

A Systematic Omission

The UK-based Lancet Commission on Dementia Prevention is meant to objectively consider the evidence on dementia prevention. Yet each edition, despite being sent the relevant papers, has ignored the evidence concerning homocysteine.

Furthermore, it’s expected to uphold the standards for critical debate which allows for experts to question Published findings. That is exactly what these experts did – yet it declined to publish their letter, instead printing a rebuttal from its own Commission while refusing to let readers see the original letter. (3, 4)

The experts wrote to The Lancet again to respond to the Commission’s letter, but their second letter was also rejected. 

Thatetter has now been published in the leading Alzheimer’s journal where the authors finally have their rightful say. It includes the following:

We wish to reply to the Commission and continue the debate with the aim of reaching a common view on homocysteine, B vitamins and dementia. This is an important matter of public health.”

In other words, The Lancet published the ‘case for the defence’ for the exclusion of homocysteine without allowing readers to even read the ‘case for the prosecution’. (5)

So, what was The Lancet’s case against B vitamins? It rested on three criticisms – each of which these leading dementia researchers refute with scientific precision in their recent journal paper.

Criticism 1: Misunderstanding Who Benefited in the VITACOG Trial

The Lancet Commission questioned the relevance of the VITACOG trial, arguing that the results “do not show benefits in populations already consuming B vitamins in their food or through supplements.” But this fundamentally misrepresents the study population.

In the VITACOG trial, participants with mild cognitive impairment were given high doses of B6, B12, and folic acid for two years. The result was a 31% reduction in whole brain shrinkage and significantly slower rate of cognitive decline in those with raised homocysteine (6). In participants with levels above 11.3 μmol/L – the median – both cognitive and clinical improvements were observed. Importantly, key Alzheimer’s-related brain regions shrank seven times more slowly in these individuals (7, 8).

The Lancet Commission implied that participants were already supplementing, but that is incorrect. The study excluded anyone taking more than 300 mcg of folic acid, 3 mg of vitamin B6, or 1.5 mcg of vitamin B12 – doses lower  than those found in many common multivitamins. Only 16 to 20 percent were taking low-dose supplements, while the majority were not.. No one was excluded based on their dietary intake of B vitamins.

The experts respond:“The Commission authors’ comment is analogous to expecting additional drug treatment to provide benefits over and above the benefits being obtained in people already taking a high dose of the drug, which is why it puzzles us.”

Criticism 2: No Benefit in the Hong Kong Trial?

The Commission’s response also cited a Hong Kong trial that reported no benefit of B vitamins over two years in people with mild cognitive impairment (MCI) (9). However, this overlooks several important confounders.

Firstly, 22% of participants were taking aspirin, which the study authors themselves found to impair the effect of B vitamins. This interference has since been confirmed in further research (10).

Secondly, the authors of The Lancet response failed to consider another critical factor: omega-3 status. Numerous studies show that B vitamins only deliver cognitive benefits when omega-3 fatty acid levels are sufficient. The Hong Kong study did not measure or control for omega-3 status, which likely explains the lack of consistent benefit over the two-year period.

Thus, the absence of effect in this trial does not disprove the role of B vitamins.  The experts go on to demonstrate in their article the overwhelming body of evidence –  reported by us – that homocysteine-lowering B vitamins do not work optimally in individuals with low omega-3 status.

Criticism 3: No Benefit in the VITAL Trial in Alzheimer’s Patients?

The Lancet authors also referenced the VITAL trial, which reported no overall cognitive benefit from B vitamins in patients already diagnosed with Alzheimer’s disease (11). But again, this conclusion overlooks key details.

In a subgroup analysis, those in the early stages of Alzheimer’s disease did show significant benefit (12). The authors of the VITAL trial themselves highlighted this in their paper, suggesting that earlier intervention is more effective. This finding aligns with multiple other studies showing that B vitamin treatment is most effective in the pre-dementia stages (13).

Furthermore, participants in the VITAL trial began with an average homocysteine level of 9 μmol/L, which is below the threshold (>10–11 μmol/L) associated with brain atrophy.  It is extremely rare to find a group of people with Alzheimer’s disease that start with such a low homocysteine level.  While the B vitamins did reduce homocysteine further to 7μmol/L, there was no overall cognitive benefit observed. But this is akin to giving painkillers to people who are not in pain and then reporting no change in pain levels. At Food for the Brain, we consider a homocysteine level above 10μmol/L as in need of correction with B vitamins.

There are also concerns about conflicts of interest. The lead author, Paul Aisen, is described as “a consultant to the following pharmaceutical companies involved in the development of potential treatments for Alzheimer’s disease”. with more than a dozen firms listed. These companies would certainly favour a trial designed to fail – especially if it were widely publicised.

Additionally, when an anti-amyloid drug trial for lecanemab was published – now licensed in the US and UK – the names of Paul Aisen and Christopher Van Dyck appeared once again as lead authors. In other words, the paid pharmaceutical consultants, responsible for running the drug trial were also tasked with overseeing a trial – designed to fail – on a competing approach: lowering homocysteine with B vitamins. The conflict of interest here is both clear and concerning.

What Does the Evidence Really Say?

You can read the full expert response published in the Journal of Alzheimer’s Disease here. 

Their conclusion is clear:

“We hope that the Lancet Commission will consider the substantial existing evidence of raised homocysteine as an important risk factor for dementia and the possibility of modifying its harm by supplementation with B vitamins.”

They emphasise that the evidence for B vitamin intervention is as strong – or stronger than –  many of the risk factors the Commission did include in its 2024 report. To continue ignoring the proven impact of homocysteine, and the benefits of lowering it through B vitamins is not merely a scientific oversight –  it is a missed opportunity with major implications for medicine and public health.

Remember, prevention is better than cure, and there is so much you can do to protect your brain health

The perfect time to start? Today.

What Can You Do?

  1. Test your homocysteine (and omega-3 status) TODAY –  especially if you’re over 50 or at risk of cognitive decline. At Food for the Brain, we offer an accurate at-home test kit that reliably measures plasma homocysteine reliably. 

    You can order your single Homocysteine test here or save money and test both omega-3 index and homocysteine (plus other markers) as part of our DRIfT tests here. International shipping available.
  2. Act on your results –  if your level is above 10 μmol/L, supplementation with vitamin B6 (20 mg), methylfolate (400 µg), and vitamin B12 (500 µg) is recommended.
    Read more on supplements and homocysteine here.
  3. Support our mission – become a FRIEND of Food for the Brain! Your donation helps us advance prevention-focused brain health research and education.

    As a Friend, you’ll also gain access to:
    • Monthly group coaching
    • Your personalised brain upgrade programme: COGNITION™
  4. Share the knowledge – public awareness can change public health.
    We need a paradigm shift, and it starts with us.

References

1. Smith AD, Refsum H, Bottiglieri T, et al. Homocysteine and dementia: an international consensus statement. J Alzheimers Dis 2018; 62: 561–570.

2.Livingston G, Huntley J, Liu KY, et al. Dementia prevention, intervention, and care: 2024 report of the Lancet standing Commission. Lancet 2024; 404: 572–628.

3.Miller JW, McCaddon A, Hooshmand B, et al. The Lancet ‘Omission’: Why are  homocysteine and B vitamins missing from the Lancet Commission’s Report on Dementia Prevention, Intervention and Care? https://foodforthebrainorg/lancet-commission-letters/ (2024).

4.Livingston G, Costafreda SG, Kivimaki M, et al. B vitamins and the 2024 Lancet Commission on dementia. Lancet 2025; 405: 623.

5. Miller JW, McCaddon A, Yu J-T, Hooshmand B, Refsum H, Smith AD. Concerning the debate about homocysteine, B vitamins, and dementia. Journal of Alzheimer’s Disease. 2025;0(0). doi:10.1177/13872877251350297

6. Smith AD, Smith SM, de Jager CA, et al. Homocysteine-lowering by B vitamins slows the rate of accelerated brainatrophy in mild cognitive impairment. A randomized controlled trial. PLoS One 2010; 5: e12244.

7. de Jager CA, Oulhaj A, Jacoby R, et al. Cognitive and clinical outcomes of homocysteine-lowering B-vitamin treatment in mild cognitive impairment: a randomized controlled trial. Int J Geriatr Psychiatry 2012; 27: 592–600.

8. Douaud G, Refsum H, de Jager CA, et al. Preventing Alzheimer’s disease-related gray matter atrophy by B-vitamin treatment. Proc Natl Acad Sci U S A 2013; 110: 9523–9528.

9. Kwok T, Wu Y, Lee J, et al. A randomized placebo- controlled trial of using B vitamins to prevent cognitive decline in older mild cognitive impairment patients. ClinNutr 2020; 39: 2399–2405.

10. Wu Y, Smith AD, Refsum H, et al. Effectiveness of B vitamins and their interactions with aspirin in improving cognitive functioning in older people with mild cognitive impairment: pooled post-hoc analyses of two randomized trials. J Nutr Health Aging 2021; 25: 1154–1160.

11. Aisen PS, Schneider LS, Sano M, et al. High-dose B vitamin supplementation and cognitive decline in Alzheimer disease: a randomized controlled trial. JAMA 2008; 300: 1774–1783.

12. Smith AD and Homocysteine RH. B vitamins, and cognitive impairment. Ann Rev Nutr 2016; 36: 211–239.

13. Chen H, Liu S, Ge B, et al. Effects of folic acid and vitamin B12 supplementation on cognitive impairment and inflammation in patients with Alzheimer’s disease: a randomized, single-blinded, placebo-controlled trial. J Prev Alzheimers Dis 2021; 8: 249–256.

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