By Patrick Holford

Did you know the length of your shadow can tell you if you’re able to generate vitamin D from sunlight?

If your shadow is longer than your body – you can’t produce vitamin D from sunlight. If you are in winter and live in a country of higher latitude (like the UK), this is happening now!

Vitamin D is an all-rounder as far as your brain and mental health is concerned.

It helps neurotransmission and exerts anti-inflammatory and neuroprotective activities within the brain by reducing both inflammation and oxidative stress (1).  

—

We are all deficient in winter

Generally speaking, the lower your vitamin D, the worse your mood which makes vitamin D especially important to supplement from October to March if you live in the UK or a similar latitude, when the angle of the sun is too low and you’re also less likely to get outdoors exposing your skin to sunlight. It’s best to assume that we are all deficient in winter, unless you travel to the sun, and therefore need to supplement at least 25mcg (1000iu) although two or three times may be optimal and necessary to correct deficiency.

—

Vitamin D and depression

The lower your vitamin D level, the more depressed you are likely to feel. If your mood takes a dip in winter months this is a key sign that you might need more. That’s what researchers at the University of Tromso in Norway found on testing 441 volunteers who were given a test for depression and also a test for blood levels of vitamin D. The volunteers were then given Vitamin D supplements or placebo. Tested one year on, those given vitamin D, but not those given the placebos, had substantially lower depression ratings (2).

However, you don’t have to wait for a year to get a lift in your mood. An eight-week study in Australia found that some of those given vitamin D supplements had an improvement in mood in only five days (3). Another study, in Iran, gave a single vitamin D injection and reported improvement in depression when measured 3 months on (4).

Since vitamin D stores, there is no need to supplement daily. You can take a weekly dose. In the Norwegian study above they gave 20,000iu or 40,000iu weekly. Both worked and there wasn’t a big difference in the effects on mood. So, you can assume that 20,000iu weekly, or 3,000iu daily would likely be sufficient.

It’s what is in your blood that matters

However, the yardstick for what you need is really whatever gets your blood level into the optimal range.

In the study above, those given 20,000iu a week averaged a blood level of 88 nmol/l, while those given 40,000iu averaged 111nmol/l. It is now well recognised that levels above 75nmol/l (30 ng/ml) correlate with good health for many health measures, while levels above 100nmol/l (40ng/ml) might be even better in some respects. My recommendation is to test yourself and consider anything below 50 to be deficient, and above 75 to be sufficient with an optimal level being closer to 100nmol/l (40ng/ml). If you then supplement 3,000iu daily, or seven times this weekly, especially from October to March, retest yourself against these yardsticks.

It’s not JUST about vitamin D

But it isn’t just vitamin D we need – it’s sunlight.

During the summer months, if you are spending half an hour outdoors, with short sleeves, shorts or even more skin exposure, in the sunlight, even a multivitamin that provides you 800iu (a quarter of what you need in the darker months) might be sufficient.

Sunlight promotes serotonin, the happy neurotransmitter.

Having good vitamin D levels is a vital part of your brain upgrade since it helps optimise your brain’s serotonin levels. That’s because a vital enzyme called TPH, which converts the amino acid tryptophan into serotonin, is enhanced in the brain by vitamin D, and selectively shut down in the gut. So, with sufficient vitamin D you get higher brain levels of serotonin, promoting good mood, and lower serotonin levels in the gut (5), protecting against gut inflammation. 

The other way to boost your light exposure is with light therapy. Canadian researchers compared the effects of an anti-depressant (fluoxetine), placebo or 30 minutes daily of light therapy as soon as possible on waking for people with major depression. Light therapy was both superior to placebo and anti-depressants, which were also no better than placebo. I have a full spectrum light in my study, which I put on in the winter, when I’m writing in the early morning, before the sun comes up.

—

Vitamin D and addiction

Interestingly, vitamin D deficiency is also associated with greater opioid addiction (7), suggesting the need to up vitamin D intake to reduce cravings. There’s also something else interesting about vitamin D, sun exposure and addiction. People can become addicted to sunbeds. In relation to opioids, the lower one’s vitamin D levels, the more addictive they become. Sun exposure, which promotes higher vitamin D levels, reduces opioid addiction.

—

What to eat?

The best food sources of vitamin D are oily fish and eggs. A serving of salmon or mackerel is likely to give you 400iu of vitamin D. Two eggs will provide about 130iu. In some countries, not the UK, milk is fortified with vitamin D but otherwise, it is not a great source. Some mushrooms are purposely fortified with vitamin D by exposing them to UV light.

In summary, the way up from down is to eat a low GL diet, with plenty of oily fish and eggs, avoid sugar, cut back on stimulants and alcohol, and make sure your daily supplements include omega-3, B vitamins, with extra B12 if your homocysteine level is high, vitamin D, zinc, magnesium, chromium, plus the amino acids 5-HTP with is the precursor of serotonin.

—

Vitamin D protects your brain and memory.

Vitamin D deficiency increases the risk of Alzheimer’s (9). In a study in France involving 912 elderly patients followed for 12 years, a total of 177 dementia cases occurred. Those with low vitamin D levels had a nearly three-fold increased risk of Alzheimer’s (10). Supplementing 800iu (20mcg) a day for 12 months has also been shown to improve cognitive function (11). 

Supplements may also help ward off dementia, according to a recent, large-scale study involving over twelve thousand dementia-free 70+ year-olds in the US (12). More than a third (37%) took supplements of vitamin D. Those who did had a 40% lower incidence of dementia. Professor Zahinoor Ismail, of the University of Calgary and University of Exeter, who led the research, said: “We know that vitamin D has some effects in the brain that could have implications for reducing dementia, however so far, research has yielded conflicting results. Overall, we found evidence to suggest that earlier supplementation might be particularly beneficial, before the onset of cognitive decline.”

—

Vitamin D helps recovery from strokes and brain injury

Having a higher vitamin D level or supplementing vitamin D at levels above 2,000iu a day also helps people recover from strokes (13) and other forms of brain injury.

I recommend 3,000iu a day or 21,000iu a week in winter but most importantly, monitoring your vitamin D level to keep it above 75nmol/l (30 ng/ml). A level of 100nmol/l may be optimal. That is why testing is so vital as winter approaches. Test again 3 months later so you know if you’re taking enough or too much and that will give you a good gauge as spring approaches when you can probably lower your intake to 600 to 1,000iu depending on sun exposure and diet to top up to over 1,000iu.

Vitamin D is vital in pregnancy and for children

A breastfeeding mother must, at least, supplement omega-3 fish oils and ensure enough B vitamins for homocysteine to be below 7 mcmol/L, but many other nutrients are also necessary. Low vitamin D status in both the mother and newborn baby increases the likelihood of developing autistic spectrum disorder by 54% (14).

Without sufficient nutrients not only do brain cells not make the connections but the production and flow of neurotransmitters doesn’t happen optimally. Bruce Ames, Emeritus professor of Biochemistry and Molecular Biology at the University of California, thinks that “serotonin synthesis, release, and function in the brain are modulated by vitamin D and the 2 marine omega-3 fatty acids, eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA).” He says that ”insufficient levels of vitamin D, EPA, or DHA, in combination with genetic factors and at key periods during development, would lead to dysfunctional serotonin activation and function and may be one underlying mechanism that contributes to neuropsychiatric disorders and depression in children”. (15) 

A study in Northern Ireland found that half of schoolchildren were deficient in vitamin D, with a level below 50nmol/l (I recommend above 75 nmol/l). Another finds that low vitamin D levels in childhood are related to behaviour problems in adolescence (16). Is it any wonder so many children are neurodivergent?

A placebo-controlled trial giving ADHD children magnesium together with vitamin D for eight weeks showed a major reduction in emotional, conduct and peer problems and improved socialisation compared with children treated with the placebo (17).

—

The bottom line – we all need to supplement vitamin D

The bottom line is everyone, from children to older people, and especially anyone considering pregnancy, suffering with low mood or memory problems, must test their vitamin D, ideally, at the start of winter to guide them as to what to supplement, during winter perhaps at 3 months, and 6 months later, to learn what amount of vitamin D supplementation they need in summer and winter.

In summary, you want to get your blood level above 75nmol/l (30 ng/ml) which usually means supplementing 3,000iu from October to March for those in the Northern Hemisphere. The optimal level is, however,  likely to be above 100nmol/l (40mg/ml).  Your need for vitamin D is likely to be greater if you are overweight and have darker skin and live further North.

When spring returns, and throughout summer, 1,000iu a day may be enough depending on your sun exposure.

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 Jayedi A, Rashidy-Pour A, Shab-Bidar S. Vitamin D status and risk of dementia and Alzheimer’s disease: A meta-analysis of dose-response †. Nutr Neurosci. 2019 Nov;22(11):750-759. doi: 10.1080/1028415X.2018.1436639. Epub 2018 Feb 15. PMID: 29447107

² Jorde R, Sneve M, Figenschau Y, Svartberg J, Waterloo K. Effects of vitamin D supplementation on symptoms of depression in overweight and obese subjects: randomized double blind trial. J Intern Med. 2008 Dec;264(6):599-609. doi: 10.1111/j.1365-2796.2008.02008.x. Epub 2008 Sep 10. PMID: 18793245.

³ Khoraminya N, Tehrani-Doost M, Jazayeri S, Hosseini A, Djazayery A. Therapeutic effects of vitamin D as adjunctive therapy to fluoxetine in patients with major depressive disorder. Aust N Z J Psychiatry. 2013 Mar;47(3):271-5. doi: 10.1177/0004867412465022. Epub 2012 Oct 23. PMID: 23093054. Xxxx check the some in 5 days

⁴ Mozaffari-Khosravi H, Nabizade L, Yassini-Ardakani SM, Hadinedoushan H, Barzegar K. The effect of 2 different single injections of high dose of vitamin D on improving the depression in depressed patients with vitamin D deficiency: a randomized clinical trial. J Clin Psychopharmacol. 2013 Jun;33(3):378-85. doi: 10.1097/JCP.0b013e31828f619a. PMID: 23609390.

⁵ Patrick RP, Ames BN. Vitamin D hormone regulates serotonin synthesis. Part 1: relevance for autism. FASEB J. 2014 Jun;28(6):2398-413. doi: 10.1096/fj.13-246546. Epub 2014 Feb 20. PMID: 24558199.

⁶ Lam RW, Levitt AJ, Levitan RD, Enns MW, Morehouse R, Michalak EE, Tam EM. The Can-SAD study: a randomized controlled trial of the effectiveness of light therapy and fluoxetine in patients with winter seasonal affective disorder. Am J Psychiatry. 2006 May;163(5):805-12. doi: 10.1176/ajp.2006.163.5.805. PMID: 16648320.Psychiary, No015

⁷ Kemény LV, Robinson KC, Hermann AL, Walker DM, Regan S, Yew YW, Lai YC, Theodosakis N, Rivera PD, Ding W, Yang L, Beyer T, Loh YE, Lo JA, van der Sande AAJ, Sarnie W, Kotler D, Hsiao JJ, Su MY, Kato S, Kotler J, Bilbo SD, Chopra V, Salomon MP, Shen S, Hoon DSB, Asgari MM, Wakeman SE, Nestler EJ, Fisher DE. Vitamin D deficiency exacerbates UV/endorphin and opioid addiction. Sci Adv. 2021 Jun 11;7(24):eabe4577. doi: 10.1126/sciadv.abe4577. PMID: 34117054; PMCID: PMC8195487.

⁸ Jayedi A, Rashidy-Pour A, Shab-Bidar S. Vitamin D status and risk of dementia and Alzheimer’s disease: A meta-analysis of dose-response †. Nutr Neurosci. 2019 Nov;22(11):750-759. doi: 10.1080/1028415X.2018.1436639. Epub 2018 Feb 15. PMID: 29447107

⁹ Chai B, Gao F, Wu R, Dong T, Gu C, Lin Q, Zhang Y. Vitamin D deficiency as a risk factor for dementia and Alzheimer’s disease: an updated meta-analysis. BMC Neurol. 2019 Nov 13;19(1):284. doi: 10.1186/s12883-019-1500-6. PMID: 31722673; PMCID: PMC6854782.

10 Jia J, Hu J, Huo X, Miao R, Zhang Y, Ma F. Effects of vitamin D supplementation on cognitive function and blood Aβ-related biomarkers in older adults with Alzheimer’s disease: a randomised, double-blind, placebo-controlled trial. J Neurol Neurosurg Psychiatry. 2019 Dec;90(12):1347-1352. doi: 10.1136/jnnp-2018-320199. Epub 2019 Jul 11. PMID: 31296588.

11 Feart C, Helmer C, Merle B, Herrmann FR, Annweiler C, Dartigues JF, Delcourt C, Samieri C. Associations of lower vitamin D concentrations with cognitive decline and long-term risk of dementia and Alzheimer’s disease in older adults. Alzheimers Dement. 2017 Nov;13(11):1207-1216. doi: 10.1016/j.jalz.2017.03.003. Epub 2017 May 16. PMID: 28522216.

12 Ghahremani M, Smith EE, Chen HY, Creese B, Goodarzi Z, Ismail Z. Vitamin D supplementation and incident dementia: Effects of sex, APOE, and baseline cognitive status. Alzheimers Dement (Amst). 2023 Mar 1;15(1):e12404. doi: 10.1002/dad2.12404. PMID: 36874594; PMCID: PMC9976297.

13 Marek K, Cichoń N, Saluk-Bijak J, Bijak M, Miller E. The Role of Vitamin D in Stroke Prevention and the Effects of Its Supplementation for Post-Stroke Rehabilitation: A Narrative Review. Nutrients. 2022 Jul 4;14(13):2761. doi: 10.3390/nu14132761. PMID: 35807941; PMCID: PMC9268813.

14 Wang Z, Ding R, Wang J. The Association between Vitamin D Status and Autism Spectrum Disorder (ASD): A Systematic Review and Meta-Analysis. Nutrients. 2020 Dec 29;13(1):86. doi: 10.3390/nu13010086. PMID: 33383952; PMCID: PMC7824115.

15 Patrick RP, Ames BN. Vitamin D and the omega-3 fatty acids control serotonin synthesis and action, part 2: relevance for ADHD, bipolar disorder, schizophrenia, and impulsive behavior. FASEB J. 2015 Jun;29(6):2207-22. doi: 10.1096/fj.14-268342. Epub 2015 Feb 24. PMID: 25713056.

16 Sonia L Robinson, Constanza Marín, Henry Oliveros, Mercedes Mora-Plazas, Betsy Lozoff, Eduardo Villamor, Vitamin D Deficiency in Middle Childhood Is Related to Behavior Problems in Adolescence, The Journal of Nutrition, Volume 150, Issue 1,

2020, Pages 140-148, ISSN 0022-3166, https://doi.org/10.1093/jn/nxz185.

17 Hemamy M, Pahlavani N, Amanollahi A, Islam SMS, McVicar J, Askari G, Malekahmadi M. The effect of vitamin D and magnesium supplementation on the mental health status of attention-deficit hyperactive children: a randomized controlled trial. BMC Pediatr. 2021 Apr 17;21(1):178. doi: 10.1186/s12887-021-02631-1. Erratum in: BMC Pediatr. 2021 May 12;21(1):230. PMID: 33865361; PMCID: PMC8052751.

—

Both brain size and IQ are falling in modern humans, coinciding with a big increase in mental illness.

What we eat is to blame, says Professor Michael Crawford, author of a new book ‘The Shrinking Brain’ and Sir David Attenborough is convinced he is right.

The Falling IQ

IQ scores have also been steadily falling for the past few decades. Norwegian researchers, headed by Ole Rogeberg, a senior research fellow at the Ragnar Frisch Center for Economic Research in Norway, analysed the IQ scores of Norwegian men born between 1962 and 1991 and found that scores steadily decreased among those born after 1975 (1). “Similar studies in Denmark, Britain, France, the Netherlands, Finland and Estonia have demonstrated a similar downward trend in IQ scores” says Rogeberg. “The decline is due to environmental factors,” 

This coincides with a change in Western diet away from fat, towards carbohydrates and sugar, based on the mistaken belief that it was fat, not sugar, that was causing heart disease and that we should all eat a low-fat diet. Since then, our IQ scores have been dropping by about 7 per cent per generation. 

“We are heading for an idiocracy” says Professor Crawford who is Director of the Institute of Brain Chemistry and Human Nutrition. Currently one in five of the world’s children and adolescents have a mental health condition (2).’  If this trend continues, by 2080 he predicts that more than a third of the world’s population will have a mental disability.

The World Health Organisation report says ‘there has been a 13% rise in mental health conditions. One in eight now suffers from mental illness. The incidence of depression is through the roof. Last year in the UK there were over 100 million prescriptions for antidepressants. 

Crawford is convinced it is the modern-day diet that is causing us to dumb down. “Our genome is adapted to eating the wild foods we ate during our species’ evolution. Today’s diet bears no resemblance to this.”

Key nutrients from land & sea

In his book, The Shrinking Brain, he says “Our ancestors evolved a unique 1,600cc brain evolving from our ancestral 350cc brain of the chimpanzee, despite our genome only differing by 1.5% (3). This could only have happened by providing brain-specific building nutrients from land and sea. There is incontrovertible evidence of early Homo sapiens exploiting the marine food web in coastal Africa.” In other words, we were the waterside ape who became smart, with bigger brains, by eating mussels, oysters, crabs and fish. 

Professor Crawford discovered, in 1971, that the brains of all mammals are rich in omega-3 DHA. Their brain size varied according to their dietary supply of DHA found in seafood. A dolphin, for example, has a 1,700cc brain, slightly larger than ours, while a lion has a 320cc brain about that of a chimpanzee. “The mix of wildland and aquatic foods powered by the encephalization of the brain from the 340cc of the chimp to the 1,500-1,700 of cro-magnon. DHA is not only involved in signalling but it stimulates gene expression in the brain so the rich aquatic food sources constantly, every day, would have powered the increase in brain size and function.” says Crawford.

“Today’s diet contains less than a tenth of the omega-3 fats that our ancestors ate and this is having dire consequences on mental health. Increased rates of depression, autism, ADHD and dementia are all strongly linked to lack of seafood. Increased intake from eating fish or supplementing omega-3 fish oils reduces dementia risk by 20 per cent (4). While a plant-based diet has many benefits, those who eat no fish, are especially vulnerable and must supplement omega-3 DHA, derived from algae. The only way to be sure you have enough is to get a blood test to specifically test your levels.” Says our CEO and founder Patrick Holford.  

This is why we have just launched a simple ‘do it at home’ pin-prick test that can give you a clear indication of your Omega-3 levels, which done alongside our Cognitive Function Test, can help identify what’s driving future risk and show you how to dementia-proof your diet and lifestyle. 

Canadian neuroscientist and brain expert Professor Stephen Cunnane at the University of Sherbrook in Canada agrees “A shore-based diet, i.e., fish, molluscs, crustaceans, frogs, bird’s eggs and aquatic plants, provides the richest known dietary sources of brain selective nutrients.” says Cunnane. “Change in diet away from marine foods is the likely explanation for this decrease in brain size.”  

Sir David Attenborough, a supporter of the waterside ape theory, agrees “Gathering molluscs is far easier than chasing elephants and wildebeests across the savannah.” 

Children & omega-3

Today, under 5 per cent of children achieve the basic requirement for omega-3 from seafood (5).

Professor Michael Crawford, who is a visiting professor at Imperial College’s Chelsea & Westminster campus and on our Scientific Advisory Board, was part of the team that has recently established that, if a pregnant woman lacks omega-3 DHA she produces a substitute fat, oleic acid, to fill the baby’s brain. But it doesn’t work. Levels of oleic acid in a pregnant woman’s blood predicted preterm birth which carries the highest risk of developmental brain problems and mental deficits in their offspring, as well as a risk of learning and cognitive disabilities. Low omega-3 and B vitamins in mothers increase risk for lower IQ, learning and emotional problems in children (6).

A new study shows that the higher the omega-3 index and DHA, the greater both the brain size and the cognition of older people (7). Brain size predicts cognitive abilities, which is why we have started offering these vital tests – which are both easy and affordable to do at home.

Brain size is worked out from skull capacity. Homo sapiens skulls dating back to 29,000 years ago had a brain capacity of 1,660cc. By 10,000 years ago it was around 1,500cc or 1.5 kilograms. The average brain size today is a fifth smaller, at 1,336cc. Brain size may have started to shrink from 10,000 years ago, coinciding with mankind developing more land-based agriculture and eating less marine food along rivers and coasts.

 So we are inviting you to join our ‘citizen science’ study to track the impact of diet and Omega-3 on cognitive function over time.

Our brains and mental health are suffering as a result of our dietary changes.

So if you are concerned about your levels of Omega-3 and how it might be impacting your brain, body and life – you can now test your levels with our Omega-3 hometest kit here, which is offered alongside the free Cognitive Function Test, which assesses how well your diet is supporting your brain health.

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.

Supporting Research

IQ FALLING

Bratsberg B, Rogeberg O. Flynn effect and its reversal are both environmentally caused. Proc Natl Acad Sci U S A. 2018 Jun 26;115(26):6674-6678. doi: 10.1073/pnas.1718793115. Epub 2018 Jun 11. PMID: 29891660; PMCID: PMC6042097.

DECREASE IN BRAIN SIZE

Cunnane SC, Crawford MA. Energetic and nutritional constraints on infant brain development: implications for brain expansion during human evolution. J Hum Evol. 2014 Dec;77:88-98. doi: 10.1016/j.jhevol.2014.05.001. Epub 2014 Jun 11. PMID: 24928072.

MENTAL HEALTH RISING

OMEGA-3 PREDICTS COGNITIVE PROBLEMS IN CHILDREN

Montgomery P, Burton JR, Sewell RP, Spreckelsen TF, Richardson AJ. Low blood long chain omega-3 fatty acids in UK children are associated with poor cognitive performance and behavior: a cross-sectional analysis from the DOLAB study. PLoS One. 2013 Jun 24;8(6):e66697. doi: 10.1371/journal.pone.0066697.

OMEGA-3 PREDICTS RISK FOR DEMENTIA AND COGNITIVE DECLINE

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

OMEGA-3 LEVELS PREDICT BRAIN SIZE IN OLDER PEOPLE

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

References

¹ Bratsberg B, Rogeberg O. Flynn effect and its reversal are both environmentally caused. Proc Natl Acad Sci U S A. 2018 Jun 26;115(26):6674-6678. doi: 10.1073/pnas.1718793115. Epub 2018 Jun 11. PMID: 29891660; PMCID: PMC6042097.

² https://www.who.int/publications/i/item/9789240049338

³ Cunnane SC, Crawford MA. Energetic and nutritional constraints on infant brain development: implications for brain expansion during human evolution. J Hum Evol. 2014 Dec;77:88-98. doi: 10.1016/j.jhevol.2014.05.001. Epub 2014 Jun 11. PMID: 24928072.

⁴ Wei BZ, Li L, Dong CW, Tan CC; Alzheimer’s Disease Neuroimaging Initiative; Xu W. The Relationship of Omega-3 Fatty Acids with Dementia and Cognitive Decline: Evidence from Prospective Cohort Studies of Supplementation, Dietary Intake, and Blood Markers. Am J Clin Nutr. 2023 Jun;117(6):1096-1109. doi: 10.1016/j.ajcnut.2023.04.001. Epub 2023 Apr 5. PMID: 37028557; PMCID: PMC10447496.

⁵ Kranz, S.; Jones, N.R.V.; Monsivais, P. Intake Levels of Fish in the UK Paediatric Population. Nutrients 2017, 9, 392. https://doi.org/10.3390/nu9040392

⁶ Montgomery P, Burton JR, Sewell RP, Spreckelsen TF, Richardson AJ. Low blood long chain omega-3 fatty acids in UK children are associated with poor cognitive performance and behavior: a cross-sectional analysis from the DOLAB study. PLoS One. 2013 Jun 24;8(6):e66697. doi: 10.1371/journal.pone.0066697. Erratum in: PLoS One. 2013;8(9); see also Veena SR, Krishnaveni GV, Srinivasan K, Wills AK, Muthayya S, Kurpad AV, Yajnik CS, Fall CH. Higher maternal plasma folate but not vitamin B-12 concentrations during pregnancy are associated with better cognitive function scores in 9- to 10- year-old children in South India. J Nutr. 2010 May;140(5):1014-22. doi: 10.3945/jn.109.118075. Epub 2010 Mar 24. PMID: 20335637; PMCID: PMC3672847; see also McNulty H, Rollins M, Cassidy T, Caffrey A, Marshall B, Dornan J, McLaughlin M, McNulty BA, Ward M, Strain JJ, Molloy AM, Lees-Murdock DJ, Walsh CP, Pentieva K. Effect of continued folic acid supplementation beyond the first trimester of pregnancy on cognitive performance in the child: a follow-up study from a randomized controlled trial (FASSTT Offspring Trial). BMC Med. 2019 Oct 31;17(1):196. doi: 10.1186/s12916-019-1432-4. PMID: 31672132; PMCID: PMC6823954.

⁷ Loong, S.; Barnes, S.; Gatto, N.M.; Chowdhury, S.; Lee, G.J. Omega-3 Fatty Acids, Cognition, and Brain Volume in Older Adults. Brain Sci.2023,13,1278. https://doi.org/ 10.3390/brainsci13091278 

—-

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

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

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

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

—

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

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

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

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

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

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

What about Omega-3 from plants?

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

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

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

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

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

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

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

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

References

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

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

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

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

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

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

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

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

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

What is HbA1c?

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

Where does blood sugar (glucose) come from?

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

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

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

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

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

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

Do I need to fast for a HbA1c test?

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

Why HbA1c vs. a fasting glucose test?

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

Is the HbA1c Test NGSP-Certified?

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

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

How often should you take an HbA1c test?

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

Can HbA1c be too low?

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

Who should get their HbA1c tested?

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

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

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

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

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

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

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

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

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

By Patrick Holford

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

Sleep.

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

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

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

Why Sleep Is Essential to Brain Health?

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

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

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

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

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

Why Dreaming Matters?

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

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

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

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

How Chronic Stress Disrupts Sleep and Brain Function?

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

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

Your Brain on Cortisol: The Hippocampus Feedback Loop

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

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

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

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

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

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

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

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

Simple Ways to Break the Cycle

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

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

–

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

The Impact of B Vitamins & Omega-3

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

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

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

Alzheimer’s is preventable, but not curable

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

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

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

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

—-

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

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

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

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

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

Keeping our brain’s structure and neural network healthy may seem like a mystery at times, but often the best advice is simple: ‘use it or lose it!’

The exercise and stimulation your brain gets from an active physical, social and intellectual lifestyle is vital to keeping it healthy. Just like our bodies need movement and exercise to function well, our brains need their own workout to thrive, too.

Lifestyle expert at Food for the Brain, Assistant Professor Tommy Wood, from the University of Washington has advised people at the top of their game, from Formula 1 drivers and Olympians to world champions, on how to maximise their performance, both mentally and physically.  His top tip for keeping our brains sharp?  

“In short, use it or lose it. The brain is an amazing organ, and it’s more resilient and adaptable than we’ve been led to believe. I’m sure you’ve heard that adults have a fixed amount of brain cells. Then, as we get older (or every time we take a sip of wine) we “lose” some of those brain cells as part of an unstoppable decline towards dementia or Alzheimer’s disease.”

“That’s not necessarily true” says Professor Wood. “I like to think about the brain like I think about muscles. In order to grow our muscles, we need to provide a stimulus – like lifting weights in the gym – followed by a period of rest. The opposite also happens – if we stop going to the gym or if we stop using a limb after breaking a bone – our muscles get smaller. Most have experienced this personally, and there’s every indication that your cognitive “muscle” behaves in the same way.”

A classic example of this is a study of London taxi drivers in training who have to learn ‘The Knowledge’. Many spend three years driving the 25,000 streets of London, logging up tens of thousands of miles, on foot or on a scooter. Not all pass the first time. Katherine Woollett at University College London decided to find out if acquiring the knowledge actually changed a person’s brain by measuring the density of grey matter as an indicator of brain volume. About half of her group of training taxi drivers passed first time and the other half failed. She also had a control group of people of the same age, most in their late 30’s with similar other demographics such as IQ. Sure enough, those who passed had increased their brain density of grey matter, and specifically in the central hippocampus area most associated with cognitive resilience. (1)

Keep Cognitively Active

There’s a pattern in our society – we are meant to learn every day as we go through school in childhood and teenage years, then we get a job, which, past a training phase, may not require much more learning, then around 65 we are meant to retire, with no more ‘need’ to work or learn.

Every indicator that you can think of – leaving school early, having a lower educational standard (2), or retiring early (3), has been associated with an increasing risk of cognitive decline.

When Professor May Beydoun, at the US National Institutes of Health (NIH) did a comprehensive study of the biggest risk factors for developing Alzheimer’s, she attributed 24% of risk to educational status and 32% of risk to physical activity(4). So, using our brains, reflected in educational and physical activity, is a huge part of keeping your brain healthy. (It’s worth remembering that  omega-3/seafood and homocysteine-lowering B vitamins account for 22% each while smoking racks up 31% in the risk stakes).

Think about how you use your mind. How much time do you spend stimulated, learning something? How much time do you spend engaged in relatively mindless mental activities? 

Television can be stimulating, or mind-numbing – engaging your attention but not really making you think. Social media activity, like scrolling through TikTok or Instagram, could be mind-numbing, while digital engagement with others could be stimulating. A simple yardstick is to ask ‘am I learning anything? Am I using my mind?’ 

While these activities are keeping your brain busy, what our brains really needs is to be engaged in learning or working something out, ideally without too much stress. Many films are designed to engage you by stimulating a stress response, keeping you on the edge of our seat. On the other hand, doing Wordle or a crossword, or playing a game of backgammon or chess involves concentration and thinking without cranking up your stress response. 

Two high-rating apps designed to engage our minds Brain HQ and Lumosity. Brain HQ (www.brainhq.com) adapts according to your needs – do you want better memory, better attention or faster processing? Three 20-minute sessions weekly are recommended. Lumosity (www.lumosity.com) is also adaptive and achieves much the same improvement in cognition. In just the same way you become physically fitter by increasing the duration or intensity of an exercise, it seems the same is true with your mind.

Reading books, or listening to podcasts can also be a great way to stimulate the old grey matter, mind but it does depend on what you are reading or listening to. The golden question is  ‘am I learning anything from this?’. Even better – join a bookclub for the social stimulation, sharing views, hearing others, and working out where you stand. 

Learn by failing

Land on any social media platform and we are bombarded with stories of people succeeding, urging us to try the latest self-help, diet or exercise programme, meditation or music app (who didn’t try and learn the guitar in lockdown!) but failure, according to Professor Tommy Wood, is when the magic really happens for our brains:

“Failure constitutes protective cognitive demand. The cocktail of hormones released as we try, fail, repeat, and learn, provides the ideal environment for the brain to grow and adapt. This is a real sticking point for improving brain health – as adults we hate the feeling of being bad at something.”

Professor Wood recommends picking an activity that’s truly challenging. “Cognitive demand requires failure, so pick something you’ll be bad at initially. What’s cognitively challenging is personal, but learning a new language is better than sudoku, picking up a guitar is better than listening to music, building model airplanes is probably better than reading the news, and playing chess is definitely better than scrolling through Instagram. As you get better, add challenges to keep stimulating your brain.”

“A fascinating study looked at the brains of musicians.  While both professional and amateur musicians’ brains looked younger compared to non-musicians of the same age, the benefit was greatest in amateur musicians (5) – it’s harder, so they got more benefit. The cocktail of hormones released as we try, fail, repeat, and learn, provides the ideal environment for the brain to grow and adapt.”

In fact, learning an instrument, or a language, are considered heavy lifters when it comes to brain stimulation – it’s challenging and can take a long time to become completely proficient. But every step along the way, even just a few minutes a day, learning new words, processing the grammar, learning chords and finger positions, is a significant mental challenge.  And there are so many language learning apps, like DuoLingo now, playing on the ‘reward’ and game theory to keep us cognitively engaged and coming back for more. 

Speaking two languages is not only associated with less risk of cognitive decline but, according to one study, ‘the neuroprotective effects of lifelong bilingualism act both against neurodegenerative processes and through the modulation of brain networks connectivity.’ (6) Your brain ends up more connected – literally hardwired for brain health.

Keep physically active

The brain also benefits from physical exercise, especially if it involves complex movements and learning – think dance, yoga or t’ai chi or trail running or walking on uneven surfaces. The brain is processing a lot of information, triggering patterns of muscle movement, keeping you in balance. You want a bit of both – movement and balance. Just working out on a fixed machine or walking on a flat, straight, tarmacked path, is not nearly as challenging as hill walking up an uneven path, cycling, surfing, skateboarding or anything where your body is micro-adjusting to keep you in balance.

One study of retired people assigned to walk briskly for 40 minutes three times a week showed increased hippocampal brain volume (7).  Another study showed benefits from doing one or two sessions of resistance or strength training twice a week (8).

Of all the measures relating to how fit or fat we are, muscle mass best predicts brain volume and risk of cognitive decline in later years. 

One big study from the UK Biobank data found that those with a lower fat-to-muscle ratio) in their legs had around 40% less risk for dementia later in life (9). Muscle uses energy and ‘soaks up’ glucose. This helps keep your blood sugar stable and prevent insulin resistance. Often, as we age, it can seem like an uphill battle to keep our weight down, even if we are not eating any more than we used to. This is often simply because we’ve lost muscle mass with age. So hitting those weights can be extra beneficial in later years and many gyms offer classes especially for older clients. Even body weight exercise can build resistance, though, and there are plenty of free videos on the internet – just check with your GP first.

Step it up

A good general guideline is to aim for 30 minutes of brisk walking every day. Some days you may do none and others twice this, so this is a good weekly average to shoot for. Over time you can step it up by walking faster, jogging or including some hills in your circuit. 

A good way to monitor and up our exercise level is to count steps. Smart phones and watches have apps that do this for you. Shoot for increasing daily steps between 10% and 20% a week. If you start at 2,000 and add 200 steps per day each week, that’s a great start. If you’re at 4,000 steps already then getting up to 4,400 daily in this week is also going to stimulate our muscles and brains. While 8,000 steps a day is considered optimal, what’s much more important is to make sustainable improvements as you ‘activate’ your lifestyle.

But, we don’t need to limit ourselves to ‘exercise’. Gardening, mowing the lawn, playing a sport, vigorous cleaning, or clearing out a yard – anything that gives us a faster heart rate, a bit of sweat and engages different sets of muscles, thus including ‘resistance’(10), counts as well, especially if we can do them faster or more energetically.

Aerobic plus resistance exercise anti-ages your brain

As previously mentioned, of all the measures relating to how fit or fat we are, muscle mass best predicts brain volume and risk of cognitive decline in later years. 

Including exercise that helps build and maintain muscle tone correlates most strongly with brain health. A good weekly guideline is to include two resistance training sessions a week. Perhaps you are a member of a gym, go to a pilates or yoga class or have some equipment at home for your own workout.

If you’re not sure where to start, “Burn Fat Fast” (Piatkus, 2013), written by Patrick Holford and exercise guru and former Gladiator (Zodiac) Kate Staples, is a great resource.  Staples devised a series of strength building exercises that anyone can do at home in eight minutes, three times a week, including  beginner version, and intermediate and advanced versions (light to medium weight dumbbells (2kg – 6kg) are needed for these).

The exercises are all explained in the book and  Kate Staples demonstrates each one HERE so you can follow along until you feel comfortable. A five minute warm-up (marching on the spot is great, or stepping side to side) will get your heart rate up and help avoid injury. 

The beginner sequence includes wall sits and reverse lunges, while the advance sequence progresses to jumping squats and mountain climbers. It’s important to build up gradually, keep hydrated, and learn to do the moves safely, so watching the videos is a great way to get started. 

The secret is to find an activity that engages both mind and body, builds muscle, and is not too repetitive. As an example, our very own Patrick Holford says “I’ve taken up paragliding, and qualified at the age of 65. I had to pass an exam on meteorology, aerodynamics and air law, and failed the first time, but now I have to think about these things before and during flight. Then there’s the exercise of carrying an 11 kg pack up a mountain, and the balance and strength and adjustments my brain is having to make to keep the canopy stable even before take off.” This may not be your thing but it shows how one activity can tick so many brain boxes. It is good to learn new sports for this very reason.

Be Social

A lack of meaningful social interaction, and loneliness, is also a major driver of both low mood and cognitive decline later in life (11). 

How often do you go to social gatherings, meet new people and have engaging conversations? This could be meeting friends, going to the movies, a museum, a gallery, a show, church or temple, or a restaurant?

There are times in your lives where you might find yourself more isolated. For example, when relationships break up and you lose connection with ‘their’ friends, or if a partner dies and most of your social interaction was with them. These are extremely challenging times, but facing our fears and getting out there to meet friends can help us on the road to recovery. 

Unset your mind

It’s all too easy to get locked into routines that remove any form of challenging social interaction yet this is not only how we learn, it also nourishes the social aspect of who we are. A good strategy is to make sure you have a significant social event or interaction every week, starting with this week.

As we age, and friends move away, or pass on, it’s important to find ways to expose ourselves to new ideas and new ways of thinking and feeling differently and swapping ideas. Travelling and exploring other cultures can be an incredibly enriching way to broaden our mindset and there are lots of companies that cater for the solo traveller these days.

But there’s no need to go far from home to get the benefits of brain gain. There are many opportunities to ‘use it or lose it’, for example, volunteering at a local garden or school or supporting the local arts club. The brain boost from being out of your comfort zone will reap dividends, whether it’s joining a group of new people, engaging in a new activity you’ve never tried, like drawing, writing or yoga – or even just catching up with old friends you haven’t seen for ages, or striking up a conversation with someone you meet on the daily dog walk.

Local bookshops, art centres, churches or schools can be great sources of information, so check them out. 

Be inquisitive

As Tommy Wood says “The key is to push right at the boundaries of what you’re capable of – with occasional failure showing that you’re at the right level of difficulty. Keep at it, and you’ll be more likely to be healthy and sharp for decades to come.”

And if you want more personalised information on how you can improve and support your brain through nutrition and lifestyle changes then make sure you complete our Cognitive Function Test. A FREE, online and validated test to assess your current cognitive function and dementia risk and then get a clear plan of action on how you can improve your brain health and score over the next 6 months.

—-

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 Woollett K, Maguire EA. Acquiring “the Knowledge” of London’s layout drives structural brain changes. Current biology: CB. 2011;21(24):2109-14. Epub 2011/12/08. doi: 0.1016/j.cub.2011.11.018. PubMed PMID: 22169537.

² 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.

³ Hale JM, Bijlsma MJ, Lorenti A. Does postponing retirement affect cognitive function? A counterfactual experiment to disentangle life course risk factors. SSM – Population Health. 2021;15:100855. doi: https://doi.org/10.1016/j.ssmph.2021.100855; see also Dufouil C, Pereira E, Chêne G, Glymour MM, Alpérovitch A, Saubusse E, Risse- Fleury M, Heuls B, Salord JC, Brieu MA, Forette F. Older age at retirement is associated with decreased risk of dementia. Eur J Epidemiol. 2014;29(5):353-61. Epub 2014/05/06. doi: 10.1007/s10654-014-9906-3. PubMed PMID: 24791704.

⁴ 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 Jun 24;14:643. doi: 10.1186/1471-2458-14-643. PMID: 24962204; PMCID: PMC4099157.

⁵ Erickson KI, Voss MW, Prakash RS, Basak C, Szabo A, Chaddock L, Kim JS, Heo S, Alves H, White SM, Wojcicki TR, Mailey E, Vieira VJ, Martin SA, Pence BD, Woods JA, McAuley E, Kramer AF. Exercise training increases size of hippocampus and improves memory. Proceedings of the National Academy of Sciences. 2011;108(7):3017. doi: 10.1073/pnas.1015950108.

⁶ Sala A, Malpetti M, Farsad M, Lubian F, Magnani G, Frasca Polara G, Epiney JB, Abutalebi J, Assal F, Garibotto V, Perani D. Lifelong bilingualism and mechanisms of neuroprotection in Alzheimer dementia. Hum Brain Mapp. 2022;43(2):581-92. Epub 2021/11/04. doi: 10.1002/hbm.25605. PubMed PMID: 34729858; PMCID: PMC8720191.

⁷ Ludyga S, Gerber M, Pühse U, Looser VN, Kamijo K. Systematic review and meta- analysis investigating moderators of long-term effects of exercise on cognition in healthy individuals. Nature Human Behaviour. 2020;4(6):603-12. doi: 10.1038/s41562-020-0851-8.

⁸ Herold F, Törpel A, Schega L, Müller NG. Functional and/or structural brain changes in response to resistance exercises and resistance training lead to cognitive improvements – a systematic review. Eur Rev Aging Phys Act. 2019;16:10. Epub 2019/07/25. doi: 10.1186/s11556-019-0217-2. PubMed PMID: 31333805; PMCID: PMC6617693.

⁹ Wang W, Luo Y, Zhuang Z, Song Z, Huang N, Li Y, Dong X, Xiao W, Zhao Y, Huang T. Total and regional fat-to-muscle mass ratio and risks of incident all-cause dementia, Alzheimer’s disease, and vascular dementia. J Cachexia Sarcopenia Muscle. 2022 Oct;13(5):2447-2455. doi: 10.1002/jcsm.13054. Epub 2022 Jul 20. PMID: 35856185; PMCID: PMC9530585.

¹⁰0 Gallardo-Gómez D, Del Pozo-Cruz J, Noetel M, Álvarez-Barbosa F, Alfonso-Rosa RM, Del Pozo Cruz B. Optimal dose and type of exercise to improve cognitive function in older adults: A systematic review and bayesian model-based network meta-analysis of RCTs. Ageing Res Rev. 2022 Apr;76:101591. doi: 10.1016/j.arr.2022.101591. Epub 2022 Feb 17. PMID: 35182742.

¹¹1 Penninkilampi R, Casey AN, Singh MF, Brodaty H. The Association between Social Engagement, Loneliness, and Risk of Dementia: A Systematic Review and Meta-Analysis. J Alzheimers Dis. 2018;66(4):1619-33. Epub 2018/11/20. doi: 10.3233/jad- PubMed PMID: 30452410.

—-

Last week a discovery, published in the journal Science, showed that a high level of an abnormal ‘phosphorylated-tau’ protein triggers brain cells to self-destruct. It also gives a vital clue as to how to stop your brain cells dying with specific vitamins.

When cells become largely dysfunctional, they self-destruct. This process in neurons (brain cells) is called ‘necroptosis’. The recent discovery, made by researchers at the UK’s Dementia Research Institute at University College London (1), showed that an abnormal accumulation of a protein called tau that then becomes phosphorylated, making it tangled and dysfunctional, triggers a specific molecule called MEG3 that triggers brain cell death.

“For the first time we get a clue to how and why neurons die in Alzheimer’s disease. There’s been a lot of speculation for 30-40 years, but nobody has been able to pinpoint the mechanisms. It really provides strong evidence it’s this specific suicide pathway.” researcher Prof Bart De Strooper, from the UK’s Dementia Research Institute. told the BBC.

Even before this, too much phosphorylated-tau (abbreviated to p-tau) interferes with the cell’s energy factories (called mitochondria), potentially leading to brain fatigue. The more p-tau accumulates, the greater a person’s risk for cognitive problems and Alzheimer’s dementia. Also, those with memory decline have been shown to have relatively more p-tau to tau protein.

The critical prevention question is, then, what stops too much of the tau protein from turning into the potentially harmful p-tau and what helps restore p-tau to normal tau protein. 

—-

—-

The answer is remarkably simple – a lack of B vitamins and raised blood levels of homocysteine which is an established risk factor for memory decline, measurable in the blood. When levels of B vitamins (B6, B12 and folate) are low, blood levels of homocysteine go up. This activates one enzyme (Cdk5 kinase) that adds the bad ‘p’ to tau and blocks another enzyme (protein phosphatase A2) which removes the dangerous ‘p’ restoring normal tau protein (2)(3).  High homocysteine also damages the tiny blood vessels in the brain, leading to ‘mini strokes’ or transient ischemic attacks (TIAs), which further raise levels of p-tau (4). Homocysteine both raises levels of the dangerous p-tau and can also bind to tau (5), further generating the neurofibrillary tangles that then trigger brain cell death.

So, the simplest way to stop the formation of p-tau, and neurofibrillary tangles, and keep your brain healthy, is to keep your plasma homocysteine level below 10 mcmol/L. Half of those above 65 have a level of homocysteine higher than this. The easiest way to lower your homocysteine below 10 mcmol/L is to supplement B6, B12 and folate. 

But it’s also good to eat greens and beans that are high in folate. While B12 is only in animal foods – meat, seafood, eggs and milk. While an optimal supplemental intake for a middle-aged person might be 20mg of B6, 10 mcg of B12, and 400 mcg of folate, many older people start to dramatically lose their ability to absorb B12, the absorption of which requires stomach secretions. Antacid ‘PPI’ medication such as omeprazole accelerates this decline, promoting B12 deficiency. And, over four years of use, increases dementia risk by a third (6). Then, as studies show, you might need a lot more B12, such as 500 mcg, to get a little more into your bloodstream, and possibly more supplemental folate, in the region of 500 to 800 mcg.

This is the cheapest, safest and most logical solution to lower p-tau and prevent brain cells from committing suicide. The problem is that these nutrients, invented by nature, cannot be patented. Therefore it is not in the interest of the pharmaceutical industry to research them.

Consequently, drugs are being developed and tested that block the kinase enzyme and activate the phosphatase enzyme (7), which is exactly what the homocysteine-lowering B vitamins do. But, so far, there are no human clinical trials reporting significant benefit. 

On the other hand, trials giving these kinds of doses of B6, B12 and folic acid have shown up to a two-thirds slower rate of brain shrinkage (8) and virtually no further memory loss in those with pre-dementia (9).

—-

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 https://www.science.org/doi/10.1126/science.abp9556 Balasu S et al. Science
14 Sep 2023 Vol 381, Issue 6663 pp. 1176-1182 DOI: 10.1126/science.abp9556

² Smith AD, Refsum H. Homocysteine, B Vitamins, and Cognitive Impairment. Annu Rev Nutr. 2016 Jul 17;36:211-39. doi: 10.1146/annurev-nutr-071715-050947. PMID: 27431367.

³ LiJ-G,ChuJ,BarreroC,MeraliS,Pratico`D.2014.Homocysteine exacerbatesβ-amyloid, tau pathology, and cognitive deficit in a mouse model of Alzheimer’s disease with plaques and tangles. Ann. Neurol. 75:851–63 

⁴ Shirafuji N et al Homocysteine Increases Tau Phosphorylation, Truncation and Oligomerization. Int J Mol Sci. 2018 Mar 17;19(3):891. doi: 10.3390/ijms19030891. PMID: 29562600; PMCID: PMC5877752.

⁵ Bossenmeyer-Pourié C et al. N-homocysteinylation of tau and MAP1 is increased in autopsy specimens of Alzheimer’s disease and vascular dementia. J Pathol. 2019 Jul;248(3):291-303. doi: 10.1002/path.5254. Epub 2019 Mar 19. PMID: 307349

⁶ Northuis C, Bell E, Lutsey P, George KM, Gottesman RF, Mosley TH, Whitsel EA, Lakshminarayan K. Cumulative Use of Proton Pump Inhibitors and Risk of Dementia: The Atherosclerosis Risk in Communities Study. Neurology. 2023 Aug 9:10.1212/WNL.0000000000207747. doi: 10.1212/WNL.0000000000207747. Epub ahead of print. PMID: 37558503.

⁷ Xia, Y., Prokop, S. & Giasson, B.I. “Don’t Phos Over Tau”: recent developments in clinical biomarkers and therapies targeting tau phosphorylation in Alzheimer’s disease and other tauopathies. Mol Neurodegeneration 16, 37 (2021). https://doi.org/10.1186/s13024-021-00460-5

⁸ Smith AD, Refsum H. Homocysteine, B Vitamins, and Cognitive Impairment. Annu Rev Nutr. 2016 Jul 17;36:211-39. doi: 10.1146/annurev-nutr-071715-050947. PMID: 27431367; see also Jernerén F., et al. Am J Clin Nutr. 2015 Jul;102(1):215-21.

⁹ Oulhaj A., et al. J Alzheimers Dis. 2016;50(2):547-57.

We now know that today’s diet, lacking in brain-friendly fats and other nutrients, yet high in sugar and ultra-processed food, is likely to be shrinking our brains, dumbing us down and triggering a big increase in mental health problems. But it isn’t just nutrition that is creating the perfect storm for our mental demise.

The digital culture we exist in is pushing us towards a whole new paradigm of background stress. This is partly because the marketeers have learnt how to get us addicted to their products – applying a level of stress and variable reward to trick the brain’s reward system – leaving you with a ‘gotta have it’ feeling.

This mechanism of ‘variable reward’

This was first discovered in the 1930’s by the psychologist B.F. Skinner. He found that mice responded most frequently to reward-associated stimuli when the reward was given after a varying number of responses – so the animal didn’t know when it would get the prize. It seems we are no different; if we perceive a reward to be delivered at random, and if checking for that reward comes at little or no cost, we end up checking habitually.

So is this where smartphone addiction comes from?

This manipulation of the stress/reward response is one of the oldest mechanisms of the brain. It is both core for our survival, but also makes us more impulsive, manipulatable and, effectively, stupid.

Most of all, it makes us good consumers. Reward, based on dopamine, equals pleasure. We are living in space-age times with stone age minds and multinational companies have learnt how to get us hooked – literally neurochemically addicted to consuming their products.

We are being sold pleasure in the guise of happiness: the happy hour, the happy meal, happiness in a can. But joy and happiness are regulated by the neurotransmitter serotonin, not the latest special offer. And in fact, this pleasure-seeking may be counterproductive.

“The more pleasure you seek, the more unhappy you get” says Professor Robert Lustig, author of ‘Hacking the American Mind’. This is because too much dopamine (the ‘reward’ neurotransmitter) suppresses serotonin (the ‘happy’ neurotransmitter) and we end up feeling unhappy and depressed. This brain hijack may be why depression, suicide and psychiatric drug prescriptions have rocketed to the point where, in the UK and US (and probably elsewhere), there are almost twice as many prescriptions for psychiatric drugs per year than there are people.  

“We are the most in debt, the most obese, the most medicated and the most drugged up adult population in human history” says Lustig. We have literally learnt how to fool our brains and in doing so have fooled ourselves, by creating addictive behaviours and addictive foods. 

An example of this is what happens in your brain if you eat sugar and/or fat. 

Sugar…just like cocaine and heroin?

Sugar, just like cocaine and heroin, stimulates dopamine and endorphins. It triggers the reward system but with overuse, leads to reward deficiency (1). Dr Candace Pert, Research Professor in the Department of Physiology and Biophysics at Georgetown University Medical Center in Washington DC, and author of the seminal book ‘The Molecules of Emotion’, was the first to point this out in no uncertain terms: “I consider sugar to be a drug, a highly purified plant product that can become addictive. Relying on an artificial form of glucose – sugar – to give us a quick pick-me-up is analogous to, if not as dangerous as, shooting heroin. (2)” At the time, this was heresy but, today, most people are well aware of this. But it’s not just sugar that’s feeding our addiction.

Neuropharmacologist Professor Paul Kenny, a Dubliner now working in his Manhattan lab at Mount Sinai Hospital, discovered this when he started feeding rats different diets. When he fed one group of rats either lots of sugary foods and another group lots of fatty foods, neither group would gain much weight. They’d control their intake and it would take over a month to see a small weight gain. 

However, when he fed them a combination of 50% sugar and 50% fat, such as in a cheesecake, he noted the mice would “dive head first into a slice and gorge so vigorously that it covered its fur in blobs. It’s not pleasant.” After a binge on cheesecake they continued to graze, constantly eating food, he says, as if the off-switch telling them they were full had malfunctioned. “It completely changed them.” They stopped exercising and gained significant weight after only seven days. They also became addicted (3). When he took away the junk food and replaced it with healthy food they went on a hunger strike, refusing to eat it. 

He even tried to stop them by giving them an electric shock to their feet. “We then warned the rats as they were eating—by flashing a light—that they would receive a nasty foot shock. Rats eating the bland chow would quickly stop and scramble away, but time and again the obese rats continued to devour the rich food, ignoring the warning they had been trained to fear. Their hedonic desire overruled their basic sense of self-preservation.” 

Overeating, he found, juices up the reward systems in the brain — so much so, that in some people, it can overpower the brain’s ability to tell them to stop eating when they have had enough. As with alcoholics and drug addicts, the more they have, the more they want, creating a vicious cycle of dopamine resistance, eventually leading to the brain’s receptors for dopamine to shut down. 

It seems dopamine, the brain’s main neurotransmitter of reward and desire, is the key. 

Obese people and drug addicts have been shown to have less dopamine D2 receptors (D2R)s (4). People who are born with reduced levels of D2R are therefore at greater genetic risk of developing obesity and drug addiction – so you can be genetically predisposed to addiction. Researchers at Brookhaven National Laboratory and the Oregon Research Institute have shown that the reward system in obese people responds weakly to food, even to junk food(5). How does an individual overcome this absence of pleasure? By eating more pleasure foods to gain a temporary boost, thereby perpetuating the cycle. The researchers found that obese people may overeat just to experience the same degree of pleasure that lean individuals enjoy from less food.

Nicole Avena of the University of Florida, and others, have found that particular fats or sugars, sugars together with fats, and possibly salt, are the most addictive (6). A study by Professor David Ludwig of Boston Children’s Hospital suggests that highly processed, quickly digested fast carbs could trigger cravings (7). But research overall indicates that no one ingredient stokes food addiction better than the combo of fats and sugars, high in calories. Nature just doesn’t make these kinds of foods. Only the food industry does.

Similarly, cola drinks combine the stimulant caffeine, with sugar and salt, to make you drink more. And we crave sugary food and drink even more when fructose is used instead of glucose. Why? Because our cells run on glucose and quickly feedback when we’ve had enough. Fructose (or high fructose corn syrup, derived from corn) takes longer to send us that signal, leading us to consume more. No wonder then that glucose has been replaced by fructose and is a key ingredient in today’s ultra-processed foods.

Are you addicted to your smartphone?

Of all the changes that have taken place in the 21st century, the ‘digital revolution’ has changed our world beyond recognition, seemingly speeding up time. Yes, our diet and environment have changed a lot, but what’s really changed, especially in cities that now house half of humanity and an estimated two-thirds of the world’s population by 2035, is the pace of life. People all over the world are sleeping less, having less downtime, feeling more anxious and stressed and burning out at a far higher rate. This is reflected in the increasing rate of work absenteeism, depression and suicide, especially in cities.

The speeding up of communication – emails, smartphones and digital media – means that we are supposed to react to demands, and are bombarded with them, at an ever-increasing speed. 

We have literally become addicted to our phones(8). The average person picks up their phone 352 times a day – more than every three minutes, and swipes it thousands of times a day. A UK survey reports 62% cannot make it through dinner without checking their phone. Almost half of us report anxiety if we don’t have our phone, or a signal, suffering ‘nomophobia’. We are going to sleep with our phones and checking them first thing on waking up. One survey found that one in ten university students in the US admitted to having checked their smartphones during sex! 

Why? Basically, to sell stuff. “I feel tremendous guilt,” admitted Chamath Palihapitiya, former Vice President of User Growth at Facebook, to an audience of Stanford students. “The short-term, dopamine-driven feedback loops that we have created are destroying how society works.” Whether it’s Facebook, Instagram, Twitter, Snapchat, LinkedIn or any other platform, the core design is to get your attention, then show you ads tailored to your attributes and behaviours which the technology learns about you. Facebook, for example, has learnt how to do this with prompts, swipe downs, red icons that you press and don’t know what you receive. Is it a ‘like’? Do I have more ‘friends’? Or has another person ‘linked’ to me on LinkedIn etc. 

Facebook even knows when you’re feeling ‘insecure’, ‘worthless’ and ‘need a confidence boost’ or are ‘bored’, and can make sure you receive a notification of a ‘like’ at just the right time to keep you hooked. If you find yourself checking your phone at the slightest feeling of boredom, purely out of habit, know that programmers work very hard behind the screens to keep you doing exactly that. A study of 143 undergraduates at the University of Pennsylvania, limiting use to 30 minutes a day versus a control group found significant reductions in loneliness and depression (9). The researchers concluded, “Our findings strongly suggest that limiting social media use to approximately 30 minutes per day may lead to significant improvement in well-being.”

Whether it’s a text, a notification or a ‘like’, just like sugar, this digital consumption triggers a reward signal in our brains. The marketing algorithms schedule the precise times to deliver our digital diet and serve up the extra addictive quality of a variable reward.

Your brain’s reward system

It’s to do with a tiny organ in the central hippocampal area of the brain called the nucleus accumbens. This is the headquarters of our dopamine-based ‘reward’ system.

The more dopamine you release the more receptors shut down, so you seek more pleasurable behaviours and foods. Insidiously and unknowingly your brain has been hijacked and the symptoms you feel are the direct consequences of an intended addiction. Gambling, gaming, overeating, sex, drugs, food, social media and other digital addictions are all part of it. We end up needing this constant stimulation and, to fuel that, need instant energy foods and drinks – sugar and coffee. 

Alcohol – the opiate of the masses

Whether you’ve become addicted to sugar, food, caffeinated drinks, social media, gambling, gaming or non-stop stimulation, or simply get caught in the stress trap, perhaps due to work and life demands and debts, this often results in an inability to switch off with a background feeling on anxiety and stress without alcohol, and difficulty sleeping. 

You may find, in time, that your need for alcohol increases – from a glass a night to two, three, half a bottle or even more. Alcohol, a well-established neurotoxin (10), surely is the opiate of the masses. Consumption keeps going up. It’s the currency of a good time, normalised as a response to stress, glorified in movies and at the core of our modern culture, with a 1.5 trillion dollar industry, expected to rise to 2 trillion by 2027 (11), promoting its use. While smoking has become frowned upon, anything other than heavy drinking is considered socially acceptable. Yet according to WHO alcohol is in the top five causes of death and disability, and has become the most common cause of death in men under 50 (and soon will be for women), accounting for one-fifth of all deaths under 50 and almost 30,000 deaths a year overall, roughly a third that of smoking and ten times more than opioids (inc heroin) and is ranked more harmful than any other drug, including opioids (12). This addictive drug is so socially acceptable that governments avoid attempts to curtail its use for fear of voter reprisals.

A commonly unknown fact is that death or disability from alcohol doesn’t only occur in heavy drinkers. The risk goes up exponentially with the quantity you drink. The good news is that small reductions have big positive effects on your health. To make this real, a 12.5% vol. bottle of wine contains 75g alcohol: drinkers who have 2/3rds of a bottle of wine (two large glasses) or the equivalent 50g of alcohol, have a lifetime risk of death of 16%. But one medium glass (175ml) of wine (17.5g of alcohol) brings that risk below 1%. In terms of mitigating serious health risks, including death, the advice of the UK government’s former advisor, Professor David Nutt, is for women to consume no more than 15g of alcohol per day  and for men no more than 20g alcohol per day, and to have at least two alcohol-free days per week. Sadly, Professor Nutt was sacked for saying that alcohol was a ‘time bomb’ and more dangerous than Ecstasy, but the statistics point to this being true.

The trouble is, when you get stuck in the cycle of seeking rewards, needing stimulants and relaxants, you become more tired, more anxious and may even have started to feel more depressed. 

When things get bad and you visit your doctor they may prescribe antidepressants, tranquillisers (short-term use only) or sleeping pills. Others learn to use illicit uppers and downers.

Are you addicted to stimulants?

The other major acceptable and glorified drug is caffeine, mainly in the form of coffee, although many people don’t realise that strong tea has as much caffeine as a regular cup of coffee. Like sugar, alcohol and our digital diet, it stimulates dopamine release and the feeling of pleasure or reward. Imagine a day with no coffee, tea, sugar, chocolate or that well-earned glass of something! If you shout, ‘No way!’ there is a very real possibility that you have some level of addiction to these stimulants. This can range from a mild addiction that you can live with quite happily to a major problem that is controlling your life. 

However, whatever the level of addiction, the net consequence is always less energy, not more. One of my clients, Bobbie, serves as a case in point. She was already eating a healthy diet and took a sensible daily programme of vitamin and mineral supplements. She had only two problems: a lack of energy in the morning and occasional headaches. She also had one vice: three cups of coffee a day. After some persuasion, she agreed to stop the coffee for a month. To her surprise, her energy levels rose and the headaches stopped. 

Like Bobbie, it’s useful to audit your stimulant consumption from time to time. Using a Stimulant Inventory below can be helpful, but in making an accurate assessment of your current relationship to stimulants, you need to be honest with yourself about how you use them. There’s a space for alcohol which, while not a stimulant, still triggers those dopamine receptors.

It’s useful to write down the time of day you consume the above and to spend time thinking about what your relationship to these substances is. 

Do you, for example, ever buy sweets and hide the wrappers so other people don’t know you’ve eaten them? 
Do you swoon at the dessert menu in restaurants? 
How much do you think about and look forward to that morning cup of coffee or a mid-morning second cup? 
How important is that drink after work?
Does everyone really know how much you smoke? 
Have you cranked up your caffeine intake to ‘double espresso’ equivalent drinks using more coffee at home than you used to? 
Do you need more to get a ‘kick’ if you even get one, or does coffee now just relieve the fuzzy tiredness you feel without it?

This kind of relationship to stimulants, often cloaked in an attitude that they are just some of the innocent pleasures of life, is indicative of an underlying chemical imbalance that depletes your energy and peace of mind and, at its worst, feeds into mental health issues.

Coffee and Caffeine Withdrawal and Sleep

If you wake up feeling good and can function without a coffee, and have no major mental health issues, sleeping well for example, but enjoy one coffee a day which will give you a dopamine kick, that’s not a problem. The best measure of your relationship with coffee or caffeine, and whether your brain has ‘downregulated’ dopamine and adrenaline receptors is what happens when you quit. If the answer is nothing then there’s no issue. If, on the other hand, you get a variety of withdrawal symptoms (13), including headaches, tiredness and irritability that means your neurotransmitter receptors have downregulated and it will take a few days for them to upregulate and bring you back to normal. For many just one cup of coffee a day can result in withdrawal effects if stopped (14). It’s also worth knowing that coffee, or caffeine, consumed 6 hours before sleep, which is about as long as caffeine stays in the system, is associated with disturbed sleep (15) – either difficulty falling asleep or waking in the night so, at least, it is wise to consume no caffeine after noon, especially if you have issues with sleeping.

Tea or coffee?

The caffeine in both coffee and tea increases the release of adrenalin, cortisol and dopamine in your body and brain, while inhibiting the absorption of adenosine, a brain-calming chemical. The release of adrenaline into your system gives you a temporary boost, but frequently makes you fatigued and depressed later. If you take more caffeine to counteract these effects, you end up spending the day in an agitated state, and might find yourself jumpy and edgy by night.

Tea contains caffeine, but also theanine, which has a more calming amino acid shown to enhance cognitive abilities (16). It also protects GABA receptors, which is the brain’s adrenalin off switch. Overall then, tea is better for you. Green tea may also have some benefits over black tea (the same plant, but processed differently such that green tea contains more antioxidants and polyphenols, which are good guys as far as our bodies are concerned).

Benefits or excuses?

Many things could be written on the apparent benefits of tea, coffee, even some forms of alcohol. We read about the beneficial effects of resveratrol in red wine, polyphenols in coffee and cacao and other antioxidants in tea. However, the nature of ANY dependence creates a psychological set of ‘excuses’ that we use to justify our addictive behaviour. 

This could be anything from ‘that’s a lovely sauce’ (sugar), ‘a little bit of what you fancy won’t harm you’ ‘I’m so stressed I have to have a drink’, ‘I’ve got to focus so I need a coffee’ and so on. Of course, all these substances work, otherwise we wouldn’t be attracted to them and, in that sense, mindful consumption in certain circumstances makes sense. For example, if someone experiences a shock, a sugary drink can help. And when a deadline looms and you need to burn the candle at both ends, caffeine can certainly help.

The issue here is to understand how the combination of sugar, caffeinated stimulants, alcohol, tech and social media addiction, shopping, gambling, gaming and so on can hijack your brain’s natural reward system and result in the opposite – you feeling more tired, anxious, unfulfilled and depressed. If that’s happened to you, rest assured there are some simple suggestions that will help you reclaim your brain’s full potential for feeling good, energised, clear, focussed and purposeful.

Simple ways to win back your brain

Limit your time spent on social media – 30 minutes a day max is a good target but you may need to build down to this. Turn your phone off (or to ‘airplane’ mode) at least an hour before bed and keep it that way for at least an hour in the morning. If you have to have it on, don’t check social media for a couple of hours. 

Limit your intake of caffeine to under 100 grams a day – that’s one strong cup of coffee or two weaker cups of tea. If you have a second cup, use the same tea bag, or have a filter coffee ‘run through’. Avoid all caffeine after noon.

Avoid buying food that contains added sugar, dates or raisins – if in doubt, read the label and remember sugar is often disguised as high fructose corn syrup. When looking at food labels remember 5g is a teaspoon of sugar and foods with more than 22.5g per 100g of sugar are considered high sugar and those with 5g or less per 100g are considered low sugar. Ideally, only have sugar in whole fresh fruits. Fruit juice is also high in sugar so best avoided or limited. 

Limit your daily intake of alcohol to 20 grams, or a maximum of two small glasses (125ml is one small glass) of wine. Have at least two days a week alcohol-free.

——–

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 P. Holford, How to Quit Without Feeling S**t, Piatkus, 2008.

² P. Holford, How to Quit Without Feeling S**t, Piatkus, 2008.

³ P.M. Johnson and P.J. Kenny ‘Dopamine D2 receptors in addiction-like reward dysfunction and compulsive eating in obese rats’, Nature Neuroscience (2010), vol. 13(5), pp. 635-641. 

⁴ .P. Kenny ‘Reward Mechanisms in Obesity: New Insights and Future Directions’ Neuron. 2011 Feb 24; vol 69(4): pp.664–679. 

 ⁵  See ref 4 above

⁶ N.M. Avena and M.S. Gold, ‘Food Addiction – Sugars, Fats and Hedonic Eating’, Addiction (2011), vol. 106(7), pp. 1214-1215.

⁷ B. Lennerz et al., ‘Effects of dietary glycemic index on brain regions related to reward and craving in men’ The American Journal of Clinical Nutrition, Volume 98, Issue 3, 1 September 2013, Pages 641–647

⁸ https://explodingtopics.com/blog/smartphone-addiction-stats

⁹ https://guilfordjournals.com/doi/10.1521/jscp.2018.37.10.751

¹⁰ Nutt, D.;Hayes,A.; Fonville, L.; Zafar, R.; Palmer, E.O.; Paterson, L.; Lingford-Hughes, A. Alcohol and the Brain. Nutrients 2021, 13,3938. https://doi.org/10.3390/ nu13113938

¹¹ https://www.statista.com/forecasts/696641/market-value-alcoholic-beverages-worldwide

¹²  David J Nutt and Jürgen Rehm J Psychopharmacol 2014 28: 3 DOI: 10.1177/0269881113512038 

The online version of this article can be found at: http://jop.sagepub.com/content/28/1/3

¹³ https://www.ncbi.nlm.nih.gov/books/NBK430790/

¹⁴ Juliano LM, Griffiths RR. A critical review of caffeine withdrawal: empirical validation of symptoms and signs, incidence, severity, and associated features. Psychopharmacology (Berl). 2004 Oct;176(1):1-29. doi: 10.1007/s00213-004-2000-x. Epub 2004 Sep 21. PMID: 15448977.

¹⁵ Drake C, Roehrs T, Shambroom J, Roth T. Caffeine effects on sleep taken 0, 3, or 6 hours before going to bed. J Clin Sleep Med. 2013 Nov 15;9(11):1195-200. doi: 10.5664/jcsm.3170. PMID: 24235903; PMCID: PMC3805807.

¹⁶ Anas Sohail A, Ortiz F, Varghese T, Fabara SP, Batth AS, Sandesara DP, Sabir A, Khurana M, Datta S, Patel UK. The Cognitive-Enhancing Outcomes of Caffeine and L-theanine: A Systematic Review. Cureus. 2021 Dec 30;13(12):e20828. doi: 10.7759/cureus.20828. PMID: 35111479; PMCID: PMC8794723.

Last month’s newspaper headlines pitched the new anti-amyloid Alzheimer’s drug as a ‘turning point’. The pitch has a lot in common with the statin story.

Last month’s newspaper headlines pitched the new anti-amyloid Alzheimer’s drug as a ‘turning point’. (Read our response here) The pitch has a lot in common with the statin story.

Is high cholesterol the cause of heart disease? No. 

Do statins lower it? Yes.

Are amyloid deposits the cause of cognitive decline? No. 

Do anti-amyloid drugs lower it? Yes.

No doubt there will be a blood test soon for amyloid, just like a blood test for cholesterol, the effect of which pushed millions into taking statins.

Both statins, given to people with very high cholesterol, and anti-amyloid drugs, given to people with very high amyloid levels, do have marginal benefit but not enough to establish causation. In the case of the new Alzheimer’s drug, the benefit is considerably less than half that shown by the combination of B vitamins and omega-3. 

But, even more than statins, they come with a high risk of quite serious adverse effects – over a third in the recent trial got brain bleeding or swelling and three died. Also, the whole brain shrinkage accelerated by twenty percent compared to placebo, a fact not reported in any newspaper. Any vitamin showing such adverse effects would be immediately banned.

But the important question is: what’s causing these diseases, be it cognitive decline or heart disease? To the extent that cholesterol or amyloid is relevant, what makes them go up? Cholesterol gets damaged by sugar and oxidants and is protected by antioxidants such as vitamin C and a low-carb diet. Brain cells get damaged by homocysteine and are protected by B vitamins and omega-3.

Mind the gap 

Also, in those with cognitive decline, there’s an energy deficit in brain cells. Ironically, they can’t get the glucose they need due to ‘insulin resistance’ which is driven by eating too much sugar and ultra-processed carbs. So, the effect of too much sugar is to starve the brain of fuel which then leads to mental tiredness and cognitive decline. 

There is a way around this – and that is to give the brain an alternative fuel – ketones. 

Ketones can either be supplied as ketone salts or esters, both of which taste disgusting or made from a type of fat – principally C8 oil, which is a medium-chain triglyceride. About 7 percent of coconut oil is C8. Studies giving people with cognitive decline a C8-rich MCT oil have shown clear improvements in cognition by increasing the brain’s energy supply and production. Ripping out amyloid deposits isn’t going to fill this energy gap. Eating less carbs, reversing diabetes, which is a big risk factor for dementia, and having C8 oil will. Our podcast with Professor Stephen Cunnane, who heads the Brain Research Team at Sherbrooke University in Sherbrooke, Quebec, Canada and holds the clinical research chair in ketotherapeutics and on the Food for the Brain Scientific Advisory Board, discusses this area with Patrick Holford – listen to the podcast here.

Also, in those with cognitive decline, there’s an energy deficit in brain cells. Ironically, they can’t get the glucose they need due to ‘insulin resistance’ which is driven by eating too much sugar and ultra-processed carbs. So, the effect of too much sugar is to starve the brain of fuel which then leads to mental tiredness and cognitive decline. 

An increase in amyloid in the brain is really a consequence of the disease, not the cause. It’s part of an inflammatory reaction, much like the nodules in joints that occur from inflammation resulting in arthritis. Should you cut out the nodules or reduce inflammation? Do you eliminate the root cause or target the consequences? Inflammation is both a function of a bad diet high in ultra-processed and fried food, smoking, lack of antioxidants, omega-3 fats and vitamin C to name a few key nutrients. Having an active lifestyle is also important.

The same story exists with all major diseases. Cancer cells thrive on sugar. Do you starve them and in the process protect healthy cells, or cut or drug them out?

The big difference in approach – treat the cause or the consequences – is money.  You can’t patent nutrients, but you can patent drugs that stop you from making cholesterol or amyloid. More than $1 billion has been spent on the anti-amyloid approach and the push isn’t going to stop. Pharma needs a return on their investment. This latest drug treatment, according to the Financial Times, will be sold for $26,000 a year. Taking B vitamins, eating fish and/or supplementing omega-3, which has shown more clinical benefit and reduced the rate of brain shrinkage by over 70% with no side-effects – actually side-benefits – might cost £100 a year. Which would you choose?

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.