By Jerome Burke

Why too much fructose is driving dementia, diabetes and brain fog

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The fruit sugar ‘fructose’ isn’t generally considered a food that’s best avoided. After all, it comes from fruit.

Yet a radical new theory, developed by Richard Johnson, Professor of Nephrology at the University of Colorado, explains how it can trigger various damaging changes in our metabolism that make us more likely to develop chronic conditions such as diabetes, obesity and Alzheimer’s. If doctors better understood this, it could transform the new emphasis on sickness prevention that the government is promising.

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The science of being ‘fructed’

Professor Johnson has produced what is effectively a biochemical wiring diagram of the connections which fructose turns on and off, that are making an increasing number of people sick. Fructose makes up half of white sugar and most of fructose corn syrup which is the main sweetener in fizzy drinks and ultra-processed foods as well as being the main sugar in fruit, particularly fruit juice.

For instance, the amount of fat stored in the liver increases, driving fatty liver disease, while the cell’s mitochondria, which create the body and brain’s energy molecule ATP, become less productive and blood pressure goes up. The result is that you get fatter, with more brain fog and fatigue and feel less inclined to exercise. Fructose is also a major promoter of diabetes.

Meanwhile an anti-ageing process called autophagy, which would normally clear away used up and damaged mitochondria, the cell’s energy factories, to make room for new ones, is disabled. When fructose crosses the blood-brain barrier into the brain, it is one of the factors causing the brain to form the clumps of amyloid protein found in Alzheimer’s, which is the focus of new drug treatments. 

Why on earth does fructose carry out such a blitz on our bodies? Why would the body run a programme that was potentially so lethal?

“It would be wrong to think of fructose as some sort of major toxin, although it becomes neurotoxic in excess,” says Professor Johnson. “Instead, its remarkable range of effects are part of an ancient set of biological programs, which we call the ‘Survival Switch’, that work to prepare animals for hibernation, storing supplies in preparation for times of famine.” This is why fat storage increases and energy drops off producing brain fog. The trouble is we never run out of food or fructose in our modern times.

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Eat your fruit, don’t drink it.

None of this means that we should avoid fruits, which contain only a small amount of fructose that comes with beneficial fibre that feeds our vital gut bacteria, plus various nutrients. Not so for fruit juice, devoid of fibre. A glass of orange juice is the equivalent of three oranges in terms of fructose, but without the fibre. So, eat your fruit, don’t drink it.

But this does explain why too much blood glucose from regularly eating generous amounts of sugar-laden foods and carbohydrates, is so damaging? The liver turns the excess glucose into fructose with all its knock-on effects. Other substances that can accelerate fructose production are alcohol and salt. 

This rise in fructose intake and its presence in processed food makes it all too easy to start piling on the pounds, regardless of how many calories you have cut or how much further you are running.  It’s a connection that very few nutritionists or GPs are aware of. 

A sign of the widespread damage the Survival Switch can cause is that there are low ATP levels in the brains of people with disorders such as obesity, diabetes, fatty liver disease and Alzheimer’s. Understanding this points to new ways to cut the risks of these chronic disorders.  Adenosine triphosphate (ATP) is a molecule that stores and provides energy for cells. It’s a key biomolecule that’s involved in almost all cellular processes.

A simple, but very effective solution, is to run a blood test – HbA1c – the gold standard test GPs use to screen for diabetes. HbA1c is a test that measures your average blood sugar level (glucose) over the past two to three months. A recent study of 374,021 older men with diabetes found that keeping the level of HbA1c stable at an optimal level over a period of three years cut risk of dementia by a third. Similar benefits have been found with patients with pre-diabetes (Prediabetes means that your blood sugars are higher than usual, but not high enough for you to be diagnosed with type 2 diabetes. It also means that you are at high risk of developing type 2 diabetes.) But far lower levels of HbA1c than those used to diagnose diabetes are associated with the first signs of brain shrinkage, which is the hallmark of cognitive decline, even in teenagers.

That is why we offer, as part of our ‘citizen science’ research, an at home pin-prick test of HbA1c, to find out not only who is at risk, but also how to reverse that risk. It also works alongside the  free Cognitive Function Test that calculates your future Dementia Risk Index and suggests various lifestyle and nutrition changes to help reduce it, including a low fructose diet (Find out more about low fructose foods here).   

We also recommend increasing omega-3 intake from oily fish, increasing B vitamins, especially B12, as well as an active lifestyle, as part of COGNITION, our personalised 6-month programme. In this programme we also dive deeper into lowering your ‘glycaemic load’ (GL), which is low in fructose, alongside periods of time of eating in a ‘ketogenic’ way by keeping sugar and carbohydrates to a minimum. The body responds by creating ketones, energy packets that can replace glucose as an energy source for the brain, helping to undo the damage. 

(You get access to COGNITION when you become a FRIEND of Food for the Brain here)

‘Burning ketones can also increase the number and output of the cell’s energy factories, known as mitochondria, which are damaged by fructose,’ says Professor Robert Lustig of the University of California, author of the best-selling book Metabolical and who sits on our Scientific Advisory Board. You can read more in his detailed article here.

Both Professor Johnson and Professor Lustig are also part of the Alzheimer’s Prevention Expert Group who have written to UK dementia prevention authorities to add sugar, and specifically a high fructose diet, to the list of known risk factors.

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The connection to Ozempic…

This low fructose approach also naturally promotes the enzyme GLP-1, targeted by the weight loss drugs Ozempic and Wegovy, but without the side-effects or rebound weight gain. 

Our founder Patrick Holford says: “Today’s typical diet of burgers, carbonated drinks, fruit juice, ice cream, bread, biscuits, cakes and confectionery, plus alcohol and salt, is a dementia time-bomb. Our brains are literally being ‘fructed’. We see the same shrinkage in the same regions of the brain in teenagers with a high sugar intake that are seen in older Alzheimer’s patients. We think of the resulting dementia as type-3 diabetes.”

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Actions

To find out more about low fructose foods visit www.foodforthebrain.org/fructose 
Click here to join our research and test your HbA1c with us
Support our charitable work and research by becoming a FRIEND

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:

Johnson RJ et al. The fructose survival hypothesis for obesity. Philos Trans R Soc Lond B Biol Sci. 2023 Sep 11;378(1885):20220230. doi: 10.1098/rstb.2022.0230
Underwood PC et al HbA1cTime in Range and Dementia JAMA Netw Open. 2024 Aug 1;7(8):e2425354. doi: 10.1001/jamanetworkopen.2024.25354
https://foodforthebrain.org/lancet-commission-letters/ 
Yau PL et al Obesity and metabolic syndrome and structural brain impairments in adolescence. Pediatrics. 2012 Oct;130(4):e856-64. doi: 10.1542/peds.2012-0324

By Patrick Holford

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For those who felt they missed out on the uplifting and enlightening Upgrade Your Brain seminars, Patrick is coming to Wrexham, Leeds, the Yorkshire Dales and Glasgow at the end of October, giving 2 hour Upgrade Your Brain blockbuster seminars and an exclusive one day Upgrade Your Brain retreat in the Burgoyne Hotel in the beautiful Yorkshire Dales.  See details and book your place here.

The COGNITION project, including the free Cognitive Function Test and DRIfT blood tests, is going international – into China, Japan, Australia, New Zealand and Singapore.

Translations are in full swing and Patrick is going to China and Japan to launch the project at the end of November. We are immensely grateful to Mr Ai of Sharejoy in China where Patrick has been training the staff who will help spread the word, and Dr Atsuo Yanagisawa, President of the Japanese Orthomolecular Society, for their generous support.

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Meanwhile, thanks to our growing army of Ambassadors, we have launched COGNITION in Australia and New Zealand – thank you Linda, Drs Ron Erlich and Ian Brighthope for your support.

Although the blood tests are not yet available there, Alice Coulson is spreading the word in Kenya as our East African Ambassador. Asante Sana!

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Alice Coulson and Patrick in Kenya
Ron Erlich and Linda Conder

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Not only will we be able to reach and help millions of people to dementia-proof their diet and lifestyle, it also means that our research database will become the biggest and most comprehensive in the world. This means that researchers will want to access our data, created by you as Citizen Scientists, to do their research.

This expansion of knowledge is vital to change the whole health paradigm.

To achieve all this, which requires major technical advancements, server power and investment, we are launching COGNITION International Ltd, a company wholly owned by the charity, to maximise the potential. We do need investment and can offer what are called ‘redeemable preference shares’ for ‘impact’ investors who want both a return on their investment and their money actually being used to make a difference. If you might be interested contact Fran on donations@foodforthebrain.org.

But also know that this continued rapid growth of Foodforthebrain.org, the COGNITION project, and the ongoing development of COGNITION for Smart Kids and Teens, would never have happened if you, FRIENDS of the charity, giving £50 a year, hadn’t supported us. 

In the past year we have grown to 2,000 FRIENDS. If you have yet to join please support us in this way and help us reach our next goal of 3000! You can also pay £5 a month if that is easier for you.

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Actions:

Complete the Cognitive Function Test here if you have not done so already
Become a FRIEND of Food for the Brain 
Find out more about the Upgrade Your Brain tour
If you are interested in redeemable preference shares contact Fran on donations@foodforthebrain.org

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.

by Patrick Holford

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What has homocysteine got to do with autism?

Homocysteine, a toxic amino acid commonly associated with disorders of the brain and circulation, is an indicator of a lack of B vitamins resulting in faulty methylation, a process critical for brain function.

So are there links between autism and homocysteine and could this help us to optimise neurodivergence in our children?

(At Food for the Brain we are on a mission to help upgrade and support ALL brains. That is why we are creating the Smart Kids & Teens COGNITION programme. Click here to find out more.)

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Homocysteine Levels in Autistic Children: A Significant Risk Factor

Recent studies have drawn attention to the elevated presence of homocysteine in autistic children. In a well-controlled study involving 119 autistic children compared to age and sex-matched neurotypical children, 13.4% of the autistic group exhibited homocysteine levels above 15 mcmol/L. This contrasts sharply with only 3.4% of typically developing children who showed such elevations (1).  This means that an autistic child is three and a half times more likely to have raised homocysteine. These findings also suggest that approximately one in six autistic children have a significant methylation problem, a process critical to DNA repair and neurotransmitter production.

Previous studies have reported similar findings. A study in 2022 (2) reported that ‘Overall, an increased homocysteine level was associated with autistic spectrum disorder (ASD) in a linear manner and is thus a novel diagnostic biomarker for ASD. Decreased concentrations of folate and vitamin B12 were associated with poor clinical profiles of children with ASD. These findings suggest that homocysteine-lowering interventions or folate and vitamin B12 supplementation might be a viable treatment strategy for ASD.’

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The Role of B Vitamins in mother & child

Homocysteine-lowering interventions, particularly through the supplementation of the most important B vitamins –  B12, B6, and methylfolate, that are required for healthy methylation – have demonstrated effectiveness in clinical settings (3). These vitamins play a vital role in the metabolism of homocysteine, converting it back into methionine, thereby reducing its toxic buildup in the bloodstream.

Research also indicates that maternal homocysteine levels during pregnancy can influence child development. A study found that women with homocysteine levels above 9 mcmol/L during pregnancy were more likely to have children exhibiting behavioural problems by age 6, including withdrawal, anxiety, depression and social or aggressive behaviours (4).

This suggests that early intervention targeting homocysteine levels in expectant mothers or women planning a pregnancy may have long-term benefits for child development.

Autistic children often experience a range of developmental delays and behavioural symptoms, many of which have been linked to elevated homocysteine. These include delayed language and movement skills, cognitive challenges, and abnormal emotional responses. Given the substantial overlap between symptoms of ASD and the effects of high homocysteine, it is logical to explore and implement further research into this biomarker as a target for therapeutic intervention. (As we plan to do in our Smart Kids & Teens COGNITION Programme.)

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The Case for Homocysteine Testing in Autistic Children

Given the evidence linking elevated homocysteine with autism, it makes sense to test homocysteine in all children classified as ASD. A subset will likely have raised homocysteine and benefit from B vitamin supplementation. 

We offer at home testing of homocysteine which can be done from age 2+  and is available globally here.

Given the growing interest in homocysteine as a marker of brain health, it is worth understanding its wider role in cognition and neurological function. You can read more in our guide to homocysteine and brain health: .

Actions

Further reading –  ‘Is Autism Genetic?‘ – read here
Further reading – ‘Autism Reversed: A case study‘ – read here
Order your homocysteine test here
Find out more about our Smart Kids & Teens COGNITION Program here

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Thank you for reading!

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

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

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

References

​​1 Gulati S, Narayan CL, Mahesan A, Kamila G, Kapoor S, Chaturvedi PK, Scaria V, Velpandian, T, Jauhari P, Chakrabarty B, Datta SKR, Pandey RM. Transmethylation and Oxidative Biomarkers in Children with Autism Spectrum Disorder: A Cross Sectional Study. J Autism Dev Disord. 2024 Sep 4. doi: 10.1007/s10803-024-06542-9. Epub ahead of print. PMID: 39230783.

2 Li B, Xu Y, Pang D, Zhao Q, Zhang L, Li M, Li W, Duan G and Zhu C (2022) Interrelation between homocysteine metabolism and the development of autism spectrum disorder in children. Front. Mol. Neurosci. 15:947513. doi: 10.3389/fnmol.2022.947513

3 Adams JB, Audhya T, Geis E, Gehn E, Fimbres V, Pollard EL, Mitchell J, Ingram J, Hellmers R, Laake D, Matthews JS, Li K, Naviaux JC, Naviaux RK, Adams RL, Coleman DM, Quig DW. Comprehensive Nutritional and Dietary Intervention for Autism Spectrum Disorder-A Randomized, Controlled 12-Month Trial. Nutrients. 2018 Mar 17;10(3):369. doi: 10.3390/nu10030369. PMID: 29562612; PMCID: PMC5872787.

4 Roigé-Castellví J, Murphy M, Fernández-Ballart J, Canals J. Moderately elevated preconception fasting plasma total homocysteine is a risk factor for psychological problems in childhood. Public Health Nutr. 2019 Jun;22(9):1615-1623. doi: 10.1017/S1368980018003610. Epub 2019 Jan 14. PMID: 30636652; PMCID: PMC10261079.

Written by Dr Victoria Sampson BDS MFDS RCS Ed Pg Dip

Did you know that similar to your gut, the mouth has its own microbiome?

Not only that, it is in fact, the second most diverse microbiome after the gut and houses approximately 700 different species of bacteria that make up 2 billion bacteria!

Unlike its relatives the gut, skin and vaginal microbiomes, the oral microbiome unfortunately has remained in the shadows, with very few even knowing they have one. What people also may not know, is how important their oral microbiome is for not only their oral health, but also their general health. When the oral microbiome is imbalanced and there are more bad bacteria than good, problems occur. In the mouth, these problems can show as tooth decay, gum disease, ulcers and bad breath to name a few. For the rest of the body, an imbalanced oral microbiome can contribute to systemic diseases such as neurological diseases, metabolic diseases, cardiovascular diseases and the list goes on.

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Why is Alzheimer’s a leading cause of mortality

In the last twenty years we have witnessed an unexplainable rise in the diagnosis of neurological conditions and a decline in brain function in our population. Alzheimer’s Disease is a disease that is currently a leading cause of mortality and morbidity globally (1). It presents as one of the greatest medical challenges that we face this century due to its increasing prevalence worldwide and as yet, no effective treatment developed for it. 

Furthermore, the cause of Alzheimer’s is believed to be multifactorial and a combination of genetic, environmental and lifestyle factors. Whilst some of the risk factors for Alzheimer’s cannot be altered such as our genetic makeup, the link between Alzheimer’s and oral health has gained significant traction. Not only can it be altered (and easily), but it also can be tested in a painless and easy way through saliva collection.

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Inflammation: Why The Mouth is a Gateway to the Brain

One of the primary ways in which oral health affects brain function is through low grade chronic inflammation. 

The oral microbiome is a delicate and beautiful balance of good and bad bacteria. If more bad bacteria are able to proliferate in the mouth, this balance can shift into what we call dysbiosis (or an imbalanced oral microbiome). Things that may cause our microbiome to shift into imbalance are things like poor oral hygiene, smoking, diet, medications we take, dry mouth and mouth breathing to name a few. Once the oral microbiome shifts into dysbiosis, this can increase our risk of local diseases such as decay and gum disease, but more importantly causes the release of inflammatory markers from the mouth to the brain.

These inflammatory markers can enter the bloodstream and cross the blood-brain barrier; a protective shield that typically prevents harmful substances from reaching the brain. Once inflammation spreads to the brain, it can contribute to the development of neurological disorders. Chronic inflammation has been linked to cognitive decline and neurodegenerative diseases such as Alzheimer’s disease, as it can damage brain cells and interfere with brain function (2).

Oral Bacteria and Brain Health

Another significant link between the mouth and the brain involves the direct effects of oral bacteria. Researchers have found that bacteria from the mouth can travel to the brain, particularly in cases of poor oral health or severe gum disease. These bacteria can enter the bloodstream through infected gums or the roots of decayed teeth, and eventually reach the brain, where they can contribute to the formation of harmful plaques.

A notable example is the bacterium Porphyromonas gingivalis, commonly found in patients with chronic gum disease. Studies have detected this bacterium in the brains of patients with Alzheimer’s disease, and it has been suggested that the bacteria’s presence may contribute to the development of amyloid plaques—a hallmark of Alzheimer’s. A 2019 study published in Science Advances (3).  showed that P. gingivalis not only reaches the brain but also releases toxins known as gingipains, which can damage brain cells and accelerate cognitive decline. Another study in Taiwan performed a retrospective cohort study on 18,672 citizens and found that having gum disease for over ten years was associated with a 70% increase in the risk of developing Alzheimer’s disease (4). 

If you’re still not convinced, a study published in the journal of Alzheimer’s Disease (5) further illustrated that there is a direct correlation between periodontal disease and Alzheimer’s Disease. The research looked at 6000 participants spanned over multiple age groups and followed them for up to 26 years. They performed dental examinations for gum disease as well as testing for bacteria and antibodies. The bacteria that seemed to be elevated in patients who went on to suffer Alzheimer’s disease was again, Porphyromonas gingivalis. 

This discovery has sparked interest in the potential role of oral bacteria in neurodegenerative diseases. Although more research is needed to establish a definitive cause-and-effect relationship, the evidence suggests that maintaining good oral hygiene could play an important role in preventing or slowing the progression of conditions like Alzheimer’s disease. It also opens the door to saliva testing to test for bacteria such as Porphyromonas gingivalis in the microbiome and eradicating this before it can cause problems.

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Stroke and Oral Health

The connection between oral health and the brain is also evident in the relationship between gum disease and stroke. Stroke occurs when blood flow to the brain is interrupted, leading to brain cell death and potentially severe neurological impairment. Gum disease is associated with an increased risk of stroke due to the systemic inflammation it causes and the potential for oral bacteria to contribute to the formation of blood clots.

A 2018 study published in the journal Stroke, (6 Sen, 2018) found that individuals with severe gum disease were at a higher risk of ischemic stroke, which occurs when a blood clot blocks an artery supplying blood to the brain. The study suggested that the chronic inflammation caused by gum disease may contribute to the formation of clots, which can travel to the brain and cause a stroke.

Moreover, researchers have found that treating gum disease can reduce markers of inflammation in the body, potentially lowering the risk of stroke. This highlights the importance of oral health not only for preventing gum disease but also for reducing the risk of serious neurological events like stroke.

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The Mouth and Brain are Deeply Connected

The connection between the mouth and the brain is a reminder that the body’s systems are deeply interconnected. Poor oral health, particularly in the form of gum disease and oral infections, can have far-reaching effects on brain function and overall neurological health. Inflammation and the spread of harmful oral bacteria are two key mechanisms by which oral health can influence conditions such as Alzheimer’s disease and stroke.

As research continues to shed light on this important connection, it becomes increasingly clear that maintaining good oral hygiene is essential not only for a healthy mouth but also for a healthy brain. 

For individuals looking to protect their cognitive function and reduce the risk of neurological diseases here are a few tips:

Regular brushing
Flossing 
Keeping up to date with dental check-ups
Saliva testing should be considered – get on a wait list here 
Complete the Cognitive Function Test here today so you can get a personalised plan on how to improve your overall cognition.
All the above alongside a balanced diet and regular exercise.

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If you want to learn more about the Oral Microbiome then make sure you join us for the Oral-Gut-Brain Connection Webinar with Victoria Sampson.
Find out more 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

Vos T. Estimating the global mortality from Alzheimer’s disease and other dementias: A new method and results from the Global Burden of Disease study 2019. J Alzheimers Assoc. 2020.
Kamer, A. R. (2020). Inflammation and Alzheimer’s disease: Possible role of periodontal diseases. Alzheimer’s & Dementia.
Dominy S, et al. Porphyromonas gingivalis in Alzheimer’s disease brains: Evidence for disease causation and treatment with small-molecule inhibitors. Sci Adv. 2019.
Chang-Kai C, et al. Association between chronic periodontitis and the risk of Alzheimer’s disease: a retrospective, population-based, matched-cohort study. Alzheimers Res Ther. 2017.
Beydoun M, et al. Clinical and bacterial markers of periodontitis and their association with incident all-cause and Alzheimer’s disease dementia in a large national survey. J Alzheimers Dis. 2020;57–172.
Sen E. Periodontal Disease, Regular Dental Care Use, and Incident Ischemic Stroke. Stroke. 2018.

In this article, we will explore how to get rid of brain fog and discuss practical strategies to help you regain mental clarity.

by Patrick Holford and edited by Nuala Mcdermott

Have you ever experienced ‘brain fog’?

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

Increasingly, the term “brain fog” is used to describe a range of cognitive symptoms that affect mental clarity and sharpness. Although brain fog isn’t a medical diagnosis, it is often a sign that your brain isn’t functioning at its best. The encouraging news is that many of the underlying causes are modifiable, meaning there are practical steps you can take to improve your mental clarity and support long-term brain health.

Is your brain running out of energy?

Our brains require a constant supply of energy to function optimally, just as our bodies do. Typically, this energy comes from glucose. However, as we age, or in those experiencing cognitive decline, the brain can become less efficient at using glucose. This reduced ability to access energy is often linked with insulin resistance, leaving brain cells effectively “hungry“. When brain cells don’t receive enough fuel, they struggle to perform efficiently, which may contribute to symptoms such as poor concentration, mental fatigue, forgetfulness, and what many people describe as brain fog. It can also leave you craving sugary foods as your brain searches for a quick source of energy.

One way to address this is by improving the brain’s ability to use alternative fuels. A lower glycaemic load diet, and for some people, a lower carbohydrate or Hybrid Diet approach, may help encourage the production of ketones, an alternative fuel that the brain can use efficiently. One practical way to increase ketone production, without following a strict ketogenic diet, is through C8 MCT oil.

Mind the gap with C8 oil

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

Research by Dr Melanie Fortier and Professor Stephen Cunnane from Sherbrooke University (1,2) has shown that C8 oil can dramatically boost brain energy levels, particularly in those with cognitive decline. In studies involving people with Alzheimer’s disease or mild cognitive impairment, those who consumed C8 oil experienced an impressive 230% increase in brain energy derived from ketones, leading to significant improvements in memory, language skills, and overall cognitive function.

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

By filling this energy gap with ketones, C8 oil may not only help improve mental clarity and cognitive function but also reduce sugar cravings. When the brain has a steady, reliable source of energy, it no longer sends out urgent signals for quick fixes like sugar, helping to restore balance and mental clarity.

In Professor Cunnane’s study, participants were given 30 g, approximately two tablespoons, of predominantly C8 oil each day. It is virtually tasteless and is often best taken with food, although many people simply add it to their morning coffee. If you’re new to C8 oil, it’s sensible to start with a small amount and gradually build up over several days to allow your digestive system to adapt.

Omega-3 and B vitamins – the dynamic duo

Supporting your brain’s energy supply is only part of the picture. For brain cells to communicate efficiently, repair themselves, and continue producing energy, they also need the right nutrients. Two of these important nutrients are omega-3 DHA and B vitamins, which work together to support healthy brain function.

In recent years, researchers have discovered that omega-3 and B vitamins are co-dependent, meaning they work most effectively together. This led to a study (3) in which people with mild cognitive impairment were given either folic acid (800 mcg), omega-3 DHA (800 mg), or both nutrients together for one year and compared with those receiving placebos.

The individual nutrients each showed some cognitive benefits, but the greatest improvements were seen in those taking both omega-3 DHA and folic acid together. The combination produced significant improvements in all three measures of IQ, including full, verbal, and performance IQ, demonstrating a clear advantage for people experiencing cognitive decline.

Researchers from Tianjin Medical University and Hebei Medical University in China also investigated the effects of these nutrients on mitochondria, the tiny energy factories inside every cell. They found that participants taking the nutrients had less oxidative damage to mitochondrial DNA. (3)

“The cognitive benefits might act via DNA oxidative damage and mitochondrial function,” they reported.

Healthy mitochondria are essential for keeping brain cells functioning efficiently. When mitochondrial energy production declines and oxidative stress increases, brain cells can struggle to meet their energy demands, potentially contributing to brain fog, poor concentration, and mental fatigue.

The researchers concluded that: “Interventions of folic acid (800 mcg) combined with DHA (800 mg) daily orally for 12 months can improve cognitive function in older adults with Mild Cognitive Impairment, and the combined intervention is superior to either intervention alone.“

Folate is found naturally in green leafy vegetables, while DHA is found primarily in oily fish and other marine foods. However, the amounts used in this study would be difficult to obtain through diet alone, highlighting why targeted supplementation may sometimes be appropriate. Learn about supplements that support brain function

Could your diet be contributing to brain fog?

It’s not only a lack of energy or nutrients that may contribute to brain fog. Researchers worldwide (4,5,6,7) have identified that, in some individuals, food intolerances may also contribute to symptoms including brain fog, anxiety, and depression.

The reasons are complex, but researchers are increasingly linking digestive health with brain health through what is known as the gut-brain axis.

Our gut contains more immune cells than the rest of the body combined. Inside our 10-metre digestive tract live around 100 trillion bacteria, weighing approximately 2 kg and made up of around 130 different species, collectively known as the gut microbiome.

Excessive consumption of inflammatory foods, including refined sugars, ultra-processed foods, alcohol, trans fats, and, for some individuals, gluten, may disrupt this delicate ecosystem. This can reduce populations of beneficial bacteria such as Lactobacillus and Bifidobacterium, while encouraging the excessive growth of less beneficial bacteria that promote inflammation.

Inflammatory foods may also increase the production of zonulin, a protein that affects the tight junctions between cells lining the gut wall. This can increase intestinal permeability, often referred to as “leaky gut“, allowing undigested food particles, toxins, and microbes to pass into the bloodstream, where they may trigger ongoing immune activation and inflammation.

Because the brain and gut communicate continuously through the gut-brain axis, inflammation originating in the gut may influence neurotransmitter production, immune signalling, and brain function. For some people, this may contribute to symptoms such as brain fog, poor concentration, low mood, and anxiety.

Food intolerances are only one possible contributor to brain fog, and they are unlikely to be the cause for everyone. However, if symptoms consistently worsen after eating particular foods or digestive symptoms accompany brain fog, it may be worth exploring this further with a qualified healthcare practitioner or experimenting with eliminating certain foods for short periods of time to see if there is an improvement.

Other considerations if brain fog persists

Brain fog is rarely caused by a single factor. If improving your diet and supporting your brain’s energy don’t fully resolve your symptoms, there are several other areas worth investigating.

Vitamin D

Vitamin D is an all-rounder when it comes to brain and mental health. It supports neurotransmission, helps regulate inflammation, and has important neuroprotective effects by reducing both inflammation and oxidative stress within the brain. Low vitamin D levels have also been linked with poorer cognitive performance and mood in many studies. If brain fog is an ongoing issue, checking your vitamin D status is well worth considering. Find out more about vitamin D’s role in brain health.

Homocysteine, omega-3 and B vitamins

We also know that people with depression often have much higher homocysteine levels, indicating poorer methylation, together with significantly lower levels of vitamin B12 and vitamin D. The levels of these nutrients have been shown to predict the severity of their symptoms (9).

Homocysteine is one of the most important, yet overlooked, biomarkers for long-term brain health. Elevated levels may indicate that your body isn’t recycling homocysteine efficiently, often because of suboptimal levels of folate, vitamin B12, or vitamin B6.

If brain fog or other symptoms of cognitive decline persist, testing homocysteine, together with omega-3 and vitamin D, can provide valuable insight into your nutritional status. These are all included in our DRIfT blood test.

Order your DRIfT blood test.

Prioritise sleep

Sleep is another essential consideration because it is during sleep that many of the brain’s repair and maintenance processes take place.

During deep sleep, the circulation of blood and cerebrospinal fluid improves, helping to remove waste products generated through normal brain metabolism. These include damaging oxidants and amyloid proteins associated with Alzheimer’s disease, both of which can begin to accumulate after even one night of sleep deprivation.

If you regularly wake feeling unrefreshed or rely on caffeine simply to function, improving sleep quality may be one of the most effective ways to reduce brain fog and restore mental clarity.

Read more about improving your sleep.

Final thoughts

Brain fog shouldn’t simply be accepted as an inevitable part of getting older or living a busy life. It is often your brain’s way of telling you that something needs attention. Whether the underlying cause is poor brain energy, unstable blood sugar, nutrient deficiencies, chronic inflammation, or poor sleep, identifying and addressing those factors can make a meaningful difference to how you think, feel, and function every day.

As more research continues to emerge, these practical steps can help set you on the path towards a sharper mind, better focus, and long-term 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.

Are You Being Fructed? Fructose, Dementia, Diabetes & Brain Fog
MCTs…
Recovering Your Memory & Rebuilding the Brain

by Patrick Holford

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

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

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

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

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

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

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

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

He stated: 

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

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

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

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

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

– homocysteine below 7
– omega-3 index above 8%
– vitamin D above 40 ng/ml or 100 nmol/l
– HBA1c below 5.5%;
– Glutathione Index above 800.

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

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

Exciting, isn’t it?

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What can you do?

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

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Thank you for reading!

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

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

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

References

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

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

Anti-Age & Re-Energise Your Brain – The Glutathione Breakthrough

By Patrick Holford

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

This combustion creates oxidants that age your brain. 

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

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

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

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

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

Eating fruit and veg might not be enough…

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

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

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

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

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

Your Glutathione Index – a world first!

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

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

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

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

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

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

You want your score to be above 800.

If your score was below 500 that’s really not good. If you smoke, live in a polluted environment or rarely eat fuit, vegetables, herbs and spices, that’s where you’d be.

But we’ve found out something rather disturbing. 

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

Thank you for being a Citizen Scientist

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

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

Thank you for reading!

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

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

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

References:

¹ Peng, M., et al. Dietary Total Antioxidant Capacity and Cognitive Function in Older Adults. J Nutr Health Aging (2023).

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

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

The Lancet Report Omission! World Experts Criticise Latest Alzheimer Report

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

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

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

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

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

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

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

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

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

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

Why has important science been missed out?

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

This is simply not true.

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

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

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

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

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

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

The Lancet Omission – what can we do?

That is why we offer our free online Cognitive Function Test. In addition, our accurate, at home pin prick blood tests are available internationally, helping you understand your future dementia risk and what you can do to lower it.

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

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

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

Action steps

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

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

Thank you for reading!

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

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

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

References:

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

Can Autism Be Reversed? A Published Case Study

At Food for the Brain, we are committed to exploring the factors that influence brain development, cognitive function and mental wellbeing throughout life. While much of our work today focuses on protecting brain health as we age, we also support research and education on children’s brain development through initiatives such as Smart Kids & Teens.

The question of whether autism can be reversed remains one of the most debated topics in developmental medicine. In this guest article, Simon Martin examines a published case study describing two children with autism spectrum disorder who experienced substantial improvements following a comprehensive programme of nutritional, lifestyle and therapeutic interventions. As a single case study, its findings cannot be generalised to all children with autism, but they raise important questions about the potential role of nutrition, metabolism and environmental factors in influencing symptoms and development, and highlight areas where further research is warranted.

Autism: “reversed” in twins with personalised nutrition, supplements and therapeutic approaches

By Simon Martin – this article was originally shared by IHCAN – shared and edited with permission. 

It’s “kind of a miracle”, says one of the paediatricians consulted in a newly-published case study, as twin girls recover – one, so completely it’s as if she never had autism. 

Research charity Documenting Hope, has published a case study detailing the reversal of severe Autism Spectrum Disorder symptoms in fraternal female twin toddlers.

Diagnosed at 20 months with severe (Level 3) ASD and requiring substantial support, the twins exhibited limited communication, repetitive behaviours, and significant gastrointestinal issues. Realising that conventional approaches were unlikely to help, the parents assembled an intervention focusing on environmental and lifestyle factors. 

In a paper published in the journal Personalised Medicine by a multi-disciplinary team, Dr Chris D’Adamo PhD, (who will be speaking at our Smart Kids & Teens Event in 2025) the charity’s Scientific Director and Principal Investigator and Director of the Centre for Integrative Medicine at the University of Maryland School of Medicine, and his colleagues reported the following stunning results: 

“Both twins showed dramatic improvements on the Autism Treatment Evaluation Checklist (ATEC) . The ATEC measures the effectiveness of autism treatment by assessing  communication, social skills, sensory awareness and more. Autism Treatment Evaluation Checklist (ATEC) scores dropped from 76 to 32 and 43 to 4 (scores below 43 indicate neurotypical), respectively, with stability over six months. The progress of Twin P, whose score dropped to 4 from March 2022 to October 2023, was described as “a kind of miracle” by one of the paediatricians. Dr D’Adamo told the Telegraph, “This twin’s functions are comparable to those who have never had an autism diagnosis”.  

Twin L, who had more severe autism at 20 months, scoring 76 initially, reduced this to 32 a year and a half later. D’Adamo said she “improved dramatically, but not quite as much”.

They also highlighted “the clear environmental and lifestyle influences on ASD that these findings help establish, building upon previous studies revealing the comparatively greater impact of these types of factors than genetics”.

D’Adamo and colleagues do not use the word “cure” in their report, but say the symptoms are unlikely to come back; “Because autism is a developmental condition, one can safely say that once they have overcome the developmental aspects of autism and returned to a typical developmental trajectory, they are very unlikely to exhibit the common symptoms of autism again. Symptoms that could return might be more along the lines of things like anxiety, gastrointestinal issues and sensory issues, but not necessarily the behavioural aspects of autism”.

The team from the University of Maryland and Hope concluded: 

“This case revealed a reversal of the Level 3 Autism Spectrum Disorder diagnoses among toddler twin girls that was achieved primarily through environmental and lifestyle modifications over a two-year period. The twins’ dramatic improvements and diagnosis reversal have persisted for over six months with no signs of regression”.

“What’s more”, says Documenting Hope, “we have learned from the parents that the twins’ ATEC scores have continued to drop below those that were originally published in this paper. This is very exciting news for this family and for the promise of symptom reversal in autism as a viable clinical outcome”.

This is not the first report of a reversal/cure of autism, but certainly the first case where researchers have documented treatment initiated and led by parents. The published paper includes a review of the literature, in which D’Adamo and colleagues detail the many “alternative” approaches that have succeeded, but have been ignored by orthodox medicine, even when published, possibly due to lack of blinding, which is challenging for such interventions. Additionally, they say, a degree of expectation bias is possible and more studies are needed for conclusive results regarding any such interventions, particularly in light of both the diversity of possible causes of ASD and the presentation of symptoms.

The nutritional, supplements & therapeutic approaches

Citing almost 50 previous studies, the Hope team write: “There are limited FDA-approved pharmacological options at present to treat ASD. Accordingly, there have been a number of non-pharmacological interventions tailored to address the underlying environmental and lifestyle risk factors that have demonstrated promising, though not conclusive, improvements in ASD symptoms“. 

These include: 

Dietary interventions such as gluten and casein-free, GAPS (Gut & Psychology / Physiology Syndrome), a specific carbohydrate diet, low glutamate and ketogenic.
Targeted or personalised dietary supplements such as vitamin D, methylfolate, carnitine, vitamin B12 and other micronutrient supplementation, mitochondrial support, or supplements thought to be relevant to a child’s functional genomic situation. 
Addressing other modifiable lifestyle factors and environmental interventions, such as more time in nature, a reduction in exposure to artificial light, and improving indoor air quality, have demonstrated promise.
Therapeutic interventions addressing a child’s physical structure and function, such as cranial osteopathy, retained reflex integration, physical therapy, and occupational therapy, have also been associated with improved outcomes among ASD patients.

“While reversal of ASD diagnosis is relatively rare, there have been documented cases in the literature of complete recovery with a multi-modal intervention. One such case achieved reversal of ASD diagnosis through a combination of dietary modifications, probiotics and micronutrient supplementation, and antimicrobials that were personalised to the child’s risk factors, clinical presentation and a variety of laboratory tests”.

The approaches taken for this intervention

The parents gathered support and resources from many places.  They worked with an autism parenting coach, utilising the Child Health Inventory for Resilience and Prevention (CHIRP) survey of the Documenting Hope Project, in addition to resources at Epidemic Answers. They also used Applied Behaviour Analysis (ABA, which is typically recommended for new ASD diagnoses –  find out more here) and speech therapy with the twins.  Additionally, the twins’ parents implemented a rigorous diet and nutrition intervention around the time of diagnosis.

First to go was glutamate – aka MSG – following the principles of the Reduced Excitatory Inflammatory Diet (REID – references can be found here ) developed by PhD biochemist Dr Katherine Reid. Dr Reid is a mother of a daughter “no longer considered on the autism spectrum, which is managed 100% through diet”.

Dr Reid is also the author of Fat, Stressed, and Sick: MSG, Processed Food, and America’s Health. She says: “The Reduced Excitatory Inflammatory Diet (REID) is a food lifestyle focused on reducing excitatory and inhibitory signalling imbalances (ie improving neurotransmitter balance) and reducing inflammation through a balanced whole food approach. Some of the most prevalent excitatory and inflammatory foods are gluten, casein (a class of proteins found in dairy), soy, corn (to a lesser extent) and ready-to-eat or commercially processed foods with various food additives, particularly those containing free glutamate and aspartate. These foods can be problematic because of their high concentration of unbound/free glutamate (glutamic acid). Unbound or free glutamate (aka MSG) is most commonly found in processed foods as a food additive or created as a by-product of commercial food manufacturing processes”. The book is available in our Food for the Brain bookstore: here.

The parents put the girls on a strictly gluten-free, casein-free diet that was low in sugar and had no exposure to artificial colours, dyes, or ultra-processed foods. They emphasised organic, unprocessed, freshly prepared, and home-cooked food from local sources when possible.

The twins took a number of dietary supplements, including omega-3 fatty acids, a multivitamin, vitamin D, carnitine and 5-methyltetrahydrofolate, plus individualised homoeopathic remedies. They also used lab tests and genomic information to select nutritional supplements based on the twins’ DNA.

There were some common findings, such as impaired serotonin metabolism and a recommendation that the girls be fed a diet rich in tryptophan to upregulate serotonin production, as well as consume foods rich in vitamins B12, B6 and folate. Both twins had several genetic variants associated with a higher risk of systemic inflammation.

The mother was advised to feed the children foods that are high in betaine and choline, as well as to supplement with Lion’s mane and resolvins (found in fatty fish). However, each girl also had unique needs. P had variants that suggested an increased need for vitamin D. L had several variants associated with neuroinflammation, oxidative stress and compromised detoxification. Advice was provided to support glutathione production.

Both girls had the most sessions of any intervention with an occupational therapist who focused on the specialised technique of neuro-sensory motor reflex integration developed by Dr Svetlana Masgutova, PhD.

Eventually the parents’ research led them to check their home for air quality, mould and moisture. 

In October of 2022, they brought in a Building Biology Environmental Consultant. The consultant tested the home’s indoor air quality, evaluated possible signs of moisture intrusion, and identified other potential sources of toxicants. Air tests for mould were reported to be “very clean”. However, thermal imaging and moisture metre readings suggested the family was encouraged to further evaluate several areas of the home, which suggested water damage. A window in the twins’ bedroom was one area needing more evaluation.

Both girls were seen by a cranial osteopath. The family decided to pursue osteopathic care for L and not for P. L visited an osteopath at regular intervals in 2023 and saw notable benefits.

Outcomes

Twin L’s ATEC (Autism Treatment Evaluation Checklist) scores improved dramatically, from 76 in March 2022 to 32 in October 2023, and then remained relatively stable at 34 in March 2024. Twin P’s ATEC scores also improved dramatically, from 43 in March 2022 to 4 in October 2023, remaining stable at 4 in March 2024.

“In addition to the twins’ improved ATEC scores, numerous other behavioural and social improvements were noted after the implementation of the interventions”, the paper reports. Both L and P’s eye contact, language, and attention had all improved noticeably by autumn 2022. “This was accompanied by participation in a toddler play group three days per week and ultimately attending pre-school three days per week in Fall 2023″. 

Conclusions & future progress

The University of Maryland team give full credit to the parents’ commitment and drive in achieving these results for their twins. They also acknowledge that this level of complex and sustained treatment may be impossible for many families to take on.

“For instance, the cost of the healthy lifestyle modifications and out-of-pocket costs of care of the numerous practitioners and laboratory assessments in this case would be financially prohibitive to many families. Access to healthy foods and the types of practitioners contributing to this therapeutic approach may also be limited for many families”.

However, they conclude: “It has become increasingly clear that ASD treatment is not one-size-fits-all, and that personalised, multi-modality treatment approaches to help address the total load of stressors are likely required to achieve optimal outcomes”.

This case study does not suggest that all autism has the same underlying causes, nor that every autistic individual requires treatment or wishes to change who they are. Autism is a broad spectrum, and experiences vary considerably from person to person. As a single published case study, its findings cannot be generalised. However, it highlights the possibility that, for some children with complex medical and nutritional needs, identifying and addressing underlying biological factors may contribute to meaningful improvements in health, functioning, communication and quality of life. Further research is needed to determine which approaches may be beneficial, for whom, and under what circumstances.

Through initiatives such as Smart Kids & Teens, alongside our wider work in dementia prevention and lifelong brain health, Food for the Brain continues to explore the evidence on how nutrition and lifestyle may support optimal brain function at every stage of life.

Food for the Brain is a charity dedicated to helping people protect and optimise their brain health throughout life. By becoming a FRIEND for just £50 a year, you’ll support this mission while gaining access to our COGNITION Brain Upgrade Programme, live expert-led webinars, monthly coaching workshops, and practical tools designed to help you put the science of brain health into action.

Other resources:

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Autistic Children are Three and a Half Times More Likely to Have High Homocysteine

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By Patrick Holford

In terms of a cost-benefit ratio, Lecanemab has to be one of the worst in history.

Reported in the media this week as a ‘breakthrough Alzheimer’s medication’ – is this really the case?

On the benefit side those in the drug company’s own trial got statistically slightly less worse after 18 months of treatment versus placebo. No-one got better. The scale of improvement was not enough to be clinically significant and “does not necessarily reflect a meaningful improvement for patients or their families” according to the British Medical Journal editorial [1]. Given that almost all drug company’s own trial perform better than independent research this is likely to be an over-estimate of benefit not an under-estimate. At best it means delaying the progress of the disease by a few months.

The worst cost is that a quarter of those on the drug got either brain swelling or bleeding.
Three participants in the trial died as a consequence. Also there was accelerated brain shrinkage compared to placebo. Due to these horrendous risks patients getting the twice monthly IV infusions will need to have brain scans to check for brain bleeding and swelling.

The drug itself will cost about £25,000 a year but, with the medical costs, it may actually cost the patients or the NHS as much as double this. That is why the NHS’s watchdog NICE have rejected it “Lecanemab provides on average four to six months’ slowing in the rate of progression from mild to moderate Alzheimer’s disease, but this is just not enough benefit to justify the additional cost to the NHS,” said Helen Knight, director of medicines evaluation at NICE. The Telegraph have stated that an inside source says other anti-amyloid drug treatments would be similarly blocked for NHS use due to bad cost benefit ratio.

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The biggest problem…

The biggest lie reported in the papers is that ‘this is the first treatment that has been found to curb the condition’, says the Mail and ‘the first drug to slow down Alzheimer’s”, says the Telegraph.

It isn’t.

Inexpensive and safe B vitamins given to those with raised homocysteine (about half of all over age 65) have produced far greater clinical improvements to those with pre-dementia. In fact, a third had no clinical dementia rating at the end of the year – in other words were no longer diagnosable with dementia.

Similarly encouraging benefits have been shown when omega-3 fish oil supplements have been given to those with already low homocysteine (due to insufficient levels of B vitamins) – up to three times that of Lecanemab.[2] In addition, the omega-3 and B vitamin combo reported up to 73% less brain shrinkage, not more shrinkage reported with this drug. This gold-standard evidence, from studies at the University of Oxford by Professor of Pharmacology David Smith, is simply being ignored.

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The choice: safe supplementation or risk of brain bleed…

So, that’s the choice for dementia sufferers.

Safe supplements that might cost you £100 a year, reduce the rate of brain shrinkage and deliver clear clinical improvements. Or Lecanemab, that carries a small risk of death, a considerable risk of brain swelling or bleeding, has not shown improvement in a single patient, but is likely to deliver a small, clinically meaningless slowing down of worsening symptoms. NICE has not approved it for the NHS because it costs £50,000 a year and as it only slows down dementia progression by a couple of months (as reported by the BBC).

The caveat for the drug is that the risks for those with the ApoE4 gene variant – about a quarter of people are deemed too high. The caveat for the B vitamins is that those with normal homocysteine levels (below 10 mcmol/l), which is less than half those over 65, may not benefit from the B vitamin treatment. Homocysteine is a simple test any GP can do. Similarly, omega-3 fish oils may not benefit those with an omega-3 index above 8% (and highly likely to benefit those with an omega-3 index of 4% or less.)

That is why we recommend those wishing to prevent dementia test both omega-3 index and homocysteine and why we offer accurate, at-home test kits to help you reclaim your brain. When you support our charity by buying a test kit you become one of our Citizen Scientists and take part in our essential prevention-focused research and includes a free online Cognitive Function Test and the COGNITION questionnaire which calculates your future Dementia Risk Index, then advising you how to lower it.

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] BMJ 2022;379:o3010 http://dx.doi.org/10.1136/bmj.o3010
[2] https://foodforthebrain.org/campaigns/alzheimers-prevention/omega-3-
and-b-vitamins/