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Re: Vitamins for brain health? Experts answer your questions.

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Message 41 of 47

Dear Sarah (@SarahLenzLock),

Dear Paul (@PaulCoates),

Dear Howard (@HowardFillit),

 

Very informative study and amazing work done by all the participants.

 

I'd like to ask a few questions:

 

1. Getting all necessary nutrients, including vitamins and minerals, from food is certainly the best solution. However some vitamins (e.g. some vitamins B) and minerals (e.g. Magnesium) are difficult to obtain in sufficient amount from food, not to say that with age the absorption of nutrients often decreases, and the modern lifestyle not contributing to a regular healthy nutrition either. (And not to say about the food overall becoming less nutritious due to soil depletion because of intensive farming and other factors.) Visiting health care providers regularly just to check on this may not be realistic for most people. Health care providers often wouldn't even recommend any tests or any supplementation unless there are some alarming obvious symptoms and they may not make a call that such test / supplementation is necessary.

 

This being said, would you say that voluntarily (without checking on if you need those vitamins) personal judgement of consumers and daily consumption of 100% natural vitamins and supplements, which are most critical for mental health, in doses less that RDI (because we do get some vitamins and minerals from food) may be a reasonable approach? I'm talking about high quality vitamins and minerals derived from food and not containing any synthetic ingredients. Wouldn't such daily supplementation be a reasonable addition to a healthy, yet naturally limited, modern diet? To give you an example, say 50% of RDI for Vitamins B5, B6, B9 and B12, and something like 200 mg of Magnesium.

 

Personally I stay away from synthetic supplements because of the way they are produced, them being isolated synthetic compounds and their low bioavailability.

------------------------------

 

2. For a moment, let's forget about Alzheimer's and other mental diseases and disorders, and even "brain health", and simply look for healthier alternatives to stimulants, such as caffeine, sugar, some other ingredients of energy drinks, alcohol and others. Only for short-term and possibly medium-term effect on better focus, short-term memory, alertness, mood, etc.

 

Certain popular supplements that claim to prevent or reverse Alzheimer's are certainly going too far. However, what about (a) other supplements not mentioned in your study and (b) short- and medium-term effect of some of them, which actually have stronger scientific evidence, on memory/concentration/mood/alertness, as alternatives to stimulants?

 

To give you an example, in your report you mentioned you've listed some popular brain supplement and analyzed them. To my knowledge, they all have weak scientific evidence in the first place, such as:

 

CoQ10 - very unstable, can be of very low quality, no strong scientific evidence, as a result is likely to have almost zero bioavailability.

 

Ginkgo biloba - no scientific evidence to support the widespread historic claims. Moreover, placebo-controlled studies have shown no difference with placebo on brain performance.

 

ALA - used mostly for diabetes and may have some other health benefits, yet without a strong scientific evidence for the latter. Claims that it in some way benefits brain health don't seem to have foundation.

 

However there are some other, much more interesting supplements that have a strong scientific evidence and are more clear what they do, for example Acetyl-L-carnitine or Lion's mane (Hericium erinaceus). I've been all over PubMed and only found positive scientific evidence of their effect on brain performance and some degree mental health (again, let's leave Alzheimer's and other serious brain disorders out of this).

 

Would you say that there is a much higher possibility that such supplements may actually be beneficial for brain performance and brain health, compared to most of the supplements mentioned in your study? As a better and healthier alternative to stimulants.

 

What do you think about these two supplements, or do you perhaps know others that have not perfect, but at least strong scientific evidence for their effect on the brain?

 

I'm quite conflicted about Bacopa monnieri, couldn't find a sound proof for its performance or failure to perform.

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3. Approaching this discussion on supplementation from the perspective of neurotransmitter support. Especially to target serotonin (mood), acetylcholine (learning, memory) and norepinephrine (focus). Leaving GABA and glutamate, which are a very controversial topic when it comes to supplementation.

 

What is your opinion on neurotransmitter support by the following (or other) compounds / supplements to influence the positive effect on the brain?

 

Amino acids Glycine and Theanine that are claimed to increase the levels of serotonin; and Theanine possibly decreasing levels of norepinephrine by releasing it.

 

ALCAR may have support not only energy, but also neurotransmitter biosynthesis in the brain.

 

Citicoline and/or Alpha GPC - can these compounds increase acetylcholine levels?

 

Vitamins B6 and especially B5 are known to contribute to synthesis of acetylcholine.

------------------------------

 

Thank you,

 

Paul R.

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Re: Vitamins for brain health? Experts answer your questions.

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I just came across this forum and I just want to say that the body has to be looked at as one unit so I really think that concentrating on mind-body as one brings a balanced lifestyle. I had the opportunity of coming across an article in Wired that discussed brain regeneration of brain cells after different forms of severe trauma. Neuroscientist Michael Merzenich of BrainHQ along with his colleagues have done outstanding work proving that exercising the mind in addition to taking supplements ( my opinion) can work wonders. 

Have a great day!

Andrea Hoke 

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Hi @DanielC622952 

  1.  You highlight an important part of the problem.  There is an issue that we need more research into the effectiveness of supplements.  But that is not the only reason.  We also do not have universally recognized recommended levels established for human consumption for all essential fatty acids (EFAs).  We note the recommended amount of ALAs set forth from the National Academy of Sciences, Engineering and Medicine.  The existing studies of Omega-3 supplements did NOT show they reduced the risk of Alzheimer’s Disease, and the other studies relating to supplements' impact on mild cognitive impairment were too few and too small to be confident in the results.  That is why the GCBH calls for more research.  But as you point out, where there are not financial incentives for manufacturers to engage in large rigorous studies, we are far less likely to have them be accomplished.  This is especially true when there is no regulatory requirement that pre-market testing happen.  But that doesn’t seem to have stopped academic centers from doing the evaluation of the effectiveness of food on brain health.   
  2. It’s not impossible to consume a healthy amount of fish that has shown positive impact for people’s brain health.  As mentioned above, not everyone agrees that you need super high doses of EFAs that some supplements offer.  The GCBH simply says we need to encourage people to eat greater amounts of fish and seafood.  The MIND diet advocates for fish at least once a week.  National recommendations from Canada say to eat at least two servings of fish each week, Sweden says two to three times a week, Greece says eat five or six servings of fish each week and China calls for appropriate amounts.  Our GCBH experts have also pointed out that you can get the same nutritional value from fresh, frozen or canned foods.  So for more affordable options, look for frozen or canned fish, and ones without lots of added breading, salt, sugar and fat. 
  3. Here's what the GCBH has said about fish, along with some links for more info: 

    Fish is a good source of protein and omega-3 fatty acids, and it constitutes an important part of the Mediterranean, Nordic, DASH, Okinawan and MIND diets as described earlier. Those who typically eat fish or other seafood every week report better brain health compared to those who never ate fish or seafood, according to the 2017 AARP Brain Health and Nutrition survey. In fact, 67% of those who eat fish or seafood reported their brain health as “excellent” or “very good.” See appendix 9, figure 3. …. It should also be noted that omega-3 fatty acids are found in sources other than fish. Plant sources of omega-3 fatty acids include flaxseed, oils (olive, canola, flaxseed, soybean), nuts and other seeds (walnuts, butternut squash and sunflower). Replacements for vegans/ vegetarians exist that are not supplements, but the evidence is not as robust for plant sources of omega-3 fatty acids.”

     

    https://www.aarp.org/health/brain-health/info-2018/brain-health-nutrition-study-fd.html

     

    https://www.aarp.org/health/brain-health/global-council-on-brain-health/nutrition/

     

     
Sarah Lenz Lock, AARP Expert Brain Health
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Two questions: 

1) This report mentions the potential efficacy of B12 and EFAs. The mechanisms are not well understood, correct? Is the issue that supplements "don't work", or, that there isn't a market driver to fund the necessary, and expensive, research (i.e. no patenable molecules)? I present this question earnestly: 8 years ago lifestyle interventions were scoffed at in serious AD discussion. Might there be efficacy in "supplementation" but we lack the research, and research funding, to seriously study them? Said with serious concern about false marketing, and also in the spirit of identifying and inquiring into what we don't know.

 

2) DASH, MIND, MED, Finn diets show promising efficacy, but consuming that amount of fish is near impossible, and expensive. Does EFA / DHA supplementation directly replace and act in lieu of consuming high amounts of fish? Concerns or qualifications in this approach? Thank you!

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Looking forward to this starting tomorrow!

Sarah Lenz Lock, AARP Expert Brain Health
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Howard Fillit, MD, is a geriatrician, neuroscientist, and innovative philanthropy executive, who has led the Alzheimer’s Drug Discovery Foundation (ADDF) since its founding in 1998. Dr. Fillit has held faculty positions at The Rockefeller University, the SUNY-Stony Brook School of Medicine and the Cornell University School of Medicine. In 1987, he joined the Mount Sinai School of Medicine, where he is a clinical professor of geriatric medicine and palliative care, medicine and neuroscience. Dr. Fillit also maintains a limited private practice in consultative geriatric medicine with a focus on Alzheimer's disease and related dementias.

 

Paul Coates, PhD, is previously Director of the Office of Dietary Supplements at the National Institutes of Health. Member of the Board of the American Society for Nutrition. Member of the Expert Panel advising the Global Council on Brain Health on matters related to dietary supplements.

Sarah Lock is Senior Vice President for Policy and Brain Health in AARP’s Policy, Research and International. She leads policy initiatives on brain health and care for people living with dementia and is Executive Director of the Global Council on Brain Health, an independent collaborative of scientists, doctors and policy experts convened by AARP to provide trusted information on brain health. Ms. Lock serves on the Steering Committee for the National Research Summit on Care, Services, and Supports for Persons with Dementia and Their Caregivers, on HHS’ Administration on Community Living Aging and Cognitive Health Technical Expert Advisory Board, and on Dementia Friendly America’s National Council. Prior to AARP, she served at the Department of Justice, the office of Congressman Michael D. Barnes, and the firm Arent, Fox, Kintner, Plotkin, & Kahn. She holds a JD from the University of Maryland. 

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Vitamins for brain health? Experts answer your questions.

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Are you taking vitamins because you think they will help your memory or keep you sharp? Do you know the facts from the myths about supplements? Get answers to your questions from our expert panelists! To participate, simply ask a question by reply post! (Ends June 26.)

 

This month, AARP’s Global Council on Brain Health (GCBH) released its new report, The Real Deal on Brain Health Supplements (download available).  Now is the time to join our online discussion with our brain health experts who can set the record straight and provide you with tips and recommendations. Our expert panel includes:

 

  • Sarah Lock, Senior Vice President, Policy and Brain Health, AARP, Executive Director, Global Council on Brain Health @SarahLenzLock 
  • Paul Coates, Ph.D., former director of the Office of Dietary Supplements, NIH @PaulCoates 
  • Howard Fillit, M.D., Alzheimer’s Drug Discovery Foundation @HowardFillit 

 

Both Dr. Coates and Dr. Fillit served as contributors to the report. We’ll cover topics such as:

 

  • Americans take a lot of supplements for their brain health and spend billions each year on them.  Is it worth it?
  • How do you know if supplements are safe?
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