Nourish Your Brain

Like every other part of your body, your brain needs good nutrition to perform at its best. In the brain, nutrients facilitate essential functions that enable you to think, remember, sense, act and react – in a word, to live. 

1. Nutrients help brain cells burn glucose – their primary fuel – more efficiently.

2. Nutrients help protect brain cells from oxidative damage.

3. Nutrients help brain cells make important neurotransmitters, the chemical messengers these cells use to communicate with each other and the rest of the body.

Researchers have accelerated their efforts to find nutritional ways to support brain health, in order to help our society meet the coming challenge of an aging population. These efforts are paying off. Today, accumulating evidence suggests that not only better overall nutrition, but also supplementation with several key nutrients may help stave off the deterioration of brain cells that occurs with aging. These nutrients include: 

• B vitamins –especially those needed for metabolism (thiamin, riboflavin, niacin) and those needed to regulate homocysteine levels (folic acid, vitamin B12 and vitamin B6)
• antioxidant vitamins E and C
• other antioxidants, such as alpha-lipoic acid and plant extracts
• essential fatty acids -- the “good fats” found in fish, nuts and vegetables
• citicoline and other precursors of important neurotransmitters

General Diet

Studies suggest that a healthy diet plus supplements may help maintain cognitive function. The typical “Mediterranean” dietary pattern that includes higher levels of fish, olive oil, fruits and vegetables, cereals and wine has been found to be protective against age-related cognitive decline.[i] This type of diet delivers higher amounts of omega-3 fatty acids (from fish), monounsaturated fatty acids (from olive oil and other vegetables), antioxidants (from fruits, vegetables and wine), and B vitamins (from cereal) than the typical Western diet. All of these are beneficial to both heart health and brain health, especially when they replace saturated fat and sugars. 

Similarly, a study of elderly Spanish individuals found that people who ate more total food, fish, unsaturated fatty acids and vitamins and less refined sweets had better cognitive function than those with poorer diets.[ii] 

B Vitamins

The B vitamins, especially thiamin, niacin, folate, vitamin B₆ and vitamin B₁₂ are all implicated in mental health. Adequate levels of thiamin, niacin, vitamin B₆ and vitamin B₁₂ are needed for the metabolism of glucose, the brain’s primary fuel, and dementia is a well-documented symptom of deficiency of these vitamins.[iii] 

Folate, vitamins B₆ and vitamin B₁₂ are involved in the metabolic cycle that regulates homocysteine, an amino acid formed during the breakdown of protein. Elevated homocysteine has been shown to be a risk factor for impaired cognitive abilities in the elderly,[iv]^,[v]^,[vi] a decline in memory,[vii] and the dementia of Alzheimer’s disease.[viii] Most cases of elevated homocysteine are due to inadequate intakes of vitamin B12, vitamin B6 or folate. Thus, researchers theorize that normalizing levels of these vitamins may help protect against cognitive decline in the elderly by reducing elevated homocysteine levels.^5,7

Folate has found to be protective against cognitive impairment in a majority of observational studies,^6,7,[ix] but not all studies have found this association,⁶ and one study found that folate was protective only in people with normal vitamin B12 levels.[x] A long-term study of a group of nuns in Minnesota found a strong correlation between low folate status and the onset of Alzheimer’s disease, and post mortem examinations revealed lower concentrations of folate in the brains of those nuns who had suffered from Alzheimer’s disease during life.[xi] 

It is likely that lifelong dietary habits providing adequate B vitamin intakes are important in protecting against cognitive decline as a person ages. As dietary intakes decline with aging, supplementation may be beneficial to maintain adequate levels of B vitamins.

Antioxidants

Oxidative damage to brain cells is strongly implicated in Alzheimer’s disease and other forms of cognitive impairment.[xii]^,[xiii] Oxidative damage occurs as a result of metabolic reactions that release unstable molecules called “free radicals,” which in turn attack the fats in cell membranes and other critical cell structures. The brain is very rich in fats that are vulnerable to oxidation. 

Certain nutrients, such as vitamins E and C, are antioxidants with the ability to neutralize free radicals, thereby protecting cells and tissues against oxidative damage. For this reason, scientists have been studying a possible protective role for these vitamins in the brain and nervous system. Low levels of vitamin E have been found in the cerebrospinal fluid of Alzheimer patients, making this tissue vulnerable to oxidation. In laboratory studies, vitamins E and C were shown to protect the cells in this fluid against oxidation.[xiv]  

Most, but not all studies in humans have seen a protective effect. For example, several long-term observational studies have found that people who took a combination of vitamin E and vitamin C and/or multivitamins were less likely to experience cognitive decline or Alzheimer’s disease,[xv]^,[xvi]^,[xvii] especially if they had taken supplements for many years.¹⁵  However, another large study did not find this protective effect.[xviii] A clinical trial demonstrated that high-dose vitamin E supplementation slowed functional deterioration in Alzheimer patients.[xix] However, healthy women taking vitamin E supplements over a period of years showed no cognitive advantage over their counterparts who were not taking supplements in the Women’s Health Study.[xx]

Other antioxidants and plant compounds such as alpha-lipoic acid, coenzyme Q10, Ginkgo biloba, curcumin and fruit polyphenols are also being studied for potential benefits in brain health. Although the data are mixed, most researchers believe that the evidence for a protective role of antioxidants in brain health is promising enough to warrant continued study and future trials.  

Current data suggest that antioxidant intakes over a lifetime, as part of a healthy diet, may be more relevant than high intakes once mental decline has already started.

The “Good Fats”

Unsaturated fats – the “good fats” that promote heart health – also promote brain health. These include polyunsaturated fatty acids from vegetable sources (corn oil, safflower oil, soybean oil, peanuts) and from marine sources (fish oil; fatty fish such as tuna, salmon, herring) and monounsaturated fats from plant foods (olive oil, tree nuts).  

Unsaturated fatty acids are critical components of neural cell membranes and are needed for the production and proper functioning of neurotransmitters, the chemical messengers these cells use to communicate. The polyunsaturated fatty acid DHA (docosahexaenoic acid), often called “omega-3,” comprises up to 50% of total fatty acids in the gray matter and is believed to exert a major influence on neural composition and function. Low levels of DHA have been found in patients with Alzheimer’s disease as compared to persons without cognitive impairment, and in the Alzheimer’s patients, dementia was progressively more severe with decreasing DHA levels.[xxi]

Higher dietary intakes of fish and/or DHA have been associated with reduced cognitive decline in a number of population studies. For example, intakes of 180 mg/day of DHA, obtained by eating close to three fish meals per week, were associated with a 50% reduced risk of developing age-related dementia in the Framingham Study.[xxii] The Zutphen Elderly Study (the Netherlands) and the Chicago Health and Aging Project both found a slower rate of cognitive decline among people who consumed fish as compared to those who did not.[xxiii]^,[xxiv] Omega-3 fatty acids were particularly protective against cognitive decline among people with high blood pressure in the Atherosclerosis Risk in Communities (ARIC) study.[xxv] 

The Italian Longitudinal Study on Aging found that higher intakes of both polyunsaturated and monounsaturated fats were protective against age-related cognitive decline.[xxvi] This study followed elderly subjects aged 65-84 for eight and a half years and evaluated them with a battery of tests for mental function at three different time points.

Finally, randomized controlled trials have had some luck in reducing cognitive impairment with fatty acids. A Japanese trial found that supplementation with DHA improved immediate memory and attention score in patients with mild cognitive dysfunction and improved immediate and delayed memories in patients with organic brain lesions.[xxvii] In contrast, no improvements were seen in Alzheimer patients in this study. Similarly, in another controlled trial in Alzheimer patients, positive effects from omega-3 fatty acid supplementation were seen only in those who had very mild Alzheimer’s disease but not in those with more severe disease.[xxviii] 

In general, the scientific data support more liberal intakes of omega-3 fatty acids, preferably from fish, and particularly as they replace saturated fat intakes in the diet, as a preventive strategy that may maintain healthy mental functioning during aging. 

Citicoline

Citicoline is a substance that has specific actions in the health and functioning of neurons (nerve cells) in the brain. One of the age-related changes that reduces mental sharpness and memory is decreased production of neurotransmitters, in particular, a neurotransmitter called acetylcholine  that is important for storing and retrieving memories. 

The raw materials for acetylcholine include choline, a B vitamin-like compound that is found in the diet. Choline is converted to acetylcholine in the brain with the help of a particular enzyme. With age, levels of this enzyme in the brain decline, and therefore, the supply of acetylcholine in the brain also diminishes. Deficits of acetylcholine have been linked to loss of memory, loss of the ability to store new memories, and emotional disturbances. 

Supplementation with citicoline raises brain levels of acetylcholine[xxix] and supports memory and mental performance in healthy individuals.[xxx]^,[xxxi] Some studies have shown that citicoline is also able to reverse age-related changes in people with mild memory problems.[xxxii]^,[xxxiii]

In addition to its role in raising neurotransmitter levels, citicoline increases the amount of phospholipids (specialized fats) in brain cell membranes and helps protect them against oxidative damage.[xxxiv] This protection means that vast numbers of brain cells will not be lost to the ravages of time. 

Through its combined action on neuronal membranes and neurotransmitters, citicoline exerts targeted action to protect brain health and function during aging. 

Prescription for Brain Health

Taken altogether, the research on nutrition and brain health provides some valuable advice for those who want to remain mentally sharp into their latter years.

1. Eat a “Mediterranean” style diet with plentiful fruits, vegetables, fish, grains and healthy oils. Minimize your intake of saturated fat. 

2. If your diet does not provide adequate omega-3 fatty acids or B vitamins, consider supplementation with these nutrients. 

3. Consider supplemental intakes of a vitamin E & vitamin C combination and/or a multivitamin.

4. Supplement your nutritious diet with citicoline, sold under the brand name Cognizin®, to preserve your memory.