The correlation between unhealthy lifestyles and Alzheimer’s and dementia, and suggests promise for supplements that increase brain function.
According to 2011 Alzheimer’s Disease Facts and Figures, a report from the Alzheimer’s Association, more than 5.4 million Americans are known to be living with the disease.What’s worse, the prevalence of decreased brain health and memory decline among Americans is poised to grow rapidly in the near future.
“Studies now show that six to 10 percent of the population 65 years and older in North America have been diagnosed with dementia, and about 50 percent of those over 85 have signs of early dementia,” noted Dr. Joseph C. Maroon, MD, vice chairman and clinical professor, Heindl Scholar in Neuroscience, Department of Neurosurgery, University of Pittsburgh Medical Center and team neurosurgeon of the Pittsburgh Steelers.“This rate jumps exponentially by age 90 with greater than 37 percent of those aged 90 years and older having been diagnosed with dementia.
“Still in the U.S., 80- and 90-year-olds are a relatively small group compared to the advancing Baby Boomer generation,” Dr.Maroon added. “Due to the massive influx of Baby Boomers born after World War II who are now reaching 65 years old, the U.S. population is rapidly shifting to a much older average age. In fact, scientists believe the incidence of Alzheimer’s disease, the cause of about two thirds of age-related dementia, will increase sevenfold within the next several decades.”
Undermining Brain Health
Some of the main causes of poor brain health, according to Dr. Kira Schmid, ND, associate director of scientific affairs with Florida-based Life Extension, are biological factors, such as oxidative stress, inflammation, poor circulation, hormone imbalance and blood sugar dysregulation, as well as psychological contributors, such as stress and depression, which can increase the risk for developing dementia. “In addition, it is thought that not keeping the brain active through stimulating thought processes and too little exercise (less oxygen to the brain) are also contributors to cognitive decline,” she said.
“As we age there are numerous health changes that occur that can significantly begin to impair brain function,” added Dr.Maroon. “Reduced blood flow and poor vascular health due to excessive blood vessel plaques will often develop in many Americans. This is typically due to an unhealthy diet, which elevates cholesterol and triglyceride, which begin to deposit on the blood vessel walls.
Excessive accumulation of free radicals within our blood, associated with cellular aging itself, and increasing production of inflammatory molecules released by excessive fat, begin to affect the cells in our brain.”
Elevations of free radicals and inflammation are also caused by our modern lifestyle choices like smoking, excessive alcohol, eating saturated and trans fats, and a lack of exercise. It is the lethal combination of aging and lifestyle, diet And exposure to toxins that alter and even kill brain cells, Dr. Maroon expressed. Add to this a variety of dementia-causing diseases, such as Alzheimer’s, stroke and other neurodegenerative disorders, and the U.S. is now experiencing the “perfect storm to undermine brain health,” he said.
Studies show that many conditions that affect the brain can be improved with better lifestyle choices, alterations in diet and ideal range body weight. The key to their effectiveness is to start early to prevent the causes of dementia and brain poor function before they start.
“Despite the desire for success, most pharmaceutical treatments and interventions for neurodegenerative diseases like Alzheimer’s and dementia, due to aging, have had very limited success,” Dr.Maroon explained, adding that most drugs prescribed along with any cognitive treatments start long after symptoms have progressed and, at best, hope to slow progression, but do very little to actually cure these conditions. “The most promising areas that have shown significant help are in the area of prevention and investigation of risk factors for brain decline.”
Nutrition and the Aging Brain
Gene Bowman, ND,MPH, of Oregon Health & Science University in Portland, and a member of the American Academy of Neurology, said his clinical interests include the practice of complementary and alternative forms of medicine to promote healthy aging and wellness.Among his particular interests is helping people prevent and manage neurological, cardiovascular and gastrointestinal disorders associated with aging.
Recently, Dr. Bowman headed a study titled “Nutrient biomarker patterns, cognitive function, and MRI measures of brain aging,” that was published online in the journal Neurology in December. Its objective was to examine the cross-sectional relationship between nutrient status and psychometric and imaging indices of brain health in dementia-free elders.
According to the new research, a diet High in omega-3 fatty acids and vitamins helps keep the brain from shrinking.Those with diets high in omega-3 fatty acids and vitamins C, D, E and the B vitamins also had higher scores on mental thinking tests than people with diets low in those nutrients.
Another finding of the study showed that people with diets high in trans fats were more likely to have brain shrinkage and lower scores on the thinking and memory tests than people with diets low in trans fats.
The study involved 104 people with an average age of 87 years and very few risk factors for memory and thinking problems. Blood tests were used to determine the levels of various nutrients present in the blood of each participant.
All of the participants also took tests of their memory and thinking skills. A total of 42 of the participants had MRI scans to measure their brain volume.
Overall, the participants had good nutritional status, but seven percent were deficient in vitamin B12, and 25 percent were deficient in vitamin D. The nutrient biomarkers in the blood accounted for a significant amount of the variation in both brain volume and thinking and memory scores, according to the researchers. For the thinking and memory scores, the nutrient biomarkers accounted for 17 percent of the variation in the scores.
Other factors, such as age, number of years of education and high blood pressure, accounted for 46 percent of the variation. For brain volume, the nutrient biomarkers accounted for 37 percent of the variation.
“These results need to be confirmed, but obviously it is very exciting to think that people could potentially stop their brains from shrinking and keep them sharp by adjusting their diet,” Dr. Bowman said. “The standard advice to eat more fruits, vegetables and fish, and to avoid trans fats seems wise.”
Weight and Smoking
Another study of interest, published in Sweden in 2011, showed that elderly people who had been overweight or obese during middle age were 80 percent more likely to develop all types of dementia, including Alzheimer’s disease and reduced blood flow dementia, compared those with normal weight during that phase of life, Dr. Maroon pointed out. In the study, researchers looked at More than 8,500 twins over several decades. Nearly 30 percent of the subjects were overweight or obese in their 40s and 50s. By the age of 65, 350, or about four percent, of the twins were diagnosed with dementia or Alzheimer’s disease.
In addition, scientists at the University of Eastern Finland and at Kuopio University Hospital, Finland, analyzed data from 21,123 members of a health care system who took part in a survey between 1978 and 1985, when they were between ages 50 and 60 years.Diagnoses of dementia, Alzheimer’s disease and vascular dementia were tracked from January 1, 1994, when participants were 71.6 years old, on average, through July 31, 2008.
“The study showed that those who were heavy smokers in middle age (two or more packs/day) had twice the risk of developing dementia compared to those that didn’t smoke,” Dr.Maroon noted.
“Both excessive weight and smoking are related to increased risk of mental decline by inducing excessive inflammation and production of free radicals in the body and brain, and also result in reduced brain blood flow,” he said.
“Treatments and prevention strategies designed to address these two areas have shown success. In fact, numerous studies looking at conditions like arthritis have shown that those taking chronic long-term anti-inflammatory medications have a lower incidence of Alzheimer’s and dementia.This has also been found in people with heart disease on chronic aspirin therapy. Both of these medications can reduce the inflammatory process in the brain and help to counter inflammation from a variety of causes.”
A sedentary lifestyle, one adopted by many Americans, is also a significant risk to dementia, Dr. Maroon said, adding that reduced blood flow, increased inflammation and lower levels of brain function can all be prevented by exercise. “In fact, routine exercise has been shown to actually stimulate the growth of new brain cells.”
A recent study presented in September 2011 gives credence to the idea that a sedentary lifestyle is the greatest risk for developing dementia.
Researchers investigating potential risk factors for Alzheimer’s disease found that physical inactivity increases risk by 21 percent, smoking by 11 percent and obesity by seven percent. “Although not investigated together, imagine what the risk would be if you had all three,” Dr. Maroon said. “This same group concluded that 25 percent of Alzheimer’s disease cases might be prevented by risk factor reductions.”
Diet and supplement interventions to reduce inflammation and free radical production are generally preferable to medications, such as NSAIDs, Dr. Maroon pointed out. Chronic use of NSAIDs is associated with significant side effects including ulcers and bleeding, and is even linked to more than 16,000 deaths per year in the U.S. Diets consisting of mostly bright-colored fruits and vegetables, lean meat and good oils, such as omega-3 from fish oil, have been shown to reduce inflammatory markers and free radicals.
“In fact, studies have shown that omega-3 as both from fish and fish oil supplements can lower high triglycerides and help prevent heart disease, stroke and vascular narrowing associated with reduced blood flow,” said Dr. Maroon. “In my book, Fish Oil: The Natural Anti-inflammatory, I related human studies that show fish oil can help with depression, psychosis, attention deficit-hyperactivity disorder (ADHD) and even Alzheimer’s disease.Fish oil can also function to help build brain cells since the major component of brain cells is DHA.
Large-scale studies have shown fish oil consumption as a protective factor against dementia. Two Dutch studies in 1997 found that in people 55 years or older, daily fish reduced risk of cognitive impairment, cognitive decline, dementia and Alzheimer’s disease. A more recent prospective study that enrolled and then followed fish consumption in people for many years also reported in 2003 a link between reduced fish and omega-3 intake and increased Alzheimer’s disease.Other studies have shown lower levels of DHA in patients with Alzheimer’s disease and other dementias.A French study, also in 2003, found those with high inflammatory or saturated fats and low omega-3 fats in their blood were most at risk to experience cognitive decline as they aged.
Keri Marshall, MS, ND and chief medical officer with Nordic Naturals, a California-based supplement manufacturer, explained that fish oil, which is rich in the essential nutrients EPA and DHA, is an important basis for a longlasting foundation of brain health, memory and cognition. “With more than 8,000 clinical studies conducted on fish oil, a great majority of these focus on brain health throughout an individual’s lifetime, form birth through old age. Many of these studies suggest that lower levels of DHA put an individual at higher risk for developing memory issues, as well as dementia and/or Alzheimer’s disease,” she said, suggesting a minimum of 1-2 g of EPA + DHA from fish oil daily for people at risk of developing memory and cognitive disorders.
Dr.Marshall recommended Nordic Naturals’ line of Pro Omega products, which has a balance of both EPA and DHA; the Nordic Naturals Pro DHA 1000 is suggested when an individual really needs to have therapeutic dosing of DHA for brain health, she said.
“EPA helps to reduce generalized inflammation in the body and DHA is literally a building block for healthy brain tissue,” Dr. Marshall added. “The brain is 60 percent fat, and gray matter makes up approximately 45 percent of total brain fat. Of the gray matter, 30 percent is DHA. Myelin, which is the protective sheath that covers communicating neurons, is composed of 15-30 percent protein and 70-85 percent fat.So at the end of the day, having highquality fat and protein in the diet is critical.”
In his most recent book, The Longevity Factor: How Resveratrol and Red Wine Activate Genes for a Longer and Healthier Life, Dr. Maroon discusses the benefits of polyphenols.
“Polyphenols act as both powerful antiinflammatory molecules and antioxidants, which can counter free radicals,” he said. “As we age, excessive production of free radials is both a central cause of aging and chronic disease development.
Resveratrol is a type of polyphenol found in the skins of red grapes, cocoa beans and concentrated in red wines, dark chocolate and certain supplements, and has been found to be especially powerful to reduce inflammation and free radical.”
A randomized, double-blind, placebocontrolled, crossover study published in 2010 in the American Journal of Clinical Nutrition has shown that resveratrol can even increase blood flow to the brain.Twenty-two healthy adults who were given resveratrol as a supplement found a dose-dependent increase (i.e., the more resveratrol given, the better the response) in brain blood flow. They also found resveratrol could enhance oxygen transfer to cells. “These are the two most important things the brain needs to stay healthy—blood flow to bring adequate nutrients and oxygen to maintain peak function,” Dr.Maroon said.
Because of the relatively low concentrations of resveratrol in grapes and red wine, most human studies investigating resveratrol are using it as a concentrated supplement.
At Life Extension, Susie Rockway, PhD, executive director of product development Noted other nutrients that are beneficial for brain health in addition to omega-3s and resveratrol. “Supplements that contain alpha-glyceroylphosphorylcholine (A-GPC), phosphatidylserine (PS), ginkgo standardized extract, vinpocetine, dark berries, ginger, rosemary, magnesium threonate and the memory hormone pregnenolone are all beneficial,” she said.“Magnesium threonate is a unique magnesium source that can penetrate the blood-brain barrier and has been shown to increase synaptic density, which is associated with increased cognition and memory,” she said, adding that gingko and vinpocetine improve the circulation to the brain allowing for better delivery of oxygen and nutrients to neurons.
“The anthocyanins in blueberries fight oxidative stress and support blood vessel walls,” Dr. Rockway continued.“Ginger and rosemary have anti-inflammatory properties. PS and DHA support the health of the nerve cell membranes, which allows the neurotransmitters to more easily pass between nerves. A-GPC is a building block for the neurotransmitter, acetylcholine. Boosting this neurotransmitter improves clarity of thought and memory. Pregnenolone, nicknamed the ‘memory hormone,’ plays a critical role in production of neurotransmitters and the growth of nerves.”
Life Extension has several researched products for brain function available directly to practitioners. These include Cognitex with or without Pregnenolone, Neuro-Mag, Super Omega-3, CR Mimetic Longevity Formula, CDP-choline and the Two- Per-Day multivitamin.
Felix Corraliza, vice president of sales with Florida-based Silicium Laboratories, also suggested a multipronged approach to brain health in the form of dietary intake, physical movements and mental agility. “Examples are returning to natural foods without chemicals and desisting in intakes of alcohol, smoking and fatty foods, which have a negative effect on blood flow.
Regarding diet, it is to return to basics in the form of raw foods, [but especially] organic foods to eliminate chemicals inherent in modern farming,” he said.
“Physical exercise to promote blood flow to and throughout the brain and mental exercises to improve the ability to evaluate data (both textual and visual), engage in critical thinking, express ideas and thoughts, etc.—all of the functions which are utilized extensively in early years during schooling and later years during work, but which are less used in retirement.”
In terms of nutrition, Silicium Laboratories specializes in silica research regarding the full range of therapeutic use and, in particular, the known benefit to silica supplementation as a tool to eliminate aluminum concentrations in the brain, Corraliza explained. The return of glass products for cooking and aluminum-free steel for stovetop use is a positive precautionary trend, he said.
“In summary, the brain is like every other organ in the body: if you abuse it and don’t provide it the proper nutrition, stimulation and toxin free environment, it will fail,” said Dr. Maroon.“But if you choose to keep your brain healthy with proper lifestyle choices, foods, supplements and activities, for most people, you will be able to avoid the mental decline that people fear even more than death. It is your choice— choose wisely.”
The correlation between unhealthy lifestyles and Alzheimer’s and dementia, and suggests promise for supplements that increase brain function.