Can Dietary Supplements Improve Brain Health? By Joseph C. Maroon, sickness MD, FACS
Have you ever misplaced your car keys or left the house not sure if you turned off the stove? Are these lapses in memory becoming more frequent? Are you having normal forgetfulness due to your hectic life or is it a sign of something more serious? I am frequently asked these very same questions and fortunately very few people require further medical evaluation. For most people it is normal to occasionally forget things or names but it still could be a sign that your brain is not as healthy as it should be.
Our brains are the most complex organ in our body. Almost everything we do, consume or are exposed to in our environment can have a profound influence on brain function and longevity. Just like most organs the key to preserving brain health is to prevent diseases from occurring in the first place. To this end many people look to dietary supplements as a way to provide the vital nutrients the brain needs and often lacks in our typical American diet.
The fact is the vast majority of Americans consume less than half of the daily recommended amounts of fruits and vegetables. Plant food sources contain the majority of required vitamins, minerals and other healthy molecules that are required for our brains to function at their peak. According to a 2010 US Dietary Guidelines adequate consumption of vegetables and fruits is associated with reduced risk of many common chronic diseases. Specifically, eating at least 2 1/2 cups of vegetables and fruits per day has been shown to reduce the risk of cardiovascular disease, including heart attack and stroke. In addition, certain vegetables and fruits can be protective against various types of cancer. So if you can’t find time to buy, prepare and eat these superfoods, dietary supplements may hold the answer to improve and maintain your brain health for years to come.
Show Me the Evidence
As a physician and scientist I have approached the use of dietary supplements based on the facts available. Fortunately there are now hundreds and even thousands of scientific articles showing brain health benefits of a wide range of dietary supplements. Having reviewed many below is a list of some of the top brain health supplements and the evidence we have showing their benefits. But remember you can’t just pop a pill and expect your brain to remain healthy. Being healthy is a commitment to more exercise, eliminating toxins, such as cigarette smoke, maintaining ideal weight, reducing saturated fats and sugars in your diet and limiting alcohol consumption. The fact is medical science can now keep our bodies alive and functioning much longer than our brains. It is up to you to keep your brain in the game!
Omega-3 Fish Oils
Our brain is mostly made of specialized fat molecules that are concentrated in our nerve cells or neurons. This most common type of fat in the brain is an omega-3 fatty acid called docosahexaenoic acid or referred to as DHA. For humans DHA can only obtained from the food we eat and is therefore called “an essential” fat. DHA is found in most seafood and fish and is also commonly available as an omega-3 fish oil supplement.
Healthy brains may have up to 30% of their structure made from DHA molecules. But if the food source of DHA is missing, or becomes depleted as occurs with aging, the amount of DHA in the brain and throughout the body will also decrease. Lower levels of DHA can have a significant impact on brain function especially for the very young and very old.
Eating fish can have significant benefits for our brains especially as we age. This was the finding of a recent study by researchers at the University of North Carolina and Duke University Medical Center published this month. The study involves over 1,500 older subjects for slightly longer than 5 years and found that those over 65 yrs old that ate fish at least once per week reduced their rate of cognitive decline by about 1 ½ years. The authors attributed this benefit to the larger amounts of omega-3 (EPA and DHA) found in fish compared to other food sources. They reported that the brain benefits of omega-3 were accomplished by reducing inflammation and oxidative stress which worsens with age.
Many neurodegenerative diseases and aging itself will cause excessive brain inflammation and release of free radicals. Omega-3’s benefits, from fish as well as from omega-3 (fish oil) supplements, are well documented in other organs as well, especially the heart and vascular system. One problem with fish and other sea food consumption is that lead and other toxins found in water are concentrated in fish tissues and too much fish can lead to excessive amounts of these same toxins in people. Omega-3 supplements are a pure source of this important supplement and can be taken in higher amounts than typically found in fish.
Polyphenols – The Molecules in Fruits and Vegetables
Polyphenols are molecules found in fruits and vegetables and are classified as antioxidants. Studies have shown that polyphenols can help the brain to stay healthy by reducing toxicity, inflammation and promote normal brain activity. Polyphenols’ neuroprotective functions are to strengthen neurons against injury induced by neurotoxins and suppress neuroinflammation which is the most common cause of chronic neurological diseases like Alzheimer’s.
A recent study involving the preservation of telomeres and DNA integrity showed that those who regularly consumed at least 85% cocoa dark chocolate, which is packed with polyphenols, had less telomere shortening as they aged. Telomeres are structures that protect the ends of our chromosomes, or strands of DNA found in the cell nucleus, and protect normal cell division. Telomeres exposed to oxidative stress, either from environmental sources, diet or age-related free radicals, can become shortened. Many chronic disease of the brain have been linked to shortened telomeres.
The polyphenol in dark chocolate is called a flavanol and is also available as a concentrated dietary supplement. Other brain protective polyphenols include those found in green tea called epicatechins and in red apples, red onions and supplements called quercetin.
Perhaps one of the most studied polyphenol is resveratrol. Resveratrol is a found only rarely and in small amounts in several fruits and vegetables. It is however found more concentrated in the skin of red/purple grapes and concentrated further in red wine. Resveratrol, like other polyphenols, functions to protect the plant from infection, excessive UV radiation and aids in general plant defense. Also like other polyphenols resveratrol has been found to offer significant anti-cancer, anti-inflammatory, ant-oxidant and DNA protective actions when consumed by animals and humans. It is also available as a concentrated dietary supplement.
In a recent Germany study published in June 2014, scientists evaluated the brain benefit of improved memory when taking resveratrol as a supplement on 46 older (ages 50 -76 year) volunteers after 6 months on the supplement. Compared to the placebo group those on resveratrol had significantly better memory. Great news, but here is the phenomenal part, those that took resveratrol actually had bigger brain size compared to the control group and the baseline MRI they had 6 months earlier. The part of the brain that was larger is called the hippocampus, and you guessed it, it the part of the brain that controls memory. Other benefits found included decreased diabetes blood markers, reduced body fat and increases in a hormone called leptin, known as the satiety hormone, thought to reduce appetite and help with weight loss. This is an amazing list of benefits from a naturally occurring plant molecule.
Curcumin-Curcumin is a powerful antioxidant obtained from the spice turmeric. It has been shown to counteract the effects of oxidative stress due to brain trauma, improve brain cell communication and connections and even improve cognition. By boosting the immune system curcumin has been shown to even remove amyloid beta plaques in the brains of patients with Alzheimer’s. Curcumin has also been reported to act as an anti-inflammatory and is frequently found in arthritis and joint pain preparations. Several studies investigating cancer prevention have indicated curcumin can prevent certain cancers and also has been used as a cancer treatment.
Magnesium –The mineral magnesium has been shown to also reduce brain inflammation by reducing brain toxicity and can also function as an antioxidant, to promote brain cell repair. Increased levels of brain magnesium have also been shown to be highly protective of the brain following brain trauma such as from a fall or blow to the head.
Added Protein Supplement-Often as we age we consume fewer and fewer calories from protein sources. Maintaining adequate levels of protein in not only critical for muscle and tissue development but is also critical for maintaining brain health. Reduction in protein has been shown to occur as early as age of 35 years in most people. About 25% of men and 35% women consume less than the current Recommended Dietary Allowance (RDA) of dietary protein. By combining a higher protein intake along with increased resistance exercising researchers have demonstrated in an older population of both men and women increased strength, greater whole-body protein usage, and reduced fat mass, compared to those not taking increased protein.
What about the brain? Neurotransmitters are molecules stored and made by our nerve cells that allow brain cells to “talk” to each over. The neurotransmitters in the brain are made directly from food components, specifically amino acids from the breakdown of protein containing foods or supplements. The levels and activity of these neurotransmitters are sensitive to food intake, and changes in dietary patterns can have profound effects on behavior, eating patterns, sleep, and even energy levels.
Antioxidants-Foods, such as fresh fruits and vegetables, along with numerous vitamins and mineral supplements have antioxidant functions that can counter free radicals, lipid peroxides and other toxins that can accumulate with aging. Supplemental antioxidants, such as beta-carotene, lutein, lycopene, selenium, vitamin A, C and E can also function to decrease inflammation. Excessive inflammation has been link to most neurodegenerative diseases as well as the aging process itself. Niacinamide (B3) and the other B vitamins have been shown to improve brain energy production and blood flow through the small blood vessels of the brain, something that is critical for maintaining brain health.
Phosphatidylcholine and Phosphatidylserine -These phospholipids are also structural components of brain cells similar to DNA and not only promote repair of damaged brain cell membranes, but also can significantly reduce brain inflammation though the cholinergic anti-inflammatory system. They can be found in egg yolk and soybeans and are available as supplements. Numerous studies have been done using these as a possible treatment for early dementia and Alzheimer’s disease.
Treat your brain well and odds are it will continue to serve you throughout the decades of your life. Act now and take the right steps to avoid brain deterioration and decline with aging. Consider using these supplements and foods not only for better brain health but for your whole body. About Joseph Maroon, MD, FACS-Joseph C. Maroon, MD, FACS, is a board-certified neurosurgeon with more than 30 years of clinical experience at the University of Pittsburgh Medical Center. He has been the team neurosurgeon for the Pittsburgh Steelers for 25 years. Dr. Maroon is an expert and consultant in the areas of sports nutrition, concussion management, and brain and spinal problems. He has completes 8 Ironman triathlons – last in October 2013. In January 2014 he climbed Mount Kilimanjaro as the expedition physician for disabled athletes. Dr Maroon is author of The Longevity Factor: How Resveratrol and Red Wine Activate Genes for a Longer and Healthier Life. For more information on Dr Maroon go to www.josephmaroon.com