10/9: A Guide to Supplements & Health
This week, we will be introducing Canvas, which we will use for the discussion board.
Recording of lesson:
Did you miss the lesson? Instructor Bridget Wright has recorded it just for you!
Chat notes from Wednesday night class
Vit D activation for biochemists:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3968073
Vit D activation cycle if you are not a biochemist
https://clinref.com/rheumatology/vitamin-d-metabolism/
Per Mayo Clinic, foods to avoid when taking Warfarin (blood thinner)
https://www.mayoclinic.org/diseases-conditions/thrombophlebitis/expert-answers/warfarin/faq-20058443
The companies that make the supplements have to pay for testing and quality control to be able to make health claims on supplements. The FDA does regulate labeling.
https://www.fda.gov/news-events/rumor-control/facts-about-dietary-supplements
There are two forms of CoQ10: Ubiquinone (CoQ10) and Ubiquinol (‘active’ CoQ10). Both forms of CoQ10 are naturally present in the body. However, our body needs to convert CoQ10 into ubiquinol before it can be used to create energy. This is Herculean work! And it can get harder with age since the body’s ability to produce CoQ10 and convert it into ubiquinol declines as we get older. That’s why ubiquinol is a popular choice for people over 50.
(Regarding supplement use) Distilled, two word, version of my B,S. degree in Nutrition Science from UC Davis:
Moderation and variety.
Always look for the % RDA on supplements. Some products are really over the top.
Zinc, Manganese, and other metals etc are important in our normal biochemistry. Usually catalysts. Only needed in small amounts.
Iodozed salt has essentially resolved the problem goiter in the population. Same with fluoride in the water has improved the dental health of the populations where fluoridated water is provided.
Supplements and You
(AARP, 2019; Jaime, 2017)
Every day, our body needs nutrients from the foods we eat to function properly. Every cell in the body, including brain cells, requires adequate nutrition to perform at an optimum level. Many people rely on supplements because they believe that supplements can help make up for a poor diet, prevent or treat disease, or increase cognitive functioning.
Supplements are a big business. In the United States, there are more than 85,000 different types of supplements on the market, with over $40 billion dollars in annual sales. Due to our aging population, supplements for brain health are becoming increasingly popular, with over $3 billion dollars’ worth sold every year.
Many older adults think that supplements are necessary for overall health and cognitive function. According to surveys by the American Association of Retired Persons (AARP) 81% of older adults believe supplements are important for health, and 25% regularly take a supplement for brain health. But are supplements necessary? How can you determine if you need a supplement, and how can you choose one that is safe and effective? In this lesson, we will examine supplements, learn about the scientific evidence behind them, how they are manufactured and regulated, and help you choose supplements safely and wisely.
Types of Nutrients:
(NIH, 2023; Colorado State University 2021)
Let’s begin with a brief overview of the different types of nutrients or substances that may be found in foods and supplements:
Vitamins
Vitamins perform a wide variety of functions. Vitamins from foods or supplements can help make our bones strong, improve immune function, regulate hormones, assist with cellular metabolism, and much more.
There are two main types of vitamins: fat soluble and water soluble.
Water soluble vitamins are the 9 different types of B vitamins, as well as Vitamin C. Water soluble vitamins aren’t stored in the body in significant amounts and must be replenished daily. If your body has an excess of water-soluble vitamins from taking high doses of supplements, it is excreted via the urine.
Fat-soluble vitamins are vitamins A, D, E and K. Fat-soluble vitamins need fat from foods to be adequately absorbed. They do not need to be consumed daily, and excess is stored in the liver and fatty tissues. While it is difficult to get too many fat-soluble vitamins from food sources, if you take high doses of fat-soluble vitamin pills, the excess can have unhealthy side effects.
Minerals
Like vitamins, minerals also are necessary for daily body functions. There are 15 essential minerals that the body needs. These minerals are classified either as major minerals, meaning your body needs them in large amounts every day, or trace minerals, which means your body needs smaller amounts. Calcium is an example of a major mineral, while iron is an example of a trace mineral.
Antioxidants (Pooja, et al., 2014)
Antioxidants are substances found in plant foods. They are natural molecules that help neutralize harmful free radicals that damage our cells. While antioxidants are not essential for daily body functions like vitamins and minerals are, research shows that they play a role in disease prevention. For example, the antioxidants lutein and zeaxanthin found in dark green leafy vegetables have been linked to improved eye and brain health. The antioxidant lycopene found in tomatoes and watermelon has been linked to lower rates of prostate cancer. Scientists estimate that there are thousands of different beneficial antioxidant compounds from food sources. Antioxidants are often sold as supplements, but research shows supplements are not as beneficial as obtaining antioxidants from foods.
Herbal Supplements (Greger; Center for Science in the Public Interest, 2022)
Herbal supplements are not necessary for body functioning, but they are popular for treatment of symptoms or diseases. For example, the herb chamomile is often used to promote relaxation, St John’s Wort may be used for depression, and echinacea is commonly used to boost the immune system. It is important to note that the FDA classifies herbal supplements as foods, not drugs, so they are not subject to rigorous testing like medications are. Studies show many herbal supplements are not effective for the conditions they are supposed to treat.
Nutrient Needs and Aging
Research shows the best way for the body to utilize and absorb vitamins, minerals and antioxidants is to get them from foods. However, as we get older, it may become more difficult to obtain the daily nutrients our body needs.
There are many factors that affect our ability to get adequate nutrition as we age:
· Some vitamins and minerals, like Vitamin B12, are not absorbed as efficiently in older adults.
· Appetite may decrease as we get older, due to things like medication interactions, less physical activity, or depression.
· The ability to cook and prepare nutritious meals may be affected by conditions like poor vision or arthritis.
· Physical conditions like heart disease, diabetes, or cancer may change dietary needs.
· Chewing, swallowing, or digestive disorders may inhibit the ability to eat certain foods.
· Metabolism may slow, resulting in fewer calorie needs per day
Despite these changes, older adults still need adequate nutrition daily for the brain and body to function properly. Choosing nutrient dense foods like fruits, vegetables, lean proteins, legumes, nuts, seeds, and whole grains is the optimal way to get the fuel we need.
Supplements are best used when a vitamin or mineral deficiency is detected. For example, if you have low bone density you may need to supplement with calcium or Vitamin D. If you have anemia, you may need to supplement with iron or B vitamins. Talk to your doctor if you think you have a vitamin or mineral deficiency that needs supplementation.
Percentage by number of dietary supplements vs age
Percentage by sex and age
Percentage of types of vitamins/minerals by age
Role of Vitamins and Minerals in Brain Health:
(Global Council on Brain Health 2019; NIH, 2023)
Many vitamins and minerals play a role in the health of our brain. Here are just a few examples:
Vitamin B12 (cycanobalamin): Vitamin B12 helps keep brain cells, nerve cells, and blood cells healthy. A lack of Vitamin B12 can contribute to vitamin-deficiency anemia. In older adults, vitamin B12 deficiency can also mimic the symptoms of dementia, such as confusion or memory loss. Approximately 20% of older adults have a B12 deficiency. Vegans and vegetarians are especially susceptible to Vitamin B12 deficiency, because the main food sources of B12 are animal products like meat, eggs, and fish.
Vitamin B9 (folate): Vitamin B9 plays a role in brain health, nerve function and the production of red blood cells. A deficiency of Vitamin B9 is rare, because in the United States breads and cereals are fortified with folic acid. High doses of Vitamin B9 from supplements can have negative interactions with some drugs, including anticonvulsants and barbiturates. High doses of B9 may also mask the symptoms of B12 deficiency. Good food sources of Vitamin B9 are dark leafy greens, beans, and citrus.
Vitamin B3 (niacin): Vitamin B3 helps keep the nervous system, digestive system, and skin healthy. A deficiency of B3 may lead to pellagra (cracked, scaly skin). High doses of B3 from supplements may cause nausea and skin flushing. Vitamin B3 has received a lot of attention recently because a derivative of B3 can be converted to a coenzyme called NAD+, which has been linked to anti-aging. Although NAD+ levels in the body naturally decrease with age, there is little evidence that NAD+ supplementation has anti-aging benefits. Food sources of B3 include meat, poultry, fatty fish, and nuts.
Vitamin D: Vitamin D has many functions, including calcium absorption and immune function. As we get older, our body tends to absorb Vitamin D from the sun less efficiently. Many older adults therefore need to supplement with Vitamin D. There have been some recent studies linking low levels of Vitamin D to dementia, but the exact mechanism behind the relationship is not clear. Because Vitamin D is a fat-soluble vitamin, high doses can have toxic side effects. If you are concerned about Vitamin D deficiency, it is very important to have your Vitamin D levels assessed via a blood test done at your physician’s office. This way your doctor can determine what dose of Vitamin D is appropriate for you. The best source of Vitamin D is from sunshine, but fatty fish, egg yolks, and fortified dairy products also contain Vitamin D.
Vitamin E: Vitamin E plays a role in immune function, and it helps the body form red blood cells and keep arteries healthy. Vitamin E also has antioxidant disease-fighting properties. Some studies have shown that people who consume high levels of Vitamin E from foods may have a lower risk of dementia. Vitamin E supplementation, however, has not been shown to be brain protective. Because Vitamin E is a fat-soluble vitamin, excess can build up and toxic side effects can occur, including a risk of bleeding in the brain in people who take blood thinners. Good food sources of Vitamin E include safflower oil, sunflower seeds, corn, and certain green vegetables.
Iron: Iron is a trace mineral that the body uses to make hemoglobin, a protein in red blood cells that carries oxygen from the lungs to the brain and body, and myoglobin, a protein that carries oxygen to the muscles. A deficiency of iron can mimic the symptoms of dementia, including weakness, fatigue, and difficulty concentrating. Iron deficiency often occurs due to a poor diet, blood loss, or chronic vigorous exercise. Good food sources of iron include meat, eggs, seafood, spinach and fortified breads and cereals.
Supplements for Brain Health: What Does the Research Say?
Because our population is aging, supplements for brain health have become increasingly popular. It’s difficult to watch television, read a magazine or do an internet search without coming across claims about substances that are supposed to improve memory or prevent dementia.
Let’s examine some of the more common products:
Multivitamins (Yeung, et.al. 2023; Raubenhemar, 2023)
Although multivitamins may be beneficial for older adults who have difficulty getting enough nutrients from foods, most studies that have examined multivitamin supplementation for memory have not found benefits. A more recent study, the COSMOS trial, did find associations between daily multivitamin use and increased cognitive function. In the COSMOS trial, 3562 adults over age 65 without dementia were asked to take a daily multivitamin (Centrum Silver) for 3 years. Results showed that multivitamin use improved immediate recall memory. However, multivitamin use did not improve memory retention or executive function. Because the ingredients in multivitamin brands can vary widely, a drawback of this study is that the results may not be replicable to other brands of multivitamins other than Centrum Silver.
Caffeine (GCBH,2022)
Caffeine is found in many sources, including coffee, tea, energy drinks, sodas, and some protein shakes and bars. It is also added to certain supplements and protein powders. Caffeine has beneficial short-term effects on the brain and body, including improvements in memory, focus, attention, and athletic performance. These beneficial effects can last for several hours. However, there is no evidence that caffeine has long-term positive effects on the brain. Up to 400 milligrams a day of caffeine (the amount found in four 8-ounce cups of brewed coffee) is generally considered safe for most adults, although some caffeine-sensitive people may need to consume less. High doses of caffeine can cause insomnia, headaches, anxiety, and heart palpitations.
Coenzyme Q10 (Alzheimer’s Association, 2023; Global Council on Brain Health 2019)
Coenzyme Q10 is a compound that the body makes naturally. It helps convert the food we eat into energy. It also helps protect against oxidative stress that can damage cells, including brain cells. Like some other natural compounds made by the body, levels of Coenzyme Q10 tend to decrease with age. Many people on cholesterol-lowering drugs take CoQ10 supplements to reduce the side effects of statin medications, like muscle pain or weakness. Some studies done in mice have shown that Coenzyme Q10 may have neuroprotective effects on the brain. However, there is no reliable evidence that Coenzyme Q10 supplements protect the aging brain or treat Alzheimer’s Disease in humans. More research on humans is needed before definitive conclusions can be made. Food sources of Coenzyme Q10 include organ meats, fatty fish, meat, soybeans, and broccoli.
Turmeric (Mellor, 2023)
Turmeric is a bright yellow or orange spice often used in Indian and Asian cuisines. The active ingredient in turmeric, called curcumin, has antioxidant and anti-inflammatory benefits. Some small studies have shown that consuming turmeric spice may be effective for improving short-term memory and attention. One of the challenges with turmeric is that the curcumin in turmeric is not very bioavailable, which means that the body does not absorb it very efficiently. To increase the bioavailability of turmeric spice, add a small amount of black pepper and a little bit of fat, like oil, to the spice. Although turmeric supplements are very popular, studies have not shown significant health or brain benefits. One of the reasons for this is that the body cannot always absorb the high dosage of curcumin found in turmeric supplements. In rare cases, high doses of turmeric supplements can cause liver damage. Enjoying turmeric in spice form is the best way to gain health benefits.
Fish Oil (Consumerlabs.com; Medscape.com; Global Council on Brain Health, 2019))
The Omega-3 fatty acids DHA and EPA found in fish are beneficial for brain and heart health. These polyunsaturated fatty acids help promote communication between brain cells, decrease triglyceride levels, decrease the risk of blood clots, and help support cellular membranes. Because of its benefits, the American Heart Association recommends eating at least two servings of fatty fish weekly to help protect the heart and brain. When it comes to consuming fish oil supplements, however, studies are mixed. Some studies have shown benefits from fish oil supplementation, while others have not. The benefits of fish oil consumption are mainly seen in those with low levels of DHA, or in those who don’t consume fish. If you do not eat fish, consult your physician about whether fish oil supplements would be appropriate for you. There is an increased risk of internal bleeding and interactions with anti-clotting medications when taking fish oil supplements, especially at high doses. In some studies, fish oil supplementation has also been linked to an increased risk of atrial fibrillation.
Cocoa flavanols (Global Council on Brain Health, 2019; Medscape.com)
Cocoa flavanols are antioxidants found in cocoa beans, the substance used to make dark chocolate. Many food and supplement manufacturers market high-flavanol cocoa powders or supplements for brain and heart health. Some small studies funded by the cocoa industry have found slight benefits in attention and processing speed in the brain with these products. Other studies have found that cocoa flavanols may improve cardiovascular health by decreasing blood clotting and improving vascular health. Currently, the FDA states that there is limited evidence for the cardiovascular benefits of cocoa flavanols. Keep in mind that although dark chocolate contains flavanols, it is also high in calories and contains saturated fats, so it’s consumption should be limited. Tea, berries, and apples are also good sources of beneficial antioxidant flavanols.
Gingko Biloba (Alzheimer’s Association 2023; Dekosky, 2008; Global Council on Brain Health, 2019)
Gingko is a popular supplement made from the leaves of the gingko biloba tree. It has been used in Chinese medicine for centuries to treat the brain, heart, and lungs. Some small studies have shown that gingko promotes blood circulation and may have a positive effect on memory. However, a large study of 3000 people published in 2008 in the Journal of the American Medical Association found that gingko biloba supplements had no effect on preventing Alzheimer’s Disease, dementia, or mild cognitive impairment. Despite these findings, gingko biloba continues to be marketed to seniors as a brain health supplement.
Coconut Oil (Alzheimer’s Association, 2023; Spichak, 2022; Global Council on Brain Health, 2019)
Coconut oil is another product that is heavily marketed as a health food. Coconut oil contains a type of fat called medium-chain triglycerides (MCT’s). Some studies have found that medium-chain triglycerides have brain health benefits. However, it is important to note that the type of MCT oil used in many of these studies was a medically derived 100% MCT oil. Commercially available coconut oil, like the kind found in grocery stores, only contains about 13-14% MCT’s. Therefore, the average person would have to consume large amounts of coconut oil to derive brain benefits from the medium-chain triglycerides. Since one tablespoon of coconut oil contains 120 calories and is 95% saturated fat, consuming large amounts of coconut oil may have negative effects on heart and brain health. The Alzheimer’s Association states that “there has never been adequate clinical testing of coconut oil for Alzheimer’s, and there is no evidence that it helps”.
Melatonin (Global Council on Brain Health, 2019)
Melatonin is a hormone produced by the pineal gland in the brain. It helps regulate circadian rhythm and induce sleep. Some studies have shown that melatonin can improve sleep quality, which is important for overall brain health. Studies have also found that those with dementia tend to have lower levels of melatonin. In people with advanced dementia, melatonin may also help with the effects of “sundowning”, which is the agitation that occurs in the evening. However, since melatonin can negatively affect cognitive function and increase the risk of falls, regular use is not recommended for most older adults. Since dosage and efficacy standards for melatonin have not been established, if you choose to take melatonin supplements, take the lowest possible dose for the shortest period of time, and do not become dependent on taking melatonin nightly.
Neuriva (Alzheimer’s Association, 2023; Global Council on Brain Health, 2022; Consumerlabs.com 2022)
Neuriva is a popular brain health supplement marketed by many celebrities, most notably Mayim Bialik, the host of the game show Jeopardy. The main ingredients in Neuriva are coffee cherry extract (an antioxidant) and phosphatidylserine (a fat molecule). The few studies done on coffee cherry extract have been conducted by the company that makes Neuriva. Research on the effectiveness of phosphatidylserine is also considered weak. In April of 2021, the makers of Neuriva settled a lawsuit that prohibits them from claiming that their product is backed by science. Despite this, Neuriva is still being sold as a brain health supplement, with a cost of $650 for a year’s supply.
Prevagen (Alzheimer’s Association 2023; Consumerlabs.com 2022)
Prevagen is another brain health supplement that is heavily marketed to seniors. The main ingredient in Prevagen is a substance called apoaequorin, which is a protein obtained from a type of jellyfish. The makers of Prevagen sponsored a study that claimed to show benefits; however, the study design was flawed. In 2012, the FDA issued a warning to Prevagen stating that their product claims violate law, that there is no evidence the product is effective, and that there were many reports of adverse effects, such as seizures and strokes. In 2021, Prevagen settled a class-action lawsuit that mandates changes on Prevagen’s labels and provides refunds to consumers. Despite this, Prevagen remains on the market, with estimated annual sales of $7 million.
Global Council on Brain Health Policy Statement on Supplements
(GCBH, 2019)
The Global Council on Brain Health (GCBH) is an independent collaboration of scientists, scholars, and health professionals convened by the American Association of Retired Persons (AARP) to provide trusted information on brain health. In 2018, the GCBH issued a report on supplements for brain health titled “The Real Deal on Brain Health Supplements”. This comprehensive report reviewed the scientific evidence on supplements commonly used for brain health and issued recommendations about their use.
Some of the consensus statements from the Global Council on Brain Health include:
· For most people, the best way to get nutrients for brain health is from a healthy diet.
· We do not endorse any ingredient, product, or supplement formulation specifically for brain health, unless your health care provider has identified that you have a nutrient deficiency.
Very few supplements have been carefully studied for their effects on brain health. For the handful that have been researched, several well-designed studies found no benefit for people with normal nutrient levels.
· The quality of the ingredients in supplements can vary widely. The ingredients in supplements are not reviewed for purity and content by government agencies before they are allowed to be sold. Some may contain ingredients that can harm consumers.
Evaluating Supplements
(Whittington, 2023; NIH, 2023; Consumerlabs.com; Center for Science in the Public Interest, 2022)
At some point during life, most people will need to take a supplement, or choose to take one. If you have a nutrient deficiency, or if you use a supplement to treat a symptom or medical condition, how do you know which product to use? With thousands of dietary supplements on the market, it can be overwhelming to try to find the one that is best for you.
Supplements come in many forms – pills, powders, shakes, gummies, and more. Many consumers are under the impression that taking a supplement is usually safe and effective. However, this is not always the case.
The quality and efficacy of supplements can vary widely, due to the following reasons:
· Under the federal 1994 Dietary Supplements and Health Education Act, supplements in the United States are classified as foods, not drugs. This means that they are not regulated like prescription or over-the-counter medications are.
· The FDA does not test supplements for quality or efficacy prior to them being sold. This is the responsibility of the supplement manufacturers.
· Since supplements are not well-regulated, many do not contain ingredients in the strengths and concentrations that they claim. Other supplements may have unwanted or unnecessary ingredients that can be harmful to health.
· The FDA will only intervene if it receives reports of side effects, illnesses, or other complaints about supplements. Even then (as in the case of Prevagen and Neuriva), it may take years for action to occur.
· Vitamin and mineral supplements are a synthetic form of the vitamins and minerals found in foods. The body may not digest, absorb, metabolize, or utilize the nutrients in supplements as efficiently as it does from foods.
Video: From the FDA, practical advice on dietary supplements.
Video: From ABC news, a report on dietary supplements (using Consumer Reports) (opens in YouTube)
Video: The truth on supplements in an interview with Dr. Pieter Cohen, Harvard Medical school (opens in YouTube)
Research on Quality of Dietary Supplements for Brain Health
(Crawford, et al., 2020; Veatch et al., 2021)
With so many dietary supplements on the market, it is nearly impossible for scientists and health professionals to research and evaluate all of them. Several studies have attempted to shed light on this issue by evaluating random samples of supplements.
In a study published in The Journal of Alternative and Complementary Medicine, researchers randomly selected 12 of 650 brain health supplements for independent analysis to verify whether their claims were truthful and the product labels accurate. They found that 92% of products contained scientific sounding claims that were not backed by accurate science. 83% of the supplements tested contained compounds that were not listed on the Supplement Facts Label, and 67% had at least one ingredient listed on the label that was not detected in the supplement. Researchers concluded that there are dietary supplements targeting brain health being marketed to consumers that are adulterated or misbranded.
In another study, researchers analyzed 29 duplicate bottles of herbal supplements to examine consistency of antioxidant concentration, presence of metals, and fungal contamination. They found a high variability in antioxidant concentration within and between different brands of supplements. They also found metals like zinc and nickel in over half of the supplements. Additionally, 60% of the products were contaminated with fungus, although the type of fungus was not hazardous except for people with compromised immune systems. Researchers concluded that there is contamination and lack of consistency in herbal supplements, and they recommended that the FDA regulate herbal supplements in the same way as prescription drugs.
Video: From a recent study, conflicting views of efficacy of vitamins and supplements (opens in YouTube)
Video: From FDA, adverse effects of dietary supplements (opens in YouTube)
Video: From FDA, effects of medications combined with supplements (opens in YouTube)
Finding Quality Supplements
(Consumerlabs.com; Center for Science in the Public Interest)
Since dietary supplements are not well-regulated, it is difficult for consumers to choose a supplement that is safe and contains the ingredients it is supposed to. Fortunately, there are several organizations which independently test supplements for quality and safety. If you would like to purchase a supplement that has been independently tested, look for one of the following seals on supplement labels:
NSF: National Science Foundation
USP: United States Pharmacopeia
CL: Consumer Labs
Keep in mind that if a supplement does not display one of these seals, it does not mean that it is unsafe or poor quality. It just means that it hasn’t been independently tested, and there is no reliable way for you to know what it contains.
Another factor to consider when choosing supplements is price. Expensive supplements are not necessarily more effective or better quality. Many lower price supplements, including some Walmart, Target, and Costco brands, are highly rated by organizations that independently test.
Red Flags for Consumers
(Consumerlabs.com)
Beware of claims like “clinically studied” or “scientifically proven”. Most research on supplements is done by the supplement company itself and has not been independently verified or peer reviewed.
If a supplement has been shown to be effective in lab studies or mice studies, these results don’t necessarily translate to humans.
Unlike prescription medications, the FDA does not approve supplements for safety or efficacy prior to sale. Likewise, the FTC (Federal Trade Commission) does not verify that the claims made about supplements in television or other advertising are truthful.
Be cautious about supplements that are endorsed by celebrities, athletes, media personalities, or actors posing as regular people. These individuals are usually paid for endorsing a product.
These illustrations point out the red flags of supplements, including:
Marketing
Ingredients
Company
It is an illustration of the complexity of finding safe and effective supplements. (source)
Tips for Supplement Use
When possible, try to get the nutrients your body and brain needs from foods.
Many foods are fortified with added vitamins and minerals, including some cereals, breads, orange juices, protein bars, and milks. Check the Nutrition Facts label to know how many additional vitamins and minerals you are getting from foods.
Multivitamins may be appropriate for older adults who can’t get enough nutrients from foods but be sure to check the label carefully. Multivitamin supplement ingredients vary widely among different brands, and some may contain 100%, 200% or even more of the RDA for certain nutrients, which can cause side effects.
If you suspect you have a nutrient deficiency and need a supplement, check with your physician, who will be able to test, diagnose and treat the condition properly. Your physician can also refer you to a Registered Dietitian Nutritionist (RDN) who can work with you on your dietary and supplement needs.
Some supplements can interfere with medications, or cause complications with certain medical conditions. Always inform your physician if you start on a new supplement. Your pharmacist is also a good resource for supplement/medication interactions.
Try to choose supplements that have been independently tested for quality and safety.
Consider expanding your food choices for a healthier diet.
Conclusion
Although many older adults choose to take supplements, they may not always need them. It’s best to get nutrients from foods first, and supplement when necessary due to a nutrient deficiency. Be mindful that more is not always better – high doses of supplements can interact with medications and cause side effects. The best way to determine if you need a supplement is to be evaluated by your physician. When it comes to brain health supplements, current research does not support their benefits.
Works Cited
Alzheimer’s Association, 2023. Alternative Treatments for Brain Health. Retrieved from: https://www.alz.org/alzheimers-dementia/treatments/alternative-treatments
American Association of Retired Persons. Brain Health and Dietary Supplements: Where’s the Evidence? 2019. Retrieved from: https://www.aarp.org/pri/topics/health/prevention-wellness/brain-health-and-dietary-supplements-survey.html#
Consumer Labs. Consumerlabs.com: Does Prevagen Really Improve Memory? 2022. Retrieved from: www.consumerlab.com/answers/does-prevagen-really-improve-memory/prevagen-memory/
Crawford C, Boyd C, Avula B, Wang YH, Khan IA, Deuster PA. A Public Health Issue: Dietary Supplements Promoted for Brain Health and Cognitive Performance. J Altern Complement Med. 2020 Apr;26(4):265-272.
Center for Science in the Public Interest. Problem Pills: Why the Supplement Aisle is the Wild West. Nutrition Action Newsletter, November 2022.
Colorado State University. Dietary Supplements: Vitamins and Minerals. Retrieved from: https://extension.colostate.edu/topic-areas/nutrition-food-safety-health/dietary-supplements-vitamins-and-minerals-9-338/
Consumerlabs.com. Do Supplements Improve Brain Health, Memory, and Cognition? Retrieved from: https://www.consumerlab.com/answers/do-any-supplements-help-with-brain-function/supplements-for-memory/?
Consumerlabs.com. Seven Red Flags to Watch out For When Buying Supplements. Retrieved from: https://www.consumerlab.com/answers/what-to-watch-out-for-when-buying-vitamins-and-supplements/vitamin-and-supplement-red-flags/?search=6%20red%20flags%20to%20watch%20out%20for%20when%20buying%20supplements
DeKosky ST, Williamson JD, Fitzpatrick AL, et al. Ginkgo biloba for Prevention of Dementia. Journal of the American Medical Association. 2008 300(19): 2253-2262.
Global Council on Brain Health (2019). “The Real Deal on Brain Health Supplements: GCBH Recommendations on Vitamins, Minerals, and Other Dietary Supplements.” Available at www.GlobalCouncilOnBrainHealth.org.
DOI: https://doi.org/10.26419/pia.00094.001.
Greger, Michael MD, FACLM. Contaminants Found in 90% of Herbal Supplements Tested. Retrieved from: https://nutritionfacts.org/blog/contaminants-found-in-90-of-herbal-supplements-tested/
Jaime J Gahche and others, Dietary Supplement Use Was Very High among Older Adults in the United States in 2011–2014, The Journal of Nutrition, Volume 147, Issue 10, October 2017, Pages 1968–1976, https://doi.org/10.3945/jn.117.255984
Medscape.com. Fish Oil Labels Make Health Claims, Despite Lack of Data - Medscape - Sep 15, 2023.
Medscape.com. Multivitamins, but Not Cocoa, Tied to Slowed Brain Aging - Medscape - Nov 11, 2021. Retrieved from: https://www.medscape.com/viewarticle/962772#vp_2
Mellor, Duane MD. Do Turmeric Supplements Work? Here’s What the Science Says. August, 2023. Retrieved from: https://www.beingpatient.com/turmeric-for-brain-health/
National Institutes of Health, Office of Dietary Supplements. Dietary Supplements: What You Need to Know. Retrieved from: https://ods.od.nih.gov/factsheets/WYNTK-Consumer/
Pooja, Verma PhD and Sunita, Mishra PhD. Antioxidants and Disease Prevention. International Journal of Advanced Scientific and Technical Research Volume 2, March-April 2014, pp 903-907.
Raubenhemar, Jacques, PhD. Are Multivitamins Good for Memory? July 2023. Retrieved from: https://www.beingpatient.com/best-daily-multivitamins-for-memory/? fbclid=IwAR0TkMnirr7v9lj1RQkp2UY3uwNNICWvGW3tFwM_YFG1QBrg2WLMTC_xawE
Spichak, Simon MSc. Can You Treat Dementia with Coconut Oil? Retrieved from: https://www.beingpatient.com/can-you-reverse-dementia-with-coconut-oil/
Spichak, Simon MSc. What Does Omega-3 fish oil do for dementia risk? Retrieved from: https://www.beingpatient.com/omega-3-fish-oil-for-brain-health-dementia-risk/
Veatch-Blohm ME, Chicas I, Margolis K, Vanderminden R, Gochie M, Lila K. Screening for consistency and contamination within and between bottles of 29 herbal supplements. PLoS One. 2021 Nov 23;16(11.
Yeung, Lok-Kin, Alschuler, Daniel M., et al. Multivitamin and Mineral Supplementation Improves Memory in Older Adults. American Journal of Clinical Nutrition, May 24, 2023. Retrieved from: https://ajcn.nutrition.org/article/S0002-9165(23)48904-6/fulltext