Compared to placebo, patients taking Vitamin E had slower functional decline and needed less caregiver assistance.

A study published in the Journal of the American Medical Association reports on the benefit of high dose Vitamin E in patients with mild to moderate Alzheimer’s Disease. The double-blind, placebo-controlled, randomized clinical trial involved 613 patients with mild to moderate Alzheimer’s Disease. Participants were randomized to receive 2,000 international units (IU) of vitamin E, 20 milligrams of memantine, a combination of both, or a placebo daily. Average follow-up was 2.3 years.

Patients were analyzed on their capability to perform daily living activities, memory and language, cognitive function, behavioral and psychological issues, and the time needing caregiver assistance. The data was measured and collected at the beginning of the study and every six months during the trial.

Over the years of follow-up, scores declined by 3.15 units less in the Vitamin E group compared with the placebo group. In the memantine group, the scores declined 1.98 units less than the decline in the placebo group. Compared to the placebo group, those taking Vitamin E had an average delay in clinical progression of 19% per year, or approximately 6.2 months over the follow-up period.

Patients receiving the vitamin also needed less caregiver assistance in comparison with the placebo group. There was no significant difference in all-cause mortality or safety issues reported between the placebo and Vitamin E groups.

This study showed that high dose Vitamin E appears to slow functional decline and caregiver burden in patients with mild to moderate Alzheimer’s Disease.

Dysken MW, Sano M, Asthana S, et al. Effect of vitamin E and memantine on functional decline in Alzheimer disease: the TEAM-AD VA cooperative randomized trial. JAMA. 2014;311(1):33-44.

Cigarette smokers are known to have an increased risk of heart disease and myocardial infarction (MI). Smoking negatively affects the cells lining the blood vessels (endothelial cells) and reduces the body’s output of plasminogen activator (t-PA), a substance involved in the normal breakdown of clots within the vessels. Previous research has linked fish oil to heart health benefits associated with improvements in blood lipid levels, blood pressure, heart rate, reductions in clotting, and overall vascular health.

In a study published in the journal Heart, researchers investigated the effects of omega-3 fatty acid supplementation on cardiovascular health and vascular function in otherwise healthy smokers. The randomized, double-blind, placebo controlled crossover trial included 20 cigarette smokers that were given either 2 grams of fish oil or placebo for a 6 week period.

The daily fish oil supplements were associated with an increase in t-PA at twice the level of the placebo group. Substances known to dilate blood vessels, thereby increasing blood flow, were also significantly higher in the omega-3 supplemented group compared to placebo.

This study is the first to show that omega-3 fatty acids may enhance endothelial t-PA release and improve endothelial vasomotor function in cigarette smokers. The researchers note that while the omega-3 supplements may have improved vascular function in smokers, they still aren’t likely to match the endothelial function of non-smokers, so quitting smoking is still a key factor in reducing heart disease risk.

For tips on how to quit smoking:

Din JN et al. Effect of ω-3 fatty acid supplementation on endothelial function, endogenous fibrinolysis and platelet activation in male cigarette smokers. Heart. 2013 Feb;99(3):168-74.

Nutrient levels account for a 17% variation in memory and thinking ability, and a 37% variation in brain volume in a group of study individuals.

A study published in Neurology has found that certain nutrients work together synergistically to promote brain health. The study looked at the effects of diet and nutrient intake in seniors on memory, thinking and brain volume.

The researchers recruited 104 individuals (average age 87) and measured blood levels of certain nutrients, as well as memory and thinking in all study participants. They also analyzed MRI scans to determine the brain volume of 42 of the subjects.

Participants in the study were healthy nonsmokers with relatively few chronic diseases and free of memory and thinking problems. Most had generally healthy diets, but there were some with deficiencies of certain nutrients. This created enough variation to determine that nutrient status does play a significant role in memory, thinking, and brain volume. It was determined that nutrient levels accounted for 17% of the variation found in memory and thinking, and for the 37% of the variation in brain volume.

With this data, the researchers came to three conclusions. The first conclusion is that individuals with diets high in omega-3 fatty acids, vitamins C, D, E, and B were more likely to score better on memory and thinking tests. Those with diets high in trans-fat were more likely to both score poorly on memory and thinking tests, and to have brain shrinkage. Finally, individuals with low omega-3 fatty acid intake and other nutrient intake are more likely to have lower brain volume.

Getting adequate nutrients through a balanced diet and supplements may be an important overall approach to maintaining good brain health and thinking ability as we age.

Bowman GL, Silbert LC, Howieson D, et al. Nutrient biomarker patterns, cognitive function, and MRI measures of brain aging. Neurology. 2012;78(4):241-9.

Vitamin B12 plays an important role in neurodevelopment in children.

Vitamin B12 is essential for human life. It is involved in the synthesis of DNA, red blood cell formation, energy production, and the metabolism of folic acid. Studies have shown vitamin B12 is also involved in the neural development of young children. Researchers predict that vitamin B12 deficiency early in life may negatively impact cognitive performance years later.

Unfortunately, vitamin B12 deficiency is common around the world. This creates a problem for breastfeeding infants. These infants’ only source of vitamin B12 is their mother, who may already be B12 deficient herself. Studies have shown that only a small, often unpredictable, amount of B12 ends up in breast milk, regardless of a woman’s B12 status. That could worsen this potential health concern.

A study conducted in Nepal, a region known for vitamin B12 deficiency, examined the link between vitamin B12 deficiency and long-term cognitive development and performance. 500 children were initially included in the study.

The mothers’ dietary intake was determined through three, 24-hour dietary recalls over a one year period. In children, 24-hour dietary recall and blood samples were used to determine vitamin B12 status. Researchers measured neurological development through questionnaires and assessments of communication skills, motor skills, problem solving, eye-hand coordination, and puzzle-solving ability.

Follow-up occurred five years later. A total of 321 of the initial 500 children were found and assessed. Results confirmed the researchers’ initial hypothesis that poor vitamin B12 status does have a long-term impact on the neural development and the cognitive performance of children.

This study shows that vitamin B12 plays an important role in neural development. It also confirms and expounds upon previous research. Now showing that poor B12 intake can have impacts years later. Future research could help determine the best treatment option for infants that are low in vitamin B12. Such research could include supplement intervention trials for infants deficient in vitamin B12.

Kvestad I, Hysing M, Shrestha M, et al. Vitamin B-12 status in infancy is positively associated with development and cognitive functioning 5 y later in Nepalese children. Am J Clin Nutr. 2017;105(5):1122-1131.

For those with diabetes, folic acid supplementation may be beneficial in reducing the risk of stroke.

Folic acid is a derivative of folate (an essential B vitamin) and is an essential nutrient which has been linked to numerous health benefits. It is important enough that many governments require grains to be fortified with folate/folic acid to provide their citizens with regular, daily access to this important vitamin.

In countries with low access to folate, research has demonstrated an incredible reduction of incidences of neural tube defects (NTDs) in infants whose mothers had access to folic acid supplementation during pregnancy. Folic acid supplementation has proven to be a safe, inexpensive, and effective way to reduce the risk of NTDs and other birth defects in third-world countries and at-risk populations all around the world.

Folic acid supplementation has also been purported to improve heart health. The American Heart Association (AHA) published an article last year exploring the decrease in congenital heart defects associated with folic-acid supplementation and folic-acid-fortified foods. This connection between the B vitamin and heart health suggests that folic acid can work preventatively with regards to stroke and myocardial infarction, otherwise known as heart attack.

Diabetes, which is characterized by high blood glucose concentrations during and after periods of fasting, is a known risk factor for stroke. Researchers at several universities and hospitals in China hypothesized about the link between folic acid supplementation and the first stroke associated with elevated blood glucose levels. They performed a randomized double-blind study over the course of several years.

Participants in this study were men and women between the ages of 45 and 75 with hypertension, who were diagnosed as diabetic (type 2 diabetes mellitus) or normoglycemic prior to the study. The subjects were provided with either a daily oral dose of 10mg enalapril and 0.8mg folic acid, or 10 mg enalapril only. Follow-up visits for each participant were scheduled every three months for the duration of the study (median duration = 4.5 years).

Results indicate that, for any given glucose category (hypoglycemic, normoglycemic, diabetic), risk of stroke was significantly reduced by folic acid supplementation. Those with fasting glucose blood levels indicating diabetes showed the greatest risk reduction due to folic acid supplementation.

From the results of this study, it can be inferred that folic acid supplementation may be beneficial in reducing the risk of stroke for those with diabetes. Increasing the amount of folic in the diet should be a priority for everyone; however, without regular access to folate-fortified grains, this goal can be hard to achieve. Folic acid supplements can be a great way to regularly meet the daily recommended value of this essential nutrient.

Xu RB, Kong X, Xu BP, et al. Longitudinal association between fasting blood glucose concentrations and first stroke in hypertensive adults in China: effect of folic acid intervention. The American Journal of Clinical Nutrition. 2017;105(3):564-570. doi:10.3945/ajcn.116.145656.

Folic acid fortified food linked to decrease in congenital heart defects. News on Published August 29, 2016. Accessed May 10, 2017.

Patients with mental disorders are often deficient in omega–3 fatty acids, B vitamins, minerals, and amino acids that are precursors to neurotransmitters.

About 10-20% of the population experience mental health conditions each year, including depression, anxiety, bipolar disorder, schizophrenia, and post-traumatic stress. Research shows that nutrition can influence mental health.

According to a published review of nutrition and mental health, the most common nutritional deficiencies seen in patients with mental disorders are of omega–3 fatty acids, B vitamins, minerals, and amino acids that are precursors to neurotransmitters.

Although the connection between nutritional deficiencies and physical illness is better understood, fewer people are aware of the connection between nutrition and mental health. Many dietary patterns that precede depression are the same as those that occur during depression. These may include poor appetite, skipping meals, and a dominant desire for sweet foods. Nutritional neuroscience is an emerging discipline shedding light on the fact that nutritional factors are intertwined with human cognition, behavior, and emotions.

This is not meant to imply that a particular nutrient or nutrients can cure or prevent all mental illness, simply that there is a connection between mental health and many nutrients, including carbohydrates, protein, omega-3 fats, B-complex, vitamin B12, folate, calcium, chromium, iron, selenium, iodine, zinc, and mental health. Good nutrition plays a significant role in overall brain health. And poor nutritional status may negatively influence brain health, mood, depression, etc.

Note: Discontinuing appropriate medications or therapies is not recommended without specific advice by a health professional, but making sure that you get all the nutrients you need to support mental health is always recommended.

Rao TS, Asha MR, Ramesh BN, Rao KS. Understanding nutrition, depression and mental illnesses. Indian J Psychiatry. 2008;50(2):77-82.