| Why B Vitamins Are Essential for Brain Health and How to Get Them
April’s Consumer Guidelines Tip:
- Be sure you get enough B vitamins in the correct proportions.
- B vitamins are vital to brain function, both thinking and emotional as well as preventing excess homocysteine, inflammation, and oxidation.
- Synthetic B vitamins such as found in enriched grains and vitamins work well as we age.
- Most important are B-12 and niacin.
- Taking extra folate or folic acid is helpful only when taking B-12 or not deficient in B-12.
- Best choice is a B-50 complex to avoid imbalances and excess B-6.
Several population-based studies indicated B Vitamins are Essential for Brain Health and for Reducing Risk of Alzheimer’s disease
People whose food or vitamin intake of both specific and groups of B vitamins was higher than average, were shown to have a lower risk of Alzheimer’s disease or cognitive decline. Various B-vitamins have been indicated as protective against AD and cognitive decline in many studies. The details are still unfolding. [1]
The mechanisms of biological action are multiple. Some are known; others are not yet. Certain B vitamins such as folic acid, vitamin B6 and vitamin B12, are known to control levels of the amino acid homocysteine in the blood. High levels of homocysteine are also associated with an increased risk of Alzheimer’s as well as heart disease.
Folates and B12 have also been found to be important in the treatment of depression.
Population studies produced only “circumstantial evidence” suggesting the relevance of B vitamins to brain health. B vitamins well known role of acting as co-enzymes in the brain’s production of neurotransmitters lent further plausibility to these findings.
The next step was for researchers to undertake placebo-controlled, randomized clinical trials, “gold standard” evidence
.
New Study Shows Extra B Vitamins Slow Cognitive Decline in People with Mild Cognitive Impairment and May Help Reduce Alzheimer’s Risk – But Study Was Small So Regard the Results with Caution
A few years ago a clinical trial examining whether a combination of 3 B vitamins might slow Alzheimer’s progression concluded with disappointing results, as reported in the Journal of the American Medical Association.[2] The 3 B vitamins were: Folic acid (5 mg = 5000 mcg), B-12 (1000 mcg) and vitamin B 6 (25 mg). These were very high levels of folic acid; the other two levels are not unusual and there is no upper limit established for vitamin B-12.
The patient population was people with mild to moderate Alzheimer’s disease; the primary outcome measure was a comprehensive cognitive scale called the ADAS-cog.
The results: – no significant difference between those taking a placebo pill with those taking the B vitamins. The people who took the B vitamins saw their homocysteine levels decline, but that did not translate into any benefits in terms of cognitive abilities compared to the placebo group. And in addition, those who were taking the high doses of these 3 B vitamins unexpectedly experienced higher rates of depression.
However, a study reported in December 2010, found promising results.[3] The primary differences with this study were several. 1) the patients in the new study were at an earlier stage of cognitive decline – they were diagnosed with Mild Cognitive Impairment (MCI), not yet full blown dementia or Alzheimer’s disease. Typically about ½ of people with MCI go on to develop Alzheimer’s disease within a few years. 2) The researchers used a lower dose of the B vitamins…a level which the researchers still called “a drug, not a vitamin intervention”. They used 800 mcg folic acid, 500 mcg of vitamin B 12, and 20 mg of vitamin B 6.
The study followed 168 volunteers with mild memory problems, half of whom took a high-dose vitamin B tablet for two years and the other half who took a placebo.
CNN reported that researchers used MRI scans to measure the rate of brain shrinkage over a two-year period. They found that on average, the brains of those taking a tablet that combined folic acid and vitamins B6 and B12 shrank at a rate of 0.76 percent a year, while those in the placebo group had a mean brain shrinkage rate of 1.08 percent.
“These are immensely promising results, but we do need to do more trials to conclude whether these particular B vitamins can slow or prevent development of Alzheimer’s,” said David Smith of the Department of Pharmacology at Oxford and a co-leader of the trial. “So I wouldn’t yet recommend that anyone getting a bit older and beginning to be worried about memory lapses should rush out and buy vitamin B supplements without seeing a doctor.”
The study was co-funded by the Alzheimer’s Research Trust, a British research charity. Chief Executive Rebecca Wood said the results are important but also said they require further study.
The U.S. Alzheimer’s Association also raised concerns about the study noting the small size, the fact that it was conducted at a single research center and that one of the researchers involved has patents in this area and might, under certain circumstances, result in his financially benefit.
“Only people with elevated homocysteine in the study showed benefit from the intervention. People with the lowest homocysteine levels in the study saw no benefit. So, B vitamins — if it shown to be effective in further studies — are unlikely to be beneficial for everyone, particularly if you already have healthy homocysteine levels,” said William Thies, chief medical and scientific officer of the Alzheimer’s Association.
“Clearly, this is not enough data to go on. No conclusions can be drawn from this single study about use of B vitamins in MCI (or Alzheimer’s disease or related dementias). No recommendations can or should be made to doctors or the public regarding use of B vitamins based on this study. ”
All B vitamins Important for Brain Health
While both of these clinical trials featured just 3 B vitamins, several other B vitamins, especially niacin[4], have also thought to be essential for brain health. The evidence is clear that B vitamins, including B12, B6, B1, B2, folate (B9) and niacin (B3) are essential for brain health. B vitamins also help with sleep (B6 and niacin are co-factors needed to produce serotonin), and maintain healthy skin, eyes, digestive tract, and nervous system. Because B-vitamins help release energy from carbohydrates consumed, they also help decrease fatigue.
Niacin (also known as nicotinamide, nicotinic acid or Vitamin B3) is a coenzyme that assists in the breakdown of carbohydrates, fats and proteins. Niacin is essential for the health of the skin, nerves, tongue and digestive system. It is found in every cell of the body and is necessary for energy production and DNA formation. Niacin can also increase circulation and reduce high blood pressure and lower cholesterol.
Niacin[5], has been shown in clinical trials to be effective in lowering plasma cholesterol as well as triglycerides which statins are less likely to affect. Along with vitamin B-6, niacin is a co-factor needed to make serotonin. Necessary for normal mental function, niacin is sometimes considered a memory enhancer. Niacin also enhances levels of brain choline, the precursor to acetylcholine. Sufficient intake of niacin has been found to reduce risk of AD. Niacin is the only B vitamin Dr. Martha C. Morris has found to be clearly liked to risk of incident Alzheimer’s disease. In one of her observational studies, relative importance of folate, B6, B12 all disappear when controlling for both vitamin E and niacin (and cognitive activities).
The Memory Preservation Nutrition® program suggests that most nutrients should come from food but it also includes specific evidence-based recommended supplements and vitamins to ensure sufficiency of key nutrients. Very important are all the B vitamins with these minimum amounts:[6] (B1 thiamine 10mg, B6 pyridoxine 10 mg, B12 10 mcg, as well as B2 riboflavin 10 mg, and niacin 30 mg; as well as 200 mcg of folate. A B-50 complex will usually supply all of these.
We advise against more than 400 mcg supplemental folate unless you are also taking B12 or this was recommended by your doctor for high homocysteine levels since many foods are fortified with folate. If you should be deficient in B12, several studies suggest that folate levels over 800 mcg could be harmful to your cognitive health.
The Memory Preservation Nutrition® program also always includes a disclaimer “Before making changes in your diet consult your physician e.g. re specific conditions or drug interactions.”
FOOD SOURCES [7],
Eat green leafy & certain other vegetables, beans, orange juice & other citrus; strawberries, avocados (B-6), bananas (B-6, biotin), meat and fish (B12 and B6), dairy and eggs (B12), whole grains and brewers’ yeast (B1-thiamine, B2-riboflavin, and niacin-B-3).
The only reliable unfortified sources of vitamin B12 are fish, meat, poultry, dairy products and eggs; liver is an especially good source. The current nutritional consensus is that no plant foods can be relied on as a safe source of vitamin B12. Fortified breakfast cereals and B12 supplements are a particularly valuable source of vitamin B12 for vegetarians and older adults.
Foods sources for Vitamin B-6 (pyridoxine) include fortified breakfast cereals, fish including salmon and tuna fish, meats such as pork and chicken, bananas, beans, and peanut butter, some nuts and seeds such as walnuts and sunflower, and many vegetables and fruits including potatoes with skins, spinach, tomatoes and avocados, as well as liver and kidneys, eggs, peas, wheat germ and carrots.
Biotin is found in various foods, including liver, cauliflower, salmon, carrots, bananas, soy flour, cereals, and yeast.
Folic acid is a member of the B-vitamin family. It occurs naturally in foods as folates, and is available in synthetic form in vitamin pills. Most diets provide only half of the daily required amount of folates, the natural form of folic acid found in foods; hence the high levels of folic acid supplements in processed foods. Americans who eat cereals, breads, pasta, enriched rice and other processed grain products on a daily basis are probably getting enough folic acid from their food, since the latter are fortified with folates and certain other B complex vitamins.
Foods naturally rich in folates include
- green leafy vegetables (such as spinach, bok choy, cabbage, savoy),
- other green vegetables such as asparagus, broccoli, Brussels sprouts; beets;
- avocados, beans and peas, particularly peanuts, garbanzo beans, lima beans, lentils, chickpeas (note: main ingredient of humus), green peas;
- fruits: particularly orange juice, other citrus fruits and juices, strawberries and rose hips;
- eggs, and meats, and some dairy products (e.g. cheeses and yoghurt), and
- Whole-grain products, Sunflower seeds and wheat germ, and yeast extracts such as Marmite.
The synthetic form of folic acid, which is considered as healthy as folates, is found in multivitamins, fortified breakfast cereals, and enriched grain products such as pasta, rice and breads.
We do offer a great quality B-50 complex on our website. ( www.healthcareinsights.net “shop”)
[1] Morris MC. Schneider JA. Tangney CC. (2006) Thoughts on B-vitamins and dementia
J of Alzh. Dis. 9(4): 429-433.
[2] Aisen PS, Schneider LS, Sano M, Thal L. et al. High-Dose B Vitamin Supplementation and Cognitive Decline in Alzheimer Disease: A Randomized Controlled Trial JAMA 2008; 300(15):1774-1783. doi: 10.1001/jama.300.15.1774.
[3] Smith AD, Smith SM, deJageri CA, et al. Homocysteine-Lowering by B Vitamins Slows the Rate of Accelerated Brain Atrophy in Mild Cognitive Impairment:
A Randomized Controlled Trial PLoS ONE | www.plosone.org (on line) Sept 2010; 5 (9) e12244
[4] Morris MC. Evans DA. Bienias JL. Scherr PA. Tangney CC. Hebert LE. Bennett DA. Wilson RS. Aggarwal N. (2004) Dietary niacin and the risk of incident Alzheimer’s disease and of cognitive decline. J Neur, Neurosurgery & Psych. 75(8): 1093-9.
[5] Emerson Lombardo, NB et al. Beyond Magic Bullets: Evidence-based Memory Preservation Nutrition® ©2006, 2007 to Reduce Risk and Slow Progression of Alzheimer’s disease
unpublished manuscript.
[6] Emerson Lombardo, NB, Volicer L, Martin A, Wu B. Zhang XW.(2006) Memory Preservation Diet to Reduce Risk and Slow Progression of Alzheimer’s Disease (AD) in Vellas B, Grundman M, Feldman H, Fitten LJ, Winblad B, editors, Research and Practice in Alzheimer’s Disease and Cognitive Decline, vol 9:138-59.
[7] Emerson Lombardo, NB. Memory Preservation Nutrition®
(available on www.healthcareinsights.net “shop”) |
