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As we age a number of factors predispose us to a decline in memory capacity and the development of more severe forms of cognitive decline, such as dementia and Alzheimer’s disease. One of these factors is the lifetime accumulation of free radical damage to brain cells induced by the brain’s high use of oxygen.
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Helping Patients Prevent Mental Decline and Alzheimerrsquos Disease as they Age
James Meschino DC MS ND
As we age a number of factors predispose us to a decline in memory capacity and the development of more severe forms of cognitive decline such as dementia and Alzheimerrsquos disease One of these factors is the lifetime accumulation of free radical damage to brain cells induced by the brainrsquos high use of oxygen The same way that oxygen in the air causes apples to rot or metal to rust oxygen in the body damages our tissues in a similar fashion The brain uses about 20 of the bodyrsquos oxygen supply at any given moment to help brain cells metabolize blood sugar into energy which enables brain cells to keep functioning But the side effect is a build up of oxygen free radicals which can damage brain cells and impair their function over time Free radical events are a known factor in Alzheimerrsquos disease and other forms of cognitive decline Of importance is the fact that some studies show that individuals who supplement with antioxidants (like vitamin C and vitamin E) have a lower incidence of Alzheimerrsquos disease as they age Thus it may be wise to ensure that your patients get 1000mg of vitamin C and 400IU of vitamin E per day from a high potency multiple vitamin The high potency multiple vitamin and mineral should also contain a B-50 complex ndash as a number of B-vitamins are required to synthesize various of brain chemicals (neurotransmitters) which are essential to alertness concentration and cognition in general For instance the synthesis of dopamine serotonin melatonin epinephrine and nor epinephrine all important neurotransmitters require B-vitamins as co-factors for their synthesis A second way in which we are predisposed to memory loss as we age is the decline in synthesis of the memory chemical (neurotransmitter) acetylcholine which really kicks in after age 54 As we age the brain is less able to make this important memory chemical setting us up for memory loss and many of the manifestations of dementia and Alzheimerrsquos disease There appears to be a decline in the production of the enzyme that combines acetyl coenzyme A with choline known as acetyl transferase As such the brain makes less acetylcholine and memory fails In some cases it is thought that the brain has trouble getting its hands on sufficient amounts of choline in order to make acetylcholine In any case the good news is that there are several natural agents that have been shown in clinical studies to help the aging brain boost its production of acetylcholine thereby helping to combat age-related decline in memory The most important natural agents include
CDP-Choline (cytidine 5-diphosphocholine or citidinediphosphocholine or citicholine)
Phosphatidylserine
Bocopa Monnieri
Huperzine A CDP-Choline is a normal component of the nerve cell membrane which is important for transmission of nerve impulses from one nerve to the next It is also vital to the formation of the memory chemical acetylcholine Unfortunately the aging brain is less able to synthesize the CDP-Choline it requires However studies have shown that supplementation with CDP-Choline can re-constitute brain levels of CDP-Choline boosting levels of several important brain neurotransmitters and improving nerve conduction ability These results translate into enhanced
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mental acuity and improvement in a number of disorders involving memory loss and cognitive decline Note that supplementing with most other forms of choline have not been shown to be effective Therefore you can not substitute lecithin or other forms of phosphatidylcholine in place of CDP-choline as these forms donrsquot appear to cross the blood-brain barrier as readily and in clinical trials they have not shown benefit Phosphatidylserine ndash like CDP-Choline Phosphatidylserine is a natural component of the nerve cell membrane and it too is a victim of age-related decline in synthesis Studies show that supplementation with phosphatidylserine can also elevate brain levels of acetylcholine and has been shown to improve memory and cognition in clinical trials with afflicted individuals Bacopa Monnieri - the leaf of Bacopa or water hyssop has been used in the Indian medical system of Ayurveda since the 6th century AD to help improve mental performance Its active ingredients (bacosides A and B) have been shown to enhance nerve transmission and are potent antioxidants which have been shown to protect brain cells from free radicals and other toxic substances Human studies indicate that Bacopa Monnieri can preserve memory function and has been used in the treatment of various conditions involving memory loss Huperzine A - this natural substance was initially discovered within a club moss that grows in Asia which has been used traditionally to aid memory loss problems Since being isolated Huperzine A is now synthesized for use in natural health products and has shown a remarkable ability to support brain levels of acetylcholine (the memory chemical) It does so by partially inhibiting the enzyme that breaks down acetylcholine (acetylcholinesterase) which results in higher acetylcholine brain levels Its positive effects on memory and brain function have been shown in a number of human clinical trials Consider Recommending a Brain Support Supplement to Patients 55 and Older Alzheimerrsquos disease affects 6-8 of the population over 64 years of age and 47 of people who live to be 85 or older Part of maintaining onersquos quality of life requires putting nutrition and lifestyle practices in place that maintain a highly functional body and ldquomindrdquo Many wellness-striving individuals focus on preserving their bodies and donrsquot realize that their brain is also responsive to wellness interventions Due to the fact that the aging process is associated with decreased synthesis of the memory chemical acetylcholine as well as important phospholipids (CDP-Choline Phosphatidylserine) which are required for optimal nerve impulse transmission I suggest that patients begin ingesting a supplement at age 55 that can help combat memory loss and other related problems Key ingredients in a memory support supplement include CDP-Choline Phosphatidylserine Bacopa Monnieri and Huperzine A All of these have been shown to be safe effective natural ingredients when taken at appropriate dosages and unlike Ginkgo Biloba and Vinpocetine do not increase risk for bleeding disorders The only caveat is that these supplements can not be used in conjunction with drugs commonly used to treat Alzheimerrsquos disease One final note includes the fact that brain support nutrients of this type are best used in conjunction with an antioxidantB-vitamin enriched Multiple Vitamin and Mineral Supplement as well as an Essential Fatty Acid Supplement containing borage seed flaxseed and fish oil Nutrients from these supplements have also been shown to support brain function and discourage the development of age-related cognitive decline problems including Alzheimerrsquos disease
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References
Agnoli A et al New strategies in the management of Parkinsonrsquos disease A biological approach using a phospholipid precursor (CDP-Choline) Neuropsycholbiology 19828(6)289-96
Canty DJ et al Lecithin and chloine in human health and disease Nutr Reviews 199452327-339
Citicoline Alzheimerrsquos disease and cognitive performance Life Extension 20006(9)692(Alt Health Watch data base)
Encyclopedia of Nutritional Supplements Prima Publishing 1996Murray M137-141
Foiravanti M Yanagi M Cytidinediphosphocholine (CDP-Choline) for cognitive and behavioral disturbances associated with chronic cerebral disorders in the elderly Cochrane Syst Revi 2002(2)000269 In The Cochrane Library 12002 Oxford Update Software
Present Knowledge in Nutrition (5th edition) The Nutrition Foundation Inc 1984Choline383-399
Secades JJ et al CDP-Choline pharmacological and clinical review Methods Find Exp Clin Pharmacol 199517(Suppl B)1-54
Zeisel SH et al Cholinean essential nutrient for humans FASEB J 1991520093-2098
Cenacchi T Bertoldin T Farina C et al Cognitive decline in the elderly A double-blind placebo-controlled multicenter study on efficacy of phosphatidylserine administration Aging 19935123-33
Crook T Petrie W Wells C Massari DC Effects of phosphatidylserine in Alzheimerrsquos disease Psychopharmacol Bull 19922861-6
Crook TH Tinklenberg J Yesavage J Petrie W Nunzi MG Massari DC Effect of phosphatidylserine in age-associated memory impairment Neurology 199141644-9
Engel RR Satzger W Gunther W Kathmann N Bove D Gerke S et al Double-blind cross-over study of phosphatidylserine vs placebo in subjects with early cognitive deterioration of the Alzheimer type Eur Neuropsychopharmacol 19922149-55
Funfgeld EW Baggen M Nedwidek P Richstein B Mistlberger G Double-blind study with phosphatidylserine (PS) in parkinsonian patients with senile dementia of Alzheimerrsquos type (SKAT) Prog Clin Biol Res 19893171235-46
Maggioni M Picotti GB Bondiolotti GP Panerai A Cenacchi T Nobil P et al Effects of phosphatidylserine therapy in geriatric patients with depressive disorders Acta Psychiatr Scand 199081265-70
Nunzi MG Milan F Guidolin D et al Effects of phosphatidylserine administration on age-related structural changes in the rat hippocampus and septal complex Pharmacopsychiat 198922125-8
Valzelli L Kozak W Zanotti A Toffano G Activity of phosphatidylserine on memory retrieval and on exploration in mice Meth Find Extl Clin Pharmacol 19879657-60
Vannucchi MG Casamenti F Pepeu G Decrease of acetylcholine release from cortical slices in aged rats Investigations into its reversal by phosphatidylserine J Neurochem 199055819-25
4 | P a g e
Dar A Channa S Calcium antagonistic activity of Bacopa monniera on vascular intestinal smooth muscles of rabbit and ginea-pig J Ethnopharmacol 199966(2)167-74
Dietary Supplement Information Bureau wwwcontentintramedicinecom Bacopa monnieri
Kidd PM A review of nutrients and botanicals in the integrative management of cognitive dysfunction Altern Med Rev 1999 Jun4(3)144-61
Mukherjee GD et al Clinical trial on brahmi I J Exp Med Sci 196610(1)5-11
Stough C Lloyd J Clarke J Downey LA Hutchison CW Rodgers T et la The chronic effects of an extract of Bacopa monniera (Brahmi) on cognitive function in healthy human subjects Psychopharmacology (Berl) 2001 Aug156(4)481-4
Tripathi YB et al Bacopa monniera linn As an antioxidant Mechanism of action Indian J Exp Biol 1996 Jun34(6)523-6
Vohora D Pal SN Pillai KK Protection from phenbytoin-induced cognitive deficit by Bacopa monniera a reputed Indian nootropic plant J Ethnopharmacol 2000 Aug71(3)383-90
Ashani Y Peggins JO Doctor BP Mechanism of inhibition of cholinesterases by huperzine A Biochem Biophys Res Commun 1992184719-26
Bai DL et al Huperzine A a potential therapeutic agent for treatment of Alzheimerrsquos disease Curr Med Chem 2000 Mar7(3)355-74
Cheng DH Ren H Tang XC Huperzine A a novel promising acetylcholinesterase inhibitor Neuroreport 1996897-101
Cheng DH Tang XC Comparative studies of huperzine A E2020 and tacrine on behavior and cholinesterase activites Pharmacol Biochem Behav 199860377-86
Dworkin N Restoring memory Psychology Today 2000 JulAug32(4)p28
McCaleb R Huperzia looks promising for improving memory HerbalGram 1031199535p14
Pirisi Angela Plant wisdom Memory moss Yoga Journal 08311999147p95
Sun QQ Xu SS Pan JL et al Huperzine-A capsules enhance memory and learning performance in 34 pairs of matched adolescent students Acta Pharmacol Sin 199920601-3
Tang XC Huperzine A (shuangyiping) A promising drug for Alzheimerrsquos disease Chung Kuo Yao Li Hsueh Pao 1996 Nov17(6)481-4
Wang Z Ren G Zhao Y et al A double-blind study of huperzine A and piracetam in patients with age-associated memory impairment and dementia In Kanba S Richelson E (eds) Herbal Medicines for Nonpsychiatric Diseases Tokyo Seiwa Choten Publishers 199939-50
Xu SS Gao ZX Weng Z et al Efficacy of tablet huperzine-A on memory cognition and behavior in Alzheimerrsquos disease Chung Kuo Yao Li Hsueh Pao 199516391-5
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OMEGA-3 FATS MAY REDUCE RISK OF AGE-RELATED COGNITIVE DECLINE
DEMENTIA AND ALZHEIMERrsquoS DISEASE
James Meschino DC MS ND
Biological Mechanisms Addressing Neuroprotective Effects of Omega-3 Fats
Several recent studies have suggested that higher intake and blood levels of omega-3 fatty acids may help to reduce risk of age-related cognitive decline dementia and Alzheimerrsquos disease (1-5) Three of four epidemiological studies have suggested a protective effect for omega-3 fatty acids in this regard (6) The major dietary sources of these fatty acids are fish and shellfish from both salt water and fresh water EPA and DHA can also be synthesized from the elongation and desaturation of alpha-linolenic acid which is present in some vegetable oils (7) Flaxseed oil is an especially rich source of alpha-linolenic acid an omega-3 fatty acid
DHA is 22 carbons long and has six double bonds with the first one occurring between carbon three and four from the omega end (the methyl end) of the fatty acid chain It is the most prominent fatty acid in the brain retina and spermatozoa and is necessary for vision cognition and sperm motility The neurons and synaptosomes of the cerebral cortex are especially rich in DHA where it is incorporated into the membrane phospholipid structure The brains of Alzheimerrsquos patients have been shown to contain a lower content of DHA in the grey matter of the frontal lobe and the hypocampus than do the brains of patients without Alzheimerrsquos disease The brains of Alzheimerrsquos patients also demonstrate a build-up of amyloid protein complex and an inflammatory component(7)
The Framingham Heart Study showed that persons with plasma phosphatidylcholine DHA in the top quartile of values had a significantly (47) lower risk of developing all-cause dementia than did those in the bottom quartile and significantly greater protection was obtained from consuming 29 fish meals per week than from consuming only 13 fish meals per week on average (7)
Several mechanisms have been proposed to explain how omega-3-fats can reduce nerve cell degeneration associated with these conditions Omega-3 fatty acids are known to provide anti-inflammatory effects due to their conversion to anti-inflammatory eicosanoids
within the body The eicosanoids formed from omega-3 fatty acids also improve blood flow by dilating vessels and decreasing
platelet stickiness (anti-thrombotic) and provide other benefits associated with cardiovascular health such as improving
endothelial function and lowering triglyceride blood levels All of these effects are also associated with prevention of cognitive
decline largely via preserved blood flow circulation to brain tissue (lower risk of cerebrovascular disease)
However omega-3 fatty acids also play a direct role in nerve cell structure and function Eicosapentaenoic acid (EPA) and docsahexaenoic acid (DHA) have been shown to improve the composition of nerve cell membranes and stimulate the development regeneration and function of nerve cells by stimulating synaptic plasticity and increasing neurotransmission as well as increasing memory abilities In short long chain omega-3 fatty acids are structural components of neuronal and other cell membranes affecting membrane fluidity nerve transmission and nerve cell function in a positive way They also modulate the production of eicosanoids and inflammatory cytokines and help preserve blood flow to the brain
There is also the suggestion that oxidative stress (from oxygen and other free radicals) significantly contributes to neuronal damage seen in cases of cognitive impairment and Alzheimerrsquos disease by depleting the brain of vulnerable highly unsaturated fatty acids (eg
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EPA and DHA) Some researchers suggest that by replenishing brain cells with EPA and DHA via higher intake levels individuals may help protect themselves against cognitive decline to a significant degree (8-11)
Adding support to the epidemiological and experimental studies that suggest that omega-3 fatty acids can reduce risk of cognitive decline the April 2007 issue of the American Journal of Clinical Nutrition contained the findings of two large prospective studies that evaluated intake of omega-3 fatty acids and subsequent risk of cognitive decline dementia and Alzheimerrsquos disease in older human subjects Taken together the findings of MA Beydoun et al (the Atherosclerosis Risk in Communities Study) and those of BM van Gelder et al (the Zutphen Elderly Study) indicate that a moderate intake of EPA and DHA were strongly associated with reduced risk of cognitive decline (9 10)
The ARIC Study
The Atherosclerosis Risk in Communities Study analyzed plasma fatty acids in cholesterol esters and phospholipids in whites residing in Minneapolis MN from 1987 through 1989 From 1990 through 1992 and from 1996 through 1998 3 neurophysiological tests were administered Effectively this study assessed the association between plasma fatty acids and cognitive decline in adults aged 50-65 years of age at baseline and conducted a subgroup analysis A striking finding among the 2251 study subjects was that higher levels of omega-3 fatty acids were associated with reduced risk of decline in verbal fluency particularly in hypertensive and dyslipedemic subjects whose tissues are exposed to greater oxidative stress from these conditions In contrast the risk of global cognitive decline increased with elevated palmitic acid (a saturated fat) and in subjects with higher levels of arachidonic acid (an omega-6 fatty acid found in meat and dairy products) (9) It should be noted that palmitic acid is a saturated fat that is highly associated with thrombosis and the elevation of LDL-cholesterol both of which can lead to atherosclerosis obstruction increasing the tendency to develop dementia (11)
The Zutphen Elderly Study
In the Zuthen Elderly Study data on fish consumption of 210 male participants who were aged 70-89 years of age in 1990 and data on cognitive functioning collected in 1990 and 1995 were assessed The intake of EPA and DHA was calculated for each participant Results showed that fish consumers had significantly less 5-year subsequent cognitive decline than did non fish consumers and a linear trend (dose-dependent trend) was observed for the relation between the intake of EPA and DHA and cognitive decline More specifically the results showed that elderly men who consumed an average of approximately 400 mg per day of omega-3 fatty acids from EPA and DHA had significantly less cognitive decline over the five year period than did those consuming an average of approximately 20 mg per day of omega-3 fatty acids
At present the American Heart Association recommends the consumption of fish (preferably fatty fish) at least twice per week a recommendation that is compatible with the results of the Zutphen Elderly Study To achieve 400 mg per day of EPA and DHA one would have to consume 6 servings per week of lean fish (average serving size 140 gm or about 5 ounces) or one serving per week of fatty fish such as mackerel or herring (10) One can also achieve this level of intake by consuming a mere 20 gm of Chinook salmon (less than one ounce) or 100 gm of cod (a little more than 35 ounces) As such two to three meals of fish per week would supply approximately 380 mg of EPADHA per day on average (7)
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Summary
A number of epidemiological studies and experimental studies suggest that higher intake levels brain levels and blood levels of EPA and DHA may help preserve cognitive function as we age and reduce risk of dementia and Alzheimerrsquos disease A number of biological mechanisms have been proposed to explain the protective effects of EPA and DHA in regards to these neurodegenerative conditions More recently two prospective studies involving older and elderly humans (the ARIC and Zutphen Elderly Studies) have shown a strong correlation between higher plasma and intake levels respectively of EPA and DHA and subsequent decreased cognitive decline The Zutphen Elderly Study highlighted the fact that an average daily intake of 400 mg of EPA and DHA appears to be a significant threshold level at which a marked protective effect is observed Some experts suggest that for people who are allergic to fish andor shellfish and those who cannot or will not obtain sufficient intake of fish that they consume 1000 mg per day of fish oil from supplementation (Connor WE Connor SL 2007) A supplement containing fish oil and flaxseed oil may also be a consideration providing the total amount of EPA and DHA reaches a minimum threshold intake value of 400 mg per day Health practitioners should bear this information and these dosage levels in mind when making recommendations about specific essential fatty acid supplement products to their patients
For more information on this or other related topics visit Dr Meschinorsquos website at httpwwwmeschinohealthcom
References
1 Conquer JA Tierney MC Zecevic J Bettger WJ Fisher RH Fatty acid analysis of blood plasma of patients with Alzheimerrsquos disease other types of dementia and cognitive impairment Lipids 2000351305-12
2 Heude B Ducimetiere P Berr C Cognitive decline and fatty acid composition of erythrocyte membranes ndash the EVA Study Am J Clin Nutr 200377803-8
3 Tully AM Roche HM Doyle R et al Low serum cholesteryl esterdocosahexaenoic acid levels in Alzheimerrsquos disease a case-control study Br J Nutr 200389483-9
4 Kalmijn S van Boxtel MP Ocke M Vershcuren WM Kromhout D Launer LJ Dietary intake of fatty acids and fish in relation to cognitive performance at middle age Neurology 200462275-80
5 Kalmign S Feskens EJ Launer LJ Kromhout D Polyunsaturated fatty acids antioxidants and cognitive function in very old men Am J Epidemiol 199714533-41
6 He K Song Y Daviglus MI et al Fish consumption and incidence of stroke a meta-analysis of cohort studies Stroke 2004351538-42
7 Connor WE and Connor SL The importance of fish and docosahexaenoic acid in Alzheimerrsquos disease Am J Clin Nutr85929-30 2007
8 Brunner E Oily fish and omega 3 fat supplements BMJ332739-7402006
9 Beydoun MA Kaufman JS Satia JA Rousamond W Folson AR Plasma n-3 fatty acids and the risk of cognitive decline in older adults the Atherosclerosis Risk Communities Study Am J Clin Nutr 851103-11 2007
10 Van Gelder BM Tijuis M Kalmijn S Kromhout D Fish consumption n-3 fatty acids and subsequent 5-y cognitive decline in elderly men the Zutphen Elderly Study Am J Clin Nutr 85 1142-7 2007
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11 Scientific Advisory Committee on Nutrition Committee on Toxicity Advice on fish consumption benefits and risks London Stationery Office 2004 wwwfoodgovukmultimediapdfsfishreport2004fullpdf (accessed 9 Feb 2006)
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DHA ndash Omega-3 Fat Shown To Block Amyloid Synthesis In Alzheimerrsquos Disease Prevention
James Meschino DC MS ND
Recent studies indicate that higher intake and blood levels of omega-3 fats are associated with reduced risk of age-related cognitive decline dementia and Alzheimerrsquos disease The Atherosclerosis Risk in Communities Study which followed 2251 individuals (aged 50-65) showed that higher blood levels of omega-3 fats were associated with reduced risk of decline in verbal fluency The Zutphen Elderly Study which followed 210 elderly men (aged 70-89) for five years showed that men who consumed an average of approximately 400 mg per day of omega-3 fats (from fish) had significantly less cognitive decline over the five year period than did those consuming approximately 20 mg per day The Framingham Heart Study showed that persons with blood levels of omega-3 fats (phosphatidylcholine DHA) in the top 25 had a significantly (47) lower risk of developing all-cause dementia than did those in the bottom 25 In addition Alzheimerrsquos patients have been shown to have less DHA (an omega-3 fat) in the regions of the brain most affected by Alzheimerrsquos disease (the frontal lobe and hypocampus)
Experimental studies have shed light on the ways in which omega-3 fats may reduce risk of these conditions For example omega-3 fats have been shown to reduce brain inflammation increase blood circulation to brain cells inhibit abnormal clots in blood vessels within the brain More recently omega-3 fats were shown to improve nerve transmission among brain cells and support brain cell repair mechanisms
The most recent finding however was reported in the Journal of Neuroscience (Dec 2007 Qiu-Lan Ma and fellow researchers) showing that omega-3 fats inhibit the build up of amyloid plaque in brain cells The accumulation of amyloid plaque (a protein) in brain cells is a hallmark feature of Alzheimerrsquos disease and is considered to be the main culprit leading to brain cell disruption which manifests as memory loss confusion personality changes and other Alzheimerrsquos signs and symptoms These researchers discovered that omega-3 fats (particularly DHA) increases the number of receptors (the LR11- receptor) on human and murine (mice) brain cells which in turn transmits signals within the cell that block the accumulation of amyloid protein
Taken together my advice is to ingest at least 400 mg per day on average of omega-3 fats This means consuming 3-4 fish servings per week In addition I personally take 2-3 capsules per day of a supplement containing 400 mg each of fish oil flaxseed oil and borage seed oil For those allergic to fish and seafood I strongly recommend flaxseed oil supplementation (1200 mg 2-3 capsules per day) as an alternative
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New Evidence That Vitamin E Supplementation Improves Outcomes In
Alzheimerrsquos Patients
A 2008 study adds to the body of evidence
James Meschino DC MS ND
In a paper presented at 2008 American Academy of Neurology Annual Meeting(Chicago Il
Poster Sessions III Aging) researchers showed that Alzheimerrsquos disease patients who
supplemented their diet with 2000 IU per day of Vitamin E had a 26 lower mortality rate As
explained by the lead researcher Dr Valory Pavlik from the Baylor College of Medicines
(Alzheimers Disease and Memory Disorders Center Houston TX) many previous studies have
shown that Vitamin E supplementation can slow the progression of Alzheimerrsquos disease The
study by Pavlik et was able to show additional features and benefits of Vitamin E
supplementation in Alzheimerrsquos disease patients and answered some common concerns about
the safety of using high dosages of Vitamin E and combining Vitamin E with conventional drugs
used to manage this condition In their study of 847 Alzheimerrsquos disease patients who were
followed for 49 years their results showed the following
A A 26 reduced mortality rate in the patients administered 2000 IU of Vitamin E per day
compared to Alzheimerrsquos disease patients not taking the Vitamin E supplement
B Combining Vitamin E supplementation (2000 IU per day) with standard drugs used to treat Alzheimerrsquos disease (cholinesterase inhibitors) produced the best overall results with respect to longevity and disease progression Thus it appears to be safe to recommend Vitamin E supplementation to Alzheimerrsquos patients already taking a cholinesterase inhibitor drug such as AriceptTM (donepezil) ExelonTM(rivastigmine) ReminylTM(galantamine) and Ebixareg (memantine hydrochloride)
C Recent concerns about Vitamin E supplementation increasing risk of cancer and heart disease were put to rest as this study showed that individuals with Alzheimerrsquo disease who were in a high-risk age group for death from cardiovascular disease and cancer
(average age 735 86 years) showed a 26 lower mortality rate than Alzheimerrsquos patients who did not take the 2000 IU per day of Vitamin E
D In the Alzheimerrsquos disease patients who used only Vitamin E supplementation (2000 IU per day) and did not take any Alzheimerrsquos disease medication these patients still showed a 26 lower mortality rate than patients not taking the Vitamin E supplement along with significant disease management outcomes
Overall the researchers concluded ldquoRegimens that included vitamin E were associated with a 26 lower mortality rate There was a suggestion that of vitamin E plus a cholinesterase inhibitor was more beneficial than taking either agent alonerdquo
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The Alzheimerrsquos Disease Cooperative Study
A landmark study in the year 2000 known as the Alzheimerrsquos Disease Cooperative Study was one of the first published studies to show that providing Alzheimerrsquos patients with 2000 IU per day of Vitamin E could slow the progression of their disease The Alzheimers Disease Cooperative Study (ADCS) was formed in 1991 as a cooperative agreement between the National Institute on Aging (NIA) and the University of California San Diego The ADCS is a major initiative for Alzheimers disease (AD) clinical studies in the Federal government addressing treatments for both cognitive and behavioral symptoms Reporting in the American Journal of Clinical Nutrition researchers published results showing that vitamin E supplementation (2000 IU per day) may slow functional deterioration leading to nursing home placement
Why Vitamin E Supplementation The brains of Alzheimers disease patients frequently shows generalized atrophy neuritic plaques (dystrophic axons and dendrites surrounding an amyloid core) and neurofibrillary Evidence suggests that oxidative stress (free radicals) may lead to permanent cellular damage in the brain that triggers some of the changes seen in the brain of Alzheimerrsquos patients The presence of excessive szlig-amyloid protein formation (an extracellular insoluble protein) is a hallmark feature of the Alzheimerrsquos brain A proposed mechanism of szlig-amyloid toxicity is that it induces free radicals which disrupt cellular lipid protein and DNA In addition to szlig-amyloid several other processes may also induce oxidative stress in AD Activated microglial cells found in association with neuritic plaques may release cytokines prooxidants and free radicals As well other etiological factor such as cytoskeletal destabilization energy deprivation or toxic inflammatory responses may all converge in a common final pathway involving free radicals as well
Prior to the Alzheimerrsquos Disease Cooperative Study earlier clinical trials and epidemiologic studies had suggested that several agents may help prevent the development of AD or slow further deterioration These agents include vitamin E selegiline estrogen and anti-inflammatory drugs One property that they all share is the ability to protect against free radicalndashmediated
damage either directly or indirectly
Conclusion
The recent study (2008) by Pavlik et al adds to the body of evidence indicating that supplementing Alzheimerrsquos disease patients with 2000 IU per day of natural Vitamin E can slow the progression of their disease and lower the mortality rate by 26 (over a five-year period) Unfortunately many medical doctors have not been exposed to these studies and thus Vitamin E supplementation is often left out of the management of many Alzheimerrsquos disease cases In these instances it is up to Complementary Health Care Professionals to provide patients and family members with the research and recommendations that have been shown to be meaningful in regards to Vitamin E supplementation (as well as other effective natural interventions) The study by Pavlik et al suggests that Vitamin E supplementation at a dosage of 2000 IU per day is effective safe enhances the benefits of conventional Alzheimerrsquos drugs and does not increase the risk of cancer or heart disease in this older and elderly population
For more information on this or other related topics please visit httpwwwmeschinohealthcom
12 | P a g e
References
1 Valory Pavlik Rachelle Doody Susan Rountree Eveleen Darby Vitamin E Use Is Associated
with Improved Survival in an AD Cohort 2008 American Academy of Neurology Annual
Meeting(Chicago Il) Poster Sessions III Aging and Dementia Clinical II P03076
2 Grundman M Vitamin E and Alzheimer disease the basis for additional clinical trials American Journal of Clinical Nutrition Vol 71 No 2 630S-636s 2000
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Summary The Quick Checklist of How to Best Maintain Memory Function Maintaining healthy brain function and memory over a lifetime requires that you be proactive Dementia and Alzheimerrsquos disease affect way too many people as they age and we now see that much of this could be avoided if people would use some targeted strategies during their lifetime Here are some important recommendations
1 Take every precaution to avoid head injuries throughout your entire life
2 Always be learning something new or further developing an existing talent or skill set
3 Donrsquot damage your brain with cigarettes alcohol or illicit drugs and try to use the least
number of medications as possible throughout your lifetime
4 Nourish your brain with omega-3 fats from fish twice per week on average
5 Take a high potency multiple vitamin that is antioxidant enriched and contains a B-50
complex (example Adeeva Multiple Vitamin)
6 Take 2-3 capsules per day of an Essential Oil supplement to ensure adequate omega-3
fat and essential fatty acid support for your brain I recommend a supplement that
combines fish oil flaxseed oil and borage seed oil (example Adeeva Naturersquos Essential
Oil)
7 Keep your fasting blood sugar level below 50 mmolL (90 mgdL) Elevated blood sugar
(glucose) and high insulin levels are strongly linked to Alzheimerrsquos disease development
This means eating sugary foods and starchy foods in moderation if at all performing
aerobic exercise for 30 mins at least 3-4 times per week and having a waist
circumference under 36 inches if you are a man and under 34 inches if you are a
woman Have your doctor check your blood glucose level on your next appointment and
ask for the number
8 Ensure that your blood cholesterol level is below 48 mmolL (185 mgdL) This means
avoiding high fat meat and dairy products as well as deep fried foods and transfats
After Age 55 Add The Following
1 Take a Memory Support Supplement each day that contains meaningful doses of
CDP-choline Phosphatidylserine Huperzine A and Bocapa monnieri (example
Adeeva Memory Support Complex) ndash to help your brain continue to make the
memory chemical acetylcholine as you get older
2 Learn a new skill such as a learning to play a musical instrument or a foreign
language ndash something that is outside of your usual knowledge base
Participate in a mind-body activity that builds new neural circuits such as playing ping-pong or
taking dance lessons or martial arts lessons
2 | P a g e
mental acuity and improvement in a number of disorders involving memory loss and cognitive decline Note that supplementing with most other forms of choline have not been shown to be effective Therefore you can not substitute lecithin or other forms of phosphatidylcholine in place of CDP-choline as these forms donrsquot appear to cross the blood-brain barrier as readily and in clinical trials they have not shown benefit Phosphatidylserine ndash like CDP-Choline Phosphatidylserine is a natural component of the nerve cell membrane and it too is a victim of age-related decline in synthesis Studies show that supplementation with phosphatidylserine can also elevate brain levels of acetylcholine and has been shown to improve memory and cognition in clinical trials with afflicted individuals Bacopa Monnieri - the leaf of Bacopa or water hyssop has been used in the Indian medical system of Ayurveda since the 6th century AD to help improve mental performance Its active ingredients (bacosides A and B) have been shown to enhance nerve transmission and are potent antioxidants which have been shown to protect brain cells from free radicals and other toxic substances Human studies indicate that Bacopa Monnieri can preserve memory function and has been used in the treatment of various conditions involving memory loss Huperzine A - this natural substance was initially discovered within a club moss that grows in Asia which has been used traditionally to aid memory loss problems Since being isolated Huperzine A is now synthesized for use in natural health products and has shown a remarkable ability to support brain levels of acetylcholine (the memory chemical) It does so by partially inhibiting the enzyme that breaks down acetylcholine (acetylcholinesterase) which results in higher acetylcholine brain levels Its positive effects on memory and brain function have been shown in a number of human clinical trials Consider Recommending a Brain Support Supplement to Patients 55 and Older Alzheimerrsquos disease affects 6-8 of the population over 64 years of age and 47 of people who live to be 85 or older Part of maintaining onersquos quality of life requires putting nutrition and lifestyle practices in place that maintain a highly functional body and ldquomindrdquo Many wellness-striving individuals focus on preserving their bodies and donrsquot realize that their brain is also responsive to wellness interventions Due to the fact that the aging process is associated with decreased synthesis of the memory chemical acetylcholine as well as important phospholipids (CDP-Choline Phosphatidylserine) which are required for optimal nerve impulse transmission I suggest that patients begin ingesting a supplement at age 55 that can help combat memory loss and other related problems Key ingredients in a memory support supplement include CDP-Choline Phosphatidylserine Bacopa Monnieri and Huperzine A All of these have been shown to be safe effective natural ingredients when taken at appropriate dosages and unlike Ginkgo Biloba and Vinpocetine do not increase risk for bleeding disorders The only caveat is that these supplements can not be used in conjunction with drugs commonly used to treat Alzheimerrsquos disease One final note includes the fact that brain support nutrients of this type are best used in conjunction with an antioxidantB-vitamin enriched Multiple Vitamin and Mineral Supplement as well as an Essential Fatty Acid Supplement containing borage seed flaxseed and fish oil Nutrients from these supplements have also been shown to support brain function and discourage the development of age-related cognitive decline problems including Alzheimerrsquos disease
3 | P a g e
References
Agnoli A et al New strategies in the management of Parkinsonrsquos disease A biological approach using a phospholipid precursor (CDP-Choline) Neuropsycholbiology 19828(6)289-96
Canty DJ et al Lecithin and chloine in human health and disease Nutr Reviews 199452327-339
Citicoline Alzheimerrsquos disease and cognitive performance Life Extension 20006(9)692(Alt Health Watch data base)
Encyclopedia of Nutritional Supplements Prima Publishing 1996Murray M137-141
Foiravanti M Yanagi M Cytidinediphosphocholine (CDP-Choline) for cognitive and behavioral disturbances associated with chronic cerebral disorders in the elderly Cochrane Syst Revi 2002(2)000269 In The Cochrane Library 12002 Oxford Update Software
Present Knowledge in Nutrition (5th edition) The Nutrition Foundation Inc 1984Choline383-399
Secades JJ et al CDP-Choline pharmacological and clinical review Methods Find Exp Clin Pharmacol 199517(Suppl B)1-54
Zeisel SH et al Cholinean essential nutrient for humans FASEB J 1991520093-2098
Cenacchi T Bertoldin T Farina C et al Cognitive decline in the elderly A double-blind placebo-controlled multicenter study on efficacy of phosphatidylserine administration Aging 19935123-33
Crook T Petrie W Wells C Massari DC Effects of phosphatidylserine in Alzheimerrsquos disease Psychopharmacol Bull 19922861-6
Crook TH Tinklenberg J Yesavage J Petrie W Nunzi MG Massari DC Effect of phosphatidylserine in age-associated memory impairment Neurology 199141644-9
Engel RR Satzger W Gunther W Kathmann N Bove D Gerke S et al Double-blind cross-over study of phosphatidylserine vs placebo in subjects with early cognitive deterioration of the Alzheimer type Eur Neuropsychopharmacol 19922149-55
Funfgeld EW Baggen M Nedwidek P Richstein B Mistlberger G Double-blind study with phosphatidylserine (PS) in parkinsonian patients with senile dementia of Alzheimerrsquos type (SKAT) Prog Clin Biol Res 19893171235-46
Maggioni M Picotti GB Bondiolotti GP Panerai A Cenacchi T Nobil P et al Effects of phosphatidylserine therapy in geriatric patients with depressive disorders Acta Psychiatr Scand 199081265-70
Nunzi MG Milan F Guidolin D et al Effects of phosphatidylserine administration on age-related structural changes in the rat hippocampus and septal complex Pharmacopsychiat 198922125-8
Valzelli L Kozak W Zanotti A Toffano G Activity of phosphatidylserine on memory retrieval and on exploration in mice Meth Find Extl Clin Pharmacol 19879657-60
Vannucchi MG Casamenti F Pepeu G Decrease of acetylcholine release from cortical slices in aged rats Investigations into its reversal by phosphatidylserine J Neurochem 199055819-25
4 | P a g e
Dar A Channa S Calcium antagonistic activity of Bacopa monniera on vascular intestinal smooth muscles of rabbit and ginea-pig J Ethnopharmacol 199966(2)167-74
Dietary Supplement Information Bureau wwwcontentintramedicinecom Bacopa monnieri
Kidd PM A review of nutrients and botanicals in the integrative management of cognitive dysfunction Altern Med Rev 1999 Jun4(3)144-61
Mukherjee GD et al Clinical trial on brahmi I J Exp Med Sci 196610(1)5-11
Stough C Lloyd J Clarke J Downey LA Hutchison CW Rodgers T et la The chronic effects of an extract of Bacopa monniera (Brahmi) on cognitive function in healthy human subjects Psychopharmacology (Berl) 2001 Aug156(4)481-4
Tripathi YB et al Bacopa monniera linn As an antioxidant Mechanism of action Indian J Exp Biol 1996 Jun34(6)523-6
Vohora D Pal SN Pillai KK Protection from phenbytoin-induced cognitive deficit by Bacopa monniera a reputed Indian nootropic plant J Ethnopharmacol 2000 Aug71(3)383-90
Ashani Y Peggins JO Doctor BP Mechanism of inhibition of cholinesterases by huperzine A Biochem Biophys Res Commun 1992184719-26
Bai DL et al Huperzine A a potential therapeutic agent for treatment of Alzheimerrsquos disease Curr Med Chem 2000 Mar7(3)355-74
Cheng DH Ren H Tang XC Huperzine A a novel promising acetylcholinesterase inhibitor Neuroreport 1996897-101
Cheng DH Tang XC Comparative studies of huperzine A E2020 and tacrine on behavior and cholinesterase activites Pharmacol Biochem Behav 199860377-86
Dworkin N Restoring memory Psychology Today 2000 JulAug32(4)p28
McCaleb R Huperzia looks promising for improving memory HerbalGram 1031199535p14
Pirisi Angela Plant wisdom Memory moss Yoga Journal 08311999147p95
Sun QQ Xu SS Pan JL et al Huperzine-A capsules enhance memory and learning performance in 34 pairs of matched adolescent students Acta Pharmacol Sin 199920601-3
Tang XC Huperzine A (shuangyiping) A promising drug for Alzheimerrsquos disease Chung Kuo Yao Li Hsueh Pao 1996 Nov17(6)481-4
Wang Z Ren G Zhao Y et al A double-blind study of huperzine A and piracetam in patients with age-associated memory impairment and dementia In Kanba S Richelson E (eds) Herbal Medicines for Nonpsychiatric Diseases Tokyo Seiwa Choten Publishers 199939-50
Xu SS Gao ZX Weng Z et al Efficacy of tablet huperzine-A on memory cognition and behavior in Alzheimerrsquos disease Chung Kuo Yao Li Hsueh Pao 199516391-5
5 | P a g e
OMEGA-3 FATS MAY REDUCE RISK OF AGE-RELATED COGNITIVE DECLINE
DEMENTIA AND ALZHEIMERrsquoS DISEASE
James Meschino DC MS ND
Biological Mechanisms Addressing Neuroprotective Effects of Omega-3 Fats
Several recent studies have suggested that higher intake and blood levels of omega-3 fatty acids may help to reduce risk of age-related cognitive decline dementia and Alzheimerrsquos disease (1-5) Three of four epidemiological studies have suggested a protective effect for omega-3 fatty acids in this regard (6) The major dietary sources of these fatty acids are fish and shellfish from both salt water and fresh water EPA and DHA can also be synthesized from the elongation and desaturation of alpha-linolenic acid which is present in some vegetable oils (7) Flaxseed oil is an especially rich source of alpha-linolenic acid an omega-3 fatty acid
DHA is 22 carbons long and has six double bonds with the first one occurring between carbon three and four from the omega end (the methyl end) of the fatty acid chain It is the most prominent fatty acid in the brain retina and spermatozoa and is necessary for vision cognition and sperm motility The neurons and synaptosomes of the cerebral cortex are especially rich in DHA where it is incorporated into the membrane phospholipid structure The brains of Alzheimerrsquos patients have been shown to contain a lower content of DHA in the grey matter of the frontal lobe and the hypocampus than do the brains of patients without Alzheimerrsquos disease The brains of Alzheimerrsquos patients also demonstrate a build-up of amyloid protein complex and an inflammatory component(7)
The Framingham Heart Study showed that persons with plasma phosphatidylcholine DHA in the top quartile of values had a significantly (47) lower risk of developing all-cause dementia than did those in the bottom quartile and significantly greater protection was obtained from consuming 29 fish meals per week than from consuming only 13 fish meals per week on average (7)
Several mechanisms have been proposed to explain how omega-3-fats can reduce nerve cell degeneration associated with these conditions Omega-3 fatty acids are known to provide anti-inflammatory effects due to their conversion to anti-inflammatory eicosanoids
within the body The eicosanoids formed from omega-3 fatty acids also improve blood flow by dilating vessels and decreasing
platelet stickiness (anti-thrombotic) and provide other benefits associated with cardiovascular health such as improving
endothelial function and lowering triglyceride blood levels All of these effects are also associated with prevention of cognitive
decline largely via preserved blood flow circulation to brain tissue (lower risk of cerebrovascular disease)
However omega-3 fatty acids also play a direct role in nerve cell structure and function Eicosapentaenoic acid (EPA) and docsahexaenoic acid (DHA) have been shown to improve the composition of nerve cell membranes and stimulate the development regeneration and function of nerve cells by stimulating synaptic plasticity and increasing neurotransmission as well as increasing memory abilities In short long chain omega-3 fatty acids are structural components of neuronal and other cell membranes affecting membrane fluidity nerve transmission and nerve cell function in a positive way They also modulate the production of eicosanoids and inflammatory cytokines and help preserve blood flow to the brain
There is also the suggestion that oxidative stress (from oxygen and other free radicals) significantly contributes to neuronal damage seen in cases of cognitive impairment and Alzheimerrsquos disease by depleting the brain of vulnerable highly unsaturated fatty acids (eg
6 | P a g e
EPA and DHA) Some researchers suggest that by replenishing brain cells with EPA and DHA via higher intake levels individuals may help protect themselves against cognitive decline to a significant degree (8-11)
Adding support to the epidemiological and experimental studies that suggest that omega-3 fatty acids can reduce risk of cognitive decline the April 2007 issue of the American Journal of Clinical Nutrition contained the findings of two large prospective studies that evaluated intake of omega-3 fatty acids and subsequent risk of cognitive decline dementia and Alzheimerrsquos disease in older human subjects Taken together the findings of MA Beydoun et al (the Atherosclerosis Risk in Communities Study) and those of BM van Gelder et al (the Zutphen Elderly Study) indicate that a moderate intake of EPA and DHA were strongly associated with reduced risk of cognitive decline (9 10)
The ARIC Study
The Atherosclerosis Risk in Communities Study analyzed plasma fatty acids in cholesterol esters and phospholipids in whites residing in Minneapolis MN from 1987 through 1989 From 1990 through 1992 and from 1996 through 1998 3 neurophysiological tests were administered Effectively this study assessed the association between plasma fatty acids and cognitive decline in adults aged 50-65 years of age at baseline and conducted a subgroup analysis A striking finding among the 2251 study subjects was that higher levels of omega-3 fatty acids were associated with reduced risk of decline in verbal fluency particularly in hypertensive and dyslipedemic subjects whose tissues are exposed to greater oxidative stress from these conditions In contrast the risk of global cognitive decline increased with elevated palmitic acid (a saturated fat) and in subjects with higher levels of arachidonic acid (an omega-6 fatty acid found in meat and dairy products) (9) It should be noted that palmitic acid is a saturated fat that is highly associated with thrombosis and the elevation of LDL-cholesterol both of which can lead to atherosclerosis obstruction increasing the tendency to develop dementia (11)
The Zutphen Elderly Study
In the Zuthen Elderly Study data on fish consumption of 210 male participants who were aged 70-89 years of age in 1990 and data on cognitive functioning collected in 1990 and 1995 were assessed The intake of EPA and DHA was calculated for each participant Results showed that fish consumers had significantly less 5-year subsequent cognitive decline than did non fish consumers and a linear trend (dose-dependent trend) was observed for the relation between the intake of EPA and DHA and cognitive decline More specifically the results showed that elderly men who consumed an average of approximately 400 mg per day of omega-3 fatty acids from EPA and DHA had significantly less cognitive decline over the five year period than did those consuming an average of approximately 20 mg per day of omega-3 fatty acids
At present the American Heart Association recommends the consumption of fish (preferably fatty fish) at least twice per week a recommendation that is compatible with the results of the Zutphen Elderly Study To achieve 400 mg per day of EPA and DHA one would have to consume 6 servings per week of lean fish (average serving size 140 gm or about 5 ounces) or one serving per week of fatty fish such as mackerel or herring (10) One can also achieve this level of intake by consuming a mere 20 gm of Chinook salmon (less than one ounce) or 100 gm of cod (a little more than 35 ounces) As such two to three meals of fish per week would supply approximately 380 mg of EPADHA per day on average (7)
7 | P a g e
Summary
A number of epidemiological studies and experimental studies suggest that higher intake levels brain levels and blood levels of EPA and DHA may help preserve cognitive function as we age and reduce risk of dementia and Alzheimerrsquos disease A number of biological mechanisms have been proposed to explain the protective effects of EPA and DHA in regards to these neurodegenerative conditions More recently two prospective studies involving older and elderly humans (the ARIC and Zutphen Elderly Studies) have shown a strong correlation between higher plasma and intake levels respectively of EPA and DHA and subsequent decreased cognitive decline The Zutphen Elderly Study highlighted the fact that an average daily intake of 400 mg of EPA and DHA appears to be a significant threshold level at which a marked protective effect is observed Some experts suggest that for people who are allergic to fish andor shellfish and those who cannot or will not obtain sufficient intake of fish that they consume 1000 mg per day of fish oil from supplementation (Connor WE Connor SL 2007) A supplement containing fish oil and flaxseed oil may also be a consideration providing the total amount of EPA and DHA reaches a minimum threshold intake value of 400 mg per day Health practitioners should bear this information and these dosage levels in mind when making recommendations about specific essential fatty acid supplement products to their patients
For more information on this or other related topics visit Dr Meschinorsquos website at httpwwwmeschinohealthcom
References
1 Conquer JA Tierney MC Zecevic J Bettger WJ Fisher RH Fatty acid analysis of blood plasma of patients with Alzheimerrsquos disease other types of dementia and cognitive impairment Lipids 2000351305-12
2 Heude B Ducimetiere P Berr C Cognitive decline and fatty acid composition of erythrocyte membranes ndash the EVA Study Am J Clin Nutr 200377803-8
3 Tully AM Roche HM Doyle R et al Low serum cholesteryl esterdocosahexaenoic acid levels in Alzheimerrsquos disease a case-control study Br J Nutr 200389483-9
4 Kalmijn S van Boxtel MP Ocke M Vershcuren WM Kromhout D Launer LJ Dietary intake of fatty acids and fish in relation to cognitive performance at middle age Neurology 200462275-80
5 Kalmign S Feskens EJ Launer LJ Kromhout D Polyunsaturated fatty acids antioxidants and cognitive function in very old men Am J Epidemiol 199714533-41
6 He K Song Y Daviglus MI et al Fish consumption and incidence of stroke a meta-analysis of cohort studies Stroke 2004351538-42
7 Connor WE and Connor SL The importance of fish and docosahexaenoic acid in Alzheimerrsquos disease Am J Clin Nutr85929-30 2007
8 Brunner E Oily fish and omega 3 fat supplements BMJ332739-7402006
9 Beydoun MA Kaufman JS Satia JA Rousamond W Folson AR Plasma n-3 fatty acids and the risk of cognitive decline in older adults the Atherosclerosis Risk Communities Study Am J Clin Nutr 851103-11 2007
10 Van Gelder BM Tijuis M Kalmijn S Kromhout D Fish consumption n-3 fatty acids and subsequent 5-y cognitive decline in elderly men the Zutphen Elderly Study Am J Clin Nutr 85 1142-7 2007
8 | P a g e
11 Scientific Advisory Committee on Nutrition Committee on Toxicity Advice on fish consumption benefits and risks London Stationery Office 2004 wwwfoodgovukmultimediapdfsfishreport2004fullpdf (accessed 9 Feb 2006)
9 | P a g e
DHA ndash Omega-3 Fat Shown To Block Amyloid Synthesis In Alzheimerrsquos Disease Prevention
James Meschino DC MS ND
Recent studies indicate that higher intake and blood levels of omega-3 fats are associated with reduced risk of age-related cognitive decline dementia and Alzheimerrsquos disease The Atherosclerosis Risk in Communities Study which followed 2251 individuals (aged 50-65) showed that higher blood levels of omega-3 fats were associated with reduced risk of decline in verbal fluency The Zutphen Elderly Study which followed 210 elderly men (aged 70-89) for five years showed that men who consumed an average of approximately 400 mg per day of omega-3 fats (from fish) had significantly less cognitive decline over the five year period than did those consuming approximately 20 mg per day The Framingham Heart Study showed that persons with blood levels of omega-3 fats (phosphatidylcholine DHA) in the top 25 had a significantly (47) lower risk of developing all-cause dementia than did those in the bottom 25 In addition Alzheimerrsquos patients have been shown to have less DHA (an omega-3 fat) in the regions of the brain most affected by Alzheimerrsquos disease (the frontal lobe and hypocampus)
Experimental studies have shed light on the ways in which omega-3 fats may reduce risk of these conditions For example omega-3 fats have been shown to reduce brain inflammation increase blood circulation to brain cells inhibit abnormal clots in blood vessels within the brain More recently omega-3 fats were shown to improve nerve transmission among brain cells and support brain cell repair mechanisms
The most recent finding however was reported in the Journal of Neuroscience (Dec 2007 Qiu-Lan Ma and fellow researchers) showing that omega-3 fats inhibit the build up of amyloid plaque in brain cells The accumulation of amyloid plaque (a protein) in brain cells is a hallmark feature of Alzheimerrsquos disease and is considered to be the main culprit leading to brain cell disruption which manifests as memory loss confusion personality changes and other Alzheimerrsquos signs and symptoms These researchers discovered that omega-3 fats (particularly DHA) increases the number of receptors (the LR11- receptor) on human and murine (mice) brain cells which in turn transmits signals within the cell that block the accumulation of amyloid protein
Taken together my advice is to ingest at least 400 mg per day on average of omega-3 fats This means consuming 3-4 fish servings per week In addition I personally take 2-3 capsules per day of a supplement containing 400 mg each of fish oil flaxseed oil and borage seed oil For those allergic to fish and seafood I strongly recommend flaxseed oil supplementation (1200 mg 2-3 capsules per day) as an alternative
10 | P a g e
New Evidence That Vitamin E Supplementation Improves Outcomes In
Alzheimerrsquos Patients
A 2008 study adds to the body of evidence
James Meschino DC MS ND
In a paper presented at 2008 American Academy of Neurology Annual Meeting(Chicago Il
Poster Sessions III Aging) researchers showed that Alzheimerrsquos disease patients who
supplemented their diet with 2000 IU per day of Vitamin E had a 26 lower mortality rate As
explained by the lead researcher Dr Valory Pavlik from the Baylor College of Medicines
(Alzheimers Disease and Memory Disorders Center Houston TX) many previous studies have
shown that Vitamin E supplementation can slow the progression of Alzheimerrsquos disease The
study by Pavlik et was able to show additional features and benefits of Vitamin E
supplementation in Alzheimerrsquos disease patients and answered some common concerns about
the safety of using high dosages of Vitamin E and combining Vitamin E with conventional drugs
used to manage this condition In their study of 847 Alzheimerrsquos disease patients who were
followed for 49 years their results showed the following
A A 26 reduced mortality rate in the patients administered 2000 IU of Vitamin E per day
compared to Alzheimerrsquos disease patients not taking the Vitamin E supplement
B Combining Vitamin E supplementation (2000 IU per day) with standard drugs used to treat Alzheimerrsquos disease (cholinesterase inhibitors) produced the best overall results with respect to longevity and disease progression Thus it appears to be safe to recommend Vitamin E supplementation to Alzheimerrsquos patients already taking a cholinesterase inhibitor drug such as AriceptTM (donepezil) ExelonTM(rivastigmine) ReminylTM(galantamine) and Ebixareg (memantine hydrochloride)
C Recent concerns about Vitamin E supplementation increasing risk of cancer and heart disease were put to rest as this study showed that individuals with Alzheimerrsquo disease who were in a high-risk age group for death from cardiovascular disease and cancer
(average age 735 86 years) showed a 26 lower mortality rate than Alzheimerrsquos patients who did not take the 2000 IU per day of Vitamin E
D In the Alzheimerrsquos disease patients who used only Vitamin E supplementation (2000 IU per day) and did not take any Alzheimerrsquos disease medication these patients still showed a 26 lower mortality rate than patients not taking the Vitamin E supplement along with significant disease management outcomes
Overall the researchers concluded ldquoRegimens that included vitamin E were associated with a 26 lower mortality rate There was a suggestion that of vitamin E plus a cholinesterase inhibitor was more beneficial than taking either agent alonerdquo
11 | P a g e
The Alzheimerrsquos Disease Cooperative Study
A landmark study in the year 2000 known as the Alzheimerrsquos Disease Cooperative Study was one of the first published studies to show that providing Alzheimerrsquos patients with 2000 IU per day of Vitamin E could slow the progression of their disease The Alzheimers Disease Cooperative Study (ADCS) was formed in 1991 as a cooperative agreement between the National Institute on Aging (NIA) and the University of California San Diego The ADCS is a major initiative for Alzheimers disease (AD) clinical studies in the Federal government addressing treatments for both cognitive and behavioral symptoms Reporting in the American Journal of Clinical Nutrition researchers published results showing that vitamin E supplementation (2000 IU per day) may slow functional deterioration leading to nursing home placement
Why Vitamin E Supplementation The brains of Alzheimers disease patients frequently shows generalized atrophy neuritic plaques (dystrophic axons and dendrites surrounding an amyloid core) and neurofibrillary Evidence suggests that oxidative stress (free radicals) may lead to permanent cellular damage in the brain that triggers some of the changes seen in the brain of Alzheimerrsquos patients The presence of excessive szlig-amyloid protein formation (an extracellular insoluble protein) is a hallmark feature of the Alzheimerrsquos brain A proposed mechanism of szlig-amyloid toxicity is that it induces free radicals which disrupt cellular lipid protein and DNA In addition to szlig-amyloid several other processes may also induce oxidative stress in AD Activated microglial cells found in association with neuritic plaques may release cytokines prooxidants and free radicals As well other etiological factor such as cytoskeletal destabilization energy deprivation or toxic inflammatory responses may all converge in a common final pathway involving free radicals as well
Prior to the Alzheimerrsquos Disease Cooperative Study earlier clinical trials and epidemiologic studies had suggested that several agents may help prevent the development of AD or slow further deterioration These agents include vitamin E selegiline estrogen and anti-inflammatory drugs One property that they all share is the ability to protect against free radicalndashmediated
damage either directly or indirectly
Conclusion
The recent study (2008) by Pavlik et al adds to the body of evidence indicating that supplementing Alzheimerrsquos disease patients with 2000 IU per day of natural Vitamin E can slow the progression of their disease and lower the mortality rate by 26 (over a five-year period) Unfortunately many medical doctors have not been exposed to these studies and thus Vitamin E supplementation is often left out of the management of many Alzheimerrsquos disease cases In these instances it is up to Complementary Health Care Professionals to provide patients and family members with the research and recommendations that have been shown to be meaningful in regards to Vitamin E supplementation (as well as other effective natural interventions) The study by Pavlik et al suggests that Vitamin E supplementation at a dosage of 2000 IU per day is effective safe enhances the benefits of conventional Alzheimerrsquos drugs and does not increase the risk of cancer or heart disease in this older and elderly population
For more information on this or other related topics please visit httpwwwmeschinohealthcom
12 | P a g e
References
1 Valory Pavlik Rachelle Doody Susan Rountree Eveleen Darby Vitamin E Use Is Associated
with Improved Survival in an AD Cohort 2008 American Academy of Neurology Annual
Meeting(Chicago Il) Poster Sessions III Aging and Dementia Clinical II P03076
2 Grundman M Vitamin E and Alzheimer disease the basis for additional clinical trials American Journal of Clinical Nutrition Vol 71 No 2 630S-636s 2000
13 | P a g e
Summary The Quick Checklist of How to Best Maintain Memory Function Maintaining healthy brain function and memory over a lifetime requires that you be proactive Dementia and Alzheimerrsquos disease affect way too many people as they age and we now see that much of this could be avoided if people would use some targeted strategies during their lifetime Here are some important recommendations
1 Take every precaution to avoid head injuries throughout your entire life
2 Always be learning something new or further developing an existing talent or skill set
3 Donrsquot damage your brain with cigarettes alcohol or illicit drugs and try to use the least
number of medications as possible throughout your lifetime
4 Nourish your brain with omega-3 fats from fish twice per week on average
5 Take a high potency multiple vitamin that is antioxidant enriched and contains a B-50
complex (example Adeeva Multiple Vitamin)
6 Take 2-3 capsules per day of an Essential Oil supplement to ensure adequate omega-3
fat and essential fatty acid support for your brain I recommend a supplement that
combines fish oil flaxseed oil and borage seed oil (example Adeeva Naturersquos Essential
Oil)
7 Keep your fasting blood sugar level below 50 mmolL (90 mgdL) Elevated blood sugar
(glucose) and high insulin levels are strongly linked to Alzheimerrsquos disease development
This means eating sugary foods and starchy foods in moderation if at all performing
aerobic exercise for 30 mins at least 3-4 times per week and having a waist
circumference under 36 inches if you are a man and under 34 inches if you are a
woman Have your doctor check your blood glucose level on your next appointment and
ask for the number
8 Ensure that your blood cholesterol level is below 48 mmolL (185 mgdL) This means
avoiding high fat meat and dairy products as well as deep fried foods and transfats
After Age 55 Add The Following
1 Take a Memory Support Supplement each day that contains meaningful doses of
CDP-choline Phosphatidylserine Huperzine A and Bocapa monnieri (example
Adeeva Memory Support Complex) ndash to help your brain continue to make the
memory chemical acetylcholine as you get older
2 Learn a new skill such as a learning to play a musical instrument or a foreign
language ndash something that is outside of your usual knowledge base
Participate in a mind-body activity that builds new neural circuits such as playing ping-pong or
taking dance lessons or martial arts lessons
3 | P a g e
References
Agnoli A et al New strategies in the management of Parkinsonrsquos disease A biological approach using a phospholipid precursor (CDP-Choline) Neuropsycholbiology 19828(6)289-96
Canty DJ et al Lecithin and chloine in human health and disease Nutr Reviews 199452327-339
Citicoline Alzheimerrsquos disease and cognitive performance Life Extension 20006(9)692(Alt Health Watch data base)
Encyclopedia of Nutritional Supplements Prima Publishing 1996Murray M137-141
Foiravanti M Yanagi M Cytidinediphosphocholine (CDP-Choline) for cognitive and behavioral disturbances associated with chronic cerebral disorders in the elderly Cochrane Syst Revi 2002(2)000269 In The Cochrane Library 12002 Oxford Update Software
Present Knowledge in Nutrition (5th edition) The Nutrition Foundation Inc 1984Choline383-399
Secades JJ et al CDP-Choline pharmacological and clinical review Methods Find Exp Clin Pharmacol 199517(Suppl B)1-54
Zeisel SH et al Cholinean essential nutrient for humans FASEB J 1991520093-2098
Cenacchi T Bertoldin T Farina C et al Cognitive decline in the elderly A double-blind placebo-controlled multicenter study on efficacy of phosphatidylserine administration Aging 19935123-33
Crook T Petrie W Wells C Massari DC Effects of phosphatidylserine in Alzheimerrsquos disease Psychopharmacol Bull 19922861-6
Crook TH Tinklenberg J Yesavage J Petrie W Nunzi MG Massari DC Effect of phosphatidylserine in age-associated memory impairment Neurology 199141644-9
Engel RR Satzger W Gunther W Kathmann N Bove D Gerke S et al Double-blind cross-over study of phosphatidylserine vs placebo in subjects with early cognitive deterioration of the Alzheimer type Eur Neuropsychopharmacol 19922149-55
Funfgeld EW Baggen M Nedwidek P Richstein B Mistlberger G Double-blind study with phosphatidylserine (PS) in parkinsonian patients with senile dementia of Alzheimerrsquos type (SKAT) Prog Clin Biol Res 19893171235-46
Maggioni M Picotti GB Bondiolotti GP Panerai A Cenacchi T Nobil P et al Effects of phosphatidylserine therapy in geriatric patients with depressive disorders Acta Psychiatr Scand 199081265-70
Nunzi MG Milan F Guidolin D et al Effects of phosphatidylserine administration on age-related structural changes in the rat hippocampus and septal complex Pharmacopsychiat 198922125-8
Valzelli L Kozak W Zanotti A Toffano G Activity of phosphatidylserine on memory retrieval and on exploration in mice Meth Find Extl Clin Pharmacol 19879657-60
Vannucchi MG Casamenti F Pepeu G Decrease of acetylcholine release from cortical slices in aged rats Investigations into its reversal by phosphatidylserine J Neurochem 199055819-25
4 | P a g e
Dar A Channa S Calcium antagonistic activity of Bacopa monniera on vascular intestinal smooth muscles of rabbit and ginea-pig J Ethnopharmacol 199966(2)167-74
Dietary Supplement Information Bureau wwwcontentintramedicinecom Bacopa monnieri
Kidd PM A review of nutrients and botanicals in the integrative management of cognitive dysfunction Altern Med Rev 1999 Jun4(3)144-61
Mukherjee GD et al Clinical trial on brahmi I J Exp Med Sci 196610(1)5-11
Stough C Lloyd J Clarke J Downey LA Hutchison CW Rodgers T et la The chronic effects of an extract of Bacopa monniera (Brahmi) on cognitive function in healthy human subjects Psychopharmacology (Berl) 2001 Aug156(4)481-4
Tripathi YB et al Bacopa monniera linn As an antioxidant Mechanism of action Indian J Exp Biol 1996 Jun34(6)523-6
Vohora D Pal SN Pillai KK Protection from phenbytoin-induced cognitive deficit by Bacopa monniera a reputed Indian nootropic plant J Ethnopharmacol 2000 Aug71(3)383-90
Ashani Y Peggins JO Doctor BP Mechanism of inhibition of cholinesterases by huperzine A Biochem Biophys Res Commun 1992184719-26
Bai DL et al Huperzine A a potential therapeutic agent for treatment of Alzheimerrsquos disease Curr Med Chem 2000 Mar7(3)355-74
Cheng DH Ren H Tang XC Huperzine A a novel promising acetylcholinesterase inhibitor Neuroreport 1996897-101
Cheng DH Tang XC Comparative studies of huperzine A E2020 and tacrine on behavior and cholinesterase activites Pharmacol Biochem Behav 199860377-86
Dworkin N Restoring memory Psychology Today 2000 JulAug32(4)p28
McCaleb R Huperzia looks promising for improving memory HerbalGram 1031199535p14
Pirisi Angela Plant wisdom Memory moss Yoga Journal 08311999147p95
Sun QQ Xu SS Pan JL et al Huperzine-A capsules enhance memory and learning performance in 34 pairs of matched adolescent students Acta Pharmacol Sin 199920601-3
Tang XC Huperzine A (shuangyiping) A promising drug for Alzheimerrsquos disease Chung Kuo Yao Li Hsueh Pao 1996 Nov17(6)481-4
Wang Z Ren G Zhao Y et al A double-blind study of huperzine A and piracetam in patients with age-associated memory impairment and dementia In Kanba S Richelson E (eds) Herbal Medicines for Nonpsychiatric Diseases Tokyo Seiwa Choten Publishers 199939-50
Xu SS Gao ZX Weng Z et al Efficacy of tablet huperzine-A on memory cognition and behavior in Alzheimerrsquos disease Chung Kuo Yao Li Hsueh Pao 199516391-5
5 | P a g e
OMEGA-3 FATS MAY REDUCE RISK OF AGE-RELATED COGNITIVE DECLINE
DEMENTIA AND ALZHEIMERrsquoS DISEASE
James Meschino DC MS ND
Biological Mechanisms Addressing Neuroprotective Effects of Omega-3 Fats
Several recent studies have suggested that higher intake and blood levels of omega-3 fatty acids may help to reduce risk of age-related cognitive decline dementia and Alzheimerrsquos disease (1-5) Three of four epidemiological studies have suggested a protective effect for omega-3 fatty acids in this regard (6) The major dietary sources of these fatty acids are fish and shellfish from both salt water and fresh water EPA and DHA can also be synthesized from the elongation and desaturation of alpha-linolenic acid which is present in some vegetable oils (7) Flaxseed oil is an especially rich source of alpha-linolenic acid an omega-3 fatty acid
DHA is 22 carbons long and has six double bonds with the first one occurring between carbon three and four from the omega end (the methyl end) of the fatty acid chain It is the most prominent fatty acid in the brain retina and spermatozoa and is necessary for vision cognition and sperm motility The neurons and synaptosomes of the cerebral cortex are especially rich in DHA where it is incorporated into the membrane phospholipid structure The brains of Alzheimerrsquos patients have been shown to contain a lower content of DHA in the grey matter of the frontal lobe and the hypocampus than do the brains of patients without Alzheimerrsquos disease The brains of Alzheimerrsquos patients also demonstrate a build-up of amyloid protein complex and an inflammatory component(7)
The Framingham Heart Study showed that persons with plasma phosphatidylcholine DHA in the top quartile of values had a significantly (47) lower risk of developing all-cause dementia than did those in the bottom quartile and significantly greater protection was obtained from consuming 29 fish meals per week than from consuming only 13 fish meals per week on average (7)
Several mechanisms have been proposed to explain how omega-3-fats can reduce nerve cell degeneration associated with these conditions Omega-3 fatty acids are known to provide anti-inflammatory effects due to their conversion to anti-inflammatory eicosanoids
within the body The eicosanoids formed from omega-3 fatty acids also improve blood flow by dilating vessels and decreasing
platelet stickiness (anti-thrombotic) and provide other benefits associated with cardiovascular health such as improving
endothelial function and lowering triglyceride blood levels All of these effects are also associated with prevention of cognitive
decline largely via preserved blood flow circulation to brain tissue (lower risk of cerebrovascular disease)
However omega-3 fatty acids also play a direct role in nerve cell structure and function Eicosapentaenoic acid (EPA) and docsahexaenoic acid (DHA) have been shown to improve the composition of nerve cell membranes and stimulate the development regeneration and function of nerve cells by stimulating synaptic plasticity and increasing neurotransmission as well as increasing memory abilities In short long chain omega-3 fatty acids are structural components of neuronal and other cell membranes affecting membrane fluidity nerve transmission and nerve cell function in a positive way They also modulate the production of eicosanoids and inflammatory cytokines and help preserve blood flow to the brain
There is also the suggestion that oxidative stress (from oxygen and other free radicals) significantly contributes to neuronal damage seen in cases of cognitive impairment and Alzheimerrsquos disease by depleting the brain of vulnerable highly unsaturated fatty acids (eg
6 | P a g e
EPA and DHA) Some researchers suggest that by replenishing brain cells with EPA and DHA via higher intake levels individuals may help protect themselves against cognitive decline to a significant degree (8-11)
Adding support to the epidemiological and experimental studies that suggest that omega-3 fatty acids can reduce risk of cognitive decline the April 2007 issue of the American Journal of Clinical Nutrition contained the findings of two large prospective studies that evaluated intake of omega-3 fatty acids and subsequent risk of cognitive decline dementia and Alzheimerrsquos disease in older human subjects Taken together the findings of MA Beydoun et al (the Atherosclerosis Risk in Communities Study) and those of BM van Gelder et al (the Zutphen Elderly Study) indicate that a moderate intake of EPA and DHA were strongly associated with reduced risk of cognitive decline (9 10)
The ARIC Study
The Atherosclerosis Risk in Communities Study analyzed plasma fatty acids in cholesterol esters and phospholipids in whites residing in Minneapolis MN from 1987 through 1989 From 1990 through 1992 and from 1996 through 1998 3 neurophysiological tests were administered Effectively this study assessed the association between plasma fatty acids and cognitive decline in adults aged 50-65 years of age at baseline and conducted a subgroup analysis A striking finding among the 2251 study subjects was that higher levels of omega-3 fatty acids were associated with reduced risk of decline in verbal fluency particularly in hypertensive and dyslipedemic subjects whose tissues are exposed to greater oxidative stress from these conditions In contrast the risk of global cognitive decline increased with elevated palmitic acid (a saturated fat) and in subjects with higher levels of arachidonic acid (an omega-6 fatty acid found in meat and dairy products) (9) It should be noted that palmitic acid is a saturated fat that is highly associated with thrombosis and the elevation of LDL-cholesterol both of which can lead to atherosclerosis obstruction increasing the tendency to develop dementia (11)
The Zutphen Elderly Study
In the Zuthen Elderly Study data on fish consumption of 210 male participants who were aged 70-89 years of age in 1990 and data on cognitive functioning collected in 1990 and 1995 were assessed The intake of EPA and DHA was calculated for each participant Results showed that fish consumers had significantly less 5-year subsequent cognitive decline than did non fish consumers and a linear trend (dose-dependent trend) was observed for the relation between the intake of EPA and DHA and cognitive decline More specifically the results showed that elderly men who consumed an average of approximately 400 mg per day of omega-3 fatty acids from EPA and DHA had significantly less cognitive decline over the five year period than did those consuming an average of approximately 20 mg per day of omega-3 fatty acids
At present the American Heart Association recommends the consumption of fish (preferably fatty fish) at least twice per week a recommendation that is compatible with the results of the Zutphen Elderly Study To achieve 400 mg per day of EPA and DHA one would have to consume 6 servings per week of lean fish (average serving size 140 gm or about 5 ounces) or one serving per week of fatty fish such as mackerel or herring (10) One can also achieve this level of intake by consuming a mere 20 gm of Chinook salmon (less than one ounce) or 100 gm of cod (a little more than 35 ounces) As such two to three meals of fish per week would supply approximately 380 mg of EPADHA per day on average (7)
7 | P a g e
Summary
A number of epidemiological studies and experimental studies suggest that higher intake levels brain levels and blood levels of EPA and DHA may help preserve cognitive function as we age and reduce risk of dementia and Alzheimerrsquos disease A number of biological mechanisms have been proposed to explain the protective effects of EPA and DHA in regards to these neurodegenerative conditions More recently two prospective studies involving older and elderly humans (the ARIC and Zutphen Elderly Studies) have shown a strong correlation between higher plasma and intake levels respectively of EPA and DHA and subsequent decreased cognitive decline The Zutphen Elderly Study highlighted the fact that an average daily intake of 400 mg of EPA and DHA appears to be a significant threshold level at which a marked protective effect is observed Some experts suggest that for people who are allergic to fish andor shellfish and those who cannot or will not obtain sufficient intake of fish that they consume 1000 mg per day of fish oil from supplementation (Connor WE Connor SL 2007) A supplement containing fish oil and flaxseed oil may also be a consideration providing the total amount of EPA and DHA reaches a minimum threshold intake value of 400 mg per day Health practitioners should bear this information and these dosage levels in mind when making recommendations about specific essential fatty acid supplement products to their patients
For more information on this or other related topics visit Dr Meschinorsquos website at httpwwwmeschinohealthcom
References
1 Conquer JA Tierney MC Zecevic J Bettger WJ Fisher RH Fatty acid analysis of blood plasma of patients with Alzheimerrsquos disease other types of dementia and cognitive impairment Lipids 2000351305-12
2 Heude B Ducimetiere P Berr C Cognitive decline and fatty acid composition of erythrocyte membranes ndash the EVA Study Am J Clin Nutr 200377803-8
3 Tully AM Roche HM Doyle R et al Low serum cholesteryl esterdocosahexaenoic acid levels in Alzheimerrsquos disease a case-control study Br J Nutr 200389483-9
4 Kalmijn S van Boxtel MP Ocke M Vershcuren WM Kromhout D Launer LJ Dietary intake of fatty acids and fish in relation to cognitive performance at middle age Neurology 200462275-80
5 Kalmign S Feskens EJ Launer LJ Kromhout D Polyunsaturated fatty acids antioxidants and cognitive function in very old men Am J Epidemiol 199714533-41
6 He K Song Y Daviglus MI et al Fish consumption and incidence of stroke a meta-analysis of cohort studies Stroke 2004351538-42
7 Connor WE and Connor SL The importance of fish and docosahexaenoic acid in Alzheimerrsquos disease Am J Clin Nutr85929-30 2007
8 Brunner E Oily fish and omega 3 fat supplements BMJ332739-7402006
9 Beydoun MA Kaufman JS Satia JA Rousamond W Folson AR Plasma n-3 fatty acids and the risk of cognitive decline in older adults the Atherosclerosis Risk Communities Study Am J Clin Nutr 851103-11 2007
10 Van Gelder BM Tijuis M Kalmijn S Kromhout D Fish consumption n-3 fatty acids and subsequent 5-y cognitive decline in elderly men the Zutphen Elderly Study Am J Clin Nutr 85 1142-7 2007
8 | P a g e
11 Scientific Advisory Committee on Nutrition Committee on Toxicity Advice on fish consumption benefits and risks London Stationery Office 2004 wwwfoodgovukmultimediapdfsfishreport2004fullpdf (accessed 9 Feb 2006)
9 | P a g e
DHA ndash Omega-3 Fat Shown To Block Amyloid Synthesis In Alzheimerrsquos Disease Prevention
James Meschino DC MS ND
Recent studies indicate that higher intake and blood levels of omega-3 fats are associated with reduced risk of age-related cognitive decline dementia and Alzheimerrsquos disease The Atherosclerosis Risk in Communities Study which followed 2251 individuals (aged 50-65) showed that higher blood levels of omega-3 fats were associated with reduced risk of decline in verbal fluency The Zutphen Elderly Study which followed 210 elderly men (aged 70-89) for five years showed that men who consumed an average of approximately 400 mg per day of omega-3 fats (from fish) had significantly less cognitive decline over the five year period than did those consuming approximately 20 mg per day The Framingham Heart Study showed that persons with blood levels of omega-3 fats (phosphatidylcholine DHA) in the top 25 had a significantly (47) lower risk of developing all-cause dementia than did those in the bottom 25 In addition Alzheimerrsquos patients have been shown to have less DHA (an omega-3 fat) in the regions of the brain most affected by Alzheimerrsquos disease (the frontal lobe and hypocampus)
Experimental studies have shed light on the ways in which omega-3 fats may reduce risk of these conditions For example omega-3 fats have been shown to reduce brain inflammation increase blood circulation to brain cells inhibit abnormal clots in blood vessels within the brain More recently omega-3 fats were shown to improve nerve transmission among brain cells and support brain cell repair mechanisms
The most recent finding however was reported in the Journal of Neuroscience (Dec 2007 Qiu-Lan Ma and fellow researchers) showing that omega-3 fats inhibit the build up of amyloid plaque in brain cells The accumulation of amyloid plaque (a protein) in brain cells is a hallmark feature of Alzheimerrsquos disease and is considered to be the main culprit leading to brain cell disruption which manifests as memory loss confusion personality changes and other Alzheimerrsquos signs and symptoms These researchers discovered that omega-3 fats (particularly DHA) increases the number of receptors (the LR11- receptor) on human and murine (mice) brain cells which in turn transmits signals within the cell that block the accumulation of amyloid protein
Taken together my advice is to ingest at least 400 mg per day on average of omega-3 fats This means consuming 3-4 fish servings per week In addition I personally take 2-3 capsules per day of a supplement containing 400 mg each of fish oil flaxseed oil and borage seed oil For those allergic to fish and seafood I strongly recommend flaxseed oil supplementation (1200 mg 2-3 capsules per day) as an alternative
10 | P a g e
New Evidence That Vitamin E Supplementation Improves Outcomes In
Alzheimerrsquos Patients
A 2008 study adds to the body of evidence
James Meschino DC MS ND
In a paper presented at 2008 American Academy of Neurology Annual Meeting(Chicago Il
Poster Sessions III Aging) researchers showed that Alzheimerrsquos disease patients who
supplemented their diet with 2000 IU per day of Vitamin E had a 26 lower mortality rate As
explained by the lead researcher Dr Valory Pavlik from the Baylor College of Medicines
(Alzheimers Disease and Memory Disorders Center Houston TX) many previous studies have
shown that Vitamin E supplementation can slow the progression of Alzheimerrsquos disease The
study by Pavlik et was able to show additional features and benefits of Vitamin E
supplementation in Alzheimerrsquos disease patients and answered some common concerns about
the safety of using high dosages of Vitamin E and combining Vitamin E with conventional drugs
used to manage this condition In their study of 847 Alzheimerrsquos disease patients who were
followed for 49 years their results showed the following
A A 26 reduced mortality rate in the patients administered 2000 IU of Vitamin E per day
compared to Alzheimerrsquos disease patients not taking the Vitamin E supplement
B Combining Vitamin E supplementation (2000 IU per day) with standard drugs used to treat Alzheimerrsquos disease (cholinesterase inhibitors) produced the best overall results with respect to longevity and disease progression Thus it appears to be safe to recommend Vitamin E supplementation to Alzheimerrsquos patients already taking a cholinesterase inhibitor drug such as AriceptTM (donepezil) ExelonTM(rivastigmine) ReminylTM(galantamine) and Ebixareg (memantine hydrochloride)
C Recent concerns about Vitamin E supplementation increasing risk of cancer and heart disease were put to rest as this study showed that individuals with Alzheimerrsquo disease who were in a high-risk age group for death from cardiovascular disease and cancer
(average age 735 86 years) showed a 26 lower mortality rate than Alzheimerrsquos patients who did not take the 2000 IU per day of Vitamin E
D In the Alzheimerrsquos disease patients who used only Vitamin E supplementation (2000 IU per day) and did not take any Alzheimerrsquos disease medication these patients still showed a 26 lower mortality rate than patients not taking the Vitamin E supplement along with significant disease management outcomes
Overall the researchers concluded ldquoRegimens that included vitamin E were associated with a 26 lower mortality rate There was a suggestion that of vitamin E plus a cholinesterase inhibitor was more beneficial than taking either agent alonerdquo
11 | P a g e
The Alzheimerrsquos Disease Cooperative Study
A landmark study in the year 2000 known as the Alzheimerrsquos Disease Cooperative Study was one of the first published studies to show that providing Alzheimerrsquos patients with 2000 IU per day of Vitamin E could slow the progression of their disease The Alzheimers Disease Cooperative Study (ADCS) was formed in 1991 as a cooperative agreement between the National Institute on Aging (NIA) and the University of California San Diego The ADCS is a major initiative for Alzheimers disease (AD) clinical studies in the Federal government addressing treatments for both cognitive and behavioral symptoms Reporting in the American Journal of Clinical Nutrition researchers published results showing that vitamin E supplementation (2000 IU per day) may slow functional deterioration leading to nursing home placement
Why Vitamin E Supplementation The brains of Alzheimers disease patients frequently shows generalized atrophy neuritic plaques (dystrophic axons and dendrites surrounding an amyloid core) and neurofibrillary Evidence suggests that oxidative stress (free radicals) may lead to permanent cellular damage in the brain that triggers some of the changes seen in the brain of Alzheimerrsquos patients The presence of excessive szlig-amyloid protein formation (an extracellular insoluble protein) is a hallmark feature of the Alzheimerrsquos brain A proposed mechanism of szlig-amyloid toxicity is that it induces free radicals which disrupt cellular lipid protein and DNA In addition to szlig-amyloid several other processes may also induce oxidative stress in AD Activated microglial cells found in association with neuritic plaques may release cytokines prooxidants and free radicals As well other etiological factor such as cytoskeletal destabilization energy deprivation or toxic inflammatory responses may all converge in a common final pathway involving free radicals as well
Prior to the Alzheimerrsquos Disease Cooperative Study earlier clinical trials and epidemiologic studies had suggested that several agents may help prevent the development of AD or slow further deterioration These agents include vitamin E selegiline estrogen and anti-inflammatory drugs One property that they all share is the ability to protect against free radicalndashmediated
damage either directly or indirectly
Conclusion
The recent study (2008) by Pavlik et al adds to the body of evidence indicating that supplementing Alzheimerrsquos disease patients with 2000 IU per day of natural Vitamin E can slow the progression of their disease and lower the mortality rate by 26 (over a five-year period) Unfortunately many medical doctors have not been exposed to these studies and thus Vitamin E supplementation is often left out of the management of many Alzheimerrsquos disease cases In these instances it is up to Complementary Health Care Professionals to provide patients and family members with the research and recommendations that have been shown to be meaningful in regards to Vitamin E supplementation (as well as other effective natural interventions) The study by Pavlik et al suggests that Vitamin E supplementation at a dosage of 2000 IU per day is effective safe enhances the benefits of conventional Alzheimerrsquos drugs and does not increase the risk of cancer or heart disease in this older and elderly population
For more information on this or other related topics please visit httpwwwmeschinohealthcom
12 | P a g e
References
1 Valory Pavlik Rachelle Doody Susan Rountree Eveleen Darby Vitamin E Use Is Associated
with Improved Survival in an AD Cohort 2008 American Academy of Neurology Annual
Meeting(Chicago Il) Poster Sessions III Aging and Dementia Clinical II P03076
2 Grundman M Vitamin E and Alzheimer disease the basis for additional clinical trials American Journal of Clinical Nutrition Vol 71 No 2 630S-636s 2000
13 | P a g e
Summary The Quick Checklist of How to Best Maintain Memory Function Maintaining healthy brain function and memory over a lifetime requires that you be proactive Dementia and Alzheimerrsquos disease affect way too many people as they age and we now see that much of this could be avoided if people would use some targeted strategies during their lifetime Here are some important recommendations
1 Take every precaution to avoid head injuries throughout your entire life
2 Always be learning something new or further developing an existing talent or skill set
3 Donrsquot damage your brain with cigarettes alcohol or illicit drugs and try to use the least
number of medications as possible throughout your lifetime
4 Nourish your brain with omega-3 fats from fish twice per week on average
5 Take a high potency multiple vitamin that is antioxidant enriched and contains a B-50
complex (example Adeeva Multiple Vitamin)
6 Take 2-3 capsules per day of an Essential Oil supplement to ensure adequate omega-3
fat and essential fatty acid support for your brain I recommend a supplement that
combines fish oil flaxseed oil and borage seed oil (example Adeeva Naturersquos Essential
Oil)
7 Keep your fasting blood sugar level below 50 mmolL (90 mgdL) Elevated blood sugar
(glucose) and high insulin levels are strongly linked to Alzheimerrsquos disease development
This means eating sugary foods and starchy foods in moderation if at all performing
aerobic exercise for 30 mins at least 3-4 times per week and having a waist
circumference under 36 inches if you are a man and under 34 inches if you are a
woman Have your doctor check your blood glucose level on your next appointment and
ask for the number
8 Ensure that your blood cholesterol level is below 48 mmolL (185 mgdL) This means
avoiding high fat meat and dairy products as well as deep fried foods and transfats
After Age 55 Add The Following
1 Take a Memory Support Supplement each day that contains meaningful doses of
CDP-choline Phosphatidylserine Huperzine A and Bocapa monnieri (example
Adeeva Memory Support Complex) ndash to help your brain continue to make the
memory chemical acetylcholine as you get older
2 Learn a new skill such as a learning to play a musical instrument or a foreign
language ndash something that is outside of your usual knowledge base
Participate in a mind-body activity that builds new neural circuits such as playing ping-pong or
taking dance lessons or martial arts lessons
4 | P a g e
Dar A Channa S Calcium antagonistic activity of Bacopa monniera on vascular intestinal smooth muscles of rabbit and ginea-pig J Ethnopharmacol 199966(2)167-74
Dietary Supplement Information Bureau wwwcontentintramedicinecom Bacopa monnieri
Kidd PM A review of nutrients and botanicals in the integrative management of cognitive dysfunction Altern Med Rev 1999 Jun4(3)144-61
Mukherjee GD et al Clinical trial on brahmi I J Exp Med Sci 196610(1)5-11
Stough C Lloyd J Clarke J Downey LA Hutchison CW Rodgers T et la The chronic effects of an extract of Bacopa monniera (Brahmi) on cognitive function in healthy human subjects Psychopharmacology (Berl) 2001 Aug156(4)481-4
Tripathi YB et al Bacopa monniera linn As an antioxidant Mechanism of action Indian J Exp Biol 1996 Jun34(6)523-6
Vohora D Pal SN Pillai KK Protection from phenbytoin-induced cognitive deficit by Bacopa monniera a reputed Indian nootropic plant J Ethnopharmacol 2000 Aug71(3)383-90
Ashani Y Peggins JO Doctor BP Mechanism of inhibition of cholinesterases by huperzine A Biochem Biophys Res Commun 1992184719-26
Bai DL et al Huperzine A a potential therapeutic agent for treatment of Alzheimerrsquos disease Curr Med Chem 2000 Mar7(3)355-74
Cheng DH Ren H Tang XC Huperzine A a novel promising acetylcholinesterase inhibitor Neuroreport 1996897-101
Cheng DH Tang XC Comparative studies of huperzine A E2020 and tacrine on behavior and cholinesterase activites Pharmacol Biochem Behav 199860377-86
Dworkin N Restoring memory Psychology Today 2000 JulAug32(4)p28
McCaleb R Huperzia looks promising for improving memory HerbalGram 1031199535p14
Pirisi Angela Plant wisdom Memory moss Yoga Journal 08311999147p95
Sun QQ Xu SS Pan JL et al Huperzine-A capsules enhance memory and learning performance in 34 pairs of matched adolescent students Acta Pharmacol Sin 199920601-3
Tang XC Huperzine A (shuangyiping) A promising drug for Alzheimerrsquos disease Chung Kuo Yao Li Hsueh Pao 1996 Nov17(6)481-4
Wang Z Ren G Zhao Y et al A double-blind study of huperzine A and piracetam in patients with age-associated memory impairment and dementia In Kanba S Richelson E (eds) Herbal Medicines for Nonpsychiatric Diseases Tokyo Seiwa Choten Publishers 199939-50
Xu SS Gao ZX Weng Z et al Efficacy of tablet huperzine-A on memory cognition and behavior in Alzheimerrsquos disease Chung Kuo Yao Li Hsueh Pao 199516391-5
5 | P a g e
OMEGA-3 FATS MAY REDUCE RISK OF AGE-RELATED COGNITIVE DECLINE
DEMENTIA AND ALZHEIMERrsquoS DISEASE
James Meschino DC MS ND
Biological Mechanisms Addressing Neuroprotective Effects of Omega-3 Fats
Several recent studies have suggested that higher intake and blood levels of omega-3 fatty acids may help to reduce risk of age-related cognitive decline dementia and Alzheimerrsquos disease (1-5) Three of four epidemiological studies have suggested a protective effect for omega-3 fatty acids in this regard (6) The major dietary sources of these fatty acids are fish and shellfish from both salt water and fresh water EPA and DHA can also be synthesized from the elongation and desaturation of alpha-linolenic acid which is present in some vegetable oils (7) Flaxseed oil is an especially rich source of alpha-linolenic acid an omega-3 fatty acid
DHA is 22 carbons long and has six double bonds with the first one occurring between carbon three and four from the omega end (the methyl end) of the fatty acid chain It is the most prominent fatty acid in the brain retina and spermatozoa and is necessary for vision cognition and sperm motility The neurons and synaptosomes of the cerebral cortex are especially rich in DHA where it is incorporated into the membrane phospholipid structure The brains of Alzheimerrsquos patients have been shown to contain a lower content of DHA in the grey matter of the frontal lobe and the hypocampus than do the brains of patients without Alzheimerrsquos disease The brains of Alzheimerrsquos patients also demonstrate a build-up of amyloid protein complex and an inflammatory component(7)
The Framingham Heart Study showed that persons with plasma phosphatidylcholine DHA in the top quartile of values had a significantly (47) lower risk of developing all-cause dementia than did those in the bottom quartile and significantly greater protection was obtained from consuming 29 fish meals per week than from consuming only 13 fish meals per week on average (7)
Several mechanisms have been proposed to explain how omega-3-fats can reduce nerve cell degeneration associated with these conditions Omega-3 fatty acids are known to provide anti-inflammatory effects due to their conversion to anti-inflammatory eicosanoids
within the body The eicosanoids formed from omega-3 fatty acids also improve blood flow by dilating vessels and decreasing
platelet stickiness (anti-thrombotic) and provide other benefits associated with cardiovascular health such as improving
endothelial function and lowering triglyceride blood levels All of these effects are also associated with prevention of cognitive
decline largely via preserved blood flow circulation to brain tissue (lower risk of cerebrovascular disease)
However omega-3 fatty acids also play a direct role in nerve cell structure and function Eicosapentaenoic acid (EPA) and docsahexaenoic acid (DHA) have been shown to improve the composition of nerve cell membranes and stimulate the development regeneration and function of nerve cells by stimulating synaptic plasticity and increasing neurotransmission as well as increasing memory abilities In short long chain omega-3 fatty acids are structural components of neuronal and other cell membranes affecting membrane fluidity nerve transmission and nerve cell function in a positive way They also modulate the production of eicosanoids and inflammatory cytokines and help preserve blood flow to the brain
There is also the suggestion that oxidative stress (from oxygen and other free radicals) significantly contributes to neuronal damage seen in cases of cognitive impairment and Alzheimerrsquos disease by depleting the brain of vulnerable highly unsaturated fatty acids (eg
6 | P a g e
EPA and DHA) Some researchers suggest that by replenishing brain cells with EPA and DHA via higher intake levels individuals may help protect themselves against cognitive decline to a significant degree (8-11)
Adding support to the epidemiological and experimental studies that suggest that omega-3 fatty acids can reduce risk of cognitive decline the April 2007 issue of the American Journal of Clinical Nutrition contained the findings of two large prospective studies that evaluated intake of omega-3 fatty acids and subsequent risk of cognitive decline dementia and Alzheimerrsquos disease in older human subjects Taken together the findings of MA Beydoun et al (the Atherosclerosis Risk in Communities Study) and those of BM van Gelder et al (the Zutphen Elderly Study) indicate that a moderate intake of EPA and DHA were strongly associated with reduced risk of cognitive decline (9 10)
The ARIC Study
The Atherosclerosis Risk in Communities Study analyzed plasma fatty acids in cholesterol esters and phospholipids in whites residing in Minneapolis MN from 1987 through 1989 From 1990 through 1992 and from 1996 through 1998 3 neurophysiological tests were administered Effectively this study assessed the association between plasma fatty acids and cognitive decline in adults aged 50-65 years of age at baseline and conducted a subgroup analysis A striking finding among the 2251 study subjects was that higher levels of omega-3 fatty acids were associated with reduced risk of decline in verbal fluency particularly in hypertensive and dyslipedemic subjects whose tissues are exposed to greater oxidative stress from these conditions In contrast the risk of global cognitive decline increased with elevated palmitic acid (a saturated fat) and in subjects with higher levels of arachidonic acid (an omega-6 fatty acid found in meat and dairy products) (9) It should be noted that palmitic acid is a saturated fat that is highly associated with thrombosis and the elevation of LDL-cholesterol both of which can lead to atherosclerosis obstruction increasing the tendency to develop dementia (11)
The Zutphen Elderly Study
In the Zuthen Elderly Study data on fish consumption of 210 male participants who were aged 70-89 years of age in 1990 and data on cognitive functioning collected in 1990 and 1995 were assessed The intake of EPA and DHA was calculated for each participant Results showed that fish consumers had significantly less 5-year subsequent cognitive decline than did non fish consumers and a linear trend (dose-dependent trend) was observed for the relation between the intake of EPA and DHA and cognitive decline More specifically the results showed that elderly men who consumed an average of approximately 400 mg per day of omega-3 fatty acids from EPA and DHA had significantly less cognitive decline over the five year period than did those consuming an average of approximately 20 mg per day of omega-3 fatty acids
At present the American Heart Association recommends the consumption of fish (preferably fatty fish) at least twice per week a recommendation that is compatible with the results of the Zutphen Elderly Study To achieve 400 mg per day of EPA and DHA one would have to consume 6 servings per week of lean fish (average serving size 140 gm or about 5 ounces) or one serving per week of fatty fish such as mackerel or herring (10) One can also achieve this level of intake by consuming a mere 20 gm of Chinook salmon (less than one ounce) or 100 gm of cod (a little more than 35 ounces) As such two to three meals of fish per week would supply approximately 380 mg of EPADHA per day on average (7)
7 | P a g e
Summary
A number of epidemiological studies and experimental studies suggest that higher intake levels brain levels and blood levels of EPA and DHA may help preserve cognitive function as we age and reduce risk of dementia and Alzheimerrsquos disease A number of biological mechanisms have been proposed to explain the protective effects of EPA and DHA in regards to these neurodegenerative conditions More recently two prospective studies involving older and elderly humans (the ARIC and Zutphen Elderly Studies) have shown a strong correlation between higher plasma and intake levels respectively of EPA and DHA and subsequent decreased cognitive decline The Zutphen Elderly Study highlighted the fact that an average daily intake of 400 mg of EPA and DHA appears to be a significant threshold level at which a marked protective effect is observed Some experts suggest that for people who are allergic to fish andor shellfish and those who cannot or will not obtain sufficient intake of fish that they consume 1000 mg per day of fish oil from supplementation (Connor WE Connor SL 2007) A supplement containing fish oil and flaxseed oil may also be a consideration providing the total amount of EPA and DHA reaches a minimum threshold intake value of 400 mg per day Health practitioners should bear this information and these dosage levels in mind when making recommendations about specific essential fatty acid supplement products to their patients
For more information on this or other related topics visit Dr Meschinorsquos website at httpwwwmeschinohealthcom
References
1 Conquer JA Tierney MC Zecevic J Bettger WJ Fisher RH Fatty acid analysis of blood plasma of patients with Alzheimerrsquos disease other types of dementia and cognitive impairment Lipids 2000351305-12
2 Heude B Ducimetiere P Berr C Cognitive decline and fatty acid composition of erythrocyte membranes ndash the EVA Study Am J Clin Nutr 200377803-8
3 Tully AM Roche HM Doyle R et al Low serum cholesteryl esterdocosahexaenoic acid levels in Alzheimerrsquos disease a case-control study Br J Nutr 200389483-9
4 Kalmijn S van Boxtel MP Ocke M Vershcuren WM Kromhout D Launer LJ Dietary intake of fatty acids and fish in relation to cognitive performance at middle age Neurology 200462275-80
5 Kalmign S Feskens EJ Launer LJ Kromhout D Polyunsaturated fatty acids antioxidants and cognitive function in very old men Am J Epidemiol 199714533-41
6 He K Song Y Daviglus MI et al Fish consumption and incidence of stroke a meta-analysis of cohort studies Stroke 2004351538-42
7 Connor WE and Connor SL The importance of fish and docosahexaenoic acid in Alzheimerrsquos disease Am J Clin Nutr85929-30 2007
8 Brunner E Oily fish and omega 3 fat supplements BMJ332739-7402006
9 Beydoun MA Kaufman JS Satia JA Rousamond W Folson AR Plasma n-3 fatty acids and the risk of cognitive decline in older adults the Atherosclerosis Risk Communities Study Am J Clin Nutr 851103-11 2007
10 Van Gelder BM Tijuis M Kalmijn S Kromhout D Fish consumption n-3 fatty acids and subsequent 5-y cognitive decline in elderly men the Zutphen Elderly Study Am J Clin Nutr 85 1142-7 2007
8 | P a g e
11 Scientific Advisory Committee on Nutrition Committee on Toxicity Advice on fish consumption benefits and risks London Stationery Office 2004 wwwfoodgovukmultimediapdfsfishreport2004fullpdf (accessed 9 Feb 2006)
9 | P a g e
DHA ndash Omega-3 Fat Shown To Block Amyloid Synthesis In Alzheimerrsquos Disease Prevention
James Meschino DC MS ND
Recent studies indicate that higher intake and blood levels of omega-3 fats are associated with reduced risk of age-related cognitive decline dementia and Alzheimerrsquos disease The Atherosclerosis Risk in Communities Study which followed 2251 individuals (aged 50-65) showed that higher blood levels of omega-3 fats were associated with reduced risk of decline in verbal fluency The Zutphen Elderly Study which followed 210 elderly men (aged 70-89) for five years showed that men who consumed an average of approximately 400 mg per day of omega-3 fats (from fish) had significantly less cognitive decline over the five year period than did those consuming approximately 20 mg per day The Framingham Heart Study showed that persons with blood levels of omega-3 fats (phosphatidylcholine DHA) in the top 25 had a significantly (47) lower risk of developing all-cause dementia than did those in the bottom 25 In addition Alzheimerrsquos patients have been shown to have less DHA (an omega-3 fat) in the regions of the brain most affected by Alzheimerrsquos disease (the frontal lobe and hypocampus)
Experimental studies have shed light on the ways in which omega-3 fats may reduce risk of these conditions For example omega-3 fats have been shown to reduce brain inflammation increase blood circulation to brain cells inhibit abnormal clots in blood vessels within the brain More recently omega-3 fats were shown to improve nerve transmission among brain cells and support brain cell repair mechanisms
The most recent finding however was reported in the Journal of Neuroscience (Dec 2007 Qiu-Lan Ma and fellow researchers) showing that omega-3 fats inhibit the build up of amyloid plaque in brain cells The accumulation of amyloid plaque (a protein) in brain cells is a hallmark feature of Alzheimerrsquos disease and is considered to be the main culprit leading to brain cell disruption which manifests as memory loss confusion personality changes and other Alzheimerrsquos signs and symptoms These researchers discovered that omega-3 fats (particularly DHA) increases the number of receptors (the LR11- receptor) on human and murine (mice) brain cells which in turn transmits signals within the cell that block the accumulation of amyloid protein
Taken together my advice is to ingest at least 400 mg per day on average of omega-3 fats This means consuming 3-4 fish servings per week In addition I personally take 2-3 capsules per day of a supplement containing 400 mg each of fish oil flaxseed oil and borage seed oil For those allergic to fish and seafood I strongly recommend flaxseed oil supplementation (1200 mg 2-3 capsules per day) as an alternative
10 | P a g e
New Evidence That Vitamin E Supplementation Improves Outcomes In
Alzheimerrsquos Patients
A 2008 study adds to the body of evidence
James Meschino DC MS ND
In a paper presented at 2008 American Academy of Neurology Annual Meeting(Chicago Il
Poster Sessions III Aging) researchers showed that Alzheimerrsquos disease patients who
supplemented their diet with 2000 IU per day of Vitamin E had a 26 lower mortality rate As
explained by the lead researcher Dr Valory Pavlik from the Baylor College of Medicines
(Alzheimers Disease and Memory Disorders Center Houston TX) many previous studies have
shown that Vitamin E supplementation can slow the progression of Alzheimerrsquos disease The
study by Pavlik et was able to show additional features and benefits of Vitamin E
supplementation in Alzheimerrsquos disease patients and answered some common concerns about
the safety of using high dosages of Vitamin E and combining Vitamin E with conventional drugs
used to manage this condition In their study of 847 Alzheimerrsquos disease patients who were
followed for 49 years their results showed the following
A A 26 reduced mortality rate in the patients administered 2000 IU of Vitamin E per day
compared to Alzheimerrsquos disease patients not taking the Vitamin E supplement
B Combining Vitamin E supplementation (2000 IU per day) with standard drugs used to treat Alzheimerrsquos disease (cholinesterase inhibitors) produced the best overall results with respect to longevity and disease progression Thus it appears to be safe to recommend Vitamin E supplementation to Alzheimerrsquos patients already taking a cholinesterase inhibitor drug such as AriceptTM (donepezil) ExelonTM(rivastigmine) ReminylTM(galantamine) and Ebixareg (memantine hydrochloride)
C Recent concerns about Vitamin E supplementation increasing risk of cancer and heart disease were put to rest as this study showed that individuals with Alzheimerrsquo disease who were in a high-risk age group for death from cardiovascular disease and cancer
(average age 735 86 years) showed a 26 lower mortality rate than Alzheimerrsquos patients who did not take the 2000 IU per day of Vitamin E
D In the Alzheimerrsquos disease patients who used only Vitamin E supplementation (2000 IU per day) and did not take any Alzheimerrsquos disease medication these patients still showed a 26 lower mortality rate than patients not taking the Vitamin E supplement along with significant disease management outcomes
Overall the researchers concluded ldquoRegimens that included vitamin E were associated with a 26 lower mortality rate There was a suggestion that of vitamin E plus a cholinesterase inhibitor was more beneficial than taking either agent alonerdquo
11 | P a g e
The Alzheimerrsquos Disease Cooperative Study
A landmark study in the year 2000 known as the Alzheimerrsquos Disease Cooperative Study was one of the first published studies to show that providing Alzheimerrsquos patients with 2000 IU per day of Vitamin E could slow the progression of their disease The Alzheimers Disease Cooperative Study (ADCS) was formed in 1991 as a cooperative agreement between the National Institute on Aging (NIA) and the University of California San Diego The ADCS is a major initiative for Alzheimers disease (AD) clinical studies in the Federal government addressing treatments for both cognitive and behavioral symptoms Reporting in the American Journal of Clinical Nutrition researchers published results showing that vitamin E supplementation (2000 IU per day) may slow functional deterioration leading to nursing home placement
Why Vitamin E Supplementation The brains of Alzheimers disease patients frequently shows generalized atrophy neuritic plaques (dystrophic axons and dendrites surrounding an amyloid core) and neurofibrillary Evidence suggests that oxidative stress (free radicals) may lead to permanent cellular damage in the brain that triggers some of the changes seen in the brain of Alzheimerrsquos patients The presence of excessive szlig-amyloid protein formation (an extracellular insoluble protein) is a hallmark feature of the Alzheimerrsquos brain A proposed mechanism of szlig-amyloid toxicity is that it induces free radicals which disrupt cellular lipid protein and DNA In addition to szlig-amyloid several other processes may also induce oxidative stress in AD Activated microglial cells found in association with neuritic plaques may release cytokines prooxidants and free radicals As well other etiological factor such as cytoskeletal destabilization energy deprivation or toxic inflammatory responses may all converge in a common final pathway involving free radicals as well
Prior to the Alzheimerrsquos Disease Cooperative Study earlier clinical trials and epidemiologic studies had suggested that several agents may help prevent the development of AD or slow further deterioration These agents include vitamin E selegiline estrogen and anti-inflammatory drugs One property that they all share is the ability to protect against free radicalndashmediated
damage either directly or indirectly
Conclusion
The recent study (2008) by Pavlik et al adds to the body of evidence indicating that supplementing Alzheimerrsquos disease patients with 2000 IU per day of natural Vitamin E can slow the progression of their disease and lower the mortality rate by 26 (over a five-year period) Unfortunately many medical doctors have not been exposed to these studies and thus Vitamin E supplementation is often left out of the management of many Alzheimerrsquos disease cases In these instances it is up to Complementary Health Care Professionals to provide patients and family members with the research and recommendations that have been shown to be meaningful in regards to Vitamin E supplementation (as well as other effective natural interventions) The study by Pavlik et al suggests that Vitamin E supplementation at a dosage of 2000 IU per day is effective safe enhances the benefits of conventional Alzheimerrsquos drugs and does not increase the risk of cancer or heart disease in this older and elderly population
For more information on this or other related topics please visit httpwwwmeschinohealthcom
12 | P a g e
References
1 Valory Pavlik Rachelle Doody Susan Rountree Eveleen Darby Vitamin E Use Is Associated
with Improved Survival in an AD Cohort 2008 American Academy of Neurology Annual
Meeting(Chicago Il) Poster Sessions III Aging and Dementia Clinical II P03076
2 Grundman M Vitamin E and Alzheimer disease the basis for additional clinical trials American Journal of Clinical Nutrition Vol 71 No 2 630S-636s 2000
13 | P a g e
Summary The Quick Checklist of How to Best Maintain Memory Function Maintaining healthy brain function and memory over a lifetime requires that you be proactive Dementia and Alzheimerrsquos disease affect way too many people as they age and we now see that much of this could be avoided if people would use some targeted strategies during their lifetime Here are some important recommendations
1 Take every precaution to avoid head injuries throughout your entire life
2 Always be learning something new or further developing an existing talent or skill set
3 Donrsquot damage your brain with cigarettes alcohol or illicit drugs and try to use the least
number of medications as possible throughout your lifetime
4 Nourish your brain with omega-3 fats from fish twice per week on average
5 Take a high potency multiple vitamin that is antioxidant enriched and contains a B-50
complex (example Adeeva Multiple Vitamin)
6 Take 2-3 capsules per day of an Essential Oil supplement to ensure adequate omega-3
fat and essential fatty acid support for your brain I recommend a supplement that
combines fish oil flaxseed oil and borage seed oil (example Adeeva Naturersquos Essential
Oil)
7 Keep your fasting blood sugar level below 50 mmolL (90 mgdL) Elevated blood sugar
(glucose) and high insulin levels are strongly linked to Alzheimerrsquos disease development
This means eating sugary foods and starchy foods in moderation if at all performing
aerobic exercise for 30 mins at least 3-4 times per week and having a waist
circumference under 36 inches if you are a man and under 34 inches if you are a
woman Have your doctor check your blood glucose level on your next appointment and
ask for the number
8 Ensure that your blood cholesterol level is below 48 mmolL (185 mgdL) This means
avoiding high fat meat and dairy products as well as deep fried foods and transfats
After Age 55 Add The Following
1 Take a Memory Support Supplement each day that contains meaningful doses of
CDP-choline Phosphatidylserine Huperzine A and Bocapa monnieri (example
Adeeva Memory Support Complex) ndash to help your brain continue to make the
memory chemical acetylcholine as you get older
2 Learn a new skill such as a learning to play a musical instrument or a foreign
language ndash something that is outside of your usual knowledge base
Participate in a mind-body activity that builds new neural circuits such as playing ping-pong or
taking dance lessons or martial arts lessons
5 | P a g e
OMEGA-3 FATS MAY REDUCE RISK OF AGE-RELATED COGNITIVE DECLINE
DEMENTIA AND ALZHEIMERrsquoS DISEASE
James Meschino DC MS ND
Biological Mechanisms Addressing Neuroprotective Effects of Omega-3 Fats
Several recent studies have suggested that higher intake and blood levels of omega-3 fatty acids may help to reduce risk of age-related cognitive decline dementia and Alzheimerrsquos disease (1-5) Three of four epidemiological studies have suggested a protective effect for omega-3 fatty acids in this regard (6) The major dietary sources of these fatty acids are fish and shellfish from both salt water and fresh water EPA and DHA can also be synthesized from the elongation and desaturation of alpha-linolenic acid which is present in some vegetable oils (7) Flaxseed oil is an especially rich source of alpha-linolenic acid an omega-3 fatty acid
DHA is 22 carbons long and has six double bonds with the first one occurring between carbon three and four from the omega end (the methyl end) of the fatty acid chain It is the most prominent fatty acid in the brain retina and spermatozoa and is necessary for vision cognition and sperm motility The neurons and synaptosomes of the cerebral cortex are especially rich in DHA where it is incorporated into the membrane phospholipid structure The brains of Alzheimerrsquos patients have been shown to contain a lower content of DHA in the grey matter of the frontal lobe and the hypocampus than do the brains of patients without Alzheimerrsquos disease The brains of Alzheimerrsquos patients also demonstrate a build-up of amyloid protein complex and an inflammatory component(7)
The Framingham Heart Study showed that persons with plasma phosphatidylcholine DHA in the top quartile of values had a significantly (47) lower risk of developing all-cause dementia than did those in the bottom quartile and significantly greater protection was obtained from consuming 29 fish meals per week than from consuming only 13 fish meals per week on average (7)
Several mechanisms have been proposed to explain how omega-3-fats can reduce nerve cell degeneration associated with these conditions Omega-3 fatty acids are known to provide anti-inflammatory effects due to their conversion to anti-inflammatory eicosanoids
within the body The eicosanoids formed from omega-3 fatty acids also improve blood flow by dilating vessels and decreasing
platelet stickiness (anti-thrombotic) and provide other benefits associated with cardiovascular health such as improving
endothelial function and lowering triglyceride blood levels All of these effects are also associated with prevention of cognitive
decline largely via preserved blood flow circulation to brain tissue (lower risk of cerebrovascular disease)
However omega-3 fatty acids also play a direct role in nerve cell structure and function Eicosapentaenoic acid (EPA) and docsahexaenoic acid (DHA) have been shown to improve the composition of nerve cell membranes and stimulate the development regeneration and function of nerve cells by stimulating synaptic plasticity and increasing neurotransmission as well as increasing memory abilities In short long chain omega-3 fatty acids are structural components of neuronal and other cell membranes affecting membrane fluidity nerve transmission and nerve cell function in a positive way They also modulate the production of eicosanoids and inflammatory cytokines and help preserve blood flow to the brain
There is also the suggestion that oxidative stress (from oxygen and other free radicals) significantly contributes to neuronal damage seen in cases of cognitive impairment and Alzheimerrsquos disease by depleting the brain of vulnerable highly unsaturated fatty acids (eg
6 | P a g e
EPA and DHA) Some researchers suggest that by replenishing brain cells with EPA and DHA via higher intake levels individuals may help protect themselves against cognitive decline to a significant degree (8-11)
Adding support to the epidemiological and experimental studies that suggest that omega-3 fatty acids can reduce risk of cognitive decline the April 2007 issue of the American Journal of Clinical Nutrition contained the findings of two large prospective studies that evaluated intake of omega-3 fatty acids and subsequent risk of cognitive decline dementia and Alzheimerrsquos disease in older human subjects Taken together the findings of MA Beydoun et al (the Atherosclerosis Risk in Communities Study) and those of BM van Gelder et al (the Zutphen Elderly Study) indicate that a moderate intake of EPA and DHA were strongly associated with reduced risk of cognitive decline (9 10)
The ARIC Study
The Atherosclerosis Risk in Communities Study analyzed plasma fatty acids in cholesterol esters and phospholipids in whites residing in Minneapolis MN from 1987 through 1989 From 1990 through 1992 and from 1996 through 1998 3 neurophysiological tests were administered Effectively this study assessed the association between plasma fatty acids and cognitive decline in adults aged 50-65 years of age at baseline and conducted a subgroup analysis A striking finding among the 2251 study subjects was that higher levels of omega-3 fatty acids were associated with reduced risk of decline in verbal fluency particularly in hypertensive and dyslipedemic subjects whose tissues are exposed to greater oxidative stress from these conditions In contrast the risk of global cognitive decline increased with elevated palmitic acid (a saturated fat) and in subjects with higher levels of arachidonic acid (an omega-6 fatty acid found in meat and dairy products) (9) It should be noted that palmitic acid is a saturated fat that is highly associated with thrombosis and the elevation of LDL-cholesterol both of which can lead to atherosclerosis obstruction increasing the tendency to develop dementia (11)
The Zutphen Elderly Study
In the Zuthen Elderly Study data on fish consumption of 210 male participants who were aged 70-89 years of age in 1990 and data on cognitive functioning collected in 1990 and 1995 were assessed The intake of EPA and DHA was calculated for each participant Results showed that fish consumers had significantly less 5-year subsequent cognitive decline than did non fish consumers and a linear trend (dose-dependent trend) was observed for the relation between the intake of EPA and DHA and cognitive decline More specifically the results showed that elderly men who consumed an average of approximately 400 mg per day of omega-3 fatty acids from EPA and DHA had significantly less cognitive decline over the five year period than did those consuming an average of approximately 20 mg per day of omega-3 fatty acids
At present the American Heart Association recommends the consumption of fish (preferably fatty fish) at least twice per week a recommendation that is compatible with the results of the Zutphen Elderly Study To achieve 400 mg per day of EPA and DHA one would have to consume 6 servings per week of lean fish (average serving size 140 gm or about 5 ounces) or one serving per week of fatty fish such as mackerel or herring (10) One can also achieve this level of intake by consuming a mere 20 gm of Chinook salmon (less than one ounce) or 100 gm of cod (a little more than 35 ounces) As such two to three meals of fish per week would supply approximately 380 mg of EPADHA per day on average (7)
7 | P a g e
Summary
A number of epidemiological studies and experimental studies suggest that higher intake levels brain levels and blood levels of EPA and DHA may help preserve cognitive function as we age and reduce risk of dementia and Alzheimerrsquos disease A number of biological mechanisms have been proposed to explain the protective effects of EPA and DHA in regards to these neurodegenerative conditions More recently two prospective studies involving older and elderly humans (the ARIC and Zutphen Elderly Studies) have shown a strong correlation between higher plasma and intake levels respectively of EPA and DHA and subsequent decreased cognitive decline The Zutphen Elderly Study highlighted the fact that an average daily intake of 400 mg of EPA and DHA appears to be a significant threshold level at which a marked protective effect is observed Some experts suggest that for people who are allergic to fish andor shellfish and those who cannot or will not obtain sufficient intake of fish that they consume 1000 mg per day of fish oil from supplementation (Connor WE Connor SL 2007) A supplement containing fish oil and flaxseed oil may also be a consideration providing the total amount of EPA and DHA reaches a minimum threshold intake value of 400 mg per day Health practitioners should bear this information and these dosage levels in mind when making recommendations about specific essential fatty acid supplement products to their patients
For more information on this or other related topics visit Dr Meschinorsquos website at httpwwwmeschinohealthcom
References
1 Conquer JA Tierney MC Zecevic J Bettger WJ Fisher RH Fatty acid analysis of blood plasma of patients with Alzheimerrsquos disease other types of dementia and cognitive impairment Lipids 2000351305-12
2 Heude B Ducimetiere P Berr C Cognitive decline and fatty acid composition of erythrocyte membranes ndash the EVA Study Am J Clin Nutr 200377803-8
3 Tully AM Roche HM Doyle R et al Low serum cholesteryl esterdocosahexaenoic acid levels in Alzheimerrsquos disease a case-control study Br J Nutr 200389483-9
4 Kalmijn S van Boxtel MP Ocke M Vershcuren WM Kromhout D Launer LJ Dietary intake of fatty acids and fish in relation to cognitive performance at middle age Neurology 200462275-80
5 Kalmign S Feskens EJ Launer LJ Kromhout D Polyunsaturated fatty acids antioxidants and cognitive function in very old men Am J Epidemiol 199714533-41
6 He K Song Y Daviglus MI et al Fish consumption and incidence of stroke a meta-analysis of cohort studies Stroke 2004351538-42
7 Connor WE and Connor SL The importance of fish and docosahexaenoic acid in Alzheimerrsquos disease Am J Clin Nutr85929-30 2007
8 Brunner E Oily fish and omega 3 fat supplements BMJ332739-7402006
9 Beydoun MA Kaufman JS Satia JA Rousamond W Folson AR Plasma n-3 fatty acids and the risk of cognitive decline in older adults the Atherosclerosis Risk Communities Study Am J Clin Nutr 851103-11 2007
10 Van Gelder BM Tijuis M Kalmijn S Kromhout D Fish consumption n-3 fatty acids and subsequent 5-y cognitive decline in elderly men the Zutphen Elderly Study Am J Clin Nutr 85 1142-7 2007
8 | P a g e
11 Scientific Advisory Committee on Nutrition Committee on Toxicity Advice on fish consumption benefits and risks London Stationery Office 2004 wwwfoodgovukmultimediapdfsfishreport2004fullpdf (accessed 9 Feb 2006)
9 | P a g e
DHA ndash Omega-3 Fat Shown To Block Amyloid Synthesis In Alzheimerrsquos Disease Prevention
James Meschino DC MS ND
Recent studies indicate that higher intake and blood levels of omega-3 fats are associated with reduced risk of age-related cognitive decline dementia and Alzheimerrsquos disease The Atherosclerosis Risk in Communities Study which followed 2251 individuals (aged 50-65) showed that higher blood levels of omega-3 fats were associated with reduced risk of decline in verbal fluency The Zutphen Elderly Study which followed 210 elderly men (aged 70-89) for five years showed that men who consumed an average of approximately 400 mg per day of omega-3 fats (from fish) had significantly less cognitive decline over the five year period than did those consuming approximately 20 mg per day The Framingham Heart Study showed that persons with blood levels of omega-3 fats (phosphatidylcholine DHA) in the top 25 had a significantly (47) lower risk of developing all-cause dementia than did those in the bottom 25 In addition Alzheimerrsquos patients have been shown to have less DHA (an omega-3 fat) in the regions of the brain most affected by Alzheimerrsquos disease (the frontal lobe and hypocampus)
Experimental studies have shed light on the ways in which omega-3 fats may reduce risk of these conditions For example omega-3 fats have been shown to reduce brain inflammation increase blood circulation to brain cells inhibit abnormal clots in blood vessels within the brain More recently omega-3 fats were shown to improve nerve transmission among brain cells and support brain cell repair mechanisms
The most recent finding however was reported in the Journal of Neuroscience (Dec 2007 Qiu-Lan Ma and fellow researchers) showing that omega-3 fats inhibit the build up of amyloid plaque in brain cells The accumulation of amyloid plaque (a protein) in brain cells is a hallmark feature of Alzheimerrsquos disease and is considered to be the main culprit leading to brain cell disruption which manifests as memory loss confusion personality changes and other Alzheimerrsquos signs and symptoms These researchers discovered that omega-3 fats (particularly DHA) increases the number of receptors (the LR11- receptor) on human and murine (mice) brain cells which in turn transmits signals within the cell that block the accumulation of amyloid protein
Taken together my advice is to ingest at least 400 mg per day on average of omega-3 fats This means consuming 3-4 fish servings per week In addition I personally take 2-3 capsules per day of a supplement containing 400 mg each of fish oil flaxseed oil and borage seed oil For those allergic to fish and seafood I strongly recommend flaxseed oil supplementation (1200 mg 2-3 capsules per day) as an alternative
10 | P a g e
New Evidence That Vitamin E Supplementation Improves Outcomes In
Alzheimerrsquos Patients
A 2008 study adds to the body of evidence
James Meschino DC MS ND
In a paper presented at 2008 American Academy of Neurology Annual Meeting(Chicago Il
Poster Sessions III Aging) researchers showed that Alzheimerrsquos disease patients who
supplemented their diet with 2000 IU per day of Vitamin E had a 26 lower mortality rate As
explained by the lead researcher Dr Valory Pavlik from the Baylor College of Medicines
(Alzheimers Disease and Memory Disorders Center Houston TX) many previous studies have
shown that Vitamin E supplementation can slow the progression of Alzheimerrsquos disease The
study by Pavlik et was able to show additional features and benefits of Vitamin E
supplementation in Alzheimerrsquos disease patients and answered some common concerns about
the safety of using high dosages of Vitamin E and combining Vitamin E with conventional drugs
used to manage this condition In their study of 847 Alzheimerrsquos disease patients who were
followed for 49 years their results showed the following
A A 26 reduced mortality rate in the patients administered 2000 IU of Vitamin E per day
compared to Alzheimerrsquos disease patients not taking the Vitamin E supplement
B Combining Vitamin E supplementation (2000 IU per day) with standard drugs used to treat Alzheimerrsquos disease (cholinesterase inhibitors) produced the best overall results with respect to longevity and disease progression Thus it appears to be safe to recommend Vitamin E supplementation to Alzheimerrsquos patients already taking a cholinesterase inhibitor drug such as AriceptTM (donepezil) ExelonTM(rivastigmine) ReminylTM(galantamine) and Ebixareg (memantine hydrochloride)
C Recent concerns about Vitamin E supplementation increasing risk of cancer and heart disease were put to rest as this study showed that individuals with Alzheimerrsquo disease who were in a high-risk age group for death from cardiovascular disease and cancer
(average age 735 86 years) showed a 26 lower mortality rate than Alzheimerrsquos patients who did not take the 2000 IU per day of Vitamin E
D In the Alzheimerrsquos disease patients who used only Vitamin E supplementation (2000 IU per day) and did not take any Alzheimerrsquos disease medication these patients still showed a 26 lower mortality rate than patients not taking the Vitamin E supplement along with significant disease management outcomes
Overall the researchers concluded ldquoRegimens that included vitamin E were associated with a 26 lower mortality rate There was a suggestion that of vitamin E plus a cholinesterase inhibitor was more beneficial than taking either agent alonerdquo
11 | P a g e
The Alzheimerrsquos Disease Cooperative Study
A landmark study in the year 2000 known as the Alzheimerrsquos Disease Cooperative Study was one of the first published studies to show that providing Alzheimerrsquos patients with 2000 IU per day of Vitamin E could slow the progression of their disease The Alzheimers Disease Cooperative Study (ADCS) was formed in 1991 as a cooperative agreement between the National Institute on Aging (NIA) and the University of California San Diego The ADCS is a major initiative for Alzheimers disease (AD) clinical studies in the Federal government addressing treatments for both cognitive and behavioral symptoms Reporting in the American Journal of Clinical Nutrition researchers published results showing that vitamin E supplementation (2000 IU per day) may slow functional deterioration leading to nursing home placement
Why Vitamin E Supplementation The brains of Alzheimers disease patients frequently shows generalized atrophy neuritic plaques (dystrophic axons and dendrites surrounding an amyloid core) and neurofibrillary Evidence suggests that oxidative stress (free radicals) may lead to permanent cellular damage in the brain that triggers some of the changes seen in the brain of Alzheimerrsquos patients The presence of excessive szlig-amyloid protein formation (an extracellular insoluble protein) is a hallmark feature of the Alzheimerrsquos brain A proposed mechanism of szlig-amyloid toxicity is that it induces free radicals which disrupt cellular lipid protein and DNA In addition to szlig-amyloid several other processes may also induce oxidative stress in AD Activated microglial cells found in association with neuritic plaques may release cytokines prooxidants and free radicals As well other etiological factor such as cytoskeletal destabilization energy deprivation or toxic inflammatory responses may all converge in a common final pathway involving free radicals as well
Prior to the Alzheimerrsquos Disease Cooperative Study earlier clinical trials and epidemiologic studies had suggested that several agents may help prevent the development of AD or slow further deterioration These agents include vitamin E selegiline estrogen and anti-inflammatory drugs One property that they all share is the ability to protect against free radicalndashmediated
damage either directly or indirectly
Conclusion
The recent study (2008) by Pavlik et al adds to the body of evidence indicating that supplementing Alzheimerrsquos disease patients with 2000 IU per day of natural Vitamin E can slow the progression of their disease and lower the mortality rate by 26 (over a five-year period) Unfortunately many medical doctors have not been exposed to these studies and thus Vitamin E supplementation is often left out of the management of many Alzheimerrsquos disease cases In these instances it is up to Complementary Health Care Professionals to provide patients and family members with the research and recommendations that have been shown to be meaningful in regards to Vitamin E supplementation (as well as other effective natural interventions) The study by Pavlik et al suggests that Vitamin E supplementation at a dosage of 2000 IU per day is effective safe enhances the benefits of conventional Alzheimerrsquos drugs and does not increase the risk of cancer or heart disease in this older and elderly population
For more information on this or other related topics please visit httpwwwmeschinohealthcom
12 | P a g e
References
1 Valory Pavlik Rachelle Doody Susan Rountree Eveleen Darby Vitamin E Use Is Associated
with Improved Survival in an AD Cohort 2008 American Academy of Neurology Annual
Meeting(Chicago Il) Poster Sessions III Aging and Dementia Clinical II P03076
2 Grundman M Vitamin E and Alzheimer disease the basis for additional clinical trials American Journal of Clinical Nutrition Vol 71 No 2 630S-636s 2000
13 | P a g e
Summary The Quick Checklist of How to Best Maintain Memory Function Maintaining healthy brain function and memory over a lifetime requires that you be proactive Dementia and Alzheimerrsquos disease affect way too many people as they age and we now see that much of this could be avoided if people would use some targeted strategies during their lifetime Here are some important recommendations
1 Take every precaution to avoid head injuries throughout your entire life
2 Always be learning something new or further developing an existing talent or skill set
3 Donrsquot damage your brain with cigarettes alcohol or illicit drugs and try to use the least
number of medications as possible throughout your lifetime
4 Nourish your brain with omega-3 fats from fish twice per week on average
5 Take a high potency multiple vitamin that is antioxidant enriched and contains a B-50
complex (example Adeeva Multiple Vitamin)
6 Take 2-3 capsules per day of an Essential Oil supplement to ensure adequate omega-3
fat and essential fatty acid support for your brain I recommend a supplement that
combines fish oil flaxseed oil and borage seed oil (example Adeeva Naturersquos Essential
Oil)
7 Keep your fasting blood sugar level below 50 mmolL (90 mgdL) Elevated blood sugar
(glucose) and high insulin levels are strongly linked to Alzheimerrsquos disease development
This means eating sugary foods and starchy foods in moderation if at all performing
aerobic exercise for 30 mins at least 3-4 times per week and having a waist
circumference under 36 inches if you are a man and under 34 inches if you are a
woman Have your doctor check your blood glucose level on your next appointment and
ask for the number
8 Ensure that your blood cholesterol level is below 48 mmolL (185 mgdL) This means
avoiding high fat meat and dairy products as well as deep fried foods and transfats
After Age 55 Add The Following
1 Take a Memory Support Supplement each day that contains meaningful doses of
CDP-choline Phosphatidylserine Huperzine A and Bocapa monnieri (example
Adeeva Memory Support Complex) ndash to help your brain continue to make the
memory chemical acetylcholine as you get older
2 Learn a new skill such as a learning to play a musical instrument or a foreign
language ndash something that is outside of your usual knowledge base
Participate in a mind-body activity that builds new neural circuits such as playing ping-pong or
taking dance lessons or martial arts lessons
6 | P a g e
EPA and DHA) Some researchers suggest that by replenishing brain cells with EPA and DHA via higher intake levels individuals may help protect themselves against cognitive decline to a significant degree (8-11)
Adding support to the epidemiological and experimental studies that suggest that omega-3 fatty acids can reduce risk of cognitive decline the April 2007 issue of the American Journal of Clinical Nutrition contained the findings of two large prospective studies that evaluated intake of omega-3 fatty acids and subsequent risk of cognitive decline dementia and Alzheimerrsquos disease in older human subjects Taken together the findings of MA Beydoun et al (the Atherosclerosis Risk in Communities Study) and those of BM van Gelder et al (the Zutphen Elderly Study) indicate that a moderate intake of EPA and DHA were strongly associated with reduced risk of cognitive decline (9 10)
The ARIC Study
The Atherosclerosis Risk in Communities Study analyzed plasma fatty acids in cholesterol esters and phospholipids in whites residing in Minneapolis MN from 1987 through 1989 From 1990 through 1992 and from 1996 through 1998 3 neurophysiological tests were administered Effectively this study assessed the association between plasma fatty acids and cognitive decline in adults aged 50-65 years of age at baseline and conducted a subgroup analysis A striking finding among the 2251 study subjects was that higher levels of omega-3 fatty acids were associated with reduced risk of decline in verbal fluency particularly in hypertensive and dyslipedemic subjects whose tissues are exposed to greater oxidative stress from these conditions In contrast the risk of global cognitive decline increased with elevated palmitic acid (a saturated fat) and in subjects with higher levels of arachidonic acid (an omega-6 fatty acid found in meat and dairy products) (9) It should be noted that palmitic acid is a saturated fat that is highly associated with thrombosis and the elevation of LDL-cholesterol both of which can lead to atherosclerosis obstruction increasing the tendency to develop dementia (11)
The Zutphen Elderly Study
In the Zuthen Elderly Study data on fish consumption of 210 male participants who were aged 70-89 years of age in 1990 and data on cognitive functioning collected in 1990 and 1995 were assessed The intake of EPA and DHA was calculated for each participant Results showed that fish consumers had significantly less 5-year subsequent cognitive decline than did non fish consumers and a linear trend (dose-dependent trend) was observed for the relation between the intake of EPA and DHA and cognitive decline More specifically the results showed that elderly men who consumed an average of approximately 400 mg per day of omega-3 fatty acids from EPA and DHA had significantly less cognitive decline over the five year period than did those consuming an average of approximately 20 mg per day of omega-3 fatty acids
At present the American Heart Association recommends the consumption of fish (preferably fatty fish) at least twice per week a recommendation that is compatible with the results of the Zutphen Elderly Study To achieve 400 mg per day of EPA and DHA one would have to consume 6 servings per week of lean fish (average serving size 140 gm or about 5 ounces) or one serving per week of fatty fish such as mackerel or herring (10) One can also achieve this level of intake by consuming a mere 20 gm of Chinook salmon (less than one ounce) or 100 gm of cod (a little more than 35 ounces) As such two to three meals of fish per week would supply approximately 380 mg of EPADHA per day on average (7)
7 | P a g e
Summary
A number of epidemiological studies and experimental studies suggest that higher intake levels brain levels and blood levels of EPA and DHA may help preserve cognitive function as we age and reduce risk of dementia and Alzheimerrsquos disease A number of biological mechanisms have been proposed to explain the protective effects of EPA and DHA in regards to these neurodegenerative conditions More recently two prospective studies involving older and elderly humans (the ARIC and Zutphen Elderly Studies) have shown a strong correlation between higher plasma and intake levels respectively of EPA and DHA and subsequent decreased cognitive decline The Zutphen Elderly Study highlighted the fact that an average daily intake of 400 mg of EPA and DHA appears to be a significant threshold level at which a marked protective effect is observed Some experts suggest that for people who are allergic to fish andor shellfish and those who cannot or will not obtain sufficient intake of fish that they consume 1000 mg per day of fish oil from supplementation (Connor WE Connor SL 2007) A supplement containing fish oil and flaxseed oil may also be a consideration providing the total amount of EPA and DHA reaches a minimum threshold intake value of 400 mg per day Health practitioners should bear this information and these dosage levels in mind when making recommendations about specific essential fatty acid supplement products to their patients
For more information on this or other related topics visit Dr Meschinorsquos website at httpwwwmeschinohealthcom
References
1 Conquer JA Tierney MC Zecevic J Bettger WJ Fisher RH Fatty acid analysis of blood plasma of patients with Alzheimerrsquos disease other types of dementia and cognitive impairment Lipids 2000351305-12
2 Heude B Ducimetiere P Berr C Cognitive decline and fatty acid composition of erythrocyte membranes ndash the EVA Study Am J Clin Nutr 200377803-8
3 Tully AM Roche HM Doyle R et al Low serum cholesteryl esterdocosahexaenoic acid levels in Alzheimerrsquos disease a case-control study Br J Nutr 200389483-9
4 Kalmijn S van Boxtel MP Ocke M Vershcuren WM Kromhout D Launer LJ Dietary intake of fatty acids and fish in relation to cognitive performance at middle age Neurology 200462275-80
5 Kalmign S Feskens EJ Launer LJ Kromhout D Polyunsaturated fatty acids antioxidants and cognitive function in very old men Am J Epidemiol 199714533-41
6 He K Song Y Daviglus MI et al Fish consumption and incidence of stroke a meta-analysis of cohort studies Stroke 2004351538-42
7 Connor WE and Connor SL The importance of fish and docosahexaenoic acid in Alzheimerrsquos disease Am J Clin Nutr85929-30 2007
8 Brunner E Oily fish and omega 3 fat supplements BMJ332739-7402006
9 Beydoun MA Kaufman JS Satia JA Rousamond W Folson AR Plasma n-3 fatty acids and the risk of cognitive decline in older adults the Atherosclerosis Risk Communities Study Am J Clin Nutr 851103-11 2007
10 Van Gelder BM Tijuis M Kalmijn S Kromhout D Fish consumption n-3 fatty acids and subsequent 5-y cognitive decline in elderly men the Zutphen Elderly Study Am J Clin Nutr 85 1142-7 2007
8 | P a g e
11 Scientific Advisory Committee on Nutrition Committee on Toxicity Advice on fish consumption benefits and risks London Stationery Office 2004 wwwfoodgovukmultimediapdfsfishreport2004fullpdf (accessed 9 Feb 2006)
9 | P a g e
DHA ndash Omega-3 Fat Shown To Block Amyloid Synthesis In Alzheimerrsquos Disease Prevention
James Meschino DC MS ND
Recent studies indicate that higher intake and blood levels of omega-3 fats are associated with reduced risk of age-related cognitive decline dementia and Alzheimerrsquos disease The Atherosclerosis Risk in Communities Study which followed 2251 individuals (aged 50-65) showed that higher blood levels of omega-3 fats were associated with reduced risk of decline in verbal fluency The Zutphen Elderly Study which followed 210 elderly men (aged 70-89) for five years showed that men who consumed an average of approximately 400 mg per day of omega-3 fats (from fish) had significantly less cognitive decline over the five year period than did those consuming approximately 20 mg per day The Framingham Heart Study showed that persons with blood levels of omega-3 fats (phosphatidylcholine DHA) in the top 25 had a significantly (47) lower risk of developing all-cause dementia than did those in the bottom 25 In addition Alzheimerrsquos patients have been shown to have less DHA (an omega-3 fat) in the regions of the brain most affected by Alzheimerrsquos disease (the frontal lobe and hypocampus)
Experimental studies have shed light on the ways in which omega-3 fats may reduce risk of these conditions For example omega-3 fats have been shown to reduce brain inflammation increase blood circulation to brain cells inhibit abnormal clots in blood vessels within the brain More recently omega-3 fats were shown to improve nerve transmission among brain cells and support brain cell repair mechanisms
The most recent finding however was reported in the Journal of Neuroscience (Dec 2007 Qiu-Lan Ma and fellow researchers) showing that omega-3 fats inhibit the build up of amyloid plaque in brain cells The accumulation of amyloid plaque (a protein) in brain cells is a hallmark feature of Alzheimerrsquos disease and is considered to be the main culprit leading to brain cell disruption which manifests as memory loss confusion personality changes and other Alzheimerrsquos signs and symptoms These researchers discovered that omega-3 fats (particularly DHA) increases the number of receptors (the LR11- receptor) on human and murine (mice) brain cells which in turn transmits signals within the cell that block the accumulation of amyloid protein
Taken together my advice is to ingest at least 400 mg per day on average of omega-3 fats This means consuming 3-4 fish servings per week In addition I personally take 2-3 capsules per day of a supplement containing 400 mg each of fish oil flaxseed oil and borage seed oil For those allergic to fish and seafood I strongly recommend flaxseed oil supplementation (1200 mg 2-3 capsules per day) as an alternative
10 | P a g e
New Evidence That Vitamin E Supplementation Improves Outcomes In
Alzheimerrsquos Patients
A 2008 study adds to the body of evidence
James Meschino DC MS ND
In a paper presented at 2008 American Academy of Neurology Annual Meeting(Chicago Il
Poster Sessions III Aging) researchers showed that Alzheimerrsquos disease patients who
supplemented their diet with 2000 IU per day of Vitamin E had a 26 lower mortality rate As
explained by the lead researcher Dr Valory Pavlik from the Baylor College of Medicines
(Alzheimers Disease and Memory Disorders Center Houston TX) many previous studies have
shown that Vitamin E supplementation can slow the progression of Alzheimerrsquos disease The
study by Pavlik et was able to show additional features and benefits of Vitamin E
supplementation in Alzheimerrsquos disease patients and answered some common concerns about
the safety of using high dosages of Vitamin E and combining Vitamin E with conventional drugs
used to manage this condition In their study of 847 Alzheimerrsquos disease patients who were
followed for 49 years their results showed the following
A A 26 reduced mortality rate in the patients administered 2000 IU of Vitamin E per day
compared to Alzheimerrsquos disease patients not taking the Vitamin E supplement
B Combining Vitamin E supplementation (2000 IU per day) with standard drugs used to treat Alzheimerrsquos disease (cholinesterase inhibitors) produced the best overall results with respect to longevity and disease progression Thus it appears to be safe to recommend Vitamin E supplementation to Alzheimerrsquos patients already taking a cholinesterase inhibitor drug such as AriceptTM (donepezil) ExelonTM(rivastigmine) ReminylTM(galantamine) and Ebixareg (memantine hydrochloride)
C Recent concerns about Vitamin E supplementation increasing risk of cancer and heart disease were put to rest as this study showed that individuals with Alzheimerrsquo disease who were in a high-risk age group for death from cardiovascular disease and cancer
(average age 735 86 years) showed a 26 lower mortality rate than Alzheimerrsquos patients who did not take the 2000 IU per day of Vitamin E
D In the Alzheimerrsquos disease patients who used only Vitamin E supplementation (2000 IU per day) and did not take any Alzheimerrsquos disease medication these patients still showed a 26 lower mortality rate than patients not taking the Vitamin E supplement along with significant disease management outcomes
Overall the researchers concluded ldquoRegimens that included vitamin E were associated with a 26 lower mortality rate There was a suggestion that of vitamin E plus a cholinesterase inhibitor was more beneficial than taking either agent alonerdquo
11 | P a g e
The Alzheimerrsquos Disease Cooperative Study
A landmark study in the year 2000 known as the Alzheimerrsquos Disease Cooperative Study was one of the first published studies to show that providing Alzheimerrsquos patients with 2000 IU per day of Vitamin E could slow the progression of their disease The Alzheimers Disease Cooperative Study (ADCS) was formed in 1991 as a cooperative agreement between the National Institute on Aging (NIA) and the University of California San Diego The ADCS is a major initiative for Alzheimers disease (AD) clinical studies in the Federal government addressing treatments for both cognitive and behavioral symptoms Reporting in the American Journal of Clinical Nutrition researchers published results showing that vitamin E supplementation (2000 IU per day) may slow functional deterioration leading to nursing home placement
Why Vitamin E Supplementation The brains of Alzheimers disease patients frequently shows generalized atrophy neuritic plaques (dystrophic axons and dendrites surrounding an amyloid core) and neurofibrillary Evidence suggests that oxidative stress (free radicals) may lead to permanent cellular damage in the brain that triggers some of the changes seen in the brain of Alzheimerrsquos patients The presence of excessive szlig-amyloid protein formation (an extracellular insoluble protein) is a hallmark feature of the Alzheimerrsquos brain A proposed mechanism of szlig-amyloid toxicity is that it induces free radicals which disrupt cellular lipid protein and DNA In addition to szlig-amyloid several other processes may also induce oxidative stress in AD Activated microglial cells found in association with neuritic plaques may release cytokines prooxidants and free radicals As well other etiological factor such as cytoskeletal destabilization energy deprivation or toxic inflammatory responses may all converge in a common final pathway involving free radicals as well
Prior to the Alzheimerrsquos Disease Cooperative Study earlier clinical trials and epidemiologic studies had suggested that several agents may help prevent the development of AD or slow further deterioration These agents include vitamin E selegiline estrogen and anti-inflammatory drugs One property that they all share is the ability to protect against free radicalndashmediated
damage either directly or indirectly
Conclusion
The recent study (2008) by Pavlik et al adds to the body of evidence indicating that supplementing Alzheimerrsquos disease patients with 2000 IU per day of natural Vitamin E can slow the progression of their disease and lower the mortality rate by 26 (over a five-year period) Unfortunately many medical doctors have not been exposed to these studies and thus Vitamin E supplementation is often left out of the management of many Alzheimerrsquos disease cases In these instances it is up to Complementary Health Care Professionals to provide patients and family members with the research and recommendations that have been shown to be meaningful in regards to Vitamin E supplementation (as well as other effective natural interventions) The study by Pavlik et al suggests that Vitamin E supplementation at a dosage of 2000 IU per day is effective safe enhances the benefits of conventional Alzheimerrsquos drugs and does not increase the risk of cancer or heart disease in this older and elderly population
For more information on this or other related topics please visit httpwwwmeschinohealthcom
12 | P a g e
References
1 Valory Pavlik Rachelle Doody Susan Rountree Eveleen Darby Vitamin E Use Is Associated
with Improved Survival in an AD Cohort 2008 American Academy of Neurology Annual
Meeting(Chicago Il) Poster Sessions III Aging and Dementia Clinical II P03076
2 Grundman M Vitamin E and Alzheimer disease the basis for additional clinical trials American Journal of Clinical Nutrition Vol 71 No 2 630S-636s 2000
13 | P a g e
Summary The Quick Checklist of How to Best Maintain Memory Function Maintaining healthy brain function and memory over a lifetime requires that you be proactive Dementia and Alzheimerrsquos disease affect way too many people as they age and we now see that much of this could be avoided if people would use some targeted strategies during their lifetime Here are some important recommendations
1 Take every precaution to avoid head injuries throughout your entire life
2 Always be learning something new or further developing an existing talent or skill set
3 Donrsquot damage your brain with cigarettes alcohol or illicit drugs and try to use the least
number of medications as possible throughout your lifetime
4 Nourish your brain with omega-3 fats from fish twice per week on average
5 Take a high potency multiple vitamin that is antioxidant enriched and contains a B-50
complex (example Adeeva Multiple Vitamin)
6 Take 2-3 capsules per day of an Essential Oil supplement to ensure adequate omega-3
fat and essential fatty acid support for your brain I recommend a supplement that
combines fish oil flaxseed oil and borage seed oil (example Adeeva Naturersquos Essential
Oil)
7 Keep your fasting blood sugar level below 50 mmolL (90 mgdL) Elevated blood sugar
(glucose) and high insulin levels are strongly linked to Alzheimerrsquos disease development
This means eating sugary foods and starchy foods in moderation if at all performing
aerobic exercise for 30 mins at least 3-4 times per week and having a waist
circumference under 36 inches if you are a man and under 34 inches if you are a
woman Have your doctor check your blood glucose level on your next appointment and
ask for the number
8 Ensure that your blood cholesterol level is below 48 mmolL (185 mgdL) This means
avoiding high fat meat and dairy products as well as deep fried foods and transfats
After Age 55 Add The Following
1 Take a Memory Support Supplement each day that contains meaningful doses of
CDP-choline Phosphatidylserine Huperzine A and Bocapa monnieri (example
Adeeva Memory Support Complex) ndash to help your brain continue to make the
memory chemical acetylcholine as you get older
2 Learn a new skill such as a learning to play a musical instrument or a foreign
language ndash something that is outside of your usual knowledge base
Participate in a mind-body activity that builds new neural circuits such as playing ping-pong or
taking dance lessons or martial arts lessons
7 | P a g e
Summary
A number of epidemiological studies and experimental studies suggest that higher intake levels brain levels and blood levels of EPA and DHA may help preserve cognitive function as we age and reduce risk of dementia and Alzheimerrsquos disease A number of biological mechanisms have been proposed to explain the protective effects of EPA and DHA in regards to these neurodegenerative conditions More recently two prospective studies involving older and elderly humans (the ARIC and Zutphen Elderly Studies) have shown a strong correlation between higher plasma and intake levels respectively of EPA and DHA and subsequent decreased cognitive decline The Zutphen Elderly Study highlighted the fact that an average daily intake of 400 mg of EPA and DHA appears to be a significant threshold level at which a marked protective effect is observed Some experts suggest that for people who are allergic to fish andor shellfish and those who cannot or will not obtain sufficient intake of fish that they consume 1000 mg per day of fish oil from supplementation (Connor WE Connor SL 2007) A supplement containing fish oil and flaxseed oil may also be a consideration providing the total amount of EPA and DHA reaches a minimum threshold intake value of 400 mg per day Health practitioners should bear this information and these dosage levels in mind when making recommendations about specific essential fatty acid supplement products to their patients
For more information on this or other related topics visit Dr Meschinorsquos website at httpwwwmeschinohealthcom
References
1 Conquer JA Tierney MC Zecevic J Bettger WJ Fisher RH Fatty acid analysis of blood plasma of patients with Alzheimerrsquos disease other types of dementia and cognitive impairment Lipids 2000351305-12
2 Heude B Ducimetiere P Berr C Cognitive decline and fatty acid composition of erythrocyte membranes ndash the EVA Study Am J Clin Nutr 200377803-8
3 Tully AM Roche HM Doyle R et al Low serum cholesteryl esterdocosahexaenoic acid levels in Alzheimerrsquos disease a case-control study Br J Nutr 200389483-9
4 Kalmijn S van Boxtel MP Ocke M Vershcuren WM Kromhout D Launer LJ Dietary intake of fatty acids and fish in relation to cognitive performance at middle age Neurology 200462275-80
5 Kalmign S Feskens EJ Launer LJ Kromhout D Polyunsaturated fatty acids antioxidants and cognitive function in very old men Am J Epidemiol 199714533-41
6 He K Song Y Daviglus MI et al Fish consumption and incidence of stroke a meta-analysis of cohort studies Stroke 2004351538-42
7 Connor WE and Connor SL The importance of fish and docosahexaenoic acid in Alzheimerrsquos disease Am J Clin Nutr85929-30 2007
8 Brunner E Oily fish and omega 3 fat supplements BMJ332739-7402006
9 Beydoun MA Kaufman JS Satia JA Rousamond W Folson AR Plasma n-3 fatty acids and the risk of cognitive decline in older adults the Atherosclerosis Risk Communities Study Am J Clin Nutr 851103-11 2007
10 Van Gelder BM Tijuis M Kalmijn S Kromhout D Fish consumption n-3 fatty acids and subsequent 5-y cognitive decline in elderly men the Zutphen Elderly Study Am J Clin Nutr 85 1142-7 2007
8 | P a g e
11 Scientific Advisory Committee on Nutrition Committee on Toxicity Advice on fish consumption benefits and risks London Stationery Office 2004 wwwfoodgovukmultimediapdfsfishreport2004fullpdf (accessed 9 Feb 2006)
9 | P a g e
DHA ndash Omega-3 Fat Shown To Block Amyloid Synthesis In Alzheimerrsquos Disease Prevention
James Meschino DC MS ND
Recent studies indicate that higher intake and blood levels of omega-3 fats are associated with reduced risk of age-related cognitive decline dementia and Alzheimerrsquos disease The Atherosclerosis Risk in Communities Study which followed 2251 individuals (aged 50-65) showed that higher blood levels of omega-3 fats were associated with reduced risk of decline in verbal fluency The Zutphen Elderly Study which followed 210 elderly men (aged 70-89) for five years showed that men who consumed an average of approximately 400 mg per day of omega-3 fats (from fish) had significantly less cognitive decline over the five year period than did those consuming approximately 20 mg per day The Framingham Heart Study showed that persons with blood levels of omega-3 fats (phosphatidylcholine DHA) in the top 25 had a significantly (47) lower risk of developing all-cause dementia than did those in the bottom 25 In addition Alzheimerrsquos patients have been shown to have less DHA (an omega-3 fat) in the regions of the brain most affected by Alzheimerrsquos disease (the frontal lobe and hypocampus)
Experimental studies have shed light on the ways in which omega-3 fats may reduce risk of these conditions For example omega-3 fats have been shown to reduce brain inflammation increase blood circulation to brain cells inhibit abnormal clots in blood vessels within the brain More recently omega-3 fats were shown to improve nerve transmission among brain cells and support brain cell repair mechanisms
The most recent finding however was reported in the Journal of Neuroscience (Dec 2007 Qiu-Lan Ma and fellow researchers) showing that omega-3 fats inhibit the build up of amyloid plaque in brain cells The accumulation of amyloid plaque (a protein) in brain cells is a hallmark feature of Alzheimerrsquos disease and is considered to be the main culprit leading to brain cell disruption which manifests as memory loss confusion personality changes and other Alzheimerrsquos signs and symptoms These researchers discovered that omega-3 fats (particularly DHA) increases the number of receptors (the LR11- receptor) on human and murine (mice) brain cells which in turn transmits signals within the cell that block the accumulation of amyloid protein
Taken together my advice is to ingest at least 400 mg per day on average of omega-3 fats This means consuming 3-4 fish servings per week In addition I personally take 2-3 capsules per day of a supplement containing 400 mg each of fish oil flaxseed oil and borage seed oil For those allergic to fish and seafood I strongly recommend flaxseed oil supplementation (1200 mg 2-3 capsules per day) as an alternative
10 | P a g e
New Evidence That Vitamin E Supplementation Improves Outcomes In
Alzheimerrsquos Patients
A 2008 study adds to the body of evidence
James Meschino DC MS ND
In a paper presented at 2008 American Academy of Neurology Annual Meeting(Chicago Il
Poster Sessions III Aging) researchers showed that Alzheimerrsquos disease patients who
supplemented their diet with 2000 IU per day of Vitamin E had a 26 lower mortality rate As
explained by the lead researcher Dr Valory Pavlik from the Baylor College of Medicines
(Alzheimers Disease and Memory Disorders Center Houston TX) many previous studies have
shown that Vitamin E supplementation can slow the progression of Alzheimerrsquos disease The
study by Pavlik et was able to show additional features and benefits of Vitamin E
supplementation in Alzheimerrsquos disease patients and answered some common concerns about
the safety of using high dosages of Vitamin E and combining Vitamin E with conventional drugs
used to manage this condition In their study of 847 Alzheimerrsquos disease patients who were
followed for 49 years their results showed the following
A A 26 reduced mortality rate in the patients administered 2000 IU of Vitamin E per day
compared to Alzheimerrsquos disease patients not taking the Vitamin E supplement
B Combining Vitamin E supplementation (2000 IU per day) with standard drugs used to treat Alzheimerrsquos disease (cholinesterase inhibitors) produced the best overall results with respect to longevity and disease progression Thus it appears to be safe to recommend Vitamin E supplementation to Alzheimerrsquos patients already taking a cholinesterase inhibitor drug such as AriceptTM (donepezil) ExelonTM(rivastigmine) ReminylTM(galantamine) and Ebixareg (memantine hydrochloride)
C Recent concerns about Vitamin E supplementation increasing risk of cancer and heart disease were put to rest as this study showed that individuals with Alzheimerrsquo disease who were in a high-risk age group for death from cardiovascular disease and cancer
(average age 735 86 years) showed a 26 lower mortality rate than Alzheimerrsquos patients who did not take the 2000 IU per day of Vitamin E
D In the Alzheimerrsquos disease patients who used only Vitamin E supplementation (2000 IU per day) and did not take any Alzheimerrsquos disease medication these patients still showed a 26 lower mortality rate than patients not taking the Vitamin E supplement along with significant disease management outcomes
Overall the researchers concluded ldquoRegimens that included vitamin E were associated with a 26 lower mortality rate There was a suggestion that of vitamin E plus a cholinesterase inhibitor was more beneficial than taking either agent alonerdquo
11 | P a g e
The Alzheimerrsquos Disease Cooperative Study
A landmark study in the year 2000 known as the Alzheimerrsquos Disease Cooperative Study was one of the first published studies to show that providing Alzheimerrsquos patients with 2000 IU per day of Vitamin E could slow the progression of their disease The Alzheimers Disease Cooperative Study (ADCS) was formed in 1991 as a cooperative agreement between the National Institute on Aging (NIA) and the University of California San Diego The ADCS is a major initiative for Alzheimers disease (AD) clinical studies in the Federal government addressing treatments for both cognitive and behavioral symptoms Reporting in the American Journal of Clinical Nutrition researchers published results showing that vitamin E supplementation (2000 IU per day) may slow functional deterioration leading to nursing home placement
Why Vitamin E Supplementation The brains of Alzheimers disease patients frequently shows generalized atrophy neuritic plaques (dystrophic axons and dendrites surrounding an amyloid core) and neurofibrillary Evidence suggests that oxidative stress (free radicals) may lead to permanent cellular damage in the brain that triggers some of the changes seen in the brain of Alzheimerrsquos patients The presence of excessive szlig-amyloid protein formation (an extracellular insoluble protein) is a hallmark feature of the Alzheimerrsquos brain A proposed mechanism of szlig-amyloid toxicity is that it induces free radicals which disrupt cellular lipid protein and DNA In addition to szlig-amyloid several other processes may also induce oxidative stress in AD Activated microglial cells found in association with neuritic plaques may release cytokines prooxidants and free radicals As well other etiological factor such as cytoskeletal destabilization energy deprivation or toxic inflammatory responses may all converge in a common final pathway involving free radicals as well
Prior to the Alzheimerrsquos Disease Cooperative Study earlier clinical trials and epidemiologic studies had suggested that several agents may help prevent the development of AD or slow further deterioration These agents include vitamin E selegiline estrogen and anti-inflammatory drugs One property that they all share is the ability to protect against free radicalndashmediated
damage either directly or indirectly
Conclusion
The recent study (2008) by Pavlik et al adds to the body of evidence indicating that supplementing Alzheimerrsquos disease patients with 2000 IU per day of natural Vitamin E can slow the progression of their disease and lower the mortality rate by 26 (over a five-year period) Unfortunately many medical doctors have not been exposed to these studies and thus Vitamin E supplementation is often left out of the management of many Alzheimerrsquos disease cases In these instances it is up to Complementary Health Care Professionals to provide patients and family members with the research and recommendations that have been shown to be meaningful in regards to Vitamin E supplementation (as well as other effective natural interventions) The study by Pavlik et al suggests that Vitamin E supplementation at a dosage of 2000 IU per day is effective safe enhances the benefits of conventional Alzheimerrsquos drugs and does not increase the risk of cancer or heart disease in this older and elderly population
For more information on this or other related topics please visit httpwwwmeschinohealthcom
12 | P a g e
References
1 Valory Pavlik Rachelle Doody Susan Rountree Eveleen Darby Vitamin E Use Is Associated
with Improved Survival in an AD Cohort 2008 American Academy of Neurology Annual
Meeting(Chicago Il) Poster Sessions III Aging and Dementia Clinical II P03076
2 Grundman M Vitamin E and Alzheimer disease the basis for additional clinical trials American Journal of Clinical Nutrition Vol 71 No 2 630S-636s 2000
13 | P a g e
Summary The Quick Checklist of How to Best Maintain Memory Function Maintaining healthy brain function and memory over a lifetime requires that you be proactive Dementia and Alzheimerrsquos disease affect way too many people as they age and we now see that much of this could be avoided if people would use some targeted strategies during their lifetime Here are some important recommendations
1 Take every precaution to avoid head injuries throughout your entire life
2 Always be learning something new or further developing an existing talent or skill set
3 Donrsquot damage your brain with cigarettes alcohol or illicit drugs and try to use the least
number of medications as possible throughout your lifetime
4 Nourish your brain with omega-3 fats from fish twice per week on average
5 Take a high potency multiple vitamin that is antioxidant enriched and contains a B-50
complex (example Adeeva Multiple Vitamin)
6 Take 2-3 capsules per day of an Essential Oil supplement to ensure adequate omega-3
fat and essential fatty acid support for your brain I recommend a supplement that
combines fish oil flaxseed oil and borage seed oil (example Adeeva Naturersquos Essential
Oil)
7 Keep your fasting blood sugar level below 50 mmolL (90 mgdL) Elevated blood sugar
(glucose) and high insulin levels are strongly linked to Alzheimerrsquos disease development
This means eating sugary foods and starchy foods in moderation if at all performing
aerobic exercise for 30 mins at least 3-4 times per week and having a waist
circumference under 36 inches if you are a man and under 34 inches if you are a
woman Have your doctor check your blood glucose level on your next appointment and
ask for the number
8 Ensure that your blood cholesterol level is below 48 mmolL (185 mgdL) This means
avoiding high fat meat and dairy products as well as deep fried foods and transfats
After Age 55 Add The Following
1 Take a Memory Support Supplement each day that contains meaningful doses of
CDP-choline Phosphatidylserine Huperzine A and Bocapa monnieri (example
Adeeva Memory Support Complex) ndash to help your brain continue to make the
memory chemical acetylcholine as you get older
2 Learn a new skill such as a learning to play a musical instrument or a foreign
language ndash something that is outside of your usual knowledge base
Participate in a mind-body activity that builds new neural circuits such as playing ping-pong or
taking dance lessons or martial arts lessons
8 | P a g e
11 Scientific Advisory Committee on Nutrition Committee on Toxicity Advice on fish consumption benefits and risks London Stationery Office 2004 wwwfoodgovukmultimediapdfsfishreport2004fullpdf (accessed 9 Feb 2006)
9 | P a g e
DHA ndash Omega-3 Fat Shown To Block Amyloid Synthesis In Alzheimerrsquos Disease Prevention
James Meschino DC MS ND
Recent studies indicate that higher intake and blood levels of omega-3 fats are associated with reduced risk of age-related cognitive decline dementia and Alzheimerrsquos disease The Atherosclerosis Risk in Communities Study which followed 2251 individuals (aged 50-65) showed that higher blood levels of omega-3 fats were associated with reduced risk of decline in verbal fluency The Zutphen Elderly Study which followed 210 elderly men (aged 70-89) for five years showed that men who consumed an average of approximately 400 mg per day of omega-3 fats (from fish) had significantly less cognitive decline over the five year period than did those consuming approximately 20 mg per day The Framingham Heart Study showed that persons with blood levels of omega-3 fats (phosphatidylcholine DHA) in the top 25 had a significantly (47) lower risk of developing all-cause dementia than did those in the bottom 25 In addition Alzheimerrsquos patients have been shown to have less DHA (an omega-3 fat) in the regions of the brain most affected by Alzheimerrsquos disease (the frontal lobe and hypocampus)
Experimental studies have shed light on the ways in which omega-3 fats may reduce risk of these conditions For example omega-3 fats have been shown to reduce brain inflammation increase blood circulation to brain cells inhibit abnormal clots in blood vessels within the brain More recently omega-3 fats were shown to improve nerve transmission among brain cells and support brain cell repair mechanisms
The most recent finding however was reported in the Journal of Neuroscience (Dec 2007 Qiu-Lan Ma and fellow researchers) showing that omega-3 fats inhibit the build up of amyloid plaque in brain cells The accumulation of amyloid plaque (a protein) in brain cells is a hallmark feature of Alzheimerrsquos disease and is considered to be the main culprit leading to brain cell disruption which manifests as memory loss confusion personality changes and other Alzheimerrsquos signs and symptoms These researchers discovered that omega-3 fats (particularly DHA) increases the number of receptors (the LR11- receptor) on human and murine (mice) brain cells which in turn transmits signals within the cell that block the accumulation of amyloid protein
Taken together my advice is to ingest at least 400 mg per day on average of omega-3 fats This means consuming 3-4 fish servings per week In addition I personally take 2-3 capsules per day of a supplement containing 400 mg each of fish oil flaxseed oil and borage seed oil For those allergic to fish and seafood I strongly recommend flaxseed oil supplementation (1200 mg 2-3 capsules per day) as an alternative
10 | P a g e
New Evidence That Vitamin E Supplementation Improves Outcomes In
Alzheimerrsquos Patients
A 2008 study adds to the body of evidence
James Meschino DC MS ND
In a paper presented at 2008 American Academy of Neurology Annual Meeting(Chicago Il
Poster Sessions III Aging) researchers showed that Alzheimerrsquos disease patients who
supplemented their diet with 2000 IU per day of Vitamin E had a 26 lower mortality rate As
explained by the lead researcher Dr Valory Pavlik from the Baylor College of Medicines
(Alzheimers Disease and Memory Disorders Center Houston TX) many previous studies have
shown that Vitamin E supplementation can slow the progression of Alzheimerrsquos disease The
study by Pavlik et was able to show additional features and benefits of Vitamin E
supplementation in Alzheimerrsquos disease patients and answered some common concerns about
the safety of using high dosages of Vitamin E and combining Vitamin E with conventional drugs
used to manage this condition In their study of 847 Alzheimerrsquos disease patients who were
followed for 49 years their results showed the following
A A 26 reduced mortality rate in the patients administered 2000 IU of Vitamin E per day
compared to Alzheimerrsquos disease patients not taking the Vitamin E supplement
B Combining Vitamin E supplementation (2000 IU per day) with standard drugs used to treat Alzheimerrsquos disease (cholinesterase inhibitors) produced the best overall results with respect to longevity and disease progression Thus it appears to be safe to recommend Vitamin E supplementation to Alzheimerrsquos patients already taking a cholinesterase inhibitor drug such as AriceptTM (donepezil) ExelonTM(rivastigmine) ReminylTM(galantamine) and Ebixareg (memantine hydrochloride)
C Recent concerns about Vitamin E supplementation increasing risk of cancer and heart disease were put to rest as this study showed that individuals with Alzheimerrsquo disease who were in a high-risk age group for death from cardiovascular disease and cancer
(average age 735 86 years) showed a 26 lower mortality rate than Alzheimerrsquos patients who did not take the 2000 IU per day of Vitamin E
D In the Alzheimerrsquos disease patients who used only Vitamin E supplementation (2000 IU per day) and did not take any Alzheimerrsquos disease medication these patients still showed a 26 lower mortality rate than patients not taking the Vitamin E supplement along with significant disease management outcomes
Overall the researchers concluded ldquoRegimens that included vitamin E were associated with a 26 lower mortality rate There was a suggestion that of vitamin E plus a cholinesterase inhibitor was more beneficial than taking either agent alonerdquo
11 | P a g e
The Alzheimerrsquos Disease Cooperative Study
A landmark study in the year 2000 known as the Alzheimerrsquos Disease Cooperative Study was one of the first published studies to show that providing Alzheimerrsquos patients with 2000 IU per day of Vitamin E could slow the progression of their disease The Alzheimers Disease Cooperative Study (ADCS) was formed in 1991 as a cooperative agreement between the National Institute on Aging (NIA) and the University of California San Diego The ADCS is a major initiative for Alzheimers disease (AD) clinical studies in the Federal government addressing treatments for both cognitive and behavioral symptoms Reporting in the American Journal of Clinical Nutrition researchers published results showing that vitamin E supplementation (2000 IU per day) may slow functional deterioration leading to nursing home placement
Why Vitamin E Supplementation The brains of Alzheimers disease patients frequently shows generalized atrophy neuritic plaques (dystrophic axons and dendrites surrounding an amyloid core) and neurofibrillary Evidence suggests that oxidative stress (free radicals) may lead to permanent cellular damage in the brain that triggers some of the changes seen in the brain of Alzheimerrsquos patients The presence of excessive szlig-amyloid protein formation (an extracellular insoluble protein) is a hallmark feature of the Alzheimerrsquos brain A proposed mechanism of szlig-amyloid toxicity is that it induces free radicals which disrupt cellular lipid protein and DNA In addition to szlig-amyloid several other processes may also induce oxidative stress in AD Activated microglial cells found in association with neuritic plaques may release cytokines prooxidants and free radicals As well other etiological factor such as cytoskeletal destabilization energy deprivation or toxic inflammatory responses may all converge in a common final pathway involving free radicals as well
Prior to the Alzheimerrsquos Disease Cooperative Study earlier clinical trials and epidemiologic studies had suggested that several agents may help prevent the development of AD or slow further deterioration These agents include vitamin E selegiline estrogen and anti-inflammatory drugs One property that they all share is the ability to protect against free radicalndashmediated
damage either directly or indirectly
Conclusion
The recent study (2008) by Pavlik et al adds to the body of evidence indicating that supplementing Alzheimerrsquos disease patients with 2000 IU per day of natural Vitamin E can slow the progression of their disease and lower the mortality rate by 26 (over a five-year period) Unfortunately many medical doctors have not been exposed to these studies and thus Vitamin E supplementation is often left out of the management of many Alzheimerrsquos disease cases In these instances it is up to Complementary Health Care Professionals to provide patients and family members with the research and recommendations that have been shown to be meaningful in regards to Vitamin E supplementation (as well as other effective natural interventions) The study by Pavlik et al suggests that Vitamin E supplementation at a dosage of 2000 IU per day is effective safe enhances the benefits of conventional Alzheimerrsquos drugs and does not increase the risk of cancer or heart disease in this older and elderly population
For more information on this or other related topics please visit httpwwwmeschinohealthcom
12 | P a g e
References
1 Valory Pavlik Rachelle Doody Susan Rountree Eveleen Darby Vitamin E Use Is Associated
with Improved Survival in an AD Cohort 2008 American Academy of Neurology Annual
Meeting(Chicago Il) Poster Sessions III Aging and Dementia Clinical II P03076
2 Grundman M Vitamin E and Alzheimer disease the basis for additional clinical trials American Journal of Clinical Nutrition Vol 71 No 2 630S-636s 2000
13 | P a g e
Summary The Quick Checklist of How to Best Maintain Memory Function Maintaining healthy brain function and memory over a lifetime requires that you be proactive Dementia and Alzheimerrsquos disease affect way too many people as they age and we now see that much of this could be avoided if people would use some targeted strategies during their lifetime Here are some important recommendations
1 Take every precaution to avoid head injuries throughout your entire life
2 Always be learning something new or further developing an existing talent or skill set
3 Donrsquot damage your brain with cigarettes alcohol or illicit drugs and try to use the least
number of medications as possible throughout your lifetime
4 Nourish your brain with omega-3 fats from fish twice per week on average
5 Take a high potency multiple vitamin that is antioxidant enriched and contains a B-50
complex (example Adeeva Multiple Vitamin)
6 Take 2-3 capsules per day of an Essential Oil supplement to ensure adequate omega-3
fat and essential fatty acid support for your brain I recommend a supplement that
combines fish oil flaxseed oil and borage seed oil (example Adeeva Naturersquos Essential
Oil)
7 Keep your fasting blood sugar level below 50 mmolL (90 mgdL) Elevated blood sugar
(glucose) and high insulin levels are strongly linked to Alzheimerrsquos disease development
This means eating sugary foods and starchy foods in moderation if at all performing
aerobic exercise for 30 mins at least 3-4 times per week and having a waist
circumference under 36 inches if you are a man and under 34 inches if you are a
woman Have your doctor check your blood glucose level on your next appointment and
ask for the number
8 Ensure that your blood cholesterol level is below 48 mmolL (185 mgdL) This means
avoiding high fat meat and dairy products as well as deep fried foods and transfats
After Age 55 Add The Following
1 Take a Memory Support Supplement each day that contains meaningful doses of
CDP-choline Phosphatidylserine Huperzine A and Bocapa monnieri (example
Adeeva Memory Support Complex) ndash to help your brain continue to make the
memory chemical acetylcholine as you get older
2 Learn a new skill such as a learning to play a musical instrument or a foreign
language ndash something that is outside of your usual knowledge base
Participate in a mind-body activity that builds new neural circuits such as playing ping-pong or
taking dance lessons or martial arts lessons
9 | P a g e
DHA ndash Omega-3 Fat Shown To Block Amyloid Synthesis In Alzheimerrsquos Disease Prevention
James Meschino DC MS ND
Recent studies indicate that higher intake and blood levels of omega-3 fats are associated with reduced risk of age-related cognitive decline dementia and Alzheimerrsquos disease The Atherosclerosis Risk in Communities Study which followed 2251 individuals (aged 50-65) showed that higher blood levels of omega-3 fats were associated with reduced risk of decline in verbal fluency The Zutphen Elderly Study which followed 210 elderly men (aged 70-89) for five years showed that men who consumed an average of approximately 400 mg per day of omega-3 fats (from fish) had significantly less cognitive decline over the five year period than did those consuming approximately 20 mg per day The Framingham Heart Study showed that persons with blood levels of omega-3 fats (phosphatidylcholine DHA) in the top 25 had a significantly (47) lower risk of developing all-cause dementia than did those in the bottom 25 In addition Alzheimerrsquos patients have been shown to have less DHA (an omega-3 fat) in the regions of the brain most affected by Alzheimerrsquos disease (the frontal lobe and hypocampus)
Experimental studies have shed light on the ways in which omega-3 fats may reduce risk of these conditions For example omega-3 fats have been shown to reduce brain inflammation increase blood circulation to brain cells inhibit abnormal clots in blood vessels within the brain More recently omega-3 fats were shown to improve nerve transmission among brain cells and support brain cell repair mechanisms
The most recent finding however was reported in the Journal of Neuroscience (Dec 2007 Qiu-Lan Ma and fellow researchers) showing that omega-3 fats inhibit the build up of amyloid plaque in brain cells The accumulation of amyloid plaque (a protein) in brain cells is a hallmark feature of Alzheimerrsquos disease and is considered to be the main culprit leading to brain cell disruption which manifests as memory loss confusion personality changes and other Alzheimerrsquos signs and symptoms These researchers discovered that omega-3 fats (particularly DHA) increases the number of receptors (the LR11- receptor) on human and murine (mice) brain cells which in turn transmits signals within the cell that block the accumulation of amyloid protein
Taken together my advice is to ingest at least 400 mg per day on average of omega-3 fats This means consuming 3-4 fish servings per week In addition I personally take 2-3 capsules per day of a supplement containing 400 mg each of fish oil flaxseed oil and borage seed oil For those allergic to fish and seafood I strongly recommend flaxseed oil supplementation (1200 mg 2-3 capsules per day) as an alternative
10 | P a g e
New Evidence That Vitamin E Supplementation Improves Outcomes In
Alzheimerrsquos Patients
A 2008 study adds to the body of evidence
James Meschino DC MS ND
In a paper presented at 2008 American Academy of Neurology Annual Meeting(Chicago Il
Poster Sessions III Aging) researchers showed that Alzheimerrsquos disease patients who
supplemented their diet with 2000 IU per day of Vitamin E had a 26 lower mortality rate As
explained by the lead researcher Dr Valory Pavlik from the Baylor College of Medicines
(Alzheimers Disease and Memory Disorders Center Houston TX) many previous studies have
shown that Vitamin E supplementation can slow the progression of Alzheimerrsquos disease The
study by Pavlik et was able to show additional features and benefits of Vitamin E
supplementation in Alzheimerrsquos disease patients and answered some common concerns about
the safety of using high dosages of Vitamin E and combining Vitamin E with conventional drugs
used to manage this condition In their study of 847 Alzheimerrsquos disease patients who were
followed for 49 years their results showed the following
A A 26 reduced mortality rate in the patients administered 2000 IU of Vitamin E per day
compared to Alzheimerrsquos disease patients not taking the Vitamin E supplement
B Combining Vitamin E supplementation (2000 IU per day) with standard drugs used to treat Alzheimerrsquos disease (cholinesterase inhibitors) produced the best overall results with respect to longevity and disease progression Thus it appears to be safe to recommend Vitamin E supplementation to Alzheimerrsquos patients already taking a cholinesterase inhibitor drug such as AriceptTM (donepezil) ExelonTM(rivastigmine) ReminylTM(galantamine) and Ebixareg (memantine hydrochloride)
C Recent concerns about Vitamin E supplementation increasing risk of cancer and heart disease were put to rest as this study showed that individuals with Alzheimerrsquo disease who were in a high-risk age group for death from cardiovascular disease and cancer
(average age 735 86 years) showed a 26 lower mortality rate than Alzheimerrsquos patients who did not take the 2000 IU per day of Vitamin E
D In the Alzheimerrsquos disease patients who used only Vitamin E supplementation (2000 IU per day) and did not take any Alzheimerrsquos disease medication these patients still showed a 26 lower mortality rate than patients not taking the Vitamin E supplement along with significant disease management outcomes
Overall the researchers concluded ldquoRegimens that included vitamin E were associated with a 26 lower mortality rate There was a suggestion that of vitamin E plus a cholinesterase inhibitor was more beneficial than taking either agent alonerdquo
11 | P a g e
The Alzheimerrsquos Disease Cooperative Study
A landmark study in the year 2000 known as the Alzheimerrsquos Disease Cooperative Study was one of the first published studies to show that providing Alzheimerrsquos patients with 2000 IU per day of Vitamin E could slow the progression of their disease The Alzheimers Disease Cooperative Study (ADCS) was formed in 1991 as a cooperative agreement between the National Institute on Aging (NIA) and the University of California San Diego The ADCS is a major initiative for Alzheimers disease (AD) clinical studies in the Federal government addressing treatments for both cognitive and behavioral symptoms Reporting in the American Journal of Clinical Nutrition researchers published results showing that vitamin E supplementation (2000 IU per day) may slow functional deterioration leading to nursing home placement
Why Vitamin E Supplementation The brains of Alzheimers disease patients frequently shows generalized atrophy neuritic plaques (dystrophic axons and dendrites surrounding an amyloid core) and neurofibrillary Evidence suggests that oxidative stress (free radicals) may lead to permanent cellular damage in the brain that triggers some of the changes seen in the brain of Alzheimerrsquos patients The presence of excessive szlig-amyloid protein formation (an extracellular insoluble protein) is a hallmark feature of the Alzheimerrsquos brain A proposed mechanism of szlig-amyloid toxicity is that it induces free radicals which disrupt cellular lipid protein and DNA In addition to szlig-amyloid several other processes may also induce oxidative stress in AD Activated microglial cells found in association with neuritic plaques may release cytokines prooxidants and free radicals As well other etiological factor such as cytoskeletal destabilization energy deprivation or toxic inflammatory responses may all converge in a common final pathway involving free radicals as well
Prior to the Alzheimerrsquos Disease Cooperative Study earlier clinical trials and epidemiologic studies had suggested that several agents may help prevent the development of AD or slow further deterioration These agents include vitamin E selegiline estrogen and anti-inflammatory drugs One property that they all share is the ability to protect against free radicalndashmediated
damage either directly or indirectly
Conclusion
The recent study (2008) by Pavlik et al adds to the body of evidence indicating that supplementing Alzheimerrsquos disease patients with 2000 IU per day of natural Vitamin E can slow the progression of their disease and lower the mortality rate by 26 (over a five-year period) Unfortunately many medical doctors have not been exposed to these studies and thus Vitamin E supplementation is often left out of the management of many Alzheimerrsquos disease cases In these instances it is up to Complementary Health Care Professionals to provide patients and family members with the research and recommendations that have been shown to be meaningful in regards to Vitamin E supplementation (as well as other effective natural interventions) The study by Pavlik et al suggests that Vitamin E supplementation at a dosage of 2000 IU per day is effective safe enhances the benefits of conventional Alzheimerrsquos drugs and does not increase the risk of cancer or heart disease in this older and elderly population
For more information on this or other related topics please visit httpwwwmeschinohealthcom
12 | P a g e
References
1 Valory Pavlik Rachelle Doody Susan Rountree Eveleen Darby Vitamin E Use Is Associated
with Improved Survival in an AD Cohort 2008 American Academy of Neurology Annual
Meeting(Chicago Il) Poster Sessions III Aging and Dementia Clinical II P03076
2 Grundman M Vitamin E and Alzheimer disease the basis for additional clinical trials American Journal of Clinical Nutrition Vol 71 No 2 630S-636s 2000
13 | P a g e
Summary The Quick Checklist of How to Best Maintain Memory Function Maintaining healthy brain function and memory over a lifetime requires that you be proactive Dementia and Alzheimerrsquos disease affect way too many people as they age and we now see that much of this could be avoided if people would use some targeted strategies during their lifetime Here are some important recommendations
1 Take every precaution to avoid head injuries throughout your entire life
2 Always be learning something new or further developing an existing talent or skill set
3 Donrsquot damage your brain with cigarettes alcohol or illicit drugs and try to use the least
number of medications as possible throughout your lifetime
4 Nourish your brain with omega-3 fats from fish twice per week on average
5 Take a high potency multiple vitamin that is antioxidant enriched and contains a B-50
complex (example Adeeva Multiple Vitamin)
6 Take 2-3 capsules per day of an Essential Oil supplement to ensure adequate omega-3
fat and essential fatty acid support for your brain I recommend a supplement that
combines fish oil flaxseed oil and borage seed oil (example Adeeva Naturersquos Essential
Oil)
7 Keep your fasting blood sugar level below 50 mmolL (90 mgdL) Elevated blood sugar
(glucose) and high insulin levels are strongly linked to Alzheimerrsquos disease development
This means eating sugary foods and starchy foods in moderation if at all performing
aerobic exercise for 30 mins at least 3-4 times per week and having a waist
circumference under 36 inches if you are a man and under 34 inches if you are a
woman Have your doctor check your blood glucose level on your next appointment and
ask for the number
8 Ensure that your blood cholesterol level is below 48 mmolL (185 mgdL) This means
avoiding high fat meat and dairy products as well as deep fried foods and transfats
After Age 55 Add The Following
1 Take a Memory Support Supplement each day that contains meaningful doses of
CDP-choline Phosphatidylserine Huperzine A and Bocapa monnieri (example
Adeeva Memory Support Complex) ndash to help your brain continue to make the
memory chemical acetylcholine as you get older
2 Learn a new skill such as a learning to play a musical instrument or a foreign
language ndash something that is outside of your usual knowledge base
Participate in a mind-body activity that builds new neural circuits such as playing ping-pong or
taking dance lessons or martial arts lessons
10 | P a g e
New Evidence That Vitamin E Supplementation Improves Outcomes In
Alzheimerrsquos Patients
A 2008 study adds to the body of evidence
James Meschino DC MS ND
In a paper presented at 2008 American Academy of Neurology Annual Meeting(Chicago Il
Poster Sessions III Aging) researchers showed that Alzheimerrsquos disease patients who
supplemented their diet with 2000 IU per day of Vitamin E had a 26 lower mortality rate As
explained by the lead researcher Dr Valory Pavlik from the Baylor College of Medicines
(Alzheimers Disease and Memory Disorders Center Houston TX) many previous studies have
shown that Vitamin E supplementation can slow the progression of Alzheimerrsquos disease The
study by Pavlik et was able to show additional features and benefits of Vitamin E
supplementation in Alzheimerrsquos disease patients and answered some common concerns about
the safety of using high dosages of Vitamin E and combining Vitamin E with conventional drugs
used to manage this condition In their study of 847 Alzheimerrsquos disease patients who were
followed for 49 years their results showed the following
A A 26 reduced mortality rate in the patients administered 2000 IU of Vitamin E per day
compared to Alzheimerrsquos disease patients not taking the Vitamin E supplement
B Combining Vitamin E supplementation (2000 IU per day) with standard drugs used to treat Alzheimerrsquos disease (cholinesterase inhibitors) produced the best overall results with respect to longevity and disease progression Thus it appears to be safe to recommend Vitamin E supplementation to Alzheimerrsquos patients already taking a cholinesterase inhibitor drug such as AriceptTM (donepezil) ExelonTM(rivastigmine) ReminylTM(galantamine) and Ebixareg (memantine hydrochloride)
C Recent concerns about Vitamin E supplementation increasing risk of cancer and heart disease were put to rest as this study showed that individuals with Alzheimerrsquo disease who were in a high-risk age group for death from cardiovascular disease and cancer
(average age 735 86 years) showed a 26 lower mortality rate than Alzheimerrsquos patients who did not take the 2000 IU per day of Vitamin E
D In the Alzheimerrsquos disease patients who used only Vitamin E supplementation (2000 IU per day) and did not take any Alzheimerrsquos disease medication these patients still showed a 26 lower mortality rate than patients not taking the Vitamin E supplement along with significant disease management outcomes
Overall the researchers concluded ldquoRegimens that included vitamin E were associated with a 26 lower mortality rate There was a suggestion that of vitamin E plus a cholinesterase inhibitor was more beneficial than taking either agent alonerdquo
11 | P a g e
The Alzheimerrsquos Disease Cooperative Study
A landmark study in the year 2000 known as the Alzheimerrsquos Disease Cooperative Study was one of the first published studies to show that providing Alzheimerrsquos patients with 2000 IU per day of Vitamin E could slow the progression of their disease The Alzheimers Disease Cooperative Study (ADCS) was formed in 1991 as a cooperative agreement between the National Institute on Aging (NIA) and the University of California San Diego The ADCS is a major initiative for Alzheimers disease (AD) clinical studies in the Federal government addressing treatments for both cognitive and behavioral symptoms Reporting in the American Journal of Clinical Nutrition researchers published results showing that vitamin E supplementation (2000 IU per day) may slow functional deterioration leading to nursing home placement
Why Vitamin E Supplementation The brains of Alzheimers disease patients frequently shows generalized atrophy neuritic plaques (dystrophic axons and dendrites surrounding an amyloid core) and neurofibrillary Evidence suggests that oxidative stress (free radicals) may lead to permanent cellular damage in the brain that triggers some of the changes seen in the brain of Alzheimerrsquos patients The presence of excessive szlig-amyloid protein formation (an extracellular insoluble protein) is a hallmark feature of the Alzheimerrsquos brain A proposed mechanism of szlig-amyloid toxicity is that it induces free radicals which disrupt cellular lipid protein and DNA In addition to szlig-amyloid several other processes may also induce oxidative stress in AD Activated microglial cells found in association with neuritic plaques may release cytokines prooxidants and free radicals As well other etiological factor such as cytoskeletal destabilization energy deprivation or toxic inflammatory responses may all converge in a common final pathway involving free radicals as well
Prior to the Alzheimerrsquos Disease Cooperative Study earlier clinical trials and epidemiologic studies had suggested that several agents may help prevent the development of AD or slow further deterioration These agents include vitamin E selegiline estrogen and anti-inflammatory drugs One property that they all share is the ability to protect against free radicalndashmediated
damage either directly or indirectly
Conclusion
The recent study (2008) by Pavlik et al adds to the body of evidence indicating that supplementing Alzheimerrsquos disease patients with 2000 IU per day of natural Vitamin E can slow the progression of their disease and lower the mortality rate by 26 (over a five-year period) Unfortunately many medical doctors have not been exposed to these studies and thus Vitamin E supplementation is often left out of the management of many Alzheimerrsquos disease cases In these instances it is up to Complementary Health Care Professionals to provide patients and family members with the research and recommendations that have been shown to be meaningful in regards to Vitamin E supplementation (as well as other effective natural interventions) The study by Pavlik et al suggests that Vitamin E supplementation at a dosage of 2000 IU per day is effective safe enhances the benefits of conventional Alzheimerrsquos drugs and does not increase the risk of cancer or heart disease in this older and elderly population
For more information on this or other related topics please visit httpwwwmeschinohealthcom
12 | P a g e
References
1 Valory Pavlik Rachelle Doody Susan Rountree Eveleen Darby Vitamin E Use Is Associated
with Improved Survival in an AD Cohort 2008 American Academy of Neurology Annual
Meeting(Chicago Il) Poster Sessions III Aging and Dementia Clinical II P03076
2 Grundman M Vitamin E and Alzheimer disease the basis for additional clinical trials American Journal of Clinical Nutrition Vol 71 No 2 630S-636s 2000
13 | P a g e
Summary The Quick Checklist of How to Best Maintain Memory Function Maintaining healthy brain function and memory over a lifetime requires that you be proactive Dementia and Alzheimerrsquos disease affect way too many people as they age and we now see that much of this could be avoided if people would use some targeted strategies during their lifetime Here are some important recommendations
1 Take every precaution to avoid head injuries throughout your entire life
2 Always be learning something new or further developing an existing talent or skill set
3 Donrsquot damage your brain with cigarettes alcohol or illicit drugs and try to use the least
number of medications as possible throughout your lifetime
4 Nourish your brain with omega-3 fats from fish twice per week on average
5 Take a high potency multiple vitamin that is antioxidant enriched and contains a B-50
complex (example Adeeva Multiple Vitamin)
6 Take 2-3 capsules per day of an Essential Oil supplement to ensure adequate omega-3
fat and essential fatty acid support for your brain I recommend a supplement that
combines fish oil flaxseed oil and borage seed oil (example Adeeva Naturersquos Essential
Oil)
7 Keep your fasting blood sugar level below 50 mmolL (90 mgdL) Elevated blood sugar
(glucose) and high insulin levels are strongly linked to Alzheimerrsquos disease development
This means eating sugary foods and starchy foods in moderation if at all performing
aerobic exercise for 30 mins at least 3-4 times per week and having a waist
circumference under 36 inches if you are a man and under 34 inches if you are a
woman Have your doctor check your blood glucose level on your next appointment and
ask for the number
8 Ensure that your blood cholesterol level is below 48 mmolL (185 mgdL) This means
avoiding high fat meat and dairy products as well as deep fried foods and transfats
After Age 55 Add The Following
1 Take a Memory Support Supplement each day that contains meaningful doses of
CDP-choline Phosphatidylserine Huperzine A and Bocapa monnieri (example
Adeeva Memory Support Complex) ndash to help your brain continue to make the
memory chemical acetylcholine as you get older
2 Learn a new skill such as a learning to play a musical instrument or a foreign
language ndash something that is outside of your usual knowledge base
Participate in a mind-body activity that builds new neural circuits such as playing ping-pong or
taking dance lessons or martial arts lessons
11 | P a g e
The Alzheimerrsquos Disease Cooperative Study
A landmark study in the year 2000 known as the Alzheimerrsquos Disease Cooperative Study was one of the first published studies to show that providing Alzheimerrsquos patients with 2000 IU per day of Vitamin E could slow the progression of their disease The Alzheimers Disease Cooperative Study (ADCS) was formed in 1991 as a cooperative agreement between the National Institute on Aging (NIA) and the University of California San Diego The ADCS is a major initiative for Alzheimers disease (AD) clinical studies in the Federal government addressing treatments for both cognitive and behavioral symptoms Reporting in the American Journal of Clinical Nutrition researchers published results showing that vitamin E supplementation (2000 IU per day) may slow functional deterioration leading to nursing home placement
Why Vitamin E Supplementation The brains of Alzheimers disease patients frequently shows generalized atrophy neuritic plaques (dystrophic axons and dendrites surrounding an amyloid core) and neurofibrillary Evidence suggests that oxidative stress (free radicals) may lead to permanent cellular damage in the brain that triggers some of the changes seen in the brain of Alzheimerrsquos patients The presence of excessive szlig-amyloid protein formation (an extracellular insoluble protein) is a hallmark feature of the Alzheimerrsquos brain A proposed mechanism of szlig-amyloid toxicity is that it induces free radicals which disrupt cellular lipid protein and DNA In addition to szlig-amyloid several other processes may also induce oxidative stress in AD Activated microglial cells found in association with neuritic plaques may release cytokines prooxidants and free radicals As well other etiological factor such as cytoskeletal destabilization energy deprivation or toxic inflammatory responses may all converge in a common final pathway involving free radicals as well
Prior to the Alzheimerrsquos Disease Cooperative Study earlier clinical trials and epidemiologic studies had suggested that several agents may help prevent the development of AD or slow further deterioration These agents include vitamin E selegiline estrogen and anti-inflammatory drugs One property that they all share is the ability to protect against free radicalndashmediated
damage either directly or indirectly
Conclusion
The recent study (2008) by Pavlik et al adds to the body of evidence indicating that supplementing Alzheimerrsquos disease patients with 2000 IU per day of natural Vitamin E can slow the progression of their disease and lower the mortality rate by 26 (over a five-year period) Unfortunately many medical doctors have not been exposed to these studies and thus Vitamin E supplementation is often left out of the management of many Alzheimerrsquos disease cases In these instances it is up to Complementary Health Care Professionals to provide patients and family members with the research and recommendations that have been shown to be meaningful in regards to Vitamin E supplementation (as well as other effective natural interventions) The study by Pavlik et al suggests that Vitamin E supplementation at a dosage of 2000 IU per day is effective safe enhances the benefits of conventional Alzheimerrsquos drugs and does not increase the risk of cancer or heart disease in this older and elderly population
For more information on this or other related topics please visit httpwwwmeschinohealthcom
12 | P a g e
References
1 Valory Pavlik Rachelle Doody Susan Rountree Eveleen Darby Vitamin E Use Is Associated
with Improved Survival in an AD Cohort 2008 American Academy of Neurology Annual
Meeting(Chicago Il) Poster Sessions III Aging and Dementia Clinical II P03076
2 Grundman M Vitamin E and Alzheimer disease the basis for additional clinical trials American Journal of Clinical Nutrition Vol 71 No 2 630S-636s 2000
13 | P a g e
Summary The Quick Checklist of How to Best Maintain Memory Function Maintaining healthy brain function and memory over a lifetime requires that you be proactive Dementia and Alzheimerrsquos disease affect way too many people as they age and we now see that much of this could be avoided if people would use some targeted strategies during their lifetime Here are some important recommendations
1 Take every precaution to avoid head injuries throughout your entire life
2 Always be learning something new or further developing an existing talent or skill set
3 Donrsquot damage your brain with cigarettes alcohol or illicit drugs and try to use the least
number of medications as possible throughout your lifetime
4 Nourish your brain with omega-3 fats from fish twice per week on average
5 Take a high potency multiple vitamin that is antioxidant enriched and contains a B-50
complex (example Adeeva Multiple Vitamin)
6 Take 2-3 capsules per day of an Essential Oil supplement to ensure adequate omega-3
fat and essential fatty acid support for your brain I recommend a supplement that
combines fish oil flaxseed oil and borage seed oil (example Adeeva Naturersquos Essential
Oil)
7 Keep your fasting blood sugar level below 50 mmolL (90 mgdL) Elevated blood sugar
(glucose) and high insulin levels are strongly linked to Alzheimerrsquos disease development
This means eating sugary foods and starchy foods in moderation if at all performing
aerobic exercise for 30 mins at least 3-4 times per week and having a waist
circumference under 36 inches if you are a man and under 34 inches if you are a
woman Have your doctor check your blood glucose level on your next appointment and
ask for the number
8 Ensure that your blood cholesterol level is below 48 mmolL (185 mgdL) This means
avoiding high fat meat and dairy products as well as deep fried foods and transfats
After Age 55 Add The Following
1 Take a Memory Support Supplement each day that contains meaningful doses of
CDP-choline Phosphatidylserine Huperzine A and Bocapa monnieri (example
Adeeva Memory Support Complex) ndash to help your brain continue to make the
memory chemical acetylcholine as you get older
2 Learn a new skill such as a learning to play a musical instrument or a foreign
language ndash something that is outside of your usual knowledge base
Participate in a mind-body activity that builds new neural circuits such as playing ping-pong or
taking dance lessons or martial arts lessons
12 | P a g e
References
1 Valory Pavlik Rachelle Doody Susan Rountree Eveleen Darby Vitamin E Use Is Associated
with Improved Survival in an AD Cohort 2008 American Academy of Neurology Annual
Meeting(Chicago Il) Poster Sessions III Aging and Dementia Clinical II P03076
2 Grundman M Vitamin E and Alzheimer disease the basis for additional clinical trials American Journal of Clinical Nutrition Vol 71 No 2 630S-636s 2000
13 | P a g e
Summary The Quick Checklist of How to Best Maintain Memory Function Maintaining healthy brain function and memory over a lifetime requires that you be proactive Dementia and Alzheimerrsquos disease affect way too many people as they age and we now see that much of this could be avoided if people would use some targeted strategies during their lifetime Here are some important recommendations
1 Take every precaution to avoid head injuries throughout your entire life
2 Always be learning something new or further developing an existing talent or skill set
3 Donrsquot damage your brain with cigarettes alcohol or illicit drugs and try to use the least
number of medications as possible throughout your lifetime
4 Nourish your brain with omega-3 fats from fish twice per week on average
5 Take a high potency multiple vitamin that is antioxidant enriched and contains a B-50
complex (example Adeeva Multiple Vitamin)
6 Take 2-3 capsules per day of an Essential Oil supplement to ensure adequate omega-3
fat and essential fatty acid support for your brain I recommend a supplement that
combines fish oil flaxseed oil and borage seed oil (example Adeeva Naturersquos Essential
Oil)
7 Keep your fasting blood sugar level below 50 mmolL (90 mgdL) Elevated blood sugar
(glucose) and high insulin levels are strongly linked to Alzheimerrsquos disease development
This means eating sugary foods and starchy foods in moderation if at all performing
aerobic exercise for 30 mins at least 3-4 times per week and having a waist
circumference under 36 inches if you are a man and under 34 inches if you are a
woman Have your doctor check your blood glucose level on your next appointment and
ask for the number
8 Ensure that your blood cholesterol level is below 48 mmolL (185 mgdL) This means
avoiding high fat meat and dairy products as well as deep fried foods and transfats
After Age 55 Add The Following
1 Take a Memory Support Supplement each day that contains meaningful doses of
CDP-choline Phosphatidylserine Huperzine A and Bocapa monnieri (example
Adeeva Memory Support Complex) ndash to help your brain continue to make the
memory chemical acetylcholine as you get older
2 Learn a new skill such as a learning to play a musical instrument or a foreign
language ndash something that is outside of your usual knowledge base
Participate in a mind-body activity that builds new neural circuits such as playing ping-pong or
taking dance lessons or martial arts lessons
13 | P a g e
Summary The Quick Checklist of How to Best Maintain Memory Function Maintaining healthy brain function and memory over a lifetime requires that you be proactive Dementia and Alzheimerrsquos disease affect way too many people as they age and we now see that much of this could be avoided if people would use some targeted strategies during their lifetime Here are some important recommendations
1 Take every precaution to avoid head injuries throughout your entire life
2 Always be learning something new or further developing an existing talent or skill set
3 Donrsquot damage your brain with cigarettes alcohol or illicit drugs and try to use the least
number of medications as possible throughout your lifetime
4 Nourish your brain with omega-3 fats from fish twice per week on average
5 Take a high potency multiple vitamin that is antioxidant enriched and contains a B-50
complex (example Adeeva Multiple Vitamin)
6 Take 2-3 capsules per day of an Essential Oil supplement to ensure adequate omega-3
fat and essential fatty acid support for your brain I recommend a supplement that
combines fish oil flaxseed oil and borage seed oil (example Adeeva Naturersquos Essential
Oil)
7 Keep your fasting blood sugar level below 50 mmolL (90 mgdL) Elevated blood sugar
(glucose) and high insulin levels are strongly linked to Alzheimerrsquos disease development
This means eating sugary foods and starchy foods in moderation if at all performing
aerobic exercise for 30 mins at least 3-4 times per week and having a waist
circumference under 36 inches if you are a man and under 34 inches if you are a
woman Have your doctor check your blood glucose level on your next appointment and
ask for the number
8 Ensure that your blood cholesterol level is below 48 mmolL (185 mgdL) This means
avoiding high fat meat and dairy products as well as deep fried foods and transfats
After Age 55 Add The Following
1 Take a Memory Support Supplement each day that contains meaningful doses of
CDP-choline Phosphatidylserine Huperzine A and Bocapa monnieri (example
Adeeva Memory Support Complex) ndash to help your brain continue to make the
memory chemical acetylcholine as you get older
2 Learn a new skill such as a learning to play a musical instrument or a foreign
language ndash something that is outside of your usual knowledge base
Participate in a mind-body activity that builds new neural circuits such as playing ping-pong or
taking dance lessons or martial arts lessons
