Dietary supplements that claim to improve brain health probably do not work and are a waste of money for healthy individuals, according to a new Cochrane report.
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An international team of doctors and professors forming the Global Council on Brain Health (GCBH) have warned that the tablets, powders and capsules that claim to improve memory, cognitive ability and even fight off dementia are “too good to be true.”
The GCBH members have instead put together a list of tips for keeping the brain healthy, with diet referred to as the key factor.
“For most people, the best way to get your nutrients for brain health is from a healthy diet,” the report said.
The charity Age UK has backed the report and asked older people to save their money and not buy into the £1 billion-pound supplements market.
The GCBH members have said: “We do not endorse any ingredient, product or supplement formulation specifically for brain health, unless your health care provider has identified that you have a specific nutrient deficiency… Save your money. Buying supplements to benefit your brain health is likely a waste of your money.”
‘No convincing evidence’
According to estimates for the U.S., the so-called “memory supplements” market reached a value of $643m in 2015 and more than one-quarter of those aged 50 plus take the supplements in the hope of keeping their brain healthy.
However, the GCBH members say there is currently little evidence that these supplements benefit healthy people and that they could even be detrimental to health.
There is no convincing evidence to recommend dietary supplements for brain health in healthy older adults. Supplements have not been demonstrated to delay the onset of dementia, nor can they prevent, treat or reverse Alzheimer’s disease or other neurological diseases that cause dementia.”
However, they do note that deficiency in certain nutrients such as vitamin B12 do seem to be associated with poor brain health and cognitive problems and that in such cases, the supplements could prove useful.
In the UK, around one-fifth of people aged over 60 years are estimated to be B12-deficient. The experts stress that it is vital that people do ask their doctor before taking any supplements and that obtaining nutrients by following a healthy diet is preferable.
The current review looked at the evidence available for various different supplements including omega-3 fatty acids, B vitamins, Vitamin D, ginkgo biloba and coenzyme Q10.
The team searched for studies from ALOIS, the Cochrane Dementia and Cognitive Improvement Group’s (CDCIG) specialized register, MEDLINE, PsycINFO, CINAHL, Embase, ClinicalTrials.gov and the WHO Portal/ICTRP from inception through to 26th January 2018.
Overall, they included 28 studies involving more than 83,000 participants.
They found that few of the supplements had actually been assessed for their impact on brain health. Where studies had been conducted, they had significant limitations and provided little or mixed evidence that the supplements can boost brain function or protect against dementia.
“The big problem is that these things are being marketed to people as if they have evidence,” says Linda Clare, CGBH member and professor of clinical psychology of aging and dementia at the University of Exeter.
Major holes in previous studies
Some general limitations of the study were that most participants had been enrolled in studies that did not primarily assess cognition, a baseline cognitive assessment was often missing, and only brief cognitive assessments were conducted at follow-up.
Very few studies looked at the incidence of dementia and most studies made little mention of adverse events or only made very general statements about them. Only ten studies had mean follow-up periods of more than five years and only two included patients with a mean age of less than 60 years.
“We considered the certainty of the evidence behind almost all results to be moderate or low,” writes the team.
The panel members recommend taking a sceptical view, saying that many of the supplements are marketed with exaggerated claims about their impact on mental functions. They also point out that such products are not usually subjected to the same safety and efficacy tests as medications.
If it sounds too good to be true, it probably is. Beware if a supplement claims to improve brain health or memory, make you smarter, or cure a brain disease. The GCBH encourages manufacturers of dietary supplements to conduct, support and publish rigorous human studies that are independently reviewed by other scientists who can evaluate supplements’ effects on brain health.”
David Smith, professor emeritus of pharmacology at the University of Oxford, added that, while the report has called for more high-quality research, there was a significant problem with this: “the authorities and drug companies seem to be reluctant to support such trials on vitamins, partly because there is no obvious financial benefit and because no patents can be filed.”
In the meantime, experts say there are many other measures people can take to help make sure they stay sharp as they grow older such as sleeping well, exercising, not smoking and keeping mentally stimulated and socially engaged.
Caroline Abrahams, charity director at Age UK, concludes: “These eminent experts have concluded it doesn’t do any good to take supplements to promote your brain health in later life so our advice to older people is to save your money and spend it on a healthy diet, full of delicious fruit and vegetables instead.”
Preventing dementia: do vitamin and mineral supplements have a role? (2019). Cochrane Press Release. https://www.cochrane.org/news/preventing-dementia-do-vitamin-and-mineral-supplements-have-role
Rutjes, A. W. S, et al. (2018). Vitamin and mineral supplementation for maintaining cognitive function in cognitively healthy people in mid and late life. Cochrane Database of Systematic Reviews. https://doi.org/10.1002/14651858.CD011906.pub2