Well Being: "Brain Food" for Cognition

Nutrients can improve brain function

Time can take a toll on brain function. Therefore, striving to maintain cognitive function in most definitely important as we age. Over the past decades, a wide variety of researchers have found that nutritional supplements can help tremendously in preserving and even improving brain function.

Both diet and exercise play an important role in maintaining cognitive health. Foods that are rich in omega 3 fatty acids, selenium, flavonoids, vitamin B (including folic acid), vitamin E, choline and iron have all been shown to improve cognitive function [1]. If your diet is deficient or even average in any of these, consider supplementation.

Starting in mid-life, there is a strong association between obesity and impaired cognitive function. Studies have shown that measures of obesity are also associated with both grey and white matter atrophy (reduced neural integrity). Increasing age coupled with the negative metabolic consequences of obesity (such as type 2 diabetes) also significantly contribute to cognitive decline as well as increased incidence of dementia [2].

Below, I focus on a few supplements that many people do not know about - supplements that will help improve memory, processing skills and even augment the ability to learn.

Of course, if you have health issues, such as reduced renal function or are on prescription medications - it is always good to check-in with a health professional before consuming new supplements or nutraceuticals.

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MAGNESIUM

Magnesium is important in many cellular processes. This includes cellular respiration, protein synthesis, membrane stability and regulation of vascular tone. Which is why it is often recommended as a supplement for cardiovascular health. However, magnesiums’ importance in cognition, learning and memory has only recently been documented.

In mouse models, the elevation of brain magnesium has substantial synapto- protective effects against Alzheimer's disease. In fact, there are many studies showing the benefits of magnesium for the treatment of dementia [3]. One meta-analysis study documented that patients with Alzheimer's disease had significantly lower magnesium in cerebrospinal fluid and in hair samples. Furthermore, Alzheimer's disease appears to to be associated with a lower magnesium levels when compared to matched healthy controls [4].

In one relevant prospective clinical study, a group of women aged 65-79 years were followed for a twenty year period. Diet was assessed for magnesium levels. Total magnesium intake between the estimated average requirement and the recommended dietary allowances appeared to be associated with a lower risk of mild cognitive impairment and probable dementia [5].

Another study shows that learning and memory increased by specific compounds of magnesium targeting the brain. In this rat model, a newly developed magnesium compound called magnesium-L-threonate, MgT leads to the enhancement of learning abilities, working memory, and short- and long-term memory [6]. Further clinical trials have shown the benefits of taking magnesium-L-threonate for improving cognitive health in humans, as its bioavailability is greatly enhanced. This is the form that I recommend both for heart and brain health.

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Creatine

Creatine has long been known as a way to build muscle, and there are many studies demonstrating that it helps keep older people stronger. But the benefits of using creatine to to increase memory performance and learning in adults is less known. However, there are plenty of clinical trial evidence to support its usage for this application as well.

A 2022 systematic review and meta-analysis of randomized controlled trials published in Nutrition Reviews documented that creatine supplementation improved memory performance, particularly in older adults aged 66 to 76 [7].

One study examined the effects of creatine supplementation on the cognitive performance of elderly people. Participants were divided into two groups, which were tested on pattern recognition, spatial recall, and long-term memory tasks to establish a baseline level. Group 1 (n = 15) were given 5 grams of creatine four times a day of placebo for 1 week, followed by the same dosage of creatine for the second week. Group 2 (n = 17) were given placebo both weeks. Participants were retested at the end of each week. Results showed a significant effect of creatine supplementation on all tasks except backward number recall, showing that creatine supplementation aids cognition in this population group [8]. This study was conducted in 2007, so the question is why aren’t more physicians recommending creatine to their older patients?

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Vitamin D3

The evidence that vitamin D will improve cognition is somewhat mixed, mostly because the doses of vitamin often administered in clinical trials measuring the effects of vitamin D3 on cognition are often too low. Therefore, there are a number of clinical trials and meta-analysis studies of those trials that come to inconclusive results. However, there is enough evidence that higher vitamin D3 levels play an important component to mitigating cognitive decline due to aging, that I think it is important to include some of the recent studies that document a positive effect of vitamin D3 on memory and cognition.

Recently, a pilot clinical trial was published that showed Vitamin D replacement has a positive effect on cognitive domains related to visuospatial, executive, and memory processing functions in women over 60 years of age [9]. The study description, results and conclusion are as follows (from the abstract):

Participants were administered 50 000 IU vitamin D3 weekly for 8 weeks followed by a maintenance therapy of 1000 U/day. Detailed neuropsychological assessment was performed prior to vitamin D replacement and repeated at 6 months by the same psychologist. RESULTS: Mean age was 63 +/- 6.7 years and baseline vitamin D level was 7.8 +/- 2.0 (range: 3.5-10.3) ng/ml. At 6 months, vitamin D level was 32.5 +/- 3.4 (32.2-55) ng/ml. The Judgement of Line Orientation Test (P = 0.04), inaccurate word memorizing of the Verbal Memory Processes Test (P = 0.02), perseveration scores of the Verbal Memory Processes Test (P = 0.005), topographical accuracy of the Warrington Recognition Memory Test (P = 0.002), and the spontaneous self-correction of an error in the Boston Naming Test (P = 0.003) scores increased significantly,

while the delayed recall score in the Verbal Memory Processes Test (P = 0.03), incorrect naming of words in the Boston Naming Test (P = 0.04), interference time of the Stroop Test (P = 0.05), and spontaneous corrections of the Stroop Test (P = 0.02) scores decreased significantly from baseline (which means a significantly improvement). 

CONCLUSION: Vitamin D replacement has a positive effect on cognitive domains related to visuospatial, executive, and memory processing functions.

A study from China assessed cognitive function in older asian adults with vitamin D deficiency and those with high levels of circulating vitamin D. The statistically significant results showed that Vitamin D insufficiency is associated with a greater likelihood of and more severe cognitive impairment in Asian populations [10].

Another retrospective study out of China found that vitamin D3 sufficiency was significantly associated with a 33% lower risk of cognitive impairment compared with VD3 deficiency; good sleep quality was associated with 34% lower odds of cognitive impairment [11].

There is also a strong association between low vitamin D status and Alzheimer's disease which warrants more investigation [12]. In a paper titled, Association between low vitamin D status, serotonin and clinico-bio-behavioral parameters in Alzheimer's disease, that authors found that among Alzheimer's disease patients, vitamin D deficiency was highly prevalent. Regression analyses, adjusted for age, gender and psychotropic medications showed that the molecular associations between low vitamin D status and CSF Abeta1-42 levels ( a marker for Alzheimer's disease) are highly significant.

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Conclusions:

There are ways to mitigate the effects of aging on cognition. They include eating right, avoiding the obesity trap and supplementing wisely. The supplements to consider and discuss with your personal physician include magnesium-L-threonate, creatine and vitamin D3.

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1.         Ekstrand, B., et al., Brain foods - the role of diet in brain performance and health. Nutr Rev, 2021. 79(6): p. 693-708.

2.         Dye, L., N.B. Boyle, C. Champ, and C. Lawton, The relationship between obesity and cognitive health and decline. Proc Nutr Soc, 2017. 76(4): p. 443-454.

3.         Orhan, C., et al., Effects of a Novel Magnesium Complex on Metabolic and Cognitive Functions and the Expression of Synapse-Associated Proteins in Rats Fed a High-Fat Diet. Biol Trace Elem Res, 2022. 200(1): p. 247-260.

4.         Du, K., et al., Association of Circulating Magnesium Levels in Patients With Alzheimer's Disease From 1991 to 2021: A Systematic Review and Meta-Analysis. Front Aging Neurosci, 2021. 13: p. 799824.

5.         Lo, K., et al., Relations of magnesium intake to cognitive impairment and dementia among participants in the Women's Health Initiative Memory Study: a prospective cohort study. BMJ Open, 2019. 9(11): p. e030052.

6.         Slutsky, I., et al., Enhancement of learning and memory by elevating brain magnesium. Neuron, 2010. 65(2): p. 165-77.

7.         Prokopidis, K., et al., Effects of creatine supplementation on memory in healthy individuals: a systematic review and meta-analysis of randomized controlled trials. Nutr Rev, 2023. 81(4): p. 416-427.

8.         McMorris, T., et al., Creatine supplementation and cognitive performance in elderly individuals. Neuropsychol Dev Cogn B Aging Neuropsychol Cogn, 2007. 14(5): p. 517-28.

9.         Turkmen, B.O., et al., The effect of vitamin D on neurocognitive functions in older vitamin D deficient adults: a pilot longitudinal interventional study. Psychogeriatrics, 2023. 23(5): p. 781-788.

10.       Annweiler, C., et al., Vitamin D insufficiency and cognitive impairment in Asians: a multi-ethnic population-based study and meta-analysis. J Intern Med, 2016. 280(3): p. 300-11.

11.       Xie, Y., C. Bai, Q. Feng, and D. Gu, Serum Vitamin D(3) Concentration, Sleep, and Cognitive Impairment among Older Adults in China. Nutrients, 2023. 15(19).

12.       Richter, A.L., et al., Association between low vitamin D status, serotonin and clinico-bio-behavioral parameters in Alzheimer's disease. Dement Geriatr Cogn Disord, 2023.

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