Diabetes Self-Management Blog

Last week a study was released in The British Journal of Psychiatry. This study involved 103 men and women with mild cognitive impairment. Nineteen of the 103 participants developed dementia (probably Alzheimer) over the course of the study, which was four years. And sixteen of those participants had diabetes; they were about three times as likely to develop dementia as those without diabetes. Granted, this was a small study, but it does reinforce the link between diabetes and dementia.

Now, on to what you might be able to do about it! Last week we looked at a couple of supplements. Ginkgo biloba is no longer the leader of the pack in terms of brain health, but perhaps we shouldn’t write it off altogether. And beta carotene may hold some promise (just don’t take beta carotene if you’re a smoker or a former smoker). This week we’ll look at some other supplements.

Choline. You don’t hear too much about this nutrient, but choline is definitely essential for good health. While it’s not exactly a vitamin (because the body can make some of what it needs), it does have to be consumed to help ensure good health. Choline is a component of certain types of building blocks of cell membranes: phospholipids, phosphatidylcholine, and sphingomyelin. In turn, these three substances are necessary to form intracellular messenger molecules.

Choline is also needed to form acetylcholine, which is a neurotransmitter (chemical messenger) that carries messages to and from nerves. Alzheimer disease has been linked with a deficiency in acetylcholine. While choline supplementation hasn’t, unfortunately, halted the progression of Alzheimer, researchers at MIT gave 225 people with Alzheimer a “cocktail” of three nutrients: choline, uridine (a component of RNA), and the omega-3 fatty acid DHA, along with B vitamins, phospholipids, and antioxidants. These nutrients were in the form of a drink called Souvenaid (made in collaboration with the French company Danone, known as Dannon in the US), which the subjects drank daily for 24 weeks. Other participants drank a placebo (inactive) drink for 24 weeks. The results? Forty percent of the Souvenaid drinkers showed improvement in a test of verbal memory. The people with the mildest form of Alzheimer showed the most improvement. Results of this study are published in the journal Alzheimer’s & Dementia.

Choline may play a role in treating other diseases, too. In the meantime, until we learn more, make sure you get your choline from food sources; eggs, peanuts, cod, broccoli, milk, soybeans, wheat germ, and liver are key sources. The Daily Reference Intake (DRI) for choline is 550 milligrams per day. It’s probably not warranted to take choline supplements unless you just don’t eat any food sources of this nutrient. The usual supplement dose is about 650–2,000 milligrams per day. Excess choline may lower blood pressure too much, and lead to diarrhea, depression, and a fishy body odor.

Omega-3 fatty acids. Looks like eating fatty fish may do more than just protect your heart. Two omega-3 fatty acids, docosahexanoic acid (DHA) and eicosapentaenoic acid (EPA), but especially DHA, are apparently essential not just for brain development in infants and children, but also for promoting brain health as we get older. Omega-3 fatty acids improve memory, learning ability, and likely prevent depression, mood disorders, schizophrenia, and dementia. A large percentage of the gray matter in the brain is made up of DHA. DHA and EPA help make brain cells more fluid, which, in turn, improves communication between brain cells. In mice, DHA seems to slow the buildup of tau, which is a protein that forms neurofibrillary tangles. DHA also reduced the formation of beta amyloid. Both the “tangles” and the beta amyloid are characteristic of Alzheimer lesions. In Japan, DHA is considered to be such an important nutrient for brain health that foods are fortified with it and it’s also taken as a supplement.

The main sources of DHA (and EPA) are types of fatty fish (salmon, tuna, mackerel, sardines, herring). Smaller amounts are found in eggs and algae (not a popular food for humans). While exact doses for brain health aren’t known, aiming for 1,000–3,000 milligrams of DHA daily, via food or supplements, may be beneficial. DHA and EPA may interact with blood thinning, blood pressure, and diabetes medicine, so it’s wise to check with your health-care provider before taking supplements. Also, pregnant women should also check with their physicians before taking DHA and EPA as a supplement.

More next week!

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Boosting Brain Health: Do Supplements Really Help? (Part 1)
Boosting Brain Health: Do Supplements Really Help? (Part 2)
Boosting Brain Health: Do Supplements Really Help? (Part 3)


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