Daily Value

The Nutrient Duo That Could Save Your Mind

Dr. William Wallace

In this episode of Daily Value, we look into the synergistic relationship between two nutrient classes in supporting brain health and mitigating cognitive decline. Drawing on evidence from past clinical evidence suggesting these two nutrient classes work in tandem to support brain function and health.

Discussion Points:
-Homocysteine’s role in disrupting fatty acid incorporation into cell membranes and amyloid-beta clearance.
-Findings from one study, where some 70-year-old participants experienced up to 30% reduction in brain atrophy.
-Practical strategies to optimize intake of these nutrients.

https://pubmed.ncbi.nlm.nih.gov/22260268/
https://pubmed.ncbi.nlm.nih.gov/29480200/
https://pubmed.ncbi.nlm.nih.gov/26757190/

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Speaker 0:

Hello everyone, welcome back to Daily Value. I'm William Wallace, and today we're exploring the intersection of nutrition and brain health, that being, the role or roles, I should say of specific B vitamins, like vitamins B6, b9, and 12, and the omega-3 fatty acid docosahexaenoic acid, better known as DHA, in cognitive performance, particularly in people with mild cognitive impairment. In today's episode, we'll talk about the complementary roles of these nutrients in brain health, how they may work in a synergistic manner, such that both DHA and folate and other B vitamins may be needed to fully reap the cognitive benefits of these nutrient classes, and how one study, known as the VitaCog study, was able to determine that preventing brain atrophy by up to 30% was only possible in this case, when all of these nutrients were working together. Mild cognitive impairment is a condition characterized by noticeable declines in cognitive abilities such as memory and decision-making that fall short of dementia. While not everyone with mild cognitive impairment progresses to Alzheimer's disease or other dementias, it does represent a critical window for intervention. It's very well known at this point that in the case of something like sporadic Alzheimer's disease, once mild cognitive impairment presents, the rate of progression of the disease can begin to accelerate quite dramatically. Now, nutritional strategies are certainly one tool for slowing cognitive decline.

Speaker 0:

Right now, just speaking about general cognitive decline with age, folate, a form of vitamin B9, vitamin B6, vitamin B12, and DHA and omega-3 fatty acid play distinct yet interconnected roles in the brain. The mentioned B vitamins are all cornerstone nutrients of what's called one-carbon metabolism. One-carbon metabolism is a network of biochemical pathways that transfers single carbon units between molecules to support essential functions like supporting DNA synthesis, repair and methylation. B vitamins facilitate the incorporation of DHA into phospholipids, improving the fluidity and functionality of cell membranes. This enhances signal transmission between neurons, a process critical for memory and cognition. Obviously, now back to one carbon metabolism. In this cycle, these three B vitamins are responsible for converting homocysteine, a neurotoxic amino acid, into methionine, a precursor to S-adenosylmethionine, or SAMe as many people know it. Same is a universal methyl donor involved in DNA methylation. Here's where omega-3 fatty acids, particularly DHA, come into play. Dha is a structural component of brain cell membranes, contributing to their fluidity and ability to transmit signals efficiently. Again, however, elevated homocysteine levels disrupt phospholipid metabolism, reducing the incorporation of DHA into cell membranes. This creates a vicious cycle where neurons become less resilient and more vulnerable to damage.

Speaker 0:

Homocysteine has been shown to interfere with the metabolism of amyloid beta plaques. Amyloid beta is a protein fragment produced when a larger protein called amyloid precursor protein is broken down in the brain. While it is naturally occurring, problems arise when amyloid beta accumulates abnormally, forming plaques between brain cells. These plaques can become toxic and disrupt communication between neurons. They also trigger inflammation and oxidative stress, leading to neuronal damage and cell death. B vitamins step in to break this cycle by lowering homocysteine levels, enabling the brain to effectively utilize omega-3s and actually omega-3 fatty acid intake has been shown to increase the expression of critical enzymes responsible for homocysteine metabolism.

Speaker 0:

One of the most compelling studies in this area is the VitaCog trial. That was a two-year randomized controlled trial involving 266 participants aged 70 years and older with mild cognitive impairment. This study investigated whether B vitamin supplementation, specifically 800 micrograms of folate, 20 milligrams of vitamin B6, and 500 micrograms of vitamin B12, could slow cognitive decline, and the results were striking. B vitamin supplementation slowed brain atrophy by up to 30% and participants with elevated homocysteine levels that's homocysteine levels over 11 micromoles per liter. However, the study revealed an important factor Participants with higher baseline omega-3 status experienced the greatest cognitive benefits. For instance, those with the highest levels of DHA showed significant improvements in verbal memory and global cognition, compared to those with lower DHA levels. In contrast, participants with low omega-3 levels derive little to no benefit from B vitamins. In this case, those with good omega-3 status had blood levels of greater than 579 micromoles per liter. This would be considered the upper range of normal. Another randomized trial supported these findings Participants who took B vitamins alongside DHA and EPA, the two primary omega-3 fatty acids. They saw slower progression from mild cognitive impairment to Alzheimer's disease. Those in the placebo group showed no such protection. However, the primary outcomes of that study were not meant to assess cognitive decline or the rate of cognitive decline, so that's just another interesting tidbit in the literature. These findings align with the broader literature on the neuroprotective effects of B vitamins and DHA. For instance, a 2016 review on B vitamins emphasizes their role as coenzymes in energy metabolism and DNA and RNA synthesis.

Speaker 0:

Deficiencies in folate and vitamin B12 are particularly linked to homocysteine levels, which again are implicated in neurogeneration, oxidative stress and impaired methylation capacity. The synergistic effects of these two classes of nutrients observed in the VITCog study highlight an important point no single nutrient operates in isolation. Optimal brain health requires a holistic approach that considers the interconnected roles of multiple nutrients, including folate, dha and the broader B vitamin complex. Based on current evidence, the combination of B vitamins and omega-3 fatty acids like DHA may offer greater benefits than either nutrient class alone. Foods rich in B vitamins include leafy greens, legumes and fortified grains. Animal proteins can be an excellent source of vitamin B12 and B6, while fatty fish like salmon and mackerel are excellent sources of DHA and EPA.

Speaker 0:

When considering supplementing, especially as it comes to omega-3s, if you are starting at an omega-3 index below 4% to get yourself into the desirable range, that being close to 8% and above 2,000 mg of EPA plus DHA daily for 4-6 months has been shown to help up to 90% of the general population reach an omega-3 index of 8%. I generally am a fan of high-quality omega-3 supplementation in most people, as the American Heart Association recommendation for omega-3 intake that being at least two servings of fatty fish per week, it only gives someone an approximate 10% chance of reaching a desirable omega-3 index value. As it comes to this topic, consistency and adherence over time is what matters most. Nutrition is one piece of the puzzle. Regular exercise, adequate sleep and cognitive engagement are all equally important for maintaining brain health. Thank you for tuning in to Daily Value. If you enjoyed this episode. Consider sharing it with someone who might benefit. Stay sharp and stay healthy.

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