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High Dose B Vitamins and Alzheimer's Disease

There are no medications at this point that can slow the decline from cognitive impairment to Alzheimer's disease. A new study published in the Proceedings of the National Academy of Sciences offers some hope in supplementation with B vitamins. 156 elderly people with mild cognitive impairment, and high serum homocysteine levels, were given a combination of vitamin B12 (500 mcg), B6 (20 mg), and folic acid or a placebo over a two year period. The 80 subjects receiving the B vitamins showed significantly less brain degeneration than the placebo group. These B vitamins lower homocysteine levels in the blood. High homocysteine has been associated with a number of conditions, including neurodegenerative conditions. My recommendation would be to use folic acid in the form of 5-methyltetrahydrofolate, a better absorbed form of folic acid, especially in individuals with genetically impaired enzyme function. 

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Fish oil studies

The May 9, 2013 issue of the New England Journal of Medicine published a large Italian study that concluded that fish oil did not prevent cardiovascular disease or death from cardiovascular disease. The subjects in this study were given 1,000 mg of ethyl ester omega-3 fatty acids. The preferred form that the body recognizes as natural is the triglyceride form. So right here there are some issues. There also seemed to be more benefit from fish oil in women, although the researchers downplayed that effect. Previous studies have shown a benefit of omega-3 fatty acids, so while this study has been strong points, I wouldn't quit taking fish oil. I also think it is foolish to have just one intervention and hope to prevent heart disease. Quitting smoking, eating a healthy, plant-based diet with lean protein and healthy fats, and exercising at least 150 minutes per week are as important as taking fish oil. Eating fish is also healthy, but more than twice per week is not recommended because of mercury contamination found in fish. 

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Omega 3 Fatty Acids and Mortality

A study published in the April 2, 2013 Annals of Internal Medicine, showed a positive association between higher levels of serum omega-3 fatty acids and reduced risk of death, primarily from heart disease. While there are several weaknesses in the study, such as only measuring the serum omega-3 at the beginning of the study, there are some interesting points. The authors found that DHA was more important than EPA, two of the most talked about omega-3 fatty acids, in preventing cardiovascular death. The take home message here is to not just supplement with EPA (there is now even an EPA-only prescription drug), but to use a balanced formula. I like to include DHA, EPA, as well as GLA. Together they have a powerful anti-inflammatory effect. 

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Fruits, Vegetables, and Mortality

A Swedish study published in the American Journal of Clinical Nutrition August 2013 found that eating fruits and vegetables are associated with living longer for both men and women. Consuming fewer than 5 servings of fruits and/or vegetables per day is associated with shorter survival and higher mortality rates. Those who never consumed fruit lived 19 months less than those who ate at least one fruit per day. On the vegetable side, those who consumed 3 vegetables per day lived 32 months longer than those who never consumed vegetables. 

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High Intensity Exercise and Overweight Men

The International Journal of Obesity published a study in June 2013 that looked at the effect that various intensities of exercise have on appetite in overweight sedentary men. Continuous moderate intensity exercise did not suppress appetite. However both high intensity intermittent exercise and very high intensity intermittent exercise suppressed appetite, even up to 38 hours later. They found that the overweight men tolerated the high intensity intermittent exercise very well. While most doctors would recommend that you start an exercise program more moderately, this shows that for weight loss, it is necessary to build up to high intensity intermittent exercise, such as interval training. 

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Breast Cancer and Fish

The July edition of the British Medical Journal has a large meta-analysis looking at fish, fish oil consumption and the risk of breast cancer. All in all the examined data covering 20,905 cases of breast cancer and 883,585 participants. Their conclusion was that a higher consumption of omega-3 fatty acids (found in fish and fish oil) was associated with a lower risk of breast cancer. They found this to be true in both studies that looked at dietary consumption and in studies that looked at omega-3 blood levels. Because so much fish is contaminated, it is a good idea to limit one's fish intake to twice a week and then supplement with a high quality fish oil that mimics the natural form of fish oil (not the prescription fish oil). 

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