We are progressing into an aging society where people live longer due to advancements in medical knowledge and technology, making it easier to diagnose and cure diseases.  However, living longer does not imply that your body is not aging and degenerating; and one of the unavoidable diseases that comes with age is dementia.  There is a lot of research on how to slow down brain degradation – whether through exercise, diet, or brain training.  In 2023, a study was conducted in the United States to gather information on people’s comprehension and beliefs about drugs or supplements that affected brain health in order to determine whether they knew if their medication or supplement was beneficial or harmful.  In the questionnaire, a selection of commonly used products included vitamin E, ginkgo, estrogen, fish oil, liver, statin, and sleeping pills.  Surprisingly, over half (46 – 64%) were unaware of whether such drugs or supplements were beneficial to the brain.  Worse still, 63 – 77% were unaware of side effects that such medicines would have on their brains.  It is remarkable to find also that up to 68% of the respondents were college graduates.  So, it is critical for us to be aware of the specifics of our medications or supplements and how they affect brain health, as well as to learn how we should care for our brain.

Brain Supplements

Most dietary supplements that are believed to have benefits for the brain include vitamin E, ginkgo, fish liver oil, and vitamin D.  However, from a review of researches and articles, there is clear evidence that vitamin E does not help prevent dementia or memory decline.  As for fish liver oil, ginkgo, and vitamin B, there is still little information; but indications are in the same direction, that they do not contribute to the prevention of dementia either.

Only vitamin B12, in combination with folic acid, has been shown to help improve memory.  However, its impact is not clinically significant. At the same time, drugs and supplements that are generally used for nourishing brain function – such as estrogen hormone, medications for diabetes, blood pressure, fat burners, or nonsteroidal anti-inflammatory drugs (NSAIDS) – have not been sufficiently studied to determine their effectiveness on the prevention of dementia.  Available information appears to similarly indicate that they do not prevent dementia.

Moreover, using some medicines unnecessarily may lead to serious side effects such as stroke, heart disease, breast cancer, or pulmonary embolism.  Thus, as there is no clear evidence to conclude that brain nourishment drugs can prevent dementia or brain impairment, these medications should be used in accordance with instructions; and you should always consult a doctor before using any of them to minimize its side effects.

In terms of supplements, there is insufficient information available on their clear benefits for dementia prevention.  However, there is no report of any serious or dangerous side effects from them either.  The fact that there is no clear evidence of benefits may be attributed to factors such as the types of supplement used, different brands, different population groups as well as their races.  As a result, some people who use supplements may experience both benefits and side effects.

Drugs and Brain Health

Various studies have shown that anticholinergic drugs have a clear negative impact on the brain, causing a decline in brain function.  In addition, earlier studies have shown that people who use drugs in the benzodiazepines group are at a higher risk of brain deterioration, but that the condition will improve after the medication is stopped.

However, new studies are now emerging to show that such risks may not be as obvious as previously known. This could be because the various researches used dissimilar parameters – such as the use of different brain function tests, different types of sleeping pills, the quantity of samples collected, or the length of the follow-up periods – making it unclear if consuming this group of sleeping pills impacted brain function.  Nonetheless, it has already been established that the group of drugs not only have negative impact on the brain function, it also increases the risk of a fall and bone fracture in older people especially.  For these reasons, you need to be careful when taking this type of medication, to avoid the high risk of undesirable side effects.

In conclusion, there is no definitive evidence that supplements or drugs can nourish your brain.  Importantly, some medicines actually cause more harm than good to your brain.

How to Nourish Your Brain against Degeneration

According to a 2017 research published in Lancet, there are 2 main preventive measures for brain deterioration, as follows:

1. Reduce Brain Injury and Inflammation
   This preventive measure focuses on controlling comorbidities such as diabetes, cholesterol, hypertension, and weight (BMI less than 25), as well as on quitting smoking.  These factors will reduce the risk of cerebrovascular disease/stroke and further brain injury.
2. Improve Brain Function
   There are many ways to improve your brain function: for example, social engagement, regular aerobic exercises, and cognitive training such as reading, calculating, learning new equipment or new items.  Some researches have shown that these approaches can delay and prevent cognitive decline.  Furthermore, these approaches – particularly exercises – are not harmful to your health; rather, they may have positive effects on other areas of the body.  In addition, if you are experiencing a problem with your hearing, you should have it addressed quickly; as hearing loss is also a risk factor for dementia. 

Mediterranean Food and Brain Health

There have been some studies on how the Mediterranean diet can help lower inflammation in the body and brain.  The most recent study, published in Alzheimer’s & Dementia Journal in April 2020, validated previous findings that this type of diet could indeed reduce the risk of dementia.  It further found that fish category of the Mediterranean diet could delay dementia progression as well.

Alcohol and Brain Health

It is quite clear from researches that excessive drinking is related to declined brain function.  People who drink moderately to excessively (more than 8 drinks/week) exhibit significantly worsen brain function.  However, for the group that drink minimally (less than 4 drinks/week), several studies found that alcohol consumption did not contribute to preventing mental impairment, but that it did have a substantial effect on preventing heart disease.

Importantly, several studies have found that, for people who used to consume large amounts of alcohol but are now drinking at minimal levels, their brain function improves as compared to those who continue to drink excessively. This is not to say that you should start drinking if you are not a drinker.  Rather, it is recommended that, if you are already a heavy drinker, you should reduce it to as low as possible (1 drink of about 360 cc of beer with 4 – 5% alcohol, or 150 cc of wine with 12% alcohol, or 45 cc liquor / whiskey with 40% alcohol).

Whether it is diet, medication, or enhancing the brain’s potential through various methods, it may not considerably delay the decline of brain function.  This is why studies have included all these options, namely diet, exercise, cognitive training, and controlling risks of vascular diseases – such as diabetes, hypertension, etc.   The conclusions are generally in the same direction, that these techniques contribute to minimizing brain degeneration.

To summarize, the simple methods to maintain your brain health are preventing brain injury and continuously improving brain function by avoiding brain-damaging medications, controlling comorbidities and weight (in accordance with BMI), quitting smoking, participating in social activities, preventing hearing loss, eating a balanced and healthy diet (such as Mediterranean food), and engaging in regular aerobic exercises 3 – 5 times per week.  That is all you need to do, to ensure optimal brain health and to prevent premature brain degeneration.

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