Folic acid for stroke – and to remember

June 12, 2007

You must remember your folic acid, otherwise you forget it.
This sounds like nonsense, but its not.

Folic acid helps keep the brain in good shape, and if you don’t get enough you might have problems thinking clearly and remembering when you get older.

Folic acid is the vitamin that fertile women should take (0.4 mg per day) unless they are 100% sure that they will not become pregnant. Far from all do this, even though folic acid prevents children from being a lifelong invalids due to spinal chord herniation (spina bifida) and reduces the risk of cleft lip and palate! That it is preventative is so called new knowledge (1) which is to say that it was pointed out, but ignored, over twenty years ago.

But folic acid also helps the memory and thought ability. Who do we know this? The English neurologist Edward Reynolds demonstrated it 40 years ago in hi article in The Lancet. He showed that 26 epilepsy patients who suffered folic acid deficiency due to their medicine improved when they received folic acid (2). This has since been forgotten.

Now there are new studies. One had negative results. Its authors concluded that folic acid has no effect on cognitive function, which did not improve for study participants who received 0.4 mg folic acid daily (without vitamin B12, in which they were mildly deficient) (3).

There is a simple explanation for this: the only lasted 24 weeks. This is not long enough, which will be explained below, but first a couple of other results.

An issue of the American Journal of Clinical Nutrition from last February included an article which outlined that the more pronounced folic acid deficiency in elderly people, the poorer (statistically) their cognitive function. The likelihood of decreasing cognitive function was more than doubled in those with a deficiency of folic acid (4). There are many people with folic acid deficiency because folic acid is primarily found in liver and leafy vegetables, which many people push to the side if their plates.

20% fewer strokes
Lack of folic acid is shown roughly by finding increased blood levels of the substance, homocysteine. It is an amino acid which is poisonous to the blood vessels (among other things) and which is believed to lead to atherosclerosis, but that the body nonetheless creates. Normally it is neutralised in part by folic acid. If you lack folic acid, you homocysteine levels rise.

A link between lowered cognitive function and homocysteine has been shown in Sweden (5). There it was shown that elderly people with documented memory problems often had high levels of homocysteine. This was only true with the poor memory was found along with atherosclerosis, which homocysteine is believed to promote!

In addition, Dutch researchers recently showed in a randomised trail that a supplement of folic acid (o.8 mg daily) for 50 – 70 year olds not only reduced their levels of homocysteine, but also statistically improved the “brain functions which have a tendency to decline with age.” Memory, reaction time, and the ability to speak quickly and fluently were bettered. The study lasted for three years, which is a necessary time period (6).

If that is not enough, a comprehensive study of eight randomised studies has recently shown that the risk of stroke resulting from atherosclerosis generally is reduced by 20% when taking folic acid supplements. The studies which lasted longer than three years showed the best results. Participants who had already had a stroke were less protected and if those who were lucky enough to live in a country where food is enriched with folic acid (USA, Canada) showed fewer effects.

We should remember our folic acid. The daily dosage should be between 0.4 and 0.8 mg daily.

By: Vitality Council

 

References:
1. Bille C et al. Folic acid and birth malformations. BMJ 2007;334:433-34.
2. Reynolds E. Folate and aging. Lancet 2007;;369:1601.
3. Eussen SJ et al. Effect of oral vitamin B12 with or without folic acid on cognitive function in older people with mild vitamin B-12 deficiency: A randomized, placebo-controlled trial. Am J Clin Nutr 2006;84(2):361-70.
4. Haan M et al. Homocysteine, B-vitamins, and the incidence of dementia and cognitive impairment: Results from the Sacramento area latino study on aging. Am J Clin Nutr 2007;85:511-7.
5. Nilsson K et al. Plasma homocysteine is elevated in elderly patients with memory complaints and vascular disease. Dement Geriatr Cogn Discord 2007;23(5):321-6.
6. Durga J et al. Effect of 3-year folic acid supplementation on cognitive function in older adults in the FACIT trial: A randomised double blind controlled trial. The Lancet 2007;369:208-16.
7. Xiaobin Wang et al. Efficacy of folic acid supplementation in stroke prevention: a meta-analysis. The Lancet 2007;369:1876-82.

www.bmj.com
www.thelancet.com
www.ajcn.org

Summer sun prevents multiple sclerosis

April 10, 2007

Still more supports the theory that vitamin D can prevent multiple sclerosis. Enjoy the sun while its there.

Multiple sclerosis (MS) is a feared disease. Many believe that sclerosis is synonymous with a life in a wheelchair, and many have heard about tragic examples of how the disease can progress. It is worth remembering that even 20 years after the emergence of the disease, 75% of patients can walk unaided. Also, the death rate for those suffering from sclerosis is not much higher than that of the rest of the population.

On the other hand, MS affects especially younger people, primarily women. It is disquieting that the frequency of this disease has increased in the last 50 years and continues to increase. Over 80,000 people in the UK suffer from MS, which at a prevalence of over 140 people per 100,000 the highest in the industrialised world.

MS is an “autoimmune” disease, which is to say a disease where the body’s immune system turns against the body itself. In the case of MS the so called myelin sheaths which coat and isolate the nerves are attacked. On average, every fourth person with MS also suffers from another autoimmune disease, for example psoriasis, arthritis, or metabolism diseases.

Can one prevent MS? It is tempting to have this thought when one notices the enormous geographic variations. In England, Denmark, Norway, Sweden, Finland, Germany, and Canada the frequency is about the same. In Greece and Turkey it is about half as common while in northern Spain and Italy the frequency lies in between that of these areas.

These and other figures support a growing belief that MS has something to do with lack of sunlight; or more accurately, lack of vitamin D, of which the sun is the most important source. Vitamin D has in studies prevented an experimental form of MS (EAE, Experimental Autoimmune Encephalitis). In countries north of a latitude of 42, corresponding to Corsica, the sun is so low during the winter months that vitamin D practically cannot be produced in the skin. The result is widespread vitamin D deficiency.

Less than half the risk
Researches from Harvard University among others analyzed the problem in more detail. They studied 257 blood tests from military personnel who contracted MS between 1992 and 2004. The blood tests were taken and frozen before these people became sick. The question was whether they had remarkably little vitamin D in their blood when compared to people who did not contract MS.

It was shown that they did. 25-OH-D, the best measure for vitamin D status, was measured in both the sick and a large number of healthy people who were randomly chosen from 7 million personnel. It was found that “high circulating levels of vitamin D are associated with a lower risk of multiple sclerosis.” Low vitamin D levels were especially risky for people under 20 years of age.

How much vitamin D is enough? When the level of 25-OH-D was at least 99 nannomol/litre serum, the risk of MS was the lowest at about 40% average. The difference was statistically certain. For comparison, levels under 50 are indicative of insufficient levels of vitamin D. Such values can be found in most people during the winter.

The theory that vitamin D prevents MS is thus strengthened. One should attempt to distance oneself from vitamin D deficiency. This is easy during the summer, but from October to April it requires, for the majority of those in our latitudes, supplements.

By: Niels Hertz MD

References:
1. Munger L et al. Serum 25-Hydroxyvitamin D levels and risk of multiple sclerosis. JAMA 2006;296:2832-2838.
2. MS prevalence data for selected countries: http://www.mult-sclerosis.org/prev_tab.html
3. Newsletter from Vitalrådet dec. 27. 2006

jama.ama-assn.org

Fish oil is good for the heart and the brain

August 21, 2006

There is no doubt that fish oil is good for the heart. This has been shown by a new extensive survey on the subject. But no one knows how much is ideal.

The scientific interest for fish oil is enormous. Since September of last year, almost 800 articles about fish oil have been publicised in established journals.

This is with very good reason. Notably, fish oil contains two types of fatty acid, both of which are attributed with having a positive effect against many serious chronic diseases. If this is even in part true, it should be considered very imprudent not to receive fish oil every day. The primary disease that it is believed to prevent is cardiovascular disease, but there is also good reason to believe that fish oil works against, for example, depression, dementia, arthritis, and diabetes, even though there is no concrete evidence as of yet in these areas.

The two fatty acids are called EPA (eicosapentic acid) and DHA (docosahexaenoic acid). Together they compose one third of the contents of fish oil and two thirds of the concentrated fish oil products, which can be found in capsule form.

Much attention has been given to DHA which, contrary to EPA, is found in large amounts in the brain (14% of the cerebral cortex’s fat content) and in even greater amounts in the retina (22%). Breast fed children have much higher concentrations of DHA in their brains than bottle fed children (babies cannot produce DHA themselves). It is hard to believe that there are no consequences of receive too little.

There are an incredible number of adults who take supplements of fish oil daily to maintain their cardiac health.

But does it work?

Six months ago a group of English researchers maintained that it does not. They had looked at all of the relevant studies and then calculated the averages of their results. In their opinion, the results showed that fish oil neither protects the heart nor lengthens life span. This is just the opposite of what was previously believed.

This meta-analysis was strongly criticized and, as discussed in another of The Danish Vitality Council’s newsletters (“Fish Oil – Still indispensible”) there were so many question raised by the analysis that it lacked credibility.

Doubts regarding the dosage
This is now supported by a summary article from the distinguished American Journal of Clinical Nutrition. According to the head authors, a group of researchers undertook an extensive survey, taking “a large step forward” in spreading light into the darkness. There is no longer much doubt that fish oil reduces the overall risk of premature death and the risk of death due to a blood clot in the heart, and that it possibly reduces the risk of stroke.

Completing this survey was an extensive project. The researchers first read summaries of 8,039 scientific articles. They then picked 842 relevant articles from these to be read in their entirety. 46 articles of these 842 met the strict quality requirements and were studied further. The researches requirements regarded the length of the studies (at least one year), the dose of the fish oil given, and proper documentation.

How big are the advantages and how much fish oil should one take? This actually cannot be answered with certainty! The studies surveyed were too different regarding the dose given, the type of participants, the time taken, and so on to answer such questions. It is simply bad form to establish any averages, as the English researchers did. But if one wants to draw conclusions anyway, it is safe to guess that the overall risk of premature death and the risk of death due to cardiac disease can be reduced by 15-20% or more.

It is however nearly certain that fish oil helps those who have had a blood clot in the heart and wish to avoid another. But what about the dose, how much should one take?

Until more information surfaces, we should rely on the American Heart Association’s recommendations, which are based on estimates. Heart patients should receive 1 gr. EPA + DHA daily. This is the equivalent of about two large capsules of 1 gr. concentrated fish oil. Everyone else should receive at least half this amount. This can be achieved by eating fatty fish for dinner 1-2 times weekly.

There is a lot of knowledge lying in wait, not just about fish oil and the heart. More results will surface in the next year. While we wait we wait in the knowledge that it is important to get enough.

By: Vitality Council

References:
1. Wang C et al. n-3 fatty acids from fish or fish-oil supplements, but not á-linolenic acid, benefit cardiovascular disease outcome in primary- and secondary-prevention studies: A systematic review. Am J Clin Nutr 2006;84:5-17.
2. Deckelbaum R et al. n-3 fatty acids and cardiovascular disease: navigating toward recommendations. Am J Clin Nutr 2006;84:1-2.
3. Distribution, interconversion, and dose response of n-3 fatty acids in humans. Am J Clin Nutr 2006;83(suppl):1467S-76S.

www.ajcn.org

Alzheimer’s disease: The third diabetes

May 4, 2006

According to a revolutionary theory, Alzheimer’s is caused by diabetes in the brain. The theory throws light on the need for antioxidants.

It has been one hundred years since the discovery of Alzheimer’s disease. Alzheimer’s is the most severe disease of dementia, and many of us will suffer from it if we become old enough. Those who get Alzheimer’s suffer from an unavoidable dementia which worsens until they loose contact with reality entirely. The brain shrinks and the spaces between the brain cells become filled with a peculiar substance called amyloid. A network of fibres is produced within the cells, decreasing the strength of the chemical signals that the cells use to communicate.

The medical treatment for Alzheimer’s is currently nothing to get exited about. Its function is to strengthen the chemical signals between the cells, but its effects are few. Now, one hundred years after the disease’s discovery, a surprising new theory has paved the way for new possibilities in the treatment of Alzheimer’s. According to the theory, Alzheimer’s is nothing more than a type of diabetes! The theory has such strong foundations that some already call Alzheimer’s “type 3 diabetes.”

Diabetics should not be alarmed by this find. Type 3 diabetes is in no way connected with either insulin requiring type 1 diabetes or the so called old age diabetes, type 2 diabetes. Type 3 diabetes only shows itself in the brain. How does it get there?

The explanation is simple when one knows a few facts about diabetes and insulin: With classic diabetes one lacks insulin, which is normally produced in the pancreas. This is unfortunate because insulin is necessary for the sugar I the blood to enter the cells, where it can be used for energy. The brain is especially dependent on insulin, because it can only metabolise blood sugar (fructose and glucose), not fat as in other tissues.

Therefore the brain needs insulin. But where does it get it? The new theory is based on new knowledge. The brain makes its own insulin! This occurs in the temporal lobes and in deep lying areas of the brain, namely the hippocampus and the hypothalamus. Insulin produced in the brain only affects blood sugar locally as it cannot leave the brain. Likewise, insulin produced by the pancreas cannot enter the brain. One can thus have diabetes in the brain without having it in the rest of the body and the reverse.

Q10 protects the brain
Multitudes of data have shown that there are signs of defect in the brain’s sugar metabolism already in the early stages of Alzheimer’s. Is this due to type 3 diabetes, seen as a lack of insulin and therefore sugar within the cells? A solid argument for this new theory is based on a recent animal study where the effect of insulin in the brains of the animals was blocked chemically by an injection of a special insulin toxin (streptozotocin). The animals not only became demented due to the resulting brain diabetes, but also produced fewer neurotransmitters, produced deposits of amyloid, and produced fibres within the nerve cells; just like one finds in Alzheimer’s.

Alzheimer’s could thus be the result of the brain lacking the energy it needs to perform its functions. According to a very prominent researcher in this field, Suzanne de la Monte from Brown University, lack of insulin in the brain causes the production of free radicals (causing oxidative stress) because the weakened cells cannot neutralize them because, for example, they cannot produce the necessary enzymes. The amassed free radicals cause the amyloid deposits, and fibre formation, and so on. They also kill the brain cells.

But if the free radicals are the central reason for the nervous damage, antioxidants should help. Is this the case? Yes; in another recent animal study utilizing the same insulin poison, the animals (rats) were given large doses of Q10 for three weeks following the injection of the poison. The treated animals were much better off in all of the subsequent tests. Their brain cells produced more energy, they were better able to find their way in a labyrinth, and they produced more signalling chemicals in their brains.

It is not unreasonable to mention here that there have been many studies which have shown that long time users of vitamins C and E have a considerably reduced risk of getting Alzheimer’s; or that there is a statistical link between low blood levels of selenium and the quick development of dementia. Vitamins E and C, as well as selenium and Q10, are antioxidants.

Is this comparison valid? This can be considered; studies using human subjects will take shape in the coming years.

By: Vitality Council

References:
1. Ishrat T et al. Coenzyme Q10 modulates cognitive impairment against intracerebroventricular injection of streptozotocin in rats. Behav. Brain Res. 2006; Apr 16;(Epub ahead of print)
2. Lester-Coll N et al. Intracerebral streptozotocin model of type 3 diabetes: Relevance to sporadic Alzheimer disease. J Alzheimers Dis. 2006;9:13-33.

Vitamin B12 And Folic Acid Reduce The Risk Of Blood Clots In The Brain

October 31, 2005

After Americans enriched their diet with folic acid in 1996, the frequency of blood clots in the brain was reduced by 15%. Now research shows that added supplementation of Vitamin B12 will markedly lower this risk even further.

Immediately, it sounds simple: People with high levels of the amino acid homocysteine in the blood have an increased risk of blood clots in the brain and in the heart. You also know that you can lower homocysteine with folic acid and, to a lesser extent, with B6 and B12 vitamins. When the Americans began to enrich cereal products with folic acid from 1996, both the average American’s homocysteine and the rate of blood clot in the brain decreased by about 15% in three years.

“The money fits”, and then the result is almost obvious in advance, if you want to conduct a lottery experiment, where every other participant gets folic acid, B6 and B12 vitamins. Of course, they get fewer blood clots in the brain.

But the reality is more varied. In Norway, such an experiment (NORVIT) was conducted with 3,750 patients who had just survived a blood clot in the heart. For 3.5 years, they were supplemented with either folic acid (0.8 mg), vitamin B6 (40 mg), both or blind tablets (placebo). Among those who only received folic acid, mortality decreased approx. 10%, but not statistically certain. But in the other two groups the death tolls were increased, not statistically certain either.

Perhaps it is too late to start taking supplements when you are already severely calcified. Or, as will appear, perhaps it was more decisive that the Norwegians “forgot” to give the participants vitamin B12.

An experiment has also been carried out in the USA (VISP). It was with people who had recovered from a blood clot in the brain, but had an increased risk of a new one. Admittedly, the Americans did not initially find any effect either. Supplementation of folic acid (2.5 mg), vitamin B6 (25 mg) and vitamin B12 (0.4 mg) did not reduce or improve mortality or risk of blood clots in the brain. Therefore, the experiment was simply stopped after two years. It was useless, they thought.

B12 is useful if it is absorbed
A close explanation could be the aforementioned enrichment of cereal products with folic acid. After all, the average homocysteine had already fallen by approx. 15% in the Americans. During the trial, it only dropped a further 2%.

But the Americans have since studied the numbers more closely. In doing so, they discovered one important source of error in particular: Many of the 3,680 elderly participants had reduced absorption of vitamin B12 from the gut and therefore had relatively little B12 in their blood (less than 250 pmol/l). This is often seen in the elderly, and it is now known that these elderly need supplements of at least 1,000 micrograms of vitamin B12 per day. But the participants had only received 400.

What would it look like if you now disregarded these participants and concentrated on those with normal B12 uptake? It was decided to investigate. At the same time, participants with reduced kidney function were disregarded, as they also respond sluggishly to these supplements. Finally, participants who were previously receiving medical treatment with B12 were naturally disregarded.

There remained 2,155 people who had no problems absorbing B12. In this large group, the supplements both lowered homocysteine further and reduced the overall risk of death, blood clot in the heart or blood clot in the brain – by 21%! The treatment helped anyway; even a lot when the ability to absorb B12 was intact.

As stated, it appears that the fortification of cereal products with folic acid has reduced the Americans’ risk of blood clots in the brain by approx. 15%. Now it seems that a solid supplement of vitamin B12 on top of that can reduce it significantly more – but the many elderly people, who absorb vitamin B12 poorly, presumably need larger supplements.

This is the result at the moment. It must be verified before it is approved. But the indications are there.

By: Vitality Council

References:
1. Toole JF, et al. Lowering homocysteine in patients with ischemic stroke to prevent recurrent stroke, myocardial infarction, and death: the Vitamin Intervention for Stroke Prevention (VISP) randomized controlled trial. JAMA. 2004 Feb 4;291(5):565-75.
2. Bonaa KH. NORVIT: Randomized trial of homocysteine-lowering with B-vitamins for secondary prevention of cardiovascular disease after acute myocardial infarction. Program and Abstracts from the European Society of Cardiology Congress 2005; September 3-7, 2005; Stockholm, Sweden. Hot Line II. Iflg. Linda Brooks. NORVIT: The norwegian vitamin trial. Medscape sept. 2005. (Ikke publiceret i trykt medie)
3. Spence DJ et al. Vitamin intervention for stroke prevention trial. An efficacy analysis. Stroke 2005;36:2404-2409.

jama.ama-assn.org
www.medscape.com
stroke.ahajournals.org
www.iom.dk

Children Get Smarter From Taking Fish Oil

October 24, 2005

The omega-3 fatty acid DHA in fish oil is an important building block for the brain. DHA deficiency in the first years of life may impact the normal development of the child’s brain.

Are children getting smarter from eating fish? Recent studies suggest that fatty acids in fish oil can help certain children with ADHD or dyslexia. But what about infants?

From the last third of fetal life to the end of the second year of life, children’s brains grow so strongly that one speaks of a brain growth spurt. During this period, a lack of a number of vital nutrients, such as fish oil, will affect brain function. The American Journal of Clinical Nutrition recently published a comprehensive review of what is known about fish and young children’s brains.

As a starting point, it is known that the polyunsaturated n-3 fatty acid DHA (docosahexaenoic acid) is highly concentrated in the cell walls of nerve cells. DHA is one of the two important n-3 fatty acids in fish oil. The other is EPA (eicosa-pentaenoic acid). EPA can be converted to DHA, and to a certain extent they can both be formed from the n-3 fatty acid alpha-linolenic acid in e.g. linseed oil.

But does it form enough in a child who is not breastfed or gets oily fish? The question is relevant. It is known that breast-fed babies have up to 40% more DHA in the brain’s gray matter than bottle-fed babies. In addition, it is known that young animals and probably also infants, even if they are neither near-sighted nor far-sighted, will see a little less sharply if they lack n-3 fatty acids. The significance of this is debated.

The importance of DHA has been investigated e.g. by comparing bottle-fed babies with breast-fed babies who got DHA from breast milk. Bottle babies have also been compared with other bottle babies who have received n-3-enriched formula. The children have been tested for intellectual and motor development, attention, etc.

Greater attention
In these kinds of experiments, it has been shown that breast-fed babies fare slightly better on average than bottle-fed babies. But is the difference due to DHA? Nursing mothers may function slightly better than non-nursing mothers, and may have better social relationships, etc. When you correct for this, the differences diminish. Furthermore, there are many other differences between milk substitute and mother’s milk other than the DHA content.

It becomes somewhat clearer when you compare bottle babies, where only half receive extra n-3 supplements. Here the results have been mixed, but on one point a difference has been seen quite consistently: Infants who receive n-3 supplements have a greater capacity for visual attention, i.e. to follow the things they see. This important result has also been obtained in experiments with monkeys.

In animal experiments with rodents, the clearest differences have been found. This is due, among other things, to the fact that these experiments can be set up, so that the difference in brain DHA becomes particularly large. Animals that are starved of n-3 fat become less agile, find it harder to find their way around a maze, etc. Even if there are only minor differences in brain DHA, the animals that do not get fish oils are weakened. Roughly speaking, this is what is known.

So what can be concluded? The authors do not claim that children should demonstrably have n-3 supplementation during the brain spurt. But they claim, after sifting through 258 scientific papers, that the need cannot be ruled out.

– Small differences in brain DHA, which most likely occur between bottle-fed babies with and without n-3 supplementation, may have effects that are currently difficult to detect but could be important, it says. Or to put it more simply: Remember to give babies and toddlers fatty fish or fish oil! They seem to be getting wiser from it.

By: Vitality Council

Reference:
Mc Cann J C, Ames, Bruce N. Is docosahexaenoic acid, an n-3 long chain polyunsaturated fatty acid, required for development of normal brain function? An overview of evidence from cognitive and behavioural tests in humans and animals. Am J Clin Nutr 2005;82:281-95

www.ajcn.org
www.iom.dk

Vegetables And Dietary Supplementation Protect Against Alzheimer’s

August 30, 2005

Elderly persons who get adequate amounts of folic acid have a 55% reduced risk of getting dementia induced by Alzheimer’s disease, says an American study.

Lack of the B vitamin folic acid is probably the most common deficiency in Denmark. Too few people manage to chew the 2-300 grams of green vegetables that are needed every day if they want the recommended 0.3 mg from the diet. In the United States, 0.4 mg is recommended, but here grain products are legally enriched with folic acid.

By: Vitality Council

References:
1. Corrada MM. et al. Alzheimer’s & Dementia. 2005;1:11-18.
2. Fuso A. et al. S-adenosylmethionine/homocysteine cycle alterations modify DNA methylation status with consequent deregulation of PS1 and BACE and beta-amyloid production. Mol Cell Neurosci. 2005 Jan;28(1):195-204.
3. Quadri P. et al. Homocysteine, folate and vitamin B12 in mild cognitive impairment, Alzheimer disease aqmd vascular dementia. Am J Clin Nutr 2004,80:114-22

www.sciencedirect.com/science
www.ajcn.org
www.iom.dk

Carnitine, a Stimulant for Heart, Brain, and Muscles

May 9, 2005

Carnitine creates energy in aged cells. The message from a new scientific congress is that supplementation of carnitine seems to help against both heart disease, arteriosclerosis, and dementia.

Are your memory failing or are you loosing strength, then perhaps carnitine is the remedy for rescue

Carnitine is an – undeservedly – overlooked dietary supplement that is on its way into the ‘scientific warmth’. A clear signal is that the New York Academy of Sciences dedicate a whole volume of its famous scientific annals to carnitine alone.

Here you can read more than 197 pages from all 18 contributions given at a two-day conference on carnitine held by the academy in March 2004. The contributions are, among other things, about the importance of carnitine for the burning of fat, for the functioning of the muscles and the heart and about its promising role in the fight against a weakened memory.

………………………

By: Vitality Council

Reference:
Salvatore Alesci et al. (Eds.). Carnitine: The Science behind a Conditionally Essential Nutrient. Annals of The New York Academy of Sciences 2005, vol. 1033.

www.annalsnyas.org
www.iom.dk

Fish Oil Prevents Stroke

April 25, 2005

Many believe that fish oil protects against stroke, but French researchers have now discovered how this works. Fish oil helps the brain to better cope with a reduced blood supply.

Fish oil must be close to being the world’s best medicine. If you get fatty fish two to three times a week, you protect yourself against suddenly suffering cardiac arrest. The risk is halved. But also the risk of a blood clot in the brain – by far the most frequent cause of so-called cerebral hemorrhage – and thus suffering a stroke, decreases. According to the largest, but not final study, so far, it is reduced by 40%.

It is consistent with animal research. Mice that are artificially exposed to a blood clot in the brain get less extensive brain damage if they in advance are fed with fish oil. Now French scientists have proven a mechanism that might explain this phenomenon.

Scientists from France’s National Science Research Center, CNRS, are behind the discovery. They have shown that the protection of the brain cells is due to the effect of fish oil on the cell’s potassium channels.

…………………………

By: Vitality Council

References:
1. Heurteaux, C et al. TREK-1, a K(+) channel involved inneuroprotection and generaql anesthesia. EMBO J. 2004, E-pub 2004, June 03.
2. Lauritzen, I et al. Polyunsaturated fatty acids are potent neuroprotectors. EMBO J 2000;19:1784-93.
3. Ka He et al. Fish consumption and risk of stroke in men. JAMA 2002;288:3130-6.
4. Salachas, A., et al. Effects of low-dose fish oil concentrate on angina, exercise tolerance time, serum triglycerides, and platelet function. Angiology, Vol. 45, December 1994, pp. 1023-31.

embojournal.npgjournals.com
jama.ama-assn.org
www.springerlink.com
www.iom.dk

Deficiency in B-vitamin Causes Dementia

April 18, 2005

According to one American study, folic acid weakens the memory of the elderly. According to another study, the opposite happens. Nearly all studies, however, indirectly indicate that folic acid prevents both arteriosclerosis and dementia.

It is a well-known fact that the B-vitamin folic acid prevents congenital neural tube defects. However, it can also lower the blood’s content of homocysteine; a biproduct in human metabolism that promotes atherosclerosis, among other things. Having an increased level of homocysteine is just as dangerous as cholesterol: Up to 40% of all individuals with premature atherosclerosis have increased blood levels of homocysteine.

The fact that homocysteine also damages the brain is indicated by more than 20 different studies. It has been found with almost unerring certainty that demented old people have more homocysteine in their blood than others and that the ones who score highest on memory tests are the ones with the least homocysteine in their blood. This is a clear argument for taking folic acid.

However, completely unexpectedly, a fly in the ointment has now appeared. A study at Rush University in Chicago has shown that the exact opposite might be the case. If you are elderly and you get more than the typical 0.4mg. of folic acid a day, your memory will decline more rapidly.

A total of 3,718 trial subjects over 65 years of age were followed for five to six years after having reported their eating habits. They were then mentally tested three times during the course of the 5 – 6 years. The results were the same whether they got folic acid from their diet or from dietary supplements: In the people taking folic acid, memory declined more rapidly than in the others.

Are these results the result of a coincidence? Anyhow, it does make you wonder that the 20% who got the most folic acid (0.7 mg. a day) did far better on the mental tests than the rest. Granted, their memory deteriorated more rapidly, but they obviously had a better memory to begin with. Why was that so, if folic acid is actually harmful?

In addition to this, doctors from the UCLA in February 2005 published results stating the exact opposite. Among 499 well-functioning 70 – 79 year-olds, most folic acid was found in the blood of the ones who had the best memory. And equally importantly: Seven years later, they were in better posession of all their faculties.

No explanation
What is true, then? If the truth lies in the Chicago study, it might be based on the co-operation between vitamin B12 and folic acid. Both vitamins reduce blood levels of homocysteine and the major task of both of them is to produce small, chemical units – which only contain a single carbon atom – for building other molecules.

Folic acid delivers its units to vitamin B12 which are then further delivered to – homocysteine. In this way, homocysteine is neutralized and is transformed into a harmless amino acid and the blood level of homocysteine will drop.

Whether you lack vitamin B12, folic acid, or both, the transport of the single-carbon units will be complicated. In all three cases, the result will be a specific type of anaemia (pernicious anaemia) which is characterized by the red blood cells being abnormally large.

However, the symptoms in vitamin B12 deficiency and folic acid deficiency are not quite similar. In folic acid deficiency, neuritis – i.e. nerve damage – will not occur. In vitamin B12 deficiency, it will. The anaemia in vitamin B12 deficiency can be removed by taking folic acid, but the neuritis cannot. Vitamin B12 has an affect on nervous tissue that folic acid cannot imitate.

In up to 30% of all elderly people, vitamin B12 deficiency can be demonstrated. Imagine large amounts of folic acid enhancing the B12 deficiency in the nervous system by blocking the small amounts of vitamin B12 with single-carbon compounds. This could correlate to another finding in the Chicago study: Memory declined by 25% less in the ones with the largest consumption of vitamin B12.

The leader of the study, Martha Clare Morris, believes that folic acid might mask the very common vitamin B12 deficiency in the elderly. This is more or less the same thing. In both cases, the consequence should be that the elderly get more vitamin B12 and not less folic acid which can have a protective effect in other areas.

This is the message – that is if you do not choose to believe that the new finding is a coincidence and that the truth is the exact opposite – which is actually also quite likely!

For the time being, however, Morris’ conclusion is simple: “We don’t know yet what is going on,” she says.

Up to every third elderly person may have demonstrable signs of mild vitamin B12 deficiency. If the results of the Chicago study are truthful, elderly persons possibly should not reduce their folic acid intake but rather focus on getting enough vitamin B12.

By: Vitality Council

References:
1. Morris MC et al. Dietary folate and vitamin B12 and cognitive decline among community-dwelling older persons. Arch Neurol 2005;62:641-5
2. Austin RC et al. Role of hyperhomocysteinemia in endothelial dysfunction and atherthrombotic disease. Cell Death and Differentiation 2004;11:S56-S64
3. Morris MS. Homocysteine and Alzheimers disease. Lancet Neurol 2003;2:425-8
4. Kado DM et al. Homocysteine versus the vitamins folate, B6, and B12 as predictors of cognitive function and decline in older high-functioning adults: Mac Arthur Studies of Successfull Aging. Am J Med 2005;118:161-7
5. Garcia A et al. Homocysteine and cognitive function in elderly people. CMAJ, Oct. 12, 2004; 171 (8).

archneur.ama-assn.org
www.nature.com/cdd/index.html
www.thelancet.com
www.sciencedirect.com
www.cmaj.ca
www.iom.dk