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19 April 2015 - Express - Supplements can halt Alzheimer's in groundbreaking dementia prevention treatment

Lucy Johnston

FAB RESEARCH COMMENT:

FAB Research spoke to Dr Jernerén about the VITACOG trial and the recent publication: FAB Research: Dr Jernerén, could you please give us some background on the previous VITACOG studies, and how your recently published work builds on this?

Dr Jernerén: VITACOG is a randomised placebo-controlled trial conducted in Oxford, with the aim of investigating the effect of treating elderly (over 70 years) suffering from Mild Cognitive Impairment with high doses of B vitamins for 2 years on brain atrophy rates and cognitive performance. The first paper on VITACOG was published in 2010, showing an average 30% reduction of brain atrophy rates in subjects treated with B vitamins, compared with the placebo group.  

In our recent paper, we show that the beneficial effect of B vitamins in VITACOG is dependent on circulating levels of omega-3 fatty acids (“fish oils”).

FAB Research: Could you please summarise the main findings of your recently published research for us?

Dr Jernerén: In our most recent publication on VITACOG, we describe an interaction effect between the B vitamin treatment and circulating levels of omega-3 fatty acids on brain atrophy. The higher the baseline concentration of combined omega-3 fatty acids (DHA and EPA), the greater the protective effect of the B vitamin treatment on brain atrophy.  

In subjects with high omega-3 status, B vitamin treatment reduced brain atrophy rates by 40%.  In subjects with high omega-3 status, who also had high homocysteine levels at baseline (indicating insufficient B vitamin levels), the B vitamin treatment reduced brain atrophy rates by almost 70%.  Interestingly, B vitamin treatment had no protective effect in subjects with poor omega-3 status.

FAB Research: Could you briefly explain what homocysteine is and why it is an important biomarker?

Dr Jernerén: Homocysteine is an amino acid synthesised from methionine.
The homocysteine level is to a large degree regulated by the combined effects of three B vitamins: Vitamin B12, vitamin B6, and folate (sometimes referred to as vitamin B9).
A high homocysteine level can therefore be seen as an indicator of insufficient B vitamin status.

FAB Research: Based on your findings, can there be one treatment or nutrient solution for all patients with Mild Cognitive Impairment? 

Dr Jernerén: No, I don’t think we’ll be able to find treatment that fits all.
If there is one thing our research highlights, it is the importance of understanding the underlying deficiencies and the nutrient status of a patient in order to recommend the optimal treatment. But in order to do that, hospitals need to be able to offer the relevant tests. Tests for homocysteine, for example, are offered in many countries.  But unfortunately, it is not normally offered by the NHS.

FAB Research: Please give our readers a recommendation regarding Vitamin B and Omega-3 supplements and tests which should be done before taking supplements. 

Dr Jernerén: 
Ideally, both homocysteine and omega-3 status should be tested before deciding whether supplementation is necessary. Unfortunately, these tests aren’t readily available through the NHS. Nevertheless, it is important to discuss these issues with a physician before stating taking supplements, as these supplements may cause side-effects in certain populations, and may interact with other drugs.

For more information on this subject, please see: 

Other publications from OPTIMA and VITACOG can be found here:

Please also visit our bookstore for more literature on Healthy Eating to Reduce the Risk of Dementia

The research has excited health experts worldwide and could lead to new public health advice on the treatment of early stage dementia using nutritional supplements.

Researchers analysed people over 70 who had memory problems. They found brain atrophy was slowed by 70 per cent in patients who had high levels of these nutrients.

Oxford professor David Smith, who lead the study, said: “This is a very exciting and important result. It is the first treatment to show Alzheimer’s related brain shrinkage can be prevented. It means that something so simple as keeping your omega-3 levels high and supplementing B vitamins if you are at risk could dramatically reduce a person’s risk.”

Researchers analysed MRI scans in 168 patients with early signs of dementia and measured the shrinkage of their brains over 24 months.

Those with high levels of omega-3 fish oils in their blood but low levels of B vitamins at the start of the study, who were given B vitamin supplements, showed a dramatic reduction in the rate of brain atrophy compared to those given dummy pills.

The study was in the American Journal of Clinical Nutrition and presented at the Alzheimer’s Disease International Conference in Australia.

Previous studies by the Oxford group found B vitamins could help slow brain shrinkage to a lesser degree and a link between fish oils and prevention of dementia.

However, this study examining high levels of both is the first to show brain shrinkage can be arrested altogether.