Nutrition and cognition

Nutrition and cognition

While our brain health inevitably will decline as we get older, there is much you can do to maintain your cognitive function with healthy nutrition and lifestyle.

We ask a lot of our brains on a day-to-day basis and without properly nourishing them, it stands to reason our cognitive function could fall below par.

And there are so many ways that we can nourish this organ, from the fuel that we put into it in terms of food, the supplements we take to bridge any nutritional gaps, and the life choices we make.

What’s important to note is cognitive decline to a degree is inevitable – age being a key factor in this – but we should also be aware that there is much we can do to help support our brains.

Jenny Carson, Technical Services Manager at Viridian Nutrition, explained: “Age-related mild cognitive impairment is a condition that has attracted mainstream awareness and education, especially with regards to management strategies. The UK prevalence rate for cognitive impairment is estimated to be 3.9-5.4 per cent for moderate to severe impairment and 8.5-9.8 per cent for mild impairment. These rates are largely made up of higher rates in older age groups. A generation ago the older population were a smaller proportion that nowadays and so it is likely that although the rates were probably the same, less focus and clinical care was allocated to the conditions.

“As cognitive decline is considered a product of ageing, genes and the environment such as diet, lifestyle and toxic load, it is not necessarily inevitable. Although we cannot control our genes, lifestyle, diet and to an extent the hygiene of our surroundings can be manipulated in a beneficial manner.”

Melanie Dixon, Registered Nutritional Therapist for Vitaminology, went on: “With an increasing global population of people aged over 60 and life expectancy estimated to have increased by more than eight years since 1990, it is little wonder that there is a growing interest in cognitive-related issues. It’s natural for cognition to decline as we age, but the age of onset and severity can vary.

“Dementia is the umbrella term used for cognitive decline disorders. For some people, normal cognitive ageing can decline to mild cognitive impairment, where activities of daily living are largely intact, through to more severe dementia. Alzheimer’s is one of the most common forms of dementia, where amyloid plaques (a type of protein) accumulate in the brain. Other diseases exhibiting cognitive decline include Lewy body dementia and Parkinson’s disease.”

Signs of decline

So, what do you need to be aware of in terms of signs you might be experiencing cognitive decline?

“Initially, mild cognitive decline can manifest as forgetfulness or a little confusion when completing daily tasks, and difficulty when participating in more demanding cognitive exercises such as crosswords and complex knowledge recall,” Jenny explained. “However, brain fog, forgetfulness and confusion can be distressing and so the feeling of a slow brain may be alongside stress, anxiety, and low mood.”

Melanie added: “Signs which may indicate issues with cognitive decline can vary, but often include memory loss, difficulty concentrating, difficulty finding words or with speech, difficulty learning new things, disorientation, lack of motivation and social engagement or a change in personality and behaviour.”

And who is most at risk?

“Biological changes and inflammatory processes in the body contribute to cognitive difficulties, such as nutritional deficiencies, neurotransmitter balance and neuroinflammation. The most common, and often modifiable, factors which can increase the likelihood and progression of cognitive decline are poor nutrition, an inactive lifestyle, environmental and social factors, and genetic factors,” Melanie advised.

“Indeed, certain health issues have been found to be associated with an increased risk of cognitive difficulties and decreased brain function, such as cardiovascular disease, metabolic syndrome (diabetes, obesity, high blood pressure and high cholesterol levels), sleep and mental health disorders or side effects from certain medications.”

Lorraine Perretta, Registered Nutritional Therapy Practitioner at the Institute for Optimum Nutrition’s Brain Bio Centre, went on: “Many factors can contribute to a decline in cognitive function. Stress is particularly relevant in current times. It can impact cognitive function via a number of mechanisms, for example, elevated levels of the hormone, cortisol, part of the stress response, can contribute to systemic inflammation.

“Poor appetite may mean we are not eating enough healthy foods to support mental wellness. People who comfort eat when stressed often reach for foods that are high in sugar, salt and/or fat – which also tend to have lower levels of vitamins and minerals and essential fatty acids. Insomnia and disturbed sleep patterns may interfere with brain function.”

She added: “Environmental toxins can interfere with how the brain functions. This includes pollution as well as toxins, herbicides, pesticides, and heavy metals such as lead and aluminium. Excessive alcohol consumption and smoking also increase toxic burden.”

And let’s not forget the role of the gut, with Lorraine explaining: “The gut-brain axis refers to the connection between our gut and our brain. An unhealthy gut and poor digestion can impact our brain’s ability to function optimally. As we age, digestion becomes less efficient and we may suffer with indigestion, bloating and constipation. Also, age has a detrimental impact on our gut microbiome. Research is now suggesting that with age – after 60-65 years of age – the gut microbiome diversity begins to decline, and the balance may favour bacterial strains which are pro-inflammatory.”

Jenny went on: “According to the Alzheimer’s Society, statistics show that women are twice as likely to develop dementia that men worldwide. Brain scans show that female brain cells die off at a greater rate than that of men, however, women generally live longer than men. Although the risk of dementia increases with age, it is defined as a disease of the brain and not caused by age. In addition, brain fog, forgetfulness, and failure to recall certain words or pieces of information can be experienced in times of stress, upset and during the perimenopause and menopause.”

The importance of good nutrition

Let’s then focus in greater detail on nutrition, and the role a poor diet can have.

“The brain is a nutrient hungry organ and so by replacing a processed food dominated diet with a wholefood-based diet will increase nutrient intake,” Jenny explained. “Consider replacing the ready meals, packet burgers and pizza with homemade salads, soups, stews and slow roasts. A simple way to identify a processed food from a wholefood is to read the ingredients list. If it has one ingredient, it is a wholefood, for example, cabbage, banana, eggs, compared to a ready meal which has a long list of ingredients, some of which are unpronounceable!

“Aim to eat at least one portion of vegetables or fruit daily in each of the colours, red, green, orange, yellow alongside white, purple and blue. Plan for four or more meals weekly that provide omega 3 essential fatty acids, these can include oily fish and algae such as spirulina and chlorella or nuts and seeds. Oily fish and algae are great sources of omega 3 in the form of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), while flaxseed, almonds and walnuts provide alpha linolenic acid which has to be transformed into EPA and DHA. Research has shown that EPA and DHA can interrupt the inflammatory cascade and so contribute to an anti-inflammatory effect.”

She continued: “Replace sugar laden foods with fruit, nuts, seeds or dates. While we are on the subject of sugar, breakfast cereals often contain a lot of sugar. Consider yogurt with fruit, smoothies, eggs with vegetables, besides sugar free porridge or avocado based meals.

Consider the foods you eat and if you react to them is also important, Lorraine reminded: “Food intolerances may contribute to symptoms such as brain fog and inability to concentrate in some people. Food intolerances may become more apparent as we age, and the main culprits include gluten and dairy products. A short-term exclusion diet can be helpful for identifying whether a particular food is contributing to symptoms – so if you suspect a food intolerance, avoid the item for two weeks and monitor symptoms. For complex cases or those who suspect multiple food intolerances, it is recommended you seek the support of a registered nutritional therapy practitioner or other healthcare professional.”

She added: “Antioxidants from fruits including cherries, papaya, pomegranate and berries. Aim for three portions of fruit per day and remember, variety is key. Eat five portions per day from a rainbow colour of vegetables: kale, cauliflower, broccoli, red pepper, beetroot, red onions, carrots, tomatoes, etc. Beneficial bacteria help supply key B vitamins, especially vitamin B12, which is important for supporting the health of the nervous system. Eat fermented foods daily, including kimchi, kombucha, kefir (milk or coconut version), tempeh and sauerkraut.

“Choline is important for the nervous system and brain health; it produces the neurotransmitter, acetylcholine, which plays an essential role in memory and mood. Choline is found in liver, chicken, lecithin and eggs.”

Should you supplement?

Many of us can benefit from nutritional supplements, which should be taken as a support to a healthy diet, not a replacement. And there are some specific brain nutrients that are worth considering, although if you are unsure, speak to your practitioner about what’s right for you.

Melanie advised: “Nutritional deficiencies can contribute to cognitive decline and there are specific nutrients which are essential for healthy brain function. You should get most of these nutrients from a well-balanced diet, although sometimes supplementation is recommended if you’re not getting enough from food alone.

“Alpha-lipoic acid (ALA) is anti-inflammatory and protective against cognitive decline. ALA is found in small amounts in broccoli, spinach, Brussels sprouts, chard and beetroot.

“A deficiency of folate, vitamins B6, B9 and B12 have been shown to be linked with dementia. Vitamin B12 can only be sourced in animal-derived foods. Otherwise, B vitamins can be sourced from meat, liver, seafood, poultry, eggs, legumes and leafy greens. Involved in brain signalling and nerve growth, vitamin D deficiency has been associated with memory loss and cognitive decline. It is best obtained through natural exposure to UV light during summer months and should be supplemented during the winter.”

And she added: “Phosphatidylserine is a fatty substance which covers and protects brain cells. Found in soy-derived products, white beans, eggs and liver. An extract of turmeric, which is an antioxidant and anti-inflammatory, curcumin has been found to improve memory and cognitive function and reduce the build-up of amyloid plaques which are characteristic of Alzheimer’s disease.”

Jenny went on: “Several members of the B vitamin family are essential for good brain function. Choline, B2, B6, B12 and folate are involved in the functioning and maintenance of brain cells. Choline, found in eggs, offal and in very small amounts in legumes, is used in the production of the neurotransmitter acetylcholine. This neurotransmitter is responsible for cognitive performance within learning and memory. The other B vitamins assist the production of energy, hormones, neurotransmitters and in the replacement of old or injured brain cells.

“Additionally, the importance of omega 3, especially in the forms EPA and DHA, in the structure of the brain cells and for quelling inflammation has become a major focus in research. When a brain cell has a large volume of omega 3 in the membrane, it allows for the easy passage of nutrients into the cell and the exit of waste compounds. This flexibility maintains a healthy cell.  Should the brain cell have a dominance of omega 6 within the membrane, it loses this flexibility.

“Magnesium is involved in several processes that influence brain activity, for instance, not only does it help to produce neurotransmitters and hormones, but it supports energy production, the elimination of waste from brain cells, regulates blood pressure in the brain and adds balance to the fluid of the brain.”

And Lorraine also suggested: “As we age, digestion may become less efficient and there’s often a decline in food intake – so older people can be at increased risk of nutritional deficiencies. Supplementation may help support some of the factors that contribute not only to cognitive wellness but also overall general and physical wellness.

“A multivitamin containing at least 10mcg (400ius) of vitamin D. Some people may have increased needs for vitamin D and the GP can measure vitamin D status and make recommendations based on that result. A B-complex (provides co-factors for neurotransmitter synthesis and metabolism), and probiotics – look for a probiotic that contains at least four different strains  for diversity and the package should state that there is at least five billion CFUs  (colony forming units) at the end of the best before date.”

There are also some herbs that can be beneficial.

Jenny suggested: “In recent years, lemon balm and sage have attracted research interest. This is especially so in trials that investigated their effects on brain function.  Data shows that the herbs influenced beneficial action in the brain which makes them the perfect partners.

“Sage is generally categorised for menopausal support, subsequently its brain supporting effects are often overlooked. However, research evidence has shown that combined common sage (Salvia officinalis) and Spanish sage (Salvia lavanulaefolia) may exert potent cognitive enhancing benefits. Lemon balm (Melissa officinalis) is a prolific herb throughout Europe which has a history of use in herbal medicine, reputed to improve mood through the balance of neurotransmitters. In addition to which contemporary studies have shown improved mood and stress tolerance, alongside enhanced cognitive performance in response to 600mg lemon balm supplementation daily.”

What else?

There are some simple switches in your lifestyle that can make a difference to your brain function.

Jenny suggested: “Keep the brain flexible, it needs a daily work out, this can be journaling, mindfulness and meditation besides your favourite puzzles.

And Melanie suggested: “There are many ways to help promote healthy cognitive ageing:

  • Eat a heart-healthy, anti-inflammatory Mediterranean-style diet.
  • Intermittent fasting.
  • Aim to drink around two litres of water daily.
  • Limit alcohol.
  • Quit smoking or recreational drug use.
  • Take regular exercise.
  • Ensure good quality sleep.
  • Avoid stress.
  • Learn a new skill and practice cognitive training.
  • Take part in social activities.

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