Study: Multivitamin Improves Memory in Older Adults

Taking a daily multivitamin supplement can slow age-related memory decline, finds a large study led by researchers at Columbia University and Brigham and Women’s Hospital/Harvard.

“Cognitive aging is a top health concern for older adults, and this study suggests that there may be a simple, inexpensive way to help older adults slow down memory decline,” says study leader Adam M. Brickman, PhD, professor of neuropsychology at Columbia University Vagelos College of Physicians and Surgeons.

Many older people take vitamins or dietary supplements under the assumption that they will help maintain general health. But studies that have tested whether they improve memory and brain function have been mixed, and very few large-scale, randomized trials have been done.

Study methods

In the current study, more than 3,500 adults (mostly non-Hispanic white) over age 60 were randomly assigned to take a daily multivitamin supplement or placebo for three years. At the end of each year, participants performed a series of online cognitive assessments at home designed to test memory function of the hippocampus, an area of the brain that is affected by normal aging. The COSMOS-Web study is part of a large clinical trial led by Brigham & Women’s Hospital and Harvard called the COcoa Supplement and Multivitamin Outcomes Study (COSMOS).

By the end of the first year, memory improved for people taking a daily multivitamin, compared with those taking a placebo. The researchers estimate the improvement, which was sustained over the three-year study period, was equivalent to about three years of age-related memory decline. The effect was more pronounced in participants with underlying cardiovascular disease.

The results of the new study are consistent with another recent COSMOS study(link is external and opens in a new window) of more than 2,200 older adults that found that taking a daily multivitamin improved overall cognition, memory recall, and attention, effects that were also more pronounced in those with underlying cardiovascular disease.

“There is evidence that people with cardiovascular disease may have lower micronutrient levels that multivitamins may correct, but we don’t really know right now why the effect is stronger in this group,” says Brickman.

Good nutrition important for aging brain

Though the researchers did not look at whether any specific component of the multivitamin supplement was linked to the improvement in memory, the findings support growing evidence that nutrition is important for optimizing brain health as we age.

“Our study shows that the aging brain may be more sensitive to nutrition than we realized, though it may not be so important to find out which specific nutrient helps slow age-related cognitive decline,” says Lok-Kin Yeung, PhD, a postdoctoral researcher in Columbia’s Taub Institute for Research on Alzheimer’s Disease and the Aging Brain and first author of the study.

“The finding that a daily multivitamin improved memory in two separate cognition studies in the COSMOS randomized trial is remarkable, suggesting that multivitamin supplementation holds promise as a safe, accessible, and affordable approach to protecting cognitive health in older adults,” says co-author JoAnn Manson, MD, chief of the Division of Preventive Medicine at Brigham and Women’s Hospital.

“Supplementation of any kind shouldn’t take the place of more holistic ways of getting the same micronutrients,” adds Brickman. “Though multivitamins are generally safe, people should always consult a physician before taking them.”

The study was published in the American Journal of Clinical Nutrition.

Source: Columbia University Irving Medical Center






What an Expert Says About Taking Magnesium for Sleep

Cara Murez wrote . . . . . . . . .

When people struggle to fall asleep, it’s no surprise they seek solutions.

Options can range from prescription medications to sleep therapy, good habits and an abundance of supplements.

Taking magnesium for sleep is something some say has real benefits, but does it really?

It’s not entirely certain, but the mineral serves a variety of other important functions, so it just might actually work.

“The science on whether taking magnesium helps improve the length or quality of sleep has been mixed,” said Dr. Indira Gurubhagavatula, an associate professor of medicine in the Veteran’s Administration Medical Center at the University of Pennsylvania, in Philadelphia.

Past research has had various design limitations and has not been of high enough quality to support a general recommendation for magnesium supplementation in insomnia sufferers, Gurubhagavatula said.

“We don’t have definitive, large, randomized trials across healthy populations, or those with specific diseases, over long periods of time,” she said.

What is magnesium?

Magnesium is a mineral found in a range of foods and in dietary supplements, according to the Sleep Foundation.

It produces protein, bone and DNA; maintains blood sugar and pressure; and regulates the muscles, nerves and the cardiovascular system, according to the foundation.

This nutrient is needed for more than 300 biochemical reactions in the body, according to the National Library of Medicine.

“It is used by hundreds of enzymes in the body to complete important functions at the cellular level,” Gurubhagavatula said.

People with type 2 diabetes, a gastrointestinal disorder, alcohol use disorder or who are seniors may be more at risk for magnesium deficiency, according to a Cleveland Clinic story on magnesium for sleep.

Is magnesium good for sleep?

A preliminary study presented recently at the American College of Cardiology annual meeting found that getting enough sleep was associated with greater protection of death from all causes.

If magnesium does work to help someone get a little shuteye, that may be because it is acting on certain receptors on the surface of brain cells to quiet down brain cell activity, Gurubhagavatula said.

The nutrient acts on the benzodiazepine receptor, which is the same receptor used by Valium-type drugs and the sleep medication Ambien, she said.

“Magnesium is also thought to affect levels of melatonin, the hormone associated with when we fall asleep and when we wake up, known as our circadian rhythm,” Gurubhagavatula added.

Magnesium can relax muscles and may help improve symptoms of restless legs in some people, she said. About 5% to 15% of people have that condition and should see a doctor for diagnosis.

How much magnesium should you take?

So, exactly how much magnesium for sleep? Your doctor can answer that after taking into account your health conditions and medications.

Still, the U.S. National Library of Medicine said taking magnesium supplements isn’t advised and that it’s better if people consume the nutrient through their diet.

Those still planning to take a magnesium supplement should know that the best magnesium for sleep is magnesium glycinate or magnesium citrate at 200 milligrams, according to the Cleveland Clinic. Avoid the stool-softening magnesium oxide, it suggested.

When to take magnesium for sleep? About 30 minutes before bedtime, according to the Cleveland Clinic.

A systematic review and meta-analysis published recently in the journal BMC Complementary Medicine and Therapies looked at three randomized, controlled trials on magnesium for sleeping in older adults.

The quality of research wasn’t strong enough to make a recommendation, the researchers concluded, but the supplement is cheap and widely available so evidence may support its use.

Side effects of magnesium

Taking magnesium supplements can bring a range of side effects, such as drowsiness or fatigue during the day, muscle weakness, nausea, vomiting, skin flushing or diarrhea, Gurubhagavatula said.

Some risks are even more serious.

“With very high levels of magnesium in the blood, dangerous heart rhythm abnormalities can happen, including cardiac arrest,” Gurubhagavatula added.

Can you overdose on magnesium?

The short answer is yes.

While people with healthy kidneys can dispose of excess magnesium through the urine, some with kidney disease may not be able to get rid of quickly building levels of the mineral, Gurubhagavatula said.

Other medical conditions can also lead to high blood levels of magnesium, she said. That may happen with cancer treatment or in very uncontrolled diabetes.

Is it OK to take magnesium every night?

You really shouldn’t.

Insomnia can be a sign of an unidentified sleep disorder, Gurubhagavatula said. You may find you have sleep apnea, restless legs, narcolepsy or a circadian rhythm sleep disorder.

“A comprehensive evaluation can help identify the root cause, so that potentially serious conditions are not missed, and so that appropriate treatment can be given,” she said.

You may also be experiencing depression, anxiety, chronic pain, lung disease or heart disease.

If you’re not able to fall asleep without requiring medications for weeks or months, see an expert, Gurubhagavatula advised.

Foods high in magnesium

While it might be easiest to turn to a supplement to boost your magnesium, the nutrient is readily available in certain foods.

According to the Sleep Foundation, they include:

  • Fish
  • Soy and soy milk
  • Legumes
  • Fortified breakfast cereal and various whole grains
  • Green leafy vegetables
  • Pumpkin and chia seeds
  • Almonds and cashews

Source: HealthDay





Vitamin D Might Help You Avoid Dementia

Alan Mozes wrote . . . . . . . . .

Can vitamin D lower dementia risk?

Quite possibly, a team of British and Canadian researchers report.

In their study, investigators spent roughly a decade tracking more than 12,000 older people. None had dementia at the start of the study period. In the end, the team determined that those who had been taking vitamin D supplements during that time appeared to face a 40% lower risk for dementia, compared with those who had never taken the supplements.

Even so, Claire Sexton, senior director of scientific programs and outreach at the Alzheimer’s Association, cautioned that much more research is needed to better understand a possible link between vitamin D and dementia risk.

For one thing, she noted that the study team did not track how much vitamin D supplementation any of the participants took, nor how long they had been taking them. Similarly, overall patient vitamin D levels were never assessed — either at the study launch or conclusion.

In addition, the study was observational, Sexton added, meaning at no point were patients told to take, or not to take, vitamin D. That means the study cannot prove that vitamin D actually causes dementia risk to fall.

Still, study author Dr. Zahinoor Ismail said that fresh evidence of vitamin D’s power against dementia has “great biological plausibility.”

For example, prior research indicates that people with genetic mutations that render them low in vitamin D “have much greater development of Alzheimer’s than those who don’t,” said Ismail, a professor of psychiatry, neurology, epidemiology and pathology with the Hotchkiss Brain Institute and O’Brien Institute for Public Health at the University of Calgary in Alberta, Canada.

Vitamin D, he added, has also been shown to be anti-inflammatory and key to preventing the build-up of both abnormal protein “tangles” and amyloid beta plaque in the brain. Both are hallmarks of Alzheimer’s, with the latter often cited as a likely root cause.

“So, I’m not at all surprised that we found something,” said Ismail.

The study team noted that an estimated 50 million people worldwide now live with some degree of dementia; that figure is projected to triple by 2050.

At the same time, vitamin D deficiency is thought to be a concern among roughly 1 billion people.

To explore the potential protective benefit of vitamin D supplementation among older Americans, the study team focused on thousands of patients who had previously enrolled in one of 40 Alzheimer’s Disease Research Centers across the United States.

On average, participants were 71 years of age, and 80% were white. The patient pool included both those with no signs of mental impairment as well as those struggling with so-called mild cognitive impairment (MCI).

Out of the entire pool of patients, about 2,700 developed dementia. But the risk appeared to differ in relation to vitamin D habits.

For example, the team found that over the course of the study timeframe, a little less than 4 in 10 had taken vitamin D, and dementia risk in this pool of patients was nearly 15%.

But among the roughly 60% who had never taken vitamin D supplements, that figure shot up to 26%.

And after taking into account a variety of factors — including age, gender, race, depression status and educational background — the team concluded that vitamin D supplementation was linked to a 40% lower risk for dementia, compared with no exposure.

Taking vitamin D was also linked to notably better survival rates, the investigators found.

For example, about 84% of those who had taken vitamin D supplements were still alive five years out from the study launch; that figure dropped to just over 68% among those who had never taken vitamin D.

The findings were published online March 1 in Alzheimer’s & Dementia: Diagnosis, Assessment & Disease Monitoring, a publication of the Alzheimer’s Association.

The investigators noted that the apparent protective effect of vitamin D was notably stronger among those with no prior mental impairment, compared with those who already had MCI. That suggests that vitamin D supplementation might be most impactful in warding off dementia when started earlier rather than later.

But Ismail said that one of the most important and surprising findings was a sizeable gender gap in vitamin D’s impact on dementia risk. While vitamin D supplementation was linked to a 50% lower dementia risk among women, that figure fell to just 25% among men.

Why? Ismail said it could have to do with plummeting estrogen levels during perimenopause and menopause, given that “estrogen helps to activate vitamin D. So, it could be that women have relatively greater vitamin D deficiency than men, so supplements have a greater effect.”

What are seniors to think? Should vitamin D supplements now figure into everyone’s daily health regimen? No, said Sexton.

Given the “significant limitation[s]” of the latest research, “it is not recommended to start vitamin D supplementation to reduce dementia risk,” she said, though Sexton advised anyone contemplating such a move to “always talk to your health care provider before starting supplements or other dietary interventions, and let them know which ones you are already taking.”

Ismail, who takes vitamin D himself, is more equivocal.

“While vitamin D can do good, it can also do harm,” he acknowledged, highlighting the adverse impact that mega-dosing can have on bone health. “But I would say that if people are going to take it anyway they should do so cautiously,” and always within the recommended dosing limits of a patient’s respective country.

Vitamin D is often referred to as “the sunshine vitamin” because sunlight is one source of this nutrient. In addition, certain types of food, including eggs, fatty fish and seafood can be natural dietary sources of vitamin D. The vitamin is also often added to food staples — such as milk and breakfast cereals.

Source: HealthDay





Not All Micronutrients Created Equal: Study Identifies Some Supplements That Benefit Cardiovascular Health

Healthy diets are rich in antioxidants like amino acids, omega-3 fatty acids and vitamin C, but exactly how beneficial these micronutrients are for cardiovascular health has long been controversial. Now a new meta-analysis published in the Journal of the American College of Cardiology provides some clarity.

Researchers systematically reviewed a total of 884 studies available to date on micronutrients taken as dietary supplements and analyzed their data. They identified several micronutrients that do reduce cardiovascular risk—as well as others that offer no benefit or even have a negative effect. More than 883,000 patients were involved in the combined studies.

“For the first time, we developed a comprehensive, evidence-based integrative map to characterize and quantify micronutrient supplements’ potential effects on cardiometabolic outcomes,” said Simin Liu, MD, MS, MPH, ScD, professor of epidemiology and medicine at Brown University and a principal investigator for the study. “Our study highlights the importance of micronutrient diversity and the balance of health benefits and risks.”

The findings could be used as the basis of future clinical trials to study specific combinations of micronutrients and their impact on cardiovascular health, he said.

Antioxidant supplementation has long been thought to play a role in heart health. That’s because these nutrients work to reduce oxidative stress, a known contributor to many cardiovascular diseases. Heart-healthy diets like the Mediterranean diet and the Dietary Approach to Stop Hypertension (DASH) feature foods that are naturally rich in antioxidants. However, results from studies of antioxidant supplements have been inconsistent—one reason why this approach hasn’t yet been widely adopted in preventative cardiology.

“Research on micronutrient supplementation has mainly focused on the health effects of a single or a few vitamins and minerals,” Liu said. “We decided to take a comprehensive and systematic approach to evaluate all the publicly available and accessible studies reporting all micronutrients, including phytochemicals and antioxidant supplements and their effects on cardiovascular risk factors as well as multiple cardiovascular diseases.”

The researchers looked at randomized, controlled intervention trials evaluating 27 different types of antioxidant supplements. They found strong evidence that several offered cardiovascular benefit. These included omega-3 fatty acid, which decreased mortality from cardiovascular disease; folic acid, which lowered stroke risk; and coenzyme Q10, an antioxidant sometimes marketed as CoQ10, which decreased all-cause mortality. Omega-6 fatty acid, L-arginine, L-citrulline, Vitamin D, magnesium, zinc, alpha-lipoic acid, melatonin, catechin, curcumin, flavanol, genistein and quercetin also showed evidence of reducing cardiovascular risk.

Not all supplements were beneficial. Vitamin C, Vitamin D, Vitamin E and selenium showed no effect on long-term cardiovascular disease outcomes or type-2 diabetes risk. And beta carotene supplements increased all-cause mortality.

According to the researchers, the findings point to the need for more personalized, precision-based dietary interventions that involve specific combinations of beneficial supplements. Further study is needed, including large, high-quality interventional trials to investigate the long-term effects of certain micronutrients on health.

“Identifying the optimal mixture of micronutrients is important, as not all are beneficial, and some may even have harmful effects,” Liu said.

Source: American College of Cardiology





Which Source of Dietary Fiber Works Best?

Amy Norton wrote . . . . . . . . .

If your diet is low in fiber, you can do your gut some good by adding more — regardless of the fiber source, new research suggests.

Many people know fiber as the nutrient that keeps you regular. But it’s also a key player in the makeup of the gut microbiome — the vast collection of bacteria and other microbes that reside in the digestive tract.

When bacteria in the gut break down the fiber, they produce certain short-chain fatty acids that are the main source of nutrition for cells in the colon. Research also suggests the fatty acids play a role in regulating functions as vital as metabolism and immune defenses.

But it hasn’t been clear whether any one type of fiber supplement is better for people’s gut bacteria than others.

In the new study, researchers tested three common fiber-powder supplements: inulin (an extract of chicory root), wheat dextrin (in this case, the brand Benefiber), and galactooligosaccharides (Bimuno).

They recruited 28 healthy adults and gave them each of the supplements to use for one week, with one week off in between each product.

Overall, the study found, no one supplement outperformed the others in changing consumers’ gut microbiome. Each supplement boosted the production of butyrate — an important fatty acid that helps control inflammation.

If a study participant churned out more butyrate after using one fiber supplement, they responded just as well to the other two, said Jeffrey Letourneau, a doctoral student at Duke University in Durham, N.C., who was part of the research team.

But while the fiber supplement didn’t matter, the person did: Supplements revved up butyrate production only in participants who normally ate few fiber-rich foods, the study found.

That does make sense, according to Letourneau: It’s the “low fiber consumers” who would be making a substantial change by adding a daily fiber supplement.

But that term also describes most Americans, he pointed out.

Experts generally recommend that women strive for 25 grams of fiber per day, while men should aim for 38 grams. The average U.S. adult, however, consumes only in the neighborhood of 30% of those amounts.

And in the grand scheme of human history, Letourneau said, even the recommended fiber amounts probably fall far short of what our ancestors downed. He pointed to research showing that members of the Hadza tribe, in Tanzania, still consume a whopping 100 to 150 grams of fiber a day — owing to diets high in foods like berries, honey and tubers.

So the new research — published in the journal Microbiome — emphasizes the importance of getting more fiber, whatever the source.

The study focused on supplements, in part, because they are easy to study, Letourneau said. Researchers gave each participant pre-measured individual doses of the fiber supplements, so they simply had to dump the powder into a drink once a day.

Those doses amounted to 9 grams of either inulin or wheat dextrin, or 3.6 grams of galactooligosaccharides, per day.

Fiber from food, however, would be preferable, according to a registered dietitian who was not involved in the study.

Plant foods provide not only various forms of fiber, but also a range of vitamins, minerals and beneficial “phytochemicals,” said Nancy Farrell Allen, a spokeswoman for the Academy of Nutrition and Dietetics and an instructor at Rosalind Franklin University of Medicine and Science in North Chicago, Ill.

“I believe that food is the best way to meet fiber needs,” she said.

Farrell Allen pointed to a long list of fiber-rich foods, including an array of vegetables and fruit; bran cereals and whole grains like farro; “pulses” such as lentils and chickpeas, and legumes like soybeans and peanuts.

She also had a caution on fiber supplements: They can cause unpleasant gas, bloating and prolonged indigestion.

Letourneau agreed that whole foods have “real benefits” that cannot be captured in a supplement. But given the importance of fiber — and the dearth of it in Americans’ diets — he supports getting more of it, however you can.

“My attitude is: Whatever you can fit into your life, in a sustainable way, is good,” Letourneau said.

In some more good news, it doesn’t take long for any added fiber to make a difference to your gut bacteria. In a separate study, the Duke researchers found that fiber supplements began to alter people’s gut bacteria within a day — changing the microbiome makeup and activity.

“Things do seem to change really quickly,” Letourneau said.

Source: HealthDay