A healthy lifestyle has been shown to be good for our brain health and can reduce our risk of dementia. A key component of a healthy lifestyle is a healthy diet, with scientific evidence showing that the healthier our diet the lower our risk for dementia. However, the picture has been less clear for dietary supplements, which are a popular alternative for people to boost their diet. Specifically, do such dietary supplements work in the prevention of Alzheimer’s disease?
A recent clinical trial explored the long-term effects of a popular dietary supplement drink (Souvenaid) on brain health and dementia risk. The results are highly interesting.
Nutrition is such a key part of our lives. Nearly every person would agree that food is one of the most important aspects of our lives. But what many people do not know is that food can also be seen as a form of medication.
Medication was historically plant-based with modern medications simply being more potent or synthetic forms of such historic plant-based medications. This undervalued fact is pretty astonishing if one thinks about it. Since we are eating every day several meals, we can in effect determine our health by what we eat, among other lifestyle factors.
If nutrition can be potentially seen as medication then it will make a big difference to our health as to what we eat. Public health campaigns across many countries have therefore tried to promote healthier diets to convince people that a healthy diet can make a significant difference to their health. Not only can it reduce our risk of dementia but also other highly common diseases such as cardiovascular disease and cancer.
The key to a healthy diet is to eat a great variety of foods, including vegetables, fruits, pulses, grains, fish and meats, as long as we do not eat too much of them. To put it in a nutshell – the more colourful our food plate the better, as it indicates a variety of foods. And before you ask – no, different coloured sweets do not count!
Scientific evidence has shown that particular diets who adhere to these principles are especially good at reducing our risk for cardiovascular risk and dementia. At the top of these diet-based interventions is the Mediterranean diet, which has been shown across several studies to reduce our risk for dementia. Several clinical trials are currently ongoing to investigate whether the Mediterranean diet can be ‘translated’ to other cultures and their diets.
But isn’t there another way to boost our diet by simply taking dietary supplements?
Dietary supplements promise us with a drink or a few pills we get to boost our health while still maintaining our current lifestyle and diet. Dietary supplements are highly popular as they provide a convenient way to give us key nutrients which might be otherwise lacking in our diet. It is therefore not a surprise that so many people take, for example, multi-vitamin tablets or vitamin C supplements. However, whether they are actually effective in the body is still a controversial topic.
The science behind dietary supplements is in fact highly complex. The reason for this is that our body is highly complex and we do not yet fully understand for example how different nutrients are absorbed in the body. A classic example is the absorption of iron via our diet. Iron absorption is generally quite slow but can be accelerated if taken together with vitamin C. This means you should have your spinach ideally with some citrus fruit or your iron supplement should contain vitamin C. This example highlights that the health effects of dietary supplements are often not well established or proven.
The other key element of dietary supplements is that they provide a high dosage of certain nutritional elements. This might seem a good thing but as in life it can be ‘too much of a good thing’. The reason is that the body cannot absorb more nutritional elements than required for its daily needs. This means that any surplus of the nutritional elements we are taking as supplements might go ‘straight through us’. Not surprisingly, a long-ranging debate has been, therefore, whether dietary supplements are worth their money as we might figuratively and literally flush our money, spent on the supplements, down the toilet.
Still, taken supplements in a regulated way, for example as a prescription by your doctor is clearly of a benefit for our health. It is therefore important to seriously consider whether dietary supplements are worth taking, in particular those promising to reduce our risk for dementia.
A new clinical trial* investigated exactly this issue by examining whether – Souvenaid/Fortasyn Connect – a highly popular dietary supplement drink promising to reduce our risk of dementia by improving our brain health actually does so.
Souvenaid is a dietary supplement drink produced by Nutricia Ltd, the medical nutrition arm of Danone – one of the largest food production company on the planet, which also co-funded the clinical trial. Nutricia claims that the supplements contained in Souvenaid were designed specifically to target Alzheimer’s disease changes. Each 125ml bottle contains the following ingredients: Eicosapentaenoic acid (fish oil) 300mg;Docosahexaenoic acid (fish oil) 1200mg; Phospholipids 106mg; Choline 400mg; Uridine monophosphate 625mg; Vitamin E 40mg; Vitamin C 80mg; Selenium 60µg; Vitamin B12 3µg; Vitamin B6 1mg; Folic acid 400µg.
This supplement mixture contains various ingredients with different actions for brain health. For example, fish oils have been shown in research studies to be beneficial for our brain and the hippocampus, which is early affected in Alzheimer’s disease and important for our memories. Other ingredients are more for general immune system health, like Vitamin C and E, while vitamin B12 is particularly important for our memory functioning in the brain. Choline is provided as it is meant to boast a chemical (Acetylcholine) important for brain cell functioning, which is often depleted in the early stages of Alzheimer’s disease, and so on.
Taken together Souvenaid is meant to provide dietary supplements for the best brain health and reduce the risk for Alzheimer’s disease. However, we need to state very clearly that none of the ingredients is targeting directly the disease processes in Alzheimer’s disease. Instead, they are meant to boost the overall brain health and therefore indirectly reducing our risk for Alzheimer’s disease by having a healthier brain, which might be more resilient to Alzheimer’s disease.
The clinical trial for Souvenaid made in fact headlines already in 2017 when the researchers published their data after having given people with Mild Cognitive Impairment, which is considered an early stage of Alzheimer’s disease, Souvenaid once daily for a two year period. The results in 2017 were unequivocal by showing that Souvenaid did not bring a benefit to people with Mild Cognitive Impairment. This meant that people who took Souvenaid did not show clinical or cognitive benefits compared to the control group.
If Souvenaid showed no health benefit then why would we look at it now again?
The reason is that the same researchers have now published the data from the 3-year follow-up of the same Mild Cognitive Impairment people who took Souvenaid once daily and in fact it shows now a mild benefit for those people. Not only were there clinical scores for dementia reduced but they also showed better memory and less shrinkage of the hippocampus compared to the control group – which took an identical drink except for the supplements.
The new findings suggest that dietary supplements might have a mild benefit for brain health for people with Mild Cognitive Impairment if taken for 3 years or longer. It shows again how lifestyle interventions have a much larger timescale than medication, as we need to change our lifestyle long-term to reap the health benefits.
So, should we take therefore Souvenaid to reduce our risk for dementia?
This is clearly a very personal decision, I leave to my readers to decide. However, there are few aspects worth considering before you decide to take Souvenaid:
The first is financial. Each bottle of Souvenaid costs on ~$4.5/£3.5. This seems maybe not a large amount considering it is for our health. However, since we know now that the benefits of this dietary supplement are long-term, we will need to consider taking it for years if not decades. This amounts therefore to ~$1,679/£1,278 yearly, which would have to be paid out of our own pocket as no national health or insurance system is currently covering the costs for Souvenaid.
The second aspect to consider is that although Souvenaid showed mild benefits for brain health, it does not affect the rate of people in the clinical trial developed actually Alzheimer’s disease. In other words, the people in the Souvenaid and the control group developed still Alzheimer’s disease at the same rate. This means that Souvenaid did not show an effect on reducing the rate of dementia in people with Mild Cognitive Impairment – they simply developed Alzheimer’s disease with a healthier brain. The researchers argue that if Souvenaid is taken for longer before people develop Mild Cognitive Impairment it might also reduce the rate of Alzheimer’s disease. In short, the jury is still out whether Souvenaid really reduces our risk for Alzheimer’s disease even though it improves our brain health.
The final aspect to understand with supplements is that they are differently regulated to medicine. Although Souvenaid claims to reduce our risk of developing Alzheimer’s disease, it does not need to prove that it actually does that. The reason is that Souvenaid as a dietary supplement is regulated in most countries, such as North America and Europe, as food and not medicine, even though it makes medical claims. Since Souvenaid is regulated as a food, it can be sold and marketed even without any scientific evidence backing its health claims – no medication would be allowed to be sold or marketed under these circumstances. The Souvenaid results show clearly that it affects our brain health positively but the main claim that it reduces our risk for Alzheimer’s disease is still not proven.
Where does this leave us?
As I said, it is a very personal decision of whether to take Souvenaid. But you need to ask yourself the question as to whether taking Souvenaid is worth for you or whether adopting a healthier diet would give you the same health benefits.
Food for thought!
*Soininen H, Solomon A, Visser PJ, Hendrix SB, Blennow K, Kivipelto M, Hartmann T; LipiDiDiet clinical study group. 36-month LipiDiDiet multinutrient clinical trial in prodromal Alzheimer’s disease. Alzheimers Dement. 2020 Sep 13. doi: 10.1002/alz.12172. Epub ahead of print. PMID: 32920957.