RE: We hear a lot about supplementing with omega-fats, 
beta-carotene etc., for improving memory and cognitive
processes. These are fats and fat soluble vitamins.
What are the risks associated with such
supplementation? Is there any research on safe doses? 

Here are some recent studies regarding the effect of vitamins and supplements to improve cognitive function. Most show little or no positive effect from multivitamin and multimineral supplements, antioxidant supplements, Vitamins B6 and B12, Vitamin E, folic acid, ginkgo biloba,  or omega-3 fatty acids. (To keep this post short, I did not include the full abstract for these studies).


McNeill G, Avenell A, Campbell MK, Cook JA, Hannaford PC, Kilonzo MM, Milne AC, Ramsay CR, Seymour DG, Stephen AI, Vale LD. Effect of multivitamin and multimineral supplementation on cognitive function in men and women aged 65 years and over: a randomised controlled trial. Nutr J. 2007 May 2;6:10.

BACKGROUND: Observational studies have frequently reported an association between cognitive function and nutrition in later life but randomised trials of B vitamins and antioxidant supplements have mostly found no beneficial effect. We examined the effect of daily supplementation with 11 vitamins and 5 minerals on cognitive function in older adults to assess the possibility that this could help to prevent cognitive decline. CONCLUSION: The results provide no evidence for a beneficial effect of daily multivitamin and multimineral supplements on these domains of cognitive function in community-living people over 65 years. However, the possibility of beneficial effects in older people and those at greater risk of nutritional deficiency deserves further attention.



Eussen SJ, de Groot LC, Joosten LW, Bloo RJ, Clarke R, Ueland PM, Schneede J, Blom HJ, Hoefnagels WH, van Staveren WA. Effect of oral vitamin B-12 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 Aug;84(2):361-70.

BACKGROUND: Vitamin B-12 deficiency is associated with cognitive impairment in older people. However, evidence from randomized trials of the effects of vitamin B-12 supplementation on cognitive function is limited and inconclusive. CONCLUSION: Oral supplementation with vitamin B-12 alone or in combination with folic acid for 24 wk does not improve cognitive function.



Malouf M, Grimley EJ, Areosa SA. Folic acid with or without vitamin B12 for cognition and dementia. Cochrane Database Syst Rev. 2003;(4):CD004514.

BACKGROUND: Folates are vitamins essential to the development of the central nervous system. Insufficient folate activity at the time of conception and early pregnancy can result in congenital neural tube defects. In adult life folate deficiency has been known for decades to produce a characteristic form of anaemia ("megaloblastic"). More recently degrees of folate inadequacy, not severe enough to produce anaemia, have been found to be associated with high blood levels of the amino acid homocysteine. Such degrees of folate inadequacy can arise because of insufficient folates in the diet or because of inefficient absorption or metabolic utilisation of folates due to genetic variations. Conventional criteria for diagnosing folate deficiency may be inadequate for identifying people capable of benefiting from dietary supplementation. High blood levels of homocysteine have been linked with the risk of arterial disease, dementia and Alzheimer's disease. There is therefore interest!
  in whether dietary supplements of folic acid (an artificial chemical analogue of naturally occurring folates) can improve cognitive function of people at risk of cognitive decline associated with ageing or dementia, whether by affecting homocysteine metabolism or through other mechanisms.There is a risk that if folic acid is given to people who have undiagnosed deficiency of vitamin B12 it may lead to neurological damage. Vitamin B12 deficiency produces both an anaemia identical to that of folate deficiency but also causes irreversible damage to the central and peripheral nervous systems. Folic acid will correct the anaemia of vitamin B12 deficiency and so delay diagnosis but will not prevent progression to neurological damage. For this reason trials of folic acid supplements may involve simultaneous administration of vitamin B12. Apparent benefit from folic acid given in the combination would therefore need to be "corrected" for any effect of vitamin B12 alone. A separate!
  Cochrane review of vitamin B12 and cognitive function is being prepar
ed. REVIEWER'S CONCLUSIONS: There was no beneficial effect of 750 mcg of folic acid per day on measures of cognition or mood in older healthy women. In patients with mild to moderate cognitive decline and different forms of dementia there was no benefit from folic acid on measures of cognition or mood. Folic acid plus vitamin B12 was effective in reducing the serum homocysteine concentrations. Folic acid was well tolerated and no adverse effects were reported. More studies are needed.



Malouf R, Grimley Evans J. The effect of vitamin B6 on cognition. Cochrane Database Syst Rev. 2003;(4):CD004393. 

BACKGROUND: Micronutrient status can affect cognitive function at all ages. Vitamin deficiencies could influence memory function and might contribute to age-associated cognitive impairment and dementia.Vitamin B6, comprising three chemically distinct compounds pyridoxal, pyridoxamine, and pyridoxine, is involved in the regulation of mental function and mood. Vitamin B6 is also an essential homocysteine re-methylation cofactor, and deficiency is associated with increase in blood homocysteine levels. Homocysteine is a risk factor for cerebrovascular disease and may also have directly toxic effects on neurons of the central nervous system. Neuropsychiatric disorders including seizures, migraine, chronic pain and depression have been linked to vitamin B6 deficiency. Epidemiological studies indicate that poor vitamin B6 status is common among older people. Hyperhomocysteinaemia has been suggested as a cause or mechanism in the development Alzheimer's disease and other forms of de!
 mentia. Supplementation with B vitamins including vitamin B6 has been shown to reduce blood homocysteine levels. REVIEWER'S CONCLUSIONS: This review found no evidence for short-term benefit from vitamin B6 in improving mood (depression, fatigue and tension symptoms) or cognitive functions. For the older people included in one of the two trials included in the review, oral vitamin B6 supplements improved biochemical indices of vitamin B6 status, but potential effects on blood homocysteine levels were not assessed in either study. This review found evidence that there is scope for increasing some biochemical indices of vitamin B6 status among older people. More randomized controlled trials are needed to explore possible benefits from vitamin B6 supplementation for healthy older people and those with cognitively impairment or dementia.



McMahon JA, Green TJ, Skeaff CM, Knight RG, Mann JI, Williams SM. A controlled trial of homocysteine lowering and cognitive performance. N Engl J Med. 2006 Jun 29;354(26):2764-72.

BACKGROUND: The results of observational studies suggest that plasma homocysteine concentrations are inversely related to cognitive function in older people. Our objective was to test the hypothesis that lowering the plasma homocysteine concentration improves cognitive function in healthy older people. CONCLUSIONS: The results of this trial do not support the hypothesis that homocysteine lowering with B vitamins improves cognitive performance. 



Balk EM, Raman G, Tatsioni A, Chung M, Lau J, Rosenberg IH. Vitamin B6, B12, and folic acid supplementation and cognitive function: a systematic review of randomized trials. Arch Intern Med. 2007 Jan 8;167(1):21-30.

BACKGROUND: Despite their important role in cognitive function, the value of B vitamin supplementation is unknown. A systematic review of the effect of pyridoxine hydrochloride (hereinafter "vitamin B(6)"), cyanocobalamin or hydroxycobalamin (hereinafter "vitamin B(12)"), and folic acid supplementation on cognitive function was performed. CONCLUSION: The evidence does not yet provide adequate evidence of an effect of vitamin B(6) or B(12) or folic acid supplementation, alone or in combination, on cognitive function testing in people with either normal or impaired cognitive function.


Kang JH, Cook N, Manson J, Buring JE, Grodstein F. A randomized trial of vitamin E supplementation and cognitive function in women. Arch Intern Med. 2006 Dec 11-25;166(22):2462-8.

BACKGROUND: Oxidative stress may play a key role in the development of cognitive impairment. Long-term supplementation with vitamin E, a strong antioxidant, may provide cognitive benefits. CONCLUSION: Long-term use of vitamin E supplements did not provide cognitive benefits among generally healthy older women.



Elsabagh S, Hartley DE, File SE. Limited cognitive benefits in Stage +2 postmenopausal women after 6 weeks of treatment with Ginkgo biloba. J Psychopharmacol. 2005 Mar;19(2):173-81.

Gingko biloba has cognitive benefits both in populations suffering from dementia and after acute treatment in healthy volunteers, with some evidence indicating that those with poorer cognitive performance show greater benefit. We have previously found that 1 week of treatment with ginkgo improved attention, memory and mental flexibility in post-menopausal women, but the evidence for any beneficial effects of longer treatment is less well-established.



Arendash GW, Jensen MT, Salem N Jr, Hussein N, Cracchiolo J, Dickson A, Leighty R, Potter H. A diet high in omega-3 fatty acids does not improve or protect cognitive performance in Alzheimer's transgenic mice. Neuroscience. 2007 Oct 26;149(2):286-302. Epub 2007 Aug 14.

Although a number of epidemiologic studies reported that higher intake of omega-3 fatty acids (largely associated with fish consumption) is protective against Alzheimer's disease (AD), other human studies reported no such effect. Our results suggest that diets high in omega-3 fatty acids, or use of fish oil supplements (DHA+EPA), will not protect against AD, at least in high-risk individuals. However, normal individuals conceivably could derive cognitive benefits from high omega-3 intake if it corrects an elevation in the brain level of n-6 fatty acids as a result. Alternatively, dietary fish may contain nutrients, other than DHA and EPA, that could provide some protection against AD.


Doug Seubert
Guideline Editor
Quality Improvement & Care Management
Marshfield Clinic
1000 N Oak Avenue
Marshfield, WI 54449
(715) 387-5096 (1-800-782-8581 ext. 75096)
seubert.douglas at marshfieldclinic.org


------Original Message------
From:	"Lalitha Garapaty" <lgarapaty at yahoo.com>
Date:	Sun Nov 18, 2007 -- 08:17:22 AM
To:	"healthliteracy at nifl.gov" <healthliteracy at nifl.gov>
Subject:	[HealthLiteracy 1492] Re: health impacting literacy

Think of Older adults, and retirees actively seeking
education, for various reasons. Some learning for
learning sake, others trying to improve their skills
to continue in their present job or change to a new
one. 

Declining cognitive and sensory process have a major
impact on their learning.

Some other questions - 

We hear a lot about supplementing with omega-fats,
beta-carotene etc., for improving memory and cognitive
processes. These are fats and fat soluble vitamins.
What are the risks associated with such
supplementation? Is there any research on safe doses? 

Similarly exercise of body and mind are also
considered to improve cognitive processes. Are these
claims just popular beliefs? Is there any existing
research to support this?

What other health related risks could be effecting the
learning of these adults and how to navigate around
these issues for a better learning experience? Any
thoughts, research in this field? 

Lalitha

--- healthliteracy-request at nifl.gov wrote:


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>    1. [HealthLiteracy 1487] Re: how does health

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>       (AZSA at aol.com)

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> Message: 1

> Date: Fri, 9 Nov 2007 12:47:48 EST

> From: AZSA at aol.com

> Subject: [HealthLiteracy 1487] Re: how does health

> impact literacy?

> To: healthliteracy at nifl.gov

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> 

> The number of health issues that can have a direct

> impact on literacy is  

> vast.  I'd like to add a few more to the ones

> already named in the  discussion.  

> Some of them are, in fact, rather common! 

>     *   asthma/bronchitis/common cold - anything

> that generates frequent  

> coughing 

>     *   pin worms and other parasitic diseases -

> these not only cause sleep  

> deprivation, but daytime symptoms as well (not to

> mention nutritional  

> aspects) 

>     *   dental and oral issues - pain,

> embarrassment, speech and nutritional  

> considerations  (even 'normal' growth and

> development events like  losing 

> primary teeth can be incredibly distracting) 

>     *   anything causing itching - poison ivy,

> scabies/lice, eczema, etc. 

>     *   menstrual symptoms 

>     *   sleep deprivation 

>     *   bullying and interpersonal violence 

>     *   eating disorders

> Anne Zettek-Sumner, RN., M.Ed.

> 

> 

> 

> ************************************** See what's

> new at http://www.aol.com

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