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To take supplements or not to take supplements-that is the question. It can be complicated to sort out what, if anything, to take for better health. Brain health is an important concern and supplements for that purpose are being touted. The truth is that we cannot separate the brain from the body; therefore, focusing on good overall health will benefit the body and mind alike.

Assuming you are able to eat a healthy, balanced diet the general wisdom about supplements would be to proceed with caution. Getting nutrients naturally from whole, fresh, unprocessed food is always best. However, getting a healthy balanced diet may be challenging and therefore backing up with supplements may be wise. If you chose to take supplements follow the ABC’s laid out below:

A- Avoid harm

Remember that we always want to avoid harm if using a supplement. Harm can be done by taking larger than recommended doses, taking herbs and combinations of herbs that will interfere with medications, cause side effects or make a medical condition worse and taking supplements that do not contain the appropriate amount of the active ingredient or contain contaminants.

B- Be informed

A good rule for taking supplements is to take those that have research that shows some benefit to health and addresses safety concerns. Some of those are listed below. You can check out supplements and herbs at www.medlineplus.gov. Buy reputable brands from stores that have oversight by a pharmacist who is aware of the quality of products sold in their store.

C- Consult

Because we are living longer, many people are living with chronic medical conditions that require the use of medications and in some cases seeing more than one doctor. Due to the complexity of managing health, it is unwise to go it alone. You should have a primary care provider who you trust and consult for every aspect of your health care including what supplements you chose to take. It is ok to do research on your own and make suggestions to that person, but always collaborate. The ability to have that type of relationship should be one of your measures of a good health care practitioner. Commonly suggested supplements for brain health:

Gingko - Until recently, gingko was considered to be a reputable supplement for memory and brain health. However, the recently published Gingko Evaluation of Memory study at the University of Pittsburg, a large study, showed no benefit from gingko for preventing dementia. Gingko can interact with blood thinning medication and cause serious problems. Many makers of supplements containing gingko are still making claims about its benefits for brain health. Research related to other possible benefits of gingko is ongoing.

Fish oil-Omega 3 fatty acid - The benefits of omega 3 fats such as those found in fish oil are well documented both for brain health and heart health. It is possible to get the required amount by eating two cold water fish meals per week. If you are not able to do that, talk to your health care provider about supplementing with a high quality fish oil supplement. Your doctor may also suggest fish oil supplements if you have heart or vascular disease or multiple risk factors for these conditions (e.g., hypertension, diabetes, or elevated cholesterol levels). Other sources of omega 3 fats are nuts especially walnuts and almonds.

Folic acid- University of Iowa researchers found that 75 percent or older adults consumed too little folate, a B vitamin that might help prevent heart disease and stroke. In a more recent study published in "The Lancet," supplementing with folic acid (the synthetic form of folate) for three years was shown to improve cognitive function in adults. Even so, experts aren't sure whether taking a supplement can delay or prevent the onset of dementia. If you don't eat a lot of fortified foods such as cereals and store-bought bread, taking a supplement might help. Other good food sources include legumes such as beans, vegetables such as asparagus and green leafy vegetables, fruits including strawberries, melons, and oranges, and sunflower seeds The recommended daily amount is 400 mcg a day. Avoid doses greater than 1000 mcg a day unless recommended by your physician.

Vitamin C and E - Most of us get adequate vitamin C and E from a well-balanced diet. A multivitamin will help ensure that we get at least the recommended daily allowance. Avoid doses of vitamin E greater than 1000 mg/day unless recommended otherwise by your doctor. Good food sources of vitamin E include: green leafy vegetables, vegetable oils, eggs, fortified cereals, and nuts. Foods high in vitamin C include citrus fruits, orange juice, tomato juice, cantaloupe, broccoli, and green and red peppers.

Antioxidants - Found in colorful fruits and vegetables, tea, coffee, red wine and chocolate to name a few, antioxidants have been shown to have benefit for heart health, cancer prevention and brain health (in animal studies). A diet like the Mediterranean diet that is rich in the foods mentioned above should be adequate. There are many supplements that claim to be very high in antioxidants and therefore good for health. Research has not yet shown that taking antioxidants in pill form is beneficial with the possible exception of grape seed extract. More study is recommended. In the meantime, food sources highest in antioxidants include apples, blueberries, strawberries, cranberries, raspberries, plums, red onions, beans, and artichokes. Be cautious with antioxidant supplements as many do not have research to back them up and some may cause harm, especially to your pocket book.

Vitamin D - While not specifically recommended for brain health, vitamin D deficiency is very common. Most vitamin D is manufactured in the skin in the presence of sun exposure. Usually 15 minutes of unprotected sun exposure daily will do the trick. Very few foods in nature contain vitamin D.  An exception is the fish we recommend for omega-3 fatty acids (cold water fish such as salmon, mackerel, sardines, herring, and lake trout).

Fish oils such as cod liver oil are also rich in vitamin D. One tablespoon of cod liver oil has 1300 units. Other food sources include products fortified with vitamin D such as breakfast cereals, milk, and some brands of orange juice and yogurt. Those who have vitamin D deficiency are usually people who don’t have adequate exposure to sunlight or who have poor dietary intake of vitamin D.

Many doctors are now checking vitamin D levels especially in older adults and/or suggesting supplementation. If you are deficient, ask your doctor what dosage of vitamin D you should take. In some cases, a prescription supplement may be advised. Symptoms of vitamin D deficiency include muscle weakness, cramping and bone pain.

Hippocrates, the father of medicine said "let food be your medicine and medicine your food." Heed this advice when choosing what to eat. The better your diet, the fewer supplements you will need to consider.


Best Wishes,
Carol Cummings, BSN, RN
Certified Wellness Coach
Brookdale Senior Living



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