A big welcome to the October 2024 of CMG Topic Series, where we look at cognitive health, with a particular focus on nutritional and herbal medicine in Alzheimer’s Disease.
Cognitive Health
By Dr Brad McEwen PhD, MHSc (Hum Nutr), MPH, BHSc
CMG Head of Products and Innovation
I had the honour of presenting on the important topic of “Alzheimer’s disease and Nutritional medicine: an intricate metabolic network” at the ACNEM conference on Saturday 19 October. Stay tuned for an upcoming journal article to be published in December 2024.
Alzheimer’s disease is the main cause of dementia and is quickly becoming one of the most burdening, lethal, and expensive diseases of the 21st Century. Recent data and current projections indicate that by the year 2050, the prevalence of dementia will double in Europe and triple worldwide.
Alzheimer’s disease is the predominant type of dementia, representing 60-80% of all dementia cases. It is characterised by a degenerative brain condition that leads to a decline in cognitive abilities, memory loss, impaired thinking, reasoning, and behavioural changes. These symptoms are severe enough to disrupt an individual’s daily routines and social interactions, eventually leading to difficulties in communication and responsiveness to their surroundings.
Alzheimer’s disease is a degenerative condition that deteriorates progressively over time, with dementia symptoms gradually worsening over a span of several years. In the initial stages, memory loss is mild, and the primary early indication of Alzheimer’s is the difficulty in recalling recently acquired information. The alterations in the brain may commence a decade or even earlier before the manifestation of symptoms. During this early phase of Alzheimer’s, the brain undergoes detrimental alterations, characterised by the abnormal accumulation of proteins that form amyloid plaques and tau tangles. Neurons that were previously healthy cease to function, lose connections with other neurons, and ultimately perish. While Alzheimer’s disease can affect anyone, it is more prevalent among older individuals.
Alzheimer’s disease is considered a metabolic condition due to a multitude of pathophysiological alterations and an array of risk factors like cognitive inactivity, sedentary behaviour, obesity, type 2 diabetes, high cholesterol, hypertension, and other factors.
Nutritional medicine is the foundation of optimum physical and mental health and wellbeing. Essential nutrients such as vitamins, minerals, amino acids, and food phytochemicals offer a wide range of health benefits, including promoting brain and nerve function, improving cardiometabolic health, supporting energy metabolism, regulating immune system function, reducing inflammation, and having antioxidant effects.
A variety of herbal medicines and nutrients contribute to the improvement of the digestive system through both direct and indirect mechanisms. The following examples illustrate various herbal medicines and nutrients that can be incorporated into your products. Contact CMG to discuss NPD opportunities for cognitive and mental health and other products.
Herbal Medicines
Ashwagandha
Ashwagandha (Withania somnifera) is a widely utilised herb known for its various beneficial properties. It is particularly recognized for its nootropic effects, which enhance memory, cognitive function, concentration, attention, and overall mood. As an adaptogen, Ashwagandha aids the body in managing stress, thereby alleviating symptoms of stress, anxiety, and depression, while also promoting better sleep quality.
Ashwagandha has tonic, anti-inflammatory, antioxidant, immunomodulatory, and neuroprotective properties. Research has shown that Ashwagandha can improve cardiorespiratory fitness, fatigue, and recovery.
Lemon Balm
Lemon Balm (Melissa officinalis) is a multipurpose versatile herb recognised for its various applications in cognitive and mental health. Lemon Balm has beneficial properties for digestion and exhibits antispasmodic and carminative properties. Furthermore, it is known to enhance memory, cognitive function and performance, mood, and improves stress and anxiety.
An open-label study found that after 15 days, Lemon Balm reduced insomnia, time taken to get to sleep, delayed insomnia (e.g. early awakening at dawn), anxiety, agitation, tension, and feelings of guilt, along with an improvement of fatigue.
Sage
Salvia originates from a Latin word meaning “to heal”. The use of Sage (Salvia officinalis) spans several millennia and has a long history of use. Sage has a long-standing use as a traditional herbal remedy that can enhance memory and improve cognitive functions. The use of Sage as a cognition enhancer and for the treatment of cognitive decline dates back to the ancient Greeks.
Sage has cognitive effects and has numerous applications for improving cognition, memory, secondary memory, improved delayed word recall attention, alertness, and learning, and for cognitive disorders, learning disorders, and cognitive decline.
Sage has been found to inhibit acetylcholinesterase. Acetylcholinesterase is an enzyme that metabolises and breaks down acetylcholine. Acetylcholine plays an essential role in the formation of memories and cognition.
Turmeric
Turmeric (Curcuma longa) has a long history of use and is a favourite among health professionals. Turmeric has memory enhancing, neuroprotective, anti-inflammatory, antioxidant, hepatoprotective, immunomodulatory, antimicrobial, anti-depressant and wound healing properties. Turmeric is used for inflammation, oxidative stress, cardiovascular disease, cardiometabolic disease, hyperlipidaemia, depression, gastrointestinal disorders, Crohn’s disease, liver conditions, osteoarthritis, acne, dermatitis, psoriasis, and pain.
Nutrients
B Vitamins
Numerous studies have indicated that reduced plasma levels of B vitamins in patients with Alzheimer’s disease are associated with disrupted homocysteine metabolism, as well as a diminished release of docosahexaenoic acid and choline into the bloodstream. B vitamins play a vital role in one-carbon metabolism and are essential for sustaining cellular methylation processes.
Active Folate
Active Folate (5-MTHF) has multiple functions within the human body. Active Folate (5-MTHF) is essential for normal healthy growth and development and plays a critical role in cell growth and division. Active Folate is involved in one-carbon metabolism, methylation processes, neurotransmitter synthesis, metabolism of homocysteine, and endothelial cell function.
The classical symptom of folate deficiency is megaloblastic anaemia. A deficiency of folate disrupts DNA synthesis and methylation and results in reduced DNA synthesis and altered cell division, altered synthesis of purines and pyrimidines, cognitive dysfunction and decline, peripheral neuropathy, depression, anaemia, cardiovascular diseases, and hyperhomocysteinaemia.
Vitamin K2
Vitamin K2 (Menaquinone-7) plays a significant role in various aspects of health, including brain health, brain signalling, coagulation, vascular health, and bone health. Vitamin K2 has anti-inflammatory and antioxidant properties. Vitamin K2 has shown beneficial effects in reducing arterial stiffness and vascular calcification.
Menaquinone-7 has numerous clinical applications, some of these include brain health, arterial stiffness, coronary and vascular calcification, type 2 diabetes, osteoporosis, rheumatoid arthritis, and depression in women with polycystic ovary syndrome.
Tocotrienols
Vitamin E Tocotrienols are antioxidants and free radical scavengers. Vitamin E Tocotrienols protect cell membranes from oxidative damage and optimise and enhance the immune system. Additionally, tocotrienols have cholesterol-lowering properties.
Magnesium
Magnesium ranks among the most well-known and favourite minerals, playing a crucial role in more than 300 enzymatic reactions. Magnesium is involved in the synthesis of ATP, DNA, and RNA, mitochondrial health, metabolic functions, energy metabolism, metabolism of carbohydrates, protein and fats, glycolysis, and oxidative phosphorylation. Magnesium is involved in nerve function, neurotransmission, neurotransmitters, nitric oxide metabolism, regulation of intracellular calcium levels, and transmembrane electrolyte flux.
In the musculoskeletal and nervous systems, magnesium is involved in the relaxation of smooth muscle, normal muscle function, muscle contraction, muscle relaxation, bone strength, bone metabolism, bone mineralisation, bone mineral density, and bone integrity. Magnesium is involved in the maintenance of normal muscle and nerve function, heart rhythm, and the immune system.
A deficiency of magnesium has been associated with depression, fatigue, anxiety, apathy, agitation, and irritability, muscle spasms, and nervousness.
Zinc
Zinc has various roles within the human body. Zinc is involved in for catalytic, structural, and regulatory functions. This essential mineral is a constituent of approximately 300 enzymes and plays a critical role in the synthesis of DNA and RNA, regulation of gene expression, maintenance of cell structure, facilitation of neurotransmission, neuromodulator in synaptic vesicles, and supports brain function. It is involved in the enhancement of immune system health, promotion of cardiovascular wellbeing, and exhibits both antioxidant and anti-inflammatory effects.
Other Ingredients
Ubiquinol
Ubiquinol (Coenzyme Q10) is involved in mitochondrial energetics, antioxidant action, reducing inflammation, and improving vasodilation. Coenzyme Q10 improves fatigue in people with fibromyalgia and improves exercise capacity. It also reduces statin-related fatigue.
Probiotics
Probiotics have a beneficial role in improving physical and mental health. Probiotics are involved in the modulation of microbiota within the microbiota-gut-brain axis. Probiotics are clinically indicated for their application in several areas, including digestive health, cognitive function and memory, overall mental health, depression, anxiety, mood, stress, post-partum depression and anxiety, autism spectrum disorder, obsessive-compulsive disorder, fatigue, anger, aggression, sleep quality, system inflammation, and oxidative stress. Probiotics mediate their anti-inflammatory effects via the modulation of proinflammatory cytokines and restoration of gut permeability.
Conclusion
Alzheimer’s Disease is a multifactorial long-term chronic disease state. The dis-ease state occurs 15-20 years before symptoms appear. Reducing risk factors at any time of life improves cognitive outcomes. Nutritional medicine is the foundation of optimum cognitive health. Various herbs and nutrients are utilised for optimising cognitive health, such as Ashwagandha, Lemon Balm, Sage, Turmeric, Active Folate, Vitamin K2, Tocotrienols, Magnesium, Zinc, Ubiquinol, and probiotics. Contact CMG to discuss NPD opportunities for your brand.
References
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For information purposes only. Not a substitute for medical advice. If symptoms persist, talk to a health professional.