The 3 Vitamins that Prevent Brain Loss

The 3 Vitamins that Prevent Brain Loss.jpeg

By our seventies, one in five of us will suffer from cognitive impairment. Within five years, half of those cognitively impaired will progress to dementia and death. The earlier we can slow or stop this process, the better.

Although an effective treatment for Alzheimer's disease is unavailable, interventions just to control risk factors could prevent millions of cases. An immense effort has been spent on identifying such risk factors for Alzheimer's and developing treatments to reduce them.

In 1990, a small study of 22 Alzheimer's patients reported high concentrations of homocysteine in their blood. The homocysteine story goes back to 1969 when a Harvard pathologist reported two cases of children, one dating back to 1933, whose brains had turned to mush. They both suffered from extremely rare genetic mutations that led to abnormally high levels of homocysteine in their bodies. Is it possible, he asked, that homocysteine could cause brain damage even in people without genetic defects?

Here we are in the 21st century, and homocysteine is considered "a strong, independent risk factor for the development of dementia and Alzheimer's disease." Having a blood level over 14 (µmol/L) may double our risk. In the Framingham Study, researchers estimate that as many as one in six Alzheimer's cases may be attributable to elevated homocysteine in the blood, which is now thought to play a role in brain damage and cognitive and memory decline. Our body can detoxify homocysteine, though, using three vitamins: folate, vitamin B12, and vitamin B6. So why don't we put them to the test? No matter how many studies find an association between high homocysteinea and cognitive decline, dementia, or Alzheimer's disease, a cause-and-effect role can only be confirmed by interventional studies.

Initially, the results were disappointing. Vitamin supplementation did not seem to work, but the studies were tracking neuropsychological assessments, which are more subjective compared to structural neuroimaging--that is, actually seeing what's happening to the brain. A double-blind randomized controlled trial found that homocysteine-lowering by B vitamins can slow the rate of accelerated brain atrophy in people with mild cognitive impairment. As we age, our brains slowly atrophy, but the shrinking is much accelerated in patients suffering from Alzheimer's disease. An intermediate rate of shrinkage is found in people with mild cognitive impairment. The thinking is if we could slow the rate of brain loss, we may be able to slow the conversion to Alzheimer's disease. Researchers tried giving people B vitamins for two years and found it markedly slowed the rate of brain shrinkage. The rate of atrophy in those with high homocysteine levels was cut in half. A simple, safe treatment can slow the accelerated rate of brain loss.

A follow-up study went further by demonstrating that B-vitamin treatment reduces, by as much as seven-fold, the brain atrophy in the regions specifically vulnerable to the Alzheimer's disease process. You can see the amount of brain atrophy over a two-year period in the placebo group versus the B-vitamin group in my Preventing Brain Loss with B Vitamins? video.

The beneficial effect of B vitamins was confined to those with high homocysteine, indicating a relative deficiency in one of those three vitamins. Wouldn't it be better to not become deficient in the first place? Most people get enough B12 and B6. The reason these folks were stuck at a homocysteine of 11 µmoles per liter is that they probably weren't getting enough folate, which is found concentrated in beans and greens. Ninety-six percent of Americans don't even make the minimum recommended amount of dark green leafy vegetables, which is the same pitiful number who don't eat the minimum recommendation for beans.

If we put people on a healthy diet--a plant-based diet--we can drop their homocysteine levels by 20% in just one week, from around 11 mmoles per liter down to 9 mmoles per liter. The fact that they showed rapid and significant homocysteine lowering without any pills or supplements implies that multiple mechanisms may have been at work. The researchers suggest it may be because of the fiber. Every gram of daily fiber consumption may increase folate levels in the blood nearly 2%, perhaps by boosting vitamin production in the colon by all our friendly gut bacteria. It also could be from the decreased methionine intake.

Methionine is where homocysteine comes from. Homocysteine is a breakdown product of methionine, which comes mostly from animal protein. If we give someone bacon and eggs for breakfast and a steak for dinner, we can get spikes of homocysteine levels in the blood. Thus, decreased methionine intake on a plant-based diet may be another factor contributing to lower, safer homocysteine levels.

The irony is that those who eat plant-based diets long-term, not just at a health spa for a week, have terrible homocysteine levels. Meat-eaters are up at 11 µmoles per liter, but vegetarians at nearly 14 µmoles per liter and vegans at 16 µmoles per liter. Why? The vegetarians and vegans were getting more fiber and folate, but not enough vitamin B12. Most vegans were at risk for suffering from hyperhomocysteinaemia (too much homocysteine in the blood) because most vegans in the study were not supplementing with vitamin B12 or eating vitamin B12-fortified foods, which is critical for anyone eating a plant-based diet. If you take vegans and give them B12, their homocysteine levels can drop down below 5. Why not down to just 11? The reason meat-eaters were stuck up at 11 is presumably because they weren't getting enough folate. Once vegans got enough B12, they could finally fully exploit the benefits of their plant-based diets and come out with the lowest levels of all.

This is very similar to the findings in my video Vitamin B12 Necessary for Arterial Health.

For more details on ensuring a regular reliable source of vitamin B12:

There are more benefits to lowering your methionine intake. Check out Methionine Restriction as a Life Extension Strategy and Starving Cancer with Methionine Restriction.

For more on brain health in general, see these videos:

In health,

Michael Greger, M.D.

PS: If you haven't yet, you can subscribe to my free videos here and watch my live, year-in-review presentations:

Image Credit: Thomas Hawk / Flickr. This image has been modified.

Original Link

The 3 Vitamins that Prevent Brain Loss

The 3 Vitamins that Prevent Brain Loss.jpeg

By our seventies, one in five of us will suffer from cognitive impairment. Within five years, half of those cognitively impaired will progress to dementia and death. The earlier we can slow or stop this process, the better.

Although an effective treatment for Alzheimer's disease is unavailable, interventions just to control risk factors could prevent millions of cases. An immense effort has been spent on identifying such risk factors for Alzheimer's and developing treatments to reduce them.

In 1990, a small study of 22 Alzheimer's patients reported high concentrations of homocysteine in their blood. The homocysteine story goes back to 1969 when a Harvard pathologist reported two cases of children, one dating back to 1933, whose brains had turned to mush. They both suffered from extremely rare genetic mutations that led to abnormally high levels of homocysteine in their bodies. Is it possible, he asked, that homocysteine could cause brain damage even in people without genetic defects?

Here we are in the 21st century, and homocysteine is considered "a strong, independent risk factor for the development of dementia and Alzheimer's disease." Having a blood level over 14 (µmol/L) may double our risk. In the Framingham Study, researchers estimate that as many as one in six Alzheimer's cases may be attributable to elevated homocysteine in the blood, which is now thought to play a role in brain damage and cognitive and memory decline. Our body can detoxify homocysteine, though, using three vitamins: folate, vitamin B12, and vitamin B6. So why don't we put them to the test? No matter how many studies find an association between high homocysteinea and cognitive decline, dementia, or Alzheimer's disease, a cause-and-effect role can only be confirmed by interventional studies.

Initially, the results were disappointing. Vitamin supplementation did not seem to work, but the studies were tracking neuropsychological assessments, which are more subjective compared to structural neuroimaging--that is, actually seeing what's happening to the brain. A double-blind randomized controlled trial found that homocysteine-lowering by B vitamins can slow the rate of accelerated brain atrophy in people with mild cognitive impairment. As we age, our brains slowly atrophy, but the shrinking is much accelerated in patients suffering from Alzheimer's disease. An intermediate rate of shrinkage is found in people with mild cognitive impairment. The thinking is if we could slow the rate of brain loss, we may be able to slow the conversion to Alzheimer's disease. Researchers tried giving people B vitamins for two years and found it markedly slowed the rate of brain shrinkage. The rate of atrophy in those with high homocysteine levels was cut in half. A simple, safe treatment can slow the accelerated rate of brain loss.

A follow-up study went further by demonstrating that B-vitamin treatment reduces, by as much as seven-fold, the brain atrophy in the regions specifically vulnerable to the Alzheimer's disease process. You can see the amount of brain atrophy over a two-year period in the placebo group versus the B-vitamin group in my Preventing Brain Loss with B Vitamins? video.

The beneficial effect of B vitamins was confined to those with high homocysteine, indicating a relative deficiency in one of those three vitamins. Wouldn't it be better to not become deficient in the first place? Most people get enough B12 and B6. The reason these folks were stuck at a homocysteine of 11 µmoles per liter is that they probably weren't getting enough folate, which is found concentrated in beans and greens. Ninety-six percent of Americans don't even make the minimum recommended amount of dark green leafy vegetables, which is the same pitiful number who don't eat the minimum recommendation for beans.

If we put people on a healthy diet--a plant-based diet--we can drop their homocysteine levels by 20% in just one week, from around 11 mmoles per liter down to 9 mmoles per liter. The fact that they showed rapid and significant homocysteine lowering without any pills or supplements implies that multiple mechanisms may have been at work. The researchers suggest it may be because of the fiber. Every gram of daily fiber consumption may increase folate levels in the blood nearly 2%, perhaps by boosting vitamin production in the colon by all our friendly gut bacteria. It also could be from the decreased methionine intake.

Methionine is where homocysteine comes from. Homocysteine is a breakdown product of methionine, which comes mostly from animal protein. If we give someone bacon and eggs for breakfast and a steak for dinner, we can get spikes of homocysteine levels in the blood. Thus, decreased methionine intake on a plant-based diet may be another factor contributing to lower, safer homocysteine levels.

The irony is that those who eat plant-based diets long-term, not just at a health spa for a week, have terrible homocysteine levels. Meat-eaters are up at 11 µmoles per liter, but vegetarians at nearly 14 µmoles per liter and vegans at 16 µmoles per liter. Why? The vegetarians and vegans were getting more fiber and folate, but not enough vitamin B12. Most vegans were at risk for suffering from hyperhomocysteinaemia (too much homocysteine in the blood) because most vegans in the study were not supplementing with vitamin B12 or eating vitamin B12-fortified foods, which is critical for anyone eating a plant-based diet. If you take vegans and give them B12, their homocysteine levels can drop down below 5. Why not down to just 11? The reason meat-eaters were stuck up at 11 is presumably because they weren't getting enough folate. Once vegans got enough B12, they could finally fully exploit the benefits of their plant-based diets and come out with the lowest levels of all.

This is very similar to the findings in my video Vitamin B12 Necessary for Arterial Health.

For more details on ensuring a regular reliable source of vitamin B12:

There are more benefits to lowering your methionine intake. Check out Methionine Restriction as a Life Extension Strategy and Starving Cancer with Methionine Restriction.

For more on brain health in general, see these videos:

In health,

Michael Greger, M.D.

PS: If you haven't yet, you can subscribe to my free videos here and watch my live, year-in-review presentations:

Image Credit: Thomas Hawk / Flickr. This image has been modified.

Original Link

Dr. Greger’s 2015 Live Year-in-Review Presentation

Food as Medicine

View my new live presentation here: Food as Medicine: Preventing and Treating the Most Dreaded Diseases with Diet

Every year I scour the world's scholarly literature on clinical nutrition, pulling together what I find to be the most interesting, practical, and groundbreaking science on how to best feed ourselves and our families. I start with the thousands of papers published annually on nutrition (27,000 this year--a new record!) and, thanks to a crack team of volunteers (and now staff!), I'm able to whittle those down (to a mere 8,000 this year). They are then downloaded, categorized, read, analyzed, and churned into the few hundred short videos. This allows me to post new videos and articles every day, year-round, to NutritionFacts.org. This certainly makes the site unique. There's no other science-based source for free daily updates on the latest discoveries in nutrition. The problem is that the amount of information can be overwhelming.

Currently I have more than a thousand videos covering 1,931 nutrition topics. Where do you even begin? Many have expressed their appreciation for the breadth of material, but asked that I try to distill it into a coherent summary of how best to use diet to prevent and treat chronic disease. I took this feedback to heart and in 2012 developed Uprooting the Leading Causes of Death, which explored the role diet may play in preventing, arresting, and even reversing our top 15 killers. Not only did it rise to become one of the Top 10 Most Popular Videos of 2012, it remains my single most viewed video to date, watched over a million times (NutritionFacts.org is now up to more than 1.5 million hits a month!).

In 2013 I developed the sequel, More Than an Apple a Day, in which I explored the role diet could play in treating some of our most common conditions. I presented it around the country and it ended up #1 on our Top 10 Most Popular Videos of 2013. Then in 2014 I premiered the sequel-sequel, From Table to Able, in which I explored the role diet could play in treating some of our most disabling diseases, landing #1 on our Top 10 Most Popular Videos of 2014.

Every year I wonder how I'm going to top the year before. Knowing how popular these live presentations can be and hearing all the stories from folks about what a powerful impact they can have on people's lives, I put my all into this new 2015 one. I spent more time putting together this presentation than any other in my life. It took me an entire month, and when you see it I think you'll appreciate why.

This year, I'm honored to bring you Food as Medicine, in which I go through our most dreaded diseases--but that's not even the best part! I'm really proud of what I put together for the ending. I spend the last 20 minutes or so (starting at 56:22) going through a thought experiment that I'm hoping everyone will find compelling. I think it may be my best presentation ever. You be the judge.

You can watch it at no cost online, but it is also available on DVD through my website or on Amazon. If you want to share copies with others, I have a five for $40 special (enter coupon code 5FOR40FAM). All proceeds from the sales of all my books, DVDs, downloads, and presentations go to the 501c3 nonprofit charity that keeps NutritionFacts.org free for all, for all time. If you want to support this initiative to educate millions about eradicating dietary diseases, please consider making a donation.

After you've watched the new presentation, make sure you're subscribed to get my video updates daily, weekly, or monthly to stay on top of all the latest.

-Michael Greger

Original Link

How Plant-Based Diets May Extend Our Lives

NF-July10 How a Plant Based Diet May Help you Live Longer.jpg

A recent review suggested that plant-based diets may prove to be a useful nutritional strategy for lifespan extension in part because they tend to be naturally low in the amino acid methionine (see my video Starving Cancer with Methionine Restriction). Apparently, the less methionine there is in body tissues, the longer different animals tend to live. But what are the possible implications for humans? See my video Methionine Restriction as a Life Extension Strategy.

I've talked before about the free radical theory of aging, the concept that aging can be thought of as the oxidation of our bodies just like rust is the oxidation of metal (see Mitochondrial Theory of Aging). Methionine is thought to have a pro-oxidant effect. The thinking is that lowering methionine intake leads to less free radical production, thereby slowing aging. Fewer free radicals would decrease the rate of DNA damage, which would curtail the rate of DNA mutation, slowing the rate of aging and disease and potentially increasing our lifespan.

There are three ways to lower methionine intake: The first is caloric restriction. By decreasing our overall intake of food, we would reduce our intake of methionine. Or, because methionine is found protein, we could practice protein restriction, eating a relatively protein deficient diet. The third option is eat enough food, eat enough protein, but just stick to proteins that are relatively low in methionine, which tends to mean plant proteins.

Caloric restriction is hard, because we walk around starving all the time. Something like every-other-day eating is described as "never likely to gain much popularity as a pro-longevity strategy for humans, so it may be more feasible to achieve moderate methionine restriction by eating a plant-based diet." On a population-wide level, folks could benefit from just lowering their protein intake, period. Researchers noted that "the mean intake of proteins [and thus methionine] of Western human populations is much higher than needed. Therefore, decreasing such levels has a great potential to lower tissue oxidative stress and to increase healthy life span in humans while avoiding the possible undesirable effects of caloric restriction."

We're eating around double the protein we need, so the first thing doctors can recommend is to decrease the intake of protein, but we can also get our methionine even lower by eating a plant-based diet.

The fact that beans have comparably low methionine has been classically considered a disadvantage. But, given the capacity of methionine restriction to decrease the rate of free radical generation in internal organs, to lower markers of chronic disease, and to increase maximum longevity, this "disadvantage" may actually be a strong advantage. This fits well with the important role of beans in healthy diets like the traditional Mediterranean diet. Interestingly, soy protein is also especially poor in methionine, which may help explain the healthy effects iof soyfoods. Watch my video Increased Lifespan from Beans.

The reason why plant-based diets are so protective is not known. Yes, vegetables contain thousands of phytochemicals, but separately investigating their possible protective roles would be an impossible task. The idea that the protective effect is not due to any of the individual plant food components, but to a synergic "combined effect" is gaining acceptance. However, based on the relationship of excess dietary methionine to vital organ toxicity, as well as its likely mechanism of action through increases in free radical generation, the possibility exists that the protective effects of plant-based diets can be due, at least in part, to their lower methionine content. As one paper concluded, "The low-methionine content of vegan diets may make methionine restriction feasible as a life extension strategy."

Plant-based diets can also mimic other benefits of caloric restriction, such as improving levels of the "fountain of youth" hormone DHEA. See The Benefits of Caloric Restriction Without the Actual Restricting.

Americans are living longer but sicker lives. That's why we need a diet and lifestyle that supports health and longevity. I have a whole presentation on the role diet can play in preventing, arresting, and even reversing many of our top 15 killers: Uprooting the Leading Causes of Death.

I've touched previously on the irony that animal protein may be detrimental for the same reasons it's touted as superior in Higher Quality May Mean Higher Risk.

-Michael Greger, M.D.

PS: If you haven't yet, you can subscribe to my free videos here and watch my 2013 live year-in-review presentation More Than an Apple a Day.

Original Link

A Low Methionine Diet May Help Starve Cancer Cells

NF-July8 A Low Methionine Diet May Help Starve Cancer Cells.jpg

When designing an antibiotic, we can't create a drug that destroys DNA because that's something that both humans and bacteria share in common. It would kill bacteria, but it might kill us, too. Instead, many antibiotics work by attacking bacterial cell walls, which is something bacteria have that we don't.

Similarly, antifungals can attack the unique cell walls of fungus. Pesticides can work by attacking the special exoskeleton of insects. But fighting cancer is harder because cancer cells are our own cells. So fighting cancer comes down to trying to find and exploit differences between cancer cells and normal cells.

Forty years ago, a landmark paper was published showing for the first time that many human cancers have what's called "absolute methionine dependency," meaning that if we try to grow cells in a Petri dish without giving them the amino acid methionine, normal cells thrive, but without methionine, cancer cells die. Normal breast cells grow no matter what, with or without methionine, but cancer cells need that added methionine to grow.

What does cancer do with the methionine? Tumors use it to generate gaseous sulfur-containing compounds that, interestingly, can be detected by specially trained diagnostic dogs. There are mole-sniffing dogs that can pick out skin cancer. There are breath-sniffing dogs that can pick out people with lung cancer. Pee-sniffing dogs that can diagnose bladder cancer and--you guessed it--fart-sniffing dogs for colorectal cancer. Doctors can now bring their lab to the lab!

It gives a whole new meaning to the term pet scan :)

Methionine dependency is not just present in cancer cell lines in a Petri dish. Fresh tumors taken from patients show that many cancers appear to have a biochemical defect that makes them dependent on methionine, including some tumors of the colon, breast, ovary, prostate, and skin. Pharmaceutical companies are fighting to be the first to come out with a drug that decreases methionine levels. But since methionine is sourced mainly from food, a better strategy may be to lower methionine levels by lowering methionine intake, eliminating high methionine foods to control cancer growth as well as improve our lifespan (see Methionine Restriction as a Life-Extension Strategy).

Here's the thinking: smoking cessation, consumption of diets rich in plants, and other lifestyle measures can prevent the majority of cancers. Unfortunately, people don't do them, and as a result hundreds of thousands of Americans develop metastatic cancer each year. Chemotherapy cures only a few types of metastatic cancer. Unfortunately, the vast majority of common metastatic cancers, such as breast, prostate, colon, and lung, are lethal. We therefore desperately need novel treatment strategies for metastatic cancer, and dietary methionine restriction may be one such strategy.

So, where is methionine found? In my video, Starving Cancer with Methionine Restriction, you can see a graph of foods with their respective methionine levels. Chicken and fish have the highest levels. Milk, red meat, and eggs have less, but if we really want to stick with lower methionine foods, fruits, nuts, veggies, grains, and beans are the best. In other words, "In humans, methionine restriction may be achieved using a predominately vegan diet."

There are also compounds in animal products that may actually stimulate tumor growth. See, for example, How Tumors Use Meat to Grow: Xeno-Autoantibodies. Animal protein may also boost levels of the cancer-promoting hormone IGF-1 (The Answer to the Pritikin Puzzle). Combined, this could all help explain why plants and plant-based diets have been found effective in potentially reversing some cancer processes. See Cancer Reversal Through Diet?, Strawberries versus Esophageal Cancer, and Black Raspberries versus Oral Cancer.

So why isn't every oncologist prescribing a low-methionine diet? One researcher notes that "Despite many promising preclinical and clinical studies in recent years, dietary methionine restriction and other dietary approaches to cancer treatment have not yet gained wide clinical application. Most clinicians and investigators are probably unfamiliar with nutritional approaches to cancer." That's an understatement! "Many others may consider amino acid restriction as an 'old idea,' since it has been examined for several decades. However, many good ideas remain latent for decades if not centuries before they prove valuable in the clinic....With the proper development, dietary methionine restriction, either alone or in combination with other treatments, may prove to have a major impact on patients with cancer."

Why might the medical profession be so resistant to therapies proven to be effective? The Tomato Effect may be partially to blame.

In my video, Anti-Angiogenesis: Cutting Off Tumor Supply Lines, researchers come to the same plant-based conclusion from a different perspective, starving cancers of their blood supply.

-Michael Greger, M.D.

PS: If you haven't yet, you can subscribe to my free videos here and watch my live year-in-review presentations Uprooting the Leading Causes of Death and More Than an Apple a Day.

Image Credit: PNNL - Pacific Northwest National Laboratory / Flickr

Original Link