The more than a quarter of Americans over the age of 50 who take a dietary supplement to improve their brain health are not only wasting their money, they may also be putting their health at risk, according to a report released this month by a panel of experts convened by AARP.
For the report, an international team of independent neurologists, nutritionists and researchers reviewed the best available studies on the impact of various dietary supplements on people’s memory or other cognitive functions as they age.
They found no good evidence that any of the products worked.
The analysis included vitamin and mineral supplements, especially those containing the eight B vitamins and vitamins D and E, as well as other products commonly marketed for brain health, such as apoaequorin (a jellyfish protein), coenzyme Q10, turmeric/curcumin, ginkgo biloba, melatonin and omega-3 fatty acid capsules.
“People taking these pills are spending between $20 and $60 a month and flushing dollars down the toilet that could be better spent on things that actually improve their brain health,” said Sarah Lenz Lock, a senior vice president at AARP, in a released statement. Lock is also executive director of the AARP’s Global Council on Brain Health, the group of experts who wrote the report.
The amount of money being wasted on so-called brain-health supplements is quite large. The report notes that American consumers spent an estimated $3 billion on these products in 2016. That number is expected to grow to $5.8 billion by 2023.
Safety concerns
As the report points out, unlike prescription and over-the-counter drugs, dietary supplements are not regulated by the Food and Drug Administration (FDA) — or any other agency — for their effectiveness or safety before they go on the market.
The FDA and other agencies “can only take enforcement action against unsubstantiated or false claims once the product is already on the market,” the authors of the new report explain. “This situation may lead many people to have a false sense of security when it comes to taking dietary supplements they find on store shelves or online.”
Indeed, an AARP survey taken earlier this year found almost half of older adults mistakenly believe that the FDA tests supplements before they are sold.
This lack of pre-sale regulation means products can contain ingredients that are harmful — and, in some cases, even deadly — to consumers. As I’ve reported here before, some dietary supplements have been found to contain actual pharmaceutical drugs, such as sibutramine, which raises blood pressure, and fluoxetine, which has been linked to suicidal thoughts, abnormal bleeding and seizures. Consumers have no way of knowing that those drugs are in the supplements, however, because they are not listed on the products’ labels.
Each year, about 23,000 Americans are treated in hospital emergency rooms for side effects related to known and unknown ingredients in dietary supplements.
Another major concern about the safety of dietary supplements is their potential for having a harmful interaction with medications and other medical treatments. As the authors of the new report point out, taking supplements with vitamin K can, for example, decrease the effectiveness of blood thinners used to treat cardiovascular disease, and antioxidant vitamins such as C and E may reduce the effectiveness of chemotherapy. In addition, herbal supplements, including echinacea, ginseng, valerian, saw palmetto and St. John’s wort, can increase risks during surgery.
Caveat emptor
Before you waste your money on dietary supplements, the experts who put together the report urge you to consider these points:
- Rather than turning to supplements to boost brain health, choose foods known to support a healthy brain. [According to an earlier report by the same group of experts, these foods include berries (not juice), fresh vegetables (especially leafy greens), healthy fats (such as those found in extra virgin olive oil), nuts (in moderation because of their calories), and fish and seafood.]
- Consult your health care provider if you are considering taking a supplement, and ask about the risks, benefits and medication interactions. We do not recommend taking dietary supplements for brain health unless your health care provider has determined you are nutrient-deficient or are at risk of becoming so (i.e., for reasons of deficiencies caused by diet, lifestyle, certain surgeries or other health issues).
- Carefully check ingredients and information on supplement labels. Be aware that product labels may not reflect the actual ingredients or their amounts in the supplements. Products often contain less or more of what they claim. In some cases, there may be additional ingredients not listed on the label at all, some of which may be harmful to your health.
- Verify the quality of evidence about the product’s effectiveness, purity and quality. [The report offers tips on how to do this.]
- If you are experiencing significant memory loss, consult your health care provider, who may wish to check your folate and B12 levels. Individuals should follow their health care provider’s advice to make sure the supplements taken are appropriate to address their specific deficiency or problem. Make sure you do not take too much of any of the B vitamins and check to see if the foods you eat are already fortified with them. If your health care provider advises that you take folic acid, ask whether you should take it with vitamin B12. Vitamin B “complex” supplements contain different mixtures of B-vitamins at different doses, not all of which are needed by a particular individual.
- Although caffeine may provide some short-term benefits in mental alertness and focus, caffeine supplements in the form of energy drinks and pills may carry health risks and are not recommended.
You can read the report in full on AARP’s website.
We can actually make this much more simple: Just don’t waste your time, it’s not even worth following these recommendations, asking Dr’s, checking this and that and the other thing. Just skip it. These products have been and always will be marketing projects designed to separate people from their money. There’s never any real science or research behind them, and the most dangerous scenario is that they actually DO something to your brain or body in some way. Just ignore this stuff, it’s not even worth checking into. Eat healthy, exercise safely, get those lumps and funny looking skin things looked at, stay active. Forget this nonsense.
Nutrition can be a highly complex subject, with many ambiguous and conflicting claims. It doesn’t help at all that many doctors receive inadequate training in nutrition.
Another problem seems to be blanket statements, pro or con, regarding any number of nutritional claims.
Take CoQ10, a molecule (like all the ones mentioned above) that’s the subject of ongoing research. If one were to take the AARP or Perry’s article at face value regarding the role of CoQ10, you’d get the impression that research has settled the matter: CoQ10 lacks efficacy relative to brain health. But this impression is possibly or likely false.
A quick search using google scholar immediately casts doubt on the claim that CoQ10 doesn’t improve brain health. Here’s one research study title published in 2019:
“Water-soluble CoQ10 as A Promising Anti-aging Agent for Neurological Dysfunction in Brain Mitochondria”
Another, finding “potent” effects of CoQ10:
“Efficacy of CoQ10 as supplementation for migraine: A meta‐analysis”
Where does this leave the average person like me, finding articles like this? Well, to do due diligence you’d have to know something about the legitimacy of the journal that published the study. You’d have to know how to read journal articles, understand something about statistics and also the limitations of in vitro and animal test subjects vs. in vivo trials. In other words, you need a bit of specialized training to make sense of this study. You’d also need to be aware that one study isn’t necessarily definitive at all, and even that many studies showing the same result might have underlying flaws or limitations, and that sometimes an established scientific claim about some nutrient might be overturned or found to be more complex than previously thought.
My overall point is the following. Medical and health journalism runs the risk of misinforming the public due to the inherent complexities and uncertainties of science.
It’s a safe assumption that Perry understands all of the above perfectly well, and perhaps better than I do.
This in turn makes me wonder if there’s an implicit audience in mind for the above article. That audience’s profile is that it won’t read (or have access to) journal articles, it isn’t equipped at the moment to understand them, and it might not grasp the ambiguities, complexities and opinion reversals so common in research. If an underlying goal of health journalism is to improve public health by providing reliable information, then the assumption seems to be to err on the side of caution rather than lead people into the confusing weeds.
A justifiable approach, certainly, but it leaves the informed but non-expert in a place of uncertainty.
Eric,
If you going to participate in a scientific discussion you should provide proper citations, not simply titles. We need the Journal, volume number, date, and authors at a minimum.
Brain chemistry, bio-chemistry, neuro-chemistry, organic chemistry, and the physiology of digestive systems, brain cells, and neurological systems, are all part of standard training for MD’s and way beyond the the scope of nutritionist training and education. The MD’s that study these areas have even more training and education in this area than typical MD’s.
These ARE complex issues involving multiple disciplines and scientific fields of expertise. Without sufficient training and education regarding the subject matter, methodology, and empirical methods, interpreting technical peer reviewed articles can be very difficult. Extrapolating from a study about mitochondria for instance to make a claim about eating sea weed or something can be completely ridiculous. These not subjects you can just google your way into.
I was looking for an excuse to stop taking a B12 tablet every morning, and Susan has provided it.