Perry Renshaw M.D., Ph.D.

Feed Your Brain

Creating a Good Brain Health Menu

Studies suggest healthy diet, supplements may help maintain cognitive function

Posted Mar 21, 2013

Like every other part of your body, your brain needs good nutrition to perform at its best. In the brain, nutrients facilitate essential functions that enable you to think, remember, sense, act and react – in a word, to live.

1. Nutrients help brain cells burn glucose – their primary fuel – more efficiently.

2. Nutrients help protect brain cells from oxidative damage.

3. Nutrients help brain cells make important neurotransmitters, the chemical messengers these cells use to communicate with each other and the rest of the body.

Researchers have accelerated their efforts to find nutritional ways to support brain health, in order to help our society meet the coming challenge of an aging population. These efforts are paying off. Today, accumulating evidence suggests that not only better overall nutrition, but also supplementation with several key nutrients may help stave off the reduced efficiency of brain cells that occurs with aging. These nutrients include:

• B vitamins – Especially those needed for metabolism (thiamin, riboflavin, niacin) and those needed to regulate homocysteine levels (folic acid, vitamin B12 and vitamin B6)

• Antioxidant vitamins E and C

o Other antioxidants, such as alpha-lipoic acid and plant extracts

• Essential fatty acids -- the “good fats” found in fish, nuts and vegetables

• Supplements and other precursor neurotransmitters

Studies suggest that a healthy diet plus supplements may help maintain cognitive function. The typical “Mediterranean” dietary pattern that includes higher levels of fish, olive oil, fruits and vegetables, cereals and wine has been found to be protective against age-related cognitive decline.1 This type of diet delivers higher amounts of omega-3 fatty acids (from fish), monounsaturated fatty acids (from olive oil and other vegetables), antioxidants (from fruits, vegetables and wine), and B vitamins (from cereal) than the typical Western diet. All of these are beneficial to both heart health and brain health, especially when they replace saturated fat and sugars.

B Vitamins

The B vitamins, especially thiamin, niacin, folate, vitamin B6 and vitamin B12 are all implicated in brain health. Adequate levels of thiamin, niacin, vitamin B6 and vitamin B12 are needed for the efficient metabolism of glucose, the brain’s primary fuel, and dementia is a well-documented symptom of deficiency of these vitamins.2

Folate, vitamins B6 and vitamin B12 are involved in the metabolic cycle that regulates homocysteine, an amino acid formed during the breakdown of protein. Elevated homocysteine has been shown to be a risk factor for impaired cognitive abilities in the elderly,3,4,5 as well as for a decline in memory,6 and the dementia related to Alzheimer’s disease.7 Elevated homocysteine has been associated with inadequate intake of vitamin B12, vitamin B6 or folate.


Oxidative damage to brain cells is strongly implicated in Alzheimer’s disease and other forms of cognitive decline.8,9 Oxidative damage occurs as a result of metabolic reactions that release unstable molecules called “free radicals,” which in turn attack the fats in cell membranes and other critical cell structures. The brain is very rich in fats that are vulnerable to oxidation.

Certain nutrients, such as vitamins E and C, are antioxidants with the ability to neutralize free radicals, thereby protecting cells and tissues against oxidative damage. For this reason, scientists have been studying a possible protective role for these vitamins in the brain and nervous system. Low levels of vitamin E have been found in the cerebrospinal fluid of Alzheimer patients, making this tissue vulnerable to oxidation. In laboratory studies, vitamins E and C were shown to protect the cells in this fluid against oxidation.10

Other antioxidants and plant compounds such as alpha-lipoic acid, coenzyme Q10, Ginkgo biloba, curcumin and fruit polyphenols are also being studied for potential benefits in brain health.

The “Good Fats”

Unsaturated fats – the “good fats” that promote heart health – also promote brain health. These include polyunsaturated fatty acids from vegetable sources (corn oil, safflower oil, soybean oil, peanuts) and from marine sources (fish oil; fatty fish such as tuna, salmon, herring) and monounsaturated fats from plant foods (olive oil, tree nuts).

Unsaturated fatty acids are critical components of neural cell membranes and are needed for the production and proper functioning of neurotransmitters, the chemical messengers these cells use to communicate. The polyunsaturated fatty acid DHA (docosahexaenoic acid), often called “omega-3,” comprises up to 50% of total fatty acids in the gray matter and is believed to exert a major influence on neural composition and function. Higher dietary intakes of fish and/or DHA have been associated with reduced cognitive decline in a number of population studies.11


It’s sometimes hard to get the nutrients needed to keep the brain operating at optimal levels. In those cases, it may be necessary to complement vitamin intake and diet with supplements, including:

• Citicoline – Supplementation with citicoline raises brain levels of acetylcholine and supports memory and mental performance in healthy individuals. Some studies have shown that citicoline is also able to reverse age-related changes in people with mild memory problems. In addition to its role in raising neurotransmitter levels, citicoline increases the amount of phospholipids (specialized fats) in brain cell membranes and helps protect them against oxidative damage. This protection means that vast numbers of brain cells will not be lost to the ravages of time.12,13,14

• CoQ10 – Coenzyme Q10 (CoQ10) is a substance that's found naturally in the body and helps convert food into energy. CoQ10 is found in almost every cell in the body, and is a powerful antioxidant. Some researchers believe that CoQ10 may help with heart-related conditions, because it can improve energy production in cells, prevent blood clot formation, and act as an antioxidant.15

• Ginkgo Biloba – Ginkgo leaf extracts have been shown to protect neurons from oxidative damage potentially preventing the progression of tissue degeneration in patients with dementia.16

• Magnesium – Various regions in the brain associated with learning and memory experienced significant improvements in synaptic function as a result of magnesium dietary supplementation.17

1. Panza F et al. Mediterranean diet and cognitive decline. Public Health Nutr. 2004;7(7):959-63.

2. Food and Nutrition Board, Institute of Medicine. Dietary Reference Intakes for Thiamin, Riboflavin, Niacin, Vitamin B6, Folate, Vitamin B12, Pantothenic Acid, Biotin, and Choline. National Academy Press, Washington, DC; 1998.

3. Riggs KM et al. Relations of vitamin B12, vitamin B6, folate, and homocysteine to cognitive performance in the Normative Aging Study. Am J Clin Nutr 1996;63:306-14.

4. Miller JW et al. Homocysteine and cognitive function in the Sacramento Area Latino Study on Aging. Am J Clin Nutr. 2003;78;3:441-47.

5. Raman G et al. heterogeneity and lack of good quality studies limit association between folate, vitamins B6 and B12, and cognitive function. J Nutr. 2007;137(7):1789-94.

6. Tucker KL et al. High homocysteine and low B vitamins predict cognitive decline in aging men: the Veterans Affairs Normative Aging Study. Am J Clin Nutr. 2005;82(3):627-35.

7. Clarke R et al. Folate, vitamin B12, and serum total homocysteine levels in confirmed Alzheimer disease. Arch Neurol. 1998;55:1449-55.

8. Behl C. Oxidative stress in Alzheimer's disease: implications for prevention and therapy. Subcell Biochem. 2005;38:65-78.

9. Rutten BP et al. Antioxidants and Alzheimer’s disease: from bench to bedside (and back again). Curr Opin Clin Nutr Metab Care. 2002;5(6)645-51.

10. Kontush K et al. Vitamin E in neurodegenerative disorders: Alzheimer’s disease. Ann NY Acad Sci. 2004;1031:249-62.

11. Review by Denis et al., Ageing Research Review, 2013.

12. Secades JJ et al. CDP-choline: pharmacological and clinical review, 2006 update. Meth Find Exp Clin Pharmacol. 2006;27(Suppl B):1-56.

13. Alvarez XA et al. Citicoline improves memory performance in elderly subjects. Meth Find Exp Clin Pharmacol. 199719(3):201-10.

14. Spiers PA et al. Citicoline improves verbal memory in aging. Arch Neurol. 1996;53(5):441-48.

15. Source:


17. ^ Magnesium Boosts Memory and Learning Neuron Inna Slutsky, Nashat Abumaria, Long-Jun Wu, Chao Huang, Ling Zhang, Bo Li, Xiang Zhao, Arvind Govindarajan, Ming-Gao Zhao, Min Zhuo, Susumu Tonegawa, Guosong Liu.