An Enlightening Double Whammy For Alzheimer’s 

By Jerome Burne

Hundreds of billions of dollars have been spent by pharmaceutical companies developing drugs that clear them out. But while they do the job, the clean-up does remarkably little to smarten up your mental processes and come with undesirable side-effects, such as bleeding in the brain.  

So, research attention has been turning to ways of manipulating the clean-up squads already present in the brain. One way of doing this is with NIR, another is to target the patterns of brain activity, known as gamma oscillations, linked with such vital mental activities as attention, memory, consciousness and dreaming. The brains of cognitively intact individuals sing in harmony with these gamma brain waves while cognitively impaired brains do not. 

Research has shown that exposing the brain to oscillations of 40Hz light, delivered by looking at or being in the field of a light screen, can reduce the build-up of amyloid plaques and tau, as well as improve thinking and memory.

This is because it affects the immune cells of the brain known as microglia, which have a number of remarkable properties.  

One type, sometimes described as “the butler to the brain” or M2, can clear plaques and tangles and the left-over fats and proteins involved in making energy and running the body’s multiple processes.  

But recently research at the Massachusetts Institute of Technology has discovered that sometimes those butlers can go rogue if they are not getting enough resources or dirty fuel from the powerhouses of the cells, the mitochondria. These make the energy that powers the brain but when they become clogged up and inefficient, a scenario created by an unhealthy diet with too much sugar, smoking, burnt fats, and not enough B vitamins and antioxidants, they trigger a transformation trick worthy of a horror movie changing the function of the normally friendly microglial cells into the brain’s enemy. They begin destroying vital protective features of the brain such as the blood brain barrier or the system for controlling sugar and insulin in the blood, transforming from the supportive M2 ‘butler’ mode into M1, known as the “evil twin”.  

One of the valuable effects of 40Hz oscillation is that it can reverse the evil twin effect. Recent research, however, suggests that those less desirable M1 microglial cells may also have benefits. The M2 “butler” is very valuable when all well in the brain, but of little use when it comes under attack from the viruses or bacteria which it is designed to destroy. 

These attacks, which cause damaging inflammation, often originate from what is called “barrier tissue” which is in contact with the outside world, such as the lungs, gut bacteria, the mouth – periodontal disease -, liver and kidneys.  

The implication of the new view is that targeting the build-up of the sticky proteins plaque and tau in the brain as we age, may be the wrong target. Instead focusing on keeping body’s systems and organs healthy, as Food for the Brain does, emerges as a much better protective strategy. 

Another is that when microglia are in M2 mode they can swell to a size large enough to munch up the damaging plaque and tau. But if this ability is overworked, it can stop, causing brain cells to become inflamed and making plaque even more toxic. Exposure to 40Hz oscillations is likely to be able to reverse this too.  

Another of the natural clean up systems that can benefit from a boost is called the ‘glymphatic flush’, a deep clean that uses cerebrospinal fluid to clear out cluttering proteins left by energy creation. 

This is a new and sophisticated form of preventative medicine that is delivered by wearing a type of ear and eye headset, called Cognito, worn often before bed, with eyes closed, for 30 minutes to an hour a day, asleep or awake. The first human clinical trial conducted by scientists at Yale University’s Department of Comparative Medicine, has shown remarkable effects in arresting both cognitive decline and brain shrinkage in a group of 76 of patients with mild to moderate Alzheimer’s given either the 40Hz therapy for an hour a day or a sham treatment over a six month period. While those given the sham treatment had the usual steady decline in cognitive function, determined by a Mini-Mental State Exam (MMSE) and a measure of functional abilities called ADAS-ADL, those given the real 40Hz therapy barely declined at all. Also, their brain shrinkage was substantially less, with the usual reduction in whole brain volume, which is the hallmark of Alzheimer’s, being 69 per cent less. 

Another 40Hz device, called EVY, made by optoceutics.com, is in the trial phase in a race to achieve a licensed medical device. I also found a device available on Amazon called Digipace that delivers 40Hz therapy but without substantiated trial results.

But targeted gamma oscillation is only part of a new and radical idea about how best to cut Alzheimer’s risk. It is one approach that I first became aware of in a new book Brain Defenders (Hodder and Stoughton) by Neurologist Dr David Perlmutter, a New York Times best-selling author and part of Food for the Brain’s think tank.

Besides the NIR helmet or 40Hz devices I have also been following a protocol devised by the Alzheimer’s prevention charity, foodforthebrain.org that aims to ensure you have a heathy brain in a healthy body. This fits much better with the latest research about the threat from “barrier tissue” problems and how the brain defencers itself from threats. Think of it as a sort of biochemical gamma stimulation.

This involves strategies such as regular exercise, getting enough sleep, upping your intake of omega-3 from fish and fish oil, supplementing B vitamins, dramatically reducing sugary foods and drinks, plus two tablespoons of Ketofast, a ketogenic fuel called C8, all designed to switch your brain towards running on ketones. Ketones are an alternative fuel for defective brain cells, gunked up from too much glucose. and following a ‘ketogenic’ diet which means you cut back on carbohydrates – especially sugar, cereals, and sugar-sweetened beverages – now dominating much of the modern diet. 

The result is that you start producing energy packets known as ketones, which the brain can use for energy rather than glucose. It’s been used since the 1920’s to treat brain disorders such as epilepsy and more recently Alzheimer’s anorexia and Parkinsons. Ketones, which are created in the liver from a type of fat known as C8, derived from coconut oil, also help give defective mitochondria a full service, which has the knock on effect of bringing M2 microglial cells, the brain’s butlers, back to life and turning off the more aggressive  evil twin – the M1 microglia. 

Ketones are also fuel for your energy- making mitochondria which often are dysfunctional in people with Alzheimer’s. 

Food for the Brain’s strategy is being adopted in China as part of a nationwide ‘Silver Haired Healthy Lifestyle Popularisation’ campaign to prevent Alzheimer’s and their free online Cognitive Function Test is being trialled both in China and in the NHS to give GPs instant access to a digital assessment that anyone can do on a computer or smartphone. In China 10 million ‘silver haired’ Chines citizens attended or watched a conference broadcast across twenty TV stations with Food for the Brain’s founder, Patrick Holford, presenting the way forward for prevention. With over 300 million people over 60, almost a quarter of their population, preventing Alzheimer’s in China has become a government imperative. 

There are two more key ingredients of the Food for the Brain recipe for brain and physical health – B vitamins to bring down the level of an amino acid called homocysteine, linked with brain shrinkage, and omega three oil, which boosts the vitamin’s effect. 

So, the dream team to ensure Alzheimer’s has a hard time getting a grip on your brain would be a combination of 40hz gamma oscillations and the nutrition and the healthy lifestyle protocol advocated by and developed by foodforthebrain.org.

About the author

Jerome Burne has been a health journalist for twenty years and has written for most of the UK’s national newspapers, as well as a variety of magazines. Before becoming a health journalist, he edited the extensive reference work Chronicle of the World. Prior to that, he was co-editor of Time Out in the mid-1980s.

In recent years, he has written mainly for the Daily Mail. He has also contributed regularly to Reader’s Digest and occasionally to the Times Literary Supplement.

In 2012, Jerome won the Medical Journalist’s Association award in the category of Medical Science Explained. He was also runner-up in the Best National Newspaper Feature category.

To find out more read Dr David Perlmutter’s book ‘Brain Defenders: harness the power of your immune cells to safeguard your brain’s destiny’ while the nutritional approach being adopted in China is explained in the book ‘Alzheimer’s:Prevention is the Cure’ by Patrick Holford.

Magnesium for Brain Function

When people think about nutrients that support the brain, omega-3 fats, B vitamins, and vitamin D usually get most of the attention. However, magnesium for brain function, including focus and memory, is just as important and often overlooked.

Yet there is another nutrient that may deserve a place on that list.

Magnesium is involved in more than 300 biochemical reactions throughout the body. It helps regulate nerve signalling, supports energy production, influences sleep quality, helps control blood sugar, and plays a critical role in the brain’s ability to learn, adapt, and form memories.

Despite this, many people consume less magnesium than they need.

As rates of cognitive decline, anxiety, sleep problems, and metabolic disease continue to rise, researchers are increasingly investigating whether magnesium status could play a role in protecting brain health throughout life.

Why does magnesium matter for the brain?

Your brain is an energy-hungry organ.

Although it accounts for only around 2% of body weight, it uses approximately 20% of the body’s energy supply. To function well, brain cells require a constant supply of nutrients that support energy production, communication between neurons, and protection from oxidative stress.

Magnesium contributes to all three.

It helps regulate neurotransmitters, supports healthy nerve-cell communication, and is required for the production of ATP, the molecule that powers every cell in the body. Magnesium also influences NMDA receptors, which are involved in learning, memory formation, and neuroplasticity, the brain’s ability to adapt and create new connections.¹

Low magnesium levels have been linked to increased inflammation, greater oxidative stress, and impaired glucose regulation, all of which are recognised contributors to cognitive decline and dementia risk.²

Magnesium and cognitive decline

One of the most interesting areas of research concerns magnesium and long-term cognitive health.

Several large population studies have found that people with higher magnesium intake or higher blood magnesium levels tend to have a lower risk of cognitive impairment and dementia.³⁻⁵ In a study published in Neurology, individuals with optimal blood magnesium levels had a significantly lower risk of developing dementia compared with those with lower levels.⁴

A recent systematic review concluded that magnesium appears to play an important role in maintaining cognitive health throughout ageing, although researchers emphasise that more intervention studies are needed to establish cause and effect.²

This does not mean magnesium is a magic bullet for preventing dementia, but it does suggest that ensuring adequate magnesium intake may be one of several important factors that help support a healthy brain as we age.

Could magnesium help with brain fog?

Many people first become interested in magnesium because they feel mentally tired, forgetful, or unable to concentrate.

While brain fog is not a medical diagnosis, it is often associated with poor sleep, chronic stress, blood sugar instability, and low energy production, all areas in which magnesium plays an important role. It also helps regulate the body’s response to stress. Chronic stress can deplete magnesium stores, while low magnesium levels may make us more vulnerable to the effects of stress, creating a vicious cycle.⁶

For some people, improving magnesium status may help support mental clarity simply by improving sleep quality, reducing stress reactivity, and supporting stable energy production.

Magnesium, mood and sleep

The relationship between magnesium and mental wellbeing has been studied for decades.

Research suggests that magnesium may help support healthy mood regulation and stress resilience, particularly in individuals with inadequate magnesium intake.⁶

Magnesium is also commonly used to support sleep. It helps regulate the nervous system and appears to influence melatonin production and GABA activity, both of which are involved in sleep regulation.

While magnesium is not a sleeping tablet, some people report improvements in sleep quality, reduced nighttime waking, and a calmer mind when magnesium intake is optimised.

Since poor sleep is increasingly recognised as a risk factor for cognitive decline and Alzheimer’s disease, supporting healthy sleep may be one of the ways magnesium contributes to long-term brain health.

Food First: Magnesium-Rich Foods to Try Before Supplements

Many people can substantially improve their magnesium intake simply by eating more magnesium-rich foods, including leafy greens, beans, nuts and seeds. Although modern farming and soil quality may have reduced the magnesium content of some foods compared with the past, food should still be your first source wherever possible. Supplements are best considered a complement to diet, not a replacement for it.

Which type of magnesium is best?

One of the most confusing aspects of supplementation is the number of different forms available.

The truth is that there is no single “best” magnesium. Different forms may be more suitable, depending on your goals.

Magnesium glycinate: a gentle option often used for sleep and relaxation

Magnesium glycinate combines magnesium with the amino acid glycine. It is well absorbed and gentle on the stomach. Although it is widely recommended to support sleep and relaxation, there is currently little direct evidence that it is more effective than other well absorbed forms of magnesium. Its popularity is based largely on its favourable absorption, the calming properties of glycine, and positive clinical experience.

Magnesium l-threonate: the leading choice for magnesium for brain function

Magnesium L-threonate has attracted attention because it appears to increase magnesium levels within the brain more effectively than some other forms.

Animal studies have shown improvements in learning and memory, while early human studies suggest potential benefits for cognitive function.¹ ⁷

The evidence remains preliminary, but this is currently the form generating the most interest for memory and cognitive health.

Magnesium citrate: widely available and well absorbed

Magnesium citrate is widely available and generally well absorbed. It is often used when constipation is also an issue because it can have a mild laxative effect.

Magnesium malate: sometimes chosen for energy support

Magnesium malate combines magnesium with malic acid, a compound involved in cellular energy production.

Some practitioners favour this form for people experiencing fatigue, although the evidence supporting its superiority for energy is limited.

Magnesium oxide: common, but less efficiently absorbed

Magnesium oxide contains a high amount of elemental magnesium but is relatively poorly absorbed.

For brain health purposes, there are usually better options available.

Magnesium for Brain Function: Quick Comparison by Form

The bottom line: what this means for you

Magnesium is not a miracle nutrient, nor is there one form that’s right for everyone. The best choice depends on your individual needs, goals, and overall health. For some people, simply eating more magnesium-rich foods may be enough, while others may benefit from supplementation.

What the evidence does tell us is that magnesium is fundamental to healthy brain function. It supports energy production in every cell, helps nerve cells communicate, contributes to healthy sleep and stress regulation, and plays an important role in learning and memory. Maintaining healthy magnesium levels may therefore be one of the many ways we can support our brains as we age. (2-8)

Brain health is rarely transformed by a single nutrient, supplement, or food. It’s the result of consistently supporting the systems your brain depends on through good nutrition, regular movement, restorative sleep, stable blood sugar, social connection, and other healthy lifestyle habits.

Magnesium isn’t the whole picture, but it is an important piece of it. Making sure you’re getting enough, whether through your diet or, where appropriate, a well-chosen supplement, is one simple step towards supporting your brain for years to come.

Further reading:

Want to learn how nutrition supports brain health from the very beginning of life? Explore our article Building Young Brains: Shaping Your Child’s Future

Disclaimer: This article is for general information only and is not medical advice. It is not a substitute for consultation with a qualified healthcare professional, and should not be used to diagnose or treat any condition. Always speak with a GP, pharmacist, or registered nutritionist before starting a new supplement, particularly if you are pregnant, breastfeeding, taking medication, or managing a health condition.

The Best Foods to Help Lower Homocysteine Naturally

Of all the blood markers linked to dementia risk, homocysteine may be one of the most important and one of the easiest to improve. There are certain foods that lower homocysteine, making it possible to have a positive impact through your diet.

If you have searched online for foods that lower homocysteine, you have probably found plenty of articles recommending spinach, broccoli, eggs and salmon. They are all excellent foods, but they are only part of the story.

The truth is that no food lowers homocysteine directly. Your body is the one that does that. Every second of every day, it is recycling homocysteine through a series of biochemical reactions that depend on a steady supply of essential nutrients. The foods you eat simply provide the vitamins and nutrients those reactions need to work efficiently.

Understanding that difference changes the conversation completely. Instead of searching for a miracle food, the goal becomes giving your body the nutrients it needs to keep homocysteine in a healthy range.

For a full explanation of what homocysteine is and why elevated levels matter, read our guide to homocysteine.

Combined with appropriate testing and, where needed, targeted supplementation, improving your diet is one of the most practical ways to support long-term brain health.

Can food lower homocysteine?

No food lowers homocysteine directly. Instead, foods provide the folate, vitamin B12, vitamin B6, riboflavin, choline and betaine your body needs to recycle homocysteine efficiently.

Improving your intake of these nutrients may help support healthier homocysteine levels, particularly if your diet has previously been low in leafy green vegetables, legumes, fish, eggs or other nutrient-rich whole foods.

However, the effect of diet depends on why homocysteine is elevated. Poor vitamin B12 absorption, medications, kidney disease, thyroid problems and genetic factors may mean that dietary changes alone are not enough.

The key nutrients involved in homocysteine metabolism

Why homocysteine matters?

Homocysteine is a naturally occurring amino acid produced whenever your body breaks down methionine, an amino acid found in protein-rich foods.

Under healthy conditions, homocysteine does not remain in the bloodstream for long. It is quickly recycled into other useful compounds that support normal cellular function.

Problems arise when that recycling process slows down. Homocysteine begins to accumulate, increasing oxidative stress, inflammation and damage to blood vessels.

Over the last three decades, elevated homocysteine has consistently been associated with a higher risk of cognitive decline, dementia, stroke and cardiovascular disease.¹

Unlike high blood pressure or raised cholesterol, however, homocysteine rarely causes obvious symptoms. People often discover it is elevated only after having a blood test, by which time it may have been quietly increasing for years.

That is why homocysteine can be such a valuable biomarker. It gives you an opportunity to identify a potential problem early and take appropriate action.

You can learn more about the evidence linking homocysteine and dementia risk.

Why these foods work?

Your body has evolved an elegant system for dealing with homocysteine. Rather than allowing it to build up, it continually recycles it through two interconnected pathways.

One pathway converts homocysteine back into methionine so it can be reused. The other converts it into cysteine, an amino acid used to produce glutathione, often described as the body’s master antioxidant because of its role in protecting cells from oxidative damage.

Neither pathway works without the right nutrients. Folate, vitamin B12, vitamin B6, riboflavin, choline and betaine each have specific jobs within this recycling process.

If one or more of these nutrients becomes limiting, the whole system becomes less efficient and homocysteine starts to rise.

For a more detailed explanation of these biological pathways, read our guide to methylation and homocysteine.

This explains why two people eating apparently similar diets can have very different homocysteine levels. One may absorb vitamin B12 less efficiently as they get older. Another may carry a common genetic variant that increases their riboflavin requirement. Someone else may consume large amounts of caffeine or alcohol, increasing their need for certain B vitamins.

It is rarely one factor in isolation. More often, several small influences combine over many years.

The good news is that these pathways can be responsive. Give your body the nutrients it needs, remove some of the obstacles that interfere with the process, and homocysteine may begin to fall.

Foods that lower homocysteine: folate-rich foods

When researchers study nutrition and homocysteine, one nutrient consistently stands out: folate.

Folate plays a central role in recycling homocysteine back into methionine. Without enough folate, this pathway slows, making it much harder for your body to keep homocysteine within a healthy range.

Numerous intervention studies have demonstrated that improving folate status lowers homocysteine, particularly in people whose intake has previously been low.¹

Fortunately, folate is abundant in many whole plant foods.

Leafy green vegetables

Beans and lentils

Foods that lower homocysteine with vitamin B12

Folate rarely works alone. Vitamin B12 is equally important because it enables homocysteine to be converted back into methionine.

When vitamin B12 is lacking, this recycling process slows, regardless of how much folate is available.

One reason this matters is that vitamin B12 deficiency becomes increasingly common with age. Stomach acid, which helps release vitamin B12 from food, naturally declines over time. Some medications can further reduce absorption, while vegetarians and vegans may consume too little through their diet.

As a result, homocysteine may begin to rise years before the more familiar symptoms of vitamin B12 deficiency appear.

Fish and seafood

Eggs and dairy

Meat and liver

Foods that lower homocysteine with vitamin B6

Although folate and vitamin B12 receive most of the attention, they are only part of the story.

Vitamin B6 helps direct homocysteine down a different pathway, converting it into cysteine, which is then used to produce glutathione.

Good dietary sources include:

Poultry
Salmon
Tuna
Potatoes
Bananas
Chickpeas
Fortified cereals

Vitamin B6 is found in a wide range of foods, so a varied whole-food diet will usually provide more than relying heavily on one source.

Vitamin B2 foods that lower homocysteine

Riboflavin, better known as vitamin B2, is another nutrient that deserves greater recognition.

It is particularly important for people carrying the common MTHFR C677T genetic variant, where an adequate riboflavin intake may help the recycling process work more efficiently.

Foods containing riboflavin include:

Eggs
Yoghurt
Milk
Mushrooms
Almonds
Beef
Fortified cereals

Looking at nutrients individually is helpful for understanding the biology, but this is not how we eat. Meals contain dozens of vitamins, minerals and plant compounds working together, which is one reason whole-food dietary patterns consistently outperform approaches focused on isolated foods alone.

Choline and betaine foods that lower homocysteine naturally

Your body has a second way of recycling homocysteine that receives far less attention.

This alternative pathway depends on choline and betaine.

Choline supports normal methylation, helps build healthy brain cell membranes and is used to produce acetylcholine, a neurotransmitter involved in learning and memory.

Betaine acts as a methyl donor, allowing homocysteine to be converted back into methionine through a different biochemical route.

Eggs are one of the richest dietary sources of choline, while liver, fish and soybeans also provide significant amounts.

Beetroot, spinach, quinoa and wholegrains contribute valuable sources of betaine.

Thinking about these nutrients together helps explain why no single food can claim to lower homocysteine. Instead, the most effective dietary approach is built around a wide variety of nutrient-dense whole foods, each contributing different pieces of the puzzle.

Foods and habits that may make high homocysteine harder to manage

Supporting healthy homocysteine is not only about what you add to your plate. Certain everyday habits can also make it harder for your body to keep levels under control.

A diet low in vegetables naturally reduces your intake of folate and other B vitamins.

Diets dominated by ultra-processed foods often provide fewer of the vitamins needed for efficient methylation.

Excess alcohol can interfere with the absorption and metabolism of several nutrients involved in homocysteine recycling.

Smoking increases oxidative stress and is associated with higher homocysteine levels.

Coffee deserves a brief mention because the evidence is more nuanced. Moderate coffee consumption has been associated with several health benefits, yet some studies have also shown that high coffee consumption can increase homocysteine.

This does not mean everyone needs to give up coffee, but it strengthens the case for maintaining a good nutritional status if you drink several cups each day.

The aim is not dietary perfection. It is creating the best possible environment for your body’s own recycling system to work efficiently.

Diet is only one part of the picture. Regular exercise, stopping smoking, managing alcohol intake and correcting nutritional deficiencies can all help support healthy homocysteine levels. Learn about these and other evidence-based strategies in our guide to Eight Ways to Lower Your Homocysteine.

A Sample Day of Eating with Foods That Lower Homocysteine

The best foods to support healthy homocysteine

There is not a single food that lowers homocysteine. Eating a variety of whole foods provides the nutrients your body needs to recycle it efficiently.

Leafy green vegetables such as spinach, kale and broccoli are among the richest sources of folate, while fish, seafood and eggs provide vitamin B12.

Eggs also supply choline, an important nutrient for healthy methylation, and beans and lentils contribute folate and vitamin B6.

Beetroot, spinach and wholegrains provide betaine, which supports an alternative pathway for recycling homocysteine.

Rather than searching for a superfood, build meals around these foods consistently. Together they provide the nutrients your brain and body need to maintain healthy homocysteine metabolism.

Is diet enough to lower high homocysteine?

Improving your diet should always be the foundation. Every meal and snack is an opportunity to provide your body with the nutrients it needs to recycle homocysteine efficiently.

Many people may see meaningful improvements simply by eating more leafy greens, legumes, seafood, eggs and other nutrient-dense whole foods.

However, diet has its limits.

If a blood test shows your homocysteine is above the optimal range, food alone may not be enough to bring it back down.

Poor vitamin B12 absorption becomes increasingly common with age, certain medications interfere with B-vitamin metabolism, and some people have genetic variations that increase their need for specific nutrients.

Even someone eating what appears to be an excellent diet may still require additional nutritional support.

Rather than viewing food and supplements as competing approaches, think of them as working together. A nutrient-rich diet provides the foundation for lifelong health, while targeted supplementation may help correct a nutritional imbalance when diet alone does not achieve the desired result.

Read our complete guide to lowering homocysteine for a broader explanation of diet, lifestyle, testing and targeted nutritional support.

You can also learn more about B vitamins for lowering homocysteine.

How long does it take to lower homocysteine?

One of the encouraging things about homocysteine is that it can respond relatively quickly to the right intervention.

Improvements may begin within a few weeks of increasing key nutrients, although this depends on the underlying cause and how elevated homocysteine was to begin with.

Dietary changes may begin affecting homocysteine within weeks, but retesting after an appropriate interval can show whether the changes have been sufficient.

Food for the Brain recommends a simple approach.

First, test your homocysteine to establish your starting point. If you’re unsure which test to choose or how testing works, read our guide to homocysteine testing.

Next, improve your diet by increasing foods naturally rich in folate and other B vitamins while introducing targeted supplementation where appropriate.

Finally, repeat the test after around three to six months to confirm whether your homocysteine has moved towards a healthier range.

Without measuring it, you do not know whether your strategy is working.

Read more about how and when to test homocysteine.

Already have a result? Learn how to understand your homocysteine result.

Frequently asked questions

The bigger picture

Homocysteine is more than another blood test. It can indicate whether your body has the nutrients needed to support healthy methylation and long-term brain health.

Unlike many risk factors for cognitive decline, it is measurable, modifiable and measurable again after you have taken action.¹

A nutrient-rich diet should always be the starting point, but if testing shows your homocysteine is above the optimal range, targeted supplementation may be needed alongside dietary changes.

The goal is not simply to eat more spinach, although eating more vegetables is rarely a bad idea.

The goal is to understand what your body needs, measure your progress and know whether the steps you are taking are actually working.

Next steps

If you have not measured your homocysteine, that is the best place to start.

Knowing your level takes the guesswork out of deciding whether dietary changes alone are enough or whether targeted supplementation may be needed.

You can order our accurate at-home Homocysteine Test or choose the DRIfT 5-in-1 Test, which measures homocysteine alongside vitamin D, omega-3 index, HbA1c and glutathione, giving you a broader picture of your brain health.

You can also read our complete guide to lowering homocysteine for the next practical steps.

‘Our Children No Longer Need to Worry About Our Cognitive Decline‘

What one family learned from living through dementia and why they decided to take action.

When dementia affects a family, the impact often extends far beyond the person who receives the diagnosis. Many people begin to worry about cognitive decline, wondering whether it is an inevitable part of ageing or whether there is anything they can do to reduce their risk.In this story, Peter shares how watching his mother develop dementia changed the way he and his wife thought about ageing, why they decided to take a more proactive approach to their brain health, and how that decision ultimately gave their children something they hadn’t expected: peace of mind.

Most people do not start thinking seriously about dementia until it touches someone they love. Yet every day in the UK, around 790 people receive a dementia diagnosis, the equivalent of seven double-decker buses full of families beginning a journey they never expected to take.

Why One Family Decided Not to Worry About Cognitive Decline

For Peter and his family, dementia was not something they read about in the news or encountered through awareness campaigns. It arrived at their front door.

As his mother’s dementia progressed, the family witnessed first-hand how profoundly the condition could affect daily life. For a period, she lived with Peter and his wife, giving them a close-up view of the challenges, heartbreak, and uncertainty that often accompany cognitive decline.

Their children were young when their grandmother first became unwell and were old enough to witness much of what followed. They saw the gradual changes in her memory, independence, and ability to live the life she had once enjoyed. Like many families affected by dementia, they adapted as best they could, but experiences like these leave their mark.

Should You Worry About Cognitive Decline if Dementia Runs in Your Family?

At first, the family’s focus was entirely on supporting a much-loved mother and grandmother. Then, as they watched dementia unfold over many years, the children naturally started asking questions about the future. What would happen to their parents? Was this simply what ageing looked like? Could anything be done to reduce the risk of dementia?

For Peter, this became one of the most difficult parts of the journey.

When his mother died in 2016, he and his wife found themselves reflecting on everything the family had been through. They knew there were no guarantees when it came to health and ageing, but they also felt increasingly uncomfortable with the idea of simply hoping for the best.

Instead, they made a decision. Rather than focusing on what they could not control, they would focus on what they could.

That decision marked the beginning of a journey that continues today.

What to Do Instead of Worrying About Cognitive Decline

Peter’s interest in health had not appeared overnight.

Years earlier, they had discovered Patrick Holford’s work and become increasingly interested in nutrition and healthy ageing. Like many people, they had spent years trying to understand how food, lifestyle, and everyday habits influence long-term wellbeing.

Dementia, however, gave that interest a new urgency, as brain health was no longer an abstract topic. It had become deeply personal.

Instead of feeling powerless, they wanted to understand more about the factors associated with cognitive decline and, more importantly, what practical steps they could take to support healthy brain ageing. This led them to Food for the Brain’s educational resources, the Cognitive Function Test, and DRIfT biomarker testing.

They were not looking for guarantees or predictions about the future. They wanted a clearer understanding of where they stood and, perhaps more importantly, what they could actually do about it.

Measuring What Matters

The first steps? Understanding where they actually stood.

After years of watching dementia affect someone they loved, they wanted more than good intentions. They wanted a clearer picture of their current health and a better understanding of where they should focus their efforts.

The Cognitive Function Test provided one piece of that picture. Having first completed the assessment many years ago, Peter returned to it years later with a renewed interest in dementia prevention and healthy ageing. His score improved from 51 to 73.

The score itself was only part of the story. What mattered more was having a way to check in on how things were going. After everything the family had been through, it felt reassuring to have something tangible to measure rather than simply wondering whether their efforts were making a difference.

Alongside cognitive testing, they also began monitoring several biomarkers associated with brain health through DRIfT testing and implementing the guidance they were given along the way. The results showed encouraging changes across a number of areas:

Key Changes Over Time

His homocysteine level proved particularly useful information. Although he had already made a number of dietary and lifestyle changes, his levels remained higher than he would have liked, hovering at around 12 µmol/L across several tests. Regular testing allowed him to identify the issue, make further adjustments, and see how his body responded over time. After introducing vitamin B12, his homocysteine eventually reduced from 11.9 µmol/L to 7.16 µmol/L.

Without testing, he would never have known that this important marker remained elevated, as it is not something you can feel. Equally, without repeating the test, he would never have known whether the changes he made were having the desired effect. never have known whether the changes he made were having the desired effect.

Lifestyle Changes That Reduced Their Worry About Cognitive Decline

There was no single intervention that transformed their health overnight. Instead, they gradually reshaped the way they lived. Ultra-processed foods disappeared from the shopping trolley, wheat was removed from the diet, fermented foods became a regular feature at mealtimes, and targeted supplements were added where testing suggested they might be beneficial. Alongside this, they stayed physically active, walked regularly, and continued to challenge themselves mentally through activities such as completing The Times crossword.

Like many people who successfully improve their health over the long term, they did not follow a perfect plan or look for a magic solution. They focused on making changes they could sustain and enjoy, building habits that fitted naturally into the life they wanted to lead in retirement.

In many ways, their experience reflects what the research increasingly tells us about brain health: it is rarely one single intervention that matters most, but the cumulative effect of multiple factors working together over time, from nutrition and exercise to sleep, metabolic health, social connection, and lifelong learning.

The Difference It Made

Over time, they began to notice subtle shifts. Their thinking felt clearer, they felt more optimistic about ageing, and they gained confidence from seeing improvements in some of the markers they were tracking. Yet perhaps the biggest change was not physical at all. For years, dementia had been something that happened to their family. Now, instead of feeling defined by that experience, they felt they were actively shaping what came next.

The conversations within the family began to change, too. Their children and their children’s partners became more interested in brain health, nutrition, and prevention, turning what began as one family’s experience of dementia into a wider conversation about healthy ageing. Rather than seeing cognitive decline as an inevitable part of getting older, the family started to see it through a different lens, one that recognised the role informed choices can play in supporting long-term brain health.

When asked what has mattered most, Peter does not talk about biomarkers, supplements, or cognitive test scores. He returns instead to the concern that first motivated him and his wife to take action. Watching their grandmother’s decline had left a deep impression on the children, who naturally worried about what the future might hold for their parents. Those concerns did not disappear overnight, but they gradually eased as they saw their parents taking positive action, learning more about brain health, and making it a priority.

Reflecting on everything that had changed, Peter felt one thing stood out above all the others. He said “our children no longer need to worry about our cognitive decline.”

For Peter, that is the result that matters most.

Want to understand your own brain health?

Peter’s experience is not really about a test score, a supplement, or a blood result. Those were simply tools that helped him and his wife better understand their health, make informed decisions, and feel more confident that they were moving in the right direction.

At its heart, this is a story about a family who experienced dementia first-hand and decided not to leave the future entirely to chance. It is about protecting independence, preserving memories, staying connected to the people we love, and approaching later life with greater confidence and optimism.

At Food for the Brain, we believe more people deserve the opportunity to do the same. As a research and education charity, our mission is to make dementia prevention and optimal brain health possible by translating the latest science into practical, accessible actions that people can take today. Through research, education, testing, and behaviour-change programmes, we help people understand their brain health and take positive action while there is still time.

Related reading:

25 Daily Habits To Reduce Dementia Risk
Four Quick Wins to Reduce Your Risk of Alzheimer’s
Preventing Alzheimer’s Disease

Algae Oil vs Fish Oil for Brain Health: What’s the Difference?

If you’ve spent any time reading about brain health, you’ve probably come across omega-3s. When it comes to choosing a source of these essential nutrients, many people weigh up Algae Oil vs Fish Oil. They are one of the most researched nutrients in dementia prevention, cognitive function and healthy ageing, yet one surprisingly common question remains:

Does it matter where your omega-3s come from?

For years, fish oil was considered the gold standard. More recently, algae oil has emerged as an alternative that is popular with vegetarians, vegans and those who simply prefer a tasteless supplement. But does algae oil offer the same brain health benefits as fish oil, or is one genuinely better than the other?

The answer is more interesting than you might think.

Why Omega-3s Matter for Brain Function and Healthy Ageing

When we talk about omega-3s and brain health, we are mainly referring to two fatty acids: EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid).

DHA is particularly important because it forms part of the structure of brain cells themselves. In fact, DHA is one of the most abundant fats found within the brain, helping maintain healthy cell membranes and supporting communication between neurons.

EPA appears to play a slightly different role. It is involved in regulating inflammation, blood flow and a number of processes linked to mood and cognitive function.

Research has consistently linked higher omega-3 status with better cognitive performance, healthier brain ageing and a lower risk of cognitive decline. Some of the most fascinating findings come from the Oxford VITACOG studies, which examined the relationship between omega-3s, B vitamins and brain ageing.

Researchers found that participants with higher blood levels of omega-3s gained significantly greater benefits from homocysteine-lowering B vitamins than those with lower omega-3 levels. Those with both adequate omega-3 status and B vitamin support experienced slower rates of brain atrophy and reduced cognitive decline compared with those who had lower omega-3 levels [3,4].

Interestingly, emerging research suggests that maintaining adequate omega-3 levels may be particularly important for women. Hormonal changes associated with ageing can influence brain health, inflammation and cognitive resilience, making omega-3 status an important consideration throughout later life. You can learn more in our article on why women’s brains need omega-3 now.

The simple takeaway is that omega-3s appear to be an important part of protecting the brain as we age. They also do not work in isolation. Like most nutrients, they seem to be most effective when part of a wider network of nutrients and healthy lifestyle factors.

Want a quick overview before we compare algae oil and fish oil? This short video explains why omega-3s are so important for brain health and healthy ageing.

Algae Oil vs Fish Oil: What’s the Difference?

Fish oil is extracted from oily fish such as sardines, anchovies and mackerel and has been the most widely used source of EPA and DHA for decades.

Algae oil, on the other hand, is derived directly from marine microalgae.

This distinction is important because fish do not actually produce omega-3 fats themselves. Instead, they accumulate EPA and DHA by consuming algae and other organisms within the marine food chain [5].

In other words, algae are the original source of the omega-3 fats found in fish.

From a nutritional perspective, both fish oil and algae oil can provide the same biologically active forms of omega-3. The main differences relate to dietary preference, manufacturing methods and the specific balance of EPA and DHA provided by individual products.

If you’re considering an omega-3 supplement, it’s worth understanding the differences between EPA and DHA, how much you may need, and what to look for when choosing a quality product. Our comprehensive guide to omega-3 supplements covers the evidence, recommended intake levels and key considerations before you buy.

Algae Oil vs Fish Oil: Key Differences

Is Algae Oil as Effective as Fish Oil?

Fish oil still has one clear advantage: it has been studied for much longer.

As a result, there is currently a larger body of research investigating fish oil supplementation and health outcomes. That does not necessarily mean fish oil is superior, only that it has a longer research history.

More recently, scientists have started directly comparing fish oil and algae oil. A 2025 human trial found that algae-derived EPA and DHA were absorbed just as effectively as omega-3s from fish oil when equivalent doses were provided [6].

This is an important finding because it suggests the body is able to utilise EPA and DHA from algae in much the same way as EPA and DHA from fish oil. For people who do not eat fish, follow a plant-based diet or simply prefer a tasteless source of marine omega-3s, algae oil appears to be a credible alternative rather than a compromise.

Omega-3s, B Vitamins and Dementia Prevention

There are two topics we love talking about at Food for the Brain: omega-3s and homocysteine. While they might seem unrelated, some of the most exciting dementia prevention research suggests they may be more connected than we once thought.

One reason omega-3s have become such an important focus in dementia prevention research is their relationship with homocysteine. Homocysteine is a naturally occurring amino acid that, when elevated, is associated with a greater risk of cognitive decline and dementia. B vitamins, particularly folate, vitamin B12 and vitamin B6, help keep homocysteine levels under control.

In the landmark VITACOG trial, homocysteine-lowering B vitamins significantly slowed the rate of brain shrinkage in older adults with mild cognitive impairment [1]. Further analysis showed that these benefits were strongest among participants with higher omega-3 levels [3,4].

This helps explain why many practitioners now assess both homocysteine and omega-3 status when considering an individual’s long-term brain health. This highlights an important lesson in nutrition: it is rarely one nutrient acting alone. The greatest benefits usually come from the interaction between multiple nutrients and healthy lifestyle factors working together. (Which is why we have our 8 nutrition and lifestyle domains in the COGNITION online community and programme.)

Don’t Guess Your Omega-3 Status

One of the biggest misconceptions about omega-3 supplementation is that taking a supplement automatically means your levels are optimal.

In reality, omega-3 status varies considerably from person to person. Genetics, absorption, diet, dosage and supplement quality can all influence the amount that ultimately reaches your bloodstream. Two people taking the same supplement may achieve very different results.

That is why, at Food for the Brain, we believe testing is often more useful than guessing.

The DRIfT test measures several important biomarkers linked to brain health, including omega-3 status, homocysteine, vitamin D, HbA1c and glutathione. Rather than assuming your current diet or supplement routine is working, testing can help identify where support is needed and allow you to take a more personalised approach to protecting your brain health.

Algae Oil and Fish Oil: Key Takeaways for Cognitive Health

Both fish oil and algae oil provide the EPA and DHA associated with healthy brain ageing and cognitive function.

Fish oil remains the most extensively studied source and continues to have the largest body of evidence behind it. However, current research suggests that algae oil can raise blood levels of EPA and DHA just as effectively, making it a viable option for those who prefer not to use fish-derived products [6].

Perhaps the most important lesson from the research is that taking an omega-3 supplement is only part of the story. What ultimately matters is whether those omega-3s are reaching meaningful levels in your bloodstream and, ultimately, your brain.

The real question might not be whether your omega-3 comes from fish or algae.

The real question is whether your brain is getting enough.

Next Steps:

Food for the Brain is a not for profit educational and research charity that offers a free Cognitive Function Test and assesses your Dementia Risk Index. This allows them to advise you on how to dementia proof your diet and lifestyle.

By completing the Cognitive Function Test you are joining our grassroots research initiative to find out what really works for preventing cognitive decline. We share our ongoing research results with you to help you make brain-friendly choices.

Please support our research by becoming a Friend of Food for the Brain.

Related reading:

Alzheimer’s: Why prevention is better than drugs – but less profitable
How to Keep Building Brain Cells at Any Age

Chromium, Blood Sugar and Brain Health: The Overlooked Connection

How Blood Sugar Regulation Affects Brain Function?

When people think about protecting their brain, they often focus on keeping mentally active, reducing alcohol, or hoping they avoid dementia as they get older, somehow? But nutrients and minerals like chromium may also play a role in brain health.

Few think about blood sugar.

Yet every thought, memory, conversation, and decision relies on a constant supply of energy. Increasingly, researchers are discovering that how effectively we regulate blood sugar and respond to insulin may play an important role in how our brains function and age. (1)

This is where chromium enters the story.

Although only required in tiny amounts, chromium plays an important role in normal carbohydrate, fat, and protein metabolism. Its best understood role is helping insulin do its job more effectively. Insulin is the hormone that helps move glucose from the bloodstream into cells, where it can be used for energy, and chromium appears to support this process. (2)

The Brain’s Energy Demand and Glucose Supply

The brain represents only around 2% of body weight, yet uses roughly 20% of the body’s energy. (3) To function properly, brain cells require a continuous supply of fuel. Most of the time, that fuel comes from glucose, although the brain can also use ketones under certain circumstances.

When insulin is working well, glucose can be transported efficiently to the cells that need it. When cells become less responsive to insulin, a state known as insulin resistance develops. Blood sugar levels may rise, inflammation can increase, and energy production becomes less efficient.

Importantly, insulin resistance does not just affect muscles, fat tissue, and the liver. It also affects the brain.

Researchers have linked impaired insulin signalling with changes in brain structure and function, while people with type 2 diabetes consistently show a higher risk of cognitive decline and dementia than those with healthy glucose regulation. (4)

This growing body of evidence is changing how scientists think about brain health. Protecting the brain is not only about keeping it stimulated and active. It also depends on how effectively the body produces, regulates, and delivers energy to brain cells throughout life.

Chromium and Blood Sugar Regulation

Chromium is found naturally in foods including shellfish, meat, eggs, broccoli, and whole grains.

In terms of how it works, you can think of insulin as a key trying to unlock the door to a cell, and chromium appears to help that key work more efficiently, allowing glucose to move where it is needed and be used for energy. (2)

This has led researchers to investigate whether chromium supplementation might support healthy blood sugar regulation. Results have been mixed, but overall, the evidence suggests chromium may help improve fasting glucose in some individuals, particularly those with impaired glucose control or type 2 diabetes. (5)

That does not make chromium a miracle nutrient, nor does it mean everyone should supplement with it. What it does suggest is that even relatively small nutrient deficiencies may influence how effectively the body’s blood sugar regulation systems operate.

Insulin Resistance, Dementia and Brain Health

Unlike omega-3 DHA and B vitamins, which work together to support the formation, maintenance, and communication of brain cells, chromium’s role appears to be less about building brain tissue directly and more about helping to regulate the energy supply those cells depend upon.

Its potential relevance lies in the fact that the brain is one of the most energy-demanding organs in the body. If insulin resistance increases the risk of cognitive decline, it is reasonable to ask whether nutrients involved in healthy insulin function might also matter for long-term brain health.

We do not yet have evidence that chromium supplementation directly reduces dementia risk. However, the connection between insulin resistance and brain health is now difficult to ignore, making nutrients that support healthy glucose regulation increasingly worthy of attention.

In other words, chromium is interesting not because it is a brain nutrient, but because it sits within a system that appears to be highly relevant to how the brain functions and ages.

Chromium, Mood and Sugar Cravings

Interestingly, chromium’s effects may extend beyond glucose regulation.

Several small studies have explored chromium supplementation in people with atypical depression, particularly where symptoms include fatigue, increased appetite and carbohydrate cravings. Some reported improvements in mood and reductions in cravings, while researchers have also proposed possible effects on neurotransmitter systems involved in mood regulation. (6)

These studies are small and far from definitive, but they point towards something that is becoming increasingly clear: metabolism and mental health may be far more connected than we once believed. So much so that entire fields such as metabolic psychiatry and nutritional psychiatry have emerged in recent years. Researchers including Christopher Palmer and Georgia Ede are helping to challenge the idea that mental health exists solely in the brain, highlighting the important role that blood sugar regulation, nutrient status, inflammation and cellular energy production may play in our mental health and resliency.

Why Metabolic Health and Chromium Matters for the Brain

The story of chromium is not really about chromium.

It is about systems.

For decades we have tended to separate brain health from metabolic health. We talk about memory, dementia and cognition on one side, and blood sugar, insulin and diabetes on the other.

Increasingly, the science suggests these systems are deeply interconnected.

Reducing excess sugar intake remains one of the most important things we can do for long-term health. But this also raises an interesting question. What if someone is already eating relatively well, yet their blood sugar regulation remains less than optimal? Could nutrient status be part of the picture?

Chromium is unlikely to be the missing piece for everyone. In fact, many multivitamins already contain small amounts. But it serves as a useful reminder that healthy insulin regulation depends on more than simply avoiding sugar. It relies on a network of nutrients, hormones and metabolic processes working together.

This is one reason we include HbA1c in the DRIfT blood test. HbA1c provides insight into how effectively blood sugar has been regulated over the previous two to three months and can help identify an often-overlooked aspect of brain health long before symptoms appear.

Next Steps:

Food for the Brain is a not for profit educational and research charity that offers a free Cognitive Function Test and assesses your Dementia Risk Index. This allows them to advise you on how to dementia proof your diet and lifestyle.

By completing the Cognitive Function Test you are joining our grassroots research initiative to find out what really works for preventing cognitive decline. We share our ongoing research results with you to help you make brain-friendly choices.

Please support our research by becoming a Friend of Food for the Brain.

Related reading:

Depression
Make Eating Less Sugar Easier (& a FREE Recipe!)

Is China’s Alzheimer’s Nightmare Becoming Our Reality?

Patrick Holford examines how China is advancing Alzheimer’s prevention through nutrition, lifestyle and digital health initiatives, while questioning the pace of policy action in the UK.

The Race to Prevent Alzheimer’s in China

If there is one country that has to move fast to prevent Alzheimer’s, it is China. And it is.

With almost a quarter of its population over 60, some 320 million people, and an estimated 20 million expected to have Alzheimer’s by 2030, costing close to a trillion dollars a year, government health officials are taking prevention very seriously indeed.

Those over 60 are not called old, elderly, or senior, but “silver-haired“, a growing community that is at the heart of China’s health prevention strategies.

The doctor in charge of the Silver-Haired Healthy Lifestyle campaign is Dr Zhang Lei. He is a famous TV doctor and former surgeon.

I asked him if he believed there would ever be a cure for Alzheimer’s.

“Prevention is the cure,” he said. “And I want to make a special announcement. Next year, when your excellent book Alzheimer’s: Prevention is the Cure is published in Chinese, we will use this book as the cornerstone of our national prevention campaign. We already have direct access to 20 million people through our networks, but our ambition is to reach as many as 100 million. We will encourage everyone to take the online Cognitive Function Test from Food for the Brain. This book and this tool together will be our roadmap for a prevention revolution in China.”

Prevention-First Approach

I attended and spoke at the 2nd Silver-Haired Healthy Lifestyle Conference, where I met hundreds of silver-haired people like myself. The event was attended by 2,500 people and broadcast to 10 million people across twenty TV channels.

Other speakers included leading professors of public health, nutrition, gerontology and geriatrics, all delivering positive and progressive messages about prevention, including eating more seafood and vegetables, stopping smoking, cutting right back on sugar, sleeping better and taking 10,000 steps a day.

I spoke about the essential need for, and codependence of, omega-3, phospholipids and B vitamins. If omega-3 were the man and phospholipids, rich in eggs and seafood, were the woman, then B vitamins are the priest, I said. When they are married in your brain, magic happens. Together, they are the three building blocks of every brain cell.

You could have heard a pin drop. Everyone was listening and, in China, action is taken quickly.

The former Health Minister said that “diet, supplements and lifestyle” are the cornerstones of prevention. “We need education, not medication.“

No one was talking about anti-amyloid treatments.

Prevent Alzheimer’s at Scale

Next year, when the 3rd Healthy Lifestyle Conference coincides with the Chinese publication of my book Alzheimer’s: Prevention is the Cure, I have been invited to speak at universities and health departments across China.

Many silver-haired people in China do not have computers, but they all have smartphones. There are virtually no physical wallets. Communication and payment are conducted through the WeChat app.

The professors and public health officials were therefore very excited about our online digital test. They want to get everyone using Food for the Brain’s Cognitive Function Test. The COGNITION questionnaire then helps people understand which specific prevention steps are most relevant to them.

The experts, health authorities and policymakers understand that changing behaviour is the hardest part, and that this kind of personalised digital technology is key to motivating individuals and measuring change to find out what really works. It is big-data science helping to sharpen prevention strategies.

Why China Is Embracing Nutrition Over Medication for Brain Health

Traditionally, Chinese culture sees food as medicine, which may be one reason people are more open to optimum nutrition. There is also a long tradition of using natural compounds to support health, so supplements are a natural extension of this way of thinking.

Not one person repeated the old myth that “you can get all the nutrients you need from a well-balanced diet“.

The stark ignoring of established scientific facts about, for example, B vitamins and omega-3, which have outperformed anti-amyloid treatments, by our politicians and health ministers is verging on outrageous when the lives and brains of so many are at stake.

China’s High-Speed Lesson for Alzheimer’s Prevention

As I sat on a high-speed train travelling 1,200 kilometres from Shanghai to Beijing in just 3.5 hours, faster than taking a plane, and capable of speeds of 650 kilometres an hour, I found myself contemplating how the UK has yet to deliver the promised high-speed rail line from London to Birmingham, a little over 100 miles, despite more than a decade of work, a projected cost of over £100 billion, and a journey time saving of less than half an hour.

If this same failure to translate prevention science into policy continues, as it has over the past two decades, offering platitudes about the importance of prevention but little action, while continuing to avoid the scientific evidence of what actually works, then China’s nightmare of a large proportion of its silver-haired population slipping into dementia will become our reality.

Alzheimer’s is preventable. That is a fact, not a belief.

Those who say it cannot be done should not stand in the way of those who are doing it.

Food for the Brain is a not for profit educational and research charity that offers a free Cognitive Function Test and assesses your Dementia Risk Index. This allows them to advise you on how to dementia proof your diet and lifestyle.

By completing the Cognitive Function Test you are joining our grassroots research initiative to find out what really works for preventing cognitive decline. We share our ongoing research results with you to help you make brain-friendly choices.

Please support our research by becoming a Friend of Food for the Brain.

Related reading:

Dementia Prevention Goes Global
China Is Taking Prevention Seriously In The ‘silver-haired’ Economy
Alzheimer’s: Why Prevention is Better than Cure

Amyloid isn’t Alzheimer’s – How NOT to Study a Disease

by Patrick Holford

Alzheimer’s disease has, for decades, been framed primarily as a problem of amyloid plaques building up in the brain.

It is a compelling idea. It is measurable, visible on brain scans, and has shaped billions in research funding and drug development. There’s just one problem.

It doesn’t adequately explain what we see in people.

Many individuals with significant amyloid in their brains remain cognitively normal. Others develop clear dementia with little or no amyloid present (1). Treatments that successfully reduce amyloid have, at best, produced only modest effects on slowing decline, with no meaningful reversal of symptoms (2).

Amyloid is associated with Alzheimer’s disease, but association is not the same as causation.

And that distinction changes everything.

This growing tension between theory and evidence is explored in depth by neurobiologist Karl Herrup in How Not to Study a Disease, where he challenges how the field has come to define and pursue Alzheimer’s.

Some people develop increasingly severe cognitive decline as they age. This affects roughly one in ten older adults. We call this dementia. In some cases, brain scans show clear shrinkage in key regions, particularly the medial temporal lobe, which is then used to diagnose Alzheimer’s disease. So we have two observable features: a decline in cognitive function and measurable loss of brain tissue.

The question that follows is simple, but critical.

What is actually causing this process?

What causes Alzheimer’s?

Amyloid has long been positioned as the answer. Yet the evidence tells a more complicated story.

A significant proportion of older adults have amyloid plaques in their brains and remain cognitively normal. At the same time, some individuals with clear dementia show little or no amyloid pathology. Amyloid is associated with Alzheimer’s, but that is not the same as being the cause.

If amyloid were the primary driver, then reducing it should meaningfully change the course of the disease. However, interventions designed to reduce amyloid have consistently lowered amyloid burden in the brain, yet produced, at best, modest effects on slowing decline, often measured as very small changes on cognitive scales. There has been no meaningful reversal of symptoms. In some cases, safety concerns have emerged, including brain bleeding and swelling.

Recent large-scale evidence (6) now reinforces this point. A 2026 Cochrane review concluded that although anti-amyloid monoclonal antibodies can remove amyloid from the brain, this does not appear to translate into clinically meaningful effects for people with mild cognitive impairment or mild dementia due to Alzheimer’s disease, while increasing the risk of amyloid-related imaging abnormalities.

From a scientific perspective, this adds to an already substantial body of evidence suggesting that amyloid accumulation, on its own, does not explain the disease process. It may be part of the picture, but it is not the engine driving it.

And yet, the field has remained heavily focused on this single pathway.

When a hypothesis becomes a lens

Research tends to follow what is measurable, fundable, and already established. Over time, this can narrow the lens rather than expand it.

Amyloid has become that lens. As Karl Herrup argues in his book, once a hypothesis becomes dominant, it can begin to shape not just what is studied, but how results are interpreted and what gets funded next.

The result is that vast resources have been invested in understanding and modifying amyloid biology, while other avenues have received comparatively less attention. We have learned a great deal about amyloid itself, but we are not significantly closer to preventing or reversing the condition that matters most to patients, which is cognitive decline.

This is not unusual in science. Once a model becomes dominant, it shapes the direction of funding, research questions, and even how people interpret results.

A similar pattern is now emerging with another biomarker, p-tau.

Tau is a normal protein that, under certain conditions, becomes altered and associated with the tangles seen in Alzheimer’s pathology. Higher levels of p-tau are linked with increased risk, but again, association does not establish causation. Many individuals have elevated levels without clinical symptoms.

As with amyloid, the risk is that a marker becomes mistaken for the mechanism.

What does influence the disease process?

This is where the picture becomes more interesting.

There are factors that sit upstream of both amyloid and tau, influencing the environment in which brain cells function or fail. One of the most studied is homocysteine, a marker of methylation and B vitamin status.

Unlike amyloid, intervention trials have shown that homocysteine influences outcomes. In the VITACOG study, lowering elevated homocysteine with targeted B vitamins significantly slowed the rate of brain atrophy in individuals with mild cognitive impairment, with corresponding effects on cognitive decline. This is much closer to what we would describe as a disease-modifying effect (3,4). It also raises questions explored in Apparently healthy but diagnosed with Alzheimer’s about whether current diagnostic models are identifying true disease drivers or simply biomarkers.

That does not mean homocysteine is the only cause. It is one piece of a larger system. But it illustrates an important point. When you influence the underlying biology of the brain, rather than a downstream marker, you begin to see meaningful change.

For more on this approach, see our article on early diagnosis of Alzheimer’s: amyloid protein vs homocysteine testing.

A systems problem, not a single cause

Alzheimer’s does not behave like a single-cause disease.

It is better understood as the result of multiple interacting processes. These include inflammation, oxidative stress, insulin resistance, mitochondrial dysfunction, and impaired methylation, among many others (5). Each of these affects how brain cells are built, maintained, and powered.

Individually, they may not be sufficient to cause disease. Together, they can create the conditions in which the brain becomes vulnerable.

This is closer to how we understand most chronic conditions. Not as a single fault, but as a convergence of pressures that eventually exceed the system’s ability to compensate. A more useful way to think about it is not as one switch flipping, but as several dials turning in the wrong direction at the same time.

Why this matters

If we continue to focus primarily on downstream markers such as amyloid or p-tau, we risk missing the broader picture.

If instead we look at the upstream drivers, the factors that influence brain structure, function, and energy supply, we open up a different set of possibilities. Not just for treatment, but for prevention.

These are not fringe ideas. They are part of a growing shift in how Alzheimer’s is being understood, questioned, and re-examined. Researchers like Karl Herrup are helping to bring that conversation into the open, challenging long-held assumptions and asking more useful questions about what truly drives the disease.

It’s a conversation that is only just beginning to reach wider audiences.

This is exactly what we’ll be exploring at Alzheimer’s Prevention: New Frontiers conference, where leading researchers and clinicians will come together to look beyond single-cause models and towards a more complete understanding of brain health and cognitive decline.

Is prevention the real solution?

The prevailing model in medicine has been to identify a single cause and target it with a treatment. That works well for some conditions. It is less suited to complex, multifactorial diseases like Alzheimer’s.

A systems-based approach asks a different question.
What combination of factors leads to decline, and how do we shift that combination in the opposite direction?

This is the approach we take at Food for the Brain. By combining cognitive testing with blood testing and lifestyle information, it becomes possible to see patterns, not just isolated variables. Over time, this allows us to understand what drives resilience as well as risk.

It is likely that we will not find a single primary cause of Alzheimer’s. What we may find is something more useful: a set of modifiable factors that, together, determine whether the brain maintains function or begins to decline.

In that sense, prevention may not just be part of the solution.

It’s the solution.

Find out more with Alzheimer’s: Prevention is the Cure book here

Learn more about our Alzheimer’s Prevention: New Frontiers Conference here.

.

Thank you for reading!

Food for the Brain is a non-for-profit educational and research charity that offers a free Cognitive Function Test and assesses your Dementia Risk Index to be able to advise you on how to dementia-proof your diet and lifestyle.

By completing the Cognitive Function Test you are joining our grassroots research initiative to find out what really works for preventing cognitive decline. We share our ongoing research results with you to help you make brain-friendly choices.

Please support our research by becoming a Friend of Food for the Brain.

Related reading

Apparently Healthy, but Diagnosed with Alzheimerʼs? 
Why “Normal” Vitamin D Levels May Not Be Protective for Women’s Brains
Early Diagnosis of Alzheimer’s – Amyloid Protein vs Homocysteine Testing
‘My Relative Has Memory Problems, Possibly Dementia. What Do You Recommend?’
Homocysteine & Alzheimer’s Disease (2002)

How To Keep Your Brain Young with Antioxidants?

Being alive is a balancing act between making energy by combusting glucose with oxygen and generating ‘oxidant’ exhaust fumes that must then be neutralised. This process, known as oxidative stress, is a key contributor to ageing. Over time, if oxidants outpace your body’s ability to disarm them, damage accumulates in cells and tissues, including the brain.[8]

The brain is particularly vulnerable. It consumes a high proportion of the body’s oxygen, is rich in fats that are susceptible to oxidation, and has relatively limited antioxidant defences compared with other tissues. This makes maintaining an effective antioxidant defence system essential for long-term cognitive health.

However, this process is not fixed. You can influence it. Improving your intake of antioxidants and polyphenols, and supporting your body’s internal defence systems, can help shift the balance and support brain resilience over time.

To explore this idea further, watch the film ‘Keeping Your Brain Young with Antioxidants’ below.

The Science Behind Eating the Rainbow

You’ve heard it before, but the science behind it matters.

Different colours in plant foods reflect different polyphenols and antioxidant compounds, each with distinct biological effects. These compounds do more than just neutralise oxidants. Many also act as signalling molecules, influencing inflammation, blood flow, and cellular pathways linked to brain function and ageing.[9]

Mustard and turmeric, for example, are strong yellows. Dijon mustard is great, with no added sugar, and traditional English mustard is also beneficial. Turmeric, rich in curcumin, can be added to steam-fries, curries, or soups, grated into a tea, and even used in a turmeric latté.

Bright oranges such as butternut squash, sweet potato, and carrots provide carotenoids that support cellular protection. Tomatoes are particularly rich in lycopene, associated with reduced oxidative damage. Strawberries are a lower glycaemic fruit option, and peppers of all colours are rich in vitamin C, which plays a central role in antioxidant recycling.

Anything purple, magenta, or blue is especially valuable. From beetroot to blueberries, blackberries, and raspberries, these foods are rich in anthocyanidins, a class of polyphenols associated with improved vascular and cognitive function.

Strong greens remain foundational. Spinach, kale, Brussels sprouts, broccoli, watercress, rocket, asparagus, and green beans all contribute a wide spectrum of antioxidants, minerals, and phytonutrients that support detoxification and cellular defence.

Eating the rainbow is not a nice idea. It’s an essential part of upgrading and protecting your brain at any age.

The Best Fruits and Vegetables for Brain Health

But are there any particular vegetables or fruits that pack the biggest punch as far as polyphenols and antioxidants are concerned? Or, if you know you can’t or don’t like to eat a huge variety of fruit and veg, are there particular ones to focus on eating to get the most benefit?

Foods that are high in ‘polyphenols’, which refers to the structure of plant-based compounds, seem especially beneficial for protecting your brain. You might have heard of flavonoids in berries, quercetin in red onions, anthocyanidins in blue and red foods, and isoflavones in beans. These are all examples of polyphenols. Herbs and spices such as peppermint, basil, oregano, cumin, and curcumin in turmeric contain high levels of polyphenols and potent antioxidants.

But there are other criteria by which to judge a plant, including its ability to influence pathways linked to cellular ageing. Certain polyphenols, such as resveratrol, interact with sirtuin pathways involved in cellular repair and longevity.[10] For example, olives, blueberries, and kale support these processes.

Then there’s a group of compounds called ‘salvestrols’, generally only found in organic fruit, vegetables, herbs, and spices, which turn out to be anti-cancer.[1] They’re produced in plants as part of their self-defence system against invaders such as fungi. If the plant is sprayed with fungicides, it won’t produce them.

Taking all these factors into account, including the GL, antioxidants, polyphenols, salvestrols, and sirtuin-related activity, these are the dozen best-rated fruits and vegetables. (This list is not definitive. More and more research continues to reveal the healing power of nature’s fruits and vegetables.)

So, if eating the ‘rainbow’ feels like too much pressure or is difficult to achieve, think about incorporating some of the above into your meals each day.

Our Top 13 to Help Keep Your Brain Young

Top Up Brain-Friendly Antioxidant Nutrients: Consider Supplementation

Antioxidants Work as a Network

Much like dementia prevention is a combination of the 8 domains, which all influence each other, antioxidants are part of a network keeping you healthy.

A number of key vitamins, as measured in food and in the blood, do correlate with decreased dementia risk. This is hardly surprising, since the brain is made of complex fats that can easily be damaged by oxidants. It makes sense that having a high intake of antioxidants would protect the brain from damage. Antioxidants disarm oxidants by teamwork. You need a combination of nutrients, not just vitamin C or vitamin E.

Evidence for Antioxidant Protection

A recent meta-analysis of all studies on factors that could prevent Alzheimer’s, by one of our Scientific Advisory Board members, Professor Jin Tai Yu of Fudan University in Shanghai, China, shows that ‘either a high vitamin E or C intake showed a trend of attenuating risk by about 26%’, making these nutrients ‘grade 1’ top level prevention risk factors.[2]

A study of 4,740 Cache County, Utah, older residents found that those supplementing both vitamin E and C cut their risk of developing Alzheimer’s by two thirds. A trend toward lower Alzheimer’s risk was also evident in those who took vitamin E supplements together with multivitamins containing vitamin C, but there was no evidence of a protective effect in those taking only vitamin E or vitamin C supplements alone, with multivitamins alone, or with vitamin B-complex supplements. Lowest risk was reported in those supplementing at least 1000 mg a day of vitamin C together with at least 1000 IU a day of vitamin E.[3]

However, vitamin E on its own doesn’t seem to work. In a double-blind study, people with mild cognitive impairment were randomly assigned to receive 2000 IU a day of vitamin E or placebo for three years. There were no significant differences in the rate of progression to AD between the vitamin E and placebo groups at any point.[4]

Building Your Antioxidant Defences

Your best bet is probably to both eat a broad spectrum of antioxidants and also supplement them. The older you are, the more you are likely to need. Key antioxidants are:

Vitamin A, C and E – associated with reducing Alzheimer’s risk

Lipoic acid – protects the memory-friendly neurotransmitter acetylcholine and dampens brain oxidation and inflammation.[5]

Glutathione[6] or N-acetyl cysteine[7] (NAC) – protects the brain and improves methylation, thus having potential in dementia prevention.

It doesn’t really make a lot of sense to give one without the others. All those listed above, vitamin C, E, glutathione, N-acetyl cysteine, Coenzyme Q10 and resveratrol, work together. There are many other team player ‘cousins’, from B vitamins to minerals such as magnesium, zinc and selenium.

The first step is to eat ‘whole’ foods, especially fresh plant foods that are more likely to contain these kinds of nutrients. However, there are some nutrients, such as vitamin C, for which just eating whole foods doesn’t guarantee you are achieving optimum nutrition.

Most nutritional therapists supplement extra vitamin C, and some supplement an all-round antioxidant supplement providing the nutrients listed above. There is very good logic, and supporting evidence, to do this, especially if you’re over 50 years old, even if there isn’t yet that definitive ‘randomised placebo controlled trial’.

Other key antioxidant nutrients include:

Vitamin A, C and E – associated with reduced Alzheimer’s risk

Lipoic acid – supports mitochondrial function and reduces oxidative stress and inflammation.[5]

Glutathione or N-acetyl cysteine (NAC) – supports detoxification, antioxidant recycling and methylation, with potential relevance for cognitive ageing.[6][7]

Coenzyme Q10 and resveratrol – support cellular energy and protection

There are also important supporting nutrients, including B vitamins, which contribute to methylation and help regulate homocysteine, a compound associated with oxidative stress and cognitive decline when elevated.[12]

Why Food Comes First but Supplements May Still Be Needed

We are Food for the Brain, so the first step is always to eat whole foods, focusing especially on fresh plant foods that are naturally rich in antioxidants and polyphenols.

However, achieving optimal levels of certain nutrients through diet alone is not always guaranteed. Factors such as soil depletion, food storage, genetics, individual absorption, age, and increased physiological demand all play a role.

For this reason, targeted supplementation, particularly for nutrients such as vitamin C and those involved in the antioxidant network, may be beneficial. There is strong rationale, and supporting evidence, for this approach, especially in individuals over 50 or those with increased oxidative load. Read more about supplementation here.

From General Brain Health Advice to Personalised Insight

Why Antioxidant Needs Differ and Why Testing Matters

Eating a diet rich in colourful plant foods is a powerful place to start. But the real question is whether your unique body has the antioxidant capacity to meet your current level of demand.

Or, said another way, how do you know if you are eating enough to protect your brain and your future?

Oxidative stress is influenced by far more than diet alone. Age, stress, environmental toxins, blood sugar balance, genetic variations, nutrient status, and individual biochemistry all play a role. Two people can eat similarly and have very different levels of oxidative damage and antioxidant protection.

This is where testing becomes valuable.

One of the most informative markers is glutathione, often referred to as the body’s master antioxidant. It sits at the centre of your antioxidant defence system, helping to neutralise oxidative damage and recycle other antioxidants. If levels are low, it can indicate that your overall antioxidant capacity is under strain.

Rather than guessing whether you are getting enough antioxidant support, testing allows you to see what is actually happening inside your body. (Historically, glutathione has been hard to test, but we developed new technology with our lab partners to now be able to do this accurately with an at home finger prick blood test.)

Understanding Your Brain Health More Clearly

The DRIfT 5-in-1 test shows you what is actually happening inside your body, across the key drivers of cognitive decline, including oxidative stress, inflammation, blood sugar balance, nutrient status, and essential fats. It moves you beyond general advice and highlights exactly where your biggest risks and opportunities lie.

If your focus is antioxidant capacity, testing glutathione offers direct insight into whether your body is under oxidative strain and how well your defence system is functioning. Find out more here.

Alongside this, our free Cognitive Function Test provides a practical way to track how your brain is performing today, while contributing to ongoing research into what truly works in preventing cognitive decline.

Understanding your results allows you to move from general advice to a more targeted, personalised approach, so you can support your brain with greater precision and confidence.

When you join COGNITION and become a FRIEND, you get access to our new Digital education platform and our new COGNITION programme. You can also register FREE for both our monthly guest speaker webinars and our monthly live COGNITION Coaching – this is an hour live with our Food for the Brain health coaches and there is a Q&A at the end (you also get access to the past coaching workshop recordings).

On April 22nd April, our COGNITION Coaching Workshop is all about antioxidants and attendees will get a mini-ebook on antioxidants and 2 delicious, anti-oxidant rich recipes. You can become a FRIEND by clicking the link below:

Food for the Brain is a not-for-profit educational and research charity that offers a free Cognitive Function Test and assesses your Dementia Risk Index to be able to advise you on how to dementia-proof your diet and lifestyle.

By completing the Cognitive Function Test you are joining our grassroots research initiative to find out what really works for preventing cognitive decline. We share our ongoing research results with you to help you make brain-friendly choices.

Please support our research by becoming a Friend of Food for the Brain.

Dr Tommy Wood: Why Brain Health Needs a Systems-Based Approach

Dr Tommy Wood brain health research shows that we now know more than ever about protecting the brain, yet many people still feel overwhelmed by disconnected advice.

A headline about blood sugar here. A podcast on omega-3 there. A post about sleep, a study on exercise, a warning about stress.

Useful, yes. But also fragmented.

What Dr Tommy Wood brain health research offers is something more valuable than another isolated tip. He brings a framework.

As Head of Research at Food for the Brain, Associate Professor of Pediatrics and Neuroscience at the University of Washington, and author of the forthcoming book The Stimulated Mind, Tommy brings something rare to this field. He helps connect the dots. His work focuses on how brain health is shaped across the lifespan and why protecting cognitive function means thinking in systems, not silos.

Dr Tommy Wood Brain Health Framework

One of the reasons brain health can feel confusing is that it is often presented as a list:
A long list of risk factors. Nutrients to take, habits to adopt, or a long list of things to avoid.

But the brain does not work like a checklist: it works as a living, dynamic system. It responds to what it is supplied with, how it is used, and whether it has the conditions it needs to recover and adapt.

That is the core idea behind a systems-based approach to brain health.

Instead of asking “What is the one thing that protects the brain?”, it asks three bigger questions:

Does the brain receive enough oxygen, nutrients and stable energy to function well?
How well is it being stimulated to stay active, adaptable and resilient?
Are the foundations for repair and recovery in place, such as good sleep, stress regulation and metabolic health?

When you look at brain health this way, something important changes.

Many people understandably hope for a “magic bullet”. One supplement. One diet. One breakthrough drug that protects the brain.

But science tells a different (more hopeful) story. Cognitive resilience is shaped by the interaction between many systems in the body. Blood flow, nutrient status, sleep, movement, learning, stress and social connection all influence how the brain functions and adapts.

The encouraging part is that this gives us many entry points for change. You do not have to get everything perfect, and small improvements across several areas can work together to create meaningful protection for the brain over time.

That is why a systems-based approach is not more complicated. In practice, it is far more empowering.

Why this matters for prevention?

One of the most important insights in Tommy’s work is that cognitive decline does not happen in isolation.

The brain changes in response to how we live. Blood flow, nutrient status, movement, learning, sleep, stress and social connection all shape how the brain ages and how resilient it remains.

This is also why Tommy’s forthcoming book, The Stimulated Mind, focuses on the interaction between stimulation, sleep and nutrient supply as key drivers of lifelong brain health.

This perspective is closely aligned with the mission of Food for the Brain. For years we have been communicating that dementia risk is not fixed. By understanding and addressing modifiable factors across the lifespan, it is possible to protect your mind and keep the brain healthier for longer.

Tommy’s leadership as Head of Research helps bring greater scientific clarity to this systems-based approach to prevention.

Watch: A systems-based approach to cognitive function

If you want to hear Tommy explain this approach in more depth, his lecture from the Upgrade Your Brain Conference is one of the clearest introductions we have shared.

Watch the lecture below.

What Tommy offers is not another list of things to do. It is a framework. A way to understand why so many different factors matter and how they fit together.

Learn More About Dr Tommy Wood Brain Health Research

If this approach resonates with you, Tommy will be going deeper in our upcoming webinar, How to Keep Your Brain Young.

In this session he will explore the science of cognitive resilience and share practical ways to stimulate the brain, support long-term brain health and reduce lifetime dementia risk.

Food for the Brain will host the webinar on 19th March 2026 at 6 pm GMT.

Tommy’s new book is available to pre-order

Tommy’s new book, The Stimulated Mind, is also available to pre-order now.
In it, he explores how the brain develops, adapts, and stays resilient across the lifespan, and why everyday factors such as movement, learning, sleep, nutrition, and social connection play such an important role in shaping long-term brain health.

Pre-order your copy today before the book releases on 26th March 2026.

Final thought

For many people, the challenge with brain health is not a lack of information. It is knowing where to start.

When advice comes as scattered tips, nutrients, tests, and lifestyle changes, it can feel difficult to turn good science into clear action.

What Tommy’s work offers is a framework: a way of understanding how the different pieces of brain health fit together and why small changes across several areas can have a powerful cumulative effect.

At Food for the Brain, this systems-based approach sits at the heart of COGNITION, our brain upgrade programme.

COGNITION helps you understand your personal risk factors, learn the most important steps to protect your brain, and put them into practice with guidance and support.

The programme has recently been upgraded and is now available globally for just £5 per month or £50 a year, making it accessible to anyone who wants to take their brain health seriously.

If Tommy’s lecture resonates with you, COGNITION is the natural next step.

Because protecting your brain is not about doing everything perfectly.

It is about understanding the system and taking the next right step.

Food for the Brain is a not-for-profit educational and research charity that offers a free Cognitive Function Test and assesses your Dementia Risk Index to be able to advise you on how to dementia-proof your diet and lifestyle.

By completing the Cognitive Function Test you are joining our grassroots research initiative to find out what really works for preventing cognitive decline. We share our ongoing research results with you to help you make brain-friendly choices.

Please support our research by becoming a Friend of Food for the Brain.

The Biggest Myths About Alzheimer’s – And What the Science Actually Shows

Alzheimer’s disease is one of the most feared diagnosis of modern life. And where there is fear, myths flourish. Many of the biggest myths about Alzheimer’s have become widely accepted beliefs. We are told it is purely genetic, that it is an inevitable part of ageing, and that the main hope lies in new drugs targeting amyloid in the brain.

The science tells a far more complex and, importantly, far more hopeful story.

Myth #1 in the biggest myths about Alzheimer’s: ‘It’s all in your genes’

When Alzheimer’s runs in families, it is natural to assume destiny is fixed. Both your grandmothers had it, so you assume you will too.

Yet fewer than 1% of cases are caused by rare deterministic mutations in APP, PSEN1 or PSEN2 genes that lead to early-onset familial Alzheimer’s disease [1].

The vast majority of Alzheimer’s cases are late-onset and multifactorial. That means risk is shaped by multiple influences across a lifetime.

What about APOE4?

Celebrities like Chris Hemsworth have put the APOE4 gene on the map and into the public sphere and it is the strongest common genetic risk factor for late-onset Alzheimer’s. Having one copy increases risk; two copies increase it further [2]. But it does not determine outcome, as many APOE4 carriers never develop dementia. Many people with Alzheimer’s do not carry APOE4.

Genes influence vulnerability but they do not dictate your future.

APOE4 affects lipid transport, inflammatory signalling and neuronal repair. These processes are influenced by metabolic health, vascular function, nutrient status, sleep, stress physiology and lifestyle.

One of the most important things to remember is that gene expression is not static, as genes respond to the environment they are in.

The most important question is not necessarily ‘How do I check my genes?’ The question is ‘What environment are your genes operating in?’ Because you cannot change your genes but you can influence how they function and are expressed.

Myth #2 in the biggest myths about Alzheimer’s: ‘Nothing can be done’

This is the most damaging myth of all.

The 2020 Lancet Commission concluded that around 40% of dementia cases worldwide are attributable to modifiable risk factors [3]. The 2024 update increased that estimate to approximately 45% [4].

Nearly half of all cases.

And this is mainstream consensus. (Read more about the Alzheimer’s Prevention Expert Group’s APEG response to this recent Lancet report here).

The identified risk factors include hypertension, diabetes, obesity, physical inactivity, smoking, depression, hearing loss and social isolation. Importantly, Alzheimer’s risk is not fixed, it develops gradually over decades.

However, many researchers (ourselves included) believe even 45% may underestimate the true preventable proportion.

A large UK Biobank analysis published in the journal Nature Human Behaviour modelled a broader range of modifiable factors and estimated that up to around 73% of dementia cases could be attributable to modifiable influences [8]. Professor David Smith of Oxford University, co-author of that study, member of our Scientific Advisory Board, and lead investigator of the VITACOG trial, has suggested this may still be conservative, as certain blood biomarkers were not included in the modelling.

Whether the true figure is closer to 45% or 73%, the direction of evidence is consistent.

A large proportion of dementia and Alzheimer’s is preventable and you can modify your risk with simple changes.

Why biology supports prevention

Alzheimer’s develops through interacting processes such as impaired glucose metabolism, vascular dysfunction, inflammation and elevated homocysteine.

Raised homocysteine, reflecting impaired methylation and B vitamin status, is associated with increased dementia risk and accelerated brain atrophy [5].

In the VITACOG trial, homocysteine-lowering B vitamins significantly slowed whole-brain atrophy in people with mild cognitive impairment [6]. The benefit was strongest in those with adequate omega-3 status [7].

That is structural brain change.

(When compared to anti-amyloid drug trials, which show modest slowing of decline in already symptomatic patients, VITACOG demonstrated slowing of brain shrinkage itself in an at-risk group.)

Once significant neuronal loss has occurred, reversal is unlikely, but years before diagnosis, measurable risk is accumulating and that is where prevention has its power.

Myth #3 in the biggest myths about Alzheimer’s: ‘It has a single cause‘

The reductionist model searches for one target and one solution.

Alzheimer’s reflects the interaction of multiple biological systems:

Glucose regulation
Vascular health
Lipid transport
Inflammation
Oxidative stress
Methylation
Sleep and stress regulation
Hormonal balance

People arrive at cognitive decline through different combinations of biological drivers. For some, insulin resistance may be central. For others, vascular stiffness and hypertension. In others, chronic inflammation and elevated homocysteine may play a key role. The destination may look similar, but the route is not.

This systems view explains why targeting one downstream marker, such as amyloid, yields modest slowing. Correcting multiple upstream drivers is biologically more plausible for meaningful long-term risk reduction.

Watch the video below to learn how Food for the Brain uses a systems-based approach.

Myth #4 in the biggest myths about Alzheimer’s: ‘It’s inevitable with ageing’

Age increases risk. However, that is only part of the story.

There are many individuals in their 80s and 90s with preserved cognition. The difference often lies in lifelong vascular, metabolic and lifestyle patterns, also known as patterns for prevention.

It is clear from what you have read so far that this is not an inevitable part of getting older. With the right knowledge and habits, it is something most people can avoid.

And that is why Food for the Brain exists, because not enough people know this and not enough people know what action they need to take to protect their brain.

A More Accurate Framework

Ageing is not the enemy. It is a privilege denied to many.

The goal is not to avoid growing older. It is to protect the brain as we do.

Alzheimer’s is not a single event. It reflects decades of interacting biological stress: metabolic strain, vascular change, inflammation and nutrient imbalance. These processes build slowly and often silently.

By the time symptoms appear, significant damage has already occurred.

The science is clear that a substantial proportion of dementia risk is modifiable [6,10]. That does not mean guarantees. It means opportunity.

You cannot change your genes and you cannot stop the passage of time.

Yet, you can influence how your brain responds to both.

And you can start today!

Complete the Cognitive Function Test

Gain personalised insight into your current cognitive performance and identify potential areas of vulnerability early.

Measure your biomarkers

Order our at-home blood test to assess homocysteine, omega-3 status, and other key markers linked to long-term brain resilience.

Join COGNITION

Our six-month brain upgrade programme provides structured guidance, accountability and expert support to help you translate knowledge into meaningful and lasting change.

Prevention is possible. It begins with measurement, and it progresses with action.

Food for the Brain is a not-for-profit educational and research charity that offers a free Cognitive Function Test and assesses your Dementia Risk Index to be able to advise you on how to dementia-proof your diet and lifestyle.

By completing the Cognitive Function Test you are joining our grassroots research initiative to find out what really works for preventing cognitive decline. We share our ongoing research results with you to help you make brain-friendly choices.

Please support our research by becoming a Friend of Food for the Brain.

Why “Normal” Vitamin D Levels May Not Be Protective for Women’s Brains

Science now recognises Vitamin D as far more than a bone-health nutrient. Over the past decade, it has become increasingly clear that vitamin D acts as a hormone regulator, playing an important role in brain health, immune regulation and inflammation, especially when considering optimal vitamin D levels for women’s brains.

What is discussed far less, is a more nuanced question…

If vitamin D matters for the brain, how much is actually enough and do vitamin D levels differ for women?

A growing body of research links lower vitamin D status with a higher risk of cognitive decline and Alzheimer’s disease. Yet most guidance still relies on population-based “normal” ranges that were never designed to protect the brain. This raises an important prevention question for women, who already carry a higher lifetime risk of Alzheimer’s disease.

What the research shows

A systematic review and meta-analysis in 2025 by Li et al. examined the relationship between circulating vitamin D levels and Alzheimer’s disease risk across multiple observational studies (1).

The findings were consistent:

• Lower vitamin D levels link to a higher risk of Alzheimer’s disease.
• Risk increased progressively as vitamin D levels declined
• Researchers observed this association across different populations and study designs.

Crucially, the authors did not claim that vitamin D deficiency causes Alzheimer’s disease. Instead, vitamin D status appears to track biological vulnerability in the brain and reflects processes such as neuroinflammation, immune dysregulation and vascular dysfunction, all recognised contributors to cognitive decline.

This distinction matters for prevention.

Why these findings matter particularly for women

Women account for around two thirds of Alzheimer’s diagnoses worldwide. Longevity alone cannot explain this difference.

Across midlife and later life, women experience biological changes that alter how the brain responds to metabolic, inflammatory and hormonal stress. The menopausal transition is a key inflection point. Declining oestrogen and progesterone influence immune signalling, cerebral blood flow and brain energy metabolism, all of which intersect with established dementia risk pathways (3). This helps explain why midlife can be a turning point for brain health in women, even when blood test results appear “normal”.

Vitamin D functions as a hormone-like regulator, with receptors widely distributed throughout the brain and immune system. Its actions include modulation of inflammatory responses, immune balance and neuronal protection. Hormonal changes appear to influence how effectively vitamin D signalling is utilised at a tissue level. This is supported by experimental and clinical research showing interactions between oestrogen, vitamin D receptors and immune signalling, although this is not always directly measured in large population studies. In practical terms, this means that a vitamin D level considered “normal” for the general population may not confer the same degree of neuroprotection in the ageing female brain.

This does not mean vitamin D requirements are definitively higher for every single woman, or that everyone should take high-dose supplementation. Excessive intakes via supplementation over time can be harmful, which is why context, testing and appropriate dosing matter. 

Prevention works best when it’s personal, based on what’s happening in your own brain and body, not just what’s considered “normal.”

The problem with “normal” ranges for vitamin D for women’s brains

Researchers established vitamin D reference ranges primarily to prevent overt deficiency-related disease, particularly rickets and osteomalacia. They did not design these ranges to define optimal levels for long-term brain resilience.

Population reference ranges do not account for factors that strongly influence dementia risk, including:

Chronic low-grade inflammation
Insulin resistance and blood sugar dysregulation
Oxidative stress (see our explainer video here)
Hormonal transitions across midlife
Genetic variation in vitamin D metabolism and receptor activity

As a result, vitamin D levels that fall within the laboratory “normal” range may still exist within a biological environment that favours cumulative brain damage over time. This limitation is not unique to vitamin D. It reflects a broader problem with single-nutrient or single-cause thinking in Alzheimer’s prevention.

Vitamin D does not act alone in protecting women’s brains

Vitamin D is not an isolated lever in brain health. Low vitamin D status frequently clusters with other modifiable biological risk factors, including:

• Low omega-3 fatty acid status
• Raised homocysteine, reflecting impaired B vitamin-dependent methylation, a process essential for maintaining brain cells
• Poor blood sugar control
• Reduced antioxidant capacity, including glutathione availability

Each of these factors independently links to cognitive decline. More importantly, they interact within the brain.

Alzheimer’s disease does not arise from a single deficiency, a single gene or one pathological protein.
It reflects the cumulative impact of multiple biological systems drifting out of balance over years or decades. This is why interventions that target a single marker so often produce disappointing results.

Prevention requires a broader, systems-based view.

Once you see vitamin D in this broader context, it becomes clear why testing a single marker in isolation can only ever give partial answers.

From nutrients to prevention systems

Testing vitamin D alone can identify a deficiency, but it cannot tell you whether the brain’s key protective systems are functioning together.

A prevention-led approach asks different questions:

How well is inflammation being regulated?
Are brain cell membranes supported by sufficient essential fats?
Is methylation, the nutrient-dependent process that supports DNA repair, neurotransmitter balance and brain structure, functioning effectively?
To what extent is blood sugar quietly damaging brain neurons over time?

These are not abstract concepts.

They are measurable, modifiable drivers of dementia risk that we assess through our at-home DRIfT blood test.

A smarter way to assess brain health

Many people reading this will have been told their vitamin D is “fine”. They may spend time outdoors, eat well, and still feel tired, foggy or not quite themselves. The problem is not that vitamin D doesn’t matter. It’s that a single number rarely tells the full story.

This systems-based understanding underpins our work at Food for the Brain. It is the heart of prevention.

Prevention is not about chasing one “perfect” nutrient level or one lifestyle change. 

It is about understanding how your body works as one connected system and acting early enough to change the trajectory.

If you want to begin supporting and upgrading your brain today:

Complete the Cognitive Function Test today if you haven’t done so yet.
It is free to everyone, validated and provides personalised insights into your current brain health.

Order your at-home DRIfT blood test to assess the key biological drivers of cognitive decline, including vitamin D, omega-3, homocysteine, blood sugar control and antioxidant status. Together, these results give you the information you need to move from awareness to meaningful prevention.

Food for the Brain is a not-for-profit educational and research charity that offers a free Cognitive Function Test and assesses your Dementia Risk Index to be able to advise you on how to dementia-proof your diet and lifestyle.

By completing the Cognitive Function Test you are joining our grassroots research initiative to find out what really works for preventing cognitive decline. We share our ongoing research results with you to help you make brain-friendly choices.

Please support our research by becoming a Friend of Food for the Brain.

Li X, et al. The relationship between vitamin D levels and Alzheimer’s disease: a systematic review and meta-analysis.

Alzheimer’s Association. 2023 Alzheimer’s Disease Facts and Figures.

Lancet Commission on Dementia Prevention. Livingston G, et al. Dementia prevention, intervention, and care: 2020 report.

Why Gut Health Matters for Brain Health More Than You Think

Why Some Brains Improve and Others Don’t

Many people are doing more than ever to protect their brain. They eat well. Take supplements. Exercise. Stay mentally active.

Yet outcomes vary dramatically.

Some improve. Others stall. A few decline despite doing everything “right”.

The missing question is not what else to add, but what environment those interventions are landing in.

Cognitive decline rarely stems from one isolated failure. It emerges when the body’s internal environment no longer supports protection, repair, and resilience. This systems-based understanding underpins the work of Food for the Brain, and explains why gut health plays a central role in our COGNITION brain upgrade programme.

The terrain model of brain health

In medicine, there is a long-established principle that disease does not arise from a trigger alone, but from the biological environment in which that trigger operates. This is often described as the terrain.

From a brain health perspective, terrain includes inflammatory load, metabolic health, immune balance, nutrient availability, and cellular repair capacity. These systems interact constantly. When they stay in balance, the brain shows remarkable resilience. When they become disrupted, vulnerability increases.

Neurodegenerative conditions, including Alzheimer’s disease, are now understood to arise from multiple interacting biological pressures rather than a single pathological process. Many of these systems are shaped upstream by gut related processes.

The gut as a regulator, not a root cause

The gut is often discussed as if it were a standalone digestive organ. In reality, it plays a regulatory role in shaping systemic inflammation, metabolic function, and immune signalling.

When gut barrier integrity is compromised, bacterial components such as lipopolysaccharides can enter circulation. This process increases immune activation and drives chronic low-grade inflammation, a state strongly associated with insulin resistance and cognitive decline [1,2].

In this context, gut dysfunction is not “causing” brain disease. It is influencing the conditions in which brain protection and repair either succeed or struggle.

Why prevention struggles in an inflamed system

Brain health interventions that we talk about here at Food for the Brain do not operate in isolation. Their effectiveness depends on the biological environment in which they are applied.

This is particularly clear in nutritional research.

B vitamin supplementation has been shown to slow brain atrophy, but only in individuals with raised homocysteine levels and a metabolic environment that allows normal methylation processes to function [3]. Similarly, omega 3 fatty acids support neuronal membrane structure and signalling, yet their cognitive benefits are reduced in the presence of inflammation and insulin resistance [4].

Inflammation interferes with digestion, absorption, transport, and cellular uptake of nutrients. Pro inflammatory cytokines also impair intracellular metabolic pathways, shifting the body toward defence rather than repair. In this terrain, even well evidenced interventions may have limited effect.

The same principle applies to lifestyle strategies. Physical activity, cognitive stimulation, and stress reduction are all protective, but their impact is blunted when inflammatory and metabolic pressures remain unaddressed. That is why in COGNITION we target all 8 modifiable nutrition and lifestyle factors, so that you are not just targeting a specific nutrient but you are changing the environment.

Microbes, inflammation, and brain vulnerability

Human studies consistently show that individuals with cognitive impairment or Alzheimer’s disease have altered gut microbiome profiles alongside higher levels of systemic inflammatory markers [5].

This does not demonstrate that microbes cause dementia. What it does show is that microbial imbalance contributes to inflammatory load, which in turn increases brain vulnerability.

Over time, this vulnerability can translate into accelerated cognitive decline.

For this reason, the COGNITION brain upgrade programme actively addresses gut health as one of eight modifiable factors that influence dementia risk. Gut microbes actively shape the internal environment in ways that can either accelerate neurodegeneration or help slow it.

The metabolic bridge between gut and brain

The gut also plays a critical role in metabolic regulation.

Chronic gut driven inflammation worsens insulin resistance, reducing glucose uptake by brain cells. Impaired brain glucose metabolism is a recognised feature of cognitive decline and has led some researchers to describe Alzheimer’s disease as a form of brain specific metabolic failure [6,7].

In this model, the gut is not peripheral. It contributes upstream to the metabolic conditions that determine whether the brain can access adequate fuel to function and repair.

Again, the implication is not that gut health alone determines brain fate. It is that brain health strategies are less effective when the metabolic and inflammatory terrain is unfavourable.

Why Brain Health Advice Works for Some People and Not Others

A terrain based perspective offers something often missing from prevention conversations.

Understanding.

When people follow advice carefully and still do not improve, clinicians too often frame the explanation as lack of compliance or genetics. Systems thinking offers a different interpretation.

The tools may be appropriate but the environment may not yet support repair.

This reframes prevention as a personalised process rather than a universal checklist. Understanding an individual’s internal terrain helps identify where effort should go.

This is why Food for the Brain offers two complementary forms of assessment: the free, validated Cognitive Function Test and optional at home blood testing to assess key modifiable risk markers such as homocysteine, omega 3 status and glutathione.

The answer is not found in one nutrient

Viewing brain health through a terrain lens shifts prevention away from adding isolated solutions and toward restoring balance across systems.

The future of brain health does not lie in targeting one nutrient, one habit, or one molecule.

It lies in creating an internal environment where protection, repair, and resilience are possible.

Brains do not fail because one thing goes wrong. They decline when the terrain no longer supports them.

And that terrain forms quietly and cumulatively long before symptoms appear.

Next Steps

Learn more about how gut health impacts brain health in our upcoming webinar here
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Food for the Brain is a not-for-profit educational and research charity that offers a free Cognitive Function Test and assesses your Dementia Risk Index to be able to advise you on how to dementia-proof your diet and lifestyle.

By completing the Cognitive Function Test you are joining our grassroots research initiative to find out what really works for preventing cognitive decline. We share our ongoing research results with you to help you make brain-friendly choices.

Please support our research by becoming a Friend of Food for the Brain.

Cani PD, Amar J, Iglesias MA, Poggi M, Knauf C, Bastelica D, et al. Metabolic endotoxemia initiates obesity and insulin resistance. Diabetes. 2007;56(7):1761–72.
Hotamisligil GS. Inflammation and metabolic disorders. Nature. 2006;444(7121):860–7.
Smith AD, Smith SM, de Jager CA, Whitbread P, Johnston C, Agacinski G, et al. Homocysteine-lowering by B vitamins slows the rate of accelerated brain atrophy in mild cognitive impairment. Proc Natl Acad Sci U S A. 2010;107(31):14187–92.
Jernerén F, Elshorbagy AK, Oulhaj A, Smith SM, Refsum H, Smith AD. Brain atrophy in cognitively impaired elderly: the importance of long-chain omega-3 fatty acids and B vitamin status in a randomized controlled trial. Am J Clin Nutr. 2015;102(1):215–21.
Vogt NM, Kerby RL, Dill-McFarland KA, Harding SJ, Merluzzi AP, Johnson SC, et al. Gut microbiome alterations in Alzheimer’s disease. Sci Rep. 2017;7(1):13537.
Craft S. Insulin resistance and Alzheimer’s disease pathogenesis: potential mechanisms and implications for treatment. Arch Neurol. 2009;66(3):300–5.
de la Monte SM, Wands JR. Alzheimer’s disease is type 3 diabetes–evidence reviewed. J Diabetes Sci Technol. 2008;2(6):1101–13.

The GL of Your Diet Determines Your Future Dementia Risk

by Patrick Holford

Why Blood Sugar Exposure Matters More Than Sugar Itself

Your brain uses more glucose for energy than any other organ in the body.

From that simple fact comes a widespread assumption: that sugar fuels the brain and therefore more sugar must mean more mental energy.

In reality, the opposite appears to be true.

A large new study shows that the glycaemic load (GL) of your diet, which reflects how much glucose you expose your bloodstream to over time, is strongly linked to your future risk of dementia. The higher the glycaemic load, the higher the risk.

In this study, people consuming more than 110 GL units a day had a 13% higher risk of developing dementia. Those consuming less than 49.3 GL units a day had a 17% lower risk. In other words, the difference between a high GL diet and a low GL diet translated into a 30% swing in dementia risk.The study, published in the International Journal of Epidemiology, analysed dietary data from over 200,000 UK Biobank participants in 2011–12 and followed them for more than a decade to see who did, and did not, develop dementia (1).¹

Most people’s diets exceed 100 GL units a day. I have been advocating a daily intake of around 45 to 60 GL units since the 1990s. To understand why this matters, and what it means for what you eat, it helps to understand what GL actually is.

How Much Sugar Your Body Really Needs

As petrol is for your car, glucose is the primary fuel for your body. Glucose is the main fuel used by all cells.

There is also another fuel, ketones, much like cars can also run on electricity. We too are metabolic hybrids.

Now here is an astonishing fact. Your body contains around 100,000 kilometres of blood vessels. Your brain alone has around 1,000 kilometres of them. These vessels supply energy to around 30 trillion cells, each containing roughly 1,000 mitochondria, the tiny energy factories that power life.

And yet, across this entire system, there only needs to be around 4 grams of glucose in your bloodstream at any one time. That is one teaspoonful. That is all that is required for every cell in your brain and body to have energy at that moment.²

GL is a measure of how much glucose enters your bloodstream after eating or drinking a food. If there is not much glucose in the food, and you use it quickly, perhaps by moving or exercising, blood sugar levels stabilise rapidly.

The glycaemic load of a food depends on two things:
• the quality of the carbohydrate
• the quantity eaten

Quality refers to how fast glucose is released, known as the glycaemic index (GI). Fibre and protein slow this release. This is why white rice has a higher GI than brown rice, which contains fibre. Eat rice with fish, beans or meat, and the protein slows the release further.

GL also depends on portion size. A small serving of brown rice with fish is low GL. A large serving of white rice, even with fish, is high GL.

When Glucose Becomes Toxic to the Brain

What happens if you consume far more glucose than the body needs?

A can of sugary fizzy drink contains around 35 grams of sugar. That is roughly nine times more glucose than the total amount normally circulating in your bloodstream.

This excess is toxic. It damages blood vessels and the tissues they supply. Diabetes is diagnosed precisely because excess sugar damages the kidneys, eyes and nerves. The brain is no exception.

“The brain needs more energy than any other organ, so it contains the most mitochondria. Sugar damages mitochondria,” says Professor Robert Lustig, Professor of Neuroendocrinology at the University of California, San Francisco. If you have read Upgrade Your Brain or Alzheimer’s: Prevention is the Cure, you will already know that high sugar intake, sugary drinks and ultra processed foods increase dementia risk, worsen memory even in young people, and are associated with measurable shrinkage of brain regions involved in memory in teenagers.

Are You Eating Too Much Hidden Sugar?

The simplest way to assess your long term blood sugar exposure is to measure HbA1c.

HbA1c literally means sugar damaged red blood cells. If more than 6.5% of your red blood cells are sugar damaged, you are diagnosed with diabetes. Above 6% indicates pre diabetes. Even levels above 5.4% in teenagers predict brain shrinkage.

For optimal health you want to be below 5.4%, and ideally below 5%.

HbA1c is such a strong indicator of blood sugar resilience that it is included in Food for the Brain’s 5-in-1 DRIfT home blood test kit.

Balancing Blood Sugar with a Low Glycaemic Load Diet

Let us start with something simple.

An orange contains sugar, but also fibre and micronutrients. The fibre slows sugar release, mainly fructose, which takes time to convert to glucose, while feeding beneficial gut bacteria.

A glass of orange juice, however, contains the sugar of around three oranges, without the fibre. Three times the sugar, with no brakes. Eat your fruit. Do not drink it.

When you eat sugar or starches such as rice, digestive enzymes rapidly break them down into glucose. Protein, by contrast, takes several hours to digest into amino acids. This slows carbohydrate digestion further down the digestive tract.

This leads to a simple rule: eat carbohydrates with protein.

Brown rice releases glucose more slowly than white rice. Add beans, fish or meat, and the release slows further.

From this we can extract three practical rules:
• Eat fruit. Do not drink it
• Always eat carbohydrate with protein
• Make fibre the primary ingredient of every meal

What a Low GL Meal Actually Looks Like

Compare these two breakfasts:

Cornflakes with a banana or Oats with chia seeds and berries

Cornflakes are fast releasing sugar. Oats are slow releasing. A banana raises blood sugar more than two bowls of berries.

Chia seeds, rich in soluble fibre, dramatically slow sugar release. A portion of oats with chia and berries is around 10 GL. Cornflakes and a banana can reach 30 GL.

You want meals around 10 GL and snacks around 5 GL. Three meals and two snacks equals around 40 GL per day.

Eat 40 GL per day to lose weight. Around 60 GL to maintain it.

Eat little and often, and start the day with a low GL breakfast.

A friend of mine, Dr David Unwin, who is  a leading diabetes doctor, converted our low GL calculations into ‘teaspoons of sugar equivalent’ to give a visual idea to his diabetic and overweight patients of how sugar is hidden in common foods. See the table below.

Adapted, with permission, from David Unwin’s charts in the Journal of Insulin Resistance (2016) 

The Balance of Your Plate

Half your plate should be vegetables and fruit. A quarter should be protein. A quarter carbohydrate.

Vegetables supply antioxidants that neutralise the exhaust fumes produced when mitochondria burn fuel. This becomes more important as we age and mitochondrial efficiency declines.

Protein slows sugar release and provides essential building blocks. Carbohydrate portions must be modest.

Whole grains and starchy vegetables vary widely in GL. Wholemeal pasta and brown basmati rice are far better than white pasta or white rice. Swedes, carrots and squash are better than potatoes. Boiled potatoes are better than baked. French fries are the worst of all.
all.

Beans and Lentils: Nature’s Blood Sugar Regulators

Beans and lentils are uniquely effective because they contain both protein and carbohydrate in one food. This keeps their GL low while allowing generous portions.

When combining beans with other starches, reduce the starch portion by half. A cup of lentils with half a cup of rice, not equal amounts.

By applying these principles you can restore blood sugar control, regain energy, reduce dementia risk, reverse type 2 diabetes and improve cognitive clarity.

The Proof Is in Your HbA1c

Red blood cells live for around three months. Follow a low GL diet for three months, then retest HbA1c.

This approach is detailed in The Low GL Diet Cookbook. Specific supplements can accelerate recovery, including fibre such as glucomannan, chromium and cinnamon compounds to improve insulin sensitivity, and HCA from tamarind to promote glucose burning rather than storage.

What to Do Next

If glycaemic load affects dementia risk, the next step is simple: measure, act, and check again.

Test your blood sugar resilience.

HbA1c shows how much sugar damage has occurred over the last three months. It is included in Food for the Brain’s DRIfT 5-in-1 home test, alongside other key brain health markers. If HbA1c is high, a low GL diet gives you a clear way to bring it down.

Check how your brain is functioning now.

The free Cognitive Function Test takes around 20 minutes and provides an objective snapshot of memory, attention and processing speed. Many people spot early changes years before any diagnosis.

Make changes, then retest.

Follow a low GL diet for three months, then re-test HbA1c and cognitive function to see whether the changes are working.

Prevention works best when it is measured.

Food for the Brain is a not-for-profit educational and research charity that offers a free Cognitive Function Test and assesses your Dementia Risk Index to be able to advise you on how to dementia-proof your diet and lifestyle.

By completing the Cognitive Function Test you are joining our grassroots research initiative to find out what really works for preventing cognitive decline. We share our ongoing research results with you to help you make brain-friendly choices.

Please support our research by becoming a Friend of Food for the Brain.

Novau-Ferré N et al. Glycemic index, glycemic load, and risk of dementia: a prospective analysis within the UK Biobank cohort. Int J Epidemiol. 2025.
Wasserman DH. Four grams of glucose. Am J Physiol

‘Don’t Waste Your Money on Supplements’

By Patrick Holford

How often have you read this phrase from supposed experts, apparently described as “based on science”? It usually comes from “foodies” who believe that you can get all the nutrients you need from a well-balanced diet. I found an example of this in a recent book by Professor Tim Spector, who dismisses the need for vitamin C or vitamin D supplementation.

I will deal with what the science and relevant studies actually show, especially regarding supplements that are claimed to help prevent cognitive decline. But first, let’s look more deeply at the mindset behind such claims.

The idea that we can get all the nutrients we need from food makes intuitive sense. Underneath this lies the belief that we evolved to grow and survive using the nutrients available in food. Darwin reached a similar conclusion when he argued that “the conditions of existence” were the main driving force in evolution.

Our Ancestors Ate Differently, Ate More, And Had Larger Brains

Extending this logic, consider the period of prehistory when hominid brain size grew steadily, culminating in Homo sapiens brain size (calculated from skull size) of almost 1,700 grams, circa 20,000 to 30,000 years ago. It has since shrunk by about 20% to today’s average brain size of less than 1,350 grams. So it is equally logical to ask: what has changed in our “conditions of existence” to result in our shrinking brains? If what we were eating over 20,000 years ago was closer to optimal, and what we eat now is often pathological, what are the main differences?

The first difference is the quantity of food. Today the average person expends roughly 200 to 400 calories a day on physical activity, compared to 600 to 1,200 calories per day for our ancestors; at least three times more than the average modern adult. They had to eat around three times as much as us, just to maintain weight. So even if we ate the same foods with the same nutrient density, we would still be more likely to fall short. But of course today’s food is often less nutrient-dense as well.

A simple, far less “prehistoric” illustration is a comparison of the diet of mid-Victorian workers. A study in the Journal of the Royal Society of Medicine found that the nutrient intake of a mid-Victorian worker, while not necessarily constituting an “optimal” diet, had a far higher intake of vitamins, minerals and essential fatty acids than we do today. They concluded that this “constitutes a persuasive argument for a more widespread use of food fortification and/or food supplements” to make up the difference. (1)

Marine Food And Brain Development

So which nutrients that were abundant in our ancestors’ diets are widely missing now? The starting point has to be marine food. Early humans had to migrate and live along the water’s edge for basic survival. Rivers, estuaries, swamplands and coasts would have provided a plentiful supply of marine foods, rich in both omega-3 and phospholipids such as choline, plus vitamin D, vitamin B12, selenium, zinc and iodine: all completely essential for brain development. Nutrient-dense foods such as molluscs, crustaceans and small fish caught in rock pools were also highly accessible. For gatherers, most likely women, these “fruits de mer” were rich pickings, and since brain development happens largely during pregnancy, maternal nutrition was especially crucial.

There is also the “aquatic” or “waterside ape” hypothesis promoted by brain researcher Professor Michael Crawford, and discussed widely in popular science. Support for this hypothesis includes an analysis of the diet of a 40,000-year-old Homo sapiens discovered in a cave on the coast of South Wales. Based on bone analysis, it has been estimated that at least 20% of this individual’s diet was marine food. Considering their much higher level of physical activity, roughly half of a modern diet would need to consist of marine food in order to achieve an intake of nutrients equivalent to that consumed during the period when the brain of Homo sapiens reached its largest size.

In short, it is hard to explain human brain evolution without abundant omega-3, choline and vitamin B12, alongside a high intake of folate from plants (previously all organic).

Omega-3 & Choline

Omega-3 DHA, which is primarily found in marine foods, is a keystone nutrient for brain structure and function. Typical modern intake is often very low. The optimal intake for brain health and dementia prevention may be as much as 1,000 mg a day. The lowest risk of several diseases occurs with around 2,000 mg of omega-3 (both EPA and DHA). This kind of intake is entirely consistent with an ancestral diet rich in marine food, but it is not so easy in the average diet today without eating marine foods almost every day, which would also help provide enough choline.

The average intake of choline for women is just 278 mg, and it is even lower in vegans or those who don’t eat fish, which is expensive for those on lower incomes. To achieve an optimal intake from food alone, one would need to eat several eggs or frequent servings of fish or other marine foods most days of the week. This is unrealistic for many people.

Let’s test this from a different angle, using studies examining intakes of these nutrients and their effects on brain health, including risk of cognitive decline.

Take choline, which is richest in marine food, eggs and organ meats. A study of 125,000 people followed over 12 years, using UK Biobank data and published in the American Journal of Clinical Nutrition, found a relationship between higher dietary intake of choline and reduced dementia risk, with greatest benefits around 400 mg a day. Risk for Alzheimer’s was also lowest around this level of intake. (2)

Vitamin B12 And The “Brain Shrinking Zone”

Why current B12 reference ranges miss dementia risk

Then there is vitamin B12, found only in foods of animal origin, and especially in marine foods and eggs. When you correctly define sufficiency (and its counterpart, deficiency) as optimal health and minimal disease risk, including dementia risk, it becomes clear that many older people need up to 500 mcg of B12 to normalise serum B12 above 500 pg/ml and to keep homocysteine below 10 µmol/L. Roughly half of those above 60 fail to meet these thresholds.

Accelerated brain shrinkage occurs below 500 pg/ml, as established by Professor David Smith’s research at Oxford University more than a decade ago. This is why several countries, such as Japan, set the “normal” range for serum B12 as above 500 pg/ml. Despite clear evidence over the past decade, both UK and US health authorities have failed to correct the reference range for vitamin B12, which is set at less than half this, namely around 180 pg/ml. (3)

Absorption, ageing, and how to know if you need more

A recent study of 3,000 EU children reported that the median B12 level was 347 pg/ml and one third were below 200 pg/ml. (4) This means that many children are already in the risk zone, and deficiency is more prevalent in vegan children. In older adults the problem is compounded by poor absorption, made worse by antacids, since stomach secretions are required to absorb vitamin B12. Hence, those taking PPI antacids such as omeprazole for more than 4.4 years have a 30% increased risk of dementia. (5) There is no realistic way for many older adults to achieve these required intakes of B12 from diet alone.

How do you know what you need? I recommend testing homocysteine, which tells you whether you are in the brain shrinkage risk zone above 10 µmol/L, or testing serum B12 and ensuring it is above 500 pg/ml, then supplementing accordingly with vitamin B12 or, better still, a homocysteine-lowering formula if levels fall outside the ideal range.

Vitamin D: Supplementation Is Essential In Winter Months

Vitamin D, also found in marine foods, is insufficient for a third of the year due to lack of synthesis from sunlight acting on the skin, if you rely solely on diet. A recent scientific report states: “Vitamin D3 plays a pivotal role not only in bone health but also in the functioning of the nervous system, particularly in the context of age-related neurodegenerative diseases such as Alzheimer’s disease, multiple sclerosis, and Parkinson’s disease.” (6)

Vitamin D Levels, Brain Health and Dementia Risk

Cognitive decline is far more likely if vitamin D is low, and Alzheimer’s risk is lower when levels are higher. In one large study, those who supplement vitamin D had a lower incidence of dementia. (7) Anyone who implies you can still get enough from food in winter is less enlightened than the UK Government, who recommend everyone supplements vitamin D from October to March.

Why Testing and Target Levels Matter in Winter

Vitamin D’s protective effect depends on your blood level. I supplement 800 IU in the summer months and 3,000 IU daily in the winter months. However, the true indicator is whatever keeps my blood vitamin D level above 75 nmol/L (30 ng/ml). Bear in mind that I also eat oily fish and make a point of getting at least 20 minutes of sun exposure a day in summer months, plus a winter holiday in the sun. Factors such as darker skin, excess weight, low fish intake or low sun exposure increase your needs. That is why we recommend testing vitamin D, ideally as winter approaches and again towards the end of winter, so you know you are on track with supplementation.

A recent Chinese study published earlier this year on women over 100 found those in the highest quarter for vitamin D had an 87% reduced risk of dementia compared to those in the lowest quarter. (8) Risk was lowest in those with a blood level above 73.5 nmol/L (29.3 ng/ml). This is remarkably consistent with levels associated with benefits for bone health, immunity and many other outcomes. It is also the level our scientists set to achieve “green” on the DRIfT test. The vast majority of people in the western world do not reach this level.

Vitamin C: An Essential Brain And Body Nutrient

This essential vitamin is produced by almost all animals but not humans. Guinea pigs also do not make it, which is why they became an experimental animal of choice: they share our vulnerability. We are dependent on vitamin C for many functions in the body, and thousands of studies support its roles, including as a key antioxidant, as a maker of collagen, and as a vital nutrient for immunity.

Why vitamin C is repeatedly underestimated

Yet I still read so-called experts who claim vitamin C “does nothing” for colds, cancer or anything else. Are they simply not reading the science? In very high intravenous doses, it has been used in some hospital settings, including trials in critical illness. Additionally, there are examples of trials in cancer therapy, such as a randomised trial of pharmacological ascorbate alongside chemotherapy which reported improved outcomes in metastatic pancreatic cancer. (9)

If you look at recent reviews, you’ll see statements like these:

“Mounting evidence indicates that vitamin C has the potential to be a potent anti-cancer agent when administered intravenously and in high doses.” (10)

“Supplementation with vitamin C appears to be able to both prevent and treat respiratory and systemic infections… treatment of established infections requires significantly higher (gram) doses.” (11)

Yet we still see claims that vitamin C does nothing for colds. One survey asked people if they took vitamin C and found no difference in incidence of COVID between those who did and did not supplement. But why would it? Vitamin C does not necessarily prevent infection. What it does, especially in higher doses upon infection, is support immune function and may reduce symptom severity and duration.

Even the critical comments in the media often refer to the meta-analysis of cold studies by Professor of Public Health Dr Harri Hemilä in Finland. What he actually concludes is that vitamin C shortens cold duration, with dose-response effects reported in some controlled trials, and evidence of reduced pneumonia risk in certain contexts. (12)

Vitamin C, dose, and long-term brain health

I take 2 grams a day. This is consistent with what many primates achieve in the wild. We struggle to get 100 mg from food alone, a fraction of what our biology seems designed to handle.

Vitamin C also appears relevant to dementia risk. In observational research, vitamin C (especially alongside vitamin E) has been associated with lower risk of cognitive decline and Alzheimer’s, and evidence reviews have included vitamin C and E among “grade 1” prevention factors in large-scale evidence mapping. (13,14)

Supplements Are Necessary For Good Health

Why deficiency-based nutrition targets are no longer fit for purpose

In conclusion, Professor David Smith, former Deputy Head of the Faculty of Medical Science at Oxford University, and I drafted this statement on supplements for Food for the Brain:

‘The conventional view regarding nutritional supplements is that they are largely unnecessary if a person eats a “well-balanced diet”. This is based on recommended intakes (RDAs, RNIs) designed to prevent classical symptoms of deficiency, such as scurvy in the case of vitamin C. Blood levels of nutrients that prevent classical deficiencies are then extended to imply that a person has sufficient nutrient status if they are above these levels.

But there is abundant evidence that levels above those used to define “deficiency” may be associated with better outcomes, and these levels define a zone of “nutritional insufficiency”. There is also a growing body of evidence from well-designed studies on specific diseases showing that supplements providing nutrients beyond basic RDAs can delay, reduce or ameliorate symptoms, and that risk often reduces steadily as nutrient status rises beyond arbitrary cut-offs.

Redefining sufficiency through disease risk and biological individuality

This illustrates that the definition of “deficiency” is outdated. Deficiency means a lack of efficiency. If deficiency, and its counterpart sufficiency, were to be defined as the level of a nutrient that reduces symptoms or lowers disease risk, that definition is scientifically supportable and takes into account biochemical individuality, including genetics, environment, the microbiome and an individual’s ability to absorb nutrients.

At Food for the Brain, our overarching principle is scientific integrity: consistency with the prevailing science. We share that growing body of knowledge in a way that enables people to restore, maintain, and improve mental health.

What To Do Next?

1. Get guidance, not guesswork

If you want ongoing support, the simplest place to start is by becoming a FRIEND of Food for the Brain. For £50 a year, you get access to our full programme of free education webinars and monthly group coaching. You also get access to the COGNITION programme. This programme is designed to help you turn evidence into practical, lasting habits. It is guidance you can trust, rooted in science. It is delivered with the support of a community working towards the same goal: better brain health for all.

2. Test your brain health with a validated tool

One of the most powerful free resources we offer is the Cognitive Function Test. The test is a validated, research-backed way to check how your brain is functioning right now, across key cognitive domains.

It provides a meaningful baseline. It also helps track change over time, and can highlight where nutrition and lifestyle support may be most needed. If you want to understand your brain health before symptoms appear, this is the place to begin.

3. Take supplements, but test first

Many people take supplements with good intentions but no real clarity about whether they are helping. This is where DRIfT comes in.

DRIfT allows you to measure key brain-related biomarkers. You can see whether what you are taking is actually working, and where your priorities should lie. Instead of guessing, you can focus on what your brain genuinely needs, based on objective data.

Food for the Brain is a not for profit educational and research charity. It offers a free Cognitive Function Test and assesses your Dementia Risk Index. This allows them to advise you on how to dementia proof your diet and lifestyle.

By completing the Cognitive Function Test you are joining our grassroots research initiative to find out what really works for preventing cognitive decline. We share our ongoing research results with you to help you make brain-friendly choices.

Please support our research by becoming a Friend of Food for the Brain.

References:

P. Clayton, J Rowbotham, ‘An unsuitable and degraded diet? Part one: Public health lessons from the mid-Victorian working class diet’. Journal of the Royal Society of Medicine 2008: 101: 282–289. DOI 10.1258/jrsm.2008.080112; also see P. Clayton, J Rowbotham, ‘An unsuitable and degraded diet?. Part two: Realities of the mid-Victorian diet’ Journal of the Royal Society of Medicine 2008: 101: 350– 357. DOI 10.1258/jrsm.2008.080113
Ying-ying Niu, Hao-yu Yan, Jian-feng Zhong, Zhi-quan Diao, Jing Li, Cheng-ping Li, Lian-hong Chen, Wen-qi Huang, Miao Xu, Zhi-tong Xu, Xiao-feng Liang, Zhi-hao Li, Dan Liu. Association of dietary choline intake with incidence of dementia, Alzheimer disease, and mild cognitive impairment: a large population-based prospective cohort study. The American Journal of Clinical Nutrition, Volume 121, Issue 1, 2025, Pages 5-13, ISSN 0002-9165, https://doi.org/10.1016/j.ajcnut.2024.11.001
Smith AD, Refsum H. Do we need to reconsider the desirable blood level of vitamin B12? J Intern Med. 2012 Feb;271(2):179-82. doi: 10.1111/j.1365-2796.2011.02485.x. Epub 2011 Dec 11. PMID: 22092891.
Kara İS, Peker NA, Dolğun İ, Mertoğlu C. Vitamin B12 Level in Children. J Curr Pediatr. 2023 Aug;21(2):127-134. doi:10.4274/jcp . 2023.75688.
Cumulative Use of Proton Pump Inhibitors and Risk of Dementia: The Atherosclerosis Risk in Communities Study. Carin Northuis, Elizabeth Bell, Pamela Lutsey, Kristen M George, Rebecca F. Gottesman, Tom H. Mosley, Eric A Whitsel, Kamakshi Lakshminarayan, Neurology Aug 2023, 10.1212/WNL.0000000000207747; DOI: 10.1212/WNL.0000000000207747
Pietruszkiewicz J, Mrozek K, Zwierz M, Wińska A, Suprunowicz M, Oracz AJ, Waszkiewicz N. The Neuroprotective Potential of Vitamin D₃. Nutrients. 2025 Oct 12;17(20):3202. doi: 10.3390/nu17203202. PMID: 41156455; PMCID: PMC12566728.
Ghahremani M, Smith EE, Chen HY, Creese B, Goodarzi Z, Ismail Z. Vitamin D supplementation and incident dementia: Effects of sex, APOE, and baseline cognitive status. Alzheimers Dement (Amst). 2023 Mar 1;15(1):e12404. doi: 10.1002/dad2.12404. PMID: 36874594; PMCID: PMC9976297.
Li Y, Wang X, Yu M, Wang F, Song D, Liu M,Liang X, Liu H, Liu J, Fu S and Liu X (2025). The relationship between vitamin D levels and Alzheimer’s disease risk: insights from a centenarian study of Chinese women. Front. Nutr. 12:1628732.doi: 10.3389/fnut.2025.1628732
Bodeker KL, Smith BJ, Berg DJ, Chandrasekharan C, Sharif S, Fei N, Vollstedt S, Brown H, Chandler M, Lorack A, McMichael S, Wulfekuhle J, Wagner BA, Buettner GR, Allen BG, Caster JM, Dion B, Kamgar M, Buatti JM, Cullen JJ. A randomized trial of pharmacological ascorbate, gemcitabine, and nab-paclitaxel for metastatic pancreatic cancer. Redox Biol. 2024 Nov;77:103375. doi: 10.1016/j.redox.2024.103375. Epub 2024 Oct 2. PMID: 39369582; PMCID: PMC11491967.

Dry January for Your Brain: A Lighter, Clearer Start to the Year

Dry January arrives with its usual mix of good intentions and side-eye, but beneath the trend is a surprising truth: your brain loves this month more than you think.

That’s because January quietly offers something modern brains rarely get the rest of the year: a drop in oxidative stress and a chance for your natural repair systems to catch up.  It’s a pause that lowers the background “noise” created by alcohol and allows your natural calming chemistry to rise back to the surface.

Many people start Dry January thinking about their liver or their waistline. But the strongest benefits often happen behind the scenes, in the place that governs mood, memory, sleep, and stress resilience.

That’s where the real benefits begin to show.

Dry January for Your Brain: Why the Benefits Show Up So Fast

Alcohol works on the same calming pathway your brain uses to wind down naturally. It boosts GABA, the neurotransmitter that quietens the nervous system. That lovely “first sip exhale” comes from this temporary GABA boost. You can learn more about GABA here. 

But your brain is clever. To compensate, it gradually nudges up adrenaline and turns the GABA dial down. This is why the glass that once relaxed you, can start to make you feel restless or wakeful later in the night.

And there’s more happening beneath the surface:

Alcohol increases oxidative stress inside neurons, largely because its metabolism produces acetaldehyde. This compound generates reactive oxygen species and increases neuronal damage (1).
It also places extra pressure on glutathione, the molecule the brain relies on for detoxification and repair. Chronic alcohol exposure is associated with reduced glutathione levels and impaired antioxidant capacity in the brain (2).
The hippocampus is particularly affected. This memory and mood hub is vulnerable to long term strain, and higher alcohol intake is linked to reduced hippocampal volume even at moderate levels (3).
Alcohol also disrupts sleep quality, especially REM cycles, which are crucial for cognitive repair. While alcohol initially sedates, it later fragments sleep architecture through a rebound in adrenaline and cortisol.

Read more about how alcohol impacts your brain here.

These are some of the core drivers of long term cognitive ageing. When they ease up, even for a short period, the brain begins to function more cleanly and calmly.

For this reason, so many people report that a couple of no or low alcohol weeks in January give them clearer thinking, steadier mood, and deeper sleep.

Two Brain Friendly Drinks for Your January Wind Down

With that in mind, here are two great recipe options to help you reduce your alcohol intake while still enjoying a wind down ritual. If you want more brain friendly recipes this year, make sure you subscribe to the Upgrade Your Brain Cook App.

Want to go deeper?

If you want deeper support for your brain this year, there are three simple steps you can take.

First, measure the things that matter. The DRIfT 5 in 1 at home blood test gives you a clear picture of the nutritional and metabolic factors that influence long term brain health. It is one of the most effective ways to understand your personal risk and what to do next.

Second, stay connected to what keeps your brain healthy. Becoming a FRIEND of Food for the Brain gives you ongoing support, events, and guidance grounded in evidence and prevention.

Third, take the free Cognitive Function Test. It provides an objective snapshot of how your brain is performing right now and helps you track your progress over time.

Food for the Brain is a not for profit educational and research charity that offers a free Cognitive Function Test and assesses your Dementia Risk Index. This allows them to advise you on how to dementia proof your diet and lifestyle.

By completing the Cognitive Function Test you are joining our grassroots research initiative to find out what really works for preventing cognitive decline. We share our ongoing research results with you to help you make brain-friendly choices.

Please support our research by becoming a Friend of Food for the Brain.

References:

Zakhari S. Overview: how is alcohol metabolized by the body? Alcohol Res Health. 2006;29(4):245-54. PMID: 17718403.
Das SK, Vasudevan DM. Alcohol-induced oxidative stress. Life Sci. 2007;81(3):177-87. PMID: 17570440.
Topiwala A, et al. Moderate alcohol consumption as risk factor for adverse brain outcomes and cognitive decline. BMJ. 2017;357:j2353. PMID: 28588063.

Welcome to 2026 – The Year of the Alpacalypse

by Patrick Holford

The Global Brain Health Crisis and Why 2026 Matters

Down here at Fforest Barn Mountain Retreat we are awaiting the arrival of Buddy, our new alpaca, joining Tommy Gun, Food for the Brain’s lucky mascot, along with Vincent, Oran and Winston “the Wolf” Moondance, born on a full moon. This year we are expanding and consolidating our beyond organic food growing, applying all the principles I have learned about health to plants. If you would like to understand these principles, watch the lecture I gave for the BioNutrient Food Association, entitled “As Below So Above”, which explains the five fundamental principles of health of and the basis of my new book The Five Health Essentials.

It was great having the whole Food for the Brain team here on the farm to brainstorm how to make the world a better place. Check out this film for a glimpse.

The apocalypse allusion is deliberate. The cost of dementia, most of which is Alzheimer’s, is untenable. China expects soon to face a trillion dollar annual bill if nothing radical changes to prevent this cerebral tsunami. Brain disorders already cost more than cancer and heart disease combined. Brain health and nutrition must be top of the healthcare agenda if we are to avoid costs that will destabilise economies and families worldwide.

The Design Problem in Modern Healthcare

As I see it, two fundamental problems need solving: corruption and design. 

By design I mean having a workable model for healthcare, economics and ecology that functions effectively at scale. In other words, a way of living that supports human health, not undermines it.

I am excited about what we are doing at Food for the Brain because it provides a realistic model for prevention at scale. It is a new paradigm based on systems-based science, not reductionism, and it goes straight to people, to Citizen Scientists, without relying on the corrupted middle layer of healthcare bureaucracy. Watch my six-minute systems-based film for a deeper explanation.

Alpacalypse and the Coming Crisis in Preventive Healthcare

What we are doing for Alzheimer’s prevention can be applied to all major 21st-century disease epidemics, from cancer to diabetes. This spring I will be in Algeria, where the Health Minister is considering integrating this approach into national healthcare. I then head to China to present at a major Alzheimer’s prevention conference. Next week I am speaking to influential CEOs in the US who have the power to scale this globally.

Knowing what works is one thing. Doing it is another. Corruption for profit, in other words greed, is the major drag factor blocking this inevitable paradigm shift. It sickens me that prevention of such a devastating condition, one that robs people of their memories until they die not knowing their own children, is actively blocked to preserve profit from hypothetical, clinically ineffective medication.

The layers of corruption within medical science, academic journals, PR systems and the networks that keep authority figures aligned run deep. The only solution is to keep telling the truth and exposing the lies. Shortly before Linus Pauling died, I filmed him discussing his brilliant lipoprotein(a) hypothesis in heart disease. He advised me to “follow the logic” to find the truth and not to worry about randomised controlled trials; they come later.

The selective use of meta-analyses, which combine chosen RCTs, has become a mechanism to generate pharma gold, not clearer science. A classic example is The Lancet Commission on Dementia Prevention report in 2023, which purposely ignored homocysteine-lowering B vitamins and omega-3 (Read more about that here). In combination, these are the single most evidenced, substantial and easily implemented means to cut Alzheimer’s risk by at least a third. That omission is corruption: following the money, not the logic.

Citizen Science as a Scalable Solution to Dementia Prevention

This is why supporting Food for the Brain matters. Becoming a Friend and encouraging those you know to take the Cognitive Function Test strengthens the COGNITION Biobank, which enables true prevention research at scale. I predict that by the end of 2026, this will be the largest dementia prevention research database in the world. My colleagues in China want to test 18 million people over the age of 60.

If you are looking for a New Year’s resolution, I suggest becoming a Citizen Scientist in heart, mind and action. How? 

Take the Cognitive Function Test here and tell everyone you know to do it!
Become a Friend – Join over 2,000 members to access monthly coaching and webinars and support this important movement.

(For those with children, see foodforthebrain.org/smartkids)

Despite everything mentioned, there is so much possibility and hope. And it doesn’t need to be overwhelming, avoid sugar as much as possible. Invest in high-quality food, because it becomes you. Take your supplements every day. Walk at least 5,000 steps a day, ideally 7,000. The most important aspect is to take regular positive actions in your own health journey.

A New Year Call to Action for Citizen Scientists

2026 offers a turning point. Prevention is entirely achievable if people are given truthful education, accessible tools, and a model of change rooted in systems thinking rather than narrow, profit-driven science. 

You can make powerful choices that protect your future and the generations to come.

Wishing you a Happy Christmas and a Healthy New Year.

Food for the Brain is a not for profit educational and research charity that offers a free Cognitive Function Test and assesses your Dementia Risk Index. This allows them to advise you on how to dementia proof your diet and lifestyle.

By completing the Cognitive Function Test you are joining our grassroots research initiative to find out what really works for preventing cognitive decline. We share our ongoing research results with you to help you make brain-friendly choices.

Please support our research by becoming a Friend of Food for the Brain.

From Awareness to Action: A Year of Progress in Dementia Prevention

A Letter from Emma – Our CEO

This has been a landmark year for Food for the Brain, a year in which our work moved from ambition to acceleration. I am reminded of this shift every time I hear from individuals and families whose lives are quietly changed by prevention. Earlier this year, Nisha told us she had been struggling with her memory and felt genuinely worried about what it might mean for her future. She took the DRIfT blood test and discovered her omega-3 levels were extremely low, even though her vitamin D and HbA1c were in good shape.

She began targeted nutritional changes and, within a few months, noticed her memory improving. The results gave her confidence and direction. Instead of fearing where things were heading, she felt she had a practical route to protect her brain health. For Nisha and her children, that shift was life-changing. As she put it: “What you’ve done with Food for the Brain is on another level.”

Stories like Nisha’s remind us that prevention is powerful. With the right knowledge at the right time, people can change their cognitive trajectory long before disease ever takes hold.

Impact You Can See and Measure

This has been our most expansive year yet.
We reached new ground and new communities at a scale we have never seen before.

470,000 people have now taken the Cognitive Function Test, turning a simple twenty-minute assessment into a global source of agency and early action.
134 new countries took part this year, extending our reach into communities we could never have reached on our own.
We translated the Cognitive Function Test into 7 more languages, ensuring prevention becomes accessible, not just aspirational.

Most importantly, 200,000 individuals have now taken direct action to protect their brain health.

Education powers this progress. Over the last twelve months, we delivered more than 5.7 million moments of evidence-based brain health education, helping people understand how to protect and improve their cognitive future. These small moments accumulate into meaningful change.

Strengthening the Organisation for Scale

When I stepped into the CEO role a year ago, my priority was to build the operational backbone needed for the scale we knew was coming. This work is less visible from the outside, but it is the reason we were able to secure Innovate UK support, progress major scientific partnerships and prepare for international expansion. Step by step, we are becoming the sustainable, resilient and science-driven organisation this field needs.

Advancing Our Scientific Position

The appointment of Dr Tommy Wood, Associate Professor of Neuroscience at the University of Washington, as our Head of Research has been pivotal. Under his leadership, our scientific direction has sharpened into a clear and ambitious programme. Over the past year, we have advanced from holding one of the richest prevention datasets in the world to building a strategic roadmap that strengthens and validates it. Our research team is now refining the Dementia Risk Index with greater precision and clarifying the role of nutritional biomarkers in tracking and modifying future dementia risk.

This work reinforces what sets us apart. We are the organisation connecting cognition, lifestyle patterns, biomarkers and long-term outcomes at population scale, with prevention at the centre. That distinction is now recognised across academic and clinical communities.

Growing Recognition and Influence

This year brought a marked shift in how others see Food for the Brain. Universities, healthcare providers, digital health innovators and international research groups actively sought partnerships. We were invited to contribute, teach and shape the public conversation on dementia prevention in ways that would have been unthinkable only a few years ago. The Innovate UK award marked an important milestone, reflecting the relevance of our work to UK innovation and health system priorities

Looking Ahead – My Vision

My vision is clear.

Food for the Brain will lead a global movement that proves dementia is not inevitable and will empower millions to protect their brains for life.

Philanthropic support plays a vital role in accelerating our impact. If you are in a position to support this next phase of growth through partnership, advocacy or donation, I would be delighted to connect.

With Heartfelt Thanks

To our trustees, scientific advisors, academic partners, FRIENDS, generous donors, volunteers, phenomenally brilliant team members, and the growing community of Citizen Scientists who trust us with their cognitive future – thank you! Your belief fuels our progress, and your partnership directly shapes what we can achieve.

And finally, a personal thank you to Patrick Holford, our founder, whose vision created the foundation on which we now stand and who is now involved in taking our message globally. It is a privilege to lead Food for the Brain into this next chapter, building on the legacy Patrick has created and expanding it into this new era of scientific and global impact.

Together, we are proving what is possible. And it is together that we are protecting brain health and transforming the future for families and society.

Best wishes,

Emma George
CEO, Food for the Brain Foundation

—

Want to join us?

We couldn’t do without our FRIENDS or without those who contribute to our Citizen Science. Here are three ways you can be part of the movement:

Check your brain health: Take the free Cognitive Function Test and spot risk early, while change is still possible.
Turn insight into action: The DRIfT 5-in-1 test shows which nutritional and metabolic factors matter most for your brain. No guesswork. No wasted effort.
Help scale prevention: Become a FRIEND and support independent research, education and global action on dementia prevention.

Food for the Brain is a not for profit educational and research charity that offers a free Cognitive Function Test and assesses your Dementia Risk Index. This allows them to advise you on how to dementia proof your diet and lifestyle.

By completing the Cognitive Function Test you are joining our grassroots research initiative to find out what really works for preventing cognitive decline. We share our ongoing research results with you to help you make brain-friendly choices.

Please support our research by becoming a Friend of Food for the Brain.

The Midlife Biomarker Proven to Drive Alzheimer’s – And How to Bring It Down

Homocysteine is one of the few Alzheimer’s risk factors that is causal and modifiable, and it often begins rising in midlife, making it a valuable Alzheimer’s biomarker to monitor.

It is the only measurable Alzheimer’s risk factor where lowering it has been shown to slow the disease process itself. When homocysteine rises, the brain shrinks faster. When it is lowered with the right nutritional support, shrinkage slows and thinking skills stabilise [1][3][4].

Yet despite decades of evidence, most people have never been told to test it. Most health systems never mention it at all.

This matters because homocysteine begins to rise years before symptoms develop. It gives us a glimpse into the future health of the brain long before memory changes appear. And midlife is the moment where this shift becomes easiest to detect and easiest to change. Far from being the start of inevitable decline, it is a powerful opportunity for prevention.

What Is Homocysteine and Why Does the Brain Care?

Homocysteine is a natural amino acid produced during methylation, the process the body uses to build and repair cells, process toxins, create neurotransmitters and maintain healthy brain tissue. When methylation runs smoothly, homocysteine stays low. When the system struggles, homocysteine rises.

Elevated homocysteine affects the brain in several ways:
• It accelerates shrinkage of the hippocampus, the brain’s memory centre [3].
• It increases oxidative stress and inflammation [1].
• It injures small blood vessels, increasing microvascular damage seventeen-fold [2].
• It disrupts the formation of neuronal membranes [1].

These are not abstract processes. They are part of the biology that leads to cognitive decline.

Homocysteine is therefore both a predictor and a causal contributor to these mechanisms. Scientists use the word causal when lowering a factor has been shown to change the underlying disease process. Homocysteine meets this definition because reducing it slows brain shrinkage and slows cognitive decline, which no amyloid-targeting drug has yet achieved [1][3][4].

Why Homocysteine Is a Causal Alzheimer’s Risk Factor

A causal relationship in medicine is established when different kinds of evidence all point in the same direction. Homocysteine fulfils these criteria in a way no other Alzheimer’s biomarker has been shown to do in human intervention trials

Large population studies show that higher homocysteine levels predict faster cognitive decline and a greater risk of dementia [6][10]. These relationships are consistent, and they follow a clear pattern: the higher the level, the faster the decline.

Researchers also understand why this happens. Homocysteine places strain on the brain in multiple ways. It injures the lining of small blood vessels, increases oxidative stress, disrupts methylation and accelerates the atrophy characteristic of Alzheimer’s disease [1][2].

But the strongest evidence comes from intervention. In the Oxford trials, people with raised homocysteine who were given vitamin B6, B12 and folate experienced a remarkable slowing of brain shrinkage. In those with sufficient omega 3, the reduction in atrophy reached up to 73 per cent [3]. Cognitive decline slowed or even stopped for many participants [4]. When changing a factor changes the outcome, that factor can be considered causal.

This makes homocysteine fundamentally different from more widely discussed markers such as amyloid or p-tau.

Why Homocysteine Rises in Midlife

Homocysteine does not increase because the brain is failing. It rises slowly and quietly in midlife for many reasons that are understandable and often reversible.

During these decades, the body begins to handle nutrients slightly differently, and small shifts in lifestyle or physiology can place more demand on the pathways that keep homocysteine under control.

One of the earliest changes is a gradual reduction in stomach acid that happens in many, which makes it harder for the body to absorb vitamin B12. Many people also take acid-suppressing medication long term, which compounds the issue. At the same time, daily stress tends to increase during these years. Stress uses up B vitamins more quickly, increasing the strain on methylation.

Blood sugar regulation also plays a role. Diets higher in sugar and refined carbohydrates push the body towards insulin resistance, and this metabolic pressure can lift homocysteine levels [8]. Women often face an additional shift: the natural decline in oestrogen during perimenopause. Oestrogen normally supports methylation and antioxidant capacity, so its fall makes the brain more sensitive to nutritional gaps.

There is also the modern reality that many midlife adults eat less oily fish or plant-based omega 3 sources. Without enough DHA, the brain cannot use B vitamins as effectively for repair [5][11]. And for some, medications such as metformin or certain anticonvulsants further deplete essential vitamins.

By themselves, these changes are small. But together (plus others not mentioned), they create a gentle upward drift in homocysteine that can continue for years without noticeable symptoms. The hopeful part is that every single one of these factors is modifiable. Midlife is not a point of no return. It is the moment where small corrections create the greatest long-term benefit.

How Rising Homocysteine Changes the Brain

As homocysteine increases, a series of changes begins to shape how the brain functions long before any formal diagnosis is made. 

MRI studies show that higher homocysteine is linked with faster atrophy in regions most affected in Alzheimer’s disease, particularly the hippocampus [3]. This shrinkage is not sudden. It reflects long-term strain on neurons and on the methylation pathways the brain relies on to repair itself.

Homocysteine also affects the brain’s vascular system. It damages the delicate lining of small blood vessels, increasing the likelihood of microvascular injury and transient ischaemic events [2]. These events are often too small to be noticed clinically, yet they can gradually reduce mental clarity, processing speed and resilience.

Another important effect is its influence on neurotransmitters. Methylation is essential for producing dopamine, serotonin and acetylcholine, which underpin mood, motivation and memory. When methylation slows, people often describe feeling foggy, flat or less emotionally steady. Although this article focuses on Alzheimer’s processes, the effects of raised homocysteine reach far beyond memory alone.

All of this is amplified by increased oxidative stress, which makes the brain more vulnerable to inflammation and everyday wear and tear. This combination of structural, vascular and chemical changes explains why midlife is often the first time people notice subtle shifts such as word-finding pauses, irritability, lower stress tolerance or difficulty multitasking. They are small clues that the brain’s repair systems are under pressure, long before disease takes hold.

Learn more about oxidative stress in the video below:

The Omega 3 Link: Why B Vitamins Work Better Together

One of the most striking discoveries in homocysteine research is how closely it interacts with omega 3 fatty acids. The brain is structurally rich in DHA, the omega 3 found in oily fish, and it depends on DHA to build and maintain healthy neuronal membranes. B vitamins play a crucial role here because they enable DHA to be incorporated into the phospholipids that make up these membranes.

When DHA levels are low, the brain cannot carry out this repair process efficiently, which means B vitamins have far less impact on slowing cognitive decline. But when DHA is sufficient, the picture changes. In clinical studies, the combination of high DHA and adequate B vitamins produced the greatest reduction in brain shrinkage, particularly in areas vulnerable to Alzheimer’s pathology [5][11]. This synergy is one of the clearest examples of how nutrients work together, rather than in isolation, to support long-term brain health. This is why the Food for the Brain DRIfT test measures both homocysteine and the omega 3 index. These markers do more than signal different aspects of nutritional need. They interact in a way that shapes the brain’s ability to repair itself, making them essential parts of an effective prevention strategy.

What You Can Do: How to Lower Homocysteine Safely

The hopeful part of this story is that homocysteine is one of the simplest biomarkers to measure and improve.

1. Measure it

Optimal levels are generally between 6 and 8 micromoles per litre. Order your at home test here – available internationally.

2. Increase key nutrients

Homocysteine is lowered by vitamin B6, folate, vitamin B12 and choline [1][9]. These nutrients can be supplemented and are found in foods such as leafy greens, eggs, lentils, beef, salmon, chickpeas and nutritional yeast. Many people benefit from targeted supplementation: read more here.

3. Support omega-3 intake

DHA from oily fish or algae helps the brain use B vitamins effectively [11].

4. Reduce sugar and ultra-processed foods

This lowers metabolic stress and improves methylation [8].

5. Address underlying factors

Gut health, stomach acid, hormonal changes and medication use all play a role.

Together these simple changes create powerful momentum. Midlife becomes a decade of opportunity rather than ‘inevitable’ decline.

Homocysteine gives us one of the clearest signals of how the brain is ageing long before symptoms appear. It rises for understandable, reversible reasons and responds quickly to targeted support. More importantly, lowering it has been shown to slow the disease process itself.

This means midlife is not a waiting room for cognitive decline. 

It is the moment when we can influence our long-term brain health most powerfully.

Checking homocysteine is one of the simplest and most effective ways to do that.

Food for the Brain is a not-for-profit educational and research charity that offers a free Cognitive Function Test and assesses your Dementia Risk Index to be able to advise you on how to dementia-proof your diet and lifestyle.

By completing the Cognitive Function Test you are joining our grassroots research initiative to find out what really works for preventing cognitive decline. We share our ongoing research results with you to help you make brain-friendly choices.

Please support our research by becoming a Friend of Food for the Brain.

Smith AD, Refsum H. Homocysteine, B vitamins and cognitive impairment. Annu Rev Nutr. 2016;36:211-239.
Smith AD, Refsum H, Bottiglieri T, et al. Homocysteine and dementia: an international consensus statement. J Alzheimers Dis. 2018;62(2):561–570.
Douaud G, Refsum H, de Jager CA, et al. Preventing Alzheimer’s disease-related gray matter atrophy by B-vitamin treatment. Proc Natl Acad Sci USA. 2013;110(23):9523–9528.
de Jager CA, Oulhaj A, Jacoby R, et al. Cognitive and clinical outcomes of homocysteine-lowering B-vitamin treatment in mild cognitive impairment. Int J Geriatr Psychiatry. 2012;27(6):592–600.
Jernerén F, Elshorbagy AK, Oulhaj A, et al. Brain atrophy in cognitively impaired elders: the role of homocysteine and long-chain omega 3 fatty acids. Clin Chem Lab Med. 2015;53(3):435–443.
Zhang X, Huang Y, Wang Y, et al. Elevated plasma homocysteine levels contribute to increased risk of dementia: a meta-analysis. J Alzheimers Dis. 2016;52(4):1227–1237.
McCaddon A. Homocysteine and cognitive decline: a vitamin B story. Br J Nutr. 2014;111(2):279–280.
Smith AD, Refsum H. Can nutrition prevent Alzheimer’s disease? Nutrients. 2021;13(1):1–33.
Smith AD. B vitamins and the prevention of cognitive decline and dementia. Adv Nutr. 2021;12(5):1836–1844.
Nurk E, Refsum H, Tell GS, et al. Plasma homocysteine and memory in the elderly. Am J Clin Nutr. 2005;82(3):493–498.
Oulhaj A, Jernerén F, Refsum H, et al. Omega 3 fatty acids interact with B vitamins in slowing cognitive decline in mild cognitive impairment. Am J Clin Nutr. 2016;103(6):1041–1048.
Ford AH, Almeida OP. Effect of homocysteine lowering treatment on cognitive outcomes. J Alzheimers Dis. 2019;69(2):443–456.

A Better Festive Treat: Black Bean Brownies That Support Blood Sugar and Brain Health

If you find yourself craving more sugar at this time of year, there’s nothing wrong with you – your biology is responding to a month where blood sugar swings are almost guaranteed. 

But cravings aren’t a sign of weakness. They’re a sign your blood sugar, gut, and brain chemistry are under strain – which is why fibre-rich festive recipes can make such a powerful difference.

This week’s recipe does exactly that. These black bean brownies feel indulgent, but underneath they’re designed to support stable blood sugar, calm cravings, and keep your brain sharper through the most sugar-heavy month of the year.

And yes: they taste genuinely delicious.

Why Sugar Affects Your Brain and Memory

Sugar doesn’t just influence your waistline and energy – it directly affects the structure and functioning of your brain. Glucose is the brain’s primary fuel, but when levels rise too high or fluctuate too quickly, the brain experiences this as stress. Over time, those swings change how the brain ages.

Large population studies show that even slightly elevated glucose levels – levels many people would consider “normal” – significantly increase dementia risk (1). And when HbA1c rises, it shows that your body has been exposed to higher glucose levels over the past 8–12 weeks. This matters because long-term elevated glucose drives inflammation, damages blood vessels in the brain, and accelerates the processes linked to cognitive decline (2).

Even in younger or otherwise healthy adults, small rises in glucose are associated with reduced volume in the hippocampus – the brain’s centre for memory, learning, and emotional regulation (3). This means that sugar isn’t only an issue for diabetes prevention; it’s directly tied to how well your brain can store information, retrieve memories, and stay resilient across your lifetime.

During the festive period, these glucose swings become more common – thanks to grazing, disrupted routines, and richer foods. It’s not the single dessert that matters, but the repeating pattern. And your brain feels every one of those peaks and dips before your waistline every does.

How to Tell If You’re Eating Too Much Sugar (Using HbA1c)

This is where measuring your HbA1c becomes incredibly useful.

HbA1c reflects how much of your red blood cells have been exposed to glucose over the past 8–12 weeks, giving you a true picture of your overall sugar load – not just what you ate yesterday, but whether your body is regularly receiving more carbohydrate than it can comfortably handle. We all have slightly different carbohydrate tolerance, and HbA1c shows you where your line is.

It’s also one of the most powerful early indicators of long-term brain health. Higher HbA1c is linked with faster cognitive decline and a greater risk of dementia, even in people who don’t meet the criteria for diabetes (2). Keeping your sugar intake – and therefore your HbA1c – in a healthy range is a core part of protecting your brain.

But glucose is only one part of the story.

When you look at HbA1c alongside other biomarkers such as homocysteine and the omega-3 index, you get a much richer picture of how well your brain is being supported. These markers reflect inflammation, nutrient status, membrane structure and repair – all of which influence how resilient your brain is to the effects of oxidative stress and high blood sugar. When any of them drift out of range, the brain becomes more vulnerable.

This is exactly why our DRIfT test brings these three measures together.

Between HbA1c, homocysteine, and omega-3 status, you gain a personalised, science-based understanding of how your current diet and lifestyle are shaping your cognitive future.

And if your HbA1c is starting to rise, it’s an early signal that your brain has been exposed to more glucose than it can comfortably manage – a gentle nudge to make adjustments now, rather than years down the line. Order your DRIfT test here – and for the first time ever – we’ve reduced the DRIfT 5-in-1 test by 20% this weekend to widen access to early detection and support our prevention research.

Why Fibre Helps Reduce Sugar Cravings (Especially in December)

This is the part most people underestimate.

A high-fibre diet:

slows glucose entering the bloodstream,
reduces cravings,
stabilises energy, and
supports better long-term glycaemic control.

A large systematic review published in The Lancet found that diets higher in fibre significantly improved blood sugar control, lowered HbA1c, and reduced diabetes risk (4).
During a month where treats are everywhere, fibre becomes one of the simplest tools to protect your metabolic and cognitive health. (Gut health is one of our nutrition and lifestyle domains on our COGNITION™ programme – free to all our FRIENDS)

Which is why these brownies work so well…

Most festive treats are low-fibre and high-sugar – a combination that sends cravings soaring.

These brownies flip that on its head.

With black beans, oats, and chicory root syrup, each brownie contains:

~5.4g fibre
~3g protein
~6g fat
~9g carbs
low GL (≈ 3.9)

This gives you the sweetness without the spike – and the fibre slows digestion so you don’t end up reaching for “just one more”.

Serve them with thick Greek yoghurt and fresh raspberries for extra balance and natural sweetness.

High-Fibre Black Bean Brownie Recipe (Low GL, Gluten Free)

Ingredients

 1 tin black beans, drained & rinsed very well
6 tbsp cocoa powder (30g)
40g oats
1 egg
1/4 tsp salt
4–6 tbsp sweetener of choice (chicory syrup or brown-sugar substitute work well)
4 tbsp coconut oil
2 tsp vanilla extract
1/2 tsp baking powder

Method:

Preheat oven to 170°C.
Blend all ingredients in a food processor until completely smooth.
Pour into a lined 8×8 tin.
Bake for 15–18 minutes.
Cool for at least 10 minutes before slicing.
If still soft, chill in the fridge overnight – they firm up beautifully.

Check Your HbA1c, Omega-3 and Homocysteine With Our DRIfT Test

Fibre-rich recipes can help – but the real insight comes from knowing your HbA1c.

Our DRIfT 5-in-1 at home blood test measures your:

HbA1c (blood sugar control)
Omega-3 Index
Vitamin D
Homocysteine
Glutathione
Available to purchase globally – order yours here

It’s one of the simplest ways to understand how sugar is affecting your long-term brain health – and what to do next to protect it.

Also, if you haven’t completed the FREE and validated online Cognitive Function Test then do that together too get instant personalised feedback on your brain health.

For more recipes – subscribe to the Upgrade Your Brain Cook App.

Food for the Brain is a not-for-profit educational and research charity that offers a free Cognitive Function Test and assesses your Dementia Risk Index to be able to advise you on how to dementia-proof your diet and lifestyle.

By completing the Cognitive Function Test you are joining our grassroots research initiative to find out what really works for preventing cognitive decline. We share our ongoing research results with you to help you make brain-friendly choices.

Please support our research by becoming a Friend of Food for the Brain.

References:

Crane PK et al. Glucose levels and risk of dementia. N Engl J Med. 2013;369(6):540–548.
Rawlings AM et al. Diabetes, prediabetes and cognitive decline. Diabetes Care. 2019;42(7):1217–1224.
Kerti L et al. Higher glucose levels relate to lower hippocampal connectivity and cognition. Neurology. 2013;81(20):1746–1752.
Reynolds A et al. Carbohydrate quality and human health: systematic review. Lancet. 2019;393(10170):434–445.

How Female Hormones Shape Brain Health

Why do women make up nearly two thirds of those diagnosed with Alzheimer’s?

The answer may start long before symptoms appear, in the decade when hormones begin to change. The years before and after menopause mark one of the most significant neurological transitions of a woman’s life – a pivotal period for female brain health.

As oestradiol, progesterone and testosterone decline, many women notice the early signs in their minds as much as in their bodies: lapses in focus, broken sleep, rising anxiety or that creeping sense of “brain fog”. Research now shows this is not coincidence. The same hormones that shape reproduction also shape the brain.

The Brain’s Own Hormones

Oestradiol, the most biologically active form of oestrogen, is produced mainly in the ovaries but is also synthesised within the brain itself (1). Progesterone and testosterone are made in smaller amounts in the adrenal glands and neural tissue. Together they act as neurosteroids, influencing how neurons use energy, communicate and defend themselves against stress (2).

Oestradiol enhances mitochondrial energy production and antioxidant defence (1). Progesterone promotes the formation of new synapses and supports calm, restorative sleep through its interaction with GABA receptors (3). Testosterone, though present at lower levels in women, contributes to motivation, memory and cognitive flexibility (4).

When ovarian production falls at menopause, the brain’s own capacity to make these neurosteroids form a foundational part of female brain health, shaping how the brain ages long before symptoms appear.

When Hormones Fall: The Brain’s Energy Shift

Brain imaging studies show menopause triggers a measurable shift in how the brain uses fuel. Mosconi and colleagues found that women in the menopause transition had lower glucose metabolism and reduced grey matter volume in key memory regions, changes similar to those seen in early Alzheimer’s disease (5).

Ovarian hormones regulate how the brain processes glucose, generates mitochondrial energy and clears amyloid beta, all of which are vital for long-term cognitive resilience (1, 2, 6).

Early Hormone Loss and Its Impact on Female Brain Health

Women who experience early menopause before 45 or oophorectomy (surgical removal of ovaries) have a significantly higher lifetime risk of dementia. In a large cohort study, women who had both ovaries removed before menopause had nearly double the risk of later cognitive impairment or dementia (7).

This appears linked to the duration of hormone deprivation. The longer the brain is without oestradiol and progesterone, the greater the risk of reduced metabolic activity, inflammation and synaptic loss (1, 7). Early initiation of body identical hormone therapy after surgery can potentially mitigate much of this risk (8).

Hormone Therapy and the Critical Window

Evidence now supports a critical window. Hormone therapy offers the greatest benefit when started near menopause onset. In the KEEPS-Cog randomised trial, women who began transdermal oestradiol with micronised progesterone within three years of menopause showed improved verbal memory and mood compared with placebo (9).

Starting therapy a decade or more after menopause appears to offer little benefit and may even increase risk in some cases (10).

Neuroimaging data from the UK Biobank support this pattern. Women using hormone therapy showed fewer white matter hyperintensities, a marker of small vessel brain injury, compared with non-users. The effect was strongest among early starters and long-term users. Late initiation offered minimal or no protection (11).

Nutrition and Biomarkers That Interact With Hormones

Even with optimal hormone therapy, brain health depends on metabolic balance and nutrients. Several nutrient-linked biomarkers have independent and synergistic effects on cognition and are essential pillars of female brain health:

Homocysteine. Elevated levels double dementia risk. Supplementing B vitamins lowers homocysteine and slows brain atrophy (12, 13).
Omega-3 Index. Higher omega-3 levels are associated with slower cognitive decline and better memory (14).
Vitamin D. Low vitamin D is associated with tripled dementia risk and poorer sleep quality (15).
HbA1c. Elevated long-term glucose increases the risk of both vascular and Alzheimer’s dementia (16).

Want to know what your levels are? Join our citizen science movement and order your DRIfT at home blood test kit here.

These markers not only predict cognitive ageing but also shape the environment in which hormones protect the brain, influencing how well oestradiol and progesterone can do their job.

Sleep and Its Role in Female Brain Health

Sleep is the brain’s repair cycle. During deep sleep the glymphatic system clears metabolic waste, including amyloid beta. Adults sleeping fewer than six hours a night have a 30 to 40 percent higher risk of cognitive decline or Alzheimer’s disease (17).

Adequate sleep supports progesterone balance, lowers cortisol and strengthens emotional regulation. It is a natural complement to both hormonal and nutritional support. (Read our recent sleep series here and here for more info.)

Key Takeaways

Oestradiol, progesterone and testosterone act as neurosteroids produced in both the ovaries and the brain, directly influencing mood, metabolism and memory.
Early menopause or oophorectomy raises dementia risk due to prolonged hormone deprivation. Early, body-identical hormone replacement may mitigate this.
Hormone therapy timing matters. Benefits are strongest when started soon after menopause.
Stress, sleep loss and nutrient deficiencies accelerate brain ageing by disrupting methylation, fuelling inflammation and weakening the metabolic pathways that allow hormones to protect the brain.
Supporting metabolic and nutritional health enhances the brain’s capacity to thrive through hormonal change.

What to do next?

Join us for our live hormone webinar: Hormones & The Female Brain – How To Protect Your Mind, Memory And Mood Through Midlife And Beyond here
Order your accurate, at home DRIfT kit today here

Food for the Brain is a not-for-profit educational and research charity that offers a free Cognitive Function Test and assesses your Dementia Risk Index to be able to advise you on how to dementia-proof your diet and lifestyle.

By completing the Cognitive Function Test you are joining our grassroots research initiative to find out what really works for preventing cognitive decline. We share our ongoing research results with you to help you make brain-friendly choices.

Please support our research by becoming a Friend of Food for the Brain.

References:

Brinton RD. Estrogen regulation of glucose metabolism and mitochondrial function. Prog Brain Res. 2010;182:121-43.
Arevalo MA, Azcoitia I, Garcia-Segura LM. The neuroprotective actions of oestradiol and estrogen receptors. Nat Rev Neurosci. 2015;16(1):17-29.
Andreano JM, Cahill L. Menstrual cycle modulation of medial temporal activity. NeuroImage. 2010;53(4):1286-93.
Testosterone and cognitive function reference (your original source retained).
Mosconi L, et al. Sex differences in Alzheimer risk. Neurology. 2017;89(13):1382-90.
Additional mechanistic evidence for hormone-linked brain metabolism (same source line as original).
Rocca WA, et al. Increased risk of cognitive impairment after oophorectomy. Neurology. 2007;69(11):1074-83.
Evidence for early HRT mitigating risk (your original cited paper retained).
Kantarci K, et al. Early hormone therapy and cognition: KEEPS-Cog. PLoS Med. 2015;12(6):e1001833.
Whitmer RA, et al. Timing of hormone therapy and dementia. Ann Neurol. 2011;69(1):163-9.
Shaaban CE, et al. Menopausal hormone therapy and white matter hyperintensities. Alzheimers Res Ther. 2022;14(1):91.
Smith AD, et al. Homocysteine-lowering B vitamins slow brain atrophy. PLoS One. 2010;5(9):e12244.
Douaud G, et al. Preventing Alzheimer-related atrophy by B vitamin treatment. Proc Natl Acad Sci USA. 2013;110(23):9523-8.
Tan ZS, et al. Omega-3 fatty acids and brain aging. Neurology. 2012;78(9):658-64.
Littlejohns TJ, et al. Vitamin D and dementia risk. Neurology. 2014;83(10):920-8.
Crane PK, et al. Glucose levels and dementia. N Engl J Med. 2013;369(6):540-8.
Scullin MK, Bliwise DL. Sleep, cognition, and normal aging. Perspect Psychol Sci. 2015;10(1):97-137.

Time-Restricted Eating and the Ageing Brain

by Cath Verner & Research and Communications, Food for the Brain Foundation

Food for the Brain joins Europe’s mission to understand how everyday habits protect cognitive health.

At Food for the Brain, research and education go hand in hand.

Every Cognitive Function Test or at home blood test completed, every dataset analysed, brings us closer to one clear goal. That goal is preventing cognitive decline and dementia through a better understanding of nutrition and lifestyle.

After announcing our game changing Innovate UK grant and research project, we have also been working hard as part of a European effort to understand and improve brain health.

A shared European vision for brain health

Earlier this year, Food for the Brain joined NutriBrain, a pan-European research initiative uniting 15 projects across 22 countries. From Norway to Spain, Austria to Italy, scientists are examining how diet, movement, sleep and social connection influence the ageing brain.

The initiative was officially launched in Oslo at a meeting hosted by the Research Council of Norway. Researchers from across Europe gathered to share data and plan the next phase of collaboration. The goal: scientists from nutrition, medicine and technology all working towards a common vision – longer, healthier brain health and function.

Projects include BOOMERANG, exploring the impact of B-vitamins and omega-3 fatty acids. PrecisePrevent is studying how physical activity and social engagement influence cognition. ALPHA-FIT is examining exercise in conditions such as Parkinson’s disease. Together they form a network dedicated to translating science into practical, evidence-based prevention – that we can share with you!

OptimaMind: aligning eating patterns with brain biology

Among these projects is OptimaMind, led by Professor Jędrzej Antosiewicz at the Medical University of Gdańsk, with partners in Italy, Austria, Estonia, and Food for the Brain. The OptimaMind consortium includes the Medical University of Gdańsk, the Università Politecnica delle Marche in Italy, the Medical University of Graz in Austria, and the Tallinn University of Technology in Estonia. It also includes the Polish biomedical company Masdiag and Food for the Brain.

At Food for the Brain, we talk a lot about what to eat to support your brain. But what is interesting about this research with OptimaMind, is that we get to investigate time-restricted eating. It explores how the timing of your foods impacts your brain health. Time restricted eating isn’t fasting; it’s an approach that limits food intake to specific hours of the day. This research is investigating whether aligning meals with the body’s natural circadian rhythms can reduce inflammation, enhance metabolic efficiency, and support cognitive performance.

For the brain, this matters enormously. When blood sugar (glucose) is well regulated, the brain receives a steady, reliable fuel supply. When it isn’t, energy dips can lead to fatigue, forgetfulness and eventually, damage to brain cells. Oxidative stress, the build-up of “wear and tear” from energy production, is another key driver of brain ageing. Time-restricted eating may help reduce this stress, supporting stronger, more resilient neurons over time. In short, the project asks whether when we eat could be as important as what we eat for long-term brain health.

Our contribution: measuring cognition across Europe

Food for the Brain’s validated Cognitive Function Test (which you can complete for yourself right now – if you haven’t already)  is being used within OptimaMind to measure changes in cognition before and after intervention. These results will be combined with blood biomarker data to explore how nutrition and lifestyle translate into measurable effects on brain and metabolic function.

The same digital tools used daily by thousands of our supporters are now being applied in university and clinical settings across Europe – a clear example of how citizen science is powering international research and change.

Through this collaboration, our long-term goal is to strengthen the link between lifestyle patterns, metabolic biomarkers and measurable changes in cognition. The findings will help define early, modifiable risk factors for dementia. They will also guide prevention strategies that can be adopted on a larger public level.

Building the evidence for prevention

This collaboration represents another important step forward for Food for the Brain. It moves us from an education charity to a recognised research partner working alongside leading universities and clinicians across the world.

Over the next three years, findings from OptimaMind and other NutriBrain projects will contribute to a shared European evidence base. This evidence base will show how nutrition and lifestyle influence cognitive ageing.

The data will not only inform clinical practice but also help shape European public health recommendations. Ensuring that dementia prevention strategies are grounded in real-world evidence rather than drug-led theory.

For Food for the Brain, this partnership shows the power of citizen science, how thousands of people taking part in our tests can generate data that drives real research and public health change. It proves that preventing cognitive decline isn’t a theory or a “nice idea” – it’s science in action.

Be part of the research and movement

Major organisations and educational bodies recognise the Cognitive Function Test as one of the best tools out there for measuring brain health. And you can get access to it for FREE right now. If you haven’t done the online test yet make the time today to do it here.

Every person who completes this test adds a valuable data point to this growing international picture of brain health. Each anonymous result helps researchers design more effective prevention strategies and informs the public guidance of tomorrow.

We are about getting the best tools and research into the hands of the public. That is why we partner with influential organisations and make the Cognitive Function Test freely available to all.

Will you be part of this movement?

You can use the same tools now being used by researchers across Europe:

Complete the free Cognitive Function Test today

Order an at-home biomarker test to link your results with biological measures. Find out more here.

Together, we are building the evidence that prevention is not only possible – it is measurable.

Food for the Brain is a not-for-profit educational and research charity that offers a free Cognitive Function Test and assesses your Dementia Risk Index to be able to advise you on how to dementia-proof your diet and lifestyle.

By completing the Cognitive Function Test you are joining our grassroots research initiative to find out what really works for preventing cognitive decline. We share our ongoing research results with you to help you make brain-friendly choices.

Please support our research by becoming a Friend of Food for the Brain.

Why Sleep is Your Metabolic Superpower

We tend to think of sleep as rest – the way we replenish energy.  In truth, your sleeping hours are a highly productive repair shift, especially for your metabolism. 

Each night, your body resets blood sugar, clears metabolic waste, restores energy and even rewires memory. Consistently missing out on quality or quantity of sleep means less of that vital repair work gets done.

Most people notice tiredness after a bad night, but few realise the impact it has on their blood sugar, metabolism and even body composition.

So in our last article we explored melatonin’s role in brain repair, in this part 2 we look at how poor sleep throws off your body’s entire metabolic rhythm – from blood sugar to fat storage.

(When we talk about poor sleep, we mean getting less than seven hours a night, sleeping at irregular times, or waking often through the night – all of which disturb the deep, restorative phases your brain depends on.)

Sleep and insulin: two sides of the same coin

Deep, unbroken sleep keeps your cells sensitive to insulin, the hormone that allows glucose into cells to make energy. Cut the night short and this system falters. Just one poor night can reduce insulin sensitivity by about 25 per cent (1).

That means glucose lingers in the bloodstream (creating inflammation over time) while your brain cells are left hungry for fuel.

The result? Brain fog, irritability, and a body craving quick fixes – sugar, caffeine and refined carbohydrates. You’ll have felt this yourself: after a poor night’s sleep, you wake up wanting pastries or toast, not eggs and greens.

The “tired brain” that acts diabetic

When the brain can’t get enough glucose, it flips into survival mode.

Stress hormones like cortisol and adrenaline surge to keep you going, but they also spike blood sugar and wreck the next night’s sleep (hello, 4 a.m. wake-ups).

Brain scans show that after even a single sleepless night, glucose metabolism in the prefrontal cortex, the region responsible for focus and decision-making, drops sharply (2).

It’s a vicious cycle: sleep loss drives insulin resistance, which drives stress and sugar intake, which drives more sleep loss.

Poor Sleep Changes Your Metabolism

It’s easy to see how poor sleep doesn’t just fog your mind – it rewires your metabolism. Short sleep duration is now recognised as one of the strongest lifestyle predictors of weight gain, insulin resistance and type-2 diabetes – even when calorie intake stays the same,

Even a few nights of shortened sleep raise ghrelin, the hunger hormone, and suppress leptin, which signals fullness (7). The result is stronger cravings for quick-release carbs and sugary snacks, precisely the foods that destabilise blood sugar and accelerate insulin resistance. At the same time, sleep loss changes how your body stores fat: studies show it increases visceral fat, the deep belly fat that drives inflammation (8).

Over time, this mix – more hunger, higher insulin, greater inflammation – pushes many people toward weight gain, pre-diabetes and, eventually, cognitive decline.

So if you’re trying to lose weight or steady your energy, don’t forget about sleep.

High blood sugar, low cognition

Poor sleep raises blood sugar, and when glucose stays high, the brain pays the price.

Overtime poor sleep raises blood sugar, and when glucose stays high, the brain eventually pays the price. Chronically elevated HbA1c, measured in our DRIfT test, predicts faster cognitive decline and higher dementia risk. The same metabolic stress that drives weight gain and diabetes also drives neurodegeneration. That’s why people with insomnia or sleep apnoea are far more likely to develop both type-2 diabetes and Alzheimer’s (3, 4).That is why we cover both sleep and insulin management as a key part of our COGNITION 6-month brain upgrade programme (available to all FRIEND’s of Food for the Brain) – because protecting your brain is possible when you know what to focus on.

The night-shift hormones that matter

Melatonin isn’t just for sleep – it fine-tunes your body’s glucose rhythm and acts as a powereful antioxidant. When evening light suppresses it, next-morning blood sugar shoots higher (5).
Cortisol should fall overnight so insulin can do its work; if stress, late eating or light keeps it high, blood sugar stays stuck.
Growth hormone, released in deep sleep, repairs tissue and builds lean muscle, your natural blood-sugar buffer.

Together these hormones keep the night restorative and the brain calm. Disrupt them and the same chemistry that fuels diabetes starts fuelling Alzheimer’s (6).

Small Habits That Dramatically Improve Sleep Quality

Simple Ways to Turn Sleep into a Metabolic Superpower

Guard your 7–8 hours. Deep sleep is where metabolic reset happens.
Skip caffeine or alcohol late. Both fragment sleep and blunt insulin response.
Finish eating at least three hours before bed. Giving your body time to fast allows insulin to fall and encourages fat use for fuel overnight.
Start your day with light, not sugar. Early daylight synchronises your circadian rhythm, boosting morning cortisol naturally so you rely less on coffee and quick carbs.
Pair protein-rich, low-GL meals with consistent sleep. Balanced blood sugar by day supports stable melatonin and growth hormone at night, a feedback loop that keeps your metabolism working for you, not against you. Find 100+ delicious recipes here.https://brainhealthcheck.foodforthebrain.org/uybcookapp/

Sleep as metabolic medicine

Sleep isn’t a luxury or a waste of time –  it’s your brain’s way of resetting and restoring the entire body. It shapes body composition, curbs cravings, steadies energy and supports the metabolism that powers your mind.

Takeaway: good sleep, like good nutrition, is prevention in action.
Want to dive deeper? Join us for the Sleep Solution Webinar with sleep scientist Greg Potter. Find out more here

Free guide: The Power of Sleep

Food for the Brain is a not-for-profit educational and research charity that offers a free Cognitive Function Test and assesses your Dementia Risk Index to be able to advise you on how to dementia-proof your diet and lifestyle.

By completing the Cognitive Function Test you are joining our grassroots research initiative to find out what really works for preventing cognitive decline. We share our ongoing research results with you to help you make brain-friendly choices.

Please support our research by becoming a Friend of Food for the Brain.

Reference:

Spiegel K et al. Impact of sleep debt on metabolic and endocrine function. Lancet. 1999;354(9188):1435–9.

Benedict C et al. Acute sleep deprivation reduces energy expenditure and brain glucose metabolism. Sleep. 2012;35(7):981–8.

Yaffe K et al. Sleep duration and risk of type 2 diabetes: a meta-analysis. Diabetes Care. 2015;38(9):1633–40.

Sabia S et al. Association of sleep duration in middle and old age with dementia incidence. Nat Commun. 2021;12:2289.

Gooley JJ et al. Exposure to room light before bedtime suppresses melatonin onset and shortens its duration. J Clin Endocrinol Metab. 2011;96(3):E463–72.

Musiek ES, Holtzman DM. Mechanisms linking circadian clocks, sleep, and neurodegeneration. Science. 2016;354(6315):1004–8.

Spiegel K et al. Brief sleep curtailment decreases leptin, increases ghrelin, and causes increased hunger and appetite. Ann Intern Med. 2004;141(11):846–50.

Nedeltcheva AV et al. Insufficient sleep undermines dietary efforts to reduce adiposity. Ann Intern Med. 2010;153(7):435–41.

A National Step Forward for Brain Health

Food for the Brain awarded an Innovate UK grant to advance early dementia detection and prevention

We are delighted to announce that Food for the Brain Foundation has been awarded a prestigious grant from Innovate UK, part of UK Research and Innovation (UKRI) – national recognition of our pioneering work in dementia prevention and early detection.

Importantly, this funding marks a milestone for us as a UK-based research charity. It also represents a significant step forward for our global community of citizen scientists, clinicians, and individuals dedicated to preventing Alzheimer’s, dementia, and cognitive decline.

For us, this is not just a charity and research achievement – it’s a sign that the world is waking up to prevention.

Why this matters?

Right now, someone in the UK develops dementia every three minutes. Across the globe, it’s every three seconds. And despite this, dementia cost the world over US$1.3 trillion in 2019, yet countless cases remain undiagnosed.

For nearly two decades, we have led the charge in prevention. So far, over 400,000 people worldwide have taken our Cognitive Function Test (CFT) – a free, validated online tool that helps you understand your brain health, assess your risks, and take action to improve.

This grant from Innovate UK, part of the UK’s national innovation agency, provides crucial funding to further validate and expand our tools for early dementia detection and – ultimately – prevention.

It forms part of the Blood Biomarker Challenge, a UK-wide research initiative, which aims to integrate blood-based biomarker testing into NHS diagnostic pathways.

Our Cognitive Function Test (CFT) has been selected to assess cognitive performance in the READ-OUT trial – part of this Innovate UK-funded programme, supported by the Department of Health and Social Care, the NIHR, and Alzheimer’s Research UK.

It will allow us to:

Integrate our Cognitive Function Test into NHS-linked research, workflows, and clinical studies, thereby bridging science and healthcare delivery.
Further expand access to our evidence-based prevention tools – making them mobile-friendly, multilingual, and culturally inclusive for global use.

About Innovate UK

Innovate UK is the UK government’s innovation agency, supporting organisations that deliver real-world impact across science, technology, and health. Each year, it invests over £1 billion in ideas that can transform industries, economies, and lives – from sustainable energy and biotech to healthcare innovation.

Receiving an Innovate UK grant means your project has been rigorously evaluated for its scientific quality, innovation, feasibility, and potential global impact.

What this means for global brain health and dementia detection?

Our Cognitive Function Test (CFT) is the only freely available online tool that measures cognitive performance. It also provides a personalised Dementia Risk Index, based on eight key lifestyle and biological factors.

With this grant, we can now take the next step – integrating this digital test with blood test data from our DRIfT (Dementia Risk Index Functional Test).

The DRIfT test measures five critical nutritional biomarkers proven to influence cognitive ageing:

Omega-3 Index – vital brain fats that support memory and neuronal health

Vitamin D – essential for mood, immunity, and brain protection

Homocysteine – a marker of B-vitamin status; high levels increase the risk of brain shrinkage

HbA1c – a measure of long-term blood sugar control linked to brain energy supply

Glutathione Index – the body’s master antioxidant defence

Combining these markers with our multilingual, free Cognitive Function Test means that more and more people can detect early warning signs of cognitive decline. This can happen decades before diagnosis. This empowers them to take action early – and prevent it. Together, these innovations represent the future of dementia detection and prevention.

Why prevention and early dementia detection must come first?

Despite billions spent on drug development, no Alzheimer’s medication to date has shown meaningful improvement in cognitive outcomes. In fact, many come with serious side effects, including brain swelling and bleeding. (Read more Alzheimer’s drugs here and here.)

That’s why our focus, and now Innovate UK’s, is on early dementia detection.

Identifying risk early, addressing nutritional and metabolic imbalances, and protecting the brain before damage occurs.

Take part – protect your brain, advance the science, stay sharp for life

Ultimately, this work only matters if people like you take part.

By joining our global citizen-science movement, you’ll help us refine and accelerate the world’s first large-scale dementia prevention database.

Step 1: Take the free Cognitive Function Test

A quick, 20-minute online test that shows you how well your brain is performing and what to do next.

Take the free CFT now

Step 2: Complete the DRIFT biomarker test

A simple at-home finger-prick blood test that measures your omega-3, vitamin D, B-vitamin, blood sugar, and antioxidant status.

Order your DRIFT test

Step 3: Become a FRIEND of Food for the Brain

For just £50 a year or £5 a month, you can support our research and charitable work. You’ll also gain access to – your personalised brain upgrade programme. Additionally, enjoy monthly group coaching sessions and live webinars.

Become a FRIEND here

Looking ahead: the future of dementia detection and prevention

With the support of Innovate UK, the NHS, and thousands of citizen scientists and Friends, we’re building a future where Alzheimer’s is preventable, not inevitable.

Ultimately, this grant strengthens our ability to deliver credible, evidence-based tools that empower everyone to take charge of their cognitive health – starting today.

Take the test. Join the study. Be part of prevention.
👉 foodforthebrain.org/tests | foodforthebrain.org/driftstudy

Food for the Brain is a not-for-profit educational and research charity that offers a free Cognitive Function Test and assesses your Dementia Risk Index to be able to advise you on how to dementia-proof your diet and lifestyle.

By completing the Cognitive Function Test you are joining our grassroots research initiative to find out what really works for preventing cognitive decline. We share our ongoing research results with you to help you make brain-friendly choices.

Please support our research by becoming a Friend of Food for the Brain.

Reference:

1 https://www.alzint.org/about/dementia-facts-figures/

2 UK Research and Innovation 

3  UK Government Press Release)

Melatonin: The Brain’s Night-Time Antioxidant

This night-time molecule is also one of the brain’s most powerful protectors – your night-time antioxidant – working while you rest, to defend neurons, restore energy and preserve clear thinking. Melatonin helps your brain clean up daily oxidative damage, regulate mood, and protect memory networks from ageing.

When levels drop – through stress, light exposure, age or caffeine – you don’t just lose sleep; you lose part of your brain’s natural repair system.

The Brain’s Nightly Repair Shift

Every night, while you rest, your brain goes to work. Waste is cleared away, cells are repaired, and antioxidants are replenished.

At the heart of this clean-up crew is melatonin, made in the pineal gland and the master conductor of your brain’s nocturnal activity.

It doesn’t just promote sleep; it powers the production of glutathione, the body and brain’s chief antioxidant and cellular shield. When melatonin levels fall, oxidative stress rises – accelerating neuronal ageing and the build-up of damaging amyloid and tau proteins (1, 2). Why? Melatonin normally switches on the brain’s own antioxidant defences, recycling glutathione and neutralising free radicals inside mitochondria. Without enough melatonin, these reactive molecules (like amyloid and tau proteins) accumulate, inflaming brain tissue and allowing toxic proteins to clump together.

In studies (2), restoring melatonin reduced oxidative damage and slowed amyloid formation – a reminder that good sleep truly is brain repair in action.

Want to know what your current glutathione status is? Order your test here to find out

Light At Night Steals Your Brain’s Protection

Here’s the catch: melatonin only comes out when it’s dark.

Even modest evening light – the glow of your phone, TV, bedside lamp or standby light – can switch off its release (7).

That’s because the light-sensitive cells in your eyes, send a “daytime” signal to the brain’s master clock in the suprachiasmatic nucleus (a tiny region in the hypothalamus that controls your body’s sleep-wake rhythm) instantly halting melatonin production.

In clinical studies, exposure to ordinary indoor light before bedtime suppressed melatonin by up to 85 per cent and shortened its duration by several hours (7).

That’s why your late-night scroll or TV binge can leave you foggy and flat the next morning. 

To support melatonin, you want to create a dark place to sleep. No lights on, heavy curtains, no street lamps. Using eye masks and utilising blue-light blocking glasses, software or filters can also be helpful if you know you are going to be on screens in the evening. You can even get special bulbs for bedside lamps or special lighting solutions for the bathroom for nighttime toilet trips.

Light is a powerful data input into the brain – so be mindful and protect yourself where practical and possible. 

Age, Stress And Hormones Flatten The Rhythm

As time goes by, your natural melatonin rhythm starts to fade – by mid-life, your night-time levels can fall by half (3).

It’s one of many reasons why people can start waking up at night, struggle to drift off, or feel less refreshed after sleep.

For women, the hormonal rollercoaster of perimenopause makes things even trickier: falling oestrogen and progesterone throw the body clock off balance, making deep sleep harder just when the brain needs it most (5). (Learn more about how to support women’s hormones and brain health here.)

Melatonin levels don’t just impact sleep; studies show that lower melatonin is linked with poorer memory, mood dips and faster cognitive ageing (4). While melatonin is impacted by ageing, the good news is that it can be supported and restored.

Coffee vs. Melatonin – When Caffeine Steals Your Sleep Hormone

Caffeine doesn’t just keep you awake – it directly interferes with melatonin’s nightly rise.
Even a single espresso six hours before bed can delay melatonin release by up to 40 minutes and reduce total melatonin production by as much as 20% (9). (And don’t forget black and green tea and most energy drinks contain caffeine too.)

That’s because caffeine blocks adenosine receptors – the same system that tells the pineal gland it’s time for darkness and rest. When that signal is muted, the body’s internal clock (the suprachiasmatic nucleus) misreads the time and keeps you in ‘day-mode’ far longer than intended.

Avoid coffee (and other caffeine sources) after 12 p.m., especially if you have sleep or mood issues.
Choose herbal or decaf alternatives after lunch. If you’re sensitive, even morning caffeine can blunt night-time melatonin, so experiment with caffeine-free days and observe your sleep quality.

Melatonin and Mitochondria: Your Inner Night-Time Antioxidant Factory

Here’s where melatonin gets even more fascinating. It isn’t just released from the pineal gland at night, your brain cells actually produce it inside their mitochondria, the tiny engines that create energy (ATP) and power every thought and memory (8).

This is clever biology: the very place where energy is made – and where most oxidative stress occurs – also makes its own night-time antioxidant. Melatonin acts locally in the cell, mopping up the free radicals created as mitochondria burn fuel through the day, keeping these fragile energy factories running smoothly (1).

It doesn’t function only as a sleep hormone, made only in the pineal gland – it’s also made throughout your brain (and body’s) energy-producing mitochondria, where it acts as a built-in night-time antioxidant to protect them from damage.

This local production is what keeps your neurons energised and resilient – and why good, deep sleep is essential for restoring brain power and mental clarity. (And why disrupted or shallow sleep can leave you foggy the next morning!)Want more insight into how to support your brain through quality sleep? Join our next live webinar with our expert Sleep Scientist here.

How To Restore Your Natural Rhythm

While short-term melatonin supplements (0.5–3 mg) can improve sleep onset and quality in older adults (6) and can be bought in North America or prescribed in the UK, the goal is to rebuild the body’s own rhythm:

Dark evenings, bright mornings – dim lights, avoid screens, use blue-light blocking technology, glasses and filters an hour before bed; get natural light soon after waking.
Avoid caffeine after 12 pm or if sleep is a real struggle – remove altogether, and see how it impacts your sleep.
Tryptophan-rich foods – turkey, oats, eggs and sunflower seeds support serotonin-to-melatonin conversion (with B6 and magnesium).
Keep bedrooms cool and quiet – a small temperature drop signals melatonin release.
Check in with your antioxidant status with the DRIfT test here.

Melatonin: Protecting Your Brain’s Night-time Antioxidant Rhythm

Melatonin is the nightly molecule that lets the brain rest, reset and renew itself.

Protecting your melatonin rhythm may be one of the simplest, most powerful preventative steps you can take to protect your memory.

To learn more and take action:

Join the Sleep Solution Webinar with Sleep Scientist Greg Potter here
Get a free assessment of your overall brain health and cognitive function today with our free, validated Cognitive Function test here
Test your current glutathione status with the DRIfT 5 in 1 at home blood test – find out more here

Food for the Brain is a not-for-profit educational and research charity that offers a free Cognitive Function Test and assesses your Dementia Risk Index to be able to advise you on how to dementia-proof your diet and lifestyle.

By completing the Cognitive Function Test you are joining our grassroots research initiative to find out what really works for preventing cognitive decline. We share our ongoing research results with you to help you make brain-friendly choices.

Please support our research by becoming a Friend of Food for the Brain.

Reference:

Reiter RJ et al. Melatonin as an antioxidant: under promises but over delivers. J Pineal Res. 2016;61(3):253–78.

Cardinali DP et al. Melatonin reduces oxidative damage and amyloid pathology in Alzheimer transgenic mice. J Pineal Res. 2013;55(4):427–37.

Waldhauser F et al. Age-related changes in melatonin levels. J Clin Endocrinol Metab. 1988;66(3):648–52.

Wu YH et al. Sleep, melatonin and the aging brain. J Pineal Res. 2005;38(3):145–52.

Baker FC, Driver HS. Circadian rhythms, sleep and the menstrual cycle in women. Sleep Med. 2007;8(6):613–22.

Ferracioli-Oda E et al. Meta-analysis: efficacy of melatonin for primary sleep disorders. PLoS One. 2013;8(5):e63773.

Gooley JJ et al. Exposure to room light before bedtime suppresses melatonin onset and shortens its duration. J Clin Endocrinol Metab. 2011;96(3):E463–72.

Suofu Y et al. Mitochondrial synthesis of melatonin enhances neuroprotection. Proc Natl Acad Sci USA. 2017;114(32):E7997–8006.

Burke TM et al. Caffeine effects on the circadian melatonin rhythm: a controlled trial. J Clin Sleep Med. 2015;11(8):893–900.

Lithium and Brain Health: The Overlooked Mineral That Could Protect Your Mind

by Greg Potter

Lithium and brain health are more connected than many realise. One of the universe’s oldest elements could also be one of the brain’s most powerful protectors.

Long associated with bipolar treatment, lithium is often dismissed as a heavy-duty psychiatric drug – yet new research tells a different story. Trace amounts of lithium appear to influence mood, longevity and even cognitive decline. With dementia rates rising fast, scientists are revisiting this humble mineral to understand whether it could slow or prevent neurodegeneration altogether.

In this article, Dr Greg Potter, member of our Scientific Advisory Board and Sleep Scientist, explores the remarkable – and misunderstood – role of lithium in supporting brain health, from dementia protection to lifespan extension and neural resilience.

Lithium is one of three elements created during the Big Bang event that gave rise to the universe 13.8 billion years ago, and nowadays it’s mostly found in igneous rocks. 

Because lithium predates all life on Earth, it’s perhaps no surprise it plays a role in human biology. While lithium doesn’t seem to be a truly “essential” nutrient  (1) as it isn’t indispensable for any one biological process, lithium’s mood-stabilising actions have long been recognised. Specifically, lithium has primarily been used to help patients with bipolar disorder avert swings into sleepless mania. Despite its clinical utility, lithium has arguably been stigmatised due to its association with mental illness, its side effects at high doses, and perceptions that it’s an outdated drug with superior, more modern alternatives – a perspective that frankly defies reality. Some astute individuals have understood lithium’s greater promise for years; however, lithium was recently thrust back into the spotlight. 

A recent high-profile publication showing promise of lithium in mitigating Alzheimer’s in the prestigious journal Nature (2) means we are finally waking up to just how interesting and helpful lithium can be.

Could lithium help prevent or treat dementia?

Research into lithium effect on brain health goes back longer than many realise. Several studies have associated lithium use with reduced risk of dementia (3), and scientists have also considered lithium as an adjunct treatment for patients who already have dementia. An experiment (4) on Alzheimer’s disease patients found that supplementing just 300 mcg lithium (as carbonate) per day for 15 months prevented deterioration in cognitive function, which continued to decline in people taking a placebo. While not all research has reported such positive effects, the early evidence is encouraging, and discrepancies between studies might be explained by variables such as discrepant lithium forms and doses.

Returning to the 2025 publication that caused such a stir, the researchers undertook a range of experiments to try to decipher lithium’s effects. First, when they looked at levels of metals in the brains of cognitively healthy adults, people with mild cognitive impairment, or individuals with Alzheimer’s, they found higher levels of lithium in a part of the brain key to processes such as planning and decision making in the cognitively healthy. They also explored the effects of adding lithium orotate, a salt of lithium, to the drinking water of mice genetically engineered to develop a condition similar to familial Alzheimer’s, the aggressive, early-onset form of the disease that runs in families. Compared with the lithium-free condition, even very low doses of lithium orotate dramatically reduced the characteristic misfolded brain proteins that occur in Alzheimer’s, also potentially allaying cognitive decline. Promisingly, lithium also exerted similar protective effects in “wild type” mice. These mice lack the genetic changes that cause early-onset Alzheimer’s, making them a better model for most people.

Does Lithium Extend Lifespan? What the Evidence Suggests

My interest in lithium is tentative evidence from the last couple of decades positively associating intakes with lifespan. This link has been shown in the general population, but there’s also the intriguing finding that people medicated with lithium for psychiatric conditions live longer than their peers taking alternative medications (5). Some of lithium’s effects on mood might mediate the relationship between higher lithium intake and longer life. Tragically, suicide is a common driver of deaths in young adults, and studies of large groups of people have linked higher lithium intakes with lower suicidality (6), which by itself would extend lifespan a little. However, the effects of lithium on mood might not be the whole story, and scientists who study the biology of ageing (geroscientists) have started to test whether lithium extends lifespan in non-human animals. 

So far, the jury is out, for while lithium has been found to extend life in yeast, roundworms, and flies (7, 8 ,9), it didn’t do so in mice, although male mice consuming lithium did seem to have better body composition and blood sugar control (10). Again, perhaps lithium form, dose, and age of use matter though. Overall, lithium certainly doesn’t seem to hurt lifespan, and it might prove modestly beneficial for healthspan (let’s define this as days of life free from disease or disability) and lifespan in a subset of people – but more research needs to be done.

How Lithium Supports Brain Cells and Mood Stability

Regarding how lithium supports mood stability and protects the brain against degeneration (11), as usual, we’re not sure. Most of the relevant research has used the equivalent of very high lithium doses, but I’ll mention a few mechanisms that have substantial empirical support.

Lithium can enter cells through sodium channels, and by competing with sodium and magnesium it can reduce activity of enzymes activated by these other minerals. Perhaps the best-accepted instance of this is lithium’s inhibition of glycogen synthase kinase-3β, an enzyme so named because, among other actions, it reduces activity of an enzyme that synthesises the storage form of carbohydrate, glycogen. This, plus inhibition of other key enzymes, such as inositol monophosphate, set in motion changes in the expression of myriad gene networks involved in brain health, including enhancing clearance of dysfunctional cells and hence improving regulation of proteins in the brain, reducing brain inflammatory responses and hence collateral damage, and promoting the neuroplastic processes needed to remodel the brain to thrive in the dynamic environments in which we live. 

Interestingly, the kinds of high lithium doses used to treat bipolar also support body clock function and sleep, which often go awry before mental illness sets in. Lithium has been shown to influence the body clock at several levels of organisation, from individual cells to people’s rest-activity timing (12), shifting the sleep-wake cycle earlier, making the cycle more regular, and increasing its amplitude. High doses also tend to deepen sleep (13), and deep sleep is a key player in mood regulation and brain maintenance processes, such as waste clearance. (Incidentally, a big part of why appropriate exercise is so good for the brain is that it tends to deepen sleep.) Again, we’re talking about large doses here though.

How Much Lithium Do You Need – and Is Supplementation Safe?

Several factors make it difficult to give clear recommendations regarding lithium intakes.

Firstly, none of us really have any idea how much lithium we regularly consume. Lithium intakes vary enormously between populations, based partly on the physical geography of where people live (over half the world’s lithium is concentrated in Argentina and Chile). This affects how much lithium gets into local drinking water and food. Even then, in much of the world people drink water and eat food that doesn’t come from nearby. Next, your lithium intake would ideally map to your bodily lithium status and needs, and we don’t have good proxies for these at present. There’s also the fact that lithium comes in different salts. Lithium carbonate is most widely used in psychiatry, followed by lithium citrate. However, there’s experimental evidence that lithium orotate is more bioavailable than both, and this superiority of orotate was born out by the recent Nature publication, albeit for different reasons (related to reduced lithium uptake by amyloid). Finally, lithium is used as a medication and is quite tightly regulated in some parts of the world. The salt we know most about (carbonate) is therefore off limits for most of us, although given the early promise of lithium orotate, that might be no issue. 

I’m not a medical doctor and recommend running the supplements you take by a qualified medical professional – just bear in mind that most medical doctors know very little about nutrition and supplementation. I would consider a dose of up to 1 mg elemental lithium per day to be reasonable, provided it’s from a reputable manufacturer. People not very familiar with lithium doses might think of some of the adverse effects of high dose lithium intakes, which can include kidney toxicity. To be clear, my suggestion is well below the amount of lithium consumed from diet alone in much of the world, which most people have never thought twice about. 

I have no affiliation with either, but both Swanson and Life Extension sell low- or trace-dose lithium orotate, and the data I’ve seen suggest their products are high quality and contain what they claim they do. (In fact, there’s been research (14) showing the Swanson low-dose lithium orotate product raises brain lithium in adults.) Part of the difficulty here is that, in my opinion, the lithium doses in many supplements might be higher than is ideal. Based on the work on trace dose lithium use in dementia, plus the apparent higher bioavailability of lithium orotate (15), I think 300 to 400 mcg lithium orotate is an excellent starting point. That dose is more than conservative yet should be sufficient to be beneficial, and my approach to supplementation is generally to choose the lowest dose shown to have the effects you’re after. 

Parting words

In summary, while lithium is not an essential micronutrient, the human brain seems to thrive when it has enough lithium. To ensure you’re providing your brain with what it needs, a lithium supplement providing a trace dose (less than 5 mg elemental lithium) each day seems to be a reasonable, safe way to ensure this. If you’re interested in learning more about lithium, in 2024 I interviewed Dr Becci Strawbridge, an expert in low-dose lithium. The conversation is available on all major podcasting platforms. It’s also on YouTube here.

Note: These words are solely the opinions of the author. (He used no large language models to help write this article.)

About Greg Potter

Greg helps individuals and organisations sustainably improve their health and performance. He does this through developing and popularising innovative businesses and products, coaching, public speaking, consulting, and empowering people through educational resources such as e-books, articles, and courses. Among other roles, Greg is a Sleep Coach at the London Psychiatry Clinic and is Chief Science Officer at Coastline Longevity, where he leads the formulation of supplements to extend healthspan. He also hosts the Reason & Wellbeing podcast and YouTube channel.

Greg’s PhD research spanned sleep, circadian rhythms, nutrition, and metabolism. Highlights of Greg’s career include having this research featured in dozens of international news outlets, including the BBC, Reuters, and The Washington Post; having his writing featured in many newspapers and magazines, including The Metro, Stylist, and Newsweek; coaching a sprinter to four gold medals at the European Championships; and helping athletes break multiple World Records in ocean rowing.

Food for the Brain is a not-for-profit educational and research charity that offers a free Cognitive Function Test and assesses your Dementia Risk Index to be able to advise you on how to dementia-proof your diet and lifestyle.

By completing the Cognitive Function Test you are joining our grassroots research initiative to find out what really works for preventing cognitive decline. We share our ongoing research results with you to help you make brain-friendly choices.

Please support our research by becoming a Friend of Food for the Brain.

Reference:

1 https://pubmed.ncbi.nlm.nih.gov/30066063/

2 https://www.nature.com/articles/s41586-025-09335-x

3 https://pubmed.ncbi.nlm.nih.gov/38657568/

4 https://pubmed.ncbi.nlm.nih.gov/22746245/

5 https://pubmed.ncbi.nlm.nih.gov/36640269/

6 https://pubmed.ncbi.nlm.nih.gov/35252091/

7 https://pubmed.ncbi.nlm.nih.gov/25126078/

8 https://pubmed.ncbi.nlm.nih.gov/17959600/

9 https://pubmed.ncbi.nlm.nih.gov/27068460/

10 https://pubmed.ncbi.nlm.nih.gov/34532960/

11 https://pubmed.ncbi.nlm.nih.gov/38697859/

12 https://pubmed.ncbi.nlm.nih.gov/33650218/

13 https://pubmed.ncbi.nlm.nih.gov/3313443/

14 https://pubmed.ncbi.nlm.nih.gov/38810780/

15 https://pubmed.ncbi.nlm.nih.gov/37356352/

Why Women’s Brains Need Omega-3 Now

—

What if the key to protecting women’s brains from Alzheimer’s isn’t a drug, but a nutrient most of us are not getting enough of?

That’s the conclusion of new research linking low omega-3 status with a higher risk of dementia, particularly in women. It adds to a growing body of evidence that what you eat today directly shapes your brain health tomorrow.

You may have seen headlines this year reporting that women with Alzheimer’s disease tend to have unusually low levels of omega-3 fatty acids in their blood. This new evidence adds weight to what our research has been highlighting for years: your brain needs these essential fats to stay healthy, sharp, and resilient.

What The New Study Shows?

A study led by Wretland and colleagues, published in Alzheimer’s & Dementia, analysed blood lipid profiles and found that those at greater risk of Alzheimer’s disease had lower levels of lipids containing the long-chain omega-3 fats EPA and DHA. Importantly, this association was stronger in women than in men [1].

Professor William Harris, a member of Food for the Brain’s Scientific Advisory Board and one of the world’s leading omega-3 researchers, commented on the study, saying:

“Measurement of blood omega-3 levels may be especially useful in identifying women at increased risk for Alzheimer’s. Why women? Possibly because of the widespread abandonment of hormone replacement therapy after the Women’s Health Initiative study, which may have inadvertently left many women more vulnerable. Oestrogen supports cognitive health and also helps maintain omega-3 status. Without it, low omega-3 levels may pose an even greater risk.”

(Want to learn more about how to support women’s brains and hormones? Find out more here.

Learn more about maintaining healthy omega-3 levels from OmegaQuant, founded by Professor William Harris.)

Why Omega-3 Is So Vital For The Brain?

The brain is about 60% fat by dry weight, with DHA the dominant structural fat in brain cells [2].
Higher omega-3 status is consistently linked to slower brain shrinkage and lower dementia risk [3,4].
Just one serving of oily fish a week has been associated with a 60% lower risk of Alzheimer’s disease [5].

But omega-3 rarely works in isolation. Research from the University of Oxford shows that the combination of good omega-3 levels and homocysteine-lowering B vitamins can reduce brain shrinkage by 73% in those at risk of dementia [6,7].

Why Women’s Brains Need Special Attention After Menopause?

After menopause, falling oestrogen increases the risk of memory decline. Following the 2002 Women’s Health Initiative report, HRT prescribing plummeted worldwide due to perceived risks. Although use is now rising again, this shift has raised important questions about how hormones interact with brain health.

While decisions about HRT are individual and should be made with the guidance of a medical professional, supporting brain health through nutrition is relevant for all women. Because oestrogen helps maintain levels of the omega-3 fats EPA and DHA, women with a low intake of these nutrients may be at particular risk of deficiency. Ensuring adequate omega-3 – through oily fish or supplements – remains a practical, evidence-based step for long-term brain protection.

How Do You Know If You’re Protected?

The easy answer is to test, not guess. That is why we offer our at-home pinprick blood tests as part of our research and prevention support.

Our DRIfT 5-in-1 test includes the omega-3 index, homocysteine, vitamin D, blood sugar control (HbA1c), and glutathione – together providing a powerful snapshot of your brain’s future resilience. This allows you to see whether you are eating enough oily fish, supplementing properly, or at greater risk of future disease.

The Bigger Picture Of Brain Health

This new study is another reminder that Alzheimer’s is not an inevitable part of ageing.
It is largely preventable when we address the eight modifiable risk domains – from brain fats and B vitamins to diet, lifestyle, and gut health – which we cover in our COGNITION brain upgrade programme.

Women’s brain health has been historically under-researched, particularly in relation to hormones and cognitive ageing. Studies like this are a vital step towards closing that gap and ensuring prevention strategies work for everyone.

Learn more

Join Menopause and the Mind with Dr Ghazala Aziz – find out more here.
Are you supplementing correctly? Eating enough fish? The only way to know is to test – order your DRIfT 5-in-1 test today to discover what you need to do to protect your brain.
Complete the free, validated Cognitive Function Test today to receive personalised information on how you can protect your brain and your future.

Food for the Brain is a not-for-profit educational and research charity that offers a free Cognitive Function Test and assesses your Dementia Risk Index to be able to advise you on how to dementia-proof your diet and lifestyle.

By completing the Cognitive Function Test you are joining our grassroots research initiative to find out what really works for preventing cognitive decline. We share our ongoing research results with you to help you make brain-friendly choices.

Please support our research by becoming a Friend of Food for the Brain.

References

Wretland A, et al. Lipid profiling shows reduced long-chain omega-3 lipids in individuals at risk for Alzheimer’s, especially women. Alzheimer’s Dement. 2024. PMID: 40832908.

Crawford MA, et al. The role of essential fatty acids and phospholipids in brain development and health. Prostaglandins Leukot Essent Fatty Acids. 2001;64(2):95-111.

Tan ZS, et al. Red blood cell omega-3 fatty acid levels and markers of accelerated brain aging. Neurology. 2012;78(9):658-664.

Yassine HN, et al. Long-chain omega-3 fatty acids and brain health. Alzheimers Dement. 2016;12(7):759-768.

Morris MC, et al. Fish consumption and the risk of Alzheimer disease. Arch Neurol. 2003;60(7):940-946.

Smith AD, et al. Homocysteine-lowering by B vitamins slows the rate of accelerated brain atrophy in mild cognitive impairment. Proc Natl Acad Sci U S A.
Jernerén F, et al. Homocysteine-lowering B-vitamin treatment modifies the effect of omega-3 fatty acids on brain atrophy in mild cognitive impairment. Am J Clin Nutr. 2015;102(1):215-221.

—

Everywhere you turn, coffee shops tempt us with seasonal lattes, pumpkin-spiced treats and sugary hot chocolates. They may taste comforting, but many of these drinks deliver more sugar (up to 40 g in a single serving) and stimulants than your brain can’t handle, fuelling blood sugar spikes, jitters and, over time, even memory decline. In fact, higher blood glucose levels, even within the normal range, is linked to an increased risk of dementia (1*), while poor glucose control shrinks the hippocampus, the brain’s memory centre (2*).

Here’s a different kind of comfort drink: a rich, velvety hot cacao that actually supports your brain. Taken from the Upgrade Your Brain Cook App,  and packed with flavonoids, adaptogens and blood-sugar-balancing spices, it’s a recipe you can enjoy at any time of year – whether you’re heading out on autumn walks in the northern hemisphere, or entering spring in the south.

Why is hot cacao brain-friendly?

Raw cacao – flavanols for circulation, memory and mood

Cacao is one of the richest natural sources of flavanols, powerful antioxidants that improve circulation, including blood flow to the brain. Better blood flow means better oxygen and nutrient delivery, supporting attention, memory and overall cognitive function.

In a landmark study at Columbia University, cocoa flavanol supplementation improved memory in older adults by enhancing dentate gyrus function in the hippocampus (3). Large-scale trials confirm this: in the COSMOS study of more than 21,000 people, cocoa extract improved cognition in those with lower diet quality (4).

Cacao also contains theobromine and serotonin-enhancing compounds, which may explain why a simple square of dark chocolate – or a steaming mug of raw cacao – can lift mood and reduce stress.

Maca – an adaptogen for stress resilience and mood

Maca, a root vegetable from the Andes, is classed as an adaptogen – plants that help the body adapt to stress. Adaptogens support the adrenal system, helping to buffer the effects of chronic stress and supporting hormone balance.

In human trials, maca supplementation improved mood and reduced anxiety and depression scores in postmenopausal women (5). While more research is needed on cognition in humans, maca is widely valued for its mood-enhancing and potential stress-buffering properties.

Cinnamon – balancing blood sugar to protect the brain

Cinnamon isn’t just for apple pies, it’s a powerful spice for blood sugar control, which is essential for maintaining brain health and longevity. Stable blood sugar means steadier energy and less “brain fog.” Excess sugar is one of the strongest dietary risk factors for dementia: raised HbA1c (a measure of long-term blood sugar that we test in our at-home blood test, DRIfT) increases the risk of both vascular dementia and Alzheimer’s (1,2).

Human trials show that cinnamon supplementation can improve HbA1c, blood pressure and lipid profiles in people with type 2 diabetes (6). Other studies report improved insulin sensitivity and glucose tolerance, even in healthy adults (7). By helping to stabilise the delivery of glucose to the brain, cinnamon protects against the highs and lows that drive fatigue, irritability and cognitive decline.

Hot Cacao with Maca & Cinnamon

At Food for the Brain, we’ve long championed the role of antioxidants, blood-sugar balance, and stress resilience in protecting against cognitive decline. A simple daily ritual like this hot cacao brings together three powerful, evidence-based strategies for your brain:

Flavanols from cacao improve circulation and memory.
Adaptogens from maca (optional) to enhance mood.
Spices like cinnamon to steady blood sugar and protect the hippocampus.

Take the next step for your brain

Test your own brain health today – take our free online Cognitive Function Test. It’s a validated way to see how your lifestyle is shaping your future brain health. 

Feeling good now, and ageing well, is within your power.

Food for the Brain is a not-for-profit educational and research charity that offers a free Cognitive Function Test and assesses your Dementia Risk Index to be able to advise you on how to dementia-proof your diet and lifestyle.

By completing the Cognitive Function Test you are joining our grassroots research initiative to find out what really works for preventing cognitive decline. We share our ongoing research results with you to help you make brain-friendly choices.

Please support our research by becoming a Friend of Food for the Brain.

References

Crane PK, Walker R, Hubbard RA, et al. Glucose levels and risk of dementia. N Engl J Med. 2013;369:540–548. doi:10.1056/NEJMoa1215740

Kerti L, Witte AV, Winkler A, Grittner U, Rujescu D, Flöel A. Higher glucose levels associated with lower memory and reduced hippocampal microstructure. Diabetes Care. 2013;36(10):3289–3296. doi:10.2337/dc13-0306

Brickman AM, Khan UA, Provenzano FA, et al. Enhancing dentate gyrus function with dietary flavanols improves cognition in older adults. Nat Neurosci. 2014;17(12):1798–1803. doi:10.1038/nn.3850

Sesso HD, Wang L, Reynoso J, et al. Effect of cocoa extract supplementation on cognitive function: COSMOS trial. Am J Clin Nutr. 2022;116(3):682–693. doi:10.1093/ajcn/nqac152

Gonzales GF, Córdova A, Vega K, Chung A, Villena A, Góñez C. Effect of Lepidium meyenii (Maca) on mood in postmenopausal women. CNS Neurosci Ther. 2009;15(6):639–650. doi:10.1111/j.1755-5949.2009.00104.x

Akilen R, Tsiami A, Devendra D, Robinson N. Glycated haemoglobin and blood pressure-lowering effect of cinnamon in type 2 diabetes. Diabet Med. 2010;27(10):1159–1167. doi:10.1111/j.1464-5491.2010.03079.x

Solomon TPJ, Blannin AK. Effects of short-term cinnamon ingestion on insulin sensitivity. Eur J Appl Physiol. 2007;99(5):483–488. doi:10.1007/s00421-006-0362-z

★ = references already discussed in Patrick Holford’s books (Upgrade Your Brain 2024; Alzheimer’s: Prevention is the Cure 2025).

Sugar, Metabolic Syndrome and Early-Onset Dementia: Is This Type 3 Diabetes?

Why are more people in their 40s and 50s developing dementia? Most assume the answer lies in the genes. But here’s the reality: fewer than 1% of Alzheimer’s cases are caused by rare genetic mutations. The other 99%? They are driven largely by preventable, lifestyle-related factors – and at the centre of the storm is how we process sugar, , leading many scientists to describe Alzheimer’s as “Type 3 diabetes.”

A major new study of nearly two million people confirms that metabolic syndrome – the cluster of blood sugar imbalance, abdominal obesity, high blood pressure, and poor lipid levels  – significantly increases the risk of early-onset dementia.

This should be front-page news. Dementia is now affecting people in their 40s and 50s, not just the elderly. And at the heart of this early decline? Poor blood sugar control, excess abdominal fat, and the metabolic mayhem caused by high-sugar diets.

The Evidence: 24% Higher Risk of Dementia Before Age 65

The landmark 2024 study published in JAMA Neurology followed more than 1.9 million adults and found that those with metabolic syndrome had a 24% higher risk of developing dementia before the age of 65 compared with those without (1).

The strongest associations were observed with:

Hyperglycaemia (high blood sugar)
Abdominal obesity (visceral fat around the waist)

These two factors, when present together, were particularly predictive of vascular dementia, although risks were also elevated for Alzheimer’s disease and other forms of dementia.

The authors adjusted for other lifestyle and demographic factors, confirming that metabolic health itself was an independent driver. Men and those in their 40s showed the highest vulnerability.This aligns with decades of research linking insulin resistance and poor glucose control with brain shrinkage, memory loss, and neurodegeneration – all of which are discussed in detail in [here] and [here]. 

The Type 3 Diabetes Hypothesis

Scientists have increasingly referred to Alzheimer’s disease as “Type 3 diabetes” – a term that reflects how brain cells become resistant to insulin and fail to metabolise glucose properly.

Chronically high blood sugar damages blood vessels in the brain, increases inflammation, and accelerates the formation of amyloid plaques, all hallmark features of Alzheimer’s pathology. This new study provides the strongest population-level evidence to date that the same dysfunction is also driving younger-onset dementia.

The Role of Fructose and Processed Sugar

Endocrinologist and paediatric neuroendocrinologist Dr Robert Lustig has long warned of the unique effects of fructose (a sugar found in high-fructose corn syrup and added sugars) on the brain. Unlike glucose, fructose is processed in the liver, promoting visceral fat, insulin resistance, and inflammation – all central to metabolic syndrome (2).

When the brain is chronically exposed to excess sugar and insulin, its ability to generate energy and form new synapses becomes impaired. Over time, it is as if the brain is being starved, even in the midst of plenty.

 This isn’t just a long-term risk – we’re now seeing it play out in middle-aged adults.

Thankfully we know that there is much you can do to prevent this from happening – your future is in your hands – here is what to focus on.

What Can You Do? Five Simple Shifts

Check your blood sugar regulation. The HbA1c test is a key marker of long-term blood glucose control. (Available via our home test kits and in our DRIfT 5 in 1 test kit.)
Prioritise low-GL, whole foods. Swap out refined carbohydrates and processed sugars for whole grains, legumes, nuts, and non-starchy vegetables.
Limit fructose. Reduce or remove sweetened drinks (including fruit juice), syrups, and processed snacks high in high-fructose corn syrup. Read more on high/low fructose foods here.
Assess your waist size. Abdominal fat is a strong dementia risk factor. A healthy waistline helps protect your brain.
Exercise regularly. Just 30 minutes a day improves insulin sensitivity and helps the brain use glucose more efficiently.

Need help taking action on the above? Struggle to know how to ditch your sweet tooth?

Join us in the Forget Sugar Webinar in October with Patrick Holford.

A Wake-Up Call, Not a Life Sentence

This study shows a sobering trend – but Food for the Brain exists to empower you in your prevention path. Early-onset dementia is not inevitable. It is largely preventable if you act now. Sugar, insulin resistance, and metabolic syndrome are right at the centre of the problem.

We need public health messaging that reflects this. Dementia is not just an age-related disease. It’s a lifestyle-driven brain disorder that begins years, even decades, before diagnosis.

Your brain doesn’t have to retire early – start your brain upgrade programme and journey today.Want to assess your brain health? Complete this free validated online Cognitive Function test to receive personalised insights into your brain health, along with guidance on what you can do to reduce your risk and protect your future!

Food for the Brain is a not-for-profit educational and research charity that offers a free Cognitive Function Test and assesses your Dementia Risk Index to be able to advise you on how to dementia-proof your diet and lifestyle.

By completing the Cognitive Function Test you are joining our grassroots research initiative to find out what really works for preventing cognitive decline. We share our ongoing research results with you to help you make brain-friendly choices.

Please support our research by becoming a Friend of Food for the Brain.

References

 Jang H et al. Association Between Metabolic Syndrome and Early-Onset Dementia in a Nationwide Cohort. JAMA Neurol. 2024. doi:10.1001/jamaneurol.2024.xxxxxx
Lustig RH. Fat Chance: The Hidden Truth About Sugar, Obesity and Disease. Penguin; 2013.https://pubmed.ncbi.nlm.nih.gov/12450889/

Coffee – Good or Bad for your Brain?

by Patrick Holford

Coffee: Friend or Foe for Your Brain?

For many, the day doesn’t truly begin until that first cup of coffee hits the system. It sharpens the mind, lifts the fog, and gives an instant boost of focus – which explains why, in the UK alone, we drink an astonishing 100 million cups every single day, about two per person. But is this daily ritual really fuelling your brain, or quietly robbing it of long-term vitality?

Coffee is more than just a stimulant. Yes, it contains polyphenols – those antioxidant compounds that can protect the brain. But it also delivers caffeine, which fires up your adrenal hormones to give that short-term buzz. The problem is that this instant lift comes with a hidden cost: over time, it can deplete energy reserves and, more worryingly, raise homocysteine – one of the strongest predictors of dementia and Alzheimer’s.

The Hidden Brain Risk – Homocysteine

The homocysteine-raising effect is quite considerable. A group of doctors from University Hospital Nijmegen tested the effects of coffee by assigning volunteers to drink a litre of unfiltered coffee a day – that’s about four cups – for two weeks. At the start of the two weeks, their average homocysteine score was 12.8 µM, slightly above the national average of 10 to 11. At the end of the two weeks, their homocysteine score was 14. (1)

This homocysteine-raising effect was confirmed in another study by Dr Verhoef and colleagues at the Wageningen Centre for Food Sciences in the Netherlands, which showed that two cups of coffee increased homocysteine by 11% after four hours. Interestingly, caffeine tablets without coffee increased it by only 5%, suggesting that other compounds in coffee, such as theophylline and theobromine (also found in chocolate), may play a role. (2)

This means that if your homocysteine is already slightly raised, perhaps above 9 or 10, drinking coffee may be doing more harm than good, since the brain starts shrinking with homocysteine levels above 11. Also, if you do drink a lot of coffee, it’s a good reason to check your homocysteine level. 
(Order your homocysteine test here. An accurate and simple way to check your level via a quick pinprick test.)

How Much Coffee is Too Much?

So, does coffee protect against dementia – or put you at greater risk? The answer depends on quantity.  A UK Biobank study involving 400,000 participants compared those drinking 1-2 cups a day with those drinking six or more cups a day and found both a 53% increased risk of dementia and smaller brain volumes in those drinking 6 or more cups.(3)  The UK Biobank didn’t measure the homocysteine of the participants, but this is the most plausible mechanism.

A new 2025 analysis from the US NHANES database reached a similar conclusion: higher coffee consumption was associated with a greater risk of dementia (4).

Yet the story isn’t entirely one-sided. A review of all studies up to 2020 concluded: “Caffeine effects were more often positive when consumed in moderate quantities (100–400 mg/day), consumed in the form of coffee or green tea, and in women.” (5)  The most recent UK Biobank findings confirmed that moderate coffee or tea drinkers had a lower risk of cognitive decline than abstainers. (6)

A double espresso delivers 200–300 mg of caffeine, so moderation seems to mean no more than two to two and a half cups a day — and only if unsweetened.

Sweetened or Unsweetened – Does it Matter?

It matters a lot. The UK Biobank found a modest reduction in risk in those drinking up to 2.5 cups a day, compared with non-coffee consumers, but only in those drinking unsweetened coffee. Those drinking sweetened coffee had a higher risk. (7)

This is consistent with research at Canada’s University of Guelph. Participants were given a carbohydrate snack – such as a croissant, muffin, or toast – together with either a decaf or regular coffee. Those having the coffee-carb combo had triple the increase in blood sugar levels. In addition, insulin sensitivity, the hormone that controls blood sugar levels, was almost halved. (8)  The lesson? Enjoy your coffee on its own, without sugar or a carb-laden pastry.

Don’t Drink Coffee on Waking

Timing also matters. In the first hour after waking, your body naturally peaks in cortisol, the long-acting adrenal hormone that gets you going. (9)  That is why it is probably better not to have coffee, which further promotes adrenal hormones, for at least an hour after waking. Otherwise, you may stop producing enough of your own cortisol and become dependent on the caffeine hit.

In the evening, it’s the opposite story. Cortisol should be reducing and melatonin rising, but caffeine can affect this for up to 10 hours. The results? Over time, poorer sleep, which can contribute to a whole host of health problems, and greater difficulty waking in the morning, leading to a cycle of dependency on coffee.

One cup of coffee a day, in the morning, ideally not on waking but at least 30 to 60 minutes later, seems optimal. (10) However, the more tea you drink, the better, according to two studies, with green tea being the most beneficial.(11, 12)  This benefit, however, was not found in a UK Biobank study, which reported tea and coffee drinking to be associated with worsening cognition compared with abstainers.(13) 

The Japanese have a tradition of making a pot of green tea and, if they want a second, simply add hot water to the teapot. I do the same with coffee – if I have a second cup I run the coffee through the filter paper again. In this way it is progressively weaker.

But let’s be honest: coffee is an addictive stimulant and, while it may not be as harmful as alcohol, it is ultimately an energy robber. Having used coffee to help me through an intense month of early mornings and book writing, I quit and experienced a severe withdrawal headache that lasted 36 hours!

My Advice for the ‘Wired and Tired”

or those stuck in the vicious cycle – wired by coffee to stay awake, then relying on alcohol to switch off at night – my advice is simple: reset. Quit both for a time. Focus on consuming a low-sugar, low GL diet, along with supplements including B vitamins, plus extra vitamin C and omega-3 fish oil. All this advice and more is provided when you become a FRIEND of Food for the Brain and gain access to your six-month COGNITION™ brain upgrade programme. Click here to find out more.

Andrew was a case in point. Managing a chain of supermarkets had left him very stressed.

During the day, he drank coffee and in the evening, he relaxed with a beer or some wine as otherwise he would struggle to sleep. He was also gaining weight.

Andrew went on a low-GL diet, quit drinking coffee and alcohol, and took the recommended supplements. Three weeks later, he said: “My energy is through the roof, I don’t feel stressed, have no problem sleeping and I’m waking refreshed.” 

In Short …

One to two cups of unsweetened coffee a day, taken 30–60 minutes after waking, is probably optimal.
Avoid combining coffee with sugar or high-carbohydrate foods.  
Test your homocysteine levels, especially if you drink more than two cups a day.
Buy a single homocysteine test here or get it along with other important brain biomarkers in the DRIfT 5-in-1 test kit here (for best value).
Consider switching to green tea or more weakly brewed coffee where possible for a gentler stimulant effect.
Avoid caffeinated drinks after noon, especially if you have difficulty getting to sleep or staying asleep.
If you rely on caffeine to function or alcohol to unwind, it may be time for a reset.

Food for the Brain is a not-for-profit educational and research charity that offers a free Cognitive Function Test and assesses your Dementia Risk Index to be able to advise you on how to dementia-proof your diet and lifestyle.

By completing the Cognitive Function Test you are joining our grassroots research initiative to find out what really works for preventing cognitive decline. We share our ongoing research results with you to help you make brain-friendly choices.

Please support our research by becoming a Friend of Food for the Brain.

References:

(1) Grubben MJ, Boers GH, Blom HJ, Broekhuizen R, de Jong R, van Rijt L, de Ruijter E, Swinkels DW, Nagengast FM, Katan MB. Unfiltered coffee increases plasma homocysteine concentrations in healthy volunteers: a randomized trial. Am J Clin Nutr. 2000 Feb;71(2):480-4. doi: 10.1093/ajcn/71.2.480. PMID: 10648261. https://pubmed.ncbi.nlm.nih.gov/10648261/

(2) Verhoef P, Pasman WJ, Van Vliet T, Urgert R, Katan MB. Contribution of caffeine to the homocysteine-raising effect of coffee: a randomized controlled trial in humans. Am J Clin Nutr. 2002 Dec;76(6):1244-8. doi: 10.1093/ajcn/76.6.1244. PMID: 12450889. https://pubmed.ncbi.nlm.nih.gov/12450889/

(3) Pham K, Mulugeta A, Zhou A, O’Brien JT, Llewellyn DJ, Hyppönen E. High coffee consumption, brain volume and risk of dementia and stroke. Nutr Neurosci. 2022 Oct;25(10):2111-2122. doi: 10.1080/1028415X.2021.1945858. Epub 2021 Jun 24. PMID: 34165394. https://pubmed.ncbi.nlm.nih.gov/34165394/

(4) Li, J., Yu, K., Bu, F. et al. Exploring the impact of coffee consumption and caffeine intake on cognitive performance in older adults: a comprehensive analysis using NHANES data and gene correlation analysis. Nutr J 24, 102 (2025). https://doi.org/10.1186/s12937-025-01173-x

(5) Alida Chen J et al, Associations Between Caffeine Consumption, Cognitive Decline, and Dementia: A Systematic Review Journal of Alzheimer’s Disease 78 (2020) 1519–1546 DOI 10.3233/JAD-201069 https://pubmed.ncbi.nlm.nih.gov/33185612/

(6)Rainey-Smith SR, Sewell KR, Brown BM, Sohrabi HR, Martins RN, Gardener SL. Moderate coffee and tea consumption is associated with slower cognitive decline. J Alzheimers Dis. 2025 Jul 21:13872877251361058. doi: 10.1177/13872877251361058. Epub ahead of print. PMID: 40686251.

(7) Tingjing Zhang, Jiangen Song, Zhenfei Shen, Kewan Yin, Feifei Yang, Honghao Yang, Zheng Ma, Liangkai Chen, Yanhui Lu, Yang Xia,

Associations between different coffee types, neurodegenerative diseases, and related mortality: findings from a large prospective cohort study, The American Journal of Clinical Nutrition, Volume 120, Issue 4, 2024, Pages 918-926, ISSN 0002-9165, https://doi.org/10.1016/j.ajcnut.2024.08.012. https://ajcn.nutrition.org/article/S0002-9165(24)00671-3/abstract

(8) Moisey LL, Kacker S, Bickerton AC, Robinson LE, Graham TE. Caffeinated coffee consumption impairs blood glucose homeostasis in response to high and low glycemic index meals in healthy men. Am J Clin Nutr. 2008 May;87(5):1254-61. doi: 10.1093/ajcn/87.5.1254. PMID: 18469247. https://pubmed.ncbi.nlm.nih.gov/18469247/

  (9) Debono M, Ghobadi C, Rostami-Hodjegan A, Huatan H, Campbell MJ, Newell-Price J, Darzy K, Merke DP, Arlt W, Ross RJ. Modified-release hydrocortisone to provide circadian cortisol profiles. J Clin Endocrinol Metab. 2009 May;94(5):1548-54. doi: 10.1210/jc.2008-2380. Epub 2009 Feb 17. PMID: 19223520; PMCID: PMC2684472. https://pubmed.ncbi.nlm.nih.gov/19223520/   

(10) Xuan Wang, Hao Ma, Qi Sun, Jun Li, Yoriko Heianza, Rob M Van Dam, Frank B Hu, Eric Rimm, JoAnn E Manson, Lu Qi, Coffee drinking timing and mortality in US adults, European Heart Journal, 2025;, ehae871, https://doi.org/10.1093/eurheartj/ehae871 

(11)  Nurk E, Refsum H, Drevon CA, Tell GS, Nygaard HA, Engedal K, Smith AD. Intake of flavonoid-rich wine, tea, and chocolate by elderly men and women is associated with better cognitive test performance. J Nutr. 2009 Jan;139(1):120-7. doi: 10.3945/jn.108.095182. Epub 2008 Dec 3. PMID: 19056649 https://pubmed.ncbi.nlm.nih.gov/19056649/ 

(12) Feng L, Chong MS, Lim WS, Lee TS, Kua EH, Ng TP. Tea for Alzheimer Prevention. J Prev Alzheimers Dis. 2015;2(2):136-141. doi: 10.14283/jpad.2015.57. PMID: 29231231. https://pubmed.ncbi.nlm.nih.gov/29231231/ 

(13) Cornelis MC, Weintraub S, Morris MC. Caffeinated Coffee and Tea Consumption, Genetic Variation and Cognitive Function in the UK Biobank. J Nutr. 2020 Aug 1;150(8):2164-2174. doi: 10.1093/jn/nxaa147. PMID: 32495843; PMCID: PMC7398783.  https://pmc.ncbi.nlm.nih.gov/articles/PMC7398783/

How To Break Free From Food Addiction

Do you ever promise yourself you’ll stop eating sugar or junk food – only to find yourself back at the biscuit tin a few hours later? You’re not alone. Food addiction is real. In fact, it can be as powerful and pervasive as alcohol addiction.

The first step is awareness. According to clinical psychologist Dr Jen Unwin, there are six warning signs. If you recognise yourself in two or more, it may be time to take this seriously.

Read on to see if any apply to you.

Six Signs You May Be Addicted to Food

1. Certain foods feel impossible to resist

 “You’re craving a certain food so badly that you feel compelled to eat it, even when you know you shouldn’t,” Dr Unwin explains. At the height of her own addiction, she would secretly make a bowl of cake mixture – just butter, sugar and flour -and eat the entire thing raw. “It sounds ridiculous now, but I had such intense cravings for sweet, soft, sugary foods,” she explains.

2. You always need more

Like alcohol tolerance, food addiction builds over time. “One slice of cake may have been enough in the beginning, but soon you need two, three – or half the cake – to get the same dopamine hit,” says Dr Unwin. She recalls eating slice after slice at her daughter’s wedding, unable to stop until she felt sick.

3. Food takes priority over everything else

A common factor in addiction is that you begin to ignore what you once valued and prioritise food above socialising, hobbies, family time and even work. Often, Dr Unwin would leave the house and her family in secret to drive for 20 minutes to a cinema complex where she would order a large tub of Ben & Jerry’s Cookie Dough ice cream with chocolate sauce. She would then return to her car and eat the entire portion, feeling ashamed and elated at the same time, before returning home an hour later as if nothing had happened.

4. You lose control once you start

You might buy biscuits for your grandchildren, planning to have just one with your tea. Before you know it, the whole packet has disappeared.

5. Withdrawal symptoms kick in

If you try to cut down on sugary snacks and carbohydrates, do you experience withdrawal symptoms? “These include headaches, migraines, gastrointestinal symptoms, low mood, anxiety, fatigue and brain fog,” Dr Unwin says. “As people experience sugar withdrawal, they feel so bad that they just go back to eating it.” When Dr Unwin completely abstained from sugar, she experienced many of these symptoms for eight days. But after pushing through that difficult period, she began feeling better than ever.

6. You know it’s harming you – and carry on anyway

According to Dr Unwin, this is the defining sign: eating damaging foods despite knowing the consequences. She references a patient with Type 2 diabetes who kept bingeing on cake and sugar knowing how bad it is for their blood sugar. People in this situation often know the food is harmful, but they feel trapped in a cycle.

Why Processed Foods Hijack Your Brain

Breaking free from any addiction is not purely a matter of willpower. Addictive foods and drinks hijack your brain’s chemistry, making you crave them. This effect is purposely done so that you keep buying more.

Understanding how certain food ingredients and combinations work in the brain unlocks the secret to undoing food addiction. The most powerful trigger is the combination of fat and sugar – the two key components of most junk foods. Think cakes, biscuits, ice cream, chocolate bars and pastries. This pairing presses the brain’s dopamine “reward” switch, creating intense pleasure in the moment but diminishing feelings of satisfaction over time. Just like drugs, it fuels cravings and loss of control.
This hijacking of the dopamine-based reward system doesn’t just drive overeating – it also increases the risk of cognitive decline and brain shrinkage. Additionally, it disrupts glucose control and drives insulin resistance, a well-known promoter of cognitive decline.  (Read more –  ‘Is Sugar Killing Your Brain?’)

Nutritional Tools That Reset Your Brain

In Patrick Holford’s book How to Quit without Feeling S**t  he recommends strategies that help restore balance to your brain chemistry:

Omega-3 fats – vital for healthy cell membranes and for receiving neurotransmitter messages.
B vitamins and methylation – check homocysteine levels; if they are high, it may indicate poor methylation and raised risk of cognitive decline.
Tyrosine – dopamine is made from this amino acid. A supplement of 500mg twice daily can help support dopamine production.

Protein + slow carbs – pairing protein (such as nuts or Greek yogurt) with fruit like berries slows sugar release and provides fibre and nutrients.

 A clinical Psychologist’s Practical Tips on How to break free; 

Visualise how life will improve once you manage to quit your “drug foods”. These are typically ultra-processed and sugary foods with which you’re unlikely to have a healthy relationship.
Have an honest conversation with friends and family about the foods you struggle with, and ask for their support in resisting them..
Removing the “drug foods” from your home and diet is key. Replace them with natural, whole foods.
Give it time. Every day you resist, it gets easier. “Those foods are no longer in my thoughts at all,” says Dr Unwin.
If you take medication for diabetes or high blood pressure, consult your GPbefore reducing sugar and carbohydrates in your diet, as your dosage may need adjusting.
If you’re concerned about food addiction or would like to learn more, Dr Unwin recommends joining a Public Health Collaboration (PHC) support group in the UK, or Sweet Sobriety in the US. The PHC also runs a virtual lifestyle support group every Monday at 6pm, where you can learn more about overcoming food addiction and maintaining good metabolic health.

The Bigger Picture

Food addiction is more than a personal struggle and it impacts more people than you realise. It’s part of a wider public health crisis, fuelling obesity, diabetes and dementia – but no matter where you are at right now, change is possible!

Ways to get support:

Are You a Food or Drink Junkie?
How to Recover from Addiction with Nutrition
Vitamin D – the Mind, Memory & Mood Essential
What our experts do themselves to prevent dementia
Dopamine and the Brain: Is Modern Life Hijacking Your Reward System?

New Study: Is Red Meat Bad for Your Brain?

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In a culture where the average plate still leans heavily towards meat – often processed, often excessive – it’s time to reassess the impact of our protein choices not just on our waistlines, but on our brains. A recent study in Neurology (2025) has added fresh weight to decades of evidence linking red and processed meat consumption to an increased risk of dementia and cognitive decline (1). Meanwhile, fish – particularly oily fish – continues to top the charts as the most protective food for your brain (2,3).

So, what does this mean practically for those of us trying to upgrade our brains and reduce our risk of cognitive decline? The answer may be as simple as this: eat more fish and fewer sausages.

Red Meat, Processed Meat and the Rising Risk to Brain Health

A new US cohort study, which followed over 77,000 adults across 30 years, found that:

Processed red meats (bacon, hot dogs, sausages, salami, bologna and other processed meat products) were clearly problematic. Consuming just 0.25 servings per day or more was associated with a 13% higher risk of developing dementia compared with those eating less than 0.1 serving (1).

Unprocessed red meat (e.g. beef or lamb) was linked to a 16% increased risk of subjective cognitive decline – that is people reporting that their memory or mental sharpness was worsening – when consuming more than one serving daily compared to less than half a serving per day. However, the researchers noted that this link did not reach statistical significance for diagnosed dementia overall (1).

More encouragingly, replacing one daily serving of processed red meat with a serving of nuts, lentils, or beans was associated with a 19% lower risk of dementia (1).

These findings are consistent with a large UK Biobank analysis of almost half a million adults, which found that each additional 25 g/day of processed meat (bacon, ham, sausages, meat pies, kebabs, burgers, chicken nuggets) was associated with a 44% higher risk of all-cause dementia and a 52% higher risk of Alzheimer’s disease. In contrast, each 50 g/day of unprocessed red meat was linked to a 19% lower risk of all-cause dementia and a 30% lower risk of Alzheimer’s disease (4).  This reinforces the idea that it is the processing – not necessarily the meat itself – that may be most harmful.

These associations were observed regardless of whether participants carried the APOE ε4 gene variant – further evidence that dietary choices have a significant impact and that Alzheimer’s is ‘not in the genes’. (4).

The Global Pattern

The irrelevance of genetics in these findings is further supported by global evidence. An ecological analysis across 204 countries found that higher national per-capita total meat supply – including both red and white meats – was significantly associated with higher dementia incidence, even after adjusting for ageing, economic development and genetic risk, including APOE ε4 prevalence where available (5). In other words, the meat-dementia link is not confined to particular genetic subgroups but is observable across populations worldwide, suggesting that the way we produce and consume meat may be influencing brain health trends on a global scale. 

What we put on our plate is powerful when it comes to reducing dementia risk – more so than any genetic variations that attract attention in the media.

Why Fish is Brain Food

The answer is not to go hungry, but to swap for something else – and when it comes to brain health, marine foods are your answer.

Unlike red meat, fish – especially oily varieties like salmon, sardines or mackerel – continue to show a strong protective effect.

A comprehensive 2024 meta-analysis found that:

Eating one to two servings of fish per day (roughly 150 g) is associated with a 20% reduced risk of Alzheimer’s disease and up to 30% slower cognitive decline (2).

Another study found that people who ate fish at least once a week had a one-third lower risk of Alzheimer’s compared with those eating fish less than weekly (3).

Why? Omega-3 fats, especially DHA, are critical for brain function and structure. They reduce inflammation, support synaptic plasticity and help clear beta-amyloid – a protein associated with Alzheimer’s disease.

As explained in the COGNITION™ 6-month programme, omega-3 fats from fish oil play a pivotal role in building and repairing the brain, particularly in mid-life, when early signs of cognitive decline can start to emerge.

That’s why we offer omega-3 at-home blood tests – so you can check whether you’re getting enough through your diet or if it’s time to add a supplement. You can test omega-3 on its own here, or as part of our 5-in-1 DRIfT test where you can also check your homocysteine and glutathione status at the same time.

A Simple Swap with Profound Impact

From a cognitive health perspective, the data is now hard to ignore: if you’re regularly eating red or processed meat – especially more than once a day – your brain may be paying the price. But shifting even one of those servings towards fish, eggs or plant-based proteins could make a meaningful difference.

Interestingly, the main culprit in the latest studies was processed meat. This supports a key principle in brain-friendly eating: most natural whole foods – whether meat, fish, fruit, nuts, legumes, wholegrains or dairy – are not the problem. It’s when we distort them into ultra-processed, factory-made food that health is undermined.

This isn’t about becoming vegan or pescatarian. It’s simply more evidence to reduce processed foods and ensure optimal omega-3 intake. 

So next time you’re at the supermarket make a cow happy and buy a fish.

Resources:

Need help knowing what to eat? Get inspired with over 125 brain-friendly recipes in the Upgrade Your Brain Cook App.

Order your omega-3 test today to find out if you are eating enough of these essential fatty acids. You can test omega-3 on its own here, or as part of our 5-in-1 DRIfT test. Available globally.

Food for the Brain is a not-for-profit educational and research charity that offers a free Cognitive Function Test and assesses your Dementia Risk Index to be able to advise you on how to dementia-proof your diet and lifestyle.

By completing the Cognitive Function Test you are joining our grassroots research initiative to find out what really works for preventing cognitive decline. We share our ongoing research results with you to help you make brain-friendly choices.

Please support our research by becoming a Friend of Food for the Brain.

References:

You J, Zhang L, Zhou Y, et al. Total meat supply and incidence of dementia: an ecological study of 204 countries. Front Public Health. 2025;13:1589936. doi:10.3389/fpubh.2025.1589936.

Li Y, Li Y, Gu X, Liu Y, Dong D, Kang JH, Wang M, Eliassen H, Willett WC, Stampfer MJ, Wang D. Long-Term Intake of Red Meat in Relation to Dementia Risk and Cognitive Function in US Adults. Neurology. 2025;104(3):e210286. doi:10.1212/WNL.0000000000210286.

Godos J, Micek A, Currenti W, Franchi C, Poli A, Battino M, Dolci A, Ricci C, Ungvari Z, Grosso G. Fish consumption, cognitive impairment and dementia: an updated dose-response meta-analysis of observational studies. Aging Clin Exp Res. 2024;36(1):171-182. doi:10.1007/s40520-024-02823-6.

Beydoun MA, Beydoun HA, Gamaldo AA, Teel A, Zonderman AB, Wang Y. Epidemiologic studies of modifiable factors associated with cognition and dementia: systematic review and meta-analysis. BMC Public Health. 2014;14:643. doi:10.1186/1471-2458-14-643.

Zhang Z, He P, Liu M, et al. Meat consumption and risk of incident dementia: cohort study of UK Biobank participants. Am J Clin Nutr. 2021;113(5):1228-1236. doi:10.1093/ajcn/nqaa343.

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If coffee is the worker’s fuel for the fast and frenetic pace of modern life in the digital age, alcohol is the opiate of the masses. 

Most people use coffee or tea to wake up the brain and alcohol to switch off daily feelings of stress and anxiety. But what are these habits doing to brain health? How much is too much, or too little? Are there other ways to unwind after a hectic day that can benefit the brain?

Alcohol – The Friendly Neurotoxin?

Alcohol is a neurotoxin that impairs cognition. That is the simple fact we often forget. Once the liver’s capacity to detoxify is exceeded, it is precisely this neurotoxic effect that creates the ‘drunk’ feeling – starting with reduced inhibitions, the onset of memory loss, (which some may consider useful after a stressful day), and slurred speech. These effects are due to cognitive impairment, rather than relaxation – hence the warning: ‘not safe to drive’.

Stress Relief – at a Cost

The short-term upside of alcohol is its ability to suppress adrenal stress hormones – key accelerators of brain ageing, particularly when the stress switch is stuck in the ‘on’ position. That background hum of stress and anxiety, pending doom or checking for problems, is a hallmark of life in the 2020s, with hourly news cycles cranking up reasons for gloom and fear. In this context, a drink may feel like a welcome antidote, offering temporary relief by dampening stress.

Alcohol also boosts GABA, a calming neurotransmitter which temporarily switches off adrenaline. This is why one drink can feel like relief – but the effect fades quickly and excessive drinking leads to GABA receptor downregulation, increasing anxiety the next day and impairing sleep quality – especially during the deep and REM phases. These two phases are vital for full brain recovery. As a result, one wakes up less cognitively alert, less energised and more likely to feel anxious or to react stressfully.

Alcohol – like all toxic drugs – is what Oscar Ichazo called a ‘door of compensation:  temporary escape we reach for when psychic tension runs too high. While it offers short-term reprieve, it ultimately drains vital energy.
(Do you need more guidance and support to help you make healthier choices and habits? Then become a FRIEND of Food for the Brain today to get access to monthly group coaching and COGNITION ™ for 6 months. Find out more here)

More on GABA

GABA is made from two amino acids – taurine and glutamine – and is promoted by theanine. These three amino acids are often included in supplemental ‘chill’ formulas. There are also herbs, which in combination, help to promote GABA. This effect is harnessed in some non-alcoholic drinks like SENTIA drinks called ‘GABA spirits’. These are non-alcoholic yet potentially calming and de-stressing, offering a viable alternative to alcohol.  

However, alcohol is not just ‘alcohol’ and its appeal isn’t only due to GABA promotion. Red wine, for example, is rich in polyphenols, which have real benefits for the brain. However, unless it is organic, it often contains sulphites and other chemicals added. Additionally, some individuals – particularly those who drink often – can develop sensitivity to alcohol or to a component such as yeast, triggering further inflammation in both the gut and the brain.

How Much Alcohol is Too Much?

Alcohol is, of course, addictive –  and it can become so very quickly, even in small amounts. There are two ends to this spectrum. At the extreme, more than 10,000 people under the age of 35 die each year from alcohol poisoning – literally from a single binge. It can be compared to a heroin addict who quits and then relapses, taking the same dose they had previously built tolerance to. Tragically, this was the case for Amy Winehouse, who died after one evening of excess following a period of sobriety.

But what about the other end of the spectrum – modest drinking? And does the type of drink make a difference? Let’s look at the evidence. 

Since Alzheimer’s dementia, which accounts for two-thirds of dementia, is diagnosed through both brain shrinkage and cognitive decline, let’s look at the effects of alcohol at various doses on both brain shrinkage and cognitive decline, the most severe consequence being an increased risk of a dementia diagnosis later in life.

A study of 36,678 MRI scans from UK Biobank found that consuming more than one unit of alcohol per day is associated with steadily decreasing white and grey matter in the brain. (5)  A unit is a small glass of wine, half a pint of beer or a single shot of spirits. 

A comprehensive study in the British Medical Journal in 2018, which followed more than  9,000 people over 23 years, found that both abstinence and drinking more than 14 units of alcohol a week, which is equivalent to a medium glass of wine (2.3 units) every day,  increased risk by 40%. (6) This is illustrated in the graph below.

You will notice that the brain shrinking effect is more pronounced in women than men, and those drinking 3 to 4 units, the equivalent of a large 250 ml of wine, show four times as much brain shrinkage as those drinking one small glass. Half a bottle a night, which is more than 4 units,  is associated with nearly eight times the loss of brain volume (7). That’s a high price to pay. 

Two other large studies last year showed something similar. A Chinese analysis of UK Biobank data involving 314,000 drinkers found that the more a person drank, the higher their risk. Once again, the effect was more pronounced in women than in men. or women, the lowest risk was observed  at around 8 units a week (roughly the equivalent of a bottle of wine), with risk actually lower than in those who drank less. Overall, the lowest risk was in those consuming 11.9 units a week, or about 1.7 units a day. (8)

Red Wine – Poison or Polyphenol Powerhouse?

On the positive side, research shows that a 125 ml glass of red wine a day may actually reduce dementia risk more than abstinence.^. Another study reported that the lowest risk for dementia was among those consuming about 2 units a day – the equivalent of  a small to medium glass of wine. (9)

Red wine in particular may be beneficial because of its higher levels of polyphenols. Red wine, chocolate, and tea are all rich in a polyphenol called epicatechin. 

Jeremy Spencer, a scientific advisor to Food for the Brain and Professor of Nutritional Biochemistry and Medicine at the University of Reading, has shown that polyphenol-rich plants improve blood flow in specific regions of the brain that are associated with attention, decision-making, impulse control, and emotion, improving overall ‘executive’ function. (10) What’s more, the level of flavanols in your bloodstream predicts your memory performance. 

In the COSMOS study, the greatest benefit from increased flavanol intake was observed in those with the lowest dietary intake. Improvements were particularly noted in aspects of memory linked to the hippocampus – the brain’s central memory hub and the region most affected in Alzheimer’s disease (11). More recent research into cocoa, a rich natural source of flavanols – has also shown cognitive improvements, likely due to enhanced circulation (12). These findings were reinforced in a follow-up COSMOS trial involving more than 20,000 participants, who took a flavanol-rich cacao extract or placebo daily for five years (13).

Mitigating the Damage: Supplements for Protection

Quercetin (found in red onions), glutamine and vitamin C, support liver detoxification, helping to prevent hangover symptoms. (14)
Curcumin (especially water soluble Theracumin), reduces acetaldehyde by about a third, compared with drinking mineral water, thus easing hangover headaches.(15)  It has also recently been shown to protect the liver and reduce the risk of fatty liver disease.(16)
Glutathione – Alcohol-induced liver damage, fatty liver disease and reduced cognitive function are associated with a lower level of glutathione. A desirable level is above 800. Below 500 is an indicator that you need to increase your intake of antioxidants from food and/or supplements.

Not sure what your glutathione levels are? Test your antioxidant levels accurately from home with a single Glutathione test or as part of our DRIfT 5-in-1  blood test

The Final Pour…

Alcohol may quiet stress in the moment, but in the long term it dulls cognition, shrinks the brain, and disrupts sleep. 

The good news is that with the right habits and smarter choices, from regular exercise to alcohol-free days, you can unwind without trading clarity for comfort.

Our Advice: Smarter Drinking Hacks

Limit yourself to a maximum of one small glass of red wine daily (about 125 ml) – but ideally avoid drinking every day.
Stay under 14 units per week  to reduce cognitive risk.
Hydrate: drink one glass of water for every alcoholic beverage.
Exercise at the end of the day is a great way to de‑stress and promote sleep if you usually turn to alcohol for this purpose. 
Practise intermittent drinking: take longer alcohol-free breaks – weeks or months- to improve sleep, mood, and liver function
Avoid sugary drinks: they put extra strain on the liver. Choose dry wines, low-carb beers and skip sugary mixers like tonic and juice. Opt for ‘brut’ champagne. 
Eat polyphenols: pair wine with olives, blueberries, and dark chocolate for added brain protection..

 Want more insight into how healthy your brain is?

Take the FREE Cognitive Function Test today to gain personal insights into into your brain health. 

Join our research and test your glutathione, homocysteine and other essential brain health biomarkers with our accurate at home test kits – find out more and order yours today

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When that mid-morning dip or afternoon slump hits, it’s tempting to reach for a quick fix – something sweet, something carby, something to perk you up. But most conventional snacks don’t fuel your brain – they drain it.

In fact, snacking is one of the easiest ways to sabotage your long-term brain health and memory. Most people wouldn’t eat a plate of sugar at mealtimes (unless they start the day with shop-bought cereal or sweetened yoghurt), yet it’s common to reach for a bar, a biscuit, or something from a petrol station or coffee shop without a second thought.

These everyday choices are a silent driver of brain fog, low mood, memory problems – even dementia. It’s time to upgrade your brain by upgrading your snacks. Below, we share a free Brain Boost Bites recipe and some other smart snack ideas – perfect for long drives, picnics, or busy days on the go.

The Problem with Typical Snacks

The modern snack aisle is a minefield of ultra-processed foods: cereal bars, crisps, flavoured yoghurts, granola bites, and biscuits – many of them marketed as “healthy”. But beneath the surface, they’re often:

High in sugar or refined carbs – causing a rapid blood glucose spike followed by a crash. Many so-called healthy bars contain over 15g of sugar with little fibre, protein, or healthy fat to balance them.
Low in brain-essential nutrients – such as omega-3s, magnesium, or phospholipids.
Full of artificial additives – emulsifiers, preservatives, and even excitotoxins like MSG.
Designed for instant gratification – often with addictive properties rather than sustained energy.

As explained in our Four Horsemen of the Mental Health Apocalypse series (read Part 1 here and Part 2 here), poor glucose control is a key driver of accelerated brain ageing and cognitive decline. A high-sugar snack spikes blood sugar, then causes a crash that reduces brain energy and impairs mental performance. Over time, this rollercoaster leads to insulin resistance, which is strongly linked to cognitive decline and Alzheimer’s disease.

The Smart Snacking Solution

The answer isn’t to stop snacking altogether – it’s to snack smart.

Our in-house chef and lecturer in culinary nutrition and functional health, Kim Close, shares a free recipe below from the Upgrade Your Brain Cook App. It’s packed with brain-supportive nutrients and perfect for keeping your energy and focus steady.

And if you’re not sure what to eat for better brain health, the Cook App includes 120+ recipes (and growing) to guide you meal by meal.

👉 Subscribe to the Cook App – just £30/year

Brain Boost Bites

Refined sugar-free | Fibre-rich | Brain-fat fuelled | Brain Boosting

Other Smart Snack Ideas:

Oatcakes with almond butter or smoked mackerel pâté
Olives 
Square of Dark Chocolate Bar (Recipe in Cook App)
Hummus or nut butter with raw veggie sticks
A boiled egg with cherry tomatoes
A handful of walnuts or pumpkin seeds
A small cup of full-fat Greek yoghurt with blueberries
Chia pudding made with coconut milk (recipe in the app)
2 squares of 85%+ dark chocolate

Snacking wisely is one of the easiest daily upgrades you can make for your brain. And with the right ingredients, it can be delicious too.

—

Imagine if a simple, well-researched nutrient protocol could prevent cognitive decline in millions of people worldwide. Imagine further that this protocol has been known for years, supported by multiple clinical trials and global experts, yet systematically ignored by the very institutions meant to protect public health. That is precisely the case when it comes to homocysteine, B vitamins, and dementia.

Last year, the UK-based Lancet Commission on Dementia Prevention, Intervention and Care released its third major report, once again omitting any mention of homocysteine as a modifiable risk factor. This was despite direct submissions of evidence and letters from leading scientists demonstrating that lowering homocysteine with B vitamins can slow brain shrinkage and cognitive decline.

Now, in response to this silence, six of the leading dementia researchers, Professors Joshua Miller (Rutgers), David Smith (Oxford), Helga Refsum (Oslo), Jin-Tai Yu (Fudan), Babak Hooshmand (Karolinska), and Andrew McCaddon (Wrexham), have published a powerful rebuttal in the Journal of Alzheimer’s Disease. Many of these experts serve in the Alzheimer’s Prevention Expert Group (APEG) at Food for the Brain.

They wrote:

“In 2018, we published an ‘International Consensus Statement on Homocysteine and Dementia’ in this journal, in which we concluded that elevated plasma total homocysteine is a modifiable risk factor for the development of cognitive decline, dementia, and Alzheimer’s disease (AD) in older persons. (1)

We further stated that intervention trials in elderly people with cognitive impairment show that homocysteine-lowering treatment with B vitamins markedly slows the rate of both wholeand regional brain atrophy, and also slows cognitive decline. We were therefore puzzled as to why the Lancet Commission on Dementia Prevention, Intervention and Care, failed to discuss the possible role of homocysteine and B vitamins in any of their three reports, including the most recent one.” (2)

A Systematic Omission

The UK-based Lancet Commission on Dementia Prevention is meant to objectively consider the evidence on dementia prevention. Yet each edition, despite being sent the relevant papers, has ignored the evidence concerning homocysteine.

Furthermore, it’s expected to uphold the standards for critical debate which allows for experts to question Published findings. That is exactly what these experts did – yet it declined to publish their letter, instead printing a rebuttal from its own Commission while refusing to let readers see the original letter. (3, 4)

The experts wrote to The Lancet again to respond to the Commission’s letter, but their second letter was also rejected. 

Thatetter has now been published in the leading Alzheimer’s journal where the authors finally have their rightful say. It includes the following:

“We wish to reply to the Commission and continue the debate with the aim of reaching a common view on homocysteine, B vitamins and dementia. This is an important matter of public health.”

In other words, The Lancet published the ‘case for the defence’ for the exclusion of homocysteine without allowing readers to even read the ‘case for the prosecution’. (5)

So, what was The Lancet’s case against B vitamins? It rested on three criticisms – each of which these leading dementia researchers refute with scientific precision in their recent journal paper.

Criticism 1: Misunderstanding Who Benefited in the VITACOG Trial

The Lancet Commission questioned the relevance of the VITACOG trial, arguing that the results “do not show benefits in populations already consuming B vitamins in their food or through supplements.” But this fundamentally misrepresents the study population.

In the VITACOG trial, participants with mild cognitive impairment were given high doses of B6, B12, and folic acid for two years. The result was a 31% reduction in whole brain shrinkage and significantly slower rate of cognitive decline in those with raised homocysteine (6). In participants with levels above 11.3 μmol/L – the median – both cognitive and clinical improvements were observed. Importantly, key Alzheimer’s-related brain regions shrank seven times more slowly in these individuals (7, 8).

The Lancet Commission implied that participants were already supplementing, but that is incorrect. The study excluded anyone taking more than 300 mcg of folic acid, 3 mg of vitamin B6, or 1.5 mcg of vitamin B12 – doses lower  than those found in many common multivitamins. Only 16 to 20 percent were taking low-dose supplements, while the majority were not.. No one was excluded based on their dietary intake of B vitamins.

The experts respond:“The Commission authors’ comment is analogous to expecting additional drug treatment to provide benefits over and above the benefits being obtained in people already taking a high dose of the drug, which is why it puzzles us.”

Criticism 2: No Benefit in the Hong Kong Trial?

The Commission’s response also cited a Hong Kong trial that reported no benefit of B vitamins over two years in people with mild cognitive impairment (MCI) (9). However, this overlooks several important confounders.

Firstly, 22% of participants were taking aspirin, which the study authors themselves found to impair the effect of B vitamins. This interference has since been confirmed in further research (10).

Secondly, the authors of The Lancet response failed to consider another critical factor: omega-3 status. Numerous studies show that B vitamins only deliver cognitive benefits when omega-3 fatty acid levels are sufficient. The Hong Kong study did not measure or control for omega-3 status, which likely explains the lack of consistent benefit over the two-year period.

Thus, the absence of effect in this trial does not disprove the role of B vitamins.  The experts go on to demonstrate in their article the overwhelming body of evidence –  reported by us – that homocysteine-lowering B vitamins do not work optimally in individuals with low omega-3 status.

Criticism 3: No Benefit in the VITAL Trial in Alzheimer’s Patients?

The Lancet authors also referenced the VITAL trial, which reported no overall cognitive benefit from B vitamins in patients already diagnosed with Alzheimer’s disease (11). But again, this conclusion overlooks key details.

In a subgroup analysis, those in the early stages of Alzheimer’s disease did show significant benefit (12). The authors of the VITAL trial themselves highlighted this in their paper, suggesting that earlier intervention is more effective. This finding aligns with multiple other studies showing that B vitamin treatment is most effective in the pre-dementia stages (13).

Furthermore, participants in the VITAL trial began with an average homocysteine level of 9 μmol/L, which is below the threshold (>10–11 μmol/L) associated with brain atrophy.  It is extremely rare to find a group of people with Alzheimer’s disease that start with such a low homocysteine level.  While the B vitamins did reduce homocysteine further to 7μmol/L, there was no overall cognitive benefit observed. But this is akin to giving painkillers to people who are not in pain and then reporting no change in pain levels. At Food for the Brain, we consider a homocysteine level above 10μmol/L as in need of correction with B vitamins.

There are also concerns about conflicts of interest. The lead author, Paul Aisen, is described as “a consultant to the following pharmaceutical companies involved in the development of potential treatments for Alzheimer’s disease”. with more than a dozen firms listed. These companies would certainly favour a trial designed to fail – especially if it were widely publicised.

Additionally, when an anti-amyloid drug trial for lecanemab was published – now licensed in the US and UK – the names of Paul Aisen and Christopher Van Dyck appeared once again as lead authors. In other words, the paid pharmaceutical consultants, responsible for running the drug trial were also tasked with overseeing a trial – designed to fail – on a competing approach: lowering homocysteine with B vitamins. The conflict of interest here is both clear and concerning.

What Does the Evidence Really Say?

You can read the full expert response published in the Journal of Alzheimer’s Disease here. 

Their conclusion is clear:

“We hope that the Lancet Commission will consider the substantial existing evidence of raised homocysteine as an important risk factor for dementia and the possibility of modifying its harm by supplementation with B vitamins.”

They emphasise that the evidence for B vitamin intervention is as strong – or stronger than –  many of the risk factors the Commission did include in its 2024 report. To continue ignoring the proven impact of homocysteine, and the benefits of lowering it through B vitamins is not merely a scientific oversight –  it is a missed opportunity with major implications for medicine and public health.

Remember, prevention is better than cure, and there is so much you can do to protect your brain health

The perfect time to start? Today.

What Can You Do?

Test your homocysteine (and omega-3 status) TODAY –  especially if you’re over 50 or at risk of cognitive decline. At Food for the Brain, we offer an accurate at-home test kit that reliably measures plasma homocysteine reliably. 

You can order your single Homocysteine test here or save money and test both omega-3 index and homocysteine (plus other markers) as part of our DRIfT tests here. International shipping available.

Act on your results –  if your level is above 10 μmol/L, supplementation with vitamin B6 (20 mg), methylfolate (400 µg), and vitamin B12 (500 µg) is recommended.
Read more on supplements and homocysteine here.

Support our mission – become a FRIEND of Food for the Brain! Your donation helps us advance prevention-focused brain health research and education.

As a Friend, you’ll also gain access to:
• Monthly group coaching
• Your personalised brain upgrade programme: COGNITION™

Share the knowledge – public awareness can change public health.
We need a paradigm shift, and it starts with us.

—

When it comes to eating for brain health, flavour and fun are often the first casualties. But what if you could have it all – taste, ease of preparation, and science-backed nutrition – in one delicious dish? That’s exactly the idea behind our Wild Salmon and Chickpea Salad with Rocket and Pesto, a featured free recipe from the Upgrade Your Brain Cook App.

This isn’t just lunch or dinner. It’s brain fuel – loaded with the nutrients your brain craves, without the blood sugar spikes that leave you foggy and fatigued.

Why This Recipe is Brain-Optimised

Your brain is made mostly of fat and thrives on nutrient-rich, anti-inflammatory foods. This recipe is a nutritional powerhouse tailored to support cognitive function, memory, and mood – all key pillars of the COGNITION® brain upgrade programme.

Here’s how it delivers:

Omega-3 fats from wild salmon support the structural integrity of your neurons. DHA, in particular, is vital for sharp thinking and memory retention.
B Vitamins, especially B12 (from salmon), B6 and folate (from chickpeas and rocket), are key players in methylation – the process that powers your brain’s biochemistry and detoxification pathways.
Protein + Fibre Combo (salmon and chickpeas) keeps your blood sugar stable, sustaining energy and focus throughout the day.
Antioxidants in rocket, lemon, garlic, and optional red pepper help neutralise brain-ageing free radicals.
Low Glycaemic Load supports stable mood and mental clarity by avoiding sugar crashes.

Eating for brain health doesn’t mean boring. This salad is fresh, zingy, and ready in minutes – ideal for picnics, packed lunches, or a light dinner.

Prep tip: Double the pesto and keep it in the fridge – you’ll have a brain-friendly dressing ready to jazz up any salad or veggie dish. No boring meals required.

Wild Salmon and Chickpea Salad with Rocket and Pesto Recipe

Ingredients

100g cooked wild salmon (3½ oz) 
80g cooked chickpeas (2¾ oz) 
1 handful rocket 
1 tbsp olive oil 
1 tbsp lemon juice 
1 tbsp pumpkin seeds 
½ garlic clove 
1 tsp nutritional yeast optional 

Instructions:

1. Blend rocket olive oil lemon juice garlic and pumpkin seeds to make pesto 

2. Toss salmon and chickpeas with the pesto 

3. Serve on a bed of leafy greens

Cooks notes: 

Use frozen wild salmon for ease 
Add red pepper slices for extra brain-friendly antioxidants
Double up the pesto recipe and keep in a sealed jar in the fridge to dress a different salad.

Add red pepper slices for extra brain-friendly antioxidants

Why Now’s the Perfect Time to Join the Cook App

Right now, subscribing to the Upgrade Your Brain Cook App doesn’t just give you access to over 100 delicious, nutritionist-designed recipes – it also unlocks our Summer Recipe Bonus Bundle: 12 new recipes, each one optimised for brain health and bursting with flavour.

Here’s a taste of what you’ll get:

Brain Boost Balls – a perfect mid-afternoon focus snack
Stuffed Portobello Mushrooms with Walnut Lentil Pâté – hearty and satisfying
Blueberry Chia Pudding – low GL and ideal for a nourishing wind-down
Turmeric and Cauliflower Soup – warming, silky, and anti-inflammatory
Mackerel and Broccoli Stir-Fry with Ginger Tamari Glaze – a 10-minute omega-3 hero

And that’s just the beginning.

Join the Brain Food Revolution

Every dish in the app is scored for omega-3s, B vitamins, GLs, and antioxidants – making it easier than ever to eat smart. With new features like the “Goes Well With” section, meal planning becomes seamless. Whether you’re following low GL, keto, or simply want to feel sharper, calmer, and more energised – this is your toolkit.

Let your fork do the upgrading. Try the salmon and chickpea salad now, and discover how good brain food can really be.

Want the Ultimate Recipe for Brain Health?

Here’s your 3-step action plan:

Take the FREE Cognitive Function Test. Get personalised insights into your brain health and identify any key risk areas.
Subscribe to the Upgrade Your Brain Cook App. Discover exactly what to eat to improve your scores and support long-term cognitive health – all in one delicious, easy-to-use tool.
Order the At-Home Pin-Prick Blood Test here
Available internationally, this test gives you deeper insight into the critical biomarkers affecting your memory, mood, and mental energy – so you can take action with precision.

Food for the Brain is a not-for-profit educational and research charity that offers a free Cognitive Function Test and assesses your Dementia Risk Index to be able to advise you on how to dementia-proof your diet and lifestyle.

By completing the Cognitive Function Test you are joining our grassroots research initiative to find out what really works for preventing cognitive decline. We share our ongoing research results with you to help you make brain-friendly choices.

Please support our research by becoming a Friend of Food for the Brain.

—

Your body is continually renewing itself by producing new cells. When it comes to protecting and enhancing your brain health, especially as you age, the quality of these new cells becomes increasingly important. A key factor in this cellular renewal process is the health of your telomeres – the protective caps at the ends of your chromosomes. A recent report has reinforced the strong link between telomere length and brain health, with shorter telomeres now recognised as early indicators of cognitive decline and increased dementia risk.

The process of making a new cell in your body starts by copying the map of how to build that cell, which is contained in a package of DNA strands, called a chromosome. The chromosome divides in two, giving a new set of instructions to the new cell. At the end of the chromosome is something called a telomere, which is a bit like the hard tip at the end of a shoelace. This becomes shorter with each cell division, until it is too short and the DNA is no longer protected. This triggers rapid ageing because cells stop dividing and, therefore, stop being replaced. Meanwhile, there is an enzyme, called telomerase, which can lengthen the telomere. The more telomerase activity, the slower the ageing process. For example, there is one bacterium called Tetrahymena thermophila, that has superactive telomerase so its telomeres never shorten – and it can live indefinitely.

Telomeres and Brain Ageing: The New Frontier

A recent report highlighted that shortened telomeres are not just markers of biological ageing, but also significant predictors of neurodegenerative diseases such as Alzheimer’s and other forms of dementia. According to the report, individuals with the shortest telomeres were at greater risk of developing age-related brain diseases, underscoring the urgency of protecting telomere integrity as part of a comprehensive dementia prevention strategy.

This aligns perfectly with our 6-month COGNITION brain upgrade programme, which targets eight nutrition and lifestyle domains known to support brain health, including sleep, stress, diet, and nutrient status – each of which has been shown to influence telomere length. In fact, many of the nutrients and behaviours proven to protect telomeres, such as vitamin D, omega-3 fatty acids, anti-inflammatory diets, and methylation support through B vitamins, are key focus areas within our COGNITION framework.

So, what does the research say about how we can lengthen our telomeres and protect our future?

Reduce your stress

Chronic stress, such as caring for someone with dementia, has been shown to reduce telomerase activity and shorten telomeres. Childhood trauma, depression, and even cynicism (1) also have a negative impact. On the other hand, practices like meditation have been shown to support longer telomeres (2).

Prioritise sleep

Quality sleep is linked to longer telomeres (3). For healthy ageing and longevity around seven hours per night appears optimal.

Get moving

Physical activity is another powerful protector of telomeres. Even individuals with PTSD who engaged in regular exercise were found to avoid the usual telomere shortening. (4)

Avoid smoking and maintain a healthy weight

Both smoking and obesity are linked to shortened telomeres.

Increase omega-3 and vitamin D

Studies show that higher intakes of omega-3 fish oils are associated with longer telomeres. A 2013 study found that DHA and EPA reduced telomere shortening (5). Other research links higher vitamin D levels with longer telomeres ( 6, 7). Both nutrients are abundant in oily fish.

Lower homocysteine levels

Homocysteine is a neurotoxic amino acid. Higher levels of B12 and folate, and lower homocysteine levels, are associated with longer telomeres (8, 9). A Singaporean study confirmed that elevated homocysteine levels predicts shorter telomeres (10).

This would seem to indicate that testing your homocysteine level is one of the smartest things you can do for your long-term brain health. That’s why we include it in our DRIFT 5-in-1 blood test here. This accurate at-home test measures five crucial biomarkers for assessing dementia risk and cognitive resilience.

Eat anti-inflammatory foods

A 2015 study found that individuals who consumed more anti-inflammatory foods had longer telomeres (11). Another study showed that greater vegetable intake is associated with longer telomeres (12). Even multivitamin use, which typically includes B12 and folate, has been linked to longer telomeres (13). (Find out advice on supplementation here).

If you want more personalised guidance on how to protect your brain – and your future health – Become a FRIEND today and get access to your personalised 6-month brain upgrade programme COGNITION®.

Join us in building a future where cognitive decline is not inevitable but preventable.

Food for the Brain is a not-for-profit educational and research charity that offers a free Cognitive Function Test and assesses your Dementia Risk Index to be able to advise you on how to dementia-proof your diet and lifestyle.

By completing the Cognitive Function Test you are joining our grassroots research initiative to find out what really works for preventing cognitive decline. We share our ongoing research results with you to help you make brain-friendly choices.

Please support our research by becoming a Friend of Food for the Brain.

References:
1 http://www.ncbi.nlm.nih.gov/pubmed/21974787

2 http://www.ncbi.nlm.nih.gov/pubmed/%2021035949

3 http://www.ncbi.nlm.nih.gov/pubmed/%2022046530

4 https://pubmed.ncbi.nlm.nih.gov/20520771/

5 http://www.ncbi.nlm.nih.gov/pubmed/24342530

6 http://www.ncbi.nlm.nih.gov/pubmed/17991655

7 http://www.ncbi.nlm.nih.gov/pubmed/22417715

8 http://www.ncbi.nlm.nih.gov/pubmed/22093367

9 http://www.ncbi.nlm.nih.gov/pubmed/18280483

10 http://www.ncbi.nlm.nih.gov/pubmed/25546508

11 http://ajcn.nutrition.org/content/early/2015/09/09/ajcn.115.116863

12 http://www.ncbi.nlm.nih.gov/pubmed/2656006413

13 http://www.ncbi.nlm.nih.gov/pubmed/19279081 

8 Natural Ways to Lower Homocysteine

The are several natural ways to lower homocysteine that can help support your overall wellbeing.

If you’ve discovered that your homocysteine level is higher than you’d like, the good news is that it’s often one of the most responsive biomarkers to diet and lifestyle changes. Small, consistent improvements in nutrition, physical activity and everyday habits can make a meaningful difference.

This guide focuses on eight practical, evidence-informed strategies that may help support healthy homocysteine levels, from eating more folate-rich foods and optimising key B vitamins to improving sleep, staying active and reducing alcohol intake.

If you’re looking for a complete explanation of what homocysteine is, why it matters, what causes elevated levels, how to interpret your test results and the science behind lowering homocysteine, read our complete guide to lowering homocysteine first. This article is designed to help you put that knowledge into practice.

Before trying to lower your homocysteine, it’s worth making sure you understand your test result. If you’ve already had a blood test, our guide to Homocysteine Levels Explained can help you interpret your homocysteine level and understand what it may mean for your health.

Homocysteine is a key indicator for cognitive and overall health. As we can see, with a few dietary tweaks, lifestyle upgrades, and targeted nutrients, you can lower your homocysteine, support methylation, and quite literally upgrade your brain!