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!)

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.

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

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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.

by Patrick Holford

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Choline is an often-overlooked but vital nutrient for brain health.

A new study suggests the optimal intake is 400mg, yet there is no Recommended Daily Allowance or widespread promotion of this crucial nutrient. It is also notably low in vegetarian and especially vegan diets.

(We discuss this and more in our COGNITION 6-month brain upgrade programme – available when you become a FRIEND of Food for the Brain.)

A major study published this year found that higher choline intake lowers the risk of dementia, Alzheimer’s, and cognitive decline.

Researchers tracked 125,000 people from the UK Biobank for 12 years and the study was published in the American Journal of Clinical Nutrition. It showed that higher choline intake reduced risk, with the most benefit around 400mg per day.

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Why does it matter?

Brain cells are made of a membrane containing choline (and other phospholipids) attached to the omega-3 fat DHA. Without choline the omega-3 doesn’t work. The attaching of the two depends on methylation, a process that is dependent on B vitamins, especially B12, folate and B6. Choline helps methylation and healthy methylation, indicated by low homocysteine, helps synthesise choline.

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Also previous studies (2) have found remarkable effects supplementing 480-900mg of choline in pregnancy on promoting ‘smart’ babies with faster reflexes and cognitive processes. It’s important for all ages and a key topic in our Smart Kids & Teens Programme.

What should you do or eat?

Choline is essential for the body, especially the brain, yet it has no Recommended Daily Allowance.

Choline is abundant in eggs, fish, and meat. An egg provides about 120mg, while a 50g serving of beef or salmon contains around 50mg. Beef liver is the richest source, but eggs are the best overall because they contain phosphatidylcholine which is more easily absorbed by the body. Plant-based sources include soy, quinoa, nuts, seeds, beans, and broccoli. A 50g serving of almonds or broccoli provides about 25mg. Phosphatidylcholine, found in lecithin capsules and granules, is an easy supplement option for vegans and vegetarians.

We recommend eating two eggs most days, with a minimum of six per week. Include fish and some meat if you eat it, or soy, quinoa, broccoli, nuts, and seeds if you don’t. Supplementing is likely beneficial, especially for vegetarians. Taking two high-PC lecithin 1,200mg capsules daily provides 250mg of phosphatidylcholine (PC), the form used by the body. These supplements are available at your local health food store.

Remember, your brain is built from what you feed it – and how you use it (as covered in COGNITION). What choline-rich foods can you add to your diet this week?

If you’re unsure what to eat to support your brain or need inspiration, the Cook App is here to help! With over 100 recipes at your fingertips, eating delicious, brain-boosting foods has never been easier—all for just £30 a year.

Actions:

Take the Cognitive Function Test today – our validated online assessment – to find out exactly what you need to focus on.
Become a FRIEND and get access to your 6-month COGNITION programme so you know how to upgrade your brain.

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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.

—Reference list

Reference

Niu YY, Yan HY, Zhong JF, Diao ZQ, Li J, Li CP, Chen LH, Huang WQ, Xu M, Xu ZT, Liang XF, Li ZH, Liu D. Association of dietary choline intake with incidence of dementia, Alzheimer disease, and mild cognitive impairment: a large population-based prospective cohort study. Am J Clin Nutr. 2025 Jan;121(1):5-13. doi: 10.1016/j.ajcnut.2024.11.001. Epub 2024 Nov 7. PMID: 39521435.
Caudill, M. et al, ‘Maternal choline supplementation during the third trimester of pregnancy improves infant information processing speed: a randomized, double-blind, controlled feeding study’ FASEB Journal (Apr 2018); 32(4): 2172-80. doi: 10.1096/fj.201700692RR.

By Patrick Holford

If you are eating a healthy whole food diet, do you need supplements? Surely the food you eat should be enough?

When it comes to supplements, the conventional view is based on government supported recommended intakes (RDAs, RNIs, NRVs or DRVs) designed to prevent classical symptoms of deficiency, such as scurvy in the case of vitamin C. The implication here is that if blood levels of nutrients are enough to prevent classical deficiencies then nutrient status is considered to be sufficient.  However, there is abundant evidence that even levels above those used to define ‘deficiency’, may still often be associated with adverse signs or symptoms or increased risk of diseases such as dementia. These levels therefore define a zone of ‘nutritional insufficiency’.

There is furthermore, a growing body of evidence from well-designed studies on specific mental health diseases, showing that supplements giving nutrients at levels beyond the basic ‘RDAs’, delay or reverse the disease or eliminate or ameliorate symptoms of disease, including cognitive decline. 

There are also many studies showing a steady reduction in symptoms or diseases, when blood levels of nutrients increase beyond the arbitrary cut-off levels, set to prevent classical deficiencies. Thus, neither RDAs nor normal reference ranges given for blood levels of nutrients, are ‘optimal’.

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Outdated definitions

This illustrates that the definition of ‘deficiency’ is outdated. Deficiency means a lack of efficiency. If the definition of nutrient deficiency, and its counterpart, sufficiency, were to be defined as the level of a nutrient that relieves symptoms of disease or promotes its prevention, that definition is scientifically supportable. It also takes into account the unique biochemical individuality that occurs as a function of both genetics, environmental exposure, microbiomics and an individual’s ability to absorb nutrients.

While medical and advertising law prohibits the description of a nutritional supplement or food as ‘preventing, reversing or treating a disease’ this is scientifically not correct. Nutrients do prevent, reverse and treat disease.

The overarching principle of the Food for the Brain Foundation is that of scientific integrity – that is to be consistent with the prevailing science and share that growing body of knowledge in a way that enables people like you to restore, maintain and improve mental health.

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What nutrients should we pay special attention to?

Four nutrients are especially significant in this regard.

Vitamin D – it is now well established that anyone living far from the Equator has to supplement vitamin D for several months (October to March in the UK and for cooler months in most of Europe, Australia, New Zealand and the US). The UK Government, in 2016, recommended that everyone should supplement during the Autumn and Winter. Almost a decade earlier, in 2007, I made the same point but was reported to the Advertising Standards Agency whose rule says “A well-balanced diet should provide the vitamins and minerals needed each day by a normal, healthy individual …”. I felt like reporting the government to the ASA!

Vitamin B12 – many people, especially people over age 50, simply do not absorb vitamin B12 well enough for food alone to be a sufficient supply. The ignorance regarding vitamin B12 is compounded by the inaccurate lower reference range for serum B12 in the UK of anything above 180pg/ml being sufficient (and the US level of 200pg/ml) being out of date and urgently in need of revision. In Europe and Japan anything below 500pg/ml is considered deficient. Against this yardstick, two in five over 60 have levels of B12 which are too low to stop accelerated brain shrinkage. 

Ignorance regarding B12, and the inability of doctors to prescribe it to those with cognitive concerns, is feeding the epidemic of dementia.

Omega-3 DHA – In the UK doctors are not allowed to prescribe omega-3 supplements for any condition, be it depression or dementia, despite all the evidence. I first wrote about omega-3 in 1981, and recommendations have gradually increased with each decade. However, there is still no official Nutrient Reference Value. The current guideline is to have 250mg of combined EPA and DHA a day but this is well below the level of DHA that confers the greatest protection from cognitive decline.

Choline – despite clear evidence of the need for choline, which makes the phospholipid phosphatidylcholine, in pregnancy for normal infant brain development, there is no recommended intake. Vegans can be assumed to be deficient unless supplementing.

I prefer to err on the side of caution, that is to provide the highest optimal level that research suggests would improve mood, memory, mental alertness and is consistent with minimising the risk of cognitive decline.

Click here to find out more on our supplement guidelines

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How many have developed dementia waiting for health officials to catch up?

Don’t be one of them and if you want to know more about what you can do to support your brain then make sure you:

1. Complete your DRIfT test to check your Omega-3 and Vitamin D status, alongside your HbA1c and Homocysteine markers. These are at home, pin-prick, accurate test kits available from UK, EU USA and soon Australia too!
(There is also the option of the DRIfT 5 in 1 test where you also test all of the above PLUS your antioxidant status via our unique Glutathione Index marker – find out more here.)
>> Learn about all our tests here.

2. Complete the FREE Cognitive Function Test. This validated online assessment will create a personalised set of results so you know exactly what you need to work on.
>> Do the online test here

3. Become a FRIEND. Join our mission and become one of our Citizen Scientists, you will get access to a community of like minded people in additionl to COGNITION, your 6-month interactive personalised programme to ensure you upgrade your brain.
>> Find out more 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.

By Patrick Holford

Did you know the length of your shadow can tell you if you’re able to generate vitamin D from sunlight?

If your shadow is longer than your body – you can’t produce vitamin D from sunlight. If you are in winter and live in a country of higher latitude (like the UK), this is happening now!

Vitamin D is an all-rounder as far as your brain and mental health is concerned.

It helps neurotransmission and exerts anti-inflammatory and neuroprotective activities within the brain by reducing both inflammation and oxidative stress (1).  

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We are all deficient in winter

Generally speaking, the lower your vitamin D, the worse your mood which makes vitamin D especially important to supplement from October to March if you live in the UK or a similar latitude, when the angle of the sun is too low and you’re also less likely to get outdoors exposing your skin to sunlight. It’s best to assume that we are all deficient in winter, unless you travel to the sun, and therefore need to supplement at least 25mcg (1000iu) although two or three times may be optimal and necessary to correct deficiency.

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Vitamin D and depression

The lower your vitamin D level, the more depressed you are likely to feel. If your mood takes a dip in winter months this is a key sign that you might need more. That’s what researchers at the University of Tromso in Norway found on testing 441 volunteers who were given a test for depression and also a test for blood levels of vitamin D. The volunteers were then given Vitamin D supplements or placebo. Tested one year on, those given vitamin D, but not those given the placebos, had substantially lower depression ratings (2).

However, you don’t have to wait for a year to get a lift in your mood. An eight-week study in Australia found that some of those given vitamin D supplements had an improvement in mood in only five days (3). Another study, in Iran, gave a single vitamin D injection and reported improvement in depression when measured 3 months on (4).

Since vitamin D stores, there is no need to supplement daily. You can take a weekly dose. In the Norwegian study above they gave 20,000iu or 40,000iu weekly. Both worked and there wasn’t a big difference in the effects on mood. So, you can assume that 20,000iu weekly, or 3,000iu daily would likely be sufficient.

It’s what is in your blood that matters

However, the yardstick for what you need is really whatever gets your blood level into the optimal range.

In the study above, those given 20,000iu a week averaged a blood level of 88 nmol/l, while those given 40,000iu averaged 111nmol/l. It is now well recognised that levels above 75nmol/l (30 ng/ml) correlate with good health for many health measures, while levels above 100nmol/l (40ng/ml) might be even better in some respects. My recommendation is to test yourself and consider anything below 50 to be deficient, and above 75 to be sufficient with an optimal level being closer to 100nmol/l (40ng/ml). If you then supplement 3,000iu daily, or seven times this weekly, especially from October to March, retest yourself against these yardsticks.

It’s not JUST about vitamin D

But it isn’t just vitamin D we need – it’s sunlight.

During the summer months, if you are spending half an hour outdoors, with short sleeves, shorts or even more skin exposure, in the sunlight, even a multivitamin that provides you 800iu (a quarter of what you need in the darker months) might be sufficient.

Sunlight promotes serotonin, the happy neurotransmitter.

Having good vitamin D levels is a vital part of your brain upgrade since it helps optimise your brain’s serotonin levels. That’s because a vital enzyme called TPH, which converts the amino acid tryptophan into serotonin, is enhanced in the brain by vitamin D, and selectively shut down in the gut. So, with sufficient vitamin D you get higher brain levels of serotonin, promoting good mood, and lower serotonin levels in the gut (5), protecting against gut inflammation. 

The other way to boost your light exposure is with light therapy. Canadian researchers compared the effects of an anti-depressant (fluoxetine), placebo or 30 minutes daily of light therapy as soon as possible on waking for people with major depression. Light therapy was both superior to placebo and anti-depressants, which were also no better than placebo. I have a full spectrum light in my study, which I put on in the winter, when I’m writing in the early morning, before the sun comes up.

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Vitamin D and addiction

Interestingly, vitamin D deficiency is also associated with greater opioid addiction (7), suggesting the need to up vitamin D intake to reduce cravings. There’s also something else interesting about vitamin D, sun exposure and addiction. People can become addicted to sunbeds. In relation to opioids, the lower one’s vitamin D levels, the more addictive they become. Sun exposure, which promotes higher vitamin D levels, reduces opioid addiction.

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What to eat?

The best food sources of vitamin D are oily fish and eggs. A serving of salmon or mackerel is likely to give you 400iu of vitamin D. Two eggs will provide about 130iu. In some countries, not the UK, milk is fortified with vitamin D but otherwise, it is not a great source. Some mushrooms are purposely fortified with vitamin D by exposing them to UV light.

In summary, the way up from down is to eat a low GL diet, with plenty of oily fish and eggs, avoid sugar, cut back on stimulants and alcohol, and make sure your daily supplements include omega-3, B vitamins, with extra B12 if your homocysteine level is high, vitamin D, zinc, magnesium, chromium, plus the amino acids 5-HTP with is the precursor of serotonin.

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Vitamin D protects your brain and memory.

Vitamin D deficiency increases the risk of Alzheimer’s (9). In a study in France involving 912 elderly patients followed for 12 years, a total of 177 dementia cases occurred. Those with low vitamin D levels had a nearly three-fold increased risk of Alzheimer’s (10). Supplementing 800iu (20mcg) a day for 12 months has also been shown to improve cognitive function (11). 

Supplements may also help ward off dementia, according to a recent, large-scale study involving over twelve thousand dementia-free 70+ year-olds in the US (12). More than a third (37%) took supplements of vitamin D. Those who did had a 40% lower incidence of dementia. Professor Zahinoor Ismail, of the University of Calgary and University of Exeter, who led the research, said: “We know that vitamin D has some effects in the brain that could have implications for reducing dementia, however so far, research has yielded conflicting results. Overall, we found evidence to suggest that earlier supplementation might be particularly beneficial, before the onset of cognitive decline.”

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Vitamin D helps recovery from strokes and brain injury

Having a higher vitamin D level or supplementing vitamin D at levels above 2,000iu a day also helps people recover from strokes (13) and other forms of brain injury.

I recommend 3,000iu a day or 21,000iu a week in winter but most importantly, monitoring your vitamin D level to keep it above 75nmol/l (30 ng/ml). A level of 100nmol/l may be optimal. That is why testing is so vital as winter approaches. Test again 3 months later so you know if you’re taking enough or too much and that will give you a good gauge as spring approaches when you can probably lower your intake to 600 to 1,000iu depending on sun exposure and diet to top up to over 1,000iu.

Vitamin D is vital in pregnancy and for children

A breastfeeding mother must, at least, supplement omega-3 fish oils and ensure enough B vitamins for homocysteine to be below 7 mcmol/L, but many other nutrients are also necessary. Low vitamin D status in both the mother and newborn baby increases the likelihood of developing autistic spectrum disorder by 54% (14).

Without sufficient nutrients not only do brain cells not make the connections but the production and flow of neurotransmitters doesn’t happen optimally. Bruce Ames, Emeritus professor of Biochemistry and Molecular Biology at the University of California, thinks that “serotonin synthesis, release, and function in the brain are modulated by vitamin D and the 2 marine omega-3 fatty acids, eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA).” He says that ”insufficient levels of vitamin D, EPA, or DHA, in combination with genetic factors and at key periods during development, would lead to dysfunctional serotonin activation and function and may be one underlying mechanism that contributes to neuropsychiatric disorders and depression in children”. (15) 

A study in Northern Ireland found that half of schoolchildren were deficient in vitamin D, with a level below 50nmol/l (I recommend above 75 nmol/l). Another finds that low vitamin D levels in childhood are related to behaviour problems in adolescence (16). Is it any wonder so many children are neurodivergent?

A placebo-controlled trial giving ADHD children magnesium together with vitamin D for eight weeks showed a major reduction in emotional, conduct and peer problems and improved socialisation compared with children treated with the placebo (17).

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The bottom line – we all need to supplement vitamin D

The bottom line is everyone, from children to older people, and especially anyone considering pregnancy, suffering with low mood or memory problems, must test their vitamin D, ideally, at the start of winter to guide them as to what to supplement, during winter perhaps at 3 months, and 6 months later, to learn what amount of vitamin D supplementation they need in summer and winter.

In summary, you want to get your blood level above 75nmol/l (30 ng/ml) which usually means supplementing 3,000iu from October to March for those in the Northern Hemisphere. The optimal level is, however,  likely to be above 100nmol/l (40mg/ml).  Your need for vitamin D is likely to be greater if you are overweight and have darker skin and live further North.

When spring returns, and throughout summer, 1,000iu a day may be enough depending on your sun exposure.

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.

References

¹ Jayedi A, Rashidy-Pour A, Shab-Bidar S. Vitamin D status and risk of dementia and Alzheimer’s disease: A meta-analysis of dose-response †. Nutr Neurosci. 2019 Nov;22(11):750-759. doi: 10.1080/1028415X.2018.1436639. Epub 2018 Feb 15. PMID: 29447107

² Jorde R, Sneve M, Figenschau Y, Svartberg J, Waterloo K. Effects of vitamin D supplementation on symptoms of depression in overweight and obese subjects: randomized double blind trial. J Intern Med. 2008 Dec;264(6):599-609. doi: 10.1111/j.1365-2796.2008.02008.x. Epub 2008 Sep 10. PMID: 18793245.

³ Khoraminya N, Tehrani-Doost M, Jazayeri S, Hosseini A, Djazayery A. Therapeutic effects of vitamin D as adjunctive therapy to fluoxetine in patients with major depressive disorder. Aust N Z J Psychiatry. 2013 Mar;47(3):271-5. doi: 10.1177/0004867412465022. Epub 2012 Oct 23. PMID: 23093054. Xxxx check the some in 5 days

⁴ Mozaffari-Khosravi H, Nabizade L, Yassini-Ardakani SM, Hadinedoushan H, Barzegar K. The effect of 2 different single injections of high dose of vitamin D on improving the depression in depressed patients with vitamin D deficiency: a randomized clinical trial. J Clin Psychopharmacol. 2013 Jun;33(3):378-85. doi: 10.1097/JCP.0b013e31828f619a. PMID: 23609390.

⁵ Patrick RP, Ames BN. Vitamin D hormone regulates serotonin synthesis. Part 1: relevance for autism. FASEB J. 2014 Jun;28(6):2398-413. doi: 10.1096/fj.13-246546. Epub 2014 Feb 20. PMID: 24558199.

⁶ Lam RW, Levitt AJ, Levitan RD, Enns MW, Morehouse R, Michalak EE, Tam EM. The Can-SAD study: a randomized controlled trial of the effectiveness of light therapy and fluoxetine in patients with winter seasonal affective disorder. Am J Psychiatry. 2006 May;163(5):805-12. doi: 10.1176/ajp.2006.163.5.805. PMID: 16648320.Psychiary, No015

⁷ Kemény LV, Robinson KC, Hermann AL, Walker DM, Regan S, Yew YW, Lai YC, Theodosakis N, Rivera PD, Ding W, Yang L, Beyer T, Loh YE, Lo JA, van der Sande AAJ, Sarnie W, Kotler D, Hsiao JJ, Su MY, Kato S, Kotler J, Bilbo SD, Chopra V, Salomon MP, Shen S, Hoon DSB, Asgari MM, Wakeman SE, Nestler EJ, Fisher DE. Vitamin D deficiency exacerbates UV/endorphin and opioid addiction. Sci Adv. 2021 Jun 11;7(24):eabe4577. doi: 10.1126/sciadv.abe4577. PMID: 34117054; PMCID: PMC8195487.

⁸ Jayedi A, Rashidy-Pour A, Shab-Bidar S. Vitamin D status and risk of dementia and Alzheimer’s disease: A meta-analysis of dose-response †. Nutr Neurosci. 2019 Nov;22(11):750-759. doi: 10.1080/1028415X.2018.1436639. Epub 2018 Feb 15. PMID: 29447107

⁹ Chai B, Gao F, Wu R, Dong T, Gu C, Lin Q, Zhang Y. Vitamin D deficiency as a risk factor for dementia and Alzheimer’s disease: an updated meta-analysis. BMC Neurol. 2019 Nov 13;19(1):284. doi: 10.1186/s12883-019-1500-6. PMID: 31722673; PMCID: PMC6854782.

10 Jia J, Hu J, Huo X, Miao R, Zhang Y, Ma F. Effects of vitamin D supplementation on cognitive function and blood Aβ-related biomarkers in older adults with Alzheimer’s disease: a randomised, double-blind, placebo-controlled trial. J Neurol Neurosurg Psychiatry. 2019 Dec;90(12):1347-1352. doi: 10.1136/jnnp-2018-320199. Epub 2019 Jul 11. PMID: 31296588.

11 Feart C, Helmer C, Merle B, Herrmann FR, Annweiler C, Dartigues JF, Delcourt C, Samieri C. Associations of lower vitamin D concentrations with cognitive decline and long-term risk of dementia and Alzheimer’s disease in older adults. Alzheimers Dement. 2017 Nov;13(11):1207-1216. doi: 10.1016/j.jalz.2017.03.003. Epub 2017 May 16. PMID: 28522216.

12 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.

13 Marek K, Cichoń N, Saluk-Bijak J, Bijak M, Miller E. The Role of Vitamin D in Stroke Prevention and the Effects of Its Supplementation for Post-Stroke Rehabilitation: A Narrative Review. Nutrients. 2022 Jul 4;14(13):2761. doi: 10.3390/nu14132761. PMID: 35807941; PMCID: PMC9268813.

14 Wang Z, Ding R, Wang J. The Association between Vitamin D Status and Autism Spectrum Disorder (ASD): A Systematic Review and Meta-Analysis. Nutrients. 2020 Dec 29;13(1):86. doi: 10.3390/nu13010086. PMID: 33383952; PMCID: PMC7824115.

15 Patrick RP, Ames BN. Vitamin D and the omega-3 fatty acids control serotonin synthesis and action, part 2: relevance for ADHD, bipolar disorder, schizophrenia, and impulsive behavior. FASEB J. 2015 Jun;29(6):2207-22. doi: 10.1096/fj.14-268342. Epub 2015 Feb 24. PMID: 25713056.

16 Sonia L Robinson, Constanza Marín, Henry Oliveros, Mercedes Mora-Plazas, Betsy Lozoff, Eduardo Villamor, Vitamin D Deficiency in Middle Childhood Is Related to Behavior Problems in Adolescence, The Journal of Nutrition, Volume 150, Issue 1,

2020, Pages 140-148, ISSN 0022-3166, https://doi.org/10.1093/jn/nxz185.

17 Hemamy M, Pahlavani N, Amanollahi A, Islam SMS, McVicar J, Askari G, Malekahmadi M. The effect of vitamin D and magnesium supplementation on the mental health status of attention-deficit hyperactive children: a randomized controlled trial. BMC Pediatr. 2021 Apr 17;21(1):178. doi: 10.1186/s12887-021-02631-1. Erratum in: BMC Pediatr. 2021 May 12;21(1):230. PMID: 33865361; PMCID: PMC8052751.

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By Patrick Holford

Life is a balancing act between making energy by combusting glucose or ketones with oxygen, which generates ‘oxidant’ exhaust fumes and dealing with these ‘oxidant fumes’ which harm the body.

Skin goes crinkly, age spots develop all due to oxidation. That’s what makes apples go brown, leaves change colour and iron rust. In the end, we lose, which is why all oxygen-based life forms have a finite life – and why your brain and body do inevitably age.

However, you can not only add years to your life, but also life to your years by improving your intake of antioxidants and polyphenols found in whole foods, fruits, vegetables and herbs and spices. A study in Finland and Sweden compared those with a ‘healthy’ versus ‘unhealthy’ diet in mid-life for future risk of developing Alzheimer’s disease and dementia 14 years later (1). Those who ate the healthiest diet had an 86-90% decreased risk of developing dementia and a 90-92% decreased risk of developing Alzheimer’s disease. Some of the benefit comes from low sugar diets, high in omega-3 and B vitamins and some from foods high in antioxidants and polyphenols which we will focus on here.

Your intake of these versus your intake and generation of oxidants, for example from smoking and pollution, is a major determinant of brain health. An illustration of this is the fact that both smoking and pollution exposure increase risk of cognitive decline and dementia, while vitamin C, which is the antioxidant par excellence, reduces risk.

(This is why we have developed our brand new Glutathione at home blood test – the first of its kind where you can accurately test your antioxidant status from home and support our further research into this important area. You can find out more and pre order the test here )

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Oxidants vs antioxidants – moving the balance in your favour

Smoking increases risk of Alzheimer’s just as much as having low B vitamin or omega-3 status, according to the US National Institute of health’s analysis (2). Smoking is something a person can easily change. Air pollution, for many, is not. It is measured in the amount of particulate matter (PMs) and people living in polluted cities are exposed to more. A study of women living in cities in the US found that those exceeding the ‘safe’ levels (greater than 12 μg/m3) had ‘increased the risks for global cognitive decline and all-cause dementia respectively by 81% and 92%’. (3)

While you may not be able to change where you live, can you mitigate the effects of pollution? The answer is yes – in two ways. Firstly, by increasing your intake of antioxidants and also by improving your B vitamin status since the body detoxifies many toxins, including toxic metals from lead to mercury, by methylation. A similar study to the one above found that residing in locations with PM exposure above the safe level was associated with a higher risk of dementia but only among people with lower intakes of the homocysteine lowering B vitamins (B6, folate, b12) (4). ‘Vitamin C in the diet or taken as supplements might help’ concludes another.(5)

Smokers need at least twice as much vitamin C as non-smokers just to have basic vitamin C levels in their blood (serum). Men do worse than women. Even with an intake of 200mg a day they do not achieve this basic blood level, which is already two to three times the recommended dietary intake and what you’d get in four oranges (6). It is certainly wise for any smoker to supplement vitamin C, perhaps adding 50mg per cigarette – 500mg if you smoke 10 a day, although there is a good case for everyone to supplement 1,000mg a day, or 2,000mg a day if over 50.

Nature always provides a solution to help us with our evolution. It seems obvious to me we need vitamin C to combat excessive pollution.

Vitamin C is a keystone nutrient as far as swinging the antioxidant equation in your favour. It’s made in all living things, from animals to plants, including yeasts and funghi. It’s probably been the essential ‘exhaust recycler’ of all oxygen-based lifeforms. Production is even activated when oxidants are sensed. Animals also make more when stressed or exposed to viruses. Us humans, and all other primates, are one of very few species who can’t make it. The first non-vitamin C making animal to be discovered was the guinea pig. That’s how it became the ‘guinea pig’ for research since, like us, it’s dependent every second of every day on vitamin C from diet. Bats, a few birds and the teleost family of fish have also lost the ability to make vitamin C. 

You’ll see in this figure below and from watching the film above, that vitamin C disarms water-based oxidants, such as smoke, and vitamin E disarms fat-based oxidants such as burnt fat. Then, there are other key antioxidant team players that help to neutralise the reactive oxidants that damage our brain and body.

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Your best bet is probably to both eat a diet with 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 (7) – protects the memory-friendly neurotransmitter acetylcholine and dampens down brain oxidation and inflammation)
Glutathione (8) or N-acetyl Cysteine (NAC)(9) – protects the brain and improves methylation thus having potential in dementia prevention.
Co-enzyme Q10 – protects the mitochondria in the brain from oxidative stress (10)
Resveratrol – resveratrol has antioxidant, anti-inflammatory and neuroprotective properties and prevents hippocampal brain damage. (11)

It doesn’t really make a lot of sense to supplement one without the others.

Individually, their impact on your brain health may be less than when combined. A study of 4,740 Cache County Utah elderly residents found that those supplementing both vitamin E and C cut their risk of developing Alzheimer’s by two thirds. Taking either cut risk by a quarter (12). 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 (13).

All those listed above – vitamin C, E, glutathione and N-acetyl cysteine, Coenzyme Q10 and resveratrol – work together and are often found in combined antioxidant supplement formulas. There are many other team player ‘cousins’ from B vitamins to minerals such as magnesium, selenium and zinc found respectively in greens, seafood, nuts and seeds.

There are two ways to increase your intake – through food and from supplements. Foods can be measured for their ‘Total Antioxidant Capacity’ or TAC for short. It’s worked out from an equation involving eight key antioxidants from vitamin A, carotenes (think carrots), lycopenes (rich in tomatoes), lutein and zeaxanthine (rich in green vegetables), vitamin E (is nuts and seeds), but most of all vitamin C (rich in berries, broccoli, peppers and other vegetables).

(Click here to read our guidance on supplements)

The higher the TAC score of your diet the lower is your risk of cognitive and memory decline. This was the finding of a recent study of 2,716 people over age 60. The researchers measured the TAC score from their diet, splitting them into the highest to lowest quarter of TAC score, and compared this to a number of memory tests. Those in the highest quarter, eating the most antioxidant-rich foods had half the risk of decreasing memory. The higher the TAC score the better their memory function was. (14)

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Go Rainbow, ‘Mediterranean’ and eat five or more servings of fruit and vegetables a day

So, what do you need to eat and drink to preserve your memory and protect your brain?

Basically, eat a Mediterranean style ‘rainbow coloured’ diet. A Mediterranean diet has more fish, less meat and dairy, more olive oil, fruit and vegetables including tomatoes, legumes (beans and lentils) and whole grain cereals than a standard Western diet. It also includes small quantities of red wine. There are variations of this kind of diet, called the MIND diet and the DASH diet, but the core components are the same and as researchers drill down, we are learning what to eat and drink to keep your mind sharp and brain young, and how much.

The trick is to really start thinking of the colours you’re eating and gravitate for the strong colours.

Mustard and turmeric, for example, are strong yellows. Dijon mustard is great – no sugar. But if you like good old-fashioned English mustard go for it. Have a teaspoon every other day.

Add turmeric to almost any steam-fry, curry or soup. 

Bright oranges include butternut squash, sweet potato, carrots – but do buy organic. Translucent mass produced carrots are tasteless and have a higher water content, ie less actual carrot. 

Tomatoes are particularly good for you. Buy seeded, not seedless watermelons. Blend the flesh in a blender, perhaps with some ice. The black husk of the seeds drops to the bottom. The flesh of the seeds, full of essential nutrients, becomes part of this mouth-wateringly refreshing drink. Great for detox. Strawberries are a low GL fruit. Red, yellow, green and orange peppers are all rich in vitamin C.

Anything purple, magenta or blue is brilliant for you. From beetroots (eat them raw, grated into salads) to blueberries, blackberries and raspberries. Strawberries are particularly good. According to a study, part of the Rush Memory and Aging Project at Rush University, Chicago, having a higher intake cut Alzheimer’s risk by a quarter. They are high in both vitamin C and flavanoids, a high level of which were also confirmed to cut risk by a third. (15)

Strong greens are always beneficial – from spinach, kale, Brussels sprouts, broccoli, tender stem, watercress, rocket, asparagus, artichoke, green beans, peas, kohlrabi, and cauliflower (although not green).

Polyphenol power

Some of these foods are particularly rich in ‘polyphenols’ a group of health promoting molecules which also includes flavonoids, sometimes called flavanols.  Blue foods such as blueberries contain another polyphenol called anthocyanins. Tea, the cacao in chocolate, red wine, red onions, olives and all the blueish berries are rich sources of polyphenols. Many of these polyphenol rich foods act as antioxidants but they do much more than this. They improve circulation in the brain, lower blood pressure and dampen down inflammation which lies behind many conditions from depression to dementia. Once again, the principle of what’s good for the heart is good for the brain.

One of the first important studies was carried out in Norway more than a decade ago by Eha Nurk and Helga Refsum and colleagues in Norway. (16)(17) They found that:

Tea – the more you drink the better. The tea benefit has been confirmed more recently in a study in Singapore, with green tea being marginally better than black tea.(18) However, this benefit was not found in a UK Biobank study, which reported tea and coffee drinking to be associated with worsening cognition compared to abstainers. (19)

Chocolate – peaks at 10g, or about 3 pieces – and let’s say dark, 70 or more percent, thus with less sugar, is likely to be better, as sugar is a strong indicator of cognitive decline. If a chocolate is 80% cacao that means almost 20% will be sugar. More recent studies giving cocoa, a rich source of flavanols, have shown improved cognition, possibly by improving circulation.(20) This has been confirmed in a big COSMOS trial involving over 20,000 people given a cacao extract supplement rich in flavanols versus a placebo for five years. (21) The reduction in cardiovascular risk was even greater than that of a Mediterranean diet.

Wine – consumption reduces risk of cognitive decline up to an intake of 125ml a day, which is a small glass. A thorough study in the British Medical Journal in 2018, which had followed over 9,000 people over 23 years, showed 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, also increases risk (22). This is consistent with studies showing that a small glass of wine a day decreases risk of cardiovascular disease. Red wine, high in resveratrol is likely to be most beneficial.

All the above are rich in a polyphenol called epicatechin. Jeremy Spencer, an advisor to Food for the Brain, who is Professor of Nutritional Biochemistry and Medicine at the University of Reading, where he specialises in studying the health benefits of polyphenols and other compounds in plants, has shown that these polyphenol rich plants improve blood brain flow in specific regions of the brain that improve attention, decision-making, impulse control and emotion, thus improving overall ‘executive’ function (23). What’s more, the level of flavanols you have in your bloodstream predicts your memory. The biggest impact of increasing flavanols, was seen in the COSMOS study, in those in the lowest third for dietary intake specifically seeing improvement in aspects of memory that link to the hippocampus, that central area of the brain that degenerates in Alzheimer’s (24).

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The Best Fruit and Veg to Eat for Your Brain

Which vegetables pack the biggest punch as far as polyphenols and antioxidants are concerned and are also lower in sugar or low GL?

Taking all these factors into account – the GL, antioxidants and polyphenols these are the dozen best rated fruit and veg. But do not think of this list as finite as more and more research reveals the amazing healing power of nature’s fruits and vegetables.

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The optimal intake for brain protection is 5 to 6 servings of fruit and veg a day. 

Half a plate of a main meal counts as two. A handful of berries would count as one. So, if half your plate for two main meals is vegetables, and you had some berries with your breakfast and another piece of fresh fruit or perhaps some broccoli heads or tenderstem or carrots dipped in hummus as a snack, or half an avocado with some high polyphenol olive oil, you’ve achieved six servings.

The first step is to eat ‘whole’ foods, and especially fresh plant foods with an emphasis on those listed above that are more likely to be high in antioxidants and polyphenols. (Also see the Alzheimers Prevention Diet.) There are some nutrients such as vitamin C for which just eating whole foods doesn’t guarantee you are achieving an optimal intake and are well worth supplementing.

My advice is to supplement 500mg to 1,000mg of vitamin C twice a day and also take an antioxidant formula or antioxidant rich multivitamin containing vitamins A, C, E, lipoic acid, glutathione or NAC, resveratrol and CoQ10.

Summary

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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.

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References

Eskelinen MH, Ngandu T, Tuomilehto J, Soininen H, Kivipelto M. Midlife healthy-diet index and late-life dementia and Alzheimer’s disease. Dement Geriatr Cogn Dis Extra. 2011 Jan;1(1):103-12. doi: 10.1159/000327518. Epub 2011 Apr 27. PMID: 22163237; PMCID: PMC3199886.
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 Jun 24;14:643. doi: 10.1186/1471-2458-14-643. PMID: 24962204; PMCID: PMC4099157.
Cacciottolo M, Wang X, Driscoll I, Woodward N, Saffari A, Reyes J, Serre ML, Vizuete W, Sioutas C, Morgan TE, Gatz M, Chui HC, Shumaker SA, Resnick SM, Espeland MA, Finch CE, Chen JC. Particulate air pollutants, APOE alleles and their contributions to cognitive impairment in older women and to amyloidogenesis in experimental models. Transl Psychiatry. 2017 Jan 31;7(1):e1022. doi: 10.1038/tp.2016.280. PMID: 28140404; PMCID: PMC5299391.
 Chen C, Whitsel EA, Espeland MA, Snetselaar L, Hayden KM, Lamichhane AP, Serre ML, Vizuete W, Kaufman JD, Wang X, Chui HC, D’Alton ME, Chen JC, Kahe K. B vitamin intakes modify the association between particulate air pollutants and incidence of all-cause dementia: Findings from the Women’s Health Initiative Memory Study. Alzheimers Dement. 2022 Nov;18(11):2188-2198. doi: 10.1002/alz.12515. Epub 2022 Feb 1. PMID: 35103387; PMCID: PMC9339592.
 Yu JT, Xu W, Tan CC, Andrieu S, Suckling J, Evangelou E, Pan A, Zhang C, Jia J, Feng L, Kua EH, Wang YJ, Wang HF, Tan MS, Li JQ, Hou XH, Wan Y, Tan L, Mok V, Tan L, Dong Q, Touchon J, Gauthier S, Aisen PS, Vellas B. Evidence-based prevention of Alzheimer’s disease: systematic review and meta-analysis of 243 observational prospective studies and 153 randomised controlled trials. J Neurol Neurosurg Psychiatry. 2020 Nov;91(11):1201-1209. doi: 10.1136/jnnp-2019-321913. Epub 2020 Jul 20. PMID: 32690803; PMCID: PMC7569385.
 Carr AC, Lykkesfeldt J. Factors Affecting the Vitamin C Dose-Concentration Relationship: Implications for Global Vitamin C Dietary Recommendations. Nutrients. 2023 Mar 29;15(7):1657. doi: 10.3390/nu15071657. PMID: 37049497; PMCID: PMC10096887.
 A. Maczurek, et al., ‘Lipoic acid as an anti-inflammatory and neuroprotective treatment for Alzheimer’s disease’, Advance Drug Delivery Review, 2008;60(13-14):1463-70 
 Pocernich CB, Butterfield DA. Elevation of glutathione as a therapeutic strategy in Alzheimer disease. Biochim Biophys Acta. 2012 May;1822(5):625-30. doi: 10.1016/j.bbadis.2011.10.003. Epub 2011 Oct 12. PMID: 22015471; PMCID: PMC3277671.
 Hara Y, McKeehan N, Dacks PA, Fillit HM. Evaluation of the Neuroprotective Potential of N-Acetylcysteine for Prevention and Treatment of Cognitive Aging and Dementia. J Prev Alzheimers Dis. 2017;4(3):201-206. doi: 10.14283/jpad.2017.22. PMID: 29182711.
 Yang X, Zhang Y, Xu H, Luo X, Yu J, Liu J, Chang RC. Neuroprotection of Coenzyme Q10 in Neurodegenerative Diseases. Curr Top Med Chem. 2016;16(8):858-66. doi: 10.2174/1568026615666150827095252. PMID: 26311425.
 Gomes BAQ, Silva JPB, Romeiro CFR, Dos Santos SM, Rodrigues CA, Gonçalves PR, Sakai JT, Mendes PFS, Varela ELP, Monteiro MC. Neuroprotective Mechanisms of Resveratrol in Alzheimer’s Disease: Role of SIRT1. Oxid Med Cell Longev. 2018 Oct 30;2018:8152373. doi: 10.1155/2018/8152373. PMID: 30510627; PMCID: PMC6232815.
 Basambombo LL, Carmichael PH, Côté S, Laurin D. Use of Vitamin E and C Supplements for the Prevention of Cognitive Decline. Ann Pharmacother. 2017 Feb;51(2):118-124. doi: 10.1177/1060028016673072. Epub 2016 Oct 5. PMID: 27708183.
 See reference 5.
 Peng, M., Liu, Y., Jia, X. et al. Dietary Total Antioxidant Capacity and Cognitive Function in Older Adults in the United States: The NHANES 2011–2014. J Nutr Health Aging 27, 479–486 (2023). https://doi.org/10.1007/s12603-023-1934-9
 Agarwal P, Holland TM, Wang Y, Bennett DA, Morris MC. Association of Strawberries and Anthocyanidin Intake with Alzheimer’s Dementia Risk. Nutrients. 2019 Dec 14;11(12):3060. doi: 10.3390/nu11123060. PMID: 31847371; PMCID: PMC6950087.
 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.
 Nurk E, Refsum H, Drevon CA, Tell GS, Nygaard HA, Engedal K, Smith AD. Cognitive performance among the elderly in relation to the intake of plant foods. The Hordaland Health Study. Br J Nutr. 2010 Oct;104(8):1190-201. doi: 10.1017/S0007114510001807. Epub 2010 Jun 16. PMID: 20550741.
 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.
 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.
 Lamport DJ, Pal D, Moutsiana C, Field DT, Williams CM, Spencer JP, Butler LT. The effect of flavanol-rich cocoa on cerebral perfusion in healthy older adults during conscious resting state: a placebo controlled, crossover, acute trial. Psychopharmacology (Berl). 2015 Sep;232(17):3227-34. doi: 10.1007/s00213-015-3972-4. Epub 2015 Jun 7. PMID: 26047963; PMCID: PMC4534492.
 Sesso HD, Manson JE, Aragaki AK, Rist PM, Johnson LG, Friedenberg G, Copeland T, Clar A, Mora S, Moorthy MV, Sarkissian A, Carrick WR, Anderson GL; COSMOS Research Group. Effect of cocoa flavanol supplementation for the prevention of cardiovascular disease events: the COcoa Supplement and Multivitamin Outcomes Study (COSMOS) randomized clinical trial. Am J Clin Nutr. 2022 Jun 7;115(6):1490-1500. doi: 10.1093/ajcn/nqac055. PMID: 35294962; PMCID: PMC9170467.
 Sabia S, Fayosse A, Dumurgier J, Dugravot A, Akbaraly T, Britton A, Kivimäki M, Singh-Manoux A. Alcohol consumption and risk of dementia: 23 year follow-up of Whitehall II cohort study. BMJ. 2018 Aug 1;362:k2927. doi: 10.1136/bmj.k2927. PMID: 30068508; PMCID: PMC6066998.
 See Professor Peremy Spencer’s presentation at the Alzheimer’s is preventable masterclass (2022); also see Spencer JP. The impact of fruit flavonoids on memory and cognition. Br J Nutr. 2010 Oct;104 Suppl 3:S40-7. doi: 10.1017/S0007114510003934. PMID: 20955649.
 Brickman AM, Yeung LK, Alschuler DM, Ottaviani JI, Kuhnle GGC, Sloan RP, Luttmann-Gibson H, Copeland T, Schroeter H, Sesso HD, Manson JE, Wall M, Small SA. Dietary flavanols restore hippocampal-dependent memory in older adults with lower diet quality and lower habitual flavanol consumption. Proc Natl Acad Sci U S A. 2023 Jun 6;120(23):e2216932120. doi: 10.1073/pnas.2216932120. Epub 2023 May 30. PMID: 37252983; PMCID: PMC10265949.

This was the title of a report in the British Medical Journal (1), pointing out that choline is an essential nutrient, much like omega-3 fats, that is vital for health and especially the brain, but not sufficiently supplied in many people’s diets, and especially those who are largely vegan.

While the body can make a little, it does not make enough and thus choline is being reclassified as an essential nutrient with an adequate intake defined as between 400mg and 520mg a day, the latter for pregnant and breast-feeding women. But these levels don’t relate to brain function. They relate to the EFSA allowed claims of “choline is needed for lipids metabolism”, “maintaining healthy liver functioning” and “reduction in homocysteine levels”. You need choline to do the right thing with cholesterol in the liver. 

But even more important is choline’s role in building and maintaining a healthy brain. A pregnant woman’s intake defines the cognitive abilities of their child. Twenty years ago we knew that pregnant rats fed choline half way through their pregnancy have more connections between brain cells, plus improved learning ability and better memory recall. Now we know it’s true for babies. In fact, a lack of choline can lead to a shrinking of a woman’s brain as the foetus robs their brain to build its own – a case of ‘Mummy I shrank your brain’. Babies are born with blood choline levels three times higher than their mother, illustrating how vital this nutrient is for building neuronal connections, which newborn babies do at a rate of up to a million new connections a second! An optimal intake for brain function is likely to be a lot higher than the 400mg recommended for adults.

Brain cells are made of a membrane containing choline (and other phospholipids) attached to the omega-3 fat DHA. Without choline the omega-3 doesn’t work. The attaching of the two depends on methylation, a process that is dependent on B vitamins, especially B12, folate and B6. Choline helps methylation and healthy methylation, indicated by low homocysteine, helps synthesize choline.

The reason the BMJ says ‘crisis’ is that more people are eating a plant-based diet and shunning eggs, fish and meat, which are the best sources of, not only choline, but also B12. There’s a tiny bit of choline in broccoli and in nuts, but not enough. An egg provides around 120mg, a 50g beef or salmon steak around 50mg. The same amount of almonds or broccoli is about 25mg. Cow’s milk has a little, but a fraction of that found in human milk. Beef liver is the richest source.

Twenty years ago I found the evidence sufficiently compelling to recommend eating an egg a day, three servings of fish and one of meat (or another portion of fish) a week, a handful of nuts, plus daily supplementation of circa 100mg, which is what I do in my ‘brain food’ formula. If you also ate a serving of broccoli a day, you’d be achieving something like 2,100mg a week, or 300mg a day – still short of daily requirements.

If you don’t eat eggs, fish or meat and don’t supplement there’s no way of getting even close. That’s why it’s time to add choline, along with omega-3 DHA and B12, to the list of nutrients that must be supplemented by those eating a vegan diet. Lecithin granules and capsules are the richest vegan source of choline, derived from soya. It will not work in building the brain, without a source of DHA which can be derived, in supplements, from algae or seaweed. 

If you want more strategies on what to eat and do to support ad upgrade your brain make sure you complete the Cognitive Function Test below to get your plan of action for improving your brain over the next 6 months.

Reference:

Derbyshire E. ‘Could we be overlooking a potential choline crisis in the United Kingdom?’ BMJ Nutrition, Prevention and Health, 2019; 0:1–4

Neurons, that is brain and nerve cells, are primarily made out of what’s called ‘phosphorylated DHA’. That means the omega-3 fat DHA that is bound to a kind of fat called a phospholipid, as shown in the figure below. 

Seafood contains phosphorylated DHA but DHA supplements, whether derived from fish oil or algae, is not phosphorylated. Hence, it needs to be attached to phospholipids to work. This attachment is done by a B vitamin dependent process called methylation. 

There are several different kinds of phospholipids with strange names all starting with ‘phosphatidyl’ such as phosphatidyl choline, phosphatidyl serine, phosphatidyl inositol and phosphatidyl ethanolamine.  To a large extent these can be made from phosphatidyl choline. As a group of nutrients they are classified as ‘semi-essential’ because we can make some, but not enough for optimal health and especially optimal brain health. 

As a consequence there are moves afoot to classify choline (which can be easily attached to the ‘phosphatidyl’ part) as an essential nutrient with a recommended intake. This has come about due to the growing evidence that insufficient choline in pregnancy leads to cognitive impairment and developmental delay. This is particularly important for vegans because, like the omega-3 fatty acid DHA, there’s not much choline in plant-based foods, but there is some in foods such as quinoa, soya, beans, nuts and broccoli.

Currently an adequate intake of choline is defined as between 400mg and 520mg a day, the latter for pregnant and breast-feeding women. This is based on how much choline you need for healthy fat metabolism, liver function and reducing homocysteine levels. You also need choline to process cholesterol in the liver and brain. As you’ll see in the figure above, cholesterol is a vital brain component. But these levels don’t take into account what’s being learnt about choline’s role in brain development.. A good estimate of optimum daily choline intake would be at least 500mg and maybe double this in pregnancy. 

Most important is choline’s role in building, and maintaining, a healthy brain. A pregnant woman’s intake defines the cognitive abilities of their child. Twenty years ago we knew that pregnant rats fed choline half way through their pregnancy have more connections between brain cells, plus improved learning ability and better memory recall. Now we know it’s true for babies with several recent trials showing similar results indicating that more choline in pregnancy enhances cognitive development.

An example of this is a study which gave women in their third trimester of pregnancy either 480mg of choline or almost double this – 930mg. They then tested the babies’ information processing speed at 4,7,10 and 13 months. Not only were the babies of the mothers given the higher dose faster but also the longer the mother had been given even the lower dose the faster were the child’s reactions. The authors concluded that “even modest increases in maternal choline intake during pregnancy may produce cognitive benefits for offspring ”. Seven years later, there will still memory advantages in the children whose mother had extra choline during pregnancy.

Babies are born with blood choline levels three times higher than their mother, illustrating how vital this nutrient is for building neuronal connections, which newborn babies do at a rate of up to a million new connections a second! An optimal intake for brain function is likely to be a lot higher than the 400 to 500mg recommended for adults, and higher still in pregnancy.

Since brain cells are made of a membrane containing choline (and other phospholipids) attached to the omega-3 fat DHA, without choline the omega-3 doesn’t work. The attaching of the two depends on methylation, a process that is dependent on B vitamins, especially B12, folate and B6. Choline helps methylation and healthy methylation, indicated by a low blood level of homocysteine, helps synthesize choline. You need all three – DHA, choline and B vitamins especially B12. So, if you are lacking in DHA, or in vitamin B12, then you’ll be doubly dependent on getting enough choline.

Choline rich foods – are vegans at risk of deficiency? 

While the richest dietary sources are fish, eggs and organ meats there is significant amounts of choline in plant-based foods, notably soya as in tofu and soya milk, quinoa, nuts and seeds including flax seeds, almonds and peanuts, and cruciferous vegetables including broccoli, cauliflower and Brussels sprouts.

While, on the face of it, it does appear than vegans, especially those planning pregnancy, need to become choline focused in relation to choosing the right daily foods, and possibly supplementing, there is not yet conclusive evidence showing that vegan mothers are at risk, although it is likely that they are. One of the learnings that has come out of studies on omega-3 DHA is than vegan mothers may convert more vegan omega-3 ALA into DHA as an evolutionary imperative – not that a top up with supplementation isn’t still the recommendation. Could it be that vegan mothers make more choline if needed since it is so important for brain development? There are very few studies of vegans to know the answer to this question.

One recent study looked at choline levels in breast-milk of vegans, versus vegetarians and non-vegetarians. There was no significant difference with the author of the study concluding “This suggests that maternal plant-based diet by itself is not a risk factor for low breast-milk choline.” 

The vegan community is certainly divided on this issue. Of course, the safe or cautious position, while the science unravels, is to supplement choline during pregnancy.

What intake of choline can you achieve from a vegan diet alone? Here’s a list of the best plant-based food for choline, compared to egg and fish as a yardstick, listed in order of how much you could get in a reasonable serving*:

FOOD CHOLINE PER SERVING PER 100g

An egg (all in the yolk) 50g 113mg  226mg

Fish eg salmon (100g/3oz) 90mg 90mg

Soya milk (cup – 250g) 57mg 23mg

Shiitake mushrooms (1 cup/145g) 54mg 37mg

Soya flour 12.5g (a cake slice) 24mg 192mg

Peas (1 cup -160g) 47mg 30mg

Quinoa, raw (1/3 cup 60g) 42mg 70mg 

Beans, raw (1/3 cup – 60g) 40mg 67mg

black, white, pinto, kidney

Broccoli, cauliflower 

or sprouts (1 cup/91g) 36mg 40mg  

Tofu (half a cup-125g) 35mg  28mg

Hummus (1/2 cup) 34mg 28mg

Chickpeas (1/4 can) 33mg 33mg

Baked beans (1/4 can) 31mg 31mg

Flaxseeds (small handful) 22mg 78mg

Pistachio (small handful) 20mg 71mg

Pine nuts (small handful) 18mg 65mg

Cashews (small handful) 17mg 61mg

Wholegrain bread (2 slices – 50g) 17mg 34mg

Avocado (1/2) 14mg 28mg

Almonds 50g (small handful) 12mg 42mg

Peanuts (small handful) 12mg 42mg

Wheatgerm (tablespoon 7g) 12mg 178mg

Almonds or peanut butter (tbsp) 10mg 61mg

Source: USDA choline content database and https://nutritiondata.self.com

*Many foods have not been analysed for choline, and measurements do vary, so this is a guide rather than a definitive list.

What does this mean for your daily diet? Here’s a typical vegan daily menu aimed to maximise choline intake and how much it would give you (I’m not including all foods and recipes, just those ingredient that deliver significant amount of choline):

BREAKFAST

A cup of soya milk 57mg

Small handful of nuts or seeds 20mg

(Flax, chia, almonds etc)

LUNCH

A cup of cooked quinoa (1/3 cup raw) 43mg

A serving (100g) of either broccoli, 36mg

cauliflower or Brussels sprouts

Avocado (1/2) 14mg

SNACKS

A tablespoon of almond or peanut butter 10mg

Hummus (1/2 cup) 34mg

Two slices of wholegrain bread 17mg

DINNER

A serving of tofu (125g) or beans 35-40mg

Half a cup of shiitake mushrooms 27mg

A serving (100g) of either broccoli, 36mg

cauliflower or Brussels sprouts

TOTAL 332mg

In reality you are unlikely to achieve this every day, and it would be quite limiting on your food choices, so a realistic target would be to achieve 300mg of choline from food. If you are aiming to achieve 500mg, which is the low end of optimal – more than this may be optimal in pregnancy – that leaves a shortfall of around 200mg of choline, suggesting the need for supplementation.

The most direct source of choline is from soya-derived lecithin granules and capsules. A flat tablespoon of lecithin granules (7.5g), which has a neutral and pleasant taste and can be sprinkled on cereals, in shakes and soups or eaten as is, provides 1,500 mg of phosphatidylcholine and around 200mg (13 per cent) of choline. Some ‘high phosphatidyl choline’ lecithin, sometimes called ‘high PC lecithin’ is 18 per cent choline, thus you need less – approximately a flat dessertspoon.

One tablespoon of lecithin granules equals three 1,200mg lecithin capsules (if ‘high PC’ two capsules would suffice). We suggest that this is a sensible addition to a completely vegan diet. (If you aspire to be plant-based most, but not all of the time the addition of two eggs, or an egg and a fish serving, would achieve 500mg a day of choline.)

You can also find ‘brain food’ supplements providing a combination of different kinds of phospholipids, not just choline, but its hard to get enough choline from these if your only other food sources are plant-based foods. 

In summary, we need both omega-6 and omega-3 fats, as well as phospholipids.

Have one or two servings a day of dark green, leafy veg – especially those that grow in colder climates such a kale, broccoli, brussels sprouts, or a serving of seaweed as sources of both choline and omega-3.
Have a serving of quinoa, beans or tofu every day, if not two, for choline.
Have a dessertspoon of high PC lecithin, or two capsules of high PC lecithin granules every day. These guidelines are especially important if you are planning a pregnancy, pregnant or breast-feeding.

If you are not completely vegan the best food source for phospholipids and choline are eggs. Eat six eggs a week. The choline is in the yolk. The advice regarding omega-3 – eat three servings of fish a week, is good for choline too but it is present in all fish, not just oily fish high in omega-3 fats.

Have you taken the Cognitive Function Test to find out your Dementia Risk Index score? It’s completely FREE and you can choose to pay for the COGNITION programme afterwards if you need personalised recommendations to help you put diet and lifestyle tips into action.

Brain Fats – Seafood, Omega-3 PUFAs, Phospholipids and Vitamin D

The omega-3 fat, docosahexaenoic acid (DHA) is the most abundant PUFA in the brain, concentrated in the grey matter and, particularly at the synapses.¹ DHA is incorporated into membrane phospholipids, where it affects the properties of the membrane, for example, maintaining membrane fluidity. DHA, along with other omega-3 fats EPA, DPAn-3 and their mediators are involved in a wide variety of processes in the brain, such as making new neurons, synaptic connections and the regulation of inflammation.²

Fish, especially cold-water oily fish, contain high levels of DHA and EPA,  and epidemiological studies consistently suggest that an elevated fish intake is associated with decreased risk of neurodegenerative diseases, such as Alzheimer’s disease.³ Recent estimates suggest that worldwide many populations are currently consuming DHA and EPA at levels well below the recommendations issued by many international authorities (GOED), with and blood levels of EPA and DHA have been estimated to be low to very low for most of the world, which may increase global risk for chronic disease.⁴

Interestingly, positive associations have also been found between walnut consumption and cognitive performance.⁵ Walnuts are a source of omega-3 fat, alpha-linolenic acid (ALA) and also a range of antioxidants.

Omega-3 Supplementation and cognitive decline

DHA supplementation appears to show the greatest promise in the early stage before the onset of memory loss symptoms,¹ and at levels at or above 1000 mg per day (Ismail 2015).⁶

A study of healthy 50-75 year olds were given 2,200 mg a day of omega 3 fish oils for six months not only reported significant increase in executive function, one aspect of cognition that is a hallmark of Alzheimer’s, but also beneficial structural changes in white matter integrity and grey matter volume in the brain. The cognitive improvement correlated with blood levels of omega-3 PUFAs.⁷

A randomized, double-blind, placebo-controlled, clinical study, gave 900 mg of DHA a day for 24 weeks and reported an improvement in learning and memory function in those with age-related cognitive decline.⁸ In a further trial by the same research group, giving 2,000 mg a day of DHA or placebo to 402 people with mild to moderate Alzheimer’s disease, therefore further along the disease process, for a period of 18 months found no cognitive improvement.⁹

Phospholipids

Phospholipids, rich in eggs and seafood, are abundant in the brain. They make up the membranes of the different types of cells in the brain. These include Phosphatidylethanolamine (PE) and phosphatidylserine (PS) phosphatidylcholine (PC) and phosphatidylinositol (PI). They become attached to omega-3 DHA. (see film ‘Build Your Brain‘) Phosphatidylethanolamine (PE) and phosphatidylserine (PS) are enriched in DHA, whereas much lower levels are found in phosphatidylcholine (PC) and phosphatidylinositol (PI).³ Attaching DHA to phospholipids is a process that requires methylation, which is dependent on B vitamins.⁹ Interestingly, although DHA is typically found high in PS, levels have been found to be low in PS in post-mortem samples from Alzheimer’s disease patients.¹⁰ PS supplementation may benefit cognition in the elderly,¹¹ but as PS is highly enriched with DHA, it is currently unclear whether the potential beneficial effects of PS on cognition are due to the intact PS or DHA.  Although PC is not highly enriched in DHA, higher plasma concentrations of PC-DHA are associated with reduced risk of dementia and AD,¹² and post mortem samples from AD shows depletion of PC-DHA in grey matter.¹³

Supplementation

A number of trials have investigated the effects of providing multinutrient supplements containing a range of nutritional factors with the aim of supporting phospholipid biosynthesis. Our recent systematic review identified that omega-3 PUFAs and B vitamins as part of these multinutrient formulas confers benefits on cognition in older adults across a range of different types of measures of cognition in older adults.¹⁴ Furthermore, 12-week trial of citicoline has shown cognitive benefits in healthy older adults.¹⁵

Vitamin D

The primary source of vitamin D is exposure to sunlight. Seafood provides the most dietary vitamin D. Vitamin D deficiency increases risk of AD.^161,17,18  Supplements of vitamin D can be derived from animal or fungal sources (mushrooms and yeast). Supplementing 800iu (20mg) a day for 12 months has been shown to improve cognitive function and lessen amyloid protein markers.¹⁹

In a study in France involving 912 elderly patients followed for twelve years, a total of 177 dementia cases (124 AD) occurred: 25(OH)D deficiency was associated with a nearly three-fold increased risk of AD.²⁰

References

1.Dyall, S. C. (2015, 2015-April-21). Long-chain omega-3 fatty acids and the brain: A review of the independent and shared effects of EPA, DPA and DHA [Review]. Frontiers in Aging Neuroscience, 7(52). https://doi.org/10.3389/fnagi.2015.00052

2. Dyall, S. C., Balas, L., Bazan, N. G., Brenna, J. T., Chiang, N., da Costa Souza, F., Dalli, J., Durand, T., Galano, J. M., Lein, P. J., Serhan, C. N., & Taha, A. Y. (2022, Apr). Polyunsaturated fatty acids and fatty acid-derived lipid mediators: Recent advances in the understanding of their biosynthesis, structures, and functions. Prog Lipid Res, 86, 101165. https://doi.org/10.1016/j.plipres.2022.101165

3. Dyall SC, Michael-Titus AT. Neurological benefits of omega-3 fatty acids. Neuromolecular Med. 2008;10(4):219-35. doi: 10.1007/s12017-008-8036-z. Epub 2008 Jun 10. PMID: 18543124.

4. Stark, K. D., Van Elswyk, M. E., Higgins, M. R., Weatherford, C. A., & Salem, N., Jr. (2016, Jul). Global survey of the omega-3 fatty acids, docosahexaenoic acid and eicosapentaenoic acid in the blood stream of healthy adults. Prog Lipid Res, 63, 132-152. https://doi.org/S0163-7827(15)30033-3 [pii]10.1016/j.plipres.2016.05.001 Alzheimers Dement. 2017 Nov;13(11):1207-1216. doi: 10.1016/j.jalz.2017.03.003. Epub 2017 May 16

5. Theodore LE, Kellow NJ, McNeil EA, Close EO, Coad EG, Cardoso BR. Nut Consumption for Cognitive Performance: A Systematic Review. Adv Nutr. 2021 Jun 1;12(3):777-792. doi: 10.1093/advances/nmaa153. PMID: 33330927; PMCID: PMC8166568.

6. Ismail

7. A. Veronica Witte, Lucia Kerti, Henrike M. Hermannstädter, Jochen B. Fiebach, Stephan J. Schreiber, Jan Philipp Schuchardt, Andreas Hahn, Agnes Flöel, Long-Chain Omega-3 Fatty Acids Improve Brain Function and Structure in Older Adults, Cerebral Cortex, Volume 24, Issue 11, November 2014, Pages 3059–3068, https://doi.org/10.1093/cercor/bht163

8. Yurko-Mauro K, McCarthy D, Rom D, et al; Beneficial effects of docosahexaenoic acid on cognition in age-related cognitive decline. Alzheimers Dement. 2010; 6, 456-64

9. Quinn JF, Raman R, Thomas RG, et al; Docosahexaenoic acid supplementation and cognitive decline in Alzheimer disease: a randomized trial. JAMA, 2010; Nov 3;304(17):1903-11.

10. A David Smith, Fredrik Jernerén, Helga Refsum, ω-3 fatty acids and their interactions, The American Journal of Clinical Nutrition, Volume 113, Issue 4, April 2021, Pages 775–778, https://doi.org/10.1093/ajcn/nqab013

11. Cunnane, Stephen & Schneider, Julie & Tangney, Christine & Tremblay-Mercier, Jennifer & Fortier, Mélanie & Bennett, David & Morris, Martha. (2012). Plasma and Brain Fatty Acid Profiles in Mild Cognitive Impairment and Alzheimer’s Disease. Journal of Alzheimer’s disease : JAD. 29. 691-7. 10.3233/JAD-2012-110629.

12. Richter Y, Herzog Y, Lifshitz Y, Hayun R, Zchut S. The effect of soybean-derived phosphatidylserine on cognitive performance in elderly with subjective memory complaints: a pilot study. Clin Interv Aging. 2013;8:557-63. doi: 10.2147/CIA.S40348. Epub 2013 May 21. PMID: 23723695; PMCID: PMC3665496.

13. Schaefer EJ, Bongard V, Beiser AS, Lamon-Fava S, Robins SJ, Au R, Tucker KL, Kyle DJ, Wilson PW, Wolf PA. Plasma phosphatidylcholine docosahexaenoic acid content and risk of dementia and Alzheimer disease: the Framingham Heart Study. Arch Neurol. 2006 Nov;63(11):1545-50. doi: 10.1001/archneur.63.11.1545. PMID: 17101822.

14. Yuki D, Sugiura Y, Zaima N, Akatsu H, Takei S, Yao I, Maesako M, Kinoshita A, Yamamoto T, Kon R, Sugiyama K, Setou M. DHA-PC and PSD-95 decrease after loss of synaptophysin and before neuronal loss in patients with Alzheimer’s disease. Sci Rep. 2014 Nov 20;4:7130. doi: 10.1038/srep07130. PMID: 25410733; PMCID: PMC5382699.

15. Fairbairn, P., Dyall, S. C., & Tsofliou, F. (2022, Apr 27). The Effects of Multi-Nutrient Formulas containing a Combination of Omega-3 Polyunsaturated Fatty Acids and B vitamins on Cognition in the older adult: A Systematic Review and Meta-analysis. Br J Nutr, 1-42. https://doi.org/10.1017/S0007114522001283

16. Nakazaki E, Mah E, Sanoshy K, Citrolo D, Watanabe F. Citicoline and Memory Function in Healthy Older Adults: A Randomized, Double-Blind, Placebo-Controlled Clinical Trial. J Nutr. 2021 Aug 7;151(8):2153-2160. doi: 10.1093/jn/nxab119. PMID: 33978188; PMCID: PMC8349115.

17. Sommer I, Griebler U, Kien C, Auer S, Klerings I, Hammer R, Holzer P, Gartlehner G. Vitamin D deficiency as a risk factor for dementia: a systematic review and meta-analysis. BMC Geriatr. 2017 Jan 13;17(1):16. doi: 10.1186/s12877-016-0405-0. PMID: 28086755; PMCID: PMC5237198;

18. Jayedi A, Rashidy-Pour A, Shab-Bidar S. Vitamin D status and risk of dementia and Alzheimer’s disease: A meta-analysis of dose-response †. Nutr Neurosci. 2019 Nov;22(11):750-759. doi: 10.1080/1028415X.2018.1436639. Epub 2018 Feb 15. PMID: 29447107;

19. Chai B, Gao F, Wu R, Dong T, Gu C, Lin Q, Zhang Y. Vitamin D deficiency as a risk factor for dementia and Alzheimer’s disease: an updated meta-analysis. BMC Neurol. 2019 Nov 13;19(1):284. doi: 10.1186/s12883-019-1500-6. PMID: 31722673; PMCID: PMC6854782.

20. Jia J, Hu J, Huo X, Miao R, Zhang Y, Ma F. Effects of vitamin D supplementation on cognitive function and blood Aβ-related biomarkers in older adults with Alzheimer’s disease: a randomised, double-blind, placebo-controlled trial. J Neurol Neurosurg Psychiatry. 2019 Dec;90(12):1347-1352. doi: 10.1136/jnnp-2018-320199. Epub 2019 Jul 11. PMID: 31296588.

21. Feart C, Helmer C, Merle B, Herrmann FR, Annweiler C, Dartigues JF, Delcourt C, Samieri C. Associations of lower vitamin D concentrations with cognitive decline and long-term risk of dementia and Alzheimer’s disease in older adults. Alzheimers Dement. 2017 Nov;13(11):1207-1216. doi: 10.1016/j.jalz.2017.03.003. Epub 2017 May 16. PMID: 28522216.

Our latest blog explores specific nutrients and dietary patterns that are most supportive of female brain health across the lifespan.

Premenstruation

The age at which periods begin varies from female to female. Therefore it is highly beneficial to establish a varied diet from an early age, with a wide range of colourful vegetables and fruits, nuts, seeds, pulses and essential fats from nutritious sources such as oily fish and unprocessed olive and coconut oils. This will help to set the foundations for key nutrients, which will support female hormone health, as well as brain and overall health, across the lifespan.  

Menstruation

Periods normally begin between the ages of 10-16, although they can begin at a younger age, due to genetic and environmental factors. Periods onset may also be delayed to a later age in individuals who have a family history of late-onset periods, are doing large amounts of exercise, experience stress, are underweight, or have an eating disorder or health condition affecting the ovaries. 

Some key nutrients for menstruating women include:

Iron

The average blood loss experienced across a period is estimated to be between 3-5 tbsps of blood, and iron loss may occur at varying degrees depending on heaviness of the period blood flow. It is therefore imperative to ensure iron levels are maintained across a woman’s lifespan. Females with iron deficiency may manifest with symptoms such as pale skin, low energy, failure to thrive, reduced appetite and behavioural and emotional issues. 

Females with iron deficiency may also have higher risk of developing depression and anxiety, because deficiency of iron causes altered levels of serotonin and dopamine. Serotonin and dopamine are two neurotransmitters involved in mood regulation. Furthermore, iron deficiency results in alteration to balances of the neurotransmitters glutamate and GABA, which have an excitatory and calming effect on the nervous system, respectively. Iron status should be monitored and supported through nutrition and, if required, supplementation throughout a woman’s menstrual life. 

Fats 

Consuming fats is essential for female hormone health. Oestrogen and progesterone, hormones involved in the female reproductive system, are synthesised from cholesterol. There has been a focus in the last few decades on cholesterol levels that are too high. However, it is equally important, but perhaps less discussed, to ensure that cholesterol levels do not become too low, as this can impact on female hormone balance. Female adolescents following low fat diets, or diagnosed with an eating disorder, are particularly at risk of experiencing hormonal imbalance, for this reason.  

Women should ensure they are consuming monounsaturated fats, such as avocado and olive oil, and polyunsaturated fats, such as omega-3. Research has demonstrated that omega-3 is involved in modulating mood, memory and cognition. The role of omega-3 in supporting the gut-brain axis is also an important consideration. Omega-3 fats are essential for increasing and maintaining levels of beneficial bacteria in the gut microbiome. Some strains of beneficial gut bacteria are involved in the synthesis of neurotransmitters such as serotonin, dopamine and GABA, which are all involved in modulating mood. This provides one possible explanatory mechanism for why omega-3 may be supportive of mental well being during a woman’s cycle, as low serotonin and dopamine levels have been suggested to be associated with some symptoms of PMS and PMDD. Furthermore, in a recent study women with PMS who were administered omega-3 fatty acids were observed to experience fewer symptoms long term.

Omega-3 fats, in the forms of EPA and DHA, are found in oily fish such as salmon and mackerel, as well as in algae. They are also found in walnuts and flaxseeds, in the form of ALA. However, it should be noted that the body has to convert ALA into DHA and EPA, forms the brain can utilise more readily. This conversion process is not particularly efficient, but recent research has suggested that this conversion pathway can be enhanced by curcumin, which is found in turmeric. Although these findings hold promise for the potential role of curcumin, and possibly other polyphenols, in supporting ALA conversion, further research is required to explore these findings in humans.

Zinc

An emerging area of research is the role of zinc in supporting women’s hormone health. A recent randomised double blinded control trial indicated that women with PMS who were administered zinc sulphate were observed to experience significant improvement to PMS symptom severity and improvement to quality of life. These findings were further supported in a 2020 study on female university students. An additional study demonstrated that zinc supplementation had a significant impact on reducing physical and psychological symptoms of PMS, as well as increasing levels of BDNF (brain derived neurotrophic factor), a key molecule in the brain involved in learning and memory, and reducing oxidative stress, a major trigger for inflammatory processes.

Menopause

Menopause is a normal part of a woman’s natural ageing process. It normally occurs between the ages of 45-55. However, premature menopause affects 1 in 100 women, and may occur due to genetic and environmental factors, including early menarche and heavy alcohol consumption throughout life.

Role of Oestrogen and Homocysteine in Women’s Increased Risk of Cognitive Decline Postmenopausally

The nutrition research and strategies discussed above are of merit to continue throughout menopause due to their role in supporting female hormone health, as well as the gut-brain-axis. A key consideration for menopause and brain health is that women’s risk of developing Alzheimer’s disease increases. One hypothesis is that changes in levels of oestrogen and subsequent impact on the brain’s bioenergetic system may decrease metabolic activity and increase deposit of a key marker of Alzheimer’s disease, beta-amyloid.  Recent research has also indicated that levels of homocysteine, a marker involved in neurological diseases such as Alzheimer’s disease, rise in response to a fall in oestrogen levels during the menopause.

B Vitamins, Omega-3 and Zinc 

Research has indicated that increasing levels of folate and B12, as well as omega-3, may help to reduce levels of homocysteine. This can be done through increasing consumption of green leafy vegetables (folate), chicken and fish (B12) and oily fish (omega-3), as well as through supplementation of these nutrients (particularly B12 and omega-3 if vegetarian or vegan). Furthermore, recent research has highlighted the key role of zinc in significantly reducing concentrations of homocysteine. This may be due to its synergistic relationship with folate and B12. 

Mediterranean Diet

Following the Mediterranean diet, which involves consuming extra-virgin olive oil, vegetables, fruits, legumes, pulses, nuts and oily fish, may be particularly supportive during menopause. The European Menopause and Andropause Society has also recently proposed the Mediterranean diet as an appropriate dietary pattern post-menopause, as it may help to reduce cognitive decline, cardiovascular and metabolic diseases, which are both risk factors for Alzheimer’s disease. An additional food of note, which can be incorporated into a Mediterranean diet, is flaxseed, which has been specifically shown to support women during and post menopause. This is possibly due to flaxseed’s omega-3 content (ALA), as well as lignan content, which may help to modulate oestrogen levels. 

Manganese

An area of emerging research is manganese levels and menopause. A recent study  indicated that alterations in blood levels of manganese occur before and during menopause. Manganese is a micronutrient required for insulin secretion and blood glucose balance, as well as modulating the body’s endogenous antioxidant systems and thereby reducing oxidative stress, as well as the homeostasis of neurotransmitters such as dopamine, glutamate, and GABA. Further research is required to explore the full mechanisms through which manganese is involved in the menopause, and how altered levels may impact on female brain health.

Notably, many women opt during this stage of life to take hormone replacement therapies (HRT). A recent study published in the British Medical Journal has demonstrated that some types of HRT may increase risk of developing Alzheimer’s disease when used long term. Individuals should consult their doctor before beginning HRT, particularly raising any concerns if they have a family history of Alzheimer’s disease, or exhibiting symptoms of cognitive decline. 

Disclaimer: Always consult your doctor or a qualified healthcare practitioner if you are experiencing any symptoms that concern you, such as unexpected period cessation, heavy blood loss, mood swings or memory loss. Also always consult a qualified healthcare practitioner before beginning any new supplement regimen.

SAD (or seasonal affective disorder) is a sub-form of major depression or bipolar, according to the Diagnostic and Statistical Manual of Mental Disorders, which most commonly occurs during the darker and colder autumn and winter months. Key identified risk factors include: a family history of the disorder, and living at northern latitudes. Specifically women, people with darker skin tones and individuals between the ages of 18 to 30 years of age are most at risk of developing the disorder. In order to have a diagnosis of SAD, the condition must be observed to improve outside of the colder seasons. Depending on the latitude, SAD has a prevalence of 1.9 – 9%. Individuals with lower levels of the metabolism regulating hormone adiponectin have also been observed to be at higher risk of developing SAD.

Nutrition and SAD

Vitamin D has been hypothesised to play a key role in SAD development due to reduced sunlight in northern latitudes during colder months. Additionally, it has been observed that there is a correlation between blood levels of Vitamin D and symptoms of depression, due to reduced levels of the neurotransmitters serotonin and dopamine. Vitamin D has also been hypothesised as being involved in circadian rhythm, which is affected by seasonal changes. However, supplementation of Vitamin D in SAD has yielded mixed results, and further studies are needed in this area.

Practical Interventions for Supporting Individuals with SAD

Due to the prevalence of Vitamin D in depressive conditions, the lack of sunlight during the winter months and the hypothesised role of Vitamin D deficiency in the development of SAD, increasing Vitamin D exposure is potentially of merit. This may be done through the following:

• Consuming foods which are natural sources of Vitamin D, such as oily fish including salmon and mackerel, egg yolks and organic milk and cheese
• Increasing exposure to sunlight in the winter months by being outside, particularly engaging in physical activities and spending time in nature 
• Supplementation of Vitamin D3. The RDA in the UK for Vitamin D is 10 micrograms (µg) or 400 IU. However, some individuals may benefit from supplementing higher levels of this vitamin, particularly if they have a higher BMI, a diagnosed mental health condition or darker skin pigmentation. Baseline levels of Vitamin D as established via blood test, calcium intake, genetics, oestrogen use, dietary fat content and composition, as well as co-existing diseases and medication use may also impact on Vitamin D requirements*.

*Note: before beginning any new supplement regimen, always consult your physician and a qualified nutrition practitioner.

The COVID-19 pandemic has brought much disruption, fear and anxiety, and this is particularly true amongst children and teens who have been affected by school closures, physical distancing and new routines. It is no surprise, then, that many children have been feeling more anxious or exhibiting signs of anxiety, and that related conditions such as OCD, social anxiety and disordered eating appear to be on the rise. Witnessing this in a child can be very worrying and stressful for parents.

At Food for the Brain, we’re passionate about sharing the science and nutritional strategies that promote good brain health and mental wellbeing at every life stage. Nurturing healthy brains in children is particularly important given the growing body of evidence connecting diet and mental health. 

Diet and Mental Health

We all know that diet plays a huge part in our health, but recently we have started to understand more about its connection to mental health. Unhealthy dietary patterns have been associated with poorer mental health in children and adolescents. Furthermore, a 2017 paper published in Public Health Nutrition found the UK to have the most ‘ultra-processed’ diet in Europe, as measured by family food purchases. British children were found to be eating “exceptionally high” proportions of ultra-processed foods*, which is likely to be contributing to health problems.

Specific Nutrients for Mental Health

The brain is the most energy-hungry organ in the body, stealing roughly 25% of the body’s energy requirements. In addition, there are specific nutrients that play a role in mental wellbeing. Ensuring good levels of these nutrients can support your child’s brain and mental health. 

Zinc

Zinc is a mineral found in higher concentrations in seafood, organ meat, chickpeas, lentils and pumpkin seeds – not foods that tend to be loved by children. Zinc can also be found in other foods such as the dark meat of chicken, yogurt, almonds and peas, but it may be harder to obtain the amounts children need from these sources.

Zinc is believed to interact with an important anti-anxiety brain chemical called GABA. GABA is the body’s main inhibitory neurotransmitter, meaning that it prevents excitatory neurotransmitters like dopamine and noradrenaline from over-stimulating the brain. This relaxes us and promotes feelings of calm, as well as helping to slow down our heart rate and breathing. In those who are deficient in GABA, feelings of anxiety and stress can be common symptoms.

Although zinc has not been as well researched as other nutrients, it has been connected in research to both ‘mood disorders’ and depression. Zinc supplementation may even reduce anger and lessen depression.

If your child does not eat seafood, chickpeas or chicken, you could encourage them to eat extra almonds, cashews and pumpkin seeds, to make up for any potential shortfalls. You could try making things like energy balls with nuts and seeds, adding raisins or dried apricots, which are also high in iron. 

Vitamin B6

B6 is really important for our mental wellbeing because the body uses it to make brain chemicals like GABA and serotonin, which make us feel calm, focussed and happy.

This vitamin is found in a wide range of foods such as meat, fish, chickpeas, vegetables and wholegrains. However, if your child’s diet mostly comprises refined, white foods such as bread and pasta, they may be losing out on important sources of this vitamin. Wholegrains and wholefoods should be the focus, keeping refined white flour to a minimum to help achieve good B6 levels. 

Iron

According to the World Health Organization, iron deficiency is the most prevalent nutritional deficiency. Iron deficiency in children is known to affect behaviour and learning, and has also been associated with increased anxiety and social problems. 

The best sources of iron are red meat, seafood and the dark meat of chicken. Plant foods also contain a lot of iron, such as beans, lentils, kale, cabbage and broccoli. Eggs and dairy contain iron in smaller amounts and may be a good source if your child will not eat plant or meat sources. An emphasis on green vegetables, however, is always recommended for overall good health.

What if my child doesn’t like these foods?

The biggest challenge for parents tends to be picky eaters, and time restraints. A picky eater may exclude whole food groups, such as animal protein or plant foods such as beans or greens. This may cause children to struggle to get the nutrition they need for good mental health.

Top Tips: It’s not easy coaxing a fussy child to eat something they don’t like, but disguising the food within something they do like can be a good trick. For example, making a well seasoned vegan burger using chickpeas. Or a creamy soup, sneaking in mixed vegetables, then blending until smooth for children who don’t like lumps. Shredding onion and celery into tomato sauce also disguises them well. Follow us on social media for additional tips this month on preparing meals for picky eaters.

* This report by The Soil Association provides useful information on ultra-processed foods and how to spot them.

With thanks to our volunteer, Linda Albinsson at Thrive Kids Clinic, for this article.

According to Dr Vivette Glover, Director of the Foetal and Neonatal Stress and Research Centre: “at any one time during pregnancy, one in every ten women will suffer with depression and around one in every thirty will be depressed both during pregnancy and the postnatal period.”

It is not yet understood exactly what causes the symptoms associated with depression during and after pregnancy. However, several factors play a significant role in how the body deals with stress:

large changes that the body undergoes due to the demands of the growing foetus

breastfeeding

potential sleep deprivation

It is during this period of time that our bodies require more nourishment from food than ever and it can also be at exactly this time when we perhaps struggle to prioritise nutrition due to lack of energy, loss of appetite or sickness. 

Pre and Post-Natal Depression are both complex conditions that can have multifactorial underlying drivers, including genetic and environmental influences. These are currently poorly investigated and the gold standard of treatment is often medication to help stabilise mood. Whilst SSRIs and other types of antidepressants have proven to be helpful for many, they do not address potential causes or drivers of poor mental health and can often mask symptoms. Medication for depression (ie antidepressants) are also not regularly recommended during pregnancy, which is why being more mindful of nutrition and lifestyle habits can be a safer option for you and your baby. There are some natural, evidence-based steps you can take to help support optimal mental wellbeing:

Eat Foods to Support Energy Depletion:

Common issues such as poor sleep during pregnancy and sleep deprivation following the birth can often heighten cravings for stimulants and sugary foods, which may seem like a good option for quick sources of energy, however, these foods can often cause further issues with energy and lead to fatigue and low mood. Eating foods that are high in refined sugar and refined grains such as commercial white bread, pastries, cakes and biscuits, give us an unsustainable source of energy. 

The brain is a very metabolically active organ; despite it only being 7% of the body’s weight, it can take up to 20% of the body’s metabolic needs, meaning that it is very energy hungry. This is why it is important to nourish the brain with foods that are nutrient rich, providing the body the building blocks to produce neurotransmitters, as well as a sustainable source of energy. The best options are fresh, unprocessed foods such as wholegrains (brown bread, brown rice, quinoa, rye and oats), pulses, vegetables, good quality sources of protein (meat, poultry and fish) and healthy fats such as those found in olive oil, coconut oil, avocados and oily fish. 

Just like throughout pregnancy, nutritional needs after birth, especially if breastfeeding, are incredibly important. The healthier the diet, the easier it will be to sustain the energy needed to take care of a newborn. Research shows that a breastfeeding mother needs an extra 300-500 calories a day, from food that is rich in the right macro and micronutrients to nourish both mother and baby. For example, nutrients such as B vitamins have shown to be important in supporting the mother in ensuring she has enough energy to meet the demands of lactation. These nutrients can be found in green leafy vegetables, wholegrains and good sources of animal protein. 

Protect yourself from Oxidative Stress:

Oxidative stress refers to a biochemical process that occurs as a result of an accumulative everyday exposure to toxic burdens. These include such things as chemicals in cosmetics, furniture, paints, cars, and pollution.

Our body has its own way of armouring itself from the damage that exposure to toxins can create through its production of endogenous antioxidants. This is nature’s way of neutralising oxidative stress. Although we have our own production of these wonder molecules, when we are continuously overloaded with toxins in our environment and have problems detoxifying, the liver can become overwhelmed.

Research shows that over time oxidative stress can lead to an increase in inflammatory molecules such as cytokines, which have been shown to correlate with depression. This is why it is important to have a high intake of nutrients that support the liver in metabolising and removing toxins from the body, as well as regulating the inflammatory response.

There are a few things we can change in our diet to support this area, for example eating foods such as the cruciferous family of vegetables which includes kale, cauliflower, broccoli and cabbage. These are particularly effective at supporting the liver in ushering out toxins as they all share an antioxidant compound called indole-3 Carbinol, which plays an important role in liver health. In addition, bitter greens such as collard greens, rocket, chicory and swiss chard are also great for supporting the liver’s own antioxidant defence system.

Increase intake of Omega-3 Fatty Acids:

During pregnancy and after pregnancy there is often a concern for the potential depletion of the maternal nutrient reservoir due to the needs of the growing foetus.

A nutrient that is particularly important for mental wellbeing and is also essential for the growth of the foetus’s brain, is DHA. This is an omega 3 fatty acid that is found in oily fish and is the primary structural component of brain tissue. It also plays a crucial role in the maintenance of brain cells and neurotransmitter metabolism. Our body can also convert plant sources of omegas 3’s into DHA, such as those found in flaxseeds or chia seeds into DHA, but the conversion can often very poor.

Deficiency in this nutrient during pregnancy is common, mainly due to higher requirements during foetal growth, which can lead to depletion. Another contributor is a lack of seafood intake (the most bioavailable source of DHA) due to concerns of mercury levels in fish during pregnancy.

DHA plays an important role in neurotransmitter metabolism, so deficiency in this nutrient has been correlated to symptoms of depression during pregnancy.

In order to support your intake of omega 3, aim to have 3 portions of oily fish a week from sources that are low in mercury. These are mainly small fish that have a short life-span such as sardines, mackerel and herring.

If you are vegetarian or vegan, although omega 3 is less readily available, it is still possible to get this nutrient from your diet through flax seeds, chia seeds, walnuts and seaweed.

If you feel you may not be getting enough through your diet, you may want to consider using a good quality fish oil supplement (or algae based supplement if vegan) as an option. With fish oils, aim to choose a supplement that has been filtered for heavy metals and other pollutants to make sure you’re getting the full benefits of the omega 3 oils.

Exercise and Personalised Nutritional Therapy:

In addition to diet, there are many other things you can also do to alleviate depression in pregnancy related to lifestyle, such as stress management through mindfulness or gentle movement such as pre or post natal yoga, which have both shown to be incredibly helpful in encouraging mental wellbeing. If you feel you need extra support, personalised nutritional therapy can be very helpful as there can often be other drivers such as nutrient deficiencies and digestive complaints that can play a significant role in mental health and will need to be addressed in a way that is tailored to the individual. 

BANT (British Association for Applied Nutrition and Nutritional Therapy), have a large network of therapists you can use to find a therapist suitable for you.For wider help and information, you might want to contact the PANDAS Foundation, a charity who offer pre and post natal advice and support.