Lipids and Nutraceuticals: A Focus on Mental Health and Cognition
Mike Eyres and Laurence Eyres FNZIFST
Modern life is becoming increasingly stressful particularly in these times of COVID. This is resulting in an increase in mental health problems globally. There has been a huge surge in prescriptions for drugs for mental health including antidepressants, anxiolytics, and sleep aids. Whilst these prescriptions appear to be a necessary evil there are obvious dangers with these prescriptions and the resulting dependency that can occur with the use of these substances. This issue we look at the latest news regarding the role of supplemental lipids and other key nutraceuticals in supporting mental health.
Mental health is defined by the World Health Organization as “a state of well-being enabling individuals to realize their abilities, cope with normal stresses of life, work productively and fruitfully and contribute to their communities. The links between aging, cognitive decline and poor mental health are well established and it is recognised that treating poor mental health in the elderly is significantly different to treating younger cohorts. As the global population ages, issues around treating mental health in older people is forecast to rise.
Natural products and supplements are a commonly used intervention for supporting cognition and mental health. The current data for supplements such as omega-3 fatty acids, phospholipids, and herbs like Ginkgo and St John’s Wort and others are promising but still limited, especially regarding geriatrics.
Lipids and the brain
Nutrition plays a significant role in brain function throughout the entire lifespan. Appropriate nutrient intake allows normal brain growth and neurodevelopment in early life and is theorized to reduce the risk of cognitive decline and Alzheimer’s disease in older age.
The human brain is primarily composed of lipids being half the brain’s weight. Most brain lipids are in the form of phospholipids. If age-related changes in lipid metabolism cause cognitive decline, then nutraceuticals that affect levels of lipids in the brain may ameliorate cognitive impairment.
A recent study has added evidence to the theory that lipid dysregulation is involved in the pathogenesis of Alzheimer’s and offers an avenue for future research into therapeutics. The mouse study showed that amyloid beta complexed with lipoproteins in the blood were produced in the liver and were able to “leak” into the brain after disrupting the blood brain barrier and cause cognitive impairment via neuroinflammation. This appears to confirm the “blood to brain” hypothesis about the cause of Alzheimer’s disease. Natural diets and therapeutics that target the levels of amyloid beta complexed lipoproteins in the blood can now be investigated as tools for delaying cognitive decline and the progression of Alzheimer’s disease.
There is an interesting article in Inform magazine (AOCS) 2020 vol 31, pp 6-10 entitled “The trouble with studying omega-3’s and the brain.” The article includes comments by Professor Richard Bazinet who is Professor of +Nutritional Science at Toronto University. The article summarizes results from randomized clinical trials between 2005 and 2012 with little evidence that taking omega-3 supplements has any major effect on the course of disease including mental decline. However, work in Australia has shown that a significant omega-3 index is associated with a much lower risk of mental health disorders and cognitive decline.
So, a reasonable conclusion is that a healthy diet including fish and the right supplements over an extended period as a preventative strategy may be much better that belated treatment.
Plasmalogens: A New Zealand Bioactive Opportunity
A recent new product launch by a leader in natural health supplements intrigued us to take a deeper look at plasmalogens as a supplement for cognition and mental health.
Plasmalogens are a subclass of phospholipid and the ethanolamine plasmalogens are the predominant phospholipids in the brain. They are found naturally in many foods and can be taken as a dietary supplement. Several key New Zealand food products such as shellfish, venison and lamb have been identified by New Zealand researchers as particularly good sources. A presentation from the 2016 Oils and Fats Specialist Group Conference is well worth a review for those interested and is available on the website.
It has been established that plasma levels of plasmalogens are depleted in Alzheimer’s patients and recently this has been also associated with the degree of cognitive impairment. However, whether the decrease of plasmalogens is the cause or consequence of the disease and its symptoms is still being debated. There is preliminary evidence that it may be both.
Reduced plasmalogens in AD are thought to be caused by neuroinflammation and increased oxidative stress. Research into plasmalogens as a treatment for cognition is still in its infancy. The results from animal studies and the first RCT human studies are very promising. A recent review from 2019 describes the underlying mechanisms regarding plasmalogen metabolism and the animal studies to date:
Herbal actives for neuroinflammation – synergy with lipid targets?
Neuroinflammation has also noted as a hallmark of not only cognitive decline, but also mental health disorders such as depression and has become a recent therapeutic target for these disorders using natural bio actives.
In recent years, several herbal medicines have come to the fore for mental health treatment with reductions of neuroinflammation as their mechanism of action. Saffron is one of these that is seeing increasing attention in the form of clinical trials.
Saffron is a brightly coloured spice made from the hand harvested stigma of Crocus sativus that’s packed with antioxidant compounds, including the carotenoids crocin and crocetin and is one of the most expensive spices in the world.
Saffron has demonstrated efficacy equivalent to first line pharmaceutical drugs in Anxiety, Depression, and ADHD at doses between 30mg and 60mg per day of a novel saffron extract. Regarding cognition, Saffron has demonstrated a neuroprotective effect in pre-clinical studies.
A recent review summarizes the mechanisms of action and the research to date:
Curcumin from Turmeric is a well-recognised herbal anti-inflammatory and would appear to have excellent synergy with saffron for reducing neuroinflammation. Several dietary supplements that combine curcumin and saffron are currently on the market. Aside from its anti-inflammatory effect, curcumin offers a chance at synergy with both saffron and bioactive lipids by its lipid modulating effects. Curcumin has proven effects on both modulating blood lipids and mood in multiple RCT’s and these have been recently reviewed.
It is worth remembering the proven efficacy of the Mediterranean diet for longevity, cognition and mental wellbeing. All the actives discussed in this newsletter are found in foods and can easily be incorporated into Mediterranean meals. Dishes such as bouillabaisse and paella traditionally are made with seafoods and can easily be flavoured with a combination of saffron and turmeric. The addition of lashings of superior quality extra virgin olive oil will improve taste, absorption of the bio actives and will have an added beneficial effect on lipid metabolism. Buon appetito!