RD&T contributor, Dr. Joel Furhman, discusses the potential benefits of DHA in protecting against dementia and Parkinson’s in this article. In particular, he addresses the importance of the conservative use of supplements as found through his decades of experience in primary care practice.
DHA and Dementia
As of 2009, there were at least a dozen epidemiological studies that associate reduced blood levels of omega-3 fatty acids or omega-3 or fish intake with increased risk for age-related cognitive decline or dementia.34 In 2015, a dose-response meta-analysis of dietary DHA found that a 0.1 g/day increase in DHA intake was associated with a 14 percent lower risk of dementia and a 37 percent lower risk of Alzheimer’s Disease.35 DHA is broadly neuroprotective via multiple mechanisms, including limiting the production and accumulation of amyloid beta-peptide toxin that is widely believed to drive the disease.12,36
Importance of early prevention
That does not mean that giving a DHA supplement to someone with established cognitive impairment or to the elderly after a lifetime of deficiency will prevent or reverse established brain shrinkage or memory loss. Studies show that giving supplements to those who already have memory loss or dementia does not work.37 This reinforces how important early prevention is and the lack of effectiveness of supplementing after brain shrinkage has occurred should not be used to confuse people into thinking that DHA adequacy is not important.
For example, in the Framingham Heart Study, the top quartile of plasma DHA level was associated with a significant 47 percent reduction in the risk of developing all-cause dementia.38 This epidemiologic study was further confirmed with a case-controlled cohort study called the Rancho Bernardo Study that tracked dietary DHA and plasma DHA to confirm consistency and they found dietary DHA in the highest third was associated with a 73 percent reduced odds of all-cause dementia and plasma DHA in the highest third had a 65 percent reduced odds of all-cause dementia.39
Important Highlights
Noteworthy items from this article series:
- Severe deficiencies of DHA are potentially dangerous and associated with brain shrinkage in older adults.15,40,41
- Vegans can have severe deficiencies of DHA based on dietary factors, but also genetic differences in DHA that we can fabricate from ALA.
- You cannot guarantee you are safe from later-life neurological problems on a vegan diet, unless you either check blood work or take a supplement. To do otherwise is a foolish gamble.
- Low-dose DHA-EPA has been shown to raise omega-3 index to normal in those that are insufficient,14 and there is zero evidence that such a low dose of DHA can increase risk of any disease, including prostate cancer. In fact, being DHA deficient would likely increase the risk of colorectal cancers and breast cancers.42,43
The thought that the small, but protective, dose of DHA recommended would increase risk of prostate cancer is not merely far-fetched, but ridiculous.
The people I have seen with depression, dementia, and Parkinson’s include close friends and family, and even important well-known leaders in the vegan community. I am passionate about this not happening anymore to people following a plant-based dietary portfolio, especially because that is a diet I advocate.
DHA and Parkinson’s Disease
Parkinson’s Disease is a common neurologic disease believed to be caused by the deterioration of brain cells that produce dopamine. The link between DHA deficiency and Parkinson’s is not established in the scientific literature, but I have observed a disproportionate number of very healthy-eating vegans and near vegans (and Natural Hygienists) who have developed Parkinson’s.
This suspicion that DHA deficiency may increases one’s risk of Parkinson’s is supported by animal models which show that a deficiency of DHA increases sensitivity to the chemical toxins linked to Parkinson’s Disease. Mice fed a Parkinson-inducing toxin (MPTP) became resistant to the chemical when DHA adequacy was established, while control mice (the mice with no DHA given) lost their dopamine-producing cells. DHA protects neurons against the cytotoxicity of chemicals shown to damage dopaminergic cells. The DHA derivative neuroprotectin D1 protects the brain against oxidized proteins.44
This is particularly relevant as well-known Natural Hygiene leaders and leaders of healthy eating communities such as Keki Sidhwa and Herbert Shelton died from Parkinson’s Disease. These were my mentors and close friends and I thought they would live healthfully to 100, but instead they suffered from Parkinson’s. I have also seen this happen with some of my otherwise super-healthy eating vegan and near-vegan patients. These people were shocked to have this problem when eating so healthfully for most of their lives and certainly, this was alarming to me. When I checked the blood level of DHA in some of them I found shockingly low levels.
This fear of mine and precaution I take so my followers do not get Parkinson’s Disease may be an important discovery. Certainly, I am not going to risk this happening again in myself, my friends, family and clients following my advice.
The Conservative Use of Supplements
The DHA/EPA supplement and the other supplements I designed are an important part of my teachings and lifespan-enhancing advice, enabling people to optimize those nutrients of marginal or low presence in their diet and just as importantly avoid unfavorable supplement ingredients and excesses that can cause harm. My protocols assure nutritional excellence while consuming a vegan or near vegan diet, which may not be nutritionally optimal for all people.
My providing supplements – as part of my Nutritarian Diet that aims to do much better than the Blue Zones – assures me that people get adequate, but not excessive amounts of DHA, zinc, iodine, D, K2 and B12. This is an important part of this protocol to have a high quality of life after the age of 90. The supportive data to take these supplements when you are vegan or near vegan is overwhelming, but not a part of this paper.
A matter of personal importance
Since I also teach that conventional supplements contain folic acid, vitamin A and other harmful ingredients, the supplements I have designed make it convenient for people to follow my general recommendations without consuming unfavorable ingredients. Fish oil can contain microplastics, as can sardines and other natural sources of omega-3.
If someone has a different nutritional viewpoint and are so certain they are better off without supplements, nobody is forcing them to spend their money needlessly; they are free to hold any viewpoint they choose and follow their own path. I, however, cannot advise taking those risks, and I am not going to impair the health of my family, friends and clients to abide by some mandate that doctors should not be selling supplements, especially while many doctors make a living prescribing needless drugs, creating the need for endless appointments, invasive and needless procedures and surgeries; and while most conventionally available multivitamin supplements inflict harm. I am doing what I think is right and will be most helpful to my followers.
Experience vs. theory
When a person has insufficient evidence or misrepresents the evidence to promote their preferred viewpoint or argument, or when they can’t argue with science, logic and experience, they try tactics to destroy the credibility and integrity of their opposition or of the research. I have become the recipient of such personal attacks attempting to discredit my message.
My message is unique; it has lots of opposition. I am one of the few living physicians who has had a primary care practice for decades caring for a predominantly plant-based community with many thousands of patients. By trying to discredit me, they can ignore the experience of a clinician who has observed people damaged in some way by low-fat vegan extremism. Some may argue from a theory – I argue from real patient experience with many thousands of patients.
The only way to argue against my having observed healthy-eating vegans with dementia due to severe DHA deficiency is to say I am lying, and attempt to convince people that what I said I experienced had not really happened. They claim I am fabricating this experience of seeing healthy eating vegans with dementia in later life just to sell DHA supplements.
Note that the only argument to stand on for the support of a vegan diet that excludes nuts and seeds and DHA is claiming the hundreds of the most respected research scientists in the world are in collusion with the nut industry to fake the studies showing cardiac risk from nut exclusion and low-fat diets, and then claiming that I am also lying about non-supplementing elderly vegans developing neurologic problems.
There are various brands of algae-based DHA available. A consumer can evaluate what is available and consider price, features, and quality to meet their needs. Some are more reasonably priced compared to mine that is a refrigerated product packed in glass.
The Internet and Free Marketplace
It can be a confusing place
There are those who have used my likeness, name, writings and even excerpted video vignettes of me speaking to promote their products, juicers, infomercials, or multi-level marketing products, and placed my work or derivatives of it on their website without my consent or awareness. Please be wary; my staff has been effective in having some of these taken down, though apparently there are some we don’t find. We have already had to pursue legal action to stop the use of clips of me and statements attributed to me in a television infomercial that I did not agree to participate in. Remember, modern technology can fabricate “evidence” as well as post Internet stories that have been faked.
As Albert Einstein once said:
Don’t trust everything you hear on the Internet.
References:
12.Lukiw WJ, Bazan NG. Docosahexaenoic acid and the aging brain. J Nutr 2008, 138:2510-2514.
14. Sarter B, Kelsey KS, Schwartz TA, Harris WS. Blood docosahexaenoic acid and eicosapentaenoic acid in vegans: Associations with age and gender and effects of an algal-derived omega-3 fatty acid supplement. Clin Nutr 2014.
15. Pottala JV, Yaffe K, Robinson JG, Espeland MA, Wallace R, Harris WS. Higher RBC EPA + DHA corresponds with larger total brain and hippocampal volumes: WHIMS-MRI study. Neurology 2014, 82:435-442.
34. Cole GM, Ma QL, Frautschy SA. Omega-3 fatty acids and dementia. Prostaglandins Leukot Essent Fatty Acids 2009, 81:213-221.
35. Zhang Y, Chen J, Qiu J, Li Y, Wang J, Jiao J. Intakes of fish and polyunsaturated fatty acids and mild-to-severe cognitive impairment risks: a dose-response meta-analysis of 21 cohort studies. Am J Clin Nutr 2016, 103:330-340
36. Dyall SC. Amyloid-Beta Peptide, Oxidative Stress and Inflammation in Alzheimer’s Disease: Potential Neuroprotective Effects of Omega-3 Polyunsaturated Fatty Acids. International Journal of Alzheimer’s Disease 2010, 2010.
37. Burckhardt M, Herke M, Wustmann T, Watzke S, Langer G, Fink A. Omega-3 fatty acids for the treatment of dementia. Cochrane Database Syst Rev 2016, 4:CD009002.
38. 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, 63:1545-1550.
39. Lopez LB, Kritz-Silverstein D, Barrett Connor E. High dietary and plasma levels of the omega-3 fatty acid docosahexaenoic acid are associated with decreased dementia risk: the Rancho Bernardo study. J Nutr Health Aging 2011, 15:25-31.
40. Bowman GL, Silbert LC, Howieson D, Dodge HH, Traber MG, Frei B, Kaye JA, Shannon J, Quinn JF. Nutrient biomarker patterns, cognitive function, and MRI measures of brain aging. Neurology 2012, 78:241-249.
41. Tan ZS, Harris WS, Beiser AS, Au R, Himali JJ, Debette S, Pikula A, Decarli C, Wolf PA, Vasan RS, et al. Red blood cell omega-3 fatty acid levels and markers of accelerated brain aging. Neurology 2012, 78:658-664.
42. Yang B, Wang FL, Ren XL, Li D. Biospecimen long-chain N-3 PUFA and risk of colorectal cancer: a meta-analysis of data from 60,627 individuals. PLoS One 2014, 9:e110574.
43. Zheng JS, Hu XJ, Zhao YM, Yang J, Li D. Intake of fish and marine n-3 polyunsaturated fatty acids and risk of breast cancer: meta-analysis of data from 21 independent prospective cohort studies. BMJ 2013, 346:f3706.
44. Seidl SE, Santiago JA, Bilyk H, Potashkin JA. The emerging role of nutrition in Parkinson’s disease. Front Aging Neurosci 2014, 6:36.
This is Part Three of a three-part series.
Part One- The Need for DHA by Vegans and Vegetarians
Part Two- Why You Should Eat Nuts and Seeds
