Brain health supplements offer mostly hype, false hope

Liz Seegert

About Liz Seegert

Liz Seegert (@lseegert), is AHCJ’s topic editor on aging. Her work has appeared in NextAvenue.com, Journal of Active Aging, Cancer Today, Kaiser Health News, the Connecticut Health I-Team and other outlets. She is a senior fellow at the Center for Health Policy and Media Engagement at George Washington University and co-produces the HealthCetera podcast.

brainHealthSupplements

Photo: Kenny Stoltz via Flickr

I don’t know about you, but every time I see a commercial for one particular supplement marketed to improve brain health, I cringe. The ad is misleading and can lead people to think that consuming essentially an unregulated blend of herbs and spices can help stave off cognitive decline or even prevent Alzheimer’s. If only it were true.

The ads are so misleading that the Federal Trade Commission and state of New York actually took the manufacturer to court in 2017 to get the company to stop airing them. (A judge later dismissed charges against the company’s former president, but let the rest of the suit go forward). In July 2019, a class-action lawsuit was filed against the company for false advertising claims.  As the American Council on Science and Health stated, “the company’s ‘evidence of safety’ basically admits that the product cannot work.” The product remains on store shelves and is still a top seller, according to a leading trade publication.

It’s a sign of how desperate people are to stave off memory loss.

More than a quarter of Americans age 50 and older take at least one supplement daily for brain health, according to a 2019 AARP Brain Health and Dietary Supplements survey. Among this group, 21% said they do it to maintain memory, 20% to improve memory, 11% to delay onset of dementia and 8% to reverse it.

In 2018, an estimated 85,000 dietary supplement products worth about $40 billion were sold in the U.S., with sales topping $120 billion globally, according to the Nutrition Business Journal. While some other estimates found different numbers, they all agree that this is a booming industry. Brain health supplements generated some $3 billion in global sales in 2016 and are projected to reach $5.8 billion by 2023.

Unfortunately, the scientific evidence doesn’t back up the hype.

A recent report from the Global Council on Brain Health (GCBH) looked at whether certain dietary supplements affect cognitive health among adults 50 and older. GCBH is an international collaborative of scientists, health professionals, scholars and policy experts focusing on age, brain health and cognition. According to the organization, the goal is to offer optimal, evidence-based lifestyle recommendations that may impact brain health as people age. The organization is supported by AARP and Age UK.

“A significant lack of understanding exists about how the level of regulatory scrutiny for dietary supplements differs from prescription drugs and over-the-counter medications,” the report concluded. “People often think supplements are subject to the same government regulations as prescriptions and over the counter drugs.”

We know that brain health is strongly associated with physical health, diet and exercise.

A University of Michigan national poll on healthy aging found that one in three adults ages 50 to 64 (34%) said their memory was as good as when they were younger; 59% said it was slightly worse and 7% said it was much worse. Those who said they were in fair or poor health were more likely to say their memory was worse compared with their younger selves. Respondents who exercised felt their memory was sharper compared with those who were active once a week or less. Social activity, a healthy diet and getting enough sleep also boosted self-rated perceptions of cognition.

More than half (55%) of people in the poll thought they were as likely as others their age to develop dementia, while 39% thought they were less likely. Doing crossword puzzles or other brain games was a popular strategy for 55% of respondents. Almost as many (48%) said they took a vitamin or supplement with about a third (32%) specifically cited fish oil or omega-3 supplements. However, just 5% had discussed ways to prevent dementia with their physician.

Misconceptions about regulation

Nearly half (49%) of older adults in the U.S. mistakenly think the FDA also ensures that vitamins and supplements are safe and effective, and more than a third (36%) think herbs and enzymes are scrutinized like prescription medications by the government, according to GCBH.

While supplement companies cannot make health claims that their products treat diseases such as dementia without reliable scientific evidence, their product statements generally are not reviewed by regulatory agencies before hitting the market. Agencies can only take enforcement action after a product is on the shelf, giving many people a potentially false sense of security in the interim, the report said.

The report’s consensus statement included 15 key points about the tenuous connection between supplements and brain health, among them:

  • The best way to get nutrients is through a healthy diet.
  • Don’t take any supplements for brain health without consulting a health professional
  • There is insufficient evidence that multivitamins will improve brain health.
  • Few supplements have been carefully evaluated for their effect on brain health, and among those that have no benefit has been found for people with otherwise normal nutrient levels.
  • While problems with cognition have been associated with particular nutritional deficiencies like B12, there’s little evidence to suggest that daily dietary supplements can affect brain health in healthy older adults. Consumption of fatty fish and other seafood may benefit cognitive function, but there is less evidence to recommend taking supplements like omega-3 or fish oil.
  • There’s also insufficient evidence that other supplements can benefit brain health; be wary of exaggerated or vague claims by manufacturers or distributors.
  • Ingredients in supplements can vary widely and are not reviewed by the FDA for purity — some could even be harmful.

GCBH called for supplement manufacturers to conduct and publish rigorous, scientific studies, subject to independent peer review to evaluate supplements’ effects on brain health. According to one expert at the recent Gerontological Society of America conference, some current supplement ads are so misleading they should not only be pulled but the CEOs should go to jail. “People are wasting their money on this crap. It’s very scary and it’s irresponsible.”

Coverage ideas

  • Journalists can talk to local pharmacists about supplement use and whether they recommend any supplements or vitamins for brain health, boosting memory or staving off dementia. Why or why not?
  • What do customers who purchase these products think? Do they know the industry is unregulated and these products untested?
  • Are there any state laws requiring a complete disclosure or additional disclaimers?
  • What local programs are available in your community for either physical or social activity to help reduce the risk of developing dementia?

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