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Balanced Fats and Brain Function

One of the biggest health concerns as we age is a decline in cognitive function associated with dementia. A condition that describes changes in cognitive function without a change in consciousness and is the result of underlying neurodegenerative diseases. Dementia can be classified as Alzheimer’s disease (AD), frontotemporal lobar degeneration (FTLD), vascular dementia (VD), dementia with Lewy bodies and Parkinson’s associated dementia (PD). With each type of dementia there is a distinct pathophysiology with different genetic, metabolic and lifestyle risk factors. While dementia is difficult to treat once symptoms begin to appear it is important to consider preventative measures and implement them early and consistently throughout our lives.

These measures include regular exercise, preventing and healing traumatic brain injuries, regular sleep, stress reduction, metabolic regulation and of course, a whole foods diet. While a whole foods diet may seem like a vague term for “eating well” there are some specific recommendations research has for cognitive health. Today we will be specifically examining the delicate relationship between fats and dementia risk.

The brain and nervous system are composed of a variety of cells such as neurons, astrocytes, oligodendrocyts, ependymal cells and oligodendrocytes, and each of these cells has a large fat composition. These fats ensure cell membranes are fluid and that neurons can fire rapidly. Their importance is highlighted by the fact that the brain composition is about 60% different types of fats and lipids.

Here are some of the key fatty acids and lipids in the brain and what they do:

Omega 3 fatty acids, specifically DHA: The popularity of omega-3 fatty acid supplements over the last decade has largely been centered around cardiovascular benefits. However, it’s important to understand the importance of omegas for brain development and function. One omega 3 fatty acid is docosahexaenoic acid (DHA) which is primarily found in nerve membrane, and influences cell signaling and anti-inflammatory pathways.  DHA appears to increase brain derived neurotrophic factor (BDNF) which is an important signaling molecule to promote the growth of nerve cells. It’s so important for brain development that it has been added to most prenatal supplementation regimes and is being studied in patients’ recovery from traumatic brain injuries.

Phosphatidylserine (PS): This is one of the most abundant phospholipids in the brain. PS is incorporated into the neuronal cell membranes and therefore seems to have improvements in diseases or pathologies with underlying neuronal damage. A review article published in 2015 provides an insight into the benefits of supplemental PS in cognitive health as we age, stress responses and exercise endurance. In this review 127 articles were included demonstrating benefits in patients with memory loss, vocabulary and attention deficits.

Phosphatidylcholine (PC): PC is an important lipid for brain function as it is a source of choline, an essential nutrient which is the precursor for the neurotransmitter acetylcholine. PC is thought to enhance the brain’s ability to synthesize and use its own phospholipids, improves structural integrity of nerves, assist in membrane repair and increases the manufacture or release of key neurotransmitters. Diets high in eggs and meat seem to provide high amounts of PC and have been related to reduced risk for cognitive dysfunction and dementia. With a recent Finnish study noting dementia risk decreased by 28% in high PC intake group.

While it’s important to consume sufficient fats, the type of fat is very important. Particularly because this has a very strong influence on blood cholesterol levels.  Cholesterol is a waxy lipid substance found in all cells and is used as a base for the production of steroid hormones, bile salts and vitamin D, as well as maintaining cell membrane fluidity. In a classic goldilocks’ situation, it seems that while too little cholesterol may accelerate neurodegeneration and cognitive decline, too much (particularly the form of elevated LDL) is considered a significant risk factor for dementia. One can imagine when excess cholesterol is present in the blood it blocks blood vessels restricting blood flow to the brain. This can wreak havoc causing damage to neurons and other cells of the brain.  In 2021 researchers from Shanghai found that LDL levels in patients was strongly inversely associated with dementia risk. However, these authors point out that vascular risk factors including the genetic presence of specific APOE gene variants can shift this cholesterol-cognition association. APOE is a gene for proteins which metabolize cholesterol in neurons and is considered an important marker of risk as it can mediate beta aggregation and clearance of cholesterol. This gene has 4 known variants (E1-4), most people have ApoE3, however the rare form is the E4 and is associated with late onset Alzheimer’s disease. While the ApoE2 allele seems to confer some degree of protection. Therefore, the genetic allele type alongside insights into the total cholesterol, LDL, HDL and triglycerides is the most effective option in identifying risk.

So remember fats are friends… just not too much!

Select references:

Glade MJ, Smith K. Phosphatidylserine and the human brain. Nutrition. 2015;31(6):781-786. doi:10.1016/j.nut.2014.10.014

Maija P T Ylilauri, Sari Voutilainen, Eija Lönnroos, Heli E K Virtanen, Tomi-Pekka Tuomainen, Jukka T Salonen, Jyrki K Virtanen. Associations of dietary choline intake with risk of incident dementia and with cognitive performance: the Kuopio Ischaemic Heart Disease Risk Factor Study. The American Journal of Clinical Nutrition, 2019; DOI: 10.1093/ajcn/nqz148

Ding D, Zhou F, Cao Y, Liang X, Wu W, Xiao Z, Zhao Q, Deng W. Cholesterol profiles and incident cognitive decline among older adults: the Shanghai Aging Study. Age Ageing. 2021 Feb 26;50(2):472-479. doi: 10.1093/ageing/afaa140. PMID: 32766741.

About The Author

Dr. NavNirat Nibber, ND is a graduate of the Canadian College of Naturopathic Medicine and a registered Naturopathic Doctor. She is a Co-Owner at Crescent Health Clinic, as well as a Senior Medical Advisor at Advanced Orthomolecular Research.

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