Welcome to Straight Talk on Health, I’m your host Dr. Chet Zelasko. Straight Talk on Health is a joint production with WGVU in Grand Rapids MI. I examine the world of health. Whether it’s research that makes the news, another miracle diet, or a new food fad, I look at the science behind them, and let you know whether it’s real or not. You can check out other things that I do on my website drchet.com and sign up for my free emails.
If I ask you what you think a good brain food would be, what would be your answer? I think for most people, it would probably be fish to especially cold water fish like tuna and salmon. I don't think we can discount how important omega-3 fatty acids are to the function of our bodies, and especially, our nervous system. But based on recent research, I don't think we have to get quite as exotic as cold water fish. I think we can find what we need in the produce section or at farmers markets. I'm talking about the phytonutrient class called flavanols. Dietary flavanols are bioactive compounds commonly found in tea, apples, berries, grapes, cocoa, nuts, and other fruits and vegetables.
Today, we're going to take a look at a recent study on the phytonutrient flavanol. The title of the study is Dietary Flavanols Restore Hippocampal-Dependent Memory In Older Adults With Lower Diet Quality And Lower Habitual Flavanol Consumption. The study was published in the Proceedings of the National Academy Of Sciences in early 2023. The article is Open Access so it is available for you to read in its entirety if you choose.
A little about the sponsors of the study. The COcoa Supplement and Multivitamin Outcomes Study or COSMOS for short is supported by an investigator-initiated grant from Mars Edge, a segment of Mars dedicated to nutrition research and products, which included infrastructure support and the donation of study pills and packaging. Several researchers from Mars Edge research were co-authors of the study. Am I overly concerned about outside influence on the study? Not really. The tests that they used, as well as the length of the study to determine outcomes, seem appropriate. Let's take a look at this study.
Researchers recruited over 7,500 men over 60 and women over 65 as potential subject. After meeting the criteria established for inclusion in this clinical trial, researchers ended up with just over 3500 subjects. To test the theory that flavanols would improve memory, researchers used three different online memory tests as their criteria measures. They used a form of the Healthy Eating Index to evaluate dietary intake of flavanols. The Healthy Eating Index (HEI) is a measure of diet quality used to assess how well a set of foods aligns with key recommendations of the Dietary Guidelines for Americans.
The HEI uses a scoring system to evaluate a set of foods. The scores range from 0 to 100. An ideal overall HEI score of 100 reflects that the set of foods aligns with key dietary recommendations from the Dietary Guidelines for Americans. Perhaps I'll go over them in another edition of STOH but I'm limited by time today.
They also used a test for the urinary excretion of flavanol by-products to confirm the amount of flavanols in the diet.
Half the subjects got a flavanol extract from cacao that contained at least 500 mg of cocoa flavanols, including 80 mg of epicatechin. That’s a phytonutrient we usually find in green tea. The remainder of the subjects received the placebo. They tested the subjects before the study began and then at the end of 1, 2, and three years.
The primary outcome was not met; not all subjects saw an improvement in memory after year 1. The secondary outcome was met and it may prove to be even more important. Why? Let’s take a listen.
What they found was that those with the lowest intake of flavanols from foods and drinks had the most improvement in measures of memory function. What that means is that there were benefits for people who did not eat enough fruits and other flavanol containing foods but did supplement their diet with the cacao flavanols every day.
One thing they did not test to see if the lack of eating flavanol containing foods resulted in a decline in memory function. That would fall into the category of “first do no harm.” Understanding that flavanols are beneficial for more than just memory, it would not be responsible to have a person decrease intake of them. To be honest, it's difficult enough to get people to eat their fruits, vegetables, nuts, and other flavanol-containing foods. I wouldn't want to impact their diet just to see if my hypothesis was correct.
They also did not find additional benefits for those with the highest intake of flavanols from diet while taking the supplement. That means that a great diet has great benefits. People may not need to supplement their diet with flavanols if they get enough from their diet. However, as I just got done saying, we just don't eat enough fruits and vegetables as well as other flavanol containing foods to begin with. So supplementation may end up being critical.
There are three things we can take from this study:
1. Regular intake of flavanols from supplements can compensate for weaknesses in the diet. In this case it was a cocoa extract but there are many others from other sources of flavanols in the marketplace.
2. Eating flavanol-containing foods provides a wide variety of flavonoids including anthocyanidins, flavan-3-ols, flavanones, flavones, and isoflavones. In my opinion, eating and drinking the plant based substances is a better approach while using additional flavonoids from supplements is a great insurance policy.
3. The memory tests used in the study focused on one area of the brain - the hippocampal area. The supplementation did not appear to impact the prefrontal component of cognitive aging.
When you look at the actual changes in the results for each memory test, they do not seem to be that overwhelming. Taking flavanols is not going shift you to a genius class IQ. But the researchers said something important. This is going to be an ongoing battle as we age and if you can continue to strengthen your ability to learn and remember, the results may be additive. It's like making a 1% improvement every week, month, or year depending on the area that's being worked on. It doesn't take long before you can see dramatic improvement and when it comes to memory, that's critical as we age.
I think we should look at it as though every little bit helps if we want to age with a vengeance. I also think that the earlier one begins developing the habit of eating more fruits and vegetables, drinking teas, coffee and cocoa drinks, the better our brains will be and as a bonus, the rest of our body gets to enjoy the benefits as well.
Until next time this is Dr. Chet Zelasko saying health is a choice people. Choose wisely today and every day.
