What We Recommend

At the Memory Center, in our consultation with patients we discuss anecdotal evidence suggesting omega-3 fatty acid may be beneficial in reducing risk and possibly progression of dementia. Real benefits would require eating oily fish throughout life, like many Asian island dwelling people have done for thousands of years. Decades ago there was little dementia in Japan, where people outlive us by five years or so! However, the incidence of dementia in Japan has increased every year and seems to correlate with the gradual westernization of the Japanese diet, reducing fish products and adding more meat–think of the proliferation of fast food hamburger and fried chicken places, which has been referred to as the
The McDonaldization of Society (a book by George Ritzer).

Omega-3 Fatty Acid from Krill oil Capsules
We recommend talking with your doctor about adding high dose supplemental omega-fatty acid, as the theory is to compensate for not having eaten fish daily for decades like the Japanese used to do, by ingesting high quantities of omega 3 fatty acid via Krill oil pills (about 1200-1500 mg twice daily). Krill is a small shrimp-like red colored animal that is among the base of the food chain in the oceans. It is what turns Salmon pink. Both fish and Krill oil contain the omega-3 fatty aides EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid); the former of which has been studied for many years as a potentially cardioprotective agent and the latter as a neuroprotective agent.

As previously reviewed in the section on Omega-3 the NIH reports that omega-3 fatty acid may reduce high triglyceride levels, thus reducing risk for heart disease, but the research supporting this is equivocal. Omega-3 supplements may help reduce rheumatoid arthritis symptoms. Some people believe they relieve dry eye syndrome–although, studies have shown it no better than a placebo for this purpose.

In Japan, where Alzheimer’s dementia seemed rare many years ago, until the national diet changed, a small amount of oily fish or oil was part of the daily diet for most people’s entire life. We can’t turn the clock back and have you start including oily fish in your everyday diet going back to early childhood to now. So, instead, we recommend megadosing to compensate for not having eaten small amounts daily for your past life. This is hypothetical, but the potential benefit seems to outweigh the risk for most people.

Since you can’t easily eat an entire Salmon daily, most people attempt to megadose on omega-3 via fish oil pills which is available in giant 1200-1500 mg. soft gel pills. In order to swallow the pill, it has to be in a soft capsule, but this resolves prematurely in the stomach and when fish oil combines with stomach acid, you get GERD–typically, observed by the “fishy burp.” You can buy burpless fish oil pills which come in a hard-sided capsule, but that is like trying to swallow a ping pong ball.

Add to this the impurities and the fact that much fish oil (almost all of which is manufactured in China) is rancid inside that capsule, and you get daily GI problems. Consider that heart burn is America’s biggest health problem in the over 50 population, and you are likely contributing to, if not causing, GERD when you take fish oil pills. In contrast, Krill oil is made via a Norwegian process usually aboard factory ships and never gets to China, and comes to the U.S. in pure form–but it can be expensive.

Krill oil typically comes in 300 to 400 mg pills and can cost $40 for 60 pills, and at 1200-1500 mg twice daily that is only a ten day supply. However, since it never gets to China for processing almost all krill oil is good so you can shop for it at Amazon.com, BJ's, Costco, Walmart, etc. As for whether you memory will improve, 2012 data based on over 3,500 people over 60 who took fish oil for six to 40 months did
not improve on measures of cognitive function. For any benefit in reducing risk of dementia (neuroprotection), it should be started as early as possible and considered a preventive strategy rather then an effort at treatment. As high dose krill and fish oil can thin the blood, again discuss use of this supplement with your PCP before starting, especially if you are on a blood thinner.

Studies find, in some cases, difference between fish and Krill oil, such as Krill oil may lead to higher amounts of EPA and DHA in blood levels than fish oil. Mostly they seem the same in effect, but Krill oil while more expensive and you likely need more of it than fish oil, seems far more pure and safe to ingest.

Flavanoids by Pure Dark Chocolate
We also advise flavonoids, which are antioxidant vitamins like those in red wine that seem to keep the French living forever, despite their typically cholesterol-rich diets and low levels of exercise. Like the Japanese, the French starting drinking red wine in childhood, and then typically have it daily for life. Since, we can’t turn the clock back for you, we suggest compensating for not having a little daily all your life by megadosing now–which is again a theory. And, since we don’t advise you drink several bottles or a case of red wine daily, we suggest you get your flavonoids from high dose pure cocoa-based dark chocolate. Avoid any processed with alkali (to cut the acidic taste of pure cocoa) as that destroys the flavonoids. Your best bet is to buy it from Trader Joes and use at least 8 gm daily (that’s about one short-side row of squares from their standard size bar), and buy the darkest chocolate you can enjoy. It comes in varying levels of Cacao, but gets increasingly bitter (acidic) the darker it is. BTW, did you know you can buy Trader Joe’s products on Amazon.com?

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In Summary
The best way to prevent Alzheimer’s dementia is probably to physically exercise, aerobically at least 20 minutes to one hour per day, at least five days per week. That has “moderate” evidence behind it based on clinical trials. While the evidence is more anecdotal, we suggest adding Krill oil pills (if your doctor agrees) and daily dark chocolate to complete what seems to be the best neuroprotective protocol aimed at slowing the progression or the development of neurocognitive disorders.

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