Physical Activity Tops the List
The first relates to physical activity, with the highest levels giving you the most protection against cognitive decline. Not only is physical activity directly beneficial to brain structures, but it also helps by reducing inflammation, supporting cardiovascular health, and boosting the immune system. They strongly advise smokers to give up the habit. However, the authors had to admit that as far as safeguarding cognition is concerned, the quality of the evidence is low. But since it has so many health benefits, no downsides, and it might reduce the risk of cognitive decline, they believe it's an important action to take. Their final strong recommendation is to not take multi-complex nutritional supplements, vitamins B and E, and polyunsaturated fatty acids. Findings to support taking them are, in their view, "inconsistent." Why this appears in their top three is a mystery. The purpose of this report is to suggest actions people can take to lower their risk of dementia. Are the authors seriously suggesting that refraining from taking nutritional supplements reduces the risk of cognitive decline?Stupid Things People Say about Supplements
Not to beat around the bush, this recommendation is nutty. There exists a wealth of rigorous, placebo-controlled studies to support the benefits of vitamins and omega 3 fatty acids. Meanwhile, large-population studies do NOT tell us much regarding supplement use, because they beg the question of what supplements all those thousands of people took, whether they faithfully took them every day, and for how many years they had been taking them. They also ignore interactions among supplements. Worst of all, these large-population studies depend on the participants’ word for what supplements they took and how often. Research on supplements suggests that most of the benefits go to those who take the full range of vitamins, minerals, and omega 3s, not to mention selected herbs and extracts such as resveratrol or PS. And I’m talking about taking them for decades. The longer and more faithfully you’ve been supplementing, the better off you’ll be. Now, I want to stress that a person who is really a walking nutritional disaster (and there are a lot of them out there) may get near-miraculous results if he or she starts taking, say, B12 after learning from their doctor they’re starting to get dementia. But, to use an old-fashioned expression, “That’s no way to run a railroad.” For the most part, supplements are foods, not quick-fix pharmaceutical drugs.Eat Mediterranean
Getting back to the more sensible ideas from the WHO report, they prefer to focus on food instead of supplements, and they encourage a Mediterranean-style diet. This guideline, like all the rest that follow, is a conditional recommendation. This means -- as far as cognition is concerned, and ignoring for the moment the other effects a food has on the body -- the authors are not sure about the balance between desirable and undesirable outcomes. And they acknowledge that different choices might be appropriate for individuals according to their circumstances. They accept that dietary factors are involved with the development of dementia and that "a healthy diet may have a great preventive potential for cognitive impairment." Fruit, vegetables, nuts, olive oil, and coffee are most consistently associated with decreased dementia risk, they write. The other conditional recommendations are to:- Stop drinking excessive amounts of alcohol
- Challenge the brain with cognitive stimulation or training
- Lose weight if overweight or obese
- Reduce high blood pressure
- Manage diabetes with medications or lifestyle interventions
- Correct abnormal blood fats
