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Issue #58 (August 2019)

From the Editor

Volume 1

Regular NERD readers may have noticed that I’ve been on a safety kick for the past few volumes. Writing frequenety about safety must have planted a safety bug in my brain, since over the past month, I decided to investigate some of the supplements I take. I encourage you to do the same, since you’ll probably get something out of it: either valuable information about your supplements’ quality, or valuable information about how hard that information can be to get from some supplement companies.

I set out to find out two things about some of my supplements: purity and potency. In other words, I wanted to know if they’ve been tested for any contaminants and what the results were, and also if the manufacturer has taken a look at whether the dose on the bottle actually matches what’s in the bottle.

I don’t take a whole lot of supplements to begin with, since diet and exercise is usually the key to better health — supplements are just garnish. But I narrowed my exploration to just a couple of supplements I take that have the potential for purity and potency issues, namely whey protein and fish oil.

The possible problems with fish oil are something long-time NERD readers may be familiar with, since we’ve covered some research on this way back in NERD #5. The study we covered reported that fish oil marketed in Australia and New Zealand had a lower potency than what was on the label, in part due to the oil going rancid. While more research we covered in NERD #36, Volume 1 found that this problem was either corrected or was due to a difference in testing methods, I still thought it’d be interesting to check out my fish oil’s potency. Fish oil could also be contaminated with things like mercury (although this may not[1] be a big problem) or organic pollutants[2], so I definitely thought it was worth a check.

Whey protein can also be problematic. Fortunately, the brand I use gives the complete amino acid profile on the container, and nothing looked too fishy there. But given the possibility of contamination from metals and BPA, I also thought it’d be wise to check out my protein powder, too.

My protein powder and fish oil are both distributed by the same company, and both listed the same phone number to call for the information I wanted. I got pretty acquainted with that phone number, since I’ve called three times so far and have not received any info from them.

The customer service representatives were all great to deal with, and noted that my request was entered in their system and verified my contact info. However, the request then gets forwarded to specialists who are supposed to handle purity and potency inquiries. And, after about a month, I haven’t heard anything. I may try one more time, but the experience has definitely made me reconsider my brand choice.

I’d like to hear about any attempts you’ve made to contact the manufacturers or distributors of your supplements. If you’ve tried, have you got the info you wanted? If you haven’t tried, I encourage you to give it a try! Let me and your fellow NERD readers know how it goes in the NERD Facebook forum!

Gregory Lopez, MA, PharmD
Editor-in-chief, Nutrition Examination Research Digest

Volume 2

Examine.com gets a lot of inquiries about supplements that can improve cognitive function and brain health. While we do tackle some of these types of supplements on our site, we don’t often cover them in the NERD. The simple reason for this is that we stick mostly to clinical trials and meta-analyses of clinical trials here, since these have the best chance of determining causality. While animal and observational studies are a crucial part of research, they’re not as reliable as randomized clinical studies for determining whether or not a supplement is actually effective in people. We also mostly cover recent, higher quality research in the NERD. Since there are few recent, high quality randomized clinical trials looking at nootropics and brain health supplements, the NERD winds up with a dearth of information on them.

We do cover useful brain health stuff when the opportunity arises, though. For instance, we reported on the World Health Organization’s (WHO) first-ever set of guidelines for reducing the risk of cognitive decline and dementia in the last volume of the NERD. The strongest recommendations in those guidelines focused mostly on the staples of health: diet and exercise. Their take on supplements was that they shouldn’t be recommended to prevent age-associated cognitive decline since there wasn’t good evidence supporting their efficacy.

Roughly around the same time as the WHO guidelines were released, a report from the Global Council on Brain Health (GCBH) focusing entirely on supplementation was also released. The GCBH is a panel of health professionals and policy experts focusing on the brain health of people over 50. It’s organized by two nonprofit organizations: the American Association of Retired Persons (AARP) and Age UK.

The report came to pretty much the same conclusion that the WHO did: there’s no good evidence that any supplements are useful or keeping aging brains healthy. The GCBH doesn’t endorse any supplements for this use, unless a healthcare provider has identified a specific nutritional deficiency. They do mention that the risk for deficiency increases in older people, since dental issues, medication use, and lower absorption can all cause nutrient deficiencies. They also mention that folate and vitamin B12 deficiencies are some of the more common culprits that can impact brain health if their levels are too low. While they note that vitamin D deficiency is a concern for people as they age, too, their position is that it’s unclear how much vitamin D deficiency impacts brain health at this time.

Just like the WHO, the GCBH also thinks that nutrition is an important factor for healthy brains, but strongly recommends a healthy diet over supplementation.

The report has a lot more useful information than I can cover in a page. Some of the more interesting tidbits include suggestions on how to find quality supplements, the differences between how drugs and dietary supplements are classified in the United States, and particular details about the state of the evidence for several individual vitamins and supplements. The text is freely available online and is pretty readable, so if you’re interested, I encourage you to check it out!

Gregory Lopez, MA, PharmD
Editor-in-chief, Nutrition Examination Research Digest

See other articles in Issue #58 (August 2019) of Study Deep Dives.