Supplements & functional ingredients
of experts from a broad array of disciplines and perspectives. Members of the GCBH met in Washington, DC to address the topic of dietary supplements and brain health for people age 50 and older. Throughout the discussion, experts examined the evidence on whether the consumption of dietary supplements can impact people’s cognitive function as they age. This supplements report summarises the consensus reached by the experts and describes the major points of discussion that led to their recommendations. It also identifies gaps in knowledge about dietary supplements and brain health. The paper is not intended to be a systematic, exhaustive review of all pertinent scientific literature on the topic. Rather, the selected references provided give helpful background material and present a sizable sample of the current evidence underpinning the GCBH consensus in this area.
Supplementing health Dietary supplements or, more commonly, “supplements”, are products taken by mouth that contain a “dietary ingredient”. Dietary ingredients include vitamins, minerals, amino acids, botanicals [including herbs] and enzymes, as well as other substances alone or in combination that can be used to supplement one’s diet. Supplements come in many forms, including pills, capsules, tablets, powders, food bars and liquids. In 2018 an estimated 85,000 types of dietary- supplement products were sold in the US alone, according to the Nutrition Business Journal, with more than $40bn in retail sales in the US and $121bn worldwide. In conjunction with this report, AARP surveyed a representative sample of adults age 18 and older on their use of various dietary supplements.
Among adults age 50 and older, 81% believe that supplements are at least somewhat important for overall health; 69% are currently taking a dietary supplement at least three times a week. The US Government Accountability Office (GAO) recently examined available data and found that memory supplements were a small but growing portion of the overall market for dietary supplements. In the US, sales nearly doubled in value from 2006 to 2015, increasing to $643m in 2015. According to an industry forecast report, brain-health supplements generated $3bn in sales globally in 2016, and that figure is projected to reach $13.8bn by 2023. Given the vast interest people have in maintaining and improving their brain health as they age, the GCBH has no doubt that the use of brain-health supplements – targeted at an increasingly ageing population worldwide – is growing, and large numbers of people are already taking them.
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The 2019 AARP Brain Health and Dietary Supplements Survey shows that more than a quarter of Americans age 50 and older are regularly taking supplements for their brain health – 26% of adults take at least one supplement for brain-health reasons. Among adults specifically taking dietary supplements for brain health, 21% report taking dietary supplements to maintain – and 20% report taking them to improve – their brain health. Interestingly, 11% report currently taking a supplement to delay the onset of dementia, and 8% say they take a supplement to reverse dementia. The GCBH document summarises the state of the scientific evidence on whether dietary supplements currently on the market can benefit the brain health of adults, focusing primarily on those over 50. It discusses a broad range of issues pertaining to supplements and cognitive health and examines the evidence relating to vitamin and mineral supplements, focusing primarily on the eight B vitamins, and vitamins D and E. It also discusses other well-known supplement ingredients commonly marketed for brain health including: the omega-3 fatty acids docosahexaenoic acid (DHA), eicosapentaenoic acid (EPA), and alpha linoleic acid (ALA); fish oil; medium-chain triglycerides (coconut oil); huperzine-A; caffeine; nicotinamide riboside; phosphatidylserine; curcumin; flavanols; coenzyme Q10 (CoQ10); ginkgo biloba; and apoaequorin (derived from jellyfish). These consensus statements and recommendations are based on the GCBH experts’ knowledge of the field and their evaluation of the best available evidence from peer-reviewed, published observational studies and randomised controlled trials in humans, as well as studies conducted in animals designed to help determine the effects of dietary supplements on brain health.
81% AARP 61%
The percentage of people over 55 currently taking a dietary supplement at least five times a week.
AARP
Among adults age 50 and older, the majority believe that supplements are at least
somewhat important for overall health.
“The GCBH believes that more high-quality clinical studies of the safety and efficacy of dietary supplements on brain health outcomes in humans are needed.”
The role of manufacturers The context in which dietary supplements are manufactured and sold also plays an important role in the consensus and the resulting recommendations. Around the world, manufacturers are generally prohibited from selling unsafe ingredients, but there are no known countries that regulate or evaluate dietary supplements for effectiveness before they are permitted to be sold. There is also no global consensus on how these types of products should
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