Marmara University, Faculty of Pharmacy

"It is in our hands to maintain our cognitive health throughout life and prevent decline in cognitive function!"

Drinks To Boost Cognitive Health; Omega, Adaptogens, and Nootropics

Title:

What is cognitive health?

Cognitive health can be defined as the ability to think, learn and remember which is necessary to effectively perform daily activities. Genetic and environmental status, lifestyle, diet, thinking skills, tools use and habits are some of the factors that affect a person's cognitive health. This concept, which constitutes an important aspect of brain health, helps the brain to function healthy and perform its ongoing functions. So, what can be done to protect our cognitive health and reduce the risk of cognitive decline? Let's examine this process in more detail.

A systematic overview of cognitive health

Brain health can be affected by age-related changes, injuries such as stroke or traumatic brain injuries, mood disorders such as depression and addiction and diseases such as Alzheimer's Disease and other dementia-related disorders. Heart health has also been linked to cognitive health. One study has showed that cardiovascular risk factors, such as being overweight and having high blood sugar level and blood pressure are also associated with cognitive decline and reduced cognitive health later in life.

Factors affecting cognitive performance

Both physical and mental health affect an individual's cognitive performance. Regular exercise and a healthy diet are important for our physical health. On the other hand, socializing and engaging our minds with useful thoughts affect our mental health. Other factors affecting cognitive health are advanced age, sedentary life, drug use, addictions (alcohol, smoking, etc.) and sleep problems.

Single or combined use of medication can cause confusion and memory loss in elderies. In addition, some medications can interact with foods and beverages, nutritional supplements or alcohol. These interactions can affect how a person's brain functions. Some examples of medicines that can impair cognitive function in elderies are as follows:

Medicines to relieve stomach and intestinal cramps

Muscle relaxants

Prostate medicines

Antihistamines used for allergies

Sleep medicines

Antidepressants

Cognitive health: Age and physical activity

A healthy lifestyle at a young age is an important factor in maintaining cognitive health in later life. As individuals age, brain function begins to change and decline for a variety of reasons. Habits (such as smoking or alcohol consumption) and lack of physical activity can have a negative impact on cognitive function in old age. A study of older adults has showed that smoking increases the risk of Alzheimer's Disease, while alcohol consumption can lead to cognitive decline and dementia.

Being physically active, regular exercise and sports, walking, and participating in various physical activities, keeps you energized and in a good mood throughout the day. Routine exercise improves memory and learning mechanisms. Having a physically active life can also help delaying or preventing diseases such as blood pressure, diabetes and heart disease.

Apart from aging and physical activity, nutrition also has important effects on cognitive health. Let's take a look at the foods, drinks, eating habits and diets that are effective in cognitive activity.

Nutrition and cognitive activity

A healthy and balanced diet consists of adequate protein, carbohydrate, fat and water consumption. Consuming fruits, vegetables, cereals and fibrous foods and meeting our sugar and salt needs within daily limits ensures that we have a healthy body and weight. Consuming too much fatty foods and convenience foods causes weight gain and obesity. Obesity can have negative effects on cognitive function later in life. Today, there are some diets that are said to be effective in cognitive health. For example, there are studies showing that the Mediterranean diet and the MIND diet are effective in protecting brain health and preventing the decline in cognitive function due to aging. In one study, the MIND diet has shown to reduce the risk of Alzheimer's Disease in 53% of the participants.

Nutritional models in cognitive health: Mediterranean and MIND diet

The Mediterranean diet is the traditional diet of people living on the Mediterranean coast. Countries that come to mind when it comes to the Mediterranean-type diet may be Italy, Greece, Spain or Morocco. These types of diets are also common in the Aegean and Mediterranean regions of Turkey, which have a Mediterranean coast.

There is no uniform diet that comes to mind when we think of the Mediterranean diet. It may vary from region to region, but there are basic common factors. The Mediterranean diet is predominantly based on vegetables and olive oil as a fat. This type of diet has a food pyramid. At the base of the pyramid are mostly unrefined carbohydrates and starches such as bread, pasta, cereals, bulgur, potatoes and grains. In the middle of the pyramid are fruits and vegetables, olives and olive oil which should be consumed every day. Given that this diet is low in animal protein, towards the top of the pyramid are chicken, fish, eggs and cheese which should be eaten no more than a few times a week. Red meat and sweets form the top of the pyramid. In general, red meat is rarely consumed.

Another type of diet that is effective in maintaining cognitive health is the MIND diet, which is a combination of the Mediterranean diet and the DASH diet. We have explained the Mediterranean diet in detail above. Let's talk about the DASH diet. DASH diet is defined as “Dietary Approach to Stop Hypertension”. A diet rich in plant-based foods is recommended in the DASH diet. In this diet, consumption of foods and beverages containing saturated fats, red meat, sodium, refined sugar is limited. Consumption of fruits, vegetables, low-fat dairy products, whole grains, poultry, fish and nuts is recommended. These two types of diets are reported to lower blood pressure and reduce the risk of chronic diseases such as cardiovascular diseases and diabetes.

What drinks boost cognitive health?

In addition to the foods consumed in a normal diet and the Mediterranean-MIND diet, beverages also play an important role in cognitive activity. What do you think cognitive health-boosting drinks can be? I can hear you say omega. Yes, omega consumption improves cognitive performance; but what other types of drinks can be effective in cognitive activity? Let's take a look at these drinks that we can consume to maintain cognitive function and prevent cognitive decline.

Omega fatty acids

In chemistry, fatty acids are organic compounds composed of carbon, hydrogen and oxygen atoms. There are three different omega fatty acids. These are Omega-3, Omega-6 and Omega-9 fatty acids. Fatty acids that cannot be synthesized in the bodies of humans and other mammals must be taken from outside through supplementary foods called essential fatty acids. Omega-3 and Omega-6 fatty acids are polyunsaturated and essential fatty acids. Omega-9 fatty acids are monounsaturated and can be produced spontaneously in the body, so they are non-essential fatty acids.

The functions of the various forms of fatty acids are different. Omega-3 generally supports heart and brain health. In other words, it is effective in cognitive activity. It is especially important in the brain development of infants. Omega-6 has a positive effect on the treatment of chronic disease symptoms, while Omega-9 regulates cholesterol levels and the supports the treatment of patients with diabetes.

The key to cognitive performance: Omega-3

Omega-3, as mentioned above, is a fatty acid that cannot be produced in the human body and must be taken from outside through food and supplements. Omega-3 supports brain and nervous system functions, protects against age-related cognitive decline, protects heart and eye health, strengthens immunity and reduces inflammation. It has positive effects on mood reducing symptoms of depression and anxiety, Alzheimer's Disease and other dementia risks.

There are basically three types of omega-3 fatty acids. These include:

Alpha-Linolenic Acid (ALA)

Eicosapentaenoic Acid (EPA)

Docosahexaenoic Acid (DHA)

ALA is a plant origin fatty acid and responsible for heart health. Walnuts, flaxseeds and chia seeds are the main sources of ALA. The human body can convert some of the ALA to EPA and DHA.

EPA is derived from seafood. It has an effect on cardiovascular health and reduces inflammation. Fish oil, salmon, mackerel are examples of EPA sources.

The form of Omega-3 responsible for cognitive health and brain function is DHA. It supports brain development. Its use, especially during pregnancy, contributes to the brain development of babies. DHA supports memory and is effective in improving the mental focus. It slows down the decline in cognitive activity in elderlies, supporting lifelong cognitive health and performance. DHA is found in large amounts in neuronal membrane phospholipids which play a role in the proper functioning of the nervous system. It is therefore thought to play an important role in Alzheimer's Disease. In one study, reduced consumption of omega-3 fatty acids or fish was associated with an increased risk of age-related cognitive decline or dementia such as Alzheimer's Disease.

What are the symptoms of omega-3 deficiency? Which foods contain omega-3?

Omega-3 deficiency in the body manifests itself with some symptoms. Common symptoms in individuals with omega-3 deficiency are as follows:

Joint pain and inflammation (very frequent)

Impaired consciousness and inattention

Difficulty concentrating and memory problems

Inconsistent changes in mood

State of depression

Problems with heart health

Dry eye and visual disturbances

Dry skin and weak hair

So, which foods rich in omega-3 should people with these symptoms consume? Foods containing omega-3 are divided into two as plant and animal origin. Examples of plant sources rich in omega-3 include soybeans, walnuts, flaxseed and oil, chia seeds, canola oil, green vegetables, and seaweed. Fish oil, mackerel, salmon, sardines, anchovies and eggs are examples of foods containing omega-3 from animal sources. In the treatment of omega-3 deficiency, food intake should be preferred. If it is not enough, supplements should be used. In addition, consuming Omega-3 together with fatty foods increases its absorption in the body.

Support against mental fatigue and stress: Adaptogens

Stress is part of our lives; however, it needs to be properly controlled so that it doesn't negatively affect our lives. Prolonged exposure to the stress can lead to various diseases such as hypertension, heart disease, anxiety, depression and memory impairment. Adaptogens are active ingredients found in certain plants and fungi that influence how the human body copes with stress, anxiety and fatigue. In normal doses, they don’t cause toxic effects. The purpose of adaptogens is to help the body return to a state of balance (homeostasis). In one study, adaptogens have been shown to reduce fatigue by increasing mental working capacity under stress and fatigue conditions, especially by increasing tolerance to mental fatigue and strengthening attention.

Adaptogens of plant origin

Plant-derived adaptogens are medicinal plants and phytochemicals that can show adaptogenic activity. Some plants showing adaptogenic properties are:

Bacopa monnieri (Water marjoram)

Panax ginseng (Asian ginseng)

Eleutherococcus senticosus (Siberian ginseng)

Withania somnifera (Indian ginseng)

Rhodiola rosea (Rose root)

Bacopa monnieri is a wild plant that grows mainly in the Potohar marshlands of Pakistan. The bacosides derived from this plant which have important bioactivities, are the components responsible for cognitive enhancing effects.

Panax ginseng, also known as Asian ginseng, is one of the most widely used ginseng species. Originating from Korea, China, and Japan, Panax ginseng has long been used in the traditional medicine. This type of ginseng helps relieving both mental and physical fatigue. It increases energy and performance.

Eleutherococcus senticosus (Siberian ginseng) increases resistance to stress and fatigue. It is used as a stress coping agent. It also has an immune-boosting effect.

Withania somnifera (Indian ginseng), also known as Ashwagandha, relaxes the body by reducing the brain's response to stress. It is also a powerful antioxidant.

Rhodiola rosea (Rose root) grows at high altitudes in the polar regions of Europe and Asia. It relieves symptoms of fatigue, anxiety and depression and improves performance in stressful situations.

Usage forms of adaptogens

Adaptogens can be consumed in multiple forms; for example, you can consume the tincture form, which is the liquid form of herbal extracts. If you don’t prefer the liquid form, you can also use it as capsules. You can also consume these forms by adding them to food and drinks (tea, etc.). Can side effects occur in adaptogen consumption? Depending on the type of plant used, side effects such as allergic reactions, abdominal pain, constipation, nausea, and diarrhea can be seen though rarely. In addition, if you have disorders such as depression, insomnia, blood pressure, and diabetes adaptogens may change the effect of the medicines you regularly take; therefore, adaptogens should be used with caution.

Nootropics: Cognitive enhancers

Nootropics are a group of medicinal substances that improve cognitive functions, especially when learning and memory functions are impaired. These substances act when cognitive functions are clearly impaired. These compounds, which have the ability to increase intelligence and improve memory, are also called smart drugs and are widely used among students. However, they don’t work after one use. They require long-term use to achieve the desired results. They are usually obtained from natural origins and can be used as food supplements and herbal extracts.

Nootropics are basically analyzed under 4 main headings. Classical nootropic compounds are the plants extracts that increase brain metabolism with cholinergic and nootropic effects.

Classification of nootropics

Examples of classical nootropic compounds are decanol (DMAE), meclofenoxate, nicergoline, piracetam and piritinol. Known to be effective in the brain's learning and memory processes, these compounds are used in conditions such as memory loss, decreased alertness, difficulty concentrating, mood changes, dizziness, and fatigue. Their metabolic effects on brain tissue are also important. In a study with meclofenoxate, it was observed to increase mental alertness and improve the storage of new information in long-term memory in elderly individuals.

Substances that increase brain metabolism have nootropic, vasodilator and blood-fluidizing properties. They can be used in Alzheimer's Disease and post-traumatic dementia in old age. Examples of these substances are vinpocetine, naphthydrofuryl, dihydroergotoxin.

Cholinergics include co-factors of acetylcholine. Acetylcholine is a mediator molecule involved in processes related to memory, thinking, counting and attention. Phosphatidylcholine (Lecithin), acetyl-L-carnitine, acetyl, choline and pyrrolidine derivatives are examples of cholinergics. Supplements containing phosphatidylcholine (lecithin) are derived from soybeans and sunflower oil. Lecithin is also found in egg yolks, liver, whole grain products and nut kernels.

Herbs and extracts with nootropic effects include:

Panax ginseng (Ginseng)

Ginkgo biloba (Ginkgo)

Centella asiatica (Asian Pennywort)

Withania somnifera (Ashwagandha)

Bacopa monnieri (Water marjoram)

Paullinia cupana (Guarana)

Eleutherococcus senticosus (Siberian ginseng)

Rhodiola rosea (Rhodiola)

Schisandra chinensis (Schisandra)

Lepidium meyenii (Maca)

These herbal supplements have a low risk of side effects. However, none of these substances should be used during pregnancy or breastfeeding due to lack of sufficient studies.

Cautions in the use of plant extracts with nootropic effect

People with cardiovascular disease shouldn’t use Guarana plant extract due to its high caffeine content. It may increase the risk of heart palpitations.

Rhodiola isn’t recommended for patients with bipolar disorder.

Dihydroergotoxin is contraindicated in psychosis, Ginseng and Eleuthero in patients with hypertension. In addition, Ginkgo biloba extract causes blood thinning. Therefore, patients using anticoagulants, so blood thinners, shouldn’t use Ginkgo biloba extract before surgery.

Ashwagandha may act as a tranquilizer in large doses. Therefore, it is recommended to take it in the evening.

People who want to use nootropics to strengthen their cognitive health should take care to use the most appropriate herbal extract, drink and supplement, taking into account their health and mood before using anything. Remember, it’s up to us to maintain our cognitive health throughout life.

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