Recovering from Covid, Pt. 2

Last week’s blog was about using activity and posture to assist you or your loved one to recover from a bout of Covid.  It and this week’s blog are based on a list about “fighting Covid at home” that was circulated online by a woman who was sent home from the hospital to recover. It is important to note here that these blogs are NOT about preventing Covid, but about assisting the recovery after it been identified and treated. This week’s blog is about diet and nutrition. As I did last week, I have crossed out those items unsupported by science and added my own comments in italics.

• Eat at least 1 - 2 eggs a day, plus bananas, avocado and asparagus. These are good for potassium.  (Good foods to eat anytime. While potassium does not prevent infection, it does promote recovery.)
• Do not drink anything cold - have it at room temperature or warm it up. (There is a notion that cold water may cause lungs to become scarred. There is no evidence to support this claim.)
• Do drink lots of fluids. Water with lemon, and little honey, peppermint tea, apple cider are good suggestions for getting in fluids. (Staying hydrated is important for maintaining good health and for supporting your immune system.)
• No milk products. (Milk products are good sources of nutrition. Although once thought to create more phlegm in the lungs, they do not.  They do make existing phlegm thicker and more irritating, in which case they are best avoided just until the phlegm goes away.)
• Drink a smoothie of blueberries, strawberries, bananas, honey, tea and a spoon or two of peanut butter. (Antioxidants, a natural sweet and a little protein--all healthy foods that will help to boost immunity. Use green tea for an even greater immune boost.)

The doctor also recommended the following supplements and drugs. Brand names are shown but you can buy generics for most of these items and they will usually be just as good--and much less expensive! Be sure to check with your doctor before using any of them. Normally you might not do this for yourself, but if you are already recovering from Covid, you and your doctor need to be on the same page. Don’t take anything that hasn’t been approved. And of course, Covid or not, check with your loved one’s doctor giving them to your loved one.

• Sports drinks with electrolytes (Pedialyte, Gatorade Zero, Powerade Zero) to prevent you from becoming dehydrated. (Electrolytes help your immune system recover from Covid but drinking them will not prevent it.)
• Vitamin’s D3, C, B, Zinc, Probiotic One-Day are good ideas. (As above, these all support your immune system as you recover from Covid but they will not prevent it.)
• Acetaminophen (Tylenol) for fever. (An old favorite and fairly safe, used sparingly.)
• Guaifenesin (Mucinex) for drainage, plus helps the cough. (Avoid giving your loved one those with additional ingredients such as Mucinex DM. They can cause problems with LBD.)
• Famotidine (Pepcid) helps for cramps in your legs. (This is an antiacid used to treat heartburn and is unsupported by research for use with leg cramps. Try drinking more water!)
• One baby aspirin everyday can help prevent getting a blood clot, which can occur from low activity. (While there is evidence that Covid patients clot more easily, evidence for use in milder cases is lacking. Ask your doctor if you need this.)

The bottom line is, stay active, stay hydrated and eat healthy with a focus on potassium-rich foods (not supplements, which aren't very helpful), antioxidant-rich foods and supplements that support your immune system. I hope this helps you, your loved one or someone you know.

For more information about Lewy body disorders, read our books:
A Caregivers’ Guide to Lewy Body Dementia
Managing Cognitive Issues in Parkinson's and Lewy Body Dementia
Responsive Dementia Care: Fewer Behaviors Fewer Drugs
Lewy Body Dementia: A Manual for Staff

Helen and James Whitworth are not doctors, lawyers or social workers. As informed caregivers, they share the information here for educational purposes only. It should never be used instead of a professional's advice.

Nutrition for the Aging: Chia seeds

These tiny black seeds can be healthy additions to your diet. Although they apparently don't do much for dementia specifically, they are good soldiers against aging in general. They also are helpful with diabetes, fighting infections, increasing energy, and decreasing wrinkles. But caregivers beware! If you or your loved one are prone to swallowing or intestinal problems, do NOT eat them unless they've been cooked or well soaked. In the presence of fluid, these raw seed swell up to at least twelve times their size and have caused serious blockages in the esophagus or intestine.

This doesn't have to stop you from using them. They have little flavor and you can toss them into almost anything you cook. In mac and cheese, they look like pepper. In oatmeal, they add bulk--great for the dieter. You can even make no-cook puddings with them. See the recipes below. I made the chocolate pudding and found it tasty, although the slimy texture is a bit of of a put-off.

These tiny black seeds are NOT supplements. They are "plant-based food," which makes them especially good for your diet. With a few exceptions, it is best to get your vitamins and minerals from foods rather than supplements. Research has shown over and over that food based nutrients metabolize and do their job than supplements do.

One ounce of chia seeds (app. 28 grams or 3 tablespoons) contains:

• 10 grams of fiber (app. 30% of RDA). Fiber is a much needed substance, used for bowel regularity, colon detoxification, and to eliminate toxins. It does its job as it passes through the body and is mostly indigestible.
• 12 grams of carbohydrate, only 1 of which is digestible (the rest is fiber!)
• 138 calories. With the fiber subtracted, the useable amount is only 101 calories.
• 8-9 grams of fat. Over half is Omega3, a very healthy fat.
• 5 grams Omega3, 200%+ of the recommended daily amount (RDA)
• 4-5 grams of protein. That's almost as high as meat and higher than eggs. Although chia seeds are a vegetarian protein, they contain all the amino acids. This can be said of very few other types of plant-based vs. animal-based foods.
• 11 grams of fiber, app. 30% of RDA.
• 18% RDA of calcium
• 27% RDA of phosphorus
• 30% RDA of manganese
• 30% RDA of magnesium
• 9% of your daily requirement of calcium (more per oz than dairy products!)
• 7% of your daily requirement of iron
• "Decent amounts" of zinc, potassium, and Vitamins B1 (Thiamine), B2 and B3 (Niacin)
• Enough antioxidants so that the seeds can be stored for long times without deteriorating or becoming rancid.

Chia seeds, used safely, are fun to experiment with and they can improve your diet.

• Add 1 T chia seeds to 1 c water and store your fridge to use raw. Add these soaked seeds to smoothies, or stir them into cold cereal, yogurt, applesauce, etc. Quick method: Add seeds to boiled water and soak at least 2 hours. Stir several times.
• For a smoother texture, use a coffee grinder to pulverize the seeds or put them in the blender with juice, milk or water before use.
• Make thickened fluids by adding raw chia seeds to juice, soup or other fluids. Let stand until fluid thickens before serving. (Overnight, or at least two hours.)
• Use 1 T of chia seeds with 3 T of water as a substitute for 1 egg in baking. Let the mixture sit until it turns into a gel before adding it to the mix.
• Use soaked chia seeds in place of oil or butter in cooking or baking.
• Use chia seeds as a thickener for stews or casseroles. Soak 1 T chia seeds in 1 c water overnight (or at least 3 hours).
• Chia fruit pudding: Blend 1/2 cup of fruit, sugar, honey or sweetener to taste, 1 t vanilla extract and 2 1/2 c milk until smooth. Pour over 1/2 c chia seeds, stir thoroughly. Let rest for 5 minutes and stir again. Repeat in 10 minutes. Cover and refrigerate for at least 3 hours. Serves 4. Vanilla pudding: Leave out the fruit and decrease the milk to 2 c for vanilla pudding.
• Easy chia chocolate pudding: Mix 1 pkg hot chocolate mix, 1/4 c chia seeds. Add 3/4 c water or milk and 1/t vanilla and stir well. Let rest for several hours, stirring occasionally. Serves two.

Facts from Chia Seeds: Health Benefits and Nutritional Information.

For information about Lewy body disorders, read our books:
A Caregivers’ Guide to Lewy Body Dementia
Managing Cognitive Issues in Parkinson's and Lewy Body Dementia

Helen and James Whitworth are not doctors. As informed caregivers, they share the information here for educational purposes only. It should never be used instead of a physician's advice.

Nutrition for the Aging: Vitamin D

A few weeks ago, my doctor told me that I was highly deficient in Vitamin D. She added that this wasn't unusual for someone in my age group (over 65). About 70% of us don't have enough Vitamin D in our systems! Vitamin D helps us to keep strong bones and muscles. This is especially important with LB D, where falls are common. It also improves immunity and helps to fight infections, another issue LBD caregivers deal with continually.

Vitamin D deficiency caused loss of bone and muscle strength appears to be recoverable with adequate Vitamin D. However, extended deficiencies may result in some loss of cognitive ability--which may or may not be improved with better Vitamin D levels. Oh, yes! I need to increase my Vitamin D right away!

For anyone over 65 and anyone who is infirm, the DV (Daily Value) is 800 IU. (This has increased from 400IU for all adults.) The best, and usually, the easiest, source of this vitamin is from the sun. Sensible sun exposure (5-10 min of exposure of the arms and legs or the hands, arms, and face, 2 or 3 times per week) allows the absorption of Vitamin D without much danger of cancer.

However, several issues interfere with this. The first three apply to everyone:

• Anyone living as far north as Boston or San Francisco is at risk for Vitamin D deficiency, especially from October to April.
• Anyone of darker skin, living in a non-tropical location, is at risk for Vitamin D deficiency.
• A justified fear of cancer has led to the use of sun-block. The problem is that the same UV rays that cause cancer are also the ones that deliver the Vitamin D. Leaving the sun block off for the first few minutes, time depending on the intensity of the sun, can alleviate this issue.

Even if a person lives where there is an abundance of sun, aging can cause other problems.

• The elderly tend to be out in the sun less, especially if they are mobility challenged.
• Elderly bodies tend to be less efficient at absorbing the Vitamin D, at both skin and intestinal level, and one absorbed, turning it into a usable nutrient. Therefore, we need more than our younger relatives do.

Since getting enough Vitamin D from the sun is probably not going to happen, we need to get it from other sources. There are only a few good food sources:

• Cod liver oil. One tablespoon = 1,300 IUs of Vitamin D. Our grandmothers knew what they were doing when they made their children choke down cod liver oil every spring! Now, it comes easier to take capsules. However, cod liver oil is that is also high in Vitamin A. Taking enough to satisfy your daily Vitamin D needs may put you well over Vitamin A's upper limit of 10,000 IU. If you choose to use take the capsules, read the labels carefully.
• Fatty fish, such as swordfish, salmon, tuna, or sardines have high levels of Vitamin D, but not enough to get your full daily allowance unless you eat a LOT of fish. A three oz. portion of baked wild salmon meets the DV. The same amount of farm salmon provides only half that and if you fry either one, you lose about 50%. Few of us can afford to eat salmon everyday, especially wild salmon. But canned tuna is almost as good. A 4 oz can of white albacore tuna also meets the DV. Do include some fatty fish in your weekly diet.
• Some milk, yogurt, orange juice and cereals are fortified with Vitamin D. Read the labels. Make a habit of reading labels and choosing those of these products that are fortified even if they cost more.

Since few people, and especially the elderly, get enough Vitamin D from food, most doctors prescribe Vitamin D supplements for their elderly patients. Supplements may start as low as the former DV of 400IU/day and go up to 50,000IU taken one to three times a week. When my doctor prescribed a large dose for me to take once a week, I asked about the safety of this. After all, Vitamin D is a fat-soluble vitamin and therefore, the excess isn't secreted in the urine. Apparently, large doses are absorbed better than many small doses and when the need is great, large doses are better. Sigh. I guess I'll just have to deal with having to remember to take that weekly capsule--or I may not be able to remember!

However, there may be a downside for the elderly who are already at risk for falls--a group that often includes PwLBD. A new clinical trial found that these higher doses of Vitamin D may increase falls in this group. This report makes it even more important to monitor and maintain Vitamin D levels so that they don't get so low that the larger doses are needed.

References:
http://www.drweil.com/drw/u/QAA400033/Cod-Liver-Oil-for-Vitamin-D.html http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2698592/
http://www.jwatch.org/fw111030/2016/01/05/high-doses-vitamin-d-associated-with-increased-fall-risk?

For information about Lewy body disorders, read our books:
A Caregivers’ Guide to Lewy Body Dementia
Managing Cognitive Issues in Parkinson's and Lewy Body Dementia

Helen and James Whitworth are not doctors. As informed caregivers, they share the information here for educational purposes only. It should never be used instead of a physician's advice.

Coconut Oil: Is It Wonderful?...Or Is It NOT?

A lot of people believe coconut oil is very nutritious and that it can help dementia. But what about shredded coconut? That's something we use a lot this time of year to add flavor and fiber to many holiday foods. Well, it isn't exactly unhealthy, but it shouldn't be a regular part of your diet. It does supply some key vitamins and minerals. However, its high fat and sugar content greatly decreases its nutritional value. You can use  unsweetened shredded coconut to improve nutritional value but the fat content remains. See the discussion below about the fat in coconut oil and whether it is nutritious or not.   There is no evidence that it helps dementia.

Coconut oil. We know that coconut oil is nutritious in many ways although the jury is still out about whether it is helpful with dementia. Last year, the 10/14/13 blog was ambivalent. There's still very little supportive research although there are many glowing personal reports from a wide variety of sources. We do know that it is wonderful on the skin. But what about as nutrition?

Many people believe that coconut oil has attributes that make it heart-healthy, and that it may even be useful for treating infections. Others swear that it has a definite, positive effect on cognition. Some advocates believe that when transformed by the liver into ketones, it may even restore and renew neuron and nerve function in the brain after damage has set in. That is about as close to a cure as we’ve heard—if it works.

As for scientific proof of these claims, the strongest appears to be a 2012 study with results that showed that ingesting coconut oil provided significant short term benefits to dementia patients. From this, we can deduce that yes, coconut oil apparently does have a positive, if temporary effect. That is, like a drug that treats symptoms but doesn’t cure, it provides a benefit only as long as it is in the system.

So far there is no scientific proof that it can do anything permanent like renewing neurons. We should learn more in September, 2015, when the National Institute of Aging plans to publishes the results of their clinical trial to look at the benefits of coconut oil in people with mild to moderate Alzheimer's disease.

However, the down side is that coconut oil is high in calories and is categorized as a saturated fat, the kind that isn’t heart healthy at all. Advocates say that the way coconut oil is metabolized makes the calories less important. They also say that the oil acts more like a carbohydrate than a saturated fat.

Nevertheless, until further research changes what we know, nutritionists remind us that while healthy fats should make up about 30% of your total intake, saturated fats (including coconut) should be limited to no more than 10%--or about two tablespoons a day. Advocates suggest that you can use it to replace butter on toast or popcorn, use it as shortening in cooking, or add it to smoothies.

Omega-3 fatty acid update: The 10/4/13 blog reported that foods containing omega-3 fatty acids have a positive effect on dementia but that the use of supplements is questionable. This remains true. There is more emphasis on getting enough fats in our diets—healthy fat, that is. Human brains are at least 60% healthy fats, which must continually be replenished for proper functioning. As with essential vitamins, our bodies cannot manufacture these nutrients; they must be obtained from diet. We have been so trained to watch our fat intake that we often neglect to ingest adequate amounts of the fats that our brains need.

A Dutch study found that a diet high in fat seems to postpone the aging of the brain. Olive, canola and possibly, coconut oil, fatty fish, flax and pumpkin seeds and walnuts are examples of foods containing healthy fats. You can find a longer list here. It would probably behoove all of us to add more of these to our diet. (Notice that coconut oil is included in the list of “bad fats” on this list. Again, it IS a saturated fat, but has other attributes that makes it healthier than other saturated fats, and perhaps we will eventually find that it is as healthy as “good fats.”

LBD & Nutrition-6: Coffee and Tea

This is the last of our blogs on nutrition and its effect on LBD. We seldom think of coffee or tea as “nutrition,” yet, they do contain a variety of substances that may be helpful with dementia.

Caffeine is an alkaloid produced by several plants. It is in the coffee most Americans drink every morning. Lesser quantities are also in black tea, colas and chocolate.
Belief: Drinking coffee delays dementia.

• Fact: True, but impractical. Drinking three to five cups of coffee a day may decrease the risk of dementia. Healthy people who drink this much coffee are less likely to progress into MCI, or may not progress as quickly as they otherwise would. Those who already have MCI will not progress into dementia as quickly either.   Reference
• Concern: This much coffee per day may cause other health problems such as increased blood pressure and heartburn. It is a stimulant and when consumed too close to bedtime can interfere with sleep. It is also a diuretic which can interfere with hydration.

Quercetin. (kwer-se-ten) This nutrient is found in apples, onions, blueberries, red grapes, cranberries, green or black tea and red wine.
Belief: Quercetin improves cognition in persons with PD.

• Fact: Not yet proven. This member of the flavinoid family of plant-based compounds has recently been shown to have a cognitive enhancing effect on PD in rats.   Reference.
• Concern: While this report is hopeful, much research is still needed to support the belief that Quercetin is useful for humans.

Green tea is made from the steamed and dried leaves of the Camellia sinesis plant, native to Asia. It is available everywhere tea is sold.
Belief: Drinking green tea lowers the risk of dementia.

• Fact: True. Green tea protects brain cells from toxins and is associated with a significantly lower risk of cognitive impairment.  Make it a part of your daily fluid intake. It contains quercetin, which may be why it is effective against dementia.

Belief: Drinking green tea calms you down and helps you concentrate.

• Fact: True. It contains the amino acid L-theanine, which calms and aids with concentration.   Reference

Belief: Green tea contains some caffeine and is therefore a mild stimulant and diuretic.

• Fact: False. There is a small amount of caffeine in green tea but not enough to counteract the calming qualities of L-theranine. The amount of caffeine is also not enough to make green tea a diuretic. Therefore, it is as good as water for hydration.  Reference.

Bottom line: Green tea is probably a better choice for a healthy beverage than coffee or black tea and caregivers should consider adding it to their loved one's meals. However, a moderate amount of either black tea or coffee is not likely to be particularly harmful, especially if drunk early in the day.

LBD & Nutrition-5: Fatty Acids

We tend to lump all fats together as “bad.” However, we now know that certain types of fats are necessary for good health. Fatty acids, produced when “good” fats are metabolized, perform a multitude of services for the body. They may even improve cognition.

Source:  Fish, especially salmon, or fish oil supplements are best.  A less powerful type is also found in vegetable and plant products such as flax seed, leafy green vegetables, nuts and seeds, broccoli and cauliflower, winter squash and dry beans. Omega-6 is even less helpful. It can be found in plant oils such as corn, soybean and sunflower oil as well as nuts and seeds. It is less helpful but still better than the saturated fats from animals sources.

Belief: Omega fatty acids help with digestion, decrease infections and improve blood pressure, all systems that can be affected by LBD.

• Fact:  True. There is scientific support that these fatty acids help with the digestion of fat-based vitamins, boost the immune system and lower triglycerides, the “bad” fats which can raise the risk of several other diseases, such as diabetes, stroke and heart disease. Reference

Belief: Omega-3 fatty acids combat dementia.

• Fact: Partially true. Scientific studies about this nutrient’s effect on dementia are mixed. Its value in supplements is questionable but its value in food is supported.  Reference

Coconut oil contains a type of fatty acid also found in palm kernel oil. MCT (medium-chain triglyceride) is used extensively in South Asian countries and can be bought from online health food stores. MCT supplements can also be bought separately.

Belief: The ketones produced when coconut oil is metabolized provide an alternate energy to the brain’s cells, thus moderating the damage caused by dementia. Reference

• Fact: Not yet proven. Although there are many personal stories that ingesting coconut oil decreases dementia symptoms, there is no scientific support for this theory. However, coconut oil is a food source for omega-3 fatty acids, and as such, may have some effect, both direct and indirect upon dementia. (See omega-3 fatty acids, above.)
• Concern: It is apparently important to buy non-hydrogenated virgin oil from organic coconuts. This increases the cost. Although MCT is available as a supplement, fatty acid supplements in general have not proven to be very effective.

Food is usually a better source of fatty acids than supplements. Switch from saturated fats like butter to unsaturated ones like margarine and olive oil. Add nuts to your diet by including them in casseroles and vegetables. Have fish once a week or more.

LBD & Nutrition-4: Water-Soluble Vitamins

This week the blog is about something that at first blush doesn't have much to do with dementia of any kind. However, because LBD increases stress and impairs the immune system, these vitamins are useful and should be considered as a daily supplement.  Unlike the fat-soluble supplements discussed last week, these water-soluble vitamins are excreted in the urine. Excess water-soluble vitamins are not stored in the liver nor do they  build up to toxic levels when taken in amounts of more than the body can metabolize at the time. While food is still the best source of these nutrients, supplements can usually be taken safely in normal doses.

Vitamin B Complex (Folic acid, B6 and B12): These vitamins can be found in fish, poultry, meat and dairy sources.

• Belief: These vitamins help to prevent or slow dementia.
• Fact: True, but impractical. These water-soluble vitamins help in the formation of red blood cells and in the maintenance of the central nervous system, and appear to lower the levels of an amino acid associated with dementia. Studies have shown that large doses of these three vitamins together can decrease confusion, reduce depression and slow MCI.   Reference 
• Concern: The large dosage required makes obtaining an adequate amount from food impractical. Therefore supplements must be used. In addition, injections provide better results than oral supplements, making this a difficult and possibly impractical effort for the average person.
• Belief: These vitamins help to reduce stress, which in turn reduces dementia symptoms.
• Fact: True. A daily oral dose of these water-soluble vitamins has been shown to significantly decrease workplace stress, confusion and depression.  It is reasonable to believe that it would also reduce stress in other areas of one’s life as well. Reference.  
• Belief: Taking Vitamin B12 will prevent dementia.
• Fact: False. It has been known for some time that a deficiency in Vitamin B12 decreases the brains ability to metabolize neurotransmitters and can cause dementia. However, taking Vitamin B12 alone as a preventive measure does not help.   Reference.

Vitamin C: This water soluble vitamin is found in most fruits, green leafy vegetables, broccoli, chestnuts, soy beans and low fat yogurt.

• Belief: Taking Vitamin C lowers your risk of dementia.
• Fact: Not yet proven. This vitamin was associated with a lower risk of dementia in one small study. That study needs to be replicated, preferably with a larger number of subjects before it can be accepted as fact. Reference.
• Belief: Vitamin C is helpful in reducing the infections that occur so often with LBD and which in turn, increase LBD symptoms.
• Fact: True. It has long been known that Vitamin C is associated with the maintenance of a healthy immune system, and therefore is helpful in reducing infection.

While taking supplements of these vitamins is comparatively safe, anyone dealing with LBD should always remember that this disorder makes the whole digestion system sluggish and that drug sensitivities can occur at any time. Larger than normal doses are discouraged without a Lewy-savvy physician's supervision.

LBD & Nutrition-3: Antioxidants

Antioxidants are the body's scavengers, they combat free radicals—unstable molecules that can injure healthy cells and tissues. Lewy bodies are generated when healthy proteins are “misfolded” or damaged. It is possible that removing free radicals decreases that damage.

However, this possibly positive result does not come without dangers. Many antioxidants are fat-soluble vitamins which cannot be excreted in the urine. Taken in larger doses than the body can use, the excess is stored and can become toxic, causing liver damage or other problems.

Vitamin A: Found in most fruits and vegetables, some nuts, dairy products, and tuna.

• Belief: Vitamin A prevents free radicals from turning healthy protein cells into Lewy bodies.
• Fact:  Not yet proven. Vitamin A may be helpful with other disorders but there is still no scientific evidence that this vitamin is helpful in preventing dementia.
• Concern: This vitamin is fat-soluble and therefore, dangerous in the large amount of supplements often recommended.

Beta carotene: A vitamin A precursor can be found in most fruits and vegetables, some nuts, dairy products and tuna.

• Belief: As with Vitamin A, beta carotene combats dementia.
• Fact: Not yet proven. One small study found beta carotene levels lower in people with dementia than in those without dementia. This same study also found that a higher intake of this nutrient by healthy people was associated with a lower risk of later dementia.   More research is needed before this belief can truly be supported.
• Concern: Beta carotene is fat-soluble, and therefore can be toxic when taken as supplements in larger than recommended doses.

Vitamin D:  Small amounts can be found in fatty fish such as herring and tuna. It is also added to many dairy products and sold as supplements.

• Belief: Vitamin D is called the Sunshine Vitamin because just a few minutes of sunshine per day will provide adults with all they need.
• Fact: False. This is true for younger people. However as people age, their skins become less efficient, resulting in vitamin D deficiencies.

• Belief: As an antioxidant, vitamin D decreases the risk of dementia.
• Fact: True. Recent research supports this belief.  

• Belief: Vitamin D helps to make strong bones and keep them strong, important for people that are accident-prone, as is the case for many with Lewy body disorders.
• Fact: True. This vitamin promotes calcium absorption and works to keep bones strong.  It also helps to prevent osteoporosis, a common disorder with older women, which can also weaken bones and make them easier to break.
• Concern: Since this vitamin is less easy to find in foods, doctors may recommend a vitamin D supplement. Be careful not to take more of this fat-soluble vitamin than the recommended dose.

Vitamin E: This antioxidant is found in wheat germ, nuts such as almonds and hazelnuts, vegetable oils such as sunflower and safflower oils, and some green vegetables, such as spinach and broccoli.

• Belief: Vitamin E decreases the risk of developing dementia.
• Fact: Partially true. Since we reported on this vitamin in our 2010 book, this vitamin has been found to be helpful for long term prevention and may have a modest impact on the risk of developing dementia later in life.  
• Concern: The above pertains to vitamin E found in food only. The amount of this fat-soluble vitamin needed be effective in supplement form is toxic and can cause liver damage.

Coenzyme Q10 (CoQ10). This antioxidant can be found in organ meat (heart, liver), vegetable oils, fatty fish, and nuts. Broccoli, sweet potatoes and sweet peppers also contain moderate amounts of this nutrient.

• Belief: CoQ10 can slow down dementia.
• Fact: True, but impractical and possibly dangerous. There is some evidence that suggests this coenzyme may slow down but not cure Parkinson’s dementia.
• Concern: The amount per day required for effective treatment is too large to get easily from food. Supplements are generally used but they are expensive.
• Concern: A variety of diseases and drugs can interact negatively with CoQ10. For example, it decreases the effect of blood thinners. Also, it is fat-soluble. Be sure to talk to your doctor before adding this nutrient to your diet.

Next week: Water-soluble vitamins.

References:
Vitamin A: Dietary antioxidants and dementia 
Vitamin D: Vitamin D, cognition, and dementia.
Vitamin E:  Dietary Antioxidants and Long-term Risk of Dementia.
CoQ10: CoQ10 and Dementia.