Fats, B12 and Dementia

I can't think straight if my house is messy (so imagine how incredibly stimulating my posts would be if only I cleaned instead of blogging!), but no one can think straight if their belly's empty. What is in it is far more important - as you most certainly know - than how much. But have you ever sat down to investigate specifically what your doctor or friendly public health professional meant when they said that taking risks now would have consequences later?

Real Food Forager reports that "In a recent study published in the juried medical journal Neurology, researchers from the Oregon Health & Science University found some striking patterns relating what people eat to how their brains function. ... [Lead researcher Gene] Bowman found that people with high plasma levels of B vitamins and vitamins D, E and C had more total brain volume and better overall cognitive functioning. However, the most striking revelation of this study was that people with high levels of trans fats in their blood had significantly worse cognitive performance and less total brain volume." Digging around I came upon another study that reports reduced IQ in children consuming margarine instead of butter. To paraphrase Forrest Gump's mom: stupid is as stupid eats.

There is some utterly terrible reporting of animal studies relating to fat consumption and reproduction, and there are some utterly terrible studies which no amount of insightful and subtle reporting could save. The source for the article I just linked to claims that high fat diets cause stillbirth (yikes! panic!) and then goes on to link the risk pathway to inflammation and hyperinsulinemia. I'm not a biologist, but I have not encountered studies on real, clean fats as a cause of either of those conditions. I'm willing to make a modest wager that those monkeys were not fed grass-fed lard but rather a metric shitton of transfats and processed carbohydrates (which strip the body of nutrients) so, yeah, the womb becomes a rather less nurturing place under those circumstances. Can't we call a spade a spade and say that eating McJunk is a risk factor for stillbirth?

Trans fats are also associated with lower sperm counts and endometriosis. A lack of healthy fats may prevent ovulation. B12 plays a critical role in cellular replication so it is no surprise that prolonged B12 deficiency also results in both male and female infertility. 

Those who avoid all animal products - and we all have a veg*n or two whom we know and love - tend to be very conscious and conscientious eaters, often avoiding dietary fat (as per official dietary guidelines) as well as flesh, leaving them anemic (ie B12 deficient) and at risk of infertility. Meat-avoiders who get pregnant have some worries their bacon-loving friends and relatives may not. While the liver can horde and recycle enough B12 to keep an adult going for a good while, it's rarely enough for two; the babies of veg*n mothers are at risk of lower birth weight (see p 419) and "negative impacts in cognitive, motor, and growth outcomes". As they grow, Louwan et al. reported that veg*n children scored significantly lower than their omnivorous peers "on tests measuring spatial ability, short-term memory and "fluid intelligence," that is, the capacity to solve complex problems, abstract thinking ability and the ability to learn." (Am J Clin Nutr 2002 Sep;72:762 - no abstract publically available). These discrepancies could be the result of a lack of animal fats for brain-building, but note that the further signs and symptoms of  early childhood B12 deficiency sound a lot like autism: developmental delay or regression, cognitive problems, language delay, speech problems, seizures, involuntary movements, tremor, weakness, hypotonia, apathy–irritability, anorexia, failure to thrive. (By the way, GAPSters, there's a possbile link between dysbiosis and B12 deficiency.)

Grand. So let's say you've made it to adulthood in reasonably good shape, your kids - if you have them - appear to be in good working order, and you're wondering what that veiled threat about risks and consequences has to do with you. Have you seen the list of symptoms attributed to B12 deficiency? It's like you've been unplugged and everything is running out of you:

• diarrhea
• heavy menstrual bleeding, or nose bleeds
• bleeding gums
• memory problems
• feeling exhausted
• depression
• sensitivity to noise
• brown "liver" spots on skin
• tingling hands and feet, numbness
• burning, bone pain, or nighttime "jumpiness" in legs
• balance and gait problems
• ridged fingernails with no white moon at the base

And there's some suggestion that this can creep up over time, intensifying due to the aging process. Chris Kresser did a whole post on B12 deficiency masquerading as any number of "diseases of old age", including Alzheimer's, dementia, and memory loss. The Weston A. Price Foundation has a huge and detailed article on it too:

• "B12 deficiency mimics many of the features of old age--ataxia (shaky movements and unsteady gait) muscle weakness, spasticity, incontinence, slowed reactions, memory loss, disorientation, depression and confusion.
• Low B12 is associated with osteoporosis [while] B12 supplements can help remineralize the bones.
• The Russians have pioneered the treatment of glaucoma with B12 
• Deafness is associated with B12 deficiency; supplements have been useful in treating tinnitus and noise-related hearing loss
• A genetic predisposition to Alzheimer’s may actually be related to a genetic impairment in the ability to absorb B12.
• B12 supplementation can reverse mental decline in elderly patients as long as their deficiency is not so long-standing as to have caused irreparable nerve damage: "supplementation results in little improvement for those who have had full blown Alzheimer’s symptoms for greater than six months."
• Identifying deficiency is best done based on symptoms as, according to Sally Pacholok, coauthor of Could It Be B12? An Epidemic of Misdiagnoses, "neurological deficits precede the hemotologic changes" - on other words, by the time your bloodwork shows an official problem, you'll already have damage. [update: here's another good one from Chris on newer, more accurate B12 testing]
• "According to Dr. John Dommisse, an expert in B12 deficiency, the acceptance of high levels as normal in Japan, and the willingness to readily treat psychiatric symptoms with B12 explains the low rates of Alzheimer’s dementia in that country--as well as the reason for the very high rates of Alzheimer’s in the US."

Forget supplementation, despite "fortified grain products" being a commonly recommended source of B12. Eat the food, people; nutritionism is a blind alley. Besides which, the B12 in mutivitamins may interact with other ingredients such that it becomes biounavailable. (Herbert and Das, 1994, cited here)

We know our brains are hungry. We know that they don't eat plants and, if we insist that they do so to the exclusion of all else, they'll slide into decline until they die. Conversely, when they're crammed full of MCTs they can heal from dementia and reset our metabolism in happy ways.

It's all about the healthy fats: what are the richest sources of B12 and MCTs? Molluscs, caviar and liver, butter and coconut oil.

See, now I've tried to close a logic loop and gone and made myself hungry instead.