How low can you go?
Posted by apgaylard on October 13, 2008
Holland & Barrett have very kindly sent me a special offer for ‘World Mental Health Day‘ inviting me to, “save 50% on brain supplements”. It’s a very colourful e-mail, as you can see.
This seems wrong on two levels; first just piggy-backing on a charitable activity with no attempt to promote the aims of the event seems ethically suspect. But, perhaps I’m just a sensitive type? Second, I can’t for the life of me see what this selection of vitamins, minerals and an aromatherapy oil has to do with either the brain or good mental health!
Just to make sure that this wasn’t a grumpy knee-jerk sceptical reaction I plugged the substances into the search engine on the Cochrane library site, to see if there was any reasonable evidence to link these products to this event.
I started with Cochrane reviews and cast my net quite widely into the areas of mental health along with Holland & Barrett’s claims; here’s what I found (quotes from the plain language summaries –emphasis mine):
Omega 3 fatty acid for the prevention of dementia “There is no evidence that dietary or supplemental omega 3 polyunsaturated fatty acid (PUFA) reduces the risk of cognitive impairment or dementia in healthy elderly persons without pre-existing dementia.”
Omega-3 fatty acids for bipolar disorder “There is currently insufficient evidence on which to base any clear recommendations concerning omega-3 fatty acids for bipolar disorder. However, given the general health benefits and safety of omega-3, the preliminary evidence from this review provides a strong case for well-powered, high-quality trials in specific index populations.”
Ginkgo biloba for cognitive impairment and dementia “There is no convincing evidence that Ginkgo biloba is efficacious for dementia and cognitive impairment.”
Vitamin B6 for cognition “No evidence of benefit from vitamin B6 supplementation on mood or cognition of older people with normal vitamin B6 status or with vitamin B6 deficiency.”
Vitamin B12 for cognition “No evidence of the efficacy of vitamin B12 supplementation for cognitive function.”
Folic acid with or without vitamin B12 for the prevention [sic] and treatment of healthy elderly and demented people “No evidence that folic acid with or without vitamin B12 improves cognitive function of unselected elderly people with or without dementia. Long-term supplementation may benefit cognitive function of healthy older people with high homocysteine levels.”
When it came to the coenzyme nicotinamide adenine dinucleotide (NADH) there are currently no reviews available. I did look at trials covering anything remotely connected with “mood, sleep and relaxation.” I found that there have been some small trials looking at its use in combating jet-lag and depression.
These are summarised below. They are broadly positive; but that is probably not surprising given that they are small and, in the case of depression, “open label” trials.
Stabilized NADH (ENADA) improves jet lag-induced cognitive performance deficit “Thirty-five healthy, employed subjects participated in this double-blind, placebo-controlled study.” (18 treatment/17 control)
The coenzyme nicotinamide adenine dinucleotide (NADH) as biological antidepressive agent “…used as medication in 15 depressed patients in an open label trial. NADH has been given orally, intramuscularly or intravenously. The duration of therapy ranged from 2 to 12 weeks. In all patients a beneficial clinical effect in the order of 63% up to 96% improvement was observed.”
The coenzyme nicotinamide adenine dinucleotide (NADH) as biological antidepressive agent. Wxperience [sic] with 205 patients “…open label trial as medication in 205 patients sufferring [sic] from depression with various clinical symptoms. NADH was given orally, intramuscularly or intravenously. The duration of therapy ranged from 5 to 310 days. 93% of the patients exhibited a beneficial clinical effect.”
What struck me straight away was the very small number of reliable reviews available covering the range of claims. Maybe I have missed some really top-notch evidence; this isn’t an area where I claim any expertise. If I have missed anything important: I’d be pleased to see it. At the moment, all I can see is that if you are a healthy older person with a high homocysteine level then just maybe your cognitive function might be benefitted by folic acid/B12 supplementation. Beyond that, perhaps NADH might help with cognitive function if you are jet-lagged; but with such a small un-replicated trial to go on the evidence is, to be kind, very thin. There may even be some justficiation for better trials to see whether omega-3 fatty-acids could help people with bipolar disorder. One thing I am sure of: lavender oil smells very nice.
So, I am left with an uncomfortable feeling that not only is a charitable event being hijacked for overtly commercial ends – with no promotion of its goals: Holland & Barrett are just trying to sell pills and potions on the basis of claims that have, as far as I can tell, nothing approaching reasonable justification.
[BPSDB]
8 Responses to “How low can you go?”
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A canna’ change the laws of physics 
stavros said
You should already know that this is simply the style of Holland and Barrett. They sell homeopathic remedies claiming that they work for certain conditions (which is illegal according to the new laws in England –see here especially pages 14-15) as well as reflexology socks! And I will say that again: reflexology socks!
A little bit of sciency sounding supplements is not that far fetched, is it?
Good research info by the way.
apgaylard said
Stavros: You are quite right, I have been under few illusions about this outfit for a while – still, I thought this was pretty low. I must say that against reflexology socks anything sounds reasonable, well apart from homeopathy!
Thanks for your comment.
draust said
Was that: “reflexology socks” or: “reflexology s*cks”?
BTW: How about a theme song for H&B’s latest dire campaign? If you slightly misquote the title (at least the first word) of an old dance fave from my distant youth we could have:
“Base! How low can you go?”
apgaylard said
draust: That tune must have been lurking in my subconscious. Thanks for the reminder.
mythusmage said
What caught my eye was the promise that Folic Acid with or without Vitamin B12 would prevent healthy old people. Since it also prevents unhealthy old people one can only conclude that Folic Acid (with or without Vitamin B12) is fatal to the elderly. One must then ask at which age does Folic Acid (yadda-yadda) become fatal, and what is the triggering event?
apgaylard said
Mythusmage: Made me smile as well; It’s not the best phrased title is it? The ojectives section makes more sense, “To examine the effects of folic acid supplementation, with or without vitamin B12, on elderly healthy or demented people, in preventing cognitive impairment or retarding its progress.” I’ll add a [sic]!
dvnutrix said
It is déclassé even by the standards of H&B.
The hype is ahead of the science but I suppose the opportunity to offer cut-price mental health at a time when so many people are concerned about the economy and their future a good marketing opportunity.
Our B12 is cheap today,
Much cheaper than yesterday.
It lowers Hcy – used with folacin.
An abandoned work – modelled after La donna e mobile.
apgaylard said
Dvnutrix: Can’t fault your analysis. Another aspect that crossed my mind is that the standard advise for maintaining mental health doesn’t open up many opportunities for profit from a pill popping perspective. I must admit that I’d rather leave this topic to Holfordwatch and other better qualified bloggers. The hype here just happened to push me over my grumpiness threshold.
I do like the song by the way. Perhaps you and Dr Aust should collaborate?