Resveratrol for Alzheimer’s Disease

Post on September 23, 2015 by André Broussard, D.C.

September 23, 2015

TAKE-HOME MESSAGE

  • In this placebo-controlled, double-blind, phase II trial, 119 participants with mild to moderate Alzheimer’s disease (AD) were randomized to receive resveratrol 500 mg orally once daily with subsequent dose escalation or placebo. Common reported adverse events included nausea, diarrhea, and weight loss. There was a significantly larger decline in CSF Aβ40 and plasma Aβ40 levels in the placebo group compared with the resveratrol group. Loss of brain volume was increased in the resveratrol group compared with the control group.
  • Resveratrol treatment was safe and well-tolerated with good penetration of the blood–brain barrier.
    Written by David Rakel MD, FAAFP

    This 52-week study titrated resveratrol to 1000 mg twice daily vs placebo in patients with mild to moderate Alzheimer’s disease (AD). It showed that resveratrol did cross the blood–brain barrier and was associated with less decline of β-amyloid levels compared with placebo. The most common side effects were nausea, diarrhea, and weight loss. Surprisingly, despite greater stabilization of amyloid, MRI imaging of the brain showed a greater loss in volume in the resveratrol group.

    This was a phase II study that was not powered for clinical outcomes; so, the fact that there was a trend toward improvement in activities of daily living in the resveratrol group should be taken with some skepticism. There was also no change in Mini-Mental State Exam scores between groups.

    Further research is needed before we can feel confident prescribing this for our cognitively impaired patients; however, we can encourage intake through whole food nutrition. Here are some pearls on how to maximize intake of this powerful polyphenol through diet.

    • Enjoy dark-colored grapes and berries such as blueberries, red grapes, and mulberries.
    • Don’t heat these foods for prolonged periods (>15 minutes) as this causes degradation of the resveratrol.
    • Pinot noir and wine made from grapes grown in cold environments (eg, Bordeaux) have the most resveratrol. Don’t let the wine sit after uncorking as the resveratrol will degrade after the bottle is opened. The dose of resveratrol used in this study was equivalent to that found in 1000 bottles of wine!
    • Enjoy peanuts, nuts, and dark chocolate, which are other food sources.

    Unfortunately, the InCHIANTI study,1 which was published last year, showed that eating a diet rich in resveratrol did not influence mortality when the enrolled Italians living in Chianti were followed for just over 10 years. The question remains, will this nutrient, consumed beyond eating resveratrol-rich foods alone, in high doses reduce the progression of or even prevent AD? Until our science gives us more direction, I will continue to enjoy these foods in the company of friends and family in hopes that I can keep remembering their names.

    Reference

    1. Semba RD, Ferrucci L, Bartali, et al. Resveratrol levels and all-cause mortality in older community-dwelling adults. JAMA Intern Med. 2014;174(7):1077-1084.

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