Ask Dr. Marie: Cutting Calories for Memory? Elderly, Beware

Jan. 30, 2009— -- A small study that made national headlines this week suggests that cutting calories may help improve memory for the elderly. The title of the article, "Caloric Restriction Improves Memory in Elderly Humans" in this week's online Proceedings of the National Academy of Sciences caught my attention because it seemed so simple and yet likely too good to be true.

But yikes -- when I read the article, I found the headline not only deceptive but potentially providing risky advice for thousands of elderly seniors who can ill afford to cut calories any more than they do already.

As I have learned from caring for so many elderly patients over the years, people tend to eat less as they get older; they often stick to monotonous, low-quality food which fails to provide their daily nutritional needs. They often worry about the cost of food as well.

I am also thinking about my 84-year-old father who lives alone and eats sugar-coated corn flakes for breakfast, soup for lunch and a scrambled egg for dinner just about every day. His appetite has waned over the years, he fears gaining weight which he knows could signal fluid retention and possible heart failure, and with the recent death of my mom he is now eating alone and cooking for the first time in his life.

I know he will try to cut back his intake further when he reads the latest headline about the promise of improving his memory. It is his sharp memory that gives him a reason to get up every day; he will do almost anything to preserve it.

As a result of the media hype around this headline, I worry that too many other seniors will cut back on needed calories and nutrition with the hopes of improving their memory. After all, most seniors fear memory loss more than almost any other condition.

On the other hand, what they may not realize is that the elderly are much more likely to have cognitive impairment and increasing frailty and risk of falling as a result of poor nutritional intake leading to deficiencies in protein, vitamin D, calcium, B12 and folate, along with many other medical problems. Restricting calories, especially nutrient rich-calories, is the last thing they need.

Exploring the Effects of Cutting Calories

So what was the study really all about? Fifty mostly overweight adults, ranging in age from 50 to 80 years old (average age of 60 years and BMI of 28) agreed to be assigned to one of three groups to study the effect of diet change on the change on their memories after only three months. One group restricted their calories by 30 percent, the second group ate more heart-healthy unsaturated fats, and the last group made no dietary changes. To be sure that patients didn't reduce calories too much, the researchers recommended not reducing total calories below 1,200 calories per day.

At the end of the study, people in the calorie-cutting group lost an average of eight pounds, and researchers found that those who reduced their calorie consumption improved their scores on a word-learning task, suggesting a boost in verbal memory; the more weight that was lost, the better the verbal memory score. Other types of memory were not affected.

Blood tests also showed that cutting calories was linked to better blood sugar and insulin levels and reduced inflammation as measured by the C-reactive protein test (of course we already know that weight loss leads to reduced inflammation levels and improved blood sugar and insulin function).

Seniors Should Stay Clear of Restrictive Diets

In conclusion, it seems that even short-term modest weight loss can improve metabolic risk factors for heart and other vascular disease (which we already knew) and improve verbal memory (though it's surprising to see such statistically significant improvements over such a short period of time; I await further studies to confirm this surprising fact).

But this is in mostly middle-aged, overweight adults. Nowhere did I see this point discussed. What was "new" and therefore "news" was the notion that simple calorie restriction can improve memory -- if it were only that simple!

My advice to the elderly such as my dad (and to caregivers such as myself) is to stay clear of one-size-fits-all headlines and advice that simply sounds too good to be true. Better that all seniors have:

1) A nutritional assessment by their practitioner or a nutritionist who is experienced caring for the elderly. They will then learn exactly how they can optimize their health and memory through healthy balanced eating that matches their life and financial circumstances.

2) A comprehensive blood test to check for treatable conditions such as anemia, thyroid disease, kidney and liver disease, diabetes, osteoporosis and low vitamin D levels.

3) I am also a fan of giving most seniors extra vitamin D (about 1000 IU daily), fiber-rich antioxidant-loaded foods (i.e. fruits and vegetables), and plenty of healthy fats such as the fats found in fish, flaxseed, nuts, and canola and olive oil. Finally, daily exercise mixing both aerobic walking and isometric muscle strengthening will do far more to improve memory and prevent frailty and falls than anything else.

What nutritional concerns do you have for yourself or your aging parents? Did the headline news this week mislead you? How have you solved the problem of good nutrition with balanced calories and nutrients in your family?

As always, I welcome your questions and comments.

Dr. Marie Savard is an ABC News medical contributor. To learn more about Savard's health management system, download free forms and a sample letter to your doctor, visit http://www.drsavard.com and click on "Learn how to take charge of your health."