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Souvenaid is a nutrient cocktail that aims to improve memory in patients with early Alzheimer's disease. DietDoc takes a look at this latest advancement in medical nutrition.
In July 2012, the results of the second Souvenaid trial were reported at the Alzheimer’s Association International Conference (AAIC) in Vancouver, Canada (Cassels, 2012). Souvenaid is classified as a medical nutrition product developed by Prof Richard Wurtman at Massachusetts Institute of Technology (MIT) and manufactured by Danone, a French food products company (Trafton, 2008). The results indicated that patients with mild Alzheimer’s Disease (AD) treated with Souvenaid showed consistent improvements in memory (Cassels, 2012).
Effects of Alzheimer’s Disease
AD is regarded as the most common form of dementia and was first described by Alois Alzheimer in 1907. According to Mahan and her co-authors (2011), AD occurs in both men and women, but is three times more prevalent in women, probably because women tend to live longer and increasing age is the most important risk factor for this disease. It is estimated that more than 35 million people throughout the world already suffer from AD and that as the average age of our global population continues to increase, the number of patients with AD will rise concurrently.
AD is characterised by the accumulation of abnormal clumps of so-called amyloid beta peptide and neurofibrillary tangles in the brain. In addition, the number of synapses or signalling centres in the nerves and brains of patients with AD gradually decreases (Trafton, 2008). Without synapses, memory function becomes impaired and AD patients become increasing disorientated. Anyone who has watched the tragic portrayals of two famous women with AD, namely Iris Murdoch and Margaret Thatcher, in the movies Iris and The Iron Lady respectively, will be aware of how debilitating and catastrophic this loss of memory can be.
What does Souvenaid contain?
Souvenaid was developed by Richard Wurtman, the Cecil H. Green Distinguished Professor Emeritus at MIT, to increase the formation of synapses in the brain and central nervous system of patients with AD (Trafton, 2012). According to Cassels (2012), Souvenaid contains the following components:
- Eicosapentaenoic acid (EPA) and Docosahexaenoic acid (DHA) - Omega-3 fatty acids. Omega-3 fatty acids are found in fatty fish such as salmon, sardines, mackerel, tuna and fish oil capsules.
- Phospholipids - a type of fat or lipid that occur in most meats and eggs.
- Choline - a methyl-rich component of lecithin and the neurotransmitter acetylcholine which is responsible for normal muscle function and memory. Choline is found in liver, eggs, codfish, chicken, wheat germ, soy lecithin and soy products, including tofu.
- Uridine monophosphate - a nucleotide used in the formation of RNA, which is present in brewers yeast and organ meats (e.g. liver, kidneys).
- Vitamin E - a fat-soluble vitamin with antioxidant properties. Wheat germ, sunflower, safflower and red palm oils are rich sources of alpha-tocopherol.
- Selenium - a trace element that acts as an antioxidant. Selenium is found in nuts (particularly Brazil nuts), wholegrain cereals, meat and organ meats such as kidney, mushrooms, fish (tuna), shellfish like crab and crawfish, and eggs.
- Vitamin B12 - a B-vitamin involved with anti-ageing and prevention of megaloblastic anaemia. All animal protein foods, but especially organ meats, other types of meat, fish, and eggs are rich sources of vitamin B12.
- Vitamin B6 (pyridoxine) - also a B-vitamin associated with retardation of the ageing process. Vitamin B6 is found in meats, wholegrains, vegetables and nuts.
- Folic acid - is linked to nerve and brain development and prevention of spina bifida. Folic acid-fortified bread, maize meal, and breakfast cereals, as well as lentils and dry beans, are good sources of folic acid.
(Cassels, 2012; Mahan et al, 2011)
Two studies
In July 2008, the News Office of the Massachusetts Institute of Technology (MIT), issued a press release concerning the positive results obtained in the first Souvenaid Trial. In this study, which was carried out by Dr Philip Scheltens of the Alzheimer Center of the VU University Centre in Amsterdam and sponsored by Danone, the manufacturers of Souvenaid, 212 patients with mild AD were treated with the above mentioned combination of nutrients to enhance synapse formation. The results of these first clinical trials showed that verbal memory task deterioration in patients with mild AD was successfully delayed by the nutrient mixture developed at MIT (Trafton, 2008).
According to Prof Richard Wurtman, the concept of the treatment is “that specific combinations of certain nutrients interact to enhance synapse formation and also improve cognitive function”. (Trafton, 2008). Because the synapses are the points where information is passed between neurons in the brain and central nervous system, they play a critical role in learning and memory. If synapses are damaged or lost, memory will suffer as is the case in DA. Nutrients such as those listed above, help to improve synapse formation and thus slow down the loss of memory function.
In the second Souvenaid Trial which lasted 6 months, both the delay in memory loss and the safety of the new formulation were studied in 259 subjects with mild AD. The participants were randomly allocated to either receive 125 ml of Souvenaid or a control drink (placebo) every day for the study period (Cassels, 2012).
The results of the second Souvenaid Trial showed that the product was well tolerated, and no significant adverse side-effects occurred. In addition, the trial subjects showed a compliance rate of more than 90%.
When memory performance was measured by means of a range of neuropsychological tests, memory function continued to improve significantly in those subjects who used Souvenaid for the entire 48 weeks of the study. In addition, those participants who had been receiving placebo for the first 24 weeks and then were switched to receive Souvenaid, also showed a significant improvement in their neuropsychological test results.
Compared to results obtained with drugs called cholinesterase inhibitors, which are among the medications used at present to treat AD, the effect of Souvenaid was similar but with a more favourable risk/benefit ratio (i.e. fewer side-effects) (Cassels, 2012).
The future
Danone announced that it would launch Souvenaid in Europe in autumn of this year (Cassels, 2012). Because this is a nutritional supplement and not a medicine, it may become generally available relatively soon. It would appear that the components of Souvenaid have potential for delaying synapse and memory deterioration in patients with mild AD.
However, until the formulation does become available in South Africa, it would be prudent not to start self-dosing AD patients with a mixture of individual supplements as listed above. The reason is that most people may be tempted to increase the dose in a desperate effort to halt AD and this can lead to problems with overdosing. For example, selenium is a trace element, that is beneficial when taken in small quantities, but at high doses it can be toxic. Selenium toxicity is associated with skin and nail symptoms, tooth decay, and digestive and neurological abnormalities. It has potential mutagenic and/or genotoxic effects, and may exert an influence on thyroid function which still needs further exploration (Mahan et al, 2011).
At the moment, the best course would be to use foods rich in the nutrients listed above to supply them to AD patients until such time as Souvenaid becomes available globally and in this country for use under medical supervision.
- (Dr IV van Heerden, DietDoc, July 2012)
(References: Cassels C, 2012. Medical food linked to memory improvement in mild Alzheimer’s. http:// www.medscape.com; Mahan LK et al (2011). Krause’s Food & the Nutrition Care Process. Ed. 13. Elsevier, USA; Trafton S, 2008. Alzheimer’s treatment shows promise in clinical trials. http://web.mit.edu/newsoffice/2008/alzheimers-humans-0729.html; Trafton A, 2012. Nutrient mixture improves memory in patients with early Alzheimer’s. http://web.mit.edu/newsoffice/2012/alzheimers-nutrient-mixture-0709.html)
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