Food and Supplement Choices for Brain Health — When They Are Ineffective

This is the first in a series of discussions on thoughtful approaches to health that will give some clarity on when supplements may be useful, harmful or neutral and what is actually cost-effective. We will cover not only nutritional supplements, but lifestyle choices that can lead to a more vibrant and longer healthspan - the period of your life in which you are in optimal health, free from chronic diseases and physical and cognitive disabilities.

Balance of Nature and Zena Greens

We are bombarded with advertisements for supplements that make grandiose and unrealistic claims and substantial profits for their manufacturer. Some, such as Balance of Nature and Zena Greens, claim to distill the best of nutrition from fruits and vegetables into a few capsules of powdered produce. Both Balance of Nature and Zena Greens aggregate a lot of constituents into a proprietary blend that may ultimately offer little tangible nutrition. The freeze-drying process retains fiber and some nutritional value, but vitamin C and water-soluble B vitamins such as thiamin and folate are likely degraded while phytochemicals may be lost.[1][2] The companies are opaque in that they do not publish the exact vitamin amounts on their labels. Lack of quantitative vitamin and mineral values per serving precludes meaningful comparison to dietary recommended intakes. In addition, the amount of plant mass in the capsules is low and so dosage of nutrient will be relatively small compared to actual food or a multivitamin.

Prevagen and Neuriva

Then we come to the brain health supplements marketed to help with mild memory loss in older persons.[3] Prevagen, one of the most popular, consists of apoaequorin, a jellyfish-derived protein, and vitamin D3. The supposed manner in which apoaequorin helps the brain is by influencing brain calcium. Apoaequorin consumed orally has not been convincingly shown to reach the brain and, if it does, it is not credible to believe that it would modulate brain calcium levels in a way that would support memory.

The other, Neuriva, is composed of phosphatidylserine and coffee cherry extract. While it is true that phosphatidylserine can reach the brain when taken by mouth and is an important component of nerve cells and of membrane structure overall, it is best to consume it in foods like soybeans, fish and eggs. Both Prevagen and Neuriva are regulated as dietary supplements, but not FDA-approved for effectiveness before marketing and neither has rigorous replicated peer-reviewed research confirming efficacy.[4] Instead of concrete substantiated data, advertisements rely on testimonials and anecdotal evidence. Neuriva did conduct a 42-day company-funded trial, in middle-aged adults with self-reported memory problems and found statistically significant improvements on some computerized cognitive measures compared with placebo, but it also produced null findings on other outcomes and lacks long-term independent replication.[5]

Cerefolin and NAC

Another of these supplements is Cerefolin, which contains folate (vitamin B9), vitamin B12 and N-acetylcysteine (NAC). The most important use for NAC is as an antidote for Tylenol (acetaminophen) overdose and it has no doubt saved many lives.[6] NAC does reach the brain. However, its ability to change brain function as a supplement is unproven. B vitamins are important for overall health, but if you do need a supplement because you are told by your health professional that you have a deficiency, they are quite inexpensive. In contrast, as of July 2026, the manufacturer lists a 30-day supply of Cerefolin at $69.99. The cost of NAC if purchased alone is much less than when it is a component of Cerefolin. The list of potential brain support supplements is so long that if you consumed them all you would no doubt make yourself quite ill at great expense. Stacking overlapping supplements can duplicate ingredients and increase cost, side effects, and interaction risk.[7]

What Comes Next

The sheer volume of overlapping and poorly substantiated products creates confusion rather than clarity, making this approach both unrealistic and counterproductive. In our next segment we will discuss supplements for heart health that are not effective. Then we will cover supplements that may be good for brain and heart and the circumstances under which they may be worth taking. Prudent advice is to not treat supplements as a replacement for proven approaches to optimal brain and heart health to be discussed in future sections of this continuing conversation.

References

1. DeBenedictis JN, de Kok TM, van Breda SG. Impact of Processing Method and Storage Time on Phytochemical Concentrations in an Antioxidant-Rich Food Mixture. Antioxidants (Basel). 2023 Jun 10;12(6):1252. doi: 10.3390/antiox12061252. PMID: 37371982; PMCID: PMC10295423.
2. Wang J, Law C and Mujumdar A. The degradation mechanism and kinetics of vitamin C in fruits and vegetables during thermal processing. In: Drying Technologies for Foods: Fundamentals and Applications, ed. by PK Nema, B Pal Kaur and AS Mujumdar. CRC Press, Boca Raton, FL, USA (2018).
3. Grossman S, Nathan JP, Siuzdak A, Liang J, Sprycha C. Prevagen®: Analysis of Clinical Evidence and Its Designation as a "#1 Pharmacist Recommended Brand". Sr Care Pharm. 2022 Aug 1;37(8):335-338. doi: 10.4140/TCP.n.2022.335. PMID: 35879840.
4. Cline K, Beachy MW, Carr PW; Health and Public Policy Committee of the American College of Physicians. Modernizing the Regulatory Framework for Dietary Supplements: A Position Paper From the American College of Physicians. Ann Intern Med. 2026 Jul 14. doi: 10.7326/ANNALS-26-01119. Epub ahead of print. PMID: 42441966.
5. Doma KM, Lewis ED, Barracato JM, Brink LR, Gratson AA, Pandey N, Crowley DC, Evans M. A Randomized, Double-Blind, Placebo-Controlled, Parallel Study Investigating the Efficacy of a Whole Coffee Cherry Extract and Phosphatidylserine Formulation on Cognitive Performance of Healthy Adults with Self-Perceived Memory Problems. Neurol Ther. 2023 Jun;12(3):777-794. doi: 10.1007/s40120-023-00454-z. Epub 2023 Mar 16. PMID: 36929344; PMCID: PMC10195946.
6. Dart RC, Mullins ME, Matoushek T, Ruha AM, Burns MM, Simone K, Beuhler MC, Heard KJ, Mazer-Amirshahi M, Stork CM, Varney SM, Funk AR, Cantrell LF, Cole JB, Banner W, Stolbach AI, Hendrickson RG, Lucyk SN, Sivilotti MLA, Su MK, Nelson LS, Rumack BH. Management of Acetaminophen Poisoning in the US and Canada: A Consensus Statement. JAMA Netw Open. 2023 Aug 1;6(8):e2327739. doi: 10.1001/jamanetworkopen.2023.27739. Erratum in: JAMA Netw Open. 2023 Sep 5;6(9):e2337926. doi: 10.1001/jamanetworkopen.2023.37926. PMID: 37552484.
7. Burns EK, Perez-Sanchez A, Katta R. Risks of Skin, Hair, and Nail Supplements. Dermatol Pract Concept. 2020 Oct 26;10(4):e2020089. doi: 10.5826/dpc.1004a89. PMID: 33150030; PMCID: PMC7588165.