meto-revive

I must have seen commercials for Prevagen 50 times: story after story from everyday people who describe improvement in memory once they began taking Prevagen. And perhaps you recall older commercials playing off the idea that many people take supplements that boast of gut, joint, and heart health claims. Those commercials memorably asked, “So why wouldn’t you take something for the most important part of you… your brain? With an ingredient originally found in jellyfish! Healthier brain, better life!”

Never mind that the ingredient from jellyfish (apoaequorin) that was supposed to deliver these benefits has no known role in human memory. Or that many experts believe supplements like this are most likely digested in the stomach and never wind up anywhere near the brain.

Can a supplement actually improve memory? If it doesn’t work, why is the manufacturer allowed to suggest it does? And if apoaequorin is so great, why aren’t jellyfish smarter (as a colleague of mine wonders)?

Mind the gap between graphics and reality

A bar graph in the older ads showed a rise from 5% to 10% to 20% over 90 days in “recall tasks,” though exactly what that meant was never explained. Nor were we told how many people were studied or given any information about effects on memory after 90 days.

One small, company-sponsored study reported improvements in memory after people took apoaequorin. However, the published version demonstrated improvements only in a subset of study participants. And the real-world impact of these changes is uncertain. The study authors recommended additional research to clarify its effectiveness. But I’ve been unable to find any additional, high-quality, independent studies showing the impact of Prevagen or apoaequorin on human memory.

The Prevagen case resolved

The US Federal Trade Commission (FTC) and the New York state attorney general were also unconvinced about the supplement’s benefits. Back in 2017, they charged the supplement maker with false advertising. Fast forward to February 2024, when a New York jury found that many of the supplement’s claims were not supported by reliable evidence, and some (but not all) of the claims were “materially misleading.”

In December 2024, the FTC and New York attorney general won their lawsuit. Now the makers of Prevagen are prohibited from claiming that the supplement can improve brain function or memory.

Supplement claims sound good — so why the disclaimers?

There are many thousands of supplements marketed for hundreds of conditions. But it’s often hard to say if they’re doing much of anything.

For example:

• Glucosamine is often promoted as good for joint health. I have known patients who swore by it. But the best studies suggest this supplement has modest effects, if any.
• When vitamins tout heart-healthy claims, I think of the example of vitamin E, once considered potentially useful to prevent or treat heart disease. Yet, study after study showed no benefit. In fact, it may increase the risk of heart failure.
• As for probiotic supplements, no convincing evidence shows that their use improves digestive health or prevents digestive disease in healthy people.

So when you’re considering supplements, be skeptical of the benefits touted and remember the standard disclaimer stamped on each one: “These statements have not been evaluated by the FDA.”

What are the rules?

Supplement makers are bound by a few basic rules set by the FTC and FDA:

• They can make truthful claims about connections between their supplement and the body’s “structure and function.” For example, a vitamin maker touting calcium in a product can say that calcium is important for bone health — although it’s also true that calcium supplements may offer little or nothing for most people with healthy bones, diets rich in calcium, and no medical condition requiring extra calcium.
• They cannot claim their product treats or prevents a particular disease. That disclaimer, which may seem to contradict marketing promises, must appear on every package. So, commercials suggesting that a supplement can reverse or slow Alzheimer’s disease, or any dementia, may run afoul of the rules on marketing supplements.

The FDA and FTC continue to provide key oversight to the dietary supplement industry. That’s a daunting task given the sheer volume of products on the market.

The bottom line

This country has an enormous appetite for dietary supplements. The supplement industry is now worth an estimated $70 billion or more, with as many as 100,000 products available for purchase.

But there’s a reason dietary supplements carry a disclaimer: “This product is not intended to diagnose, treat, cure, or prevent any disease.” This should remind us all to be wary of claims we see in ads for dietary supplements. Unlike prescription drugs, supplements are not thoroughly tested or evaluated. While dietary supplements might provide benefits in certain cases, it’s vitally important that their makers not make unfounded claims to exploit consumers.

I support the efforts of the FDA and FTC to regulate dietary supplements and their ads. But regardless of how effective their regulations are, it’s best to be skeptical about ads for products that seem too good to be true. There’s a good chance they are.

About the Author

Robert H. Shmerling, MD, Senior Faculty Editor, Harvard Health Publishing; Editorial Advisory Board Member, Harvard Health Publishing

Dr. Robert H. Shmerling is the former clinical chief of the division of rheumatology at Beth Israel Deaconess Medical Center (BIDMC), and is a current member of the corresponding faculty in medicine at Harvard Medical School. … See Full Bio View all posts by Robert H. Shmerling, MD

When experts talk about the dangers of excessive drinking, we often assume those warnings apply mostly to people with alcohol use disorder, a health issue sometimes referred to as alcoholism.

But people who don’t meet formal criteria for this disorder can still experience toxic effects and suffer other serious harms from alcohol, says Dr. John F. Kelly, professor of psychiatry in addiction medicine at Harvard Medical School. And as research turns up new evidence about alcohol, many people are considering the benefits of drinking less, even if they’re not ready to stop imbibing entirely.

How does alcohol affect the body?

That depends on how much you drink. Drinking more than moderate amounts of alcohol (defined as one drink per day for women and two for men) increases your risk for developing

• liver disease
• several types of cancer including breast, liver, and colon cancer
• cardiovascular problems such as high blood pressure and atrial fibrillation.

What if you’re not drinking daily? “Even people who only drink on weekends can have serious accidents if they become intoxicated — for example, by falling or driving under the influence,” says Dr. Kelly.

What’s more, growing evidence suggests that even small amounts of alcohol may harm your health.

How could cutting down on alcohol help you?

If you’re not ready to give up drinking entirely, cutting back can lower the likelihood of all of these harms. For example, cutting down on alcohol, or stopping entirely, is linked with lower cancer risks, according to a report from the American Association for Cancer Research.

You might also notice some immediate benefits, like sleeping more soundly, memory improvements, and generally feeling more mentally sharp. And because you’ll be taking in fewer calories, you may also shed some weight.

Ready to try cutting back on alcohol? Start here

These five suggestions are a great way to start cutting back.

Keep a drinking diary

Tracking how much alcohol you drink and when can help you target your efforts to drink less. It’s also a good idea to put your reasons for cutting back in writing: for example, “I’d like to sleep better,” “I feel sharper,” “Better heart health is important to me.” That practice can reinforce your resolve to follow through with your plan.

Try alcohol-free days — or even a month of not drinking

Taking a break from alcohol can be a good way to start, allowing your brain and body to recalibrate. Decide not to drink a day or two each week. You may want to abstain for a week or a month, to see how you feel physically and emotionally without alcohol in your life. Consider doing Sober October — a variation of Dry January.

Drink slowly and with food

Sip your drink. Alternate alcoholic drinks with nonalcoholic alternatives like sparkling water, soda, or juice. Don’t drink on an empty stomach, because you’ll feel intoxicated more quickly. That can lower your inhibitions and break your resolve to stick to lower amounts of alcohol, Dr. Kelly says. Drinking with a meal slows alcohol absorption and appears to minimize the drug’s health risks.

Try low-alcohol or zero-alcohol substitutes

Alcohol-free beer, nonalcoholic distilled spirits, and similar products have become more widely available in recent years. It’s a result of the alcohol industry’s response to stay profitable, as health harms of small amounts of alcohol have been confirmed and the sober curious movement gains momentum.

If you drink beer, wine spritzers, hard seltzer, or similar products, check the alcohol content

While light beers have fewer calories, they don’t necessarily have much less alcohol than regular beer. The average light beer is about 4.3% alcohol, versus 5.0% in regular beer.

Also, be aware that some craft or specialty beers contain far higher amounts of alcohol — up to 12% or 14% or even higher. Beverages that combine wine or hard liquor with seltzer or other mixers also vary widely in their alcohol content.

Cut down on temptation

Two more tips can help you meet success when changing drinking habits.

Don’t keep alcohol in your house. Making your home an alcohol-free zone takes away the risk of immediate temptation.

Avoid temptation. Steer clear of people and places that make you want to drink. If you associate drinking with certain events, such as holidays or vacations, make a plan for managing these situations in advance. Check in with your feelings. When you’re worried, lonely, or angry, you might be tempted to reach for a drink. “Think about other ways you might alleviate those feelings, such as going for a walk or calling a friend,” Dr. Kelly suggests.

Finally, try this interactive tool from the CDC, which can help you make a personalized plan to drink less.

About the Author

Julie Corliss, Executive Editor, Harvard Heart Letter

Julie Corliss is the executive editor of the Harvard Heart Letter. Before working at Harvard, she was a medical writer and editor at HealthNews, a consumer newsletter affiliated with The New England Journal of Medicine. She … See Full Bio View all posts by Julie Corliss

About the Reviewer

Howard E. LeWine, MD, Chief Medical Editor, Harvard Health Publishing; Editorial Advisory Board Member, Harvard Health Publishing

Dr. Howard LeWine is a practicing internist at Brigham and Women’s Hospital in Boston, Chief Medical Editor at Harvard Health Publishing, and editor in chief of Harvard Men’s Health Watch. See Full Bio View all posts by Howard E. LeWine, MD