Can cooking with aluminium pans cause dementia?

SOME years ago, I watched a documentary on Alzheimer’s, which said that microscopic flakes from aluminium cooking utensils were found in the brains of Alzheimer’s patients. Should we switch to non-aluminium pots and pans?

TSuspicion began as long ago as 1921, when an association between aluminium poisoning and memory problems was first noted.

We all have some aluminium in our brains (it doesn’t occur naturally, but can get there via the foods we eat or be absorbed through the skin when we’re exposed to it), and it builds up with age.

Brain scans from post-mortem examinations of Alzheimer’s patients have shown there is an accumulation of aluminium in the brain. And patients with a genetic susceptibility to earlyonset Alzheimer’s have been found to have even more.

Also, in patients on dialysis for kidney disease, a condition called dialysis encephalopathy can develop, which leads to a type of dementia — one cause of this encephalopathy is damage caused by an accumulation of aluminium in the brain.

However, none of these cases prove a causal link, just that there is an association.

The main risk factor for Alzheimer’s disease is age — and aluminium aggregates in brain tissue with age, so these events may just be occurring in parallel.

The reason people have pointed to aluminium cookware as a potential problem is that certain acids in foods will dissolve some of the metal and form chemical salts which will then be absorbed into the body.

When these get into nerve tissue, such as in the brain, they can accumulate. Aluminium ions (charged particles) are known to be neurotoxic, meaning they can poison the brain and nervous system. However, once again, the risk posed by aluminium cookware has not been proven.

Furthermore, the view is that it would be difficult to significantly reduce the amount of aluminium we absorb by simply avoiding the use of aluminium cookware or foil for food wrapping, because it can still get into the body from other sources, such as processed foods, tea, wine, fizzy drinks, cosmetics and medicines such as aspirin (this may be because of the way they are produced or stored). O ur body removes most of the aluminium as waste, but a theory is that if we absorb large amounts, then it is deposited in tissues.

In particular, black tea — which is the leaf of a small, evergreen shrub, a variety of Camellia — as it grows, accumulates large amounts of aluminium.

Yet there is no evidence that people who drink a lot of tea have a higher incidence of dementia. And no one has suggested that we all stop drinking tea. I am not convinced there’s a risk. If you are particularly concerned, or know you are at risk of Alzheimer’s, you may be reassured if you switch to stainless steel cookware, which is cheap and widely available.

But bear in mind you can’t avoid aluminium completely. A HIATuS hernia occurs when part of the stomach squeezes into the chest through an opening in the diaphragm, the domed wall of muscle that sits across the chest and separates the gullet from the stomach (the gullet passes through the diaphragm in an opening called the hiatus, and connects to the stomach on the other side).

This part of the diaphragm acts as a valve to prevent the stomach contents rising up. But when this muscle weakens, as a result of ageing, obesity or anything else, the valve action fails, a gap opens up and the stomach itself pushes through the widened space and into the chest area.

In most cases, hiatus hernias do not cause symptoms and won’t need treatment.

However, patients with large hiatus hernias — where the stomach plus gullet move up into the chest — may have symptoms of heartburn, such as a sense of regurgitation, an acid taste in the throat, trouble swallowing, a cough, or nausea, just as you describe in your longer letter.

Treatment for hiatus hernia involves medicines that help reduce acid reflux to ease the symptoms. This includes antacids to neutralise the acid or medicines such as ranitidine which suppress acid production — both are available on prescription, as well as over-the-counter.

More powerful is a prescriptiononly medication called a proton pump inhibitor, such as highdose omeprazole. Ask your GP about a prescription for one of these medicines, if it has not been done already.

If these don’t work, you may need surgery to fix the hernia, although this involves a major operation and is a last resort.

Do bear in mind that some simple lifestyle changes can be helpful. These include not eating large meals in the evening, eating slowly and going for a short walk after each meal.

If your symptoms persist despite acid suppressant treatment and taking great care, as above, further investigations may be necessary.

Discuss again with your GP and consider a referral to a specialist gastroenterologist as your symptoms have persisted and are so troublesome.