Issue: # 14

March 2011

 

Dr. Nancy Emerson Lombardo with HealthCare Insights, LLC
 

 

 Hello Friends,

 

We hope that as spring rounds the corner you are all getting ready to shake out the winter cobwebs. In this newsletter, we hope to show you how to improve brain health and reduce the risk of Alzheimer’s. The article below describes how B Vitamin’s are healthy and helpful in many ways and where to find these important vitamins.

 

Spring is a good time to think how we can help our fellow human beings especially those who have experienced catastrophes.    Haiti is still suffering hugely over a year after the earthquake on January 12th, 2010.  Want to donate to a deserving non profit organization that is helping in Haiti?  Here is where you can do that.

 

Mario Malivert, MD, MPH, is the President of this wonderful organization called Repheka Haiti.  Repheka Haiti is providing concrete needed health care through clinics and by training health care workers.  I have known Mario for almost 10 years.  While working on his MPH at Boston University Dr. Malivert brilliantly assisted me on my acupuncture and caregiver policy research at Wellesley College.  He was the essential co-author of our published 2003 study of acupuncture to treat persons with Alzheimer’s for anxiety.  A great writer (of poetry and prose), Dr. Malivert is also a caring clinician and wonderful human being.  Active in his church in the Boston area, he decided after the earthquake to return to his country of origin, Haiti, to do what he could. They have already provided relief, primary care, and OBGYN services to over 10,000 Haitians, and need funds to continue this clinic, create another clinic and train health agents.

I have just agreed to serve on Mario’s Board of Directors, to help get the word out about this important organization and its clinics.

 

This is a rare opportunity to make your donations count, with no overhead for fundraising and the like.  Your donations will go directly to helping provide healthcare for low income Haitians in Haiti. Here is where you can do that. www.repheka.org

I hope you will join me in donating to this important cause.

 

Nancy

 

 

If you want to see Dr. Nancy Emerson Lombardo in person there is a list of her future events at the end of this newsletter.   We have just added some additional exciting event information so please check again!

 

Better B’s
Why B Vitamins Are Essential for Brain Health and How to Get Them

 

April’s Consumer Guidelines Tip:

  • Be sure you get enough B vitamins in the correct proportions.
  • B vitamins are vital to brain function, both thinking and emotional as well as preventing excess homocysteine, inflammation, and oxidation.
  • Synthetic B vitamins such as found in enriched grains and vitamins work well as we age.
  • Most important are B-12 and niacin.
  • Taking extra folate or folic acid is helpful only when taking B-12 or not deficient in B-12.
  • Best choice is a B-50 complex to avoid imbalances and excess B-6.

Several population-based studies indicated B Vitamins are Essential for Brain Health and for Reducing Risk of Alzheimer’s disease 

 

People whose food or vitamin intake of both specific and groups of B vitamins was higher than average, were shown to have a lower risk of Alzheimer’s disease or cognitive decline.  Various B-vitamins have been indicated as protective against AD and cognitive decline in many studies.  The details are still unfolding. [1]

 

The mechanisms of biological action are multiple. Some are known; others are not yet.  Certain B vitamins such as folic acid, vitamin B6 and vitamin B12, are known to control levels of the amino acid homocysteine in the blood. High levels of homocysteine are also associated with an increased risk of Alzheimer’s as well as heart disease.

 

Folates and B12 have also been found to be important in the treatment of depression.

 

Population studies produced only “circumstantial evidence” suggesting the relevance of B vitamins to brain health. B vitamins well known role of acting as co-enzymes in the brain’s production of neurotransmitters lent further plausibility to these findings.

 

The next step was for researchers to undertake placebo-controlled, randomized clinical trials, “gold standard” evidence
.

 

New Study Shows Extra B Vitamins Slow Cognitive Decline in People with Mild Cognitive Impairment and May Help Reduce Alzheimer’s Risk – But Study Was Small So Regard the Results with Caution

 

A few years ago a clinical trial examining whether a combination of 3 B vitamins might slow Alzheimer’s progression concluded with disappointing results, as reported in the Journal of the American Medical Association.[2]   The 3 B vitamins were: Folic acid (5 mg = 5000 mcg), B-12 (1000 mcg) and vitamin B 6 (25 mg).   These were very high levels of folic acid; the other two levels are not unusual and there is no upper limit established for vitamin B-12.

 

The patient population was people with mild to moderate Alzheimer’s disease; the primary outcome measure was a comprehensive cognitive scale called the ADAS-cog.

The results: – no significant difference between those taking a placebo pill with those taking the B vitamins.  The people who took the B vitamins saw their homocysteine levels decline, but that did not translate into any benefits in terms of cognitive abilities compared to the placebo group.  And in addition, those who were taking the high doses of these 3 B vitamins unexpectedly experienced higher rates of depression.

 

However, a study reported in December 2010, found promising results.[3]  The primary differences with this study were several.  1) the patients in the new study were at an earlier stage of cognitive decline – they were diagnosed with Mild Cognitive Impairment (MCI), not yet full blown dementia or Alzheimer’s disease.  Typically about ½ of people with MCI go on to develop Alzheimer’s disease within a few years.   2) The researchers used a lower dose of the B vitamins…a level which the researchers still called “a drug, not a vitamin intervention”.  They used 800 mcg folic acid, 500 mcg of vitamin B 12, and 20 mg of vitamin B 6.

 

The study followed 168 volunteers with mild memory problems, half of whom took a high-dose vitamin B tablet for two years and the other half who took a placebo.

 

CNN reported that researchers used MRI scans to measure the rate of brain shrinkage over a two-year period. They found that on average, the brains of those taking a tablet that combined folic acid and vitamins B6 and B12 shrank at a rate of 0.76 percent a year, while those in the placebo group had a mean brain shrinkage rate of 1.08 percent.

 

“These are immensely promising results, but we do need to do more trials to conclude whether these particular B vitamins can slow or prevent development of Alzheimer’s,” said David Smith of the Department of Pharmacology at Oxford and a co-leader of the trial. “So I wouldn’t yet recommend that anyone getting a bit older and beginning to be worried about memory lapses should rush out and buy vitamin B supplements without seeing a doctor.”

 

The study was co-funded by the Alzheimer’s Research Trust, a British research charity. Chief Executive Rebecca Wood said the results are important but also said they require further study.

 

The U.S. Alzheimer’s Association also raised concerns about the study noting the small size, the fact that it was conducted at a single research center and that one of the researchers involved has patents in this area and might, under certain circumstances, result in his financially benefit.

 

“Only people with elevated homocysteine in the study showed benefit from the intervention. People with the lowest homocysteine levels in the study saw no benefit. So, B vitamins — if it shown to be effective in further studies — are unlikely to be beneficial for everyone, particularly if you already have healthy homocysteine levels,” said William Thies, chief medical and scientific officer of the Alzheimer’s Association.

 

“Clearly, this is not enough data to go on. No conclusions can be drawn from this single study about use of B vitamins in MCI (or Alzheimer’s disease or related dementias). No recommendations can or should be made to doctors or the public regarding use of B vitamins based on this study. ”

 

All B vitamins Important for Brain Health

While both of these clinical trials featured just 3 B vitamins, several other B vitamins, especially niacin[4], have also thought to be essential for brain health. The evidence is clear that B vitamins, including B12, B6, B1, B2, folate (B9) and niacin (B3) are essential for brain health.  B vitamins also help with sleep (B6 and niacin are co-factors needed to produce serotonin), and maintain healthy skin, eyes, digestive tract, and nervous system. Because B-vitamins help release energy from carbohydrates consumed, they also help decrease fatigue.

 

Niacin (also known as nicotinamide, nicotinic acid or Vitamin B3) is a coenzyme that assists in the breakdown of carbohydrates, fats and proteins. Niacin is essential for the health of the skin, nerves, tongue and digestive system. It is found in every cell of the body and is necessary for energy production and DNA formation. Niacin can also increase circulation and reduce high blood pressure and lower cholesterol.

Niacin[5],  has been shown in clinical trials to be effective in lowering plasma cholesterol as well as triglycerides which statins are less likely to affect.  Along with vitamin B-6, niacin is a co-factor needed to make serotonin. Necessary for normal mental function, niacin is sometimes considered a memory enhancer.   Niacin also enhances levels of brain choline, the precursor to acetylcholine.  Sufficient intake of niacin has been found to reduce risk of AD. Niacin is the only B vitamin Dr. Martha C. Morris has found to be clearly liked to risk of incident Alzheimer’s disease.  In one of her observational studies, relative importance of folate, B6, B12 all disappear when controlling for both vitamin E and niacin (and cognitive activities).

The Memory Preservation Nutrition® program suggests that most nutrients should come from food but it also includes specific evidence-based recommended supplements and vitamins to ensure sufficiency of key nutrients.  Very important are all the B vitamins with these minimum amounts:[6] (B1 thiamine 10mg, B6  pyridoxine 10 mg, B12 10 mcg,  as well as B2 riboflavin 10 mg, and niacin 30 mg; as well as 200 mcg of folate.  A B-50 complex will usually supply all of these.

 

We advise against more than 400 mcg supplemental folate unless you are also taking B12 or this was recommended by your doctor for high homocysteine levels since many foods are fortified with folate. If you should be deficient in B12, several studies suggest that folate levels over 800 mcg could be harmful to your cognitive health.

 

The Memory Preservation Nutrition® program also always includes a disclaimer “Before making changes in your diet consult your physician e.g. re specific conditions or drug interactions.”

 

FOOD SOURCES [7],

 

Eat green leafy & certain other vegetables, beans, orange juice & other citrus; strawberries, avocados (B-6), bananas (B-6, biotin), meat and fish (B12 and B6), dairy and eggs (B12), whole grains and brewers’ yeast (B1-thiamine, B2-riboflavin, and niacin-B-3).

The only reliable unfortified sources of vitamin B12 are fish, meat, poultry, dairy products and eggs; liver is an especially good source. The current nutritional consensus is that no plant foods can be relied on as a safe source of vitamin B12.   Fortified breakfast cereals and B12 supplements are a particularly valuable source of vitamin B12 for vegetarians and older adults.

Foods sources for Vitamin B-6 (pyridoxine) include fortified breakfast cereals, fish including salmon and tuna fish, meats such as pork and chicken, bananas, beans, and peanut butter, some nuts and seeds such as walnuts and sunflower, and many vegetables and fruits including potatoes with skins, spinach, tomatoes and avocados, as well as liver and kidneys, eggs, peas, wheat germ and carrots.

Biotin is found in various foods, including liver, cauliflower, salmon, carrots, bananas, soy flour, cereals, and yeast.

 

Folic acid is a member of the B-vitamin family. It occurs naturally in foods as folates, and is available in synthetic form in vitamin pills. Most diets provide only half of the daily required amount of folates, the natural form of folic acid found in foods; hence the high levels of folic acid supplements in processed foods. Americans who eat cereals, breads, pasta, enriched rice and other processed grain products on a daily basis are probably getting enough folic acid from their food, since the latter are fortified with folates and certain other B complex vitamins.

 

Foods naturally rich in folates include

  • green leafy vegetables (such as spinach, bok choy, cabbage, savoy),
  • other green vegetables such as asparagus, broccoli, Brussels sprouts; beets;
  • avocados, beans and peas, particularly peanuts, garbanzo beans, lima beans, lentils, chickpeas (note: main ingredient of humus), green peas;
  • fruits: particularly orange juice, other citrus fruits and juices, strawberries and rose hips;
  • eggs, and meats, and some dairy products (e.g. cheeses and yoghurt), and
  • Whole-grain products, Sunflower seeds and wheat germ, and yeast extracts such as Marmite.

The synthetic form of folic acid, which is considered as healthy as folates, is found in multivitamins, fortified breakfast cereals, and enriched grain products such as pasta, rice and breads.

 

We do offer a great quality B-50 complex on our website. ( www.healthcareinsights.net  “shop”)

 


[1] Morris MC. Schneider JA. Tangney CC. (2006) Thoughts on B-vitamins and dementia

 J of Alzh. Dis. 9(4): 429-433.

 

[2] Aisen PS, Schneider LS, Sano M, Thal L. et al. High-Dose B Vitamin Supplementation and Cognitive Decline in Alzheimer Disease:  A Randomized Controlled Trial    JAMA 2008; 300(15):1774-1783. doi: 10.1001/jama.300.15.1774. 

[3] Smith AD, Smith SM, deJageri CA, et al.  Homocysteine-Lowering by B Vitamins Slows the Rate of Accelerated Brain Atrophy in Mild Cognitive Impairment:

A Randomized Controlled Trial   PLoS ONE | www.plosone.org (on line)  Sept 2010;  5  (9)  e12244

 

[4] Morris MC. Evans DA. Bienias JL. Scherr PA. Tangney CC. Hebert LE. Bennett DA. Wilson RS. Aggarwal N. (2004) Dietary niacin and the risk of incident Alzheimer’s disease and of cognitive decline. J Neur, Neurosurgery & Psych. 75(8): 1093-9.

 

[5] Emerson Lombardo, NB et al.  Beyond Magic Bullets: Evidence-based Memory Preservation Nutrition® ©2006, 2007 to Reduce Risk and Slow Progression of Alzheimer’s disease

unpublished manuscript.

 

[6] Emerson Lombardo, NB, Volicer L, Martin A, Wu B. Zhang XW.(2006) Memory Preservation Diet to Reduce Risk and Slow Progression of Alzheimer’s Disease (AD) in Vellas B, Grundman M, Feldman H, Fitten LJ, Winblad B, editors, Research and Practice in Alzheimer’s Disease and Cognitive Decline, vol 9:138-59.

 

[7] Emerson Lombardo, NB. Memory Preservation Nutrition®

(available on www.healthcareinsights.net  “shop”)

 

Please Help Us Expand our Services in Haiti
Since February 2010, a few weeks after the January 12, 2010 earthquake, Repheka Haiti , a non-profit organization, has been supporting a clinic at Pernier (Route des Freres) and mobile clinics in targeted neighborhoods. So far, we have provided relief, primary care, and OBGYN services to over 10,000 Haitians.

 

Now, we need your help to expand our services to the following areas:

  • A primary care clinic in Carrefour Feuilles
  • Training and deployment of Health Agents into neighborhoods and communities
  • Community research, needs assessment, and HIV/AIDS screening and referral
  • Prevention and treatment of Malaria, Tuberculosis, Cholera, and other infectious diseases

Please go to our website www.repheka.org to donate.

 

 

Public invited to presentations by Dr. Emerson Lombardo on March 28th and April 5th, 6th, 7th, 20th, 27th, and 28th 2011 and May 3rd, 10th, 5th, 12th, 18th, 19th and 26th 2011.
See Dr. Emerson Lombardo in Person!  

 

March 26-29th, 2011:26th International Conference of Alzheimer’s Disease International

This conference is being held in Toronto, Ontario at the Sheraton Centre Toronto Hotel, 123 Queen Street West, Toronto, Ontario, Canada M5H 2M9.  Nancy will be presenting orally on March 28th at 4:45pm

“Nutritional supplement combination therapy feasibility, safety and biomarker clinical trial in cognitively normal adults.” (about the study at Boston Univ. School of Medicine)  and will have a poster about ”Memory Preservation Nutrition  in Assisted Living: a Clinical Practice Report,” from March 27th-29th.  Please register and arrange accommodations at http://www.adi2011.org/default.aspx?PageID=Home.  Check out the events page at www.healthcareinsights.net

 

April 5th, 2011: Brain Healthy Nutrition 

This event sponsored by Standish Village will be held in Dorchester Center, MA at the Carney Hospital, 2100 Dorchester Avenue, Dorchester Center MA 02124. This event will run from 3:30-5:30 and registration will cost $4.00. A full dinner will be provided. Please register with DoctorFinder at 1 800 488 5959. It will be held in the basement level cafeteria. Check out the events page at www.healthcareinsights.net

 

April 6th, 2011: Food For Thought: Brain Healthy Eating   

This free CEU professional event will be held in Jamaica Plain, MA at the Springhouse Retirement Community, 44-46 Allandale Street, Jamaica Plain, MA 02130, sponsored by hospice association. This event starts at 8:00am and will go until 9:00am.  Open to the public and will be held in the Main Street room.  Please RSVP to Springhouse Retirement Community, Karen Pollack 617-971-1678 or kpollack@springhouseboston.org. Check out the events page at www.healthcareinsights.net

 

April 7th, 2011: Eating for a Health Brain: An Evidence Based Approach

This professional event will be held in Portsmouth, New Hampshire at the Best Western Wynwood Hotel, 508 US Highway 1 Bypass, Portsmouth, New Hampshire 03801. Register to attend.  This conference starts at 9:00am.  Dr. Nancy Emerson Lombardo will be speaking from 10:15am-11:30am. For registration information, contact Linnea Hagberg Linnea.Hagberg@seniorcareinc.org or call

978-281-1750 x366. Please Check out the events page at www.healthcareinsights.net

 

April 20th, 2011: Brain Healthy Lifestyles/The Joyful Life is a Healthy Life

Humor, Creative Expression, Spirituality and Having Purpose 

This free event will be held in Chestnut Hill, Massachusetts at EPOCH Assisted Living at Boylston Place, 615 Heath St, Chestnut Hill, Massachusetts 02467. This event open to the public starts at 1:30pm and will be running till 3:00pm.  Dr. Nancy Emerson Lombardo and Dr. Lynn Serper will be speaking on spiritual practices, humor, social engagement, creative arts and music. Check out the events page at www.healthcareinsights.net

 

April 27th, 2011: Healthy Eating for a Healthy Brain

This free event sponsored by Worcester Alzheimer’s Partnership will be held in Leominster, MA at Fidelity Bank, 9 Leominster Connector, Leominster MA 01453.  This event starts at 9:00 and Dr. Nancy Emerson Lombardo will be speaking from 9:00am-10:30am and is open to the public. RSVP with Julie McMurray at Julie.McMurray@alz.org or 508-799-2386. Please check out the events page at www.healthcareinsights.net

 

April 28th, 2011: Healthy Lifestyles to Improve Brain Health: Evidence Based Recommendations

This is a 6 part class that will take place each Thursday until June 2nd.  It is being hosted by UMASS Boston at 100 Morrissey Boulevard, Healey Library, UMASS Boston, Presentation Room 3, Lower Level, Boston MA 02125. A remote TV site is available in Plymouth.  This class will be held from 1:15-2:45pm  To register for this course contact

Mary.McCarthy@umb.edu or telephone (617) 287-7090. Check out the events page at www.healthcareinsights.net

 

May 3rd, 2011: Food for Thought: Healthy Eating for a Healthy Brain

This free event will be held in North Andover, MA at Ashland Farms at North Andover, 700 Chickering Road, North Andover, MA 01845. This event will run from 5:00-7:00pm. There will be refreshments at 5:00pm and the presentation will start at 5:30-7:00pm with time for Q & A.  Check out the events page at www.healthcareinsights.net 

 

May 5th, 2011: Healthy Lifestyles to Improve Brain Health: Evidence Based Recommendations

This the 2nd part of a 6 part class that will take place each Thursday until June 2nd.  It is being hosted by UMASS Boston at 100 Morrissey Boulevard, Healey Library, UMASS Boston, Presentation Room 3, Lower Level, Boston MA 02125. A remote TV site is available in Plymouth.  This class will be held from 1:15-2:45pm  To register for this course contact

Mary.McCarthy@umb.edu or telephone (617) 287-7090. Check out the events page at www.healthcareinsights.net

 

May 10th, 2011: Brain Healthy Nutrition

This event is at Merrimack Valley Elder Services sponsored by Methuen Village. 360 Merrimack Street, Building 5, Lawrence, MA 01843. The event will run from 9:30-11:00am.  Dr. Emerson Lombardo will present with time for Q & A at the end.  Check out the events page at www.healthcareinsights.net

 

May 12th, 2011: Healthy Lifestyles to Improve Brain Health: Evidence Based Recommendations

This the 3rd part of a 6 part class that will take place each Thursday until June 2nd.  It is being hosted by UMASS Boston at 100 Morrissey Boulevard, Healey Library, UMASS Boston, Presentation Room 3, Lower Level, Boston MA 02125. A remote TV site is available in Plymouth.  This class will be held from 1:15-2:45pm  To register for this course contact

Mary.McCarthy@umb.edu or telephone (617) 287-7090. Check out the events page at www.healthcareinsights.net

 

May 18th, 2011: Brain Healthy Lifestyles/Food for Thought Brain Healthy Foods

The Role of Nutrition in Maintaining Cognitive Function 

This free event in the 2nd part of a 3 party series that will be held in Chestnut Hill, Massachusetts at EPOCH Assisted Living at Boylston Place, 615 Heath St, Chestnut Hill, Massachusetts 02467. This event open to the public starts at 1:30pm and will be running till 3:00pm.  Dr. Nancy Emerson Lombardo and Dr. Lynn Serper will be speaking on spiritual practices, humor, social engagement, creative arts and music. Check out the events page at www.healthcareinsights.net

 

May 19th, 2011: Healthy Lifestyles to Improve Brain Health: Evidence Based Recommendations

This the 4th part of a 6 part class that will take place each Thursday until June 2nd. Dr. Lynn Serper is the guest speaker on this date. The series is being hosted by The Osher Lifelong Learning (OLLI) Program, UMASS Boston at 100 Morrissey Boulevard, Healey Library, UMASS Boston, Presentation Room 3, Lower Level, Boston MA 02125. A remote TV site is available in Plymouth.  This class will be held from 1:15-2:45pm  To register for this course contact

Mary.McCarthy@umb.edu or telephone (617) 287-7090. Check out the events page at www.healthcareinsights.net

 

May 19th 2011: Food For Thought

This free event sponsored by The Cambridge Homes will be held in Somerville, MA at the Somerville-Cambridge Elder Services at 61 Medford St, Somerville MA 02143.  This event will be held from 9:30-10:30am.  CEU’s will be offered at this event.  Check out the events page at www.healthcareinsights.net

 

May 26th, 2011: Healthy Lifestyles to Improve Brain Health: Evidence Based Recommendations

This the 5th part of a 6 part class that will take place each Thursday until June 2nd. Dr. Lynn Serper is the guest speaker on this date. The series is being hosted by The Osher Lifelong Learning (OLLI) Program, UMASS Boston at 100 Morrissey Boulevard, Healey Library, UMASS Boston, Presentation Room 3, Lower Level, Boston MA 02125. A remote TV site is available in Plymouth.  This class will be held from 1:15-2:45pm  To register for this course contact

Mary.McCarthy@umb.edu or telephone (617) 287-7090. Check out the events page at  www.healthcareinsights.net  

 

Check the website for the upcoming events in June and July.

 

CALLING ALL FORMER NATIONAL BOARD MEMBERS FOR ALZHEIMER’S ASSOCIATION.    Check your mailboxes….invitation forthcoming for “Reunion Dinner” in Chicago on June 10, 2011.   I’m planning on attending; hope you are too.  If you didn’t receive notice, just let Harry Johns know your current contact information.

 

Feb. email from President Harry Johns via Alison Bourque:

“Please save the evening of June 10, 2011

to join current and former

Alzheimer’s Association National Board of Directors

and their partners in Chicago for a special evening to celebrate all that we have accomplished over the last 30+ years to advance our cause and move forward our mission in order to realize our vision ofa “World without Alzheimer’s”.

*

This dinner will be held in conjunction with the

Alzheimer’s Association June Board Meeting at the

InterContinental Hotel in downtown Chicago .

It will be a unique and well deserved opportunity to reflect on our mission, celebrate the immense progress we have made together since our foundation, and discuss critical next steps in the fight to end Alzheimer’s disease.”

 

 

Our Website experiencing technical difficulties which makes it slow to upload information and you have to personally refresh the website or shopping cart in order to see in the cart what you have chosen to purchase.  The site is secure and your purchase will be recorded correctly by Paypal; but if all this is just too cumbersome, just email Dr. Emerson Lombardo directly and tell her what you are interested in purchasing or asking questions about and she’ll get back to you by email or otherwise.

Save 20% on any nutritional supplements ordered on-line in April 2011
Go to our website: www.healthcareinsights.net

Offer Expires: April 30th, 2011

 

 

Nancy is available to answer all questions via e-mail.  

Look for her monthly column in the South Shore Senior News!

For brain health consultations for yourself, your family, or your organization contact Nancy for further information or to book an appointment. 978-621-1926 or email at nemerson@healthcareinsights.net.

 

Nancy Emerson Lombardo, PhD
HealthCare Insights, LLC
P.O. Box 2683 , Acton , MA 01720

© 2011 HCI

 

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