Issue: # 4

  April 2010


Dr. Nancy Emerson Lombardo with HealthCare Insights, LLC


Dear Friends,

Happy Spring!!!!  Before you consider eating all those sugary things for Passover or Easter, think about making your favorite treat with natural non-sugar sweeteners instead. Too much sugar puts our brains at risk.

Now that it is spring and we have our energy back it’s time to try new things.  Let our new thing be trying natural sweeteners in our foods.

Below our article discusses why natural sweeteners are what we should be using in our baked goods and delicious drinks, instead of sugars or artificial sweeteners.

There is also a recipe that gives a wonderful example of how to use natural non-sugar sweeteners in our baking.


The Benefits of Natural

Non-Sugar Sweeteners

Sweet Natural “Brain Healthy” Substitutes for Sugar and Foods to Support Sugar Control

One primary goal for the Memory Preservation Nutrition® brain health program is to keep our sugar in balance and avoid stressing our insulin system.  Most Americans eat way too much sugar and not enough of the foods that help us metabolize sugar (vegetables, spices, anti-oxidants, whole grains, fish, etc.), and many as a result suffer from pre-diabetes or full blown diabetes, both of which conditions put the brain at risk.  Research shows that sugar imbalances actually shrink the delicate hippocampus, a metabolically active part of our brain which is critical for short-term memory and some aspects of emotion. People with pre-diabetes or diabetes are at greater risk of dementia or Alzheimer’s disease. People who already have blood sugar problems should be especially careful to protect their brains to avoid putting themselves at risk of cognitive decline.

Our goal is to use minimal refined sugar and try to slow absorption of whatever sugar you eat by adding healthy ingredients to the recipe, and eating lots of vegetables, whole grains, spices, omega-3’s as part of the rest of our meal.  Check out my website for ideas.

Create sweetness with natural non-sugar sweeteners or fruit sources such as applesauce, raisins, dates, apple or grape juice. If you use any natural sugars, use molasses, honey or raw sugar so you have at least some natural nutrients along with the fructose or sucrose.

Reduce “sweets” and instead add other flavors by using spices such as cinnamon, cloves, nutmeg and tasty flours made from almonds, beans (e.g. soy flour) and whole grain flours such as whole wheat pastry flour, buckwheat flour and mixed grain flours, oatmeal.

Add a little ground flaxseed or bean flour to add flavor and texture to your baked goods, and help slow sugar absorption.

Another way to slow absorption of sugar in baked goods is by adding vegetables such as ground spinach, carrots, squash to cakes, brownies and cookies.

One way to remove or reduce sugars in your baking and cooking and to keep your totally carb intake per meal to a 30-45g limit, is by using natural sweeteners such as Erithritol (no calories) or Xylitol (50% less calories than sugar) which are “sugar alcohols” that look and taste like sugar, but aren’t (you use the same volume).  Another natural sweetener that can be used is Stevia which is extracted from a green plant and is 200 times sweeter than sugar, so use only a very small amount!

These 3 natural sweeteners have neither sugar nor glucose metabolism challenges, and are healthy nutrients rather than health challengers, such as all sugars are. All three of these natural non-sugar sweeteners actually help decrease plaque on your teeth! They are also safe for diabetics and recommended over artificial sweeteners that are foreign to the body.  When using these natural sweeteners they will help remove calories and carbohydrates as well.  If some sugar is allowed you can use ½ sugar and ½ non sugar sweeteners, or any other combination.  If you want a sugar free recipe, then use only these non-sugar natural sweeteners.

Xylitol originated in Finland and is a sweetener derived from a birch tree, but can also be found in corn stalks.  Xylitol has a glycemic index of 7 whereas sugar has a massive glycemic index of 100.  Although Xylitol has no major side effects, it’s good to begin using it in moderation. Too much Xylitol, too quickly can cause mild laxative effect and/or gastrointestinal distress. The amount used in a cup of coffee (e.g. 1 packet) shouldn’t cause any problems except in very sensitive people the first few times.  When starting to use Xylitol in baking or other foods start with smaller amounts and let your body get used to Xylitol before using lots of it. Also, please take note that Xylitol is toxic to dogs.  When using this sweetener, be careful to keep away from your dog and not slip him any treats under the table.

Erythritol can be found naturally in small amounts in grapes, melons, mushrooms, and fermented foods such as wine, beer, cheese, and soy sauce.  Erythritol should NOT be consumed in very large amounts because it can possibly have a laxative effect in adults and children, although much less likely than for xylitol. Again, the amounts you’d use in sweetening drinks or baked goods, should be fine.  This sweetener has no calories and is 60%-70% as sweet as sugar, but unlike sugar it will not increase blood sugar levels and, unlike too much Xylitol, will not cause gas or bloating.

Stevia is a plant (specifically, a member of the chrysanthemum family) native to portions of northeastern Paraguay. It has been used to sweeten foods and beverages for more than 200 years. It is the primary sweetener used in Japan for over 3 decades. Because you only need 1 tsp or less to replace 1 cup of sugar, the overall volume of the finished product will be affected so some cooks like to add bean or almond flour and other healthy nutrients to fill out the volume.

Both Erithritol and Xylitol, as sugar alcohols, inhibit the action of yeast, so are hard to use in making bread without adding some sugar or sugar-type product like molasses. Stevia does not inhibit or facilitate the action of yeast. Thus many bakers prefer to use a pinch of stevia in their breads, or omit a sweetener altogether.  Both sugar alcohols also give a short-lived “cool” sensation when they first land on your tongue as pure. They do not affect the action of baking powder or baking soda; however they react differently with flour and butter than sugar does, so some experimentation is in order. There are also cook books available.

There are subtle differences between Xylitol or Erithritol and sugar. First, when cooking or baking, they both absorb moisture much more than sugar – so you may need to adjust brownie and cookie recipes. They may also recrystallize and create texture problems. Thus some bakers prefer to use a MIX of sugar-substitutes, such as substituting ½ of sugar with either Erithritol or Xylitol, and the other ½ with stevia (Which by volume means ½-1 tsp Stevia for every cup of sugar).  And if some sugar is allowable you might try 1/3-1/3-1/3 keeping in mind the 1/3 attributed to stevia will be a tiny amount by volume of the other two.

You may want to consult a xylitol or stevia cookbook or search online. The problem with most cooking guides from brain health perspective, it that the authors haven’t learned to also use other brain healthier ingredients such as whole wheat pastry flour, other whole grain or bean or nut flours, and eliminating or minimizing the salt.

Currently it is hard to find stevia, xylitol or erythritol outside of Whole Foods or a natural foods market, but thanks to a big corporation’s efforts to capture the consumer market and get FDA GRAS approval for their version of stevia, and combining stevia with a sugar alcohol so they could advertise their product as a natural sweetener, a few new products are appearing on supermarket shelves.  The leading one is Truvia, which Coke has chosen to flavor its new brand of “green” naturally sweetened zero calorie coke, and there are competing brands with similar mixtures, e.g. Purevia.

Truvia and Purevia chose to use Erithritol rather than Xylitol for a couple of reasons. First, Erithritol has no calories vs. Xylitol’s 40% less calories than sugar. Second, it is less likely to cause gastric upset than Xylitol.

In the recipe “Brain Healthy Baked Sweet Potatoes with Orange Raisin Sauce,” I found by removing 3 tablespoons of brown sugar and instead using natural sweeteners eliminated 135 calories and 36 grams of simple carbs. (see my website)

Another brain healthy change for sweet potatoes and many other recipes is to add cinnamon and/or pumpkin pie spice mix to enhance both flavor and nutrition. Cinnamon and the other pumpkin pie spices (usually cloves, nutmeg and sometimes cardomon) are all powerful antioxidants. Clinical research has also proved that cinnamon helps regulate our blood sugar and reduce cholesterol.  Cinnamon is also a huge flavor enhancer when used in stews, soups and many other recipes.  Brings out the other flavors. Try it in almost any recipe and you will be amazed.  My friends have found success with scrambled eggs, quinoa dishes, stir fry, pasta salads, fruit salads, cereals, and more!




Senior Living Residences & HealthCare Insights Offer Brain Healthy Nutrition Tips

Press Release:

Boston (March 1, 2010) -Senior Living Residences (SLR), a leader in providing Alzheimer’s care to New England seniors, together with HealthCare Insights, LLC’s (“HCI”) Dr. Nancy Emerson Lombardo, is celebrating National Nutrition Month®, a program created by the American Dietetic Association, by inviting the public to learn about an innovative nutrition program at SLR communities. Events hosted by SLR communities will feature Dr. Emerson Lombardo who will share her evidence-based guidelines for brain healthy eating, and she and SLR chefs will share some of their favorite “brain healthy” recipes.


SLR is the first assisted living company in the nation to implement the Memory Preservation Nutrition® program, developed by internationally recognized expert Nancy Emerson Lombardo, PhD, adjunct research assistant professor of neurology at the Boston University School of Medicine and President of HealthCare Insights, LLC. Dr. Emerson Lombardo co-founded the National Alzheimer’s Association in 1980, and Alzheimer’s Disease International in 1985, and has spent the past decade researching the effects of nutrition on the onset and progression of Alzheimer’s disease.


The Memory Preservation Nutrition® program is designed to promote brain health and lower the risk of Alzheimer’s disease. [1] Some key points of interest to those concerned about the relationship between what we eat and the health of our brains and memory capability include:


  • SLR’S MOTTO: SPICE IT UP! Substitute spices and herbs, such as cinnamon, ginger, and parsley, as tasty and healthy alternatives to salt and sugar. Spices assist key Memory Preservation Nutrition® brain-healthy strategies.


  • BE BRAINY about brain, heart, and blood sugar connections: To increase heart and brain wellness, we emphasize foods that regulate and lower blood sugar levels, reduce inflammation and cholesterol levels, and are high in anti-oxidants to prevent oxidation of cholesterol, DNA, brain cells and more.


  • HONOR YOUR INNER HIPPO: The delicate hippocampus, seat of memory, is especially sensitive to imbalances in blood sugar and fats. Increase omega-3s and reduce unhealthy fats.


  • PRIORITIZE PLANTS:  A major nutritional strategy is to use more and varied plant foods, including vegetables, beans, nuts and seeds, whole grains, spices and fruits, and fewer animal foods.

The Cambridge Homes, a Senior Living Residences Community located in Cambridge, Mass. will host Dr. Emerson Lombardo’s first of two separate events scheduled this month, at 5:30 pm on Tuesday, March 23rd. Attendees will hear Dr. Emerson Lombardo in a high-level discussion about the unique principles and benefits of the Memory Preservation Nutrition® program.


For the second part of the presentation, Kim Smith, director of dietary services, will share with the audience how some of the recipes-formulated by Dr. Emerson Lombardo or SLR chefs- are prepared for residents of SLR. During the event, the audience will have the opportunity to sample some dishes prepared following Dr. Emerson Lombardo’s Memory Preservation Nutrition® program. Brain healthy recipes will also be made available to those in attendance.


Those who are interested in attending the second event can plan to do so at 5:30 pm on Wednesday, March 31 at the Concord Park Assisted Living Residence in Concord, Mass. At this event, Dr. Emerson Lombardo and Ms. Smith will be joined by Tadd Clelland, executive vice president and principal of Senior Living Residences. Clelland will discuss how Memory Preservation Nutrition® has been implemented in SLR’s communities, and other innovations the company has introduced to improve the quality of life for its residents.


Just before the two SLR-sponsored National Nutrition Month events, Dr. Emerson Lombardo will be presenting her research, including her work with SLR’s assisted living communities, at the 25th International Conference of Alzheimer’s Disease International (ADI) in Thessaloniki, Greece on March 9 – 13, 2010.


Dr. Lombardo states that “Scientists researching Alzheimer’s disease believe changes and damage in the brain begin long before there are any symptoms of the disease. Following the Memory Preservation Nutrition® program can be an important step to take to protect your own brain health.” Since research shows that cardio- vascular disease, high blood pressure, high cholesterol and high blood sugar all threaten brain health, the Memory Preservation Nutrition® program as implemented at SLR communities, aims to help reduce or manage all these issues.


Robert Larkin, president of Senior Living Residences said, “When asked, Americans rate Alzheimer’s disease as their second most-feared illness, following cancer. We understand that fear but want people to know that they can take practical steps toward a healthier body and brain. Research tells us that proper nutrition helps us to defend against deterioration due to age and disease, and should be part of our treatment plans.”


He said that he is proud of the work that Senior Living Residences is doing in the area of nutrition to help seniors in his communities eat diets that are full of delicious brain and body protecting foods.  “At SLR, we have a truly holistic approach, aiming to improve our residents’ quality of life on all levels. Nutrition is just one of our focuses, but an important one. The feedback we’ve received since implementing the Memory Preservation Nutrition® Program has been ALL positive – anecdotally, families have been telling us they are seeing improvements in the health of their loved ones after moving to one of our communities.”


About Senior Living Residences

Since 1990, Senior Living Residences of Boston, MA has created service-enriched housing and care options for seniors in New England. Fervently adhering to its “Right Values”-Resident Quality of Life, Valued Associates, Integrity and Innovation-SLR is a trusted leader in the communities it serves through innovative programs and services. Partnering with equally committed organizations, such as the Boston University School of Medicine’s Alzheimer’s Disease Center, SLR remains at the forefront of research-based care for seniors, especially those living with Alzheimer’s disease. For more information, contact SLR at 617-268-9140 or online at


About HealthCare Insights, LLC 

Founded by Nancy Emerson Lombardo, PhD, HealthCare Insights, LLC, (HCI) is dedicated to research-based programs and educational efforts designed to help people of all ages protect and enhance their brain health.  HCI is also committed to improving the health and well-being of persons with Alzheimer’s disease, and their care partners. Dr. Emerson Lombardo has worked for more than 30 years in the fields of Alzheimer’s disease and services for older adults. During the past decade she has developed lifestyle interventions to promote brain health and to improve quality of life for adults of all ages. To learn more about how you can integrate the principles of the Memory Preservation Nutrition® program into your lifestyle or healthcare program, contact Dr. Emerson Lombardo at 978-621-1926 or online at



[1] Emerson Lombardo NB.Volicer L. Martin A et al. (2006) Memory preservation diet to Reduce Risk and Slow Progression of 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: 138-159.


Pear Bread Recipe

MPN™ PEAR BREAD – a Brain Healthy & Sugar-Free Recipe



       INGREDIENTS                                   AMOUNT

Margarine (transfat free) or butter ½ cup
Stevia 1/4 tsp

or ½ tsp truvia[1]

      Or 1 cup erythritol  or xylitol*

¼ tsp
Eggs 2
White whole wheat flour 2 cups
Sea Salt (may omit) 1/8 tsp
Baking soda ½ tsp
Baking powder 1 tsp
Nutmeg 1/4 tsp
Cinnamon 1/3 tsp
Plain Yogurt ½ cup
Pears, chopped coarsely 1 cup
Vanilla extract 1 tsp



  1. Cream margarine, beat in stevia, truvia, or other sweetener
  2. Beat in eggs one at a time
  3. Combine dry ingredients
  4. Add spices & other dry ingredients to egg mixture alternately with sour cream or yogurt
  5. Stir in pears and vanilla.
  6. Bake at 325-350 for 55-60 minutes.

* Note, for some sensitive people xylitol, while highly recommended healthy food and great for oral health, both teeth and gums, can be laxative, especially in larger amounts.  Thus start newcomers with a small piece of the pear cake.  Most people quickly become accustomed to and have no problems. Erythritol reportedly is much less likely to have laxative effects.  Also good for oral health.


[1]  For NON-SUGAR-FREE, high calorie version substitute 1 cup brown Sugar – then no longer sugar free.  May also use a ½ sugar and ½ the amount of natural sweeteners shown above.


For those in the Boston area, you might want to catch me speaking at West Acton Baptist Church/Acton Co-op School in 592 Mass Avenue, West Acton, MA, Friday April 9th at 9:00am-11:30am.  Registration and refreshments at 9:00am. “Food For Thought: Brain Food: For Smart Kids and Adults”  Workshop begins at 9:30am.  Please RSVP to Luann Colombo (978)479-4110 or email at

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



Nancy Emerson Lombardo, PhD
HealthCare Insights, LLC

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