November/December 2011

We thought it timely to share with you some new recipes as will as important tips for how to make holiday foods and meals brain healthier.

These sorts of changes may come a step at a time as it is difficult to make over your entire approach to eating and sharing food all at once!.  The important thing is to get started, try one or more of these ideas, and ask your guests which they like best.  You can become a “food for thought” leader in your own circle of friends, family and colleagues.

The lead article summarizes the 10 tips drawing upon the principles of the Memory Preservation Nutrition® program.  The subsequent articles go into details about some of the key areas such as sweet treats, brain healthy appetizers, beverages, and ideas for entrees and sides in a holiday meal.

We have also added some new sections to the website including the answers to several common questions about some of the foods recommended by the Memory Preservation Nutrition® program.

As some of you know, we’ve had a bit of extra excitement this past few days with the airing on Channel 5 Chronicle a special report on Dr. Nancy Emerson Lombardo’s Memory Preservation Nutrition® program, with clips from interviews and filming Chef Derrick Peterson preparing the MPN recipe Tuna Fresh Tomatoe Pasta Sauce, served over whole wheat pasta (now posted on our website) and The Cambridge Home Executive Director Helene Quinn, Wait Staff Supervisor Gestner, and some of the residents. To see the clip you can click this link: Channel 5 Chronicle Story on Dr. Nancy and Brain Foods

Acknowledgements:

And as always a heartfelt thanks to the amazing Samantha Turner, my right hand person, who ensures the newsletters become reality.  She is our Constant Contact and website guru who adds everyone’s email whose requested to be on our email list, drafts the overall look of the newsletter, the introduction and closing, the events lists on both the website and newsletter, gets all the articles into the electronic form and finds fun photographs to spice up the look. Samantha also does internet research as needed.  You should look her up in her “day” job especially if you love horses  and dogs the way Sam does.

HCI consulting nutritionist Cheryl Franchi, RD, helps make sure our content is accurate from a nutritionist point of view.  I also rely on Eric Reardon’s nutritional wisdom and creativity…and check out the links to his website on the sidebar.

For the past several weeks our wonderful nutrition intern, Kristina Scangas has been busy helping me edit recipes for a Memory PreservationNutrition® Cookbook that I plan on publishing in 2012.  She has also collected some wonderful recipes for vegetarian entrees, and nutritious and easy desserts that I have then adapted to be brain healthier.

Brain Healthy Foods – Ten Tips for the Holidays

from the Evidenced-Based Memory Preservation Nutrition® Program 

© 2011 Nancy B. Emerson Lombardo, Ph.D.

For brain healthier meals,

• Add nutritious ingredients such as foods full of anti-oxidants, that are anti-inflammatory, that help us lower rather than raise, our blood pressure, blood sugar and cholesterol levels.
• The easiest way to do this is add more vegetables, spices, herbs and other plant foods and use fewer animal foods as well as less sugar.
• Limit the amount of sugar, salt and saturated/trans fats you are serving yourself and your family and friends.
• Let your family and friends know you love them enough to go the extra mile, maybe trying out something new and equally delicious to what they are used to.
• Take favorite family recipes and make them a little or lot more brain and body healthy.

Here are some specific ideas:

1)    Make Your Sweets Nutritious

The general principle is: take in no sugar without some redeeming healthy ingredients such as whole grains, nuts, seeds, fruits, vegetables and spices, herbs. Another general principle is to make choices that would be safe for a person who is diabetic. We all need to eat as if we are diabetic or trying to avoid getting diabetes and that will help us achieve a brain healthy nutrition program. (For lots of ideas for brain healthy sweets see SWEET TREATS article.)

2)    Serve Brain Healthy Appetizers 

Limit the amount of appetizers you serve that are loaded with salt or saturated fats, and processed foods, and ingredients such as transfats, high fructose corn syrup, and other sugars.

• Avoid ANYTHING that has the words “partially hydrogenated” on the list of ingredients even if the Nutrition facts declare no or 0% trans fats.   FOR MORE THINGS TO AVOID, SEE APPETIZERS

NOW FOR SOME POSITIVES…A Dozen Healthy Appetizers:

• Look for whole wheat or whole grain crackers…Trader Joes and Whole Foods both have some. Annies is another good brand…the little whole wheat bunny crackers are popular with all ages. You have to read the label.
• Include vegetables, such as cut up vegetables dipped in healthy dip. These are called vegetable crudités. You can even create festive designs.
• Think about naturally healthy dips such as hummus or guacamole instead of those made with sour cream. Use yogurt in your dips.

For all 12 ideas see Appetizers

3)  Brainy Beverages:  Skip the soda. Skip any sugar-added beverage (read the label of the juices you buy! Anything that says fruit cocktail or that doesn’t say “100% fruit juice” has added sugar.)

• Make sure everyone has a glass or bottle of water in addition to whatever else you are offering.
• Offer iced tea if you have tea lovers in your group. It can be made with a strong flavored GREEN tea (especially brain healthy though black tea is good too).

For more ideas see Brainy Beverages.

4)      Make Your Smoothies “Green”. Take your favorite fruit based smoothie and make it healthier by adding some greens to your mixture before blending. Romaine lettuce, sweet flavored purple or flowering kale (or any kind of kale) and parsley are especially delicious. (For more Smoothie ideas see Brainy Beverages.)

Entrees and Sides  to Preserve Brain Power

5)    Serve Brain And Heart Healthy Soups. For flavor use herbs and spices and extra vegetables, instead of salt or fat.

6)    Include a Fresh Green Salad  

7)    Serve a Cooked Green Leafy Vegetable along with whatever other vegetables you traditionally serve. Leafy green vegetables are stars among vegetables for brain health.

8)    Make Your “Carb” Dishes Beige Instead Of White

9)    In Your Sweet Potato or Yam Dishes, Use Non-Sugar Natural Sweeteners

10)     Use Lots More Herbs And Spices In Everything You Cook (while using less salt and sugar)to add more nutrition and more flavor. (See August 2011 Newsletter articles on Cinnamon and other herbs and  spices.

If some of the listed ingredients leave you curious as to WHY the Memory Preservation Nutrition® program recommends them, go to our website Answer section.

The general principal is: take in no sugar without some redeeming healthy ingredients such as whole grains, nuts, seeds, fruits, vegetables and spices, herbs. Another general principle is to make choices that would be safe for a person who is diabetic. We all need to eat as if we are diabetic or trying to avoid getting diabetes and that will help us achieve a brain healthy nutrition program.

Why is limiting sugar related to brain health?  Sugar, in all forms, is inflammatory, and inflammation increases risk of brain and heart problems in addition to diabetes, joint pain and some cancers. In addition, excess sugar leading to pre-diabetes and diabetes shrinks the brain’s hippocampus, the seat of our short term and spatial memory, generally inflames the brain, increases the amount of the A-beta problem protein in the brain, and increases the amount of bad cholesterol that our own bodies make.

We are NOT suggesting we eliminate all of the sugar. There are some forms, for example those that are a natural part of fruit, or sweet vegetables, that come along with very important nutrients, which are themselves brain healthy. Also if you eat a brain healthier diet e.g. with more vegetables, spices and herbs, whole grains, beans, nuts and seeds, fish and fish oil, then you help your body process the sugar you do eat. Even with fruits, especially fruit juices, we need to limit the daily amount we eat, to about 5-6 servings a day, to assure we don’t take in too much sugar.

Here are some ideas for delicious brain healthier sweet treats:

• Use fruits, dates, figs, dark chocolate or natural non-sugar substitutes to get most of your sweet flavors
• Consider a fresh fruit cup or whole fruit as dessert.
• Many Italian and some Asian households for example traditionally offer at the close of a meal, for dessert, a bowl of whole fruit, and a knife at each place setting for guests/family to cut up their own fruit. Very social time and also note it slows down the eating process.
• Unsweetened applesauce, apple juice and orange juice are all quite sweet and can be used instead of sugar in many recipes.
• Banana Dessert RECIPE: Here is a delicious easy dessert made from wholesome ingredients. Using half a banana per person, slice your bananas the long way (or alternatively, little circles), then create multiple plates of delicious coatings to dip your bananas in. One is pure cocoa powder or perhaps cocoa powder mixed with cinnamon. A second is coconut flakes.   Roll the banana pieces first in the cocoa powder, then the coconut flakes, put on a dessert plate and serve!

• Explore the current natural non-sugar sweeteners now in your local grocery store and use the ones you like best

• Stevia
• Truvia® or Purevia®
• Erithritol (maybe only in natural foods markets…it is one of the two components in Truvia® and Purevia®)
• Recipe idea: Make your own cranberry or holiday sauce without adding any sugar or even honey.   To sweeten the dish, add to the usual pound of cranberries a diced pear and/or apple, orange or apple juice instead of water, a teaspoon of cinnamon (which tastes sweet on the tongue and enhances all the other flavors) and then a little pinch of stevia or teaspoon of Truvia® or Purevia® or erithritol.   Also add chopped walnuts or pecans if you want a little gentle “crunch” in your cranberry dish. (Check out my website for my own recipe – you can create your own variation)
• For all your favorite recipes, experiment with substituting for the white flour, whole wheat pastry flour or “white whole wheat” flour. The regular whole wheat flour can be a little dense or heavy for your baked goods, but the whole wheat pastry flours are almost as light as the white. Some people do half and half, still better than 100% white. You can also add a tablespoon or two of ground flax seed, rice bran and or wheat germ to add extra nutrition to your recipe. Check my website for delicious cookie and muffin recipes using this principle.
• Try creating desserts with vegetable ingredients.   Add cooked green leafy vegetables into some of your dessert recipes. Such as spinach into your brownies. Carrot, pumpkin, squash cake and cupcake recipes already exist; consider making these brain healthy by using the natural non-sugar substitutes for all or ½ of the sugar, using whole wheat pastry flour for all or ½ of the flour, and maybe adding chopped nuts or seeds or some ground flax seed, wheat germ or rice bran.
• Experiment with using one of the natural non-sugar sweeteners such as stevia, Truvia®, Purevia® or erithritol for all or1/2 of the sugar or honey in a recipe. Keep in mind these sweeteners have different properties than sugar so you need to take that into account. For instance, stevia is so sweet, 300 x sweeter than sugar, that your dish will have less volume….1/2 tsp pure stevia instead of 1 cup of sugar. This is no problem in a fruit based dish such as apple or peach crisp or cobbler.   However with cookies you might want to add some bean or almond flour to make up the difference in volume. There is more detail on my website, baking with natural non-sugar sweeteners.
• Keep in mind the delicious thought that pure 100% cocoa powder is brain food. If you use chocolate in recipes, be sure it is at least 70% cocoa powder as in dark chocolate labeled at least 70% cocoa.
• Despite the saturated fat, coconut and coconut milk is a healthy ingredient. Saturated fat in vegetables is safer than that in animals.  For one thing, no cholesterol in any plant part.

More Recipes: One great sweet treat that can be used for breakfast, lunch, dessert or a healthy snack, is yogurt parfait. The basic ingredients are layers of Greek yogurt, berries, cinnamon and nuts such as slivered almonds or crumbled walnuts.

Optional extra ingredients include cocoa powder, raisins or other dried fruits, ground flax seed, wheat germ, coconut flakes, granola, or other spices such as nutmeg or a pumpkin pie spice mix, or one of the natural non-sugar sweeteners mentioned above. Use your imagination as many variations are delicious. Berries are especially brain healthy fruits, and anti-inflammatory. Greek yogurt is preferred because it has twice the amount of protein as regular yogurt, has more pro-biotics so key to overall health, and is less tart so no added sweetener is needed.

There are a lot of no-bake healthy recipes using dates or figs for the sweetness, often adding coconut for more flavor. You just need a food processor to make little balls of healthy sweets that can be eaten any time of day.

See the recipe article below for delicious “MPN Kristina’s Cherry Date Coconut Balls– aBrain Healthy Recipe following Memory Preservation Nutrition®

• More on Transfats: The manufacturer can say they have none or 0% Trans Fats in big letters, even though trans fats are included if it is less than ½ gram per serving and the manufacturer gets to decide the serving size.
• Thus you will want to avoid any purchased product that comes wrapped in pastry dough as you are really serving a lot of fat, more white flour, salt and often-times transfats.
• Avoid adding bacon or any processed/cured meats to your appetizer recipes. Recent research suggests the red colored cured meats such as bacon, ham, most hot dogs, many sausages, salami, and yes pastrami and my favorite prosciutto, are very unhealthy for us and so should be eaten sparingly, e.g. no more than once/week. So if you do have an appetizer with one of these, such as the traditional fresh cantaloupe melon with prosciutto or scallops with bacon, limit the number to just one of these types. But also consider plain scallops with herbs served with a toothpick…and no bacon!

Now for the Healthy Dozen

1. Look for whole wheat or whole grain crackers…Trader Joes and Whole Foods both have some. Annies is another good brand…the little whole wheat bunny crackers are popular with all ages. You have to read the label.  If you use pita, look for whole wheat pita bread or chips, or made your own chips from whole wheat pita bread.
2. Include vegetables, such as cut up vegetables dipped in healthy dip. These are called vegetable crudités.
3. Think about naturally healthy dips such as hummus or guacamole instead of those made with sour cream. Use yogurt in your dips. Chickpeas, artichokes and avocadoes are wonderful brain foods to consider for appetizer recipes.
4. Taboulleh is another healthy appetizer you may buy or make from scratch. We have a delicious recipe that is made with quinoa, an ancient grain now popular in the US because it is delicious, gluten free, and a complete protein…with the bonus it cooks in 10-15 minutes!
5. Stuffed mushrooms can be healthy especially if you use whole wheat bread crumbs and no salt (or use kelp powder instead of salt, or cut the amount of salt to a fraction. If you use sea salt, you’ll get more flavor with less salt.
6. Cherry tomatoes are always popular. You can also create skewers alternating cherry tomatoes with small mozzarella balls and basil. Very festive looking.
7. Olives of any kind, or in a variety of styles and flavors, is always a good choice. Yes, they are salty, but so nutritious.
8. If you choose to serve small pizza slices, bruschettas or crostinis, use whole wheat dough or bread, and limit the salt on the toppings. Use all vegetable toppings. Low-fat cheeses such as mozzarella and provolone. Heart healthy cheeses such as provolone and parmesan.
9. Shrimp in any form is a good choice, hot or cold. Also scallops. Do include some seafood among your appetizer choices.
10. Of your meats, you can serve Asian style chicken or beef satay, bite sized pieces marinated, skewered on a stick, and grilled.
11. Nuts of all kinds are brain food! Great for body health too!
12. Assume that some of your guests will be vegan or gluten or lactose intolerant. So be sure to have some options that have no dairy, meat, gluten or even fish/seafood in them.

• For flavor use herbs and spices and extra vegetables, instead of salt or fat.
• Include chopped up green leafy veggies in your soups, stews and stir fries. Consider adding chopped fresh herbs such as parsley, cilantro (if you like it) and dill, and any other of your favorite green herbs. You may still have a few growing in your garden. Of course you use smaller amounts of the more intensely flavored ones such as oregano, mine, sage, rosemary and thyme.

6) Include a Fresh Green Salad. Avoid iceberg, use mixture of lettuces, radiccio, chopped up vegetables such as sweet red/orange or yellow bell peppers, escarole, tomatoes, cucumbers, zucchini. You can also add chopped fresh herbs for taste treats and surprises, including all the ones I mentioned for the soups. Also consider adding some avocado strips. Avocados are brain foods!   Use extra virgin olive oil in your dressings. Avoid the prepared ones labeled “no or low fat” as they usually have extra salt and sugar to make up for the lack of oils. No reason to go for low fat…the key is that the oils are healthy ones such as olive oil. You may also add small slices of apple or pear, or various small nuts, or berries for extra special fun salads.

7) Serve A Cooked Green Leafy Vegetable along with whatever other vegetables you traditionally serve. Leafy green vegetables are stars among vegetables for brain health.

8) Make Your “Carb” Dishes Beige Instead Of White.   The reason is that white processed breads, baked goods, grains, flours, pastas and starches are quickly converted in the body to the equivalent of refined sugar and trigger the insulin reaction..they are considered “high glycemic index” foods. Here are some suggestions:

• Brown or wild rice, instead of white,
• Leave the skins on your white potatoes,
• Whole grain pastas, and
• Consider sweet potatoes instead of, or in addition to, white potatoes.
• One way to enhance the healthfulness of mashed potatoes is to make them “Irish” and blend in just before serving, diced spring onions or scallions.   You can also add fresh chopped parsley. Use pepper instead of salt for flavoring.
• Here’s another delicious way to make your mashed potatoes healthier (and for this you can even peel the potatoes if you really want to have an all white looking dish):   For half the volume of your mashed dish, use cauliflower. Cut a head of cauliflower into florets and small pieces of stems; cover with water in a cooking pot on top of the stove. Cook until soft.   Using a potato masher or food processor, mash the cooked cauliflower together with 2 or more cloves of garlic pressed to paste with garlic press, using just enough of the cooking liquid to achieve the consistency you like. Add up to 6 cloves of garlic per head of cauliflower if you love garlic. Then blend with the mashed potatoes, adding a little olive oil or butter, pepper for flavor. Or you can use 100% cauliflower and skip the potatoes. This idea comes to us compliments of Ryan Snow. Here is his recipe for 100% cauliflower mash.

9) In Your Sweet Potato Or Yam Dishes, Use The Non-Sugar Natural Sweeteners mentioned earlier for desserts. Skip the marshmallows.

10) Use Lots More Herbs And Spices In Everything You Cook (while using less salt and sugar) to add more nutrition and more flavor. Cinnamon used in small quantities in stews, soups and other dishes will act as flavor enhancer to bring out the other flavors.   Use a small amount so you don’t’ actually taste the cinnamon.

• Skip the soda. All soda or man-made sparkling waters will leach calcium from bones and teeth. And most sodas have a huge amount of added sugar…or artificial sweeteners.
• Skip any sugar-added beverage (read the label of the juices you buy! Anything that says fruit cocktail or that doesn’t say “100% fruit juice” has added sugar.)
• Make sure everyone has a glass or bottle of water in addition to whatever else you are offering.
• Offer iced tea if you have tea lovers in your group. It can be made with a strong flavored GREEN tea (especially brain healthy though black tea is good too).
• Limit your alcohol. A small glass of red or white wine (red is best, especially Pinot Noir) with the meal might even be brain healthy for some people. However excessive alcohol is toxic to the brain and some people cannot tolerate any. Some research reports suggests people carrying the APOE4 allele, a risk factor gene for Alzheimer’s disease, should avoid all alcohol.   Remember, too, that your body converts alcohol to a form of sugar.
• After the meal:   offer hot green tea, ginger tea, coffee and serve cinnamon as a choice as it is delicious in the tea and coffee and can be used instead of any sweetener or even cream.
• For December holidays, consider making your own eggnog from scratch so you can use the natural non-sugar sweeteners and add lots of nutmeg and cinnamon, and real vanilla. Use Omega-3 eggs and low fat milk…or for vegans or those lactose intolerant, consider delicious, brain healthy almond milk instead of cows milk.

Offer Green Smoothies anytime

• Take your favorite fruit based smoothie and make it healthier by adding some greens to your mixture before blending. Romaine lettuce, sweet flavored purple or flowering kale (or any kind of kale) and parsley are especially delicious.
• You can try spinach, cabbage and other greens you happen to have on hand. Definitely add some cinnamon….and for a “punch” add some fresh or ground ginger as well. For extra nutrition throw in a tablespoon or two of ground flaxseed, ground chia seed or rice bran, wheat germ.
• If you add raspberries, your green smoothies can be pink!
• Consider adding some Greek yogurt if you want some dairy.   If you are making a “savory” smoothie then add some kelp powder or red dulse flakes.
• Check out my website for some sample recipes.

a Brain Healthy Recipe following Memory Preservation Nutrition®[1]

YIELD: 24-30 1-inch Balls              Preparation time: 5 minutes

  INGREDIENTS                                                                     AMOUNT

METHOD:

1. Puree dates in food processor until thick paste consistency.
2. Add almond butter, cocoa powder, and cinnamon; pulse until ingredients are blended. Add in cherries, coconut, and nuts.
3. Form mixture into 1-inch balls using your hands. Place balls on sheet of waxed parchment paper.
4. Optional: Roll balls in desired topping.
5. Store in a cool place in an airtight container or may refrigerate.

[1]Original recipe by Kristina Scangas, following the Memory Preservation Nutrition® program.  Kristina works with Dr. Emerson Lombardo at HealthCare Insights and is a graduate in nutrition from Simmons College.

MPN Ryan’s Cauliflower Mash

– A Brain Healthy Recipe[1] –

Holiday Meal Brain Healthy Suggestion: Use this instead of mashed potatoes…OR for a delicious, healthier bowl of mashed potatoes, make your mashed dish 50-50 cauliflower and potatoes, mashed deliciously together. This recipe gets rave reviews!

YIELD: 6 servings, about 1 cup each

INGREDIENTS:                                                  AMOUNT

METHOD:

1. Cut large cauliflower head into florets and rinse.
2. Place florets in large pot and add water until florets are floating.Boil florets until they are tender. Reserve stock from boiling.
3. Place florets, garlic cloves, salt and pepper into a food processor or high-powered blender with 3 to 4 ladles of the stock from boiling. Blend ingredients until well mixed; more stock can be added to adjust thickness.

^1. Recipe by Ryan Snow consistent with, and adapted to, the Memory Preservation Nutrition program, by Nancy Emerson Lombardo.

Nov 30th, 2011: Brain Healthy Eating 

This free event will be held at Sherrill House, 135 South Huntington Ave, Jamaica Plain, MA 02130.  This event will run from 5:30-7:30pm.  90 min presentation with time for Q & A.

Free brain healthy appetizers will be served.

Pre-registration is required please contact (617)731-2400 x3017 or rsvp@sherrillhouse.org. Check out the events page at www.healthcareinsights.net

Coconut, dried, unsweetened, shredded

Cocoa or carob powder

Nov 30th, 2011: Brain Healthy Eating 

This free event will be held at Sherrill House, 135 South Huntington Ave, Jamaica Plain, MA 02130.  This event will run from 5:30-7:30pm.  90 min presentation with time for Q & A.

Free brain healthy appetizers will be served.

Pre-registration is required please contact (617)731-2400 x3017 or rsvp@sherrillhouse.org. Check out the events page at www.healthcareinsights.net

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

August 2011

We hope that you are well and enjoying your summer as it draws to a close. Hopefully many of you have had a wonderful vacation somewhere warm and sunny. Maybe you’ve even found some new and exciting ways to stay brain healthy.  Before fall arrives, we can start putting those brain healthy ideas into practice.  When your brain is healthy you will notice a difference in how focused and functional you are, even in the early morning.

In the articles below we will show you more about potent foods to help keep your brain healthy.

Acknowledgements: Thanks to special summer help from two amazing Acton-Boxborough rising seniors, Jennifer Rogan and Eric Tseng, who have been working with me this summer to explore more about brain and body healthy foods, especially herbs and spices. Jenny has been compiling descriptions of special herbs and spices which eventually we’ll be able to share with our clients and readers.

Eric Tseng helped me draft the lead article and extract information from recent scientific research articles cited here. He and I share a common goal of reducing the risk of Alzheimer’s in people world-wide including us and our families. I am including his advice to readers in his own voice.

And as always a heartfelt thanks to the amazing Samantha Turner, my right hand person, who ensures the newsletters become reality.  She is our Constant Contact and website guru who adds everyone’s email whose requested to be on our email list, drafts the overall look of the newsletter, the introduction and closing, the events lists on both the website and newsletter, gets all the articles into the electronic form and finds fun photographs to spice up the look. Samantha also does internet research as needed.  You should look her up in her “day” job especially if you love horses and dogs the way Sam does.

HCI consulting nutritionist Cheryl Franchi, RD, helps make sure our content is accurate from a nutritionist point of view.  I also rely on Eric Reardon’s nutritional wisdom and creativity…and check out article #3 below. Our wonderful nutrition intern, Kristina Scangas has been busy on other endeavors this summer and hopefully will return to helping us find and develop brain healthy recipes–especially those with vegetables made even more delicious by the addition of spices and herbs!

How Cinnamon Can Help Prevent Beta-Amyloid From Harming Our Brains © 2011 Nancy B. Emerson Lombardo, Ph.D.

Introduction: beta-amyloid (Aβ)’s role in Alzheimer’s disease and the brain

As many of our readers may know, Alzheimer’s disease is a progressive, irreversible brain disorder with an unclear cause and no cure. Symptoms include memory loss, confusion, impaired judgment, disorientation, and loss of language skills.

Even though scientists and researches have not devised a notable cure for this disease, they are making great progress, especially over the past thirty years. Furthermore, the exact causes and pathways of developing Alzheimer’s are still unknown, and therapeutic treatments are limited in effectiveness and time. However, experts have identified that beta-amyloid polypeptide (Aβ), a protein, plays a key role in Alzheimer disease pathology.

Although scientists agree that beta-amyloid plays an important role in the development of Alzheimer’s disease, it is widely debated how prominent an effect it has. Some scientists believe that the “tau” pathology related to tangles is more important, especially to development of cognitive problems in AD.   Still others point out that co-morbid vascular lesions are more important than beta-amyloid in determining the degree of dementia and speed of onset of symptoms[1]  Other scientists suggest that abnormal Aβ arises secondary to other basic body/brain conditions such as oxidative stress [2]and inflammation, overlaid on what happens with aging.[3]

The real question is, when and how is beta-amyloid toxic?

When Dr. Alzheimer described the disease now bearing his name  in 1907, he mentioned two pathologies, plaques and tangles. We now understand these “plaques” to be large deposits of clumps of beta-amyloid. The high visibility of the plaques led scientists to initially believe they were the toxic form of Aβ.   Thus treatments were sought to eliminate these plaques, and to slow down the development of beta-amyloid. However, later scientists discovered that the real problem lay with an earlier stage assembly (“clumping”) of beta-amyloid.

It is now believed that plaque deposits aren’t responsible for killing brain cells. Instead, what kills brain cells is an accumulation of soluble oligomeric assemblies (small “clumps”), of beta-amyloid. In fact, large amounts of soluble oligomeric beta-amyloid are correlated with impaired cognitive function in mice bred to have AD pathology (“transgenic AD mice”). Moreover, we’ve discovered that small amounts of beta-amyloid are normal for humans.

So, if we all have some beta-amyloid in our bodies and brains, what is it there for?

Recent studies have shown that in small amounts and in single molecules (called “monomers”), beta-amyloid is normal and beneficial for the brain. It functions in the innate immune system, killing unfriendly microbes such as bacteria, fungi and other “invaders”. There is also evidence that monomers of beta-amyloid may help brain cell synapses function at a more effective level. “At physiological levels, amyloid beta is a normal, soluble product of neuronal metabolism that regulates synaptic function beginning early in life. Monomeric amyloid beta 40 and 42 are the predominant forms required for synaptic plasticity and neuronal survival….. Both aging and (excess, oligomerized) beta amyloid independently decrease neuronal plasticity.” [4]

Since this simple form of beta-amyloid may have a normal and crucial role in our bodies, treatment to remove all of it could backfire and cause other health problems.

While several factors play a role in treatment, therapeutic strategies for beta-amyloid have shown promising results. Scientists have identified that one promising therapeutic strategy is limiting the early stages of beta-amyloid oligomerization, as well as to limit excess production of beta-amyloid.

How can we target beta-amyloid ourselves through lifestyle?

First, we can try to eat foods and do other healthy activities that help lower the amount of excess beta-amyloid, as the excess itself encourages the oligomerization and clumping together that leads to the toxic forms.  And second, some foods have already been identified that inhibit the process of oligomerization itself.

Eating foods rich in anti-oxidants is a great way to reduce beta-amyloid amounts.

Every anti-oxidant food tested to date (for example spinach, strawberries, blueberries, turmeric, melatonin and many others) lowers the amount of beta-amyloid in the brain of AD mice, and also reduces inflammation in the body and brain. Even the only two nuts tested (to date) in AD mice lower the amount of beta-amyloid (almonds and walnuts…see out October 2010 Newsletter).Nuts not only reduce beta-amyloid, they are also full of important healthy fats and other nutrients that lower cholesterol, help blood sugar control, and helped the AD mice tested think better.

In addition, physical exercise also decreases the amount of beta-amyloid, while reducing inflammation in the body and brain as well.

Two foods identified to date that inhibit oligomerization of beta-amyloid and improve cognitive performance of AD transgenic mice: Cinnamon and Grape seeds

Cinnamon extract may prevent oligomerization to toxic forms of beta amyloid.

Research conducted by an Israeli scientific group reported that cinnamon extract inhibits the formation of toxic beta-amyloid (Aβ) oligomers and prevents the toxicity of Aβ on neuronal cells. The water soluble portion of cinnamon extract from cassias cinnamon bark was used. Results showed an inhibition of oligomer formation, and an increase in the relative amount of monomers, the normal and helpful form of beta-amyloid.[5]

When this cinnamon extract was tested on flies bred to have AD pathology, the results showed that the AD flies had increased longevity to normal length, and had fully recovered their locomotion defects and reduced dramatically the toxic type of Aβ oligomers (tetrameric species and others) in their brain. A parallel experiment showed similar results in AD mice, and mice cognition also reportedly improved (but the Israeli researchers used a weak test of mouse cognition according to other AD mouse researchers). Israeli scientists also reported that cinnamon extract also prevented fibrilization of Aβ (relevant to several neurodegenerative disorders).

The Israeli study suggests that cinnamon extract is an important inhibitor of both oligomerization and fibrilization of Aβ. The amount of cinnamon ingested by the mice was not precisely measured or reported. Thus, for humans, the equivalent amount of cinnamon is unclear, based on limited information available in the published article. This study will need to be replicated by more careful experiments in mice, then tested in humans before we can get overly excited.  Meanwhile it does add another good reason to several others (see below) to eat our daily teaspoon of cinnamon!

Grape seed phenols also inhibits beta-amyloid oligomerization.

Here is a case in point about the benefits of a variety of foods and potential for other foods once studied to be shown to inhibit oligomerization of beta amyloid

Grape phenols in grape seeds also inhibit beta-amyloid oligomerization and improve cognition in AD transgenic mice.[6] Of course our modern day irony is we have eliminated seeds from most grapes sold as food in the US just as nutrition science is showing innumerable benefits of them, now generally available only in supplements.

In what other ways does cinnamon help us? Cinnamon, like many other herbs and spices, is a potent anti-oxidant and is anti-inflammatory as well.  Its ORAC value per 100 grams is a huge 131,420, which translates to about 1445 ORAC units per teaspoon, the same amount as in about 3 ½ oz (just under ¼ cup) of blueberries (See article on antioxidants). Human clinical studies with cassias cinnamon reported that cinnamon can help with blood sugar control, and lower cholesterol. A randomized controlled study several years ago showed that a modest amount of cinnamon lowered people’s cholesterol by an average of 8%.[7] 1/2-1 tsp of regular ground cinnamon is the recommended amount.  Use the Cassias type of cinnamon, either Chinese or Vietnamese (also called “Saigon cinnamon”) as the research was done on this type of cinnamon.  Other cinnamons come from different tree types (e.g. Korintje from Indonesia) and may also be helpful, but no research has been reported on them.

Other studies show that cinnamon has potent anti-microbial properties and kills many species of meat-spoiling bacteria. Cinnamon is also over 50% fiber and helps add a little to our daily fiber intake.

Furthermore, recent studies have shown that cinnamon has unique healing abilities due to various components such as cinnamaldehyde.(Cinnamaldehyde is an essential oil, the organic compound that gives cinnamon its characteristic flavor and odor; comprises about 2% of the bark.) Cinnamaldehyde is responsible for some of cinnamon’s anti-inflammatory action as it inhibits nitric oxide. [8] But that same component consumed in very large amounts may overtax our livers. Thus it is recommended that adults do not exceed 10 grams (3 teaspoons) of cinnamon per day. Up to that amount is perfectly safe and healthy.

But as we know, the health and well being of our bodies is only maintained through a variety of factors, not just a diet high in anti-oxidants, spices and herbs. One reason that the MPN recommends a variety of foods is that our brains and body appear to require a large variety of nutrients, many of which are not yet named or understood. Another reason is that some foods that have excellent health benefits may become unhealthy in excessive quantities.

Cinnamon can also be easily used in everyday dining and cooking. It can be used as ground cinnamon (which is naturally “raw”) in coffee, tea, and apple juice, as well as a variety of baked goods and all sorts of apple products. Coffee lovers have discovered that a few shakes of cinnamon removes the bitter/astringent flavors and for many, takes the place of both cream and sugar.  Cinnamon is an excellent flavor enhancer and used in smaller quantities will surprise you and others with how it brings out other delicious flavors (superior to salt and MSG as a flavor enhancer, cinnamon has no health drawbacks!).   Cinnamon has been used for this reason by Greek cooks for centuries in their marinara sauces to take the acidic edge off tomatoes (no sugar please!) Cinnamon is one of the “Chinese 5 Spices” and a constant ingredient in all curries.

Eric Tseng, a high school senior at Acton Boxborough shares his advice: “Keep in mind, however, that relying on just cinnamon to improve your health will not work. While cinnamon is a brain healthy ingredient, it is just as important to exercise, eat more plant foods in general, and to avoid processed and sugary foods. Therefore, cinnamon rolls packed with processed sugar is NOT an option for a cinnamon resource! However, there are healthier and heartier recipes for cinnamon rolls that taste just as good, if not better” e.g. using non-sugar natural sweeteners such as stevia or erythritol…see our website (April 2010 Newsletter).

In closing, it is important not to think of any particular single food as a “magic” bullet to keep us healthy.  “Food is medicine” covers a vast variety of foods. Nutrients often work together with synergistic effects; hence the preference for “whole foods” or supplements based on (nearly) whole food extracts.

What other spices can help make our brains healthier?  Read article #4 on Other Spices to broaden your knowledge about the variety of herbs and spices that can help us keep our brains and body healthy. ALL OF THE ENDNOTES FOR THIS ARTICLE ARE AT THE END OF ARTICLE #4 on Other Brain Healthy Spices

The more I learn about the nutritional content and value of herbs and spices, the more I am confirmed in placing them front and center in the Memory Preservation Nutrition® program.  Not only have some spices when  researched been discovered to have specific value to help prevent cognitive decline, but most of them (all those studied to date!) have multiple health benefits….ranging from anti-microbial action, to anti-inflammatory and anti-oxidant action, and even as a source of fiber and scarce nutrients. Moreover because herbs and spices add such wonderful flavors to food, we can bear to part with excess salt, saturated fats and sugar!

One prominent reason for health benefits of herbs and spices is their anti-oxidant potency.  Oxidative stress has been identified not only as one of the key risk factors for brain diseases such as Alzheimer’s disease (and probably a prominent factor in the causal chain of events), but many other chronic diseases of the brain and body. Oxidative stress arises both from the pollutants and toxins in our environment, but also as a natural by-product of breathing oxygen. As we age our bodies are under increasing stress from “free radicals” -our very DNA is under attack — and anti-oxidants from our food is the best way to combat them. We need more and more as we get older, and low-caloric, nutrient intense sources are desirable.  Herbs and spices are the stars.  And some whole grains, nuts, seeds, beans and lentils are also very high in anti-oxidants with the various sorghum grains the most potent.

Eric Reardon’s article helps lay the background of why anti-oxidants are important to health, and how “ORAC” (Oxygen Radical Absorbance)

ratings can guide our selection of foods.  Compare his list of high ORAC value fruits and vegetables with those in my next article about spices and herb’s ORAC values.  Mr. Reardon agrees that spices and herbs can indeed help us all achieve the goal of 3,000 to 5,000 ORAC units per day; for instance, just one teaspoon of cinnamon can supply over 1,400 of these ORAC units!

Reprinted with permission from author. 

Please note that I have replaced Mr. Reardon’s listing of ORAC values with an updated table and figures. It turns out the method of determining ORAC values in the lab changed dramatically in the middle of the last decade, and current “new” values are often much higher than the older reports. Nutrition scientists are still learning just how ORAC values relate to actual biological anti-oxidant action in our brains and bodies. Some areas of agreement are that raw foods have higher ORAC values and probably thus higher anti-oxidant potential per gram; and that steamed or pressure cooked vegetables retain more anti-oxidants than boiled. However cooked vegetables can be consumed in greater volume than raw, and key for an individual is the form that they find palatable or accessible so they will and can actually eat the food!

Also, keep in mind when reviewing the ORAC table below, that some fruits and vegetables with lower ORAC values (per 100 grams) may be low because they contain a lot of water (good for us!) and normally be consumed in larger quantities. They may also contain especially important nutrients related to their particular color, such as lutein and zanthenin (critical for eye health) in corn, peas and zucchini as well as in kale, turnip and collard greens, broccoli, brussel sprouts and spinach. 

and lycopene in watermelon, pink grapefruit and tomatoes….especially cooked and concentrated tomato products such as juice, sauce and even catsup. This is just a reminder that ORAC values are not the only way to determine the value of a whole food.  NEL

‘Every second, each of our cells are bombarded with thousands of attacking free radicals. The damage these free radicals inflict underlies many of the chronic diseases associated with aging, such as cancer, heart disease and neurodegenerative disease. Scientists believe that a crucial way to protect the brain and body against the effects of disease provoking free radicals is to increase the consumption of foods possessing high ORAC values.

Stop and think for a second. What are you most concerned with when it comes to foods? Fat grams in a particular product? The amount of calories it contains? What is most important especially in the long run is the ORAC value of foods.

ORAC means oxygen radical absorbance capacity and serves as a measure of the antioxidant value of a food. The higher the ORAC value, the greater the ability to disarm dangerous free radicals.

Scientists from the United States Department of Agriculture[i] now advise consuming between 3,000 to 5,000 ORAC units each day in order to maintain optimal antioxidant protection in the body’s tissues and plasma. Yet even those who consume five daily servings of typical fruits and vegetables typically only obtain about 2,000 ORAC units each day. The reason that many health-conscious adults fail to obtain sufficient antioxidant protection is that the most commonly consumed fruits and vegetables contain only modest antioxidant protection. In order to meet the USDA’s ORAC recommendations, it is necessary to consume nutritional powerhouses like darkly colored berries. Simply adding 1/2 cup of blueberries to the diet provides a powerful 4,670 ORAC units (nearly twice that if they are wild). Other richly colored fruits and berries such as blackberries, raspberries, plums, and prunes also provide dramatic antioxidant protection for the entire body.”

Below is a list of antioxidant rich foods as measured by the ORAC value per 100 grams (approx. 3.5 ounces for many foods containing water; volume of dried foods can vary considerably as shown in HCI’s table for spices and herbs).

TOP ANTIOXIDANT Fruits and Vegetables[ii] & a few nuts selected and assembled by Dr. Nancy Emerson Lombardo(c) 2011  [ORAC* units per 100 grams**]

FRUITS                                                                VEGETABLES

* Oxygen Radical Absorbance – updated to the post 2007 ORAC values

“Richly colored fruits and vegetables provide the most abundant sources of disease preventative compounds. By regularly consuming these nutritional powerhouses you can help guard your cells against the daily onslaught of free radicals and fortify your body’s defenses against ailments ranging from cancer and cardiovascular disease to cognitive decline and macular degeneration. So the next time you think about a particular food don’t just think about fat grams and calories, think about ORAC and nutrient density.”

____________________________________________________

Eric Reardon MS, CNC operates Crossroads To Health, a unique nutrition consulting company dedicated to maximizing health and performance naturally. Eric works with clients on a range of health concerns including weight management, digestive care, hormone imbalances, blood sugar regulation, ADD/ADHD, mood disorders and more. For more information on Crossroads To Health and services provided visit crossroadstohealth.com or call 978-551-1321.
 

[i]James A. Joseph,  Ronald L. Prior, Guohua Cao, and Barbara Shukitt-Hale at Boston’s own Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University  is the source of these recommendations.  See “Can Foods Forestall Aging?”          Agricultural Research Magazine, Feb. 1999, Vol 47, No. 2

http://www.ars.usda.gov/is/AR/archive/feb99/aging0299.htm

Note: Tragically James Joseph, the innovative leader of many of these ground-breaking studies, died in 2009.
[ii]SOURCE for ORAC values of 100 grams each food:USDA Database for the Oxygen Radical Absorbance Capacity (ORAC) of Selected Foods, Release 2 – Prepared by Nutrient Data Laboratory, Beltsville Human Nutrition Research Center (BHNRC), Agricultural Research Service (ARS), U.S. Department of Agriculture (USDA) – May 2010

© 2011 Nancy Emerson Lombardo, Ph.D.

Ginger has a myriad of health benefits. It can help with stomach aches and inflammation of the joints. In addition, it is anti-microbial and anti-viral, keeping our immune systems strong and ready to fight off disease and bacteria.

Another brain healthy spice is turmeric, which is a potent antioxidant and very anti-inflammatory. It also helps insulin efficiency and lowers LDL cholesterol.  Alzheimer’s researchers have shown that curcumin, a prominent ingredient in turmeric, lowers beta-amyloid in AD transgenic mice and slows cognitive impairment. [9]^{, [10]}

Many other spices are anti-inflammatory, help lower cholesterol, and/or help our glucose metabolism. Some examples include green tea and oregano. Others such as gingko biloba (leaves) improve blood flow, and some lower blood pressure, such as parsley.  Next month we’ll share with you a summary of pilot randomized clinical trials of sage, lemon balm, and saffron with people with early AD.

[1] Monique Breteler (2011) The Relationship between Alzheimer’s Disease and Vascular Dementia   Invited plenary presentation at the 26^th Conference of Alzheimer’s Disease International, Toronto, Canada.

[2] Perry G, Castellani RJ, Hirai K and Smith MA  (1998) Reactive Oxygen Species Mediate Cellular Damage in Alzheimer Disease.  J of Alzh D, 1(1):45-55

[3] Herrup K (2010) Reimagining Alzheimer’s Disease-An Age-Based Hypothesis.  J Neuroscience, 30(50):16755-16762

[4] Mordhwaj S Parihar1 and Brewer GJ (2010) Amyloid Beta as a Modulator of Synaptic Plasticity  J  Alzheimers Dis.; 22(3): 741-763. doi:  10.3233/JAD-2010-2010 January 1 101020 PMCID: PMC3079354 NIHMSID: NIHMS262844

[5] Frydman-Marom A, Levin A, Farfara D, Benromano T, Scherzer-Attali1,

Peled S, Vassar R, Segal D, Gazit E, Frenkel D, Ovadia M. (2011) Orally Administrated Cinnamon Extract Reduces b-Amyloid Oligomerization and Corrects Cognitive Impairment in Alzheimer’s Disease Animal Models  Tel Aviv University.  www.PlosOne.org (on-line) Jan 2011:6(1) e16564

[6] Wang J, Ho L, Zhao W, Ono K, Rosenweig C, Chen L, Humala N, Teplow DB, Pasinetti GM (2008) Grape-derived polyphenolics prevent AB oligomerization and attenuate cognitive deterioration in a mouse model of Alzheimer’s disease. J Neurosci. 28, 6388-6992.

[7] Khan A, Safdar M, Ali Khan MM, Khattak KN, Anderson RA (2003) Cinnamon improves glucose and lipids of people with type 2 diabetes. Diabetes Care 26: 3215-3218.

[8]Lee SH, Lee SY, Son DJ, et al.(2005)  Inhibitory effect of 2′-hydroxycinnamaldehyde on nitric oxide production through inhibition of NF-kappa B activation in RAW 264.7 cells. Biochem Pharmacol . 2005;69(5):791-799.

[9] Lim GP, Chu T, Yang F, Beech W, Frautschy SA, Cole GM. (2001) The curry spice curcumin reduces oxidative damage and amyloid pathology in an Alzheimer transgenic mouse. J Neurosci 2001;21  (21):8370-7. [PubMed: 11606625]

[10] Ringman JM Frautschy SA Cole GM , Masterman DL and Cummings JL  (2005) A Potential Role of the Curry Spice Curcumin in Alzheimer’s Disease,  Curr Alzheimer Res. 2(2): 131-136.

The table below shows a selection of popular herbs and spices, and to put in perspective, ORAC values for a few  vegetables, fruits, grains.

A special note for chocolate lovers!

Chocolate lovers take heart:   Pure cocoa powder has a very high ORAC value per 100 grams; this is cut in half when cocoa powder is processed to make the dark chocolates we know and love.    But the ORAC value of many dark chocolates are still very high.   Select dark chocolates which are made with at least 70% cocoa powder–these are healthy for our brains and bodies, eaten in moderation of course.  At or above the 70% cocoa powder mark, dark chocolate will help you lower blood sugar and cholesterol, even if the other 30% is sugar and more cocoa butter.  Try to avoid chocolates containing milk as not only would these tend to have cholesterol from milk fats but more importantly tend to have had much of the anti-oxidant nutrients removed from the chocolate..

SOURCE for ORAC values of 100 grams each food:  USDA Database for the Oxygen Radical Absorbance Capacity (ORAC) of Selected Foods, Release 2 – Prepared by Nutrient Data Laboratory, Beltsville Human Nutrition Research Center (BHNRC), Agricultural Research Service (ARS), U.S. Department of Agriculture (USDA) – May 2010

Note: Number of teaspoons/100 gram and calculations of ORAC units per teaspoon or tablespoon collected/calculated by Nancy B. Emerson Lombardo, Ph.D. and HCI team

© 2011 NEL

It’s important for us to eat healthy and avoid the sugary, processed foods the American food industry provides for us. While tempting, the consequences of having such a diet will impact our health in the future, leading to high blood pressure, high cholesterol, and obesity. For example, sugar, high fructose corn syrup, refined white grains & other refined starches produce a spike in blood sugar & aggravate inflammation (AJCN 2008). Excess sugar increases our chances of heart disease; it even doubles your chance of having a heart attack. In addition, excess sugar increases insulin resistance, and challenges blood sugar metabolism and shrinks hippocampus (Convit, A, NYU, 2000-2010).^{[i] , [ii]}  The amount of shrinkage is correlated with levels of HbA1c.

However, there is good news. In today’s market, several brands of natural, non-sugar sweeteners are available. For more information go to my website.

Lastly, the consequences on high sugar intake on brain health are shocking and should be noted. Researchers conducted a pre-clinical trial with transgenic mice bred to develop AD pathology.  Two equivalent groups of mice were fed the same healthy mouse chow except that one (control group) was given pure water to drink as much as they wanted, and the other group was given only water containing 10% sugar (sucrose). After 6 months, the AD transgenic mice fed the diet high in sugar showed dramatically increased impairment in memory and spatial learning. There was also a 3-fold increase in the amount of beta-amyloid in their brains. Just adding the sugar caused the mice to develop abnormally high LDL cholesterol as well as unhealthy insulin resistance and weight gain.[iii]

Eric Tseng advises our readers: “Next time you sink your teeth into a slice of cake or open a bottle of soda, think about how you can limit your sugar intake to improve your health. It is far better to eat healthier and to live a longer, pain free life. Diet is one aspect of our lives we can control. Once a disease such as Alzheimer’s hits us, there is no way of curing it as of now, so do what you can to eat right and exercise!”

Coming next month:

Next month we’ll add more to the evidence for my Memory Preservation Nutrition® program by sharing with you Suzanne Craft’s ground breaking clinical trial showing convincingly the negative impact of high glycemic index, high saturated food diets on the human brain and positive impact of low glycemic index, low saturated food diets.[iv]

[i] Starr VL and Convit A.(2007) Diabetes, Sugar-Coated but Harmful to the Brain Curr Opin Pharmacol 7 (6): 638-642.

[ii] Convit A, Wolf OT, Tarshish C, deLeon MJ (2003) Reduced glucose tolerance is associated with poor memory performance and hippocampal atrophy among normal elderly  Proceedings of the National Academy of Sciences PNAS 100:(4),  2019-2022.

[iii] Cao D, Lu H, Lewis TL, Li L.  (2007) Intake of sucrose-sweetened water induces insulin resistance and exacerbates memory deficits and amyloidosis in a transgenic mouse model of Alzheimer disease.J Biol Chem, 282(50):36275-82. Epub 2007 Oct 17.

[iv] Bayer-Carter JL, Suzanne Craft et.al. (2011) Diet Intervention and Cerebrospinal Fluid Biomarkers in Amnestic Mild Cognitive Impairment, Archives of Neurology, 68(6):743-752.

August 20th, 2011: Healthy Eating for a Healthy Brain
This free event will be held at Castle Island, inside Fort Independence, 2010 William Day Boulevard, South Boston MA 02127. This event will start at 10:00am and is a featured part of a 60-minute meeting of the Castle Island Association. The Compass on the Bay is sponsoring Dr. Emerson Lombardo’s presentation.  Check out the events page at www.healthcareinsights.net

September 8th, 2011:  Brain Healthy Nutrition
This free event will be held at the Andover Senior Center, 36 Bartlet Street (Rear of town offices, Whittier Court), Andover MA 01810. This event will run from 1:30-3:00pm.  It is co-sponsored by Methuen Village Assisted Living and the Andover Senior Center.  Check out the events page at www.healthcareinsights.net

September 19th, 201 FREE CEU EVENT: Healthy Living for a Healthy Brain: How Lifestyle can Reduce the Risk of Alzheimer’s Disease 
This free event will be held at the Sherborn Town Hall, (Selectman’s Room) 19 Washington St, Sherborn MA 01770.  This event runs from 8:30-10:00am. A light breakfast will be provided.  CEU’s will be provided for nurses, social workers, and caregivers. Please RSVP by emailing coaprogram@sherbornma.org or calling 508-651-7858.  Sponsored by SLR’s Compass program at Golden Pond in Hopkinton. Check out the events page at www.healthcareinsights.net

Sept 20th, 2011: FREE CEU Brain Healthy Nutrition This free event will be held at Salem Haven Nursing Home, 23 Geremonty Drive, Salem, MA 03079.  This event will run from 8:00-9:00am. Light refreshments will be served.  This will be a free CEU Power point presentation on brain healthy nutrition and will be sponsored by Methuen Village Assisted Living Community.  Call Salem Haven at (603) 893-5586  to register.

Sept 20th, 2011: FREE CEU Brain Healthy Nutrition This free event will be held at Lawrence Hospital in Lawrence. This event will run from 12 to 1 pm. Light refreshments will be served. This will be a free CEU power point presentation on brain healthy nutrition and will be sponsored by Methuen Village Assisted Living Community. Call Methuen Village and ask for Lauriann to register. 1-978-685-2220.

Sept 30, 2011: Fall Meeting of CT-CHCC and CNC. This one-day conference for nutritionists runs 7:45 am regristration, program 8:30 am sharp to 3:00 pm. and is held at the lovely Water’s Edge Resort and Spa, 1525 Boston Post Road, Westbrook, CT 06498. (860-399-5901) CEU credits for RDs, DTRs, and dietary/food services managers.

Dr. Emerson Lombardo will present on her Brain Healthy Nutrition -Evidence Based Recommendations from 10:30 to noon in plenary session.  Call Dorothy LaGrua, President, to register, at 860-669-2823.  Mail $85 registration fee PAYABLE ATO CT-DHCC and mail to Becky Iselin, 94 Cedar Lake Road, Chester, CT 06412. Email questions to rebeccaiselin@comcast.net.

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

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

© 2011 HCI

June 2011

The second article on “Finger Foods” is for healthcare providers and families living with Alzheimer’s.  It comes to you courtesy of the Alzheimer’s Association of New York City; my long time colleague Anne Wyatt is their newsletter editor.  She wrote this article after interviewing Ariane Stein, a dietitian in France specializing in Alzheimer’s and gerontol­ogy. We’ve had similar success in introducing more “finger foods” and brain healthy snacks based on our Memory Preservation Nutrition® program for persons with Alzheimer’s.

The lead article, “The Truth About Eggs,” is for everyone:  I agree with the author, nutritionist Eric Reardon, MS, CNC, of Crossroads To Health, that, based on the latest evidence, eggs are a healthy food that has been the victim of misunderstanding and misinformation.  Not only are eggs, in moderation, not dangerous for the heart, they are essential for the brain.  And it is the yokes, the part that people have become scared to eat, that has the best nutrition, especially for the brain. Think about it, an egg has all the nutrition to support new life…and we can benefit from each part of the egg.,(just as we can for similar reasons,  by eating nuts, seeds, whole grains, peas, beans and other legumes, …and more so because these are plant foods).

This article is a nice follow-on to our February 2011 article on cholesterol, which we explained is an essential part of our body and brains and not inherently an “evil” food.

As Eric’s article explains, newer science shows that simply eating cholesterol rich foods does not raise your own blood cholesterol levels; it is eating excess (animal based) saturated and (any) trans fats, and surprise, excess sugar, and, in general, excess animal foods and insufficient plant-based foods.     In the class of animal foods, fish and seafood are the healthiest, with eggs in third place, i.e. desirable.  (Remember it is whole plant foods, especially the nuts, seeds, whole grains, legumes, vegetables and spices, which help you lower cholesterol; in addition these and several other classes of plant foods help prevent oxidation of (excess) LDL cholesterol which is what gets you into trouble.)

Among the brain healthy nutrients in eggs are choline (a constituent of your brain cells and a substance that keeps cholesterol from clogging your arteries), the anti-oxidant lutein (which gives egg yolks their bright yellow color), several key vitamins and minerals. Not only that, eggs are an important source of protein with a modest amount of fat…fat that helps your body absorb the fat soluble vitamins in eggs.

It is best to buy free range eggs, or at least eggs that contain omega-3’s…meaning the chickens have been feed meal that contains omega-3’s.  Free range eggs naturally contain omega 3’s because free-range chickens (like other free range farm animals) eat grass and weeds and then turn the vegetable-type of omega-3’s in grass and weeds into the DHA/EPA omega 3’s that our bodies and brains need.

By the way, if you need an excellent nutritionist, who is very knowledgeable about health foods and supplements, and the relationship between food and illness, biological testing to identify biochemical bases for mood and other disorders,  and can also advise you about healthy weight loss and “cleansing,” I highly recommend you give Eric a call or send him an email.  Check out his website at Crossroadtohealth.com.

Crossroads to Health Newsletter May 2011

Eggs have been demonized for years

because they contain a lot of cholesterol

(about 212 milligrams in an average large egg). But eating eggs is not likely to send your cholesterol levels soaring, or cause you to develop heart disease, as many fear.

Cholesterol is actually an essential part of your body, used to produce cell membranes, steroid hormones, vitamin D and the bile acids your body needs to digest fat. Your brain needs cholesterol to function properly, as does your immune system, and if a cell becomes damaged, it needs cholesterol in order to be repaired.

So cholesterol is not only beneficial, it is a vital part of your body.

Further, eating cholesterol is not what gives you high cholesterol. According to the Harvard Heart Letter, it’s a myth that all the cholesterol in eggs goes into your bloodstream and your arteries.

“For most people, only a small amount of the cholesterol in food passes into the blood. Saturated and trans fats have much bigger effects on blood cholesterol levels,” the Heart Letter states. “The only large study to look at the impact of egg consumption on heart disease-not on cholesterol levels or other intermediaries-found no connection between the two.”

Eggs are also an excellent source of healthy nutrients, including choline, a B vitamin that may help reduce your risk of heart disease, cancer, dementia and more. Egg yolks also provide the most readily absorbed form of lutein , a yellow-hued carotenoid that may help fight everything from cancer and cataracts to macular degeneration and aging.

As Jen Allbritton writes for the Weston A. Price Foundation:

“Besides providing all eight essential protein-building amino acids, a large whole, fresh egg offers about six to seven grams of protein and five grams of fat …, which comes in handy to help in the absorption of all the egg’s fat-soluble vitamins.

One egg also serves up around 200 milligrams of brain-loving cholesterol and contains the valuable vitamins A, K, E, D, B-complex and minerals iron, phosphorus, potassium and calcium. Choline, another egg-nutrient, is a fatty substance found in every living cell and is a major component of our brain. Additionally, choline helps break up cholesterol deposits by preventing fat and cholesterol from sticking to the arteries. So the bottom line is, don’t be chicken about eating eggs, especially the cholesterol-rich yolks!”  

The difference in feed does impact the quality of eggs you eat-buy free range eggs.  

_________________________________________________
Eric Reardon MS, CNC operates Crossroads To Health, a unique nutrition consulting company dedicated to maximizing health and performance naturally. Eric works with clients on a range of health concerns including weight management, digestive care, hormone imbalances, blood sugar regulation, ADD/ADHD, mood disorders and more. For more information on Crossroads To Health and services provided visit crossroadstohealth.com
or call 978-551-1321.

The Crossroads To Health newsletter is published monthly and includes health tips, articles, recipes and more to help you look and feel your best.

Alzheimer’s Association

New York City Chapter

ADvancing Care

Spring 2011 Volume 1

Finger food is an idea that has been around for a long time. Many people with advanced dementia, who can no longer use utensils, are able to feed themselves if they have finger food they like, presented to them in an encouraging way by staff or family members. Being fed by someone else is often an uncomfortable and sometimes embarrassing experience, and can cause people to further lose interest in eating. While not everyone is able to benefit from finger food, those who can often take more interest in eating, and sometimes find it easier to take meals in the social setting of the dining room. And, if some residents need less assistance with eating, staff is free to concen­trate more on those who are not able to help themselves.

Ariane Stein, a dietitian in France specializing in Alzheimer’s and gerontol­ogy, has done some interesting research on the use of finger foods, and gave us some new ideas about how to make them more appealing to residents. In addition to the carrot sticks, pieces of fruit, crackers, small muffins and sand­wiches we all think of as finger food, Mrs. Stein experimented with taking traditional French dishes such as casserole of beef, veal stew, pork with lentils, even rice pudding, and preparing them as finger food. There are few things as comforting as familiar foods and tastes, so imagine macaroni and cheese, lasagna, your favorite chicken dish, or pumpkin pie as finger food!

Mrs. Stein did her research in a nursing home in the Dordogne region of France, Le Verger Des Balans, with support from Dr. Genevieve Demoures. The purpose of the study was to show that nutritionally balanced, visually appealing, easy to pick up food could provide residents with Alzheimer’s the ability to feed themselves and be more independent.

Over the course of a year, Mrs. Stein worked with twenty residents long enough to assess the impact of the approach and the recipes she developed. Ten of the twenty residents were consistently fed by a caregiver at the start of the study, nine of whom improved to the point where they needed only partial assistance, or very limited assistance. The other ten residents started the study needing some assistance, and all of them improved to the point where they needed less help (thus giving staff more time to help others).

This is both compelling, and consistent with what we have known to be good practice for many years. What is new here is Mrs. Stein’s creation of recipes that are interesting, comforting and familiar to residents, as well as nutritionally balanced.

In keeping with the MDS-3 and its increased emphasis on responding to resident preference, the task is to learn more about foods that the resident enjoys through ob­servation, trying out different types, and talking with family and friends. Mrs. Stein has successfully worked with Dietary Departments in France to develop programs that integrate nutritionally balanced meals with resident preferences and overall plans of care. The rewards are the pleasure taken in eating, greater dignity, improved nutritional status, and the opportunity for staff to focus more of their time on residents who are unable to help themselves.

As the study results also underscore, it is essential residents not be given a diet of finger food while they are still able to use cutlery. The use of fingers to consume food is a natural progression of Alzheimer’s disease. As with all other aspects of care, staff will need to evaluate, step by step, what works best for each individual resident, in terms of their preference and comfort. For more infor­mation about the program she has developed, Mrs. Stein can be contacted at arianebordeaux@gmail.com.

New York City Chapter

360 Lexingon Avenue, 4th FloorNew York, NY 10017

Volume 1 Spring 2011

June 7th, 2011: Evidence Based Healthy Nutrition for  a Healthy Brain and Body

This free event will be held in Concord, MA at the Harvey Wheeler Community Center, 1276 Main St, Concord, MA 01742.  This free event will run from 2:30-5:00pm, Dr. Nancy Emerson Lombardo, who is the keynote speaker, will present from 4 to 5.  Check out the events page at www.healthcareinsights.net

June 8th, 2011: Food for Thought: Healthy Eating for a Healthy Brain 

This is a free event will be held in Avon, CT at River Ridge at Avon, 101 Bickford Extension, Avon, CT 06001. 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 

June 15th, 2011: Brain Healthy Lifestyles/Keeping the Connection: The Importance of Cognitive Stimulation & Social Engagement

This free event in the 3rd 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. Lynn Serper will be speaking on cognitive training and social engagement, and her exciting innovative program The Serper Method. Check out the events page at www.healthcareinsights.net  and learn more about Dr. Serper on www.serpermethod.com

June 16th, 2011: Brain Healthy Nutrition

This free event in conjunction with Cambridge-Somerville interagency group, will be held in Cambridge MA at The Cambridge Homes, 360 Mt. Auburn Street, Cambridge MA 02138.  This event will run from 1:30-3:00pm with time for Q & A. Please RSVP to Helene Quinn at HQuinn@thecambridgehomes.org if you wish to attend. Co-sponsored by Neville Place and The Cambridge Homes. Check out the events page at www.healthcareinsights.net

June 22nd, 2011:

Panel Discussion with Health Professionals

“Food, Brain and Body Connection”

This exciting event will be held in Boxborough, MA at the Holiday Inn, 242 Adams Place, Boxborough, MA 01719 (Exit rte 111, near exit 28  off 495). This event will run from 6:30-8:15pm and features four fabulous healthcare experts including Dr. Emerson Lombardo, licensed acupuncturist and registered pharmacist, Cynthia McMahon King, registered dietician Laurie Bilyeu, and certified trainer Sabrina Tavalone.

This educational event costs $10 if you register in advance and $15 at the door.  Please write checks to Luann Colombo.  You can RSVP with Luann Colombo at 978 479-4110 or Luann1212@comcast.net.

June 24th, 2011: Brain Healthy Nutrition 

This free event will be held in Andover, MA at The Andover Senior Center, 36 Bartlet Street, Andover, MA 01810. This event will run from 9:00-10:00am with time for Q & A.  This is a free CEU event.  Arrive at 8:30 to register and enjoy a light breakfast. Please RSVP to Andover Senior Center 978-623-8321 if you wish to attend.  Check out the events page at www.healthcareinsights.net

July 14th, 201: Healthy Eating for a Healthy Brain

This free event will be held in Sutton, MA at Pleasant Valley Country Club, 95 Armsby Rd,  Sutton, MA 01590. This event will run from 9-11:30am with breakfast and then Dr. Nancys presentation afterward.  RSVP by July 1st to Laura Black Silver at 1 800 286 6640 ext 3079 if you wish to attend.  Check out the events page at www.healthcareinsights.net

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

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.”

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

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

© 2011 HCI

March 2011

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!

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”)

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.

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.”

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

Offer Expires: April 30th, 2011

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

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

© 2011 HCI

March 2011

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!

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”)

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.

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.”

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

Offer Expires: April 30th, 2011

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

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

© 2011 HCI

February 2011

Two ways to increase size of your brain’s memory center (and reduce stress!) (1) Walk 40 minutes, 3 times a week (2) Meditate 30 minutes a day.

These two methods may affect different, important parts of the hippocampus. Meditation enlarged the grey matter in the left hippocampus (especially involved with verbal and memory of language), while walking enlarged the hippocampus’s anterior part including the dentate gyrus. The dentate gyrus is the most metabolically active part of our brain and is involved in spatial memory, short-term memory and new learning.  Neurogenesis is most prominent in this part of the adult brain; many surmise it is because creation of new brain cells and dendritic connections are essential  to the production of new memories.

To hear Nancy speak, check out the events article.

Consumer Guideline Tip for February 2011 e-newsletter:

“Favorite Fats!  Eat healthier fats such as Omega 3’s, and monounsaturated fats such as in olive oil and avocados (a great brain food!).  Use olive oil and canola oil for most of your cooking needs. Avoid transfats (partially hydrogenated oils) and reduce intake of saturated fats…emphasizing plant foods will help this strategy succeed.”  

Check the Cholesterol.  Use healthy oils such as olive and canola oils. Eat cholesterol reducing foods such as nuts, oatmeal, grapefruit, purple grapes and juice, niacin, fiber, fish, & certain spices. Eat lean meats and low-fat dairy. Avoid trans-fats (partially hydrogenated oils) and minimize foods with saturated fats, e.g. replacing ground beef, with ground turkey.      

In January we described the health benefits of our favorite fats; this month we add the cautionary tales about why we need to reduce consumption of saturated fats and avoid trans fats.  Plus we’ll give you some guidelines about how to do that, as well as reduce cholesterol to levels that are brain healthy!

Did You Know? Cholesterol and healthy fats are needed to live and think!

Each cell membrane contains a phospholipids bilayer that, in humans and other animals, contains cholesterol inside the two layers.  The cell membrane typically contains fatty acids of varying composition, ranging from polyunsaturated to saturated fats. The key fats for brain health are Omega 3’s; we need to eat enough of them to keep the brain cell membrane healthy, and to keep cholesterol in its proper place.

Cholesterol is a waxy, fat-like substance that our bodies produce, and is essential to cell structure and function. We need a certain amount of cholesterol to live and think and feel.  It is only when we consume or produce it in excess, that we get into trouble, especially when there is excess LDL (low density lipids) in our blood stream and especially when that LDL particles become oxidized and stick to the inside of our blood vessels forming a kind of plaque that inflames the vessel, and impedes the flow of blood. These plaques may break off and cause blockages in vessels, the heart or brain.

Saturated fats are generally solid at room temperature, and are found in animal products such as meat, poultry, seafood, eggs, dairy products, lard, butter, and also in coconuts, palm, and other tropical oils. While palm oil is a saturated fat, it is also a source of tocotrienols, the rarer form of vitamin E, so necessary for brain and heart health.  Saturated plant oils are also safer than animal saturated fats because THEY CONTAIN NO CHOLESTEROL. (No plant foods contain cholesterol!)

The American Heart Association also recommends you keep saturated fat consumption as low as possible because saturated fat is associated with raising cholesterol levels, which can increase risk for heart disease and stroke.

The American Heart Association currently recommends that saturated fat intake be limited to 16g or less per day, for a 2,000 calorie diet, and to 12 grams or less for a 1500 calorie diet, and generally limit saturated fat to less than 7 percent of total daily calories. http://www.livestrong.com/article/85841-recommended-fat-grams-diet/

Brain health generally requires we pursue heart health and thus follow these recommendations. Independent reasons include that brain cell membranes that contain too much saturated fat are less flexible and less permeable.  Inflexible, less permeable cell membranes impede optimum thinking and emotions. Omega 3’s are needed to help keep cholesterol “in its place” in brain cells Check out the article at the end of the newsletter.

In addition to producing our own cholesterol, we add cholesterol to our bodies whenever we eat animal products, as all animals produce cholesterol, including poultry and fish. The difference among red meat, poultry and fish is in the amounts of cholesterol, saturated fats and the other types of fat they contains, with fish and seafood generally containing the most Omega 3’s and the least saturated fats.

How Do We Limit Excess Cholesterol?

Saturated fat is the main cause of high blood cholesterol levels. When you eat too much saturated fat, your body reacts by making more cholesterol than it needs, and the surplus ends up in your blood.

Although a diet high in saturated fat is the main cause of high blood cholesterol levels, high cholesterol in the diet can also raise blood cholesterol levels. And usually the effect is twice as bad, because foods high in cholesterol are usually high in saturated fat.

Which Foods Contain Cholesterol?

Only animal foods contain cholesterol – plant foods do not contain cholesterol. In animals, as in humans, cholesterol is a part of all cells and serves many vital functions. Therefore, foods of animal origin – such as meat, poultry, fish, eggs, or milk – all contain some cholesterol.

Generally, foods high in animal fat are also high in cholesterol. Two exceptions to this generalization are liver and eggs, which are not high in fat but are high in cholesterol. However eggs are a wonderful brain food as they contain choline which is a building block of new brain cells, and other nutrients important for brain and body health.  As with sugar, when you eat foods rich in cholesterol, look for accompanying redeeming brain and heart healthy qualities, and then still moderate the overall amount.

Which Fats Lower Blood Cholesterol Levels?

Both monounsaturated and polyunsaturated fats help lower blood cholesterol levels by helping your body get rid of newly-formed cholesterol. But these fats should replace some of the saturated fat in your diet – not be used in addition to saturated fat. Eating too much of even the healthy fats could result in weight gain which in turn can raise cholesterol levels. The better strategy is to consume mostly plant foods and especially those foods known to help lower cholesterol levels such as oatmeal, grapefruit, purple grape juice, nuts, whole grains, certain spices such as cinnamon, eating lots of vegetables, and the B-vitamin niacin. (see the Memory Preservation Nutrition® program for description of these and other cholesterol lowering foods).

Trans fat is much more harmful than saturated fat.  In addition to increasing LDL levels, trans fat also decreases HDL (the good cholesterol) and has been linked to obesity, diabetes and cardiovascular disease. Sources of trans fat include partially hydrogenated or hydrogenated vegetable oils, some margarines and shortenings, fried foods, and commercial baked goods such as crackers, cookies, cakes, and other snack foods. Current dietary recommendations advise that trans fat be limited to less than 1 percent of total daily calories (http://www.cnpp.usda.gov/DGAs2010-DGACReport.htm).     The Memory Preservation Nutrition® program goes further and recommends for sake of brain health you totally avoid and eliminate trans fats from your diet whenever you have a choice. (In today’s America it is hard to avoid altogether since you are not always in position to know the ingredients of what you are eating).

Figuring out whether or not a food contains trans fat can sometimes be tricky. As of January 1, 2006, a law was created that requires all trans fat to be listed on food labels along with saturated and unsaturated fats. However, according the FDA regulations, a food product claiming to have zero trans fat can still contain up to half a gram per serving and the manufacturer determines the service size.  Thus if the serving size is less then ½ gram, then the label can say zero even if the trans fats is the #1 ingredient. Therefore, it is important to read the ingredient list and look for items such as “partially hydrogenated vegetable oil,” “vegetable shortening,” or similar phrasings. Whenever you see these ingredients, DON’T BUY OR EAT THE PRODUCT!

How Much of Which Kinds of Fats Should I Eat? (repeated from last month)   

All fats, even if they are monounsaturated and polyunsaturated, are high in calories. Fat contains nine calories per gram (a measure of weight). In comparison, protein and carbohydrates only contain four calories per gram.

So remember, when it comes to fats, the key to maintaining optimal health is eating the right types in moderate amounts.

Limit total fat intake to 20 to 35 percent of daily calories for a 2,000-calorie-a-day diet.  This amounts to about 44 to 78 grams of total fat a day. http://www.mayoclinic.com/health/healthy-diet/NU00200

Of this, no more than 16 grams should be saturated fats. About half of the remaining 14-32 calories should be comprised of mono-unsaturated fatty acids, and at least 4 to 8 grams of Omega 3’s daily (from vegetables, seed/nut and fish/seafood/seaweed sources).

(To order fish oil or fish oil capsules check out my website) 

For a 1,500 calories diet, get between 25 percent and 35 percent of calories from fat, primarily the healthy unsaturated (MUFAs and PUFAs) fats found in plant oils, fatty fish, nuts and avocados. This means about 375 to 525 fat calories daily, or because one gram of fat contains nine calories, 42 to 58 total grams of fat. http://www.livestrong.com/article/253372-1-500-calorie-healthy-eating-meal-plans/   (American Heart Association)

For all diets, try to skip all foods containing trans fats.

March 2nd, 2011: Food for Thought

This free event will be held in Methuen, MA at Methuen Village, 4 Gleason St, Methuen MA 01844.  This is a CEU event from 11:30am-1:00pm.  Free brain healthy lunch will be provided.  Please RSVP to 978-685-2220.  Check out the events page at www.healhcareinsights.net 

March 16th, 2011: Food for Thought

This free event will be held in Acton, MA at the Atlantic Sea Grille, 77 Great Road, Acton MA 01720.  This event is sponsored by the Acton/Boxborough Rotary Club.  There will a short highlight on brain healthy eating by Dr. Nancy Emerson Lombardo at 12:15pm.  Call the Rotary to register in advance.  You pay for lunch.  Check out the events page at www.healthcareinsights.net

March 23rd, 2011: Food for Thought: Healthy Eating for a Healthy Brain

This free event will be held in Brighton, MA at the Chestnut Park at Cleveland Circle, 50 Sutherland Road, Brighton MA 02135. There will be refreshments at 5:00pm with a 90 minute presentation from 5:30-7:00pm.  RSVP to 617-566-1700. Check out the events page at www.healthcareinsights.net  

March 24th, 2011: Brain Healthy Nutrition   

This free event will be held in Framingham, MA at Callahan Senior Center, 535 Union Ave, Framingham, MA 01702. This event starts at 11:00am. Registration is free and there will be a free lunch available.  This event is sponsored by Compass at Golden Pond and the Metrowest Alzheimer’s Partnership. RSVP Leanna Moran – Lmoran@slr-usa.com    Check out the events page at www.healthcareinsights.net

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 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

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 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

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

Previous studies from Lazar’s group and others found structural differences between the brains of experienced mediation practitioners and individuals with no history of meditation, observing thickening of the cerebral cortex in areas associated with attention and emotional integration. But those investigations could not document that those differences were actually produced by meditation.

For the current study, MR images were taken of the brain structure of 16 study participants two weeks before and after they took part in the 8-week Mindfulness-Based Stress Reduction (MBSR) Program at the University of Massachusetts Center for Mindfulness. In addition to weekly meetings that included practice of mindfulness meditation – which focuses on nonjudgmental awareness of sensations, feelings and state of mind – participants received audio recordings for guided meditation practice and were asked to keep track of how much time they practiced each day. A set of MR brain images were also taken of a control group of non-meditators over a similar time interval.

Meditation group participants reported spending an average of 27 minutes each day practicing mindfulness exercises, and their responses to a mindfulness questionnaire indicated significant improvements compared with pre-participation responses. The analysis of MR images, which focused on areas where meditation-associated differences were seen in earlier studies, found increased grey-matter density in the hippocampus, known to be important for learning and memory, and in structures associated with self-awareness, compassion and introspection. Participant-reported reductions in stress also were correlated with decreased grey-matter density in the amygdala, which is known to play an important role in anxiety and stress. Although no change was seen in a self-awareness-associated structure called the insula, which had been identified in earlier studies, the authors suggest that longer-term meditation practice might be needed to produce changes in that area. None of these changes were seen in the control group, indicating that they had not resulted merely from the passage of time.

“It is fascinating to see the brain’s plasticity and that, by practicing meditation, we can play an active role in changing the brain and can increase our well-being and quality of life.” says Britta Hölzel, PhD, first author of the paper and a research fellow at MGH and Giessen University in Germany. “Other studies in different patient populations have shown that meditation can make significant improvements in a variety of symptoms, and we are now investigating the underlying mechanisms in the brain that facilitate this change.”

Amishi Jha, PhD, a University of Miami neuroscientist who investigates mindfulness-training’s effects on individuals in high-stress situations, says, “These results shed light on the mechanisms of action of mindfulness-based training. They demonstrate that the first-person experience of stress can not only be reduced with an 8-week mindfulness training program but that this experiential change corresponds with structural changes in the amygdala, a finding that opens doors to many possibilities for further research on MBSR’s potential to protect against stress-related disorders, such as post-traumatic stress disorder.” Jha was not one of the study investigators.

Psychiatry Research: Neuroimaging, Volume 191, Issue 1, 30 January 2011, Pages 36-43    Britta K. Hölzel, James Carmody, Mark Vangel, Christina Congleton, Sita M. Yerramsetti, Tim Gard and Sara W. Lazar   View Abstract

Source: Massachusetts General Hospital

An exciting new study, a gold standard randomized controlled trial in normal older adults, shows that aerobic exercise training increases the size of the anterior hippocampus, leading to improvements in spatial memory. “Exercise training increased hippocampal volume by 2%, effectively reversing age-related loss in volume by 1 to 2 years.” Here are some excerpts of coverage of this study by Alzheimer’s Research Forum (ARF).

“To get such dramatic results from a few hours a week was somewhat surprising,” said senior investigator Arthur Kramer of the University of Illinois, Champaign-Urbana, in an interview with ARF. He and colleagues reported the findings online January 31 in the Proceedings of the National Academy of Sciences USA.

Plenty of research suggests that physical activity is good for the mind. Prior studies of older adults correlated regular exercise with reduced dementia risk (Larson et al., 2006). Investigations by first author Kirk Erickson, University of Pittsburgh, Pennsylvania, linked aerobic fitness to bigger hippocampi (Erickson et al., 2009) and showed, longitudinally, that walking prevents gray matter loss (Erickson et al., 2010 and ARF related news story).  Randomized trials on the benefits of physical activity are rare, though, as it is hard to get people to stick to a specific exercise regimen (McCurry et al., 2010). One such study on seniors with subjective memory complaints did have promising findings-six months of moderate exercise led to modest improvements on the Alzheimer’s Disease Assessment Scale-Cognitive Subscale (ADAS-cog), measured at 18 months (Lautenschlager et al., 2008 and ARF related news story).

The current study, another randomized trial of dementia-free seniors, offers “much more concrete proof” for the idea that exercise helps the brain, said Eric Larson of Group Health Research Institute in Seattle, Washington. “It looked at a biologic endpoint-the size of the part of the brain most important for memory, and one of the parts most affected by dementia”-i.e. the hippocampus.  Collaborating with researchers at Ohio State University in Columbus and Rice University in Houston, Texas, Kramer and Erickson analyzed 120 older adults with normal cognition (average age: 66.5 years) randomized to one year of moderate-intensity walking, OR (control group)  stretching and toning exercises, three times a week. The groups began the study with comparable hippocampal volumes, assessed by magnetic resonance imaging (MRI), and had similar attendance rates. Participants had brain scans, as well as fitness and memory assessments, at baseline, six months, and after the 12-month intervention.

Consistent with the expected 1 to 2 percent annual hippocampal loss in dementia-free seniors (Raz et al., 2005), the control group lost about 1.4 percent volume in this brain region by the end of the 12-month trial. In contrast, the hippocampi of the walkers grew roughly 2 percent. The benefit seemed specific to the anterior part of this brain structure, which mediates acquisition of spatial memory. Similar effects did not appear in the thalamus, caudate nucleus, or posterior hippocampus.

By measuring changes in the participants’ maximal oxygen consumption, the researchers determined that the intervention succeeded in raising aerobic fitness levels, and that larger fitness boosts correlated with greater hippocampal growth. Furthermore, the team found that, within the control group, people with higher baseline fitness levels had less hippocampal shrinkage than those who were less fit, suggesting that fitness protects against loss of brain tissue.

To explore possible mechanisms underlying these changes, the authors looked at serum levels of brain-derived neurotrophic factor (BDNF) in blood collected from participants at baseline and 12 months. BDNF is an important mediator of neurogenesis in the dentate gyrus of the hippocampus.  People who exercise more have higher levels of hippocampal BDNF (Cotman and Berchtold, 2002; Neeper et al., 1995), and increased serum BDNF levels have been correlated with larger hippocampi and better memory performance (Erickson et al., 2010 and Alzheimer’s Research Forum related news story). In the present study, greater elevations in serum BDNF were linked to greater gains in hippocampal volume.     All told, the study “attempted to tie together changes in anatomy with changes in blood chemistry with changes in cognition, in a brain region with a pretty well-defined function (episodic memory),” Kramer said.

Of note, participants in the present study had fairly poor cardiovascular fitness and were asked, in the exercise group, to “walk to 60 percent of their maximal heart rate,” Larson said. “This is stuff anybody could do. You’re not getting winded by this level of exercise.”-Esther Landhuis.

Reference: Erickson KI, Voss MW, Prakash RS, Basak C, Szabo A, Chaddock L, Kim JS, Heo S, Alves H, White SM, Wojcicki TR, Mailey E, Vieira VJ, Martin SA, Pence BD, Woods JA, McAuley E, Kramer AF. Exercise training increases size of hippocampus and improves memory. 2011 Jan 31. PNAS Early Edition.

View abstract.

Save 20% on any nutritional supplements ordered on-line in February and March 2011
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References: Emerson Lombardo, N.B.,Volicer, L .Martin, A,.Wu B and Zhang XW. (2006) Memory Preservation Diet To Reduce Risk and Slow Progression of Alzheimer’s Disease. in Vellas, B., Grundman, M., Feldman, H., Fitten, L.J., Winblad, B., ed., Research and Practice in Alzheimer’s Disease and Cognitive Decline, vol 9,: 138-159. and   Jesse Gray, Shana Groeschler, Tony Le, Zara Gonzalez (2002). “Membrane Structure” (SWF). Davidson College. http://www.bio.davidson.edu/people/macampbell/111/memb-swf/membranes.swf. Retrieved 2007-01-11.a

The following is an updated excerpt from my book chapter on the Memory Preservation Nutrition program cited above.  LOMBARDO 12/09/06 14:15 Page 148

Dr. Antonio Martin MD, Ph.D. has established that brain tissue membrane composition reflects dietary sources and that an optimal balance of Omega-6 and Omega-3 fatty acids is necessary to maintain brain cell membrane and vascular health, and protect against oxidative stress and cognitive decline. Dr. Martha Morris reports that dietary intake of Omega- 3 fatty acids from both vegetable and animal sources, and weekly consumption of fish (rich in docosahexaenoic acid (DHA) may reduce the risk of incident AD. Otsuka/Ueki’s case control study reported that diets of AD and vascular dementia patients were excessive in intake of Omega-6 PUFA and deficient in intake of Omega-3 PUFA, compared to matched controls who did not have dementia. The American and most Western diets are very deficient in Omega 3’s and over abundant in Omega-6’s; instead of the ideal ratio for the human body and brain of 1:4, these diets are in the range of 1:20 to 1:75.

Membrane fluidity, which is a critical factor for a membrane’s function, depends on its lipidic composition. PUFAs present in the membrane as part of phospholipids increase the membrane fluidity because, by bending some chains, double bonds in PUFAs prevent them from compacting themselves perfectly. Omega-3 fatty acids, especially DHA and EPA, are highly concentrated in the brain, comprising about 22% of the fatty acid composition of brain phospholipids & brain cell membranes. As a primary determinant of cell membrane fluidity and nerve cell communication, Omega-3’s are critically important for cognitive and behavioral function as well as normal growth and development. Hashimoto’s group in Japan (using DHA in fish oil) and Cole’s group at UCLA (using DHA in marine algae) showed that AD transgenic mice exhibited rapid cognitive decline when deprived of DHA and other Omega-3’s in their diet. Cole’s group further demonstrated that the decline was associated with significant loss of synapses and dendritic material. Cole’s group also showed reversal of effects of DHA deprivation by adding DHA back to the diet of DHA deficient TG 2576 mice; DHA allowed the mice to recover and form new synapses. Both Hashimoto and Cole conclude that DHA protects dramatically against cognitive decline and synaptic deterioration in AD transgenic mice, and thus might also do this in humans. Dick Wurtman MD’s work at MIT verifies that dendritic growth is dependent on the amount of DHA and can be enhanced by additional nutrients such as choline.

Omega-3’s have been shown to work with presenilins to control AKT, Abeta and prevent phosphylation of tau. DHA regulates neuronal functions by modulating membrane properties such as neurotransmitter release, ion channel and enzyme regulation, and receptor-mediated transcription of genes involved in critical neuronal functions, such as memory.  Other scientists have concluded that Omega-3’s may also interfere with etiology of Alzheimer’s disease by protecting the health of lipid rafts in each neuronal cell membrane and preventing the build-up of dimmers of A-beta in addition to deterring phosphorylation of tau (the second abnormal protein implicated in AD).

A higher ratio of dietary Omega-3 to Omega-6 fatty acids than is currently consumed in our population is also recommended for heart health, and can be achieved by increasing consumption of fish and alph-alinolenic acid (Omega-3) in canola, soy and flaxseed oils. Large prospective trials show that people who experience the least coronary heart disease (CHD) have a diet that is rich in fish, PUFAs, whole-grain cereals, fruits and vegetables and low-fat dairy foods, and low in saturates from dairy fat, meat fat and fried foods. The FDA has now allowed heart health claims for Omega-3’s including DHA. Studies of the efficacy of fish in the diet to slow progression (secondary prevention) of heart disease and prevent mortalities gives further reason to emphasize fish in the Memory Preservation Nutrition® program. The GISSI Prevenzione Trial reported changes in mortality rates due to increasing intake of fish could be seen in as little as 90 days, an efficacy superior to pravastatin and at the same level as simvastatin or aspirin. They reported only beta-blocking agents are superior, but long-chain Omega-3 fatty acids from fish display their beneficial effects even in patients already treated with beta-blockers.

Omega-3 fatty acids are also important for reducing risk of depression. Since depression itself is a risk factor for Alzheimer’s disease this is a yet another instance of a nutrient serving as upstream protective factor for multiple chronic diseases.

An important dietary note is that vegetables (small amounts), soybeans, nuts (especially walnuts) and seeds e.g. flaxseed, chia seed, pumpkin seed and their oils (e.g. canola, flax seed, pumpkin seed, perilla seed oil, and walnut oil), and purslane (a wild plant sometimes cultivated), are sources of shorter chain Omega-3’s while only fish and marine algae, seaweed and other marine plants, plus grass fed and free range or wild animals, are sources of longer chain DHA and EPA so essential to brain health. While the human body can manufacture DHA and EPA from shorter chain Omega-3’s, this ability often declines significantly with age. Hence the importance of direct dietary sources of DHA and the usefulness of DHA and EPA supplements for brain health.

Thus a key dietary strategy in MPD is to avoid or greatly limit foods rich in saturated or trans-fats, both of which if taken in sufficient quantity to replace PUFAs in brain cell membrane, interfere with brain cell fluidity and thus neurotransmitter transmission. A related dietary strategy is to ingest foods and spices that help reduce absorption and retention of unhealthy fats and LDL cholesterol without reducing the “good” HDL cholesterol.

Some foods that assist in lowering LDL cholesterol and other problematic lipids include cinnamon, soy (FDA recommends at least 25 grams per day of soy plus plant sterols to help lower cholesterol), fenugreek, curryleaf, mustard seeds, coriander seeds, turmeric, garlic (modest effects), and fiber.

Garlic also has anti-platelet activity facilitating increased blood flow. In the cinnamon study, decreases in LDL were 7 and 27%, in total cholesterol were 12 and 26% and in triglycerides were 23 and 30%, respectively, for doses of 1 gm and 6 grams of cinnamon for 40 days. (The MPN recommends a daily dose of ½ to 1 tsp of Cassias  Cinnamon (from either Vietnam or China). Note the less expensive Korinje Cinnamon may have similar benefits as a strong antioxidant, but is derived from a different tree and has not been subjected to clinical trials.)

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

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

© 2011 HCI

January 2011

We hope that everyone had a great holiday and was able to keep warm and brain healthy.  As New Years is now past hopefully one of your resolutions is to become more brain healthy.  Let us show you how to start this new years off right!

Eager to become brain healthy but not sure where to start?  Subscribing to this newsletter is a great start!  In this newsletter we’re going to be discussing brain healthy fats and show you what fats to embrace and which ones to avoid.

We also have a list of events where I will be speaking in person! In these events you’ll learn facts and ideas on how to change your whole lifestyle and become brain healthy. There is always time at the end for Q & A, so check out the events to find one near you.

The “added special attraction” this month is announcing a wonderful new book….by one proud mother’s son! :  Nicholas Emerson Lombardo’s “The Logic of Desire: St. Thomas Aquinas on Emotion.”  This, his first book, has already won a prestigious international award  in collaboration with Heidelberg University, the 2011 John Templeton Award for Theological Promise.   http://www.fiit.uni-heidelberg.de/award/

Nicholas and I share an interest in spiritual matters…and his interest  is his career!  A Dominican priest, Nicholas Lombardo, O.P., received his Doctorate in Theology on November 27, 2010 from Cambridge University, England (in absentia, the day after performing marriage rites for his sister, my lovely daughter, Maryanne nee Lombardo now Mrs. Thomas Speroni) in Rome, Italy.    A big week for our family!

Dr. Nicholas Lombardo has just been offered a Asst. Prof. position at Catholic University in Washington DC, which inside sources suggest he is planning to accept.

So why not check out this award winning book!  Read on!

© 2011 HCI

 
Consumer Guideline Tip for January 2011:

“Favorite Fats!  Eat healthier fats such as Omega 3’s, and monounsaturated fats such as in olive oil and avocados (a great brain food!).  Use olive oil and canola oil for most of your cooking needs. Avoid transfats (partially hydrogenated oils) and reduce intake of saturated fats…emphasizing plant foods will help this strategy succeed.”

In our November and December newsletters, we reviewed the importance of Omega-3 fatty acids for our good health and well-being, identified food sources of this key nutrient; and shared some wonderful recipes to help you include these “superfoods” in your diet.  This month we discuss the other healthy “favorite” fats, and introduce the unhealthy ones we’ll detail in February.

Omega-3 fatty acids are a type of polyunsaturated fat and, as we learned, an essential component of a brain healthy diet. There are actually several types of fats in our diet, and it’s important to understand what they are, how they affect our health, and what we should include in our diets to optimize our health (including brain health!), and help reduce our risk for developing many chronic conditions.
Part of our effort here is to dispel the myth that all fats are bad, and that all “fat-free” foods are good.
In the not-so-distant past, fat intake was greatly discouraged, and there were those who recommended severely limiting total fat intake. This advice was based on studies indicating diets too high in fat, especially certain types of fat, would increase the risk for several chronic conditions, including obesity, cardiovascular disease, diabetes, certain types of cancers, as well as cognitive decline.

What are some health benefits of fats?

Fortunately it’s almost impossible to remove fat completely from our diets, since it would be unhealthy to do so. Contrary to what many people think, fats are a key nutrient in our diet, are key components of every brain and body cell, and are essential to many functions in the body. For example, fats play a vital role in maintaining healthy hair and skin, help maintain body temperature, insulate organs in our body against shock, and, at 9 calories per gram, fats provide a significant source of calories that can be used as a source of energy. Additionally, they help the body to absorb and distribute the fat-soluble vitamins A, D, E and K and carotenoids. Furthermore, fatty acids are an integral component of cell membrane structure and help to maintain healthy cell function in the brain and body. We couldn’t think, feel, move or live without fat!

Another benefit of including some fat in the diet is that it adds flavor, and, because fat takes longer to digest than carbohydrates and proteins, it helps to satisfy hunger by making you feel full for a longer period of time. Further, fat content in foods help slow the absorption of unrefined sugars and carbs, giving your body (and anti-oxidants you hopefully also consumed) a better chance of dealing with these unhealthy foods.

High caloric content of fat!

Caution: Fats do provide a concentrated source of calories (120 calories per tablespoon!), thus we must choose our fats wisely, to avoid excessive calorie intake, which can have adverse health effects e.g. through weight gain.

Why does the TYPE of fat I eat matter so dramatically?

The type of fat you eat is just as important as the total amount of fat in your diet. Evidence suggests that different types of fats have different effects on health. When consumed in moderate amounts, some fats offer health-protective benefits.

There are three main types of fats: saturated, unsaturated, and trans fats.

Fats are made of varying combinations of fatty acids, and may be either solid or liquid at room temperature, depending on their structure and composition. Some fats are saturated (harder at room temperature) while others are unsaturated (liquid at room temperature).

What are the less healthy types of fats?

Saturated and trans fats are the less healthy kinds of fats that you should try to limit in your diet. These fats can increase your risk of heart disease by increasing your total and LDL (bad) cholesterol.  One reason eating more plant foods and fewer animal foods helps us obtain healthier fat balances is that PLANT FOODS CONTAIN NO CHOLESTEROL!!!

See our February edition for more information on saturated fats and trans fats.  http://en.wikipedia.org/wiki/Trans_fat  and http://www.mayoclinic.com/health/trans-fat/CL00032
And the healthy “favorite” fats?
In contrast, the unsaturated fats can have beneficial effects on health when consumed in moderation and as part of an overall balanced diet. There are two types of unsaturated fatty acids, monounsaturated (MUFAs) and polyunsaturated (PUFAs). The essential Omega-3 and Omega-6 fatty acids are types of polyunsaturated fats.

Both MUFAs and PUFAs provide health benefits by lowering total cholesterol and LDL cholesterol. Monounsaturated fats have the additional benefit of maintaining, and perhapsincreasing levels of HDL (the good cholesterol). Evidence is building that diets rich in mono-unsaturated fats, such as the Mediterranean Diet, are brain healthy.

Which foods are sources of monounsaturated fats?
Good sources of monounsaturated fats are avocadoes, plant oils such as canola, olive, and peanut oils, and a variety of nuts and nut butters including almonds, brazil nuts, cashews, hazelnuts (filberts), macadamia nuts, and peanuts.

What is an “essential fatty acid?”

Fatty acids that your body can’t make are considered “essential” (EFA stands for”essential fatty acid”. That means we must consume them in our diets to maintain good health. As we learned in previous articles, there are 2 basic EFA’s, both plant based: alpha-linolenic acid (an Omega-3 fatty acid), and linoleic acid (an Omega-6 fatty acid). Our bodies can build the longer chain Omega 3’s that actually comprise parts of our brains and body cells, EPA and DHA, which we wrote about in the last two articles/newsletters, although it is more reliable to get EPA and DHA directly from fish, seafood, and fish or other marine oils (calamari, algae).
While both Omega-3 and Omega-6 fatty acids are essential for the body, there is an ideal ratio of Omega-3’s to Omega-6’s that must be maintained for optimal health. That ideal ratio is what our cave dwelling ancestors experienced based on archeological evidence:  4 to 1 units of Omega 6’s for every unit of Omega 3’s. Today most American’s consume a greatly imbalanced ratio of 20 to 30 units of Omega 6’s for every unit of Omega’s 3’s.  Many scientists believe this imbalance is one of the key factors behind many chronic diseases afflicting our citizens.

Omega-6 fatty acids tend to be more widely available in foods, including vegetable oils, shortenings, nuts, meats, salad dressings, margarines and processed foods in general, in grains, and in many animal foods.  Omega 3’s are present in green leafy vegetables, in a few nuts (walnuts) and seeds (flax and chia), and in fish, seafood and grass/vegetation fed animals (see December issue).

The imbalance of Omega 6’s and 3’s is very harmful to the brain and body for multiple reasons. First and foremost, Omega 6’s are pro-inflammatory while Omega 3’s are anti-inflammatory. Having an excess of Omega 6’s, or deficiency in Omega 3’s, results in inflammation throughout the body and brain.  Furthermore, excess Omega 6’s, especially from animal sources, has been linked to a buildup of excess arachidonic acid in the brain, especially the hippocampus, which in response shrinks or atrophies. [reference: Sanchez-Mejia et. al. Phospholipase A2 reduction ameliorates cognitive deficits in a mouse model of Alzheimer’s disease. Nature Neuroscience 2008 11(11): 1311-1318. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2597064/ ]

For sources of Omega 3’s, see our December newsletter articles.  http://healthcareinsights.net/home/newsletters/decem

ber-2010-newsletter/
Choosing a variety of foods that contain these EFA’s, in the right balance, is the key to helping to moderate the inflammatory process, which has been linked to many chronic conditions such as arthritis, heart disease, certain types of cancer, and cognitive decline, and specifically, Alzheimer’s disease.

Beware “Fat-Free” Foods

Many food manufacturers have developed “fat-free” products such as cookies, cakes, snack foods, salad dressings and other food products that, although devoid of fat, often contain significantly greater amounts of calories, sugar, sodium, preservatives, additives and other ingredients that are not beneficial to our health. In fact, despite the widespread availability and ingestion of these products, the incidence of obesity has continued to rise to epidemic proportions, and this is a major risk factor in the development of the adverse health conditions listed above. The MPN program does not encourage the use of “fat-free” products. Instead, focus on eating healthy fats and reducing consumption of sugar, salt, food additives. The unhealthy saturated fats and avoid transfats altogether.

How Much of Which Kinds of Fats Should I Eat?

All fats, even if they are monounsaturated and polyunsaturated, are high in calories. Fat contains nine calories per gram (a measure of weight). In comparison, protein and carbohydrates only contain four calories per gram.
So remember, when it comes to fats, the key to maintaining optimal health is eating the right types in moderate amounts.

Limit total fat intake to 20 to 35 percent of daily calories for a 2,000-calorie-a-day diet.  This amounts to about 44 to 78 grams of total fat a day. http://www.mayoclinic.com/health/healthy-diet/NU00200
Of this, no more than 16 grams should be saturated fats. About half of the remaining 14-32 calories should be comprised of mono-unsaturated fatty acids, and at least 4 to 8 grams of Omega 3’s daily (from vegetables, seed/nut and fish/seafood/seaweed sources).
For a 1,500 calories diet, get between 25 percent and 35 percent of calories from fat, primarily the healthy unsaturated (MUFAs and PUFAs) fats found in plant oils, fatty fish, nuts and avocados. This means about 375 to 525 fat calories daily, or because one gram of fat contains nine calories, 42 to 58 total grams of fat. http://www.livestrong.com/article/253372-1-500-calorie-healthy-eating-meal-plans/   (American Heart Association)

For all diets, try to skip all foods containing trans fats.

“While fat restriction is beneficial for the elderly who are fit and well, it is contraindicated in the elderly who are frail, above the age of 75, have difficulty consuming adequate nutrition and calories due to a poor appetite, and/or those who have suffered weight loss. In fact, in these situations, it is recommended to use additional fat to increase the calories in meals and snacks and to aid weight gain.”   (Source: Suha Khoury, RD, is a dietitian who is registered with the American Dietetic Association and a Diabetes Educator. She works as a Medical Nutrition Therapist at Clalit Health Services in Jerusalem).

The American Council on Science and Health agrees, “To prevent weight loss (frail older adults) may need to ingest fat at levels above those generally recommended.”

The  Memory Preservation Nutrition program recommends that these extra fat calories should be concentrated in the O

mega-3’s and Mono-unsaturated fats as explained above. In addition to concerns about sufficient calories, protein and fats, it is critically important that nutrient intense foods be included that feature the plant nutrients rich in anti-oxidants and other phyto-nutrients essential to brain and body health. Herbs, spices, berries and berry juices, whole grains, beans, lentils and nuts, vitamins B complex, D, E* (with all 8 mixed tocopherols and tocotrienols) along with the recommended food sources of the “favorite fats,” are good examples of brain healthy nutrient intense foods.

Research findings suggest that unintended weight loss is dangerous for older persons and is often one of the first signs of cognitive decline or dementia. Poor nutrition is also linked to more rapid decline in persons with MCI, Alzheimer’s disease and other dementias.
*Looking for a Vitamin E supplement with all 8 essential tocopherols and tocotrienols?  Go to our website and look for the E Gems Elite.  Great source of Vitamin E with all 8 parts as nature provides and our brains need!

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

Offer Expires: February 28th, 2011

Feb 9th, 2011: Healthy Eating for a Healthy Brain
This free event will be held in Methuen, MA at Methuen Senior Activity Center, 77 Lowell St, Methuen MA 01844.  RSVP to Sue Foster at Senior Center tel. 978-983-8825.  This event runs from 10:00-11:30am. This event is sponsored by Methuen Village at Riverwalk Park. Brain healthy muffins will be served.  Check out the events page at www.healthcareinsights.net

Feb 9th, 2011: Make & Eat Brain Healthy Mediterranean Appetizers        This free event will be held in Methuen, MA at Methuen Village at Riverwalk Park, 4 Gleason St, Methuen MA 01844. This event runs from 5:30-6:30. Join Kathleen Corey Rahme, Director of Social Programming and her friend, Christine Ryan for a cooking demonstration. They will show you how to make hummus and a lentil salad. Dr. Nancy Emerson Lombardo will also be present to explain why these foods are brain and body healthy. There will be a tasting too! Space is limited. RSVP to Kathleen or the receptionist at Methuen Village 978-685-2220 or info@methuenvillage.com. Check out the events page at www.healthcareinsights.net

Feb 15th, 2011: Food for Thought: Healthy Eating for a Healthy Brain
This free event will be held in Danvers, MA at Putnam Farms in Danvers, 9 Summer Street, Danvers MA, 01923. This event runs from 5:00-7:00pm. Brain healthy refreshments will be available at 5:00pm with presentation starting at 5:30pm. RSVP Putnam Farms tel.(978) 774-5959.  Check out the events page at www.healthcareinsights.net

Feb 17th, 2011: Brain Healthy Nutrition
This free event is part of the regular meeting of the Healthcare Disparities Coalition which will be held in Roxbury, MA at the Twelfth Baptist Church, 150 Warren St, Roxbury MA 02119. This event starts at 11:00am. Visitors welcome. Please RSVP with Richard Roy 617-296-0849 at  Check out the events page at www.healthcareinsights.net

Feb 22nd, 2011: Highlights of Brain Healthy Eating
This free event will be held in Woburn, MA at Woburn Senior Center-COA, 144 School Street, Woburn, MA 01801.  This event starts at 3:00pm sharp where Dr. Nancy Emerson Lombardo will be a featured speaker. Please RSVP to Hilary Viola at h.viola@minutemansenior.org or (781) 221-7060. Check out the events page at www.healthcareinsights.net

February 24th, 2011: Food For Thought: Healthy Eating for a Healthy Brain
This free event will be held in Avon, CT at River Ridge at Avon, 101 Bickford Extension, Avon CT 06001. This event runs from 5:00-7:00pm.  Brain healthy refreshments will be available at 5:00pm with presentation starting at 5:30pm.
RSVP to River Ridge, tel.  860-677-2155.   Check out the events page at www.healthcareinsights.net

March 24th, 2011: Brain Healthy Nutrition
This free event will be held in Framingham, MA at Callahan Senior Center, 535 Union Ave, Framingham, MA 01702. This event starts at 11:00am. Registration is free and there will be a free lunch available.  This event is sponsored by Compass at Golden Pond and the Metrowest Alzheimer’s Partnership. RSVP Leanna Moran – Lmoran@slr-usa.com    Check out the events page at www.healthcareinsights.net

April 6th, 2011: Food For Thought: Brain Healthy Eating
This free event will be held in Jamaica Plain, MA at the Springhouse Retirement Community, 44-46 Allandale Street, Jamaica Plain, MA 02130. 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 27th, 2011: Healthy Eating for a Healthy Brain

This free event 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

by Nicholas E. Lombardo

Interested in Buying this book? Go to The Catholic University of America Press  Here is what CUAP has to say about this book:

When Thomas Aquinas completed his Treatise on the Passions, it was likely the longest sustained discussion of the emotions ever written. His influence on medieval and early modern philosophy was enormous, overshadowing every other medieval author on the topic of emotion. Although Aquinas’s account of emotion merits attention for its historical significance and enduring value, it remains neglected by philosophers and theologians.

With emotion emerging as a focus of interest in many disciplines, the time is ripe for a reconsideration of Aquinas’s contribution. Desire and emotion are central to Aquinas’s theological project, and his views on many topics, including the relationship between cognition and emotion, show remarkable prescience in the light of recent developments. Emotion is particularly important to his understanding of virtue and vice. Focusing on the Summa theologiae, Nicholas Lombardo contributes to the recovery, reconstruction, and critique of Aquinas’s account of emotion in dialogue with both the Thomist tradition and contemporary analytic philosophy. It considers Aquinas’s thought on emotion in its historical context and inner logic, and shows how it bears on larger issues in his anthropology and ethics.

ABOUT THE AUTHOR:

Nicholas E. Lombardo is a Dominican priest engaged in research at the University of Fribourg in Switzerland.

PRAISE FOR THE BOOK:

“Nicholas Lombardo’s beautifully argued and carefully documented book is a persuasive retrieval of what Saint Thomas himself obviously regarded as essential to our understanding of the moral and spiritual life–even more important now than in his own day.”–Fergus Kerr, O.P., Honorary Fellow, School of Divinity, University of Edinburgh

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

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

© 2011 HCI

December 2010

Happy Holidays! Hopefully you are keeping yourselves warm and are looking forward to spending time with your families.  As the snow begins to fall we hope you looking for brain healthy meals and snacks instead of the unhealthy comfort foods.

When thinking about what you should make for your holiday meals look into some brain healthy recipes. This month we’re featuring brain healthy cookies on our website (there’s one now and more coming). Also look for the featured brain healthy recipe in our newsletter. When you bring our brain-healthy cranberry sauce to your holiday party, it will be a show stopper.

We’re you intrigued by our last newsletter featuring Omega 3’s and have been patiently waiting for the 2nd part?  Wait no longer!  The 2nd part of our Omega 3 article is in this newsletter.  When you read through this article you will be fully informed on Omega 3’s and will be able to make brain healthy choices!

Omega-3 fatty acids make up a major part of brain and body cells but can only be ingested, not made by our bodies. Omega-3s are important for building brain cell membranes, dendrites and synapses.  They are also anti-inflammatory, and thus helpful for preventing or managing a variety of diseases. Choose fish (3 or more x a week!), seafood, fish oils, green leafy vegetables, walnuts, flax seeds, and purslane.

What are the Types of Omega-3’s?

There are two major types of Omega-3 fatty acids:

1. alpha-linolenic acid (ALA), which is the plant form,
2. eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) which is the marine or “sea” form.  EPA and DHA are found in fish, algae and all seafoods and in grass fed and free range animals and poultry.

It is the marine form, DHA and EPA, that help make up our own brains and bodies cell membranes and other components, not ALA, the plant form.

Food Sources of Omega-3’s

ALA is found in vegetable oils such soybean, canola (rapeseed), and flaxseed, pumpkin seed, hemp seed, and perilla seed oils. Other sources of ALA include flaxseeds, pumpkin seeds, chia seeds, wheat (especially wheat germ), hemp, soybeans, tofu, walnuts, kidney beans, purslane, and green vegetables such as kale, spinach, Swiss Chard, collard greens, Brussels sprouts, Chinese cabbage, bok choy, mustard greens (and all of the other types of Chinese green vegetables), grape leaves, cauliflower, and salad greens.

Most foods rich in ALA also contain vitamin E which is one of nature’s primary ways of preventing oxidation of the delicate Omega 3’s.  It is vitamin E in its multiple forms that also helps protect from oxidation the Omega 3’s in our brain cell membranes and dendrites! (see our website and previous article about Vitamin E).

Purslane, though considered an exotic weed in the US, is frequently eaten as a leaf vegetable in Europe, Asia, and Mexico. Not only is purslane a rich source of ALA (1 cup of fresh leaves contains about 300 to 400 mg), but it is also a source of Vitamin A, Vitamin C, some B vitamins, magnesium, calcium, potassium, and iron. Some types of purslane are now sold as flowering plants; these are also edible.

What are the fish and animal sources of Omega-3’s?

EPA and DHA are found mostly in marine sources, especially in higher-fat, cold-water varieties of fish such as salmon, mackerel, albacore tuna, sardines, Atlantic herring, swordfish, and lake trout, as well as in algae and krill…so today they are referred to as “marine” Omega 3’s.

Surprising to many, PASTURE-RAISED (Free Range or Grass-fed) beef, lamb, and other animals, poultry and free-range chicken’s eggs are also rich sources of “marine” Omega 3’s including DHA and EPA.

Sixty percent of the fat content of grass is ALA Omega-3 fatty acid.  When animals consume grass and green leafy “weeds,” their flesh contains both ALA and the “marine” forms of Omega 3’s.  Just like humans, cattle convert the ALA they consume into EPA and DHA forms of Omega-3’s; an analysis of grass-fed beef shows that EPA is the most prevalent Omega 3. ALA is the second most prevalent Omega-3 in grass fed beef with DHA the least abundant.  But when transferred to the feed lot to be fattened on grains, the Omega-3 content rapidly diminishes until after just a few months in the feed lots, it is mostly gone.   Animals fed only grain have high levels of Omega 6’s and very low levels of Omega 3’s in their flesh… or milk or products made from animal milk.

Some varieties of eggs are Omega-3 enriched, with either ALA or DHA/EPA depending on what the chickens are fed, and whether they are free-range. Feeding chickens flaxseed and canola (rape) seed and greens increases mostly ALA content while feeding them algae and seaweed increases EPA and DHA content of the eggs.

Thus if you do eat animal foods, and you can afford it, go for the  grass fed and free range beef and lamb, and free range chickens, and/or Omega-3 eggs, and milk and cheese from grass fed cows.  This is especially important for meat lovers who are not eating enough vegetables!

How often should I eat fish and seafood?

The Memory Preservation Nutrition (MPN)® program recommends eating fish at least three times a week and ideally some fish, seafood and/or marine oil (from fish, cod liver, or calamari) every day of the week.

The MPN does not emphasize just oily or fatty fish, even though they are higher in Omega 3 fatty acids, for several reasons. The most important reason is that many non-oily fish also are relatively high in Omega-3’s and other important nutrients, and it is key that people try to eat fish that they enjoy eating.

What about contaminants in fish?

Though some fish contain mercury and other toxins the USDA and nutritionists say it is still safe to eat as much as 12 oz/week of those with problems (i.e. some domestic salmon, and those with higher mercury levels such as tuna, swordfish, and shark). However, pregnant women and small children are, as of late 2008, still cautioned by the USDA to avoid these particular fish.

Even more important though, pregnant women and small children need to consume fish, seafood, and fish oil to foster adequate brain and nervous system development for the fetus and child. There is indication that inadequate Omega-3’s in mother (during mother’s pregnancy and lactation) and child can result in poorer cognitive performance in school would otherwise be the case.  See http://www.hsph.harvard.edu/nutritionsource/what-should-you-eat/fish/index.html for a discussion of how to achieve the benefits of fish while reducing any risks.

Benefits of Supplements

Omega-3 supplements are an important way to ensure that you are getting enough Omega-3 fatty acids for optimal brain and body health. The preferred form of supplementation is DHA and EPA from fish oils, cod liver oil, or calamari (squid) oil. Calamari oil is excellent form rich in DHA and EPA, especially for those with fish allergy concerns (or worried about sustainability of our fish supplies).

Typically the amount recommended depends on the primary reason you are taking the supplement. A general recommendation is to take enough of a supplement to ingest between 600 mg to 3g of combined DHA and EPA daily. Be sure to read the label as supplements have variable amounts of the “active ingredients” of DHA and EPA depending on the brand and type of oil or capsule.   Thus to achieve these amounts you might need to take two to four or many more of 1000 mg (large!) soft gels, or 1-3 teaspoons of an oil a day.  Be sure to let you doctor know if you are taking more than 3g of the active ingredients (DHA and EPA) because Omega-3’s thin the blood (thinning the blood is generally a good thing but may interact with other medical regimens you are pursuing, e.g. coumadin). Also be sure to purchase brands known to provide contaminant-free oils; the better companies have lab analyses proving “no detectible levels” of mercury, pcbs and dozens of other possible contaminants; these companies also properly process and package oils and capsules to prevent oxidation and spoilage.

Vegetarian alternatives include algae derived DHA/EPA or 2 Flaxseed Oil 1000 mg softgels (which typically each contain 450 mg ALA Omega-3). However, this is less optimal than supplementing with oils of a marine source because flaxseed oil contains the shorter chain ALA Omega-3 that needs to be converted by the body to DHA or EPA, and this is done much less efficiently as we age.

How do I find out what is best for me?

Dr. Nancy Emerson Lombardo can be reached by e-mail or phone for inquiries about what supplements would be best for you personally, and which brands are best. She also offers preferred nutritional supplements including some Omega-3 products through her website or by phone or email.

MPN Nancy’s Cranberry Fruit Nut Holiday Sauce- a Brain Healthy (No Added Sugar) Recipe © 2009 Healthcare Insights, LLC

Yield:25 servings (2 Qts)

METHOD:

1. Wash, clean, dice or chop all fruit and nut ingredients
2. Grate orange for zest, chop orange sections
3. Combine fruits, chopped nuts and zest into large 4 qt. cooking pot.
4. Pour in 2 cups of liquid (mixture of fruit juices and water)
5. Stir
6. Add cinnamon and pumpkin pie spices
7. Optional: add minimal amount of natural, no calorie sweetener (you really don’t need this as the fruit juices, apples, pears etc are sweet enough to balance sour of cranberries).
8. Stir.
9. Place pot on the cooktop, on high or relatively high heat
10. Stir the mixture until it comes to a boil and simmer for 5-10 minutes, stirring as the cranberries “pop” and split.
11. Remove from stove and allow to cool to room temperature
12. Store in refrigerator until ready to be served.

*To have an Omega 3 rich recipe use walnuts instead of pecans.

WHEN READY TO SERVE:

Place in serving bowls and serve….

NOTE:May be served cool or at room temperature.

Any leftovers can be stored in refrigerator, usually keeps 1 month or longer.

Or, you can heat to boiling and use sterile canning processes to put into cup or pint-sized sterilized glass jars for future holiday meals. (or holiday gifts!)

© 2010 Nancy Emerson Lombardo Ph.D., and colleagues, HealthCare Insights, LLC.All rights reserved. No part of this publication may be reproduced, stored in a retrieval system or transmitted, in any form or by any means, electronic, mechanical, Photocopying, recording or otherwise, without prior written permission of HealthCare Insights, LLC.Direct correspondence to Nancy Emerson Lombardo, Ph.D. nemerson@healthcareinsights.net978-621-1926

For more Brain Healthy Recipes check out the recipe page on the website.

December 16th, 2010: “Brain Healthy Eating” featured at Lunch and Learn, Concord Council on Aging.
This free event is open to the public and will be held at Harvey Wheeler Community Center, 1276 Main St, Concord MA 01742. RSVP to Concord COA (978) 318-3020.  This event starts at 12 noon. Check out the event page at www.healthcareinsights.net

Feb 15th, 2011: Food for Thought
This free event will be held in Danvers, MA at Putnam Farms in Danvers, 9 Summer Street, Danvers MA, 01923. This event runs from 5:00-7:00pm. Brain healthy refreshments will be available at 5:00pm with presentation starting at 5:30pm. Check out the events page at www.healthcareinsights.net

Feb 17th, 2011: Brain Healthy Nutrition
This free event is part of the regular meeting of the Healthcare Disparities Coalition which will be held in Roxbury, MA at the Twelfth Baptist Church, 150 Warren St, Roxbury MA 02119. This event starts at 11:00am. Visitors welcome. Please RSVP with Richard Roy 617-296-0849 at  Check out the events page at www.healthcareinsights.net

Feb 22nd, 2011: Highlights of Brain Healthy Eating
This free event will be held in Burlington, MA Atria Longmeadow Place, 42 Mall St, Burlington, MA 01803.  This event starts at 3:00pm sharp where Dr. Nancy Emerson Lombardo will be a featured speaker. Please RSVP to Hilary Viola at h.viola@minutemansenior.org. Check out the events page at www.healthcareinsights.net

March 24th, 2011: Brain Healthy Nutrition
This free event will be held in Framingham, MA at Callahan Senior Center, 535 Union Ave, Framingham, MA 01702. This event starts at 11:00am.  Registration is free and there will be a free lunch available.  This event is sponsored by Compass at Golden Pond and the Metrowest Alzheimer’s Partnership. Check out the events page at www.healthcareinsights.net

April 6th, 2011: Food For Thought: Brain Healthy Eating
This free event will be held in Jamaica Plain, MA at the Springhouse Retirement Community, 44-46 Allandale Street, Jamaica Plain, MA 02130.  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 27th, 2011: Healthy Eating for a Healthy Brain
This free event 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

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

© 2010 HCI