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WBUR Alzheimer’s Special

Ch 5 Boston Chronicle Brain Foods

Elma Holder, Nursing Home Reformer

In May 2013, in honor of Older Americans Month, the AARP featured 10 Americans who over the past 50 years, helped the outside world respect and protect its older citizens. This feature article called Champions of Aging & history section by Patrick J. Kiger on the AARP website. The 10 Champions include President Lyndon B. Johnson for establishing Medicare, Robert Butler for spearheading the National Institute on Aging, and Maggie Kuhn, leader of the Grey Panthers. One special person featured is Elma Holder, the only one of the 10 who is alive and well. Elma Holder is a good friend of Dr. Nancy Emerson Lombardo.  

Nancy feels privileged to know Elma and learned about this latest honor while visiting Elma in Yukon, Oklahoma (just outside Oklahoma City, tornado alley) this past July 4 weekend, along with another long time friend, Bill Keane who now lives in Chicago area. Elma, Bill and Nancy have been celebrating their summer birthdays together for many years. Nancy writes, “We enjoyed Fourth of July festivities with Elma’s wonderful extended family, helped a younger sister move to her new home, and delighted in a mourning dove hatching two young squabs on July 4th in a hanging basket of ferns on Elma’s porch!”

Nancy writes, “Our friendship goes back over 25 years as Elma was the leader of the National Citizen’s Coalition for Nursing Home Reform when I led Public Policy Committee for the Alzheimer’s Association Board of Directors. I had the Alzheimer’s Association join her coalition, and worked with Elma and NCCNHR to represent cognitively impaired people in the drafting of the Nursing Home Reform Bill.   Bill Keane was then the leader of the Philadelphia Chapter and later had several national leadership positions in the Alzheimer’s Association, did strategic planning for NCCNHR, and assisted in the culture change movement, of which Elma is also a critical original member and continuing inspiration. Both will be attending this August’s Pioneer Network Conference in Bellevue, Washington (near Seattle). ” (see related article below) http://www.pioneernetwork.net/Events/2013Conference/

“Elma is so modest, only during the visit did I learn that in May she had been named one of 10 Champions of Aging by the AARP, looking back 50 years to LBJ and Medicare!  Elma is still a strong advocate for the elderly and particular residents in long term care, and hopes one day to write the history of the nursing home reform movement which she led. Because of her self-sacrificing nature (I poignantly remember more than one occasion when her friends begged her to use various personal cash awards to fund her pension plan and instead she would donate it to cover the budget gap at NCCNHR!), Elma has very limited funds and is living on just social security. She never complains and just continues hopeful for our respective futures.”

Recently Elma and her family just endured a horrific set of tornadoes and powerful thunderstorms that destroyed two cousins’ homes and damaged part of Elma’s home. (See last article below) Coincident with our writing this blog about Elma Holder and her AARP award, her friends in the nursing home reform and culture change movement are raising funds to cover the cost of a safe room for Elma. Moreover, Elma’s house holds the most critical historical records for the nursing home reform efforts.

I am including in the article below the letter from Morris Kaplan, a long time leader in the culture change movement, representing forward thinking for-profit owners.   I encourage anyone who can to send a check, as I will be doing.

Now it is time to share with you a bit of Elma’s story as nicely summarized by AARP.

http://www.aarp.org/politics-society/history/champions-of-aging-photos/elma-holder-nursing-home-reformer.html

The more Elma learned about the nursing home world, the more she realized something had to be done to watch out for the vulnerable citizens.

Below is the start of the article on Elma Holder:

“From the mid-1970s until her retirement in the early 2000s, Elma Holder did as much as anyone to protect some of America’s most vulnerable citizens – older nursing home residents – from neglect and abuse. As the co-founder of the National Citizens’ Coalition for Nursing Home Reform (NCCNHR), Holder fought tirelessly to improve conditions in, and increase oversight of, long-term care facilities. The effort culminated in passage of the landmark Nursing Home Reform Law of 1987. After that, Holder worked just as hard to make sure the law was aggressively enforced.”

Please see the full article at http://www.aarp.org/politics-society/history/champions-of-aging-photos/elma-holder-nursing-home-reformer.html

Readers may recall that Max Wallack is an inventor and developer of Puzzles to Remember that he created when he was only 14, now offered for retail by Springbok. (Puzzles to Remember was featured in our Dec 2011 Newsletter. Max was recently honored by the Boston University Alzheimer’s Disease Center at its brunch for participants in its major HOPE research study. At the brunch, Max donated puzzles for a lucky person at each of dozens of tables. Max Wallack has also donated funds to the BUADC research efforts.

Below is a description of Max’s book, “Why Did Grandma Put Her Underwear in the Refrigerator?” as well as a brief bio for Max:

“On some days, seven-year old Julie feels like she’s living in a Fun House. Hers is a topsy-turvy world where the toaster sprouts a toothbrush, and a watermelon gets dressed up in pink underpants for Fourth of July! But on other days, Julie struggles with understanding why her Halloween trick-or-treating got cancelled, or why Grandma can’t remember her name. Julie is struggling with understanding her grandmother’s Alzheimer’s disease. Authors Max Wallack and Carolyn Given believe that no child is too young to learn about this disease, or how to participate in providing safe care for their loved one. Why Did Grandma Put Her Underwear in the Refrigerator? is a sensitive, light-hearted children’s story that seamlessly provides its young readers with a toolbox to help them overcome their fears and frustrations. It shares easy-to-understand explanations of what happens inside the brains of Alzheimer’s patients, how to cope with gradual memory loss, with a missed holiday, or even a missing Grandma! This 40-page fully illustrated children’s book is told from a second-grader’s perspective in her own style and vocabulary, but it lovingly shares real strategies, scientific insights and lessons of dignity from which adult caregivers may also benefit.”

“Max Wallack is a 17 year old junior at Boston University, as well as a researcher in the Molecular Psychiatry in Aging Laboratory at Boston University School of Medicine. Max was a caregiver to his great grandmother who had Alzheimer’s Disease, and, in 2008, he founded www.PuzzlesToRemember.org, a 501c3 organization that has supplied over 23,000 puzzles to Alzheimer’s facilities around the world. A member of the American Association for Geriatric Psychiatry, Max gives research presentations at national conferences and publishes articles about his work in scientific journals. Max plans to become a geriatric psychiatrist, working with Alzheimer’s patients and their caregivers. Carolyn Smith Given is a mother of four, a caregiver, and a resident of the Blackstone Valley in Massachusetts. Since 2000, she has taught English Language Arts and Literature at both middle and high school levels, and currently performs medical research to support her husband’s multiple myeloma therapies. For fun, she attends her children’s weddings, invents gourmet vegan entrees, maintains a humor blog with more than 80 first person narrative vignettes — all true – at www.carolyngivenwriter.blogspot.com. She enjoys any and all writing projects that come her way.”

Please check out this book and recommend it to others. Remember the proceeds will be going towards solving the major challenge that is Alzheimer’s disease.

Tornado Safe Room for Garage

Nancy Emerson Lombardo urges all those appreciative of Elma’s leadership in nursing home reform and culture change to answer Kaplan’s challenge for us to raise funds for a tornado SafeRoom for Elma Holder who lives in tornado alley, just outside Oklahoma City.

Dear Friends of Elma,

I am sure that you all were as shaken and awed by Elma’s harrowing tornado experiences as I was.  The stories of destruction and terror, and of heroism and survival are breathtaking.  I remember Elma telling me several years ago, when I called after hearing about a tornado in her area, that she and her family always went to her backyard storm cellar.  Now that she’s moved to a smaller place, unfortunately, Elma has no storm cellar or basement.  (Apparently most Oklahomans do not.)  And worse, this newer more powerful type of tornado makes the safety of a hallway closet inadequate.  While we can’t stop the tornadoes, there is something that we can do to help keep Elma safe.  It’s called a tornado shelter.  My research led me to the same company that one of Elma’s friends has used and is very happy with (especially after these last frightening and devastating tornadoes.)

The FlatSafe Tornado Shelter company, in Yukon, OK (where Elma lives), builds underground and above ground (in garage) shelters.  Their website is very impressive: http://www.flatsafe.com   These shelters appear to meet a number of FEMA standards and other OK codes.  The cost for an above ground 4 x 8 saferoom for 8-10 people (standing) is $4800 including installation. This is the largest size.

Elma herself cannot afford such an expense on a fixed social security income.  I will contribute $1,000 towards the purchase and I’m writing to ask all of you to give what you can so that we can purchase the shelter and help keep Elma (with her immediate family) safe.  I propose that anyone who is interested, please send a check made payable to Elma Holder to my office (attn: Morris Kaplan, Gwynedd Square Nursing Center, 773 Sumneytown Pike, Lansdale, PA 19446, phone: 215-699-5000).  I will send the donations to Elma. If you can email me and let me know to expect it, I can try to let everyone know the amount raised as we proceed.  The amount you donate will be kept private unless you let Elma know directly how you want it handled. Any amount will help and be greatly appreciated.

There are many bad things in life that we cannot protect ourselves or our loved ones from.  This is one thing that we can do something about.  Please join me in helping to keep Elma safe.

Thank you and best wishes,

Morris Kaplan

Gwynedd Square Nursing Center

773 Sumneytown Pike,  Lansdale, PA               

(215) 699-5000

 email: Gwyneddsquare@aol.com

Family owned & operated since 1980

P.S.  In case you did not receive a copy of Elma’s account of the May tornadoes, I’m attaching a copy (See next article)  . Also, please note that Elma’s Yahoo e-mail account was compromised in May. She is working at reconstructing her lost contact list (both e-mail addresses and mailing addresses) since she has switched to a new g-mail account: elmaholder728@gmail.com.

From: MKaplanEmail@aol.com
To: gwyneddsquare@aol.com
Sent: 7/3/2013 3:28:33 P.M. Eastern Daylight Time
Subj: Fwd: OK Tornadoes and my personal thanks

For our readers at brainwellness.com, you may want to learn more about Morris Kaplan’s nursing home because it is very highly rated and he is considered a leader in the culture change movement.  Here is the website and something I copied from it:  http://www.goodnursinghome.com/

Gwynedd Square is rated 5 stars out of 5 stars by the U.S. Government

Gwynedd Square is a recognized leader in dementia care and has been selected by the US Department of Health & Human Services, Centers for Medicaid & Medicare Services, as a model for reducing antipsychotic drug use and improving care for residents with dementia. 

See US Gov. Webcast featuring Gwynedd Square:

http://www.youtube.com/watch?v=U1_rpO0bwbM&sns=em

As you know from news coverage, the Shawnee/Moore area tornadoes were deadly.  We were blessed, because both passed within 10-15 miles from Yukon. Those 2 days were horrendous and amazing because we watched live TV as the tornadoes formed and began their destruction.  (We have our own spring “reality” show here in OK.)  We were advised that our “normally run-to sheltered hall closets” would most likely not be enough to save people as in previous, less massive storms.  We are so grateful for the current technology which keeps us “weather alert” (the new OK buzz word) with minute-to-minute, block-to-block tracking.  It is almost indescribable what emotions surface as one watches such coverage – frightening beyond imagination at times. Intense feelings and dreams linger days after each serious event.

The loss of life and “homes” was tragic. Two of our cousins in the OK City/Moore area lost their homes. Luckily, they were not harmed.  Cousin Troy managed to save his neighbor and her children by hoisting them into his pick-up truck (the closest tornado “cellar” was full).  He sped to a nearby metal culvert – helped them in, throwing his big frame around them – moments before the tornado sped by.  He was bruised by flying debris; otherwise, okay.  Afterwards, they found only a concrete foundation where her house stood.  A small part of Troy’s home was still standing with a few pieces of furniture intact.  His neighbor with children had been headed for her closet when my cousin arrived!

We could hardly imagine that it would be so soon before another F-5 hit the next week right in the backyard of our Yukon community.  Now reported to be the biggest (widest) tornado ever, it had proceeded east down route 66 destroying the local tech school and rural houses 5-6 miles away. If it had continuing tracking 66 it could have wiped out most of our town. As it was, 12 of us (immediate family) were huddled in my nephew’s basement just 2 blocks south of 66.  We had plenty of pillows to cover our heads.  Jagger almost three had a helmet. (We were all wishing we had one too!)  Although we felt vulnerable, with two small low windows in that area, we were relieved to have our family together.

When we left the basement after two hours filled with periodic tornado sirens, the nature of the sky left a remarkable impression.  The sky looked battered and violent.  It appeared to be painted, with deep colors of green, black, brown, and yellow.  It felt and looked evil, as it had been a short time before.  I hope to never see that same sky-view again.

We all know people who suffered serious property damages in this latest storm.  I was fortunate with only minor loss since the strong winds blew siding off a small part of my roof.  I returned home that evening to find my family room covered in water from the torrential rains. I’m now dealing with the insurance company – waiting to see if it will provide the roof repairs, a new ceiling and part of my wood flooring.

Thanks for listening and thanks again for your expressions of concern.  I know that each area of the country has its own share of weather misery and abuse.  It does seem certain to me that Mother Nature expresses her wrath more intensely each year.  For now, like so many others in this area, I have two backpacks filled with things (papers, pictures, etc.) I might need or want with me if all else blows away. I’ll keep them packed during tornado season – and yes, they are in that hall closet; I just may need it  as a last resort!  Everyone is exploring all their options for safety.  Each community needs its own shelters. At least we hope more schools will get them now.

P.S.  Please send Elma your email address if you are a friend or colleague, as she lost most of those she had.

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

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Ch 5 Boston Chronicle Brain Foods

  

 Brain Foods for Thanksgiving!

At the 22^nd Annual Matthew and Marcia Simons Research Symposium on Alzheimer’s Disease on Thursday, November 8, 2012, sponsored by the Alzheimer’s Association, Kristine Yaffe, MD of University of California, San Francisco, presented “Non-Pharmacological Strategies for the Prevention of Alzheimer’s Disease. ” There is currently more interest in non-drug approaches because recent attempts to find a pharmaceutical solution to prevent or dramatically slow AD have failed.

Dr. Yaffee reviewed research that shows staying physically and intellectually active, eating a brain healthy diet, and embracing a healthy lifestyle may help prevent and slow Alzheimer’s disease. Dr. Yaffe’s survey of recent studies echoed the evidence often shared by Boston area’s own brain health expert, Nancy Emerson Lombardo, Ph.D., e.g. on her new website www.BrainWellness.com, a chapter on lifestyle and Alzheimer’s disease in Sage’s 2012 Encyclopedia of Lifestyle Medicine and Health.

During the past decade Dr. Nancy Emerson Lombardo has developed nutrition and lifestyle interventions for both treatment and lowering risk of Alzheimer’s disease (AD), and to improve quality of life for all ages, particularly older adults. As many of our readers know, Dr. Emerson Lombardo has worked for over 30 years in the fields of Alzheimer’s disease and services for older adults. She is a founder of both the national Alzheimer’s Association and Alzheimer’s Disease International. She is also a member of the American Society on Aging, and the International Academy of Nutrition and Aging.

Since we now know that AD is a chronic disease with many environmental and genetic factors, and that the abnormalities/pathology most likely begin 20-30 or more years before clinical symptoms appear, it makes sense to practice evidence-based brain healthy lifestyles as soon in one’s life as possible. Even if better drugs are discovered, chances are that side effects would argue against using them for decades before symptoms appear, unless one’s genetic profile suggested very high risk. And even though much drug research is targeting beta-amyloid, one of the two problem proteins that are hallmarks of AD, other researchers think other targets might yield better results as the exact causes and etiology of AD are not fully known. This continuing uncertainly is yet another reason to adopt brain healthy lifestyles that, especially when multiple lifestyles are practiced, target all known pathways to AD.

A large body of research studies have linked nutrition, exercise, and healthy lifestyle approaches to the prevention and treatment of both cardio-vascular disease (and its risks such as hypertension, high LDL cholesterol, inflammation), stroke and diabetes and more recently shown how each of these chronic diseases in turn raise risk of cognitive decline and Alzheimer’s. Logically then, Dr Nancy Emerson Lombardo and others recommend lifestyles that are both heart healthy and diabetes and stroke preventative.

What can you do to be “brain healthy?” Dr. Emerson Lombardo lists 11 domains of brain health for which we have some or substantial evidence. According to Dr. Yaffee and others, the best gold standard randomized clinical trial evidence to date is for #2 physical exercise and #3 mental stimulation. Close behind is evidence for adequate sleep (because that is when memories are transferred into a more permanent state) and treatment of depression. During a pre-Simon lecture presentation, Dr. Alireza Atri, MD, Ph.D. also shared evidence about importance of #5, social engagement. Both Drs. Yaffee and Atri agree with Dr. Emerson Lombardo that although we have yet to have sufficient “gold standard” clinical trial evidence, there is substantial pre-clinical and epidemiological evidence to suggest that a brain healthy diet, and perhaps combinations of nutrients, rather than single stand alone nutrients, will be proven to be essential to reducing risk of Alzheimer’s disease and cognitive decline. Dr. Emerson Lombardo’s Memory Preservation Nutrition® is uniquely based on all the nutritional evidence reported to date.

The Eleven Evidence-based Domains of Brain Health (To learn more about each, follow links to relevant pages of our BrainWellness.com website)

(1)Nutrition and Hydration: Memory Preservation Nutrition®

(2)Physical Exercise

(3)Mental & Cognitive Stimulation including Cognitive Education/The Serper Method, Memory Techniques & Medication Management; cognitive training & cognitive/kinetic methods.

(4)Management of Stress and Depression

(5)Social Engagement & Support

(6)Sleep – needed for memory to be stored

(7)Balanced Chi (Energy)

(8)Music (listening to and playing music) and Other Creative Arts & crafts, story-telling.

(9)Spiritual Practices – Pray, Meditate, Forgive, Let Go, Be Kind & Loving, Practice Gratitude, Be Positive

(10)Humor, Fun, Laughter & Joy

(11)  Sense of Meaning and Purpose in Life

Here are some more details on one of these 11 domains, Nutrition.  Then read a related article on how to apply some of these ideas to your Thanksgiving dinner preparations.

NUTRITION

Nutrition is one of the 11 domains for a brain healthy lifestyle. What we eat is important. Brain healthy nutrition is key to good memory. 

Dr. Emerson Lombardo’s most important recent effort is the development of Memory Preservation Nutrition® (MPN), a nutritional program for the dual purposes of helping people reduce their own risk of Alzheimer’s disease, and to slow progression and improve the lives of persons who have already living with Alzheimer’s’. She is currently implementing her Memory Preservation Nutrition® program in several Assisted Living residences. She also works with individuals and families to help them assess all 11 lifestyles, and to implement the MPN step by step in their own lives.

The Memory Preservation Nutrition® program is easy to fit your particular situation and food preferences. We help you know:

* WHAT to eat
* WHY it is important to you
* HOW to develop strategies and plans and actually adopt brain healthy eating habits

The Memory Preservation Nutrition® program benefits adults and children, alerting people which foods are “brain foods” and which are “brain busters.” Research indicates that proper nutrition is essential to defend against brain deterioration caused by aging and disease. Vegetables and fruits, nuts, seeds, whole grains, spices and herbs, as well as fish and sources of Omega-3’s, are among the fundamentals of the Memory Preservation Nutrition® program.  This nutritional program is high in anti-oxidants, and in foods that are anti-inflammatory and safe for diabetics, and heart healthy. It is no coincidence that these  same foods help reduce risk of cancer, arthritis pain, digestive issues and other chronic diseases. The health of our brain is tied in to the health of every other organ in our body.

While it is recommended to get nutrition from whole foods, nutritional supplements should be considered. This includes supplements designed to:

1) reduce inflammation in brain and body, including joint pain and “morning stiffness.”

2) help support healthy digestion and relieve stomach issues,

3) support memory, attention, and decision-making,

4) enhance bone strength,

5) help relieve or reduce frequency of headaches,

6) support emotional health.

Our favorite supplements rely on whole food-based juices or extracts (spices, herbs, vegetables, fruits, whole grains), fish or other non-fish marine oils rich in DHA and EPA Omega-3’s. Dr. Emerson Lombardo suggests that while neither multi-vitamins nor most stand alone vitamins have proven to be helpful, there are three that are essential to brain health and often need supplementation: B (all B’s in a complex vitamin), D and E (the only one worth taking is vitamin E with all 8 tocopherols and tocotrienols). To learn more about what Dr. Emerson Lombardo recommends, see her website www.BrainWellness.com.

Holiday brain food ideas follow the Memory Preservation Nutrition® program developed by Dr. Nancy Emerson Lombardo based on the latest evidence. Research shows that brain foods can boost your brain health at ANY age. Our team at HealthCare Insights, LLC, and the talented chefs at Assisted Living communities implementing the Memory Preservation Nutrition® program, enhance these ideas and sample recipes with their own cooking skills to create scrumptious foods. We’d like to share some of these ideas for the holidays. Actual recipes can be found at BrainWellness.com and Senior Living Residences. 

For brain healthier meals for family holidays: serve

Brain Foods

brain boosters instead of brain busters.         

Here’s how:

• Add nutritious ingredients such as foods full of anti-oxidants, that are anti-inflammatory, and that help us lower, rather than raise, our blood pressure, blood sugar and cholesterol levels. To do this: Add more vegetables, spices, herbs and other plant foods, such as nuts, seeds, fruits, especially leafy green vegetables.
• Use fewer animal foods and more fish and seafood
• Limit brain busters in your recipes: sugar, white flour, white rice, refined starches, processed foods, salt and saturated and especially trans fats.
• 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.
• Adapt favorite family recipes and make them more brain and body healthy.

Here are some specific ideas to preserve brain power:  

1)Make Your Sweets Nutritious

Whenever you are offering a dish with sugar, offset that sugar with have healthy ingredients such as whole grains, nuts, seeds, fruits, vegetables and spices, herbs, and ideally some protein and healthy fats as well. Examples include: Fresh whole fruits,  Greek yogurt parfaits,   dark chocolate truffles , apple crisp

, fruit pies, or fruit & nut breads made with whole wheat pastry flour, trans-fat-free healthy fats, and natural sugar substitutes. (see BrainWellness.com for recipes). To be brain healthy for everyone, choose dishes that would be safe for a person who is diabetic. Foods that spike our blood sugar are especially damaging to the brain and our memory. Instead of sugar & corn syrup, try safe zero calorie natural sweeteners such as stevia, Truvia®, Purevia®, or lower glycemic index coconut sugar. Use these also in your cranberry sauceinstead of sugar.

2)Serve Brain Healthy Appetizers

• Limit the amount of appetizers that are loaded with salt or saturated fats, and processed foods. Especially avoid red colored meats with nitrates (such as corned beef, pastrami, salami, pepperoni, ham, and bacon). Avoid foods with ingredients such as transfats, high fructose corn syrup, and other refined sugars. Suggestions include shrimp, scallops, healthy dips (see below), lean turkey/chicken sates, veggie sticks,    olives,  artichokes, avocados, nuts and fruits.   
• Avoid ANYTHING with “partially hydrogenated” on the list of ingredients even if the Nutrition Facts declare no or 0% trans fats.
• Look for whole wheat or whole grain crackers and pita chips. Plain original Triscuits are whole wheat with no additives (avoid the newer “spice” ones which are full of additives). “Annie’s” little whole wheat bunny crackers are popular.
• Include vegetables, such as cut up vegetables dipped in healthy dips such as humus and guacamole, or use yogurt in your dips.

3) Serve Brainy Beverages: Use water, fruit juice, natural mineral waters or smoothies. 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 is offered a glass or bottle of water.
• Offer iced or hot tea (GREEN or black) if you have tea lovers in your group. Coffee is OK.
• Offer cinnamon for coffee or tea as alternative to cream or sugar.

4) Make Your Smoothies “Green”

Take your favorite fruit based smoothie and make it healthier by adding some greens (e.g. kale, romaine, parsley, spinach) to your mixture before blending.

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. (Brussels sprouts and broccoli count!)   

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

(and try adding cauliflower to your mashed potatoes (50-50 or 100% cauliflower! ) 

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

(i.e. stevia, Truvia or Purevia, or try coconut sugar or raw honey instead of sugar or brown sugar)

10) Use Lots More Herbs and Spices in Everything You Cook (while using less salt and sugar) to add more nutrition and more flavor. use lots of herbs & spices every day!

If some of the listed brain foods leave you curious as to WHY the Memory Preservation Nutrition® program recommends them, go to Answers to some whys for some Memory Preservation Nutrition Programs Recommended ingredients.

For the gene TREM2, certain loss-of-function mutations had previously been associated with an autosomal recessive form of early-onset dementia.

The UK/USA group looked at 1092 patients with Alzheimer’s disease and 1107 controls (the discovery set)  to identify the TREM2 mutant genes/alleles, and also did meta-analyses and looked at unrelated databases of patients and controls to replicate and verify their initial findings.  This group also assayed the expression of TREM2 across different regions of the human brain and looked at differential gene expression in AD and control mice to clarify genetic mutations and disease mechanisms.(Multiple funders including several in UK, NIA, NINDS)

Iceland group found that the Immune System related rare gene TREM2 increases risk of AD 3-fold.  In the study, researchers from DeCode Genetics analyzed 2,261 Icelanders and found those with a variant, or defect, on a gene called TREM2 had almost a three times higher likelihood of Alzheimer’s disease than those without the mutation. The scientists also tested a combined 2,000 people in four other groups from the U.S. and Europe, finding similar results.(multiple funders including NIA.)

The Icelandic researchers determined that carriers of the mutation who were at least 80 years old and without Alzheimer’s disease had poorer cognitive function than their unmutated peers. Authors conclude, ” Our findings strongly implicate variant TREM2 in the pathogenesis of Alzheimer’s disease. Given the reported anti-inflammatory role of TREM2 in the brain, the R47H substitution may lead to an increased predisposition to Alzheimer’s disease through impaired containment of inflammatory processes. (Funded by the National Institute on Aging and others.)   Check out the full article at New England Journal of Medicine.

According to Andrew Budson , MD of the BU Alzheimer’s Disease Center and Boston Memory Clinic who studied with him, over a decade ago Dr. Stefansson began by asking the question, how are 75 year olds newly admitted to nursing homes with dementia, different from 85 year olds with same condition.  Dr. Steffansson’s genetic research has led to uncovering several chronic disease related genes.

These two studies further underscore the importance of foods and other healthy lifestyles that decrease inflammation in body and brain. See BrainWellness.com for more details on how the Memory Preservation Nutrition® is designed to reduce inflammation. Regular physical exercise also reduces inflammation; smoking increases it.

Check out our brain health blog to see the abstracts from each article as well.

Check out our on line store.  NOTE:  ALL ORDERS PLACED BY DECEMBER 31, 2012 WILL RECEIVE A REBATE CHECK FOR 20% OF GOODS OR SERVICES PURCHASED (NOT INCLUDING ANY SALES TAX OR SHIPPING/HANDLING CHARGES)   

Many brain healthy and anti-inflammatory, anti-oxidant supplements and vitamins are available to be purchased,  as well as  reading materials and services from Dr. Nancy Emerson Lombardo. In addition to ordering on line you may email Dr. Emerson Lombardo directly to order and pay by check.
 

Look for Dr. Emerson Lombardo’s monthly column in the South Shore Senior News.

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

© 2012 HCI

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WBUR Alzheimer’s Special

Ch 5 Boston Chronicle Brain Foods

How much do you know about the benefits of Coconut Oil?

Bottom line: The story is still out on the coconut oil research so please don’t go overboard with eating coconut products or putting all your eggs in this basket. Continue to eat a brain healthy nutritional program with a variety of healthy foods such as recommended by my evidence-based Memory Preservation Nutrition® program.

On the other hand, more and more recent research is suggesting coconut oil has a variety of overall health benefits. So you might want to start consuming a modest amount of coconut products including coconut oil, keeping in mind you will want to save some of your fat calories for other fatty plant and marine foods KNOWN to be beneficial for our brains, such as nuts, seeds (including flax, hemp and chia seeds rich in omega 3’s), avocados, seafood and fish oil, olive oil, and yes, dark chocolate. (Photo taken at Neville Place’s Anniversary Party featuring Memory Preservation Nutrition® program recipes and foods!)

Brain Healthy Desserts with Dark Chocolate, Nuts, Seeds & Fruit

The concerns of 1970s and 1980s that the high saturated fat content in coconut oil was dangerous to health (over 85% of fat in coconut oil is saturated) are undergoing review. Those early findings may have been distorted because the studies included coconut oil that was artificially (i.e. by man) partially hydrogenated, i.e. included large amounts of transfats.

Whether consumption of coconut oil causes the body to produce LDL cholesterol is now controversial as others argue coconut oil reduces it. In any case there is no cholesterol in any plant based food. Nutrition scientists are taking a fresh look at whether and which saturated fats from PLANTS are beneficial rather than harmful, as most excessive saturated fats from animals appear to be in contrast to excessive saturated fats from animals which appear to be harmful in excess.

More recent research has suggested the particular fats in coconut oil are healthy fats and protective of the body in multiple respects. There are dozens to hundreds of research articles relevant to establishing the many health benefits claimed for coconut oil. See the Coconut Research Center. We do not know who sponsors this website (probably the coconut industry), but the articles listed seem legitimate.

If you click on any particular research study it will take you directly to pub med, the US government’s public access website for scientific studies related to health

http://www.ncbi.nlm.nih.gov/pubmed/

As many of the websites point out, coconut products are FOOD that have been used for hundreds to thousands of years by humans in southeast Asia and elsewhere. The main proven side effect is that eating a lot of it will add so many calories you will probably gain weight. But even that concern can disappear if the rest of your diet is healthy and balanced, and coconut oil and other parts of the coconut are being used instead of unhealthier calorie sources such as sugar, white flour/rice, refined starches and animal saturated fats/oils.

Keep in mind, whatever the source of fat, 1 gram of oil or fat equals 9 calories. And every teaspoon of coconut oil weighs on average 4.5 grams and thus means you are consuming about 40 calories; 1 Tablespoon is 120 calories. If your total diet includes too many calories vs. how many you burn off each day, your body stores the excess calories (whether from sugar or fats) as body fat and excess body fat includes cholesterol. (Yet evidence is building that the really toxic substance is excess SUGAR, that also causes the body to create fat and cholesterol).

Some of those who have incorporated coconut oil into their daily regimen use no more than about 1 or 2 Tablespoons/day of pure coconut oil, raw or heated. (That’s about 120- to 240 calories or 10-15% of total calories for the day!).

My conclusion? Eating some coconut of all kinds (coconut milk, oil, or coconut meat) is good for all of us, so long as we leave room in our diet for the other known healthy fats and oils (e.g. fish or other marine oils, olive oil, nuts and seeds, avocados, dark chocolate, to name a few). Coconut oil contains small amounts of the gamma tocopherol form of vitamin E that our brains love (see Nutrition Facts for raw coconut oil.) And another tropical plant oil, palm oil is the best commercial source of the scarcer vitamin E forms, the tocotrienols, that our brain and body need to be at peak health.

However it will take a lot of hard and collective work, internationally as well as nation-wide, to actually change the trajectory of Alzheimer’s and other brain diseases. It will take serious increases in funding of both research and care, through bipartisan collaborations to achieve the full potential of the National Alzheimer’s Plan. To quote the Alzheimer’s Association: We need substantial “more public education, improved care, better community supports, and ultimately, effective treatments to prevent and effectively treat Alzheimer’s.”

From the Alzheimer’s Association:

The development of the plan is a result of a mandate within the National Alzheimer’s Project Act that was passed unanimously through bipartisan congressional support and signed into law by the president in January last year.

“This is a strong plan that promises important progress when implemented,” said Harry Johns, president and CEO of the Alzheimer’s Association. “For all Americans – not just the more than 5 million living with Alzheimer’s and their 15 million caregivers today – this plan is an historic achievement.”

After the passage and enactment of the National Alzheimer’s Project Act, the Alzheimer’s Association and its more than 460,000 advocates have made impassioned demands for swift action on Alzheimer’s in Washington and in communities nationwide. The Alzheimer’s Association’s public input campaign included more than 130 input sessions in communities nationwide. Insights gathered from these sessions informed the creation of this plan.

The Association will continue to support the implementation process and looks forward to continued work with the Department of Health and Human Services to meet the Administration’s important goal to prevent and effectively treat Alzheimer’s disease by 2025.” Check out the article at www.alz.org

To view the complete national plan you can go online or download the attached pdf file

The Obama administration has also published a brand new website for “one stop shopping” about Alzheimer’s disease, go to www.alzheimers.gov which is a state of the art enhanced version of its ADEAR center’s website.

This will complete the wonderful information already found on the Alzheimer’s Association’s website www.alz.org

To signify that the National Plan is not just words, and that the administration is determined to start moving forward rapidly toward realizing the goals, the administration also reiterated the dedication of $50 million extra research dollars this fiscal year, and an additional $100 million for FY 2013 as well as the launch of two new important human clinical trials.

• A Phase III trial of Susan Craft’s study of a nasal insulin spray to treat people with AD.”It’s based on growing evidence that diabetes and Alzheimer’s are related, damaging how the brain is fueled.” The insulin nasal spray can reach the brain without affecting blood-sugar levels.”
• a new prevention trial for a South-American family where 50% of members develop AD. (to learn more)

More from NIH Press Release:

The first National Alzheimer’s Plan comes as the world’s top Alzheimer’s scientists are gathered at the NIH this week to debate what research needs to be given priority in order to meet that ambitious 2025 deadline. They said it may be time to start testing potential therapies differently, before people have full-blown Alzheimer’s symptoms, when it may be too late to help.

“There’s a sense of optimism” thanks to some new discoveries, Dr. Francis Collins, director of the National Institutes of Health, told scientists at the Alzheimer’s Research Summit on Monday.

But, “we need to figure out exactly where is the best window of opportunity” to battle back Alzheimer’s, Collins said. He noted that cardiologists don’t test cholesterol-lowering drugs on people already near death from heart failure.

Reisa Sperling MD

It’s clear that Alzheimer’s quietly brews in the brain, killing off cells, for 10 years or more before symptoms appear, Dr. Reisa Sperling, MD, of Harvard Medical School told the meeting. She called that time period an important opportunity to try to stave off the disease, at least postponing the memory loss and other symptoms.

Already, 5.4 million Americans have Alzheimer’s or related dementias. Barring a research breakthrough, those numbers will rise significantly by 2050, when up to 16 million Americans are projected to have Alzheimer’s. Already, it’s the sixth-leading killer in the U.S., and there is no cure. Treatments only temporarily ease some symptoms.

Beyond the suffering, it’s a budget-busting disease for Medicare, Medicaid and families. Caring for people with dementia will cost the U.S. $200 billion this year alone, and $1 trillion by 2050, the Alzheimer’s Association estimates. Even that staggering figure doesn’t fully reflect the toll. Sufferers lose the ability to do the simplest activities of daily life and can survive that way for a decade or more. Family members provide most of the care, unpaid, and too often their own health crumbles under the stress.

Caprylic acid is the active ingredient of Axona, which is marketed as a “medical food.” Caprylic acid is a medium-chain triglyceride (fat) produced by processing coconut oil or palm kernel oil. The body breaks down caprylic acid into substances called “ketone bodies.” The theory behind Axona is that the ketone bodies derived from caprylic acid may provide an alternative energy source for brain cells that have lost their ability to use glucose (sugar) as a result of Alzheimer’s. Glucose is the brain’s chief energy source. Imaging studies show reduced glucose use in brain regions affected by Alzheimer’s.

Axona’s development was preceded by development of the chemically similar Ketasyn (AC-1202). Ketasyn was tested in a Phase II clinical study enrolling 152 volunteers with mild to moderate Alzheimer’s. Most participants were also taking FDA-approved Alzheimer’s drugs. The manufacturer of Axona reports that study participants who took Ketasyn performed better on tests of memory and overall function than those who received a placebo (a look-alike, inactive treatment). (See below for abstract of the study)

The chief goal of Phase II clinical studies is to provide information about the safety and best dose of an experimental treatment. Phase II trials are generally too small to confirm that a treatment works. To demonstrate effectiveness under the prescription drug approval framework, the FDA requires drug developers to follow Phase II studies with larger Phase III trials enrolling several hundred to thousands of volunteers.

The manufacturer of Ketasyn decided not to conduct Phase III studies to confirm its effectiveness. The company chose instead to use Ketasyn as the basis of Axona and promote Axona as a “medical food.” Medical foods do not require Phase III studies or any other clinical testing. The Alzheimer’s Association Medical and Scientific Advisory Council has expressed concern that there is not enough evidence to assess the potential benefit of medical foods for Alzheimer’s disease. For more information, please see the Medical and Scientific Advisory Council statement about medical foods.

Some people with Alzheimer’s and their caregivers have turned to coconut oil as a less expensive, over-the-counter source of caprylic acid. A few people have reported that coconut oil helped the person with Alzheimer’s, but there’s never been any clinical testing of coconut oil for Alzheimer’s, and there’s no scientific evidence that it helps.

Is this true?

Dr. Mary Newport (featured in the CBN video), pediatrician author of the 2011 book Alzheimer’s Disease: What If There Was a Cure?: The Story of Ketones, supports the glucose-starvation theory and postulates ketones (delivered in the form of coconut oil) provide an alternative energy source for brain cells that have lost to Alzheimer’s their ability to use glucose (the brain’s chief energy source). She points to her own husband’s remarkable results after having had his diet supplemented with this substance as one of the proofs of this form of treatment.

But is there any solid proof that coconut oil is an effective treatment for Alzheimer’s? On his MedFriendly web site, neuropsychologist Dr. Dominic Carone uses the claim that Alzheimer’s disease can be effectively treated or reversed with coconut oil as the basis for a case study on how to evaluate suspicious medical treatment claims. He proposes the application of five criteria to the analysis of such claims:

• Search the peer-reviewed medical literature.
• Evaluate the quality of peer-reviewed medical literature.
• Research who is promoting the treatment.
• Be skeptical of suspicious claims.
• Research what respectable organizations devoted to the condition say about the treatment.

The coconut oil as a treatment for Alzheimer’s disease claim fails the first criterion (and renders the second moot) because there are no peer-reviewed articles addressing research on coconut oil as a treatment for Alzheimer’s disease.

Of the third criterion, Dr. Carone notes:

It is important to evaluate the person or group of people promoting the supposed treatment to determine if there are reasons to cause suspicion about the accuracy of the claims being made. Examples can include a financial conflict of interest, desire to help a loved one with the proposed treatment, or anger towards conventional medicine. Coconut oil treatment for Alzheimer’s is mainly promoted by a single person (a physician) whose husband has Alzheimer’s disease. This doctor is selling a book based on the claim and has published comments on a website taking personal credit for outsmarting drug companies along with apparent antipathy towards those companies that make “monopoly profits.”

Of the fourth criterion, Dr. Carone notes:

The fact is that Alzheimer’s disease is [currently] incurable and causes progressive degeneration of brain tissue, yet the claim is being made that coconut oil can reverse Alzheimer’s disease and totally halt brain atrophy. These claims are partly based on the doctor observing changes in her husband after using the coconut oil, which leads to a subjective investment in believing the treatment will work. This is not the standard by which medication effectiveness is judged and is very far from randomized, double-blind, placebo controlled studies.

For the fifth criterion and conclusion see the snopes website.

• Good nutrition with delicious foods
• Culture Heritage and
• Eating, Shopping and Cooking.

African Stew

One diet that they promote is African Heritage Diet. Many diseases that we see running rampid today were not nearly as common in earlier times such as, obesity, heart disease, and diabetes. This is due to primarily to the change in our diets, as well as lack of movement in our daily lives, together with increase of toxins, less sleep and more stress.

Scientific research suggests following traditional diets, using foods as close to those that your particular ancestors ate, will lower your risks for many of these diseases.

Check out Oldways pdf on the African Heritage Diet.

Check out their website for more information at www.oldwayspt.com. They have lots of recipes and meal planning suggestions for several traditional nutritional styles such as Mediterranean, Latino, Turkish and African American.

Mediterranean coast

And if you are into healthy baked goods, (we hope you are) a wonderful baker local to the Boston area is perfecting her delicious baked goods and will soon be marketing them more broadly. Her name is Tonya Johnson, and she is using traditional and “ancient” grains and the ancient tradition of SPROUTING GRAINS before using in cooking and baking. Guess what, sprouting turns a grain into a vegetable, so much more healthy for us, and most of the problem with gluten in wheat or spelt disappears for most people. Tonya Johnson is known as the ANCIENT BAKER; her company is “Visions Sown”. Ms. Johnson is currently earning another advanced degree, this time in management at Simmons College and she has earned the interest of professors and students at Bentley College who chose her business as the semester’s class project.

Check out Tonya’s facebook page & website to find where you can purchase her delicious cookies and other baked goods.

Want more information on healthy diets? Check out the book The Jungle Effect: A Doctor Discovers the Healthiest Diets from Around the World – Why they Work and How to Bring them Home by Daphne Miller. Watch video of Author’s summary.

Here is the Publishers Weekly review: Family physician Miller had seen countless cases of chronic illness and weight gain, but it wasn’t until she saw a patient recently returned from Brazil that a light bulb went off in her head: the patient had noticed marked improvement after just a few weeks in her father’s native village. Intrigued, Miller did some research and found a number of “cold spots” around the world, areas where chronic diseases like diabetes, depression and heart disease are disproportionately low. She then embarked on a world tour to find out why. As she travels through Copper Canyon, Mexico to Cameroon, West Africa to Iceland-where locals manage to avoid depression in one of the darkest and coldest regions in the world-and beyond, Miller finds that, in each case, local diet plays a key role. Many of her overarching tips will sound familiar (eat fresh foods, eat more fish, avoid refined sugar, watch the salt, etc.), but a handful of suggestions, such as eating fermented foods and using mushrooms to fight cancer, should come as news. Miller’s work is consistently informative and educational, if at times meandering; each “cold spot” is accompanied by a specific regimen, and Miller’s practical advice and recipes are all geared for the novice. Anyone unafraid of modifying their diet will find this anthropological diet guide useful.

The Back Story:

Allegany County Area Agency on Aging (part of the County’s Human Resources Development Commission) successfully won a Maryland state grant to teach seniors about brain healthy nutrition following Dr. Emerson Lombardo’s Memory Preservation Nutrition® program. The funds were awarded competitively by Maryland’s Department of Aging using federal stimulus funds for evidence-based health promotion programs. They hired Dr. Emerson Lombardo as a consultant, purchased several MPN booklets and used her handouts to lay out a 8 week program, enlisting local experts to explain each of the 6 major strategies of the MPN, together with selected other brain healthy lifestyles based on Dr. Emerson Lombardo’s handouts. The AAA worked through their 4 “full-service” senior centers serving this rural, low-income county in Appalachia (an area further devastated by the ongoing recession). Over 18% of the county’s population are adults over age 60. The AAA delivered the program fall of 2011, creatively adding concrete aides to inspire seniors to begin implementing changes.

Allegany County Seniors

Working in collaboration with Allegany County aging services officials to evaluate the program, Ms. Souza’s added to their before and after assays a direct survey of participants. 29 of the 32 participants responded, who gave the program a thumbs up. The seniors participating in the program reported learning a lot, and 86% said they have already been making recommended changes, “using some of the knowledge gained in their everyday meal planning” and 62% reported feeling better as a result. Ms. Souza concluded in her Capstone paper, “The survey reveals engaged, thoughtful participants. The Allegany County COA’s translation of the MPN program on a community basis appears to be successful based on the participants’ responses to the survey.”

Ms. Souza recommends that Dr. Emerson Lombardo further develop and formalize this educational program and offer to other organizations across the country who are interested in an evidence-based program on brain healthy nutrition.

If you wish to contact Ms. Souza to learn more about her project, you may contact her by email

at emsouza@comcast.net

To learn more about U Mass Boston’s Gerontology Masters, Doctoral and Certificate programs, check out their website at

Featured Presenters will each give a short overview of key facts we all need to know, and be available to meet you and answer your questions:
‘

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

Nancy’s original mentors and colleagues in brain healthy lifestyle include Professors Xiu Wen Zhang, and Dr. Bei Wu, now a full Professor at Duke University with positions at several other U.S. and Chinese universities. (see http://www.umb.edu/news_events_media for a brief bio and Dr. Wu’s April 2 talk at U. Mass. Boston). The 3 of us gave our first talks on brain healthy lifestyles about 14 years ago to New England Chinese Women’s group and staff of the Greater Boston Chinese Golden Age Center, sponsored by Ruth Moy, the leader of both organizations.

Prof. Bei Wu of Duke Univ. speaking at U Mass Boston 2012

Nancy with her mentor Prof. Xui Wen Zhang & her daughter Jing Chang celebrating at Greater Boston Golden Age Center 40th Anniversary Dinner May 23, 2012

Chef Nick Polinsky

And here is an example of the “fruits of our labors”…. a fabulous assortment of brain healthy foods served at Neville Place’s 10th Anniversary Party on May 17, 2012. Executive Chef Nick Polinsky used his superior skills to create a delicious, beautiful array of foods following the evidence-based Memory Preservation Nutrition® program which is being implemented for the residents at Neville Place in Cambridge.Some of the recipesare on our website (nut pate, avocado spinach dip, hummus, date nut truffles etc.)

Appetizer Table at Neville Place

© 2012 HCI

Note the beautiful flower vases where the bases are comprised of real fruits and vegetables in the water. Look for additional photos coming soon on the website.

Vegetable corner of Appetizer Display

www.serpermethod.com

www.wisernow.com

www.stilmee.com

www.joycesimard.com

www.southshoresenior.com

www.adriennemartin.com

Joanne Koenig Coste

Eric Reardon, Nutritionist

 www.fruitsandveggies.org

Senior Living Residences

www.thegreenhouseproject.org

www.alz.org

www.alz.org/manh

www.trivalleyinc.org

Anne Beecher, Massage & Stretching

WBUR Alzheimer’s Special

Ch 5 Boston Chronicle Brain Foods

 

Lets Start to ACT!

The US government and the Alzheimer’s Association are also looking for the public to comment on the plan.  If you’re interested in commenting, look at our article on the draft National Plan.

Some other exciting news, is Dr. Nancy Emerson Lombardo has had an article published in Encyclopedia of Lifestyle Medicine and Health, “Alzheimer’s Disease.” To get the link to read this 12 page article on line, go to our article. below

Dr. Nancy Emerson Lombardo is going to be attending and presenting at the 27th International Conference of Alzheimers’ Disease International.  To see the posters she will be presenting see below. For more information on the ADI conference check out their website.

There has also new research linking sleep problems to predicting Alzheimer’s. At this point, it is not known which comes first, AD or the sleep problems, but there is an association.

Next month we’ll share some of the breaking research on nutrition and lifestyle for brain health.  In the meantime, more and more medical leaders are voicing their hypothesis that nutrition and lifestyle are key to both prevention and treatment of AD, as happened at a recent symposium held at the American Association for Advancement of Science in Vancouver Canada.

Deadline to make comments March 30th 2012.  I encourage you to express your interest in nutrition/lifestyle research and services for prevention and treatment.

Public input sought on detailed strategies for research, outreach, caregiver support

February 22, 2012

The U.S. Department of Health and Human Services (HHS) released today an ambitious draft National Plan to overcome Alzheimer’s disease and related dementias.  The draft National Plan to Address Alzheimer’s Disease (http://aspe.hhs.gov/daltcp/napa/#DraftNatlPlan) offers specific action steps to accelerate research on treatment and prevention, as well as proposals for improving care, services, and support for patients, families, and caregivers. HHS and it’s Advisory Council look forward to receiving comments from the public on this proposed plan.

HHS is seeking comments on the draft National Plan to fully engage the Alzheimer’s disease community, the public, states, local governments, community based service organizations, the private sector and others in its development. Public comment will be accepted through March 30, 2012 and should be e-mailed to napa@hhs.gov

To learn more: www.nia.nih.gov/newsroom/announcements/2012/02/hhs-seeks-comment-draft-national-plan-fight-alzheimers-disease

To read some Research Community comments on the draft national plan so far go to:

http://www.alzforum.org/new/detail.asp?id=3028

Alzheimer’s Association has videos of President Obama and Administration Officials speaking about the NAPA and the new draft plan.  http://napa.alz.org/about

Alzheimer’s Association has links to send your comments to them to pass along to the government. http://napa.alz.org/share-your-feedback

You are also invited to make/send the Alzheimer’s Association your own video to be shared around the nation and world.

Here is the link to the on line version which you may access for a limited time.  The link will allow you to see just this article; to see the rest you’d have to go to a library or purchase your own copy for between $500 and $600!   (Of course this is part of Sage’s marketing effort, knowing that we contributors will want to share their own contributions with their publics)

‘Alzheimer’s Disease : Encyclopedia of Lifestyle Medicine and Health’ from PubFactory website! See it at: http://www.sage-ereference.com/abstract/lifestylemedicinehealth/n18.xml

To give you a taste of the 12 page article’s content, here is the opening paragraph:

This entry (a) describes the evolving definition of Alzheimer’s disease (AD) and its prevalence; (b) summarizes evidence for nutrition, physical exercise, and other healthy lifestyle interventions that may delay onset, prevent occurrence, or slow the progression of AD and other dementias and maintain the emotional and physical health of both the person with dementia and his or her care partners; (c) identifies key lifestyle strategies for preserving brain health-both cognitive and emotional-and how they may be related to body health strategies; (d) highlights some clinical trial results, and (e) introduces a groundbreaking multi-domain study under way in Finland and the body of evidence leading to this seminal trial.

Readers may take away confirmation of the importance of some of the things they are already doing and gain ideas and motivation to adopt brain-healthy nutrition and lifestyles.

Here are the subsection titles:

Possible Causes or Etiology of AD as Related to Lifestyle

Why Lifestyle Factors Are Important to Brain Health

Recommended Lifestyle Approaches for Cognitive Health

Selected Findings of Lifestyle Studies (highlighting nutrition, physical activity, meditation and spiritual practices, cognitive training, cognitive rehabilitation, and cognitive-kinetic interventions, multifaceted relationship between physical activity and cognition)

Barriers to Adopting Lifestyle Initiatives

Further Reading

Citation:  Lombardo, Nancy B. Emerson. “Alzheimer’s Disease.” Encyclopedia of Lifestyle Medicine and Health. Ed. James M. Rippe, MD. Thousand Oaks, CA: SAGE, 2012. 120-42. SAGE Reference Online. Web. 29 Feb. 2012. 6000 words   on-line accessed 2 29 2012

My good and gracious friend and “brother’ in this work, Jacob K. Roy, MD, who father died of Alzheimer’s disease, will be installed as our new Chairman of the Board of Directors, the governing body for this amazing organization. He replaces my equally wonderful “sister” Daisy Acosta, MD, who has also been a leader in the critically important “10-66″ international research effort to establish and compare prevalence and incidence rates in selected developing countries around the world, and much much more. See http://www.alz.co.uk/10/66-group.  And Dr. Acosta had in turn as Chair of ADI, followed in the illustrious footsteps of our own wonderful Orien Reid, former Chair of the US Alzheimer’s Association, and Henry Brodaty MD of Australia and Nori Graham of the UK.

I will be visiting with my friends and extended “family” and fellow researchers from over 70 countries on every continent. I am especially eager to see my friends from India, Goa, Mexico, Japan, Iran, Australia, England, Netherlands, Dominican Republic, Peru, Trinidad and Tobago, Bahamas, Lebanon, Nigeria, as well as China, Canada, Cuba, Venezuela, Egypt, Sri Lanka and elsewhere, as well as my fellow Americans who love this conference too.

Interestingly, I find that my work on brain healthy nutrition and lifestyle is given much greater recognition outside the U.S. because most other countries aren’t as captured by pharmaceutical industry as is the USA, and give greater priority to the possibilities lifestyle interventions hold for both prevention and possible treatment.

To see the recent “World Alzheimer’s Report” http://www.alz.co.uk/research/world-report   and the details about the upcoming conference in London, England (March 7-10) go to http://www.alz.co.uk/

To see pdf files of the two posters I will be presenting at the ADI conference, go to my website. The titles of the two posters are:

Poster on Whole Foods Brain Healthy Nutrition Intervtion in Assited Living

Poster on Nutritional Supplement Combination Thearpy Effective in AD Mouse Model

This free event will be held the Amesbury Council on Aging, 9 School St, Amesbury, MA 01913.  This event will run from 3:00-4:00pm. Sponsored by Methuen Village. Please RSVP to Annmary I Connor, LICSW at connora@amesburyma.gov. For more information check out the events page at www.healthcareinsights.net 

April 25th 2012:  Annual ASAP Nurses Seminar

This event will be held at Courtyard Boston Marlborough, 75 Felton St, Marlborough MA 01752.  This event will run from 11:30-1:00pm. Lunch will follow presentation.  Please RSVP with Lois Stillman at lstillman@eldercare.org. For more information 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

© 2012 HCI

www.joycesimard.com

www.southshoresenior.com

www.adriennemartin.com

Joanne Koenig Coste

Eric Reardon, Nutritionist

www.fruitsandveggies.org

Senior Living Residences

www.thegreenhouseproject.org

www.alz.org

www.alz.org/manh

www.trivalleyinc.org

Anne Beecher, Massage & Stretching

WBUR Alzheimer’s Special

Ch 5 Boston Chronicle Brain Foods

With your help, our message will be heard that Alzheimer’s can’t wait.

Thank you!

See below for the US HSS Press Release Feb 7 2012 on “We Can’t Wait”

February 8, 2012 The Obama administration announced new efforts in the fight against Alzheimer’s disease, committing to:

-immediately making an additional $50 million available to Alzheimer’s research

Fact Sheet.

The President’s announcement is part of the National Alzheimer’s Project Act, calling for a national, coordinated Alzheimer’s disease plan towards preventing and treating Alzheimer’s disease by 2025. Without efforts like these, the United States will face a public health crisis as our aging population increases.

For those of us in the Alzheimer’s movement, whether a year, a decade, or like myself, since 1979, this is a huge moment, when our national government has finally committed to making Alzheimer’s a national priority, develop a plan which, if carried out, might help us be better prepared for, or even partially avert, the crisis ahead when today’s baby boomers reach their 80′s.  If nothing changes, over the next 20-30 years, half the baby boomers will develop Alzheimer’s or another dementia, overwhelming our nations ability to provide or pay for their care.

Dark Chocolate’s benefit for the brain is both direct and indirect, through improved heart and blood sugar-related health.

Heart health: Clinical research trials suggest that dark chocolate and pure cocoa are as powerful as spices, tea, red wine, and berries in enhancing some aspects of heart health. Most of the health benefits from dark chocolate come from the potent antioxidant phytonutrients it contains, namely flavonoid compounds (a type of polyphenol) which include the monomer forms epicatechins and catechins, as well as the polymer forms, called procyanidins  or proanthcyandins, and several other nutrients including stimulants theobromine and caffeine. (To learn more about these cocoa antioxidants see http://www.hersheys.com/nutrition-professionals/chocolate/composition/antioxidants.aspx ) To put the antioxidant potency of pure cocoa in perspective, the ORAC value of pure natural cocoa powder is about the same per weight as several dried herbs such as basil and parsley, and about 1/3 that of several ground spices such as cinnamon.

The flavonoid nutrients promote health by increasing the blood flow in arteries and the heart, lowering blood pressure[1], lowering LDL (“bad”) cholesterol,[2] improving the health of endothelial cells,[3] and improving blood sugar control.[4] To view a list of recent clinical trials using cocoa products, see clinical trials.

The amount of the important antioxidants decrease a factor of 10, in descending order, from pure natural cocoa powder (the highest), milk chocolate to the least (chocolate syrup) among brown-colored chocolate products available to consumers.[5] And white chocolate having virtually none. The more the natural cocoa content, and the less sugar and added dairy fat, the better for health.  The “dutch processed” chocolate, the kind typically used in beverages, and pastries, removes the key antioxidants; heavily dutched chocolates have only 10% of the original, although that is still way better than white chocolate.  In addition, some chocolates are made in a sustainable manner, some use organic ingredients, and some manufacturers pursue fair trade practices, all which impact on healthfulness and taste of the resulting confections. Trade Joe’s, acting as a retailer who sole sources and arranges with manufacturers and suppliers to create or deliver a variety of mostly healthy foods, now offers a considerable variety of reasonably priced varieties of quality dark chocolate.  I find their established Trader Joe’s “Dark Chocolate” in the 1.75 oz bars, manufactured for them in Belgium, as still the most delicious of their offerings for flavor and smooth texture, and wish it were more than 54% cacao.    They are also now offering a fair trade SPICY hot chocolate mix. See http://www.traderjoes.com/

We also think highly of Theo Chocolates, a relatively new U.S. manufacturer, originally from Cambridge, MA and now located in Seattle, WA, which reports they are the first US manufacturer to use only organic ingredients AND practice fair trade; their products are mostly vegan and use high quality ingredients. They also offer a spicy hot cocoa mix.  We discovered Theo researching for this article, at Debra’s Gourmet in Concord, MA. Theo chocolates are also carried by Whole Foods and selected other stores, and sold on line.   See below for description of our taste tests and http://www.theochocolate.com./

See article below for more about the different kinds of chocolate and their nutrient content.

How dark chocolate may help the brain: Cross Sectional[7] Studies suggest that regular intake of dark chocolate (about 10g/day) is associated with better cognitive performance in the elderly. (http://jn.nutrition.org/content/139/1/120.long ) So far there haven’t been clinical trials similar to those in the heart health field to verify this finding for older adults, although more recent clinical trials have shown positive results for younger adults in selected cognitive areas such as visual-spatial and decision reaction time. (see healthcareinsights.net for more on this topic)

Chocolate also contains many minerals important for brain and body health such as magnesium, calcium, and potassium. 1 oz of 70% dark chocolate contains 65 mg magnesium (18% daily requirement),  87 mg phosphorus (12% daily requirement), 21mg calcium(2% daily requirement),  and 203 mg potassium (4% daily requirement).

One well known medical scientist at Yale University, David Katz, MD concludes his review of the science to date[8] “Cocoa can protect nerves from injury and inflammation, protect the skin from oxidative damage from UV radiation in topical preparations, and have beneficial effects on satiety, cognitive function, and mood. As cocoa is predominantly consumed as energy-dense chocolate, potential detrimental effects of overconsumption exist, including increased risk of weight gain. Overall, research to date suggests that the benefits of moderate cocoa or dark chocolate consumption likely outweigh the risks.

Cautions: People with migraine headaches often avoid chocolate of all kinds because it is thought to trigger migraines in some people.  In addition, chocolate does contain caffeine (about 24 mg/oz – about 1/8 to ¼ amount in a cup of coffee) so those very sensitive to caffeine may limit their intake, especially in the evening.

SAVE YOUR DOGS FROM DEATH BY CHOCOLATE: Also, chocolate and cocoa products are indeed poisonous to dogs and some other pets, so please keep them out of reach. http://www.thehersheycompany.com/nutrition-and-wellness/chocolate-101/theobromine.aspx

People with Alzheimer’s and their caregivers should not ask their doctor for this drug to treat Alzheimer’s disease. That said, investigating an already FDA-reviewed and -approved therapy may mean that the drug development process takes a somewhat shorter time because the drug has already been tested in people. There is still a great deal to learn. For example, without trials in people with Alzheimer’s, we know nothing yet about dose levels or how this compound may interact with approved Alzheimer’s drugs.

ALZHEIMER’S ASSOCIATION INVOLVEMENT

Six months before this research was published, the Alzheimer’s Association awarded the senior scientist on this article, Gary Landreth of Case Western Reserve University, Cleveland, our prestigious Zenith Award in 2011 for research that will follow on from this study to investigate this drug and how and why it works in this way, perhaps setting the stage for trials in people.

When cacao beans were first found by native peoples, they were considered so valuable they were used as currency. Avocados could be bought with 3 cacao beans or with 100, a turkey could be purchased.

After the seeds are ripe and harvested they have to go through several steps before they become chocolate; this process was first developed by the native peoples. First they are allowed to ferment for 4 to 7 days. The longer the seeds are allowed to ferment, the higher quality of chocolate will be achieved. After they ferment the seeds are dried out in the sun for about a week. Following the drying process they will be roasted and then ground into a paste. This paste is called chocolate liquor even though it contains no alcohol. After creating the chocolate liquor is made it can be used in various ways to create different types of chocolate.

The cacao bean was often transformed into a savory chocolate drink which was seasoned with vanilla, chilies (hot peppers!) and other spices. Many Aztecs liked to have their chocolate drink cold, where the Maya liked theirs hot. When the Spanish explorers were first served this drink they were not as taken with it. But they returned with the cacao bean to Spain where honey and sugar were mixed into the drink creating a slightly sweetened chocolate closer to what we are familiar with. After this alteration to the drink it was quickly favored in Spain, and to this day there are chocolate shops in Madrid and elsewhere, similar to coffee shops, that feature only liquid and solid chocolate, mostly dark and bittersweet.

Sustainability of Chocolate and Cacao Beans

What is the future of chocolate we wonder? One thing many do not know is that almost all cacao beans are grown by small individual farms in Africa and South and Central America, often small family plots of a few acres, and not mass produced. This is because of the delicate nature of the cacao plant needing particular growing conditions (e.g. the shade of larger trees, in a moist, warm forest) and not conducive to mass production (which may be a good thing as it avoids other problems typical of large scale farming).  Production and farm yields are in fact falling as the demand for chocolate worldwide increases.  One factor is that cocoa farmers do not have the education, the knowledge or the financing to be able to improve their situation. Also some plots are losing their fertility. All these factors result in low productivity which in turn perpetuates low incomes for the farmers. Research shows that by 2020 at least one million more metric tons will need to be produced to meet with the growing demand.  But without help and support for these small farms, this may prove to be impossible.  To be able to help the industry the farmers will need help from the government, food manufacturers, and other interested parties.  To see learn more about the sustainability challenge for cacao bean farming, fermentation, processing and distribution, and how mars.com is helping the cacao farmers check out their website. The newer “bean-to- bar chocolate-only company Theo Chocolates headquartered in Seattle is 100% dedicated to following sustainable and fair trade practices. See http://www.theochocolate.com./

http://www.smithsonianmag.com/arts-culture/brief-history-of-chocolate.html

http://www.allchocolate.com/understanding/where_chocolate_comes_from/

http://www.xocoatl.org/tree.htm

http://library.thinkquest.org/J0110012/made/made.htm

http://www.mars.com/global/brands/cocoa-sustainability/challenges.aspx

Knowing about its history, one is tempted to see how chocolate tastes with cayenne pepper in the mix, and more spices.

See our Truffles recipes on our website. (1) and(2) (Chocolate, Coconut & Cherry Truffle. (We’re working on one that adds a bit of cayenne to see what happens!

Just today in fact I found a wonderfully delicious (and nutritious!) THEO chocolate bar that has “70% cacao” dark chocolate with cayenne and chili powders, CINNAMON!, a bit of orange zest and oil, and vanilla bean.  Hurrah! I am reading the label as I write this, it is ORGANIC, FREE TRADE, non GMO certifed,and MADE IN USA. And no dairy or gluten!  The label says they are the first free trade AND Fair for Life chocolate maker in the US. So visit their website at www.theochocolate.com. Samantha Turner and I also sampled their “Toasted Coconut” 70% cacao Dark Chocolate product and both loved it.  Next I have to try their dark cholocate with almonds as well as their 84% Dominican chocolate.  Ah the trials and tribulations (actually delights) of researching brain healthy foods for our readers.

Companies like Theo will challenge the major manufacturers such as Mars and Hershey’s to also pursue higher standards and, probably most important for the future of chocolate’s availability world wide, support the small farmers who cultivate and harvest this delicate “food of the Gods,”

What Does the % Cocoa on the Label Mean Exactly?

As far as we could determine, the “% cocoa” on typical chocolate product labels means the percentage of cocoa in the chocolate, defined as chocolate liqueur (ie the ground up whole natural roasted cocoa bean) together with any added (natural) cocoa butter.  The higher the percentage of cocoa, the less sweet, and healthier, the chocolate is.

The amount of the important cacao antioxidants decreases by a factor of 10, in descending order, from pure natural cocoa powder (the highest), to unsweetened baking chocolate, dark chocolate, semisweet baking chips, milk chocolate to the least (chocolate syrup) among brown-colored chocolate products available to consumers.[1]

“Dutch (alkali) processed” chocolate, the kind typically used in beverages, ice cream and pastries, has significantly reduced amounts of the healthy antioxidants, so look for undutched (i.e. made with natural cocoa) or lightly dutched chocolates (which have 40% of original antioxidants).  Heavily dutched cocoa/chocolate has only 10% of the original.  Some may want to balance the best “taste and texture” with the healthiest ingredients.  The dutching method (developed by a Dutchman named Coenraad Johannes van Houten in the early 1800s) renders cocoa powder smoother, less bitter, but also less healthy.  To make things more complex for the consumer, not all labels tell you whether the chocolate is dutched/alkalized or not. Some manufacturers may or may not use the word natural to specify it is NOT dutched.  So technically, we think, a product could be labeled with high % cocoa (good) but made with heavily alkalized cocoa (not good). Our research didn’t settle this question, so any knowledgeable readers please weigh in!

Here is more information about the types of chocolate you may have heard of.

• Cocoa nibs are simply the fermented and roasted cacao bean broken up into little bits and pieces.  They are crunchy, just like roasted nuts. (You may buy nibs in many natural foods stores or on the web. Since they contain no sugar, you can eat some of them when you’ve had you chocolate limit for the day. Quoting for a website, “Nibs are incredibly versatile, and lend themselves to both sweet and savory recipes. Use them as you would nuts or chocolate chips: bake into breads and cookies, Sprinkle over oatmeal, top oven roasted vegetables, toss into trail mix and salads, incorporate in meat rubs and sauces. The possibilities are endless! (www.theochocolate.com )
• “Chocolate liquor” or “liqueur” is – the liquid or paste that is produced when cacao beans (also called cocoa beans) are roasted and ground; the basis of all chocolate.

The pure, ground, roasted cocoa beans impart a strong, deep chocolate flavor but by themselves might taste slightly strong, slightly acid and sometimes bitter, and surprisingly not sweet at all, because they contain no sugar.

• Cocoa powder is made from the chocolate liqueur or nibs, by removing most of the cocoa butter.  Cocoa powder can be natural or processed (usually by “alkalizing” as described above).  There can be low fat and higher fat forms of cocoa powder.
• “Unsweetened chocolate”, also known as “bitter”, “baking chocolate” or “cooking chocolate” is pure chocolate liquor mixed with some form of additional fat, ideally just extra cocoa butter, to produce a solid substance.

With the addition of sugar, cocoa powder and/or unsweetened or “bakers” chocolate, serves as the base for candies, cakes, brownies, confections, and cookies.

• “Dark chocolate”, also called “plain chocolate” or “black chocolate”, is produced by adding fat and sugar to cocoa. It is chocolate with zero or much less milk than milk chocolate. The U.S. has no official definition for dark chocolate but European rules specify a minimum of 35% cocoa solids.^[2] (adapted from Hershey website)

Consumers have to read the labels to see if the amount of cocoa content is included. These days, if no percentage is given, you can assume it is probably below 50%.

Types of Dark Chocolate:  Again, there are no clear definitions or standards for the commonly used subcategories of Dark Chocolate so it is best to read the nutrition facts and list of ingredients on any chocolate you are considering.  Here are a couple of traditional descriptions:

Traditionally, for example, as used by the Hershey Company, the term “dark” has been synonymous with “semisweet” chocolate, and “extra dark” with bittersweet, although the ratio of cocoa butter to solids may vary with the brand and product.  Both are used in baking and also can be eaten as is.

o   “Semisweet chocolate” is a dark chocolate with (by definition in Swiss usage) half as much sugar as cocoa, beyond which it is “sweet chocolate.”

o   “Bittersweet chocolate” is chocolate liqueur (i.e. the ground up whole cocoa beans) to which some sugar (less than a third), more cocoa butter, vanilla and sometimes other ingredients have been added. It has less sugar and more cocoa.

Milk chocolate was developed in the United States and tends to use heavily “dutched” chocolate to which additional sugar, milk and milk fats have been added.  Milk chocolate is no longer a purely “plant based” food, and introduces unhealthy animal saturated fats containing some cholesterol to the much healthier cocoa butter, a purely plant based food with no cholesterol.  Many nutritionists consider that milk chocolate and milk-based cocoa drinks are no longer healthy drinks since the ingredients with negative impact on health (sugar and animal saturated fats) outweigh the ability of the few remaining cocoa anti-oxidants to counter the negative ingredients.

So-called “white chocolate” is thought to have little to NO health benefits since it has practically NONE of the antioxidants described above, and consists primarily of sugar (55%) and fat (24%) (20% cocoa butter and 4% milk fat). http://en.wikipedia.org/wiki/White_chocolate (See www. Healthcare insights for scientific references and description of the different kinds of chocolate, as well as detailed nutritional content of cocoa powder and dark chocolate).

This is not to say that cocoa butter by itself is bad for you.  There is increasing thought based on recent nutritional research, that plant based saturated fats are not nearly as unhealthy as those coming from animal or poultry fat, including dairy, and that some may actually be GOOD for you, including cocoa butter and coconut oil.

Although a biased source, Hershey’s website outlines some of the reasons cocoa butter is now considered a healthy food,

“About 36 percent of the fat in the cocoa bean is “good fat” – either mono- or polyunsaturated fat, of which oleic acid (the fatty acid also abundant in olive oil) makes up the largest proportion. Of the saturated fat content in cocoa butter, over half comes from stearic acid. Stearic acid has been shown in numerous studies to have a neutral impact on blood cholesterol. In fact, the 2010 Dietary Guidelines Advisory Committee recommended that stearic acid should be excluded from other “cholesterol-raising” saturated fats and states that foods high in stearic acid are not problematic for managing blood cholesterol levels.

Why? The main reason may be that stearic acid converts from a saturated fat to an unsaturated fat when metabolized in the body. Studies have been conducted where participants fed chocolate daily for two weeks showed no change in blood cholesterol when total calories in the diet were kept the same.”    http://www.thehersheycompany.com/nutrition-and-wellness/chocolate-101/cocoa-butter-and-stearic-acid.aspx

Some of you may also have questions about what is “real chocolate” and what isn’t.  To give equal time to two major Chocolate manufacturers, here is a useful description from the Mars.com website

Question: How Do You Tell If It’s Real Chocolate?  Answer: Just read the package. For 100% real, authentic chocolate, look for the words “milk chocolate,” “semi-sweet chocolate,” or “bittersweet chocolate” on the package. It’s probably not the real thing if you see the words, “chocolate flavor,” “chocolate coating,” “chocolaty,” or “made with chocolate.” And don’t be fooled by packaging that implies chocolate, but doesn’t even mention it by name. (http://www.marshealthyliving.com/real-chocolate)

The U.S. government has also set standards for what can be called chocolate in all of its different forms Link: http://www.access.gpo.gov/nara/cfr/waisidx_05/21cfr163_05.html

To learn more:  Understandably, the major chocolate companies have helped pioneer research into the potent antioxidants in cocoa and chocolate, and some are vigorously defending their patented processes for retaining more of the flavanols which earlier practices removed from the natural cocoa beans. (see for example http://www.cocoavia.com/cocoapro ), Mars related website for reporting research results (http://www.healthycocoa.com/) and summary of cocoa related clinical trials on government website.  http://clinicaltrials.gov/ct2/results?term=cocoa

Below are a couple of charts (or links on the website) of the key nutrients in the different types of chocolate.  We’ll highlight where there are key differences.

A chart from the Hershey website showing how the “dutching” or alkalizing process removes the beneficial flavonoids from natural cocoa powder. Hershey’s plain natural cocoa powder is close to the positive anti-oxidant values of what the scientists conducting this analysis term “commercial natural cocoa” i.e. NOT treated with alkalis.  From this table one can also quickly discern that Hershey’s “Special Dark’ cocoa powder must be heavily alkalized and otherwise treated, since the content of anti-oxidants and flavanols is below even the heavily dutched/alkalized standard products. While this refers to a type of Hershey’s cocoa powder, it might be a safe guess that this is what goes into Hershey’s “Special Dark” chocolate bars and therefore they won’t be as healthy for us as other bars labeled with the actual content of natural cocoa powder.

See Chart on our Website.

It should be noted that dark chocolate, both kinds, actually has more fat and calories from fat than either milk or white chocolate, but all of this fat is cocoa butter i.e. plant fats which we have pointed out are relatively healthy fats. The animal fats in milk and white chocolate carry with them a small amount of cholesterol, typically 7 mg in milk chocolate and 6 mg in white chocolate.  Some dark chocolates contain a small amount of milk and if so they will show trace amounts of cholesterol as well; chocolates made from purely plant sources will contain zero amount of cholesterol as cholesterol is an animal phenomenon (a constituent of every cell in our bodies and brains!), absent from all plants.

To see the table go to our website.

hence the movement toward more sensitive cognitive tests and biological measures such as brain scans, and measurement of ABeta and other problem proteins in the blood or spinal fluid.  A further limitation may be that the placebo used actually had some treatment effect since it contained a small amount of the active flavanoids, though less than 1/10^th of the amount in the active treatment. Authors also speculate that the dose of cocoa or active flavanoids may not have been high enough to see an effect in a short period of time.

A more recent study[2] demonstrated positive acute test results in younger adults using a higher dose of cocoa flavonoids vs. White chocolate using a 1 week cross-over design and selected vision and special cognitive tests less subject to learning effects.  The study found significant improved performance from those consuming the dark chocolate in vision tests featuring contrast sensitivity and motion sensitivity as well as visual-spatial memory and performance on some aspects of the choice reaction time task.

No clinical trials yet about chocolate and mood.  And the major epidemiological studies are not conclusive, because of chocolate cultural reputation and popular use as a comfort food when people are depressed.  Usually we use epidemiological studies to suggest which foods are linked to absence of disease and therefore recommend eating more of such foods, because people who did, tended not to have x y and z illnesses. And we recommend against high saturated fat content because people who eat it in excess have higher rates of cardiovascular, brain and body illnesses.  These findings become hyptheses for clinical trials;  Clinical trials where people actually ate more of the good or bad foods and then were compared to similar people randomly assigned to eat different food (or placebo foods) can help us test the hypotheses.  For instance, Dr. Craft’s group in Seattle has shown in a preliminary 4 week clinical trial that people who eat excess saturated fat and high glycemic index foods (e.g sugar and WHITE refined flour/bread/pasta/rice) had significantly poorer cognition and worse levels of the problem A-beta protein in their blood, than those who ate low saturated fat, low glycemic index foods.

If we used the same logic for epidemiological or “circumstantial” evidence related to chocolate, we would conclude that chocolate caused people to become depressed.

Many people believe chocolate helps boost our moods, perhaps by increasing endorphins.  In any case, one cross-sectional (epidemiological) study[3] showed that people who tested high on measures of depression, consumed considerably more  chocolate (all types, including those high in sugar and low in flavanoids), than those who tested below cut off levels for depression. Chocolate, along with cigarettes and caffeine is considered to be a “self-medicating” substance for depression.  So far there are no clinical trials of high quality dark chocolate to see if it does help improve mood.

April 25th 2012:  Annual ASAP Nurses Seminar

This event will be held at Courtyard Boston Marlborough, 75 Felton St, Marlborough MA 01752.  This event will run from 11:30-1:00pm. Lunch will follow presentation.  Please RSVP with Lois Stillman at lstillman@eldercare.org. For more information check out the events page at

www.healthcareinsights.net

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

© 2012 HCI