Volume 17 Number 11 November 2016
We all worry about losing our minds. Of course, if you do there is nothing to worry about.
In the last newsletter we reviewed how bad diets, toxic environments and inactivity are the main factors contributing to our brains aging poorly. The mechanisms involved are Toxicity, Inflammation, Oxidation and Less Optimal Mitochondrial function (T.O.I.L.)This is issue reviews simple ways to reduce the risk of Cognitive Decline.
Hugo Rodier, MD
Better Brain Balance
The more inflamed your brain is the higher the risk of Alzheimer’s disease and cognitive problems.
How neuroinflammation contributes to neurodegeneration
- Science 19 Aug 2016:Vol. 353, Issue 6301, pp. 777-783
“Neurodegenerative diseases such as Alzheimer’s disease, Parkinson’s disease, amyotrophic lateral sclerosis, and frontotemporal lobar dementia are among the most pressing problems of developed societies with aging populations. Neurons carry out essential functions such as signal transmission and network integration in the central nervous system and are the main targets of neurodegenerative disease. The neuron’s environment also contributes to neurodegeneration. Maintaining an optimal milieu for neuronal function rests with supportive cells termed glia and the blood-brain barrier. Accumulating evidence suggests that neurodegeneration occurs in part because the environment is affected during disease in a cascade of processes collectively termed neuroinflammation.”
Inactivity also increases inflammation, especially if we become couch potatoes. Inflammation leads to poor circulation that not only increases the risk of decreased blood flow to the brain, but, that of fatal clots like Pulmonary Embolisms.
Study links nut consumption to low inflammation
Reuters (8/24, Kennedy) reports that, according to a study in the American Journal of Clinical Nutrition, “eating a handful of nuts five times per week may reduce inflammation.” Researchers “analyzed data from two different long-term studies of health professionals, the Nurses’ Health Study (NHS) and the Health Professionals Follow-Up Study (HPFS),” and found that “people who ate nuts at least five times per week had 20 percent lower levels of C-reactive protein (CRP) compared to people who never or rarely ate nuts.” In addition, they “had 16 percent lower levels of interleukin-6 (IL-6), another inflammatory marker.”
Exercise boosts long term memory
The New York Times (8/24, Reynolds) reports in its “Well” blog that a 2014 study on mice suggested that exercise might have detrimental effects on long-term memory. Meanwhile, in a new study published in The Journal of Neuroscience “researchers decided to replicate aspects of the 2014 mouse experiment but instead use rats” because research has shown rat brains “are more similar to our brains.” The new study found that rats that exercised displayed long-term memory as good as sedentary rats and had developed “about twice as many new cells as did the brains of the sedentary animals.”
Acupuncture may help improve memory in people with amnestic Mild Congnitive Impairment, study suggests
Fox News (8/5) reported that acupuncture may “help improve symptoms of dementia,” researchers say. After analyzing “two types of studAGERies including one that compared acupuncture directly to nimodipine, which is a calcium blocker that treats a gene mutation associated with dementia, and another that measured the effect of acupuncture when combined with nimodipine,” researchers “found that patients who chose acupuncture saw significant changes on mini-mental state examination scores compared to patients who only took nimodipine.”
HealthDay (8/4, Reinberg) reported that researchers analyzed five studies including “nearly 600 people with” amnestic mild cognitive impairment [MCI], “a type of memory loss that’s considered pre-dementia.” The findings were published online Aug. 4 in Acupuncture in Medicine.
It is hard to stop eating junk. Some people can do it overnight. Others need baby steps, such as giving up soda pop. Amazingly, many are still unaware of the toxic nature of soda. It has been compared to that of tobacco and alcohol.
“Sugar-sweetened beverage consumption and genetic predisposition to obesity in 2 Swedish cohorts,” Am J Clin Nutr 2016 104: 809
“Intake of Caffeinated Soft Drinks before and during Pregnancy, but Not Total Caffeine Intake, Is Associated with Increased Cerebral Palsy Risk in the Norwegian Mother and Child Cohort Study,” J. Nutr. 2016 146: 1701
Another change that may be implemented first is to explore our childhoods with the eyes of an adult. Although the book Homecoming is written for people who have an alcohol abuse problem it is also helpful for those who have developed toxic habits that impair their health. Often they are rooted in unresolved issues from childhood. After all, eating is highly psychological. Most people explain this insidious problem by labeling it a “comfort food” issue.
Childhood abuse associated with higher risk of death for women, study finds
TIME (8/17, Sifferlin) reports a new study published online Aug. 17 in JAMA Psychiatry suggests that “being physically or emotionally abused as a child can increase a woman’s risk of death.” The study did not determine a causal realtion as to why childhood abuse is linked “with a higher risk for death, but the researchers speculate that abuse may heighten women’s risk for mental health issues, like depression, that can take a toll later on.”
NPR (8/17, Hobson) reports the research examined “a government-funded study that” asked roughly 6,200 men and women about their childhood experiences with physical and emotional abuse, tracking them for 20 years. Edith Chen, an author of the study, pointed out in an email that “the link to early death was with self-reported abuse, not abuse confirmed by courts or independently documented in other ways.” Researchers also said it was unclear why the association appeared in women, but not men.
Another simple start is to check some basic laboratory tests. I prefer the Comprehensive Metabolic Panel, GlycoHb A1c and Vitamin D25OH. The latter is associated with insulin resistance which can create a lot of problems, even an atrophied brain. As noted previously, women are particularly at risk for hormonal problems that will end up impacting not only brain function, but fertility. Optimal levels of Vitamin D reduces the risk of all three problems:
“Vitamin D Status Relates to Reproductive Outcome in Women With Polycystic Ovary Syndrome: Secondary Analysis of a Multicenter Randomized Controlled Trial,” JCEM 2016;101(8), pp. 3027–3035. Vitamin D best >45 to increase chance of conceiving.
Herbs and supplements that have been noted to help with cognitive issues:
Sage, Huperzine-A (Herbs)
B complex vitamins
Glutamine (amino acid)
Coffee, tea, chocolate
AND, OF COURSE, MY FAVORITE TOPIC: THE BRAIN-GUT CONNECTION.
This is an article reproduced in its entirety for those of you with time to spare. If you don’t have the time or the will to read it the main message is that your gut flora has a huge impact on how your brain functions. Feed it well.
The Microbiome and Brain Health: What’s the Connection? Medscape March 28 2015
Researchers are now beginning to understand the ways in which bacteria living in the human gut—the gut microbiota—communicate with and influence brain health. The concept of a faulty “gut/brain axis” has been associated with various neurologic and psychiatric outcomes and is thought to be explained, at least in part, by immune dysfunction and inflammation triggered by poor gut health.
The gut microbiota has emerged as an important focus in the understanding of noncommunicable diseases, including type 2 diabetes and cardiovascular disease, as well as disorders of the brain. Brain-related conditions place a great burden on society, and the limitations of current interventions reflects the need for ongoing investigations into understanding and treating brain disorders, in part by exploring the close relationship between our biome and our brain.
Biome and Brain Overview
The human intestinal microbiome is seeded at birth; it is influenced initially by delivery and feeding mode, and reaches an adult-like state within the first few years of life. Alterations in the composition, diversity, and stability of gut microbiota have been linked to a broad range of diseases, including autoimmune, metabolic, gastrointestinal, and brain disorders.
Although the composition of the gut microbiota remains relatively stable during our middle years, it continues to be influenced by such factors as geography, antibiotics, exercise, and diet. This is particularly important when considering possible prevention and intervention in brain disorders.
It is well known that bidirectional gut/brain communication may occur directly and indirectly via the central and enteric nervous systems, the vagus nerve, and the endocrine and immunoinflammatory systems and through the modulation of neurotransmitters. Diet could also utilize these pathways, because the gut microbiota supports optimal nutritional bioavailability—for example, by maintaining normal plasma tryptophan levels, an important building block for making serotonin, a key central nervous system neurotransmitter. Advances in this field have come from the development of DNA sequencing technology, which allows researchers to conduct large-scale screening of the bacteria in the gut and their associated physiologic functions. This has helped researchers to link disruption of the gut microbiota with biological markers of the communication pathways mentioned above.
It is important to note that there is so far no “gold standard” healthy intestinal microbial profile. Genetic and environmental factors mean that there may be significant variability in gut composition from person to person. In general, a “healthy,” diverse gut microbiota promotes gut health and maintains essential structural, metabolic and signaling functions. The human gut can be “unhealthy” for a variety of reasons. Typically, a shift away from normal gut microbiota diversity and stability—termed “dysbiosis”—means it is unable to sustain one or more of the functions of a healthy gut, and this may contribute to metabolic, autoimmune, and brain disorders.
Increased intestinal permeability, often called “leaky gut,” occurs when the mucosal gut barrier fails to prevent potentially harmful molecules from entering the bloodstream; these molecules include lipopolysaccharides, which are found on the outer membrane of gram-negative bacteria and may elicit inflammatory responses in the body. Increased intestinal permeability is a common feature of an unhealthy gut.
Keeping in mind that each gut microbiome looks different, the terms “healthy” and “unhealthy” used here refer to instances in which gut microbiota functioning, composition, or ratio may deviate from a person’s individual-specific “normal” state.
The Biome and Brain Disorders
Microbial and neurologic development share similar windows of developmental vulnerability, during which they are particularly susceptible to damage The mother provides an infant’s first bacterial exposure; thus, maternal health is very important to a how a child’s microbiome develops. Maternal illness and use of medications may disrupt an optimal microbiota transfer to the infant.
Early life continues to be developmentally critical; disruptions, such as stress or severe illness, can be damaging to gut/brain signaling and have been linked to brain disorders later in life. Several animal studies have shown that early life stress can alter the development of the key stress response system, the hypothalamic-pituitary-adrenal axis, establishing a lifelong alteration in how an animal responds to stress. The impact on the two-way relationship between stress and the gut microbiota may be at the root of this problem. Maternal stress and infection during pregnancy have been linked to neurologic and central nervous system disorders, such as schizophrenia, autism spectrum disorders, and distinct cognitive and behavioral symptoms later in life, and these outcomes may be mediated by the bacteria living in the gut.
Microbiota and Neurologic Disease
Gut disturbances—both gastrointestinal discomfort and altered microbiota —have been linked to neurologic disorders, including multiple sclerosis (MS), autism spectrum disorders, and Parkinson disease. Environmental risk factors for neurologic disease often promote the immunoinflammatory response.
There is suggestion that the misfolding of proteins in the brain may be an etiologic explanation for some neurologic disorders. Brain inflammation, which may originate from the gut, is one notable hypothesis behind protein misfolding.
The proinflammatory state prompted by gut dysbiosis has also been linked to various autoimmune disorders, again including MS MS is most common in Western countries where dietary patterns thought to promote a proinflammatory profile and disrupt optimal gut microbiota states are common. Of note, lipopolysaccharides and antibodies against various antigens have been observed in patients with MS and Parkinson disease, with both markers signaling an increase in intestinal permeability.
Relatedly, neurodegenerative diseases, such as Alzheimer disease and generalized cognitive decline, are marked by age-related brain changes, along with disturbed immune function and increased oxidative stress, these factors have been shown in animals to be influenced by diet and the gut microbiota. Brain-derived neurotrophic factor, a neurotrophin that protects and encourages survival of healthy brain cells and whose production may be influenced by gut bacteria, is shown to be decreased in people with Alzheimer disease. It appears that age-related changes in the gut microbiota might be bidirectionally linked to age-related neurodegeneration.
It is notable that the unhealthy dietary patterns that negatively influence the gut microbiome are also risk factors for depression in older adults, whereas healthier diets protect against cognitive decline.
The Microbiota and Psychiatric Disorders
The notion of the gut/mental health connection has recently started to gain traction. It is now thought that various psychological disorders, depression in particular, may be inflammatory disorders, and that the gut may be an important mediator of these conditions In numerous animal studies, microbial manipulation produced behaviors related to anxiety or depression, and one study demonstrated that the anxious phenotype could be transferred via the intestinal microbiota between animals.
The coping mechanisms for dealing with psychological stress appear to be programmed in early life, so this development may set us up to deal with stress throughout our lives—with some coping mechanisms working better than others. Given the amount of serotonin in the gut and the influence of the gut microbiota on serotonin’s precursor, tryptophan, examining its role in mental health is worthwhile. Early correlational evidence has linked functional and structural damage in the gut with depression, schizophrenia, and autism.
Promoting a Healthy Biome: Strategies
In both neurologic and psychiatric conditions, it is difficult to know what came first: the disorder, or the unhealthy gut. It is possible that gut dysbiosis is responsible for both disease risk and the severity of a disorder, but it is equally plausible that the stress associated with brain disorders is the principal driver of gut dysbiosis. Moreover, the same environmental risk factors (eg, unhealthy diet) may disrupt both gut and brain health.
It is clear that the causes and symptomology of some neurologic/neurodegenerative and psychiatric disorders have a similar underlying pathophysiology and that an unhealthy gut influences these through several overlapping pathways. Although it is difficult to tease out the individual contribution of each of these systems, given their complexity and the difficulty of isolating them clinically, the gut appears to be a key driver of a high-risk, inflammatory state in the body and brain and may prove to be the key in unlocking a new understanding of the etiology of brain diseases that supports new clinical and public health interventions.
Although gut microbial composition appears to be quite resilient, it is also readily modified. Lifestyle factors are particularly important to the composition, diversity, and stability of the gut microbiome. Below are several strategies that research suggests could contribute to overall gut health and that, in turn, may promote the health and protection of the brain.
There is good evidence for the role of individual nutrients, such as omega-3 fatty acids and zinc, in both physical and mental health; it is therefore useful to consume these nutrients as part of an overall healthful diet.
A healthful diet composed of fruits, vegetables, and whole grains has also been linked to higher levels of Bacteroidetes. These types of bacteria are particularly good at producing short-chain fatty acids, which help regulate gut inflammation.
Three main food components are proposed to benefit gut health: living microorganisms known as “probiotics” (found in such foods as yogurt, kefir, and kimchi); nondigestible carbohydrates (eg, dietary fiber found in fruits, vegetables, and whole grains); and secondary plant metabolites, such as flavonoids (found in brightly colored fruits, vegetables, and red wine). Persons who consume a Western-style diet experience less of the protective benefits of plant foods and simultaneously provoke other metabolic disruptions through high fat and sugar consumption, which contribute to gut dysbiosis and inflammation.
Evidence suggests that exercise may increase the diversity of bacteria living in the gut. One study showed increased gut bacterial diversity and fewer markers of inflammation in athletes compared with controls. However, moderate exercise may be best; one study found that persons who exercised one to 30 times per month had higher levels of brain-protecting BDNF than nonexercisers or extreme exercisers. Exercise has been shown to have positive anti-inflammatory benefits, which may promote both gut and brain health.
Pre- and Probiotics and Fermented Foods
There is some support for the benefits of probiotic and prebiotic supplements and fermented foods within the gut, with some groups calling for the inclusion of probiotic or fermented foods in national food guide recommendations. The anti-inflammatory benefits of fiber fermentation in the colon occur naturally during digestion of healthy, fiber-rich foods, resulting in metabolic by-products that include various vitamins and antioxidants. Although some studies show promising results, larger, high-quality trials are needed to fully elucidate this relationship.
Understanding the role of the gut microbiota in neurologic and psychiatric disorders is an exciting prospect, with both conditions contributing significantly to individuals’ quality of life and to global disease burden. Identifying measurable and modifiable microbial “therapies” presents a valuable opportunity for new prevention and treatment strategies for brain disorders.
The possibility of being able to prevent or alleviate neurologic or psychiatric conditions through lifestyle interventions has significant public health implications. However, a full understanding of the gut/brain connection and its health implications is still evolving, and quality clinical trials are needed that include assessments of immune, inflammatory, and gut biomarkers to elucidate the function, behavior, and modifiability of bacteria living in the gut.
Of note, the etiology of neurologic and psychiatric disorders is highly complex and varied; it would be an oversimplification to imply that microbial modification is a cure-all solution. However, general health recommendations remain true. Exercising moderately and consuming a varied diet of whole foods, including lots of fruit and vegetables, can benefit not only your physical health, but also gut health and the health of your brain.”
 “Watching Television and Risk of Mortality From Pulmonary Embolism Among Japanese Men and Women-The JACC Study (Japan Collaborative Cohort),” http://dx.doi.org/10.1161/CIRCULATIONAHA.116.023671 Published: July 26, 2016
 “Plant protein lowers the risk of bad health habits,” JAMA Internal Medicine, online August 1.2016
 “Associations between nut consumption and inflammatory biomarkers,” Am J Clin Nutr 2016 104: 722
 J. Family Practice News, Oct 2016, p12
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