This is one question researchers set out to answer in a recent study published in the British Journal of Psychiatry, published. Many studies have focused on different nutrients as playing a role in mental health, but this group wanted to look at diet patterns as a whole to determine what big dietary factors might be affecting your mood.

The research team, from the University College of London and lead by Dr. Tasnime Akbaraly, used data from a large study called the Whitehall II study, which monitored many social, lifestyle, work and health factors in a group of over 10,000 British civil servants. Dr. Akbaraly’s team focused on evaluating whether what people ate affected their odds of becoming depressed, using a subset of approximately 3,500 people, for whom this data was available.

The researchers used a food questionnaire to lump dietary patterns into two major groups: a whole foods group (heavily loaded with fruits, vegetables and fish) and a processed food group (heavily loaded with sweets, fried foods, high-fat dairy, and processed grains and meats). What they found was that those who ate more of the whole foods or less of the process foods were less likely to become depressed.

To test the validity of their findings, they used statistical tools to remove the affects of several ‘confounding’ factors that may also be contributing to depression, including: age, gender, marital status, physical activity, smoking, education level, employment grade, and a host of other medical conditions. After adjusting for all of these, the findings still stood. A diet rich in whole foods seemed to protect against depression and a diet rich in processed foods seemed to increase the odds of depression.

These data are interesting because no other studies had really evaluated a ‘pro-depressive’ effect of processed foods. Many studies have shown benefit of individual nutrients, like omega-3s and B vitamin, but not really evaluated diet patterns as a whole.

For many people it’s kind of a no-brainer that the foods you eat can affect the way you feel. However, more studies like this one are needed to really make the link between different aspects of the diet and the risk of real depressive disorders, not just blue moods. The more we understand all the factors involved in contributing to depression and related disorders, the more we can do to effectively treat it.

Currently, psychiatrists, nurses and social workers all work together to help people deal with mental illnesses from different angles. Data is emerging, like this study, that suggests if we added nutritionists and exercise professionals into the mix, we could do an even better job.

Studies like this are the only way we can really solidify the science behind a broad treatment approach; and without the data insurance won’t cover it, and without insurance coverage the system won’t change. But do we need to wait for the system to change in order to live better today? No. Eat Well. Your brain will thank you.

Reference: Akbaraly et al., Dietary Pattern and Depressive Symptoms in Middle Age. The British Journal of Psychiatry (2009) 195:408-413.

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We all know that our diet affects our health, and hopefully, if you’ve been reading this blog, you also realize that diet plays a role in cognitive health while you age. We’ve focused many articles in the past on the role of various nutrients in boosting cognitive function.

A new study in the Journal of Nutrition took a somewhat different approach to look at overall diet quality (and lack there of) in healthy cognitive aging; as opposed to focusing on specific nutrients as most studies do. The results were interesting because they suggested that eating good food helps you age better, but eating not so good food doesn’t matter so much.

The research team from Utah State University recruited several thousand people over the age of 65 and gave them a questionnaire about the foods they typically eat. They then separated these people into four groups based on intake of ‘recommended foods’. Those that ate the most recommended foods were in the first group, those that ate the least amount of recommended foods in the fourth group, while intermediate intakes of recommended foods placed people in groups two and three. Recommended foods we’re all the standard stuff, like whole grains, fruits and vegetables, lean protein, low-fat dairy, and non-fried fish.

Researchers then implemented cognitive tests to all the participants and found that groups who ate more recommended foods performed better than those who ate less of the recommended foods. But they weren’t done yet. The research team followed the participants for an average of 11 years and found that the differences between groups were exaggerated over time.

While all the groups performed less well after 11 years than they did at the beginning of the study (since they were getting older), those who ate more recommended foods declined much slower than those who at less good stuff. In other words, we all get a little slower as we age, but those who get good doses of good foods can expect a much kinder slope than those who don’t.

There was one more surprising bit to this study. The researchers also looked at how eating non-recommended foods influenced initial cognitive performance and decline over the 11 year period, and found no association. That is, people who ate more poor foods did not fare worse than those who ate less poor foods.

How is this possible? Essentially, this research suggests is that eating good foods is more important than not eating bad foods. In other words, if you get a good dose of all the recommended stuff, then a death by chocolate cake now and again isn’t a big deal. However, if you live on a staple of hotdogs and French fries (or freedom fries for those who still hold a grudge, another unhealthy behavior), then you probably don’t have the buffer necessary to fight off the ill effects of other poor choices.

In fact, in this study the group who ate the largest amount of recommended foods, also tended to eat more non-recommended foods. This seems to get back to the whole argument that we have been making for some time now of incorporating variety into your diet (and other aspects of your life). That said, you still want to keep your total calorie intake down so you don’t gain weight. Just because you eat a big healthy meal, doesn’t mean that a whopping dessert won’t pack a caloric punch. That’s a whole different question.

The bottom line is to work on getting high quality foods into your diet to help protect your cognitive health and don’t stress out on the occasion that you want something a little more sinful.

Reference: J. Nutrition, 139:1944-1949, 2009

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By Simon J. Evans, PhD

This post will be a little different format than our usual ones. On February 25th, in Washington DC, the Institute of Medicine hosted a special summit on Integrative Health. There were some incredible talks and they’re all freely available at http://www.imsummitwebcast.org. The focus was how we can stop so many people from getting sick, instead of just trying to treat people once they get there.

Dr. Dean Ornish gave a great talk that I strongly encourage you to check out – even though it’s 45 minutes long. If you have any interest in getting more of a prevention focus into the broken health care system, you’ll enjoy his talk. Once at the webcast site, click the sessions tab and choose the session called ‘Science’. Dean’s talk is the keynote on that page. Here are some bullet points from his presentation:

• Integrative medicine should bring together lifestyle, stress management and emotional well being into therapeutic strategies.
• We can no longer simply study things in isolation. Here’s an example. Curcumin may help prevent Alzheimer’s and has data to support that, but other studies show it doesn’t do anything. However, when given with black pepper the bioavailability increases 2000%. The way we currently design studies by isolating compounds, misses these interactions.
• “Sometimes it’s more important to know what patient has a disease than what disease the patient has.”
• Social support and stress management play large roles in disease susceptibility and recovery and should be part of a treatment approach.
• “We spend so much time in medicine mopping up the floor from the sink that’s over flowing, instead of just turning off the faucet.”
• The body has a remarkable ability to heal itself if given the tools it needs. Sometimes the low-tech approaches are the most powerful.
• Changing your environment can change your genes. If you have ‘bad’ genes, you just need to make bigger changes. Genes are our predispositions, not our fate.
• Heart and blood vessel diseases kill more people than any other diseases, yet they are almost completely preventable and reversible.

Many of these points, we have spent entire blog posts on in the past, so you may have seen them before. Still I hope you can find the time to check out a couple of the videos at http://www.imsummitwebcast.org. Start with Dean’s.

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By Simon J. Evans, PhD

What does the word ‘fitness’ mean to you? Do you think of a body builder or a marathon runner? Do you think an Olympic swimmer? How about an old person reading a map? Huh? Where’d that last one come from?

A new study published in the January 2009 edition of Hippocampus finds that older adults (59 to 81 years) who were more fit had increased spatial memory compared to less fit adults of the same age. They also had a bigger part of the brain, called the hippocampus, which is involved in learning and memory. The hippocampus is also a part of the brain that is particularly targeted in Alzheimer’s disease. Currently science assumes that when it comes to the hippocampus, bigger is better.

Larger hippocampi (plural form) are also associated with better ability to handle stress. In fact, some studies show that war veterans with a larger hippocampus have less intense post-traumatic stress disorder. This may be because their bigger hippocampi protect them from stress better. It may also be that stress itself, shrinks the hippocampus. In fact, the data suggest that both are probably true.

Having a genetically endowed hippocampus probably puts you at somewhat of an advantage when it comes to handling stress. But learning to manage stress can probably also protect your hippocampus and help you age with a little more cognitive grace.

In this new study, researchers recruited 109 older adults and tested their level of physical fitness using a treadmill, measuring aerobic fitness, heart rate and blood pressure. After that, the participants all had their brains scanned in an MRI machine, allowing researchers to measure the size of their hippocampus.

When they compared the two types of measures, low and behold, increased aerobic fitness correlated with increased hippocampal volume, a bigger hippocampus. But the researchers didn’t stop there. They also tested all the participants on spatial memory tasks.

Using a computer, dots were flashed on the screen and the subjects had to remember where those dots came up, monitoring one, two or three dots at the same time. Again, the older adults with better fitness measures performed better on this test.

The researchers believe that the reason they do better on the tests is because they have bigger hippocampi, and the reason they have bigger hippocampi is because they are more fit.

This all make sense, knowing what we know about how exercise boosts brain function. However, we still have to point out that this is a retrospective study. This means you can’t say for sure that increased fitness caused increased hippocampal size and increased performance on memory tests. There may be other factors.

Still, when you look at this new study in the context of all the other studies showing that exercise is good for the brain, it sure seems to be true. This is one more piece in the mind-body connection puzzle. Every day research comes out making it clearer and clearer that the health of your body influences the health of your brain. So if you want to stay sharp in those older years don’t just rely on crossword puzzles in the daily paper to get you there – unless you’re taking a brisk walk down to the corner store to pick it up.

Reference:
Hippocampus. 2009 Jan 2. [Epub ahead of print]

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By Paul R. Burghardt & Simon J. Evans

In the last article we spoke about the age at which a person develops diabetes increases their risk for different types of dementia. In effect, the longer you can hold-off developing diabetes the less risk you have for developing vascular dementia and Alzheimer’s Disease.

A recent article by De Felice and colleagues in the Proceedings of the National Academy of Sciences speaks to how preventing diabetes or effectively managing the disease can affect brain cells at the microscopic level.

In this study, the researchers were able to show that insulin blocks the protein A-derived diffusible ligand (ADDL). This protein causes all sorts of problems for neurons including withering of the “spines” that make connections with other neurons and redistribution of other neuronal components (receptors) that are critical for the formation of memories.

In a sense, it appears that insulin is helping neurons stick to a microscopic version of the “use it or lose it” principle. When insulin was able to interact (bind to) insulin receptors the ADDL protein was not able to bind to the nerve cells. If you don’t use your insulin receptors, you lose parts of your brain cells (i.e. spines).

One issue that needs to be pointed out regarding this paper is that these studies were carried out in “cell culture.” No, this is not a New-Wave band from the 80’s. Cell culture, in science at lease, refers to a technique used to grow cells in a dish. Once you have cells growing in this very controlled laboratory situation, you can test the effects of different drugs, chemicals, nutrients on various functions of those cells. This is great for learning about how the nuts and bolts of cell biology work, however this is not a “natural” situation for a cell, and it can be difficult to directly use the information gleaned from cell culture experiments in an intact organism (i.e. a walking talking human).

With that cautionary point about cell culture experiments in mind, we’d like to point out that there are studies showing that insulin-sensitizing drugs (drugs that help the body use insulin) can improve memory in diabetics and people with Alzheimer’s Disease. So this is something that people should pay attention to! Not just us nerdy scientists that are fascinated by how things work under a microscope.

The real take-home message for diabetics, relating to the previous blog, is that good management of your diabetes is EXTREMELY important. If insulin has the ability to block these nasty little ADDL proteins from eating the branches of your brain cells, then the better control of your insulin levels should help you fend off these proteins. If you are not diabetic, but have a family history, then take steps to reduce your risk of developing diabetes. This disease occurs over time, so the longer you can avoid it (see the February 17th blog) the less you are likely to accrue.

Now, if you’ve been reading faithfully, you’ll notice Simon focused on the same article in “Control your blood sugar, Improve your memory?” on February 11th, but we wanted to revisit it to tie together with the posted on February 17th, “Diabetes increases risk for developing dementia: what control do you have” to emphasize that no matter if you have ‘normal’ blood glucose control or have diabetes you can help reduce your risk for developing dementia.

Another side-note….although the narrator of the video clip below mentions that insulin does not cross the blood brain barrier (which protects the brain from bad stuff), there is pretty good evidence indicating that insulin actually does cross into the brain.

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By Paul R. Burghardt

A recent report by Xu and colleagues in the journal Diabetes, addresses one of the “modifiable risk-factors” for developing dementia. In other words, it tried to identify those things we do and control on a day-to-day basis that ultimately reduce or increase the likelihood of developing disease. These modifiable risk-factors include things like weight-management, blood pressure control, managing diabetes, and exercise. This study focused on how diabetes can influence the chances that we develop dementia depending upon genetic traits and when in the lifespan a person develops diabetes.

Since diabetes increases the risk of developing Alzheimer’s disease, as well as vascular dementia (yep, unfortunately there are a couple of ways to develop substantial cognitive decline), understanding how genetics and lifestyle choices interact during the development of disease will provide a lot of information that can be used for both prevention and treatment. We already know that avoiding diabetes, or managing diabetes effectively, is of the utmost importance.

To address the issue of how the development of diabetes relates to the risk for dementia, Xu and colleagues utilized the Swedish Twin Registry. This is a national survey in Sweden that tracks health information about twins, which is pretty cool for research purposes. Plus, it’s good to know the Doublemint girls are keeping busy, right?

Their general findings weren’t too surprising: diabetes increases the risk for developing dementia whether it be, vascular dementia or Alzheimer’s disease. However, there were some distinct findings in this study emphasizing that timing is everything.

A particularly interesting finding was that the risk for dementia (vascular or Alzheimer’s disease) increased if a person developed diabetes before they turned 65. By the way, the most common time for Alzheimer’s disease diagnoses is in people 65 years of age or older. Remember, this disease takes a number of years to develop, so what you do now may have a substantial impact on how your brain ages.

This probably occurs by the amount of ‘wear-and-tear’ your brain is able to handle under diabetic conditions, particularly if you are genetically predisposed to developing dementia. The concept of cumulative wear-and-tear has a fancy name, “allostatic load.” This idea is important for all aspects of our health as it accounts for the interactions between our genes and environment in a time-dependent manner. But that is for another post….

In general, this study reiterates a couple of issues. First, it highlights the importance of the mind-body link. Although many people think that diabetes is a problem for blood sugar control, it influences a lot of other organs in our bodies, including our brains. Second, if you have a family history of diabetes the longer you avoid developing the disease the better this will be for your brain (and rest of your body).

Unfortunately in this study the authors weren’t able to look at individual’s ability to control/manage their diabetes. But I’d like to be optimistic and believe that better management of a disease like diabetes would help decrease its negative influence on other aspects of our biology. In line with this, please see our blog post for this Thursday!

Reference:
Diabetes. 2009 Jan;58(1):71-7. Epub 2008 Oct 24.

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