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 Simon J. Evans, PhD

A lot research has focused on omega-3 fats as good for body and brain function. Scientists have scrutinized these fats in everything from heart disease and diabetes to depression, bipolar illness, schizophrenia, ADHD and Alzheimer’s. The latest papers to add to the experimental pile come from a recent edition of the American Journal of Clinical Nutrition.

The new studies evaluate omega-3s in people in their 70s and 80s and relate to cognitive function, mood and mental well-being. The bottom line to the new findings is that having higher levels of omega-3s in your blood protects you from many cognitive problems of old age. The downside is that you can’t just start taking them in your 70s and expect quick results. However, longer use may still be beneficial.

So what’s the best way to boost omega-3 levels in your blood. First, you have to understand that there are different kinds of omega-3s that come from different sources. The kind of omega-3s that are good for your brain are called ‘long-chain’ omega-3s, most commonly DHA and EPA, and fish is the best source for these.

You may have heard that things like flaxseed oil and walnuts are high in omega-3s as well. Although this is true, these foods are only high in ‘short-chain’ omega-3s, which are not the kind that appear to have the most brain benefit.

To complicate things even further, most animals can convert the short-chain to long chain forms, but humans are not very good at this. If we want to increase long-chain omega-3s in our blood and increase our odds of aging with a healthy brain, eating sources of long-chain omega-3s is our best bet. Fish is the #1 source.

If you don’t eat about 3 servings of fish per week, you should really consider taking a fish oil supplement on a regular basis. If you are a vegetarian who does not eat fish at all, don’t fret, there are also algal oil supplements out there that have the long-chain omega-3s. After all, fish can’t make omega-3s either. They get them by eating marine plants (or eating other fish that eat marine plants). Fish are just good at concentrating omega-3s in their meat, so are a great source for us folks that don’t like chewing on seaweed.

Fish has been considered brain food for the better part of a couple of centuries. Whether you like it or not, our bodies are designed to run best on a diet high in marine sources. If you look at the cultures around the world who enjoy longevity and vibrant health into their old age, you will find fish as a staple in all of them.

There is nothing new to this advice. Only that we are now beginning to understand why fish and the omega-3s they give us, are important for many aspects of our mood and metabolism. Once again, science finally catches up to age-old wisdom to support what we have known all along – Fish is brain food, eat it and prosper.

Reference: American Journal of Clinical Nutrition (2008). 88: pp 595, 706, 714, 722.

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By Paul Burghardt, PhD

Here’s one for the notebook. People who exercise regularly obtain greater elevation in mood following a single exercise session compared to people who don’t exercise regularly. This was revealed in a recent study by Hoffman & Hoffman (2008) in the Archives of Physical Medicine and Rehabilitation.

What?! Who?!?! How?!?!?…. It just doesn’t seem fair. Isn’t exercise supposed to elevate mood for everyone!?!?

At this point, you might be saying to yourself, “There’s no point in starting an exercise program, you only get improvements in mood if you exercise regularly.” Easy there Debbie Downer, there are still plenty of reasons to increase your physical activity or start exercising.

Digression Alert!

For those of you who are unfamiliar, Debbie Downer is a character from a Saturday Night Live skit. She could transform anything that anyone said into a completely depressing anecdote. Debbie was not just a ‘glass half empty’ type of person, she was a ‘dirty glass is a three-quarters empty and it dropped and broke on the floor’ type of person. Your can follow this link to check her out. If for no other reason than it is one of the rare occasions on SNL when the cast has a difficult time ‘keeping it together.’

Back to the Science!

To recap, we were talking about how it was unfair that people who exercise regularly experience a greater elevation in mood after a single session of exercise than people who don’t exercise.

There was a couple of interesting things about this study. First, this study looked at people who were, on average, in their early 40’s. It isn’t uncommon for these types of studies to look at college-age kids or people that are in the autumn of their lives. So this snap shot of the middle portion in life is pretty interesting.

Second, this study required people from each group to exercise at the same level of perceived exertion. Everyone performed a warm-up that felt very light, and then ran on the treadmill for 20 minutes at a pace that felt somewhat difficult. An important issue to note is that those who exercised regularly were likely working at a higher absolute intensity compared to people who were sedentary. For example, regular exercisers might warm up at a pace of 4 miles per hour, whereas the sedentary people may have warmed up at 2 miles per hour…but it felt the same to both groups.

This is the main idea behind perceived exertion. There are several tools, questionnaires really, available to measure how difficult exercise feels to an individual. A commonly used scale for exercise is the Borg-scale which measures 6-20. A perceived exertion of 6 would feel like the person was resting comfortably. A perceived exertion of 20 would be a scenario where the person would feel like they are working as hard as they possibly could; for example sprinting uphill. What is really cool about this scale is that you can often match the person’s subjective verbal rating of exertion to an objective measure of heart rate.

What do I mean? Basically you take their reported exertion score on the Borg-scale, let’s say 12, and multiply it by 10 to get the person’s heart rate; in this case 120 beats-per-minute. When researchers do that, they’re typically not that far off from the heart rate actually measured.

Now you might be thinking, “hey, Debbie has a point, if I don’t exercise regularly, then why start? I won’t get anything from it.” Well that’s not true. This study showed that people who exercise regularly obtained a greater enhancement of mood following a single bout of exercise compared to those who don’t exercise regularly. But, those who didn’t exercise regularly still experienced an improvement in mood following a single exercise session.

So you can be an ultra-marathoner, a regular exerciser, or a couch potato and still experience some elevation of your mood after a single session of exercise. The thing you need to realize is that you’ll feel even better if you can make exercise a normal part of your routine. However, is that improvement in mood enough motivation for sedentary people?

The authors of this article raise this very interesting point. Namely, that the elevation in mood experienced by sedentary individuals after a single exercise session may not be substantial enough to surpass that experienced by less healthy activities. To translate, you might get more of a temporary elevation in mood from sitting on the couch eating potato chips and watching TV than if you go out for a walk. That is to say, if you are just starting to incorporate exercise into your daily routine.

This is where it helps to have some foresight and look to the future. You will continually build on your past efforts, your previous investments so to speak. As you develop your physical reserve it pays out larger dividends. It’s very similar to compound interest. The more you save, the more you have available to earn interest on partially due to what you put in, and partially due to what is paid back into your account by your own investment.

An interesting parallel to the benefits of building up a ‘physical’ bank account is the ability to withdraw from what you have accrued. If we’ve built up sufficient savings in our account, for a rainy-day, we’ll be better able to handle the unexpected challenges that life inevitably will through our way. Just remember, it takes some time to build a big enough bank account that you can take vacation for a month.

Hopefully, this information will give you some extra motivation to make it through the initial weeks when first starting an exercise program. I know it’s can be difficult to maintain in the beginning. However, it appears that if you can maintain it you will be rewarded. So take heart, it will get easier and ultimately make you feel better.

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