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

The benefits of green tea have received a lot of press lately. Several studies have shown that green tea drinkers perform well in several measures of health, including some of those relative to brain fitness. But can green tea also help you lose weight? Researchers asked that question recently and found some interesting results.

A study published in a recent edition of the Journal of Nutrition, evaluated exercise-induced weight loss in 132 overweight and obese adults who also drank green tea extracts during their weight loss regime. All adults in this study participated in exercise programs and half were given a caffeinated beverage with green tea extracts (catechins, pronounced kat-i-kins) while the other half drank equal amounts of a caffeinated beverage without the green tea.

All participants in the study lost weight due to the exercise program, however those drinking the green tea extract containing catechins lost a little more. The interesting thing about this is that the fat lost by the green tea extract drinkers was specifically belly-fat. Other areas of fat loss were fairly even between the two groups.

Why is this important? Recent research has discovered that belly fat is particularly bad for your health. Excess belly fat releases hormones that have all kinds of negative effects, including reducing sensitivity to insulin, which is a major problem. Insulin sensitivity controls many aspects of brain and body health, including risk for diabetes, and maybe even depression and late-life dementia.

So it’s very cool that the catechins found in green tea helped folks in this study lose more belly fat in response to their exercise programs since it will probably feedback on many other systems in their bodies to improve their health. In fact, those in the green tea group showed better improvement in measures of triglycerides and total cholesterol as well.

Some societies have known about the health benefits of green tea for centuries and use it as a regular part of their diet. Western science is really just catching up to explain why this beverage is a powerful component of your overall approach to health. And the best part is there are no real side-effects, as long as you don’t overdo it. Remember, it is a caffeinated beverage so still should be drunk in moderation.

If you’re a regular coffee or black tea drinker, consider replacing an occasional cup with some green tea instead. Coffee and black tea themselves have been shown to have some health benefit, when used in moderate amounts of a cup or two per day, but green-tea seems to beat them both for overall health. As in any health plan, the enjoyment factor is huge, so don’t try to adopt strategies that you really don’t like. But if you’re not a regular green tea drinker, why not try a cup or two to see how you feel.

Before signing off of this particular article, it must be pointed out that everyone in this study was exercising, and green tea just made the exercise a bit more effective. You’re not likely to lose that body fat with green tea alone, you still have to move.

Reference:
Journal of Nutrition (2009) 139:264-270

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by Simon J. Evans, PhD

In 2006, the total cost of health care in the United States was 2.1 trillion dollars, which is more than the gross national product of China. Yes, we spend more on healthcare than China spends on everything.

We’ve all heard that the war in Iraq costs the U.S. taxpayers about $10 billion per month, which is $120 billion annually. That means we are spending close to 20 times more on health care than we are on the war in Iraq. In fact, we spend more on healthcare than the entire defense budget. A big chunk of our taxes go to health care spending, and we’re not even doing a very good job at it given that 47 million Americans are still uninsured.

Here’s the real kicker, 70 to 80% of health care dollars are spent treating chronic preventable illness. Yes, preventable. If we all chose to live a little healthier, basically, eat better and exercise more, we could save so much money as a nation that we could afford to invade another country, maybe Canada.

The Obama – Biden administration is inheriting a lot of problems, including war and a financial crisis. As everyday citizens, it’s difficult to influence policies that will help remedy these situations. Not to mention that most of us (me included) would have no idea how to fix them anyway.

However, every one of us has significant control over our own health, which is the largest drain on our economy. So, can you lower your taxes by going for a walk – probably. According to a talk I attended recently by Emanuel Ezekiel, the Director of the NIH Bioethics Department and author of Health Care Guaranteed, approximately one third of most state taxes support healthcare. Not to mention the obvious burden on employers, which translates into reduced wages for employees.

So…what can we do to lower our taxes? Live with greater attention to our personal health.

If we choose to continue to ignore health issues, it may actually cost us significantly more. In 2011, Alabama will begin charging state workers who fall into the obese category an extra $25 for the health coverage. Since Alabama has one of the highest obesity rates in the country, with nearly 1 out of 3 folks packing on those kind of pounds, that’s going to sting. I don’t really agree with this approach and I think it will open up all kinds of legal challenges. However, the fact that one state is going down this road should be a wake-up call to us all.

The bottom line is that our health care crisis is getting out of control, but is largely within our control. Politicians spend big chunks of their time trying to figure out how to deliver more care to our citizens. But wouldn’t this attention be better spent trying to figure out how to stop so many people from getting sick in the first place? Maybe we should stop looking to the policy makers for answers and take our health into our own hands. Maybe it’s time for a little personal responsibility.

We will always have illness. Even if we did everything right, some folks would still get sick. That’s just the nature of our biology. But it seems to me that an 80% reduction in illness, which is what a better diet and more exercise could do, and which translates into a savings of about 1.6 trillion dollars a year, is a no-brainer.

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By Paul R. Burghardt

In a recent issue of the British Medical Journal, van Dam and colleagues assessed the combined risk of “cigarette smoking, being overweight, taking little moderate to vigorous physical activity, no light to moderate alcohol intake, and low diet quality score” on mortality (a.k.a. death).

This is a very neat set of data and speaks to the foresight of the researchers that set up this project. Back in 1976 a heap of questionnaires were sent out to a lot of nurses (almost 100,000) so researchers could gather information on the nurses’ diet, activity levels, smoking habits, body weight and alcohol consumption. Then, they pestered these nurses with questionnaires for several decades to see how their behaviors might be related to their overall health.

If you’ve been paying attention, the punch-line won’t be all that surprising. Poor lifestyle habits result in greater risk of dying. What is interesting is that the combination of those 5 lifestyle choices accounted for 55% of the deaths in the group of nurses who took part in the study. You have to remember the unfortunate reality that a percentage of people will die over a period of time due to accidents, and the researchers took this into account. Therefore, the deaths of more than half the women from this study were due to these unhealthy lifestyle choices.

Another interesting tidbit is that they found no alcohol consumption, or alcohol consumption greater than one or two drinks each day increased risk for death attributable to cardiovascular disease. In contrast, two or more alcohol drinks per day resulted in an increased risk of cancer. Just something to keep in mind when considering your family health history.

There were also some pretty substantial jumps in the risk for death (mortality) once a person accumulated at least 3 of the unhealthy behaviors. This is an important idea to keep in mind. How heavy of a burden can you deal with? One unhealthy behavior or condition may not be insurmountable, but two or three may be more than you can carry before you become exhausted. An even more precarious situation is when something unexpected comes along. The burden of unhealthy behaviors can be viewed as the slippery slope, and a major life event (e.g. death of a loved one) as the little nudge it takes to send you over the edge.

It might be useful to think of this scenario like the foundation of your house. You can think of your lifestyle choices as reinforcing, or chipping away at the foundation set-up by your genes. Your genetic inheritance may have provided you with a given stability to your foundation. Engaging in healthy behaviors would be similar to sealing the cement of your foundation and grading the lawn so that water runs away from your house.

In contrast, unhealthy behaviors actively deteriorate your foundation, almost like someone pounding away at your foundation with a ball-peen hammer…. Doesn’t seem like a big deal, but over time problems will arise. Ping, ping ping….you have a chip. Ping, ping, ping…..now there is a crack. What happens when there is a little seismic activity in your neighborhood, or rain gets into the crack and freezes? That’s when big problems occur. Now think if you had five people with hammers pounding away on your foundation.

Again, it may not be much of a surprise that partaking in unhealthy behaviors resulted in substantially higher risk of dying. Although this study didn’t look at the effect of lifestyle choices on brain health, we know that a lot of these health issues travel together and can influence our brain. Diabetes, cardiovascular disease, obesity, physical inactivity, all set the stage for decreased brain health over our lifetime. So be proactive, put the hammer down and reinforce your basement, you never know when it might rain!

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By Simon J. Evans

As the Brain Fitness industry continues to gain momentum, and people explore all the incredible brain-training tools being developed, we hope that enthusiasts don’t take their eye off the importance of the physical health of the brain and all the systems it communicates with. The brain is unique in that it houses our cognitive and emotional capacities in the form of the mind.

It is a ‘cognitive’ organ that hungers for stimulation from new experiences and challenges. Many brain fitness programs strive to satisfy this need. Yet the brain is also a physical organ that plays by many of the same rules as the heart, lungs, liver and kidneys. To stay healthy and perform optimally it requires quality nutrition, physical activity and optimal sleep.

The brain, especially, relies on a healthy vascular system to efficiently deliver oxygen and key nutrients and remove waste. In fact, the brain uses approximately 20% of the oxygen we breathe to satisfy its high-energy demands. Given that the brain only weighs about 2% of the body, we can consider it an energy hog and we must cater to its needs very carefully.

Brain Food

Nutrients play key roles in brain function. Several have shown efficacy in clinical trials treating cases of mood disorders, cognitive decline and of course benefiting the physical health of the brain. Nutrients are both the raw materials employed in creating new neural connections and important components in regulating the activity of genes involved in these processes. Specific nutrients involved in mitochondrial efficiency, the energy factories of brain and body cells, are particularly important for many aspects of brain function. Other nutrients are involved in the inner workings of neuronal membranes, responsible for ensuring that electrochemical signals, which make up our thoughts, transmit efficiently and reliably. Finally, antioxidants, important throughout the body, are especially important in the brain due to its high energy production rates and concurrent high capacity for free radical leakage. Keeping this in mind, it is readily apparent that nutrition provides the building blocks for our brain’s structure and function, and therefore cannot be ignored.

Building Brain Muscles

Exercise is a clearly established component for promoting brain health as well. No longer can we think that the brain is completely separate from the brawn. Human studies have shown the value of exercise in controlling stress and maintaining positive mood states; in improving cognitive function, including performance on memory and executive tasks; and in improving the brain’s two-way communication streams with the rest of the body. Some of these benefits are likely due to the positive effects of exercise on neurovascular health, which parallel cardiovascular health. Other benefits seem due to increased grey matter in ‘front office’ functions of the cortex; and neuronal birth, or neurogenesis, in the hippocampus, a brain region that controls aspects of memory and mood regulation. Whatever the mechanism, giving your body a workout will produce substantial benefits in terms of brain health. Remember, a body in motion tends to stay in motion, and your brain and body will be together your whole life.

Mental Workouts

Mental activity is an obvious, and critical, ingredient for optimizing and maintaining brain function. Studies have established relationships between the degree of life-time mental activity and late-life cognitive function. It’s clear that those who engage in intellectually challenging endeavors on a regular basis reap the benefits of a clear mind. There is, however a need for each individual to balance sufficient variety with a proper degree of challenge. Without variety and challenge, tasks become too mundane and too easy, eventually growing stale and losing their capacity to adequately stimulate the brain. We must also realize that mental activity goes beyond ‘cognitive’ tasks. Mental activities also include practices like meditative focus, relaxation and stress reduction techniques, as well as social interaction. These active and dynamic processes challenge the mind as well. Mixing cognitive challenges with emotional regulation provides a more complete mental workout that will help you to use it to improve it.

Rest and Regeneration

An often neglected component contributing to brain health is optimal sleep. On average, we sleep approximately 1.5 hours per night less than we did 100 years ago. Modern technology makes it easier to get less sleep and our busy lives encourage us to do it. Sleep is far more than a time of rest, and is too often misclassified as a period of lost productivity. It is an active metabolic period for our brains. Sleep is a time when we consolidate memories of the previous day, a time when we re-synchronize the circadian rhythm of at least dozens, if not hundreds, of hormones controlling our metabolism. Sleep loss is associated with a high percentage of mood disorders and certainly reduces our cognitive efficiencies. We must give ourselves permission to sleep by realizing that it is counterproductive to steal from it.

In BrainFit for Life: A User’s Guide to Life-Long Brain Health and Fitness, we focus equally on the cognitive, emotional and physical health of the brain and all of the lifestyle factors that come into play to maintain them. Today’s aging population is becoming increasingly focused on the maintenance of cognitive health and the value of ‘brain training’ programs. But we must realize that such training is not unlike that of an athlete, who must focus on their diet, sleep needs and psychological preparation in addition to their physical skill development. We explore specific aspects of nutrition, exercise, mental activity and sleep. We discuss how they regulate emotional, physical and intellectual functions of the brain. After all, they are not separable.

“To keep the body in good health is a duty…otherwise we shall not be able to keep our mind strong and clear.” – Buddha, circa 500 B.C.

BrainFit For Life is available at http://www.brainfitforlife.com/book.php

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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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