Wednesday, February 29, 2012

Brain Health improvement tips


Improve Brain Health Now: Easy Steps

We can sum­ma­rize a lot of research by say­ing that there are four essen­tial pil­lars to main­tain­ing a healthy brain that func­tions bet­ter now and lasts longer. Those pil­lars are:
  • 1) Phys­i­cal Exercise
  • 2) Men­tal Exercise
  • 3) Good Nutrition
  • 4) Stress Management
Great … now what?! How do you develop a healthy lifestyle that includes all four pil­lars? Let’s look at each one.
  1. 1. Phys­i­cal Exer­cise
    • - Start by talk­ing to your doc­tor, espe­cially if you are not cur­rently phys­i­cally active, have spe­cial health con­cerns, or are mak­ing sig­nif­i­cant changes to your cur­rent program.
    • - Set a goal that you can achieve. Do some­thing you enjoy for even just 15 min­utes a day. You can always add more time and activ­i­ties later.
    • - Sched­ule exer­cise into your daily rou­tine. It will be become a habit faster if you do.
    • - If you can only do one thing, do some­thing car­dio­vas­cu­lar, mean­ing some­thing that gets your heart beat­ing faster. This includes walk­ing, run­ning, ski­ing, swim­ming, bik­ing, hik­ing, ten­nis, bas­ket­ball, play­ing tag, ulti­mate Fris­bee, and other sim­i­lar sports/activities.
  2. 2. Men­tal Exer­cise
    • - Be curi­ous! Get to know your local library and com­mu­nity col­lege, look for local orga­ni­za­tions or churches that offer classes or workshops
    • - Do a vari­ety of things, includ­ing things you aren’t good at (if you like to sing, try paint­ing too)
    • - Work puz­zles like cross­words and sudoku or play games like chess and bridge
    • - Try a com­put­er­ized brain fit­ness pro­gram for a cus­tomized workout
    • - If you can only do one thing, learn some­thing new every day
  3. 3. Good Nutri­tion
    • - Eat a vari­ety of foods of dif­fer­ent col­ors with­out a lot of added ingre­di­ents or processes
    • - Plan your meals around your veg­eta­bles, and then add fruit, pro­tein, dairy, and/or grains
    • - Add some cold-water fish to your diet (tuna, salmon, mack­erel, hal­ibut, sar­dines, and her­ring) which con­tain omega-3 fatty acids
    • - Learn what a portion-size is, so you don’t overeat
    • - Try to eat more foods low on the Glycemic Index
    • - If you can only do one thing, eat more veg­eta­bles, par­tic­u­larly leafy green ones
  4. Stress Man­age­ment
    • - Get reg­u­lar car­dio­vas­cu­lar exercise
    • - Try to get enough sleep each night
    • - Keep con­nected with your friends and family
    • - Prac­tice med­i­ta­tionyoga, or some other calm­ing activ­ity as way to take a relax­ing time-out (maybe a bath)
    • - Try train­ing with a heart rate vari­abil­ity sen­sor, like the one in emWave (for­merly known as Freeze-Framer)
    • - If you can only do one thing, set aside 5–10 min­utes to just breathe deeply and recharge

Improve Brain Health with Physical Exercise


Physical Exercise and Brain Health

Healthy Seniors
Have you heard of or read John Ratey’s book “Spark: The Rev­o­lu­tion­ary New Sci­ence of Exer­cise and The Brain”? Accord­ing to Har­vard Psy­chi­a­try Pro­fes­sor John Ratey noth­ing beats exer­cise for pro­mot­ing brain heath.
I am sure you have also heard that exer­cis­ing your mind pro­motes brain health.
What is the con­nec­tion between phys­i­cal and men­tal exer­cises? Do they have addi­tive effects on brain health? Are they redundant?
Let’s start by review­ing what we know about the effects of phys­i­cal exer­cise on the brain.
The effect of phys­i­cal exer­cise on cog­ni­tive performance
Early stud­ies com­pared groups of peo­ple who exer­cised to groups of peo­ple who did not exer­cise much. Results showed that peo­ple who exer­cised usu­ally had bet­ter per­for­mance in a range of cog­ni­tive tasks com­pared to non-exercisers.
Lau­rin and col­leagues (2001) even sug­gested that mod­er­ate and high lev­els of phys­i­cal activ­ity were asso­ci­ated with lower risk for Alzheimer’s dis­ease and other dementias.
The prob­lem with these stud­ies is that the exer­cis­ers and the non-exercisers may dif­fer on other fac­tors than just exer­cise. The advan­tage that exer­ciser show may not come from exer­cis­ing but from other fac­tors such as more resources, bet­ter brain health to start with, bet­ter diet, etc.
The solu­tion to this prob­lem is to ran­domly assigned peo­ple to either an aer­o­bic train­ing group or a con­trol group. If the exer­ciser group and the non-exerciser group are very sim­i­lar to start with and if the exer­ciser group shows less decline or bet­ter per­for­mance over time than the non-exerciser group, then one can con­clude that phys­i­cal exer­cise is ben­e­fi­cial for brain health.
In 2003, Col­combe and Kramer, ana­lyzed the results of 18 sci­en­tific stud­ies pub­lished between 2000 and 2001 that were con­ducted in the way described above.
The results of this meta-analysis clearly showed that fit­ness train­ing increases cog­ni­tive per­for­mance in healthy adults between the ages of 55 and 80.
Another meta-analysis pub­lished in 2004 by Heyn and col­leagues shows sim­i­lar ben­e­fi­cial effects of fit­ness train­ing on peo­ple over 65 years old who had cog­ni­tive impair­ment or dementia.
What is the effect of fit­ness train­ing on the brain itself?
Research with ani­mals has shown that in mice, increased aer­o­bic fit­ness (run­ning) can increase the num­ber of new cells formed in the hip­pocam­pus (the hip­pocam­pus is cru­cial for learn­ing and mem­ory). Increased exer­cise also has a ben­e­fi­cial effect on mice’s vas­cu­lar system.
Only one study has used brain imag­ing to look at the effect of fit­ness on the human brain. In 2006, Col­combe and col­leagues ran­domly assigned 59 older adults to either a car­dio­vas­cu­lar exer­cise group, or a non­aer­o­bic exer­cise con­trol group (stretch­ing and ton­ing exer­cise). Par­tic­i­pants exer­cised 3h per week for 6 months. Col­combe et al. scanned the par­tic­i­pants’ brains before and after the train­ing period.
After 6 months, the brain vol­ume of the aer­o­bic exer­cis­ing group increased in sev­eral areas com­pared to the other group. Vol­ume increase occurred prin­ci­pally in frontal and tem­po­ral areas of the brain involved in exec­u­tive con­trol and mem­ory processes. The authors do not know what under­ly­ing cel­lu­lar changes might have caused these vol­ume changes. How­ever they sus­pect, based on ani­mal research, that vol­ume changes may be due to an increased num­ber of blood ves­sels and an increased num­ber of con­nec­tions between neurons.
How does phys­i­cal exer­cise com­pare to men­tal exercise?
Very few stud­ies have tried to com­pare the effect of phys­i­cal exer­cise and men­tal exer­cise on cog­ni­tive performance.brain books
When look­ing at each domain of research one notices the fol­low­ing differences:
- The effects of cog­ni­tive or men­tal exer­cise on per­for­mance seem to be very task spe­cific, that is trained tasks ben­e­fit from train­ing but the ben­e­fits do not trans­fer very well to tasks in which one was not trained.
- The effects of phys­i­cal exer­cise on per­for­mance seem broader. How­ever they do not gen­er­al­ize to all tasks. They ben­e­fit mostly tasks that involve executive-control com­po­nents (that is, tasks that require plan­ning, work­ing mem­ory, mul­ti­task­ing, resis­tance to distraction).
To my knowl­edge only one study tried to directly com­pare cog­ni­tive and fit­ness training:
Fabre and col­leagues, in 1999, ran­domly assigned sub­jects to 4 groups: an aer­o­bic train­ing group (walk­ing or run­ning for 2 h per week for 2 months), a mem­ory train­ing group (one 90 min ses­sion a week for 2 months), a com­bined aer­o­bic and men­tal train­ing group, or a con­trol group (no training).
Results showed that com­pared to the con­trol group, the mem­ory per­for­mance of all 3 groups increased. The com­bined group showed greater increase than the other 2 train­ing groups.
This sug­gests that the effects of cog­ni­tive and fit­ness train­ing may be addi­tive. How­ever this study involved only 8 par­tic­i­pants per group! More research is clearly needed before any­thing can be safely concluded.
In the mean­time let’s play it safe and com­bine fit­ness and cog­ni­tive train­ing for bet­ter brain health.

Exercise Your Mind


Exercising the body is exercising the mind

I apol­o­gize for the long delay in get­ting back to this col­umn but I have a good excuse. We just recently had a baby, and boy, that takes care right there of the phys­i­cal exer­cise need. Between car­ry­ing the baby upstairs and down­stairs, run­ning to get the baby, get­ting out of the bed and pick­ing the baby up and putting the baby down a cou­ple of times a night no you need not worry about get­ting your daily exer­cise dose in…Now, the major­ity of the answers to my post on the brain virtues of phys­i­cal exer­cise sug­gests that most peo­ple think that the brain ben­e­fits of phys­i­cal exer­cise are mostly to be under­stood as com­ple­men­tary effects of a healthy life style.
Is this cor­rect? In my post today I will attempt to answer this question.
First, while gen­er­ally health­ier peo­ple seem to have health­ier brains, the phys­i­cal exer­cise effect on the brain seems to be inde­pen­dent of other things. One of the most impor­tant devel­op­ment in neu­ro­science was when the offi­cial dogma claim­ing that there was no neu­ro­ge­n­e­sis (pro­duc­tion of new brain cells) in the adult brain was top­pled. Now we know that the brain is “plas­tic” mean­ing that, under the right cir­cum­stances, the brain can change in terms of both pro­duc­ing new cells and get­ting more cells con­nected to each other.
One of the places where neu­ro­ge­n­e­sis has been shown to occur in the adult brain is the den­tate gyrus, a strip of grey mat­ter placed deep down in the brain. The den­tate gyrus is a part of the hip­pocam­pus, the main mem­ory struc­ture, and has been shown to play a role in the form­ing of new mem­o­ries. What can the den­tate gyrus teach us with regards to phys­i­cal exercise?
Fol­low­ing a series of extremely thought pro­vok­ing exper­i­ments researchers from the Gage lab­o­ra­tory at UCSD con­cluded that exer­cise leads to the pro­duc­tion of new brain cells in the den­tate. First the researchers found that mice housed in an enriched envi­ron­ment (a larger cage with toys, tun­nels, and more oppor­tu­nity for phys­i­cal activ­ity, learn­ing, and social inter­ac­tion than in stan­dard bare cage) have an increased num­ber of new neu­rons in the den­tate gyrus.
The enriched envi­ron­ment is a mice equiv­a­lent of not only healthy but good liv­ing: leisurely enjoy­ing life, get­ting both phys­i­cal and intel­lec­tual stim­u­la­tion, social­iz­ing with friends. Now, the fact that new neu­rons were pro­duced was a big enough news in itself but the Gage group did not stop there. Their next goal was to fig­ure out if neu­ro­ge­n­e­sis was the result of a sum of fac­tors act­ing together (i.e. the enriched envi­ron­ment) ver­sus a spe­cific effect of indi­vid­ual fac­tor. So, they first dis­sected the enriched envi­ron­ment in a num­ber of “sub” envi­ron­ments. In their next exper­i­ment they placed the mice in a “learn­ing envi­ron­ment” where they had access to a maze, a “phys­i­cal exer­cise envi­ron­ment” where mice had unlim­ited access to a run­ning wheel, in addi­tion to enriched and stan­dard (empty cage) envi­ron­ments. Then they com­pared the groups in terms of behav­ioral per­for­mance and even­tu­ally looked at their brains.
Their con­clu­sion was any­thing but expected: while both enrich­ment and wheel run­ning led to improved spa­tial mem­ory func­tion only phys­i­cal exer­cise in a run­ning wheel also pro­moted neu­ro­ge­n­e­sis and enhanced the sur­vival of new­born neu­rons in the den­tate gyrus.
Bot­tom line: exer­cis­ing seems to lit­er­ally mean “exer­cis­ing the brain”.
So, in lieu of con­clu­sion, till next I wish you all happy trails (and I don’t mean it as just trails on the paper in a paper and pen­cil mem­ory task)!

Statins increase risk of diabetes


From News Alerts > Heartwire

FDA Adds Warnings to Statin Label

Reed Miller
Posted: 02/28/2012
     
     
    February 28, 2012 (Silver Spring, Maryland) — Taking a statin can raise blood sugar and glycosylated hemoglobin HbA1c levels, according to a new labeling change approved by the Food and Drug Administration (FDA) today for the entire drug class [1].
    As reported by heartwire , recent studies of popular statins showed a significant increase in the risk of diabetes mellitus associated with high-dose statin therapy. The Justification for the Use of Statins in Primary Prevention: An Intervention Trial Evaluating Rosuvastatin (JUPITER) trial showed a 27% increase in diabetes mellitus in patients taking rosuvastatin compared to placebo. Also, the Pravastatin or Atorvastatin Evaluation and Infection Therapy: Thrombolysis In Myocardial Infarction 22 (PROVE-IT TIMI 22) substudy showed that high-dose atorvastatin can worsen glycemic control.
    The labeling changes approved by the FDA also include new information on the potential for usually minor and reversible cognitive side effects. Also, the label for lovastatin has been significantly updated to provide information on contraindications and dose limitations for the drug in patients taking other medicines that may increase the risk for muscle injury.
    The FDA says it is also eliminating the recommendation that patients on statins undergo routine periodic monitoring of liver enzymes, because this approach is ineffective in detecting and preventing the "rare and unpredictable" serious liver injuries related to statins. Statin therapy should be interrupted if the patient shows signs of serious liver injury, hyperbilirubinemia, or jaundice. The statin therapy should not be restarted if the drugs cannot be ruled out as a cause of the problems, the labeling will now state
    .

    Wednesday, February 22, 2012

    Heart Attacks in Women


    From Heartwire

    Young Women With MI Most Likely to Have No Chest Pain

    Sue Hughes
     
     
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    February 21, 2012 (Lakeland, Florida) — Women under 55 having an MI are more likely to present without chest pain than older women or men, and they also have the highest risk of death from MI of any group, new data from the US National Registry of Myocardial Infarction (NRMI) suggest [1].
    Lead author Dr John Canto (Lakeland Regional Medical Center, FL) commented: "While chest pain is still the hallmark symptom of MI in women, more women than men present without chest pain, and this is particularly applicable to younger women. We need to be more aware that younger women with atypical symptoms could be having a MI."
    Canto's study, published in the February 22/29, 2012 issue of the Journal of the American Medical Association, used the NRMI database to examine the factors associated with MI without chest pain and the relationship between age, sex, and hospital mortality.
    Canto told heartwire : "While it has been widely reported that women often have a different MI presentation from that of men, we also know that women are an average of 10 to 15 years older than men when they have an MI. Many papers that have examined the gender differences in MI presentation have failed to adequately account for this age difference. We had an opportunity to look at this more thoroughly in the NRMI database, which includes around one million MI patients."
    They found that women are more likely to present without chest pain than men (42% vs 30%), but that this difference is more pronounced in younger women (under 55). The difference in symptoms at presentation between men and women declined with age, and in the older patients (over 75) there was little difference between the genders.
    Adjusted Odds Ratios for Lack of Chest Pain for Women vs Men
    AgeOR
    <451.30
    45–541.26
    55–641.24
    65–741.13
    >751.03
    The second major finding of the study was that younger women having an MI have a higher mortality rate. "Younger women are not supposed to have an MI, but when do, they are at higher risk of death than the rest of the population," Canto commented.
    In the registry, the in-hospital mortality rate was 14.6% for women and 10.3% for men. Younger women presenting without chest pain had greater hospital mortality than younger men without chest pain, and these sex differences decreased or even reversed with advancing age.
    Adjusted Odds Ratio for Death After an MI in Women Without Chest Pain vs Men Without Chest Pain
    AgeOR
    <451.18
    45–541.13
    55–641.02
    65–740.91
    >750.81
    The researchers also found that young women without chest pain were up to two to three times more likely to die than similarly aged men with classic presentation.
    They write: "Women in whom coronary atherosclerosis develops before age 75 years may be predisposed to a particularly aggressive disease or may have more risk factors for coronary heart disease, which might override the protective effect of estrogen." They add that young women who die after an MI are often smokers with plaque erosions and relatively little coronary narrowing, whereas older women who die tend to have a pathology more similar to men, with high cholesterol levels and subsequent plaque rupture and relatively severe coronary narrowing.
    Canto also suggested that the higher likelihood of atypical symptoms in younger women could contribute toward their high death rate. "If a young women presents without chest pain, it is easy not to realize that she is having an MI. Triage staff are less likely to think about MI in a younger woman, especially one without chest pain, so there is a higher probability of not receiving timely treatment. This could easily explain some of the increased mortality in this group."
    He added: "Our results challenge the wisdom that one size fits all in terms of men and women and presenting MI symptoms. I would argue that we need to tailor the MI message and that young women are particularly at risk for an atypical presentation." Canto noted that the atypical symptoms of MI include pain in the jaw, neck, shoulder, arm, back, or stomach and unexplained shortness of breath.

    Wednesday, February 15, 2012

    Vit D & Allergic Rhinitis


    From Current Opinion in Allergy and Clinical Immunology

    Vitamin D and Chronic Rhinitis

    Waleed M. Abuzeid; Nadeem A. Akbar; Mark A. Zacharek
    Posted: 02/05/2012; Curr Opin Allergy Clin Immunol. 2012;12(1):13-17. © 2012 Lippincott Williams & Wilkins
     
     

    Abstract and Introduction

    Abstract

    Purpose of review To discuss the role of vitamin D in chronic rhinitis and chronic rhinosinusitis (CRS).
    Recent findings Vitamin D has been shown to have an immunomodulatory effect with a significant impact on immune function. Specifically, vitamin D regulates the mechanisms which suppress the inflammatory response and direct the differentiation fate of immune cells. Vitamin D has been shown to play an important role in asthma, and the concept of the unified airway model allows the extrapolation of vitamin D as a critical player in chronic rhinitis and rhinosinusitis.
    Summary Recent findings on the function of vitamin D may explain aspects of the pathophysiology of chronic rhinitis and CRS, and may help direct future treatment of these diseases.

    Introduction

    The importance of vitamin D as an essential nutrient is well known, given its role in calcium and phosphate homeostasis. Over the past two decades, the influence of vitamin D on the immune system has become increasingly clear.[1] Recent work has elucidated that vitamin D harbors actions more akin to hormones and pro-hormones. The discovery of the vitamin D receptor (VDR) has stimulated more research into the nature of this vitamin which has, subsequently, been shown to be a steroid hormone. This steroid constitutes a component of a complex endocrine pathway termed the 'Vitamin D endocrine system'.[2] Investigators have found that vitamin D plays an integral role in the induction of cell differentiation, inhibition of cell growth, immunomodulation, and regulation of other hormonal systems.[3] This review seeks to highlight the recent research with respect to vitamin D and its role in chronic rhinitis and chronic rhinosinusitis (CRS).

    Smokers at risk for Psoriasis


    From Reuters Health Information

    Smoking Tied to Higher Psoriasis Risk

    By Amy Norton
    NEW YORK (Reuters Health) Feb 03 2012 - A large study suggests that smokers have an increased risk of developing psoriasis.
    People who were current smokers at the study's start were almost twice as likely as lifelong non-smokers to develop psoriasis. And past smokers had a 39% higher risk than non-smokers, the researchers reported January 12 in the American Journal of Epidemiology.
    It is clear that the smoking came before the psoriasis, said senior researcher Dr. Abrar A. Qureshi, of Harvard Medical School and Brigham and Women's Hospital in Boston.
    Past studies have found links between psoriasis and both obesity and heavy drinking. But after accounting for those factors, the smoking-psoriasis link remained, Dr. Qureshi told Reuters Health.
    "I think if there's one message, it's that for now, smoking seems to be a risk factor for new-onset psoriasis," Dr. Qureshi said.
    Other studies have pointed to some reasons that smoking could contribute to psoriasis -- mainly its effects on immune system activity and inflammation. Smokers, for instance, tend to have higher levels of autoantibodies.
    Using data from three large, long-running studies of U.S. health professionals - including nearly 186,000 men and women followed for 12 to 20 years - researchers found that 2,410 developed psoriasis. And the risk was greater among both current smokers and former smokers.
    As for smokers who already have psoriasis, the current findings don't speak directly to whether quitting will help their skin disease, according to Dr. Qureshi.
    Am J Epidemiol 2012.

    Antinuclear Antibodies


    From Reuters Health Information

    Antinuclear Antibodies Common in the US

     
     
    By David Douglas
    NEW YORK (Reuters Health) Feb 07 - Roughly one in seven U.S. adults has antinuclear antibodies (ANA), researchers report.
    "These findings emphasize how common ANA positive tests are in the general population and who is most likely to have them," senior author Dr. Frederick W. Miller told Reuters Health by email.
    Dr. Miller, of the National Institutes of Health in Bethesda, Maryland and colleagues note that ANA prevalence estimates have ranged from as little as 1.1% to as high as 20%. They note that estimates often come from selected populations, or are developed using different methods. Some reports suggest a higher prevalence in women and the elderly, but firm data are lacking.
    For a study published online January 5th in Arthritis & Rheumatism, the researchers analyzed serum samples from 4,754 participants in the US National Health and Nutrition Examination Survey (NHANES) from 1999-2004.
    The overall ANA prevalence in adolescents and adults together (everyone at least 12 years old) was 13.8%. The prevalence was significantly higher in women than men (17.8% vs 9.6%); the disparity peaked in the fifth decade.
    The adjusted prevalence odds ratio was slightly greater in blacks than whites (1.30). It was lower in people who were overweight or obese compared to those of normal weight (0.74). Broadly, the prevalence increased with age.
    Although some individuals had more than one ANA staining pattern, the most common patterns were nuclear (84.6%). Cytoplasmic patterns were seen in 21.8% and nucleolar patterns in 6.1%.
    The most common specific autoantibodies were anti-Ro autoantibodies (3.9%), followed by anti-Su autoantibodies (2.4%).
    These findings show "a high prevalence of ANA in the U.S., especially in females and older individuals," the authors say. They estimate that 32 million people are affected, and they say the number is likely to increase.
    Dr. Miller stressed, however, that "there are many possible causes for a positive ANA, and these causes should be considered when ordering and interpreting ANA tests in individual patients."
    Arthritis Rheum 2012.