Stay Humble We Dont Know What We Dont Know

Ive used this pic before. I dont care.

Id like to share a story with you. The other day in one of my classes, we were discussing the history of vitamin D. My professor told us a fascinating story about the early research on vitamin D and rickets, the bone disease children get as a result of a deficiency. This particular researcher, Leonard Findlay, had performed experiments with dogs, and he was convinced that rickets could be cured simply by exercising. In 1908, he published a paper detailing his experiments: "The Etiology of Rickets: A Clinical and Experimental Study".

What Findlay did, essentially, was induce rickets in dogs by keeping them sedentary. He would keep them locked up indoors in cages, providing them food of course, until they would develop symptoms of rickets. Then, as an experimental treatment, he would take some of the dogs outside and let them run around. Allowing the dogs to run around outside cured their rickets, and so Findlay assumed that exercise was the reason why.


Today we know that rickets is caused by a lack of vitamin D. As you may know, we can get vitamin D from simple sun exposure. It wasnt the exercise that cured Findlays dogs; it was the sun. But put yourself in Findlays shoes for a moment... if you didnt know that we could make vitamin D from the sun, how would you ever even identify that as a factor in your experiment? You wouldnt... because we just dont know what we dont know. Based on what we knew at that time, his experiment was air tight.

In hindsight, the idea that exercise cures rickets is absurd. But think about it in the context of the future... well likely be saying the same thing 100 years from now about what we believe to be true today. In any experiment, the goal is to control for the desired variable as best we can, so that we can be sure the results are due to that one variable and no other. We try to do this, or course. But in reality, theres no way to know what we dont know, and we cant control for that. 

Take an example. Say were testing the effectiveness of a gluten-free diet on symptoms of irritable bowel syndrome (IBS). So we recruit people with IBS, put half of them on a gluten-free diet, and keep the other half on their normal diet. We make sure both eat the same amount of calories, carbs, fat, and protein. The only difference appears to be the presence of gluten, but is it really? What dont we know? Well, for starters, we dont know much at all about the gut. Im talking about the microorganisms that live there, what their roles are in our health, and how food might impact it. We also cant quantify the impact of stress... what if its extremely stressful for someone to give up gluten? How does that impact things? We know very little of the compounds in food... take a carrot for example. We know of dozens and dozens of compounds within a carrot, and there are likely dozens more that are unidentified. On top of that, we really only know the biological function of a select few of them! What else dont we know? We just dont know! As you can see, nothing can be 100% controlled for, and nothing is really known for sure.

What will we know in 100 years? Maybe itll be common knowledge that air conditioning gives us cancer!! Doubt it, but who knows!?

My point is this: we should always keep an open mind. We should always remember to stay humble and understand that we dont know it all. Theres no telling how things could change in the future!

On another note though, there are certain things we CAN take to the bank... like eating whole foods. Doing what humans have always done, and have been successful doing, is always a safe bet! 

PCB Exposure May Increase Risk For Diabetes

In light of the recent contamination of pork in Ireland (On Saturday, Ireland recalled all pork products because they were contaminated with high levels of PCBs. PCBs are polychlorinated biphenyls, highly toxic petroleum products. Yesterday, the Irish government reported that cattle were also testing positive for dioxins), I bring the unfortunate news that exposure to PBCs can increase the risk for diabetes.

In 1978-1979, people in central Taiwan were poisoned by PCB-contaminated rice bran oil that they used for cooking. Between 1993 and 2003, researchers in Taiwan investigated the incidence of type 2 diabetes in these Yucheng ("oil disease") victims.

When compared to non-poisoned controls, women who were exposed to the dioxin-laced oil were twice as likely to have developed diabetes in the ensuing 24 years.

For women whose PCB exposure was greatest (as evidenced by the presence of chloracne - an acne-like skin disorder caused by exposure to toxic chlorinated chemicals), diabetes risk was five and a half times that of matched controls (hypertension risk was 3.5 times that of matched controls).

Men exposed to dioxin also experienced an increased risk for diabetes but it was not significant. The researchers speculated that "women tend to have a greater fat percentage than men, which might result in a longer half-life of these lipophilic compounds."

One of the studys authors, Dr. Yueliang Leon Guo, commented to Reuters Health on the implications of their findings:

"Guo said that since "everyone" has detectable PCB levels in his or her body, its possible that exposure to such pollutants has helped feed the widespread rise in diabetes in recent decades."

The authors advised:

"When planning treatments against diabetes, the body burden of PCBs and dioxins should be caully considered, especially for women."

The study appeared in the August, 2008 issue of Diabetes Care:
Increased Risk of Diabetes and Polychlorinated Biphenyls and Dioxins
________

Top Weight Loss Diet Myths

(Article first published as Top Weight Loss Diet Myths Debunked on Technorati.)

Americans are very confused about healthy weight loss, according to a report released by the National Institute of Health’s Weight-Control Information Network. Dietary myths have been passed on for generations, and the problem is compounded by the marketing efforts of food manufacturers and the multitude of diet pills, quick weight loss fad diets and bariatric surgery.

Healthy weight loss is as much about establishing a proper psychological mindset as it is reducing calories and physical activity. It’s essential to incorporate both the mental and physical aspects to achieve a new lifestyle, allowing you to drop weight and keep it off permanently. By understanding that marketing hype and wives tales are not in your best interest, you’ll be able to move forward toward a sustainable weight loss goal.

Myth 1: Crazy Fad Diets Work for Permanent Weight Loss

Everybody has seen the ads screaming ‘Lose 30 pounds in 30 days!’ They appeal to our fast paced lifestyle, thinking we can just pop a few fat burning pills or eat only grapefruit for a week. This is the ultimate myth, yet it’s the top reason that permanent weight loss is not achieved. There is no pill, food group or scalpel which will provide you with an easy road to weight loss. Only a reduced calorie diet, balanced with plenty of vegetables, proteins and healthy fats and regular exercise have been proven to deliver permanent results.

Myth 2. Low Fat Dieting is the Healthy Way to Lose Weight

This myth continues to be the leading cause of heart disease, stroke and diabetes today. Based on faulty research by Ancel Keys back in the 1950’s, we have been led to believe that fat is our enemy. Research has disproven this fallacy repeatedly, yet the driving force to market pharmaceuticals (statins) keeps this myth alive and well.

Fats are required for most cellular functions, and transport many nutrients throughout the body. The important point is to avoid all synthetic ‘trans-fats’ which are artificially produced or created by overheating oils in cooking. Stick with fat in its natural state, opting for oils such as extra virgin olive oil, coconut and walnut, and reduce your risk of a heart attack.

Myth 3. Skipping Meals is a Good Way to Lose Weight

This myth sounds like common sense. Eating less food will lead to less calories consumed and lower weight. The problem with this logic is that it undermines the intricate engine which is our metabolism. Your body has become accustomed to a certain number of calories each day.

Eliminating one meal will cause snacking between meals to make up for the difference. You don’t even realize it’s happening, until the plan backfires. Always eat three reduced calorie, balanced meals each day, and be sure to include a solid protein source with breakfast to properly rev up your fat burning metabolism for the day.

Many people follow a poor dietary lifestyle which includes these and many other faulty myths concerning weight loss. In the weight loss battle, there’s no magic pill, potion, food or surgical procedure which will deliver the trim body you desire.

Only structured discipline and effort will provide permanent weight loss. Clear your mind of all the diet myths, and commit to a new lifestyle including all healthy food groups and regular exercise. Dump the processed carbs, sugary soft drinks and fried foods, and you’ll find your true weight loss reward.

Vegetarian Wonton Noodle Soup Chinese Scallion Pancakes

Sundays are always special for us,sunday means late wake up, a filling brunch,late lunch and outings. Sometimes, i would love to make a elaborated lunch for us coz twice a month during weekends my H go for work, so obviously if he is at home definitely ill make a royal feast. Have you noticed before a week, myself and Veena announced an interesting event to give a push to your sleeping blog, we named our event as Lets Brunch On Sundays. The main motto of this event is to blog on sundays coz  most of the bloggers couldnt able to feed their blog babies during weekdays coz of their busy schedules, so we both planned to create an event to cook and post a dish which goes under Sunday brunch,lunch or dinner.

Today is the first day of our event, am posting wonderful Cantonese dishes i dished out for an another event International Food Challenge , a monthly event started by two wonderful food bloggers. Seriously i love this International  food challenge, its a wonderful platform to learn various cuisine which is not that much familiar for many of us. Thanks to  Sara and Shobana, the brain childs of this event for inviting me to this food challenge. They challenged us with 4 different dishes,i cooked three out of four. I have already posted Spiral Moon Cake and here comes my vegetarian wonton noodle soup and Chinese scallion pancakes as their accompaniment i prepared for this challenge. I served this vegetarian wonton soup with Chinese scallion pancakes for our sunday lunch before few days back. Both were super filling and we enjoyed thoroughly this Chinese foods for our lunch.

For Wonton Filling:
1/4cup Tofu
1cups Vegetables(broccoli,cauliflower,caarot Cabbage,celery)
1no Green chilli (minced)
3nos Garlic pods
1tsp Ginger (minced)
1tsp Sesame oil
Pepper & salt as per need

Mince all the veggies,select vegetable with less water content.

Heat the oil in a pan, add the minced chilli, garlic and ginger, followed by crumbled tofu,sauté everything for few seconds.

Add in the minced vegetables to the tofu minutes, cook for few minutes until the raw smell goes on.

Finally add the pepper and salt. Stir and turn off the heat, cool completely.

Place a wrapper in your hand, place a teaspoon or tablespoon of filling and fold it to make a rectangle.

Dab water on the left corner,push the middle inside and bring the right corner to the left corner,seal it tightly.

Check here for folding the wonton wrap.

For Soup:

4cups Vegetable stock
1/4cup Juilenned carrots
1/3cup Shredded cabbage
1/3cup Tofu (cubed)
1tbsp Chilly paste
1tsp Rice vinegar
1tbsp Soya sauce
100grms Vermicelli or noodles (cooked)
10 nos Vegetarian wontons
1tbsp Corn flour
Pepper powder,salt to taste
Spring onions for garnishing

Bring the vegetable stock to boil in a large sauce pan, gently add in the veggies,cook for few seconds.

Add the chilly paste, soya sauce, vinegar, salt  and cook everything for few minutes.

Now drop in the wontons, one by one to the both and let them cook until they floatto the surface.

Reduce the heat to a simmer, add the sesame oil, cooked noodles to the soup mixture.

Meanwhile mix the corn flour in water, add to the soup,bring it to boil until they turns thick.

Adjust the salt and spice

Garnish with spring onions while serving.

Recipe Source: Food Network
2cups All purpose flour
1/2tsp Salt
1cup Boiling water
4tbsp Oil
2cups Scallions or spring onions (green parts and chopped)

Dipping sauce:
1/2cup Soya sauce
1/4cup Rice vinegar
2tsp Sesame  oil
1/2tsp Dry redchilly flakes
1/2tsp Sesame seeds
1tsp Sugar

Take the flour,salt,hotwater,one tablespoon oil, knead everything for few seconds.

Transfer it to a lightly floured surface and knead as soft and smooth sough. Keep aside in a bowl, cover with a plastic wrap for half an hour.

Divide the dough as 6 equal balls. Roll the balls as a medium sized round dish,spread enough oil evenly over the rolled disc.

Sprinkle enough scallions over the pancake.

Roll the pancake from an end like a rug, curl the roll around as a sprial, pinch the end to the roll ti stick well.

With the palm of your hand, presstheroll from the top to flatten it, roll it as a pancake with 1/8th inch thickness.

Heat a pan, drop the rolled pancakes, drizzle the oil, cook the pancakes on both sidesuntil they turn golden.

Mix the ingedients together the sauce.

Cut the pancakes as wedges,serve with dipping sauce.

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Dietary Restrictions 101 Part II Macrobiotics Locavorism and More

For the first half of our quick guide to dietary restrictions, head to Dietary Restrictions 101, Part I: Allergies, Diabetes, and Beyond. This article was originally published in November 2009.

Being a LOCAVORE is an old concept with newfound popularity. It involves buying chow either grown or raised close to your geographic location. (A 100-mile radius is the most common parameter used.) Locavorism is better for the both the environment and your health, so you really can’t go wrong here. Call your CSA, man!
For more on locavorism, try: La Vida Locavore (Really, the title alone deserves a click.)

Do you know somebody on Atkins? Or Zone? Or, to a somewhat lesser extent, South Beach? Then you’ve encountered some of Earth’s most popular LOW-CARB diets. Folks on LCDs swap carbohydrates (breads, pasta, grains) out of their regimens, frequently for weight loss and/or health reasons. Some plans avoid carbs almost entirely. Others, like South Beach, are actually more like low-glycemic diets, meaning good carbs can be consumed in moderation.
For more on low-carb diets, try: About.com
Fun fact: I tried Atkins once. I lasted exactly five days. They were the best and worst five days of my life in that I ate a lot of bacon, but learned I could not subsist on bacon alone.

In recent years (decades, even), LOW-FAT plans have become pretty popular with dieters, since they’re a decent way to drop weight when followed correctly. They’ve been known to help gallbladder disease, gastroparesis, and fatty livers, as well. Fruit, veggies, legumes, whole grains, and lean meats are good options in low-fat diets, but beware of cutting too far back; fat is very necessary for maintaining good health.
For more on low-fat diets, try: Jackson Siegelmbaum Gastroenterology

A MACROBIOTIC diet actually sounds like a pretty good one: few processed foods, limited meat, not much fat, lots of produce, and a big emphasis on whole grains. Followers are supposed to chew slowly, eat only when hungry, and keep cooking areas clean. In a stunning twist, there’s a spiritual element to the macrobiotic diet, and adhering to the menu is apparently good for warding off disease, though some consider it a tad too restrictive.
For more on macrobiotic diets, try: Macrobiotic Guide
Fun fact: Madonna is a macrobiotic eater. Supposedly, it’s great for vogueing.

To be totally honest, I didn’t know MORMONS even had dietary restrictions until I began researching this article. But as it turns out, LDS don’t do coffee, tea, or alcohol. The Word of Wisdom also encourages grains and produce and moderation when it comes to meat. Individual adherence, as with every diet, varies.
For more on LDS diets, try: Mormon.org

MUSLIMS are forbidden from consuming pork, gelatin, booze, and blood. After that, many of the dietary restrictions relating to slaughter and certification vary on a person-by-person or region-by-region basis. The term Halaal is often associated with the Islamic diet, and simply means “lawful according to the Qur’an,” or “yes, this is okay to eat.”
For more on Muslim diets, try: The Islamic Food and Nutrition Council of America (INFANCA)
Fun fact: I live near a Halaal Chinese food place. It is, without exaggeration, the cleanest Chinese joint Ive ever seen. By a country mile.

Eating ORGANIC is tricky. Organic food can be pricey, tough to find, and there’s a ton of ambiguity in the term itself. Still, there are lots of apparent benefits to whole foods grown without pesticides or the specter of genetic modification. One is less poison. Another is tastier produce. A third is supporting local farms, where lots of organic produce still comes from. The list goes on.
For more on organic food, try: Organic.com
Fun fact: I (unintentionally) misspell “organic” as “orgasmic” every now and then. Good times, especially when you’re writing about eggplant.

PHENYLKETONURICS have phenylketonuria (PKY), meaning they can’t break down the amino acid phenylalanine. It’s genetic, and U.S. babies are screened for it a few days after being born. Untreated and/or ignored, it can have some pretty serious consequences (like mental retardation), but most folks keep it under control with a low-protein, lots-o-produce diet.
For more on Phenylketonuria, try: The National Institute of Child Health and Human Development
Fun fact: Now you know what "PHENYLKETONURICS: Contains phenylalanine" means on the side of soda cans.

If you’re attempting a RAW diet, I applaud you. (Go Dan!) Because avoiding foods heated over 116°F is hard. If you’re not, here’s the lowdown: believers in the raw movement feel that cooking kills important enzymes and reduces the quantities of vitamins and minerals in food. Subsequently, the majority of raw foodies are vegetarians. They tend to per organic produce, and believe their regimen will ward off disease, promote health, and increase energy.
Never, ever: take away a raw foodie’s blender. He will shiv you (with a carrot).
For more on raw diets, try: Living and Raw Foods

We all need salt, but too much of it can be bad news for people with hypertension and heart disease (and slugs). RESTRICTED SODIUM (or low-salt) diets help to lessen fluid retention and maintain a decent blood pressure. This means forgoing cured meats, salty cheeses, pickled veggies, and many, many processed foods in favor of fresher edibles. Fortunately, peeps can still season the crap out of food with a variety of herbs and spices.
For more on restricted sodium diets, try: Saltwatcher
Fun fact: My friend H used to carry a salt shaker everywhere she went. If she ever called something too salty, Id drop dead on the spot

The SLOW FOOD movement was founded in direct response to the wham-bam-thank-you-ma’amness of fast food, to further the emotional, intellectual, and physical investment of individuals in what they eat. Pretty cool, yet vague, right? Well, Slow Food USA has more details on the agricultural, cooking, and cultural aspects of the movement. Ten bucks you’ll see Alice Waters’ name come up at least twice.
For more on slow food, try: Slow Food USA

There’s a subtle, but all-important difference between vegetarians and VEGANS. While the former is free to eat dairy and eggs, the latter doesn’t consume any animal product whatsoever. Some folks go vegan for health or ethical reasons, and the benefits are said to be wondrous.
Never, ever: fear vegan food. It can be quite delicious. QUITE.
For more on veganism, try: VeganYumYum, FatFree Vegan Kitchen, and any blog or cookbook involving Isa Chandra Moskowitz
Fun fact: Famous vegans include Ellen DeGeneres, Portia DeRossi, Alice Walker, Natalie Portman, Zooey Deschanel, and a lot of guys in indie bands from Williamsburg.

Odds are you know at least one VEGETARIAN, if not several dozen. While there are many kinds of veg-heads (lacto-ovo vegetarian, pescetarian, etc.), most agree that eating meat is a no-no.
Never, ever: argue that vegetarians are missing out/unhealthy/dirty hippies. It’s largely untrue, and seriously starting to sound a little cliché. (With apologies to Tony Bourdain.)
For more on vegetarianism, try: Whoa, boy. Where don’t you try? I know CHGs own Leigh is a big fan of Vegetarian Times magazine, though, so it couldn’t hurt start there.

And that’s it. Sweet readers, what did I forget that you’d like to see? Is there anything I might have skewed a bit? Fire away in the comments section.

~~~

If you liked this article, you might also like:

• COOL (Country of Origin Labeling) for You and Me
• The FDA and USDA, Explained to the Best of My Ability: A Semi-Coherent Guide to the Government Agencies Regulating Food
• Veggie Might: Reaching into the Mailbag—Mom Seeks Help with Teen Veg

Alcohol diet drinks may increase intoxication

Alcohol + diet drinks may increase intoxication more than alcohol + regular drinks

A persons breath alcohol concentration (BrAC) after drinking is influenced by factors such as food.

New findings show that mixing alcohol with a diet soft drink can result in a higher BrAC than mixing alcohol with a regular or sugar-sweetened drink.
Individuals were unaware of these differences, which may pose safety risks such as drinking and driving.

An individuals breath alcohol concentration (BrAC) following alcohol intake is influenced by several factors, including food. While it is known that food delays the stomach emptying, thus reducing BrAC, only recently has the role of nonalcoholic drink mixers used with alcohol been explored as a factor influencing BrAC. A new comparison of BrACs of alcohol consumed with an artificial sweetener versus alcohol consumed with a sugared beverage has found that mixing alcohol with a diet soft drink can result in a higher BrAC.

Results will be published in the April 2013 issue of Alcoholism: Clinical & Experimental Research and are currently available at Early View.

"More attention needs to be paid to how alcohol is being consumed in the real world," said Cecile A. Marczinski, assistant professor of psychology at Northern Kentucky University. She erenced an earlier field study of bar patrons. "Researchers found that, one, individuals who reported consuming alcohol with diet beverages had the highest BrACs, as compared to all other bar patrons, and two, that women tended to be more frequent consumers of diet mixers with their alcohol. These good naturalistic observations give researchers many ideas to explore in a controlled laboratory setting."

Dennis L. Thombs, professor and chair of the department of behavioral and community health at UNT Health Science Center, was the author of the field study erenced by Marczinski. "Research on artificially sweetened drink mixers is new," he said. "I believe this might be only the third study published to date on this issue, and the findings are quite consistent with ours."

"I am really interested in drinking and driving as a problem, so I wanted to know if the simple choice of mixer could be the factor that puts a person above or below the legal limit," added Marczinski. "I also wanted to determine if any BrAC difference would be something that subjects would notice, since this has implications for safe drinking practices, including decisions to drive."

Study authors had 16 participants (8 females, 8 males) attend three sessions where they received one of three doses – 1.97 ml/kg vodka mixed with 3.94 ml/kg Squirt, 1.97 ml/kg vodka mixed with 3.94 ml/kg diet Squirt, and a placebo beverage – in random order. The participants BrACs were recorded, as well as their self-reported ratings of subjective intoxication, fatigue, impairment, and willingness to drive. Their objective performance was assessed using a cued go/no-go reaction time task.

"Alcohol consumed with a diet mixer results in higher BrACs as compared to the same amount of alcohol consumed with a sugar-sweetened mixer," said Marczinski. "The subjects were unaware of this difference, as measured by various subjective ratings including feelings of intoxication, impairment, and willingness to drive. Moreover, their behavior was more impaired when subjects consumed the diet mixer."

When asked why mixing alcohol with a diet drink appears to elevate BrACs, Thombs explained that the stomach seems to treat sugar-sweetened beverages like food, which delays the stomach from emptying. "The best way to think about these effects is that sugar-sweetened alcohol mixers slow down the absorption of alcohol into bloodstream," he said. "Artificially sweetened alcohol mixers do not really elevate alcohol intoxication. Rather, the lack of sugar simply allows the rate of alcohol absorption to occur without hindrance."

Both Marczinski and Thombs were concerned about the risk that diet mixers can pose for alcohol-impaired driving. "In this study, subjects felt the same whether they drank the diet or regular mixed alcoholic beverage," said Marczinski. "However, they were above the limit of .08 when they consumed the diet mixer, and below it when they drank the regular mixed beverage. Choices to drink and drive, or engage in any other risky behavior, often depend on how people feel, rather than some objective measurement of impairment. Now alcohol researchers who are interested in prevention have something new to consider when developing or modifying intervention programs."

Thombs agreed. "Research on alcohol mixers is critically important for improving serving practices in on-premise drinking establishments," he said. "About one-half of all drinking and driving incidents are estimated to occur in persons leaving these settings. This type of research can provide guidance to policy-makers interested in improving the safety of bars and nightclubs."

"We have an obesity crisis in this country," added Marczinski. "As such, individuals tend to be conscious about how many calories they are consuming, and they might think that mixing alcohol with diet drinks is a healthy choice. Yet the average reader needs to know that while mixing alcohol with a diet beverage mixer may limit the amount of calories being consumed, higher BrACs are a much more significant health risk than a few extra calories."

"In natural drinking settings, such as bars and nightclubs, young women are significantly more likely than young men to order drinks mixed with diet cola," said Thombs. "I suspect this occurs because young women tend to be more weight conscious than young men. Thus, from a public health perspective, artificially sweetened alcohol mixers may place young women at greater risk for a range of problems associated with acute alcohol intoxication."

If It Can Be Digitized Its Transport Can Be Commoditized Implications for Health Care Providers

Navy telemedicine, coming
to a clinic near you

The Disease Management Care Blog is not only a simultaneously superb and humble physician, its a needy and impatient patient.  In the course of recently seeing one of its doctors, it endured having to arrive early (waiting room), getting past the dreary check-in line (confirming my zip code again?), answering all the the nurses inane questions (no, I dont have pain), seeing the doc ("Yup! Everything is fine!") and getting out (with an after-visit summary). It was a time consuming hassle that ate up half of a day.

The time is ripe for some disruptive technology.

Enter this highly interesting video by futurist Edie Weiner, who illuminates the underestimated links between "digitization" and "commoditization." While Ms. Weiners point had more to do with the generalities of mainstream data processing, the DMCB thinks there are parallels in health care that have important downside implications for the industrys knowledge workers.

And the most vulnerable of those knowledge workers are the primary care physicians, because, thanks to digitizing of patient information, a lot of physician office visits will be going away.  Thats not only a lot of disruption, thats a lot of income.

The DMCB explains:

Recall that a "commodity" is any market good or service that is supplied without qualitative differentiation. Classic examples include wheat, copper and oil, which are bought and sold on the basis of upstream supply and downstream product demand (such as bread, computers and gasoline).

What does this have to do with health care?  While the physician DMCB is not saying that humans are the same as wheat, copper and oil, that doesnt mean that their symptoms and treatment cant be digitized.

Before you scoff, recall that the management of upper respiratory illness can be distilled down to a fairly simple algorithm. The same is arguably true for other myriad conditions such high blood pressure, diabetes mellitus and even heart attack.  "Inputs" including age, gender, concurrent conditions, disease severity, medications and other factors can be digitized.  This, in turn, can be informatically processed to create evidence-based treatment recommendations from afar.

Until now, the new paradigms associated with health care orm still rely on the assumption that patients with their colds, hypertension, diabetes and chest pains will continue to personally bring their medical problems to the doctors office.  Whats supposedly "new" is that advances like the teaming of a medical home, the decision support of an electronic record or the incentives of value-based insurance designs would make the office visit a more rewarding, efficient, effective and less costly affair. All well and good says the DMCB, but even with a new wrapper, its still destined to remain a dreary and time-consuming office visit.

Thanks to Edie Weiner, the DMCB suggests that that business model and all those caully laid policy assumptions could blow up.

Heres why.

Our clinic-based and see-the-doctor approach to care is being eclipsed by an approaching "perfect storm" made up of four key ingredients:

1. Highly organized electronic databases.  Not to be confused with electronic health records, this is the access of updated and easily accessible patient information, plus

2. Networked patient monitoring systems. This is periodic assessments of, for example, blood pressure, glucose levels and EKGs in persons with hypertension, diabetes and heart disease, plus

3. Artificial intelligence-backed decision support. While this may not be ready for prime time in the average doctors office or via a voice-activated smart phone, the recent broadcast of the game show Jeopardy featuring IBMs Watson showed us just whats possible, plus

4. A tipping point of consumer acceptance of informatics. The DMCBs spawn have applied their mobile devices to every part of their lives, why not their health care?

In a traditional care setting, patients assemble their concerns (the "data") and personally transport them to the doctor (the "processor"), who renders a treatment plan. Thanks to the four-fold perfect storm described above, the digitization of patient information will enable patients like the DMCB to avoid the high opportunity costs of a usual-care office vist.  The DMCB will be able to use the network. In effect, its the transport of the DMCBs information that will, in a round-about way, be "commoditized."

In some respects,its already begun. Because patient problems can be be digitized, packaged and transported just like all the worlds other data that are described by Edie Weiner, video physician visits, decision support-backed nurses and touch-screen kiosks are now processing the information and rendering treatment recommendations outside the office visit.

What will this mean?  Many diagnoses can be made remotely. Treatment plans can be adjusted without need for a face-to-face visit. Oversight can be provided by non-physicians.

In tomorrows post, the DMCB will review the implications and what it means for primary care physicians.

Mark It On Your Calendar

Many people start the new year with a new calendar, appointment book or journal.

Since diabetes involves a relatively busy care schedule, its helpful to mark your 2006 calendar with dates for recommended screenings and scheduled doctors visits.

If you use insulin, your physician may be scheduling you for visits every 3 months. Even if you dont use insulin, the ADA recommends you see your doctor at least every 6 months to monitor your blood pressure, weight, and glycated hemoglobin (HbA1c).

Besides regular doctor visits, you may want to make entries for visits to your podiatrist, dentist, eye doctor, diabetes educator, or dietitian. The Diabetes Monitor offers a printable log where you can keep track of your visits, lab results, and goals. It includes the helpful list:

Things to Do At Least Once a Year

• Get a flu shot (October to mid-November).
  
• Get a pneumonia shot (if you’ve never had one).
  
• Get a dilated eye exam.
  
• Get a foot exam (including check of circulation and nerves).
  
• Get a kidney test.
  
  • Have your urine tested for microalbumin.
    
  • Have your blood tested for chemicals that measure your kidney function.
• Get a 24-hour urine test (if your doctor advises).
  
• Get your blood fats checked for:
  
  • Total cholesterol.
    
  • High-density lipoprotein (HDL).
    
  • Low-density lipoprotein (LDL).
    
  • Triglycerides.
• Get a dental exam (at least twice a year).
  
• Talk with your health care team about:
  
  • How well you can tell when you have low blood glucose.
    
  • How you are treating high blood glucose.
    
  • Tobacco use (cigarettes, cigars, pipes, smokeless tobacco).
    
  • Your feelings about having diabetes.
    
  • Your plans for pregnancy (if a woman).
    
  • Other ______________________

For the Diabetes Monitors logbook:
Take Charge of Your Diabetes

Benefits of Garlic For Health

Benefits of Garlic For Health - Garlic has long been recognized that the people of Indonesia. Besides commonly used for flavoring dishes, also has many health benefits for humans.

Plants that are commonly used as an ingredient in various traditional medicine is known to have more than 100 biologically useful chemicals. Garlic also has antibacterial properties, antiviral, antifungal and antioxidant.

Well, here are some properties of garlic are legendary for health:

1. Studies show that taking 600 mg of garlic per day will lower cholesterol levels dramatically.

2. The ability of garlic to fight infection and bacteria making it the subject of an effective treatment to overcome the warts and other skin problems.

3. Garlic is also a powerful aphrodisiac because it helps increase blood circulation which helps erection.

4. Garlic regulate blood sugar levels by increasing release of insulin in diabetics.

5. Garlic has antibacterial and anesthetic properties that can help cure a toothache.

Tag: Garlic benefit of garlic garlic efficacy garlic for health

Ask the Internet Best Meals to Bring the Laid Up

Hey folks! Today’s question is inspired by chilly, sneezy weather in the Northeast.

Q: We’ve all had loved ones confined to pregnancy bedrest or a few days of quiet recovery from surgery. And during those times, it’s tough for them to put clothes on, never mind cook.

So, what are your favorite make-ahead or freezer-ready dishes to bring laid up friends and family?

A: Readers, I don’t have much experience in this area, though I’ve made a few chilis that folks seem to appreciate. What are your best all-time healing meals?

Want to ask the interweb a question? Post one in the comment section, or write to Cheaphealthygood@gmail.com. Then, tune in next Tuesday for an answer/several answers from the good people of the World Wide Net.

Walnuts Provide Most Antioxidants of any Nut

The result of a new study presented to the National Meeting & Exposition of the American Chemical Society found that the noble walnut packed the highest level of quality antioxidants of any nut species. Not only do walnuts provide plenty of high-quality protein that delivers a perfectly balanced assortment of vitamins, minerals and fiber, they also contain healthful polyunsaturated and monounsaturated fats that lower deadly artery-clogging small dense oxidized LDL cholesterol. Adding a handful of walnuts to your daily diet can provide many of the essential antioxidants necessary to ward off cardiovascular disease and cancer.

Walnuts Provide Maximum Antioxidant Punch to Prevent Chronic Disease

Dr. Joseph Vinson performed the analysis that showed walnuts provide more antioxidants to the body than other nuts including peanuts, almonds, pecans and pistachios. He noted “A handful of walnuts contains almost twice as much antioxidants as an equivalent amount of any other commonly consumed nut. But unfortunately, people dont eat a lot of them. This study suggests that consumers should eat more walnuts as part of a healthy diet.” Tree and ground nuts have long been known to be among Mother Nature`s most perfectly packaged foods, providing a complex of natural enzymes and nutrients that promote human health.

This research analysis compared walnuts to nine other nut species that are ranked among the highest in antioxidant capacity. Walnuts were found to be 2 to 15 times more potent than vitamin E in terms of their antioxidant capacity. Vitamin E is well known for its ability to promote cardiovascular health by lowering dangerous levels of small dense LDL cholesterol particles. The analysis also found that it is important to eat walnuts in their raw and natural form, as heating or roasting degrades the antioxidant properties of the nut.

Calories from Walnuts Do Not Add to Weight Gain

Dr. Vinson found that despite the powerful antioxidant and nutrient punch provided by walnuts and other tree nuts in general, they account for less than 8% of the daily antioxidant allowance for most people. This is likely due to misinformation regarding calories and excess fat content that has circulated about nuts over the past 50 years. Research has demonstrated that regular nut consumption does not lead to excess weight and provides a feeling of satiety. The polyunsaturated and monounsaturated fats provided by nuts promote cardiovascular health and have been shown to dramatically lower the risk of a heart attack.

The analysis found that just 7 walnuts each day are sufficient to boost human health. Always eat walnuts in their natural unprocessed and unroasted form to preserve the bounty of enzymes, nutrients and antioxidants that have been shown to help prevent heart disease and cancer.

ACO Final and User Friendly Rule Released Here Are The Most Important Changes

When CMS came out with the proposed regulations for Accountable Care Organizations (ACOs) in March of 2011, the Disease Management Care Blog shared in much of the provider community consternation over just how unwieldy the Feds were being.  The promise of integrated, coordinated and cost-effective care provided by hospital-physician networks had run into the reality of having to invest millions dollars with a questionable ROI, a complex maze of up and downside risk calculations, reams of burdensome quality measures and overlawyered antitrust regulations.   

Well, CMS listened to 1320 comments and, in response, released a more user-friendly "final rule" today.  While the DMCB is still tracking down and mulling over the myriad details, it found the best review of the modifications in this table appearing online in the New England Journal of Medicine. 

Changes that caught the DMCBs eye:

The 1st of the two "Tracks" will not have any downside risk in the 3rd year.  Two-sided risk remains in Track 2 (ACOs will still need to invest millions in care coordination infrastructure, but at least they wont have to cover CMSs downside risk if they fail to control utilization).

No 25% withhold of the shared savings (This was the amount that the Feds were going to hold in escrow just in case the ACOs financial performance deteriorated).

Instead of the providers having to hit a 2% savings before getting any money, shared savings kicks in once the "minimum savings rate" is achieved (This is a significant concession by CMS.  The DMCB recalls the MSR is a savings target that is based on statistical significance)

Assignment of beneficiaries will be prospective, not retrospective (Likewise a concession and good news, since the ACOs will know who is in their target population that represents their risk).

Instead of 65 quality measures, there are 33 (see page 324 of the rule linked above) and the first year will involve reporting only, not performance (While managing to 33 measures will still be a challenge, this is a vast improvement)

ACO agreements start on April 1, 2012 and can continue throughout the year (It was pretty obvious that CMS was not going to make the January 1 deadline, but getting an ACO in place in 6 to 12 months will still be an uphill battle for many delivery systems).

Prior clearance by a "reviewing antitrust agency" will not be necessary, but that doesnt mean that ACOs arent subject to antitrust law; they may want to submit to an expedited antitrust review (Given the stakes, the DMCB suspects all ACO participants will still want to lawyer up on this).

According to this press release, CMS will also make financial support available to physician- owned as well as rural providers.

The DMCBs first reaction is that CMS has done a good job of modifying its unworkable proposed rule.  It will take several days for the DMCBs sources to give it feedback.

Stay tuned!

Increasing Muscle Mass May Improve Insulin Resistance And Lower Risk For Diabetes

Is it possible to improve insulin sensitivity and stave off a diagnosis of type 2 diabetes by increasing muscle mass?

Yes, according to this study:

Relative Muscle Mass Is Inversely Associated With Insulin Resistance And Prediabetes. Findings From The Third National Health And Nutrition Examination Survey, The Journal of Clinical Endocrinology and Metabolism, September, 2011

Analysis of data from 13,644 participants of NHANES III revealed:

In people with diabetes, each 10% increase in skeletal muscle index (SMI: the ratio of total skeletal muscle mass, estimated by bioelectrical impedance, to total body weight) was associated with:

• 11% reduction in insulin resistance (HOMA-IR)
  
• 12% reduction in prediabetes prevalence

Reductions were higher in people without diabetes.

Study author Dr. Preethi Srikanthan, an assistant professor of medicine in the division of endocrinology at UCLA, said in a press release:

"Our findings suggest that beyond focusing on losing weight to improve metabolic health, there may be a role for maintaining fitness and building muscle mass. This is a welcome message for many overweight patients who experience difficulty in achieving weight loss, as any effort to get moving and keep fit should be seen as laudable and contributing to metabolic change."

________

Grapes reduce heart failure associated with hypertension

A study appearing in the Journal of Nutritional Biochemistry¹ demonstrates that grapes are able to reduce heart failure associated with chronic high blood pressure (hypertension) by increasing the activity of several genes responsible for antioxidant defense in the heart tissue. Grapes are a known natural source of antioxidants and other polyphenols, which researchers believe to be responsible for the beneficial effects observed with grape consumption. This study, funded by a grant from the National Institutes of Health (NIH), and conducted at the University of Michigan Health System, uncovered a novel way that grapes exert beneficial effects in the heart: influencing gene activities and metabolic pathways that improve the levels of glutathione, the most abundant cellular antioxidant in the heart.

An estimated 1 billion people worldwide have hypertension, which increases the risk of heart failure by 2 to 3-fold. Heart failure resulting from chronic hypertension can result in an enlarged heart muscle that becomes thick and rigid (fibrosis), and unable to fill with blood properly (diastolic dysfunction) or pump blood effectively. Oxidative stress is strongly correlated with heart failure, and deficiency of glutathione is regularly observed in both human and animal models of heart failure. Antioxidant-rich diets, containing lots of fruits and vegetables, consistently correlate with reduced hypertension.

In this study, conducted at the University of Michigan Health System, hypertensive, heart failure-prone rats were fed a grape-enriched diet for 18 weeks. The results reproduced earlier findings that grape consumption reduced the occurrence of heart muscle enlargement and fibrosis, and improved the diastolic function of the heart. Furthermore, the mechanism of action was uncovered: grape intake "turned on" antioxidant defense pathways, increasing the activity of related genes that boost production of glutathione.

"Our earlier studies showed that grapes could protect against the downward spiral of hypertensive heart failure, but just how that was accomplished – the mechanism – was not yet known," said lead investigator E. Mitchell Seymour, Ph.D. "The insights gained from our NIH study, including the ability of grapes to influence several genetic pathways related to antioxidant defense, provide further evidence that grapes work on multiple levels to deliver their beneficial effects."

Seymour noted that the next phase of the NIH study, which will continue into 2014, will allow his team to further define the mechanisms of grape action, and also look at the impact of whole grape intake compared to individual grape phytonutrients on hypertension-associated heart failure.

"Our hypothesis is that whole grapes will be superior to any individual grape component, in each of the areas being investigated," said Dr. Seymour. "The whole fruit contains hundreds of individual components, which we suspect likely work together to provide a synergistic beneficial effect."

The insights gained from this research will further the knowledge on grapes and heart health, but will also provide translational information on the value of dietary (whole foods) and dietary supplement approaches for prevention of heart disease stemming from chronic hypertension.

"The NIH grant is allowing the team at the University of Michigan Medical System to expand its work in this important area and further highlight the multi-faceted role of grapes in supporting heart health," said Kathleen Nave, president of the California Table Grape Commission. "This work will also provide key insights into the role of whole fruit versus individual components of a fruit, using grapes as the benchmark."

High supplemental calcium intake may increase risk of cardiovascular disease death in men

A high intake of supplemental calcium appears to be associated with an increased risk of cardiovascular disease (CVD) death in men but not in women in a study of more 388,000 participants between the ages of 50 and 71 years, according to a report published Online First by JAMA Internal Medicine, a JAMA Network publication.

Calcium supplementation has become widely used, especially among the elderly population, because of its proposed bone health benefits. However, beyond calciums established role in the prevention and treatment of osteoporosis, its health effect on nonskeletal outcomes, including cardiovascular health, remains largely unknown and has become "increasingly contentious," the authors write in the study background.

Qian Xiao, Ph.D., of the National Cancer Institute, Bethesda, Md., and colleagues examined whether the intake of dietary and supplemental calcium was associated with mortality from total CVD, heart disease and cerebrovascular diseases. The study participants were 388,229 men and women ages 50 to 71 years from the National Institutes of Health-AARP Diet and Health Study in six states and two metropolitan areas from 1995 through 1996.

"In this large, prospective study we found that supplemental but not dietary calcium intake was associated with an increased CVD mortality in men but not in women," the authors conclude.

During an average 12 years of follow-up, 7,904 CVD deaths in men and 3,874 CVD deaths in women were identified and supplements containing calcium were used by 51 percent of men and 70 percent of women. Compared with non-supplement users, men with an intake of supplemental calcium of more than 1,000 mg/day had an increased risk of total CVD death (risk ratio [RR], 1.20), more specifically with heart disease (RR, 1.19), but not significantly with cerebrovascular disease death (RR, 1.14).

For women, supplemental calcium intake was not associated with CVD death, heart disease death or cerebrovascular disease death. Dietary calcium intake also was not associated with CVD death in men or women.

"Whether there is a sex difference in the cardiovascular effect of calcium supplement warrants further investigation. Given the extensive use of calcium supplement in the population, it is of great importance to assess the effect of supplemental calcium use beyond bone health," the authors conclude.

Ask the Internet How Do You Organize Your Recipes

Sweet Angela, Bea, and Rosalind, readers! Ask and ye shall receive. Last week, I threw myself at your feet and you lifted me up with more slow cooker tips and recipes than I can use in this lifetime. I am heartily grateful.

This week’s multi-part question is born out two-parts need for decluttering solutions and one-part sheer curiosity:

Q: Readers, I gotta know, 1) how do you keep track of your recipes and 2) what’s your favorite method for reading a recipe while cooking? Dog-earred cookbooks? An index card file? Are you going digital? 3)What are your favorite recipe organization tools/applications?

A: My 1-ft by 1-ft countertop makes using cookbooks cramped and messy. Recently, I used Charming Boyfriend’s smartphone to pull up a recipe while at the farmer’s market and then in the kitchen while preparing the dish. (See last week’s Top-Crust Peach and Cardamom Pie on Serious Eats.) More and more, I find myself replacing my tried-and-true (and recklessly scattered) index cards, which I magnetize to the fridge, with my laptop, which I set it on top of the fridge and use as a recipeasel (though I fear one day it may meet a fiery end).

What about you, beloved readers? Do you still prop up the cookbook on the counter with a canister of flour and a wooden spoon or is the iPad-integrated kitchen on your wishlist? The comments are ready to accept your wisdom.

Want to ask the interweb a question? Post one in the comment section, or write to Cheaphealthygood@gmail.com. Then, tune in next Tuesday for an answer/several answers from the good people of the World Wide Net.

Top Ten Links of the Week 4 23 10 – 4 29 10

Happy Friday, folks! Quick update on Tuesday’s Ask the Internet question: the broth and new ratio totally worked with the polenta, and the addition of pancetta provided some much-needed depth and textural variation. Howevs, the spinach still needs work. I sautéed it much faster this time, using the oil left over from the meat, but the aftertaste remained. I’m thinking a switch to either kale, chard, or baby spinach is in order. Almost there, though! Look for the final version on Monday.

Meanwhile, BEHOLD! Here’re the links.

1) Oregon Live: Meet some of Portlands radical homemakers
A fantastic piece. Just stellar, and I love the reconceptualizing of domesticity as, “living by four tenets: ecological sustainability, social justice, family and community.” It’s extreme and ideal at the same time. An absolute must-read, though I do wish it brought a few guys into the picture.

2) The Local Cook: Top 10 Things to Do Before CSA Season
Just signed up for your first CSA? Don’t know how you’re going to handle it? No worries, sweet kale lover. This resourceful rundown will steer you in the right direction.

3) Serious Eats: Why Ben & Jerry’s Relationship with Wal-Mart is Actually Good for the Future of Food
Sometimes, the little guy can best change the big guy by working from the inside. If there’s ice cream involved, all the better.

4) The Atlantic Food: Message to Food Editors - What 30-Minute Meals Really Mean
In which Michael Ruhlman makes a decent point – learn to prioritize food – and obscures it in a cloud of unpleasantness. Dude, you want people to listen to your message? Try not to insult them in the process. Enh. Debbie says it better than me

5) Jezebel: Spoon Fed – When Food is About Love, Not Disorder
I like this whole piece on learning to reconcile personal food issues with eating’s social nature, but this statement struck me most: “I find that when we cook together we encourage each other to enjoy food for what it is — a source of nourishment and even excitement, not an enemy.”

6) Slashfood: Cook’s Illustrated vs. food52
Ladies and gentlemen, let’s get ready to RUMBLE. In this corner, Cook’s Illustrated, the venerated trial-and-error foodie mag headed up by bowtied culinary lovegod, Christopher Kimball. And in the opposite corner, food52, the new-ish website with the many-people-one-recipe mentality. Who will win next week’s cooking throwdown? Only your hairdresser knows for sure. (Pic from Village Voice.)

7) Chicago Tribune: The 50 Worst Restaurants in the World
In response to San Pellegrino’s recent naming of the World’s 50 Best Restaurants, folks at CT came up with this creative list. My favorites:
24. Haggis Hut
21. Actual Panda Express
20. Fraulein Sauerkraut’s Thwap and Serve
9. Le Jirque
3. Friday’s based on the novel Push by Sapphire

8) Wise Bread: 10 Ways to Cut Waste When Feeding Kids
These smart tips might seem pretty intuitive to experienced parents, but I’m babysitting a lot more now, so they’re spectacularly well timed. I have no idea what I’m doing, see. (Just kidding, Mary! Ha?)

9) A Good American Wife: Nutritional Values
Speaking about feeding kids, Anne has some valuable insight.

10) Serious Eats: How to Toast Spices
Toasting spices is an inexpensive, easy way to bring out their flavor. Also, “mellow, toasty complexity” is my new favorite phrase. You know what I like about 30 Rock? It’s mellow, toasty complexity. And nuclear physics? It’s mellow, toasty complexity. And socks? Guess.


HONORABLE MENTION

BoingBoing: Unicorn Meat
Finally!

Consumerist: Baseball Park Food is So Overpriced. Do I Still Have to Tip?
Yes!

Food Politics: The 2010 Dietary Guidelines – Some Hints at What They Might Say
Useful!

The Kitchn: 10 Tasty Dinners to Serve on the Cheap
Tasty!


AND ALSO

The 120 Minutes Archive
Eep! Well, slap me with a moog and call me Matt Pinfield. Someone, somewhere, is cataloguing every episode of MTV’s seminal indie/alternative music show. With video and occasional performance links! (Though, this is undoubtedly the best set in history. Johnette 4-evs. Imma let you finish, but shes the most underrated rock vocalist of all time.)

Thank you so much for visiting Cheap Healthy Good! (We appreciate it muchly). If you’d like to further support CHG, subscribe to our RSS feed! Or become a Facebook friend! Or check out our Twitter! Or buy something inexpensive, yet fulfilling via that Amazon store (on the left)! Bookmarking sites and links are nice, too. Viva la France!

Home remedies for hair care

Straight, silky, smooth hair has always been considered desirable and sexy for women. For centuries , Indian women are known for their beautiful hair . South Asia people are also known to be pioneers in the field of natural remedies and herbal home treatments or at home remedies. Theore, it is not surprising that when it comes to health and beauty , parents of South Asia to have all the answers .

Silky hairs

Recently, my hair has troubled me a lot due to sunburn, swimming and busy hectic schedule I just relied on that old flat iron I had thus, my hairs took quit a beating so I decided to go green and give a fair test of ancient Indian traditions. In one month , I tried various treatments, including vitamins , hair masks, hair care , and of course eating healthy.

Vitamins and minerals to prevent hair loss

Vitamin E is definitely an antioxidant that strengthens the scalp promoting blood circulation . Improved blood circulation means more nutrients available to help you in the hair follicles so they can produce stronger, and so much healthier hair. Vitamin A is essential for your health. It is also good for the hair follicles, as it keeps the hair root lubricated. Surplus Vitamin A can be harmful so dont take more than you might need.

B vitamins are essential for healthy hair

* Acid Para-aminobenzoic can stop your hair from aging.

* Inositol helps to prevent hair loss .

* Niacin (vitamin B-3) promote blood circulation in the head.

* Panthenol (vitamin B-5) may stop hair loss and help hair grow .

* Biotin can also prevent your hair from premature aging.

* Biotin is an essential vitamin to stop hair loss .

* Contains proven vitamins B-6 and B -12 lead role in the growth of healthy hair.

* protein

* Water .

Vitamin C is essential for healthy hair . Everyone has heard of some of the great benefits of vitamin C to prevent colds. On the other hand , you realize that this is also a great vitamin for those hair?

Food For FolliclesConsume plenty of leafy green vegetables, whole grain products, in addition to nuts, due to the fact these kinds of food consist of additional vitamins for hair growth. Vitamin A can be found in red, yellow, and orange vegetables, leafy green vegetables, liver, and eggs. Consume a lot of citrus fruits, kiwis, strawberries, pineapples, tomatoes, and green and red peppers, and you will by no means have a nutrient deficiency.

How to get Straight, Silky Smooth Hair?
The most common home remedies for naturally straightening curly hair include coconut milk, lemon juice, milk, honey, egg and olive and coconut oil. These natural hair straighteners will take a little time to make your hair straight but continuous and regular application of them would not only straighten hair naturally, but also nourish and moisturize it. 

You will be able to notice a remarkable difference in your hair quality after a few days of application. Remember that curly and dry hair need extra protection and care. These natural products will also protect your hair from damage caused by pollution and harsh chemicals and will make your hair healthy and silky soft. Here are few methods for preparing natural hair straighteners at home.

Coconut Milk and Lemon Juice
The application of coconut milk and lemon juice is not only effective in straightening curly hairs, but also to alleviate the problem of dandruff. First, grind the coconut in a blender and add lemon juice to it . Keep this mixture in the rigerator for a few hours. After a while , you can see a layer of creamy foam on top of the container. Now apply the foam on your hair and keep your head covered with a warm towel for 45 minutes to 1 hour. Then wash your hair with lukewarm water and let it dry completely . This will not only straighten curls , but also to add a brilliant shine to your hair.

Milk and Honey
Although milk can be used alone , the addition of a few drops of honey can boost its nourishing quality. This makes it suitable for dry and curly hair. You can also add some crushed strawberries to this mixture before applying to your hair. Keep at least 1-2 hours , then wash with a mild shampoo.

Egg and Olive Oil
Olive oil is known for its moisturizing properties and has been an integral part of regular hair care for a long time, on the other hand egg provides nourishment to dry and damaged hair. To make a mixture of egg and olive oil, break two eggs in a bowl and then add one or two spoons of olive oil. Mix properly and apply thoroughly on your hair using a soft brush. Leave it for few hours, after that wash with a mild shampoo and  apply conditioner in the usual way.

Hot Oil Treatment

To give your own hair a hot oil treatment , you can use any type of hair oil , while coconut oil and olive oil are the most commonly used for this purpose. For hot oil treatment, you need to heat oil and gently message your scalp with this warm oil. Then wrap your head with a hot towel and leave it for some time. Then wash your hair with a mild shampoo, and you will get well conditioned straight and silky hair.

If you want some extra Silky, Shiny Soft Hair

Follow these tips to make your hair more silky and soft.

Hibiscus Plant Paste
Apply paste made out of the leaves of hibiscus plant on your hair. Let it stay for 10-20 minutes and then wash your hair to get best results also Rubbing your hair with hibiscus flower is also a good remedy for soft and silky hair. Soak hibiscus flower in water and then use the same for applying on your hair before the hair wash.

Aloe Vera GelUse Aloe Vera gel with hair shampoo which is helpful to make it shiny and soft.

Almond Oil MassageUse almond oil to massage your hair one day before washing your hair. Frequently massaging your hair with almond oil will help you to get silky and soft hair. Massaging is good for improving blood circulation and getting stronger hair.

Aroma OilsTry massaging your hair once in a week with aroma oils to make your hair silky and soft.

Try this great Avocado Deep Conditioner
Mix ½ of mashed avocado and 1 small jar of mayonnaise in a bowl and smooth into hair, being caul to work into the ends. Seal in body heat with a plastic cap for 20 minutes with or without additional heat from a hair dryer.

All of the ingredients are easily available in the market. Shiny hair is the ultimate result from all of above amazing natural home remedies! It is not necessary to go out and spend a fortune on brand name products as the best ingredients are in your kitchen.

If you experiment with some or all of these remedies over the course of a few months, you will definitely see a difference you may also try your hands on these simple Homemade Hair Masques

1) Make a mixture of shikakai powder, henna (mehndi) powder, amla powder and curd as conditioner to get soft and silky hair.

2) Make a mixture using amla powder, shikakai powder, ritha powder, henna powder and curd as conditioner to get soft and silky hair.

3) Put some bhringaraj powder and water in a bowl. Mix well and heat it when the mixture becomes lukewarm apply gently on your hair. Leave this mixture on your hair for 15-20 minutes and wash your hair without using shampoo to get the best results.

4) Make a mixture of mustard oil, curd and lemon to apply on your hair. Leave this mixture on your hair for half an hour and then wash it.

So Its time to forget about emptying your pocket for a deep conditioning sesh at a beauty parlor. Now, you have the chance to prepare organic and extremely cheap treatments to restore the soft and healthy texture of your locks at your home........... best of luck.

Image credit becomegorgeous.com

Jam Swiss Roll

Kids are in vacation, obviously am bit busy with them.Even my oven is quite busy now, we are in baking mood. Two days back, my lil one asked me to bake a cake with jam, i know he was asking to make a roulade aka swiss roll, he helped me and we baked the simple vanilla roll with green and rose food colour as something christmassy. This roll is really very quite easy to prepare and you can also prepare them with your favourite flavour or favourite spread eventhough my choice went for strawberry jam. You can serve this super spongy swiss roll as dessert with a scoop of icecream or with a simple chocolate sauce.

My theme for this weeks blogging marathon theme is kids delight-desserts, obviously swiss roll can be served very well for dessert with an icecream or with a sauce. If you dont like adding the food colour, just skip them. Check out the other bloggers running this 23rd edition of blogging marathon here.Do check Champa, Srivalli, Sumana Deepak,Veena,Jayasri and Preeti Deo wat they baked for the 11th day of bake-a-thon.Sending to Show Me Your HITS-Festive Foods guest hosted by Roshni,event by Sangeetha.

4nos Eggs
1/2cup Sugar
1/4cup Flour
1/4cup Cornflour
1/4tsp Baking powder
1/4tsp Vanilla essence
Food colour (rose & green)
Strawberry Jam
Confectioners sugar (for dusting)

Preheat the oven to 250F.

Separate the eggs whites and egg yolks.Sieve together the flours,baking powder and keep aside.

Beat the egg yolks and sugar in a bowl until they turns smooth and pale yellow creamy mixture, add slowly the sieved flours,vanilla essence and mix everything well.

Meannwhile beat the egg whites separately with a pinch of salt until stiff peaks form, gently fold the egg whites to the already prepared flour mixture and mix everything well.

Divide the batter into three equal parts and take them in a bowl, colour one with rose food colour while the another with green colour.

Pour the batter side by side in a 10x15inch jelly roll pan lined with greased baking paper..

With a tooth pick, make some swirls in the batter and bake for 15minutes and immediately roll the baked cake in a slightly wet towel and let it get cool.

Spread generously the strawberry jam and roll it tightly, cover the roll with a cling wrap and let it sit for an hour in fridge.

Dust generously with the confectioners sugar.

Slice it and enjoy.

Combine Chronic Conditions and Facebook A New Start Up Called Woebook

Its the Disease Management Care Blogs 31st wedding anniversary. To celebrate, the happy couple is at hideaway that offers what the DMCB spouse ers to as "chaise lounges." She patted one next to hers and asked the DMCB sit, relax and "converse."

Thats when the DMCB excitedly pointed out that Facebooks launch has many lessons, including the overlaps between hype and greed, the wackiness of giving money to a 28 year old hoodie-wearing oddball and the certainty that if everyone could only "friend" everyone, cheap solar power would finally prevail.  Inspired by the luster of a multi-billion dollar IPO, it thinks now is the time to cash out the retirement funds, leverage the DMCBs brand and launch its own social media offering called "Woebook."

The User Profile: This will list any and all medical conditions that may lect a users, family members or friends medical history, or a professional interest or a passing hobby. If you dont know your condition, a partnership with IBMs "Watson" will assign one to you. If you have no condition, a bank of specialists will be on call to make one up for you.

Friends: Communities of the Diseased will spring up, share symptoms and insights and give special meaning to the term "poked."

Marketing: Instead of relying of some claptrap on how targeted and intrusive ads somehow "enrich" the users "experience," Woebook will be honest and announce its intent to bludgeon users with what they really want: information on pricey brand name drugs and the latest and most expensive medical devices.

Privacy Settings: While the default is HIPAA-level privacy and the threat of unending visits by U.S. Department of Justice bullies, Woebook will maintain a jumbotron in Silicon Valley that will rotate the pages of users who have selected the "maximally voyeur" privacy setting. Banner ads scrolling across the bottom will generate tons of advertising revenue. Best of all, those annoying Millennials in their BMWs will be reminded that something incurable is waiting them just a few years away.

Speaking of Ads: Youll have to give permission to have them appear on your pages. If you accept that option, the DMCBs Woebook will share its vast ad income with you. Users will also have the option of sanctioning spurious, malicious or uncool ads and, if enough votes are collected, the ad and the sponsoring company will be banned. That includes for profits, not-for-profits, government agencies and candidates for U.S President.

Photo sharing: You bet, including but not limited to that unsightly and tough-to-diagnose rash or non-healing sore, x-ray images and scans of the mysterious "this is not a bill" documentation.

The DMCB spouse is unsurprisingly not ready to cash out and commit the 401K. Angel investors are free to call for a copy of the Woebook business plan.

New study suggests using sedentary behavior counseling in primary care

Although primary care physicians take care of many aspects of health and disease, little is known about how they can change sedentary behavior through counseling, according to researchers at The University of Texas Health Science Center at Houston (UTHealth). Results from a new study suggest encouraging patients to decrease the time they spend sitting each day may be feasible in the primary care setting.

“Reducing sedentary time can be done by virtually everyone and requires smaller changes in energy expenditure than meeting physical activity guidelines, which usually entails a complex behavior change particularly for inactive patients,” said Kerem Shuval, Ph.D., principal investigator and assistant professor of epidemiology at The University of Texas School of Public Health Dallas Regional Campus, part of UTHealth. “Reducing sedentary time helps promote health and primary care physicians can play a major role in modifying their patients’ sedentary behavior, particularly because adults spend many of their waking hours each day sitting or in passive leisure activities.”

Results were recently published online in the British Journal of Sports Medicine.

Unlike physical activity counseling, which has been investigated over the years, sedentary behavior counseling is a new term used in this study to describe a dialogue with a patient about the harmful effects of prolonged uninterrupted sitting. The average amount of time spent sitting or reclining during waking hours in the United States is almost 8hours per day, according to data from the National Health and Nutrition Examination Survey.

In this study, Shuval and his colleagues asked adult primary care patients whether their providers asked, advised and encouraged them to modify their physical activity and sedentary behavior in the past year. The “5A” (ask, advise, agree, assist and arrange) framework was used to examine these questions.

Study results indicated that within the last year, only 10 percent of patients received sedentary behavior counseling compared to 53 percent who received physical activity counseling. No patients received a plan pertaining to decreasing sedentary behavior; however, 14 percent were provided with a written plan for increasing physical activity. More social support and specific strategies for behavior change were provided as it relates to increasing physical activity than decreasing sedentary behavior. Obese patients were more likely to receive counseling to decrease their sitting time.

“Accumulating evidence has found prolonged sitting to be associated with increased risk for chronic diseases such as obesity and type 2 diabetes as well as premature death,” said Shuval, who is also an adjunct professor at The University of Texas Southwestern Medical Center (UT Southwestern) and a member of the Harold C. Simmons Cancer Center at UT Southwestern.

Sedentary behavior has emerged as a new field of scientific investigation due to the detrimental health effects of prolonged sitting, according to Shuval. A number of studies have begun to explore the impact of interventions specifically focused on reducing and breaking up sedentary time.

“Our study provides initial insight into sedentary behavior counseling practices in the primary care setting,” said Shuval. “Additional research is needed prior to developing programs to change patients’ sedentary behavior.” Several countries have already begun to provide general recommendations to decrease sedentary time.

Going Long on the Patient Centered Medical Home PCMH Despite the Prattling Pinheads of Pessimism

Is the Disease Management Care Blog worried about the prognosis of the Patient Centered Medical Home (PCMH)?

Not in the least.

Its simply marching from its "Peak of Inflated Expectations" through the "Trough of Disillusionment." Before you decide to short the PCMH, check out this very enlightening Bloomberg editorial, Lure More Doctors Into Primary Care With Medical Homes.

Noting that many commercial insurers remain committed to the medical home model of care, Bloombergs business-savvy editorial board also points out that the PCMH has the added quality of attracting physicians to careers in primary care. The Josia Macy Jr. Foundation has some preliminary data suggesting that experience in medical home settings increases medical students enthusiasm for primary care.

Its a timely article.  While prattling pinheads of pessimism (examples here and here) glom onto imperfect research methodologies and findings that are unequal to the task at hand, top notch organizations like Sutter, University of Pittsburgh Medical Center and Horizon Blue Cross Blue Shield are going long on the PCMH.

These guys know something that the academics are missing.

Too bad there isnt a PCMH futures market; the DMCB could make some serious money.

Image from Wikipedia

Avoiding Dementia Part III

A dear friend, only 85 years old, healthy and physically and mentally active (golf, tennis, bridge) has developed serious signs of mental decline. This has alarmed me sufficiently to review what recent research says about this:


Avoiding Dementia Part I

Avoiding Dementia Part II


Eating foods rich in vitamin E associated with lower dementia risk

Consuming more vitamin E through the diet appears to be associated with a lower risk of dementia and Alzheimers disease, according to a report in the July issue of Archives of Neurology, one of the JAMA/Archives journals.

Oxidative stress—damage to the cells from oxygen exposure—is thought to play a role in the development of Alzheimers disease, according to background information in the article. Experimental data suggest that antioxidants, nutrients that help repair this damage, may protect against the degeneration of nervous system cells. "Although clinical trials have shown no benefit of antioxidant supplements for Alzheimers disease, the wider variety of antioxidants in food sources is not well studied relative to dementia risk; a few studies, with varying lengths of follow-up, have yielded inconsistent results," the authors write.

Elizabeth E. Devore, Sc.D., of Erasmus Medical Center, Rotterdam, the Netherlands, and colleagues assessed 5,395 participants 55 years and older who did not have dementia between 1990 and 1993. Participants underwent a home interview and two clinical examinations at the beginning of the study, and provided dietary information through a two-step process involving a meal-based checklist and a food questionnaire.

The researchers focused on four antioxidants: vitamin E, vitamin C, beta carotene and flavonoids. The major food sources of vitamin E were margarine, sunflower oil, butter, cooking fat, soybean oil and mayonnaise; vitamin C came mainly from oranges, kiwi, grapefruit juice, grapefruit, cauliflower, red bell peppers and red cabbage; beta carotene, from carrots, spinach, vegetable soup, endive and tomato; and flavonoids from tea, onions, apples and carrots.

Over an average of 9.6 years of follow-up, 465 participants developed dementia; 365 of those were diagnosed with Alzheimers disease. After adjusting for other potentially related factors, the one-third of individuals who consumed the most vitamin E (a median or midpoint of 18.5 milligrams per day) were 25 percent less likely to develop dementia than the one-third of participants who consumed the least (a median of 9 milligrams per day). Dietary intake levels of vitamin C, beta carotene and flavonoids were not associated with dementia risk. Results were similar when only the participants diagnosed with Alzheimers disease were assessed.

"The brain is a site of high metabolic activity, which makes it vulnerable to oxidative damage, and slow accumulation of such damage over a lifetime may contribute to the development of dementia," the authors write. "In particular, when beta-amyloid (a hallmark of pathologic Alzheimers disease) accumulates in the brain, an inflammatory response is likely evoked that produces nitric oxide radicals and downstream neurodegenerative effects. Vitamin E is a powerful fat-soluble antioxidant that may help to inhibit the pathogenesis of dementia."

Future studies are needed to evaluate dietary intake of antioxidants and dietary risks, including different points at which consuming more antioxidants might reduce risk, the authors conclude.

High blood levels of vitamin E reduces risk of Alzheimers

High levels of several vitamin E components in the blood are associated with a decreased risk for Alzheimers disease (AD) in advanced age, suggesting that vitamin E may help prevent cognitive deterioration in elderly people. This is the conclusion reached in a Swedish study published in the July 2010 issue of the Journal of Alzheimer s Disease.

"Vitamin E is a family of eight natural components, but most studies related to Alzheimer s disease investigate only one of these components, ±-tocopherol", says Dr. Francesca Mangialasche, who led the study. "We hypothesized that all the vitamin E family members could be important in protecting against AD. If confirmed, this result has implications for both individuals and society, as 70 percent of all dementia cases in the general population occur in people over 75 years of age, and the study suggests a protective effect of vitamin E against AD in individuals aged 80+."

The study was conducted at the Aging Research Center (ARC), Karolinska Institutet, Stockholm, Sweden, in collaboration with the Institute of Gerontology and Geriatrics, University of Perugia, Italy. The study included a sample of 232 participants from the Kungsholmen Project, a population-based longitudinal study on aging and dementia in Stockholm (Kungsholmen parish). All participants were aged 80+ years and were dementia-free at the beginning of the study (baseline). After 6-years of follow-up, 57 AD cases were identified.

The blood levels of all eight natural vitamin E components were measured at the beginning of the study. Subjects with higher blood levels (highest tertile) were compared with subjects who had lower blood levels (lowest tertile) to verify whether these two groups developed dementia at different rates. The study found that subjects with higher blood levels of all the vitamin E family forms had a reduced risk of developing AD, compared to subjects with lower levels. After adjusting for various confounders, the risk was reduced by 45-54%, depending on the vitamin E component.

Dr Mangialasche notes that the protective effect of vitamin E seems to be related to the combination of the different forms. Another recent study indicated that supplements containing high doses of the E vitamin form ±-tocopherol may increase mortality, emphasizing that such dietary supplements, if not used in a balanced way, may be more harmful than previously thought.

Physical activity reduces risk of cognitive impairment in later life

Women who are physically active at any point over the life course (teenage, age 30, age 50, late life) have lower risk of cognitive impairment in late-life compared to those who are inactive, but teenage physical activity appears to be most important. This is the key finding of a study of over nine thousand women published today in the Journal of the American Geriatrics Society.

There is growing evidence to suggest that people who are physically active in mid- and late life have lower chance of dementia and more minor forms of cognitive impairment in old age. However, there is a poorer understanding of the importance of early life physical activity and the relative importance of physical activity at different ages. Researchers led by Laura Middleton, PhD, of Sunnybrook Health Sciences Centre, Canada, compared the physical activity at teenage, age 30, age 50, and late life against cognition of 9,344 women from Maryland, Minnesota, Oregon and Pennsylvania to investigate the effectiveness of activity at different life stages.

Of the participants, 15.5%, 29.7%, 28.1%, and 21.1% reported being physically inactive at teenage, at 30 years, at 50 years, and in late life respectively; the increase in cognitive impairment for those who were inactive was between 50% and 100% at each time point. When physical activity measures for all four ages were entered into a single model and adjusted for variables such as age, education, marital status, diabetes, hypertension, depressive symptoms, smoking, and BMI, only teenage physical activity status remained significantly associated with cognitive performance in old age.

"Our study shows that women who are regularly physically active at any age have lower risk of cognitive impairment than those who are inactive but that being physically active at teenage is most important in preventing cognitive impairment," said Middleton.

The researchers also found that women who were physically inactive at teenage but became physically active at age 30 and age 50 had significantly reduced odds of cognitive impairment relative to those who remained physically inactive. In contrast, being physically active at age 30 and age 50 was not significantly associated with rates of cognitive impairment in those women who were already physically active at teenage.

Middleton added, "As a result, to minimize the risk of dementia, physical activity should be encouraged from early life. Not to be without hope, people who were inactive at teenage can reduce their risk of cognitive impairment by becoming active in later life."

The researchers concluded that the mechanisms by which physical activity across the life course is related to late life cognition are likely to be multi-factorial. There is evidence to suggest that physical activity has a positive effect on brain plasticity and cognition and in addition, physical activity reduces the rates and severity of vascular risk factors, such as hypertension, obesity, and type II diabetes, which are each associated with increased risk of cognitive impairment.

"Low physical activity levels in todays youth may mean increased dementia rates in the future. Dementia prevention programs and other health promotion programs encouraging physical activity should target people starting at very young ages, not just in mid- and late life," said Middleton.

"Elderly people as a group are large consumers of vitamin E supplements, which usually contain only ±-tocopherol, and this often at high doses", says Dr Mangialasche. "Our findings need to be confirmed by other studies, but they open up for the possibility that the balanced presence of different vitamin E forms can have an important neuroprotective effect."

Vitamin D Promotes Mental Agility in Elders

At a time when consumer interest in health-enhancing foods is high, Agricultural Research Service (ARS)-funded scientists have contributed to a limited but growing body of evidence of a link between vitamin D and cognitive function.

Cognitive function is measured by the level at which the brain is able to manage and use available information for activities of daily life. Alzheimers disease, the most common form of age-related dementia, affects about 47 percent of adults aged 85 years or older in the United States. Identifying nutritional factors that lower cognitive dysfunction and help preserve independent living provides economic and public health benefits, according to authors.

The study, which was supported by ARS, the National Institutes of Health, and others, was led by epidemiologist Katherine Tucker with the Jean Mayer USDA Human Nutrition Research Center on Aging (HNRCA) at Tufts University in Boston, Mass. Tucker collaborated with HNRCA laboratory directors Irwin Rosenberg, Bess Dawson-Hughes and colleagues.

Metabolic pathways for vitamin D have been found in the hippocampus and cerebellum areas of the brain involved in planning, processing, and forming new memories. This suggests that vitamin D may be implicated in cognitive processes.

The study involved more than 1,000 participants receiving home care. The researchers evaluated associations between measured vitamin D blood concentrations and neuropsychological tests. Elders requiring home care have a higher risk of not getting enough vitamin D because of limited sunlight exposure and other factors.

The participants, ages 65 to 99 years, were grouped by their vitamin D status, which was categorized as deficient, insufficient, or sufficient. Only 35 percent had sufficient vitamin D blood levels. They had better cognitive performance on the tests than those in the deficient and insufficient categories, particularly on measures of "executive performance," such as cognitive flexibility, perceptual complexity, and reasoning. The associations persisted after taking into consideration other variables that could also affect cognitive performance.

The 2009 study appears in the Journals of Gerontology, Series A, Biological Sciences and Medical Sciences.

Abdominal fat at middle age associated with greater risk of dementia

Study confirms that obesity is associated with lower total brain volume

Researchers from Boston University School of Medicine determined that excess abdominal fat places otherwise healthy, middle-aged people at risk for dementia later in life. Preliminary findings suggest a relationship between obesity and dementia that could lead to promising prevention strategies in the future. Results of this study are published early online in Annals of Neurology, a journal of the American Neurological Association.

A 2005 World Health Organization (WHO) report estimated that 24.3 million people have some form of dementia, with 4.6 million new cases annually. Individuals with dementia exhibit a decline in short-term and long-term memory, language processing, problem solving capabilities, and other cognitive function. Clinical diagnosis of dementia is made when two or more brain functions are significantly impaired. Symptoms of dementia can be attributed to irreversible causes such Alzheimers disease, vascular dementia, and Huntingtons disease, or caused by treatable conditions such as brain tumor, medication reaction, or metabolic issues.

For the current study, Sudha Seshadri, M.D. and colleagues recruited participants from the Framingham Heart Study Offspring Cohort. The sample included 733 community participants who had a mean age of 60 years with roughly 70% of the study group comprised of women. Researchers examined the association between Body Mass Index (BMI), waist circumference, waist to hip ratio, CT-based measures of abdominal fat, with MRI measures of total brain volume (TCBV), temporal horn volume (THV), white matter hyperintensity volume (WMHV) and brain infarcts in the middle-aged participants.

"Our results confirm the inverse association of increasing BMI with lower brain volumes in older adults and with younger, middle-aged adults and extends the findings to a much larger study sample," noted Dr. Seshadri. Prior studies were conducted in cohorts with less than 300 participants and the current study includes over 700 individuals.

"More importantly our data suggests a stronger connection between central obesity, particularly the visceral fat component of abdominal obesity, and risk of dementia and Alzheimers disease," Dr. Seshadri added. The research showed the association between VAT and TCBV was most robust and was also independent of BMI and insulin resistance. Researchers did not observe a statistically significant correlation between CT-based abdominal fat measures and THV, WMHV or BI.

"Our findings, while preliminary, provide greater understanding of the mechanisms underlying the link between obesity and dementia," concluded Dr. Seshadri. "Further studies will add to our knowledge and offer important methods of prevention."

Caffeine may slow Alzheimers disease and other dementias, restore cognitive function

Although caffeine is the most widely consumed psychoactive drug worldwide, its potential beneficial effect for maintenance of proper brain functioning has only recently begun to be adequately appreciated. Substantial evidence from epidemiological studies and fundamental research in animal models suggests that caffeine may be protective against the cognitive decline seen in dementia and Alzheimers disease (AD). A special supplement to the Journal of Alzheimers Disease, "Therapeutic Opportunities for Caffeine in Alzheimers Disease and Other Neurodegenerative Diseases," sheds new light on this topic and presents key findings.

Guest editors Alexandre de Mendonça, Institute of Molecular Medicine and Faculty of Medicine, University of Lisbon, Portugal, and Rodrigo A. Cunha, Center for Neuroscience and Cell Biology of Coimbra and Faculty of Medicine, University of Coimbra, Portugal, have assembled a group of international experts to explore the effects of caffeine on the brain. The resulting collection of original studies conveys multiple perspectives on topics ranging from molecular targets of caffeine, neurophysiological modifications and adaptations, to the potential mechanisms underlying the behavioral and neuroprotective actions of caffeine in distinct brain pathologies.

"Epidemiological studies first revealed an inverse association between the chronic consumption of caffeine and the incidence of Parkinsons disease," according to Mendonça and Cunha. "This was paralleled by animal studies of Parkinsons disease showing that caffeine prevented motor deficits as well as neurodegeneration "Later a few epidemiological studies showed that the consumption of moderate amounts of caffeine was inversely associated with the cognitive decline associated with aging as well as the incidence of Alzheimers disease. Again, this was paralleled by animal studies showing that chronic caffeine administration prevented memory deterioration and neurodegeneration in animal models of aging and of Alzheimers disease."


Exercise associated with preventing, improving mild cognitive impairment

Moderate physical activity performed in midlife or later appears to be associated with a reduced risk of mild cognitive impairment, whereas a six-month high-intensity aerobic exercise program may improve cognitive function in individuals who already have the condition, according to two reports in the January issue of Archives of Neurology, one of the JAMA/Archives journals.

Mild cognitive impairment is an intermediate state between the normal thinking, learning and memory changes that occur with age and dementia, according to background information in one of the articles. Each year, 10 percent to 15 percent of individuals with mild cognitive impairment will develop dementia, as compared with 1 percent to 2 percent of the general population. Previous studies in animals and humans have suggested that exercise may improve cognitive function.

In one article, Laura D. Baker, Ph.D., of the University of Washington School of Medicine and Veterans Affairs Puget Sound Health Care System, Seattle, and colleagues report the results of a randomized, controlled clinical trial involving 33 adults with mild cognitive impairment (17 women, average age 70). A group of 23 were randomly assigned to an aerobic exercise group and exercised at high intensity levels under the supervision of a trainer for 45 to 60 minutes per day, four days per week. The control group of 10 individuals performed supervised stretching exercises according to the same schedule but kept their heart rate low. Fitness testing, body fat analysis, blood tests of metabolic markers and cognitive functions were assessed before, during and after the six-month trial.

A total of 29 participants completed the study. Overall, the patients in the high-intensity aerobic exercise group experienced improved cognitive function compared with those in the control group. These effects were more pronounced in women than in men, despite similar increases in fitness. The sex differences may be related to the metabolic effects of exercise, as changes to the bodys use and production of insulin, glucose and the stress hormone cortisol differed in men and women.

"Aerobic exercise is a cost-effective practice that is associated with numerous physical benefits. The results of this study suggest that exercise also provides a cognitive benefit for some adults with mild cognitive impairment," the authors conclude. "Six months of a behavioral intervention involving regular intervals of increased heart rate was sufficient to improve cognitive performance for an at-risk group without the cost and adverse effects associated with most pharmaceutical therapies."

In another report, Yonas E. Geda, M.D., M.Sc., and colleagues at Mayo Clinic, Rochester, Minn., studied 1,324 individuals without dementia who were part of the Mayo Clinic Study of Aging. Participants completed a physical exercise questionnaire between 2006 and 2008. They were then assessed by an expert consensus panel, who classified each as having normal cognition or mild cognitive impairment.

A total of 198 participants (median or midpoint age, 83 years) were determined to have mild cognitive impairment and 1,126 (median age 80) had normal cognition. Those who reported performing moderate exercise—such as brisk walking, aerobics, yoga, strength training or swimming—during midlife or late life were less likely to have mild cognitive impairment. Midlife moderate exercise was associated with 39 percent reduction in the odds of developing the condition, and moderate exercise in late life was associated with a 32 percent reduction. The findings were consistent among men and women.

Light exercise (such as bowling, slow dancing or golfing with a cart) or vigorous exercise (including jogging, skiing and racquetball) were not independently associated with reduced risk for mild cognitive impairment.

Physical exercise may protect against mild cognitive impairment via the production of nerve-protecting compounds, greater blood flow to the brain, improved development and survival of neurons and the decreased risk of heart and blood vessel diseases, the authors note. "A second possibility is that physical exercise may be a marker for a healthy lifestyle," they write. "A subject who engages in regular physical exercise may also show the same type of discipline in dietary habits, accident prevention, adherence to preventive intervention, compliance with medical care and similar health-promoting behaviors."

Future study is needed to confirm whether exercise is associated with the decreased risk of mild cognitive impairment and provide additional information on cause and effect relationships, they conclude.

High fruit and vegetable intake positively correlated with cognitive performance

Researchers at the Institute of Biochemistry and Molecular Biology I of the Heinrich-Heine University, Düsseldorf, Germany, investigated the relationship between fruit and vegetable intake, plasma antioxidant micronutrient status and cognitive performance in healthy subjects aged 45 to 102 years. Their results, published in the August issue of the Journal of Alzheimers Disease, indicated higher cognitive performance in individuals with high daily intake of fruits and vegetables.

Subjects with a high daily intake (about 400 g) of fruits and vegetables had higher antioxidant levels, lower indicators of free radical-induced damage against lipids as well as better cognitive performance compared to healthy subjects of any age consuming low amounts (< 100 g/day) of fruits and vegetables. Modification of nutritional habits aimed at increasing intake of fruits and vegetables, therefore, should be encouraged to lower the prevalence of cognitive impairment. The work was performed in collaboration with the Department of Pharmacology at Temple University in Philadelphia, Pennsylvania, the Department of Geriatrics at Perugia University, Italy, and the Department of Neurology of the St. Elisabeth Hospital in Cologne, Germany. Dr. M. Cristina Polidori, currently at the Department of Geriatrics, Marienhospital Herne, Ruhr-University of Bochum, Germany, explains: "It is known that there is a strong association between fruit and vegetable intake and the natural antioxidant defenses of the body against free radicals. It is also known that bad nutritional habits increase the risk of developing cognitive impairment with and without dementia. With this work we show a multiple link between fruit and vegetable intake, antioxidant defenses and cognitive performance, in the absence of disease and independent of age. Among other lifestyle habits, it is recommended to improve nutrition in general and fruit and vegetable intake in particular at any age, beginning as early as possible. This may increase our chances to remain free of dementia in advanced age." These findings are independentof age, gender, body mass index, level of education, lipid profile and albumin levels, all factors able to influence cognitive and antioxidant status. The relevance of the findings is also strengthened by the large sample that included 193 healthy subjects. Further studies are planned that will include larger subject cohorts, patients with Alzheimers disease at different stages and patients with mild cognitive impairment without dementia. Mediterranean Diet = Slower Cognitive Decline

In an examination of the association between adherence to a Mediterranean-type diet and cognitive performance and risk of dementia, researchers found that high adherence to the diet was associated with slower decline in some measures of cognitive function but was not associated with decreased risk for dementia, according to a study in the August 12 , 2009 issue of JAMA.

Higher adherence to a Mediterranean-type diet is linked to lower risk for mortality and chronic diseases, and "might also have protective effects against cognitive decline in older individuals, because it combines several foods and nutrients potentially protective against cognitive dysfunction or dementia, such as fish, monounsaturated fatty acids, vitamins B12 and folate, antioxidants (vitamin E, carotenoids, flavonoids), and moderate amounts of alcohol," the authors write. But its association with cognitive decline has been unclear.

Catherine Féart, Ph.D., of the Université Victor Ségalen Bordeaux 2, Bordeaux, France, and colleagues examined whether adherence to a Mediterranean diet was associated with change in cognitive performance and with lower risk of all-cause dementia or Alzheimer disease. The study included 1,410 individuals (age 65 years or older) from Bordeaux, France, who were part of the Three-City cohort in 2001-2002 (a study of vascular risk factors of dementia) and were re-examined at least once over 5 years. Adherence to a Mediterranean diet (scored as 0 to 9) was computed from a food frequency questionnaire and 24-hour recall.

Cognitive performance was assessed on 4 neuropsychological tests: the Mini-Mental State Examination (MMSE), Isaacs Set Test (IST), Benton Visual Retention Test (BVRT), and Free and Cued Selective Reminding Test (FCSRT). New cases of dementia (n = 99) were validated by an independent expert committee of neurologists.

After adjusting for age, sex, education, marital status, energy intake, physical activity, depressive symptomatology, taking 5 medications/day or more, apolipoprotein E genotype, cardiovascular risk factors, and stroke, the researchers found that higher Mediterranean diet score was associated with fewer MMSE errors. But performance on the IST, BVRT, or FCSRT over time was not significantly associated with Mediterranean diet adherence, especially in those who remained free from dementia over 5 years. Mediterranean diet adherence was not associated with the risk for incident dementia, although the statistical strength of the data to detect a difference was limited.

"The Mediterranean diet pattern probably does not fully explain the better health of persons who adhere to it, but it may contribute directly. A Mediterranean diet also may indirectly constitute an indicator of a complex set of favorable social and lifestyle factors that contribute to better health. Further research is needed to allow the generalization of these results to other populations and to establish whether a Mediterranean diet slows cognitive decline or reduces incident dementia in addition to its cardiovascular benefits," the authors conclude.

Mediterranean diet, exercise fight Alzheimer disease

Elderly individuals who had a diet that included higher consumption of fruits, vegetables, legumes, cereal and fish and was low in red meat and poultry and who were physically active had an associated lower risk of Alzheimer disease, according to a study in the August 12. 2009 issue of JAMA.

Research regarding the effect physical activity can have on the risk of Alzheimer disease (AD) or dementia has shown mixed results, as has the effect of dietary habits. Their combined association has not been investigated, according to background information in the article.

Nikolaos Scarmeas, M.D., of Columbia University Medical Center, New York, and colleagues examined the association between physical activity and risk of AD and also the effect of physical activity and adherence to a Mediterranean-type diet on AD risk. The study included 2 groups that consisted of 1,880 community-dwelling elderly residents of New York city without dementia at the start of the study, for whom there was both diet and physical activity information available. Standardized neurological and neuropsychological measures were administered approximately every 1.5 years from 1992 through 2006.

The participants received measurements of their adherence to a Mediterranean-type diet (scale of 0-9; categorized as low, middle, or high) and their physical activity (sum of weekly participation in various physical activities, weighted by the type of physical activity [light, moderate, vigorous]; categorized into no physical activity, some, or much, also low or high), separately and combined. A higher score for diet was obtained with higher consumption of fruits, vegetables, legumes, cereals, and fish; lower consumption of meat and dairy products; a higher ratio of monounsaturated fats to saturated fats and mild to moderate alcohol consumption.

Individuals were followed up for an average of 5.4 years, during which a total of 282 developed AD. In considering only physical activity, the researchers found that more physical activity was associated with lower risk for developing AD. "Compared with physically inactive individuals, report of some physical activity was associated with a 29 percent to 41 percent lower risk of developing AD, while report of much physical activity was associated with a 37 percent to 50 percent lower risk," the authors write.

When considered simultaneously, both physical activity and Mediterranean diet adherence were significantly associated with AD incidence. According to the researchers, "Belonging to the middle diet adherence tertile was associated with a 2 percent to 14 percent risk reduction, while belonging to the highest diet adherence tertile was associated with a 32 percent to 40 percent reduced risk. Similarly, compared with individuals with no physical activity, individuals reporting some physical activity had a 25 percent to 38 percent lower risk for AD, while individuals reporting much physical activity had a 33 percent to 48 percent lower risk for AD."

The authors also write, "Compared with individuals with low physical activity plus low adherence to a diet (absolute AD risk, 19 percent), high physical activity plus high diet adherence was associated with a 35 percent to 44 percent relative risk reduction (absolute AD risk, 12 percent). … Absolute AD risks declined from 21 percent in the group with no physical activity plus low diet adherence to 9 percent in the group with much physical activity plus high diet adherence."

"In summary, our results support the potentially independent and important role of both physical activity and dietary habits in relation to AD risk. These findings should be further evaluated in other populations."


High cholesterol in midlife raises risk of late-life dementia

Elevated cholesterol levels in midlife – even levels considered only borderline elevated – significantly increase the risk of Alzheimers disease and vascular dementia later in life, according to a new study by researchers at Kaiser Permanentes Division of Research and the University of Kuopio in Finland. The study appears in the journal Dementia & Geriatric Cognitive Disorders.

The four-decade study of 9,844 men and women found that having high cholesterol in midlife (240 or higher milligrams per deciliter of blood) increases, by 66 percent, the risk for Alzheimers disease later in life. Even borderline cholesterol levels (200 – 239 mg/dL) in midlife raised risk for late-life vascular dementia by nearly the same amount: 52 percent. Vascular dementia, the second most common form of dementia after Alzheimers disease, is a group of dementia syndromes caused by conditions affecting the blood supply to the brain. Scientists are still trying to pinpoint the genetic factors and lifestyle causes for Alzheimers disease.

By measuring cholesterol levels in 1964 to 1973 based on the 2002 Adult Treatment Panel III guidelines (the current practice standard) when the Kaiser Permanente Northern California members were 40 to 45 years old, then following the participants for 40 years, this study is the largest long-term study with the most diverse population to examine the midlife cholesterol levels and late-life dementia. It is also the first study to look at borderline high cholesterol levels and vascular dementia, rather than just Alzheimers disease.

"Our study shows that even moderately high cholesterol levels in your 40s puts people at greater risk for Alzheimers disease and vascular dementia decades later," said the studys senior author. Rachel Whitmer, Ph.D., a research scientist and epidemiologist at the Kaiser Permanente Division of Research in Oakland, Calif. "Considering that nearly 100 million Americans have either high or borderline cholesterol levels, this is a disturbing finding. The good news here is that what is good for the heart is also good for the mind, and this is an early risk factor for dementia that can be modified and managed by lowering cholesterol through healthy lifestyle changes."

This study, funded by the National Institutes of Health, adds to other research emphasizing the importance of addressing dementia risk factors in midlife, before an underlying disease or symptoms appear, the researchers said.

"Our findings add to the existing body of evidence on a degree of overlap between two dementia types in terms of risk factors, symptoms and neuropathology," said the studys lead author, Alina Solomon, MD, a researcher with the Department of Neurology at the University of Kuopio, Finland. "Dementia and cardiovascular disease are common major health problems, share several risk factors and often occur simultaneously, interacting with one another. A holistic approach that addresses multiple major health problems simultaneously is needed to effectively manage these disorders."

The study tracked members of Kaiser Permanentes Northern California Medical Group from 1967 to 2007 by using the multiphasic testing records pioneered by Kaiser Permanente founding physician Morris Collen, MD, who is widely regarded worldwide as a health care informatics pioneer. Of the original 9,844 participants, 598 were diagnosed with Alzheimers disease or vascular dementia between 1994 and 2007, when the participants were between 61 and 88 years old.

This epidemiological study did not examine the mechanism of the link between cholesterol levels and dementia.

This study is part of an ongoing body of research at Kaiser Permanente to better understand the risk and protective factors for dementia. Dr. Whitmer recently authored two dementia-related studies: one that found a larger abdomen in midlife increases risk of late-life dementia, and one that showed that low blood sugar events in elderly patients with type 2 diabetes increase their risk for dementia. Another Kaiser Permanente study, led by Valerie Crooks of Kaiser Permanente in Southern California, found that having a strong social network of friends and family appears to decrease risk for dementia.

Dietary Approaches to Stop Hypertension (DASH) Eating Pattern May Reduce Age-Related Cognitive Decline

The Dietary Approaches to Stop Hypertension (DASH) diet is often recommended by physicians to people with high blood pressure or pre-hypertension. The DASH diet eating plan has been proven to lower blood pressure in studies sponsored by the National Institutes of Health. High blood pressure is considered a risk factor for Alzheimers and dementia.

Heidi Wengreen, RD, PhD, Assistant Professor of Nutrition at Utah State University, and colleagues examined associations between how closely people adhered to the DASH diet and risk of cognitive decline and dementia among older participants in the Cache County Study on Memory, Health and Aging.

In 1995, 3,831 study participants 65 years of age or older completed a survey that included a food frequency questionnaire and cognitive assessment. Cognitive function was checked again during four assessments over 11 years using the Modified Mini-Mental State examination (3MS), which is graded on a 100 point scale. A DASH diet adherence score was created based on consumption levels of nine food-group/nutrient components -- fruit, vegetables, nut/legumes, whole grains, low-fat dairy, sodium, sweets, non-fish meat, and fish. Participants were ranked by DASH score into five groups, or quintiles.

The researchers found that higher DASH scores were associated with higher scores for cognitive functioning at the beginning of the study and over time. Those in the highest quintile scored 1.42 points higher at baseline and 1.81 points higher after 11 years on the 3MS than did those in the lowest quintile of the DASH score (p-values < 0.001). They also found that four of the nine food-group/nutrient components used to create the DASH score were independently associated with 3MS scores -- vegetables, whole grains, low-fat dairy, nut/legumes. The scientists created a diet adherence score based on just these four components which they then tested for association with changes in cognitive abilities on the 3MS. Those in the highest quintile scored 1.72 points higher at baseline and 3.73 points higher after 11 years than did those in the lowest quintile of the four-component score (p-values < 0.001). "Our results suggest that including whole grains, vegetables, low-fat dairy foods, and nuts in ones diet may offer benefits for cognition in late life," Wengreen said. "However, we need more research before we can confidently say how much of these foods to include in your diet to experience some benefit." Maintaining or Increasing Activity Levels May Slow Cognitive Decline in Elderly

Studies have found that older adults who are physically active may experience slower rates of cognitive decline. Less is known about the impact of changes in physical activity levels on rate of cognitive decline.

Deborah E. Barnes, PhD, MPH, Assistant Professor of Psychiatry at the University of California, San Francisco, and a geriatrics researcher at the San Francisco VA Medical Center, and colleagues studied changes in levels of both physical activity and cognitive function over seven years in 3,075 white and black elders aged 70-79 years in the Health, Aging and Body Composition Study. Physical activity was assessed based on self-reported number of minutes walked per week at the beginning of the study and after two, four, and seven years of follow-up. Participants were classified at each time point as sedentary (0 minutes per week), low (less than 150 minutes per week) or high (150 minutes per week or more). Changes over time were classified as consistently sedentary, maintaining (low or high), decreasing, or increasing/fluctuating. Cognitive function was assessed using the 3MS.

The researchers found that 21% of study participants were consistently sedentary, 12% maintained their activity levels, 26% had declining levels, and 41% had increasing or fluctuating levels. After adjustment for age, sex, race, education, study site, diabetes, hypertension, smoking, alcohol consumption and baseline 3MS score, they found that the mean rate of decline in 3MS scores was 0.62 points/year in those who were consistently sedentary, 0.54 points/year (p=0.30) in those with declining activity levels, 0.44 points/year (p=0.01) in those with increasing/fluctuating activity levels, and 0.40 points/year (p=0.04) in those who maintained their activity levels.

"We found that older adults who were sedentary throughout the study had the lowest levels of cognitive function at the beginning and experienced the fastest rate of cognitive decline," Barnes said. "Cognitive decline also was faster in those whose physical activity levels consistently declined during the study period."

According to the researchers, sedentary elders who began new aerobic exercise programs experienced improvements in cognitive function, especially the ability to process complex information quickly. "Sedentary individuals should be encouraged to engage in physical activity at least occasionally," Barnes said. "People who are currently active should be encouraged to maintain or increase their activity levels."

Moderate Long-Term Physical Activity May Improve Late Life Cognition; Long-Term Strenuous Activity May Increase Risk of Cognitive Impairment

Long-term strenuous physical activity has been shown to decrease lifetime exposure to ovarian hormones in women and has been found to play a protective role against breast cancer. However reduction in ovarian hormone exposure has been associated with increased risk of cognitive impairment. At the same time, long-term physical activity is associated with improved cognition but the intensity required to preserve cognition is not known.

Mary C. Tierney, PhD, CPsych, Professor of Family and Community Medicine at the University of Toronto, and Senior Scientist and Director, Geriatric Research Unit, Brain Sciences Program at Sunnybrook Health Sciences Centre, and colleagues sought to examine the associations between both long-term strenuous and moderate activity levels and cognition in recently postmenopausal women.

Study participants were 90 women aged 50-63 years, one to 10 years post natural menopause, with no history of breast cancer, HRT use, psychiatric disorder, dementia or other neurological condition. Participants gave details on the amount of their strenuous and moderate physical recreational activities from high school to menopause. Eight memory and brain function tests were administered to all participants.

After adjusting for age, education, reproductive years, cigarette smoking, alcohol consumption, parity, and periods of amenorrhea, the researchers found that long-term strenuous activity was consistently associated with poorer performance on all eight of the tests; with statistically significant results on tests of semantic memory, working memory, delayed verbal recall, and sustained attention (p < 0.05). Moderate physical activity was consistently associated with better performance on all eight of the tests, with statistically significant results on cognitive flexibility, working memory, and sustained attention (p < 0.05). "Our results suggest that long-term strenuous activity may increase the risk of cognitive impairment in recently postmenopausal women," Tierney said. "On the other hand, moderate long-term physical activity may improve later life cognition. These preliminary findings have important implications for womens health and support the need for large-scale studies including both women and men." Moderate alcohol intake has cognitive benefits

A glass of wine here, a nightcap there – new research out of Wake Forest University School of Medicine suggests that moderate alcohol intake offers long-term cognitive protection and reduces the risk of dementia in older adults.

The study is being presented at the Alzheimers Association 2009 International Conference on Alzheimers Disease (ICAD), in Vienna on July 13.

While previous studies have shown that moderate alcohol intake, particularly wine, is linked with lower risk of heart attacks and dementia, most of the studies have been done in middle-aged people, and it has remained unclear if the benefits of alcohol also apply to older adults in general or to older adults who might already have some mild memory problems. This is the largest, longest U.S. study to look at the effects of regular alcohol intake on dementia in seniors, both with and without memory problems.

"As of yet, we still have no cure for Alzheimers disease and other dementias, so it is important to look for things that might help people prevent the disease," said Kaycee Sink, M.D., M.A.S (Masters of Advanced Studies in clinical research), a geriatrician and senior author of the paper. Moderate alcohol intake has been linked to lower risk of heart attacks, stroke, dementia, and death in middle-aged adults, but there is still controversy about alcohol intake in older adults."

For the study, researchers began by examining and interviewing 3,069 individuals, 75 years or older and most without any memory or thinking problems, about their drinking habits. Participants were asked about beer, wine, and liquor. The investigators then categorized the individuals as abstainers (non-drinkers), light drinkers (one to seven drinks per week), moderate drinkers (eight to 14 drinks per week), or heavy drinkers (more than 14 drinks per week). All types of alcohol were included.

The study subjects were then examined and interviewed every six months for six years to determine changes in their memory or thinking abilities and to monitor who developed dementia.

Researchers found that individuals who had no cognitive impairment at the start of the study and drank eight to 14 alcoholic beverages per week, or one to two per day, experienced an average 37 percent reduction in risk of developing dementia compared to individuals who did not drink at all and were classified as abstainers. The type of alcohol consumed did not matter.

For older adults who started the study with mild cognitive impairment, however, consumption of alcohol, at any amount, was associated with faster rates of cognitive decline. In addition, those who were classified in the heavy drinker category, consuming more than 14 drinks per week, were almost twice as likely to develop dementia during the study compared to non-drinkers with mild cognitive impairment.

"We were excited to see that even in older adults, moderate alcohol intake decreases the risk of dementia," Sink said. "It is important to note, however, that our study found a significantly higher risk of dementia for heavy drinkers who started the study with mild cognitive impairment."

The results are consistent with previous studies of middle-aged adults that suggest mild to moderate alcohol intake may reduce the risk of dementia, except in the case of individuals who already have mild to moderate cognitive impairment. The researchers findings support current recommendations not to exceed one drink per day for women and two for men.

It is unclear from this study whether an abstainer who begins drinking moderately in his/her 70s will experience the same benefit or if the benefit is associated with a long pattern of moderate alcohol intake that continues on into old age.

"Our results suggest that older adults who are normal cognitively and drink moderately do not need to change their drinking behavior," Sink said. "If you have mild cognitive impairment however, it might benefit you to restrict your drinking and certainly not exceed one drink a day for women and two drinks a day for men.

"The participants in this study self-reported their alcohol intake at the start, but it is unusual for people to start drinking in their 70s, so we assume that the habits they reported at the start of the study reflect stable drinking habits," Sink added. "Without scientific data showing that it is beneficial, I wouldnt recommend that non-drinkers start drinking in their 70s.

"We are starting to make progress in understanding how to prevent and treat Alzheimers and other dementias," she said. "It is a very exciting time to be involved in geriatrics research."

Aspirin can reduce risk of Alzheimers disease

Ibuprofen, aspirin, naproxen may be equally effective at reducing risk of Alzheimers disease

Different types of non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, naproxen, and aspirin, appear to be equally effective in lowering the risk of Alzheimer’s disease, according to the largest study of its kind published in the May 28, 2008, online issue of Neurology®, the medical journal of the American Academy of Neurology. Experts have debated whether a certain group of NSAIDs that includes ibuprofen may be more beneficial than another group that includes naproxen and aspirin.

Using information from six different studies, researchers examined data on NSAID use in 13,499 people without dementia. Over the course of these six studies, 820 participants developed Alzheimer’s disease.

Researchers found that people who used NSAIDs had 23 percent lower risk of developing Alzheimer’s disease compared to those who never used NSAIDs. The risk reduction did not appear to depend upon the type of NSAID taken.

“This is an interesting finding because it seems to challenge a current theory that the NSAID group which includes ibuprofen may work better in reducing a person’s risk of Alzheimer’s,” said study author Peter P. Zandi, PhD, with Johns Hopkins Bloomberg School of Public Health in Baltimore, MD. “The NSAID group that includes ibuprofen was thought to target a certain type of plaque in the brain found in Alzheimer’s patients. But our results suggest there may be other reasons why these drugs may reduce the risk of Alzheimer’s.”

The study’s lead author Chris Szekely, PhD, with Cedars Sinai Medical Center in Los Angeles, says the discrepancy between studies such as this one and the negative clinical trials of NSAIDs in treatment or prevention of Alzheimer’s need to be further explored.

Vasectomy may put men at risk for type of dementia

Northwestern University researchers have discovered men with an unusual form of dementia have a higher rate of vasectomy than men the same age who are cognitively normal.

The dementia is Primary Progressive Aphasia (PPA), a neurological disease in which people have trouble recalling and understanding words. In PPA, people lose the ability to express themselves and understand speech. It differs from typical Alzheimers disease in which a persons memory becomes impaired.

Sandra Weintraub, principal investigator and professor of psychiatry and behavioral sciences and of neurology at Northwesterns Feinberg School of Medicine, began investigating a possible link between the surgery and PPA when one of her male patients connected the onset of his language problem at age 43 to the period after his vasectomy.

At a twice-yearly Chicago support group for PPA patients Weintraub sees from around the country, the male patient rushed into the room and asked the men sitting there, "OK, guys, how many of you have PPA?" Nine hands went up.

"How many of you had a vasectomy?" he demanded next. Eight hands shot up.

Weintraub and her team of researchers surveyed 47 men with PPA who were being treated at Northwesterns Cognitive Neurology and Alzheimers Disease Center and 57 men with no cognitive impairment who were community volunteers. They ranged from 55 to 80 years old.

Of the non-impaired men, 16 percent had undergone a vasectomy. In contrast, 40 percent of the men with PPA had had the surgery.

"Thats a huge difference," said Weintraub, director of neuropsychology in the Cognitive Neurology and Alzheimers Disease Center. "It doesnt mean having a vasectomy will give you this disease, but it may be a risk factor to increase your chance of getting it."

In addition, the men who had undergone a vasectomy developed PPA at a younger age (58 years) than men with PPA who hadnt had one (62 years.)

While PPA robs people of their ability to speak and understand language, an unusual twist of the disease is patients are still able to maintain their hobbies and perform other complicated tasks for a number of years before other symptoms develop. Some people garden, build cabinets and even navigate a city subway system. By contrast, Alzheimers patients lose interest in their hobbies, family life and may become idle. As PPA progresses over a number of years, however, patients eventually lose their ability to function independently.

Preliminary evidence from the study also seemed to connect another form of dementia to a vasectomy. In a smaller group of 30 men with a dementia called frontotemporal dementia (FTD,) 37 percent had undergone a vasectomy. The earliest symptoms of FTD are personality changes, lack of judgment and bizarre behavior. As in PPA, FTD usually starts at an earlier age, in the 40s and 50s.

One of Weintraubs patients with FTD was eating lunch in a restaurant with his family and excused himself to go to the bathroom. When he hadnt returned after 10 minutes, his sons went to investigate. They found him doing pushups on the bathroom floor. Other FTD patients begin shoplifting, compulsively gambling, misspending large amounts of money or become sexually demanding.

The most common form of dementia caused by brain deterioration in individuals over age 65 is Alzheimers disease. Weintraub did not find an increased rate of vasectomy in patients with Alzheimers.

Many patients with FTD and PPA share a common brain disease that is completely different from Alzheimers. Whether a patient will get the behavioral or language problems depends on where the disease causes the most destruction in the brain. In FTD, most of the damage is in the frontal lobes; in PPA, its in the language centers of the left hemisphere of the brain.

Weintraub theorizes a vasectomy may raise the risk of PPA (and possibly FTD) because the surgery breeches the protective barrier between the blood and the testes, called the blood-testis barrier.

Certain organs – including the testes and the brain – exist in what is the equivalent of a gated community in the body. Tiny tubes within the testes (in which sperm are produced) are protected by a physical barrier of Sertoli cells. The tight connections between these cells prevent blood-borne infections and poisonous molecules from entering the semen.

After a vasectomy, however, the protective barrier is broken and semen mixes into the blood. The immune system recognizes the sperm as invading foreign agents and produces anti-sperm antibodies in 60 to 70 percent of men.

Weintraub said these antibodies might cross the blood-brain-barrier and cause damage resulting in dementia. "There are other neurological models of disease which you can use as a parallel," Weintraub said. Certain malignant tumors produce antibodies that reach the brain and cause an illness similar to encephalitis, she noted.

The next step in Weintraubs research will be to launch a national study to see if her results will be confirmed in a larger population.

"I dont want to scare anyone away from getting a vasectomy," Weintraub stressed. "Its obviously a major birth control alternative. This is just a correlational observation," she said of the dementia connection. "We need to do more research to find out."

Higher folate levels linked to reduced risk for Alzheimers disease

Individuals who take in higher levels of the nutrient folate through both diet and supplements may have a reduced risk of developing Alzheimers disease, according to a report in the January issue of Archives of Neurology, one of the JAMA/Archives journals.

By the year 2047, the prevalence of Alzheimers disease is expected to quadruple, according to background information in the article. Delaying the onset of this neurodegenerative disease would significantly reduce the burden it causes. Researchers suspect that elevated levels of the amino acid homocysteine in the blood, which is linked to a higher risk for cardiovascular disease and stroke, may also increase the risk for Alzheimers disease. Folate, vitamin B12 and vitamin B6, are important in the bodys processing of homocysteine--therefore, deficiencies in these nutrients increase homocysteine levels and may contribute to cardiovascular disease, stroke and dementia.

José A. Luchsinger, M.D., Columbia University Medical Center, New York, and colleagues examined, interviewed and assessed the diets of 965 individuals without dementia between 1992 and 1994 and then followed them for an average of 6.1 years to see if they developed Alzheimers disease. The participants had an average age of 75.8 and 70.2 percent were women, 32.6 percent African-American, 45.3 percent Hispanic and 22.1 percent white.

During the follow-up period, 192 of the participants developed Alzheimers disease. When the individuals were divided into four groups based on the total level of folate they took in through food and supplements and the analysis was adjusted for patient characteristics, comorbid diseases and B12 and B6 intake, the risk of Alzheimers disease was lower in the groups with higher intake. Neither dietary folate nor supplements alone were significantly linked to Alzheimers disease risk; only the two in combination appeared to produce an effect. Levels of the vitamins B12 and B6 were not associated with Alzheimers disease risk.

Higher folate intake was modestly correlated with lower homocysteine levels, "indirectly suggesting that a lower homocysteine level is a potential mechanism for the association between higher folate intake and a lower Alzheimers disease risk," the authors write.

Definitive conclusions about the role of folate in the development of Alzheimers disease cannot yet be made, they continue. The findings of this study are in contrast to those of some other research, and other compounds (such as hormones) perceived to reduce the risk for dementia in observational studies did not do so in randomized trials. "Thus, the decision to increase folate intake to prevent Alzheimers disease should await clinical trials," they conclude.

Red wine again linked to slowing Alzheimers

A Mount Sinai School of Medicine study found giving mice with amyloid plaques red wine slows their memory loss and brain cell death - adding to a body of science linking compounds in the beverage to slowing the Alzheimers disease-related symptom.

In the study - set to for publication in Novembers Federation of American Societies for Experimental Biology Journal - wine-drinking mice learned to escape from a maze significantly faster than mice drinking alcohol-spiked water or water.
The results could have implications for formulators in the production of supplements for age-related conditions.

According to the Alzheimers Society, there are nearly 18 million people in the world with dementia. Around 55 percent of those who suffer from dementia have Alzheimers.

In the Mount Sinai study, the mices wine intake was aligned to what is the equivalent of moderate consumption in humans - a five-ounce glass per day for women and two for men.

In the past, both alcohol and a red wine compound, resveratrol, have been linked to a reduction in the onset of dementia.

For several months, the Mount Sinai mice were given cabernet sauvignon or ethanol in their drinking water, while another group of mice drank plain water. All the mice had amyloid plaques in their brains that occur in humans with Alzheimers disease.

The research team, led by Dr. Giulio Maria Pasinetti, assessed the mices memory by testing their ability to get out of a maze. The wine-drinking mice were able to exit the maze significantly faster than those drinking alcohol-spiked water or water only, the scientists found.

The study only advocates moderate red wine consumption as part of an overall healthy lifestyle.

Midlife Coffee And Tea Drinking May Protect Against Late-life Dementia

Midlife coffee drinking can decrease the risk of dementia/Alzheimers disease (AD) later in life. This conclusion is made in a Finnish Cardiovascular Risk Factors, Aging and Dementia (CAIDE) Study published in the Journal of Alzheimers Disease.

This study has been conducted at the University of Kuopio, Finland in collaboration with Karolinska Institutet, Stockholm, Sweden, and the National Public Health Institute, Helsinki, Finland. The study included participants from the survivors of population-based cohorts previously surveyed within the North Karelia Project and the FINMONICA study in 1972, 1977, 1982 or 1987 (midlife visit). After an average follow-up of 21 years, 1409 individuals (71%) aged 65 to 79 completed the re-examination in 1998. A total of 61 cases were identified as demented (48 with AD).

"We aimed to study the association between coffee and tea consumption at midlife and dementia/AD risk in late-life, because the long-term impact of caffeine on the central nervous system was still unknown, and as the pathologic processes leading to Alzheimers disease may start decades before the clinical manifestation of the disease," says lead researcher, associate professor Miia Kivipelto, from the University of Kuopio, Finland and Karolinska Institutet, Stockholm, Sweden.

At the midlife examination, the consumption of coffee and tea was assessed with a previously validated semi-quantitative food-frequency questionnaire. Coffee drinking was categorized into three groups: 0-2 cups (low), 3-5 cups (moderate) and >5 cups (high) per day. Further, the question concerning tea consumption was dichotomized into those not drinking tea (0 cup/day) vs. those drinking tea (≥1 cup/day).

The study found that coffee drinkers at midlife had lower risk for dementia and AD later in life compared to those drinking no or only little coffee. The lowest risk (65% decreased) was found among moderate coffee drinkers (drinking 3-5 cups of coffee/day). Adjustments for various confounders did not change the results. Tea drinking was relatively uncommon and was not associated with dementia/AD.

Kivipelto also notes that, "Given the large amount of coffee consumption globally, the results might have important implications for the prevention of or delaying the onset of dementia/AD. The finding needs to be confirmed by other studies, but it opens the possibility that dietary interventions could modify the risk of dementia/AD. Also, identification of mechanisms of how coffee exerts its protection against dementia/AD might help in the development of new therapies for these diseases."

In women, caffeine may protect memory

Caffeine may help older women protect their thinking skills, according to a study published in the August 7, 2007, issue of Neurology, the medical journal of the American Academy of Neurology.

The study found that women age 65 and older who drank more than three cups of coffee (or the equivalent in tea) per day had less decline over time on tests of memory than women who drank one cup or less of coffee or tea per day. The results held up even after researchers adjusted for other factors that could affect memory abilities, such as age, education, disability, depression, high blood pressure, medications, cardiovascular disease, and other chronic illnesses.

“Caffeine is a psychostimulant which appears to reduce cognitive decline in women,” said study author Karen Ritchie,. “While we have some ideas as to how this works biologically, we need to have a better understanding of how caffeine affects the brain before we can start promoting caffeine intake as a way to reduce cognitive decline. But the results are interesting – caffeine use is already widespread and it has fewer side effects than other treatments for cognitive decline, and it requires a relatively small amount for a beneficial effect.”

The study involved 7,000 people whose cognitive abilities and caffeine consumption were evaluated over four years. Compared to women who drank one cup or less of coffee per day, those who drank over three cups were less likely to show as much decline in memory. Moreover, the benefits increased with age – coffee drinkers being 30 percent less likely to have memory decline at age 65 and rising to 70 percent less likely over age 80.


Coffee could protect against Alzheimers disease

A daily dose of caffeine blocks the disruptive effects of high cholesterol that scientists have linked to Alzheimers disease. A study in the open access publication, Journal of Neuroinflammation revealed that caffeine equivalent to just one cup of coffee a day could protect the blood-brain barrier (BBB) from damage that occurred with a high-fat diet.
The BBB protects the central nervous system from the rest of the bodys circulation, providing the brain with its own regulated microenvironment. Previous studies have shown that high levels of cholesterol break down the BBB which can then no longer protect the central nervous system from the damage caused by blood borne contamination. BBB leakage occurs in a variety of neurological disorders such as Alzheimers disease.

In this study, researchers from the University of North Dakota School of Medicine and Health Sciences gave rabbits 3 mg caffeine each day – the equivalent of a daily cup of coffee for an average-sized person. The rabbits were fed a cholesterol-enriched diet during this time.

After 12 weeks a number of laboratory tests showed that the BBB was significantly more intact in rabbits receiving a daily dose of caffeine.

“Caffeine appears to block several of the disruptive effects of cholesterol that make the blood-brain barrier leaky,” says Jonathan Geiger, University of North Dakota School of Medicine and Health Sciences. “High levels of cholesterol are a risk factor for Alzheimers disease, perhaps by compromising the protective nature of the blood-brain barrier. For the first time we have shown that chronic ingestion of caffeine protects the BBB from cholesterol-induced leakage.”

Caffeine appears to protect BBB breakdown by maintaining the expression levels of tight junction proteins. These proteins bind the cells of the BBB tightly to each other to stop unwanted molecules crossing into the central nervous system.

The findings confirm and extend results from other studies showing that caffeine intake protects against memory loss in aging and in Alzheimer’s disease.

“Caffeine is a safe and readily available drug and its ability to stabilise the blood-brain barrier means it could have an important part to play in therapies against neurological disorders,” says Geiger.


New study provides further evidence that apple juice can delay onset of Alzheimers disease

A growing body of evidence demonstrates that we can take steps to delay age-related cognitive decline, including in some cases that which accompanies Alzheimers disease, according to a study published in the January 2009 issue of the Journal of Alzheimers Disease.

Thomas B. Shea, PhD, of the Center for Cellular Neurobiology; Neurodegeneration Research University of Massachusetts, Lowell and his research team have carried out a number of laboratory studies demonstrating that drinking apple juice helped mice perform better than normal in maze trials, and prevented the decline in performance that was otherwise observed as these mice aged.

In the most recent study Shea and his team demonstrated that mice receiving the human equivalent of 2 glasses of apple juice per day for 1 month produced less of a small protein fragment, called "beta-amyloid" that is responsible for forming the "senile plaques" that are commonly found in brains of individuals suffering from Alzheimers disease.

Dr. Shea commented that "These findings provide further evidence linking nutritional and genetic risk factors for age-related neurodegeneration and suggest that regular consumption of apple juice can not only help to keep ones mind functioning at its best, but may also be able to delay key aspects of Alzheimers disease and augment therapeutic approaches."

The article is "Dietary Supplementation with Apple Juice Decreases Endogenous Amyloid-_ Levels in Murine Brain" by Amy Chan and Thomas B. Shea. It is published in the Journal of Alzheimers Disease 16:1 (January 2009).

Exercise helps prevent age-related brain changes in older adults

Older adults who exercise regularly show increased cerebral blood flow and a greater number of small blood vessels in the brain, according to findings presented at the annual meeting of the Radiological Society of North America (RSNA).

The study, conducted at the University of North Carolina (UNC) – Chapel Hill, is the first to compare brain scans of older adults who exercise to brain scans of those who do not.

"Our results show that exercise may reduce age-related changes in brain vasculature and blood flow," said presenter Feraz Rahman, M.S., currently a medical student at Jefferson Medical College in Philadelphia. "Other studies have shown that exercise prevents cognitive decline in the elderly. The blood vessel and flow differences may be one reason."

The researchers recruited 12 healthy adults, age 60 to 76. Six of the adults had participated in aerobic exercise for three or more hours per week over the last 10 years, and six exercised less than one hour per week. All of the volunteers underwent MRI to determine cerebral blood flow and MR angiography to depict blood vessels in the brain.

Using a novel method of three-dimensional (3-D) computer reconstruction developed in their lab, the researchers were able to make 3-D models of the blood vessels and examine them for shape and size. They then compared the blood vessel characteristics and how they related to blood flow in both the active and inactive groups.

The results showed that the inactive group exhibited fewer small blood vessels in the brain, along with more unpredictable blood flow through the brain.

"The active adults had more small blood vessels and improved cerebral blood flow," said the studys senior author, J. Keith Smith, M.D., Ph.D., associate professor of radiology at UNC School of Medicine. "These findings further point out the importance of regular exercise to healthy aging."

Red wine: How it fights Alzheimers

Alzheimers researchers at UCLA, in collaboration with Mt. Sinai School of Medicine in New York, have discovered how red wine may reduce the incidence of the disease. Reporting in the Nov. 21 issue of the Journal of Biological Chemistry, David Teplow, a UCLA professor of neurology, and colleagues show how naturally occurring compounds in red wine called polyphenols block the formation of proteins that build the toxic plaques thought to destroy brain cells, and further, how they reduce the toxicity of existing plaques, thus reducing cognitive deterioration.

Polyphenols comprise a chemical class with more than 8,000 members, many of which are found in high concentrations in wine, tea, nuts, berries, cocoa and various plants. Past research has suggested that such polyphenols may inhibit or prevent the buildup of toxic fibers composed primarily of two proteins — Aß40 and Aß42 — that deposit in the brain and form the plaques which have long been associated with Alzheimers. Until now, however, no one understood the mechanics of how polyphenols worked.

Teplows lab has been studying how amyloid beta (Aß) is involved in causing Alzheimers. In this work, researchers monitored how Aß40 and Aß42 proteins folded up and stuck to each other to produce aggregates that killed nerve cells in mice. They then treated the proteins with a polyphenol compound extracted from grape seeds. They discovered that polyphenols carried a one-two punch: They blocked the formation of the toxic aggregates of Aß and also decreased toxicity when they were combined with Aß before it was added to brain cells.

"What we found is pretty straightforward," Teplow said. "If the Aß proteins cant assemble, toxic aggregates cant form, and thus there is no toxicity. Our work in the laboratory, and Mt. Sinais Dr. Giulio Pasinettis work in mice, suggest that administration of the compound to Alzheimers patients might block the development of these toxic aggregates, prevent disease development and also ameliorate existing disease."

Human clinical trials are next.

"No disease-modifying treatments of Alzheimers now exist, and initial clinical trials of a number of different candidate drugs have been disappointing," Teplow said. "So we believe that this is an important next step."