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Can Dietary Supplements Improve Brain Health? By Joseph C. Maroon, MD, FACS


Can Dietary Supplements Improve Brain Health? By Joseph C. Maroon, sickness MD, FACS

drmaroonHave you ever misplaced your car keys or left the house not sure if you turned off the stove? Are these lapses in memory becoming more frequent?  Are you having normal forgetfulness due to your hectic life or is it a sign of something more serious?  I am frequently asked these very same questions and fortunately very few people require further medical evaluation.  For most people it is normal to occasionally forget things or names but it still could be a sign that your brain is not as healthy as it should be.

Our brains are the most complex organ in our body.  Almost everything we do, consume or are exposed to in our environment can have a profound influence on brain function and longevity.  Just like most organs the key to preserving brain health is to prevent diseases from occurring in the first place. To this end many people look to dietary supplements as a way to provide the vital nutrients the brain needs and often lacks in our typical American diet.   

The fact is the vast majority of Americans consume less than half of the daily recommended amounts of fruits and vegetables.  Plant food sources contain the majority of required vitamins, minerals and other healthy molecules that are required for our brains to function at their peak.   According to a 2010 US Dietary Guidelines adequate consumption of vegetables and fruits is associated with reduced risk of many common chronic diseases. Specifically, eating at least 2 1/2 cups of vegetables and fruits per day has been shown to reduce the risk of cardiovascular disease, including heart attack and stroke. In addition, certain vegetables and fruits can be protective against various types of cancer.  So if you can’t find time to buy, prepare and eat these superfoods, dietary supplements may hold the answer to improve and maintain your brain health for years to come.

Show Me the Evidence

As a physician and scientist I have approached the use of dietary supplements based on the facts available.  Fortunately there are now hundreds and even thousands of scientific articles showing brain health benefits of a wide range of dietary supplements.  Having reviewed many below is a list of some of the top brain health supplements and the evidence we have showing their benefits.  But remember you can’t just pop a pill and expect your brain to remain healthy.  Being healthy is a commitment to more exercise, eliminating toxins, such as cigarette smoke, maintaining ideal weight, reducing saturated fats and sugars in your diet and limiting alcohol consumption.  The fact is medical science can now keep our bodies alive and functioning much longer than our brains.  It is up to you to keep your brain in the game!

Omega-3 Fish Oils

Our brain is mostly made of specialized fat molecules that are concentrated in our nerve cells or neurons.  This most common type of fat in the brain is an omega-3 fatty acid called docosahexaenoic acid or referred to as DHA.  For humans DHA can only obtained from the food we eat and is therefore called “an essential” fat.  DHA is found in most seafood and fish and is also commonly available as an omega-3 fish oil supplement.

Healthy brains may have up to 30% of their structure made from DHA molecules. But if the food source of DHA is missing, or becomes depleted as occurs with aging, the amount of DHA in the brain and throughout the body will also decrease.  Lower levels of DHA can have a significant impact on brain function especially for the very young and very old.

Eating fish can have significant benefits for our brains especially as we age.  This was the finding of a recent study by researchers at the University of North Carolina and Duke University Medical Center published this month.  The study involves over 1,500 older subjects for slightly longer than 5 years and found that those over 65 yrs old that ate fish at least once per week reduced their rate of cognitive decline by about 1 ½ years. The authors attributed this benefit to the larger amounts of omega-3 (EPA and DHA) found in fish compared to other food sources.  They reported that the brain benefits of omega-3 were accomplished by reducing inflammation and oxidative stress which worsens with age.

Many neurodegenerative diseases and aging itself will cause excessive brain inflammation and release of free radicals.  Omega-3’s benefits, from fish as well as from omega-3 (fish oil) supplements, are well documented in other organs as well, especially the heart and vascular system.  One problem with fish and other sea food consumption is that lead and other toxins found in water are concentrated in fish tissues and too much fish can lead to excessive amounts of these same toxins in people.  Omega-3 supplements are a pure source of this important supplement and can be taken in higher amounts than typically found in fish.

Polyphenols – The Molecules in Fruits and Vegetables

Polyphenols are molecules found in fruits and vegetables and are classified as antioxidants. Studies have shown that polyphenols can help the brain to stay healthy by reducing toxicity, inflammation and promote normal brain activity. Polyphenols’ neuroprotective functions are to strengthen neurons against injury induced by neurotoxins and suppress neuroinflammation which is the most common cause of chronic neurological diseases like Alzheimer’s.

A recent study involving the preservation of telomeres and DNA integrity showed that those who regularly consumed at least 85% cocoa dark chocolate, which is packed with polyphenols, had less telomere shortening as they aged.  Telomeres are structures that protect the ends of our chromosomes, or strands of DNA found in the cell nucleus, and protect normal cell division. Telomeres exposed to oxidative stress, either from environmental sources, diet or age-related free radicals, can become shortened.   Many chronic disease of the brain have been linked to shortened telomeres.

The polyphenol in dark chocolate is called a flavanol and is also available as a concentrated dietary supplement.   Other brain protective polyphenols include those found in green tea called epicatechins and in red apples, red onions and supplements called quercetin.

Perhaps one of the most studied polyphenol is resveratrol.  Resveratrol is a found only rarely and in small amounts in several fruits and vegetables.  It is however found more concentrated in the skin of red/purple grapes and concentrated further in red wine.  Resveratrol, like other polyphenols, functions to protect the plant from infection, excessive UV radiation and aids in general plant defense.  Also like other polyphenols resveratrol has been found to offer significant anti-cancer, anti-inflammatory, ant-oxidant and DNA protective actions when consumed by animals and humans. It is also available as a concentrated dietary supplement.

In a recent Germany study published in June 2014, scientists evaluated the brain benefit of improved memory when taking resveratrol as a supplement on 46 older (ages 50 -76 year) volunteers after 6 months on the supplement.  Compared to the placebo group those on resveratrol had significantly better memory. Great news, but here is the phenomenal part, those that took resveratrol actually had bigger brain size compared to the control group and the baseline MRI they had 6 months earlier.  The part of the brain that was larger is called the hippocampus, and you guessed it, it the part of the brain that controls memory.   Other benefits found included decreased diabetes blood markers, reduced body fat and increases in a hormone called leptin, known as the satiety hormone, thought to reduce appetite and help with weight loss.  This is an amazing list of benefits from a naturally occurring plant molecule.

Curcumin-Curcumin is a powerful antioxidant obtained from the spice turmeric.  It has been shown to counteract the effects of oxidative stress due to brain trauma, improve brain cell communication and connections and even improve cognition.  By boosting the immune system curcumin has been shown to even remove amyloid beta plaques in the brains of patients with Alzheimer’s.  Curcumin has also been reported to act as an anti-inflammatory and is frequently found in arthritis and joint pain preparations.  Several studies investigating cancer prevention have indicated curcumin can prevent certain cancers and also has been used as a cancer treatment. 

Magnesium –The mineral magnesium has been shown to also reduce brain inflammation by reducing brain toxicity and can also function as an antioxidant, to promote brain cell repair.  Increased levels of brain magnesium have also been shown to be highly protective of the brain following brain trauma such as from a fall or blow to the head.

Added Protein Supplement-Often as we age we consume fewer and fewer calories from protein sources.  Maintaining adequate levels of protein in not only critical for muscle and tissue development but is also critical for maintaining brain health. Reduction in protein has been shown to occur as early as age of 35 years in most people.  About 25% of men and 35% women consume less than the current Recommended Dietary Allowance (RDA) of dietary protein. By combining a higher protein intake along with increased resistance exercising researchers have demonstrated in an older population of both men and women increased strength, greater whole-body protein usage, and reduced fat mass, compared to those not taking increased protein.

What about the brain? Neurotransmitters are molecules stored and made by our nerve cells that allow brain cells to “talk” to each over.  The neurotransmitters in the brain are made directly from food components, specifically amino acids from the breakdown of protein containing foods or supplements. The levels and activity of these neurotransmitters are sensitive to food intake, and changes in dietary patterns can have profound effects on behavior, eating patterns, sleep, and even energy levels.

Antioxidants-Foods, such as fresh fruits and vegetables, along with numerous vitamins and mineral supplements have antioxidant functions that can counter free radicals, lipid peroxides and other toxins that can accumulate with aging. Supplemental antioxidants, such as beta-carotene, lutein, lycopene, selenium, vitamin A, C and E can also function to decrease inflammation. Excessive inflammation has been link to most neurodegenerative diseases as well as the aging process itself.  Niacinamide (B3) and the other B vitamins have been shown to improve brain energy production and blood flow through the small blood vessels of the brain, something that is critical for maintaining brain health.

Phosphatidylcholine and Phosphatidylserine -These phospholipids are also structural components of brain cells similar to DNA and not only promote repair of damaged brain cell membranes, but also can significantly reduce brain inflammation though the cholinergic anti-inflammatory system. They can be found in egg yolk and soybeans and are available as supplements. Numerous studies have been done using these as a possible treatment for early dementia and Alzheimer’s disease.   

Treat your brain well and odds are it will continue to serve you throughout the decades of your life.   Act now and take the right steps to avoid brain deterioration and decline with aging. Consider using these supplements and foods not only for better brain health but for your whole body.   About Joseph Maroon, MD, FACS-Joseph C. Maroon, MD, FACS, is a board-certified neurosurgeon with more than 30 years of clinical experience at the University of Pittsburgh Medical Center. He has been the team neurosurgeon for the Pittsburgh Steelers for 25 years. Dr. Maroon is an expert and consultant in the areas of sports nutrition, concussion management, and brain and spinal problems. He has completes 8 Ironman triathlons – last in October 2013. In January 2014 he climbed Mount Kilimanjaro as the expedition physician for disabled athletes.  Dr Maroon is author of The Longevity Factor: How Resveratrol and Red Wine Activate Genes for a Longer and Healthier Life.  For more information on Dr Maroon go to www.josephmaroon.com

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Anti-Aging Tips: By Joseph C. Maroon, MD, FACS (About Joseph Maroon, MD, FACS


Anti-Aging Tips:

By Joseph C. Maroon, viagra sale MD, buy FACS  (About Joseph Maroon, rx MD, FACS

Joseph Maroon, MD. author/NeurosurgeonJoseph C. Maroon, MD, FACS, is a board-certified neurosurgeon with more than 30 years of clinical experience at the University of Pittsburgh Medical Center. He has been the team neurosurgeon for the Pittsburgh Steelers for 25 years. Dr. Maroon is an expert and consultant in the areas of sports nutrition, concussion management, and brain and spinal problems. He has completes 8 Ironman triathlons – last in October 2013. In January 2014 he climbed Mount Kilimanjaro as the team physician for disabled athletes.  Dr Maroon is author of The Longevity Factor: How Resveratrol and Red Wine Activate Genes for a Longer and Healthier Life). For more information on Dr Maroon go to www.josephmaroon.com

Even my closest friends are often surprised when they ask me my age.  Although a youthful appearance is not the only goal of adopting an anti-aging lifestyle it is a great side benefit.  Our skin, without makeup or other cosmetic enhancers, provides a fairly accurate window into our overall health and aging status.

One of the major reasons the skin is so informative about our overall health is skin aging like the rest of our body reflects the effects of cellular inflammation that occurs with aging. Aging and inflammation go hand and hand.  The accumulative effects of low level inflammation that we our exposed to throughout our lifetime can cause people to age differently.  Our skin uniquely is exposed to damaging effects of radiation and dehydration from the sun which can induce cellular inflammation.  The rest of our organs are exposed to the inflammatory effects of environment toxins, unhealthy dietary fats, processed sugars, free radicals and other inflammatory molecules that we consume and, the effects of the limited physical activity and excessive mental stress so common in our hectic society. There are numerous blood markers, such as cytokines, TNF-alpha, NFK-beta and interleukin-2, which can be tested to quantify one’s inflammatory status. These are important markers also used to keep tract of diseases of aging as well.  I have listed some of the best choices you also can make to preserve health and youth as you age.   Start making better choices today to counter or even reverse the effects of aging.

            Role of Inflammation and Aging

For most people diet is the major inflammatory source of accelerated aging.  Animal based foods such as beef, pork, cheeses and diary contain large amounts of saturated fats.  Certain vegetable oils such as coconut oil, cottonseed oil and palm kernel oil products cont. Joseoph Maroon, M.D. from pg. 1

also have greater amounts of saturated fats.  These oils are often found in deserts which also contain processed sugars. Saturated fats can directly stimulate the genes for fat storage cells called adipocytes to make the inflammatory molecules called cytokines that have been linked to the onset and severity of diabetes and vascular disease.  These diseases age us faster and reduce overall longevity.

Omega-6 fats are another type of polyunsaturated fat we get from our diet and are found in grains such as corn, safflower, cottonseed oils.  This type of fat is essential for our good health but because these oils are used as part of almost every processed food we eat they have become a detriment and contribute to excessive body-wide inflammation. By either reducing the amount of omega-6 oils we consume or consuming more polyunsaturated fats like omega-3 essential fats found in fish, seafood, and many fresh vegetables and we can actually counter this source of inflammation. 

Omega-3 and omega-6 fats molecules make up every cell membrane in the body and ideally are present in a ratio to keep cellular inflammation in check.  Excessive dietary levels of omega-6 can overwhelm the O3/O6 balance and lead to an inflammatory state.  Over the last 150 years with industrial farming of grains like corn and sun flowers manufacture of omega-6 oils has exploded and is now the dominant polyunsaturated oil in our diet.   This shift has meant much more omega-6 is used by our cell membranes compared to omega-3.  The result is not only a change in the physical properties of our cells but it has contributed to what many consider the major health epidemic of the 21st century – chronic inflammatory disease.

Atherosclerosis or “hardening of the arteries”, arthritis, inflammatory bowel disease, certain cancers, Alzheimer’s disease and even type 2 diabetes are all chronic inflammatory diseases and are now the most common diseases of the Western world.  Although eating the wrong fats is a major contributor to chronic inflammatory diseases, other dietary causes, excessive weight and lack of physical activity, environmental toxins and even emotional stress can all play major roles in the development and continuation of these diseases and thus accelerate the aging process.

Adopting a diet low in saturated fats and higher in unsaturated (mono- or omega-3 polyunsaturated) fats can reduce inflammation related diseases and allow our bodies to age healthier. In fact modified diets such as the heart healthy diet first promoted by Dr Dean Ornish using fruits and vegetables, whole grains, legumes, soy products, nonfat dairy, and egg whites, and avoidance of saturated fats, refined sugars, and processed carbs has been proven by actual heart catheterization to reduce vascular blockages. In addition to better dietary choices here is a list of some of the best and most researched tips to help reduce inflammation and promote healthy aging to remain younger on the inside and out.

            Stay in Motion throughout your Life

The human body is designed to be in motion.  Unfortunately too often it seems we do everything to avoid it.  We have cars, escalators, elevators, moving sidewalks and now the internet where we only need to move a mouse to order food, clothing and even our healthcare delivered to our front door.  All this sitting actually reduces our lifespan.

I found early on the benefit of routine exercising when I suffered a bout of depression early in my career.  Exercising not only burns excess calories to help control weight and improve cardiovascular health, it can also release an antidepressant-like hormone in the brain.  A hormone called BDNF and certain neurotransmitters naturally increase when exercising to improve mood, sleep and perhaps most importantly cause new brain cells to grow.

Although exercising at least 30 minutes per day can have tremendous health benefits, if you are really focused on anti-aging consider a more intense program.  I am a triathlete and have enjoyed both the excitement of competing and the benefits of training at a very high level. I have found it helps me focus my thoughts as a surgeon and has in many ways allowed me to live a mostly disease-free life.

Heart disease prevention research shows that exercise should be intensive enough to raise your heart rate to a level that moderately stresses the heart.  This is referred to as “target heart rate”.Your maximum heart rate (MHR) is about 220 minus your age; however for daily exercises it is best to target a rate of 85% of the MHR.  If you are older than 50 seek out medical clearance if you are just starting out.

            Avoid the Traps of Modern Society

Our modern life is a perfect cocktail designed to kill us.  We exist in a state of constant stress, exposed to cheap fatty, sugary, fast foods, our walks consist of from our front door to our cars and our environment has never been more toxic.  So we should ask ourselves: Should we just give up and allow our healthcare system to pump us up with pills and procedures or should we fight back?

There are examples of communities around the world including the Seven Day Adventist in Loma Linda, California, the natives of Okinawa, Japan and Sardinia, Italy, to name a few, that have fought back these society pressures and live on average longer than anyone else.  Referred to the “Blue Zone”, in Dan Buettner’s book of the same name, these peoples have strong social connections, practice religion or mediation, eat mostly a Mediterranean diet, do hard physical work and avoid most environmental toxins.  They experience few chronic diseases and in generally live their lives requiring very little medical care– a great example to all of us and the good news is, you don’t have to actually live in a Blue Zone to make this work. It is a matter of choice.

            Better Brain Habits

As mentioned Alzheimer’s disease including other neurodegenerative diseases like Parkinson’s disease have an inflammatory component.  Studies have actually shown that regular aspirin users have a lower incidence of have Alzheimer’s disease.  One of the more natural ways to reduce brain and body inflammation is to increase the amount of omega-3 fats in your diet. Omega-3’s can be used to make anti-inflammatory hormone that can counter omega-6 made eicosanoids and lower levels of inflammatory blood markers. Although some amount of saturated and omega-6 fats are still required by the body another healthy strategy would be to avoid excessive consumption of dairy, fatty meats, sugar, refined wheat products, corn and other vegetable oils.

Up to 40% of our brain cells are made of omega-3 fats.  They are essential to the body and organ function since they are a structural part of all human cells.  Humans do not make omega-3 and therefore they must be consumed in our diet as food or as fish oil supplements.

Exercise is critical to the production of the hormone called BDNF.  BDNF stands for brain-derived neurotrophic factor found in the human brain that can improve brain signals and activate genes that increase memory by increasing both brain cell production as well as brain connections.  Exercise is the single most important stimulus for BDNF production. Until recently researchers only knew that exercised-induced BDNF could enhance brain function. Recent research investigating neurodegenerative diseases, such as Alzheimer’s disease and major depression has found that low levels of BDNF are more common in people with these conditions. In addition, BDNF levels are low in those who are obese or have type 2 diabetes.

As of yet no definitive study has shown increased BDNF is protective to reduce the onset of these conditions, but exercise in fact can benefit and often prevent many of these conditions.   Other studies have shown that BDNF plays a role in brain pathways that controls body weight and energy production.

            Avoid Carbohydrates – SUGAR

Although insulin is an essential hormone used by the body to allow glucose, a simple carbohydrate, to enter our cells too much insulin can mean big problems over time. Consuming carbohydrates in the form of simple sugars, such as sucrose, fructose and glucose, will cause the pancreas to pump out insulin so rapidly that too much sugar is pulled into our cells and brain cells can actually begin to starve from lack of blood glucose.  This diet-related up and down cycle of blood sugar to the brain can impair thinking and induce brain and body wide inflammation.  In addition severe drops in glucose can lead to excessive or even binge eating leading to weight gain and further stress on the pancreas leading to type 2-diabetes.

Maintaining chronically higher than normal levels of glucose in the blood due to a high carbohydrate diet is associated with a condition called pre-diabetes.  Over time in both pre-diabetes and diabetes toxic molecules called AGES – Advanced Glycation End Products can development.  These “sticky” molecules can form in tissues and vessels throughout the body and are compared to the brown basted skin of a Thanksgiving turkey.  This tough, inflexible and inflammatory cover can coat major organs and even lead to organ failure.  AGES are thought to be a major cause of accelerated aging seen with undiagnosed or poorly controlled diabetes.

            Build up Muscle

Muscles become less flexible and lose mass as we age. These changes in connective and muscle tissues can also occur due to reduced physical conditioning.  Ligaments and tendons also begin to dehydrate. Calcium deposits can build up and replacement of muscle fibers with fatty, collagenous fibers reduces joint and muscle mobility and strength.  Muscle tone declines about 22 percent by age 70.

Resistance training with even very light weights has a positive effect on muscle mass. Avoid excessive weight and stick to high rep workouts. A well balanced diet containing sufficient protein is critical for muscle cell growth and maintenance.  Unfortunately about 25% of men and 35% women consume less than the current Recommended Dietary Allowance (RDA) of dietary protein and this deficiency increases with aging.  A daily protein supplement containing the amino acid Leucine has been shown to be especially effective in preventing muscle loss with aging.  Vitamin D and omega-3 fish oils can also help with new muscle cell development

            Strengthen your Bones

Bones besides providing the structure of body are an important reserve for minerals like calcium, copper, zinc and others that are used throughout our body. As aging occurs hormone changes in both men and women that alter bone density and reduce bone strength.  Reduced exercise and lack of resistance training will also add to this loss. Bone loss can start to occur as early as 35 especially in women who have had multiple births.

Walking, running and resistance training can slow bone loss with aging. Maintain a diet rich in minerals like calcium.  Short periods of sun shine exposure to the skin can build stores of vitamin D.  Don’t smoke and avoid excessive caffeine intake since these can cause minerals to leach for bone.

Minerals and vitamins in foods and as supplements are critical for maintaining bone health with aging.  Those commonly recommended for bone health are: Calcium, vitamin D3, magnesium, copper, selenium, vitamin C and K-2, silicon and boron. The inability to absorb calcium is a major reason that calcium therapy fails to prevent or slow the progression of bone loss with aging. Vitamin D3 taken with calcium will normally promote absorption and assimilation of calcium into the bone matrix.

            Don’t Lose your Senses

As early as our 40s close vision can deteriorate and details can be lost.  Aging conditions such as glaucoma and macular degeneration can steal vision as well.  Senses of taste smell and high frequency hearing will also decline.  For better eye and skin health avoid excessive exposure to UV radiation from the sun.  Less direct sun can reduce skin wrinkling and the formation of cataracts.  Avoiding excessive noise can help reduce hearing loss and regular eye checkups will detect increased eye pressure associated with glaucoma.

Vitamins A and beta-carotene are required by eyes for normal, healthy function.  Prevent age related macular degeneration with a diet or supplements containing the  antioxidants lutein, zeaxanthin and glutathione,  vitamins C and E and essential minerals such as selenium, copper and zinc.  The omega-3 DHA is found in the eye membranes and is an important structural component of the eye.

Every effort has been made by the author(s) to provide accurate, up-to-date information. However, the medical knowledge base is dynamic and errors can occur. By using the information the reader willingly assumes all risks in connection with such use.

 (note Dr. Maroon endorses www.omax3.com to help maximize omega 3 levels)

the information enclosed is for educational purposes.

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(EMAILWIRE.COM, sales May 24, 2012 ) Singapore, SG — Studies reveal that one third of adult population in the world snores. Hours of disrupted sleep not only trouble the ones who snore but also the sleeping partner of the snorer. Many relationships tend to fall apart just because of the discomfort that snoring brings to both the partners. There are, however, many Snore Stop solutions that can be utilized to get rid of snoring.

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(EMAILWIRE.COM, sales May 24, 2012 ) Singapore, SG — Studies reveal that one third of adult population in the world snores. Hours of disrupted sleep not only trouble the ones who snore but also the sleeping partner of the snorer. Many relationships tend to fall apart just because of the discomfort that snoring brings to both the partners. There are, however, many Snore Stop solutions that can be utilized to get rid of snoring.

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