Mar

11

Various 2012 studies further clarified how excessively sweet, unhealthy foods affect the brain. An animal study out of UCLA found that diets high in fructose can impair cognitive function, which is reversible with omega-3 fatty acid supplementation. High fructose consumption can induce some signs of metabolic syndrome in the brain and can disrupt the signaling of the insulin receptors and reduce the action of insulin in the brain. Other work published in JAMA suggests that fructose consumption modulates the neurophysiologic pathways involved in appetite regulation and encourages overeating. An October 2012 study published in the Journal of Alzheimer’s Disease reported that a diet high in carbohydrates and sugar raises the risk for mild cognitive impairment in the elderly, while a diet high in fat and protein may reduce this risk. Logical yet simple enough, an “optimal balance” of carbohydrates, fat, and protein may help maintain neuronal integrity and optimal cognitive function, particularly in the elderly.

Mounting evidence in 2012 reinforces that high consumption of red meat increases stroke risk. The largest meta-analysis to date looking at the atherogenic effects of red meat found that the risk for total stroke increased by up to 13% for each increase in a single serving of fresh, processed, and total amount of red meat consumed per day. Earlier in the year another study found that processed and unprocessed red meat is associated with a higher risk for stroke, while poultry was associated with a reduced risk. One study found that a diet high in fruits, vegetables, grains, and fish led to a 30% lower depression risk compared with a meat based diet. But, as pointed out last year, meat quality is a factor: Moderate consumption of unprocessed, free-range antibiotic free red meat may actually protect against depression and anxiety. Much of the livestock in the United States is raised on industrial feedlots, which increases saturated fat and decreases very important good fatty acids, whereas pasture-raised animals have a much healthier fatty acid profile.

Information derived from Medscape.

 

Jan

7

A study conducted in Spain reported that consumption of both polyunsaturated fatty acids, (found in nuts, seeds, fish, and leafy green vegetables), and monounsaturated fatty acids, (found in olive oil, avocados, and nuts), decreases the risk for depression over time. However, there were clear dose-response relationships between dietary intake of trans fats and depression risk, whereas other data support an association between trans fats and ischemic stroke risk. Trans fats are found extensively in processed foods, including many commercial chocolates, (hence, check that label when considering dietary intake of chocolate. Also, only the highest levels of dark cocoa contain healthy antioxidants, not milk chocolate). A deficiency in polyunsaturated fatty acids has been linked to attention deficit/hyperactivity disorder in children. Thanks to their high levels of polyunsaturated fatty acids, namely omega-3 fatty acids, fish can help fend off numerous diseases of the brain. A 2010 study correlated fish consumption with a lower risk for psychotic symptoms, and concurrent work suggested that fish oil may help prevent psychosis in high-risk individuals. Although data are conflicting, new research shows that the omega-3 fatty acids eicosapentaenoic acid and docosahexaenoic acid are beneficial in depression and postpartum depression, respectively, and other research suggests that omega-3 deficiency may be a risk factor for suicide. Oily, cold-water fish, such as salmon, herring, and mackerel, have the highest omega-3 levels. Keep in mind that Atlantic fish have elevated levels of mercury and PCB’s compared to Alaskan/Pacific fish, and that farm raised fish contain very little healthy omega 3 fatty acids, due to the confined breeding of farm raised fish.

Dec

19

2012 Neurology Game Changers, Which Foods Are Best for the Brain?

Dietary advice is common practice in cardiology and primary care, but recently food and drink have become important considerations for neurologists, too. Diet is inextricably linked to conditions such as heart disease, obesity, and diabetes. However, what we consume also seems to have significant implications for the brain: Unhealthy diets may increase risk for psychiatric and neurologic conditions, such as depression and dementia, whereas healthy diets may be protective. 2012 saw coffee and berries warding off dementia, caffeine supplements improving motor function in Parkinson’s and the Mediterranean diet reducing the odds of developing Parkinson’s. Lycopene-rich tomatoes and the flavanones in citrus fruits were found to protect against ischemic stroke. As for what not to eat, a study published in January in Stroke supported previous work linking red meat consumption with higher stroke risk, while diets high in carbohydrates and sugar reportedly raise the risk for mild cognitive impairment and dementia in the elderly. A 2009 study published in the Archives of General Psychiatry found that people who follow Mediterranean dietary patterns — that is, a diet high in fruits, vegetables, nuts, whole grains, fish, and unsaturated fat, (common in olive oil and other plant oils) — are up to 30% less likely to develop depression than those who typically consume meatier, dairy-heavy fare. The olive oil-inclined also show a lower risk for ischemic stroke and are less likely to develop mild cognitive impairment and Alzheimer disease, particularly when they engage in higher levels of physical activity.

All data derived from Medscape, 2012.

Aug

6

This week I would like to talk about exercise.  For the most part the word exercise appears to be a foreign word lately. I started exercising when I was 13, and I haven’t stopped since.  At the gym each day I see a myriad of individuals trying to stay fit, but in reality this is only a small minority of the population at large.  Our society has now become so obtuse in their habits that getting an extra fifteen minutes of sleep trumps an exercise regimen.  I hear excuses in my office all day long, from “I have kids”, to “my job doesn’t allow me the time”, and on and on.  I have yet to hear a reason that is not merely an excuse to not have to exercise. Quite simply, these excuses are in reality a way of stating that exercise is just not a priority.  The simple truth is that by not getting needed exercise, in effect, you are pretty much agreeing to a shorter life expectancy, which by the way, is predicted to be shorter for the first time in history with the upcoming generation associated with diabetes, hypertension and all of the syndromes associated with lethargy and poor eating habits.  Humans were not put on this earth to sit and watch television and eat yodels.  Genetically and historically, we essentially were out chasing food, or being chased as food.  Because of technology, it is now quite easy to not have to move much during the day, and even easier to eat pre-made stuff full of preservatives and chemicals with no real nutritional value whatsoever.  If you have already lost your health because of poor eating habits and lack of exercise, you should probably discuss any upcoming exercise plans with your doctor first.  However, if you still have your health, doing anything is better than doing nothing. And the more fit you are, the higher the intensity should be your exercise. As an example of light exercise, when going to the market, rather than driving around stalking that close parking space, take a far one and walk. If you are able, jogging in place for several minutes is great exercise.  Doing so in say 8 intervals of 20s of jogging with 10s of rest is extraordinary.  Just three days per week of this would actually change your health as well as your body. If you do the math, that is 4 minutes, three days per week.  Can you still honestly say that you do not have the time? Not if you are truly honest. For those interested in maximizing their fitness regimens, I have already published several articles on that topic which are readily available, (search word: HIIT), on the fitness page and in the articles section of my website.

Apr

30

This article is a great find by my office manager Debbie.  It concurs with what I have been saying all along.  If you have high cholesterol or are already on cholesterol lowering drugs, this should be cause for you to do your own research.  Similar information is available at Dr. Mercola’s website, which I have referenced many times in the past.  Readers may intuitively ask why I would be writing so many articles on cholesterol when my specialty is in neurology?  Well, quite honestly two reasons.  The main reason is that heart disease is the leading cause of death in this country.  The second?  Because I too have fallen victim to the “take these cholesterol meds or else…” story.  Cholesterol has become an incredibly hot topic in recent years as well as a financial gravy train for the pharmaceutical companies who manufacture the drugs.  Virtually no one who has been to see a doctor in the last 20 years cannot tell you their cholesterol number as quickly as how many children they have.  However, routine screening exams performed by the vast majority of primary care doctors, are next to useless with respect to predicting heart disease.  They are useful to give you a cholesterol number which will then be used to determine whether or not you will receive a prescription for cholesterol lowering drugs.  If having a low number is your goal, then this is appropriate.  However, if preventing heart disease is your goal, then this formula requires rethinking.  With the number of people taking these drugs, why has the rate of heart disease gone up? One of the main side effect of cholesterol lowering drugs is muscle fatigue and weakness.  Clinically, I hear this all of the time simply from the large number of people taking these drugs.  One must ask the question, isn’t the heart made of muscle?  Again, not sensible.  The first thing that needs to change is our screening process.  The focus of blood work needs to be on inflammatory markers rather than on total cholesterol.  There are several lab panels now available which are much more useful than simple total cholesterol screening.  If you are determined to be at elevated risk, this is most always correctable with diet and exercise.  You should be working with someone skilled specifically in this area, or, your doctor should be working directly with a lipidologist.  If you are currently taking cholesterol lowering drugs, you should not stop taking them without an alternative plan and you should always be working with a trained professional.  As always, there is a multitude of information available on my website fitness and healthy eating pages with respect to health, which is really what we all strive towards, rather than just boasting the lowest “number”.

Apr

3

Metabolic syndrome, (obesity, hypertension, dyslipidemia and hyperglycemia AKA diabetes), remains a concern in regards to increasing health risk within the United States population.  For the first time in recorded history, our current generation is projected to have a shorter life expectancy than the prior generation.  This is a projection from the New England Journal of Medicine in 2005 based on the current epidemic.  And things have only gotten worse since then.  Metabolic syndrome with its associated cardiovascular disease, stroke, blindness, amputations, etc., accounts for the majority of healthcare dollars currently being spent.  Still worse, current medical treatments focus only on symptoms, which actually make the syndrome worse.  Hyperinsulinemia causes the pancreas to secrete increased amounts of insulin in response to elevated blood glucose.  However, practitioners typically focus on glucose levels or hemoglobin A1c, and prescribe drugs which actually increase insulin levels even further.  In a typical case, a patient would present with obesity, hypertension, diabetes and elevated blood lipids.  The patient would be told to lose weight by eating more fruits and vegetables and to cut down on fats and cholesterol and to do some light exercise as a standard first-line therapy of lifestyle changes.  This certainly stands the test of reason.  The problem is that under this regimen, the syndrome actually worsens.  Eventually antihypertensive medication is prescribed as are drugs for diabetes.  Soon the patient finds themselves on 6 or more drugs with no improvement in their status.  The underlying problem is that nothing has been done to address their insulin resistance.  A more appropriate course of treatment in this scenario would be the use of a muscle sparing protein diet and more importantly carbohydrate restriction, consisting mainly of fiber and vegetables, keeping in mind that all carbohydrate, with the exception of fiber, will eventually be turned into blood glucose either quickly or slowly.  By restricted carbohydrate intake, insulin secretion can be reduced and thus reducing insulin sensitivity/resistance.  In doing this, weight loss can occur and the patient’s syndrome can actually reverse.  If you suffer from any of the symptoms associated with metabolic syndrome, you should consult with myself and/or your family physician before undertaking any therapeutic regimen as in extreme cases drug therapies may be appropriate to reduce risk of stroke and/or other consequential risks.

Jun

22

Statin drugs are being prescribed like candy for tens of millions of Americans, but you need to seriously consider statin therapy before deciding to take your physician up on this prescription, as their use has serious and significant consequential side affects and risks, and, their use is clearly not appropriate for everyone.

The majority of people using statin cholesterol-lowering drugs do so because they believe that lowering their cholesterol will prevent heart attacks and strokes. How many of these people do you think would continue to take them if they knew that their drugs have been linked to increased risk of heart attack and increased risk of stroke?  Probably no one!

Until recently, statin use has been generally accepted based on studies primarily put together by the drug company selling the drugs.  However, recently these drugs are falling under increased scrutiny. A recent study in Clinical Cardiology found that heart muscle function was “significantly better” in the control group than in those taking statin drugs.  Weakened heart muscle function is the cause of heart failure.

Statin therapy is very effective in lowering total cholesterol levels rather significantly.  The real question however is why would you want to do this?  Lowering cholesterol, the “buzz” of the millennium, makes it appear as though you are benefiting from the drug therapy and thus improving your overall health.  Further, as your health deteriorates from the drugs, other problems which manifest later in life are often misinterpreted as being  separate and distinct conditions brought on for alternative reasons rather that affiliated with the statin therapy which was truly responsible.

It is and has been my medical opinion that for certain individuals who have high risk factors for heart disease, and/or have familial hypercholesterolemia, (about 1 in 500), statin drugs may be useful. Unfortunately, the vast majority of statin users does not fit this criterion and are taking them merely to lower cholesterol.  This equation needs serious rethinking.  More information on healthy eating and lowering cholesterol though diet is available on my healthy eating page.