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Alzheimer’s Disease Part II: Preventive Life-style, Vitamins & Food Medicines
It has been established by science, as well as common sense, that to prevent a great many severe, chronic and killer diseases we need to adapt or to modify our life-styles and incorporate a healthy diet and adequate physical and mental exercise into our daily lives. The significance of this fact cannot be over-emphasized, as the need ‘to do’ it is much like Munch’s early-warning painting of ‘The Scream’.1 The painting refers to the state of our planet’s environment in the late 19th–century onwards, depicted by the artist as an “endless scream passing through nature”. Equally, the contemporary state of human health is of no less concern and, whereas in the terms of what we do Nature is to some extent influenced by or at the mercy of our ‘doings’, we are not in that unenviable position; we can do something for ourselves. Whatever added value a good healthy life-style can bring to those already suffering from any form of dementia is more than welcome, but don’t wait to shut the stable-door after the horse has bolted! The saying: “God helps those who help themselves” is not in the Bible, however, when the saying is not being misinterpreted as the humorous stand-by defence line of the ‘shop-lifter’ - shop-lifting is tantamount to what we have been doing to our planet - it may well mean ‘don’t be guilty of self-neglect’. We all know that ‘neglect’ means disregard or lack of attention and due care, and how on an emotional level that can hurt other people; the last person in the world you probably want to hurt by neglect is yourself. It maybe a no-nonsense, no-holds barred kind of ‘message’, but it is the unvarnished truth. People need a mega-strong ‘wake-up’ call, because the consequences of not ‘doing’, i.e. making the best possible efforts to stay healthy, are so dire. Will a Healthy Life-style Help Prevent Alzheimer’s Disease? Even though Alzheimer’s disease (AD), like other chronic diseases has a myriad of interconnected factors involved in disease development, including those associated with life-style, the answer to the question has got to be in the affirmative. This month, first published five years ago in an American review of Public Health, scientists said that, “adherence to a healthy life-style may directly protect against AD or may prevent diseases associated with AD, such as vascular disease and diabetes via diet, physical and mental exercise and prevention of injury. … 3 “A healthy life-style to prevent AD may be important throughout life,” which has been shown to be correct, “rather than after disease manifestation; yet may be particularly relevant if other factors, such as genetic predisposition, also increase risk of AD.4 If changes in life-style can help prevent AD by reducing modifiable risk factors,” which is what has been demonstrated since this research, “this knowledge can aid individuals who wish to take action to protect themselves and their families from the disease.”5 The message even a handful of years ago is loud and clear. Now, with research projecting into 2007, other American researchers, well aware of AD as a rapidly growing public health concern with potentially devastating effects for which presently there are no known cures or effective preventive strategies, and being mindful of the relevance of genetic factors in early-onset cases, are drawing attention to caloric intake i.e. the total number of calories taken in daily.6 They state that the evidence suggests that modification of life-style factors such as nutrition may prove crucial to AD management. The evidence also suggests ‘brain cells’ are remarkably responsive to ‘what somebody is doing’.7 Moreover, “due to the fact that the disease typically strikes very late in life, delaying symptoms could be as good as a cure for many people. For example, it is now widely accepted that if the onset of the disease could be delayed by even 5 years, the incidence could be cut in half. … Indeed, the effect of diet in AD has been an area of research that has produced promising results, at least experimentally.”8 They go on to say that the evidence supporting a direct link between nutrition and AD neuropathology continues to grow, and that a lot of recent research has resulted in the development of experimental dietary regimens that might promote, attenuate or even reverse features of AD.9 This is powerful and exciting stuff: “Most remarkably, while we found that high caloric intake based on saturated fat promotes AD type Beta-amyloidosis,10 conversely we found that dietary restriction based on reduced carbohydrate intake is able to prevent it. … ”11 They also cite that current scientific evidence suggests that obesity and diabetes are associated with a four-fold increased risk of developing AD.12 What is so promising about this research and what they are saying is, when they know more of how ‘diet’ works, they expect it will help in the development of ‘life-style therapeutic strategies’ in AD and possibly other neurodegenerative disorders.13 However, this is not a signal to abandon a ‘balanced diet’, better still create a healthier life-enhancing new one - ‘balance’ is vital to the body’s functioning. For even in the arena of fats, the type of fats consumed is what matters. Back in 1998, regarding American Dietary Guidelines that emerged over 30 years, research recommend that Americans limit their consumption of total fat and saturated fat as one way to reduce the risk of chronic diseases.14 Also, researchers said then, “a low-fat diet is not a no-fat diet”, because dietary fats serve a number of essential functions.15 It is the type of fats consumed that are of primary importance. For example, the Americans are busily trying to rid the national diet of and find alternatives to harmful Trans fatty acids (TFAs).16 It was written by another American scientist this month that “The resistance of neurons to death during aging can be enhanced by modifications of diet and life’style.”!17According to this research there’s a lot going on that may be involved in and result in apoptosis (cell death). It is well documented that antioxidants may be our best natural antidote to oxidative stress (OS). Science already knows that when subjected to OS, “neurons may respond adaptively to overcome the stress, or they may activate a programmed cell death pathway (apoptosis)”, 18 and that antioxidants are one of the mechanisms that counteract apoptosis. When there is so much proven evidence of certain Food Medicines being our first defence against all ills, with so much at stake can we afford to wait? Allowing that readers have got the healthy diet message from Part I (Alzheimer’s Disease- Preventive Exercise & Diet), an important consideration is that not all effective drugs are available to everyone, and that not all drugs are ultimately safe, which makes it imperative to use all methods on hand to avoid onset of the disease. In the area of mainstream drugs for example, recent research has shown that some second-generation atypical antipsychotic drugs, widely used to treat psychosis, aggression and agitation in patients with AD are somewhat risky i.e. their benefits are uncertain and concerns about safety have emerged.19 In a Californian 42-site, double-blind, placebo-controlled trail, 421 outpatients with AD and psychosis, aggression, or agitation were randomly assigned and tested.20 It was concluded by this scrupulous study regarding the specific drugs tested, adverse effects offset advantages in the efficacy of atypical antipsychotic drugs olanzapine,21A quetiapine21B and risperidone,21C for the treatment of psychosis, aggression, or agitation in patients with AD.21 It becomes continually clearer that every preventive action the individual can take to help themselves is a bonus. You Need Your Brain & Beauty Sleep There is another life-style consideration to be taken into account nowadays in our 24/7 society, which is essential to good health – adequate sleep! Research, and again common sense, would suggest that our modern 24/7 round-the-clock wakefulness is not doing us any favours, now or for the future. Most young people will ‘burn the candle at both ends’ for a while at least, almost as part of the animal pattern for natural selection, going out to seek a mate in day- and night-time to meet with other people in social settings. However, there has been an enormous change at what age this procedure begins. Less than 50 years ago, only people in their late teens onwards would be allowed to go to night clubs for entertainment, usually companion-vetted or at least named, according to the individual’s parental ground rules &c. True, in the late 1950s and early 1960s the ‘bottle party’ scenario appeared, mainly among the student set, which gave rise to another more liberated mode of night-time entertainment normally at week-ends that was fuelled with cheap plonk (red wine). However, in this era children (under sixteen) were not allowed to engage in late night entertainment – their brain and beauty sleep was assured. Young children acted, played and dressed like children, not aspiring to be mini-adults; they were not officially considered responsible ‘adults’ until they reached the age of twenty-one, not eighteen. Unbeknownst to stricter parents of that period, they were probably doing their progeny’s brains a good deed, because a still growing immature brain needs sleep to develop properly. Youngsters who embark on the social scene too early are potentially storing up brain-trouble for their futures. In Neanderthals,22 palaeontologists define ‘adulthood’ by when the last permanent tooth, the wisdom tooth, emerges; which means these forebears of the human race were considered ‘adults’ at fifteen. We are not Neanderthals, but are going too ‘fast forward’ in terms of ‘wanna-be adult’ teenagers’ exposure to adult behavioural patterns, such as too early sexual activity, alcohol use and abuse, and lack of sleep due to staying awake into the wee small hours ‘clubbing’. By this change in social mores and process, adult activities are being carried out by adolescents and teenagers, young adults with less-then-fully developed brains, effecting a lack of adequate sleep on a more than sporadic basis. Aggressive behaviour and disconnection from the mainstream of society appears to be one of the observable results of children with underdeveloped brains aping adulthood. This behavioural pattern causes society problems, but what else damage is being done to the participants’ brains is likely to appear sometime in the future. Scientists consider the modern humans’ prolonged pattern of growth and maturation a major step forward in human evolution, because it allows extra time for learning, or that’s the theory. To signify ‘adulthood’, if the controversial emergence of a wisdom tooth was used as a rule of thumb, the difference between the Neanderthal and today’s teenagers is that wisdom teeth (third molars), so-called because they normally appear so late and at an age where people are supposedly wiser than as a child, more usually appear between the ages of 18 and 20 or even in late 20s, although they may appear when older, younger, or not at all! 23 Although the modern human brain reaches some 95% of its final size by age six, the development of higher functions, including the ability to control impulses, is not complete until age 25, as recent research has shown.24 “The brain of an 18-year-old college freshman is still far from resembling the brain of someone in their mid-20s – when we reach adulthood is a lot later than we traditionally think.”25 The reason why sleep is so important to young developing brains and those afflicted with AD is because sleep has important homeostatic26 functions, and sleep deprivation is a stressor that has consequences for the brain, as well as many body systems.27 Whether sleep deprivation is due to anxiety, depression or a hectic life-style, there are consequences of ‘chronic sleep deprivation’ that impairs brain functions and contributes to allostatic load28 & 29 throughout the body. ‘Allostatic load’ referring to the cumulative wear and tear on the body systems caused by too much stress and/or inefficient management of the systems that promote adaptation through allostasis i.e. the ability to achieve stability through adaptation or change.30 Research has reported that in young healthy volunteers, chronic sleep deprivation results in increased appetite and energy expenditure, increased levels of pro-inflammatory cytokines (cytokines are various proteins secreted by cells of the immune system that serve to regulate the immune system); decreased parasympathetic31 and increased sympathetic32 tone, i.e. it increases the reduction of digestive secretions, speeds the heart and contracts blood vessels; increases blood pressure, increases evening cortisol33 levels, as well as elevation of insulin34 and blood glucose.35 In short, sleep deprivation sends the body and brain completely awry. Most significantly, chronic sleep deprivation observed in animal models show that repeated stress causes brain regions involved in memory and emotions, such as the hippocampus,36 amygdala,37 and prefrontal cortex, to undergo structural remodelling with the result that memory is impaired and anxiety and aggressions are increased.38 The changes in brain and body are evidence that sleep deprivation is a chronic stressor and results can contribute to cognitive problems, which can in turn further exacerbate pathways that lead to disease.39 Moreover, brain regions such as the hippocampus are sensitive to glucose and insulin, and both type 1 and type 2 diabetes mellitus are associated with cognitive impairment and (for type 2 diabetes mellitus) increased risk for AD! 40 You might think that getting a good night’s rest on a regular basis is essential for your looks, but it is far more valuable to your brain. In AD, when the breakdown of the sleep’s circadian rhythm41 is sudden, it reflects frequently a concomitant somatic (body) or psychiatric disorder.42 If the trouble appears progressively, there is less pathological or disturbing behaviours in the beginning.43 Later, it is often associated with loss of interest for daily living activities ‘perte de motivation’ – (loss of motivation, disinterest and negativity).44 Circadian disorders, such as sleep-wake cycle disturbances, are associated with ageing, but are even more pronounced in AD. According to Dutch researchers in 2005, many studies have reported disrupted melatonin45 production and rhythms in aging and in AD that are taking place as early as in the first preclinical AD stages.46 The pineal gland47 is a central structure in the circadian organization in the circadian system which produces melatonin under the control of the central clock – the suprachiasmatic nucleus (SCN).48 The SCN and the output of the pineal gland, i.e. melatonin, are synchronized to the 24-hour day by environmental light. Melatonin not only plays an important role in the regulation of circadian rhythms, but also acts as antioxidant and neuro-protector.49 The degeneration of the retina-SCN-pineal axis may underlie these changes.50 Recent studies carried out by the Dutch researchers indicate that a dysfunction of the sympathetic regulation of pineal melatonin synthesis by the SCN is responsible for melatonin changes during the early AD stages.51 The good news is, to restore the circadian rhythm and to relieve the clinical circadian disturbances, the Dutch have managed reactivation of the circadian system by means of light therapy and melatonin supplementation, which has shown promising results. Although this may be a hackneyed old proverb, it has a lot of in-depth meaning when it comes to the health of the brain: “Early to bed, early to rise, makes a man healthy, wealthy and wise.” Is it Meet to Eat Red Meat? What’s on your plate? In the past month American research has been investigating the pros and cons of ‘red meat’, which features only weakly in the Mediterranean diet. The hypothesis of the study focussed on the biochemistry of heme53 compounds and their oxidative processes because: “dietary epidemiological54 studies indicate correlations between the consumption of red meat and/or processed meat and cancer of the colon, rectum, stomach, pancreas, bladder, endometrium55 and ovaries, prostate, breast and lung, heart disease, rheumatoid arthritis, type 2 diabetes and AD.56 The correlation of all these major diseases with dietary red meat indicates the presence of factors in red meat that damage biological components.” From the study it was reported that it is apparent that decreasing the amount of dietary red meat will limit the level of oxidative catalysts57 in the tissues of the body. It was found that biochemical and tissue free radical damage caused by heme catalyzed oxidations is similar to that resulting from ionizing radiation,58 which can be dangerous to human health, i.e. cause damage to DNA or increase the potential for cells to mutate. The researcher concluded that, although these detrimental processes of heme hypothesized are not well recognized, more investigative studies in this field need to be done. However, increasing consumption of vegetables and fruits elevates the levels of antioxidative components, e.g. selenium, vitamin E, vitamin C, lycopene, 59 cysteine-glutathione60 and various phytochemicals.61 It is early days yet on how important this research may turn out to be, nor is it an advocacy to become a vegetarian, but once again it clearly demonstrates the value of the Mediterranean diet. For dedicated meat eaters, there may be a number of advantages in becoming a Midi-Veg. If you are a huge steak fan, this means reversing the centre of attention on the meat on your plate and eating a larger proportion of vegetables and salad. Perhaps having a smaller steak ‘on the side’ and using it as one would a side-salad. To eat plenty of antioxidative vitamins and other antioxidants is the goal. It has to be said that lean red meat is the leading source of heme (or haem) iron,62 bioavailable and readily absorbable by the body, which is also found in chicken and fish to a lesser extent, and can be found in green vegetables, bread, pulses, dried fruit and nuts.63 It provides important vitamins such as B vitamins and vitamin D, and is recognized as an excellent source of vitamin D. Lean red meat also provides minerals, zinc and selenium.64 Iron deficiency is one of the most commonly occurring nutrient deficiencies in the UK. It can affect many functions of the body, including, thermogenesis (heat production), infection and immunity, and mental and motor development in children. Iron absorption is enhanced by vitamin C. Vitamins for Alzheimer’s Over time, research regarding the advantages and disadvantages or a need for supplementary vitamins for AD has had mixed results and mind-set by mainstream medicine. The normal standard medical argument regarding need for, or not, of supplementary vitamins is that if a ‘balanced diet’ is consumed nothing further is required. If our world of food was the same as three-score and ten years ago this stance would have convincing validity. But, ‘what if’ the RDA of specific vitamins and minerals is no longer present in the food or a person has an illness that doesn’t metabolize what is on offer to their advantage? Despite the mixed reviews of certain vitamin supplements regarding AD, it is well to note that, with variance in individuals and their diets, plus what has been discovered by research, supplementary vitamins do have a place. Back in 1998, a French study compared the vitamin C and E plasma levels in patients with AD, (plasma being the liquid portion of the blood that contains numerous proteins and minerals and is necessary for normal body functioning), and to assess the vitamin C intake and nutritional status. The results supported the hypothesis that oxygen-free radicals may cause damage in AD.65 The researchers concluded that plasma vitamin C is lower in AD in proportion to the degree of cognitive impairment, which is not explained by lower vitamin C intake.66 This, in turn, suggested that there is a lack of antioxidative agents in AD sufferers which could be remedied. In 2002, Dutch research stated that laboratory findings suggested that oxidative stress (OS) may contribute to the pathogenisis67 of AD.68 The aim of the study, involving a total of 5,395 participants (1990-1993) aged at least 55 years, was to determine whether dietary intake of antioxidants is related to risk of AD.69 The participants were free of dementia, non-institutionalized and had reliable dietary assessment. They were also re-examined in 1997-1999 and were continuously monitored for incident dementia. After a mean (average) follow-up of 6 years, 197 participants developed dementia, of which 146 had AD. When adjustments were made for age, sex, Mini-Mental State Examination score, alcohol intake, education, smoking habits, pack-years of smoking, BMI, total energy intake, presence of carotid plaques, and use of antioxidative supplements, of antioxidants that counteract the detrimental effects of OS – “high intake of vitamin C and vitamin E was associated with lower risk of AD.”70 The production of oxygen free radicals being involved in AD having been accepted, the following year, in order to determine whether the intake of antioxidant vitamins decreases the risk of AD, American researchers investigated the relationship between AD and the intake of carotenes, vitamin C and vitamin E. This study involved 980 elderly subjects in the Washington Heights-Inwood Columbia Aging Project.71 The participants were free of dementia at baseline71A and were followed up for an average period of 4 years. Conversely, the researchers concluded that “neither dietary, supplemental, nor total intake of carotenes and vitamins C and E was associated with a decreased risk of AD in this study.”72 These results let loose one big feral cat among the pigeons! However in January 2004, other American researchers at Johns Hopkins University, Baltimore, entirely disagreed. Known as the ‘Cache County Study’, elderly (65 years or older) county residents were assessed in 1995 to 1997 for prevalent dementia and AD, and again in 1998 to 2000 for incident illness. Supplement use was ascertained at the first contact. Among 4,740 respondents (93%) the researchers identified 200 prevalent cases of AD. Among 3,227 survivors at risk, they identified 104 incident AD cases at follow-up.73 The results showed that use of vitamin E and C (ascorbic acid) supplements ‘in combination’ was associated with reduced AD prevalence and incidence.74 A trend toward lower AD risk was also evident in users of vitamin E and multivitamins containing vitamin C, but they found no evidence of a protective effect with use of vitamin E or vitamin C supplements alone, with multivitamins alone, or with vitamin B-complex supplements.75 Therefore, use of vitamin E and vitamin C supplements ‘in combination’ is associated with reduced prevalence and incidence of AD. What is more, the researchers concluded that “antioxidant supplements merit further study as agents for the primary prevention of AD.”76 Last year, Italian research pointed to the perceived problem. They reiterated that it is widely accepted that oxidative stress increases with age and that age is a major risk factor for several neurodegenerative diseases, such as Parkinson’s and AD, and that imbalanced overproduction of oxygen free radicals can induce neuronal damage, leading to neuronal death by necrosis77A or apoptosis77B (cell death).77 They stated that antioxidants are consequently considered to be a promising approach to neuro-protection, and the experimental data are consistent in demonstration of the neuro-protective effects of antioxidants ‘in vitro’ and in animal models, but the clinical evidence that antioxidant agents may prevent or slow the course of these diseases in humans is still relatively unsatisfactory – insufficient to strongly modify the clinical practice.78 & 79 One interpretation of these findings could be that you are not going to get supplementary vitamins for AD on the NHS or its equivalent; if you want to take them you will have to buy them yourself. All is far from lost, American research is going forward and patients were being recruited since August this year for a Federally funded Phase I trial of ‘Antioxidants (vitamin E, vitamin C, alpha-lipoic acid and coenzyme Q) as a treatment for mild to moderate AD.’80 In addition, another trial in the States being recruited for in the same period is for: ‘Prevention of AD by Vitamin E and Selenium’.81 There is a lot of promising research activity in progress. Moreover, this year there has also been a review of the neurology of vitamin B12 and folic-acid deficiencies together, as folates and vitamin B12 have fundamental roles in central nervous system (CNS) function at all ages.82 UK researchers found that vitamin B12 may have roles in the prevention of disorders of CNS development, mood disorders, and dementias, including AD and vascular dementia in elderly people.83 Both vitamins and supplements for AD have had a rough passage, but now it seems that satisfactory conclusions are in sight. Food Medicines Helpful to Alzheimer’s
Fresh cut Fruits and vegetables www.ars.usda.gov - Photograph by Peggy Greb Now for the fun part – Food glorious food! Our natural source of vitamins, minerals, and much more. Scientists are discovering and are increasingly aware of the value of Food Medicines and/or their derivatives for the treatment of sickness and disease. In order to find curative substances for AD and many other conditions they have progressed from Nutra-science to Neuro-science. Certain plants which provide fruits high in antioxidants appear to have potential or active roles in allaying AD onset or progression. Among the fruits and other plants that can aid AD to a greater or lesser degree are: green leafy vegetables and collards,84 including spinach and kale i.e. brassicas such as dark green cabbage, not the florid floppy-leaved ornamental ‘potager’ Japanese varieties, which may be eaten but are exceedingly bitter and more for formal garden presentation and ‘show’ than anything else; fruits such as blueberries, grapes and grape seed, pomegranate (juice), strawberries, and garlic to some extent, green tea, and curry spice turmeric’s (curcumin). Some are more powerful than others, but if not already commonly used in the daily diet, e.g. garlic is part of the Mediterranean diet and useful over a broad spectrum of ills, all are worthy of inclusion in your diet for their preventive action and wider remedial values. In 1998 and 2002, American animal studies investigated nutritional interventions by increasing dietary intake of fruits and vegetables, which can retard and even reverse age-related declines in brain function and in cognitive and motor performance in rats.85 The researchers found that as rats age, as with humans, their brains are increasingly vulnerable to oxidative stress. Dietary supplementation with fruit or vegetable’s extracts high in antioxidants e.g. blueberry, spinach, strawberry, can decrease this vulnerability to oxidative stress.86 The following year, February 2003, other aspects of the processed and modified natural oils plants provide came under scrutiny. US scientists found that a diet high in unsaturated, unhydogenated fats, found in vegetables and some oils, may help lower AD risk.87 In this study, the researchers examined 815 people aged 65 and older over a four-year period.88 At the start of the study none of the volunteers had AD, but by its end 131 had developed symptoms. What the researchers found is that the risk of developing AD was highest among those who consumed the highest levels of saturated fat, found in meat and dairy products.89 People who consumed a lot of saturated fat were 2.3 times more likely to develop symptoms than those whose diet was low in these fats.90 Conversely, people whose diet contained high levels of unsaturated fat were up to 80% less likely to develop AD than those who consumed low levels of unsaturated fats.91 It is thought that LDL (low-density lipoprotein), commonly referred to as ‘bad’ cholesterol, may play a role in the formation of the amyloid plaques92A found in the brain of AD patients.92 It was conceded that more research was required to confirm these findings, but the lead researcher, Dr Martha Clare Morris, suggested people should consider a switch to a diet with low unsaturated fat and unhydrogenated fats, if only because of abundant evidence that it helped to reduce the risk of heart disease.93 To know what you are getting, read the packaged food labels carefully. It may seem a chore, but once done it should mean you know which brands you want to select to buy in future. Previously, in 2003, the same research team had recommended the consumption of fish for its oil, because dietary n-3 94A (Omega-3) polyunsaturated fatty acids had improved brain functioning in animal studies. Their investigations resulted in the conclusion that weekly consumption of (oily) fish may reduce the risk of incident AD.94 Other plant sources are available to a lesser extent in green vegetables and some fruits such as blueberries, flaxseed oil etc. Taking fish oil is sound advice for everybody’s general health, as well as being preventive for AD, but with the world’s fish stocks in jeopardy we should eat oily fish while we can. Progressively more we may need to turn to our plant-world to provide us with what we need. Children in WWII took Cod Liver Oil and Malt. Some may remember the healthy ‘Ration Book’ era in Britain, which prescribed a diet of low fat, high fibre and sensibly-sized portions of food. The British population enjoyed a level of health and fitness unsurpassed since 1945. There was no surfeit of sugar or salt, instead daily supplements of orange juice (or rose hip syrup) for vitamin C and malt extract, as well as cod liver oil (fish oil) provided at school.94B Back to today’s world, science is seriously excited now about plant polyphenols, the most abundant dietary antioxidants, said to possess stronger neuro-protection against hydrogen peroxide than antioxidant vitamins.95 Last month, the third ‘International Conference on Polyphenols in Nutrition and Health’ was held in Malta,96 with new ingredients, new applications and new science as the focus. The purpose of the conference was to provide more information for industrialists on how better to use polyphenols in various products, highlighting the latest clinical data and bioavailability of various forms. In addition to new ingredients such as, green tea extracts, rosemary extracts, olive extracts &c., and the more established polyphenols-rich sources, such as grapes, cherries, berries, apples and citrus fruit, the conference also planned to give exposure to more exotic sources from tropical America, the Amazonian Region and the Andean highlands.97 It is somewhat reassuring that scientists are really ‘tuned in’ and ‘turned on’ to the potential of what Nutra-science can provide and are gathering not only to share and update information on the beneficial health effects of polyphenols, but also how they can play a preventive role for the main chronic diseases.98 For example, a couple of years ago, South Korean researchers investigated in an animal study the protective effects of grape seed polyphenols (Oligonol) against beta-amyloid-induced oxidative cell death regarding AD. 99 Recently, Japanese research has found the lack of toxicity supports the potential use of Oligonol as a food or dietary supplement and for use as an additive in pharmaceutical and cosmetological applications.100 Oligonol is a lead supplement in the making and so far results are promising. Grape seed extract’s proanthocyanidins101A already have demonstrated excellent protection against oxidative stress and free radical mediated tissue injury in 2000.101 Plus, resveratrol102 from red grapes hold some promise for AD.103 Because it is not possible to eat sufficient within the daily diet of some of these highly remedial compounds, found naturally in fruits or vegetables from which they are extracted, to form medical dosages of necessity some will end up as food supplements. This especially applies where a high quality diet (Mediterranean diet) has not been maintained or there is a specific deficit or the purpose is medicinal. Where possible, it is still preferable to ‘eat or drink’ Food Medicines if they are sufficient to supply your needs. Nonetheless, official attitudes towards dietary supplements to be employed in mainstream medicine are changing. Only this week it was announced that millions of heart-attack survivors are to be prescribed ‘fish oil’ supplements for life on the NHS.104 New guidelines being drawn up for doctors recommend that heart patients get a daily dose of omega-3 fatty acids to reduce the risk of a second attack. This is a secondary preventive move, but welcome news. It also shows a sea-change in official medical attitude towards necessary supplements. Furthermore, the UK National Institute for Health and Clinical Excellence (NICE) now currently advises that patients who have suffered a heart attack should eat a Mediterranean-style diet and increase their consumption of oily fish to between two and four portions a week.105 Of late, fruit and vegetables juices as an aid to AD have hit the headlines.106 In a large study on whether consumption of fruit and vegetables juices containing a high concentration of polyphenols decreases the risk of incident, probably AD, was tested in a population-based prospective study of 1,836 Japanese Americans, Washington, USA, who were dementia-free at baseline (1992-1994) and were followed through 2001.107 The forethought being that polyphenols in foods such as fruits and vegetables may disrupt the processes necessary to cause the onset of AD, and to help provide protection against free radicals. The researchers followed the participants over a 10-year period and found the risk was 76% lower for those who drank juice more than three times a week, compared to those who drank it less than once a week.108 People also seem to have more physical energy on a juice-laden diet. Conversely, and mainly affecting the young, nutritionists warn that ‘energy drinks’ are laced with caffeine and sugar, which can hook kids on an unhealthy jolt-and-crash cycle.109 The caffeine comes from multiple sources, making it hard to tell how much the drinks contain. Some have B vitamins, which when taken in mega-doses (these drinks are abused) can cause rapid heartbeat, and numbness and tingling in the hands and feet.110 So if your energy is flagging, don’t be tempted! Drink some pure fruit and/or vegetables juices instead. ‘Eat Your Greens’ contra-Alzheimer’s
Broccoli (Brassica oleracea var. botrytis) Copyright © 2005 Luigi Rignanese The old saying ‘Eat your greens’ is now a matter of ‘I told you so’! Or it could be updated to ‘Eat your greens for your brains’!111 The changes to the modern diet mean that children, and many of their parents of this generation, generally appear to be anti-eating their greens. This disinclination may prove to be very disadvantageous to them long- as well as short-term, because the most recent research regarding leafy green vegetables shows that these vegetables appear to keep the brain young and may slow the mental decline often associated with growing old. This American research involved 3,718 participants, aged 65 years and older, (62% female, 60% African American, average age 74) of the Chicago Health and Aging Project.112 The participants completed a food frequency questionnaire and were administered at least two of three cognitive assessments at baseline, with 3-year, and 6-year follow-ups.113 The research suggests that eating about three portions of green leafy, yellow and cruciferous114 vegetables every day could slow loss of mental function as we age by 40%.115 It appears that high vegetable, but not fruit, consumption may be associated with slower rate of cognitive decline with older age. The researchers have called for further research to understand the non-association with fruit, as well as exploring specific dietary components of citrus fruit.116 According to the lead author of this study, people who ate at least 2.8 servings of vegetables a day gained mental advantage, which “decrease in decline is equivalent to about five years of younger age.”117 However there is plenty of research to prove the efficacy for certain fruits and other good food medicines that also can or have the potential to aid AD. Go for the leafy green vegetables and get into cabbage with a difference, try a hot cabbage dish for winter woes and the festive season ‘Green Cabbage Thoran’ from along the Spice Coast, Kerala, India.117A Perhaps our view of the ‘Kitchen Garden’ will alter to see it more like a ‘Health Garden’, for the more scientific research uncovers the goodness of the plants we can grow, the more blessed people must feel who are in the happy position of being able to grow their own fresh produce. Special Power-house Health Fruits
Blueberries (Vaccinium angustifolium/Vaccinium spp.) www.ars.usda.gov – Photograph by Scot Bauer Modern research shows that early American settlers were wise to incorporate the native fruit of the Blueberry into their diets and medicine, eating them fresh off the bush, adding them to soups, stews and many other foods and, of course, creating the USA’s famous ‘blueberry-pie’, which latter is also a gourmet dish called ‘Mustikkapiirakka’ in Finland.118 (See recipe 118A) Today, blueberries are a ‘big time’ export of North America, which is the world’s leading blueberry producer, accounting for nearly 90% of world production. The harvest runs from mid-April through early October with its peak in July, which is also known as National Blueberry Month.119 Blueberry has been shown to be among the most powerful of plant-life antioxidants, which is partly due to its polyphenolic flavonoid, blue coloured antohcyanin101A content that may improve eyesight, eye capillary strength, and reduce eye strain. Science has also cited the blueberry with the ability to enhance cardiovascular health, reduce LDL cholesterol levels, with the potential reduction in the probability of stroke. The blueberry is also used for diminution of urinary tract infections. More recently the blueberry shows scientific promise in the treatment of Alzheimer’s and age-related decrease of mental acuity. In the summer of 2003, American scientists, building upon their previous animal research which showed via blueberry supplementation reversal of the deleterious effects of aging on motor behaviour and neuronal signalling in rodents, further progressed in animal investigations. In this later study the data indicated for the first time that it might be possible to overcome genetic predispositions to AD through diet.120 Two years later, Spanish research findings suggested that blueberry’s polyphenolic compounds (anthocyanins), are able to cross the blood brain barrier121A and localize in various brain regions important for learning and memory, and may deliver their antioxidant and signalling modifying capabilities centrally and enhance memory. In December 2005, the American researchers again stepped up their game and stipulated that research from their laboratory has shown that nutritional antioxidants, such as the polyphenols found in blueberries, can reverse age-related declines in neuronal signal transduction122 as well as cognitive and motor deficits. Furthermore, they stated that they had shown that short-term blueberry supplementation increases hippocampal plasticity.123 & 124 It is early days in AD blueberry research, i.e. it has not yet progressed beyond animal studies, but the results auger well. At the very least, eating delicious blueberries can form an excellent antioxidant defence against other ills and contribute a goodly amount of potassium, calcium, vitamins A, C, and E, and folic acid to the fruitarian part of your diet. Garlic – the Herb and Vegetable
Garlic (Allium neapolitanum) Italy 2004 (USDA) Photographer: © 2005 Luigi Rignanesse The culinary use of gastronomic garden garlic (Allium Sativum) is very much a strong member of the Mediterranean diet. It is proven to be antimicrobial (antibacterial and antifungal), anti-parasitic, anti-inflammatory, cholesterol and triglycerides lowering, and helps to balance blood pressure, as well as being anticoagulant. Eaten raw or in food, rubbed on skin, or taken in tablets or capsules, it has been credited with therapeutic use for colds, flu, coughs, sinusitis and chest infections, Candida albicans, high blood pressure (HBP) and heart disease, circulatory problems, skin problems including acne and impetigo, blood sugar regulation and digestive infections. So far garlic is not the hardest hammer in the natural tool-box for AD, but to be fair and positive with reference to its potential, to date there has been very little specific research carried out. But, it is important to include garlic in the diet because of its strength in shielding the body against or remedying, those diseases and conditions that lead to AD. This spring, an American researcher suggested that, although additional observations are warranted in humans, compelling evidence supports the beneficial health effects attributed to AGE (AGE ‘Kyloic’ is garlic extracted and aged to form an antioxidant-rich aged garlic extract) in helping prevent cardiovascular and cerebrovascular diseases and lowering the risk of dementia and AD.125 “Oxidative damage is a major factor in both cardiovascular disease and dementia, which risks increase with age. For example ‘risk factors’ for cardiovascular disease, including high cholesterol, high homocysteine, hypertension and inflammation, increase the risk of dementia, including AD. High cholesterol is also associated with elevated beta-amyloid (Abeta), the hallmark of AD.” 125 For those and dietary reasons, it is well to add fresh garlic into your cuisine and put it firmly onto your health menu. For garlic lovers, try a traditional, basic ‘Aioli’ (Garlic Sauce recipe 125A), which is a light mayonnaise-style sauce laden with fresh garlic, used atop vegetables or fish. The writer’s recommendation is an ‘aioli’ is a good way to get to grips with the last scraps of the Christmas turkey to make something distinctive and appetizing. Beautiful Health-giving Pomegranate
A fruit of the Pomegranate (Punica granatum) Photo: - http://en.wikipedia.org/wiki/Pomegranate (See other information for Pomegranate on ‘Herbsphere’ www.herbsphere.com in ‘Archived News Articles’: ‘Pomegranate –Ancient Fruit, Modern Medicine’ & ‘Pomegranate – Modern Super Fruit’) As ever, modern science is only revealing what the ancients knew so long ago, Pomegranate is not only a very special and beautiful fruit that is delicious to eat, loaded with historical reference and meanings as well as medicinal values, it is very much a ‘here and now’ food item. Pomegranates are pretty powerful stuff; one fruit can deliver 40% of an adult’s vitamin C’s RDA and much more. For the gardeners among you, it’s a cinch to grow a pomegranate from a ‘pip’ for free. Clean off the pip, and it can literally go from the mouth in to a small pot; water and keep warm and in a few weeks there you have it – your own pomegranate plant. It is frost hardy, drought tolerant, and can be grown in dry areas with either a Mediterranean winter rainfall climate, which is what is now happening to the weather in the UK, but needs fair drainage to stop the roots rotting. All being well, your efforts will be regaled with beautiful luscious and medicinal exotic red flowers, and in due course your own pomegranate fruits.126 As our climate appears to be changing into a more Mediterranean mode, it’s worth a try.127 In May 2000, Israeli research concluded that pomegranate juice had potent anti-atherogenic128 effects in healthy humans and in atherosclerotic129 mice that may be attributable to its antioxidative properties.130 And, yes, this is related to the brain. This research is important, because the ability of the heart to supply blood to the brain’s miniscule blood vessels is paramount to its functionability. Ladies please note, pomegranate is also a rich source of folic acid (folate or vitamin B9), important in red blood cell formation, protein metabolism, growth and cell division, and the prevention of birth defects. In fact, in spring 2005, American research showed that neonatal hypoxic-ischemic brain injury,131 which occurs because of a lack of blood flow to the brain and therefore the oxygenation of brain cells, remains a significant cause of morbidity and mortality and lacks effective therapies for prevention and treatment.132 What has grabbed the attention of scientists is that pomegranate is high in polyphenols, the most abundant of which are tannins, particularly punicalagins, which have been shown to be the antioxidant responsible for the ‘free radical’ scavenging ability of pomegranate juice. This recent interest in the biology of polyphenol compounds has led to the discovery that dietary supplementation with foods rich in polyphenols provides neuroprotection in adult animal models of ischemia and AD.133 The American research found that their animal study results demonstrated that maternal dietary supplementation with pomegranate juice is neuroprotective for the neonatal brain i.e. within the first four weeks of birth.134 It shows that pomegranate juice is a good thing to add to your diet at any age or stage of life. More specific to AD, in a new American study in October this year, it was found a daily glass of antioxidant-rich pomegranate juice could halve the build-up of harmful proteins linked to AD.135 When the researchers examined the quantity of beta-amyloid deposits in the brain cortex, it was found that the pomegranate juice-supplemented groups had 50% less of the protein than the non-supplemented group.136 This study was the first to show beneficial effects (both behavioural and neuropathological) of pomegranate juice in an animal model of AD. The data is based on pomegranate concentrate and no attempt was made by the research authors to discriminate the potentially ‘active’ biochemicals in the fruit that may offer protection independently or synergistically, although they said the evidence suggests a complimentary effect of the polyphenols.137 However, being the first study into the potential protective role of pomegranate concentrate and the antioxidant polyphenols contained therein, more research is called for. It is to be hoped that this will follow quickly, as all simple forms of aid and the least expensive are welcome and needed to assist AD prevention. In the meantime, the good news is: “The vast number of compounds in pomegranate juice, along with the evidence that these compounds may act together in a synergistic fashion, suggests that isolated components of pomegranate may not be as effective as dietary supplementation with either the whole fruit or its juice,” the researchers said.138 This one seems too good to miss, non-alcoholic to boot! So get drinking pomegranate juice, even it is only for your general health, and you will also be helping to protect your brain. 8 fluid ozs. a day seems to be the dosage that may provide surprising benefits. 139 There are no apparent contraindications for pomegranate and its juice, except just don’t spill it on your clothes, the stains are virtually impossible to get out! So are blueberry stains.140 Further information on herbs and AD will be found in Part III. COMMENT: It is to be remembered that no form of medication should be taken by patients without first consulting and advising your health-care giver or GP. All supplements should be checked out with a qualified herbalist and/or pharmacist for any potential side effects, contraindications and interactions with medications to get the most up-to-date information. The information below is solely to be used as a rough guide: Blueberry Extract: This may have a laxative effect, but otherwise no adverse effects are expected. Garlic: A possible side-effect is stomach upset. Garlic is contraindicated if the subject is allergic to it (some people are allergic to all the onion family); Garlic supplements should be discontinued at least 2 weeks prior to surgery or dental extractions to prevent excessive bleeding. It should be used cautiously with other anticoagulant herbs and mediations such as ginkgo biloba, ginger, aspirin and ibuprofen and should not be used with prescription anticoagulants like Warfarin. It appears to be safe for use in pregnancy and lactation. However, supplements should be discontinued several weeks before delivery to prevent excessive bleeding. Garlic may be found in breast milk, which may cause stomach upset in sensitive infants e.g. make a baby’s colic worse. References: 1. ‘The Scream’ (Skrik, 1893) originally called ‘Despair’, a famous painting by Edvard Munch (1863-1944). He reportedly painted the picture after a walk with two friends during which he sensed an “endless scream passing through nature”. To describe this experience, he developed an exciting, violent, and emotionally charged style that is recognized by most critics as leading to the birth of German Expressionism. 2. The saying, “God helps those who help themselves”, came to us by way of Benjamin Franklin (1736). Margaret Rutherford the English actress gave the saying its humorous interpretation in one her films (acting) after being caught shop-lifting. 3. ‘Will a healthy lifestyle help prevent Alzheimer’s disease?’ Pope SK, Shue VM, Beck C. Department of Geriatrics, Uv. of Arkansas for Medical Sciences, Little Rock, Arkansas, USA. Annu Rev. Public Health. 2003; 24:111-32. Epub 2001 Nov.6. 4. Ibid. 5. Ibid. 6. ‘Caloric intake and Alzheimer’s disease.’ Passinetti GM, Zhao Z, et al. Neuroinflammation Research Labs., Dept. of Psychiatry, Mount Sinai School of Medicine, New York, NY, and Bronx Veterans Affairs Medial Centre, Mount Sinai School of Medicine, Bronx, N.Y. USA. Interdiscip. Top Gerontol. 2007; 35:159-75. 7. Ibid. 8. Ibid. 9. Ibid. 10. Amydolosis: The build up of amyloid to a degree that causes damage to the tissues or action of those tissues in the body. Amyloid: A protein deposit associated with tissue degeneration; amyloid is found in the brains of individuals with AD. 11. ‘Caloric intake and Alzheimer’s disease.’ Passinetti GM, Zhao Z, et al. Neuroinflammation Research Labs., Dept. of Psychiatry, Mount Sinai School of Medicine, New York, NY, and Bronx Veterans Affairs Medial Centre, Mount Sinai School of Medicine, Bronx, N.Y. USA. Interdiscip. Top Gerontol. 2007; 35:159-75. 12. Ibid. 13. Ibid. 14. ‘Dietary fat consumption and health.’ Lichenstein AH, Kennedy E, et al. Tufts Uv., Boston, MA, USA. Nutr Rev. 1998 May; 56(5 Pt 2):S3-19; discussion S19-28. 15. Ibid. 16. Trans fatty acids (TFAs): A fat that is produced when liquid fat (oil) is turned into solid fat through a chemical process called hydrogenation. They are found in many processed foods that contain partially hydrogenated fats, vegetable oil or shortening. Trans fatty acids occur naturally in smaller quantities in animal fats. TFAs have been shown to raise blood cholesterol risking heart disease. Research, also suggests a strong link between TFAs and cancer, as well as heart disease. 17. ‘Neuronal Life-and-Death Signalling, Apoptosis, and Neurodegenerative Disorders.’ Mattson MP. Lab. of Neurosciences, National Institute on Aging Intramural Research Program, Baltimore, Maryland, USA. Antioxid Redoc Signal. 2006 Nov-Dec; 8(11-12):1997-2006. 18. Ibid. 19. ‘Study: Some Alzheimer’s drugs very risky.’ By Linda A Johnson, Associated Press Writer, 11th October 2006. 20. ‘Effectiveness of atypical antipsychotic drugs in patients with Alzheimer’s disease.’ Schnieder LS, Tariot PN et al, CATIE-AD Study Group. Keck School of Medicine, Uv. of Southern California, Los Angeles, CA, USA. N. Engl J Med. 2006 Oct 12; 355(15):1525-38. (ClinicalTrials.gov number, NCT00015548 [ClinicalTrials.gov].). 21. Ibid. 21A. Olanzapine (Zyprexa): an antipsychotic drug administered orally especially in short-term treatment of schizophrenia and acute manic episodes of bipolar disorder. 21B. Quetiapine (Seroqual): for treatment of depressive episodes associated with Bipolar I (or Bipolar II) Disorder. Also used ‘off-label’ to treat other disorders such as post-traumatic stress disorder, alcoholism, obsessive compulsive disorder, anxiety disorders, hallucinations in Parkinson’s disease patients using Ropinirole, and as a sedative for those with sleep disorders. 21C. Risperidone: used to treat schizophrenia. 22. ‘Neanderthals Were Fully Developed by Age 15, Experts Say.’ – Wisdom teeth acc. Ramirez Rozzi, researcher with Dynamigque de l’Evolutioin Humaine (Dynamics of Human Evolution) in Paris, and Bermudez de Castro, of the Musto Nacional de Ciancias Naturales (National Museum of Natural Sciences) in Madrid. http://news.nationalgeographic.com/news/2004/04/0428_040428_neandertals_2.html 23. ‘At which age do we usually get our Wisdom Teeth?’ – http://www.dmt123.com/dental/1784-dmt123.html 24. ‘MINDREADING In key ways, teen brains aren’t fully developed.’ – http://fredericksburg.com/News/FLS/2006/10222006/229496/ 25. ‘When Does the Human Brain Mature?’ Abigail A. Barid, PhD., Director, Laboratory for Adolescent Studies; Prof. Dept of Psychological and Brain Sciences, Dartmouth College, New Hampshire, USA. Pub. Journal of Human Brain Mapping Feb 2006. 26. Homoeostasis: Optimal balance of mental and physical well-being. In Medicine and Biology, this term is applied to the inherent tendency of an organism toward maintenance of physiological and psychological stability. It is a natural regulatory mechanism of the organism. The ability of the body to maintain its perfect natural balance e.g. the circulatory system, its temperature or its water and hormone balance. The hypothalamus is the central navigation system in the middle brain. 27. ‘Sleep deprivation as a neurobiologic and physiologic stressor: Allostasis and allostatic load.’ McEwen BS. Harold and Margaret Hatch, Lab. Of Neuroendocrinology, The Rockefeller Uv., New York, NY, USA. Metabolism. 2006 Oct; 55(10 Suppl 2):S20-3. 28. Allostatic load: (Psychology): The psychological wear and tear on the body that results from ongoing adaptive efforts to maintain stability (homoeostasis) in response to stressors. 29. Alostasis: The ability of the organism to achieve stability through adaptation or change. This process, which is critical to our survival, involves the autonomic nervous system, the HPA axis, and the cardiovascular, metabolic, and immune systems which act to protect the body by responding to internal and external stimuli. Paradoxically, these same systems, when activated by stress, can protect and restore as well as damage the body. 30. ‘Sleep deprivation as a neurobiologic and physiologic stressor: Allostasis and allostatic load.’ McEwen BS. Harold and Margaret Hatch, Lab. Of Neuroendocrinology, The Rockefeller Uv., New York, NY, USA. Metabolism. 2006 Oct; 55(10 Suppl 2):S20-3. 31. Parasympathetic nervous system: Originates in the brain stem and lower part of the spinal cord; opposes physiological effects of the sympathetic nervous system; stimulates digestive secretions; slows the heart; constricts the pupils; dilates blood vessels. 32. Sympathetic: Of or relating to the sympathetic nervous system. Sympathetic nervous system: Originates in the thoracic regions of the spinal cord; opposes physiological effects of the parasympathetic: reduces digestive secretions; speeds the heart; contracts blood vessels. 33. Cortisol: An adrenal-cortex hormone that is involved in the response to stress; it increases blood pressure, blood sugar levels, may cause infertility in women, and suppresses the immune system. 34. Insulin: Hormone secreted by the isles of Langerhans in the pancreas; regulates storage of glycogen in the liver and accelerates oxidation of sugar in cells. 35. Blood sugar: In medicine, blood sugar is a term used to refer to levels of glucose in the blood. Blood sugar concentration or serum glucose level is tightly regulated in the human body. Glucose, transported via the bloodstream, is a primary source of energy for the body’s cells. Diabetes mellitus is the most prominent disease related to failure of blood sugar regulation. 36. Hippocampus: A complex neural structure (shaped like a seahorse) consisting of grey matter and located on the floor of each lateral ventricle; intimately involved in motivation and emotion as part of the limbic system; has a central role in the formation of memories. 37. Amygdala: An almond-shaped neural structure in the anterior part of the temporal lobe of the cerebrum; intimately connected with the hypothalamus and the hippocampus and the cingulated gyrus; as part of the limbic system it plays an important role in motivation and emotional behaviour. 38. ‘Sleep deprivation as a neurobiologic and physiologic stressor: Allostasis and allostatic load.’ McEwen BS. Harold and Margaret Hatch, Lab. Of Neuroendocrinology, The Rockefeller Uv., New York, NY, USA. Metabolism. 2006 Oct; 55(10 Suppl 2):S20-3. 39. Ibid. 40. Ibid. 41. Circadian rhythm: is a name given to the ‘internal body-clock’ that regulates the c.24-hour cycle of biological processes in animals and plants. (The term circadian comes from the Latin circa, meaning ‘around’ and dies, ‘day’, meaning ‘around a day’.) The rhythmic repetition of certain phenomena in living organisms (a metabolic or behaviour pattern). Without cues provided by light, the human circadian lasts 25.9 hours. 42. [Circadian rhythm disorders, motivation and Alzheimer’s disease] [Article in French] Bocksberger JP. Dept. de Psychiatrie, Uv. de Geneve, Switzerland. Rev Med Suisse Romande. 1997 Sep; 117(9):643-6. 43. Ibid. 44. Ibid. 45. Melatonin: is a substance that is synthesized in the pineal gland (a pea-like organ located in the brain which is sensitive to different levels of light and is essential to the functioning of an animal’s biological clock). The pineal gland halts the synthesis of melatonin when light hits the retina of the eye. Besides influencing daily, or circadian, rhythms such as those of sleep and temperature, the pineal gland and melatonin appear to direct annual rhythms and seasonal changes in animals. 46. ‘The human pineal gland and melatonin in ageing and Alzheimer’s disease.’ Wu YH, Swaab DF. Netherlands Institute for Brain Research, Amsterdam, The Netherlands. J Pineal Res. 2005 Apr; 38(3):145-52. 47. Pineal gland: The hormone gland located in the brain that secretes melatonin. The pineal gland eventually begins to shrink and calcify during the aging process, thereby significantly reducing the amount of circulating melatonin. 48. Suprachiasmatic nucleus (SCN): is a nucleus in the hypothalamus and is so named because it resides immediately above the optic chaism (OX). It consists of two nuclei each of which lies on either side of the hemisphere separated by the third ventricle (3V). Its principal function is to create the circadian rhythm, which regulates the body functions over the 24-hour period. 49. ‘The human pineal gland and melatonin in ageing and Alzheimer’s disease.’ Wu YH, Swaab DF. Netherlands Institute for Brain Research, Amsterdam, The Netherlands. J Pineal Res. 2005 Apr; 38(3):145-52. 50. Ibid. 51. Ibid. 52. Proverb: John Clarke (d.1658): Paroemiologia Anglo-Latina […] or Proverbs English, and Latine (1639) is where this proverb comes from and was cited almost one hundred years before Benjamin Franklin used it, although it is routinely attributed to the latter. 53. Heme: the Iron-holding part of the haemoglobin and myoglobin proteins (about 40% of Fe [iron] in meat, fish and poultry is bound into heme). Hemoglobin: the oxygen-carrying protein of the red blood cells. 54. Epidemiology: is the scientific study of factors affecting the health and illness of individuals and populations, and, in this capacity, it serves as the foundation and logic of interventions made in the interest of the public’s health. 55. Endometrium: The lining of the uterus that is shed each month as the menstrual period. As the monthly cycle progresses, the endometrium thickens and thus provides a nourishing site for the implantation of a fertilized egg. 56. ’Heme of consumed red meat can act as a catalyst of oxidative damage and could initiate colon, breast and prostate cancers, heart disease and other diseases.’ Tappel A. Dept. of Food Science and Technology, Uv. of California, David, CA, USA. Med. Hypotheses. 2006 Oct 10: [Epub ahead of print] 57. Oxidative catalysts: Oxidative: of, relating to, or produced by oxidation (the combination of a substance with oxygen): Catalyst: a substance, used in relatively small amounts, which increases the rate of a chemical reaction without being consumed in the process. http://en.wiktionary.org/wiki/oxidative & http://en.wiktionary.org/wiki/catalyst 58. ’Heme of consumed red meat can act as a catalyst of oxidative damage and could initiate colon, breast and prostate cancers, heart disease and other diseases.’ Tappel A. Dept. of Food Science and Technology, Uv. of California, David, CA, USA. Med. Hypotheses. 2006 Oct 10: [Epub ahead of print] 59. Lycopene: carotenoid that makes tomatoes red; may lower the risk of prostate cancer. 60. Cysteine: an amino acid containing sulphur that is found in most proteins. Glutathione: a chemical compound, a peptide consisting of glutamic acid, cysteine, and glycine that is an important antioxidant. Glutamic acid: an amino acid found in plant and animal proteins that triggers nerve impulses in cells. Glycine: is the simplest amino acid found in proteins, (principal amino acid in sugar cane). It is an inhibitory neurotransmitter in the Central Nervous System (CNS), especially in the spinal cord, brainstem and retina. 61. ’Heme of consumed red meat can act as a catalyst of oxidative damage and could initiate colon, breast and prostate cancers, heart disease and other diseases.’ Tappel A. Dept. of Food Science and Technology, Uv. of California, David, CA, USA. Med. Hypotheses. 2006 Oct 10: [Epub ahead of print] 62. Haem or Heme Iron: The deep red, oxygen-carrying, non-protein, ferrous (iron) component of haemoglobin. Haemoglobin: a protein found in the red blood cells that is responsible for carrying oxygen around the body, picking up oxygen in the lungs, then releasing it in the tissues where it is needed. The iron content of haemoglobin is critical for it to work. 63. Meat & Health: - http://www.meatandhealth.co.uk/consumer/docs/red.htm 64. Ibid. 65. ‘Low plasma vitamin C in Alzheimer patients despite an adequate diet.’ Riviere S, Birlouez-Aragon I, et al. Hopital La Grave-Casselar, Toulouse, France. Int J Geriatr Psychiatry. 1998 Nov; 13(11):749-54. 66. Ibid. 67. Pathogenesis: the origin and development of disease; the production of damage (pathology) in a tissue. Pathology: The scientific study of the nature of disease and its causes, processes, development and consequences. 68. ’Dietary intake of antioxidants and risk of Alzheimer’s disease.’ Engelhart MJ, Geerlings MI, et al. Dept. of Epidemiology and Biostatistics, Erasmus Medical Centre, Rotterdam, the Netherlands. JAMA. 2002 Jun 26; 287(24):3223-9. Comment in: JAMA. 2002Jun 26; 287(24):3261-3. & JAMA. 2002 Nov 13; 288(18):2265; author reply 2265-6. 69. Ibid. 70. Ibid. 71. ‘Antioxidant vitamin intake and risk of Alzheimer disease.’ Luchsinger JA, Tang MX et al. Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, New York, NY, USA. Arch Neurol. 2003 Feb; 60(2):203-8. 71A. Baseline: 1.Information gathered at the beginning of a study from which variations found in the study are measured. Or, a known value or quantity with which an unknown is compared when measured or assessed. And, the initial time point in a clinical trial, just before a participant starts to receive the experimental treatment which is being tested. 72. ‘Antioxidant vitamin intake and risk of Alzheimer disease.’ Luchsinger JA, Tang MX et al. Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, New York, NY, USA. Arch Neurol. 2003 Feb; 60(2):203-8. 73. ‘Reduced risk of Alzheimer disease in users of antioxidant vitamin supplements: the Cache County Study.’ Zandi PP, Anthony JC, et al. Department of Mental Health, Bloomberg School of Public Health, The Johns Hopkins Uv, Baltimore, MD, USA. Arch Neurol. 2004 Jan; 61(1):82-8. 74. Ibid. 75. Ibid. 76. Ibid. 77. ‘Oxidative stress, antioxidants and neurodegenerative diseases.’ Casetta I, Govoni V, Granieri E. Istituto di Clinica Nuerologica, Dipartimento de Discipline Medico-Chirurgiche della Comunicazione e del Comportamento, Universatia di Ferrara, Ferrara, Italy. Curr Pham Des. 2005; 11(16):2033-52. 77A. Necrosis: is a type of cell death in which cells swell and break open, release their contents and can damage neighbouring cells and provoke inflammation. 77B. Apoptosis: is programmed cell death, or ‘cell suicide’. A form of cell death in which a controlled sequence of events (or program) leads to the elimination of cells without releasing harmful substances into the surrounding area. Many types of cell damage can trigger apoptosis, and it also occurs normally during development of the nervous system and other parts of the body. 78. ‘Oxidative stress, antioxidants and neurodegenerative diseases.’ Casetta I, Govoni V, Granieri E. Istituto di Clinica Nuerologica, Dipartimento de Discipline Medico-Chirurgiche della Comunicazione e del Comportamento, Universatia di Ferrara, Ferrara, Italy. Curr Pham Des. 2005; 11(16):2033-52. 79. Clinical Practice: “A Medical guideline (also called a clinical guideline, clinical protocol or clinical practice guideline) is a document with the aim of guiding decisions and criteria in specific area of healthcare, as defined by an authoritative examination of current evidence (evidence-based medicine). Guidelines usually include summarized consensus statements, but unlike the latter, they also address practical issues. Clinical guidelines briefly identify, summarize and evaluate the best evidence and most current data about prevention, diagnosis, prognosis, therapy, risk/benefit and cost-effectiveness. Then they define the most important questions related to clinical practice and identify all possible decision options and their outcomes. Thus, they integrate the identified decision points and respective courses of action to the clinical judgement and experience of practitioners.” - http://en.wikipedia.org/wiki/Guideline_(medical) 80. Federally funded Phase 1 trial of antioxidants (vitamin E, vitamin C, alpha-lipoic acid and coenzyme Q) as a treatment for mild to moderate Alzheimer’s disease – Anti-Oxidant Treatment of Alzheimer’s Disease: This study is recruiting patients. Verified by National Institute on Ageing (NIA) August 2006. Clinical Trials.gov Identifier: NCT00117403. http://www.alz.org/Resources/ClinicalTrialsIndex.asp 81. Prevention of Alzheimer’s Disease by Vitamin E and Selenium (PREADVISE). This study is currently recruiting patients. Verified by National Institute on Aging August 2006. Clinical Trials. Gov Identifiers: NCT00040378. http://www.alz.org/Resources/ClinicalTrialsIndex.asp 82. ‘Vitamin B12, folic acid, and the nervous system.’ Reynolds E. Institute of Eipleptology, King’s College, Denmark Hill Campus, London , UK. Lancet Neurol. 2006 Nov: 5(11):949-60. 83. Ibid. 84. Collard greens: (also called collards or borekale) are a group of loose-leafed cultivars of Brassica oleracea Acephala Group, grown for their large, dark-coloured greens and as a garden ornamental, mainly in Brazil, Portugal, the Southern United States, and in many parts of Africa. They are classified in the same Cultivar Group as kale and spring greens, to which they are extremely similar genetically. 85. ‘Membrane and receptor modifications of oxidative stress vulnerability in ageing. Nutritional considerations.’ Jospeh JA, Demisova N, et al. USDA-ARS Human Nutrition Research Centre on Ageing at Tufts Uv., Boston, Massachusetts, USA. Ann N Y Acad Sci. 1998 Nov 20; 854:268-76. 86. ‘Fruit polyphenolics and brain aging: nutritional interventions targeting age-related neuronal and behavioural deficits.’ Galli RL, Shukitt-Hale B, et al. USFA-ARS, HNRCA at Tufts Uv., Boston, Massachusetts, USA. Ann NY Acad Sci. 2002 Apr; 959:128-32. 87. ‘Vegetables ward off Alzheimer’s’ BBC News Online, 18th February, 2003. ‘Dietary fats and the risk of incident Alzheimer disease.’ Morris MC, Evans DA, et al. Rush Institute for Healthy Ageing, Chicago, IL, USA. Arch Neurol. 2003 Feb; 60(2):194-200. Erratum in: Arch Neurol. 2003 Aug; 60(8):1072. 88. Ibid. 89. Ibid. 90. Ibid. 91. Ibid. 92. ‘Vegetables ward off Alzheimer’s’ BBC News Online, 18 |
