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               Food for the brain

Alzheimer’s disease and other forms of senile dementia affect 25% of people older than 80.  Certain types of mental decline result from exposure to toxins and oxidizing agents.  Brain inflammation may result from the presence of toxins, allergies, stress, or low nutrient levels.  The inflammatory process creates free radicals that cause oxidative damage.  Exposure to free radicals can be especially damaging when brain tissues lack adequate levels of antioxidants and other nutrients.  The aging brain can have low levels of nutrients as a result of a poor diet or inadequate nutrient absorption.  As such, several nutrients are key.

Antioxidants such as beta-carotene, bioflavonoids, essential fatty acids, selenium, and vitamins C and E reduce inflammation.  Studies have shown antioxidant levels in the brain decline with age.  The lowest levels are associated with the greatest neuronal impairment.

Low levels of vitamin B12 and folic acid are associated with forgetfulness, dementia, and Alzheimer’s disease.  Supplementation with these and antioxidant vitamins may be useful for preventing and treating cognitive impairment.

In addition to antioxidants and B vitamins, alpha-lipoic acid (ALA) has been researched as a treatment for Alzheimer’s and Parkinson’s diseases.  Studies demonstrate that ALA can reduce damage to neurons caused by toxic substances that are byproducts of inflammatory processes.

Docosahexaenoic acid (DHA), an omega-3 long-chain fatty acid, is one of the primary structural components of the brain.  In a European study, elderly persons treated for six months with 90 mg per day of DHA showed marked improvement in apathy and social withdrawal symptoms.

Phosphatidylserine (PS) is present in large amounts in brain tissue.  In research trials conducted in Italy, researchers noted that PS improved depression, memory, and behavior.

Ginkgo biloba has been well documented to improve cerebral blood flow and to have antioxidant activity on the nerves.

Although studies are not yet conclusive about how certain supplements affect brain function, many nutrients certainly hold promise.

Reference:  Kieszek S. Trials and perspectives in pharmacotherapy of Alzheimer’s disease.  Psychiatr Pol May-Jun 1999; 33(3):331-40.

              New study confirming glucosamine

              reduces osteoarthritis

A recent issue of The Lancet reports the results of a clinical trial that showed administration of the nutritional supplement glucosamine sulfate slows disease progression in patients with knee osteoarthritis.

The three-year, double-blind, placebo-controlled study was performed using 212 patients suffering from knee osteoarthritis who were randomly selected to receive 1500 mg once per day of oral glucosamine sulfate or a placebo for the three-year period

Disease progression was evaluated by measuring the joint space width on x-rays of the knee.  According to the study, patients who received a placebo experienced progressive joint space narrowing, representing further loss of cartilage, but patients who received glucosamine sulfate showed no further joint space narrowing.  Additionally, pain and function limitation worsened with the placebo, but improved with glucosamine sulfate.

“For the first time, we have shown that a treatment may be able to at least reduce the progression of osteoarthritis,” said principal investigator, Professor Jean-Yves Reginster, M.D., Ph.D., of the University of Liege in Belgium.

Osteoarthritis, the most common form of arthritis, is the deterioration of cartilage that cushions bones in the joints, leading to pain and function limitation.  Many osteoarthritis sufferers eventually undergo surgical joint replacement or become disabled.

Tim McAlindon, of the Arthritis Center at Boston University and author of The Lancet commentary about the glucosamine sulfate research, offers an accurate perspective on bringing effective nutritional supplements such as glucosamine sulfate, closer to the forefront of the health care profession.

Currently, health care professionals generally expect to be involved in medical decisions of public health importance, but they are usually not regarded as a repository of objective advice about nutritional supplements, and as such are not often familiar with the research until they hear about it from a patient.

Since glucosamine sulfate and other nutritional supplements are usually self-prescribed, he observes that there needs to be a shift in the medical profession’s willingness to accommodate the fact that nutritional supplements have therapeutic effects.

The most common treatments for osteoarthritis are analgesics and non-steroidal anti-inflammatory drugs, which can relieve symptoms for short periods of time, but leave the progression of the disease unaltered, or may even make it worse.

It appears that nutritional supplements, such as glucosamine sulfate, give similar relief of symptoms, and in addition, may delay the progression of the disease.

Reference:  The Lancet, January 26, 2001.

                Fish oil improves mental health

Research shows that fish oil omega-3 fatty acids may improve mood and mental health.  In a recent study published in the Archives of General Psychiatry, Andrew L. Stoll, M.D., a Harvard Medical School psychiatry professor, studied bipolar disorder patients to determine whether eating fish oil or olive oil in conjunction with regular medication stabilized the patients’ moods. 

After four months, patients eating fish oil showed a significantly longer period of remission from the disorder than those eating olive oil.  In a related study, schizophrenic patients hospitalized for relapse were given fish oil as their sole treatment for 12 weeks.  The oil decreased one-third of the patients’ symptoms enough that they postponed taking antipsychotic drugs until the trial was concluded.  Conducted by physicians at Oxford’s Cochrane Schizophrenia Group, the study was reviewed recently in the Cochrane Database System Review.

Though they’re unsure exactly how fish oil improves mood, researchers speculate that fatty acids like docosahexaenoic acid (DHA)—which aids in neural development—may help modulate overactive communication channels in the brain.

Reference:  Psychology Today, January/February 2001.

              A healthy start

Scientists recognize that specific polyunsaturated fatty acids (PFAs) are required for the development of a baby’s brain, nerves, heart, and eyes.  Furthermore, research has revealed that pregnant North American women do not get enough PFAs in their diet, even when they are not necessarily trying to limit fat intake.  Adopting a low fat diet without considering the kind of fatty acids eaten will likely not supply enough of the proper PFAs required for optimal fetal brain development.

During pregnancy and the first 12 to 18 weeks after birth are the most critical times for a woman to consume the essential fatty acids (EFAs) her body will ultimately convert into the PFAs her baby cannot yet make on its own.  EFAs are grouped into two families known as omega-6 and omega-3 fatty acids.

Fatty-acid nutrition is crucial to developing full cognitive and visual potential and deterring common conditions such as diabetes, cardiovascular disease, retinitis, poor night vision and dyslexia.  Seventy percent of the total number of brain cells are developed before a child is born.  During the period of the most rapid fetal and infant growth, which begins at conception and continues until roughly 18 weeks of age, the integral PFAs are the omega-3 DHA and the omega-6 arachidonic acid (AA).  These two fatty acids are integrated into fetal and central nervous system membranes, including brain, nerves, and retina.

Visual acuity also depends on DHA, which attaches to the outer layers of rod photoreceptors in the retina.  Even a marginal DHA deficiency can have long-term effects on visual development.

Dennis Hoffman, Ph.D., and colleagues from the Retina Foundation of the Southwest in Dallas, TX, have proposed DHA be added to infant formulas to improve visual acuity as well as cognitive function.

Overall, North American women are less able to provide adequate DHA levels during pregnancy and lactation, even compared to women from other countries.  Consequently North American-born babies stand a good chance of having sub optimal DHA levels.

David L. Hachey, M.D., from the Baylor College of Medicine in Waco, TX, reports that women with low DHA levels may suffer more obstetric complications.  A study revealed that supplementing pregnant women with fish oil, which supplies DHA, reduced this and other obstetric complications.  In addition, full-term babies born to the supplemented mothers were generally healthier and more likely to survive than their counterparts born to non-supplemented mothers.

Adding DHA to infant formulas, although instituted in 50 other countries and approved by the expert panel of the World Health Organization, has not yet been adopted in the U.S.

Reference:  Am J Clin Nutr 1993, 703S-10S.

                Omega-3 fatty acids for bone health

Recent research has indicated that the omega-3 polyun-saturated fatty acids linoleic acid and alpha-linolenic acid can help increase bone formation and reduce bone resorption.  The human skeleton is a highly active metabolic tissue, continually changing throughout life.

The process of bone modeling is associated with body growth in children, teenagers, and young adults, when 100% of their bone surface is active.

Bone remodeling is the process of bone growth associated with maintaining a fixed adult bone mass.  In remodeling, only about 20% of the bone surface is active.  Older bone tissue is destroyed and replaced by new bone tissue in a cyclical process.  In the case of osteoporosis, the basic problem is that resorption gets ahead of formation, resulting in a new bone loss.

A human study has specifically examined the effects of essential fatty acids supplementation on osteoporosis.  Forty elderly women with age-related osteoporosis were divided into four groups.  They received one of four treatments daily for 16 weeks:  4 grams evening primrose oil; 4 grams fish oil; 4 grams of a fish and evening primrose oil mixture; or 4 grams olive oil placebo.  The women took no other medications, supplements, or special foods.

In this study fish oil increased serum calcium, osteocalcin, and collagen.  Evening primrose oil alone had no significant effects, but the positive results from the fish oil group were also seen in the fish oil plus evening primrose oil group.  According to the research team, evening primrose oil may have potentiated the effects of fish oil.

Clinical depression in both women and men has been correlated with reduced bone density.  Clinical depression is known to be associated with strongly reduced levels of omega-3 fatty acid, and clinically depressed people have been found to respond to fish oil supplementation

A most recent study indicates that doses of 2 grams per day of fish oil, evening primrose, or black currant or borage oil are safe, and may enhance bone formation, especially when used on a long-term, preventive basis.

References:  Broadhurst, C.L., Sinther, M.  “Evening primrose oil:  pharmacological and clinical applications.”  Mazza, J.G., Ooma, G.D., editors.  Functional foods:  herbs, botanicals and teas, 2000, 213-64.