Friday, August 31, 2012

Meditation Techniques: I Do It My Way, You Do It Yours

After years of on-again, off-again experiments with meditation, I finally found a technique that works for me. Here's the best part: I sense it's having more of a positive impact on my well-being than anything else I've tried in years.

The great thing about meditation is -- anyone can do it... anywhere. It doesn't require special equipment, gym membership, or an advanced degree.

A week ago, I reported on an article in the current issue of Neurology Now that reviewed the latest scientific findings on the measurable, beneficial impact meditation can have on our brains ( According to Dr. Alexander Mauskop, director of the New York Headache Center and professor of neurology at the State University of New York: "Meditation is the simplest technique in the world, but that doesn't mean it's easy to do." The key, he says, is to approach it with curiosity and without judgement, accepting what is going on in the moment, including the fact that your mind keeps wandering.

Research hasn't identified any optimal duration for meditating; experts say even five to ten minutes a day can help.

Types of Meditation
There are many different types of meditation. Here are the most common:
  • Attention Meditation: Sit on a cushioned chair with your back straight and your hands in your lap. Then concentrate on something, like your breath or a burning candle. If your mind wanders, as it will, gently turn your attention back to your focal point. 
  • Mindfulness Meditation: In this form of meditation, the aim is to monitor your mind's experiences -- thoughts, feelings, perceptions, sensations -- and simply observe them as they arise and then just let them pass without trying to interact with them or change them. You want to maintain a non-judging, detached awareness... and become more in touch with your body, your life, and your surroundings.
  • Passage Meditation: This variety involves reciting a short passage (mantra, prayer, short poem) over and over again. A widely practiced example of this technique is Transcendental Meditation (TM), popularized in the 1960s and 70s. An estimated six million people have received TM training, including the Beatles, Howard Stern, Clint Eastwood and Oprah Winfrey. Passage meditation is easy for beginners since the verbal anchor reduces distracting thoughts. Another version is the "Relaxation Response," which is also the title of a bestselling book by Herbert Benson.
  • Vipassana Meditation: Vipassana means "insight." It concerns the ability to see things as they really are, a ability attained through self-observation. It involves identifying your own nature, recognizing bad elements and consciously eliminating them from the system.
  • Progressive Muscle Relaxation: This meditation form requires contracting and relaxing muscle groups.  Most practitioners start at the feet and work their way up to the face. You begin by relaxing for a few moments with deep breathing. Then, for example, you might start with your right foot; focus your attention on how it feels; then squeeze the muscles in the foot as tightly as possible and hold for a count of ten; then relax the foot, focusing on how it feels as the tension fades away. Relax for a few moments of deep breathing. Then move on to the left foot, followed by other muscle groups as you work your way up your body.
My Adaptation -- Personalized Meditation
I've dabbled in meditation for decades. I'd see an article or book by a meditation guru, and I'd take the plunge. Sooner or later -- usually sooner -- I'd give up, blaming myself for not being able to control my wandering mind.

Then six years ago, I experienced what I dubbed "The Summer from Hell" -- several months of panic attacks, depression and insomnia unlike anything I'd experienced before. I consulted several doctors and sleep specialists, a psychiatrist and even a hypnotist. The experts prescribed a half dozen different medications, and nothing worked. Then I stumbled upon a book, The Insomnia Solution, that recommended some meditation/relaxation exercises. I tried a few of them and -- finally! -- began to experience some relief..

In the past, I tried to rigidly follow someone else's technique. I tried my best -- for example -- to make use of Jon Kabat-Zinn's meditation instructions, but my "grasshopper mind" always skipped away somewhere. Lucky for me -- though it sounds hokey -- Insomnia Solution's  "secret handshake" meditation proved particularly helpful. I continued to use that particular exercise whenever I had trouble sleeping. For a description, photos and all:

Over a year ago, I decided to use that technique as the basis for a regular meditation time every night when I get up for a toilet visit. At first, it would take ten or 20 minutes. Now it's often an hour or more, and has become my favorite time of day.

My practice mixes mindfulness meditation and progressive relaxation. I usually toss in a few yoga-like exercises and some exercises recommended by my chiropractor. I detailed some of these techniques in a blog post last month. But my routine keeps changing.

My most troubling physical ailment these days is the lower back pain that started a year ago when I totaled my car and ended up with a fractured vertebra. It healed, but the pain continued and is now attributed to osteoarthritis. I've tried all the standard treaments -- physical therapy, steroid shots, medicated pain patches, acupuncture, even Reike. Nothing worked.

A month ago, I began working with a chiropractor, which seems to be helping. But I sense I'm beginning to get even more benefit from yet another change in my meditation routine. I now pay attention to the back pain and to messages I'm getting from other parts of my body.

For example, when I woke up at 4:30 this morning, the toes in both feet felt cramped. I've had this sensation before. So I spent some time during my meditation alternately clenching my toes for a count of ten in-and-out breaths, relaxing, and then spreading the toes as wide as possible for another count of ten. While doing this, I noticed a simultaneous tingling sensation from the pain center in my lower back.

I experience this same activation of the lower back pain center when I tense and relax the muscles in my right thigh (the pain center is on the left side). It also happens when I shift my neck slightly to the left and tilt my head upward, an exercise recommended by my chiropractor.

Another example of how meditation seems to ease the back pain happened last Saturday. When I woke up for my early morning bathroom visit, I experienced unusually sharp back pains and powerful fatigue. I almost opted for bagging the meditation, popping a pain pill, and returning to bed. But I decided to forge ahead with the meditation.  An hour later the pain was gone, and so was the fatigue. Then I went right back to sleep!

The way I have "personalized" my meditation practice seems related to the intriguing emerging field of  "personalized medicine," which may transform traditional medical care by basing treatment on our unique clinical, genetic, genomic, and environmental backgrounds. I want to dig deeper; stay tuned.

So I'm NOT urging anyone to adopt my meditation techniques. They're mine. Go develop your own!

Wednesday, August 29, 2012

Contrast These Two Speeches: Has America Lost its Dream?

In one of those strange co-incidences, I was clicking on links friends had posted on Facebook and ended up watching these two speeches in sequence.

America Today: No Longer the Greatest, Not Much of a Dream
OK. This isn't an authentic speech by an actual candidate for president. But oh, how I wish it were!

America 49 Years Ago: We Had A Dream I know this is an authentic speech, because I was there when Rev. Martin Luther King, Jr delivered it on August 28, 1963 at the Lincoln Memorial here in Washington. Despite all the tumult of those days -- assassinations, riots, unrest -- we had hope that we were making a better America. A hope that, for me, was briefly rekindled four years ago. But all too briefly.

Tuesday, August 28, 2012

Nine of the Most Popular Dietary Supplements: An Update

A pal who knows my interest in dietary supplements sent me a list he'd found of the top supplements recommended for men. I checked them out and will share the results below. (Most of them also would be on any list of the top supplements used by women.) But first....

Best Sources for Checking Out Dietary Supplements
Here are the first places I go when I have questions about dietary supplements. For an old guy, I'm pretty comfortable with online research, but I prefer reading from the page than from the computer screen. So I start with:
  • The Wellness Reports Dietary Supplements, 2012, published by the University of California, Berkeley, School of Public Health
  • The Mayo Clinic Book of Alternative Medicine
  • The Truth About Vitamins and Minerals, a Harvard Medical School Special Health Report
For online research, these are the sites I visit first:
If I want to dig deeper, I put the supplement name into Google's search box and add "" (which usually excludes most of the commercial sites selling the supplement, which often dominate search results). Sometimes I hit "advanced search" and check results from the past year.

Whatever I type, I certainly find more than I really need to know... just one more example of my life-long practice of Mae West's advice -- "anything worth doing is worth overdoing."

Update on 9 Popular Supplements
So, here's what I found about that list of recommended supplements for men. Fish oil was also on the list, but we covered that in yesterday's posting. The print reports listed above provided much of what follows; I simply identify them as "Berkeley," "Mayo," or "Harvard."

I hadn't heard of this supplement before, and none of my usual sources covered it. So I did a Google search and found this summary from a 2009 study:

Boron is an element found in foods such as peanut butter, wine, grapes and other fruits, like peaches. While some reports have associated lower prostate cancer risk with higher boron intake, a large study involving over 35,000 men could not validate that finding. So, there is no official recommendation to take boron supplements to reduce prostate cancer risk.

Some small studies over the years have suggested that calcium promotes weight control. But in a large, well-designed two-year clinical trial by NIH in 2009, findings showed that 1,500mg of calcium each day did not help control weight. In a German study of about 24,000 adults, researchers found that those who regularly took calcium supplements had an 86% higher risk of heart attack than those who didn't take the supplement.  Most authorities agree that it's better to get calcium from food than from pills. The recommendation is 1000mg of calcium a day, with an upper limit of 2000mg. Reminder: only 500mg can be absorbed at a time.

Clinical trials in the U.S. involving diabetics have so far produced no clear evidence of benefit from chromium supplements. A Dutch study found no benefit from chromium in protecting against diabetes. (A Chinese study of chromium supplements did show results, but we downplay the finding here because the Chinese aren't fat like us (yet!), and chromium levels weren't evaluated at the start of the study.)

There are many conflicting studies. Some early small studies had lots of us with Parkinson's taking very high doses at very high  prices, but a later large study found no benefit. While Mayo, Berkeley and others suggest "don't bother," I still take 200mg a day, since some studies report heart health and blood pressure benefits, and no dangerous side effects have been reported.

Berkeley: "There's no reason for most people to  take creatine. It may give some competitive athletes a small edge, but this is meaningless for recreational athletes and exercisers." Those with kidney problems should avoid it.

Folic acid
A British study showed a possible reduced dementia risk from taking large doses of B-12, B-6 and folic acid.  But another study found that the risk of prostate cancer doubled for men taking folic acid supplements of  1000mg a day.

Mayo: Many older studies showed promising results in relieving arthritis pain. But the results of a large NIH-sponsored trial were mostly negative. Only those with very severe arthritis appeared to benefit. But it has few side effects, and it might help. Berkeley: Forget about it "unless you are willing to pay $20 or more a month for what is probably a placebo."

Berkeley: "Eat foods rich in selenium, such as whole grains and nuts, but skip the supplements because of the inconsistent research results." If your diet provides the recommended daily allowance (RDA), additional selenium could be risky. If you do take a selenium supplement, take no more than 200mg a day. Mayo: Same. Selenium deficiency is rare, and mostly occurs with severe gastrointestinal problems. "Despite some earlier studies, recent research indicates that selenium does not significantly lower cancer or heart disease risk."

Vitamin E
Berkeley:  "There is little or no clinical research showing that vitamin E supplements are beneficial.... In fact, the evidence is growing stronger that vitamin E supplements might actually be harmful." Mayo and Harvard agree.

Bottom Line: Get Nutrition from Diet, Not Supplements
Most sources agree: we should obtain our vitamins and minerals from food, not supplements. But NIH cautions that we might need supplements in these situations:

·        Over age 50: Tougher as we age to get enough B-12, calcium and vitamin D
·        Post-menopausal women: May need calcium and vitamin D supplements
·        Dark-skinned, or getting less than 15 minutes of sun exposure daily: May need extra vitamin D
·        So frail and elderly that they can't eat sufficient amounts of food
·        Those with nutritional deficiencies from restricted diets: Vegans, people undergoing weight-loss surgery
·        Suffering from a medical condition: Some illnesses like cancer, anemia, and celiac disease cause nutritional deficiencies that may require supplements
·        Undergoing medical treatment:  Some medicines, such as cancer drugs and proton pump inhibitors, can interfere with nutrient absorption

Monday, August 27, 2012

Dietary Supplements: Vitamin D and Fish Oil

What dietary supplements -- if any -- should we take? Here's an update with recent findings on two of the most popular: vitamin D and fish oil. I'll cover others tomorrow.

DHA Supplements vs. Vitamins D and B12 for Brain Health
When you hear about DHA, fish oil, or omega-3 fatty acids, it's basically the same thing when it comes to supplements. "Fish oils" is the umbrella term. These oils include the Omega 3 fatty acids EPA and DHA.

In a recent report, Johns Hopkins Medicine noted that vitamin D, vitamin B12, and omega-3 fatty acids have been studied for their potential brain-fortifying results... with mixed results. Of the three, docosahexaenoic acid (DHA) -- an omega-3 fatty acid found in fish oil -- seems to hold the most promise, according to the report:
While a study in the Journal of the American Medical Association found that fish-oil supplements do not slow the progression of Alzheimer's disease once it has begun, another placebo-controlled study published in Alzheimer's and Dementia found that 900mg of DHA per day, taken for 24 weeks, helped improve memory and brain function in people over age 55 with mild cognitive impairment. This suggests that to help the brain, these supplements should be started early, before a mental decline progresses too much.
I searched the Mayo Clinic's "Drugs and Supplements" site for DHA and found a report confirming the possible benefits of DHA for brain health:
Research has linked certain types of omega-3s to a reduced risk of heart disease, stroke, dementia and cognitive decline. The Food and Drug Administration (FDA) permits supplements and foods to display labels with "a qualified health claim" for two omega-3s called docosahexaenoic acid (DHA) and elecosapentaenoic acid (EPA). The FDA recommends taking no more than a combined total of 3 grams of DHA or EPA a day with no more than 2 grams from supplements.
The Mayo Clinic notes that preliminary evidence shows that omega-3s may help reduce symptoms of depression. "It's thought this is because it's an essential nutrient for brain function."

Both EPA and DHA are found in fatty fish (such as salmon, sardines, herring), and it's often recommended that we eat at least two servings of fatty fish each week.

Another recent study found that omega-3 fatty acid supplements can lower inflammation in healthy, but overweight, middle-aged older adults. (There are millions of us!) Chronic inflammation is linked to numerous conditions, including coronary heart disease, type 2 diabetes, arthritis, and Alzheimer's... and to the frailty and functional decline that accompany aging.

That did it! Fish-oil supplements for me. Fortunately, I like fatty fish and eat a can of sardines or a helping of grocery store marinated herring for lunch at least twice a week.

"The Benefits of Vitamin D"
That's the title of a special report from the School of Public Health at the University of California, Berkeley.

The editors of the report note that a major debate has been going on about the potential health benefits of Vitamin D supplements. On one side are researchers who for years have been advocating higher intakes and blood levels of vitamin D. On the other side are those who fear that the vitamin D bandwagon has gotten too far ahead of the research. This group fears a crash, as happened to the bandwagon for antioxidant supplements, when long-awaited clinical trials failed to find benefit and sometimes even suggestred harm.

Here's the official Institute of Medicine recommendation for daily intakes of Vitamin D -- whether from sun, food or supplements:
  • 400 IU for infants up to one year of age
  • 600 IU for everyone up to the age of 70
  • 800 IU for those over 70.
The Berkeley report identifies these groups as "at risk" for vitamin D deficiency:
  • Breastfed infants
  • Pregnant and breastfeeding women
  • People over 50
  • Dark-skinned people
  • People who spend nearly all of their time indoors, especially those who are housebound or institutionalized
  • People living in northern latitudes
  • Obese people
  • People taking certain drugs, such as anti-convulsants or HIV medications
  • Anyone with a chronic condition that interferes with the body's ability to absorb fat, such as Crohn's disease
The bottom line: The Berkeley report confirms vitamin D's role in bone health, but indicates continuing uncertainty about claims that vitamin D might prevent, treat, or delay a wide variety of other conditions.

For example, it has been suggested that high vitamin D levels might help protect against Parkinson's disease. But there's no evidence now that the supplement might improve symptoms or slow progression for those of us who already have the disease.  

"What's needed are large, long-term, well-designed clinical trials on vitamin D," the report says. That's a refrain we hear all the time when it comes to supplements, and one that is less likely to be answered when Big Pharma has little interest in studying low-cost supplements, and when hospitals, universities, and other medical facilities are seeing their funding dry up.

Vitamin D testing:  It's still too soon to recommend vitamin D testing for everyone, the report says.  But it does suggest talking to your doctor about a vitamin D test if you are in any of the risk groups listed above. 

Without my raising the issue, my internist scheduled a vitamin D test as  part of the blood work at my annual physical in April and, based on the results, recommended that I take a 1000mg vitamin D supplement every day. I've found a supplement that combines 1000mg of vitamin D with 1200 mg of fish oils, of which 360mg are the EPA and DHA omega-3 fatty acid oils.

If you are not tested, the reports suggests these three options:
  1. Follow the IOM's recommendation, which suggests that most people don't need to worry about vitamin D. This option is especially appropriate if you want to be cautious, don't like to take supplements, get some sun (but not too much) and  consume a lot of vitamin D fortified milk, cereals and other food products.
  2. If you are at elevated risk for vitamin D deficiency (see above list) and want to be more proactive, you might want t follow the advice of experts who suggest higher intakes (1,000 to 2,000 IU a day) to achieve blood levels of at least 30ng/ml, since there little risk of harm, and the possibility of benefits.
  3. A sensible middle ground would be to take 800 to 1,000 IU a day plus modest amounts of sun exposure.
That's a summary of the latest research findings and recommendations for vitamin D and fish oils. Tomorrow I'll recap the current thinking on some of the other most popular supplements.

Friday, August 24, 2012

Want A Bigger, Better Brain? Meditate!

Millions of people around the world claim that meditation has transformed their lives. But for centuries, only anecdotal evidence was available to back up those claims. Now, scientific support is emerging from well-designed studies which include brain scans. Some research suggests that meditating as little as 20 minutes a day can affect the function and structure of the brain in a positive way. Meditation increases attention span and focus, improves memory, and dulls the perception of pain.

Having spent an hour meditating this morning, I'm hoping the researchers are right. But my family and friends might argue that I 'm proof that meditating DOESN'T do much good for the brain. I admit: this meditator won't win any prizes for attention span or memory.

But let's get back to the bigger picture. During the past 20 years, scientists have shown great interest in studying how and why meditation works. The findings of this research are summarized in the current issue of Neurology Now.

Your Brain on Meditation: Good New for Us Seniors
This surge in research is a result of neurologists' discovery that meditation produces measurable changes in the brain. For example, in a 2011 study, researchers found that people who participated in an eight-week mindfulness meditation program experienced increased density in brain regions associated with memory, sense of self-worth, empathy, and response to stress.

In a 2006 study that I particularly liked, researchers at Harvard, Yale, and MIT found that experienced meditators grew bigger brains than non-meditators. In at least one area of gray matter, the thickening was more pronounced in senior meditators than in younger ones!

The Neurology Now article confirms this finding. Leading neurology researcher and author Alexander Mauskop says:
When researchers compared the brains of normal aging adults and same-age serious meditators, they found that the brains of the meditators did not shrink. What we accept as a normal process -- the shrinking of the brain as you get older -- may not be necessarily normal.
All That Self-Talk Chatter: Give It A Rest!
Recently, meditation researchers have investigated how meditation impacts what they call the brain's default mode network (DMN), which includes the self-talk chatter that's always in the background as we go about our day... the thoughts that mostly focus on the past and the future: "Why did I say something that stupid?" or "I have so much work to do this week" or "This pain will only get worse!"

A recent study comparing the DMN brain areas of meditators and non-meditators found signs suggesting that meditating on a regular basis enhances the ability to limit negative self-talk, like dwelling on past mistakes or imagining future problems. The meditators more successfully stayed in "the now."

"Shutting your brain off for portions of the day -- for example, through meditation -- may be a very healthy activity for your brain over the long term," Dr. Mauskop says.

Pain and the Meditating Brain
Several studies confirm that regular meditators experience less pain than non-meditators. A 2011 study reported in the Journal of Neuroscience found that newbie meditators showed a 40 percent reduction in pain intensity and a 57 percent reduction in pain unpleasantness after just a few short sessions of mindfulness meditation training. These pain-reduction percentages put meditation ahead of morphine, which typically reduces pain by about 25 percent.

Rather than engaging in the fight-or-flight response of the sympathetic nervous system in anticipation of pain, meditators can learn to accept the sensation of pain. Once they do, pain no longer grips their minds. It becomes another experience that comes and goes.

The findings in these recent studies will come as no surprise to Jon Kabat-Zinn, whose books -- particularly Wherever You Go, There You Are -- have made him my meditation guru. He founded the Stress Reduction Program at the University of Massachusetts in 1979. Over 19,000 people have taken the eight-week course, which utilizes mindfulness meditation. Most participants report experiencing a significant reduction in pain and stress as a result of the program. The clinic was featured in the 1993 PBS series Healing and the Mind with Bill Moyers.
After reporting on the research, the Neurology Now article answers the "how to" questions about meditation. I'll cover that territory next week.

Wednesday, August 22, 2012

Nine Low-Cost Things -- New & Old -- that Keep Me Healthy & Happy

My original plan: escape the swamp called Washington, D.C. this month. I was considering Maine and Nova Scotia, but by the time I got around to making plans, I found that others had already filled up the places where I wanted to stay. So, finding no rooms at the inns, I stayed home and watched the temperature soar above 100, day after day.

To restore my spirits, I made a list of the low-cost things, some newly discovered, that keep me happy and healthy regardless of the weather. Here are the top nine.

Let's start at the bottom (pun intended) and work our way up.

9. The "Blue Bidet"

Having spent a lot of time in Southeast Asia this past decade, I've discovered that water is better than paper when it comes to toilet hygiene. Earlier this year, I saw a recommendation for the Blue Bidet, which is a simple, relatively cheap ($60) attachment for our standard toilets. I tried it out on one toilet and really liked it. Now it's also installed on the other two.

8. Disco and Marching Band CDs for My Office

I spend a lot of time (make that "too much time") on the computer. It isn't good to plant our duffs in chairs for hours at a time, as I do; we need to get up and move around periodically. So, I keep a kitchen timer by my PC that's set to ring after 25 minutes. But I often forget to set it, or it goes off when I'm in the middle of something engrossing and I ignore it. A few months ago, I reviewed my old CDs and found Barry White, Diana Ross, and a compilation of "favorite marches." I play these CDs while I'm working, and --even without the timer ringing -- I get up, and start marching... or what passes for dancing with me.

7.  Serenity CDs for Bedtime

In my search for relief from lower back pain, I tried Reiki with its laying on of healing hands. It was relaxing but didn't do much for my back, so I stopped. But I really liked the background music that played during my sessions. So I bought two of the CDs: "The Silent Path" by Robert Haig Coxon and "Oriental Sunrise" by Riley Lee. I enjoy listening to this music at bedtime, naptime, and sometimes when meditating.

6.  Leonard Cohen's "Live in London" CD

Why did it take me until age 83 to discover singer/songwriter/novelist/poet Leonard Cohen? When I was researching a post about the final days of Dudley Clendinen, I read that he enjoyed the two CDs from Cohen's live concert in London. So... one click at Amazon, and the album was on its way. I like playing it in the car. His lyrics command attention, so it doesn't work for me to play this music while I'm reading or working at the computer. So I enjoy Cohen in the car. And, yes, I still pay careful attention to my driving.

5. My New Ninja Blender 

I most definitely am not a cook. But, given my age and ailments, I want to maintain a healthful diet. Eating lots of fruits and vegetables is a frequent nutrition recommendation. In my research, I often find items touted as particularly beneficial. Lately, for example, I've seen recommendations for beet juice, tart cherry juice, kale, and tomatoes. If I were a cook, I'd go online and find recipes for these items. But I'm not. The blender, which I bought a month ago at the recommendation of a friend, is the perfect solution. Almost every day, I use it to make a fruit or vegetable semi-smoothie and toss in some of these ingredients. Today, I went through the refrigerator and pulled out all the little containers of left-over veggies that were stashed away, threw the contents into the blender with some concord grape juice (another frequent recommendation) and... presto! Enough veggie smoothie to serve as a healthy accompaniment for several meals.

4. My Curcumin Pills

Several recent posts here have concerned the studies about possible benefits of curcumin (the active ingredient in the Indian curry spice turmeric) for treating many ailments, including three I have -- Parkinson's disease, cancer, and arthritis -- and one I fear -- Alzheimer's. More clinical studies are needed to confirm the promising early results, which could take years. Since I'm running out of years, I decided to start taking the BCM-95 variety of curcumin found best able to be absorbed by the body. My choice: Life Extension's "Super-Bio Curcumin," 400mg. It's recommended that this supplement be taken with meals, so the bottle pictured above sits on my kitchen counter, reminding me at mealtime. There's no good way of telling whether it's doing anything for my PD or cancer, but I sense it's helping relieve the arthritic pain. As soon as I started taking it, I felt more energetic. And my libido has shown signs of resurrection.

3. My Meditation Chair

I'm convinced. Nothing has recently done more to enhance the quality of my life than meditation. I could continue at great length on this subject, but I'll save details for later. For now, envision the pictured meditation chair at 5am, about the time I get up for a bathroom visit (don't envision THAT). I come down to the porch. Meditating for 30 to 60 minutes, I listen to the waterfall in my back yard pond accompanied by a chorus of crickets and watch the dawn come up. As close to heaven as I'll ever get!!

2. Playing Bridge with Old Friends

Family and friends usually top the list when seniors are asked what's important for their quality of life. Playing bridge with friends is one of the more enjoyable pastimes in my life these days, particularly when it brings together old friends. Here I am, playing with Vola and Marty. All three of us lived in rental units in a Georgetown house at 31st and Q Streets in 1956. Here we are, reunited at the bridge table 56 years later. (In 1956, we'd be holding beers or martinis in my case... not cards.) The  photo was taken by my good pal Daniel, whom I've known for about 20 years. The four of us play a couple times a month.

1. Celebrating a Birthday with my New Housemate

I met Nimesh at his dad's bookstore in Kathmandu about ten years ago. He came to the U.S on a student visa nine years ago and has lived at my house for the past few years while he got his masters at nearby American University. Now he works at the World Bank. I've only known Bhawana since March, when I returned to Nepal for her marriage to Nimesh. Now, I have double the pleasure of Nepali housemates.

So, even in Washington's worst summer ever, life is pretty damn good.

Monday, August 20, 2012

Coconut Oil May Not Cure Alzheimer's, But It Has Other Uses

In my earlier posting on the many health claims for coconut oil, I highlighted the lack of scientific evidence for some of those assertions, particularly those pertaining to Alzheimer's. So, are you surprised that I frequently throw a spoonful of coconut oil in the blender with my fruit or veggie smoothie... or that I may try coconut oil as a skin moisturizer and hair conditioner? More about that in a minute.

First, I want to acknowledge that some studies appear to support claims that coconut oil can help control weight and cholesterol levels. On closer examination, it seems more than a coincidence that most of those studies come from coconut-exporting Asian countries. Still, the chemical makeup of coconut oil provides a basis for these claims, so let's take a closer look.

How Does Coconut Oil Differ from Other Oils?
One of the best answers I've found to that question appeared in the June, 2012 issue of the Nutrition Action Health Letter published by the Center for Science in the Public Interest. Here's a summary:

A whopping 92 percent of coconut oil's fat is saturated. That makes it far more saturated than most other fats. Olive and soybean oils, for example, are about 15 percent saturated, while beef fat is about 50 percent saturated and butter, 63 percent. Only palm kernel oil -- 82 percent -- rivals coconut oil. All those saturated chemical bonds explain why coconut oil is solid at room temperature and doesn't spoil quickly -- like the bacon fat your mother kept under the sink in an old coffee can.

Coconut oil is also unusual because it contains a high percentage of medium-chain triglycerides, or MCTs. Most oils consist entirely of long-chain triglycerides --LCTs -- which are more than 12 carbons long. Soybean oil, for example, is 100 percent LCTs. Medium-chain triglycerides are 6 to 12 carbons long. Coconut oil contains roughly 40 percent LCTs and 60 percent MCTs.

"The difference matters because our bodies metabolize MCTs differently than LCTs. MCTs are transported directly from the intestines to the liver, where they're likely to be directly burned off as fuel and raise the metabolic rate slightly," explains researcher Marie-Pierre St-Onge of Columbia University. That means less is available to be circulated throughout the body and deposited in fat tissues.

So, if you use coconut oil instead of other oils, will those extra pounds melt away?

Coconut and Weight Loss
The evidence behind the weight loss claims for coconut oil are pretty thin, St-Onge says.

"People may be attributing to coconut oil the results from studies of MCT oil," St-Onge explains. She conducted her own clinical studies on MCT oil. Over the four months of her largest and longest study, those using MCT oil lost four pounds more than those using olive oil.

St-Onge's bottom line: "The effect of MCT oil on weight loss is modest." Since coconut oil contains only about half as much medium-chain triglycerides as MCT oil, would coconut oil have just half of that "modest" impact on weight? The studies haven't been done.

Coconut Oil and Cholesterol
Studies have shown that coconut oil increases both good and bad cholesterol. We know bad cholesterol increases the risk for heart disease, but it isn't clear if increasing good cholesterol at the same time will mitigate that risk.

Many major organizations, such as the World Health Organization and the American Heart Association, still recommend against using significant amounts of coconut oil. The science-based Natural Medicines Comprehensive Database indicates there's insufficient evidence on the effectiveness of coconut oil for heart health and other medical conditions.

This month's issue of Mayo Clinic's Health Letter advises that fish oil is a better bet than coconut oil:
Limited research suggests that eating higher amounts of coconut oil may be associated with increased levels of high-density lipoprotein (HDL) cholesterol -- the "good" cholesterol. However... reliable scientific evidence on its use to treat cholesterol so far isn't conclusive. 
In terms of oil supplements that may influence HDL, there's better evidence for fish oil.
Now, the positive scoop on coconut oil.

Using Coconut Oil in the Kitchen
If you go on the internet, you'll find hundreds of sites listing ways to use coconut oil in the kitchen. I've picked just one -- Melissa Clark's "Good Appetite" column in The New York Times. Here's what she has to say: "Non-hydrogenated, virgin coconut oil -- the pure stuff actually squeezed from coconuts -- is not as bad for you as we were led to believe.” She makes a distinction between "good" and "bad" fats. Virgin unprocessed coconut oil is viewed as a "good fat." It contains lauric acid, which has not been shown to carry a risk of heart disease, unlike the "bad fats" Clark cautions:
Of course, you can go to the Internet and type in lauric acid, and it starts to tell you that it's good for everything. It's good for acne.... It's going to cure the common cold. It's going to help you lose weight. None of those things are proven at all.
Coconut oil has some proven results in the kitchen, however. "It cooks food beautifully because it can withstand pretty high temperatures," Clark says. It doesn't impart a bitter flavor like other cooking oils. "It gives just a real gentle sweetness to foods."

But because of that slight sweetness, coconut oil isn't a full-scale replacement for standard cooking oils. Clark recommends using it for sautéing things like chicken or vegetables. She's particularly enthusiastic about using it to cook sweet potatoes.

A warning:   Coconut oil contains almost 120 calories in 1 tbsp, nearly 14 g. of fat and no fiber.

Using Coconut Oil Outside the Kitchen
Google shows almost as many recommendations for coconut oil outside the kitchen. Here's just a few:
  • Used as an over-all body moisturizer, it's readily absorbed and great for rough or dry skin
  • Great as a hair conditioner
  • Spreading a little around the eyes helps prevent wrinkles
  • Can be used to remove eye makeup
  • Helps sooth skin irritations, mosquito bites, shingles, etc.
And the list goes on... and on... and on. For example, see 122 Uses for Coconut Oil and 160 Uses for Coconut Oil. Life's barely long enough to try 'em all!

Friday, August 17, 2012

Meditation: A Loneliness Remedy for the Elderly

A few days ago while talking about the best place to die, I observed that most of us would like to keep living in our own homes right to the end. But the loneliness that comes when spouses, friends, and neighbors die -- and when children scatter -- is often a big problem for seniors.

Loneliness has been linked to increased risk of heart disease, Alzheimer's disease, depression, and even premature death. Moreover, loneliness is associated with increased activity of inflammation genes that can promote a variety of diseases. Previous treatment efforts have yielded little success.

But now researchers at UCLA have found that mindfulness meditation can help reduce the feelings of loneliness, and significantly reduce expression of the inflammatory genes.

The findings, featured in a recent online edition of the journal Brain, Behavior and Immunity, showed that the two-month program of mindfulness-based stress reduction (MBSR) helped decrease emotions related to loneliness. In the program, participants learned how to train their minds to be attentive to the present, and to limit thoughts of the past or the future.

“Our work presents the first evidence showing that a psychological intervention that decreases loneliness also reduces pro-inflammatory gene expression,” explained senior study author Steve Cole, UCLA professor of medicine and psychiatry, and member of the Norman Cousins Center for Psychoneuroimmunology. “If this is borne out by further research, MBSR could be a valuable tool to improve the quality of life for many elderly.”

Meditation and Inflammation Genes
The researchers also believe that MBSR can change the genes and protein markers of inflammation, like the genes regulated by the transcription factor NF-kB, and the inflammatory marker C-reactive protein (CRP). In particular, CRP is a dangerous risk factor for heart disease, and NF-kB is a molecular signal that can cause inflammation. We know that inflammation is a natural part of the immune system that helps defend against infections and injuries. But chronic inflammation can lead to a variety of diseases and psychological disorders.

I found this point of particular interest. Fortunately, loneliness is not an issue for me. But my most troublesome health ailment now is the low back pain attributed to osteoarthritis, which is associated with inflammation.

In the project, 40 adults, aged 55 to 85, were randomly placed in a mindfulness mediation group or a control group that did not involve meditation. All the subjects were examined at the beginning and end of the study to create a loneliness scale. Researchers also collected blood samples both times to track gene expression and inflammation levels.

Based on the study, MBSR participants self-reported lowered feelings of loneliness, and their blood tests confirmed a reduction in the expression of genes associated with inflammation.

Tai Chi and Yoga Also Can Help
“While this was a small sample, the results were very encouraging,” remarked Dr. Michael Irwin, professor of psychiatry at the Semel Institute for Neuroscience and Brain Behavior, and director of the Cousins Center. “It adds to a growing body of research that is showing the positive benefits of a variety of meditative techniques, including tai chi and yoga."

Just last month, for example, Dr. Helen Lavretsky, a UCLA professor of psychiatry and Cousins Center member, published a study showing that a form of yogic meditation involving chanting also reduced inflammatory gene expression -- and stress levels -- among individuals who care for patients with Alzheimer's disease.

"These studies begin to move us beyond simply connecting the mind and genome, and identify simple practices that an individual can harness to improve human health," Irwin said.

Thursday, August 16, 2012

Alzheimer’s, Parkinson’s, and an Interview with Ted Dawson

This past Monday, I wrote about the exciting new trial underway involving an extended family in Colombia, South America. Many of them carry a genetic mutation that will cause early onset Alzheimer’s disease (AD) when they’re in their mid 40s. Researchers know in advance which family members carry the mutation, and their aim is to use a new drug therapy to PREVENT the disease before its devastating symptoms – to date irreversible – even begin. Yes, a new paradigm.

Today, I read an interview with Ted Dawson -- Professor of neurodegenerative diseases and Director of the Institute for Cell Engineering at the Johns Hopkins University School of Medicine -- in which he essentially said the same thing about his recent Parkinson’s disease (PD) research: “…for disease modifying therapy, we are treating patients too late. We really need to treat patients earlier.”

Since AD and PD are both neurodegenerative conditions, it’s not surprising that researchers occasionally travel along the same track… in this case trying to identify likely sufferers sooner in order to begin therapy – hopefully PREVENTIVE therapy – earlier. Once either disease appears, the most we can do – at this time, anyway – is treat the symptoms. Still, I am lucky we’ve come that far.

Of course, different challenges confront scientists working on the two diseases. So far, researchers seem to have a better chance of identifying healthy, but disease-prone candidates for Alzheimer’s studies -- at least in the condition’s early-onset variety -- than for PD. Those afflicted Colombian family members all carry the presenil 1 mutation, which researchers can identify in advance. If there’s a similar, scientific way to tag PD candidates long before symptoms appear, I’m not aware of it. Writes Dawson, “Despite genetic advances in our understanding of PD, it is primarily considered a sporadic disorder with no known cause. “

There’s another difference between the Colombian AD study and Dawson’s recent PD work. In that first case, study participants will receive the drug crenezumab, which researchers hope will prevent the accumulation of amyloid plaques. Dawson’s work involves drug therapy, but also includes induced pluripotent stem (IPS) cells, “teased” from skin cells. I’ve written about that particular technology before.

The brief interview with Dawson about his work with Parkinson’s is very interesting.

Wednesday, August 15, 2012

Best Place and Best Way To Die: My Secret Strategy

Most of us oldsters would prefer to stay at home until we're carted off. The ideal scenario: do this surrounded by loving, caring family and friends. But all too often, this set-up isn't possible. (I've found a way that I think may work, which I'll get to shortly.)

In our mobile society, family members are usually scattered all over the world. Even if they aren't (and I'm one of the fortunate few with all my family still in the area), our kids and grandkids are having a hard enough time struggling with the lousy economic hand we've dealt them (I'll have more to say about THAT in another post). Most of us don't want to make their lives more difficult by burdening them with caring for us.

I was surprised to read in the Washington Post this morning that only four percent of the 65-plus population go to nursing homes. Of course, many more go to senior residences or move in with relatives. Most of us try to remain at home. The article in the Post, titled "Aging in Place," was based on an interview with Henry Cisneros, the four-term mayor of San Antonio and former secretary of the Department of Housing and Urban Development. He is co-editor of a new book, Independent for Life: Homes and Neighborhoods for an Aging America," a collection of papers authored by more than a dozen experts in aging and housing.

At the start of the interview, Cisneros talks about his elderly mother, whom he calls a "classic case of a person aging in place," still living in the home his parents bought in 1945 in a lower-middle-class San Antonio neighborhood. "I don't think there's a tractor strong enough to pull her from that house," Cisneros says.

Home Alone Is Not Easy
Based on his mother's experience, Cisneros gives this description of the problems associated with "aging in place":
Seniors fear being unable to communicate, being lonely, feeling insecure. Especially people who all their lives have had other people around them -- family, neighbors -- and now they go entire days and never see anybody.
Imagine being older, a step slower, a bit more fragile. Add to that being lonely, edging to depression and unsure about how you're going to get everything done that you used to do. But wanting above all to stay in your own home and keep on being independent. That's hard.
This description sums up why many seniors -- as much as they want to stay at home -- end up deciding to move in with relatives or into a senior residence, often under pressure from concerned family members.

My Now Not-So-Secret Strategy
One option to deal with seniors' living-alone issues described so well by Cisneros is to hire home care workers. But many elderly people are reluctant to have strangers in their houses. Home care can be very expensive, too, particularly if it's around-the-clock.

So, what's my secret strategy? Truth be told, it wasn't planned. It just emerged, a happy accident. Here's what I suggest, based on my experience:
  • In your late 60s and 70s, while you're in good health, pick a country you like in the developing world. It should be one where many young people want to come to the U.S. to study or work.
  • Start visiting that country each year, ideally a couple times a year. Perhaps a trip in the spring and another in the fall.
  • Make friends with the locals and become more than a tourist.
  • Help the most promising of your new friends get their student visas or green cards.
  • When they get to the U.S., give them as much advice and support as possible.
  • If they find jobs or schools in your area, offer to let them stay at your house for as long as they want.
Let's assume you've been able to do all of the above when you appear to be strong and independent. Then, when (as in my case) you learn you have Parkinson's or some other progressively debilitating disease, your resident is probably going to feel compelled to continue keeping you company and helping around the house -- from love, economic necessity, or guilt. Love would be best.

This development may require spending some money adapting your house to changing circumstances, e.g., your resident decides to go home, get married, and bring his bride back here with him. But it's so worth it, particularly if you end up with two care-givers whom you love having around.

My friends and family know that this "secret strategy" just sort of happened. There was no plan. Once again, so often the case in my life, serendipity blessed me. My many trips to Nepal -- and all the friendships I formed there -- have enriched my life immeasurably this past decade. Many of my Nepali friends have emigrated to America. I described in an earlier post my good fortune to be surrounded by three families -- my Schappi family, my Kathmandu family, and my Pokhara family.

While my situation is unique, I would urge any senior who has his or her own home to consider ways of sharing it with young people. My next door neighbor takes in young German interns who come here to work or study several months at a time. Another neighbor employed two young men, one from Nepal, the other from the Philippines, to help care for her husband during his final years with Parkinson's. After his death, the Filipino continued working for her, and he and his young family have become a second family for her.

There are ways to deal with the "home alone" issues described by Cisneros. Opening your house to young people is a great option. 

Tuesday, August 14, 2012

Alzheimer's Prevention: Can a Mutation-Afflicted Extended Family in Colombia Show the Way?

Two years ago, as this blog was getting started, I saw an article by Pam Belluck in the New York Times that captured my imagination. It told the story of an extended family – 5,000 strong -- in Colombia, South America… a family in which many members developed early-onset Alzheimer’s disease. The article began this way:
At frighteningly young ages, in their 40s, four of Laura Cuartas’s children began forgetting and falling apart, assaulted by what people here have long called La Bobera, the foolishness. It is a condition attributed, in hushed rumors, to everything from touching a mysterious tree to the revenge of a wronged priest.
Since all our efforts so far to treat Alzheimer’s -- in people already suffering from the disease – had pretty much come to naught, it seemed like a goldmine for scientists to find this family group plagued by an inherited genetic mutation that caused the debilitating dementia by middle age. Could researchers tap this troubled gene pool and figure a way to PREVENT the disease altogether, in a population known in advance to be acutely susceptible? The possibilities seemed fascinating, and encouraging.

Last fall, the New York Times updated its story. The new, large, and novel study to assess the possibility of preventing the disease was underway. Family members had begun travelling from their homes around Medellin, Colombia, to the Banner Alzheimer’s Institute in Phoenix, AZ, for PET scans to determine the presence of amyloid plaques, those tell-tale protein accumulations that typically accompany AD, and are thought to play a causative role.

The Mutation Target: Prdsenilin 1
If science could prevent Alzheimer’s before it began ravaging the brain, then this extended family group – all with the very same rare genetic mutation, presenilin 1, which triggers the early onset -- provided the perfect unit for investigation. Researchers knew AD would strike this group, and the subjects – before their genetic mutations kicked in – gave the scientists relatively healthy, young, undamaged brains to study. If plaques indeed caused AD, and if researchers could create and administer a drug to prevent their accumulation in the brain, medicine might take a giant step forward.

Study partners from the National Institutes of Health, biotech giant Genentech, and the Banner Alzheimer’s Institute created their methodology. About 100 people who carry the presenilin 1 mutation would receive the drug therapy. About 100 mutation carriers would receive a placebo. And about 100 non-carriers would also receive the placebo. Most participants have chosen not to know their mutation status, a fact that helps keep results "clean." The study also includes a small group of Americans whose families have shown a predisposition toward AD.

The Attack Drug: Crenezumab
A final piece in the study was selecting the drug therapy. Scientists decided to use crenezumab, described on the Genentech site as a “humanized monoclonal antibody… designed to bind to amyloid beta (Abeta), the main constituent of amyloid plaque in the brains of patients with Alzheimer’s disease.” Quite simply, the drug is designed to prevent the plaques from forming in the brain.

I’m excited to learn the outcome of this study, one of the most interesting I’ve encountered in my research. It shifts the current paradigm from reversing the symptoms of Alzheimer’s in people already afflicted to preventing the disease in healthy people likely to develop the dementia. And the study – if all the pieces fall into place – might just prove once and for all the role played by amyloid plaques in the development of the disease.

Don't hold your breath. It's a five-year trial, so we won't have results anytime soon. The $100M study was funded by NIH, the Banner Alzheimer's Institute, and Genentech -- which holds the license to crenezumab, and is poised to profit enormously if the study plays out in a positive way. Given the potential magnitude of the study’s outcome, Genentech has announced it plans to share all its findings, hoping that transparency will lead to additional research, and perhaps therapies, down the road. 

If you’d like to learn more about this trial – and see a series of brief videos featuring Genentech EVP Richard Scheller – check this page from Genentech's site.

Monday, August 13, 2012

Coconut Oil vs Curcumin as Remedies for Alzheimer's and other Ailments -- Part 2

In my last post I took a look at the health benefit claims being made for coconut oil. In this post I'll do the same for curcumin. I'll start by repeating the introduction to the last post:

The two things that have surprised me the most this year in my blogging and health-related research are:
  • The coconut oil craze. I first became aware of this in February when I put up my first post about the  reports I'd seen touting coconut oil as a remedy for Alzheimer's. That post took off like a skyrocket in terms of the hits it got and it kept on going. It has attracted five times as much traffic as any other post I've  published. Yet all the research I've done on coconut oil has yet to turn up a valid study to substantiate the claims made for it.
  • Curcumin -- the "unsung hero." Curcumin is the active ingredient in turmeric, the curry spice that Indians call the "holy powder." I had never heard anything about curcumin until I began researching dietary supplements, and I was startled to find it has been the subject of over 500 scientific studies, almost all of which verify its potential for treating not just Alzheimer's but also other neurological disorders like Parkinson's and MS, as well as cancer, diabetes, arthritis, cardiovascular disease, depression... and the list goes on.
The contrast between the much-hyped coconut oil and the little-known curcumin says a lot about how we let ourselves get seduced by internet hype, YouTube videos, anecdotal stories of miracle drugs, and our reluctance to check the validity of the claims.

Curcumin is the only botanical whose clear efficacy has been demonstrated by science. Almost 5,000 peer-reviewed studies now exist to support curcumin's beneficial effects. Most of the studies were small and many of them were done with mice and rats, not humans. There's no question: we need more large-scale, peer-reviewed, clinical studies involving people, and a number of them are now underway.

Curcumin has powerful antioxidant properties, which means it can fight inflammation. Many diseases are accompanied by inflammation and, according to some research, prompted by it. Curcumin also appears to combat ongoing cellular damage. These dual attributes -- combating both inflammation and cellular damage -- could affect virtually all the body's tissues, including the brain. What's especially exciting to me (and millions of others) is curcumin's potential to fight Alzheimer's, Parkinson's, and other neurological disorders that are known to be related to inflammation.

One of the newer theories about cancer is that it is linked to inflammation in the body: if you reduce inflammation, you reduce cancer risk. Recent studies have suggested that the anti-inflammatory properties of curcumin helps protect the cells in the pancreas that create insulin, making it more effective in preventing the onset of type 2 diabetes.

Other promising studies have shown that curcumin has the potential to treat cardiovascular disease, arthritis, depression, male-pattern baldness... and the list goes on.

Blood-Brain Barrier Problem
Most of the promising early research on this "holy spice" involved mice. An impediment to obtaining the same results with humans was the lack of product potency to cross the blood-brain barrier. Most commercial turmeric for culinary use contains only 2-8% active curcumin.

Recent research, however, has produced a curcumin derivative -- BCM-95 -- that has been shown in several studies to possess a bioavailability six times greater than conventionally prepared curcumin. So, a 400mg dose of BCM-95 delivers the same usable amount of curcumin as 2,700mg of the standard extract.

Although there is no RDA (Recommended Daily Allotment) for curcumin, a daily dose of 400-1,000mg is used in most studies. Up to ten times that amount has been used in some therapeutic studies.

Interview with Leading Researcher
One of the leading researchers on curcumin is Ajay Goel, PhD, director of epigenetics and cancer prevention at the Gastrointestinal Cancer Research Lab at Baylor University Medical Center in Dallas.

For more than 15 years, Goel has studied the power of curcumin in preventing and fighting cancer, especially gastrointestinal cancers. He’s been intrigued that the rate of colon cancer in the United States is thirty times higher than in his native India. Diet plays a major role in this type of cancer, and one key dietary difference is the heavy use of turmeric – from which curcumin is derived – in South Asia.

Goel says that pharmacology can’t really boast any great success in preventing or fighting cancer over the past four decades. So far, drugs kill not only tumors, but healthy cells, too. They typically target single molecules or genes, whereas curcumin targets multiple pathways or genes to suppress cancerous growth. Curcumin reduces inflammation and oxidative stress: conditions that abet the development of tumors.

Goel has been personally involved with more than 100 of the 5,000-plus studies done on curcumin. Turmeric is the only spice whose study has entered mainstream, clinical trials, over 40 of which have been made on humans only. He says that 80 new clinical trials involving humans are underway. He is convinced that this botanical has “passed muster,” moving well beyond in-vitro and animal studies, showing in all cases some very real efficacy.

Goel is especially excited about a recent study of curcumin’s potential for treating rheumatoid arthritis (RA), the first clinical trial involving humans. The positive outcome didn’t surprise him, since he understands curcumin’s anti-inflammatory power. The study found that curcumin was as effective as prescription pain medication. In addition, curcumin doesn't produce the toxic side effects of the prescription pain killers.

He discusses this study -- and other curcumin research now underway -- in this radio interview:

Curcumin Studies vs. Coconut Oil Hype
The best and most authoritative site for research on scientific studies related to health issues is the National Health Institute's PubMD -- I went to that site and searched first on "curcumin" and then on "coconut oil."  I limited the search to reports published this year.

The searches yielded over 500 hits for curcumin and only 28 for coconut oil. Looking at the coconut oil listings, I found that most of them did not deal with studies relating to humans, but rather dealt with agricultural products and issues. For example, this was one of the topics: "Microbial population in the rumen of swamp buffalo (Bubalus bubalis) as influenced by coconut oil and mangosteen peel supplementation."

Several months ago, I set up Google Alert for both curcumin and coconut oil. These alerts zap messages to your inbox whenever new information about your topic appears on the internet. I've been amazed at the number of reports I get of new scientific studies dealing with curcumin. My alerts on coconut oil, on the other hand, are mostly about its use in cooking -- and in skin and hair care. There are also a few unsubstantiated claims for its purported broader health benefits if used internally rather than externally. I've not been alerted to any scientific studies finding such benefits.

Curcumin and Me
I don't want to sound like Dr. Powers, who has been promoting coconut oil based on the unique experience of her Alzheimer's-stricken husband. And I don't want to sound like Dr. Oz, who has touted coconut oil for everybody, in spite of the lack of scientific evidence. I am not an advocate for curcumin.

My experience is just that: MY experience. And, in any event, my encounter with curcumin hasn't been all that spectacular, or -- for all I know -- clearly based on cause and effect.

I want to emphasize a couple things:
  • Most of those promising 5,000+ studies -- especially the initial ones -- involved mice, not people.
  • The blood-brain barrier issue remains problematic with humans.
  • Most reputable authorities urge more large-scale, peer-reviewed, controlled clinical trials before they could responsibly recommend curcumin.
But this 83-year-old with Parkinson's, prostate cancer, and osteoarthritis has decided not to wait for these trials -- which will surely take years -- particularly since curcumin's reported side effects do not seem worrisome. Goel, the leading curcumin researcher, has said that he thinks the BCM-95 version of curcumin is the most effective in passing the blood-brain barrier. So, I went online and placed my order: Life Extension's Super-Bio Curcumin, 400mg.  

It's recommended that curcumin be taken with meals, so I take one pill with each of my three meals (the easiest plan for this often-forgetful old man to remember). That's a total of 1,200mg every day. Most of the clinical trials I've seen involved administering between 500 and 2000mg a day. Much larger dosages have been tested without serious side effects.

So, what happened for me? Nothing dramatic. I did almost immediately feel an uptick in energy. The low back pain attributed to arthritis seemed to abate a bit, but persists. And I've wondered if my recent "libido revival" is somehow related to the new curcumin regimen. 

But the main reason I decided to try curcumin was my hope that it might help ward off Alzheimer's or dementia, and slow down the progression of my Parkinson's and prostate cancer. There's no easy or clear way for me to know if curcumin is helping.

I mentioned before that I learned a lesson from my experience with the serotonin-booster 5-HTP. I began touting that supplement as a wonder-drug for dealing with depression and insomnia. Only later did I find that few -- if any -- others shared my favorable experience. But with curcumin, I'm beginning to hear some favorable reviews from friends who have tried it. Several people report feeling more energetic; others say it seems to reduce pain. My internet research has found other favorable anecdotal reviews. But those are not the same as scientific studies.

So, that's where I am. I'm not urging you to rush out and buy curcumin pills.

Friday, August 10, 2012

Coconut Oil vs Curcumin as Remedies for Alzheimer's and other Ailments -- Part 1

The two things that have surprised me the most this year in my blogging and health-related research are:
  • The coconut oil craze. I first became aware of this in February when I put up my first post about the  reports I'd seen touting coconut oil as a remedy for Alzheimer's. That post took off like a skyrocket in terms of the hits it got and it kept on going. It has attracted five times as much traffic as any other post I've  published. Yet all the research I've done on coconut oil has yet to turn up a valid study to substantiate the claims made for it.
  • Curcumin -- the "unsung hero." Curcumin is the active ingredient in turmeric, the curry spice that Indians call the "holy powder." I had never heard anything about curcumin until I began researching dietary supplements, and I was startled to find it has been the subject of over 500 scientific studies, almost all of which verify its potential for treating not just Alzheimer's but also other neurological disorders like Parkinson's and MS, as well as cancer, diabetes, arthritis, cardiovascular disease, depression... and the list goes on.
The contrast between the much-hyped coconut oil and the little-known curcumin says a lot about how we let ourselves get seduced by internet hype, YouTube videos, anecdotal stories of miracle drugs, and our reluctance to check the validity of the claims.

So, let's take a closer look at both. Today, let's consider:


The Basis for Claims About Coconut Oil as a Remedy for Alzheimer's
The claim for coconut oil as a remedy for Alzheimer's has to do with substances called ketones. The damage caused by Alzheimer's disrupts the brain's ability to use its primary energy source, glucose. The brain naturally gets a portion of its energy from ketone bodies when glucose is less available (e.g. during fasting or after strenuous exercise or in newborns). Ketones may provide an alternative energy source to the brain's cells to moderate the damage caused by Alzheimer's disease. The body produces ketones when it metabolizes coconut oil and similar fatty acid substances.

That's the theory behind the claims for coconut oil. But the Alzheimer's Association says, "Unfortunately there just isn't any creditable science to support this idea."

The Alzheimer's Association notes that one study was begun on caprylic acid, a substance derived from coconut oil. That small study, funded by the manufacturer, showed promise in phase II clinical studies (which are designed to check on safety and dosage of experimental treatments, not to prove that it works). But the maker of the supplement opted to stop researching it prior to phase three trials that would have tested its effectiveness. The maker decided to use the substance instead as the basis for a product it named Axona and promote it as a "medical food." Medical foods do not require phase III studies or other clinical testing. The report on this study concludes:
The Alzheimer’s Association Medical and Scientific Advisory Council has expressed concern that there is not enough evidence to assess the potential benefit of medical foods for Alzheimer’s disease.  
I checked out Axona on the Mayo Clinic's site on "Drugs and Supplements" and here's what I found:
Axona is marketed as a medical food. Medical foods are dietary supplements that help manage a disease or condition that causes nutritional deficiencies. The Alzheimer's Association, however, disputes the notion that Alzheimer's disease causes nutritional deficiencies and requires a medical food. Medical foods are given only under the supervision of a doctor. But the Food and Drug Administration doesn't approve medical foods, nor does it test medical foods for safety or effectiveness. 
Until more is known, the Alzheimer's Association doesn't recommend the use of medical foods, including Axona, for the treatment of Alzheimer's disease
Dr. Mary Newport's Story
The source for much of the hype for coconut oil and Alzheimer's comes from the story told by Florida pediatrician Mary Newport, who experimented with putting several tablespoons of coconut oil in the oatmeal of her husband, who was seriously afflicted with Alzheimer's. He experienced a remarkable turnaround that is recounted in a video produced by the Christian Broadcasting Network. I included the video in a blog post last year (initially and mistakenly attributing the video to the more well-known CBS).  I'll admit that I was initially so taken with this that I went right to and ordered some coconut oil (when I still thought the video came from  CBS).

Newport spread the word on coconut oil's potential as an Alzheimer's cure through the YouTube video, her blog, a new book she published last year, and by lobbying scientists and politicians. Unfortunately, the evidence doesn't support the level of Newport's enthusiasm. 

National Institutes of Health researcher Richard Veech has worked with the Newports. He notes that early in diseases like Alzheimer's and Parkinson's, the brain starts to lose its ability to produce glucose, which leads to a kind of starvation of the brain. But the brain can still use ketones. He explains: "If we could get the level of ketones in the brain high enough in Alzheimer's patients, the hope is that they can use this for energy in place of glucose and we may be able to restore some of the brain's mental function."

But don't expect that to happen from consuming coconut oil, Veech cautions. While cells produce ketones when they metabolize the saturated fat in coconut oil (which has over 90 percent saturated fat, much more than most other oils and fats), "that doesn't lead to levels anywhere near high enough in the brain to do much good," he says. "It's great that Dr. Newport's husband has made such progress, but it is the story of one patient. It's not verified and it hasn't been duplicated in other patients with Alzheimer's." 

I'm reminded of my own experience with the serotonin-boosting supplement 5-HTP, which I  found was almost a miracle drug for me in dealing with insomnia and depression. I began touting it much as Newport did with coconut oil. Although I stopped short of making a video and writing a book, I did initially title this blog "Parkinson's and 5-HTP and Me." Unfortunately, family members and friends who tried it did not experience anything like the results I did. Extensive internet searches have not turned up any other "miracles" like mine.

The dramatic improvements in Dr. Newport's husband should be relatively easy to replicate. But it hasn't happened.

Other Claims for Coconut Oil
There are a lot of them out there. Here are several I've checked on:
Weight loss: TV's popular Dr. Oz says "the first of the health benefits of coconuts -- the one you're going to care about a lot -- is weight loss." By eating more coconut oil, "you might slim your waist in one week," health guru Joseph Mercolo says. (Mercola sells coconut oil for $65 a gallon on his website). The evidence behind their claims is pretty slim. Only one published study, a master's thesis in Brazil, has tested whether coconut oil could help people lose weight. It didn't.
"The Coconut Oil Miracle."  That's the title of a book by Bruce Fife. Its subtitle says "Use nature's elixir to lose weight, prevent heart disease, cancer and diabetes, strengthen the immune system, beautify skin and hair." Fife is president of the nonprofit Coconut Research Center (but the book is being sold for profit). I bought the book. At first glance, the claims made in the book seem to be substantiated by the number of studies cited in the many footnotes. But I looked at the footnotes and most of them did not relate to coconut oil. Virtually all of the ones that dealt with coconut oil came from coconut producing countries like India, the Philippines, and Malaysia, most of them done under the auspices of organizations such as the Asian and Pacific Coconut Community, or the Coconut Development Board. I found only one footnote with a study dated after the year 2000. 
For the past several months, I've set up a Google alert on coconut oil and one on curcumin. These alerts notify me each day of any news coming in on the alert topics. None of the daily coconut alerts have dealt with scientific studies or findings substantiating any of the health claims for coconut oil. Meanwhile, I've been amazed at the number of alerts I'm getting on new and promising study results on curcumin -- the subject of my next post.

"Welcome to the Land of Oz"
That's the title of an editorial in the November, 2011 issue of the Wellness Letter published by the School of Public Health at the University of California, Berkeley. It notes that many TV talk show hosts give out health advice but that no host has had more influence than Oprah. The editorial continues:
Unfortunately, when it came to health and medicine, at least, much of the advice on her show was quackery.... It's hard to imagine how much money viewers wasted on useless or potentially harmful supplements and other products promoted on her show -- and how many people missed out on the medical treatments they really needed as a result. In 2009, Newsweek's hard-hitting cover story about Oprah's  pedaling of modern-day snake oil was an eye-opener.
But Oprah may have affected the nation's health most by making Dr. Mehmet Oz her resident health expert.
Dr. Oz, the editorial acknowledges, is a well-regarded cardiac surgeon and professor at Columbia University.  But on TV, he suggests treatments for everything from endocrine disorders to cancer, and gives guidance about nutrition, weight loss, psychological well-being, and sexual  health -- just about everything. Often that advice, especially when it comes from some of his guests, is dubious at best. Even psychics and shamans show up, and their assertions are presented as plausible.

And, the editorial continues, every week Dr. Oz gives airtime to unproven supplements and the latest "super food."  His touting of coconut oil for weight loss is just one example.

The editorial advises that if you're intrigued by some tip or product from Dr. Oz's show (or any other TV guru, I'd add), research it yourself AND not just on the websites marketing the product. It's also advisable to be dubious when those touting a product have a vested interest in their product's "efficacy," like Dr. Newport and Bruce Fife in the books they've written.

Thursday, August 9, 2012

Alzheimer’s and Dementia: Egrifta, Levetiracetam, Ginseng-Fortified Milk, and Fish Oils

Since information about new studies – most of them encouraging -- keeps flooding in like a daily, unrelenting hurricane storm surge, we’ve GOT to be making progress in the good fight against cognitive decline, right? Here are four more recent tidbits in the ongoing saga.

1) HIV Drug May Support Memory in Early Alzheimer’s
Approved by the FDA in 2010 as a successful AIDS therapy, the drug Egrifta promotes production of a human growth hormone, which then activates the creation of various other hormones, including insulin.

While we know insulin’s role in regulating blood sugar, it also functions to create new nerve cells in the brain and protects existing brain cells from damage. The hormone’s potential role in treating Alzheimer’s isn’t new, but Egrifta gives it a novel application in the battle against cognitive decline in people with early Alzheimer’s.

For more info about Egrifta, see the update that appeared on the WebMD site on August 6.

2) Epilepsy Drug Reverses Memory Loss?
If an AIDS drug can slow memory deterioration in people with early Alzheimer’s, we shouldn’t be too surprised to learn that an epilepsy drug seems to reverse memory loss in Alzheimer’s-induced mice.

Scientists have reported on apparent links between epilepsy and Alzheimer’s for years, suggesting that the neural chaos of Alzheimer’s can spiral into epileptic seizures. Why shouldn’t therapy for the latter perhaps ease the former?

The epilepsy drug is levetiracetam, and its administration to rodent subjects improved the operation of compromised neural networks. Several months ago, scientists at Johns Hopkins University found that the drug had similar beneficial effects on a small test group of human subjects with mild cognitive impairment (MCI). Larger study samples – as always – are needed.

Want more information about levetiracetam’s promise in this new area? Check the August 6 article from Science Daily.

3) Better Memory with Ginseng-Fortified Milk?
Looking for something a bit more organic than epilepsy drugs for MCI? Researchers in Spain have created a low-lactose milk infused with American ginseng. The product, they say, is tasty to older drinkers, combats aging, and provides positive neuro-cognitive effects.

Initial reports seem less than scientific, and – caveat emptor – the findings are published in the August edition of the Journal of Dairy Science.

Much of the story focuses on the developers’ efforts to make the product more palatable, since ginseng – long believed to have beneficial health properties -- is notoriously bitter. Still, if you’d like to learn more, you can find details in the July 25 edition of the e-journal Medical News.

4)  Don’t Look to Fish Oils for Dementia Prevention.
There’s lots of recent literature about the positive effects from eating oily fish – like salmon, mackerel, sardines, and herring -- because they’re rich in the omega-3 fatty acids thought so crucial for brain development.

While those acids may indeed have other positive health benefits, three large, different randomized controlled trials showed that new dementia cases were just as likely to develop among daily fish-oil eaters as in those eating olive or sunflower oil placebos.

Study participants eating the rich omega-3 fish oils every day scored no higher than their control group counterparts in cognitive function tests measuring word learning and verbal fluency.

These findings, published earlier this summer in the Cochrane Summaries, included this familiar suggestion: “Longer studies are required, during which greater changes in cognitive function may occur, to enable researchers to identify possible benefits of omega-3 PUFA in preventing cognitive decline.”


In the coming days, I hope and expect we'll see new reports in the quest for treatments for dementia and Alzheimer's. On we go.