A NYC Weekend at Age 83: Will I Manage as Well as I Did Last Year? Part 1

Nimesh, Bhawana, and I spent the Labor Day weekend in New York City. For business and pleasure, I've visited NYC dozens of times over the years, far more often than any other place. So this trip provides a benchmark for me to see what's been happening as age and ailments take their toll.

This was also my first NYC trip since the onset a year ago of the lower back pain, the most disabling of my various ailments. My last NYC adventure was a similar three-day visit in June 2011, a few months before the August car crash that triggered the lower back pain. How would I handle travel now?

I'm writing this recap mostly to sort out my own thoughts. I've thrown in a few photos to perk up the post.

Friday
We took Amtrak's 5pm Acela train and arrived in New York before 8pm. I agree with a cab driver who told me years ago, "New York has the best of everything and the worst of everything." I've found that the Times Square area includes the worst of the crowding, pushing, shoving, shouting multitudes. So I prefer staying at hotels near Times Square but closer to Central Park.

One of the many great perks of my BNA job was staying at the Plaza for over ten consecutive years. I was part of an editorial team that went on the road for two weeks every March, giving briefings on developments in labor relations. Each year began with a meeting at the Plaza.

These days, when I'm picking up the tab myself, I look for something less pricey. Still, to avoid that "NYC has the worst of everything" feeling, I'm willing to pay more for a hotel there than I would elsewhere. In recent years, I've booked the Hilton on 6th Avenue, but this time I wanted a smaller, quieter boutique hotel. I've often used Frommer's guidebooks for suggestions, and one of their recommended hotels was the Shoreham on 55th between 5th and 6th. It was a good pick.

This excursion was Bhawana's introduction to the city and its wonderful craziness. So we started off Friday night by  walking around the corner from our hotel to the Trump Tower with its five-story waterfall.

Then on to Rockefeller Plaza.

When playing tourist guide in NYC, I prefer the "Top of the Rock" to the Empire State Building. From there, you get a great view of the Empire State Building.

We saved Bhawana's introduction to jammed and glittery Times Square for last.

Before heading back to the hotel, we decided to sit a while in the grandstand overlooking Times Square. It was already after 11pm and -- as we began climbing the grandstand stairs -- I lost my balance and would have fallen if Nimesh hadn't caught me. I realized I hadn't taken the last of the four carbidopa-levodopa pills I take each day to keep my Parkinson's under control. I also discovered I'd neglected to bring my pocket pill container. 

I realized I'd need help getting back to the hotel. Without medication, I have a hard time walking without lurching, staggering and possibly falling. Fortunately, Nimesh could steady me as we walked back.

And fortunately we were in New York City, where nothing shocks the natives. No one raised an eyebrow seeing a young Asian man holding hands with a clearly drunk old man! 

Saturday

On Friday, I had emailed my dear friend Bonnie and asked for recommendations on things to do in the city. She had spent several months living there earlier this year, and her suggestions came in handy for the rest of the weekend.

We started with a visit to the Plaza. Bhawana is just as elegant and beautiful as the Plaza lobby.

By the way, Nimesh took all the pictures on our trip, if you hadn't already guessed.

Then we headed for Bonnie's first recommendation: brunch at the Boathouse restaurant on the lake in Central Park. Since this was a special occasion, we hired a horse-drawn carriage to get us there.

No, Nimesh didn't drive the carriage. The 25-minute ride to the Belvedere Terrace was nice. Would I pay $80 (plus tip) to hire a horse-drawn carriage again? No.

The Boathouse brunch was great.

We passed the Conservatory Pond and headed out of the park toward 5th Avenue.

I wanted to walk back to the hotel along Madison Avenue, but by then I was running on empty. So I hailed a cab back to the Shoreham to rest up for the weekend's main event, which was... drum roll, please....

Yep! The Book of Mormon. Just before Nimesh and I took off last August for a three-week drive through the Pacific Northwest, I bought the CD of the show's music. We must have listened to it 50 times on the rental car's CD player, and we were still laughing at many of the lyrics after three weeks. So, I managed to get three tickets for the Saturday matinee.

Often when I look forward to something with this much anticipation, I end up feeling let down. Not this time. The show was terrific. Nimesh even managed to snag an autograph and photo with one of the stars of the show.

Jeez! I didn't think I get so caught up in this travelogue. It's midnight and I'm going to pause here.

to be continued tomorrow.... 

Tai Chi: For Me?

I’ve tried many things through the years in my quest for improved health and wellness. There’s been a veritable pharmacy of pills for many conditions. I've tried lots of supplements along the way, but that list is now reduced to three: the serotonin booster 5-HTP, the science-lauded curcumin, and the doctor-suggested Vitamin D. I meditate regularly and happily. My weekly Parkinson’s support group helps me feel connected and upbeat. I've experimented with hypnosis, brain wave music therapy, acupuncture, and reiki. Nowadays, I get physical therapy and make regular visits to the chiropractor.

As I mentioned in an earlier post, I’m a neophiliac: I love trying new things. So, why the heck haven’t I tried tai chi?

Dr. Andrew Weil’s Endorsement
Last Thursday, I saw a piece on natural health guru Dr. Andrew Weil’s blog titled “Tai Chi for a Better Brain.”  (Reminds me of a posting I did recently on studies showing that meditation can lead to a bigger and better brain.)  Weil recapped a study published this past June in the Journal of Alzheimer’s Disease in which a group of Chinese seniors who practiced tai chi three times a week for eight months showed increased brain size, along with improved memory and cognitive function, compared to a similar control group that did not practice tai chi.

Mayo Says YES!
I visited a favorite source -- the Mayo Clinic site -- for additional information. There, the article I found began like this: “If you're looking for another way to reduce stress, consider tai chi... sometimes described as "meditation in motion" because it promotes serenity through gentle movements — connecting the mind and body.”

Mayo staffers describe the types and forms of tai chi, and explain how it has evolved from a martial arts discipline into a very popular form of exercise. They went on: “Regardless of the variation, all forms of tai chi include rhythmic patterns of movement that are coordinated with breathing to help you achieve a sense of inner calm. The concentration required for tai chi forces you to live in the present moment, putting aside distressing thoughts.”

So this sounds just like the benefits I feel from my daily mindfulness meditations, but with some extra cardio, strength, and balance elements thrown in. And like my meditating, you can do this discipline anywhere, anytime. At home, away; day or night; with others or alone. You can take it very slow, or you can pump up the aerobic value. You don’t need any special equipment or clothing.

The article reports that tai chi may very well offer a variety of benefits beyond stress reduction, including:

• Reducing anxiety and depression 
• Improving balance, flexibility and muscle strength 
• Reducing falls in older adults 
• Improving sleep quality 
• Lowering blood pressure 
• Improving cardiovascular fitness in older adult 
• Relieving chronic pain 
• Increasing energy, endurance and agility 
• Improving overall feelings of well-being 

Harvard Catalogues the Benefits
To get yet more info, I turned to another regular, reliable source: Harvard. The article I found began this way:

This gentle form of exercise can prevent or ease many ills of aging and could be the perfect activity for the rest of your life.

Tai chi is often described as "meditation in motion," but it might well be called "medication in motion." There is growing evidence that this mind-body practice, which originated in China as a martial art, has value in treating or preventing many health problems. And you can get started even if you aren't in top shape or the best of health.

The Harvard article included this recap of tai chi's potential benefits:

When combined with standard treatment, tai chi appears to be helpful for several medical conditions. For example: 

Arthritis. In a 40-person study at Tufts University, presented in October 2008 at a meeting of the American College of Rheumatology, an hour of tai chi twice a week for 12 weeks reduced pain and improved mood and physical functioning more than standard stretching exercises in people with severe knee osteoarthritis. According to a Korean study published in December 2008 in Evidence-based Complementary and Alternative Medicine, eight weeks of tai chi classes followed by eight weeks of home practice significantly improved flexibility and slowed the disease process in patients with ankylosing spondylitis, a painful and debilitating inflammatory form of arthritis that affects the spine.

Low bone density. A review of six controlled studies by Dr. Wayne and other Harvard researchers indicates that tai chi may be a safe and effective way to maintain bone density in postmenopausal women. A controlled study of tai chi in women with osteopenia (diminished bone density not as severe as osteoporosis) is under way at the Osher Research Center and Boston's Beth Israel Deaconess Medical Center.

Breast cancer. Tai chi has shown potential for improving quality of life and functional capacity (the physical ability to carry out normal daily activities, such as work or exercise) in women suffering from breast cancer or the side effects of breast cancer treatment. For example, a 2008 study at the University of Rochester, published in Medicine and Sport Science, found that quality of life and functional capacity (including aerobic capacity, muscular strength, and flexibility) improved in women with breast cancer who did 12 weeks of tai chi, while declining in a control group that received only supportive therapy.

Heart disease. A 53-person study at National Taiwan University found that a year of tai chi significantly boosted exercise capacity, lowered blood pressure, and improved levels of cholesterol, triglycerides, insulin, and C-reactive protein in people at high risk for heart disease. The study, which was published in the September 2008 Journal of Alternative and Complementary Medicine, found no improvement in a control group that did not practice tai chi.  

Heart failure. In a 30-person pilot study at Harvard Medical School, 12 weeks of tai chi improved participants' ability to walk and quality of life. It also reduced blood levels of B-type natriuretic protein, an indicator of heart failure. A 150-patient controlled trial is under way.

Hypertension. In a review of 26 studies in English or Chinese published in Preventive Cardiology (Spring 2008), Dr. Yeh reported that in 85% of trials, tai chi lowered blood pressure — with improvements ranging from 3 to 32 mm Hg in systolic pressure and from 2 to 18 mm Hg in diastolic pressure.

Parkinson's disease. A 33-person pilot study from Washington University School of Medicine in St. Louis, published in Gait and Posture (October 2008), found that people with mild to moderately severe Parkinson's disease showed improved balance, walking ability, and overall well-being after 20 tai chi sessions.

 [Update: In a larger study reported this February in the New England Journal of Medicine, 195 people with Parkinson's were divided into three groups. One group took part in an extensive stretching class, another was taught resistance training, and the third group  performed tai chi.  After six months, patients in the tai chi group performed better on a number of measures related to strength, movement control, balance, stride length and reach.  Resistance training also offered some benefits.]

Sleep problems. In a University of California, Los Angeles, study of 112 healthy older adults with moderate sleep complaints, 16 weeks of tai chi improved the quality and duration of sleep significantly more than standard sleep education. The study was published in the July 2008 issue of the journal Sleep. 

Stroke. In 136 patients who'd had a stroke at least six months earlier, 12 weeks of tai chi improved standing balance more than a general exercise program that entailed breathing, stretching, and mobilizing muscles and joints involved in sitting and walking. Findings were published in the January 2009 issue of Neurorehabilitation and Neural Repair.

It’s  pretty easy to find tai chi instruction, though experts recommend checking with your doctor first if you’re a senior with health issues. Most instructors will happily let people observe their classes, so potential students can see what’s involved, and if they like the “vibe.”

Check with your senior center, local Y, or community center. The Arthritis Foundation (800-283-7800 or www.arthritis.org) is another resource for finding tai chi classes near you. If you're one of those lucky self-starters, you can find books and videos, athough many prefer the pleasure of sharing the experience with others.

The Iona Senior Center -- where I play bridge on Mondays and meet with my Parkinson's support group on Fridays -- offers several tai chi classes for seniors. One introductory class starts at noon on Fridays, just as my Parkinson's support group concludes. Hmmmmm. Out one door and through another?

Tai Chi and Me
I've thought about it. But -- as I mentioned in my last post about meditation -- I usually end up doing things my own way (not that I couldn't end up doing tai chi my own way, once I learned the basics). Exercise classes have never appealed to me, particularly if they involve anything like dancing or graceful movements. I'm a self-conscious, world-class klutz!

Then, there's the time issue. Mind you, I'm not complaining, but these days, I have three chiropractor appointments a week, a weekly massage, my Monday bridge game, and my Friday Parkinson's support group. Add a lunch date or two every week -- and often a performing arts event -- and it's often hard to come up with one of the things I treasure most: a day with absolutely nothing scheduled.

I have plenty of rationalizations for not taking tai chi classes. But after completing this research, I'm reconsidering my resistance. Stay tuned.

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 (http://bit.ly/PGuvUY.) 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: http://bit.ly/sxYIKi.

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!

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.

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:

• The Mayo Clinic's "drugs and supplements" link -- http://bit.ly/nZlpR
• Natural Medicines Comprehensive Database -- Consumer Version -- http://bit.ly/ScVgEX
• National Institute of Health's PubMed -- http://www.ncbi.nlm.nih.gov/pubmed/

If I want to dig deeper, I put the supplement name into Google's search box and add "-.com" (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."

Boron

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.

Calcium

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.

Chromium
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.)

CoQ10
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.

Creatine
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.

Glucosamine
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."

Selenium                      
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

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.

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!
http://hvrd.me/OzjkxV

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.

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After reporting on the research, the Neurology Now article answers the "how to" questions about meditation. I'll cover that territory next week.