Brain Food?

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Can the way we eat prevent dementia getting a grip?alzheimers-749616_1920

Dementia has been on my mind recently. A lovely family friend has been diagnosed with the disease, I’ve been writing for a elderly care service and, truth be told, I’ve also walked into the kitchen and forgotten what I came for, one time too many. So, a TED talk by Dr Mary Newton on YouTube really caught my attention. She’s a neonatologist who spoke about her experiences when her husband, Steve, developed early onset Alzheimer’s.

We still don’t fully understand Alzheimer’s. Scientists believe that many factors work together to increase an individual’s risk: genes, lifestyle, and the environment may all combine to allow the disease to take hold. But her investigations suggested that the way we eat could hold the key to finding a cure.

Mary was desperate to find a way of helping her husband, who was in a downward spiral with rapidly deteriorating function. As a doctor, she explored routine treatment options. But when his symptoms became so severe that he was not able to participate in clinical trials, her scientific deductions led to discover early investigations into a medical food that could make all the difference.

Diabetes of the Brain

Scientists have found indications that Alzheimer’s may be a sort of diabetes of the brain. Researchers at Brown University discovered insulin deficiency and resistance within the brains of affected individuals and coined the term Type 3 Diabetes for this form of dementia. They observed that this insulin resistance happened in the very early stages, often many years before symptoms began and then became increasingly severe and widespread as the disease progressed.

There’s been lots of research demonstrating that type two diabetes may predispose to Alzheimer’s. And the truth is, the demographics of people who are affected by both disorders are pretty similar. The two disorders share the same risk factors, features and similar biochemical changes, like insulin resistance. Could this be the key to understanding dementia?

Brain food

Our brain cells need glucose to fuel their function. Insulin acts as the key to unlock the cells to allow glucose to enter. Without properly functioning insulin, the cells simply can’t work properly and can die, as happens in dementia.

But glucose is not the only fuel. Ketone bodies from the breakdown of fat can act as an alternative source of energy. It’s our body’s built-in back-up for times of starvation. But you don’t have to be starved. Ketogenic diets such as the Atkin’s and South Beach encourage the body to burn ketones by advocating a high fat, low carbohydrate way of eating. In fact, these kind of diets are used successfully to help control the fits of children with intractable epilepsy, so we know that they can affect brain function.

I try and stick to a low carb diet, but I understand that this level of dietary restriction can be difficult in the elderly, confused and infirm. But there is another way:

We are what we eat

coconut-1771527_1280

Dr Newton continued researching and found that a type of fat called medium chain triglycerides (MCT) are readily taken up by the liver and burned to form ketones. An early trial found that a single dose of MCT produced an improvement in cognition and memory in more than half of those people that took it.

The use of MCT is not new, it’s added to infant formula to help new babies grow and develop. That’s because we know that breast milk is rich in these fats. Maybe our bodies knew what was best for us all along.

Coconut oil is rich in MCT, it makes up around 60% of the content. When Dr Newton gave Steve spoonfuls of coconut oil, everything changed. He described

“the light switch coming back on.”

His function, his memory and his ability to carry out activities of daily living all improved. More than that, his personality and sense of humour returned. This was reflected in dramatically improved scores in his mental testing and on his MRI, which showed that the deterioration had stabilised.

The news about this potential treatment spread by word of mouth and virally on social media and many people across the world have also experienced the benefit. But we are still waiting for proper confirmation in clinical trials, fortunately there are now several underway for the use of MCT oil and ketone esters in the treatment of both dementia and mild cognitive impairment. I’m waiting for the results with interest.

Let food by your medicine

Whilst we’re waiting, could we make a difference today? The low fat diet has been relentlessly pushed to the public, so we choose ‘healthy’ low fat alternatives which are often stuffed full of sugars to compensate for a lack of richness and flavour. Full-fat dairy produce and coconut oil are both rich in MCT, but it’s not found in olive oil or many of the other veggie oils in our diet. By making a move away from a high carb, high sugar diet and introducing more of these oils, maybe we could decrease levels of insulin resistance and protect our bodies and our brains. As Hippocrates said, let food be thy medicine.

Are your guts making you fat?

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belly-2354_1280Could your gut bacteria be making you fat?

We all know why people get fat, don’t we? We’ve had it drummed into us relentlessly that it’s all down to eating too much and moving too little. If the pounds are piling on, it’s just down to us being greedy or lazy. Or maybe not. Scientists are starting to discover that it’s really not as simple as calories out and calories in.  

 We’ve all noticed that some people appear to be able to eat whatever they want, while others have to constantly battle the bulge. Why did they get so lucky? It could all be down to their genetic make-up and the bacteria in their bowels.

 Good and bad bacteria

Our guts are home to a mind-boggling five hundred million bacteria that help us maintain a healthy digestion and break down the fibre in our food. Having the right balance between the good and bad bacteria is vital for our health and wellbeing. Researchers are now discovering that these microbes may also influence our hunger, control our metabolism and affect our sensitivity to insulin; in other words, having the wrong bacterial balance could make us fat (1).

Our bowels contain over 400 strains of bacteria and the cocktail of different varieties in each person is very individual. According to a study in the journal Cell, our genetic make-up can shape the numbers and the type of bacteria living in our gut, which may affect our tendency to gain weight (2).

In studies, slim people had seventy percent higher levels of diverse gut bacteria than those who are overweight. On average people in the United States tend to have a less diverse bacterial colonisation than those from less developed parts of the world. Our gut flora seems to be a key factor in the fight against obesity.

Identical twins, identical guts?

Researchers looked at the gut flora of twins and discovered that identical twins had more similar levels of gut bacteria than non-identical twins did. This suggests that the microbiota is down to nature rather than nurture.  They identified a particular family of bacteria that were highly heritable and were much more likely to be found in thin people. Indeed, if there was a significant difference in weight between twins, the researchers were able to accurately predict which of them was overweight, simply by looking at their gut bacteria (2).

The skinny bug

 So what is this ‘skinny bacteria’ and where can I get some? I hear you screaming. It’s snappily named Christensenellaceae and having lots of it in your gut is linked with being slim, whereas low levels were associated with obesity.

In studies, when the samples containing the skinny bacteria were transplanted into the bowels of mice, it protected against weight gain.

The researchers said

“Our findings show that specific groups of microbes living in our gut could be protective against obesity – and that their abundance is influenced by our genes. The human microbiome represents an exciting new target for dietary changes and treatments aimed at combating obesity.”

The good news is that the vast majority of us (as many as 96%) have some christensenellaceae in our digestive systems. Individual levels are partially written in our genes but there are ways of giving your healthy bacteria a boost, whatever your genetic inheritance.

 How does it work?

 The exact mechanism by which microbes influence weight isn’t fully understood. Scientists have postulated that they may affect the ability to process food, altering the body’s ability to extract nutrients and calories. Certain bacteria may also alter our sensitivity to insulin, so protecting us against diabetes and stimulating the body to burn fat instead of storing it on our waistlines.

Hunger hormone

 Your body produces a hormone called ghrelin, which lets you know you’re hungry and need to eat. Usually after eating a meal, the hormone levels drop so that your need to eat fades. The bacterium Helicobacter Pylori appears to be involved in this process. It’s a microbe that’s been frequently in the health news because it’s linked to ulcers and stomach cancer. Antibiotic treatment has helped slash infection rates by fifty percent, which is great if you’re suffering from indigestion but bad news for obesity levels. Without H Pylori the hunger hormone levels appear to stay high, even after an adequate meal, so that you keep on eating(3).

 Bacteria blitzers

 Activity, diet and antibiotics can all affect your gut bacteria. You don’t even have to be prescribed antibiotics to suffer their effects. The food industry relies on the drugs to keep livestock healthy and infection-free, in fact eighty percent of US antibiotics are used to treat animals not humans. This means that we’re ingesting them daily with the food we eat, which can disturb the delicate bacterial balance in our bowels (4).

The impact of antibiotics has been demonstrated in studies on mice. Mice who were given a high fat diet gained weight, mice that were given antibiotics also gained weight but it was the mice that were given both that got really fat (5). And when we investigate the history of the obesity epidemic, it correlates with the expansion in intensive farming and the use of antibiotics in animal feeds. Looking across the world, the countries that use this approach to livestock farming tend to have the highest levels of obesity.

What can I do?

Don’t panic if weight struggles run in your family. Although your gut bacteria are influenced by genetics, the way you live your life and the food you eat can dramatically affect your bacterial balance, so you can make a difference and lose weight.

Fibre first: choosing a plant based diet, rich in fibre has been shown to boost levels of bilophila, a type of healthy bacteria. Fibre nourishes the microbes in your gut, so choose plenty of fruit, vegetables and wholegrains daily. Food containing prebiotics will allow your bacteria to flourish, so snack on bananas and add garlic and leeks to your meals.

Pick probiotic foods: active and fermented food really pack a probiotic punch. Live yoghurt, kefir, sauerkraut, miso and raw cheeses will all top up your gut bacteria.

Take a daily supplement: it can be tricky to get the probiotics your body needs from the modern diet. If you’re struggling with kefir and kimchi then take a probiotic supplement daily – and store it in a cool environment so that it stays active.

Skip the sugar: too much sugar can feed the bad microbes and upset the delicate balance of flora in the gut, leaving you bloated, lethargic and overweight. Cut out refined sugars to look and feel better, inside and out.

Get moving: a session in the gym doesn’t just work your muscles, even your bowel benefits. Being active as a child has a real impact on the diversity of your gut microbiota (6) but it’s never too late to start. Regular exercise as an adult can also make a difference, with studies showing that the stools of rugby players contained more diverse bacteria than their less athletic peers (7).

What next?

 If, like me, you started frantically googling “christensenellaceae supplements” after reading the research, then I’m sorry to disappoint. At the moment you can choose a general probiotic supplement and work to improve your gut health with diet and lifestyle- but you can’t yet pop a skinny bacteria pill. However, there may be another way to boost your levels.

The science of faecal transplantion is developing rapidly with advocates claiming it may be the answer to weight problems. It’s been used to combat bowel superbugs. But one slim woman who received a transplant from her overweight daughter noticed that she subsequently ballooned in weight (8). Sounds far-fetched? Researchers have actually seen similar results in mice, with lean mice gaining weight after getting gut bacteria from obese mice. In a Dutch study, faecal transplants from skinny donors helped individuals with metabolic syndrome became more sensitive to insulin (9)(10)

Could something as simple as poop really help us fight the battle of the bulge? There are loads of internet sites that say that it could as well as giving instructions on how to do-it-yourself. But before you overcome the ick factor and head over to your skinny friend’s house with a potty, a blender and a syringe, think again. You could transfer bacteria that are harmful, damage your bowel or potentially trigger other diseases. The truth is, we really don’t know enough about the procedure yet. It’s safer to wait for the research evidence to build and while you’re waiting use your diet and supplements to give your gut a safe bacterial boost.

This was article was originally published on Intelligent Labs

  1. How Gut Bacteria Help Make Us Fat and Thin (Scientific American, June, 2014)

Claudia Wallis

  1. Human genetics shape the gut microbiome (Cell. 2014 Nov 6; 159(4): 789–799)

Julia K. Goodrich, Jillian L. Waters, Angela C. Poole, Jessica L. Sutter et al

  1. Ghrelin, Helicobacter pylori and body mass: is there an association?( Isr Med Assoc J. 2012 Feb;14(2):130-2) Boltin D, Niv Y.
  1. Long-term impacts of antibiotic exposure on the human intestinal microbiota (Microbiology (2010), 156, 3216–3223) Cecilia Jernberg, Sonja Lo ̈fmark, Charlotta Edlund and Janet K. Jansson
  1. Altering the Intestinal Microbiota during a Critical Developmental Window Has Lasting Metabolic Consequences (Cell, Volume 158, Issue 4, p705–721, 14 August 2014) Laura M. Cox, Shingo Yamanishi, Jiho Sohn, Alexander V. Alekseyenko, Jacqueline M. Leung et al
  1. Science Daily (2016). Early-life exercise alters gut microbes, promotes healthy brain and metabolism.
  1. Exercise and associated dietary extremes impact on gut microbial diversity (Gut 2014; 63:1913-1920) Clarke, S., Murphy, E., O’Sullivan, O., Lucey, A., Humphreys, M., & Hogan, A. et al.
  1. Obesity via Microbe Transplants (Science Daily, September 5, 2013) Ed Yong
  1. Transfer of intestinal microbiota from lean donors increases insulin sensitivity in individuals with metabolic syndrome (Gastroenterology 2012 Oct; 143(4):913-6) Vrieze A1, Van Nood E, Holleman F, Salojärvi J, Kootte RS, Bartelsman JF et al
  1. Not just obesity – faecal transplants’ weird effects (New Scientist 11 February 2015) Jessica Hamzelou

Confessions of a Chocoholic

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chocolate

Since childhood, chocolate has been my favourite indulgence. Back then it was sweet, milky, cheap and cheerful but since I’ve cut my sugar intake right back, I’ve turned to the dark side.

You know what they say; chocolate with 85% cocoa solids is more intense so you can be satisfied with just a couple of squares. Yeah, right! The thing is, my hunger and my cravings probably are satisfied by a couple of segments; then my greed gobbles up the rest of the bar. You don’t have to be a nutritionist to know that wolfing down family sized bars is not strictly low carb.

I read about someone who had totally kicked their chocolate habit using this hypnosis track. I clicked and bought it without really thinking, then left it languishing unloved on my itunes playlist and settled down in front of the telly with some Green and Blacks and a mug of coffee. I did listen to the opening bit once in the car but it was all a bit wooo, whale music and relaxation, which didn’t seem terribly safe on the A1.

Last month stress, strains and way too much caffeine were keeping me awake all night and in desperation I thought I’d try the relaxation exercises at the beginning of the track to switch off. Well, they worked. I was spark out before chocolate was even mentioned. I used it a few more times, always fell asleep after the first introductory five to ten minutes, never got to hear the pearls of chocolaty wisdom. Then my sleep improved and I didn’t give it a second thought.

But here’s the thing, I walked past Hotel Chocolat in King’s Cross station today without even going in for a free sample. This is UNPRECEDENTED. And, when I think back, I haven’t eaten chocolate, or even thought about chocolate for three weeks or so. Weird.

So is it placebo, hypnosis or coincidence? The truth is I haven’t a clue but my instinct is that the hypnosis made the difference. That is coming from a confirmed cynic. There is evidence that hypnotherapy, properly delivered can make a real difference in the management of pain, anxiety, depression and phobias. The research is less convincing when it comes to smoking cessation and weight management, with trials showing differing results .

And what about the plethora of apps that have sprung onto the market promising to help us lose weight , quit sugar, stop smoking and be generally fabulous? Well, a review looked at those and most of them have little or no research to back up their claims. Even so, quite a few have a trickle of enthusiastic reports on Amazon from satisfied clients. It seems that apps and recordings have the potential to deliver effective hypnosis but technology may have raced against science, with suppliers so keen to get the products out there that it’s difficult for us to tell the great from the gruesome.

Many scientists recommend that there should be an accreditation system so we can spot the rigorously tested and quality assured apps, which definitely makes sense. In the meantime I’m enjoying a chocolate free existence and hoping it helps my chunky little legs become smooth and slim by the summer.

Hmmmm.

On second thoughts, maybe I should look for an app that will hypnotise me to prefer kale and broccoli to white wine and pistachios. Wish me luck!

Living with lymphoedema

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I’ve spent the last few days on the beautiful Gower coast on an exciting project with Pocket Medic making film-based prescriptions to help patients manage their chronic disease. The time of the boring leaflet, left crumpled in the bottom of a handbag could well be over.

We were working with some extraordinary people from all over Wales who shared their personal stories and experiences so that others can discover the best ways of managing and living with lymphoedema.

Did you just say lympho…what?

If you did, you’re not alone, but it’s a problem that affects at least a quarter of a million people in the UK alone.

What is lymphoedema?

Lymph is the fluid that carries the white blood cells that fight infection around the body and is responsible for whisking any dead or abnormal cells, excess protein and bacteria, off to the blood stream to be chucked out or recycled.

If the lymphatic system stops working and the lymph stops moving for any reason, it can’t drain away and you’ll see swelling. That swelling is lymphoedema.

Why me?

The lymphatic system circulates around the body but unlike the blood there’s no heart to take care of all the hard, pumping work. Instead, it relies on us to keep it moving with our motion and breathing. If we stop moving, the lymph will too. Being overweight and not being active enough is a risk factor-but also some of us are just unlucky to be born with lymph systems that simply don’t work properly.

The lymph system lies under the skin and skin infections like cellulitis, especially if they are recurrent or severe can lead to lymphoedema, even eczema and varicose veins can be culprits.

Many people develop lymphoedema after cancer treatment where the lymph nodes, that work as the body’s drains are removed or damaged by radiotherapy. Without them the fluid can build up leading to swelling. This may be in the arm after breast cancer treatment or in the legs following bladder or prostate cancer.

Lymphoedema can be uncomfortable and unsightly but the patients that were interviewed really showed me that there’s lots that can be done to help manage the swelling and symptoms, ease any discomfort and allow each person with lymphoedema to live life to the full.

What can I do?

Take care of your skin

Skin care is one of the cornerstones of care. Moisturising regularly, keeping the skin clean and protecting from any bites and scratches can prevent the skin breaking and letting infection in. Avoid needles, tattoos, blood tests, razors and waxing in parts of the body that have lymphoedema and be very careful when gardening, thorns and soil can be a tricky combination.

 Infection busting

Any little infection can escalate and cause a severe skin infection called cellulitis, which can cause the skin to thicken and make lymphoedema worse. So clean any cuts or grazes and use antiseptic to bust any bugs. If there are any signs of redness, pus or increased swelling, see your doc for antibiotics.

 Move that lymph around your body

Exercise is a great way to encourage lymph to move, especially if it has got stuck somewhere in your body and you’ve got swelling. If the idea fills you with dread then start gently, there’s no need for lycra and sweat bands. Walking longer distances in the home, short walks outside and climbing steps can be a good start. Ask your lymphoedema specialist about classes in your area.

 Manage your weight

Being overweight can make lymphoedema worse and make it more difficult to get about when you have it. It’s difficult, when you’re unwell or recovering from cancer diet is often, understandably, not a priority. However getting to a healthy weight and moving around more, will help get that lymph moving again.

 Wear it well

Compression garments are really important in the management of lymphoedema. They put pressure on the tissues to stop the fluid building up and encourage fluid to drain. They can seem uncomfortable at first but if they’re properly fitted and worn regularly they can make a real difference.

Sleep easy

Sometimes it can be difficult to muster the energy and motivation to go to the bedroom but sleeping in an armchair can really make lymphoedema worse. Make sure you sleep in a bed so that the lymph can flow more easily.

 Healing hands

A gentle massage process called simple lymphatic drainage can help the fluid drain away and the good news is, you can do it on yourself. Ask your specialist nurse for guidance.

The way ahead?

A super-micro-surgical technique called LVA, or Lymphatic Venous Anastamosis has been developed to connect a damaged lymphatic vessel to a small vein. This bypasses the faulty bit of the lymphatic system and drains the fluid into the blood stream. It’s not suitable for many people and the BMI needs to below 30 but it is an exciting prospect for the future.

Super support

You are not alone. There are specialist nurses, loads of information sources and support groups for people with lymphoedema to learn and laugh together.

Find out more

http://www.wales.nhs.uk/sitesplus/863/page/39315

http://www.lymphoedema.org/menu3/Index.asp

http://ehealthdigital.co.uk/news/

http://www.walesonline.co.uk/news/health/pioneering-lymphoedema-super-microsurgery-now-10053216

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Worriers and Warriors

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The way we respond to stressful situations may be written in our genes.

I was researching and writing an article about stress last week and, as ever, the deadline had to loom so close that it could have kicked me up the backside, before my fingers started tapping diligently on the keyboard.

I always thought it was just laziness, or a singular talent for procrastination but it seems  that it might actually be written in my DNA.

Let’s face it, we all get stressed out once in a while but not everyone responds to pressure in the same way. Our lives, upbringing and experiences can all have an impact but it also seems that certain genes can make us more sensitive to life’s stresses and strains.

 Fight or flight

 It’s all down to our inner caveman. When we get shocked or feel threatened, the body responds with a primitive reflex, releasing chemicals designed to help us to survive. These catecholamines (adrenaline, noradrenaline and dopamine) boost the heart rate, raise the blood pressure and improve respiratory function to help us fight harder and run faster. They also sharpen our vision, speed up our impulses and make us super-sensitive to any threat; we become a sort of super-hero version of ourselves!

This was all fine and dandy when we were facing sabre-toothed tigers. Whether we stayed to fight or ran to hide, the stress hormones would have been safely metabolised. But now when we’re stressed out in a traffic jam, on the phone to a call-centre or facing a deadline, the body gets all revved up with no way of burning off all the pent up aggression and energy.

The genetic difference

 For lots of us, stress can be good, sharpening our focus and helping us perform better. But others just fall apart under the pressure. How can the same level of stress elicit such different physical, psychological and emotional responses?

The answer is down to genetics. We all have differing capabilities of breaking down and getting rid of dopamine, adrenaline and noradrenaline. This system is controlled by the COMT gene; in some of us, the brain is cleared of the catecholamines super fast, while others have a more slow and steady response.

Worriers

When people with slow COMT genes become stressed, their bodies just can’t get rid of the catecholamines quickly enough. Dopamine builds up in the brain’s frontal lobe causing the classic stress symptoms of anxiety, worry, panic attacks and insomnia. In severe cases it is thought to be associated with mental health problems including OCD and schizophrenia.

Warriors

Those of us with fast acting COMT genes are able to clear the brain of stress chemicals quickly and efficiently and have been shown in tests to perform better under pressure. However in low stress situations, the lack of stimulation means that they could fail to get work done effectively. Errrrrrm, sound familiar?

So, is that just all a bit depressing? Some people are destined to do terribly in exams and others won’t perform without the imminent threat of danger.

No.

It seems that our genes don’t have to be our destiny. In tests under low levels of pressure, those with slow COMT genes performed way better. When they weren’t stressed, or if they were told that feeling anxious would make them perform better, they had bright, alert minds and better memories. So by learning to manage feelings of stress they were able to really harness their true potential.

And if, like me, you know that you need a little extra push, you can set yourself targets and deadlines so that you’re not up burning the midnight oil, again!

My article was for a company called DNAfit, who test individuals’ DNA profiles to develop personalised health plans. I was paid for the work, although I was given free rein on what to write and not expected to blog about it, it just really captured my interest.