How to Correct Emotional Eating

How to Correct Emotional Eating

Emotional eaters come in all shapes, sizes, ages, and persuasions.  Just about everyone is prone to emotional eating from very young children to older adults.  What differentiates emotional eaters from those who are not?

Although there may be many reasons for emotional eating, I tend to look at the biological basis for this unhealthy habit.  Many of us are driven to eat “comfort food” when the stress hormone, cortisol, is elevated.  Comfort food, like pizza, macaroni and cheese, and ice cream is not called comfort food just because it tastes good.  It is called “comfort food” because it literally lowers cortisol levels.

Despite what you may think, cortisol isn’t always bad.  If it weren’t for cortisol, we’d have a very unproductive day.  Cortisol is what gets us moving in the morning and motivates us to meet tight deadlines.  On a typical day, cortisol levels drop roughly two hours after you wake up.  This is actually the best time to have that first cup of coffee because caffeine stimulates cortisol levels. So, you don’t really need coffee as soon as you wake up because your cortisol levels are already high; a cup of coffee will just make them higher. 

If chronically elevated levels of stress hormone promote emotional eating, then what can we do to lower cortisol levels?  Cortisol is produced from the adrenal glands, which are tiny appendages that sit on top of your kidneys.  It is part of the “HPA” axis that stands for hypothalamus-pituitary-adrenal axis, a glandular system for controlling stress.

The key to a healthy HPA axis rests in the gut.  The bacteria that live in your large intestine ensure the functionality of this system by producing serotonin, a neurotransmitter that promotes well-being.  Since 90% of serotonin is produced in the gut, a happy, healthy digestive track will insure a well-developed HPA axis.

Unfortunately, comfort foods do a terrible job of ensuring that the bacteria that live in your gut are well-fed.  Gut microbes thrive on “prebiotic” foods such as leafy greens, oats, asparagus, artichokes, onions, garlic, and the like.  They do not live on sugar and processed carbs.  As a matter of fact, pathogens, such as yeast, love sugar and carbs, which are the root cause of so many systemic yeast infections. (I had a sweet 7-year-old in the office today, who loves crackers and cookies, showing me her eczema and swollen eyes - a sure sign of a yeast infection).  A well-fed, healthy digestive track ensures production of serotonin and the neurotransmitter, dopamine, that make you calm, happy, and motivated.

Gut health is established at birth and, as a result, it’s greatly impacted by the gut health of the mother and the type of birth.  If the mother has poor gut health (and likely, a poorly functioning HPA axis) then baby will, too.  Cesarean section deliveries correlate with fewer microbes, less diversity of microbes, and higher levels of pathogens.  This, in turn, effects development of the HPA axis.  It is certainly possible to correct this, but only if the baby is well-fed.

As we get older, we have the opportunity to either improve the functionality of the HPA axis or to ensure its demise.  Taking a probiotic (i.e. a supplement that supplies billions of beneficial microbes to support gut health) helps, but we also need to feed these bacteria the food they love. If the diet does not contain the prebiotic foods previously mentioned, the bacteria in your gut will starve to death and, in a last-ditch effort to stay alive, they will eat you!

Once I clean up my patients’ diets, they frequently tell me how much better they feel mentally and physically, and how they are sleeping better at night.  Emotional eating simply begets emotional eating.  The more comfort food we eat the more we damage the health of the gut.  It is a vicious cycle that has dire health consequences.  Poor gut health correlates with just about every health condition including anxiety and depression, metabolic and autoimmune diseases, cancer, and even drug addiction.  Initially, ignoring comfort food cravings will be hard, so alternative strategies for lowering cortisol are needed.  The best antidote, for sure, is exercise. Walking outdoors is exceptionally helpful, but I also encourage the kind of exercise promoted by THE MAX Challenge, that makes you sweat and your heart beat faster (though, for some people, walking does indeed do the trick).

I also encourage meditation.  I recently hosted a transcendental meditation (TM) tutorial, and it was quite informative.  Closing your eyes and clearing the mind is incredibly effective at lowering cortisol levels.  Studies have shown that it even improves gut health.

Although I am not a psychotherapist, I believe that cognitive behavior therapy (CBT) may be used to make people more aware of issues that artificially stimulate their appetite.  A psychotherapist can also provide some coping skills that may be used as a substitute for emotional eating.

If you are concerned about your eating habits and feel that emotional eating is something that needs to be addressed, please feel free to book an appointment at www.egglrock.com.  Dr. Laura would be happy to help you identify the root cause of this futile habit so that you may establish a healthier relationship with food.

This article was published in The MAX Factor magazine, Volume 2, Issue 1

Addressing Controversial Food Claims with Patients

Addressing Controversial Food Claims with Patients

By: LauraL. Rokosz, PhD

The internet has had a resounding impact on human health. There is so much information at our fingertips but unless you are an authority interpretation of what we read in the media is open to debate. Since I am a nutritionist my patients are quite curious around commentaries that imply soybeans cause breast cancer, that gluten causes Alzheimer’s disease, that ketogenic diets are an ideal weight loss strategy, etc. I have been challenged to explain these controversial claims in simple terms but after a few iterations, I’ve come up with a three-pronged approach that is both effective and appreciated:

1.       Tease out the details with peer reviewed data

2.       Discuss the potential consequences of the claim

3.       Provide alternative recommendations

I first start by explaining the science behind the headline. Sometimes the claim is derived solely from experiments conducted in test-tubes or in rodents. These data often do not translate to humans, or, translation studies have yet to be preformed.

For example, the relationship between soy and cancer stems from studies with a breast cancer cell line. These experiments showed that the phytochemical in soybeans, genistein, increases the growth of MCF7 cells at low concentrations but inhibits their growth at high concentrations. Several meta-analyses looking at outcomes in humans have shown that soybean consumption not only reduces the risk of breast cancer, but it also reduces rates of reoccurrence of breast cancer and increases lifespan in breast cancer patients.

Calorie restriction is another hot button topic that purports extended lifespan when calorie consumption is limited. This theory has only been documented in cell lines, rodents, and monkeys, and has yet to be proven in humans. I have a strong opinion regarding calorie restriction in that I do not allow any of my patients to consume fewer calories than their metabolism will support which is typically 1,500 calories for women and 2,000 calories for men.

I then explain the physical consequences of following through on these types of claims. Eliminating entire food groups is rarely a good idea. A large percentage of my patient population is interested in testing out, for example, a ketogenic diet for weight loss or a Paleo diet if they suffer from an autoimmune condition. Following a ketogenic diet, where 70 to 80 percent of your calories are derived from fats, is a short-term strategy that will produce short term results. Tricking the body into using fats instead of glucose for energy will starve the body of fiber and critical nutrients such as folate (B9), biotin (B7), selenium, choline, vitamins A, E, and D, chromium, iodine, and magnesium, leading to malnutrition and a wicked case of constipation. Furthermore, compliance among my weight loss patients following a ketogenic diet is zero percent.

Exclusions in the Paleo diet include whole grains, legumes, and dairy, which lead to deficiencies of B vitamins, calcium and vitamin D. These deficiencies alone greatly increase the risk of osteoporosis. Although these gaps may be corrected with supplements, the body assimilates nutrients best from foods that dilute and disperse among other substances that facilitate their absorption and use by the body.

I am currently working with a young mother, diagnosed with Graves’ disease, who is still nursing her son. She has been strictly following a Paleo diet to alleviate her hyperthyroid symptoms. Her condition has not improved and she risks a calcium and vitamin D deficiency, which could be detrimental for both the mother and her baby.

As a former pharmacologist who has developed drugs for just about every therapeutic indication you can think of, I’d like to point out that medicines are nothing more than nutrients that are structurally modified to make them more potent than their original form. Medicines are used therapeutically to correct chemical deficiencies. Food, on the other hand, is used for disease prevention and health maintenance. Looked at another way, food truly is medicine, and if you do not get enough nutrients from food then medicine will become your food.

Fresh food contains all the nutrients you need in just the right concentration that nature intended. Pharmaceutical “nutrients” are at least 10,000 times more potent than the nutrient from which they are derived. This increase in potency increases risk of off-target activity and subsequent side-effects. Over-eating is akin to a nutrient overdose, which also has side-affects, including bloating, gas, diarrhea, and heart burn.

Finally, after explaining the controversy and consequences, I provide my patients with an alternative recommendation. I cannot think of any better dietary strategy then a Mediterranean diet, which does not eliminate any food group. This meal plan focuses on consumption of fruits, vegetables, and whole grains with modest consumption of animal protein and healthy fats that include avocados, olive oil, nuts and seeds. A Mediterranean diet has been clinically proven to reduce all-cause disease risk and to increase lifespan when routinely followed.

For patients who are concerned about food sensitivity, I offer blood testing that measures immunoglobulin levels produced in response to 96 different food antigens. If a bona fide food allergy is suspected, then I refer my patients to a reputable immunologist.

I welcome my colleagues and all members of the nutrition community to adopt these three useful strategies for answering patient concerns around food, explaining the controversy, discussing the consequences, and providing alternative recommendations based on scientific data. I have found that this increases compliance with my suggested guidance and prevents patients from following ideas that may not be beneficial to their health.

References

Crous-Bou, M., Fung, T.T., Prescott, J., Julin, B.,  Du, M., Sun, Q., Rexrode, K.M., Hu, F.B., and De Vivo, I. (2014) Mediterranean diet and telomere length in Nurses’ Health Study: population based cohort study. BMJ (Clinical research ed.). Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4252824/

Jacobs D.R. Jr., Gross, M.D., and Tapsell, L.C. (2009) Food synergy: an operational concept for understanding nutrition. American Journal of Clinical Nutrition. Retrieved from: https://www.ncbi.nlm.nih.gov/pubmed/19279083

Pons, D.G., Nadal-Serrano, M., Torrens-Mas, M., Oliver, J., and Roca, P. (2016) The Phytoestrogen Genistein Affects Breast Cancer Cells Treatment Depending on the ERα/ERβ Ratio. Journal of Cellular Biochemisty. Retrieved from:  https://www.ncbi.nlm.nih.gov/pubmed/26100284

Sizer, F.S., Whitney, E. N. (2017) Nutrition: Concepts and Controversies 14th Edition. Cengage Learning

Shu, X.O., Zheng, Y., Cai, H., Gu, K., Chen, Z., Zheng, W., and Lu, W. (2009) Soy food intake and breast cancer survival. JAMA. Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2874068/

Annual Testing of Vitamin D Serum Levels and Functional Activity

Annual Testing of Vitamin D Serum Levels and Functional Activity*

By: Laura L. Rokosz, PhD

The correlation between vitamin D and bone health is well-recognized by the medical community. However, its role in immune health is not nearly as appreciated. 

The functional importance of vitamin D is deep-rooted in human evolution. When humans in Africa lost their hair, their skin darkened to protect them from sun burn and skin cancer. As humans migrated to Europe and Asia, skin pigmentation lightened to facilitate UV-B-induced vitamin D3 (cholecalciferol) production needed not only for bone health but for immunity.

The activated form of vitamin D, 1α,25-dihydroxyvitamin D3 (1,25(OH)2D3), acts as a nuclear hormone that binds to and stimulates the vitamin D receptor (VDR). (It is only called a vitamin because we do not get enough sunlight and therefore need to obtain it dietarily). This process leads to the upregulation of numerous immune system-related genes and has fueled the hypothesis that a vitamin D deficiency is a risk factor for autoimmune diseases such as inflammatory bowel disease (IBD), type 1 diabetes, rheumatoid arthritis, and multiple sclerosis.

Data also exist to correlate vitamin D deficiency with metabolic diseases, cancer, and Alzheimer’s disease. Although the mechanism for these associations is not clear, it is likely related to VDR activation.

Given the criticality of vitamin D function, it is recommended to quantify both the serum levels and activity during a yearly physical. I have been using a functional cell-based assay, which propagates T cells from blood samples, to measure the activity of vitamin D. This assay informs on VDR signaling by looking at the growth of immune cells in a defined culture medium.

Functional activity is always more informative than checking levels alone. Clinically, a vitamin D deficiency is defined as serum levels less than 20 ng/mL. Vitamin D insufficiency is defined as serum levels between 21 and 29 ng/mL. If the serum levels are below 30 ng/mL, then supplementation with 1,000 to 4,000 international units (IUs) of vitamin D3 is recommended. Keep in mind, levels of at least 50 ng/mL are advised to thwart immunodeficiency. If vitamin D levels are adequate but the functional activity is below the acceptable threshold, then the dose may be increased to 5,000 IUs per day or 50,000 IUs once per week.

Since vitamin D is fat-soluble, care should be taken to avoid toxicity which occurs when serum levels exceed 150 ng/mL. Functional activity should be rechecked again in six months, which is roughly the amount of time it takes to completely replenish a new generation of T cells that have been exposed to the higher vitamin D levels.

If supplementation does not correct the functional deficiency, then it is possible that the VDR has been desensitized, meaning it has been over-stimulated and no longer responds to activation by vitamin D. This is a common receptor-mediated mechanism, and therefore supplementation should be discontinued for several weeks to one month to restore sensitivity. Although there may be unknown genetic factors that effect VDR function manipulating vitamin D levels with a supplement is a straight-forward and economical strategy to help resolve the problem.

With the advent of antiseptics, antibiotics, and vaccines, the human immune system has greatly evolved. Chronic immune-related diseases far outpace infectious disease as a cause of death. This phenomenon has been exacerbated by economic expansion that modified human behaviors contributing to vitamin D deficiency. We no longer spend adequate time outdoors and we eat less vitamin D-rich foods like fish and dairy. For the sake of our immune system perhaps, it is time to revisit food fortification efforts.

Such measures with B vitamins including B12, riboflavin, niacin, and thiamin have improved children’s heath, folate fortification has reduced neonatal spinal cord defects, and iodized salt has improved thyroid health. Dietary efforts to reduce vitamin D deficiency are sure to have a similar impact on immune health.

Multiple studies have shown that fortified milk, cereals, wheat flour and margarine restores vitamin D status to clinically healthy levels in deficient populations. Biofortification of eggs from hens fed vitamin D3-enriched feed is as effective at correcting this deficiency as using fortified foods. It has even been shown that cows fed a diet containing 4,000 IUs of vitamin D3 for 30 days prior to slaughter significantly increased vitamin D content of the resulting beef steak. Other biofortified foods include UV-treated mushrooms and baker’s yeast, which are plant-based sources of ergocalciferol (vitamin D2), for those who do not consume animal products.

Our dietary needs for vitamin D will vary on time of year and geographic location. Therefore, food industries world-wide should adjust food product production strategies according to these variables. Current fortification and biofortification efforts are aimed at ensuring that upper limits for consumption are not exceeded. For those individuals who cannot digest dairy there are many other dietary options. (Be sure to check food labels!). Keep in mind that the only way to be absolutely sure that you are consuming enough vitamin D, either through food or a supplement, is to have your blood levels and functional activity checked annually. You are welcome to book an appointment for blood testing from our website at www.egglrock.com.

References

Carlberg, C. (2019) Nutrigenomics of vitamin D. Nutrients. Retrieved from: https://www.ncbi.nlm.nih.gov/pubmed/30901909

Carlberg, C. (2019) Vitamin D signaling in the context of innate immunity: Focus on human monocytes. Frontiers in Immunology. Retrieved from: https://www.ncbi.nlm.nih.gov/pubmed/31572402

Harrison, SR.., Li, D., Jeffery, L.E., Raza, K., and Hewison, M.. (2019) Vitamin D Autoimmune Disease and Rheumatoid Arthritis. Calcified Tissue International. Retrieved from https://link.springer.com/article/10.1007%2Fs00223-019-00577-2

Holick, M.F.. (2007) Vitamin D defiency. New England Journal of Medicine. Retrieved from: https://www.ncbi.nlm.nih.gov/pubmed/17634462

Martin, T. and Campbell, K.. (2011) Vitamin D and diabetes. Diabetes Spectrum. Retrieved from: https://spectrum.diabetesjournals.org/content/24/2/113

Moulas, A.N. and Vaiou, M. (2018) Vitamin D fortification of foods and prospective health outcomes. Journal of Biotechnology Retrieved from: https://www.ncbi.nlm.nih.gov/pubmed/30176270

Littlejohns, T.J., Henley, W.E., Lang, I.A., Annweiler, C., Beauchet, O., Chaves, P.H., Fried, L., Kestenbaum, B.R., Kuller, L.H., Langa, K.M., Lopez, O.L., Kos, K., Soni, M., and Llewellyn, D.J. (2014) Vitamin D and the risk of dementia and Alzheimer disease Neurology. Retrieved from: https://www.ncbi.nlm.nih.gov/pubmed/25098535

Venkatramanan, S., Armata, I.E., Strupp, B.J., and Finkelstein, J.L. (2016). Vitamin B-12 and Cognition in Children. Advances in Nutrition. Retrieved from: https://www.ncbi.nlm.nih.gov/pubmed/27633104

Walsh, J.S., Bowles, S., and Evans, A.L. (2017) Vitamin D in Obesity. Current Opinion in Endocrinology, Diabetes and Obesity. Retrieved from: https://www.ncbi.nlm.nih.gov/pubmed/28915134

Young, M.R.I. and Xiong, Y. (2018) Influence of vitamin D on cancer risk and treatment: Why the variability? Trends in Cancer Research. Retrieved from: https://www.ncbi.nlm.nih.gov/pubmed/30369773

*This article was published in Integrative Practitioner on November 26, 2019 and can be retrieved here: https://www.integrativepractitioner.com/patient-care-planning/2019-11-26-annual-testing-vitamin-d-serum-levels-and-functional-activity

Why Are You Afraid of Soybeans?

Why Are You Afraid of Soybeans?

Soybeans have been consumed by Asian cultures for thousands of years.  These legumes are so nutritionally complete that they sustained Eastern populations through drought and famine.  Like most legumes they are composed of protein, carbohydrate, fat, fiber, vitamins and minerals and thousands of plant-based compounds called phytochemicals that keep the plant from getting sick. When you eat these plants they prevent you from getting sick.

The protein of a soybean is unique in that it is the only plant-based protein whose amino acid composition mirrors the protein found in animals[1].  Soybeans are extremely heart healthy because they are low in saturated fat and are a good source of polyunsaturated fatty acids such as Omega-3 fatty acids, and roughly 40% of the carbohydrate content of soybeans comes from fiber.  The cardioprotective effects promoted by these macronutrients are derived from lower cholesterol levels.

All plants contain phytochemicals and one noteworthy compound found in soybeans is a phytoestrogen called genistein.  As its name implies it is an estrogen analog and therefore associated with an increased risk of breast cancer.  However, this is a gross misunderstanding.  Although genistein has been shown to stimulate the growth of a breast cancer cell line in test tube experiments clinical studies in patient volunteers have proven the opposite is true.  Not only does consumption of soy foods reduce the risk of breast cancer it also reduces rates of re-occurrence of breast cancer and increases lifespan in breast cancer patients.  Additional studies have shown that soy food consumption reduces rates of endometrial cancer and prostate cancer.

One reason why women in Asian communities enjoy a healthy body composition is related to their consumption of soy foods.  Estrogen is a hormone that helps to regulate fat storage so when levels are low, such as during menopause, foods containing phytoestrogens will help to restore that balance. These women also suffer from fewer menopausal symptoms (caused by low estrogen levels) and suffer less from bone loss.

Men also need not fear the mighty soybean.  No clinical studies have documented a correlation between soy consumption[2] and breast tissue growth nor do these foods interference with testosterone function.  Soybeans can be goitrogenic meaning that because they are so nutritionally dense the high mineral content may interfere with iodine absorption.  Therefore, men and women who suffer from an underactive thyroid should take an iodine containing multivitamin when consuming diets rich in goitrogenic foods.

A final area of concern for soybeans includes the topic of food allergy.  Soy protein is the 4^th most common food allergy and I’d like to think that it is related to the fact that 99% of the soybean crop in the US is genetically modified.  These soybeans[3] are largely used for the production of food additives such as soy lecithin, soy protein isolate and textured soy protein.  These foods should be avoided in favor of organic (non-GMO) edamame, soy milk, tofu, tempeh and other fermented derivatives of soybeans.

---

[1] Soy is not a complete protein for infants as it needs to be supplemented with methionine.

[2] Consumption of soy supplements, which contain very high phytoestrogen levels, is not recommended.

[3] GMO soybeans are typically treated with pesticides such as glyphosate which is the main health concern for this crop.

Top Ten Reasons Why Women Cannot Lose Weight

Top Ten Reasons Why Women Cannot Lose Weight

Weight gain is just so exasperating, especially for women who seemingly do everything right with diet and exercise and yet suffer from that irritating midriff bulge.  However, understanding and being aware of a few contributing habits can make a big difference on your waistline.  Let’s consider these ten leading culprits of weight gain in women:

1.       Eating too much at one meal:  Large meals increase insulin levels, a real Jekyll and Hyde hormone.  Insulin is helpful in that it lowers your blood sugar but is harmful in that it inhibits fat burning and encourages fat storage.

2.       Eating too fast at meals:  Eating too fast, whether it’s a healthy food or not, will spike your insulin levels and stimulate fat storage in the same way as eating too much at one meal.

3.       Insulin Resistance: In this age of food abundance we have the liberty to snack as often as we like.  No matter what those snacks consist of (although most of the time it is a nutrient depleted processed food) your blood sugar will rise followed by an increase in insulin.  After a few decades of this bad habit, the insulin will stop working to lower the blood sugar and will just make you store fat.  This is what is called insulin resistance.  Learning how to properly eat a low glycemic index diet can easily correct this problem.

4.       Eating too late:  Eating dinner after 6:00 pm is never a good idea as the body does not have enough time to metabolize all those macronutrients.  Those late-night calories just get stored as fat instead of being burned by say, an after-dinner walk.

5.       Not eating enough throughout the day: So many women complain of hardly eating anything at all but gaining so much weight.  This is because you are not eating enough food to support your basal metabolic rate (BMR), which is the number of calories you need to stay alive.  Basically you are starving yourself to death so the body responds by storing every last calorie.  Eating stimulates calorie burning, referred to as the thermic effect of food. When you skip meals or eat like a mouse you do not benefit from this process.

6.       Estrogen is too high or too low:  Women will gain weight when their estrogen levels are too high, such as during puberty to support fertility, and when their levels are too low, such as during peri-menopause and menopause. The best way to regulate estrogen levels is through exercise, ideally the kind that makes you sweat and increases your heart rate.  A brisk walk outside can do wonders for your hormones.  Dietarily, if estrogen levels are low then you should eat foods that are high in phytoestrogens such as tofu and flax seeds.

7.       Overproduction of the hunger hormone ghrelin:  Ghrelin is a hormone that stimulates your appetite when the stomach is empty.  Constantly eating large meals (even if it’s just one meal per day) will stretch out your stomach so that you will feel like you are starving as soon as your stomach empties. This is one reason why it is better to eat four to six small meals per day instead of three large meals.  Also, it takes about an hour for ghrelin levels to decline once you start eating so just eat half your meal and then wait about an hour.  If you’re still hungry then finish your plate (just be truly mindful about how you feel).

8.       Leptin resistance:  Leptin is a hormone that reducs your appetite and promotes satiety. However, if you are insulin resistent then you may also be leptin resistent-You produce leptin but it does not work to reduce your appetite.  Following a low glycemic index diet to reverse insulin resistance will restore leptin to its full functionality.

9.       Over production of the stress hormone, cortisol:  Cortisol is a stress hormone made by the adrenal glands.  A little bit of this hormone is a good thing.  It gets us going in the morning, but chronic production leads us to eat “comfort foods”.  Comforts foods such as macaroni and cheese and pizza are not necessarily called comforts foods because they taste good but because they literally lower cortisol levels and make us relax.  Aside from the day-to-day minutia of life two bad habits that increase cortisol levels unnecessarily are over-exercising and undereating. The take-home message here is that running marathons and living off of protein bars may not get you to your weight goal.

10.   Underactive thyroid:  The thyroid gland is responsible for the production of thyroid hormones that regulate your ability to metabolize food.  When they are not doing their job the first thing you will notice is weight gain, along with chronic fatigue, sensitivity to cold, and hair loss.  Be sure to see your endocrinologist if you suspect a thyroid problem or listen to this Eat Right with Laura podcast to learn more about thyroid health.

Being made aware of these ten contributing factors of weight gain may inspire you to change your behavior.  Be sure to include nutrients in your diet that boost your metabolism such as protein-rich foods including meat, fish, eggs, dairy, legumes, nuts and seeds.  Proteins are a complex macronutrient that take more energy to digest than fats and carbohydrates.  Make sure you get enough sleep but not too much.  If you are truly struggling with your weight then avoid alcohol of any kind.  Alcohol is not recognized by your body as a nutrient and ultimately is converted to fat. Finally, consider working with a dietician, nutritionist or health coach to get you on track and to keep you accountable to your weight loss goals.

The Current State of Alzheimer’s Disease Treatment

The Current State of Alzheimer’s Disease Treatment

Is a bona fide cure for Alzheimer’s disease (AD) truly right around the corner? Despite the glowing reports we read about from experiments conducted in test tubes and animals, the short answer is No.

I have spent decades in the Pharmaceutical and Biotech industries looking for the elusive small molecule or biologic to halt the production of the plaques and tangles that are a hallmark feature of this neurologically destructive disease. These compounds work just fine in animals but do not improve cognitive health in humans. 

The current pharmaceutical agents to treat AD patients focus on acetylcholine which is a neurotransmitter that supports memory. For mild to moderate cases of AD, doctors prescribe Aricept® or Exelon® which are cholinesterase inhibitors that prevent the breakdown of acetylcholine. For moderate to severe AD doctors recommend Namenda® which is a N-methy-D-aspartate (NMDA) antagonist that blocks the toxic effects associated with another neurotransmitter, glutamate. The newest drug, Namzaric®, is simply a combination of Aricept® and Namenda® to treat symptoms of moderate to severe AD.

Other classes of drug treatment merely help with the depression, aggression, restlessness and anxiety seen in AD but none of these drugs, including the cholinesterase inhibitors, reverse neurodegeneration and also come with numerous side effects.  

Novel treatments in clinical development focus on reducing plaques and tangles, and while several compounds have proven to be effective in this manner they do not reverse or delay disease progression.  The current theory for this lack of efficacy is that treatment must start long before obvious symptoms of AD appear.  In most cases this could be a matter of decades, not years. As a result  the founders and active members of the AD foundation and physicians from the Weill Cornell Medical Center  are strong supporters of disease prevention using dietary and lifestyle intervention to reduce cognitive decline in AD. Although statistical significance is much harder to quantify for these remedies, since there are so many variables, the results cannot be ignored. 

Since I am a fitness enthusiast I am happy to report that there is a wealth of data to show that exercise, weight lifting in particular, improves cognitive health in a variety of ways. These studies have shown that exercise increases brain size and function with measurable improvement in memory.  These changes may be related to increased blood flow and subsequent oxygenation of the brain along with increased delivery of glucose. Decreased glucose utilization is a hallmark feature of Alzheimer’s disease which is why it is sometimes referred to as Type 3 Diabetes.  Also, yoga and meditation are shown to reduce the stress hormone cortisol to improve overall well-being.  These studies mirror the utility of physical therapy used to restore neuronal function in brain injury.

Numerous studies have been undertaken to assess the importance of nutrients that are critical for brain health, including vitamins B1, B6, B12 and D3 along with Omega-3 fatty acids.  Huperzine is a moss extract that has properties similar to those of colinesterase inhibitors. Other nutrients under investigation include coconut oil, phosphatidylserine, and a Medical food called Tramiprosate.  Coconut oil is high in medium chain triglycerides thought to be an exceptional energy source for the brain.  Phosphatidylserine is a primary component of the membranes that surround nerve cells and Tramiprosate is rich in taurine, an amino acid that plays an important role in creating new brain cells and is often used to boost cardiac function.

A more practical solution to ensure consumption of all of these nutrients would be to follow The Mind Diet which is basically a combination of a Mediterranean diet that is rich in healthy fats from fish, olives, olive oil, nuts and seeds, and avocados, and the DASH diet which helps to reduce sodium levels and increase fiber from fruits, vegetables and whole grains. These foods increase the growth of beneficial bacteria in the gut, leading to greater production of acetylcholine.  Improved gut health will also increase levels of serotonin and dopamine to obviate the need for anti-depressant and anti-anxiety meds.  One piece of The Mind Diet that I probably would not support is the inclusion of red wine. Alcohol is a solvent that inhibits nutrient absorption and may interfere with digestion. It is also a stimulant that will interfere with a good night’s sleep. Despite it’s reputation for being heart healthy I do not believe that red wine is beneficial in AD.

Treatment of Alzheimer’s disease is not nearly where it needs to be, given the acceleration in aging of the World’s population (Fig. 1). In their quest to chase down that next billion-dollar drug pharmaceutical researchers are wasting valuable time and resources. A greater emphasis on holistic treatments that increase memory will lead to improved outcomes with less pain and suffering by both patients and families.

Lower Your Cholesterol Levels Without Drugs

Are you sitting on the fence? Use food as your medicine, otherwise medicine will become your food

As a seasoned Pharmacologist AND Food Scientist I have a unique perspective on the utility of both medicine and food. My doctoral thesis, written in 1992, focused on the development of new drugs to lower cholesterol levels.  It was a time when Statins were initially developed but had numerous undesirable side effects. They were designed for people with extremely high cholesterol levels, possibly caused by mutations that affect clearance of the "bad" cholesterol, LDL. They were so effective at lowering cholesterol levels that doctors started prescribing them to anyone with even modestly high cholesterol levels.  We are now seeing a backlash from patients who refuse to tolerate the side effects: myalgia (muscle pain), memory loss (neurons in the brain need cholesterol to provide fluidity that enables them to communicate with one another) and loss of blood sugar control. When we train the liver to inhibit cholesterol synthesis it may respond by kicking out glucose from its glycogen stores into the blood.

In early Nov. 2018 I had a major reality check. Over the past three decades I've watched my total cholesterol and LDL cholesterol levels slowly inch higher and higher.  This year they finally made it in to the red zone (see chart below).  Since I am fitness enthusiast and at a healthy weight my blood pressure is still in a healthy range but higher than usual.  I also have healthy levels of HDL cholesterol (the "good" cholesterol) and triglycerides but the non-HDL cholesterol (all forms of cholesterol that are NOT good) is officially in the statin prescribing zone.

I know that a high fiber diet that is low in saturated fat will help but what else can I do to make sure that my Primary Care Doctor (the awesome Dr. Vincent Codella) doesn't whip out the prescription pad? Right after Thanksgiving I pulled out all the stops to do a ten-day cleanse (no cheating) using the Clear Change® 10 Day Detox Program. The process is fairly straight forward and is based on clean eating, NOT fasting. For ten days you may eat fruits, vegetables, legumes, fish (no shellfish), healthy fats, water and tea in unlimited quantities. You may also eat nuts (but no peanuts) and seeds, gluten-free grains and free-range poultry but only on certain days. You must completely eliminate sugar, dairy, gluten, coffee, alcohol and any genetically modified (GMO) crops such as corn and soy. My results were amazing!

Missing out on Happy Hour after an intense week at the office was tough but so worth it. My total cholesterol decreased from 213 to 160 mg/dL, my LDL cholesterol decreased from 132 to 89 mg/dL and the non-HDL cholesterol decreased from 148 to well under 100 mg/dL.  My HDL cholesterol, which was already pretty good, increased a bit and my triglycerides dropped from 78 to 42 mg/dL. The Clear Change Program was already a tool that I rely on to improve the health of just about all of my patients but my own data convinced me that this is probably one of the most practical holistic strategies to correct biomarkers of human health. It is designed to eliminate toxins from the body by improving liver and kidney function, the two organs we rely on specifically for this purpose. Although it is not designed for weight loss it is the perfect tool to launch a weight loss journey or to promote a change in body composition when your metabolism has plateaued. 

A new year means a new you. It is a perfect time to commit to our 10-Day Clear Change program. Get your organs firing on all cylinders, remove toxins such as heavy metals, lower your blood sugar and of course, improve your cholesterol levels. If you'd like to learn more about this detoxification program then book an appointment today at EGGLRock Nutrition. Most insurance plans accepted.