The Neuro-Protective Lifestyle

Say “Science Says Celery Saves Brain Cells” Seven Times

Posted on 21. May, 2008 by Kerry Friesen, M.D..

photo credit: Francesca:Nocella

If you think that’s hard, try the original title from the current issue of the Proceedings of the National Academy of Sciences:
“Luteolin reduces IL-6 production in microglia by inhibiting JNK phosphorylation and activation of AP-1″

*Division of Nutritional Sciences, Integrative Immunology and Behavior Program, Department of Animal Sciences, and Department of Pathology, University of Illinois at Urbana–Champaign, 1207 West Gregory Drive, Urbana, IL 61801

Regardless of how you say it, foods full of flavonoids (such as the luteolin in celery), fight neuroinflammation faster than aspirin. No, I just made that up about the aspirin, but the science is still very, very convincing.

In this study, brave mice were given an intraperitoneal (inside the abdomen) injection of lipopolysachharide (LPS) to stimulate the production of brain damaging inflammatory mediators.

Three weeks earlier researchers had replaced the study animals regular water with water “spiked” with luteolin, a protective flavonoid found in especially high concentrations in celery. At different time intervals they evaluated blood samples to precisely measure the amount of proinflammatory cytokines – chemicals responsible for neuroinflammation.

You’ll remember that neuroinflammation is the hallmark of common neurodegenerative diseases such as Parkinson’s disease, Alzheimer’s and others.

Chronic inflammation anywhere in the body can contribute to disease and the brain is no exception.

Three weeks worth of luteolin spiked water, dramatically reduced the amount of inflammation present in hippocampus of the study animals, confirming the neuroprotective properties of simple celery.

Practically speaking, a human would have to consume 47 servings of celery per day to replicate the concentration of luteolin found in the animals drinking water.

Do not despair however, since flavonoids are found in abundance in many many foods. There are in fact over 4,000 aromatic compounds found in tea, honey, wine, fruits, vegetables, nuts, olive oil, cocoa and others.

For a more complete list see “Eat Your Antioxidants – Or Else”.

A daily intake of a gram or more of a variety of bioflavonoids is a reasonable dietary goal.

Soooooo when you’re out grocery shopping be courteous and save some celery for the next person.

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Your Waist Size NOW, Predicts Brain-Wasting Later: Here’s Why

Posted on 14. Apr, 2008 by Kerry Friesen, M.D..

The power to predict disease is – well – powerful. And nothing is more powerful in scientific circles than a carefully constructed, decades long, longitudinal study.

In case you haven’t noticed, approximately fifty percent of adult Americans have abdominal obesity. “Abdominal” or “visceral” obesity is defined as a waist circumference greater than 102 cm for men (40 in.) and 88 cm (35 in.) for women. Your “viscera” (internal organs) now double as a convenient “dumping-ground” for fat. No surprise then, that researchers in Northern California were easily able to recruit 6,583 “apple-shaped”, middle-aged, men and women. Thirty-six years later, a whopping sixteen percent (1053 people) had developed dementia.

Apparently abdominal obesity at 40, doubles or triples your risk for dementia in your 70’s.

To put it into perspective, every-other vibrant, active, middle-aged person with belly fat that you see today, will reach retirement and be rewarded with difficulty remembering their own name.

But what is it about belly fat that ultimately leaves our brains battered and bewildered?

When fat is progressively packed around internal organs it literally takes on a life of it’s own. Adipocyte (fat cell) signaling becomes so strong that it becomes the dominant “endocrine” or hormone secreting organ in the body. Over time, insulin levels rise. Soon after, persistently elevated blood-sugars increase production of a very dangerous by-product of glucose metabolism known as Advanced Glycosylated End-products (AGE’s).

When diabetic patients undergo HbA1c testing, whether they know it or not, they are having their advanced glycosylated end-products measured. Levels greater than 6.1 are considered abnormal and require treatment. AGE’s are found within the plaque and neurofibrillary tangles of specially stained brain tissue of Alzheimer’s patients and directly contribute to neuronal damage.

These same autopsy studies suggest that damage occurs long before the symptoms of dementia arise.

So here’s what to do if you’re 40 and find yourself in that other 50 percent category:

1. Determine your waist circumference by wrapping a tape measure midway between the top or your pelvis and the bottom of your ribs (between the bony parts in other words)

2. Ask your doctor to measure a fasting blood-sugar (fasting means nothing to eat – not even juice – after midnight of the night before)

3. Levels greater than 109 mg/dl require further evaluation with HbA1c testing

4. Exercise, exercise, exercise (all the crunches in the world will not remove this fat – neither will liposuction)

5. If you have a low HDL (good) cholesterol and elevated triglycerides, consider having Apo-E testing performed as well

I’m here to help – so feel free to leave a comment if you have a [fat] burning question!

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Some “Berry” Good News About Brain (tissue) Transplants

Posted on 15. Mar, 2008 by Kerry Friesen, M.D..

The central nervous system and the brain in particular are considered “immunologically privileged” sites. Brain function is so important from a survival standpoint that it is essentially “immune” to its own immune system. No immune response to a foreign antigen in the brain, means no inflammatory response and no tissue rejection.

While receiving a “brain tissue” transplant may not turn your crank, thanks to the phenomenon of immune privilege it may soon be your best bet at treating accelerated brain aging and other neurodegenerative diseases. Until recently, survival rates for transplanted neural tissue have been dismal. Rates of less than 10% are considered the norm. Listen up aging baby-boomers, rates are even lower if the host happens to be “middle-aged” and above.

Now for the “berry” good news! Previous studies confirmed that the polpyphenols found for example in the lowbush blueberry (vaccinium augustifolium), dramatically increase survival rates of developing neurons in vitro.

Now a recent in vivo (read rat study) study confirms it.

The lucky rats received a fetal hippocampal tissue transplant to the anterior chamber of the eye (the eye is another immunologically privileged site), plus a diet enriched with the lowly lowbush blueberry. The unlucky rats got the knife but no berries. Final hippocampal graft size increased dramatically in the polyphenol-rich blueberry diet fed rats and not-so-much in the other.

Conclusion? In the future, if your doctor recommends a brain transplant, stock up on blueberries. Remember though, prevention is better than cure.

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Save Your Heart–Save Your Head: In Five “E”asy Steps

Posted on 02. Mar, 2008 by Kerry Friesen, M.D..

Remember you heard it here first.

There now exists a formidable body of literature linking cardiovascular disease and neurodegenerative disorders. More than ten years ago I found myself lecturing my patients on the not-so- subtle connection between abdominal obesity; insulin resistance; syndrome-X and endothelial-cell dysfunction. With abdominal obesity, fat is progressively packed around internal organs until it literally takes on a life of it’s own. Adipocyte (fat cell) signalling becomes so strong that it becomes the dominant “endocrine” or hormone secreting organ in the body. In the vernacular, all hormonal “hell” breaks loose.

Resistance is futile. You have become one with your fat cells. The delicate yin and yang balance between your immune system and other major organ systems is lost. The cytotoxic and neurotoxic effects of inflammatory mediators like TNF-alpha; peroxynitrite and IL-6 to name a few, reign supreme. Over time, free-radical formation and the subsequent oxidative damage result in irreversible mitochondrial DNA decay and cell death. If the affected cells reside in your brain, then any one of a multitude of neurodegenerative diseases is possible. If they happen to line the vascular endothelium in your heart, then you are well on you way to your first heart attack.

Most people reading this blog will find themselves in between the two extremes. In this “no-mans land” of disease, doctors euphemistlcally tell patients they have a “touch of sugar” (you have frank diabetes) or their blood pressure is a “little elevated” (you’ve been diagnosed with high blood pressure) or your “good cholesterol” (HDL) is a little low (you are at high-risk for heart disease and diabetes). I could go on…

As it turns out, the common denominator in the above scenario is inflammation overload. Nothing, not even the micro-circulation of the brain escapes the damaging effects of IL-6 and tumor-necrosis factor-alpha. Atherosclerosis “hardening of the arteries”, impairs blood flow to the already hypermetabolic brain tissue, as a result underperfused neurons respond with ß-amyloid plaque deposition, acetylcholine signaling defects, oxidative stress and more inflammation.

The only known genetic risk factor for Alzheimer’s disease not surprisingly, is a gene that codes for Apolipoprotein E4. Apolipoprotein E in one of its three isoforms, is responsible for the transport of triglyceride, phospholipid, cholesteryl esters, and cholesterol into cells.

Of the three main isoforms of the apo E allele, apoE3 is most common, followed by apoE4 and lastly apoE2. The lifetime risk for Alzheimer’s disease in someone with apoE3 is about 9%. The lifetime risk for Alzheimer’s in someone with the apoE4 allele is a whopping 29%. If you happen to be homozygous for apoE4 (both alleles on paired chromosomes are apoE4) the lifetime risk for Alzheimer’s sky-rockets to 91% by age 80. Apparently the apoE4 allele is so inefficient at cholesterol metabolism within the brain that sulphated galactocerebroside (sulphatide) levels drop. Sulfatide has everything to do with neuronal plasticity, cell growth and repair in addition to normal signal transduction.

How do you know if you possess the apoE4 allele? While various labs offer this test Berkley Heart Lab is consistently the most reliable.

In addition, the one-time Apo E test will help decide whether or not diet will have an effect on elevated cholesterol levels. If you possess the apoE4 isoform without question diet therapy can have dramatic effect on your LDL-C (bad cholesterol) levels. If you have seen your doctor and were told you had elevated LDL-C and have altered your diet without success, then this test is for you.

Here are the five easy steps I recommend for my patients. In this case, I personally take a double dose of my own medicine.

1. Consider Apolipoprotein E testing (ask your doctor)
2. Adopt the Mediterranean diet
3. Increase Omega-3-FA consumption
4. Decrease Omega-6-FA intake (PUFA in the form of vegetable oil)
5. Dramatically increase your intake of dietary polyphenols† (see list below)

To put it another way, make a concerted effort to bathe your body’s biochemical milieu daily in a rich blend of phytochemicals. This is the essence of the “French Paradox”, that is, while the French consume much more saturated fat than their North American counterparts, they also consume far less omega-6-FA’s and far more polyphenols (in the form of red wine primarily), and have much less heart disease to show for it. It is precisely when science flies in the face of convention that you know you’re “gettin’ warm”. So, in the case of the French, consciously or not, they have 3 out of 5 of the “E”asy steps nailed down.

Next time, “How To Put Polyphenols On Your Plate” or “Pass The Polyphenols Please” or something like that! I know, I know…you can’t wait.

†Food sources rich in polyphenols include onion, apple, green-tea, red wine, red grapes, grape juice, strawberries, raspberries, blueberries, cranberries and walnuts to name a few.

Polyphenols can be classified as non-flavonoids and flavonoids. The flavonoids quercetin and catechins are currently the most extensively studied polyphenols.

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