With a greater life expectancy and an increased prevalence of type 2 diabetes, the prevalence of dementia is expected to rise (1). In order to understand the commonalities of Alzheimer’s disease and diabetes, we must have a better handle on their definitions.

Alzheimer’s disease is a progressive degenerative disease of the brain in which brain cells stop functioning, lose connections with other brain cells, and eventually die. The damage initially appears to take place in the hippocampus, the part of the brain essential in forming memories.

On the other hand, type 2 diabetes is characterized by high levels of blood glucose due to inadequate insulin production and/or insulin resistance. Insulin resistance is the inability of cells to respond to the action of insulin in transporting glucose from the bloodstream into muscle and other tissues.

So, what do they have in common?

A study of the Mayo Clinic Alzheimer Disease Patient Registry reported that greater than 80% of Alzheimer’s disease patients exhibit type 2 diabetes or abnormal blood glucose levels. Furthermore, a 2018 publication discovered that individuals with type 2 diabetes are twice as likely to develop dementia (2). These findings suggest the possibility of a linkage between the processes responsible for loss of brain and pancreatic B-cells in these disorders (3).

Growing evidence has shown similarities between Alzheimer’s disease and type 2 diabetes. Both diseases present insulin resistance and impaired insulin signaling. Alzheimer’s disease has even been deemed as an “insulin-resistant brain state”. Furthermore, both diseases experience apoptosis, inflammation, oxidative stress, mitochondrial dysfunction, and amyloid deposition (Figure 1).

Mediterranean Diet and Cognition

A mediterranean diet emphasizes fruits, vegetables, nuts, whole grains and olive oil while limiting red meat and other saturated fats, refined sugars and processed foods. Research has focused much of its attention on determining whether a Mediterranean diet, supplemented with olive oil or nuts, influences cognitive function.

In particular, a 4-year, parallel-group randomized clinical trial investigated 334 cognitively healthy volunteers with a mean age of 67 and concluded that a Mediterranean diet is associated with improved cognitive function. Participants belonging to the Mediterranean diet scored better on tests assessing immediate and delayed episodic verbal memory, attention, visuomotor speed, and cognitive flexibility (4).

A similarly designed study investigated 522 participants at high vascular risk with a mean age of 75. Compared to the control, participants belonging to the mediterranean diet scored significantly higher on neuropsychological tests evaluating orientation to time and place, registration, attention and calculation, recall, language, and visual construction (5).

Nutrition for Treatment and Prevention of Type 2 Diabetes and Alzheimer’s Disease

Say “yes” to unsaturated fats and “no” to saturated and trans fats.
Look for foods high in fiber such as…

• Vegetables
• Legumes, nuts and seeds
• Whole grains
• Fruits

Increase your intake of vegetables, legumes, fruits, and whole grains.
Incorporate foods with anti-inflammatory properties such as…

• Tomatoes
• Olive oil
• Green leafy vegetables
• Nuts
• Fatty fish
• Fruit

Ensure adequate intake of the following vitamins and minerals:

• Calcium
• Potassium
• Magnesium
• Vitamin A
• Vitamin C
• Vitamin E
• Vitamin B12
• Vitamin K

Obtain omega 3 fatty acids from…

• Makeral
• Salmon
• Cod liver oil

For additional resources relating to type 2 diabetes and Alzheimer’s disease, visit www.diabetes.org and https://alz.org.

References

(1) Li X, Song D, Leng SX. Link between type 2 diabetes and Alzheimer’s disease: from epidemiology to mechanism and treatment. Clinical Interventions in Aging 2015; 10: 549-560.

(2) Silzer TK, Phillips NR. Etiology of type 2 diabetes and Alzheimer’s disease: Exploring the mitochondria. Mitochondrion 2018.

(3) Moreira PI. Sweet Mitochondria: A Shortcut to Alzheimer’s Disease. Journal of Alzheimer’s Disease 2018; 62: 1391-1401.

(4) Valls-Pedret C, Sala-Vila A, Serra-Mir M, Corella D, Torre R, Martinez-Gonzalez M, Martinez Lapiscina EH, Fito M, Perez-Heras A, Salas-Salvado J, Estruch R, Ros E. Mediterranean Diet and Age-Related Cognitive Decline: A Randomized Clinical Trial. JAMA Intern Med 2015; 175(7): 1094-1103.

(5) Aridi YS, Walker JL, Wright OR. The Association between the Mediterranean Dietary Pattern and Cognitive Health: A Systematic Review. Nutrients 2017; 9(7): 674.

Written by Nicole Lindel ~ Nutrition Education Master’s Student at Columbia University

Although these versatile fruits are awfully expensive, avocados are deliciously smooth and LOADED with nutrients!

Vitamin C

To start, avocados contain vitamin C, an antioxidant that plays an important role in maintaining circulatory antioxidant protection and contributing to vascular health and arterial plaque stabilization. A 2009 review article suggests greatest cardiovascular disease protective effects on specific populations such as smokers, obese and overweight people, patients with elevated cholesterol, hypertension, or type 2 diabetes over 55 years of age (1).

B-Vitamins

Deficiencies in B-vitamins such as folate and vitamin B-6 may increase homocysteine levels, which could reduce vascular endothelial health and increase cardiovascular disease risk (2).

Unsaturated Fats

In addition to vitamin C and B-vitamins, avocados are a great source of protein, fiber, and healthy unsaturated fats. Avocados are fatty—and fat scares people! Yet, the author of The Secret Life of Fat explains, “Fat is not just fat.” Fat is an endocrine organ that produces hormones that are vital to our health. Our body needs fat and we possess many defense mechanisms to protect and hold on to it. So, even with its fat and all, avocados are not to be feared! In fact, their high fat and fiber content makes them exceedingly satiating—and if you are full, you are less likely to continue eating.

The Science

Several studies have shown promising benefits of an avocado-enriched diet on serum lipid concentrations (3, 4). A 2018 systematic review and meta-analysis concluded that avocado consumption increases serum HDL-cholesterol—often known as the “good” cholesterol due to its ability to metabolize and rid LDL-cholesterol and other harmful forms of lipids from the body (5).

However, in a 2013 randomized controlled parallel study, Park and colleagues found no significant impact of avocado consumption on serum HDL-cholesterol in type 2 diabetic patients. This study (2), in addition to a 2016 meta-analysis, also found a lowering effect on total cholesterol, LDL-cholesterol, and triglycerides by 15, 12, and 20 mg/dL respectively (6).

Lastly, a 2015 randomized controlled trial reported lowering effects of LDL-cholesterol and concluded that avocados have beneficial effects on cardio-metabolic risk factors that extend beyond their heart-healthy fatty acid profile” (3).

Avocados also have a diverse range of other nutrients and phytochemicals that may have beyond cholesterol vascular health benefits. In particular, avocado’s potassium and lutein may help promote normal blood pressure and help to control oxidative or inflammatory stress, respectively (7).

Recipes

Nutritious and delicious, avocados can be added to your breakfast, lunch, dinner, or dessert. YES—dessert! Turn it into gelato or make yourself a creamy milkshake—the possibilities are endless.

For fun, easy, and tasty recipes see below:

Marisa Moore, MBA. RDN. LD. shares 4 ways to make the most of your avocado leftovers! Check out the recipes here.

4 Ways to Use Leftover Avocado

Looking for a guiltless dessert? Visit Rachael’s Good Eats for her avocado chocolate mousse recipe to satisfy your sweet tooth.

Avocado Chocolate Mousse

Add avocado to your next smoothie with this delicious recipe from Yummy Body Nutrition.

Pineapple Avocado Cilantro Summer Smoothie

References
(1) Honarbakhsh S., Schachter M. Vitamins and cardiovascular disease. Br. J. Nutr 2009; 101: 1113–1131.
(2) Antoniades C., Antonopoulos A. S., Tousoulis D., Marinou K., Stefanadis C. Homocysteine and coronary atherosclerosis: From folate fortification to the recent clinical. Eur. Heart J 2009; 30: 6–15.
(3) Wang L, Bordi PL, Fleming JA, Hill AM, Kris-Etherton PM. Effect of a Moderate Fat Diet With and Without Avocados on Lipoprotein Particle Number, Size and Subclasses in Overweight and Obese Adults: A Randomized, Controlled Trial. Journal of the American Heart Association 2015; 4(1).
(4) Park C, Cuypers LE, Sin A. Impact of Avocado Enriched Diet on Serum Lipids of Diabetic Patients. Journal of Cardiovascular Disease 2013; 1(1): 13-14.
(5) Mahmassani HA, Avendano EE, Raman G, Johnson EJ. Avocado consumption and risk factors for heart disease: a systematic review and meta-analysis. The American Journal of Clinical Nutrition 2018; 107(4): 523-536.
(6) Peou S, Milliard-Hasting B, Shah SA. Impact of avocado-enriched diets on plasma lipoproteins: A meta-analysis. Journal of Clinical Lipidology 2016; 10(1): 161-171.
(7) Dreher ML, Davenport AJ. Hass Avocado Composition and Potential Health Effects. Critical Reviews in Food Science and Nutrition 2013; 53: 738-750.
 

Written by Nicole Lindel ~ Nutrition Education Master’s Student at Columbia University

Do you suffer from obstructive sleep apnea? Are you tired during the day? In middle-aged adults, the prevalence of obstructive sleep apnea is estimated to be 4%-9%, although the condition is often undiagnosed and untreated (1).

What is it? “Obstructive sleep apnea is defined by the occurrence of daytime sleepiness, loud snoring, witnessed breathing interruption, or awakenings due to gasping or choking in the presence of at least 5 obstructive respiratory events per hour of sleep,” (1). The number of apnea or hypopnea events per hour of sleep reflects the Apnea– Hypopnea Index (AHI), which classifies the severity of obstructive sleep apnea. An AHI of 5-15 is mild, 15-30 is moderate, and > 30 events per hour characterize severe sleep apnea (1).

What are the risk factors? Risk factors for obstructive sleep apnea are dependent on gender, age, weight, neck girth, snoring, and frequent breathing pauses. With that being said, obstructive sleep apnea is a risk factor in itself for a number of chronic diseases, such as hypertension, diabetes, stroke, and cardiovascular disease (1).

Can your diet really help improve your quality of sleep?

Fat. A recent publication (1) examined dietary intake in patients with newly diagnosed obstructive sleep apnea. Of particular interest was the percentage of fat contributing to their total caloric intake. Participants with a BMI < 30 kg/m2 who received 35% or more energy from fat had significantly higher AHI than those with less than 35% energy from fat (P = .022). Among those with BMI ≥ 30 kg/m2, elevated fat intake was associated with a higher AHI although the difference is not significant.

Processed meats. Although not significant, the intake of processed meats was associated with sleep apnea (P = .056)

Dairy. Low-fat dairy was found to be significantly associated with less severity of sleep apnea in overweight participants.

Snacks. Consumption of snacks was associated with increased apnea in subjects with BMI < 30 kg/m2 (P = .016 but not in participants with BMI ≥ 30 kg/m2.

Key Takeaways (1).

1. In overweight patients, severity of sleep apnea was related to an increased intake of saturated fats

2. Intake of processed meats was associated with sleep apnea

3. Low-fat dairy was associated with a decreased severity of obstructive sleep apnea on presentation.

Tart cherries and kiwifruit. Additional research found an association between consumption of fruit, specifically tart cherries and kiwifruit, and enhanced sleep in individuals with sleep disorders. This association may be due to the presence of antioxidants in cherries, which help to reduce oxidative stress in patients with obstructive sleep apnea. It is also important to note the influence of consumption time and quantity on total sleep time and sleep efficacy. The consumption of 2 kiwifruits, 1 hour before bedtime enhanced the sleep of individuals with sleep disorders (2).

What are the dietary recommendations if I suffer from obstructive sleep apnea (1)?

1. Fat intake should be less than 10% total calories per day

2. Encourage the consumption monounsaturated “healthy” fats and limit saturated “unhealthy” fats

3. If dairy products are eaten, they should be of the low-fat variety.

What about exercise?

As a whole, the scientific literature indicates improved clinical outcomes for obstructive sleep apnea patients who are physically active. These improved clinical outcomes include a “reduction in disease severity and in daytime sleepiness, as well as an increase in sleep efficiency and in peak oxygen consumption, regardless of weight loss,” (3). Furthermore, exercise has been shown to improve AHI and cardiorespiratory fitness in patients with obstructive sleep apnea (4,5).

Obstructive sleep apnea has become quite common in the United States and, just as with any other disease state or condition, nutrition and exercise can play a significant role in improving clinical outcomes. If you are suffering from obstructive sleep apnea and are looking for a longer and better-quality sleep, try to reduce fat to < 10% of your daily caloric intake and take part in at least 150 minutes/week of moderate-intensity, or 75 minutes/week of vigorous-intensity aerobic physical activity.

References

(1) Bove C, Jain V, Younes N, Hynes M. What You Eat Could Affect Your Sleep: Dietary Findings in Patients With Newly Diagnosed Obstructive Sleep Apnea. American Journal of Lifestyle Medicine 2018;

(2) St-Onge MP, Mikic A, Pietrolungo CE. Effects of Diet on Sleep Quality. American Society for Nutrition 2016; 7: 938-949.

(3) de Andrade FM, Pedrosa RP. The role of physical exercise in obstructive sleep apnea. Jornal Brasileiro de Pneumologia 2016; 42(6): 457-464

(4) Aiello KD, Caughey WG, Nelluri B, Sharma A, Mookadam F, Mookadam M. Effect of exercise training on sleep apnea: A systematic review and meta-analysis. Respiratory Medicine 2016; 116: 85-92.

(5) Iftikhar IH, Kline CE, Youngstedt, SD. Effects of Exercise Training on Sleep Apnea: A Meta-analysis. Lung 2014; 192(1): 175-184.

Written by Nicole Lindel ~ Nutrition Education Master’s Student at Columbia University

…for moms-to-be

With the endless supply of information on what you “should” and “shouldn’t” do while pregnant, it is no surprise moms-to-be feel overwhelmed.

As a highly motivated mom-to-be, you want to do everything right. You want to eat the right things, do the right exercises, read every single pregnancy book, and buy all the right things! But, when all is said and done, you are going to make mistakes—and that’s okay. No one expects you to be perfect or suddenly know all the “ins and outs” of a healthy pregnancy.

With that being said, here are some important nutrition recommendations that may help put your mind at ease.

Here are the nitty gritty, straight-to-the-point, evidence-based recommendations:

Let’s start with CALORIE RECOMMENDATIONS. Most reasonably active reproductive-age females need about 2,100 to 2,300 calories each day. During your 1st trimester, YOU DON’T NEED ADDITIONAL CALORIES!! Shocking, I know. Yet, for the 2nd and 3rd trimesters, aim to increase your calories by 340 and 450 calories/day, respectively.

MACRONUTRIENT RECOMMENDATIONS

Protein. Prior to pregnancy, women should consume about 50 g/day protein, and during the 2nd and 3rd trimester of pregnancy, women should consume an additional 25 g/day.

Fat. Pregnant women should consume daily at least 300 mg of DHA—which is an omega-3 fatty acid. Furthermore, pregnant women should eat a total of 8 to 12 ounces of fatty fish each week to obtain omega-3 fatty acids, iodine, iron and choline.

However, the FDA cautions pregnant women and parents about avoiding fish with high levels of mercury. For detailed information, visit Eating Fish: What Pregnant Women and Parents Should Know

Carbohydrates. Pregnant women should ingest at least 175 g/day.

MICRONUTRIENT RECOMMENDATIONS

NEXT, THE VITAMINS. How much vitamin A do I need? 2500 IU/day but no more than 10,000 IU/day. Vitamin A is important during pregnancy HOWEVER, too much vitamin A can be dangerous for you and your baby.

How about vitamin D? 600 IU/day

LET’S TALK B VITAMINS!

Folic Acid. For healthy, reproductive-age women, 400 mcg/day. For pregnant women without a prior neural tube defect, 600 mcg/day. For women with a prior neural tube defect, 4000 mcg/day.

Cobalamin. How much do I need? 2.4 mcg/day prior to pregnancy and 2.6 mcg/day during pregnancy.

Choline. How much do I need? At least 450 mg/day during pregnancy and 550 mg/day when nursing.

MINERALS, such as calcium, iron, and iodine, are also important for pregnant women.

How much calcium do I need? 1000 mg/day.

What about iron? 18 mg/day prior to pregnancy and 27 mg/day during pregnancy.

…and iodine? Pregnant and lactating women need at least 220 and 290 mcg/day, respectively.

A GLIMSE AT THE RESEARCH

A recent systematic review included 17 trials with 137,791 pregnant women who incorporated multiple-micronutrient supplementation into their diet. The authors concluded that “pregnant women who received multiple-micronutrient supplementation had fewer low birthweight babies and small-for-gestational-age babies than pregnant women who received only iron, with or without folic acid,” (1).

Additionally, authors of a review article on micronutrient supplementation and placental function suggest micronutrient supplementation to be a “cost effective, applicable, and safe method of improving pregnancy outcomes for millions of women across the globe,” (2). For additional AND reputable resources, visit the World Health Organization, Academy of Nutrition and Dietetics, Centers for Disease Control & Prevention, or the U.S. Food and Drug Administration.

REFERENCES

(1) Haider BA, Bhutta ZA. Multiple-micronutrient supplementation for women during pregnancy. Cochrane Database of Systematic Reviews 2017.

(2) Richard K, Holland O, Landers K, Vanderlelie JJ, Hofstee P, Cuffe JSM, Perkins AV. Review: Effects of maternal micronutrient supplementation on placental function. Placenta. 2017; 54: 38-44.

Written by Nicole Lindel ~ Nutrition Education Master’s Student at Columbia University

What is it?
You may be wondering, “What is kombucha?”. For starters, Kombucha is a recently popularized probiotic beverage consumed for its anti-inflammatory and antioxidant properties. Now you may be wondering, “What is a probiotic?”. The World Health Organization defines a probiotic as “live microorganisms which when administered in adequate amounts confer a health benefit on the host.”
For a product to be considered a probiotic, Lynne McFarland, an associate professor at the University of Washington explains, “…they have to be alive. They can be a bacteria or a yeast. They have to be used in an adequate dose, and they have to have some proven beneficial health effect.”

How is it made?
Kombucha derives from a process known as fermentation. So, before we continue on about Kombucha, let’s explore this antique method for extending the life and safety of food.

Kombucha fermentation is an aerobic process in which sugar and tea are converted, in the presence of a SCOBY, or a symbiotic colony of bacteria and yeast, to “a lightly carbonated, slightly sour, and refreshing drink, which is composed of several acids, 14 amino acids, vitamins, and some hydrolytic enzymes,” (1). Specifically, Kombucha contains the following vitamins and minerals: Vitamins B1, B2, B6, B12, and C
Minerals Copper, Iron, Manganese, Nickel, and Zinc (1)

Preferable conditions for kombucha fermentation
Fermentation is influenced by many factors such as time, temperature, and pH. Therefore, any changes in the fermentation condition may affect the final product. With that being said, below are general recommendations based on the finding of current literature (1).
Time: Average of 15 days
Temperature: Generally, between 22-30 degrees Celsius
pH: No lower than 3

The science
Research has been conducted to examine antimicrobial, antioxidant, anti-inflammatory, and anticarcinogenic properties of Kombucha (1). The findings of one particular study is highlighted below. However, further research is warranted to better understand the characterization of its active components and their evolution during fermentation.

Anti-inflammatory properties (2)
• Fermented beverages of oak effectively down-regulated the production of nitric oxide
• Pro-inflammatory cytokines (TNF-alpha and IL-6) in macrophages were stimulated with lipopolysaccharide.
• Phytochemical compounds, present in kombucha analogues from oak, decrease oxidative stress.

Make your own!
Visit The Kitchn, an online food magazine, at https://www.thekitchn.com/how-to-make-kombucha-tea-at-home-cooking-lessons-from-the-kitchn-173858 for help on how to make your very own Kombucha.

References

(1) Villarreal-Soto SA, Beaufort S, Bouajila J, Souchard JP, Taillandier P. Understanding Kombucha Tea Fermentation: A Review. Journal of Food Science. 2018; 83(3): 580-588.
(2) Vázquez-Cabral BD, Larrosa-Pérez M, Gallegos-Infante JA, Moreno-Jiménez MR, González-Laredo RF, Rutiaga-Quiñones JG, Gamboa-Gómez CI, Rocha-Guzmán NE. Oak kombucha protects against oxidative stress and inflammatory processes. Chemico-Biological Interactions. 2017; 272: 1-9.
(3) Chakravorty S. Kombucha tea fermentation: Microbial and biochemical dynamics. International Journal of Food Microbiology. 2016; 220: 63-72.

Written by Nicole Lindel ~ Nutrition Education Master’s Student at Columbia University

Popular weight loss programs represent a multibillion dollar industry. A 2014 systematic review of 48 randomized control trials was conducted to compare weight loss outcomes with popular diets, such as Atkins, Weight Watchers, Ornish, Jenny Craig, Volumetrics, and Nutrisystem. Overweight or obese adult participants were randomized to a particular diet and were followed up with at 6 and 12 months. Of the 48 randomized control trials, 5 did not report weight loss at 6 months, and 23 trials did not report weight loss at 12 months (2).

At 6 and 12 months, low-fat and low carbohydrate diets resulted in the greatest weight loss compared to other diets, or no diet at all. Greatest weight loss at 6 months was seen with the Atkins diet (22.3 lbs), followed by the Volumetrics diet (21.7 lbs), and the Ornish diet (19.9 lbs). At 12 months, the Ornish, Rosemary Conley, Jenny Craig, and Atkins diets were associated with the greatest weight loss, at approximately 14 lbs. Although these diets were associated with the greatest weight loss at 6 and 12 months, approximately 2 to 4 lbs were regained by 12 months. In fact, all diets except Jenny Craig slightly decreased in their estimated effects at 12 months compared to 6 months (2).

The authors of this systematic review concluded, “Because different diets are variably tolerated by individuals, the ideal diet is the one that is best adhered to by individuals so that they can stay on the diet as long as possible” (2).

To this point, a randomized control trial included in this meta-analysis assessed adherence and effectiveness of the Atkins, Zone, Weight Watchers, and Ornish diet, for weight loss and cardiac risk factors. Participants had a mean age of 49 and BMI of 35. Only 93 of the 160 participants completed the study, indicating a high dropout rate of 42%. Attrition rates were highest amongst the more extreme diets, the Atkins diet at 48%, and the Ornish diet at 50% (1).

Although both the Atkins and Ornish diets resulted in modest, statistically significant weight loss (10.6 lbs for Atkins, 13.2 lbs for Zone, 10.8 lbs for Weight Watchers, and 16.1 for Ornish) and improved cardiac risk factors at 1 year, these diets had poor sustainability and adherence rates which resulted in weight regain and worsening cardiac risk factors for each diet group as a whole (1). The research also found a strong association between weight loss and self-reported dietary adherence, but not with weight loss and diet type. This underscores the concept that adherence level, rather than diet type, is the key determinant of clinical benefits (1).

Johnston et al. (2014) concludes, “The weight loss differences between individual named diets were small with likely little importance to those seeking weight loss.” There is no need for a one-size-fits-all approach to dieting. Diet adherence alone is the basis to having the greatest success at weight loss.

References

(1) Dansinger ML, Gleason JA, Griffith JL, Selker HP, Schaefer EJ. Comparison of Atkins, Ornish, Weight Watchers, and Zone diets for weight loss and heart disease risk reduction. JAMA 2005; 293(1): 43-53.

(2) Johnston BC, Kanters S, Bandayrel K et al. Comparison of weight loss among named diet programs in overweight and obese adults. A meta-analysis. JAMA. 2014; 312(9): 923-933.

Written by Nicole Lindel ~ Nutrition Education Master’s Student at Columbia University

Intermittent fasting, for the purposes of weight loss, has taken over the dieting world. Instead of continuously restricting your diet on a daily basis, intermittent fasting entails intermittent periods of substantial energy restriction combined with periods of normal eating.

A recent study published in the March 2018 issue of the British Journal of Nutrition compared the effects of intermittent and continuous energy-restrictive diet groups on postprandial glucose levels and fat metabolism, following a 5% matched weight loss.

Summary of Results

 1. The elapsed time to achieve 5% weight loss, and the reduction of insulin in the blood were not different between diet groups

2. Reductions in triglycerides (the storage form of energy) and C-peptides (a byproduct of insulin production) were greater following intermittent versus continuous energy-restrictive diets

These findings highlight differences between both diet approaches, including a superiority of intermittent fasting in postprandial reduction of triglycerides in the blood.

Reference

 Antoni R, Johnston KL, Collins AL, Robertson MD. Intermittent v. continuous energy restriction: differential effects on postprandial glucose and lipid metabolism following matched weight loss in overweight/obese participants. British Journal of Nutrition 2018; 119(5): 507-516.

Written by Nicole Lindel ~ Nutrition Education Master’s Student at Columbia University

WHAT IS THE TURMERIC CRAZE ALL ABOUT?

As an antioxidant, polyphenol, and bioactive component of turmeric, curcumin has surely made a name for itself(1).

More than 300 bioactive compounds have been identified in turmeric but curcumin, is the most widely studied(2). Yet, turmeric is only 2-6% percent curcumin by weight, so the levels of curcumin in turmeric are not nearly as high as the doses tested in most studies. In addition to its low concentration, curcumin has a poor absorption rate(2).

Ready for the good news? Current research has explored the chemical and metabolic properties of curcumin to improve its bioavailability. With that came the patented and registered formulation of curcumin BCM-95®, a total curcuminoids complex with both enhanced bioavailability and sustained retention time in the body. Such a formulation can be found in Health Thru Nutrition’s Curcu-Gel Ultra, providing 650 mg of BCM-95®.

INFLAMMATION AND THE BRAIN

Acute and chronic inflammation play a pivotal role in various medical conditions and diseases, such as the progression of obesity, type 2 diabetes, cancer, pancreatitis, arthritis, neurodegenerative, cardiovascular, and metabolic diseases(3).

A recent publication from March 2018 found that daily ingestion of curcumin in 50-90-year-old adults led to significant benefits in memory and attention—with memory scores improving 28% over 18 months.

“Exactly how curcumin exerts its effects is not certain, but it may be due to its ability to reduce brain inflammation, which has been linked to both Alzheimer’s disease and major depression,” said Dr. Gary Small, the study’s first author(4).

Aside from curcumin’s cognitive benefits deriving from its anti-inflammatory brain effects, it may also be attributed to its antiamyloid effects(4). Amyloid plaques are the sticky buildup of proteins that accumulate outside nerve cells. When the protein folds improperly, it forms amyloid deposits that are associated with brain inflammation. Therefore, in this particular study participants with daily curcumin showed less amyloid activity in the brain than those without daily curcumin. These specific regions of the brain are known as the amygdala and hypothalamus, which control several memory and emotional functions.

CANCER

Aside from its role in promoting mental health among aging adults, curcumin has also been studied for its role in the treatment of cancer. Statistically, cancer occurs in 14.1 million people in the world annually. In the last few decades, more than 10,200 research publications and 258 clinical studies have been conducted to investigate the relationship between curcumin and cancer(5).

A 2016 review article determined that the anticancer effects of curcumin are multi-targeted in nature. “It can modulate all kinds of cancer hallmarks, including cell proliferation, cancer signaling pathways, transcription factors, tumor angiogenesis, and metastas”(5). With that being said, Pandima Kasi and colleagues concluded that curcumin could be used for the treatment of different types of cancer(5).

ARTHRITIS

Adding to the list of benefits, a 500 mg dose of curcumin in the form of BCM-95® was found to significantly improve disease activity and severity of inflammation in patients with rheumatoid arthritis(6).

Research was also conducted in middle-aged patients with osteoarthritis, demonstrating significant improvements in pain scores and range of movement, after ingesting a 500 mg BCM-95® and Boswellia serrata formulation(7).

SAFETY

Aside from its benefits, research has also explored the safety of curcumin. The USDA has approved curcumin as a “Generally Regarded As Safe” compound and the daily intake of curcumin at a dose of 0.1-3 mg/kg body weight has been considered an acceptable dose by the Joint FAO/WHO Expert Committee on Food Additives (1996)(1).

References

(1) Ghosh S, Banerjee S, Sil PC. The beneficial role of curcumin on inflammation, diabetes and neurodegenerative disease: A recent update. Food and chemical toxicology. 2015; 83: 111-124.

(2) Moore HG, Spiro A. Can turmeric really prevent cancer? British Nutrition Foundation. 2017; 42: 141-147.

(3) Shehzad A, Rehman G, Lee YS. Curcumin in inflammatory diseases. BioFactors. 2013; 39(1): 69-77.

(4) Small GW, Siddarth P, Li Z, et al. Memory and Brain Amyloid and Tau Effects of a Bioavailable Form of Curcumin in Non-Demented Adults: A Double-Blind, Placebo-Controlled 18-Month Trial. The American Journal of Geriatric Psychiatry. 2017; 26(3): 266-277.

(5) Kasi PD, Tamilselvam R, Wozniak KS, et al. Molecular targets of curcumin for cancer therapy: an updated review. Tumor Biol. 2016; 37: 13017-13028.

(6) Chandran B. A Randomized, Pilot Study to Assess the Efficacy and Safety of Curcumin in Patients with Active Rheumatoid Arthritis. Phytotherapy Research. 2012; 26(11): 1719-1725.

(7) Kizhakkedath R. Clinical evaluation of a formulation containing Curcuma longa and Boswellia serrata extracts in the management of knee osteoarthritis. Molecular Medicine Reports. 2013; 8(5): 1542-1548.

Written by Nicole Lindel ~ Nutrition Education Master’s Student at Columbia University

Vitamin D can have protective effects against cancers at many sites, according to a recently published study in the BMJ.

This large prospective study cohort aimed to evaluate the association between pre-diagnostic circulating vitamin D concentration and the subsequent risk of overall and site-specific cancer in 40-59 year-old Japanese adults over the course of 16 years.

3,301 incident cases of cancer and 4,044 randomly selected subcohort participants were included in this study, and the incidence of overall or site-specific cancer was recorded and analyzed.

Plasma 25-hydroxyvitamin D concentration was inversely associated with the risk of total cancer and liver cancer. Although these findings are statistically significant, it is important to note that this study cannot prove causality.

In their closing remarks, Budhathoki et al. (2018) reported, “…although maintaining an optimal 25-hydroxyvitamin D concentration is important for the prevention of cancer, having a concentration beyond this optimal level may provide no further benefit. Future studies are needed to clarify the dose-response pattern and the optimal concentrations for cancer prevention.”

Budhathoki S, Hidaka A, Yamaji T, et al. Plasma 25-hydroxyvitamin D concentration and subsequent risk of total and site specific cancers in Japanese population: large case-cohort study within Japan Public Health Center-based Prospective Study cohort. BMJ. 2018;360:k671

Written by Nicole Lindel ~ Nutrition Education Master’s Student at Columbia University

Nuts about Nuts? Should nuts be consumed to reduce risk of chronic disease?

In a Nutshell discusses whether or not nuts are all they are cracked up to be. Nuts are advertised as a great source of protein and unsaturated fats. Although this may be true, other sources of protein have much fewer calories, such as beans, tofu, Greek yogurt, milk, fish, and poultry. Due to its caloric density, serving size recommendations for nuts may just seem nuts. Just one serving of brazil nuts (6-8 nuts) equates to 150 to 200 . So maybe we shouldn’t be nuts about nuts.

Reasons to go nuts about nuts. Nuts are known to be a good source of protein, especially for those who do not consume animal protein. An ounce of most nuts has 4 to 6 grams of . Nuts are also a good source of dietary fiber, polyunsaturated fats (also known as the “good” type of fat), and antioxidants, such as vitamin E. Such a nutrient dense composition may reduce risk of cardiovascular disease by reducing insulin resistance, cholesterol concentrations, lipid peroxidation, and oxidative . “Nuts also contain other bioactive compounds…which may reduce cancer risk by inducing cell cycle arrest, apoptosis, inhibiting cell proliferation, migration, invasion, and angiogenesis”.

A randomized controlled trial design, comparing participants on either a control diet or a Mediterranean diet, with either nuts or olive oil, found the lowest total mortality risk associated with those who were on a Mediterranean diet, consuming nuts greater than 3 servings/week at . However, who is to say that this association was attributed to the Mediterranean diet and not the actual nut consumption?

The New England Journal of Medicine published the findings of a cohort study, which examined the association between nut consumption and total mortality amongst nurses and other health . This study found that nut consumption was inversely associated with total mortality among both women and men. Specifically, significant inverse associations were observed between nut consumption and deaths due to cancer, cardiovascular disease, and respiratory . In agreeance with Bao et al. (2013), Aune et al. (2016) found a reduced risk of developing cancer, specifically colorectal cancer. Furthermore, current literature suggests a reduced risk of coronary heart , and type 2 diabetes

Research also demonstrates an association between nut consumption and blood cholesterol—specifically lowering LDL, or the “bad” , and elevating HDL, or the “good” cholesterol.

O’Neil et al. (2015) conducted a cross-sectional study, examining the association between nut consumption, weight, and cardiovascular risk factors. Findings indicated a lower BMI and waist circumference, and a lower likelihood of obesity in those consuming tree nuts. To further strengthen these findings, Aune et al. (2016) also found a better weight status among those who consumed tree nuts.

Although it is safe to say that much of the current research supports the notion of “going nuts for nuts”, it is important to realize the limitations of existing studies and other contradictory findings. For example, O’Neil et al. (2015) states that previous research has shown inconsistencies in the association of tree nut consumption with risk factors for cardiovascular disease and metabolic syndrome. With that being said, nut consumption and reduced risk of chronic disease is not a “black and white” issue—hence its ongoing controversy.

Not-so-nutty tips for nut eaters. Rather than eating nuts out of a bag, grab a quick handful, put the bag away, and be done with it. Also, purchase nuts low in sodium and sugar. Look for words such as, “unsalted” or “lightly salted” and try to avoid nuts smothered in chocolate or yogurt. Nuts can also serve as a good substitute for less healthful foods. For example, instead of croutons, sprinkle toasted nuts on your salad. Or, replace a sugary cereal with a whole grain cereal, and add your own nuts and fresh

References

(1) Hurley J and Liebman B. In a Nutshell: Are nuts all they’re cracked up to be? Nutrition Action Health Letter. October 2015.

(2) Aune D, Keum N, Giovannucci E, et al. Nut consumption and risk of cardiovascular disease, total cancer, all-cause and cause-specific mortality: a systematic review and dose-response meta-analysis of prospective studies. BMC Medicine; 2016: 14: 207-220.

(3) Guasch-Ferre M, Bullo M, Martinez-Gonzalez AM, et al. Frequency of nut consumption and mortality risk in PREDIMED nutrition intervention trial. BMC Medicine. 2013; 11: 164. Abstract Only.

(4) Bao Y, Han J, Hu FB, Giovannucci E, Stampfer MJ, Willett WC, et al. Association of nut consumption with total and cause-specific mortality. N Engl J Med. 2013; 269: 2001-2011. Abstract Only.

(5) O’Neil Ce, Fulgoni VL, Nicklas TA. Tree nut consumption is associated with better adiposity measures and cardiovascular and metabolic syndrome health risk factors in US Adults: NHANES 2005-2010; Nutrition Journal. 2015; 14: 64-71. Abstract Only.

Written by Nicole Lindel ~ Nutrition Education Master’s Student at Columbia University