I must confess to being somewhat of a sceptic when it comes to companies who promote “their” vitamin or mineral supplement as being the way to true health and happiness. But the report into the development of the “CHORI-Bar” caught my attention and it may be something, whose real worth will be evaluated more clearly in the not too distant future.
And no, they are not available yet at your local supermarket or health food store.

So what is a CHORI- Bar?

The CHORI-Bar is a low kilojoule, fruit based, high fibre, vitamin and mineral nutrition bar that aims to improve those biological markers that will promote a reduced risk of cardiovascular disease and cognitive decline.
The name comes from the Children’s Hospital Oakland Research Institute’s Nutrition and Metabolism Centre led by Dr Ames.

Dr Ames has spent a number of years studying the interactions of vitamins and minerals on metabolic processes in the body. It has been recognised that many Americans do not consume enough vitamins and minerals in their diet, and Dr Ames believes that this contributes to those diseases associated with obesity and ageing.
He proposes that even modest vitamin and mineral deficiencies may be associated with the subsequent development of disease.

It has taken around 6 years to make the bar palatable. Let’s face it; if it doesn’t taste good, people aren’t going to eat it, no matter how good it supposed to be for them. The other advantage is that it is satiating, so you feel full after eating it – which is helpful for those wishing to lose weight.

What does the CHORI-Bar do?

The aim is to correct micronutrient malnutrition (i.e. insufficient vitamins and minerals) associated with caloric over nutrition (too much “fast” food)
The aim of the CHORI-Bar is to restore metabolic balance.

There have already been a number of pilot studies conducted on the CHORI-Bar. In a small trial recently, 25 individuals of variable age and BMI (body mass index) ate two bars a day for two weeks. They underwent assessment of biomarkers, lipids (fats), glucose metabolism and inflammatory markers at the beginning and end of the two -week period.
Even in such a short time frame, metabolic changes such as an increase in HDL cholesterol (good cholesterol) lowering of homocysteine and increasing glutathione levels were demonstrated.

Raised homocysteine levels have been associated with an increased risk of cardiovascular disease and cognitive decline.
Glutathione levels tend to decrease with age. It is important in regulating the effects of oxidative stress in the body.

What’s next?

Good nutrition does not come from eating a bar alone. However, the researchers do consider that the CHORI-Bar could be a useful adjunct in improving health through improved metabolic processes, whilst encouraging someone to change to an overall healthier eating plan.

Clinical trials are now underway to further examine how the various food components in the bar interact synergistically to produce this positive effect on biomarkers and to look for ways to measure other biomarkers associated with insulin resistance, inflammation and LDL (bad) cholesterol.

Currently it has not been determined whether the bar would be used as a supplement or meal replacement. What is encouraging from the findings is that the CHORI-Bar appears to be able to produce a positive metabolic effect without having to use large doses of the various constituents.

Perhaps in the future, those people with obesity, asthma and hypertension will be helped by the added prescription of a nutritional bar as part of their management to assist them in improving their overall metabolic health.

Ref:
Mietus-Snyder, M. L., Shigenaga, M. K., Suh, J. H., Shenvi, S. V., Lal, A., McHugh, T., Olson, D., Lilienstein, J., Krauss, R. M., Gildengoren, G., McCann, J. C., and Ames, B. N. A nutrient-dense high fiber, fruit-based supplement bar increases HDL, particularly large HDL, lowers homocysteine, and raises glutathione in in a 2-week trial. FASEB Journal, May 1, 2012 DOI: 10.1096/fj.11-201558 fj.11-201558

Who needs a nap? Around 18% of the population are sleep deprived and it affects our performance and our health http://t.co/g725OfVs

I was recently given the results of some blood work I had had done and was amazed to be told that my vitamin D levels were a little low and I need to start taking some vitamin D supplements.

My surprise was due to the fact that as an Australian living in a sunny climate, I had thought my sun exposure through daily walking and exercise would have kept my vitamin D levels more than adequately topped up. Obviously not.

Vitamin D is known to be important for maintaining strong muscles and bones.
It is also important in helping keep our brain clear of amyloid.

Having a low level of vitamin D3 has been associated with cognitive decline
Previous studies have looked at the role of vitamin D in combination with turmeric (curcumin), which was shown to stimulate the body’s immune system to clear amyloid beta, although the mechanism of how this was achieved was not understood.

Our immune system includes cells called macrophages, which act as rubbish scavengers removing waste products and amyloid in a process called phagocytosis. They surround the waste and engulf it. We have two types of macrophages, imaginatively called Type One and Type Two. (This makes me think of B1 and B2 from “Bananas in Pyjamas” – but I digress.)

The earlier studies showed that the efficiency of Type One macrophages was enhanced, by adding vitamin D3 and curcurminoids, while Type two macrophages were improved by adding the vitamin only. In a new collaborative study using a technique called mass spectrometry, the researchers have shown that not only is vitamin D3 important in supporting phagocytosis by the macrophages it also has a role in regulating the activity of gene expression.

The implication is that Vitamin D3 may be a possible future therapeutic agent for Alzheimer’s disease. To investigate this further a clinical trial will need to be carried out to see what if any impact it may have for people living with Alzheimer’s disease.

Meanwhile the researchers say it is too early to recommend a definitive dose of Vitamin D3 to help with brain health and Alzheimer’s.

Nevertheless, I shall be taking my daily supplement to ensure my levels are restored to normal. The other message is that it could be a good idea to have your Vitamin D levels checked occasionally, to ensure they are in the normal range, even if you think you spend enough time outside.

Ref:
Mathew T. Mizwicki, Danusa Menegaz, Jun Zhang, Antonio Barrientos-Durán, Stephen Tse, John R. Cashman, Patrick R. Griffin, Milan Fiala , 
Genomic and Nongenomic Signaling Induced by 1α,25(OH)2-Vitamin D3 Promotes the Recovery of Amyloid-β Phagocytosis by Alzheimer’s Disease Macrophages: Journal Of Alzheimer’s Disease. Volume 29, Number 1, March 2012 Pages 51-62

Image by Zazzle

Some things in life are less than fair. Not only do many women experience “Pregnancy brain” and “Mummy brain” when our ability to retain relevant information sometimes appears to go to mush, it also appears we can joyfully expect to experience “Menopause brain” when transitioning from being fertile to becoming infertile.

“Menopause brain” is nothing new, in fact 60% of women going through menopause will report memory problems, yet this has remained an area where fabulously little research has been undertaken to try and understand what is really going on with our brains at this time in our lives.

What has been reported, is that not only do many women experience significant changes with their memory, but because these changes occur typically in our late forties and early fifties, we become frightened that these changes could herald the first signs of cognitive impairment and Alzheimer’s disease. That fear of course then compounds the brain’s inability to think clearly and a vicious cycle can ensue.

So first things first: there are brain changes, which occur in the menopausal brain that can affect memory.
These changes reflect a physiological change and are not the first signs of neurodegenerative disease i.e. Alzheimer’s.

So what is going on here?

Back in 2009 a study on 2362 women aged between 42 and 52 looked at

• Verbal memory
• Working memory (short term)
• Speed of processing information

The women were tested at four different stages of transition through menopause i.e. pre- menopause (regular periods), early peri- menopause (some irregularity of periods), late peri-menopause (no period for 3 – 11 months) and post menopause.

As I mentioned earlier, up to 60% of women will report memory difficulties during menopause and this study confirmed that during the early and late peri menopause, women do not learn as well as when they are in the other stages.

The good news is that this effect appears to be temporary. Our ability to learn returns to pre menopausal levels once we become post menopausal.

Phew!

The other interesting note here is the role of hormones (or rather HRT) on our verbal memory and processing speed.

Taking HRT before menopause appears to help verbal memory and processing speed.
But taking HRT postmenopausally has no effect on these skills.

This suggests there is a critical window of opportunity for the benefit of oestrogen and progesterone supplementation here. However much depends on the individual and their relative risk factors for consideration of using HRT at all.

Another study in 2009 examined the relationship between peri menopausal memory complaints and performance in relation to other relevant factors such as hormone levels, mood state, and sleep quality. In this small study of 24 women, there was no association of memory complaint and performance on tests of retentive memory. What they did show was memory complaints were linked to poorer memory encoding (i.e. learning) and depressive symptoms.

Miriam Weber PhD a neuropsychologist at the University of Rochester Medical Centre has now published the findings of a new study in the journal Menopause. In this study 75 women aged 40 to 60 who were in early peri menopause underwent a series of cognitive tests to look at their

• Ability to learn and retain new information (encoding memory)
• Ability to mentally manipulate new information (using working or short term memory)
• Sustain attention over a period of time (paying attention)

They were also asked about any symptoms associated with menopause such as hot flushes, depression, and anxiety and sleep difficulty. Plus they underwent blood tests measuring oestrogen and FSH levels.

The study showed that those women who had noted memory problems were the ones who demonstrated difficulty with learning, retaining and manipulating new information.

The examples given of difficulty experienced included

“Calculating the tip after a meal at a restaurant, doing mental math, or adjusting a flight itinerary for a journey”

They were also noted to have difficulty staying on task i.e. paying attention.

Remembering specific items for example on a grocery list and recalling them when in a shop were not an issue.

The actual hormone levels were found to have no association with the memory complaints, though experiencing difficulty sleeping or anxiety and depression symptoms did.

What can we do to help?

The best thing to do if you are experiencing memory difficulty associated with the peri menopause would be to

1. Address any sleep problems. Talk to your GP. Follow good sleep hygiene practice.

2. Address anxiety or symptoms of depression. Talk to you GP about the different options you could choose to ameliorate these.

3. Find and use strategies to help you with encoding and retaining information. This could include simple tricks such as
• Repeating a new price of information out loud
• Saying it back to another person for confirmation
• Practice attention building skills such as meditation to help stay on task for longer.

And of course relax, it’s only your “Menopause brain” playing up and the good news is that by the time the post menopausal state is reached, your brain fog will have cleared and you can then enjoy the wisdom and serenity that being post menopausal will bring.

Refs:
1. Miriam T. Weber, Mark Mapstone. Memory complaints and memory performance in the menopausal transition. Menopause. 2009 Jul-Aug;16(4):694-700.

2. American Academy of Neurology (2009, May 25). Menopause Transition May Cause Trouble Learning. ScienceDaily. Retrieved March 18, 2012, from http://www.sciencedaily.com¬ /releases/2009/05/090525173427.htm

3. Miriam T. Weber, Mark Mapstone, Jennifer Staskiewicz, Pauline M. Maki. Reconciling subjective memory complaints with objective memory performance in the menopausal transition. Menopause, 2012; 1 DOI: 10.1097/gme.0b013e318241fd22

Caring for someone who is ill is emotionally and often physically draining as well.
Caring for someone who has Alzheimer’s or other form of dementia can often lead to the carers themselves becoming sick, exhausted, stressed, depressed, fearful and lonely.

In Australia we have over 250,000 people living with dementia, that’s over 1% of our total population. For every person with the disease there are on average 2.5 caregivers involved in their care. Often the primary caregiver is a spouse, partner or family member. They themselves may be relatively elderly with other associated health problems and susceptibility to stress induced cardiovascular illness and increased mortality.

With the number of people living with dementia expected to triple by 2050, we need to be looking at ways not only to assist the person with the illness, but also the carers themselves: providing sufficient support and access to appropriate services.

The problem in being a carer is not only does it increase your own risk of illness and exhaustion; the ongoing stress significantly increases your risk of depression and for developing dementia.

So what can be done to help alleviate some of the strain?

Dr Helen Lavretsky from UCLA Semel Institute for Neuroscience and Human Behaviour has published the findings of a new study, which examined the value of providing yoga meditation practice for carers.

What the study showed was firstly

1. An improved level of cognitive function and lower levels of depression and

2. A reduction in stress induced cellular aging

What does this means for carers?

Carers will often report high levels of emotional distress and 50% are at risk of developing clinical depression.
In the study, 49 carers (age range 45- 91) were either taught a brief 12 minute yogic practice that included chanting meditation Kirtan Kriya, or, if they were in the control group they sat in a quiet place with their eyes closed, listening to instrumental music on a relaxation CD for 12 minutes.

After 8 weeks of those in the mediation group, 65% showed a 50% improvement on a depression rating scale, and 52% showed an improvement on a mental health score.

This compared to a 31% depression improvement and 19% mental health improvement for the relaxation group.

So learning brief yogic mediation made a significant difference in a very short time frame. One would imagine that this would provide ongoing benefit if the carer was to continue with the practice on a daily basis. Professor Lavretsky commented that the benefits appear to be specific to Kirtan Kriya, which incorporates several different elements of chanting, finger poses and visualisation.She describes this as providing “brain fitness” in addition to the stress reduction.

The other interesting finding was in relation to cellular ageing.

At the end of our chromosomes we have what are called telomeres. An enzyme called telomerase helps to maintain our telomeres. If the enzyme telomerase activity is absent, then every time our cells divide, our telomeres get shorter until eventually the cells die. Promoting or maintaining a higher level of telomerase therefore helps our telomeres to be maintained and immune cell longevity.

In the study there was a whopping difference between the two groups in terms of increase in telomerase activity.

The mediating group showed a 43% improvement in telomerase activity compared to just 3.7% in the relaxation group.

Professor Lavretsky now plans a follow up study to confirm these findings using a neuroimaging study of Kirtan Kriya meditation. She has also incorporated yoga into the caregiver program as part of the UCLA Alzheimer’s and Dementia Care program. This program aims to provide comprehensive coordinated care, resources and support to both patients and caregivers.

The great thing about this study is the huge amount of benefit provided to the carers through a simple and inexpensive yoga program.
It would be fantastic if this could be made available on a wide scale to all carers as it could make all the difference between “just surviving” and “managing well.”

Ref:
H. Lavretsky, E.S. Epel, P. Siddarth, N. Nazarian, N. St. Cyr, D.S. Khalsa, J. Lin, E. Blackburn, M.R. Irwin. A pilot study of yogic meditation for family dementia caregivers with depressive symptoms: effects on mental health, cognition, and telomerase activity. International Journal of Geriatric Psychiatry, 2012; DOI: 10.1002/gps.3790