Dementia Rates Are Falling In The U.S.

“An important new national study finds that, after adjusting for age, Americans 65 and older are less likely to get dementia than in the past. The report, published in the Journal of the American Medical Assn (JAMA) confirms previous regional studies in the US as well as recent research in Europe. The reasons for this decline in prevalence of the many dementia-related diseases are complicated, but may be related to higher educational levels. Whatever the cause, the news is positive.”

Source: Dementia Rates Are Falling In The U.S.

Lithium as a Preventative or Treatment of Alzheimer’s Disease

The following excerpt is boring, so move along now. It’s from a recent review article on all the potential causes and therapeutic options for Alzheimer’s Disease (AD). I post it here so I can find it later. Click the link at bottom to RTWT.

“Lithium is not yet generally recognized as a trace element but several lines of evidence make it a strong candidate. For instance, long-term low-dose exposure to lithium exerts anti-aging capabilities and unambiguously decreases mortality in animal models. In humans, epidemiological studies indicate an inverse correlation between lithium concentration in drinking water and mood, depression and suicide rates, amongst other psychiatric conditions. In a study that compared elderly bipolar patients (who exhibit a higher risk for dementia) who had received chronic lithium treatment, with bipolar patients who had not received lithium, it was shown that the prevalence of the treated group was equivalent to the general, age-comparable population, whereas the non-lithium-treated patients had an incidence of dementia that was six times greater, i.e. 5 % vs. 33 %, respectively. In another study it was shown that lithium treatment resulted in an increase in volumes of the hippocampi in both hemispheres compared to an unmedicated group, an effect that was apparent even after a brief treatment period of about 4 weeks on average. Importantly, intake of lithium not only in standard therapeutic but also in trace doses reduces the risk for dementia, suicide, and other behavioural outcomes, suggesting an pharmacological interference with key regulators of these pathological processes. So, lithium naturally regulates critical cell signalling pathways and a lack of lithium in the diet can therefore cause increased disease risk.It has been shown that lithium modulates negatively the activity of the two kinases GSK-3α and GSK-3β, which might explain both the relative specificity and sensitivity of the effects of low-dose lithium treatment (see below). Since GSK-3β-activation by oligomeric Aβ promotes neuroinflammation, phosphorylation of tau and disturbance of AHN [adult hippocampal neurogenesis], all key mechanisms in the AD process, in inhibition of GSK-3 by lithium results in reduced tauopathy and neurodegeneration in vivo. Likewise, lithium treatment was shown to improve AHN, neuropathology and cognitive functions in a mouse model of AD. Furthermore, such “AD-mice” treated from two months of age had decreased numbers of senile plaques, no neuronal loss in cortex and hippocampus and increased BDNF levels when compared to non-treated transgenic mice. In order to achieve this effect, it was sufficient to give lithium at about one per mill of the high standard-dose therapy in bipolar disorder, a dose which can cause some significant side effects. Hence the authors of the study believe that their data support the use of (virtually side-effect free) microdose lithium in the prevention and treatment of Alzheimer’s disease.Indeed, long-term lithium treatment already provided preliminary evidence of its disease-modifying properties for amnestic MCI [mild cognitive impairment] in a randomised controlled trial, where the lithium-treated group had fewer conversions from MCI to AD. Lithium treatment was associated with a significant decrease in cerebrospinal fluid concentrations of hyperphosphorylated tau and better performance on the cognitive subscale of the Alzheimer’s Disease Assessment Scale and in attention tasks. At a more advanced stage of AD, microdose treatment with only 300 μg lithium administered once daily stabilized the AD patients during the complete evaluation phase of 15 months. For instance, whereas the treated group showed no decreased performance in the mini-mental state examination (MMSE), lower scores were observed for the control group during the same period, with significant differences occurring after three months, and increasing progressively.Importantly, lithium, besides being required for efficient AHN and blocking AD-specific pathological processes, also impacts on cell-rejuvenating autophagy. Lithium was found to inhibit the activity of inositol monophosphatase (IMPase), which leads to a decrease of myo-1, 4, 5-triphosphate (IP3). This reduction of IP3-activity induces autophagy, independent of mTOR. In this context it is important to note that lithium chloride extends the lifespan of the nematode Caenorhabditis elegans, possibly by means of mitochondrial rejuvenation, which suggests that lithium exerts its effects on evolutionary highly conserved mechanisms. Intake of drinking water with comparable low lithium concentrations were found to be inversely correlated with all-cause mortality in a large epidemiological study in Japan. Hence a lack of lithium is linking aging and frailty (all increasing mortality) to disturbed autophagy, and AD to impaired AHN, and, thus, might represent another important and modifiable risk factor in this neurodegenerative disease. Traces of lithium can be ingested in some geographic areas by drinking local tap water or otherwise by consuming commercially available, mineral-rich spring waters, containing suitable concentrations of around 1 mg lithium per litre. Hence microdose lithium intake by means of one or two glasses of such water a day is not only of potential therapeutic value (see below) but also a safe preventive measure, by means of simply reducing an intake-deficit of an important novel trace element.”

Source: Unified theory of Alzheimer’s disease (UTAD): implications for prevention and curative therapy

Bonus excerpt:

“Taken together, besides the importance of IMF and physical exercise, also dietary MCTGs [medium-chain trigylcerides] can be an attractive (indirect) source of ketone bodies during the non-fasting state. The intake of coconut oil as a healthy source of MCTGs has additional positive effects on neuronal insulin resistance, neuroinflammation as well as Aβ-toxicity, improves the LDL/HDL-cholesterol quotient by increasing HDL, and ameliorates several others key progression factors of AD. Hence the use of virgin coconut oil is highly recommended as a safe and healthy alternative for polyunsaturated oils for frying and baking and butter and an important part of a comprehensive strategy for the prevention and treatment of AD.”

QOTD: Abraham Lincoln, White Supremacist

“I will say then that I am not, nor ever have been in favor of bringing about in any way the social and political equality of the white and black races, that I am not nor ever have been in favor of making voters or jurors of Negroes, nor of qualifying them to hold office, nor to intermarry with white people . . . . I as much as any man am in favor of the superior position assigned to the white race.”

— Abraham Lincoln, First Lincoln-Douglas Debate, Ottawa, Illinois, Sept. 18, 1858, in The Collected Works of Abraham Lincoln vol.3, pp. 145-146.

Donald Sensing argues that the Civil War, for Lincoln, was about preserving the Union of these United States, not about abolishing slavery.

Donald also wrote: “The Confederate States of America was founded to do one thing only: to preserve the power of one class of people to literally own as chattel property another class of people. There is no other reason the CSA existed.

Cold Exposure May Help You Lose Weight

Well below room temp here

Should be well below room temp here

David Mendosa found a 2016 research report suggesting that cool temperatures may help with weight management by activating our brown fat, which burns more calories. Heat generated by brown fat is derived from glucose and triglycerides. Keep in mind as you read further that a comfortable environment temperature for a clothed human is about 23°C or 73°F. Those temps don’t stress our bodies by requiring us to either generate or dissipate extra body heat.

David writes:

Researchers have discovered that when we get mildly cold, which they define as being cool without shivering, our bodies burn more calories. As a result, managing our weight can be easier.
This is the conclusion of a recent review that two researchers at Maastricht University Medical Center in the Netherlands published in the November 2016 issue of the professional journal Diabetologia. The title of their article, “Combatting type 2 diabetes by turning up the heat,” puzzled me at first.

The title confused me because the study is about turning down the heat in the room we’re in. But then our bodies compensate by turning up their internal heat production.

When our body does this, its energy expenditure increases, ratcheting up our metabolism. Being mildly cold revs up our bodies’ brown fat, which unlike white fat, burns calories instead of storing them.

It’s not quite clear how much cold exposure it takes to turn on your brown fat. From the link above:

Cold acclimation by intermittent exposure to a cool (14–17°C) [57–63°F], or cold (10°C) [50°F] environment resulted in significant increases in NST [non-shivering thermogenesis or heat production] capacity. A 10 day cold acclimation study with 6 hour exposure to 14–15°C [57–59°F] per day was enough to significantly increase NST by 65% on average. A 6 week mild cold acclimation study (daily 2 hour cold exposure at 17°C [63°F]) also resulted in an increase in NST together with a concomitant decrease in body fat mass. The latter two studies also revealed significant increases in BAT [brown adipose tissue] presence and activation. All in all, cold-induced BAT activity is significant in adults and parallels NST. The actual quantitative contributions of BAT and of other tissues (e.g. skeletal muscle) to whole-body NST are, however, not elucidated and await further studies. Furthermore, more information is needed on the duration, timing and temperatures to find out which treatments are most effective with respect to increasing NST.

Furthermore, cold exposure over the course of 10 days increased insulin sensitivity in T2 diabetics by 43%. Eight study subjects, probably in the Netherlands, were exposed to temps of 14–15°C [57–59°F] but I don’t know for how many hours a day. Increased insulin sensitivity should help keep a lid on blood sugar levels and reduce the need for diabetes drugs.

In case you’re elderly, obese, or have type 2 diabetes, be aware that the activation of brown fat by cold exposure is not as robust as in others.

On the other hand, I found evidence that higher ambient temperatures (above 23°C) [73°F] may also help with weight management, regardless of what brown fat is doing.

Science is hard.

Steve Parker, M.D.

PS: Check out my books for more ideas on weight management.

 

Yes: You Can You Regain Muscle Mass After Age 60

She'll lose muscle fibers if she gets too sedentary as she ages

She’ll lose muscle fibers if she gets too sedentary as she ages

“Our lab and others have shown repeatedly that older muscles will grow and strengthen,” says Marcas Bamman, a professor of integrative biology at the University of Alabama at Birmingham. In his studies, men and women in their 60s and 70s who began supervised weight training developed muscles that were as large and strong as those of your average 40-year-old.”

Source: Can You Regain Muscle Mass After Age 60? – The New York Times

Dr. Bamman says older folks (over 60?) don’t add new muscle fibers like young’uns do. But an effective exercise program will cause hypertrophy (growth) of the existing muscle fibers. “Effectiveness” probably depends on exhausting muscle groups during weigh training.

Recipe: Rosemary Roasted Brussels Sprouts With Onion

Final product without Parmesan sprinkles. That's sous vide chicken in the foreground.

Final product without Parmesan sprinkles. That’s sous vide chicken in the foreground.

At my request, my wife bought me a mess o’ Brussels sprouts, and I’ve been experimenting with recipes.

Sprouts sliced in half

Sprouts sliced in half

Ingredients this time are the sprouts, dried rosemary (i.e., not fresh although it grows where I live), salt, pepper, extra virgin olive oil, fresh garlic, and diced onion.

FYI, rosemary is used as an ornamental landscaping plant in southern Arizona.

To promote release of flavor, I sautéed three garlic cloves and the rosemary in EVOO.

Releasing the flavors of garlic and rosemary over medium heat for perhaps 3 minutes

Releasing the flavors of garlic and rosemary over medium heat for perhaps 3 minutes

Then I sliced the sprouts in half along their long axis, to reduce cooking time. (Cut them so the leaves stay attached to the internal stalk.) You’d have to cut them in half before you eat ’em anyway.

I dumped all ingredients into a bowel and mixed thoroughly to ensure the sprouts were coated with oil.

Ready for the oven

Ready for the oven. I used about 3/4 cup of diced onion.

Everything except the bowl was transferred to a cooking sheet covered with aluminum foil (easy clean-up!), which I then popped into an oven pre-heated to 425°F. I cooked for 25 minutes. At around the 10 and 17-minute marks, I pulled the concoction out of the oven and stirred/flipped the ingredients to promote even cooking and browning. Your cooking time will vary from 17 to 25 minutes depending on your preferences. If you want some browning of the sprouts, you likely need to cook longer than 17 minutes. Unless your oven runs hotter than mine.

This is my favorite roasted Brussels sprouts recipe thus far. For an extra flavor zing, sprinkle with some Parmesan cheese just before eating. In the future, I may  top the ingredients with some other type of cheese a minute before the cooking is completed. Bacon bits are another tasty option.

Steve Parker, M.D.

Not "real" Parmesan from Italy. For example, this one contains cellulose "to prevent caking."

Not “real” Parmesan from the Parma region of Italy. For example, this one contains cellulose “to prevent caking.”

 

Roasted Radishes and Brussels Sprouts

Roasted Radishes and Brussels Sprouts. Copyright Steve Parker MD

Roasted Radishes and Brussels Sprouts

A year ago I ran across online praise for roasted radishes. I’m not a big fan of radishes, perhaps because they weren’t part of Parker cuisine when I was growing up, but finally gave them a try.

Beautiful, huh?

Beautiful, huh?

This won’t be as detailed as most of my recipes because I ran out of time.

Raw Brussels Sprouts

Raw Brussels Sprouts

My basic ingredients were raw radishes and Brussels sprouts, diced onions, a bit of parsley (probably not needed), extra virgin olive oil, dried rosemary (i.e., not fresh), coarse salt, and pepper.

With the radishes, I cut off the little rootlet and green top, then cut them in half unless they were tiny radishes. Brussel sprouts take longer to cook, so I cut them in half, too. I put all the veggies  into a bowl, added just enough olive oil to coat them, sprinkled in some salt and pepper, then mixed with a spoon. Then I spread all that on a cooking sheet and popped it into an oven pre-heated to 425°F. (I covered my cooking sheet with aluminum foil to ease cleanup.)

All ingredients mixed in a bowl

All ingredients mixed in a bowl

I cooked in the oven for 17 minutes (15-20), using a turner to flip the veggies once or twice while cooking.

Ready for roasting

Ready for roasting

They were a little bland, so I topped off with Weber Roasted Garlic and Herb Seasoning. I enjoyed them and will do it again. Next time I may try coating with melted butter rather than olive oil. I felt very virtuous for eating my vegetables.

Steve Parker, M.D. 

PS: I ate half of this in one sitting. I refrigerated the rest and ate it about six hours later. It was much more flavorful. If you’re one of those people who never eats leftovers…

…reconsider.

Mediterranean Diet Lowered Blood Pressure By a Whopping 1 Point

Or more accurately, 1.1 to 1.3 mmHg over the course of six months in an Australian population. Systolic pressure, if you’re wondering. This isn’t clinically significant.

Details:

“A total of 166 men and women aged >64 y were allocated via minimization to consume either a MedDiet (n = 85) or their habitual diet (HabDiet; control: n = 81) for 6 mo. The MedDiet comprised mainly plant foods, abundant extra-virgin olive oil, and minimal red meat and processed foods. A total of 152 participants commenced the study, and 137 subjects completed the study. Home blood pressure was measured on 5 consecutive days at baseline (n = 149) and at 3 and 6 mo. Endothelial function (n = 82) was assessed by flow-meditated dilatation (FMD) at baseline and 6 mo. Dietary intake was monitored with the use of 3-d weighed food records. Data were analyzed with the use of linear mixed-effects models to determine adjusted between-group differences.Results: The MedDiet adherence score increased significantly in the MedDiet group but not in the HabDiet group (P < 0.001). The MedDiet, compared with the HabDiet, resulted in lower systolic blood pressure (P-diet × time interaction = 0.02) [mean: −1.3 mm Hg (95% CI: −2.2, −0.3 mm Hg; P = 0.008) at 3 mo and −1.1 mm Hg (95% CI: −2.0, −0.1 mm Hg; P = 0.03) at 6 mo]. At 6 mo, the percentage of FMD was higher by 1.3% (95% CI: 0.2%, 2.4%; P = 0.026) in the MedDiet group.”

Source: AJCN | Mobile

OMG I’ve Got PFP

My daughter and I at Tom’s Thumb on June 3. She got her good looks from her mom, obviously.

I posted this here a couple weeks ago:

I’ve developed over the last month some bothersome pain in my right knee. It’s not interfered much with my actual hiking, but I pay for it over the subsequent day or two. I’m starting to think this may put the kibosh on my Humphries Peak trek next month.

The pain is mostly anterior (front part of the knee) and is most noticeable after I’ve been sitting for a while with the bent knee, then get up to walk. The pain improves greatly after walking for a minute or less. It also hurts a bit when I step up on something using my right leg. If I sit with my knee straight (in full extension), it doesn’t hurt when I get up. The joint is neither unusually warm nor swollen. Ibuprofen doesn’t seem to help it. These pain characteristics seem classic for something, but I don’t know what, yet….My twice weekly hikes always include a fair amount of elevation gain. I suspect an over-use syndrome, basically a training error. I plan to take an entire week off from hiking and Bulgarian Split Squats, and taking ibuprofen 600 mg three times a day.

The view looking south from the base of Tom’s Thumb

I did some research in the literature and think I’ve got patellofemoral pain, aka PFP or PFP Syndrome. Can’t say I’d heard of it before. Sounds more like a description than a diagnosis. Like saying someone has fever.

This guy posed for my daughter

I got most of my info on PFP from UpToDate.com, but you probably don’t have access to that. You healthcare professionals, click for a 2007 article at American Family Physician. Mayo Clinic has info for muggles. So does American Academy of Orthopaedic Surgeons.

I hope she thinks of this hike when she sees Tom’s Thumb from Hwy 101

I may have some age-related osteoarthritis in both knees, but that’s not causing this pain.

My PFP was caused by over-use. Too much hiking with elevation gain and  accelerating my program too rapidly. Also, prior experience taught me that using trekking poles helped take strain off my knees, and I have not been using them.

The newest resident at the Parker Compound. He’s eight weeks old.

I took a week off from hiking while taking ibuprofen 600 mg three times a day, when I could remember it. The combo helped, probably the rest more than the NSAID. Then I did two six-mile walks on the flat without much trouble. On June 3, I hiked Tom’s Thumb trail with my trekking poles, 4 miles round trip, and only had mild discomfort. Most importantly, I learned that I get relief from icing down the knee for 30-45 minutes after I get home.

I’m disappointed I can’t climb Thompson Peak in preparation for Humphries Peak. It would probably kill my chance to summit Humphries (right now I put those odds at 50:50).

Steve Parker, M.D.

 

 

Is Drinking Tea Healthful?

Green tea isn’t always green

From P.D. Mangan’s new book “Best Supplements for Men“:

Green tea, which is commonly drunk in China and Japan, is associated with lower rates of cancer, about 30% lower in those who drank the highest amounts of green tea compared to the lowest. Deaths from cardiovascular disease were about 25% lower in the highest consumption group versus the lowest. This is of course epidemiological evidence, meaning that it can’t show whether green tea actually prevented disease, or that there’s some other connection such as that heather people drank more green tea.

Laboratory and other evidence, however, provides some good reasons to think that green tea is the real deal when it comes to sides prevention.

A recent study of the elderly in Singapore found tea consumption linked to much lower risk of neurocognitive decline in women and carriers of the “dementia gene” APOE ε4.

P.D. suggests that the health-promoting dose of tea is 3 to 5 cups a day, and black tea may be just as good as green.

Steve Parker, M.D.