www.healthcareinsights.com article on Omegas

THIS ARTICLE IS PART 2 of "Oh My...Omega's! and focuses on Food Sources and Supplements

Omega-3 fatty acids make up a major part of brain and body cells but can only be ingested, not made by our bodies. Omega-3s are important for building brain cell membranes, dendrites and synapses. They are also anti-inflammatory, and thus helpful for preventing or managing a variety of diseases. Choose fish (3 or more x a week!), seafood, fish oils, green leafy vegetables, walnuts, flax seeds, and purslane.

What are the Types of Omega-3's?

There are two major types of Omega-3 fatty acids:

alpha-linolenic acid (ALA), which is the plant form,
eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) which is the marine or "sea" form. EPA and DHA are found in fish, algae and all seafoods and in grass fed and free range animals and poultry.
It is the marine form, DHA and EPA, that help make up our own brains and bodies cell membranes and other components, not ALA, the plant form.

Food Sources of Omega-3's

ALA is found in vegetable oils such soybean, canola (rapeseed), and flaxseed, pumpkin seed, hemp seed, and perilla seed oils. Other sources of ALA include flaxseeds, pumpkin seeds, chia seeds, wheat (especially wheat germ), hemp, soybeans, tofu, walnuts, kidney beans, purslane, and green vegetables such as kale, spinach, Swiss Chard, collard greens, Brussels sprouts, Chinese cabbage, bok choy, mustard greens (and all of the other types of Chinese green vegetables), grape leaves, cauliflower, and salad greens.

Most foods rich in ALA also contain vitamin E which is one of nature's primary ways of preventing oxidation of the delicate Omega 3's. It is vitamin E in its multiple forms that also helps protect from oxidation the Omega 3's in our brain cell membranes and dendrites! (see our website and previous article about Vitamin E).

Purslane, though considered an exotic weed in the US, is frequently eaten as a leaf vegetable in Europe, Asia, and Mexico. Not only is purslane a rich source of ALA (1 cup of fresh leaves contains about 300 to 400 mg), but it is also a source of Vitamin A, Vitamin C, some B vitamins, magnesium, calcium, potassium, and iron. Some types of purslane are now sold as flowering plants; these are also edible.

What are the fish and animal sources of Omega-3's?

EPA and DHA are found mostly in marine sources, especially in higher-fat, cold-water varieties of fish such as salmon, mackerel, albacore tuna, sardines, Atlantic herring, swordfish, and lake trout, as well as in algae and krill...so today they are referred to as "marine" Omega 3's.

Surprising to many, PASTURE-RAISED (Free Range or Grass-fed) beef, lamb, and other animals, poultry and free-range chicken's eggs are also rich sources of "marine" Omega 3's including DHA and EPA.

Sixty percent of the fat content of grass is ALA Omega-3 fatty acid. When animals consume grass and green leafy "weeds," their flesh contains both ALA and the "marine" forms of Omega 3's. Just like humans, cattle convert the ALA they consume into EPA and DHA forms of Omega-3's; an analysis of grass-fed beef shows that EPA is the most prevalent Omega 3. ALA is the second most prevalent Omega-3 in grass fed beef with DHA the least abundant. But when transferred to the feed lot to be fattened on grains, the Omega-3 content rapidly diminishes until after just a few months in the feed lots, it is mostly gone. Animals fed only grain have high levels of Omega 6's and very low levels of Omega 3's in their flesh... or milk or products made from animal milk.

Some varieties of eggs are Omega-3 enriched, with either ALA or DHA/EPA depending on what the chickens are fed, and whether they are free-range. Feeding chickens flaxseed and canola (rape) seed and greens increases mostly ALA content while feeding them algae and seaweed increases EPA and DHA content of the eggs.

Thus if you do eat animal foods, and you can afford it, go for the grass fed and free range beef and lamb, and free range chickens, and/or Omega-3 eggs, and milk and cheese from grass fed cows. This is especially important for meat lovers who are not eating enough vegetables!

How often should I eat fish and seafood?

The Memory Preservation Nutrition (MPN)® program recommends eating fish at least three times a week and ideally some fish, seafood and/or marine oil (from fish, cod liver, or calamari) every day of the week.

The MPN™ does not emphasize just oily or fatty fish, even though they are higher in Omega 3 fatty acids, for several reasons. The most important reason is that many non-oily fish also are relatively high in Omega-3's and other important nutrients, and it is key that people try to eat fish that they enjoy eating.

What about contaminants in fish?

Though some fish contain mercury and other toxins the USDA and nutritionists say it is still safe to eat as much as 12 oz/week of those with problems (i.e. some domestic salmon, and those with higher mercury levels such as tuna, swordfish, and shark). However, pregnant women and small children are, as of late 2008, still cautioned by the USDA to avoid these particular fish.

Even more important though, pregnant women and small children need to consume fish, seafood, and fish oil to foster adequate brain and nervous system development for the fetus and child. There is indication that inadequate Omega-3's in mother (during mother's pregnancy and lactation) and child can result in poorer cognitive performance in school would otherwise be the case. See http://www.hsph.harvard.edu/nutritionsource/what-should-you-eat/fish/index.html for a discussion of how to achieve the benefits of fish while reducing any risks.

Benefits of Supplements

Omega-3 supplements are an important way to ensure that you are getting enough Omega-3 fatty acids for optimal brain and body health. The preferred form of supplementation is DHA and EPA from fish oils, cod liver oil, or calamari (squid) oil. Calamari oil is excellent form rich in DHA and EPA, especially for those with fish allergy concerns (or worried about sustainability of our fish supplies).

Typically the amount recommended depends on the primary reason you are taking the supplement. A general recommendation is to take enough of a supplement to ingest between 600 mg to 3g of combined DHA and EPA daily. Be sure to read the label as supplements have variable amounts of the "active ingredients" of DHA and EPA depending on the brand and type of oil or capsule. Thus to achieve these amounts you might need to take two to four or many more of 1000 mg (large!) soft gels, or 1-3 teaspoons of an oil a day. Be sure to let you doctor know if you are taking more than 3g of the active ingredients (DHA and EPA) because Omega-3's thin the blood (thinning the blood is generally a good thing but may interact with other medical regimens you are pursuing, e.g. coumadin). Also be sure to purchase brands known to provide contaminant-free oils; the better companies have lab analyses proving "no detectible levels" of mercury, pcbs and dozens of other possible contaminants; these companies also properly process and package oils and capsules to prevent oxidation and spoilage.

Vegetarian alternatives include algae derived DHA/EPA or 2 Flaxseed Oil 1000 mg softgels (which typically each contain 450 mg ALA Omega-3). However, this is less optimal than supplementing with oils of a marine source because flaxseed oil contains the shorter chain ALA Omega-3 that needs to be converted by the body to DHA or EPA, and this is done much less efficiently as we age.

How do I find out what is best for me?

Dr. Nancy Emerson Lombardo can be reached by e-mail or phone for inquiries about what supplements would be best for you personally, and which brands are best. She also offers preferred nutritional supplements including some Omega-3 products through her website or by phone or email.
www.healthcareinsights.com

Smoking and Alzheimer Risk..The Dementia Weekly

PREVENTION VIDEO & ARTICLE

OAKLAND, Calif. -- Heavy smoking in midlife is associated with a 157 percent increased risk of developing Alzheimer's disease and a 172 percent increased risk of developing vascular dementia, according to a Kaiser Permanente study published in the Archives of Internal Medicine.

Electronic health records were used to study 21,000 men and women for 20 years, making this a remarkably compelling piece of research.

This is the first study to look at the long-term consequences of heavy smoking on dementia.

Researchers followed an ethnically diverse population of 21,123 men and women from midlife onward for an average of 23 years. Compared with non-smokers, those who had smoked more than two packs of cigarettes a day had more than a 157 percent increased in risk of Alzheimer's disease and 172 percent increased risk of vascular dementia during the mean follow-up period of 23 years. Vascular dementia, the second most common form of dementia after Alzheimer's disease, is a group of dementia syndromes caused by conditions affecting the blood supply to the brain.

"This study shows that the brain is not immune to the long-term consequences of heavy smoking," said the study's principal investigator, Rachel A. Whitmer, Ph.D., a research scientist with the Kaiser Permanente Division of Research in Oakland, Calif."We know smoking compromises the vascular system by affecting blood pressure and elevates blood clotting factors, and we know vascular health plays a role in risk of Alzheimer's disease."

Researchers analyzed prospective data from of 21,123 Kaiser Permanente Northern California members who participated in a survey between 1978 and 1985. Diagnoses of dementia, Alzheimer's disease and vascular dementia made in internal medicine, neurology, and neuropsychology were collected from 1994 to 2008. The researchers adjusted for age, sex, education, race, marital status, hypertension, hyperlipidemia, body mass index, diabetes, heart disease, stroke, and alcohol use.

"While we don't know for sure, we think the mechanisms between smoking and Alzheimer's and vascular dementia are complex, including possible deleterious effects to brain blood vessels as well as brain cells," said study co-author Minna Rusanen, MD, of the University of Eastern Finland and Kuopio University Hospital in Finland.

This study is the latest in a series of published Kaiser Permanente research to better understand the modifiable risk factors for dementia. This ongoing body of research adds to evidence base that what is good for the heart is good for the brain, and that midlife is not too soon to begin preventing dementia with good health.


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Sequencing; a habit

I attended Dr. Lennox'talk this morning at the Atrium in Quincy entitled 'What is so funny about challenging behaviors?' After a few minutes I realized I'd heard this talk before, but as it is a salient topic, behavior, I stayed. It's always good too to get fresh material to add to my arsenal for giving presentations about the behaviors of Alzheimer's.
Well, something struck me as quite important in the care of the person with Alzheimer's; sequencing habits. We all have routines we do each morning. The question was asked What five things do you do upon arising? The only 2 activities that were common to all were toileting and brushing teeth. Then he asked, 'Which arm do you put into the coat or sweater first?' He noted when the sequence is reversed it causes some anxiety. I recently felt this when I decided to shop from the opposite end of the market than I usually do. I routinely go to the vegetables and automatically pick up onions, broccoli, mushrooms, lettuce, etc. Starting at the other end where the orange juice, ice cream, eggs, etc are made me feel quite awkward. Why? My sequence habit was disturbed. I am cognitively intact and it upset me; what does it do to the person who has a cognitive deficit, I wondered. Think about the ramifications of this knowledge in how we work with this population. I have to give this more thought. Today when I shop (again) I will save myself the trouble and start at the usual end of the store.

3 myths about Alzheimer's

I was on Greg Porell's South Shore Senior News radio this morning on my monthly Alzheimer's spotlight. I always look forward to these; giving out 6 minutes of tidbits about Alzheimer's. John Zeisel PhD of Hearthstone brought up these myths. It is disturbing to think some still believe them to be true. # 1. People with AD cannot learn. Well, ask Lynn Serper of the SerperMethod if that is true. Try to sit in the usual place at the table of the person with AD and see if she doesn't remember it is HER seat and you don't belong there. # 2. People with AD are no longer a person. I met a salesman at a recent event who, when he learned what I did, said, "They aren't really a person anymore, are they?" I nearly lost my cool, but instead did some serious teaching. Engage the person with AD and talk about something that evokes positive memories for him and see his 'person' emerge. # 3. People with AD have no future. Well, I may have a day to live, or a year, or another 3 decades. The person with AD has between 2 and 20 years to live. Is that enough of a future to pay attention to its being a meaningful one. Each day is a treasure to us all. People with and without a progressive disease like Alzheimer's need a purpose to get up in the morning and a sense of well being and value during the day. Caregivers are being taught by StilMee coaches how to bring value and purpose and control back to the person with Alzheimer's. It is a wondrous sight to see.

Food for thought

This good bit of information from Stafford Hill of Plymouth e-newsletter for June...

Low blood levels of vitamin D effect more than bone health. Studies find a greater risk of heart problems and depression in older adults. In one study, people taking a vitamin D supplement were 7% less likely to die than those who didn't take a daily supplement.

The darker a person's skin, the more difficult it is to get vitamin D from sunlight. Fair-skinned people might be willing to risk the 10 to 15 minutes they need to get enough. But there's still a problem. Unless you live south of a line from Los Angeles to Columbia, S.C., there isn't enough sunlight year round to produce all the vitamin D you need. Most people need other sources. Your diet may increase your risk if it's low in milk or the foods that naturally contain vitamin D, such as salmon and eggs. In the U.S. nearly all milk if fortified with vitamin D, and many brands of OJ are too. Even some cereals contain a healthy dose. So make every day a "D" day.

Tips from Nancy Lombardo Ph.D of BUADRC

"Eat Your Veggies"
is at the Heart of Memory Preservation Nutrition®

Continuing our series on Consumer Guidelines for a Brain Healthy Nutrition, this month's feature is VEGETABLES. Study after study, using different populations around the world, has concluded that people who eat more vegetables than others in the study, have lower risk of cognitive decline and brain diseases such as Alzheimer's disease (lead scientists include Amy Graves, Martha Morris, and James Joseph).

A variety of green leafy and brightly colored vegetables, as well as dried beans and peas and low sodium vegetable juice, are essential to brain and body health. Vegetables, beans and peas are major elements of the Mediterranean Diet and the DASH diet. People scoring high on each of these diets have been shown to have lower risk of cognitive decline (see publications by Nikolaos Scarmeas, MD at Columbia School of Medicine, and Heidi J. Wengreen with the Cache County (Utah) Study on Memory, Health and Aging).

Among vegetables, the stars appear to be leafy green vegetables which contain high levels of antioxidants including vitamins A and E, as well as traces of omega 3's, and other brain healthy nutrients. Leafy green vegetables include spinach, broccoli, delicious Swiss chard, kale, collard greens, all the bok choys and their relatives, pea stems/leaves (all the rage in Chinese restaurants) and all the lettuces except iceberg, and many many more. Explore to give your taste buds a treat!

Romaine lettuce, among other leafy vegetables, also contains high levels of S-adenosylmethionine, more well known as SAM or SAMe, which Professor Thomas Shea of the University of Massachusetts in Lowell, discovered to be important to brain health and related metabolic processes in the brain. Our bodies like all living cells make some SAM but usually not enough to meet our needs, and so it is essential to ingest more of it in the food we eat. There are also supplements available, such as Dr. Shea's/U Mass Lowell's patented product licensed and marketed as "Great Mind®" by Nature Made. Which contains SAM, folic acid, B-12, N-Acetyl Cysteine (NAC), and Acetyl L Carnatine.

Aim high, as vegetables are key to brain and body health. 7-10 portions a day of a variety of vegetables is ideal. You can obtain at least one portion's worth by drinking a glass of low sodium vegetable juice a day. Best are the 100% vegetable juices such as low-sodium V-8. Those mixed with fruit juices may taste better to you but you are then drinking less vegetable juice and more fruit juice laden with fructose (a form of sugar).

Most Americans do not eat many or hardly any vegetables. And French fries and ketchup do not really count, though they are better for you than a donut or pastry.

Another solution for people who can't or don't eat enough vegetables and fruits is a supplement with impressive research credentials comprised of dehydrated vegetable/fruit juice in a capsule or delicious chewable form (the tastiest "gummy" you ever experienced) ...salt, sugar is removed so safe for diabetics, and essential nutrients of 17 different fruits and vegetables are included so it is classified as a whole food by the FDA (no sales tax in MA!). Special orders for just the vegetable form is possible. Contact me for more information or check out my website: Nancy's Juice Plus Website

Also check out delicious veggie recipes on my other website: www.healthcareinsights.net
Public invited to five presentations

Anti-Cancer Superfoods; Do they really work?

Here is an article I found on WCVB.com. Ask Nancy Lombardo PhD from BU Research on Alzheimer nutrition. She says these also work to keep your brain healthy and help those with Alzheimer's. Remember what is good for the heart is good for the rest of the body. We are not disconnected at the neck; our brain needs our utmost attention. Eat up!!

Anti-Cancer Superfoods: Do They Really Work?
By Melanie Haiken, Caring.com senior editor

The short answer to this question is -- drum roll, please -- yes. They really do. While studies are ongoing, and in many cases experts still don't know exactly how these superfoods work, there's strong evidence that certain fruits and vegetables rich in plant-based nutrients can both prevent tumors from starting and halt their growth. Here, the top foods to work into the family diet if you'd like to cut cancer risk or help those with cancer recover. And who wouldn't?
1. Blueberries, Acai Berries, Raspberries, and Cranberries.
The rich, dark colors of blueberries, Brazilian acai berries, raspberries and cranberries come from phytochemicals that protect against numerous types of cancer. Most recently, researchers at the University of Florida found that the active ingredient in acai berries destroyed cancer cells when tested in cell cultures. And blueberries and muscadine grapes contain compounds that recent research shows cause cancer cells in the liver to self-destruct. In studies particularly important to women, cranberries have recently been discovered to be an important weapon in the fight against deadly ovarian cancer. Studies reported at the annual meeting of the American Chemical Society found that ovarian cancer cells that were becoming resistant to platinum chemotherapy – the standard of care for ovarian cancer – became six times more sensitive when exposed to a compound in cranberries.
The anti-cancer properties of all these berries are so strong that researchers have developing concentrated supplements and other products such as purees and concentrates.