Sunday, December 27, 2015

Gun Control in California - What You Can Do


The U.S. has more than 30,000 gun deaths per year.  Mass shootings, including 4 deaths, occur at least weekly in this country.  Countries with stricter gun control laws, such as the U.K., Japan, Canada and Australia, have come close to ending gun violence, with strict rules on the possession of guns.

Lt. Gov. Gavin Newsom, a Democrat, has proposed a ballot initiative that can set the gold standard for meaningful reforms in Cailfornia, creating a model that could be applied in other states. It's called the Safety for All Act; it would require on-the-spot background checks when buying ammunition, ban the possession, not just the sale, of large-capacity magazines with 10 rounds or more, and require police reports when guns are lost or stolen. This measure would make California the first in the nation to implement point-of-sale background checks for ammunition purchases, giving them the same level of scrutiny as gun purchases.

 The recent deadly shooting in San Bernardino happened in a state with some of the nation's toughest gun laws: California already bars assault weapons, blocks the sale of large-capacity magazines and requires universal background checks for all gun purchases. Authorities say they believe suspected gunman Farook and wife Malik had legally obtained two handguns and that two rifles were also legally purchased in California. Federal officials say the attackers had large-capacity magazines that violate California law in their SUV.  Since the attack, the state's strict laws and the apparent legal purchase of the weapons have set off a debate over the effectiveness of gun measures and whether getting tougher would help prevent more violence.
"Strong gun laws do prevent gun deaths. Not every law can prevent every gun death," said Allison Anderman, a staff attorney with the Law Center to Prevent Gun Violence in San Francisco. "They work most of the time."
The gun-control advocacy group rates California's gun laws No. 1 in the nation; the state ranks 42nd in its rate of gun deaths. Louisiana's gun laws were ranked 50th and it is No. 2 in deaths, according to the group's 2014 rankings. 
Gun laws vary dramatically state-to-state, even city-to-city. The patchwork of regulations means it's often easy for determined gunmen to acquire weapons by skirting laws in their home state, they say. Untraceable weapons can be built from scratch using parts bought online.
As a result, gun control advocates in the days since the shooting have called for more stringent laws in California and nationwide.

You can support Gavin Newsom’s ballot initiative by making a contribution to the Courage Campaign, at couragecampaign.org.  Sign the ballot initiative, which will require 366,000 certified signatures, when you see it outside your market or post office next year 
Sadja Greenwood MD, MPH






Sunday, December 6, 2015

Genetically Modified Salmon approved by the FDA



The U.S. Food and Drug Administration has approved a genetically engineered salmon as fit for consumption.  It will be the first genetically altered animal to reach American tables. (Plans for genetically modified pigs are being pursued in the U.S. and Korea.)  The salmon, produced by AquaBountyTechnologies, are genetically engineered with DNA that causes them to grow to market size much faster than other salmon.  They will be raised in contained, inland facilities in Panama, from eggs produced in Canada.  The company says that the fish will be all-female and reproductively sterile. Once harvested, they will be imported for sale in this country.  It is not clear when they will show up on store shelves. 

Consumer and environmental groups have strongly opposed the approval of these salmon, arguing that its safety is not certain and that wild salmon populations could be affected if the GE fish were to escape into rivers and oceans.  Being larger, they could eat more food and thus out-compete natural salmon. 

The FDA does not require, and has refused to consider, labels for genetically engineered foods, so the GE salmon will not be labeled as such.  A decision to label the new fish will be voluntary and up to the companies selling the fish. So far, Costco, Safeway, Kroger, Target, Whole Foods, Trader Joe’s and Aldi say they have no plans to sell the GE salmon.  Walmart has not said what they will decide on this matter.  Because the Aqua-Advantage salmon will be raised in Panama, it will have to carry the country of origin label required by the US Department of Agriculture.    Their rules also require imported fish to be labeled ‘farm-raised’ or ‘wild-caught’.  If shoppers see ‘’Product of Panama’ and ‘farm-raised’ on a package of salmon, it will probably be GE.  Restaurants and cafeterias must make such information available, but are not required to do so.

The Center for Food Safety, a consumer advocacy group, plans to sue the FDA in an attempt to block the sale of the fish, or to require labeling.  Food and Water Watch is also planning a lawsuit. 

On January 19th, 2016, the California Sate Assembly will vote on legislation to require that all GE fish sold in California be labeled as ‘genetically engineered’.  The Consumer Right to Know Act was introduced by into the California Assembly by Jared  Huffman, who is now on our congressman. 

There are arguments on both sides for genetic engineering of food, based on the need for more calories and protein in a world of growing human numbers.   However, the ways that GE corn and soy have been used is open to criticism.  Weeds have become resistant to the herbicides Roundup (glyphosate) and 24-D, so that larger amounts are needed.  Toxicity to beneficial soil bacteria, the Monarch butterfly and many other animals is a result.  Much of the GE soy we produce is used for animal feed, and GE corn is also made into ethanol for our cars.


The need for labeling as these questions are further analyzed is clear to me.   Please pay attention to the January vote on GE salmon in our California assembly.  You can call our Assemblyman Marc Levine at 415 479 4920 and register your opinion on labeling of this new product.
Sadja Greenwood MD, MPH   past issues on this column.






Monday, November 16, 2015

The Benefits of Prunes - Prepare to be Surprised


Besides their laxative effect, can prunes help prevent osteoporosis and colon cancer?  Can they help with weight loss?  Read on.

Osteoporosis – Studies form Florida State University, published in the British Journal of Nutrition, showed that in rats subjected to treatments that produced osteoporosis, prunes in the diet were able to reverse bone loss.  In a human study, a group of post-menopausal women was given 100 grams of prunes per day (about 10 prunes) and a comparison group was told to consume 100 grams of dried apples.  After 12 months, the group eating the prunes had significantly higher bone mineral density in the ulna (an arm bone) and spine.  Authors of the study said that prunes are able to suppress bone breakdown, which tends to exceed new bone growth as people age.  This effect may be due to good levels of the mineral boron in prunes.  Other foods high in boron are plums, grapes, avocados almonds and peanuts.  

Laxative Effect – Prunes are well known for their ability to help with constipation.  They are a safe laxative for most people. This is due to their fiber and high sorbitol content, which retains fluid in the intestines.  Sorbitol is a natural sugar found in many fruits.  It is metabolized relatively slowly, so that prunes do not cause a rapid rise in blood sugar.  Many people with diabetes can eat them in moderation (but check with your health care provider). 

Colon Cancer – Research from Texas A&M University and the University of North Carolina has shown that prunes can positively affect gut bacteria (the microbiome) and help to reduce the risk of colon cancer. There are trillions of bacteria in the intestinal tract – more than 400 individual species have been identified.  Disruptions to the microbiome are involved in intestinal inflammation, which can promote the development of colon cancer. Prunes contain antioxidant compounds that can neutralize free radicals that damage DNA.  In a rat study on colon cancer antecedents, rats fed with prunes (and their regular chow!) showed significantly reduced numbers of precancerous changes in the intestinal walls compared to a control group.

Weight Loss – Research by the University of Liverpool found that eating prunes as part of a weight loss diet helped in weight control.  100 overweight or obese men and women were tested for 12 weeks.  Half the subjects were given about 14 prunes per day along with their diet, and the other half got advice on healthy snacks.  The group that ate prunes lost 4.4 pounds and an inch from their waist.  The control group lost 3.5 pounds and .7 inches from the waist.  Also, the group eating prunes experienced greater feelings of fullness during the weight loss diet.  The diets were matched for calories.

Prunes are now called dried plums by some nutritionists, and prune makers, because of their negative image as a medicinal food for the elderly.  Additionally, some people don’t like their taste, and may need to disguise them in shakes and stir-fries.  The benefits listed in this column may change these views.  If you have colon cancer in your family, or are eating a diet high in red or processed meat, if you have osteoporosis in your family, or have low bone density yourself, you may want to give prunes a chance. 

Sadja Greenwood, MD, MPH  past issues on this blog


Tuesday, November 3, 2015

Food on the Menu at UN Climate Talks


Sam Kass was the director of Michelle Obama’s ‘Let’s Move’ campaign and the Senior Policy Advisor for her Healthy Food Initiatives.  He assisted Michelle Obama in creating the first major vegetable garden at the White House since Eleanor Roosevelt’s Victory Garden.  Kass is now preparing to be a senior food analyst on the NBC news team. 

Kass’s plans for working at the UN Conference on climate change in December may surprise many of the delegates from 190 countries, whose goal is to achieve a binding and universal agreement on climate.  Kass is planning meals for the delegates – meals that will send a message on the crucial role that food and agriculture will play in either reducing or worsening climate change.  Methane is produced by livestock and food waste; nitrous oxide escapes from manure and fertilizer; carbon dioxide is left unabsorbed when rainforests are cut down to make way for cattle and soybeans.   “If it were a nation, rotting food would be the third largest emitter of greenhouse gas (after the US and China) and takes 28% of the planet’s agricultural land to produce” says Kass.  He plans to serve a meal on two different plates – one made with typical, resource depleting, greenhouse gas emitting ingredients (such as corn-fed beef) and one made with truly sustainable ingredients.  Kass is hoping to compel leaders to place the food system on the list of sectors requiring action, along with energy and transportation

Kass recently co-hosted a sustainably focused meal with a Peruvian chef  and with Sean Penn at the World Bank, International Monetary Fund meetings in Lima, and spoke to the power of food to inspire sustainable policy.  For his work at the Paris conference, Kass will be working with allies such as the Center for Food Safety (CFS), who will be there to highlight the importance of carbon capture through agroecological practices.   CFS maintains that this kind of carbon capture can be started immediately, carries no risk and will increase crop yield, minimize erosion, and help the water carrying capacity of soil.  (Agroecology is the study of the interactions between plants, animals, humans and the environment within agricultural systems. It includes organic farming, traditional framing methods, crop rotation and polyculture rather than monoculture.) 

President Hollande of France and the French Minister of Agriculture have expressed an interest in putting soil carbon sequestration among the actions to be recommended at the UN conference.  Kass hopes to inspire high-profile chefs throughout the world to keep in mind the issues of food, agriculture and climate.

What we can do about these issues? I suggest reading and ultimately subscribing to Civil Eats, an online news source from which most of this column is taken. It is fascinating reading on many subjects related to food policy, highlighting good practices as well as bad ones.  Compost, feed your leftovers to a neighbor’s chickens (or your own), and eat lower on the food chain.  Enjoy our organic farmers’ wonderful produce.  They are agroecologists!

Sadja Greenwood, MD, MPH
 past columns on this blog



Sunday, October 11, 2015

What’s the Beef with Beef?


For every burger skipped, you can save enough water to drink for the next 3 years.
 For every burger skipped, you can save enough energy to charge your phone for 4.5 years.   
These surprising statements come from Meatless Monday, a movement started by the Johns Hopkins Bloomberg School of Public Health to promote health and the environment.  Meatless Monday has spread to many industrialized countries.  In poorer parts of the world, many days may be meatless.

The October issue of Nutrition Action Health Letter (circ@cspinet.org) has a lead article about beef – why we should be eating less of it and less of other red meats.  Here are some salient points made by Dr. Walter Willett, professor of epidemiology and nutrition at Harvard.

Risk of Dying Prematurely  This risk is 37% higher in men who ate 2 servings of red meat a day compared to those who ate 2 servings a week.  Red meat was related to a high risk of heart disease, stroke, type 2 diabetes and colorectal cancer.  Red meat consumption during adolescence is related to the risk of breast cancer.

Risk of cancer – smoking is the greatest risk factor, followed by being overweight Red meat contributes to overweight, but is a risk factor even after removing its effect on weight. 

Other Sources of protein – plant sources include nuts and beans .  There is a small amount of protein in whole grains.  Poultry has not been linked to a higher risk of cancer, heart disease stroke or diabetes.  Fish contributes omega-3 fatty acids.  Yogurt is the healthiest dairy food, probably because of its effect on microbes in the gut (our microbiome).

Red meat’s impact on the planet:  Cattle produce methane, a potent greenhouse gas.  Per cow, grass-fed cattle are equally bad for producing greenhouse gases, because they live a longer time. If we stopped feeding grain to cattle, the environment would be greatly improved.  Huge amounts of water are needed to grow grain for cattle., and manure runoff from feedlots is an unsolved problem.  The vast monocultures of grain and soy to feed animals, and also to produce ethanol and high fructose corn syrup, are seriously threatening biodiversity.

The Protein Flip – the Culinary Institute of America is working on popularizing menus with less red meat and more recipes from other cultures using beans.  Burgers made with vegetables, fish and poultry are becoming more widespread.

The Antibiotic Problem – Most livestock  animals (except those grown by organic farmers) have been fed antibiotics for growth enhancement, not just disease treatment.  This has led to antibiotic resistance, affecting everyone who gets an infection, including people who do not eat meat.  Resistant bacteria have spread widely in the environment.   

Actions we all can take:  Investigate Meatless Monday.  Reduce your red meat intake – You will be protecting your health and  reducing greenhouse gasses and water use .  Support your local farmers and enjoy their beans and eggs, as well as their vegetables.  Subscribe to Nutrition Action Health Letter, published by Center for Science in the Public Interest.  You will be inspired.


Sadja Greenwood, MD, MPH

Tuesday, September 15, 2015

HarvestPlus Tackles Micronutrient Deficiencies
Vitamin A, zinc and iron have been identified by the World Health Organization as most lacking in diets globally.  A deficiency of these ‘micronutrients’ has been called ‘hidden hunger’ and affects about 2 billion people around he world in Asia, Africa and some parts of Latin America. The diets of the poor in developing countries usually consist of staple foods such as maize, wheat and rice, but contain too few micronutrient-rich foods such as vegetables, fruits and animal products. 

Vitamin A deficiency increases the risk of childhood blindness as well as disease and death from severe infections.  Vitamin A is made in the body when foods containing beta-carotene are eaten – such as orange sweet potatoes and green vegetables.  Zinc, found in protein foods, is important for cellular growth and metabolism.  Zinc deficiency causes short stature, impaired immune function, skin disorders and cognitive dysfunction.  Iron deficiency in childhood impairs physical growth, mental development and learning capacity.  Iron deficient women are at greater risk of maternal death due to bleeding in childbirth.

Attempts to counteract these micronutrient deficiencies with supplements are expensive and often do not reach the poor.  International agencies have realized that the missing nutrients should mainly be restored through the food that people eat every day. An international organization known as HarvestPlus is working to develop and promote staple foods that have been fortified with missing micronutrients.  HarvestPlus is part of a global agricultural research partnership for a food secure future – taking climate change and gender equity into consideration.  HarvestPlus uses selective plant breeding, known as biofortification, rather than genetic modification, to develop new strains of staple foods.  They then work to get farmers to accept the seeds for the new crops and to teach the public the benefits of the change.  The strategies of international organizations working on reducing hidden hunger also include dietary diversification, supplementation and commercial fortification. 

Beans high in iron have been introduced into Rwanda and DR Congo.  Pearl Millet high in iron is now sold in parts of India.  Cassava, maize, and sweet potatoes high in Vitamin A have been introduced into Nigeria, Zambia, DR Congo, Mozambique and Uganda.  Rice and wheat high in zinc are being tried in Bangladesh, India and Pakistan.

The vitamin A story is compelling.  In Africa, more than 40% of children under five are estimated to be at risk for vitamin A deficiency. This increases the risk of diarrhea in young children, one of the leading causes of  childhood death in poor countries.  A recent study showed a marked reduction in the likelihood that children who ate the new orange sweet potato in the past week would have diarrhea.  The beta-carotene in the orange sweet potato was converted into vitamin A at once and used by the cells lining the gut to form a barrier to invading germs. 

If you visit the website of HarvestPlus  you will find inspiring short videos of farmers trying out the new crops, talking and even singing about them. 

Harvest Plus’ donors are the UK Government, the Bill and Melinda Gates Foundation, the U.S. Government’s Feed the Future Initiative and others.  Any individual can also become a donor.

The success of HarvestPlus stands in contrast to the sadder story of Golden Rice.  Rice is the staple crop for over a billion people in Asia – and white rice is lacking in micronutrients.  For about 20 years a group of scientists have been developing strains of rice that are high in vitamin A though genetic modification.  The companies Monsanto and Syngenta now have proprietary rights to Golden Rice.  The rice has a beautiful yellow color.  However, plans to market this rice in India have been strongly opposed by local organizations and people, such as Vandana Shiva, who argue against genetically modified foods and the corporate control of agriculture. She   proposes efforts to vary the diets of the poor to include more locally available vegetables rich in beta-carotene. An attempt to study the effects of Golden Rice in the Philippines ran into difficulties – lack of informed consent given to parents of the subjects, and the fact that children in the study were given meals higher in fat than usual, which enhanced the availability of the vitamin A and skewed the study’s results.  The study in the Philippines was strongly opposed by Greenpeace and some local leaders.  It is clear that genetic modifications of foods, and especially the companies that promote them, create strong resistance. 

What are the best strategies to prevent starvation and micronutrient lack in a planet beset by growing populations and climate change?  Can farmers grow enough food without the use of the herbicides and pesticides that are hurting the pollinators?  Hopefully, organizations like HarvestPlus will have more answers in coming years.   In the meantime, those of us in the land of plenty should be as generous as we can to organizations like local food banks, HarvestPlus and Oxfam.   We could also  remember Michael Pollan’s dictum:  Eat food, not too much, mostly plants.

Sadja Greenwood MD,MPH – back issues on this blog

Monday, August 31, 2015

Some Good News About Family Planning, and Some Bad News


The U.S. has one of the highest rates of teenage pregnancy in the developed world, with more than 600,000 teens becoming pregnant each year.  Recent efforts to make contraception available, accessible and cost-free have made progress.  A program launched by Washington University School of Medicine in St. Louis, Contraceptive CHOICE, enrolled over 1400 girls ages 14-19 who were sexually active, and followed them from 2007-2011.  Teens were told about all methods of family planning, and instructed that long-acting reversible methods were the most effective.  These methods were contraceptive implants, chosen most often by younger teens, and IUDs, preferred by teens ages 17-19.  The program was free of charge.  Findings were that the teenage pregnancy rate among girls in the study was 34/1000 teens, compared to 159/1000 teens nationally.  The abortion rate of girls in the study was 9.7/ 1000 teens, compared to 41.5/1000 nationally. 

Despite the success of the CHOICE program, there is hesitancy on the part of some parents and family planning providers, who fear that greater access to more effective contraception will encourage young people to have sex.  Similar fears exist with respect to sex education in schools.  Many studies have shown that this is not true.  Other fears are based on the belief that long acting contraception such as IUDs and hormonal implants will cause infertility, which is also not shown to be the case.  In the current political climate in the US, finding federal funding for family planning will be difficult.  Private foundations funded the St Louis project.   However, since contraception is provided free of charge in Obamacare, regional efforts to prevent teenage pregnancy with long-acting, reversible methods are underway. Family planning clinicians will need training for insertion and removal of contraceptive implants in the upper arm.

Legal Abortion in Latin America
 Cuba, Puerto Rico and Guyana allow abortion upon request.   Many Caribbean countries have liberal policies. Since 2008, first trimester abortions have been legal in Mexico City, where they are provided free of charge at public health centers and hospitals.  Abortions are also available for a fee from private clinics.  However, some Mexican states still have very restrictive laws and have jailed women for seeking or obtaining abortions. According to the United Nations, more than 500,000 Mexican women seek illegal abortions every year, with more than 2000 dying from unsafe procedures. Poverty and difficulty in getting to Mexico City plays a role in this situation.    Uruguay legalized abortion in 2012.  Prior to legalization, the punishment for having an abortion was 3-12 months in prison, while performing an abortion could lead to 6-24 months in prison.  The new law, passed in 2012, legalizes abortion within the first 12 weeks, provided it is discussed with a panel of social workers and doctors, who will advise the woman on risks.  The woman must then wait 5 days to ponder her options, and the last word is hers.  The procedure is paid for by the country’s universal health care.
Colombia has also made abortion legal under certain circumstances – rape, incest, mental health of the woman, and serious fetal malformations, but the procedure is very difficult to obtain and most women still go the illegal route in that country.  Latin America is home to 5 of the 7 countries in the world where abortion is banned in all instances, even when the life of the mother is at risk: Chile, Nicaragua, El Salvador, Honduras and the Dominican Republic.  (The 2 countries outside Latin America are the Vatican City and Malta. )

Currently, in the U.S., many states are passing or planning to pass laws restricting access to abortion.  Planned Parenthood is under attack for accepting money for the costs of providing fetal tissue to universities for stem cell research, and may completely lose its funding from Congress. This makes up about 40% of its yearly income. It should be noted that federal funding for Planned Parenthood is not for abortion care but for contraception, and testing for sexually transmitted diseases and breast and cervical cancer.  What will happen as a result of this is the subject for another article.  Look for a substantial increase in the use of  misoprostol  for do-it-yourself abortions. While this method is much safer than the coat-hanger abortions of the past, it is a tragic and infuriating development in the land of the free.
 
Sadja Greenwood, MD, MPH  past issues on this blog

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Friday, August 21, 2015

How Your Diet Affects Your Brain


A study at Oregon State University, published in the journal Neuroscience, showed that diets high in fat and/or sugar cause changes in gut bacteria that appear related to a loss of ‘cognitive flexibility’.  This is the power to adjust and adapt to changing situations.  A high sugar diet had the strongest effect, also showing an impairment of  long and short term memory.  

These problems may be linked to alteration in the microbiome, the complex mixture of about 100 trillion microorganisms living in your digestive system.  It is comprised of many different species of bacteria, yeast, fungi and even viruses.  
These microbes help us obtain nutrients from foods we normally can’t digest, and also help to protect us from infections by disease causing bacteria.  The microbiome in each person changes over time, depending on the food that is eaten.  Different microorganisms prefer different food, so species may grow or decline in numbers depending on what you choose to eat.  Some people take foods that contain live bacteria, such as yogurt or probiotic supplements.  Probiotics must be consumed regularly to maintain the bacteria they contain, or the microbiome may revert to what it was before their introduction.  

The study at Oregon State was done by Kathy Magnusson, who tested laboratory mice who consumed different diets.  The animals then faced a variety of tests, assessing changes in their mental and physical function.  She found that after just four weeks on a high-fat or high-sugar diet, the performance of mice on various tests of mental and physical functioning began to drop compared to animals on a normal diet. 

 Mice have proven to be a particularly good model for studies relevant to humans on such topics as aging, spatial memory and obesity, according to Dr. Magnusson.  Comparable studies in humans would be extremely costly, due to difficulties in recruiting subjects, securing agreement on the assigned diet, and keeping subjects adhering to the plan for weeks.

The mechanisms by which diet can affect behavior is still under study.  Bacteria in the microbiome can release compounds that act as neurotransmitters, stimulate sensory nerves and modulate the immune system.  It is also possible that the types of fatty acids and carbohydrates in a particular diet my be transformed by the microbiome into compounds that enter the blood stream and affect cognition.  In the Oregon study discussed here, cognitive impairment in the mice was specifically related to an increased number of one group of intestinal bacteria  (Clostridiales) and a loss of two others (Bacteriodales and Lactobacillales).  The researchers guessed that the bacteria themselves somehow brought about the brain changes. 

Here’s a take-home lesson from this study: think about the importance of your microbiome and protect the good bacteria therein.  They thrive on vegetables and fruits, lots of fiber, healthy protein and healthy fats.  Don’t send donuts, soda pop or junk food their way.  Sugary foods may make your thinking less flexible.  Who needs that?  We all need to be able to adapt to our world of continuous, rapid change.

Sadja Greenwood, MD, MPH  back issues on this blog  Leave me a message if you wish

Wednesday, August 12, 2015

A New Approach to Interval Training & The MIND Diet

A New Approach to Interval Training
It has long been known that highly motivated athletes benefit from interval training, but that most people don’t stick to programs that call for all-out effort for 4 minutes, or even 30 seconds.  It’s hard!  Researchers in Denmark looked for easier ways to improve athletic endurance that would keep people motivated, even non-athletes.  They devised a method called 30-20-10 (some prefer to call it 10-20-30) that keeps the all-out effort down to 10 seconds, and yet is effective in improving overall speed, endurance, and also may bring down blood pressure and LDL cholesterol in some adherents.  Here’s how it works.  Warm up at an easy pace by jogging, riding a bike, rowing, or walking before you begin the intervals.  Then start by spending the first 30 seconds at a easy, gentle pace, the second 20 seconds going moderately hard, and the final 10 seconds in all out effort.  Do five of these 30-20-10 intervals in a row, and then rest for two minutes by standing or walking slowly.  Do one more set of the five intervals and then stop for the day.  The Danish researchers recommend that you take a day off between this method of training.  

If you are already a jogger, rower or cyclist, this type of interval training my help you improve your speed in less time and with less pain.  If you are not in shape, be sure to have a checkup with your healthcare provider, and start with a gentle walking program.  Don’t take chances with your heart!  If all goes well, you can bring interval training into your walking program as time goes on.

The Mind Diet
Researchers at Rush University in Chicago have published a study in the journal Alzheimer’s and Dementia in which they describe the benefits of what they call the MIND Diet .  This diet, a combination of the Mediterranean diet and the Dietary Approach to Stop Hypertension (the DASH diet) was shown to lower the risk of Alzheimer’s by as much as 53% in participants who adhered to the plan rigorously, and by about 35 % in those who followed it moderately well.  The diet advises people to eat the following foods:  green leafy vegetables, other vegetables, nuts, berries, beans, whole grains, fish, poultry, olive oil and a glass of wine.  Salad is advised daily, along with another vegetable.  Three servings of whole grains are advised.  The diet also involves snacking on nuts most days, eating beans every day or so, poultry and berries at least twice a week and fish at least once a week.  Blueberries and strawberries are considered especially helpful for the brain.  

Foods to avoid include: red meat, butter and stick margarine, cheese, pastries and sweets, fried foods and fast foods.  Butter should be less than a tablespoon daily, the other foods should b eaten less than once a week.

Subjects for the Rush University study were volunteers already participating in the Rush Memory and Aging Project.  They were enlisted among residents of Chicago-area retirement communities and senior public housing.  The study began in 1997; an optional food frequency questionnaire was added from 2004 to 20013.  There were 923 volunteers, and 144 cases of Alzheimer’s developed in this cohort.  In this study, the diet plan was shown to lower the risk of Alzheimer’s by as much as 53% in participants who adhered to the plan rigorously, and by about 35 % in those who followed it moderately well.  

It is important to know that there are lifestyle interventions that can help reduce the risk of dementia.  Exercise is one of them, and the dietary approaches outlined here (familiar to all my readers!) can be added to the list.   Give a virtual hug to our local farmers and the workers at the People’s Store, who make adherence to a healthy diet so easy and pleasant.

Sadja Greenwood, MD, MPH