Testosterone & cortisol in high & low power poses

Hair samples on violent offenders?

A few weeks ago while at the hospital having lunch with some physician colleagues discussion turned to the recent Colorado school shooting. I argued that violent criminals should have hair samples tested for toxic metals. Today, Andrew Blankstein of NBC News published the article Are the Xbox and unleaded gas helping keep you safe from violent crime? Of the "seven other seldom-mentioned factors" that may be responsible for the decrease in U.S. homicide rates, Blankstein writes:

In a landmark 2007 study, Amherst College Public Health Professor Jessica Wolpaw Reyes found a remarkable correlation between lead exposure and violent crime. According to her calculations, exposure to the heavy metal could have accounted for between 28 percent and 91 percent of the 83 percent increase in violent crime in the U.S. between 1972 and 1992. And as lead exposure dropped, so too did violent crime, falling 56 percent during the 1990s, she found.

Neurologist David Perlmutter on Diet & the Brain

"Nutrition matters. The brain is more responsive to diet and lifestyle than any other part of the body and until now it's been virtually ignored. We load up on medications when our mood is off, we hope for an Alzheimer's disease pill when we get older. I submit that we need to take a step back and ask, 'Is this really how we want to treat ourselves?’”

David Perlmutter, MD 

Read More: The Modern American Diet Is Killing Our Brains

Post-partum depression and "the promise-filled halls of psychiatry"

"Annie was ushered into the promise-filled halls of psychiatry three months after the birth of her first baby when she began to experience racing heart, insomnia, vigilance, irritability, and a host of physical complaints including joint pain and hair loss. No one did blood work, asked about her diet, or cared about any of the myriad observations about her body and its changes in functioning. This was a “head-up” intervention. I believe women deserve better. People deserve better."

Read More: The New Psychiatry: Forget Everything 
You Think You Know About Mental Health

Neurologist David Perlmutter on Brain Dysfunction & Your Daily Bread

"Yes, you read that right: Brain dysfunction starts in your daily bread, and I'm going to prove it. I'll state it again because I realize it sounds absurd: Modern grains are silently destroying your brain. By "modern" I'm not just referring to the refined white flours, pastas, and rice that have already been demonized by the anti-obesity folks; I'm referring to all the grains that so many of us have embraced as being healthful - whole wheat, whole grain, multigrain, seven-grain, live grain, stone-ground, and so on. Basically, I am calling what is arguably our most beloved dietary staple a terrorist group that bullies our most precious organ, the brain. I will demonstrate how fruit and other carbohydrates could be health hazards with far-reaching consequences that not only will wreak physical havoc on your brain, but also will accelerate your body's aging process from the inside out. This isn't science fiction; it's now a documented fact."

Grain Brain: The Surprising Truth About Wheat, Carbs, and Sugar – Your Brain’s Silent Killers

Image credit: Don't Die Early - The Book

Western diets & Depression

In a previous post, I wrote about depression being considered an inflammatory and degenerative disorder. In a recent post on Primal Docs, Jen Knutson, MA, MS writes an opinion piece on depression and nutrition:

"It is clear that ingesting unhealthy and/or processed food and abstaining from nutrient dense quality food is correlated with higher depression rates and depressive symptoms. This is likely due to the innate connection between the body and the mind via biological issues, such as inflammation, oxidative processes, and brain plasticity and function, which are altered due to diet quality and nutrient intake. Being able to determine precisely which foods positively and negatively affect depression, and its various forms, has the potential to dramatically change both the number of people suffering from this illness and the way in which it is treated."

Learn More: 
Nutrient-Rich Food and Depression – Part 1 of 2

Related Post
Is depression an inflammatory & degenerative disorder?

Does an inflammatory diet play a role in schizophrenia?

"Overall, there is accumulating evidence, albeit mostly adjunctive treatments, that agents working on inflammatory pathways have some benefits in people with schizophrenia. In the next few years the field will begin to see data on many treatments with anti-inflammatory properties that are currently under study. Hopefully advancements in understanding inflammation and effective treatments having anti-inflammatory properties may help revolutionize our understanding and provide new targets for prevention and treatment in schizophrenia."

Source: A review of anti-inflammatory agents for symptoms of schizophrenia.

High carbohydrate intake and cognitive impairment in the elderly

An issue of Neurosciences Update published in 2012 by the Mayo Clinic  contains a Research Highlight on the Association Between Macronutrient Intake and Risk of Dementia. The authors studied the 128-item food-frequency questionnaires of 937 cognitively normal elderly, 2oo of which later developed mild cognitive impairment (MCI) or dementia.

Findings showed that among the 937 participants who were cognitively normal at baseline, MCI or dementia developed in 200 and that the risk of either condition was increased in participants with dietary patterns showing a high percentage of carbohydrate intake and reduced in those with a high percentage of fat and protein intake. The authors concluded that a diet high in carbohydrates and low in fats and proteins may increase the risk of MCI or dementia in elderly persons (Roberts et al. J Alzheimer’s Dis. 2012;32[2]:329-39).

The research study, freely available online, does not lists the type of carbohydrates consumed by the participants.  From the food-frequency questionnaires, the authors

… computed the proportion of total daily energy derived from total carbohydrates (% carbohydrate), fat (% fat), and protein (% protein); from carbohydrate components (sugar, non-sugar carbohydrate, fiber); and fat components (polyunsaturated fatty acids [PUFA], monounsaturated fatty acids [MUFA], saturated fats [saturated fats], and trans-fatty acids), and ranked participants by quartiles of intake.

The researchers suggest several mechanisms for the impact of high carbohydrate intake on cognitive function in the elderly, among them:

High carbohydrate and sugar intake may adversely affect cognition through several mechanisms. Hyperglycemia and diabetes may contribute to increased formation of advanced glycation endproducts (AGE), upregulation of the soluble receptors for AGEs, and may generate oxidative stress which in turn, enhances AGE formation. AGEs and oxidative stress have also been associated with greater cognitive decline and with AD through effects on amyloid and tau metabolism.

The increased risk of MCI with lower intake of fats and proteins may involve non-energy related pathways. Fat and protein intake may be required for the integrity of neuronal membranes and fats for the integrity of the myelin sheaths in the brain.

Bottom Line: Don’t let your grandparents skip out on high quality sources of fat and protein.

Is depression an inflammatory & degenerative disorder?

Image by Hendrike, Wikimedia CommonsAccording to the CDC (Centers for Disease Control and Prevention), depression affects 1 of 10 adults in the U.S. While many factors, such as abuse, medications, conflict, or death or loss, increase the chances of depression, Maes and colleagues writing in Neuroendocrinology Newsletters, propose depression to be an inflammatory and degenerative disorder:

There is now evidence that depression, as characterized by melancholic symptoms, anxiety, and fatigue and somatic (F&S) symptoms, is the clinical expression of peripheral cell-mediated activation, inflammation and induction of oxidative and nitrosative stress (IO&NS) pathways and of central microglial activation, decreased neurogenesis and increased apoptosis.

As listed in the abstract, this would help explain the frequent co-existence of depression in brain disorders such as "Alzheimer's, Parkinson's and Huntington's disease, multiple sclerosis and stroke", and medical disorders such as "cardiovascular disorder, chronic fatigue syndrome, chronic obstructive pulmonary disease, rheumatoid arthritis, psoriasis, systemic lupus erythematosus, inflammatory bowel disease, irritable bowel syndrome, leaky gut, diabetes, obesity and the metabolic syndrome, and HIV infection."

The authors propose the “common denominator” in these disorders is activation of the microglial cells (the immune cells of the brain) and/or activation of the body’s “inflammation and induction of oxidative and nitrosative stress pathways” (IO&NS pathways). These “pathways function as a smoke sensor that detect threats in the peripheral and central parts of the body and signal these threats as melancholic, anxiety, and fatigue and somatic (F&S) symptoms." (emphasis added)

The authors' conclusion:

It is concluded that the activation of peripheral and / or central IO&NS pathways may explain the co-occurrence of depression with the above disorders. This shows that depression belongs to the spectrum of inflammatory and degenerative disorders. (emphasis added)

Now, for the mental health question of the decade: Is depression largely a nutritional disorder?

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Brain Health: "a fine line between moderate and binge drinking"

A study published in the November 8 issue of Neuroscience looked at the effects of drinking alcohol on the brain of rats. According to the study abstract, the rats “drinking regime resulted in an average blood alcohol concentration of approximately 0.08%,” the legal driving limit in the U.S. According to ScienceDaily:

The researchers discovered that at this level of intoxication in rats -- comparable to about 3-4 drinks for women and five drinks for men -- the number of nerve cells in the hippocampus of the brain were reduced by nearly 40 percent compared to those in the abstinent group of rodents. The hippocampus is a part of the brain where the new neurons are made and is also known to be necessary for some types of new learning.

First author M. L. Anderson commented to ScienceDaily:

Moderate drinking can become binge drinking without the person realizing it. In the short term there may not be any noticeable motor skills or overall functioning problems, but in the long term this type of behavior could have an adverse effect on learning and memory.

The study was conducted by researchers working in Behavioral and Systems Neuroscience in the Department of Psychology at Rutgers University and at the University of Jyvaskyla in Finland.

Brain Health: Put down that puzzle and go for a walk

Today’s issue of Neurology includes a research study on the relationship between physical activity and brain protection during aging. The amount of self-reported physical activity in 638 persons was correlated to brain health as visualized on MRI. The brains of those with a greater amount of physical activity showed less brain aging as measured by less atrophy (shrinkage), less loss of grey and white brain matter, and fewer hits (tiny holes) in white matter. While these hits, called hyperintensities on MRI, are often viewed as a normal part of aging, they most likely have underlying causes such as hypertension or neuroinflammation. This study provides evidence that they are occur less frequently in people who are active.

Also, the commonly held belief that performing crossword puzzles keeps older people sharp was not supported in this study. As the BBC reports:

Exercise did not have to be strenuous - going for a walk several times a week sufficed, the journal Neurology says.

But giving the mind a workout by doing a tricky crossword had little impact.

The study found no real brain-size benefit from mentally challenging activities, such as reading a book, or other pastimes such as socialising with friends and family.

Take home: In the elderly, exercise beats puzzles for brain health.   

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Obesity increases chances migraine headaches will become chronic

Migraines affect 30 million Americans. While most have episodic migraines, 2.5% of migraine sufferers (migraineurs) progress to chronic migraine each year. According to the National Headache Foundation, chronic migraine is present when persons “experience headache more than half the time.”

Chronic migraine markedly impacts individual health and society. Researchers at the Department of Neurology, University of Essen, in Essen, Germany, describe the impact:

Chronic migraine (CM) and episodic migraine (EM) are part of the spectrum of migraine disorders, but they are distinct clinical entities. Population-based studies have shown that those with CM demonstrate higher individual and societal burden because they are significantly more disabled than those with EM and have greater impaired quality of life both inside and outside the home.

Thus, being able to prevent or reduce the transformation of episodic to chronic migraine would provide pronounced health benefits. Among the researchers investigating the underlying factors that might trigger this transformation is Johns Hopkins neurologist, Dr. Lee Peterlin. In an article published in the Spring 2012 print issue of NeuroLogic, Dr. Peterlin, herself a migraineur, describes the observation that stimulated her interest in studying the relationship between migraines and obesity:

One thing physicians have long known, however, is that migraine sufferers – or migraineurs – are significantly more likely to be women of reproductive age. After puberty, body fat makes a significant jump in this population.

Dr. Peterlin began her work by reviewing previous migraine research. From this she learned that persons with episodic migraines were 5 times more likely to develop chronic migraines if they were obese. She also found evidence that a sedentary lifestyle increased the chances of developing chronic migraine.

In 2008, Dr. Peterlin discovered that adiponectin (a protein hormone secreted by adipose tissue) was elevated in persons with migraine in comparison to those without migraine. Currently, she is studying pro-inflammatory substances called adipokines secreted by fatty tissue.

To date, Dr. Peterlin's research has identified two suspects, protein hormones and pro-inflammatory substances, secreted by adipose tissue that may trigger the conversion of episodic to chronic migraine.

Bottom line: Weight reduction in obese persons will decrease the likelihood that migraine becomes chronic. Overweight or obese persons suffering from migraine should discuss a non-inflammatory diet (such as the ancestral diet) with their doctor. Exercise also appears effective in reducing the chances of developing chronic migraine. The mechanisms leading to the development of chronic migraine are under study.

Note: Another headache condition associated with obesity is idiopathic intracranial hypertension (IIH), also know as pseudotumor cerebri (not a true tumor).  In this condition, debilitating headaches (and sometimes loss of vision) are due to increased brain pressure. IIH most often occurs in obese women of childbearing age and is treated differently from migraine.

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