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Tuesday, 30 June 2020
Zucchini Fritters Recipe (Healthy Alternative to Tater Tots!)
Tater tots were a very occasional treat when I was growing up. (I confess, I loved them.) The grated zucchini in these fritters mimics the texture of tater tots and is a great way to reinvent an old favorite in a healthier way. The zucchini gives them a nutritional boost that tater tots don’t have, …
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Monday, 29 June 2020
352: How Protein Improves Metabolism and Health With Billy Bosch From Iconic Protein
Today on the podcast we’re talking all about protein: how much do we need, what kind do we need, and how can know our kids are getting enough! I’m here with my friend Billy Bosch, the founder of ICONIC Protein, who knows this area inside and out. We’ll explain exactly how protein works as a …
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Can controlling blood pressure later in life reduce risk of dementia?
Everyone talks about the importance of treating high blood pressure, the “silent killer.” And everybody knows that untreated high blood pressure can lead to heart attacks and strokes. But can treating high blood pressure reduce your risk of cognitive impairment and dementia?
High blood pressure is a risk factor for cognitive impairment and dementia
Cognition encompasses thinking, memory, language, attention, and other mental abilities. Researchers have known for many years that if you have high blood pressure, you have a higher risk of developing cognitive impairment and dementia. However, just because high blood pressure is a risk factor, it does not necessarily mean that lowering high blood pressure will lower your risk. Many things in health and science correlate without one causing the other (my favorite is the correlation between the drop in birth rate and the decline in the stork population). Thus, randomized, double-blind, controlled studies are needed to answer this question.
Prior studies have not provided clear answers
There have, in fact, been a lot of these studies. The most recent relevant study is the SPRINT-MIND study, designed to measure the effects of lowering high blood pressure on dementia and/or mild cognitive impairment. This study was so successful at reducing the risk of mild cognitive impairment by lowering high blood pressure that it ended early, because the data and safety monitoring board felt that it was unethical to continue the control group. However, the dementia endpoint had not yet reached statistical significance — likely because of this early termination. Thus, while the study succeeded in one sense, it ultimately concluded that treating systolic blood pressure to below 120 mmHg (versus lower than 140 mmHg) did not reduce risk of dementia.
A new analysis of many studies
Because SPRINT-MIND and many other prior studies have not clearly shown whether lowering our high blood pressure can reduce our risk of cognitive impairment and dementia, meta-analyses are needed to answer this question. Researchers in Ireland looked at data from 14 studies comprising almost 100,000 participants, followed over an average of more than four years. They found that older individuals (average age 69) who lowered their blood pressure are slightly less likely to develop dementia or cognitive impairment (7.0% versus 7.5%). Thus, the answer is: Yes! Lowering high blood pressure will lower our risk of dementia and cognitive impairment.
The relationship between high blood pressure and dementia
So, how does lowering high blood pressure reduce our risk of cognitive impairment and dementia? Most people who have dementia don’t have just a single cause. Two or even three different problems in the brain cause their cognitive impairment and lead to their decline in function. One study estimates that the fraction of dementia risk attributable to cerebrovascular disease — that is, strokes — was nearly 25% in people who developed significant memory loss late in life. These researchers also found that the dementia risk attributable to Alzheimer’s disease was considerably higher, nearly 40%.
My reading of the literature is that lowering blood pressure reduces dementia risk because it reduces the risk of stroke. It’s the strokes — not high blood pressure by itself — that cause cognitive impairment. Note, however, that the strokes may be so tiny that one doesn’t even know that they have them. But developing a lot of these tiny strokes (or a few big ones) will greatly increase our risk of dementia.
Optimal blood pressure for optimal brain health
Okay, but what’s considered a healthy blood pressure from the perspective of the brain? The SPRINT-MIND study answers that question: people are less likely to develop mild cognitive impairment if their systolic blood pressure is lower than 120 mm Hg compared to the control condition of between 120 and 140 mm Hg. Thus, for optimal brain health, it’s best to keep your systolic blood pressure below 120 mm Hg — at least according to the SPRINT-MIND study.
The bottom line
The take-home message is clear: You can reduce your risk of cognitive impairment and dementia by lowering your systolic blood pressure to less than 120 mm Hg, preferably with aerobic exercise, a Mediterranean diet, and a healthy weight, and by adding medications if those lifestyle changes alone are not sufficient.
The post Can controlling blood pressure later in life reduce risk of dementia? appeared first on Harvard Health Blog.
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Sunday, 28 June 2020
Saturday, 27 June 2020
Friday, 26 June 2020
12 Delicious Herbs and Spices With Proven Health Benefits
You probably add herbs and spices to your recipes without even thinking about it! While they can usually make or break your culinary creations, there’s so much more to the humble herb or spice than taste. I try to include a regular variety in our family’s diet since they have incredible health benefits that are …
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Brain plasticity in drug addiction: Burden and benefit
The human brain is the most complex organ in our body, and is characterized by a unique ability called neuroplasticity. Neuroplasticity refers to our brain’s ability to change and adapt in its structural and functional levels in response to experience. Neuroplasticity makes it possible for us to learn new languages, solve complex mathematical problems, acquire technical skills, and perform challenging athletic skills, which are all positive and advantageous for us. However, neuroplasticity is not beneficial if we develop non-advantageous learned behaviors. One example of non-advantageous learning is habitual drug misuse that can lead to addiction.
Our brain learns to respond to drugs of abuse
Our first decision to use a drug may be triggered by curiosity, circumstances, personality, and stressful life events. This first drug exposure increases the release of a molecule (neurotransmitter) called dopamine, which conveys the feeling of reward. The increased changes in dopamine levels in the brain reward system can lead to further neuroplasticity following repeated exposure to drugs of abuse; these neuroplasticity changes are also fundamental characteristics of learning. Experience-dependent learning, including repeated drug use, might increase or decrease the transmission of signals between neurons. Neuroplasticity in the brain’s reward system following repeated drug use leads to more habitual and (in vulnerable people) more compulsive drug use, where people ignore the negative consequences. Thus, repeated exposure to drugs of abuse creates experience-dependent learning and related brain changes, which can lead to maladaptive patterns of drug use.
Views on addiction: Learning and disease
A recent learning model proposed by Dr. Marc Lewis in New England Journal of Medicine highlights the evidence of brain changes in drug addiction, and explains those changes as normal, habitual learning without referring to pathology or disease. This learning model accepts that drug addiction is disadvantageous, but believes it is a natural and context-sensitive response to challenging environmental circumstances. Dr. Nora Volkow, director of the National Institute on Drug Abuse (NIDA), and many addiction researchers and clinicians, view addiction as a brain disease triggered by many genetic, environmental, and social factors. NIDA uses the term “addiction” to describe the most severe and chronic form of substance use disorder that is characterized by changes in the brain’s reward, stress, and self-control systems. Importantly, both learning and brain disease models accept that addiction is treatable, as our brain is plastic.
We can adapt to new learned behaviors
Our brain’s plastic nature suggests that we can change our behaviors throughout our lives by learning new skills and habits. Learning models support that overcoming addiction can be facilitated by adopting new cognitive modifications. Learning models suggest pursing counseling or psychotherapy, including approaches such as cognitive behavioral therapy (CBT), which can help a person modify their habits. NIDA suggests that, for some people, medications (also called medication-assisted treatment or MAT) can help people manage symptoms to a level that helps them pursue recovery via strategies such as counseling and behavioral therapies, including CBT. Many people use a combination approach of medications, behavioral therapies, and support groups to maintain recovery from addition.
Neuroplasticity can help us modify behaviors relevant to addiction
CBT is an example of a learning-based therapeutic intervention; thus, it utilizes neuroplasticity. Scientific evidence suggests that CBT, alone or in combination with other treatment strategies, can be effective intervention for substance use disorders. CBT teaches a person to recognize, avoid, and learn to handle situations when they would be likely to use drugs. Another example of evidence-based behavioral therapy that has been shown to be effective for substance use disorders is contingency management. Contingency management provides a reward (such as vouchers redeemable for goods or movie passes) to individuals undergoing addiction treatment, to reinforce positive behaviors such as abstinence. This approach is based on operant conditioning theory, a form of learning, where a behavior that is positively reinforced tends to be repeated. Overall, multiple evidence-based approaches are used for the treatment of substance use disorders that require learning and utilize neuroplasticity.
The bottom line
Our brain is plastic, and this trait helps us learn new skills and retrain our brain. As the brain can change in a negative way as observed in drug addiction, the brain can also change in a positive way when we adopt skills learned in therapy and form new, healthier habits.
References
Targeting Behavioral Therapies to Enhance Naltrexone Treatment of Opioid Dependence: Efficacy of Contingency Management and Significant Other Involvement. Archives of General Psychiatry, August 2001.
Efficacy of Disulfiram and Cognitive Behavior Therapy in Cocaine-Dependent Outpatients: A Randomized Placebo-Controlled Trial. Archives of General Psychiatry, March 2004.
Cognitive Behavioral Therapy and the Nicotine Transdermal Patch for Dual Nicotine and Cannabis Dependence: A Pilot Study. American Journal on Addictions, May-June 2013.
Brain Change in Addiction as Learning, Not Disease. New England Journal of Medicine, October 18, 2018.
Cognitive Behavioral Therapy for Substance Use Disorders. The Psychiatric Clinics of North America, September 2010.
Neurobiologic Advances from the Brain Disease Model of Addiction. New England Journal of Medicine, January 28, 2016.
The post Brain plasticity in drug addiction: Burden and benefit appeared first on Harvard Health Blog.
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Thursday, 25 June 2020
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