Citicoline: Better Than Dietary Choline?
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Citicoline: Better Than Dietary Choline?
Citicoline, also known as cytidine diphosphate-choline (or CDP-Choline, to its friends, or cytidine 5′-diphosphocholine if it wants to get fancy) is a dietary supplement that the stomach can metabolize easily for all the brain’s choline needs. What are those needs?
Choline is an essential nutrient. We technically can synthesize it, but only in minute amounts, far less than we need. Choline is a key part of the neurotransmitter acetylcholine, as well as having other functions in other parts of the body.
As for citicoline specifically… it appears to do the job better than dietary sources of choline:
❝Intriguing data, showing that on a molar mass basis citicoline is significantly less toxic than choline, are also analyzed.
It is hypothesized that, compared to choline moiety in other dietary sources such as phosphatidylcholine, choline in citicoline is less prone to conversion to trimethylamine (TMA) and its putative atherogenic N-oxide (TMAO).
Epidemiological studies have suggested that choline supplementation may improve cognitive performance, and for this application citicoline may be safer and more efficacious.❞
Source: Citicoline: A Superior Form of Choline?
Great! What does it do?
What doesn’t it do? When it comes to cognitive function, anyway, citicoline covers a lot of bases.
Short version: it improves just about every way a brain’s healthy functions can be clinically measured. From cognitive improvements in all manner of tests (far beyond just “improves memory” etc; also focus, alertness, verbal fluency, logic, computation, and more), to purely neurological things like curing tinnitus (!), alleviating mobility disorders, and undoing alcohol-related damage.
One of the reasons it’s so wide in its applications, is that it has a knock-on effect to other systems in the brain, including the dopaminergic system.
Long version: Citicoline: pharmacological and clinical review, 2022 update
(if you don’t want to sit down for a long read, we recommend skimming to the charts and figures, which are very elucidating even alone)
Spotlight study in memory
For a quick-reading example of how it helps memory specifically:
Keeping dementia at bay
For many older people looking to improve memory, it’s less a matter of wanting to perform impressive feats of memory, and more a matter of wanting to keep a sharp memory throughout our later years.
Dr. Maria Bonvicini et al. looked into this:
❝We selected seven studies including patients with mild cognitive impairment, Alzheimer’s disease or post-stroke dementia
All the studies showed a positive effect of citicoline on cognitive functions. Six studies could be included in the meta-analysis.
Overall, citicoline improved cognitive status, with pooled standardized mean differences ranging from 0.56 (95% CI: 0.37-0.75) to 1.57 (95% CI: 0.77-2.37) in different sensitivity analyses❞
The researchers concluded “yes”, and yet, called for more studies, and of higher quality. In many such studies, the heterogeneity of the subjects (often, residents of nursing homes) can be as much a problem (unclear whether the results will be applicable to other people in different situations) as it is a strength (fewer confounding variables).
Another team looked at 47 pre-existing reviews, and concluded:
❝The review found that citicoline has been proven to be a useful compound in preventing dementia progression.
Citicoline has a wide range of effects and could be an essential substance in the treatment of many neurological diseases.
Its positive impact on learning and cognitive functions among the healthy population is also worth noting.❞
Source: Application of Citicoline in Neurological Disorders: A Systematic Review
The dopamine bonus
Remember how we said that citicoline has a knock-on effect on other systems, including the dopaminergic system? This means that it’s been studied (and found meritorious) for alleviating symptoms of Parkinson’s disease:
❝Patients with Parkinson’s disease who were taking citicoline had significant improvement in rigidity, akinesia, tremor, handwriting, and speech.
Citicoline allowed effective reduction of levodopa by up to 50%.
Significant improvement in cognitive status evaluation was also noted with citicoline adjunctive therapy.❞
Source: Citicoline as Adjuvant Therapy in Parkinson’s Disease: A Systematic Review
Where to get it?
We don’t sell it, but here’s an example product on Amazon, for your convenience
Enjoy!
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Are Waist Trainers Just A Waste, And Are Posture Fixers A Quick Fix?
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Are Waist Trainers Just A Waste, And Are Posture Fixers A Quick Fix?
Yesterday, we asked you for your opinions on waist trainers and posture-fixing harnesses, and got the above-depicted, below-described set of results:
- The most popular response was “Waist trainers are purely cosmetic, so useless. Posture-fixers have merit”, with a little over a quarter of the votes.
- The least popular response was “Both are great tools to help us to optimal waist size and posture, respectively!”
- The other three answers each got a little under a quarter of the vote. In terms of discrete data, these were all 7±1, so basically, there was nothing in it.
The sample size was smaller than usual—perhaps the cluster of American holiday dates yesterday and today kept people busy! But, pressing on…
What does the science say?
Waist trainers are purely cosmetic, so, useless. True or False?
True, simply. Honestly, they’re not even that great for cosmetic purposes. They will indeed cinch in your middle, and this shape will be retained for a (very) short while after uncinching, because your organs have been squished inwards and may take a short while to get back to where they are supposed to be.
The American Board of Cosmetic Surgery may not be an unbiased source, but we’re struggling to find scientists who will even touch one of these, so, let’s see what these doctors have to say:
- Waist training can damage vital organs
- You will be slowly suffocating yourself
- Waist training simply doesn’t work
- You cannot drastically change your body shape with a piece of fabric*
Read: ABCS | 4 Reasons to Throw Your Waist Trainer in the Trash
*”But what about foot-binding?”—feet have many bones, whose growth can be physically restricted. Your waist has:
- organs: necessary! (long-term damage possible, but they’re not going away)
- muscles: slightly restrictable! (temporary restriction; no permanent change)
- fat: very squeezable! (temporary muffin; no permanent change)
Posture correctors have merit: True or False?
True—probably, and as a stepping-stone measure only.
The Ergonomics Health Association (a workplace health & safety organization) says:
❝Looking at the clinical evidence of posture correctors, we can say without a doubt that they do work, just not for everyone and not in the same way for all patients.❞
Source: Do Posture Correctors Work? Here’s What Our Experts Think
That’s not very compelling, so we looked for studies, and found… Not much, actually. However, what we did find supported the idea that “they probably do help, but we seriously need better studies with less bias”:
That is also not a compelling title, but here is where it pays to look at the studies and not just the titles. Basically, they found that the results were favorable to the posture-correctors—the science itself was just trash:
❝ The overall findings were that posture-correcting shirts change posture and subjectively have a positive effect on discomfort, energy levels and productivity.
The quality of the included literature was poor to fair with only one study being of good quality. The risk of bias was serious or critical for the included studies. Overall, this resulted in very low confidence in available evidence.❞
Since the benefit of posture correctors like this one is due to reminding the wearer to keep good posture, there is a lot more (good quality!) science for wearable biofeedback tech devices, such as this one:
Spine Cop: Posture Correction Monitor and Assistant
Take care!
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What are nootropics and do they really boost your brain?
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Humans have long been searching for a “magic elixir” to make us smarter, and improve our focus and memory. This includes traditional Chinese medicine used thousands of years ago to improve cognitive function.
Now we have nootropics, also known as smart drugs, brain boosters or cognitive enhancers.
You can buy these gummies, chewing gums, pills and skin patches online, or from supermarkets, pharmacies or petrol stations. You don’t need a prescription or to consult a health professional.
But do nootropics actually boost your brain? Here’s what the science says.
LuckyStep/Shutterstock What are nootropics and how do they work?
Romanian psychologist and chemist Cornelius E. Giurgea coined the term nootropics in the early 1970s to describe compounds that may boost memory and learning. The term comes from the Greek words nӧos (thinking) and tropein (guide).
Nootropics may work in the brain by improving transmission of signals between nerve cells, maintaining the health of nerve cells, and helping in energy production. Some nootropics have antioxidant properties and may reduce damage to nerve cells in the brain caused by the accumulation of free radicals.
But how safe and effective are they? Let’s look at four of the most widely used nootropics.
1. Caffeine
You might be surprised to know caffeine is a nootropic. No wonder so many of us start our day with a coffee. It stimulates our nervous system.
Caffeine is rapidly absorbed into the blood and distributed in nearly all human tissues. This includes the brain where it increases our alertness, reaction time and mood, and we feel as if we have more energy.
For caffeine to have these effects, you need to consume 32-300 milligrams in a single dose. That’s equivalent to around two espressos (for the 300mg dose). So, why the wide range? Genetic variations in a particular gene (the CYP1A2 gene) can affect how fast you metabolise caffeine. So this can explain why some people need more caffeine than others to recognise any neurostimulant effect.
Unfortunately too much caffeine can lead to anxiety-like symptoms and panic attacks, sleep disturbances, hallucinations, gut disturbances and heart problems.
So it’s recommended adults drink no more than 400mg caffeine a day, the equivalent of up to three espressos.
Caffeine can make you feel alert and can boost your mood. That makes it a nootropic. LHshooter/Shutterstock 2. L-theanine
L-theanine comes as a supplement, chewing gum or in a beverage. It’s also the most common amino acid in green tea.
Consuming L-theanine as a supplement may increase production of alpha waves in the brain. These are associated with increased alertness and perception of calmness.
However, it’s effect on cognitive functioning is still unclear. Various studies including those comparing a single dose with a daily dose for several weeks, and in different populations, show different outcomes.
But taking L-theanine with caffeine as a supplement improved cognitive performance and alertness in one study. Young adults who consumed L-theanine (97mg) plus caffeine (40mg) could more accurately switch between tasks after a single dose, and said they were more alert.
Another study of people who took L-theanine with caffeine at similar doses to the study above found improvements in several cognitive outcomes, including being less susceptible to distraction.
Although pure L-theanine is well tolerated, there are still relatively few human trials to show it works or is safe over a prolonged period of time. Larger and longer studies examining the optimal dose are also needed.
The amino acid L-theanine is also in green tea. grafvision/Shutterstock 3. Ashwaghanda
Ashwaghanda is a plant extract commonly used in Indian Ayurvedic medicine for improving memory and cognitive function.
In one study, 225-400mg daily for 30 days improved cognitive performance in healthy males. There were significant improvements in cognitive flexibility (the ability to switch tasks), visual memory (recalling an image), reaction time (response to a stimulus) and executive functioning (recognising rules and categories, and managing rapid decision making).
There are similar effects in older adults with mild cognitive impairment.
But we should be cautious about results from studies using Ashwaghanda supplements; the studies are relatively small and only treated participants for a short time.
Ashwaghanda is a plant extract commonly used in Ayurvedic medicine. Agnieszka Kwiecień, Nova/Wikimedia, CC BY-SA 4. Creatine
Creatine is an organic compound involved in how the body generates energy and is used as a sports supplement. But it also has cognitive effects.
In a review of available evidence, healthy adults aged 66-76 who took creatine supplements had improved short-term memory.
Long-term supplementation may also have benefits. In another study, people with fatigue after COVID took 4g a day of creatine for six months and reported they were better able to concentrate, and were less fatigued. Creatine may reduce brain inflammation and oxidative stress, to improve cognitive performance and reduce fatigue.
Side effects of creatine supplements in studies are rarely reported. But they include weight gain, gastrointestinal upset and changes in the liver and kidneys.
Where to now?
There is good evidence for brain boosting effects of caffeine and creatine. But the jury is still out on the efficacy, optimal dose and safety of most other nootropics.
So until we have more evidence, consult your health professional before taking a nootropic.
But drinking your daily coffee isn’t likely to do much harm. Thank goodness, because for some of us, it is a magic elixir.
Nenad Naumovski, Professor in Food Science and Human Nutrition, University of Canberra; Amanda Bulman, PhD candidate studying the effects of nutrients on sleep, University of Canberra, and Andrew McKune, Professor, Exercise Science, University of Canberra
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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The Truth About Statins – by Barbara H. Roberts, M.D.
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All too often, doctors looking to dispense a “quick fix” will prescribe from their playbook of a dozen or so “this will get you out of my office” drugs. Most commonly, things that treat symptoms rather than the cause. Sometimes, this can be fine! For example, in some cases, painkillers and antidepressants can make a big improvement to people’s lives. What about statins, though?
Prescribed to lower cholesterol, they broadly do exactly that. However…
Dr. Roberts wants us to know that we could be missing the big picture of heart health, and making a potentially fatal mistake.
This is not to say that the book argues that statins are necessarily terrible, or that they don’t have their place. Just, we need to understand what they will and won’t do, and make an informed choice.
To which end, she does advise regards when statins can help the most, and when they may not help at all. She also covers the questions to ask if your doctor wants to prescribe them. And—all so frequently overlooked—the important differences between men’s and women’s heart health, and the implications these have for the efficacy (or not) of statins.
With regard to the “alternatives to cholesterol-lowering drugs” promised in the subtitle… we won’t keep any secrets here:
Dr. Roberts (uncontroversially) recommends the Mediterranean diet. She also provides two weeks’ worth of recipes for such, in the final part of the book.
All in all, an important book to read if you or a loved one are taking, or thinking of taking, statins.
Pick up your copy of The Truth About Statins on Amazon today!
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Water Fluoridation, Atheroma, & More
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It’s Q&A Day at 10almonds!
Have a question or a request? You can always hit “reply” to any of our emails, or use the feedback widget at the bottom!
In cases where we’ve already covered something, we might link to what we wrote before, but will always be happy to revisit any of our topics again in the future too—there’s always more to say!
As ever: if the question/request can be answered briefly, we’ll do it here in our Q&A Thursday edition. If not, we’ll make a main feature of it shortly afterwards!
So, no question/request too big or small 😎
❝I watched a documentary recently on Fluoride in our drinking water & the dangers of it. Why are we poisoning our water?❞
This is a great question, and it certainly is controversial. It sounds like the documentary you watched was predominantly or entirely negative, but there’s a lot of science to back both sides of this, and it’s not even that the science is contradictory (it’s not). It’s that what differs is people’s opinions about whether benefiting one thing is worth creating a risk to another, and that means looking at:
- What is the risk associated with taking no action (error of omission)?
- What is the risk associated with taking an action (error of commission)?
The whole topic is worth a main feature, but to summarize a few key points:
- Water fluoridation is considered good for the prevention of dental cavities
- Water fluoridation aims to deliver fluoride and doses far below dangerous levels
- This requires working on consumer averages, though
- ”Where do we put the safety margins?” is to some extent a subjective question, in terms of trading off one aspect of health for another
- Too much fluoride can also be bad for the teeth (at least cosmetically, creating little white* spots)
- Detractors of fluoride tend to mostly be worried about neurological harm
- However, the doses in public water supplies are almost certainly far below the levels required to cause this harm.
- That said, again this is working on consumer averages, though.
- However, the doses in public water supplies are almost certainly far below the levels required to cause this harm.
- A good guide is: watch your teeth! Those white* spots will be “the canary in the coal mine” of more serious harm that could potentially come from higher levels due to overconsumption of fluorine.
*Teeth are not supposed to be pure white. The “Hollywood smile” is a lie. Teeth are supposed to be a slightly off-white, ivory color. Anything whiter than that is adding something else that shouldn’t be there, or stripping something off that should be there.
❝How does your diet change clean out your arteries of the bad cholesterol?❞
There’s good news and bad news here, and they can both be delivered with a one-word reply:
Slowly.
Or rather: what’s being cleaned out is mostly not the LDL (bad) cholesterol, but rather, the result of that.
When our diet is bad for cardiovascular health, our arteries get fatty deposits on their walls. Cholesterol gets stuck here too, but that’s not the main physical problem.
Our body’s natural defenses come into action and try to clean it up, but they (for example macrophages, a kind of white blood cell that consumes invaders and then dies, before being recycled by the next part of the system) often get stuck and become part of the buildup (called atheroma), which can lead to atherosclerosis and (if calcium levels are high) hardening of the arteries, which is the worst end of this.
This can then require medical attention, precisely because the body can’t remove it very well—especially if you are still maintaining a heart-unhealthy diet, thus continuing to add to the mess.
However, if it is not too bad yet, yes, a dietary change alone will reverse this process. Without new material being added to the arterial walls, the body’s continual process of rejuvenation will eventually fix it, given time (free from things making it worse) and resources.
In fact, your arteries can be one of the quickest places for your body to make something better or worse, because the blood is the means by which the body moves most things (good or bad) around the body.
All the more reason to take extra care of it, since everything else depends on it!
You might also like our previous main feature:
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Eat Real Food and Love It – by Kari McCloskey
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Half the battle of healthy eating is enjoying it—because once you do, it’s no longer a battle!
So that’s what this book focuses on. The author, a Registered Nutritionist, does indeed dispense nutritional advice, as you might expect, but also bids us pay attention to what nature’s foods do for us, and notice what less healthy foods take from us. She goes through these category by category, quite comprehensively, before moving on to the more “active” parts of the book.
There’s a lot about training our senses, and about taking a holistic approach to eating, as well as renewing not just our relationship with food, but also various other parts of our life that are inextricably linked to it (from sleep and exercise, to social considerations, and medical issues that healthier eating will help us to avoid or at least tame).
The style is… Joyful. Much like this reviewer, the author loves food, and it shows. She also (again much like this reviewer) cares deeply about the impact food has on her, and (for a third time: like this reviewer!) wants to share that joy and care with the reader. The priority is readability and helpfulness; scientific references are still provided wherever appropriate, though.
Bottom line: if you’d like to improve your eating but it seems like a chore, this book can help turn it into an excitingly enjoyable journey instead.
Click here to check out Eat Real Food And Love It, and eat real food and love it!
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Natural Tips for Falling Asleep
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Questions and Answers at 10almonds
Have a question or a request? You can always hit “reply” to any of our emails, or use the feedback widget at the bottom!
This newsletter has been growing a lot lately, and so have the questions/requests, and we love that! In cases where we’ve already covered something, we might link to what we wrote before, but will always be happy to revisit any of our topics again in the future too—there’s always more to say!
As ever: if the question/request can be answered briefly, we’ll do it here in our Q&A Thursday edition. If not, we’ll make a main feature of it shortly afterwards!
So, no question/request too big or small
How to get to sleep at night as fast and as naturally as possible? Thank you!
We’ll definitely write more on that! You might like these articles we wrote already, meanwhile:
- Beating The Insomnia Blues ← this one is general advice and tips
- Time For Some Pillow Talk ← this one compares and reviews some popular sleep apps
- Insomnia? High Blood Pressure? Try these! ← this one tackles the matter from a dietary angle
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Learn to Age Gracefully
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