The SharpBrains Guide to Brain Fitness – by Alvaro Fernandez et al.

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We say “et al.” in the by-line, because this one has a flock of authors, including Dr. Pascale Michelon, Dr. Sandra Bond Chapman, Dr. Elkehon Goldberg, and various others if we include the foreword, introduction, etc.

This is relevant, because those who contributed to the meat of the book (i.e., those listed above), it makes the work a lot more scientifically reliable; one skilled science writer might make a mistake; it’s much less likely to make it through to publication when there are a bevy of doctors in the mix, each staking their reputation on the book’s content, and thus having a vested interest in checking each other’s work as well as their own.

As for what this multidisciplinary team have to offer? The book covers such things as:

  • how the brain works (especially the possibilities of neuroplasticity), and what that means for such things as memory and attention
  • being “a coach not a patient”; i.e., being active rather than passive in one’s approach to brain health
  • the relevance of physical exercise, how much, and what kind
  • the relevance (and limitations) of diet choices for brain health
  • the relevance of such things as learning new languages and musical training
  • the relevance of social engagement, and how some (but not all) social engagement can boost cognition
  • methods for managing stress and building resilience to same (critical for maintaining a healthy brain)
  • “cross-fit for your brain”, that is to say, a multi-vector collection of tools to explore, ranging from meditation to CBT to biofeedback and more.

The style is pop-science without being sensationalist, just communicating ideas clearly, with enough padding to feel casual, and not like a dense read. Importantly, it’s also practical and applicable too, which is something we always look for here.

Bottom line: if you’d like to be given a good overview of what things work (and how much they can be expected to work), along with a good framework to put that knowledge into practice, then this is a great book for you.

Click here to check out The SharpBrains Guide to Brain Fitness, and optimize your brain health and performance!

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    Durian trumps jackfruit with more fiber, B-vitamins, and minerals, despite its devilish appearance and notorious smell! Just don’t mix with alcohol.

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  • Lifestyle vs Multiple Sclerosis & More

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    This is Dr. Saray Stancic. She’s another from the ranks of “doctors who got a serious illness and it completely changed how they view the treatment of serious illness”.

    In her case, Stancic was diagnosed with multiple sclerosis, and wasn’t impressed with the results from the treatments offered, so (after 8 years of pain, suffering, and many medications, only for her condition to worsen) she set about doing better with an evidence-based lifestyle medicine approach.

    After 7 years of her new approach, she would go on to successfully run a marathon and live symptom-free.

    All this to say: her approach isn’t a magic quick fix, but it is a serious method for serious results, and after all, while it’d be nice to be magically in perfect health tomorrow, what’s important is being in good health for life, right?

    If you’re interested in her impressive story, check out:

    Doctor With Multiple Sclerosis On The Collapse Of US Healthcare

    If you want to know what she did, then read on…

    Six key lifestyle changes

    Dr. Stancic credits her recovery to focus on the following evidence-based approaches:

    The plant-centered plate

    This is critical, and is the one she places most emphasis on. Most chronic diseases are exacerbated, if not outright caused, by chronic inflammation, and one cannot fix that without an anti-inflammatory diet.

    An anti-inflammatory diet doesn’t have to be 100% plant-based, but broadly speaking, plants are almost always anti-inflammatory to a greater or lesser degree, while animal products are often pro-inflammatory—especially red meat and unfermented dairy.

    For more details, see:

    Anti-Inflammatory Diet 101 (What to Eat to Fight Inflammation)

    Movement every day

    While “exercise is good for you” is in principle not a shocker, remember that her starting point was being in terrible condition with badly flared-up MS.

    Important to understand here is that excessive exercise can weaken the immune system and sometimes cause flare-ups of various chronic diseases.

    Moving thoroughly and moving often, however, is best. So walking yes, absolutely, but also don’t neglect the rest of your body, do some gentle bodyweight squats (if you can; if you can’t, work up to them), stretch your arms as well as your legs, take all your joints through a full range of motion.

    See also:

    The Doctor Who Wants Us To Exercise Less, & Move More

    Mindful stress management

    Stress in life is unavoidable, but how we manage it is up to us. Bad things will continue to happen, great and small, but we can take a deep breath, remember that those things aren’t the boss of us, and deal with it calmly and conscientiously.

    Mindfulness-Based Stress Reduction is of course the evidence-based “gold standard” for this, but whatever (not substance-based) method works for you, works for you!

    About MBSR:

    No-Frills, Evidence-Based Mindfulness

    Good sleeping habits

    Getting good sleep can be hard for anyone, let alone if you have chronic pain. However, Dr. Stancic advocates for doing whatever we can to get good sleep—which means not just duration (the famous “7–9 hours”), but also quality.

    Learn more:

    The 6 Dimensions Of Sleep (And Why They Matter)

    Substance intake awareness

    This one’s not so much of a “don’t do drugs, kids” as the heading makes it look. Dr. Stancic assumes we already know, for example, that smoking is bad for us in a long list of ways, and alcohol isn’t much better.

    However, she also advises us that in our eagerness to do that plant-based diet, we would do better to go for whole foods plant-based, rather than the latest processed meat substitutes, for example.

    And supplements? She bids us exercise caution, and to make sure to get good quality, as poor quality supplements can be worse than taking nothing (looking at you, cheap turmeric supplements that contain heavy metals).

    And of course, that nutrients gained from diet will almost always be better than nutrients gained from supplements, as our body can usually use them better.

    And see also, some commonly-made supplements mistakes:

    Do You Know Which Supplements You Shouldn’t Take Together? (10 Pairs!)

    Human connection

    Lastly, we humans are a social species by evolution; as individuals, we may enjoy relatively more or less social contact, but having access to such is important not just for our mental health, but our physical health too—we will tend to deteriorate much more quickly when we have to deal with everything alone, all other things being equal.

    It doesn’t mean you need a busy social life if that’s not in your nature, but it does mean it’s incredibly beneficial to have at least a small number of people that you trust and whose company you enjoy, at least relatively accessible to you (i.e., their life need not revolve around you, but they are the kind of people who will generally happily spend time with you and provide support when needed if they can).

    As for how:

    How To Beat Loneliness & Isolation

    Want to know more from Dr. Stancic?

    We recently reviewed this very good book of hers, which goes over each of these six things in much more detail than we have room for here:

    What’s Missing from Medicine – by Dr. Saray Stancic

    Enjoy!

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  • An RSV vaccine has been approved for people over 60. But what about young children?

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    The Therapeutic Goods Administration (TGA) has approved a vaccine against respiratory syncytial virus (RSV) in Australia for the first time. The shot, called Arexvy and manufactured by GSK, will be available by prescription to adults over 60.

    RSV is a contagious respiratory virus which causes an illness similar to influenza, most notably in babies and older adults.

    So while it will be good to have an RSV vaccine available for older people, where is protection up to for the youngest children?

    A bit about RSV

    RSV was discovered in chimpanzees with respiratory illness in 1956, and was soon found to be a common cause of illness in humans.

    There are two key groups of people we would like to protect from RSV: babies (up to about one year old) and people older than 60.

    Babies tend to fill up hospitals during the RSV season in late spring and winter in large numbers, but severe infection requiring admission to intensive care is less common.

    In babies and younger children, RSV generally causes a wheezing asthma-like illness (bronchiolitis), but can also cause pneumonia and croup.

    Although there are far fewer hospital admissions among older people, they can develop severe disease and die from an infection.

    A baby sitting on a bed.
    Babies account for the majority of hospitalisations with RSV.
    Prostock-studio/Shutterstock

    RSV vaccines for older people

    For older adults, there are actually several RSV vaccines in the pipeline. The recent Australian TGA approval of Arexvy is likely to be the first of several, with other vaccines from Pfizer and Moderna currently in development.

    The GSK and Pfizer RSV vaccines are similar. They both contain a small component of the virus, called the pre-fusion protein, that the immune system can recognise.

    Both vaccines have been shown to reduce illness from RSV by more than 80% in the first season after vaccination.

    In older adults, side effects following Arexvy appear to be similar to other vaccines, with a sore arm and generalised aches and fatigue frequently reported.

    Unlike influenza vaccines which are given each year, it is anticipated the RSV vaccine would be a one-off dose, at least at this stage.

    Protecting young children from RSV

    Younger babies don’t tend to respond well to some vaccines due to their immature immune system. To prevent other diseases, this can be overcome by giving multiple vaccine doses over time. But the highest risk group for RSV are those in the first few months of life.

    To protect this youngest age group from the virus, there are two potential strategies available instead of vaccinating the child directly.

    The first is to give a vaccine to the mother and rely on the protective antibodies passing to the infant through the placenta. This is similar to how we protect babies by vaccinating pregnant women against influenza and pertussis (whooping cough).

    The second is to give antibodies directly to the baby as an injection. With both these strategies, the protection provided is only temporary as antibodies wane over time, but this is sufficient to protect infants through their highest risk period.

    A pregnant woman receives a vaccination.
    Women could be vaccinated during pregnancy to protect their baby in its first months of life.
    Image Point Fr/Shutterstock

    Abrysvo, the Pfizer RSV vaccine, has been trialled in pregnant women. In clinical trials, this vaccine has been shown to reduce illness in infants for up to six months. It has been approved in pregnant women in the United States, but is not yet approved in Australia.

    An antibody product called palivizumab has been available for many years, but is only partially effective and extremely expensive, so has only been given to a small number of children at very high risk.

    A newer antibody product, nirsevimab, has been shown to be effective in reducing infections and hospitalisations in infants. It was approved by the TGA in November, but it isn’t yet clear how this would be accessed in Australia.

    What now?

    RSV, like influenza, is a major cause of respiratory illness, and the development of effective vaccines represents a major advance.

    While the approval of the first vaccine for older people is an important step, many details are yet to be made available, including the cost and the timing of availability. GSK has indicated its vaccine should be available soon. While the vaccine will initially only be available on private prescription (with the costs paid by the consumer), GSK has applied for it to be made free under the National Immunisation Program.

    In the near future, we expect to hear further news about the other vaccines and antibodies to protect those at higher risk from RSV disease, including young children.The Conversation

    Allen Cheng, Professor of Infectious Diseases, Monash University

    This article is republished from The Conversation under a Creative Commons license. Read the original article.

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  • No-Frills, Evidence-Based Mindfulness

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    What’s on your mind, really?

    We hear a lot about “the evidence-based benefits of mindfulness”, but what actually are they? And what is the evidence? And, perhaps most importantly: how do we do it?

    What are the benefits?

    The benefits of mindfulness are many, and include:

    • reducing stress
    • reducing pain
    • improving quality of life
    • reducing fatigue
    • providing relief from digestive disorders
    • reducing symptoms of sleep disorders
    • improving immune response
    • providing support for caregivers

    The evidence is also abundant, and includes:

    Sounds great… What actually is it, though?

    Mindfulness is the state of being attentive to one’s mind. This is at its heart a meditative practice, but that doesn’t necessarily mean you have to be sitting in the lotus position with candles—mindfulness can be built into any daily activity, or even no activity at all.

    An exercise you can try right now:

    Take a moment to notice everything you can hear. For this writer, that includes:

    • The noise of my keystrokes as I type
    • The ticking of the clock on the wall
    • The gentle humming of my computer’s processor
    • The higher-pitched noise of my computer’s monitor
    • Birdsong outside
    • Traffic further away
    • My own breathing
    • The sound of my eyelids as I blink

    Whatever it is for you, notice how much you can notice that you had previously taken for granted.

    You can repeat this exercise with other senses, by the way! For example:

    • Notice five things you can see in your immediate environment that you’ve never noticed before. If you’re at home reading this, you probably think you’re very familiar with everything around you, but now see that mark on the wall you’d never noticed before, or a quirk of some electrical wiring, or the stitching on some furnishing, for example.
    • Notice the textures of your clothes, or your face, or perhaps an object you’ve never paid attention to touching before. Your fingertips, unless you have some special reason this doesn’t apply to you, are far more sensitive than you probably give them credit for, and can notice the tiniest differentiation in textures, so take a moment to do that now.
    • Mindful eating can be an especially healthful practice because it requires that we pay every attention to what we’re putting in our mouth, tasting, chewing, swallowing. No more thoughtlessly downing a box of cookies; every bite is now an experience. On the one hand, you’ll probably eat less at a sitting. On the other hand, what a sensory experience! It really reminds one that life is for living, not just for zipping through at a speed-run pace!

    What about mindfulness as a meditative practice?

    Well, those are meditative practices! But yes, mindfulness goes for more formal meditation too. For example:

    Sit comfortably, with good posture, whatever that means to you. No need to get too caught up in the physical mechanics here—it’d take a whole article. For now, if you’re sitting and comfortable, that’s enough.

    Notice your breathing. No need to try to control it—that’s not what this is about today. Just notice it. The in, the out, whether you breathe to your chest or abdomen, through your nose or mouth, don’t worry about doing it “right”, just notice what you are doing. Observe without judgement.

    Notice your thoughts—no need to try to stop them. Notice noticing your thoughts, and again, observe without judgement. Notice your feelings; are you angry, hopeful, stressed, serene? There are no wrong answers here, and there’s nothing you should try to “correct”. Just observe. No judgement, only observe. Watch your thoughts, and watch your thoughts go.

    Did you forget about your breathing while watching your thoughts? Don’t worry about that either if so, just notice that it happened. If you have any feelings about that, notice them too, and carry on observing.

    We go through so much of our lives in “autopilot”, that it can be an amazing experience to sometimes just “be”—and be aware of being.

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Related Posts

  • Foods That Cause You to Lose Weight – by Dr. Neal Barnard
  • Citicoline: Better Than Dietary Choline?

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    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.❞

    ~ Synoradzki & Grieb

    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:

    Citicoline and Memory Function in Healthy Older Adults: A Randomized, Double-Blind, Placebo-Controlled Clinical Trial

    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❞

    Source: Is Citicoline Effective in Preventing and Slowing Down Dementia?-A Systematic Review and a Meta-Analysis

    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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  • Sizing Aside: Are You Wearing The Right Bra For Your Breast Shape?

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    It’s well-known that most women wear incorrectly-fitting bras. Even with careful measurements, buying “off-the-rack” can be a challenge, because the sizing system only takes two measurements, when there are actually many more things to consider. Today’s video demystifies a lot of what else is going on!

    For example…

    Some of the different breast shapes/arrangements to consider:

    • Wide-set breasts: likely to find there’s a bit of a gap between your breasts and the inside (nearest to your sternum) parts of the cups—while spilling out a little at the outside edges. The solution? Bras that offer side-support, to keep things pointing more forwards. Central-closing bras can also help gather things together, and a balconette bra can redistribute things more evenly. Any of these options will be a lot more comfortable.
    • Small breasts: bralettes are your friend, keeping things comfortable while not wearing more bra than necessary to do the job (of course going braless is also an option, but we’re talking bra-fitting here, not bra-flinging-off never to be seen again)
    • Deflated breasts: often the case for someone who used to have larger breasts, but they lost size for hormonal reasons rather than for weight loss reasons. This often occurs a little while after childbirth, and also happens a lot in menopause. The bra recommendation for this? A push-up plunge bra with ¾ coverage not only provides cleavage if that’s wanted, but also, will keep things much more snug and thus more evenly-distributed. If ever you’ve found yourself needing to adjust yourself every now and gain while out, this will fix that and keep you comfortable for much longer.

    There’s more, along with a visual guide, so do check it out:

    Click Here If The Embedded Video Doesn’t Load Automatically!

    Further reading

    While we haven’t written about this specifically (maybe we’ll do a “Life Hacks” edition one of these days), we have written about…

    Keeping Abreast Of Your Cancer Risk

    Take care!

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  • Hormones & Health, Beyond The Obvious

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    Wholesome Health

    This is Dr. Sara Gottfried, who some decades ago got her MD from Harvard and specialized as an OB/GYN at MIT. She’s since then spent the more recent part of her career educating people (mostly: women) about hormonal health, precision, functional, & integrative medicine, and the importance of lifestyle medicine in general.

    What does she want us to know?

    Beyond “bikini zone health”

    Dr. Gottfried urges us to pay attention to our whole health, in context.

    “Women’s health” is often thought of as what lies beneath a bikini, and if it’s not in those places, then we can basically treat a woman like a man.

    And that’s often not actually true—because hormones affect every living cell in our body, and as a result, while prepubescent girls and postmenopausal women (specifically, those who are not on HRT) may share a few more similarities with boys and men of similar respective ages, for most people at most ages, men and women are by default quite different metabolically—which is what counts for a lot of diseases! And note, that difference is not just “faster” or “slower””, but is often very different in manner also.

    That’s why, even in cases where incidence of disease is approximately similar in men and women when other factors are controlled for (age, lifestyle, medical history, etc), the disease course and response to treatment may vary considerable. For a strong example of this, see for example:

    • The well-known: Heart Attack: His & Hers ← most people know these differences exist, but it’s always good to brush up on what they actually are
    • The less-known: Statins: His & Hers ← most people don’t know these differences exist, and it pays to know, especially if you are a woman or care about one

    Nor are brains exempt from his…

    The female brain (kinda)

    While the notion of an anatomically different brain for men and women has long since been thrown out as unscientific phrenology, and the idea of a genetically different brain is… Well, it’s an unreliable indicator, because technically the cells will have DNA and that DNA will usually (but not always; there are other options) have XX or XY chromosomes, which will usually (but again, not always) match apparent sex (in about 1/2000 cases there’s a mismatch, which is more common than, say, red hair; sometimes people find out about a chromosomal mismatch only later in life when getting a DNA test for some unrelated reason), and in any case, even for most of us, the chromosomal differences don’t count for much outside of antenatal development (telling the default genital materials which genitals to develop into, though this too can get diverted, per many intersex possibilities, which is also a lot more common than people think) or chromosome-specific conditions like colorblindness…

    The notion of a hormonally different brain is, in contrast to all of the above, a reliable and easily verifiable thing.

    See for example:

    Alzheimer’s Sex Differences May Not Be What They Appear

    Dr. Gottfried urges us to take the above seriously!

    Because, if women get Alzheimer’s much more commonly than men, and the disease progresses much more quickly in women than men, but that’s based on postmenopausal women not on HRT, then that’s saying “Women, without women’s usual hormones, don’t do so well as men with men’s usual hormones”.

    She does, by the way, advocate for bioidentical HRT for menopausal women, unless contraindicated for some important reason that your doctor/endocrinologist knows about. See also:

    Menopausal HRT: A Tale Of Two Approaches (Bioidentical vs Animal)

    The other very relevant hormone

    …that Dr. Gottfried wants us to pay attention to is insulin.

    Or rather, its scrubbing enzyme, the prosaically-named “insulin-degrading enzyme”, but it doesn’t only scrub insulin. It also scrubs amyloid beta—yes, the same that produces the amyloid beta plaques in the brain associated with Alzheimer’s. And, there’s only so much insulin-degrading enzyme to go around, and if it’s all busy breaking down excess insulin, there’s not enough left to do the other job too, and thus can’t break down amyloid beta.

    In other words: to fight neurodegeneration, keep your blood sugars healthy.

    This may actually work by multiple mechanisms besides the amyloid hypothesis, by the way:

    The Surprising Link Between Type 2 Diabetes & Alzheimer’s

    Want more from Dr. Gottfried?

    You might like this interview with Dr. Gottfried by Dr. Benson at the IMCJ:

    Integrative Medicine: A Clinician’s Journal | Conversations with Sara Gottfried, MD

    …in which she discusses some of the things we talked about today, and also about her shift from a pharmaceutical-heavy approach to a predominantly lifestyle medicine approach.

    Enjoy!

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    Learn to Age Gracefully

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