Preventing Caregiver Burnout with Good Nutrition and Foods that Support Neurotransmitters

Keto diet concept - salmon, avocado, eggs, nuts and seedsWhether you want to support your brain health, relieve stress and anxiety about caregiving responsibilities, or just want to rev up your energy, stamina and immunity, here are some ways to protect your health and support your mood.

Start your day with an energizing breakfast to stabilize your blood sugar, so your mood stays even and you can perform at your best. When blood sugar is too high or low it’s a signal to the body to store calories, which adds fat around your middle. If you’re nauseous in the morning it means your blood sugar is low.

Eat within one hour upon rising and by 10am, and make sure your breakfast isn’t coffee and a doughnut. Have some protein and a healthy fat such as an omelet and avocado and a piece of whole grain or gluten-free toast. It’ll provide you with the energy you need to get through the morning while maintaining a sense of equilibrium.

Healthy Breakfast with Wholemeal Bread Toast and Poached Egg

Breakfast of Champions

  • Top a bagel or slice of whole wheat break with a fried egg, sliced tomato, avocado, slice of low-fat cheese
  • Bagel topped with hummus, tomato, goat cheese
  • Spread a tablespoon of almond butter on a piece of bread or bagel
  • Yogurt/granola parfait with fresh fruit
  • Sautéed greens (kale or spinach) and onion, and a corn tortilla topped with eggs, beans, sprinkle of cheese, salsa
  • Oatmeal or multi-grain cereal with almonds or walnuts, prunes, cinnamon, flax seed meal, Greek yogurt
  • Spinach mushroom omelet with salsa, berries and wheat toast
  • Whole-grain mini-quiche with ½ cup of berries

Hydrate!

Senior couple staying hydrated after running jogging

Our body is 50-65% water. Drink plenty of water to stay hydrated and to flush out toxins. The brain, which is 70% water, gets dehydrated just like your body. When it is dehydrated, neurotransmission—which is heavily dependent on water—is impaired, resulting in poor memory, concentration and impaired abstract thinking. The next time your mind is muddled, drink a tall glass of water and notice the difference. Choose smoothies, fresh juices, water, herbal teas.

Neurotransmitters are the brain chemicals that communicate information throughout your brain and body. The brain uses neurotransmitters to tell your heart to beat, your lungs to breathe, and your stomach to digest. They can also affect mood, sleep, concentration, weight, and can cause adverse symptoms when they are out of balance. Neurotransmitter levels can be depleted many ways. It is estimated that 86% of Americans have suboptimal neurotransmitter levels. Stress, poor diet, poor digestion, poor blood sugar control, drug (prescription and recreational), alcohol and caffeine can deplete them. (Emmons, The Chemistry of Joy, 2006).

 

list of neurotransmitters

Serotonin is necessary for a stable mood.

A deficiency can result in depression, irritability, sudden tears, insomnia, anxiety, or panic attacks, binge eating, carbohydrate craving, an overactive mind, and low tolerance to stress. When chronic stress is combined with nutrient deficiencies because of poor eating habits the risk of mood disorders can increase.

Foods that enhance serotonin: Salmon, Soy, turkey, cheese, eggs, spinach, cottage cheese, nuts, milk, avocado, meat, chocolate

Activities that enhance serotonin: cross crawl movement, as in swimming, hiking, biking

Dopamine keeps us focused and motivated. Dopamine is sometimes referred to as a “gas pedal” neurotransmitter. A deficiency can result in depressed mood, excessive sleeping, eight gain, obesity, lack of energy, addictions. When in balance, dopamine increases alertness, wakefulness, energy. It is depleted by addictions, sugar, cigarettes.

Foods that enhance dopamine: Meat, wild game, eggs, chocolate, blueberries, yoghurt, milk, soy, cheese, seeds and nuts, beans and legumes.

Activities than enhance dopamine: Deep breathing, weight bearing exercise and strength training enhance dopamine.

GABA inhibits nerve cells from firing. Too many carbs and refined foods deplete GABA. Exercise, and being outdoors, paying attention to your personal needs are important.

Passion flower, lemon balm and valerian help support GABA, especially helps you fall asleep.

How to boost your neurotransmitters

  • Focus on complex carbohydrates (whole grains, fruits and veggies) and eliminate junk foods or refined carbs.
  • Eat 3 balanced meals and 1-2 snacks/day. Include a high-quality protein with every meal
  • Unlimited amounts of fresh veggies
  • Eat a good breakfast

Do you lie awake at night?

Lack of sleep triggers the body to increase production of cortisol, the stress hormone, which makes it harder to fall asleep and stay in a deep sleep because on some level your body and brain think they need to stay alert for danger. Although insomnia isn’t considered a disease by itself, it can lead to numerous health problems. Lack of sleep may result in slower reflexes, irritability, fatigue, lack of motivation and depression. Your health, motivation, productivity, mood and energy all depend on getting quality sleep.

Foods that promote sleep

Although it’s not recommended to have a full meal close to bedtime, eating a snack helps maintain blood sugar levels, which helps promote restful sleep.

A cheese slice, or slice of turkey contain tryptophan, an essential amino acid, that promotes sleep. Other foods that might help: Whole grain crackers with nut butter, oatmeal, popcorn, almonds and walnuts. Some fruits (oranges, bananas, tart cherries, kiwis) contain melatonin.

  • Small amount of protein
  • Complex carbs
  • Nuts
  • Cottage cheese
  • Chamomile tea, warm milk
  • Fruits

Eat more healthy fats and skip the hydrogenated and trans fats found in doughnuts, potato chips and other pastries and desserts.  Omega-3 fatty acids are rich in DHA, the major unsaturated fat in the brain. This long-chain fatty acid provides the necessary fluid quality to the membranes of the nerve cells so that electrical nerve impulses can flow easily along the circuits of the brain. One study found that Alzheimer’s patients given an omega-3-rich supplement experienced a significant improvement in their quality of life. Eating fish such as wild-caught salmon, sardines and other cold-water fish can protect you against Alzheimer’s disease and other forms of dementia. Numerous studies have shown that elderly people who did not have dementia had high blood levels of docosahexaenoic acid (DHA), an essential fatty acid found in cold-water fish, in comparison to those with dementia, who had on average 30% to 40% lower blood levels of DHA.

 Ways to increase your DHA intake: eat cold-water fish such as wild-caught salmon, sardines and mackerel, at least twice a week. Add flax meal to cereal and baked goods, sprinkle flax oil on your salad, eat a small handful of walnuts at least several times a week.

Make Healthy Choices

Choose these

  • Water, green tea, herbal teas
  • Nuts & seeds
  • Avocado, olive oil, omega-3 fatty acids
  • Fresh fruits and Veggies
  • Fish, high-quality protein
  • SOUL foods (seasonal, organic, unadulterated, local)
  • Sugar alternatives: stevia, monk fruit, coconut sugar, maple syrup, agave, birch sugar, honey

Avoid these

  • Coffee, soda, artificial sweeteners
  • Chips, cookies, pastries, candy
  • Poor quality fats (hydrogenated,
  • Processed lunch meats
  • Dairy products with rBGH (growth hormones)

Remember this

Whether you’re eating breakfast, lunch, dinner or a snack, always think protein!

Assortment of healthy protein source and body building food

Build your meal around chicken, fish, tofu, cottage cheese or eggs, and then add low-starch vegetables or fruits. The general rule is to eat 3-4 ounces of lean, dense meat or 6 ounces of fish. Women should aim for around 30 grams of protein. Men should aim for around 40 grams of protein. Another rule of thumb is to divide your plate in half. Fill half of the plate with veggies, one quart with a protein, and the other quarter with a whole grain such as quinoa, rice, barley, etc.

Happy eating!


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Barbra Cohn cared for her husband Morris for 10 years. He passed away from younger-onset Alzheimer’s disease in 2010. Afterward, she was compelled to write “Calmer Waters: The Caregiver’s Journey Through Alzheimer’s & Dementia”–winner of the 2018 Book Excellence Award in self-help– in order to help other caregivers feel healthier and happier, have more energy, sleep better, feel more confident, deal with feelings of guilt and grief, and to ultimately experience inner peace. “Calmer Waters” is available at AmazonBarnes & NobleBoulder Book StoreTattered Cover Book Store,  Indie Bound.org, and many other fine independent bookstores, as well as public libraries.

 

10 of the best nutrients for men that you may not know about

Man eating salad

Calling all men, and the people who love them. June is Men’s Health Month, and a perfect time of year to evaluate your diet. There are no more excuses for being a couch potato. It’s time to get up, go outdoors, have fun, and get some exercise!

It’s also a great time to boost your nutrition with antioxidants found in fruits and vegetables, and learn some easy ways to cook them on the grill. Here’s a list of some of the important nutrients to add to your health regimen for a boost in overall health, energy, uplifted mood, brain support, and, yes, your sex life.

  1. Lycopene offers the best antioxidant protection of the 600 naturally occurring carotenoids. Carotenoids are the pigments found in colorful fruits such as watermelon, guavas, and tomatoes.  Thousands of articles have been published discussing lycopene’s potential as a protectant against prostate, lung, breast, skin, and pancreatic cancer. There is even a new study indicating that because of the strength of its antioxidant ability, lycopene has the potential to be developed as a clinical nutrient supplement for the prevention of AD –Alzheimer’s disease. The best way to get the benefits of lycopene is by eating tomatoes cooked in olive oil or tomato sauce.
  2. Did you know that if you are a man living in the United States it’s almost inevitable you’ll eventually have to face prostate problems? The prostate gland begins to grow in most males after they reach 40 years of age because DHT (dihydrotestosterone), a potent form of the male hormone testosterone, increases in the body. Testosterone is produced by the testicles and the adrenal glands and DHT accumulates in the prostate, causing prostate cells to rapidly divide. This overgrowth of prostate tissue compresses the urethra and slows or even stops the flow of urine in a similar way that a bent garden hose inhibits the flow of water. This occurs in 75 percent of men over 60 and sometimes the enlargement is the result of something more serious. Numerous studies have found that saw palmetto contains fatty acids and sterols effective in balancing male hormones, supporting testicular functions, and relieving prostate discomfort. Saw Palmetto helps reduce the level of dihydrotestosterone (DHT) by blocking its receptor sites in the prostate, and by inhibiting enzymes necessary for DHT conversion. It also helps shrink over-grown prostate tissue without bothersome side effects.
  3. B6, B12, and folic acid are important for reducing homocysteine levels, which is considered a major culprit in heart disease. Medical professionals are learning that homocysteine—a by-product of the amino acid methionine—is often a better indicator of your cardiovascular health than cholesterol. High levels of homocysteine indicate inflammation within the arteries, which can increase injury to the arterial wall. Consequently, this causes plaque to form, inhibiting blood flow, which increases risk of a blood clot from forming. Scientists and physicians have observed that most people with a high homocysteine level don’t get enough folic acid, vitamin B6 or B12 in their diet. In fact, in 1969 Dr. Kilmer S. McCully of Harvard Medical School discovered that patients with heart disease had nearly 80% less vitamin B6 in their blood serum than healthy individuals. Supplementing with these vitamins helps return the homocysteine level to normal. B6 also helps support healthy blood pressure.
  4. Resveratrol is a super antioxidant found in red grapes and wine. It has also been shown to reduce the inflammation and damage in the blood vessels that results from homocysteine. Hundreds of studies have shown that it supports cardiovascular health and may even provide anti-aging benefits.
  5. CoQ10 (Coenzyme Q10) is a co-enzyme that is called the “spark plug” of your cells. It is essential for electron transport within the mitochondria, and the production of adenosine triphosphate (ATP), which is responsible for energizing the 70-100 trillion cells in your body. The highest concentration of this important antioxidant resides in the heart. Without it your heart wouldn’t be able to beat 100,000 times a day, and some experts believe that if deficiency levels reach 75% your heart would stop beating. As we get older our levels of CoQ10 naturally start to decline. Our body needs vitamins, trace minerals and the amino acid tyrosine in order to produce CoQ10. If you are deficient in any of those nutrients because your diet is inadequate then your body will not be able to adequately produce CoQ10.Also, statins (cholesterol-lowering drugs) block CoQ10 production by blocking cholesterol synthesis, which is necessary for the production of CoQ10. So if you take Lipator or another statin drug it is crucial that you take a CoQ10 supplement. An 8-week study of 59 men already taking medications for high blood pressure found that 120 mg daily of CoQ10 reduced blood pressure by about 9% when compared to placebo.  Recent studies have shown that CoQ10 supplementation can save the lives of patients with congestive heart failure, and that 91% of heart attack victims improve within 30 days of adding CoQ10 to their list of daily supplements.  CoQ10 supplementation has also been found to support numerous cardiovascular illnesses, including atherosclerosis, ischemic heart disease, heart failure, and hypertension.
  6. Siberian ginseng is an adaptogen or substance that normalizes and balances all of the body’s systems, increasing your ability to handle physical and mental stress. It also helps support the adrenal glands, which help regulate energy levels.
  7. Multi-vitamin mineral supplements for men are formulated to address the unique nutritional needs of today’s man and to insure your  health. Look for one that is iron-free, since iron can negatively affect heart health.
  8. L-Arginine is an amino acid that is involved in the production of nitric oxide (NO), a chemical released by the blood that helps the muscles in the penis to relax. This, in turn, allows healthy blood flow in order to sustain a healthy erection. Without arginine in the diet, there would be no NO, and without NO men would not be able to have erections. And without erections there would be no . . . . Get the picture? But beyond sex, L-arginine helps build muscle mass, enhance immune function, improve blood pressure, increase memory, and speed wound healing. Arginine-derived nitric oxide has also been found to play a supporting role in the cardiovascular, immune, and nervous systems and has been validated by hundreds of studies. Foods that include arginine include meat, legumes, nuts and seeds, and turkey breast, chicken, and pork.
  9. Omega-3 fatty acids are essential acids, meaning your body does not manufacture them. You must obtain them through diet or nutritional supplementation. They are vital to supporting cardiovascular health, including blood flow to your heart and brain, and numerous other body functions. EPA and DHA, the long-chain omega-3s support healthy function of the brain and retina. DHA is a building block of tissue in the brain and retina in the eye. It is important in the production of phosphatidylserine, a neurotransmitter vital to brain cell communication. Studies show that omega-3s are also important to supporting an uplifted, even mood, and that a deficiency can lead to depression. It is also beneficial to creaky joints. Omega-3 fatty acids are the healthy fats that you can’t live without. To make sure you are getting adequate amounts, eat cold-water fish such as salmon, mackerel, cod, herring, sardines, at least twice a week. It is also found in freshly ground flaxseed or flaxseed oil; dark, leafy greens, hemp seed, soybeans, canola, walnut and flaxseed and oils made from those beans, nuts and seeds. To play it safe, my advice is to take an omega-3 fatty acid supplement.
  10. Chromium Picolinate is a first class blood sugar and insulin regulator. Nine out of 10 American diets fall short of this trace mineral, which is essential for the transfer of sugar from the bloodstream to muscle cells, thereby giving them the fuel they need to work.  Chromium is involved in maintaining cholesterol and triglyceride levels, and it is also necessary for our muscles to function properly. Chromium is believed to help build new muscle and act as a fat burner. When combined with an exercise program, chromium supplementation has been shown to produce significant weight loss.  Research suggests that chromium may help those with diabetes II and hypoglycemia. In a recent study, participants with a binge-eating disorder who took chromium picolinate supplementation, had improved glucose regulation.

Happy Father’s Day to everyone who is involved in the life of a child.

You are appreciated!


 

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Barbra Cohn cared for her husband Morris for 10 years. He passed away from younger-onset Alzheimer’s disease in 2010. Afterward, she was compelled to write “Calmer Waters: The Caregiver’s Journey Through Alzheimer’s & Dementia”–winner of the 2018 Book Excellence Award in self-help– in order to help other caregivers feel healthier and happier, have more energy, sleep better, feel more confident, deal with feelings of guilt and grief, and to ultimately experience inner peace. “Calmer Waters” is available at AmazonBarnes & NobleBoulder Book StoreTattered Cover Book Store,  Indie Bound.org, and many other fine independent bookstores, as well as public libraries.

 

Why are U.S. Pregnancy Deaths up?

belly of pregnant woman  monochrome on dark backgroundHappy Mother’s Day! I don’t normally write about pregnancy, but I feel compelled to address the fact that more U.S. women are dying from pregnancy-related causes. According to Dr. Neel Shah, a Harvard Medical School obstetrician, an American mother today is 50% more likely to die in childbirth than her own mother was.  Possible reasons include the high rate of C-sections, high blood pressure which can lead to preeclampsia, diabetes, and obesity. Although these deaths are rare, there are about 700 of them each year and according to the CDC (centers for disease control) more than half of them are preventable.

I taught the Bradley Method of Natural Childbirth thirty years ago. Back then, I warned my students that there was a possibility that their doctor might want to schedule a delivery around a vacation or tee time. I taught ways to have the healthiest outcome possible with the least amount of intervention.

Here we are three decades later and the percentage of C-sections has nearly doubled globally since to 2000, according to a study published in The Lancet, Oct. 13, 2018. In the U.S. 32% of all babies are now delivered by C-section.

Globally, maternal mortality fell about 44% between 1990 and 2016, according to the World Health Organization. That’s good news. But in the U.S., 17 out of every 100,000 new moms die. That’s up from 12 per 100,000 25 years ago. And black women in the U.S. are three times as likely to die from a pregnancy-related health issues than others. This could be due to lack of medical care, racial bias, and/or poor health to begin with (high blood pressure, etc.).

If you or a loved one is pregnant or plans to get pregnant

  • Please see a physician as soon as you suspect you are pregnant in order to get the best medical care possible.
  • Get a comprehensive heart-risk evaluation 12 weeks after delivery.
  • Eat a healthy, whole-foods diet and monitor you salt and sugar intake.
  • Practice a stress-reducing technique such as yoga, deep breathing, meditation.
  • Take a birth preparation class—these are usually offered at hospitals throughout the county.
  • Practice a relaxation birth technique with the person who will be your support during delivery and labor.
  • Keep your fitness up or strive to improve it. Walk or swim.

There are many articles posted on this blog on ways to reduce stress, eat well, and exercise. Even though many of them pertain to caregivers, there’s a lot of general information that applies to everyone.

Best wishes for a Happy Mother’s Day, a happy pregnancy, and a happy baby!


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Grief and Relief: When caregiving ends

GedankenCaregiving for a person with dementia is one of the most difficult things anyone will have to do. The pain and suffering is intense, but the rewards are plenty. Even though the person you are caring for cannot express gratitude, on some level they know and appreciate your sacrifice. They are eternally indebted to you. As Lou Gehrig said in his farewell speech, “When you have a wife (caregiver) who has been a tower of strength and shown more courage than you dreamed exists—that’s the finest I know. So I close in saying that I might have been given a bad break, but I’ve got an awful lot to live for.”

Kim Mooney, the Board President of Conversations on Death, and Director of Community Education for Tru Community Care, Colorado’s first hospice, has said that as caregivers “the sacrifices you made changed the course of your life. As you once again look at finding a new course, you will over time grieve your loved one and what you let go of or stored away. You will also begin to discover the things you learned from giving so much. As you recognize and honor what you did, it will begin to shape the meaning of your life now. Whatever the challenges ahead in rebuilding, that understanding can give you the strength, commitment, and satisfaction to make your life more meaningful than ever.”

So, what’s next? Stop, take a deep breath, and think about your journey: where you came from, what you did, and how you feel. When my husband’s final health crisis was over and after I buried him, I realized that I hadn’t fully breathed for years and that my body was strangled with tension and fatigue. I had meditated, eaten fairly well (besides the times I was too tired to cook and made a dinner out of popcorn and ice cream), danced, exercised, and practiced yoga. All these things helped keep me calm, and brought me back to my “self.” But being on call for years took its toll. And after it was all over, while ensnared in the tentacles of grieving, I felt relief. Relief that I wouldn’t feel the pain of watching Morris lose yet another function. Relief that I wouldn’t have to fill another prescription or talk to a physician about my husband’s condition. Relief that I didn’t have to travel the 15 miles to visit him in the memory care home, where I’d inevitably get depressed. Relief that I could stay home and not have an obligation other than caring for myself.

And yet, the final letting go of my role as caregiver was uncomfortable and felt strangely similar to sending my children out into the world. How would I define myself if I were no longer a caregiver? How would I fill up the time I had spent caring for my husband for an entire decade, one fifth of my life? Creating a new identity takes time, practice, and patience. And we are told by grief counselors to not rush things. Do not make a major change in your life, such as moving out of the house you’ve lived in for years, or to another state. But day-by-day, it’s okay to acknowledge that we are not the same person who heard the dreaded words from our loved one’s doctor: “You have dementia, most likely of the Alzheimer’s type.”

As caregivers we take a journey through fire and ice and land on solid ground surrounded by calm waters. Then it’s time to swim to shore and get our bearings. Be patient, be kind to yourself, and set out to discover different activities, small and large, that ease you to calmer waters. Here are some ways to help you get there:

  1. Choose at least one healing modality in this book and integrate it into your life. Dance, do yoga, try journaling, find someone to walk with, etc.
  2. Clean out your closets and drawers.
  3. Wash the garage floor and then paint it.
  4. Take a cooking class.
  5. Join a health club or YMCA.
  6. Take a Zumba® fitness class.
  7. Ride your bike.
  8. Join a hiking club.
  9. Learn how to sew or knit.
  10. Serve food at a community table or sort food at a food bank.
  11. Plant a garden.
  12. Play a musical instrument.
  13. Learn a new language.
  14. Travel! Visit friends and family.
  15. Take long nature walks.
  16. Make it a habit to soak in a bath with Epsom salts.
  17. Get a puppy or kitten.
  18. Volunteer at the Humane Society.
  19. Read to elementary school children.
  20. Join a book club.

My journey to calmer waters

My husband’s illness changed the course of my family’s lives in ways that were unexpected, devastating, and empowering. I developed into a strong matriarch and quickly learned how to take charge of my husband’s care, family business, and my children, without the help of my partner. And not having a partner, with whom I would typically make important decisions with, was one of the hardest things of all about being a partner to someone with Alzheimer’s disease.

Not having a partner, with whom I would typically make important decisions, was one of the hardest things of all about being a partner to someone with Alzheimer’s disease. Deciding where and when to place Morris in a memory care home, figuring out how to finance it, and deciding when to enlist the help of hospice were the kinds of decisions I would have discussed with my husband.

I became a compassionate caregiver, not just for Morris, but for other residents of the memory care home where he lived the last two years of his life. I went through a lot—as all caregivers do—but I’ve come through. I’ve recreated my life, and have learned to look forward with hope, wonder, delight, and inspiration after giving so much of myself to the person I vowed to spend my life with.

There are days that go by without my thinking about Morris. After all, it’s been over eight years since he’s been gone. It’s still hard for me to look at family photos because our family was happy, and a link is missing. I know for my children the hardest thing is that their own children are growing up without knowing their grandfather, who would have loved to be a part of their lives. We will always miss him, but our happy memories fill in the gaps, and we honor him eery year on his yahrzeit the anniversary of a Jewish loved one’s death.

I have a new love in my life and grandchildren to enjoy and cherish. I feel good and I am happy! As my beloved teacher Swami Kaleshwar always said, “Life is short, make it sweet.” I will and I do.


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Barbra Cohn cared for her husband Morris for 10 years. He passed away from younger-onset Alzheimer’s disease in 2010. Afterward, she was compelled to write “Calmer Waters: The Caregiver’s Journey Through Alzheimer’s & Dementia”–winner of the 2018 Book Excellence Award in self-help– in order to help other caregivers feel healthier and happier, have more energy, sleep better, feel more confident, deal with feelings of guilt and grief, and to ultimately experience inner peace. “Calmer Waters” is available at AmazonBarnes & NobleBoulder Book StoreTattered Cover Book Store,  Indie Bound.org, and many other fine independent bookstores, as well as public libraries.

Mushrooms may reduce risk of mild cognitive impairment by 50%

Mushrooms - morchella mushrooms, boletus mushrooms, oyster mushrooms, on white background.If  you eat golden, oyster, shiitake and/or white button mushrooms, as well as dried and canned mushrooms, you’re in luck! A team from the Department of Psychological Medicine and Department of Biochemistry at the Yong Loo Lin School of Medicine at the National University of Singapore (NUS) has found that seniors who consume more than one and one-half cups of mushrooms weekly may reduce their odds of having mild cognitive impairment (MCI) by 50%. 

What is MCI?

Mild cognitive impairment causes cognitive changes that are serious enough to be noticed by people experiencing them or to other family and friends. The changes are not severe enough to interfere with daily activity. People with MCI that involves memory problems are more likely to develop Alzheimer’s disease or other dementias than people without MCI. Approximately 15-20 percent of people age 65 or older have MCI.

Mushrooms might be a key to reducing MCI

The correlation between eating mushrooms and reducing risk of MCI is surprising and encouraging, according to Assistant Professor Lei Feng, who is from the NUS Department of Psychological Medicine, and the lead author of this work.

The six-year study, which was conducted from 2011 to 2017, collected data from more than 600 Chinese seniors over the age of 60 living in Singapore. The research was carried out with support from the Life Sciences Institute and the Mind Science Centre at NUS, as well as the Singapore Ministry of Health’s National Medical Research Council. The results were published online in the Journal of Alzheimer’s Disease on 12 March 2019.

The researchers found that the compound called ergothioneine (ET), a unique antioxidant and anti-inflammatory which humans are unable to synthesize on their own, is the key to possibly reducing MCI. Ergothioneine is found in liver, kidney, black beans, kidney bean and oat bran. But the highest levels are found in bolete and oyster mushrooms.

Other compounds contained within mushrooms may also be advantageous for decreasing the risk of cognitive decline. Certain hericenones, erinacines, scabronines and dictyophorines may promote the synthesis of nerve growth factors. Bioactive compounds in mushrooms may also protect the brain from neurodegeneration by inhibiting production of beta amyloid and phosphorylated tau, and acetylcholinesterase, the culprits of Alzheimer’s disease.

How much do you need to eat?

In the study, a portion was defined as three quarters of a cup of cooked mushrooms with an average weight of around 150 grams. Two portions would be equivalent to approximately half a plate. While the portion sizes act as a guideline, it was shown that even one small portion of mushrooms a week may still be beneficial to reduce chances of MCI.

An article in Science Daily said this: According to Robert Beelman, professor emeritus of food science and director of the Penn State Center for Plant and Mushroom Products for Health, it’s preliminary, but you can see that countries that have more ergothioneine in their diets, countries like France and Italy, also have lower incidents of neurodegenerative diseases, while people in countries like the United States, which has low amounts of ergothioneine in the diet, have a higher probability of diseases like Parkinson’s Disease and Alzheimer’s,” said Beelman. “Now, whether that’s just a correlation or causative, we don’t know. But, it’s something to look into, especially because the difference between the countries with low rates of neurodegenerative diseases is about 3 milligrams per day, which is about five button mushrooms each day.”

 

Mushroom recipes

Cooking mushrooms does not seem to significantly affect the compounds. Roasted or baked mushrooms are simple to make and delicious, and go well with most foods as a side dish or topping.

Wash and slice musthrooms. Lightly oil shallow baking pan large enough to hold mushrooms in single layer. Add mushrooms and toss with 2 to 3 tablespoons oil. Add garlic; season with salt; roastfor 20 minutes stirring on occasion; mushrooms should be browned. Season with pepper.

For baked mushrooms with parmesan, thyme and lemon simply toss with olive oil, Paremesan cheese, garlic, thyme, lemon zest and lemon juice.

For more mushroom recipes google for mushroom risotto, mushroom gravy, cream of mushroom soup, creamy mushroom pasta, mushroom and barley soup.


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Barbra Cohn cared for her husband Morris for 10 years. He passed away from younger-onset Alzheimer’s disease in 2010. Afterward, she was compelled to write “Calmer Waters: The Caregiver’s Journey Through Alzheimer’s & Dementia”–winner of the 2018 Book Excellence Award in self-help– in order to help other caregivers feel healthier and happier, have more energy, sleep better, feel more confident, deal with feelings of guilt and grief, and to ultimately experience inner peace. “Calmer Waters” is available at AmazonBarnes & NobleBoulder Book StoreTattered Cover Book Store,  Indie Bound.org, and many other fine independent bookstores, as well as public libraries.

What happens to your body when you’re a stressed caregiver?

Woman having a headacheStatistics show the stress of care giving can result in chronic disease for the caregiver and take as many as 10 years off one’s life. In comparison to caregivers of people in all categories, caregivers of Alzheimer’s patients in particular rate their health more poorly, take worse care of themselves, and spend more money on their health care. Feeling more tired and depleted, they evaluate themselves as less healthy, engage in fewer health-promoting behaviors, and use more health services.

Given the demands on caregivers’ time and energy, they may neglect their own self-care by sleeping less, eating too much or too little, not exercising, or not managing their own health problems. Neglect of their own health may worsen pre-existing illnesses or increase vulnerabilities to new stress-related problems.

The Physiology of Stress

Walter Cannon described the fight or flight response in 1929.  Adrenaline is the fight-or-flight hormone: It causes cells, especially muscle cells, to speed up energy production so that the body will be ready to fight a foe or run away. It is needed for short blasts of stress.

  • Pupils dilate to sharpen vision.
  • Heart rate and blood pressure increase to accelerate the delivery of oxygen to fuel the muscles and critical organs.
  • Blood flow is diverted from non-critical areas such as the gastrointestinal tract to the critical areas such as the heart, skeletal muscles and liver.
  • Liver releases glucose and fatty acids into the bloodstream. Glucose is for immediate energy; fat is needed when the fight-or-flight response lasts longer than expected.
  • Bronchial tubes dilate to maximize the exchange of oxygen and carbon dioxide.

Cortisol bolsters us in long-lasting stress situations. But when the body is dealing with chronic stress, the adrenals get “stuck” in the on position and the whole system goes into chronic “fight or flight.”

  • Glucose that is dumped into your bloodstream goes unused, so your body has to produce an enormous amount of insulin to handle it. Eventually, this may result in hypoglycemia or diabetes.
  • Fat that is dumped into your blood also goes unused, so it clogs your arteries, leading to cardiovascular disease.
  • If you drink caffeine, the stress hormone cortisol becomes elevated, which can set you up for countless health problems including: poor quality of sleep, impaired immunity and age-related deterioration.

Adrenal exhaustion–The adrenal glands produce or contribute to the production of about 150 hormones. When they are stressed, they become exhausted. Once the adrenal buffer is gone, you become a prime candidate for asthma, allergy, fibromyalgia, chronic fatigue syndrome, autoimmune disorders, hypoglycemia

Alcohol, caffeine, sugar and salt put added stress on the adrenals.

Stimulate, such as caffeine increase the effects of your body’s own stimulating neurotransmitters: norepinephrine and dopamine, which are similar to adrenaline in their effects. Caffeine and these natural stimulants provide short-term energy, focus and even a lifted mood. But in the long-term, caffeine depletes your stores of norepinephrine and dopamine, leaving you more tired, sluggish and down than you were before the caffeine habit.

Psychological stress can impact cardiovascular function and lead to cardiovascular disease, and possible stroke/heart attack.

Stress and sleep

Adequate sleep repairs your body, sharpens your mind and stabilizes emotions. Lack of sleep triggers the body to increase production of cortisol, which makes it harder to fall asleep and stay in a deep sleep because on some level your body and brain think they need to stay alert for danger.

  • Loss of sleep as a result of caring for a loved one can lead to serious depression.
  • As little as five nights of poor sleep can significantly stress the heart.

Weight gain and insulin resistance

  • Increased cortisol production leads to weight gain. The adrenals increase gluconeogenesis, which provides the body with glucose from protein, rather than carbohydrates. This decreases serotonin and melatonin, which results in poor sleep and leads to food cravings for carbohydrate-rich foods in order to uplift mood, which releases more serotonin and insulin. This leads to more stress and insulin production to regulate glucose, which may lead to fat storage, weight gain and insulin resistance. It becomes a vicious cycle.
  • Insufficient sleep is also associated with lower levels of leptin, a hormone that alerts the brain that it has enough food, as well as higher levels of ghrelin, a biochemical that stimulates appetite. Consequently, poor sleep may result in food cravings.

Exercise

  1. Insufficient sleep may leave us too tired to burn off extra calories with exercise.
  2. When your body is stressed and prepared to fight or run it’s full of stress hormones. If you’re sedentary, those hormones will continue to circulate and cause damage to your body. Vigorous exercise, however, burns off those hormones. Exercise also releases the neurotransmitter serotonin and endorphins, the body’s natural pain relievers.
  3. Doctors from Nottingham Trent University suggest the chemical phenylethylamine is released during exercise and could play a part in uplifting mood as a result of exercise. Phenylethylamine is a naturally produced chemical that has been linked to the regulation of physical energy, mood and attention.

Impact of food on mood and physiology

Hazards of caffeine

  1. Caffeine stresses the adrenal glands and can contribute to anxiety, insomnia, depression, irritability, anxiousness—not good for caregivers. In fact, studies show that those who drink the most coffee often suffer from chronic depression. It depletes the body of B1, biotin, inositol, vitamin C, calcium, potassium, and zinc. It increases thirst because it is dehydrating, over stimulates and weakens the kidneys, pancreas, liver, stomach, intestines, heart, and nervous system.
  2. Can increase production of cortisol, leading to stronger cravings for fat and carbohydrates. This increases blood glucose, release of insulin and fat stored in the abdomen.
  3. Increases dopamine levels, making you feel good until it wears off
  4. May interfere with restful sleep
  5. Try not to drink coffee after 2pm
  6. Simple carbohydrates increase insulin production.

People who are stressed often crave and overeat sugar and simple carbohydrates, like chips, cookies and white bread or pasta, because those foods provide a fast release of the feel-good chemical serotonin. But eating this way causes a blood-sugar crash a couple of hours later, leaving you tired and moody. The more of these foods that you eat the more you crave. Although these foods are high in calories, they contribute few nutrients and deplete the body of essential vitamins and minerals, raise triglycerides, and contribute to inflammation and excess weight.

  1. Lack of water/fiber can rob the body of nutrients because of problems with digestion and assimilation
  • HFCS and other artificial sweeteners can interfere with your natural production of neurotransmitters. Aspartame (NutraSweet and Equal) competes with tryptophan by blocking its conversion into serotonin. Artificial sweeteners contribute to numerous adverse symptoms, as compiled by the Food and Drug Administration and include everything from menstrual changes, weight gain, and headaches to severe depression, insomnia and anxiety attacks.

High fructose corn syrup (glucose and fructose) can lead to a decrease in leptin production leading your body into thinking it’s hungry so you eat more, especially processed foods. HFCS can lead to insulin resistance and higher levels of triglycerides, as well as obesity, hypertension and cardiovascular disease.

Bad habits, i.e. forgetting to eat, eating on the run, not eating breakfast all contribute to unstable blood sugar and adrenal exhaustion, which makes you grab foods that aren’t good for you, so you end up feeling irritable, moody, and even more stressed.


You get the picture? It’s important to take care of yourself, especially when you are taking care of someone else. I don’t want to overwhelm you with information or preach to you. Here’s a short checklist to help you stay healthy and balanced.

  • Eat a serving of high-quality protein with every meal and snack
  • Focus on complex carbohydrates (whole grains, veggies and fruits), and eliminate junk foods (refined carbs).
  • Enjoy unlimited amounts of fresh veggies.
  • Eat a good breakfast!
  • Eat 3 balanced meals and 1-2 snacks/day.
  • Magnesium, B complex, fish-oil, walnuts, flax seeds, dark leafy greens, and high quality all help reduce stress and uplift mood.
  • Meditate or find some quiet time for yourself
  • Exercise! At least take a short walk everyday.
  • Put on a funny YouTube video and laugh.
  • Use aromatherapy.
  • Do the best you can.

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Barbra Cohn cared for her husband Morris for 10 years. He passed away from younger-onset Alzheimer’s disease in 2010. Afterward, she was compelled to write “Calmer Waters: The Caregiver’s Journey Through Alzheimer’s & Dementia”–winner of the 2018 Book Excellence Award in self-help– in order to help other caregivers feel healthier and happier, have more energy, sleep better, feel more confident, deal with feelings of guilt and grief, and to ultimately experience inner peace. “Calmer Waters” is available at AmazonBarnes & NobleBoulder Book StoreTattered Cover Book Store,  Indie Bound.org, and many other fine independent bookstores, as well as public libraries.

Calmer Waters: Spring 2019 book signings and events

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Especially for folks in the Denver-metro area: You are warmly invited! Please drop by at a book signing to say hello, or attend the caregiver symposium or conference (or both!) for lots of great information, networking and support. Respite care is available for both events. Click on the links to find out more.

Falling in love while caring for your spouse with Alzheimer’s

This is a controversial and delicate topic. Is it possible to judge someone unless we’ve walked in their shoes? Watch the video and let me know what you think.

In the meanwhile, you might want to check out my article “Sexual intimacy between care partners” at The topic of sex is often uncomfortable in the best of relationships in the best of times. The topic is especially prickly when one of the partners has Alzheimer’s disease.

 

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Barbra Cohn cared for her husband Morris for 10 years. He passed away from younger-onset Alzheimer’s disease in 2010. Afterward, she was compelled to write “Calmer Waters: The Caregiver’s Journey Through Alzheimer’s & Dementia”–winner of the 2018 Book Excellence Award in self-help– in order to help other caregivers feel healthier and happier, have more energy, sleep better, feel more confident, deal with feelings of guilt and grief, and to ultimately experience inner peace. “Calmer Waters” is available at AmazonBarnes & NobleBoulder Book StoreTattered Cover Book Store,  Indie Bound.org, and many other fine independent bookstores, as well as public libraries.

What are you doing for your brain health?

Brain Nutrition

MIND diet includes salmon, beans, greens, nuts, berries

This week is Brain Health Awareness Week, and I’m reposting this piece so you can evaluate your diet and make improvements to support your brain–and heart health. Here’s to your healthy brain and heart!

Have you heard of the MIND diet? It’s the Mediterranean diet and DASH diet slightly remade and combined to form the MIND diet. (MIND is an acronym that stands for the Mediterranean-DASH intervention for Neurodegenerative Delay.)

In a study published in September 2015 in Alzheimer’s & Dementia, the nutritional epidemiologist Martha Clare Morris and her colleagues at Rush University Medical Center borrowed concepts from the Mediterranean diet and the DASH diet. The result is the MIND diet.

The study followed 923 participantsages 58 to 98 years, for an average 4.5 years, and found the MIND diet lowered Alzheimer’s risk by about 35 percent for people who followed it moderately well and up to 53 percent for those who adhered to it rigorously. While more study is needed to better understand the long-term impact of the diet, Morris’s team’s second paper on the MIND diet notes that it’s superior to the DASH and Mediterranean diets for preventing cognitive decline. But it should be noted that high adherence to all three diets may reduce risk of Alzheimer’s disease.

Food to eat on the MIND Diet

  • Green leafy vegetables: a minimum of 6 servings a week (kale, Swiss chard, spinach, collard, etc.)
  • Nuts: a minimum of 5 servings a week (walnuts, pistachios, almonds, cashews, etc)
  • Berries: a minimum of 2 servings a week
  • Beans: a minimum of 3 servings a week (garbanzo, red, black, kidney, white, pinto, etc.)
  • Whole grains: a minimum of 3 servings a day (millet, oats, brown rice, quinoa, wheat berries, etc.)
  • Fish: at least 1 serving a week
  • Poultry (like chicken or turkey): at least twice a week
  • Olive oil as the primary oil used
  • Wine: no more than 1 glass a day

Foods to limit or avoid

  • Red meat: no more than 4 servings a week
  • Butter and margarine: no more than 1 tablespoon (tbsp) daily
  • Cheese: no more than 1 serving a week
  • Sweets: no more than 5 servings a week
  • Fried or fast food: no more than 1 serving a week

To summarize the MIND DIET—

On a daily basis you eat at least three servings of whole grains, a salad and another vegetable, along with drinking a glass of wine. The jury is still out on whether a little alcohol consumption is better for the brain than none at all. I just heard a panel of researchers and neuroscientist address this issue. If you don’t consumer alcohol, there is certainly no reason for you to start now. But if you do, limit your consumption to one glass of wine a day.)

It’s advised that on most days you should snack on nuts, and every other day eat half a cup of beans. At least twice a week eat poultry and a half-cup serving of berries (blueberries are best), and eat fish at least weekly. Olive oil is the preferred cooking oil.

What is the DASH diet?

The healthy DASH diet plan was developed to lower blood pressure without medication in research sponsored by the US National Institutes of Health, Dietary Approaches to Stop Hypertension. The first DASH diet research showed that it could lower blood pressure as well as the first line blood pressure medications, even with a sodium intake of 3300 mg/day!  Since then, numerous studies have shown that the DASH diet reduces the risk of many diseases, including some kinds of cancer, stroke, heart disease, heart failure, kidney stones, and diabetes. It has been proven to be an effective way to lose weight and become healthier at the same time.

The DASH diet eating plan is a diet rich in fruits, vegetables, low-fat or non-fat dairy. It also includes mostly whole grains; lean meats, fish and poultry; nuts and beans. It is high fiber and low to moderate in fat. It is a plan that follows US guidelines for sodium content, along with vitamins and minerals. In addition to lowering blood pressure, the DASH eating plan lowers cholesterol and makes it easy to lose weight. It is a healthy way of eating, designed to be flexible enough to meet the lifestyle and food preferences of most people.

How is it different from the Mediterranean diet? It can be considered to be an Americanized version of the Mediterranean diet, and to be easier to follow, since it has more specific guidelines. But if you love tabouli, hummus, and olives, you might prefer the Mediterranean diet.

Although there are similarities among all three diets, the MIND diet is the only one that encourages the consumption of foods that have been found to promote cognitive health.

There is a saying that “what’s good for your heart is good for your brain.” So please start switching over to the MIND diet while eliminating foods high in calories and low in nutrients. You will feel better and your brain will stay healthier longer.


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Barbra Cohn cared for her husband Morris for 10 years. He passed away from younger-onset Alzheimer’s disease in 2010. Afterward, she was compelled to write “Calmer Waters: The Caregiver’s Journey Through Alzheimer’s & Dementia”–winner of the 2018 Book Excellence Award in self-help– in order to help other caregivers feel healthier and happier, have more energy, sleep better, feel more confident, deal with feelings of guilt and grief, and to ultimately experience inner peace. “Calmer Waters” is available at AmazonBarnes & NobleBoulder Book StoreTattered Cover Book Store,  Indie Bound.org, and many other fine independent bookstores, as well as public libraries.

Urinary incontinence, UTIs, and dementia

Incontinence inscription isolated

There are lots of reasons that people develop incontinence. This blog focuses on people with dementia: their care and ways to prevent urinary tract infections, a serious consequence of incontinence in the elderly.

People with Alzheimer’s disease and dementia often have problems with urinary incontinence. This can be a result of not realizing they need to urinate, forgetting to go to the bathroom, not being able to find the toilet, or limited mobility.

Ways a caregiver can help

  • Avoid giving drinks like caffeinated coffee, tea, and sodas that may increase urination. It is important, however, that healthy liquids including water, smoothies, and fresh fruit juices are not restricted. Hydration is vital to overall health and to prevent urinary tract infections.
  • Keep pathways clear and the bathroom clutter-free, with a light on at all times.
  • Make sure you provide regular bathroom breaks–at least every 2-3 hours.
  • Mark the bathroom door with a large sign that says “Bathroom.”
  • Provide a portable commode or a toilet frame with handrails or grab bars to make getting on and off easier. Make sure it’s the right height.
  • Supply underwear that is easy to get on and off.
  • Use absorbent underclothes for trips away from home and/or adult diapers.
  • When going to a restaurant or public place such as a movie theater, try to sit as close to the bathroom as possible.
  • Limit liquid intake after dinner

Talking to the doctor

  • Ask if it’s possible to cut back on prescribed medications such as water pills that increase urination
  • Does the patient have undiagnosed diabetes? Diabetes increases urination.
  • Is an enlarged prostate the problem? Rule out any medical issues that increase urination or block urination.

Preventing urinary tract infections

Urinary tract infections, commonly called UTIsare more common in people who are elderly, bed-ridden and incontinent. Symptoms can include general weakness, confusion, nausea, dizziness, sudden incontinence or increased severity of incontinence. Often these symptoms seem connected to other conditions that are unrelated to a UTI, and can make it difficult to determine that the cause is an infection.

  • The most important method of prevention is to keep the genital area clean and healthy. Wipe from front to back to avoid transferring bacteria to the urinary tract, especially in women.
  • Remove used diapers from front to back.
  • Dry the skin when changing or after bathing since bacteria grows better in moist areas.
  • Use recommended hygienic products for washing that are not drying to the urogenital area.
  • Keep the patient hydrated since urination can flush out unwanted bacteria from the urinary tract.
  • Try to make sure your loved one gets help to empty their bladder entirely, since urine remaining in the bladder can help bacteria thrive and multiply.
  • Help to prevent constipation by providing plenty of fruit (applesauce, apples, berries, prunes, figs) and other foods high in fiber, such as oatmeal, legumes, peas, chia seeds, carrots, beets, broccoli, Brussels sprouts, popcorn, nuts, and whole grains.

The dangers of UTIs

Urinary tract infections are notorious for causing delirium and delusional behavior in the elderly. When younger people get a urinary tract infection, they typically experience painful urination, an urgent need to urinate, lower abdominal pain, back pain on one side, and fever and chills. However, an older adult might not experience those symptoms. As we get older our immune system changes and it responds differently to infection. Instead of pain symptoms, seniors with a UTI may show increased signs of confusion, agitation or withdrawal. In older adults with dementia, these behavioral changes may come across as part of that condition or signs of advanced aging. If the underlying UTI goes unrecognized and untreated for too long, it can spread to the bloodstream and become life-threatening. In fact, I have a dear friend who died from a UTI that quickly became septic.

If you suspect a UTI

  • Get medical help, especially if your loved one has fever or complains of nausea or back pain. An antibiotic will be prescribed. Make sure the entire prescription is taken even if the symptoms subside. Otherwise, the infection can come back with a vengeance.
  • If it is appropriate, have the patient drink unsweetened cranberry juice on a regular basis, and/or take a cranberry/D-Mannose supplement to help stave off future infections.
  • Give the patient plenty of water to flush out the harmful bacteria
  • Apply a heating pad to the lower abdomen and/or back to help with discomfort
  • A pain reliever such as Advil can help alleviate pain and fever

Urinary tract infections are nothing to mess around with. Please get your loved one medical help if you suspect an infection.


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Barbra Cohn cared for her husband Morris for 10 years. He passed away from younger-onset Alzheimer’s disease in 2010. Afterward, she was compelled to write “Calmer Waters: The Caregiver’s Journey Through Alzheimer’s & Dementia”—Winner of the 2018 Book Excellence Award in Self-Help—in order to help other caregivers feel healthier and happier, have more energy, sleep better, feel more confident, deal with feelings of guilt and grief, and to ultimately experience inner peace. “Calmer Waters” is available at AmazonBarnes & NobleBoulder Book StoreTattered Cover Book Store,  Indie Bound.org, and many other fine independent bookstores, as well as public libraries.