Citicoline and Brain Health

My husband is concerned about his brain. He exercises, is lean, and eats right, but increasingly he says he has a hard time remembering the right word or clearly articulating his thoughts. So, when I attended a lecture by Drs. Deborah Yurgelun-Todd and Perry Renshaw from The Brain Institute of the University of Utah on the brain health benefits of the dietary supplement, CognizinÒ citicoline, I was intrigued. (The session was sponsored by Kyowa Hakko, USA (http://kyowa-usa.com/), a global manufacturer of compounds used in dietary supplements and CognizinÒ brand citicoline).

After the conference I did some research by starting with Natural Medicines and then doing a literature search through Pub Med (http://www.ncbi.nlm.nih.gov/pubmed) to learn more about citicoline. I also contacted Dr. Yurgelun-Todd about her research on citicoline, as she has been studying it for over a decade. I found that citicoline was originally used as a treatment for individuals who had a stroke.  It is estimated that 2 million brain cells die every minute after a stroke so early treatment is essential to preserve the brain and maintain normal function. In a recent review of citicoline used in stroke patients, it was found that citicoline was safe to use and had beneficial effects on recovery, especially in older patients (>70 yrs) who had no other treatments. One study found that when citicoline was given to stroke patients within 3 hours, they were more likely to have complete recovery compared to those who got a placebo. Not all studies find such great results, but overall the evidence of a positive improvement in brain function after a stroke is well founded.

Food is not a good source of citicoline; only a small amount is found in organ meats. When citicoline is taken orally (in a pill) it is broken down into a B-vitamin, choline, and cytidine which is further metabolized into a compound called uridine. Both choline and uridine can cross the blood brain barrier and once in the brain, they can be converted back to citicoline, sometimes referred to as CDP-choline. Within the brain citicoline has several actions. First, it helps stimulate the production of cell membranes. Second, citicoline increases the production of the neurotransmitters which have been shown to increase attention, focus and memory.

Research on citicoline for other disorders where cognitive abilities are affected is scant, but promising. Researchers can’t yet say that citicoline will improve memory or cognition in individuals with Alzheimer’s disease, Bipolar disorder, Parkinson’s disease or traumatic brain injury, but stay tuned as more research is conducted in these areas.
I asked Dr. Yurgelun-Todd what she would say about healthy 50+ adults taking citicoline and she said that there is some good evidence to support the use of the supplement on improved focus and sustained attention. Her studies have used doses ranging from 250-4000 mg/day but she says a dose of 250-500 mg/day is effective and well-tolerated.

What about my husband? He has been taking citicoline for a couple of months (250 mg twice a day) and notices an improvement in word finding and clarity in conversations. He said he sometimes had to “think in pictures” when telling a story, but now he thinks he has better mental clarity. Of course, this is anecdotal. As for his memory, well, he still leaves the house without his wallet and phone and can’t find the milk in the refrigerator, but he feels it has helped him and that is a good thing.

 

Tomaotes…in winter?

 
I had the good fortune to be an invited guest at The Culinary Institute of America’s yearly conference, World of Healthy Flavors in January. World of Healthy Flavors is a collaboration between the CIA and Harvard School of Public Health. It brings chefs, food service operators, growers, and suppliers together to marry nutrition science with delicious food. From quick service restaurants to campus dining, innovations in food preparation and flavor is the outcome of this conference, now in it’s 10th year.
 
After the conference, there is a day added to celebrate “Produce First.” This is where the real fun begins. Teams are established that include chefs, nutritionists, and produce representatives to come up with several dishes showcasing one produce ingredient. I was on the “Tomato” team, sponsored by NatureSweet tomatoes. (Disclosure, I have no financial relationship to the company to promote the product.) We had three types of tomatoes from NatureSweet….”Glorys” (cherry tomatoes, )”Cherubs” (grape tomatoes), and “SunBursts” (yellow tomatoes). All of these fully vine-ripened tomatoes are produced in greenhouses under controlled environmental conditions; everything from the seeds to soil to water is controlled. The result is a delicious, juicy tomato that tastes good all year long. When I first discovered NatureSweet tomatoes at my local discount shopping club, I was excited because, (1) they taste great and I love them as a snack with only 27 calories per cup, (2) they are great roasted and used to top fish, chicken, or pasta. To roast, heat the oven to 450 degrees F. and drizzle olive oil on a baking sheet. Add a carton or two of tomatoes, swirl them around the pan to coat in olive oil and sprinkle with salt and pepper. Roast in oven for 15 minutes and then turn them. Continue roasting for another 10 to 15 minutes until they begin to split open. I use them on pasta for a much tastier and nutrient-rich topping than jarred marinara sauce, or over grilled fish or chicken breast for a quick dinner.
 
Tomatoes, raw or cooked, are a tasty, healthy food. Tomatoes are anti-inflammatory foods and are loaded with anti-oxidants of the carotenoid family. One carotenoid that has gotten a lot of media attend for it’s role in prostate health is lycopene. This compound in tomatoes is associated with lower risk of prostate cancer and stroke. Cooking the tomatoes breaks down the cells, releasing the lycopene making it more readily absorbed. Lycopene is also fat-soluble so eating tomatoes with some fat will also help it be better absorbed. Eighty percent of lycopene in the U.S. diet comes from tomatoes, so start roasting tomatoes in a bit of olive oil to get even more health benefits.
 
Back to my “team.” The creative chefs came up with many dishes but the highlight was our “Tomato Cod with Smoked Roasted eggplant, Fried Citrus Rind, and Pickled Roasted Tomatoes.” A dish that begins and ends with tomatoes…what could be better?
 
 
For more recipes, check out www.naturesweet.com
 
 

362 Exhibitors and So Little Time!

Every year I attend the Food and Nutrition Conference & Expo of the Academy of Nutrition and Dietetics and like a kid in a video game store, I love the exhibit hall. This year 362 exhibitors were doling out food and beverage samples in Houston and as I walked through the aisles of vendors I thought about what might appeal to the 50+ audience. So, here are some of my favorites that can help improve your health and taste great at the same time. (I have no financial interest nor have I done any consulting with these companies or products.)

The Mushroom Council, representing fresh mushroom producers or importers, was preparing samples of turkey-mushroom burgers. The smell drew me in but the taste made me a true believer. Paring mushrooms and meat to make healthier burgers, meatballs, tacos…or any recipe that calls for ground beef or turkey… can reduce the fat, sodium and calories of a dish while increasing vitamins, minerals and fiber. And, let’s not forget the cost. One study showed a 27% reduction in cost when using mushrooms for part of the ground meat. Recently, research sponsored by the Mushroom Council was highlighted on NPR at http://www.npr.org/blogs/thesalt/2013/11/05/243218136/make-room-for-mushrooms-fungi-compete-with-meat-in-burgers. So, next time you are using ground meat in a favorite dish, finely chop mushrooms and mix into the meat and be prepared to be surprised at the flavor punch.

The Almond Board of California was handing out a dietitian’s favorite snack…a tin filled with natural whole almonds. The tin holds the “perfect portion” of 1-ounce or 23 almonds. Almonds make a great a snack for those of us 50+ as a serving has 6 grams of protein, 3.5 grams of fiber, and 35% of the daily value for vitamin E. A 2013 study from Purdue University with 137 participants who were given 1.5 ounces of almonds (about 35 whole almonds) every day for a snack showed that hunger levels were decreased, vitamin E and “good” fats were increased without weight gain. So, when the mid-morning or afternoon hunger hits, grab a handful of nutrient-rich almonds.

The Cherry Marketing Institute was serving refreshing tart cherry juice. While I don’t like the term “super food,” cherries are making a pitch for that title. Some studies using tart cherry juice (about 10-ounces a day) have shown anti-inflammatory effects in those with arthritis and gout. Athletes are getting in the cherry juice cheering section, too, as a recovery drink. Some college and professional athletes are drinking cherry juice after a hard workout or during injury rehab to reduce inflammation and promote healing. Cherry juice is a nutritious beverage that might be worth a try for active older adults who experience muscle soreness after a tough workout.

The Canola Info/Canola of Canada booth caught my eye because in Georgia I’ve noticed the beautiful fields of canola plants in the early spring. Fields of yellow flowering canola plants are quite a sight to see. Canola oil has the least saturated fat of all the oils (even olive oil) and it also contains alpha-linolenic acid, an omega-3-fat, associated with fatty fish or flaxseed. It is about 60% oleic acid (the kind of fat in olive oil) and 21% polyunsaturated fat. All of those numbers give canola oil a heart healthy profile for those who want the lowest saturated fat oil and don’t always like the taste of olive oil.

Last, I was happy to see Flatout at the expo. I’ve been using these flatbreads as a bread substitute for about a year because they are higher in protein and fiber with half the calories of sliced bread. This Chicago-based company was sampling a new product, a rosemary and olive oil “fold it” flatbread. Great taste for 100 calories and I bought a package when I got home (found in the deli/bakery section of most grocery stores) and it will be a staple in my house. The flatbreads are also great for quick pizzas on a busy night…top with mushrooms, of course!

Can’t wait for next year’s expo to see what else I can taste…and enjoy!

What is junk food?

Last week a study in Pediatrics (Athlete Endorsements in Food Marketing, October 7, 2013) made headlines. Almost without fail the headlines used the word “junk” food to describe athletes’ endorsements and one headline went so far to say, “Yes, Peyton Manning is making you fat.”

When I read the study, it got me thinking about what is a “junk” food and who defines the parameters of what is and is not considered a “junk” food. As a registered dietitian nutritionist, I am not so sure what a “junk” food is….is it a side of pork belly or a soft drink or cheese puffs?  Usually, a junk food describes one that is calorie-rich without providing nutrients. Does a sports drink fit that definition? Some would say yes, and athletes have been endorsing sports drinks for decades. While a sports drink might be a junk food to a sedentary person who never breaks a sweat, to an athlete a sports drink is a proven hydration beverage. The joint position paper of the American Dietetic Association, Dietitians of Canada, and the American College of Sports Medicine states that “beverages containing 6-8% carbohydrate are recommended for exercise events lasting longer than 1 hour.” The Evidence Analysis Library of the Academy of Nutrition and Dietetics goes on to say that ” current research supports the benefit of carbohydrate consumption in amounts typically found in sport drinks (6-8%) to endurance performance in events lasting 1 hour or more.”  Anyone who watches Peyton Manning or Serena Williams or LeBron James (all called out in the media reports for endorsing “junk” foods) knows they perform at a high intensity and duration and can benefit from the carbs and electrolytes in sports drinks. So, to a competitive athlete a sports drink is not a “junk” food so why shouldn’t football, basketball or tennis players endorse sports drinks?

Quick service restaurants were also on the hook for “junk” food and athletes’ endorsements. McDonald’s is often picked on as a provider of  “junk” food but did you know that 80% of McDonald’s menu items are under 400 calories? And, that in 2012 the default in the new happy meal is a side of fruit, a kid’s size fry, and a fat-free milk? McDonald’s has served 530 million packs of apple slices to kids in a one year period from 2012-2013. Of course, there are high calorie and high fat and high sodium items in any restaurant, but we often forget that there are healthy choices in every restaurant if one chooses to look for them.

And, of course we mustn’t forget the fry…a real junk food that is making us all fat, right? On average, Americans get about 1.5% of their calories from French fries. Potatoes are an excellent source of potassium, a nutrient identified by the 2010 Dietary Guidelines Advisory Committee as a shortfall nutrient. Only 2-3% of Americans had adequate intakes of this important mineral. And, frying of potatoes does not destroy the potassium as some people believe.

A further look at the Pediatrics article showed that famous athletes endorse more sports goods and apparel than foods and beverages. Yet, I didn’t hear anyone complain about sneakers made in less than desirable conditions in developing countries and sold for a tidy profit by U.S. companies.

I would like to see the media stop demonizing foods and instead help people enjoy their favorite foods in moderation (another word some people don’t like), but I like it just fine.

Should you avoid white vegetables?

Last Saturday I was at a rural Georgia Farm Festival and I bought a bag of potatoes from a local farmer (photo of my purchase to the left). As I carried the 5-pound bag to my car, a stranger approached me wagging her finger at me. She said, “You shouldn’t eat those. I stopped eating potatoes years ago because white vegetables are horrible and you might as well pour sugar down your throat.”  I was stunned by her comment on many levels. First, when did it become acceptable for a stranger to give out nutrition advice? Second, she was just plain wrong.

A recent paper (executive summary available for free at http://advances.nutrition.org/content/4/3/318S.full.pdf) published a roundtable discussion convened on the campus of Purdue with leading nutrition experts. The topic of the roundtable and the summary was, “White vegetables: A forgotten sources of nutrients.”  As nutritionists, we often tell our clients to choose a colorful diet but maybe we should have emphasized that white vegetables are healthy, too, and certainly are not devoid of nutrients. One of the experts cited in the paper reminded us that white vegetables contain important nutrients like vitamins C and D, potassium, calcium, and dietary fiber, and color is not an accurate indicator of these nutrients. In addition to potatoes, other white vegetables include onions, cauliflower, mushrooms, and turnips and if we only used color as a guide to choosing our veggies we would miss some key nutrients.

Only 2-3% of Americans get the recommended intake of potassium and potatoes are one of our best sources of this important mineral. Higher potassium intakes are associated with lower blood pressure and the DASH diet, a meal plan designed to lower blood pressure, contains many potassium-rich foods, including potatoes. Potatoes are naturally low in sodium and high in potassium; a healthy combination.

Potatoes are also a good source of dietary fiber and not just in the skin. The flesh of the potato has soluble fiber, the kind of fiber that helps to lower blood cholesterol levels.

As for the comment that potatoes=sugar, well, that is a reference to the glycemic index; a measure of how a fixed amount of a carbohydrate in a food affects blood sugar. Potatoes have a higher glycemic index than other vegetables but that doesn’t mean they are the same as eating sugar. Most of use eat potatoes as part of a meal and the other foods in the meal can alter or lower the glycemic response of a single food.

I am going to prepare my potatoes by roasting them with a drizzle of olive oil and dried rosemary for a delicious side dish. Oh, and by the way, I saw the woman who admonished me later on at the festival eating hot dogs and, you guessed it, a bag of potato chips!

Spice it up

Lately, I’ve been in a food rut; going back to the same recipes time and time again. Then I read an article in the summer issue of the American Institute for Cancer Research (available at aicr.org under publications tab Science Now) called The Spices of Cancer Protection. Herbs and spices have long been known to have plant compounds called phytochemicals similar to those found in fruits and vegetables. Scientists have been trying to unlock the cancer protective effects of phytochemicals and they are discovering that certain spices have potent anti-cancer effects; well, at least in the lab. It is too early to swallow tablespoons of  the stuff out of your spice rack, but it is never too early to learn how to use these spices in cooking for many reasons. Using spices can help you replace sodium, impart flavor without fat, and wake up your palate to new flavors.

The spices being studied for cancer protection include allspice, cinnamon, cumin, turmeric, and black pepper. Garlic, although not a spice, is also included as we tend to use garlic as a seasoning (unless you trying to ward off vampires and then it becomes costume jewelry.)  The ways in which spices fight cancer are many and range from repairing DNA, reducing inflammation, regulating hormones, and altering cancer cell metabolism. Not all spices have the same effects so for now it is a good idea to include a wide variety of spices in your diet.

But, getting back to my food rut…how to overcome it? That is where a cool online tool from McCormick comes in (I have no relationship with the company and learned about it at a presentation at The Culinary Institute of America). McCormick has launched “Flavor Print” (accessed from McCormick website at mccormick.com/flavor print) an online tool based on sensory science that “reads your palate” to discover your personal flavor print. I started by rating foods that I liked; a thumbs up or thumbs down task. I rated everything from my like or dislike of hoppy beer (dislike), arugula (like), and pfeffernuse cookies (dislike). After rating a bunch of foods, my flavor print appeared. Turns out, I’m cheesey, garlic and onionish, and coffee and chocolatey. Next, I rated by cooking preferences (I’ve never deep-fried but I love to grill) and went to the recipe section to find matches to my flavor print. Based on my palate, I found several mouth- watering recipes like Slow Cooker Italian Beef (89% match), Almond and Date Bulgar Salad with Sofrito (88% match), and Grilled Chicken and Blueberry Pasta Salad (88% match). Fair warning, this online exercise will make your hungry!

I think this tool could break me out of my food rut and help me include more cancer-fighting spices in my diet. My 80-something year old mother-in-law will be spending some time with me and as many seniors do, she complains she has little appetite. I think the first thing we’ll do is her Flavor Print and then head to the grocery store!

Peanuts and Baseball

“Take me out to the ballgame….buy me some peanuts….”

Baseball and peanuts are a natural combination and with baseball season right around the corner it got me thinking about peanuts (that, and the fact that I live in Georgia!) But, peanuts don’t seem to get the love like the tree nuts almonds, walnuts, pecans and pistachios. I love all of the tree nuts, but the humble legume, the peanut, should also be celebrated for its nutritional content and health benefits. So, here are all the reasons you should eat peanuts:

  • Peanuts are a protein powerhouse with 7 grams of protein per 1-ounce serving (that is about 40 pieces from a jar of peanuts) and that is the same amount of protein found in one egg. Peanuts are rich in the amino acid arginine which is a precursor to a potent compound that relaxes blood vessels to help keep the blood flowing and lower blood pressure.
  • Peanuts are not high in sodium contrary to what you might think. Roasted unsalted peanuts have only 5 milligrams of sodium per ounce and roasted salted nuts have 230 mg so a serving of salted nuts can easily fit into a diet with a heart healthy 2300 mg of sodium per day.
  • Research has shown that frequent nut eaters have lower lipid levels than those who don’t eat nuts. Eating peanuts lowers your risk of heart disease. Peanuts also reduce inflammation; a condition that can set the stage for heart disease and other chronic diseases.
  • Peanuts are high in the mineral magnesium; a nutrient in short supply for many Americans.
  • Peanuts are also high in two plant nutrients (phytonutrients) beta-sitosterol and resveratrol and both are tied to reducing cancer risk.
  • Lastly, peanuts have a low glycemic index (GI) helping to keep your blood sugar level in a healthy range.

Peanuts, like all nuts, are high in calories and fat. The fats in peanuts are “good” kinds of fat (monounsaturated and polyunsaturated) but all fats have 9 calories/gram so keep your portion sizes in check. Share your bag of peanuts at the baseball with your family and friends!

Enjoy baseball and enjoy peanuts this season.

National Almond Day

Happy National Almond Day! Active people are always asking me about healthy snacking options and with February 16 as National Almond Day it is the perfect time to talk about the benefits of one of my favorite foods. I am proud to be teaming up with the Almond Board of California to host a giveaway celebrating the healthfulness of almonds to one of my readers.

Just post a comment on the ways you enjoy almonds and a winner will be selected to receive an almond cookbook and almonds in several forms for snacking or making heart healthy almond appetizers, entrees, salads and desserts.

I’ve had the good fortune to visit almond orchards during the harvest and you can see from my photo that not only do almonds look heart healthy, they are! The American Heart Association recommends eating nuts, legumes and seeds at least four times a week as part of a heart healthy diet. Almonds pack a nutrition punch with nutrients that are good for your heart. One serving (1 ounce or about 23 whole almonds) contains 35% of the antioxidant vitamin E and that is more than any other tree nut. Almonds are also a rich source of fiber and monounsaturated fats; all recommended for reducing your risk of heart disease.

For active people, almonds have other great benefits. One serving contains 6 grams of protein and 75 milligrams of calcium to support muscle and bone health. Many of you are exercising to lose or maintain your weight but don’t fear the calories in almonds. Research from the USDA shows that almonds contain about 20% fewer calories than what is stated on the label. So, your 100-calorie snack pack of almonds only provides 80 calories. When we eat nuts, especially hard nuts like almonds, the cell walls are not completely broken down and the fat contained inside the cells does not get absorbed so you get fewer calories but will all the great taste and nutrition.

If you are looking for satisfying snack that is:

  • a good source of protein
  • rich in vitamin E
  • high in fiver
  • calcium-rich
  • gluten-free
  • tasty
  • crunchy
  • and, delicious, almonds check all the boxes.

For more information and great recipes visit the Almond Board of California at www.almondboard.com. Tell me your favorite way to snack on almonds before February 16 to be eligible for a cool giveaway. (Disclaimer: I was not paid to write this post but the Almond Board sent me the almond bundle to enjoy and that you can also enjoy!)

Good Food News of 2012

 
 
Nutrition headlines seem to shout the “worst” food news…from “everything causes cancer” to “no health benefits found” by consuming your favorite food. So, let’s take a moment as 2012 comes to a close to celebrate those nutrition stories that you may have overlooked in all of the noise. The following nutrition stories were good news stories and should be embraced in 2013.


1. A healthy diet (one high in the usual suspects…fruits, vegetables, whole grains, nuts and fish) is additive to the protective effects of medications used to treat heart disease. In a study of over 31,000 patients from 40 countries, researchers found that those who ate a healthy diet along with taking prescription meds reduced their risk of cardiovascular disease by 35%, stroke by 19%, heart attack by 14%, and congestive heart failure by 28%. This study looked at secondary prevention….that is preventing another disease after one disease has been diagnosed and treated. Paying attention to diet…and not just relying on medication to treat our most common diseases has a better outcome than just popping pills.

2. Speaking of nuts…did you see the study from researchers at the United States Department of Agriculture who found hat calories on the label are too high for our of the most heart healthy foods….almonds (check out my photo above to see that almonds even look heart healthy!) Researchers found that almonds contain 20% fewer calories as stated on the label; so that means your 100-calorie snack pack of almonds provides only 80 calories to your body. When we eat nuts, especially hard nuts like almonds, the cell walls are not completely broken down and the fat content inside of the cells does not get absorbed. Voila…fewer calories but all of the great taste and nutrition.

3. For the 2.9 million breast cancer survivors in the U.S. there is good news on eating soy. For years, those of use who have had breast cancer have been frightened to eat soy because of reports that the isoflavones in soy exert an estrogenic effect on breast tissue. Recently, the American Institute for Cancer Research reported that “six recent human studies and one major meta-analysis have found that consuming moderate amounts of soy foods does not increase a breast cancer survivor’s risk of recurrence or death.” A moderate serving of soy is defined as one or two servings of soy a day; a serving is 1 cup of soy milk, 1/2 cup of edamame, 3-ounces of tofu, or a soy-based veggie burger.

4. Lastly, one of my good food news stories comes from McDonald’s…yes, McDonald’s. In September they announced that they will voluntarily post calorie counts on menu boards and I applaud any quick service restaurant that provides nutrition information to the public. And, if you haven’t tried some of their healthier options like the strawberry banana real fruit smoothie, Southwest salad with grilled chicken, or the new Egg White Delight McMuffin, try one in 2013 and be prepared to be surprised.