Fatter Body, Slower Brain: Two New Studies

Putting on extra pounds may damage your mental, as well as your physical, fitness but overweight middle-aged people who follow a program of high-intensity interval training can lose weight and improve their cognitive functioning.  These are the implications of two recent small studies, one headed by Timothy Verstynen, PhD of Carnegie Mellon, the other by Dr. Anil Nigam of the University of Montreal and the Montreal Heart Institute.  

In the Carnegie Mellon study, researchers examined the brains of 29 adults using functional magnetic resonance imaging.  The subjects’ body mass index scores ranged from normal to obese.  In the overweight and obese subjects there was evidence of hyper-connectivity in parts relating to memory and decision-making, indicating that the brain needed to work harder in those individuals.  These parts functioned normally in people of average weight.  The obese subjects also needed more effort to perform a decision-making task.  “As people put on unhealthy amounts of weight, the body’s energy systems begin to degrade and you can start to see the negative effect on brain circuitry, particularly areas that are important for controlling impulsive behaviors,” according to Verstynen.  The key factor seems to be inflammation, which interferes with the body’s communication system.

The Canadian research involved six subjects in their late 40’s with body mass index numbers in the “overweight” range.  Dr. Nigam said, “We worked with six adults who all followed a four-month program of twice weekly interval training on stationary bicycles and twice weekly resistance training.  Cognitive function, VO₂max and brain oxygenation during exercise testing revealed that the participants/ cognitive functions had greatly improved thanks to the exercise.”  VO₂max refers to the maximum amount of oxygen that a person’s body can use during intense exercise; it is an indicator of cardio-vascular fitness and aerobic endurance.  Participants in the study lost inches around the waist and reduced body weight but they also significantly improved performance on cognitive tasks, such as remembering pairs of numbers and symbols.

These studies suggest that exercise allows the body to recover mental as well as physical functioning, even in middle age.  Based on the descriptions I’ve read there wasn’t a huge time commitment, just four sessions per week, but the exercise was at a fairly intense level, interval training and weights.  A leisurely walk might not have the same effect on the brain, though it probably helps the body.

Colds

On Saturdays during the winter when I was five or six years old I was taken to the doctor for cold shots.  Sixty years later, a cure for the common cold remains as elusive as ever and I am wondering what was in those shots.  These days I don’t get many colds, which is typical for the over-fifty crowd.  The rhinoviruses that cause colds, though many, are limited in number.  After fifty years of two or more colds per year my body has developed immunity to lots of them. 

For the most part, I have acquired my cold resistance the hard way, one cold at a time, but I’ve also learned some helpful strategies.  When we had colds as children, my brothers and I were sent to school, business as usual, unless we had a fever.  These days, when I first get a sore throat, I immediately try to slow down in order to let my immune system do its work.  I prepare meals and do some regular activities, including a little exercise, but no strenuous workouts.  The most important parts of my strategy are to take zinc lozenges (Cold-Eeze) and to sleep extra hours, probably a long nap in the afternoon in addition to 7-8 hours at night.  If I can do this, very often the threatened cold goes away without any further symptoms.  

When I was younger, colds used to last for a miserable week or ten days of sore throat, sneezing, and coughing, often succeeded by lingering chest congestion.  Sometimes all that would be followed by secondary infections that could drag on for weeks.  These days, once in a great while, I get a cold that really knocks me sideways – but it never lasts more than a couple of days.  This happened to me last week.  On Wednesday I got a sore throat and started taking zinc lozenges and resting.  By Thursday I was sneezing but I felt OK.  Friday I was totally wiped out – my sinuses hurt, my teeth all ached in unison, my throat was raw – and I spent most of the day sleeping.  When I woke up Saturday morning, it had pretty much all gone by, though I felt a little as if I had been in a fight, and today (Sunday)  it is hard to believe that it even happened.

Why do I get shorter, nastier colds? Apparently, it’s because my immune system now is stronger than it was when I was younger.  As Jennifer Ackerman points out, cold symptoms are caused not by the virus but by the action of the immune system in fighting it off.  The more powerful the response, the worse you feel.  The trade-off, I believe, is that the cold gets knocked out of your system much faster so that you spend more days feeling good and have a reduced risk of secondary infections.

Medical science has learned a lot about colds in recent years.  It seems that genetic variations may cause some people to get more colds than others.  Also, the more years your parents owned their own home before you were 18, the less likely you are to get a lot of colds during your lifetime.  The key here is stress, which can reduce the ability of the immune system to regulate inflammation, leaving the body more vulnerable to disease.  Important research in this area has been done by Sheldon Cohen at Carnegie Mellon University.  Coldwise, my destiny may have been forged in early childhood.  My parents never owned their own home – we lived in a place provided by the church where my father was rector – and there was always plenty of stress.  As for the cure for the common cold, we’re still waiting.

How to Make a Thick, Fluffy Protein Smoothie: Breville vs. Vitamix

Chocolate Protein Smoothie

I'm not a big eater and I don't consume a lot of meat.  Without supplements I probably wouldn't get enough protein, so I have a smoothie with whey protein powder every day.  This is no great hardship because today's blenders make it easy to whirl up a concoction with the taste and consistency of a milk shake.  The basic recipe takes protein powder (chocolate or vanilla), milk, and ice.  With vanilla smoothies I add frozen fruit (so less ice) and half a banana; with chocolate I add a couple of small peppermint patties, crushed.

I've had a series of Breville blenders, which are quite good.  They're well made, quiet, and have a special smoothie setting that produces an ideal thick, creamy result.  The downside is dealing with Breville.  Their customer support is uneven, to say the least, and ordering parts can be difficult.  (When I wanted to get a new rubber ring, I was told I'd have to buy a whole new container, $50 please.)  So, when the most recent Breville died, I decided to get a Vitamix.  Vitamix blenders are well known for their outstanding quality, but that comes at a price, about $500 in my case.  On the other hand, the machine I bought has a seven-year warranty; $500/7=$71, the annual cost of owning a Vitamix.  A $200 Breville that lasted 2.5 years would have an annual cost of $80.  Buying fewer machines is easier for me and better for the environment, so I went for it.

So far I'm impressed with the Vitamix.  It came with good instructions and a very nice cookbook demonstrating the full range of its capabilities.  The only distinct negative was that the smoothies weren't as good.  They tend to be watery and to have a grainy, icy texture.  I called Vitamix Customer Support and the representative advised me to turn the machine to the highest speed and leave it there for a couple of minutes.  I tried that and the results were no better.

At that point I started to analyze the problem: what was the Breville doing that the Vitamix wasn't?  The Breville's smoothie cycle automatically alternates between pulsing and blending for a few seconds for a total of one full minute.  Sometimes I had to do a second one-minute cycle but not always.  The advantage of this method is that it gets a lot of air into the mixture but, because the blades aren't continuously running and getting hot, it doesn't melt the ice.

With the Vitamix (and probably other blenders as well) you can simulate this process by pulsing a few times and then processing 10 seconds or more.  When I'm making two drinks I pulse 15 times and process for a count of 25. I repeat these steps until the surface of the mixture looks shiny rather than grainy.  I tend to get better results if I add the ice in two stages. When I'm using frozen fruit, I do everything but the ice first and mix then add the ice and repeat. If the ingredients stop rotating, I stop the machine, pick up the container and shake it from side to side to get rid of air bubbles.  It takes a little longer and you can't just push a button and walk away but it does produce a thick, fluffy, delicious smoothie.

Update: Two new smoothie recipes with anti-cancer ingredients appear here and here. Healthy drinks without the terrible taste.

Should I Be Taking This? 6

The most important information you should know about Cymbalta:

Antidepressants can increase suicidal thoughts and behaviors in children, teens, and young adults. Suicide is a known risk of depression and some other psychiatric disorders. Call your doctor right away if you have new or worsening depression symptoms, unusual changes in behavior, or thoughts of suicide. Be especially observant within the first few months of treatment or after a change in dose. Approved only for adults 18 and over.

Cymbalta^® (duloxetine HCl) is not for everyone. Do not take Cymbalta if you:

• have recently taken a type of antidepressant called a monoamine oxidase inhibitor (MAOI) or Mellaril^® (thioridazine)
• have uncontrolled narrow-angle glaucoma (increased eye pressure)

Before taking Cymbalta, talk with your healthcare provider:

• about all your medical conditions, including kidney or liver problems, glaucoma, diabetes, seizures, or if you have bipolar disorder. Cymbalta may worsen a type of glaucoma or diabetes
• about all your prescription and nonprescription medicines. A potentially life-threatening condition has been reported when Cymbalta was taken with certain drugs for migraine, mood, or psychotic disorders
• if you are taking NSAID pain relievers, aspirin, or blood thinners. Use with Cymbalta may increase bleeding risk
• about your alcohol use
• about your blood pressure. Cymbalta can increase your blood pressure. Your healthcare provider should check your blood pressure prior to and while taking Cymbalta
• if you are pregnant or plan to become pregnant during therapy, or are breast-feeding

While taking Cymbalta, talk to your healthcare provider right away:

• if you have itching, right upper-belly pain, dark urine, yellow skin/eyes, or unexplained flu-like symptoms, which may be signs of liver problems. Severe liver problems, sometimes fatal, have been reported
• if you have high fever, confusion and stiff muscles, which may be symptoms of a potentially life-threatening condition
• if you have skin blisters, serious or peeling rash, hives, mouth sores, or any other allergic reaction. These may be serious, possibly life-threatening, skin reactions
• if you experience dizziness or fainting upon standing. This tends to occur in the first week or when increasing the dose, but may occur at any time during treatment
• before you stop Cymbalta or change your dose
• if you experience headache, weakness, confusion, problems concentrating, memory problems, or feel unsteady, which may be signs of low sodium levels
• if you develop problems with urine flow

Most common side effects of Cymbalta (this is not a complete list):

• nausea, dry mouth, sleepiness, fatigue, constipation, dizziness, decreased appetite, and increased sweating

You are encouraged to report negative side effects of Prescription drugs to the FDA. Visit www.fda.gov/medwatch or call 1-800-FDA-1088.

Other safety information about Cymbalta:

• Cymbalta may cause sleepiness and dizziness. Until you know how Cymbalta affects you, you should not drive a car or operate hazardous machinery.
• People age 65 and older who took Cymbalta reported more falls, some resulting in serious injuries.

How to take Cymbalta:

Take Cymbalta exactly as directed by your healthcare provider. Cymbalta should be taken by mouth. Do not open, break or chew capsule; it must be swallowed whole. Cymbalta can be taken with or without food.
Cymbalta is available by prescription only.
See Prescribing Information, including Boxed Warning about antidepressants and risk of suicide, and Medication Guide.

Cymbalta is indicated for the treatment of major depressive disorder (MDD). The efficacy of Cymbalta was established in four short-term and one maintenance trial in adults.

Cymbalta is indicated for the treatment of generalized anxiety disorder (GAD). The efficacy of Cymbalta was established in three short-term and one maintenance trial in adults.

Cymbalta is indicated for the management of diabetic peripheral neuropathic pain and fibromyalgia.

Cymbalta is indicated for the management of chronic musculoskeletal pain due to chronic osteoarthritis pain and chronic low back pain.

The Only Rule

As a young child growing up in the 1950’s, I used to believe that there were lots of rules. Years later, with decades of life experience behind me, I have decided that there is only one rule that counts: PAY ATTENTION. In the natural world, attention and alertness are qualities that keep animals safe. While a wild creature loses the ability to notice and approaching predator or to find food and shelter, its days are numbered. Here in the developed world we have able-bodied people walking into walls or in front of cars because they are totally engrossed in their cell phones.

The other day I saw a pleasant sight. A young mother was walking down the street with her little boy, holding him by the hand. Then I noticed that her other hand was holding a cell phone to the side of her head as she continued a conversation. Was the little boy aware that he was being ignored? A recent article cites studies showing that children take more risks when they’re not being watched. Over the past five years, the number of unintentional injuries to children under five has sharply increased after years of decline. Some researchers believe that this change may be related to texting while parenting.

Many people believe that they are proficient multitaskers but most of them are wrong. Research has shown that only about 2.5% of the population can juggle several activities at once; “our brains are wired for ‘selective attention’ and can focus on only one thing at a time.”A driver talking on a cell phone may actually not see another car up ahead. In a column entitled “Yes, Sell All My Stocks. No, the 3:15 From JFK. And Get Me Mr. Sister.” Jared Sandberg tells a series of hilarious and unsettling anecdotes illustrating the hazards of multitasking.One marketing firm actually sent direct mail offers to 4000 nuns with the greeting, “Dear Mr. Sister.”>

The effects of divided attention are also apparent in the medical care business. The connection between doctor and patient is central to the healing process but that relationship is now being curtailed to fifteen-minute meetings devoted to reviewing test results and prescribing drugs. The radiologist who told me I might have breast cancer did not turn off his cell phone during our conversation and it rang once while we talked. Maybe that was part of the reason why I asked for a second opinion (rightly, as it turned out). If I’m having a routine physical and the doctor gets an urgent call, I don’t mind waiting for a few minutes, but what could be more important than telling someone that they might have a fatal illness?

The following incident was reported in the 10/6/12 issue of the Bloomington Herald-Times.  Auto technician Tracy Grubb was driving home along a rural road and noticed a man lying on the ground next to his truck near the side of the road.  By stopping and offering help, he probably saved the life of William Fox, who had suffered an allergic reaction from a bee sting.  Grubb later noted that about 30 cars had driven past while he was waiting for the ambulance.  He said, “I don’t feel that I done anything special or anything.  I was just paying attention while I was driving.”

Finnish Study: “Eat Your Tomatoes, Preferably Processed.”

A few years back I read about a study showing that people who drank fruit and vegetable juice three or more times per week were 76 percent less likely to develop Alzheimer’s disease than people who drank juice less than once per week.  Since my mother died of Alzheimer’s, drinking juice seemed like a sensible thing to do.  We bought a juicer and started making fruit and vegetable juice a couple of times a week, as I described in a blog post.  We have fruit juice for breakfast and vegetable juice (mixed with commercial low-salt tomato juice) for lunch or dinner.  Since then, we don’t seem to get sick very much and, when we do, we get over it quickly.  Coincidence? Maybe.

Now it turns out that the tomato juice part may also help to protect us from stroke.  A Finnish study of 1031 men has shown that those with the highest levels of lycopene had a 55% lower risk of stroke than those with the lowest levels.  Tomatoes are the best source of lycopene and processed tomato products, especially tomato sauce and tomato juice, have 7-10 times the amount of lycopene found in a single tomato.

Exercise Is Powerful - but the Body is Slow

Ten years ago I began to get pains in my shoulders and upper arms.  I started lifting heavier weights and the pains went away.  Fifteen years ago I would get out of breath from going upstairs.  That doesn’t happen anymore.  These days, at the age of 66, I do a brisk 33-minute cardio routine that feels challenging but not exhausting.  I also do jumping jacks and plyo, which I started only a couple of years ago.  Recently my feet, which had given trouble for years, have started to improve.  Is it the impact exercise I have been doing? Who knows? 

Exercise can accomplish truly amazing things.  If it were a drug, everyone would want to take it.  It’s safe (apart from the occasional injury), doesn’t interact with foods or medications, and has lots of collateral benefits, like counteracting depression and improving sleep.  The downside to exercise is that it requires actual work.  Being in good condition at my age is a luxury; spending 8-9 hours a week working out is the way I pay for it.  (Side note:  When I first starting trying to get into shape I used to exercise 12 hours a week doing a less intense routine.  By gradually increasing the difficulty of my workouts I’ve been able to cut back the time while still improving my condition.) 

I started this personal fitness project twelve years ago as a way of avoiding statins, which my doctor had recommended because of my high cholesterol.  In those days, when I would work out on the cross trainer, my heart rate would max out at 125 beats per minute and I would never break a sweat.  I think that my muscles simply weren’t strong enough to work any harder.  Later on I started taking a protein supplement and proteolytic enzymes and gradually found that I could do more.  Technology has accustomed us to believe that results should be instant and life should be user-friendly but that’s not the way the body works.  The human body has its priorities (mainly ensuring its own survival and comfort) and it is not going to be rushed.  If you’re older and have a slow metabolism like me, that’s true in spades.  When I start a new exercise program I don't expect to see results for at least a month.  If there are no changes after 6 weeks, I conclude that I'm on the wrong program and try something else.  To work into P90X so that I could finally do all the classes (mostly) took 2-3 years.  It has taken 12 years to get to my present level of fitness. 

One of the unfair aspects of exercise is that some people have to work a lot harder than others in order to see results.  I am naturally muscular and strong so you would think I could do less.  Instead, I have a physique that you really have to hammer on in order to see results.  (I suspect that may be true of muscular people in general.)  Walking, even brisk walking, and swimming do absolutely nothing for me and, with the cross trainer, my heart rate needs to be over 80% of maximum in order for me to maintain my current condition.  In order to see improvement I need to be working near the upper edge of what I can do.  It’s a delicate balance:  too much and it’s tiring and too hard on my body, too little and I put on weight and feel sluggish. 

Developing a fitness routine is a process of self-discovery:  it’s important to try different types of exercise to find out what works for you.  It takes time, persistence, and patience but the potential rewards are huge:  feeling better than you ever have in your life and being totally comfortable in your own body.