Coffee Consumption, Brain Volume & Dementia – Moderation is the Key

Researchers at the Australian Center for Precision Health at the University of South Australia reported on a study looking at coffee consumption and its effects on the brain. The study investigator, Elina Hypponen, PhD found that drinking coffee in moderation had no ill effect on the brain but drinking six or more cups a day produced adverse effects.

The researchers looked at the United Kingdom Biobank which had information on 500,000 participants ranging in age from 37-73 representing 22 study sites in a four-year period between March 2006 and October 2010. From the 500,000 Biobank patients they looked, at 398,646 coffee drinkers. These participants had undergone health questioning, physical exams and lab evaluation of blood, urine and saliva. MRIs of the brain, heart and body were done on 100,000.

Participants reported coffee intake in cups per day. They compared drinkers of 1-2 cups per day with others who consumed 3-4 cups per day, 5-6 cups per day and more than 6 cups per day. Brain imaging was done at entry into the data bank and 4-6 years later.

There turned out to be an inverse linear relationship between daily coffee consumption and non-white matter brain volume. They concluded that drinking six or more cups of coffee per day is associated with smaller brain volume and a 53% increased risk for dementia compared to light coffee consumption of 1-2 cups per day.

The study was published online on MDedge Internal Medicine and Nutritional Neuroscience. After reading this work, it once again becomes clear that consuming coffee in moderation seems to produce no ill effect on the brain.

Sleep, Foods and Melatonin

Marie-Pierre St-Onge is an associate professor of nutritional medicine at Columbia University Irving Medical Center. She is the director of their Sleep Center of Excellence at Columbia and has spent years studying the relationships between the foods we eat and our sleep satisfaction. She believes eating a diet rich in plants, fibers and unsaturated fat such as nuts, olive oil, fish and avocados promotes sound sleep while a diet high in sugar, saturated fat and processed carbohydrates can be disruptive. She also believes pairing foods rich in tryptophan with complex carbohydrates helps the tryptophan cross the blood brain barrier and stimulate the pineal gland to make and secrete melatonin. She cites the Mediterranean Diet as a perfect balance of tryptophan producing foods and complex carbohydrates to stimulate more satisfying sleep.

When one eats a diet rich in saturated fats, simple carbohydrates such as white bread, pasta, bagels and pastries they tend to fall asleep faster but wake up often and don’t always move into those sleep patterns that produce a rested state. She believes this is due to wide fluctuations in blood glucose levels and insulin responses not seen with a diet rich in plants, high fiber, unsaturated fats and complex carbohydrates.

The converse is additionally true so if you are sleep deprived you tend to crave unhealthy diets rich in sugars, unsaturated fats and highly processed foods. In men short sleep promotes an increased appetite and greater activation in the brain reward centers for foods such as pepperoni pizza, doughnuts and candy. When these subjects were fed a healthy diet with carrots, yogurt, oatmeal and fruit and had five nights of excellent sleep their brain reward center reverted to normal response when exposed to junk foods. Sleep deprived women do not develop a need for more food they just produce a lesser amount of a chemical which tells them they are full.

Apparently, tryptophan rich foods eaten without complex carbohydrates do not cross the blood brain barrier to help produce melatonin. What exactly is melatonin and what is its role in this process. Melatonin is a hormone that regulates sleep timing. The pineal gland starts secreting it after dark and it tells your body it’s time for sleep by lowering alertness and reducing your core body temperature. It works together with your body’s natural rhythms to tell you it’s time to go to sleep.

You can purchase melatonin over the counter. Be sure the product you buy is certified by USP labs or a similar service to make sure that what you see on the label is what you are taking when you ingest it. If you are taking it to overcome a circadian rhythm issue such as jetlag Dr. Bhanu Kolla, an associate professor of psychiatry and psychology and consultant at the Center for Sleep Medicine at the Mayo Clinic, suggests using a low dose such as 0.5 mg two to three hours prior to sleep. For people with insomnia, she suggests 5 mg thirty minutes before sleep and suggests additional sleep ritual actions such as:

1. Turn off computers, tablets and electronic devices two hours before bedtime

2. Do not watch the news within two hours of bedtime

3. Avoid alcohol and caffeine at night

4. Cool the room down to 67 degrees Fahrenheit

5. Get as much sunlight as you can during the day to regulate your internal clock

6. Maintain a regular sleep schedule trying to go to bed the same time and perform the same rituals before getting into bed and once you are under the covers.

7 Most sleep experts will tell you that the bedroom is for sleeping and intimacy and nothing else. If despite a healthy diet, a great sleep ritual and use of melatonin you cannot get a restful night’s sleep then it is time to see a physician who specializes in sleep disorders. Experts suggest you give the melatonin, improved diet and sleep rituals two or three weeks to work before seeking additional help.

A Positive Research Article on Drinking Wine

We have all read the peer reviewed research papers about the increased consumption of wine and spirits during the pandemic. On mornings for recycling collection in my community, as I walk or job, I notice an increased number of empty wine bottles, beer cans and alcohol bottles being sent for recycling.

Articles about increased liver disease prevail. All negative articles about alcohol consumption and health until the July 27, 2021 publication in the Journal of Clinical Cardiology: Clinical Electrophysiology looking at the relationship between alcohol consumption versus beer or cider. Their study examined 400,000 adults and raised the idea” that for current consumers, drinking red or white wine could potentially be a safer alternative to other types of alcoholic beverages with respect to the development of atrial fibrillation. The study looked at adults in the United Kingdom Bio-Bank aged 40-69.

Those who consumed 1-7 glasses of wine per week had the lowest risk of developing atrial fibrillation -even lower than non-drinkers. For white wine the same risk applied until you reached extremely high levels of white wine intake. For beer and cider there was a direct relationship between the amount of product consumed and the increase in risk of atrial fibrillation.

This was an observational study and does not allow for concluding cause and effect. There are also differences in what the United Kingdom defines as a glass of wine and what other countries do. For example, in Austria one drink can contain up to 20 grams of alcohol. In the United States it contains 14 grams of alcohol while in the UK only 8 grams of alcohol.

The overall conclusion I derive from this study is that a small amount of wine, especially red wine, is probably not going to contribute to you developing atrial fibrillation. On the other hand, the definition of a drink in this article is probably far smaller than we pour at home from the bottles we open.

COVID-19: Bringing Back Precautions & Restrictions

We recently spoke with our Friday night Shabbat Dinner friends of 40 years and cancelled our dinner plans because of the aggressive resurgence of the COVID-19 Delta Pandemic. I remember our last dinner eating outside in early February 2020 on a beautiful evening wondering if we should all be together one last time before suspending our weekly meals together. We were joined by a physician friend and his wife visiting from Cleveland and they were poking fun at my concerns and over reaction to the “Wuhan Flu.” The proverbial “shit hit the fan” the next week and we went into lockdown.

One year later we were all excited lining up for the Pfizer and Moderna vaccine. We really thought that would be the solution. We really thought our leaders at the federal and state levels would stand up and promote vaccinations. We really expected community leaders, respected by people of color, including church leaders, community activists, respected community members would be out there championing the vaccine, helping at vaccination sites and getting the shot into the arms of the most vulnerable.

Several months ago, when things began to calm down, we started having dinner together again in our homes. The rate of positivity in the spring of 2021 was low and our friends masked and kept distance when indoors shopping for supplies. We felt comfortable enjoying our friends’ company once again outdoors at a few restaurants and in our homes. Then came the Delta surge and with it the relaxation of restrictions.

It reminds me of pictures of the start of the Oklahoma Land Rush. A gun was fired, and everyone rode off to stake their claim. In 2021 they made their plane flight reservations, bought their concert tickets, made their hotel reservations and resumed everything they did prior to the pandemic. They stopped tracking cases, and, in many states, they stopped looking for new genetic mutations and variants of the virus. They forgot to get the vaccine to poorer nations but left the air and ship travel paths open to anyone and everyone. They underestimated the ability of the virus to find a way to survive by changing once inside the bodies of the vaccinated and unvaccinated.

Yes, it’s true that if you are vaccinated and get infected with the virus you most likely will not require inpatient hospitalization and die but according to those who went through this you will feel miserable for quite awhile. Yes, it’s true that you probably can transmit it to others even though the data on that is still new and quite controversial including passing it to unvaccinated children and the immunosuppressed.

To make matters worse, our Governor thinks he’s Bob Barker screaming; “Come on Down” as he invites foreign and out of state residents to come visit our beautiful state, spend money, pick up the virus and bring it home to your locale. I bet Florida is the leading exporter of sickness, death and chronic illness in the world over the last 12 months and no one in our state capitol seems to care.

We are returning to a bunker mentality in our household. No more dinners out. No more social engagements with friends whose activities and travels we are unsure of. If our grandson is sent to his preschool my wife will stop being his nanny because she does not want to risk catching the virus.

As college and NFL football season approach, it is unlikely I will sit in a stadium with thousands of unmasked individuals to see my teams play. The same goes for the theater and for travel. It’s really disheartening and depressing but we will do what is necessary to stay healthy and we hope you will too.