health

Memory Training Can Create New Pathways in the Brain

Ask the Doctors by by Eve Glazier, M.D. and Elizabeth Ko, M.D
by Eve Glazier, M.D. and Elizabeth Ko, M.D
Ask the Doctors | April 29th, 2017

Dear Doctor: My memory is terrible. To be honest, it always has been. I seem to spend half my time searching for my keys or wondering whether I forgot to turn off the stove and lights. Could memory training help?

Dear Reader: Ready for a short answer that you're not likely to forget?

Yes.

As long as problems with recall do not arise from either medical or physiological issues, it is indeed possible to improve one's memory. And it's not just a matter of mastering complex systems or relying on clever tricks. An intriguing study published in the scientific journal Neuron shows that a certain type of memory training has a measurable and lasting effect on networks that connect different regions of our brains.

Researchers compared the brain activity of 23 top memory athletes with 23 people with no memory training at all. After just six weeks of training, scans of the brains of the amateurs began to resemble those of the memory athletes.

The training focused on a strategy known as "method of loci," also sometimes called the memory palace. The idea is that you mentally "place" things you want to remember -- a person's name, where you put the phone bill, what your spouse asked you to pick up at the store -- into a landscape you know really well. Then when you picture yourself moving through that landscape, you'll encounter the items you wanted to remember.

What was striking about the study wasn't just that the amateurs significantly improved their memories. In the months after learning and adopting the method of loci technique, the new pathways created in their brains were still there.

That's all pretty high-octane stuff. But science shows that maintaining a good memory is a whole-body endeavor, and that simple lifestyle changes can make a difference.

Here at UCLA, we have a memory program for adults with known risk factors for cognitive decline. These risk factors include being sedentary, being overweight, having diabetes or having a family history of Alzheimer's or dementia. Studies show that stress and depression can also have a hand in memory issues.

Participants in the UCLA program improve their diets and are asked to exercise regularly and work on stress reduction. They also do brain training, some of it quite similar to the regimens reported in the Neuron study. They make a point of memorizing the kind of information that we now relegate to our electronic devices, such as a shopping list, frequently called phone numbers, birthdays of family and friends, addresses, and one or two credit card numbers.

At the end of 12 weeks, participants reported improvements not only to their memories, but also to their moods and general sense of well-being. They enjoyed the challenges of shopping without a list and skipping the autodial feature on their phones to make calls themselves.

Perhaps a similar memory program is available in your area. And even if not, an improved diet, more exercise and basic memory practice are changes that you can incorporate into your own life.

(Send your questions to askthedoctors@mednet.ucla.edu, or write: Ask the Doctors, c/o Media Relations, UCLA Health, 924 Westwood Blvd., Suite 350, Los Angeles, CA, 90095. Owing to the volume of mail, personal replies cannot be provided.)

health

Apple Cider Vinegar's Benefits Still Not Fully Known

Ask the Doctors by by Eve Glazier, M.D. and Elizabeth Ko, M.D
by Eve Glazier, M.D. and Elizabeth Ko, M.D
Ask the Doctors | April 28th, 2017

Dear Doctor: What are the benefits of apple cider vinegar? I hear about it on social media, but I don't understand how vinegar can lead to weight loss or help me control my blood sugar.

Dear Reader: My mom is a big proponent of apple cider vinegar. She likes to put it on her salads and vegetables, or just drink a spoonful of it. I am somewhat dubious about her claims of its health benefits, but I am also skeptical of my own resistance to accepting her belief.

Vinegar is created by the fermentation of many natural substances, including grapes, sugar cane, rice and, in this case, apples. The fermentation process produces acetic acid of various concentrations. With apple cider vinegar, the acidity is fairly high -- at a pH of about 3 on a scale of 0 to 14 (a pH of 1 to 7 is acidic).

Apple cider vinegar also contains many polyphenols, or plant-based compounds. These antioxidant compounds have been shown to decrease blood pressure in laboratory animals, improve the ability to metabolize sugar and have beneficial effects on cholesterol.

Now let's analyze the potential medical benefits of apple cider vinegar. In one interesting study, researchers removed the ovaries of mice to increase their oxidative stress and to mimic menopause; then they fed the mice a high-cholesterol diet. One group of mice was given apple cider vinegar, while another group was not. The mice given apple cider vinegar had improvements in their cholesterol; a decrease in the oxidation of LDL, the so-called "bad" cholesterol; and an increase in the antioxidant glutathione. However, there were only 10 mice in each of the groups, so the numbers don't carry much power.

In a French study of rats fed a high-fat diet and apple cider vinegar, researchers found a decrease in blood sugar and benefits in all cholesterol numbers -- triglycerides, LDL cholesterol and HDL cholesterol. Researchers also found in the apple cider vinegar group a decrease in food intake and a decrease in body weight. The authors proposed that apple cider vinegar had an effect of reducing appetite. Again, the number of rats in the study was small, with only six in the apple cider vinegar group.

Obviously, rodents are not humans, but that said, many studies of humans have shown that vinegar reduces the glycemic response and the glycemic index of sugars and carbohydrates. Vinegar itself may help lower blood sugar, but the mechanism of action is not understood.

Along those lines, a 2004 study looked at 11 patients who had insulin resistance and 10 patients who had Type 2 diabetes. Compared with a placebo, apple cider vinegar improved patients' insulin sensitivity, meaning that it improved insulin's ability to bring sugar out of the bloodstream and into the cells of the body. Also, apple cider vinegar decreased the rise of both sugar and insulin when the subjects were given a bagel and orange juice -- normally insulin- and glucose-spiking foods.

Lastly, in a Swedish study of 12 healthy males given bread both with and without white vinegar, those who consumed the vinegar showed a lowering of blood sugar and insulin. Those who consumed the vinegar also felt full more quickly.

So the benefit of apple cider vinegar may be in vinegar itself, not anything specific to the vinegar from the fermentation of apples. But because the studies above didn't all concern humans and weren't conducted long-term, it's difficult to make a conclusion about the benefits of apple cider vinegar or any other vinegar.

(Send your questions to askthedoctors@mednet.ucla.edu, or write: Ask the Doctors, c/o Media Relations, UCLA Health, 924 Westwood Blvd., Suite 350, Los Angeles, CA, 90095. Owing to the volume of mail, personal replies cannot be provided.)

health

When Indulging in Chocolate, Be Sure to Enjoy in Moderation

Ask the Doctors by by Eve Glazier, M.D. and Elizabeth Ko, M.D
by Eve Glazier, M.D. and Elizabeth Ko, M.D
Ask the Doctors | April 27th, 2017

Dear Doctor: I have read about the health benefits of dark chocolate for the brain and the heart, but that it must contain about 80 percent chocolate to be effective. How much sugar or additives (nuts, fruit) can be added before chocolate loses its health benefits?

Dear Reader: Ah, chocolate, a food that so often inspires a passionate response. The fact that it also offers a host of proven health benefits seems almost too good to be true.

A number of studies over the years have linked cocoa, the basic building block of chocolate, to cardiovascular benefits, cancer prevention, a lower risk of stroke, better blood flow to the brain, lower blood pressure and improved insulin metabolism. Cocoa also contains important minerals, including zinc, iron, magnesium and potassium.

With your question about the percentage of cocoa in a chocolate product, you've zeroed in on the vital detail. At what point does chocolate go from being just another kind of candy to becoming a beneficial food?

Let's start with a bit of background.

Chocolate is derived from cocoa beans, which are the seeds of the cacao tree, a small, shade-loving evergreen in the tropical regions of the Americas. These beans are high in a substance known as flavonols -- sometimes also referred to as flavonoids. Flavonols, which fall into the category of antioxidants, have anti-inflammatory properties.

The catch is that cocoa -- or pure chocolate -- is quite bitter. That means sweetening agents and milk solids are added to make it more palatable. Depending on the percentage of cocoa in any particular preparation, the result is a product that contains varying degrees of sugar and calories. And while cocoa has proven health benefits, sugar definitely does not.

When it comes to the health benefits of chocolate, the higher the percentage of cocoa content, the better. Sixty percent cocoa is widely considered the minimum when looking to a chocolate product for health benefits. But don't rely solely on the words "dark chocolate" when looking at the label.

In the U.S., a product with as little as 35 percent cocoa may be designated as dark chocolate. European chocolates set the bar a bit higher, with a minimum of 43 percent cocoa. And if you're one of those who love white chocolate, we're afraid there's some bad news. White chocolate is made from the fat of the cocoa bean and contains no actual cocoa at all.

And now, amid all this amazing chocolate news, a bit of a reality check.

A group of scientists from Harvard who reviewed the data from 24 studies pinpointing various health benefits associated with cocoa found that the average dose of flavonols ingested by the test subjects was 400 milligrams per day. Turns out, that's the equivalent of (are you sitting down?) eight bars of dark chocolate, or 30 bars of milk chocolate per day.

If you want to match that intake, cocoa supplements are available that skip the sweeteners and fillers that make chocolate so delicious. But if you're going to add actual chocolate to your diet, limit it to 2 ounces per day, and go with as high a percentage as you will actually enjoy.

(Send your questions to askthedoctors@mednet.ucla.edu, or write: Ask the Doctors, c/o Media Relations, UCLA Health, 924 Westwood Blvd., Suite 350, Los Angeles, CA, 90095. Owing to the volume of mail, personal replies cannot be provided.)

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