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.

 

Guilt-free snacks?

The email caught my eye..."guilt-free snacks for healthy habits." Sounded like something I would be interested in and it had all of the buzz words for today's consumer: "pure, natural, real, organic, gluten-free, and straight from nature."  Well, that last one is a lie because no processed snack food comes "straight from nature." I've never seen a chocolate hazelnut brownie coconut butter tree or a dark chocolate Brazil nut bush.

Never mind that, snacking is big business and many of us graze all day long, forgoing meals for snacks. So, how did these 3 "guilt-free" snacks fare on closer look? Spoiler alert....not so good.

For those of us 50+ adults, snacks should be nutrient-rich but not calorie-rich. Even for the most active among us, calories count and I've seen many older adults sabotage their weight and fitness goals by consuming too many "healthy" snacks. Snacks have calories and to avoid the weight creep of aging we have to be mindful of calories from all snacks. Let's take a closer look at these so-called "guilt-free snacks."

• Dark chocolate Brazil nuts. A 4-oz bag sells for $6.00 with 5 servings/bag. Each serving has 230 calories, 18 g fat, 7 g saturated fat, 12 g sugar, and 3 g protein. Let's face it, how many of you can stop at one serving? A pretty pricey snack, loaded with calories, fat and sugar and not much protein to promote satiety...that feeling of fullness that keeps you from eating more a few hours later.
• Chocolate hazelnut brownie coconut butter. This one costs $13.33 for a 12-oz jar. Two tablespoons comes with 220 calories, 20g fat and 3 g protein. Coconut butter is all the rage and we can debate the health aspects of it another time, but as a snack it packs a calorie and fat wallop.
• Crunch cluster almonds. A one-oz serving will set you back 160 calories and 13 g fat with only 5 g protein. And, a 9-oz bag costs $6.32.

To me, a guilt-free snack is affordable and delivers on nutrition and taste. Snacks that are much (much!) less expensive and more (more!) nutrient-rich include plain Greek yogurt (100 calories and 18 g protein) mixed with your favorite seasonal fruit or try cottage cheese (1/2 cup has 90 calories and 13 g protein) with a few whole grain crackers. If you like a creamy, cheesy snack, try a portion-controlled wedge (like The Laughing Cow spreadable cheese wedges with only 35 calories per wedge) on crisp apple slices.

Don't be fooled by the health-halo surrounding "guilt-free" snacks. Eat nourishing, healthy snacks without the high price tag. I'll bet you have some in your fridge right now!










Hydration Tips for Active Older Adults

As the temperatures soar, active 50+ exercisers (myself included!) need to pay special attention to hydration. There are some who say that thirst should be your only guide for hydration, but that advice could be dangerous as we age. When older adults exercise, especially in hot and humid climates, they have a diminished sensation of thirst. And we know that "normal" thirst kicks in after you are already thirsty so waiting for thirst may lead to heat illnesses.

Aging also brings about other changes in normal physiology that contribute to dehydration. Our sweat rate changes, our kidneys change the way they handle fluids and electrolytes, like sodium and potassium, and there is an altered blood flow response. All of these normal age changes mean that we need to be aware of hydration and adopt strategies to keep us hydrated during the physiological stress of exercise.

In addition, many 50+ take medications that contribute to loss of body water. Chief among the drugs are common blood pressure medications that act as diuretics which can increase water loss. When you add in other common drugs, caffeine and alcohol, both which are mild diuretics, hydration becomes even more important.

How do you know if you are dehydrated? This question is of great interest to researchers and unfortunately there is no single, easy test to assess hydration. Until there is an easy reliable and valid test, the best strategy is to weigh yourself before and after exercise. For every pound loss, drink 16-24 ounces for every pound loss during exercise. If you gain weight after exercise that means you are most likely overhydrated, but a loss of 1 pound or less means you are doing pretty well at hydrating. Another way to assess hydration is by monitoring urine volume and color. A dark colored urine usually means you are dehydrated (although some dietary supplements like vitamins with a high concentration of riboflavin can cause a bright colored urine) as well as infrequent urination.

Here are some tips to keep you hydrated:

• Monitor body weight before and after exercise to gauge fluid loss
• Monitor urine volume and color
• Drink fluids before activity and during activity when exercising in hot, humid environments
• Replace fluids after exercise
• Eat foods with high water content (fruits and vegetables)
• Consume fluids with meal
• Use sport drinks if you are a heavy sweater and/or a salty sweater; if watching calories, try the "light" verisons that provide some carbohydrate but with the same electrolyte content as the regular sport drinks.