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Cognitive Training or Gingko Biloba to prevent cognitive decline and dementia? New comprehensive report by the National Academies of Sciences, Engineering, and Medicine clarifies priorities for public health and for future research

Evi­dence Sup­port­ing Three Inter­ven­tions That Might Slow Cog­ni­tive Decline and the Onset of Demen­tia Is Encour­ag­ing but Insuf­fi­cient to Jus­ti­fy a Pub­lic Health Cam­paign Focused on Their Adop­tion (Nation­al Acad­e­mies of Sci­ences, Engi­neer­ing, and Med­i­cine):

Cog­ni­tive train­ing, blood pres­sure man­age­ment for peo­ple with hyper­ten­sion, and increased phys­i­cal activ­i­ty all show mod­est but incon­clu­sive evi­dence that they can help pre­vent cog­ni­tive decline and demen­tia, but there is insuf­fi­cient evi­dence to sup­port a pub­lic health cam­paign encour­ag­ing their adop­tion, says a new report from the Nation­al Acad­e­mies of Sci­ences, Engi­neer­ing, and Med­i­cine. Addi­tion­al research is need­ed to fur­ther under­stand and gain con­fi­dence in their effec­tive­ness, said the com­mit­tee that con­duct­ed the study and wrote the report Read the rest of this entry »

Study: Dietary interventions can help children with ADHD (especially with proper monitoring and adjustment)

food_pyramidAre dietary inter­ven­tions effec­tive for treat­ing ADHD? This has been a con­tro­ver­sial ques­tion over the years with strong pro­po­nents on both sides of the issue. For many par­ents and pro­fes­sion­als, try­ing to parse through the dif­fer­ent claims about the impact of diet on ADHD has been chal­leng­ing and con­fus­ing. Read the rest of this entry »

No effects of omega‑3 supplements on Alzheimer’s symptoms

The L.A. Times reports today the neg­a­tive results of the lat­est ran­dom­ized tri­al test­ing the effects of DHA sup­ple­ments on Alzheimer’s symp­toms (DHA is an omega‑3 fat­ty acid).

The study … exam­ined 402 peo­ple with mild to mod­er­ate Alzheimer’s. They were ran­dom­ly assigned to take 2 grams a day of omega‑3 cap­sules con­tain­ing docosa­hexaenoic acid (or DHA) or a place­bo cap­sule. The par­tic­i­pants were fol­lowed for 18 months, and their cog­ni­tive and func­tion­al abil­i­ties were reassessed. They also under­went MRI to look at the brain.

There was no ben­e­fit seen in the patients tak­ing omega‑3 fat­ty-acid sup­ple­ments in either brain vol­ume or cog­ni­tive func­tion.

Com­ments: Does this study mean that DHA or omega‑3 in gen­er­al are not good for the brain? No! This study sug­gests that tak­ing DHA sup­ple­ments after Alzheimer’s diag­no­sis is not help­ful. Pri­or evi­dence shows that omega‑3 con­sump­tion (espe­cial­ly DHA) long before the onset of Alzheimer’s symp­toms reduces the risk of devel­op­ing the dis­ease. Indeed, sev­er­al stud­ies have shown that eat­ing fish (the pri­ma­ry source in our diet of omega‑3 fat­ty acids) is asso­ci­at­ed with a reduced risk of cog­ni­tive decline or demen­tia.

The authors of the JAMA study also spec­u­late that DHA sup­ple­ments could be used as a treat­ment for peo­ple who have not yet been diag­nosed with Alzheimer’s but are already devel­op­ing demen­tia pathol­o­gy in their brain: “Indi­vid­u­als inter­me­di­ate between healthy aging and demen­tia, such as those with mild cog­ni­tive impair­ment, might derive ben­e­fit from DHA sup­ple­men­ta­tion, although fur­ther study will be nec­es­sary to test this hypoth­e­sis.” 

A Controlled Trial of Herbal Treatment for ADHD

Many par­ents, health care pro­fes­sion­als, and edu­ca­tors agree that there is a press­ing need to devel­op effec­tive treat­ments for ADHD to com­ple­ment or sub­sti­tute for tra­di­tion­al med­ica­tion and behav­ior ther­a­py approach­es. This is because such treat­ments do not work for every­one, impor­tant dif­fi­cul­ties often remain even when these treat­ments are effec­tive, and evi­dence for the long-term ben­e­fits of these treat­ments remains less com­pelling than one would like. In addi­tion, in the case of med­ica­tion treat­ment, some indi­vid­u­als expe­ri­ence intol­er­a­ble side effects and many have con­cerns about tak­ing ADHD med­ica­tion for an extend­ed peri­od.

One alter­na­tive approach to treat­ing ADHD has relied on the use of Com­pound Herbal Prepa­ra­tions (CHP) derived from tra­di­tion­al Chi­nese med­i­cine. Prac­ti­tion­ers of this approach believe that such prepa­ra­tions have impor­tant cog­ni­tive enhanc­ing prop­er­ties because they sup­ply essen­tial nutri­ents, fat­ty acids, phos­pho­lipids, amino acids, B vit­a­mins, min­er­als, and oth­er micronu­tri­ents that are impor­tant for opti­mal brain growth and devel­op­ment. As a treat­ment for ADHD, the idea is that many indi­vid­u­als with ADHD have defi­cien­cies in essen­tial nutri­ents that com­pro­mise healthy brain devel­op­ment and result in ADHD symp­toms. Pro­vid­ing these nutri­ents via an appro­pri­ate­ly pre­pared herbal com­pound thus has the poten­tial to be ther­a­peu­tic and reduce these symp­toms.

This idea was test­ed recent­ly in a ran­dom­ized-con­trolled tri­al of a spe­cif­ic CHP for chil­dren with ADHD [Katz, Kol-Degani, & Kav-Vena­ki (2010). A com­pound herbal prepa­ra­tion (CHP) in the treat­ment of ADHD: A ran­dom­ized con­trolled tri­al. Jour­nal of Atten­tion Dis­or­ders. Pub­lished online on March 12, 2010.] Par­tic­i­pants were 120 6–12 year-old chil­dren new­ly diag­nosed with ADHD based on a com­pre­hen­sive diag­nos­tic eval­u­a­tion. These chil­dren were all eval­u­at­ed at the She­ba Med­ical Cen­ter, one of the largest uni­ver­si­ty-affil­i­at­ed ter­tiary care cen­ters in Israel.

(Editor´s note: Dr. David Rabin­er, author of this arti­cle, pre­vi­ous­ly reviewed a 2005 meta-analy­sis whose find­ings need to be kept in mind to con­tex­tu­al­ize this new study. In the arti­cle Dietary Inter­ven­tion for ADHD: A Meta-Analy­sis, Dr. Rabin­er con­clud­ed that “Results from this meta-analy­sis pro­vide strong evi­dence that the behav­ior of chil­dren with ADHD can be made worse by dietary fac­tors, and that elim­i­nat­ing AFCs from their diets will, on aver­age, result in behav­ioral improve­ments. This result is con­sis­tent with with accu­mu­lat­ing evi­dence that neu­robe­hav­ioral tox­i­c­i­ty may result from a wide vari­ety of dis­trib­uted chem­i­cals.”)

Chil­dren were ran­dom­ly assigned to receive either the CHP (n=80) or a place­bo (n=40) that was spe­cial­ly pre­pared to Read the rest of this entry »

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