Monthly Archives: September 2013

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In Taiwan and Balkan countries, Arthur Grollman has seen first hand how Aristolochia, a popular ingredient in herbal remedies, can be anything but helpful.

The plant, which includes over 800 species, was a part of herbal medicine in ancient Greece and Rome, where it was used to expel the placenta. It has also been a remedy for gout, arthritis, stomach pain and female disorders. Called birthwort in herbal remedies, Aristolochia grows in temperate climates throughout the world.

“This is the most potent human carcinogen ever reported,” said Grollman, distinguished professor in pharmacological sciences at Stony Brook and the Evelyn Glick Professor of Experimental Medicine. Aristolochia causes chronic kidney disease and, over time, also causes urothelial cancers of the upper urinary tract. Symptoms of cancers of the urothelium, which lines the renal pelvis and the upper ureter, often include bleeding.

“If [a patient] comes in with bleeding, doctors can do the appropriate X-ray and see a tumor and remove the single kidney,” he said. The carcinogenic properties of the plant, however, are unlikely confined to one kidney. “What usually happens,” he said, “is anywhere from one to five years later, the other kidney develops it.”

The United States, most European countries and many Asian countries have banned importation of any Aristolochia herb. Consumer Reports put it at the top of their list of dangerous herbs sold as dietary supplements.

Grollman has been “involved in integrating much of this” research, said Francis Johnson, a professor in pharmacological sciences at Stony Brook, who has known Grollman since 1965. Grollman is a researcher who “can take a bird’s-eye view.”

In 2004, Grollman went to the Balkans with his wife Annette, where he spoke with farmers in a dialysis clinic through an interpreter about whether they took herbal remedies. The farmers insisted they hadn’t consumed them. Still, while he was there, he went to a library, where he found an article in German that indicated that horses in the area that had ingested Aristolochia weeds also had kidney problems.

Grollman traveled with one of the farmers to his farm, where he noticed Aristolochia growing in the wheat fields.

Grollman deduced later on that seeds from Aristolochia contaminated the wheat. A staple of the diet of many farmers in these villages, bread contains wheat which, in this case, also had toxic seeds. Over time, “only a few seeds was enough” to damage their kidneys since the toxin/carcinogen binds to DNA in renal and urothelial tissue and remains there for many years.

He held his first symposium on the subject in 2007. Most of the scientists believed the data, but the public had heard before about possible causes of the disease, called Balkan endemic nephropathy, that didn’t work out and remained skeptical.

One of the biggest challenges in sharing his lab’s conclusion about BEN was that the country had just gone through a civil war, which minimized cooperation among Bosnians, Serbians and Croatians. He arranged a scientific conference in each capital city, showing results of studies from their own country.

Grollman has been “very much involved in the epidemiology, the biochemistry and biology of this situation,” said Johnson. In Asia, herbal remedies that include Aristolochia have been a part of Chinese herbal medicines for 2,000 years.

Except for a few scientists, the Asian communities were “very skeptical” of the dangers of Aristolochia at first. Based on the frequency of use of this plant as a part of herbal remedies, there could be as many as 100 million people in China suffering from kidney problems, Grollman estimates.

In his own lab, Grollman discovered a genetic fingerprint in a tumor suppressor gene that shows exposure to Aristolochia. The next step, he said, is to develop a cost-effective test that will show not only who has taken it but who is at risk of developing health problems as a result.

A resident of Setauket, Grollman, who is traveling in Taiwan this week as one of the main outside speakers in a symposium on cancer in Taiwan, said he has a keen appreciation for Long Island each time he travels.

“Wherever I go in the world, when I come back, I know I’m living in a great place,” he said. That’s helped over the years because it’s “awfully easy to recruit faculty to Stony Brook.”

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Some objects are like closed boxes. They have some observable properties but scientists don’t know exactly what is happening inside or why.

That’s where experimental physicists like Mark Dean and his colleagues at Brookhaven National Laboratory enter the picture. Dean fires X-rays with a specific energy level at copper oxide-containing materials (compounds that have copper and oxygen). To determine what’s going on inside, he sees how the X-rays change in energy and direction.

“We try to understand materials at a fairly fundamental level,” Dean said. “We think of that as a recipe that can be used for future technology.”

Copper oxide materials have magnetic properties and act as superconductors. Typical conductors have resistance, which reduces the amount of electricity received.

Superconductors, however, don’t have any resistance, which makes them potentially more efficient materials to send electricity. The catch, however, is that most superconductors require temperatures at near absolute zero — the universe’s coldest possible temperature — which makes them less practical. The energy required to cool the superconductors can be higher than the cost savings from avoiding the resistance of typical conductors.

Dean is focused on understanding the relationship between magnetism and superconductivity in these copper oxide substances.

The X-rays he fires into a material kick an electron out of the core of an atom, sending it up into a higher energy state where that electron can interact magnetically. That makes the X-rays sensitive to the magnetic properties of the material, he explained.

When a new electron replaces the one that was kicked out, it emits an X-ray photon. Dean measures the direction and energy loss of the photon in a process called resonant inelastic X-ray scattering.

Dean studies flat planes of compounds with copper and oxygen that are stacked on top of each other. These objects have superconducting properties at a relatively high temperature — about 90 Celsius degrees above absolute zero. That is still incredibly cold by human standards: about 300 degrees below zero on the Fahrenheit scale.

In the world of superconductors, that is considered “very warm,” or about a factor of 10 higher temperature than most normal superconductors, he said.

In terms of the energy trade-off between benefiting from the properties of a superconducting material and keeping that object cold enough to function, it is “becoming closer and closer to break-even,” Dean said. In five to 10 years, “we might hope to see some more areas where it’s economic” to use superconductors instead of conventional wiring.

Researchers discovered objects with copper and oxygen that had superconducting properties about 25 years ago and have been studying them extensively. To this point, they have “yet to find a satisfactory explanation of this phenomenon,” Dean said.

Dean is eager to refine the experiments when the National Synchrotron Light Source II comes online in 2015. At the NSLS-II, researchers will produce X-rays that are 10,000 times brighter than the current NSLS, enabling researchers to analyze the structure of new materials.

Chris Howard, a lecturer in the Department of Physics and Astronomy at University College in London, U.K., has confidence that Dean, with whom he has collaborated since 2007, will build on his success.

Dean is “currently proving his ability with a string of important and far-reaching publications in superconductivity and materials physics,” Howard offered. He called Dean a “real doer” and observed that he “is rapidly gaining the respect of the community he works in.” Howard appreciates the combination of Dean’s technical expertise, scientific discipline, writing skills, analytical skills and experimentation abilities.

Growing up in Broadstairs, Kent, a coastal town in southeast England, Dean developed an interest in science when he was young, where nature, through insects and wildlife documentaries and trips to zoos, appealed to him.

“As I grew older, the elegance of physics is what caught me,” he said. “The idea to conceptualize something and write down a formula: it’s such a beautifully efficient way of explaining something. You can convey a spectacular amount of information if you know how to write down the formula to describe it.”

A resident of Rocky Point, Dean came to the United States immediately after earning his doctorate. He enjoys mountain biking.

As for his work, Dean said the first semiconductor transistor was made at Bell Labs without any thought for its possible connection to the computer. It was made by scientists who were working to understand the properties of semiconductors. They didn’t realize this would lead to a semiconductor-based computer.

In a similar way, he said, by studying materials with novel properties, scientists will create “opportunities to make interesting new devices.”

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That self-described slow jogger who makes his way back and forth along Old Field Road five days a week — when he’s not in high-level meetings in Austria or Japan — just might be making everyone safer. That’s especially true for those people who live or work near nuclear power plants.

A condensed-matter physicist at Brookhaven National Laboratory, Robert Bari specializes in the kinds of “what if” scenarios scientists, policymakers and government officials need to consider when building, maintaining, and running the country’s nuclear power plants.

Bari is one of 22 people on a committee studying the lessons learned from the Fukushima power plant meltdown, which occurred two years ago in March following an earthquake that triggered a deadly tsunami. The committee, created by the National Academy of Sciences, will present its findings to Congress next spring.

“I visited Fukushima last November and talked with officials from the plant, from government and with the public,” Bari said. “We had open and closed meetings as appropriate.”

A physicist at Brookhaven since 1971 (with a year at Stony Brook as a visiting professor), Bari brings his expertise in nuclear power reactor safety, security and proliferation resistance to the committee.

Recently elected as a fellow of the prestigious American Physical Society, Bari has developed a career around probabilistic risk assessment and methods for analyzing proliferation resistance. He does severe accident analysis, mainly for nuclear power plants, but also for other nuclear fuel cycle facilities. He has also performed analyses of ship safety for the Navy and electrical grid performance for the Department of Energy.

In the immediate aftermath of Fukushima, he spoke with officials at the DOE at least weekly. He contributed as a part of a briefing for the Secretary of Energy and the president’s science adviser, who attended at least two presentations.

Robert Budnitz, a physicist at the Lawrence Berkeley National Laboratory at the University of California, said Bari’s role on the NAS committee is well-deserved and earned.

Bari is “an analyst who is more likely than most to come up with an imaginative answer,” Budnitz added. Bari can consider a design problem and, more effectively than most, figure it out, Budnitz said.

Bari gained experience in March of 1979, after the Three Mile Island accident. He built a risk-assessment capability for other plants. He eventually led a division of 60 people who specialized in “what can go wrong in a U.S.-type facility; what are the consequences, physical parameters and human factors involved in those types of activities,” he said.

Through his career, he said he’s been involved in studying nuclear safety and nuclear reactors through a range of responsibilities, from managing large teams to serving as associate lab director and department chair.

Budnitz said nuclear power plants are safer today than they were when many of them were built in the 1970s. The reason is that there a few dozen people worldwide who have worked to improve their design. “[Bari’s] in the middle” of that group and is “one of the most respected” contributors, Budnitz said.

A decade ago, the U.S. and 12 other countries got together to discuss the design of the next set of nuclear facilities, called Generation IV reactors. The Generation IV members discussed design plans for the commercial introduction of new nuclear plants from 2015 to 2030 and beyond.

As the co-chairman of the proliferation-resistance and physical protection group, Bari is responsible for increasing the assurance that the reactors are unattractive and the least desirable route for diversion or theft of weapons-usable materials, and to provide increased physical protection against acts of terrorism.

The Generation IV discussions started before 9/11, but took on a different urgency and design component when potential terrorism became a concern.

Bari lives in Setauket with his wife, Angela Bari, who is an instructor at the Osher Lifelong Learning Institute at Stony Brook, where she teaches courses in physics and on the history and holdings of the Metropolitan Museum. The couple have two children, Robin Sanchez, who works in a media company, and Robert Bari, who is an agent for Aflac Insurance.

As for his work, Bari recognizes that his scientific approach isn’t the typical “publish or perish” paradigm. “I like to think at the end of the day that we’re doing something that is for the public good and also creating new knowledge. I always ask myself ‘Have I created new knowledge?’”

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Mildly elevated sugar levels increase risk of disease

I recently wrote that mild cognitive impairment is one of the most feared disorders, especially as we age. One of the reasons for this is the fear of progressing to Alzheimer’s disease. The fear of developing Alzheimer’s with MCI is grounded in reality.

A recent study of patients with MCI and a protein biomarker called amyloid in the brain showed that the probability of developing Alzheimer’s disease was 50% after three years (ADI Conference 2012; Abstracts OC037 and OC035). However, those who had MCI without the amyloid proteins had a reduced one in ten chance of developing Alzheimer’s. Amyloid-beta plaques tend to accumulate in the brain and may be an early sign of Alzheimer’s. Researchers used a positron emissions tomography scan to make these assessments.

Modifiable risk factors for Alzheimer’s disease include chronic diseases, such as diabetes, high cholesterol and high blood pressure.

Where are we with medical therapies, and what can we do to possibly modify our risk for Alzheimer’s? Drug therapies in the research pipeline have had mixed results. However, one drug already on the market may be beneficial for those with diabetes: metformin.

What about diet? The answer depends on the type of diet. The standard American diet, with its high saturated fat and increased sugars, may increase the risk of Alzheimer’s, while a low-fat, nutrient-dense diet may reduce the risk of Alzheimer’s disease. Let’s review the evidence.

Future potential drug therapies

There is good news and bad news for potential Alzheimer’s drugs in development. Recently, the FDA stopped a drug trial because Phase III (the final stage) of development did not show better results than placebo in patients with Alzheimer’s (N Engl J Med. 2013;369:341-350). The drug that failed, semagacestat, was tested at two different doses and compared to a placebo. Its focus, like many Alzheimer’s drugs in development, was on reducing amyloid-beta plaques.

This was a well-designed, randomized controlled trial involving over 1,500 patients with a duration of about a year and a half. The patients on the drug actually did worse in terms of cognitive abilities and had more side effects than those on the placebo. This is disheartening.

However, don’t lose hope. There is another drug in the early stages of development, a microglial modulator. Microglia is to the brain as HDL or “good cholesterol” is to the cholesterol profile. They remove the “garbage.” Amyloid plaques interfere with microglia and ultimately cause inflammation. Microglial modulators are able to resist this process in mice, potentially reducing amyloid plaque deposits in the brain and improving memory. In a recent preliminary trial in humans, it showed promise for preventing patients with MCI from progressing to Alzheimer’s disease (AAI Conference 2013; oral presentation: O3-06-5). These were early results, and a much larger Phase III study is needed before conclusions can be drawn. But this is a potentially exciting new approach.

Dietary impact

Even mildly elevated blood glucose (sugar) levels may be a contributor to Alzheimer’s disease. In a recent study, even slightly elevated sugar levels led to increased risk (N Engl J Med. 2013;369:540-548). When a blood glucose level of 115 mg/dL, a prediabetes level, was compared to 100 mg/dL, risk increased by 18%. The risk of developing Alzheimer’s was even greater in those who were diabetic with higher sugars. Those with a blood glucose of 190 mg/dL, compared to those with a blood sugar of 160 mg/dL, had 40% greater risk for developing Alzheimer’s. This study followed over 2,000 patients for approximately seven years.

The scary aspect is that a slight rise in sugars from normal can lead to a significant rise in Alzheimer’s risk. The authors concluded that those who had slight glucose elevations should make lifestyle changes, including diet and exercise.


It is thought that diabetes may increase the risk of Alzheimer’s by at least twofold. In a recent observational trial, involving over 14,000 patients with a follow-up of five years, they found that metformin may reduce the risk of Alzheimer’s dementia substantially (AAIC 2013. Oral Presentation: O1-05-05). There was an approximate 20% reduced Alzheimer’s risk with metformin. Other medications, when compared to metformin, increased the risk of Alzheimer’s. For example, insulin increased risk 23%. However, this was not a randomized controlled trial. So, I might lean toward using metformin in diabetes patients, but not draw dramatic conclusions about other diabetic medications.

Integrative conference

In July, I attended an integrative conference, the International Conference on Nutrition and the Brain, hosted by Physicians Committee for Responsible Medicine in Washington, D.C. Presented evidence suggested that diet has an impact on Alzheimer’s disease ( A diet high in saturated fat may negatively affect cognition and increase the risk of Alzheimer’s. On the other hand, a high-nutrient, plant-based diet may have the opposite effect. The suggested diet consists of low saturated fat, a focus on fruits, vegetables, beans and legumes, and a small handful of nuts and seeds daily. They also stressed the importance of cardiovascular exercise, such as a walking with alacrity for 30 minutes, four times a week. You should also avoid aluminum from sources like cookware and antacids.

High saturated fat and high sugar effect

Interestingly there is a RCT that shows a high-saturated fat and high-sugar diet may increase the load of amyloid-beta protein plaques by preventing their clearance from the brain, whereas the diet with lower saturated fat and sugar had beneficial results (JAMA Neurol. 2013;70(8):972-980). According to the authors, diet may modify the risk profile for this disease, depending on the diet’s composition. Though the trial was small and short in duration, four weeks, it was still impressive.

I mentioned the word “fear” in the introduction several times. Hopefully, this article turned that fear into confidence that you can reduce the risk of developing Alzheimer’s disease. Decreasing saturated fat and sugar intake may be the first steps to reaching this goal. Whether metformin is needed by those with high blood sugar levels or not, lifestyle modifications, including a high-nutrient, plant-based diet, seems to have promise.

We hope for the best with drug therapies in the pipeline, though most have disappointed or are only in early stages of development, so it is even more imperative to utilize what may be our most powerful weapon, lifestyle changes.


Dr. Dunaief is a speaker, author and local lifestyle medicine physician focusing on the integration of medicine, nutrition, fitness and stress management. For further information, go to the website and/or consult your personal physician.

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By Daniel Dunaief

While plants don’t generally reach for a glass of milk, crouch down to stalk their prey or seek higher ground in a storm, they do respond to changes around them. They compete for sunlight, water and territory. They also have ways of turning on or off their own genes in response to stressful conditions.

Qiong Alison Liu, a principal investigator and research assistant professor at Stony Brook University, recently revealed how microRNA, which is involved in gene expression, changes in response to elevated carbon dioxide levels and higher temperatures.

These conditions are likely to continue to increase as a result of global warming.

In a research paper published in the journal Nature Communications, Liu is the “first to show greenhouse gas can function quite similarly as other stressors,” she said. “This opens up many questions.” Other greenhouse gases, like ozone, methane and nitrous oxide, could possibly have a similar impact on small RNA expression, she said.

She explored how a change of 3 to 5 degrees Celsius alters miRNA, Liu said.

While scientists have known that higher temperatures and carbon dioxide have opposite effects on plant growth, Liu showed that they have competing characteristics in miRNA.

The next step, Liu suggested, is to understand which influence is dominant.

If higher temperatures prevail, leading to photorespiration, plants may produce less biomass and become less productive. Scientists can potentially lend a hand, Liu suggested, through genetic engineering.

These altered plants can be “made to mask miRNAs effects by simply introducing mutations in miRNA target genes to block” their activity, she said.

The Stony Brook researcher cautioned, however, that such engineering, especially with economically important plant species, would need to await a better understanding of how “all the factors work together.” The information in model plants, like the Arabidopsis in Liu’s studies, could be used as a guide to study higher and more complex plants.

Liu explained that the study of miRNA is relatively new. Scientists recognized their role as biological regulators with conserved functions in the early 2000s.

The reason she took this approach relates to her indirect path to plants. From 1985 to 1987, she was enrolled in the first environmental program at Beijing University, where she studied environmental law and environmental biology and ecology.

When she worked at Cold Spring Harbor Laboratory in Michael Hengartner’s lab, she conducted her research in the shadow of Barbara McClintock, a Nobel Prize winner who had occupied the same lab space at CSHL. Indeed, she saw a portrait of McClintock holding a magnifying glass observing corn on the wall next to the entrance to the lab.

“My idea that elevated carbon dioxide and elevated temperature will lead to epigenetic changes in 2007 was inspired by [McClintock’s] ‘dynamic genome’ theory,” Liu explained. McClintock’s theory gave Liu the initial confidence that there would be epigenetic responses, although there weren’t any previous reports suggesting that.

“The climate changes slowly,” said Vitaly Citovsky, a professor of biochemistry and cell biology at Stony Brook. “We want to know the effect on all different organisms, including plants. This is an important step in understanding that effect.”

Citovsky, who has known Liu for three years and provides space in his lab for her research, described her as “very dedicated” and “committed to her career.”

On Long Island, Liu feels like a part of an international community. That group includes her husband, BNL scientist Andrew Gifford, who is originally from England. The couple live in Brookhaven with their 11-year-old daughter Helena.

While Liu feels at home on Long Island, she said she “satisfies myself by eating what I like to eat,” at home with her parents in China. She is especially fond of a cold rice noodle dish.

When she’s out bicycling or walking on the beach, Liu feels as if she can see through the surface of nature.

“I can imagine, when I see the forests, trees and flowers, something on a molecular level happening to them,” she said. “I can see the secret behind” their response to changes in the environment.

She has already received several requests for her manuscript and is excited about the potential future direction of these studies.

“People are interested in looking at the [effects of] climate change,” she said. This work on microRNA “adds something new” to the research direction.

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Location of stroke far outweighs frequency in terms of cognitive decline



Mild cognitive impairment is one of the more common disorders that occur as we age. But age is not the only determinant. There are a number of modifiable risk factors. MCI is feared, not only for its own challenges, but also because it may lead to dementia, with Alzheimer’s disease and vascular dementia being the more common forms. Prevalence of MCI may be as high as 1 in 5 in those over the age of 70 (Ann Intern Med. 2008;148:427-434). It is thought that those with MCI may have a 10% chance of developing Alzheimer’s disease (

Since there are very few medications presently that help prevent cognitive decline, the most compelling questions are: what increases risk and what can we do to minimize the risk of developing cognitive impairment? These are the important questions.

Many chronic diseases and disorders contribute to MCI risk. These include diabetes, heart disease, Parkinson’s disease and strokes. If we can control these maladies, we may reduce the risk of cognitive decline. This involves making lifestyle modifications such as exercise and diet. We know that we can’t stop aging, but we can age gracefully.

Heart disease

Although we have made great strides, heart disease continues to be prevalent in America. In a recent observational study, results demonstrate that those suffering from years of heart disease are at a substantial risk of developing MCI (JAMA Neurol. 2013;70:374-382). The study involved 1,450 participants who were between the ages of 70 and 89 and were not afflicted by cognitive decline at the beginning of the study. Patients with a history of cardiac disease had an almost two times greater risk of developing nonamnestic MCI, compared to those individuals without cardiac disease. Women with cardiac disease were affected even more, with a three times increased risk of cognitive impairment.

Nonamnestic MCI affects executive functioning – decision-making abilities, spatial relations, problem-solving capabilities, judgments and language. It is a more subtle form of impairment that may be more frustrating because of its subtlety. It may lead to vascular dementia and may be a result of clots. This gives us yet another reason to treat and prevent cardiac disease.


Not surprisingly, stroke may have a role in cognitive impairment. Stroke is also referred to as a type of vascular brain injury. But what is surprising is that in a recent study, the results show that the location of the stroke was more relevant than the frequency or the multitude of strokes (JAMA Neurol. 2013;70:488-495). If strokes occurred in the cortical and subcortical grey matter regions of the brain, executive functioning and memory were affected, respectively. Thus, the location of strokes may be a better predictor of subsequent cognitive decline than the number of strokes. Clinically silent strokes that were found incidentally by MRI scans had no direct effect on cognition, according to the authors.


Exercise may play a significant role in potentially preventing cognitive decline and possibly even improving MCI in patients who have the disorder. Interestingly, different types of exercise have different effects on the brain. Aerobic exercise may stimulate one type of neuronal development, while resistance training or weight lifting another.

In an animal study involving rats, researchers compared aerobic exercise to weight lifting (J Alzheimers Dis. 2012;32:329-339). Weightlifting was simulated by attaching weights to the tail of rats while they climbed ladders. Both groups showed improvements in memory tests, however, there was interesting divergence. With aerobic exercise, the level of the protein BDNF (brain-derived neurotrophic factor) increased significantly. This is important since BDNF is involved in neurons and the connections among them, called synapses, related mostly to the hippocampus, or memory center. The rats that “lifted weights” had an increase in another protein, IGF (insulin growth factor), that promotes the development of neurons in a different area of the brain. The authors stressed the most important thing is to exercise, regardless of the type.

In a recent study that complements the previous study, women were found to have improved spatial memory when they exercised – either aerobic or weight lifting (J Aging Res. 2013;2013:861893). Interestingly, verbal memory was improved more by aerobic exercise than by weight lifting. Spatial memory is the ability to recall where items were arranged, and verbal memory is the ability to recall words. The authors suggest that aerobic exercise and weight lifting affect different parts of the brain, which corroborates the animal study findings above.

This was a randomized controlled trial that was six months in duration and involved women, ages 70 to 80, who had MCI at the trial’s start. There were three groups in the study: aerobic, weight lifting and stretching and toning. Those who did stretches or toning alone experienced deterioration in memory skills over the same period.

Here is the catch with exercise: we know exercise is valuable in preventing disorders like cardiovascular disease and cognitive decline, but are Americans doing enough? A recent CDC report says the majority of the adult population is woefully deficient: only about 1 in 5 Americans exercise regularly doing both weights and aerobic exercise (Morb Mortal Wkly Rep. 2013;62:326-330).


Several studies show that the Mediterranean diet helps prevent MCI and possibly prevents conversion from MCI to Alzheimer’s (Neurology 2013;80:1684-1692; Arch Neurol. 2009 Feb.;66:216-225). In addition, a recent study showed that high levels of carbohydrates and sugars, when compared to lower levels, increased the risk of cognitive decline by more than three times (J Alzheimers Dis. 2012;32:329-339). The authors surmise that carbohydrates have a negative impact on insulin and glucose utilization in the brain.

Cognitive decline is a disorder that should be taken very seriously, and everything that can be done to prevent it should be utilized. Though the number of Americans exercising regularly is woefully deficient, the silver lining is that there is substantial room for improvement. Exercise has potentially positive effects on neuron growth and development. We need more campaigns like the NFL’s Play 60, which entices children to be active at least 60 minutes every day, but we need to also target adults of all ages. Let’s not squander the opportunity to reduce the risk of MCI, a potentially life-altering disorder.


Dr. Dunaief is a speaker, author and local lifestyle medicine physician focusing on the integration of medicine, nutrition, fitness and stress management. For further information, go to the website and/or consult your personal physician.