Health is Wealth

Preventing Decline of Memory

Sometimes our memory fails us when we needed it most; like during our exams, or when a face is familiar but not the name or where we last placed our car keys. Good memory is not just one of our most important health assets but a tool to further our career and enhance our self-development. As with any assets, we have to also look after our memory to ensure that it does not become a liability in old age.

Our memory is to help us cope and function with daily activities. Our memory function is divided into short-term memory and long-term memory. Short-term memory is when we have acquired recent facts and the facts are still intact. Examples are keeping appointments or if the electricity bill has been paid. Long-term memory calls for recollection of key events that happened in our childhood or distant past.

As we grow older, our brain mass decreases and learning becomes more difficult especially in picking up foreign languages or new skills. We tend to become more forgetful too with age. However if short-term memory becomes severely impaired, it could be due to Alzheimer''s disease (AD). AD sufferers are known to forget to get dressed after a shower, asking to be fed just after a full meal or losing their direction back home after a shopping trip. AD predominantly affects the elderly and the incidence is higher in women than in men simply because women tend to live longer.

In AD, brain cells responsible for learning, reasoning and memory gradually deteriorate and become clogged up with abnormal protein plaques and tangles. The triggering factor for the formation of plaques and tangles is unknown but scientific evidence indicates that cumulative free radical damage to brain cells is probably the primary cause of the condition.

A piece of this evidence came from a study that shocked researchers from the University of Toronto. The study showed a 250 per cent increased risk of AD in individuals drinking tap water high in aluminium over a period of 10 years in Ontario. Aluminium encourages the formation of dangerous free radicals that damage delicate cell membranes of nerve cells.

Free radicals are highly reactive molecular fragments generated internally by our body as well as from external sources such as environmental pollution, chemicals, UV light, cigarette smoking and poor dietary habits. Protective antioxidants which mop up free radicals are relatively lower in brain cells than other body cells thus making them more susceptible to excessive free radical damage.

Extensive studies on the use of antioxidant vitamins to limit free radical damage in AD have been promising. A potent antioxidant, vitamin E has been shown to slow down mental decline in older persons due to its high fat solubility This property of vitamin E is important because 60 per cent of the brain is made up of fat, which is most vulnerable to free radical injury. A high intake of dark green, yellow and coloured vegetables actually protects against Alzheimer''s disease in a study on more than 5,000 men and women. These vegetables are rich sources of antioxidant nutrients such as beta-carotene, vitamin C, zinc and selenium.

Other causes of poor memory could be reduced blood supply to the brain, depression, thyroid problems, liver problems, and vitamin deficiencies. To maintain a healthy brain, scientists suggest a diet high in antioxidant nutrients, consumption of fish at least three times a week and supplement if necessary with a good formula of antioxidants and B vitamins. Be mentally and physically active throughout life and avoid activities that may cause head injuries.

Keeping Blood Pressure Down

Called the "silent killer" because it does not manifest any symptoms till the damage is done, high blood pressure (hypertension) is estimated to affect 20 per cent of adults in the industrialized countries and even more prevalent in the developing countries. Despite billions of dollars spent on blood pressure lowering medications, blood pressure is poorly controlled in many people. WHO reports that the problem is further compounded by the poor compliance to prescribed anti-hypertensive medication.

Blood pressure is the measurement of the force of blood pushing against the walls of arteries as it flows through them. The more force the blood exerts on the artery walls, the higher the blood pressure. When the heart contracts to push blood out into the arteries, the force is at its highest and this is termed the systolic pressure. When the heart relaxes to fill with blood again, the pressure is at its lowest point, referred to as the diastolic pressure. Hence that is why there are always two figures if you had your blood pressure checked, with the systolic pressure stated first and the diastolic pressure second. Blood pressure is measured in millimeters of mercury (mm Hg) and measurements less than 120/80 mm Hg are considered ideal, reading of less than 140/90 mm Hg is considered normal, but blood pressure over 140/90 is diagnosed as hypertension.

Hypertension is one of the leading causes of death or disability, due to stroke, heart attack, and kidney failure. There are two types of high blood pressure and 90 per cent of all cases are primary or essential hypertension where the cause is unknown unlike secondary hypertension with identifiable causes that are treatable or reversible. The good news is that diet modifications, exercise, stress management and the use of nutritional supplements are pretty successful in reducing essential hypertension.

Diet lowers blood pressure

The Dietary Approaches to Stop Hypertension (DASH) trial evaluated the effect of three dietary patterns on blood pressure in persons with untreated systolic blood pressure of 140-160 mm Hg and diastolic blood pressure of 80-95 mm Hg. 459 adults participated and were randomly placed in three groups to receive either one or the following:

• the usual American diet that will act as the control
• the usual American diet but higher in fruits and vegetables
• the DASH diet that is higher in fruits, vegetables, low-fat dairy products, lower in total fat, saturated fat, cholesterol and to include foods rich in potassium, calcium, and magnesium.

All participants ate the control diet for three weeks before being randomized to receive either diet 1, 2 or 3 for another eight weeks. During the 8-week study, sodium intake, physical activity, and body weight remained constant and the outcome was that the DASH diet has a much greater blood pressure lowering effect than diet 1and 2.

The DASH diet is easy and simple to follow and can be modified to Malaysian's taste and palate. The diet is based on a daily intake of 2000 calories and you will need to reduce the serving size according to your daily calorie needs.

• 7-8 servings per day of grains and grain products (these can include breakfast cereal, whole grain bread, rice, noodle, pasta, etc.)
• 4-5 servings of vegetables
• 4-5 servings of fruit
• 2-3 servings of low-fat or nonfat dairy foods (soy milk, low-fat milk, yoghurt etc)
• No more than 2 servings per day of meat, poultry, and fish
• 4-5 servings of nuts, seeds, beans, lentils and legumes per week
• Limited intake of fats and sweets (white sugar, cakes, kueh, pisang goreng etc)

A diet low in saturated fat, high in complex carbohydrate and restricted in salt is recommended. Such a diet includes whole grains, unpolished rice, vegetables, lentils, legumes, nuts, seeds, fish, soy products, onions, garlic, foods rich in potassium, calcium, and magnesium (Chinese cabbage, carrots, cucumber, spinach, celery, sprouts, mushrooms, mung beans, potatoes, avocados, broccoli, and most fruits).

Lifestyle factors to reduce blood pressure

Mention the word, exercise, and most people will grimace. Granted it demands commitment and discipline, research indicates that if you are physically inactive, you have a 35 per cent chance of developing high blood pressure compared to an athletic person. Well the welcoming news is that you need not huff and puff and be all sweaty to reap the benefits of exercise. Published in the American Journal of Hypertension, researchers looked at 207 people with high blood pressure not on anti-hypertensive drugs and randomly divided them into four groups based on the duration and frequency of exercise per week, ranging from 30 to 60 minutes per week to more than 120 minutes per week. The exercise programme consisted of:

• A brief warm-up period
• Aerobic exercise (such as brisk walking, jogging, swimming, or cycling)
• Conditioning exercise (such as sit-ups and stretching)

After eight weeks on the programme, the researchers found that the ability to lower blood pressure was greatest among those who exercised 60 to 90 minutes per week and there were no further reductions in systolic blood pressure among those who exercised more than 90 minutes a week. It seems that the benefit was seen based on the total amount of time one exercises rather than the frequency.

Chronic stress can raise normal blood pressure. The first step to combat stress and reduce blood pressure is to identify the things that stress you and eliminating them if possible. If the stressors are things that can't be changed, then one needs to avail the help of stress-reducing techniques.
In one study, researchers found nearly 70 percent of patients with mild to moderate hypertension using techniques (meditation, deep-breathing exercises, yoga ) to reduce stress were able to reduce their medication after six weeks and after one year, 55 percent could stop their medication.

Nutritional supplements lower blood pressure

• Coenzyme Q10

Several studies on small patient numbers have clearly shown the potential benefit of coenzyme Q10 in the treatment of hypertension. In one cohort study of 109 patients with essential hypertension for an average of 9 years and on anti-hypertensive medication were supplemented with coenzyme Q10 between 75mg to 360mg daily. Patients were able to gradually decrease their medication during the first one to six months with 51 percent of patients able to cease completely their drugs after 4 months of starting on coenzyme Q10. Even with so many studies, the mechanism by which coenzyme Q10 works to reduce blood pressure remains unclear. Long term studies on the safety of coenzyme Q10 have shown it to be a safe supplement.

• Omega-3 Fatty Acids & GLA

A review of 31 studies on 1356 hypertensive subjects show that omega-3 fatty acids contributed to the blood pressure lowering effect due to the two main fatty acids found in fish oil: eicosapentaenoic acid and docosahexaenoic acid. Another fatty acid, GLA (gammalinolenic acid) is richly available from evening primrose oil is associated with a beneficial reduction of cardiovascular risk factors in lowering blood pressure and total cholesterol in the elderly over 80.

Other nutritional supplements that are known to play a role in lowering blood pressure are calcium, magnesium, potassium, vitamin B6 and vitamin C.