Food For Thought: How Nutrients Affect The Brain

Michael Lara, MD
Diplomate, American Board of Psychiatry and Neurology Private Practice Psychiatry and Psychopharmacology San Francisco, CA

After more than an hour in the choppy frigid waters of the bay, Francios gave up...heart broken and defeated, he said No man could have made that swim But Francios was not a stranger to adversity, he continued his rigorous program of diet and exercise, this time with even more intensity. He cleaned his diet up more than ever, avoiding meat and eating only whole foods. Anything that was man made, he avoided. In his exercise routine, Francious continued lifting weight and began inventing his own exercise contraptions to make his body stronger than ever. Exercise is king and nutrition is queen: together, you have a kingdom, Francios would say. He was determined to make that swim, and this time he would up the ANTE by attempting the swim while handcuffed...and pulling a 1,000 lb boat behind him. In 1974, at the strapping young age of 60, Francios nally did it....swimming from Alcatraz to Fishermans Wharf in San Francisco.

What I didnt tell you is that while Francios was training for his swim, he created a tness empire, opening the very rst commercial exercise gym in Oakland, inventing many staples of modern weightlifting gym including the leg extension machine and pulley machines using cables. In 1951, in KGO in SF, he had the premiere of his very own exercise show. In case you havent guessed, this man was known by most Americans the godfather of American Fitness.... Jack La Lane. I tell you this story because it demonstrates how one man turned his life completely around after attending a nutrition lecture. Now I have no illusions that any of you will attempt to do what Jack LaLanne has done...but I hope that the information Ill will share with you today will impact you in one tiny little way.... Quotes on diet: Let food by thy medicine, thy medicine shall be thy food -Hippocrates Or consider the Chinese proverb: He that takes medicine and neglects diet, wastes the skill of the physician The ancient ayurvedic proverb says it best: When diet is wrong, medicine is of no use When diet is correct, medicine is of no need

When diet is wrong, medicine is of no use. When diet is correct, medicine is of no need
~Ayurvedic Proverb

Michael Lara, MD
For More Information:
mlaramd@gmail.com www.brainwebinar.com Twitter: @MichaelLaraMD

Program Overview
Nutrition and Neurotransmitters Inammation and Mood Stress-Related Eating and Appetite Blood Sugar, Brain and Behavior Optimizing Alertness and Sleep

Nutrients that Inuence Key Neurotransmitters

"Let food be thy medicine and medicine be thy food"

~Hippocrates

Neurotransmitter Function

Neurotransmitters are messenger molecules produced by nerve cells to communicate and control almost every function of the body: mood, memory, appetite, and sleep-wake cycle Many are made from essential amino acids from nutrients (primarily proteins) in our diet Psychopharmacology focused on mimicking or altering the effects of neurotransmitters

Norepinephrine

Serotonin

Alertness Concentration Energy

Anxiety Impulsivity

Obsessions Compulsions Memory

Mood Cognition Appetite Sex Aggression

Attention

Pleasure Reward Motivation

Dopamine

Amino Acid Building Blocks

Protein from diet is broken down into amino
acids; during starvation muscle protein is broken down cofactors, to neurotransmitters in CNS

Amino acids are converted, with the help of Amino acids also are used to make
is the protein in your diet membrane receptors for neurotransmitters

The only source of the essential amino acids

Tryptophan

Methionine

Phenylalanine

Threonine

Valine

Leucine

Isoleucine

Lysine

Cysteine

Tyrosine

Glycine

Serine

Taurine

Carnitine

Aspartic Acid

Glutathione

Glutamine

Glutamate

Serotonin

Dopamine GABA Norepinephrine

Melatonin

Epinephrine

Serotonin

Neurotransmitter associated with feelings of wellbeing and happiness Also regulates sleep and appetite 90% of bodys total serotonin located in gut Foods with a higher ratio of tryptophan to leucine and phenylalanine increase production of serotonin (bananas, papayas, dates) Foods with a lower ratio decrease production of serotonin (wheat, rye bread)

L-Tryptophan

5-Hydroxy-Tryptophan

Serotonin
Monoamine Oxidase

5-HIAA

Dopamine

Dopamine is pleasure and reward neurotransmitter Synthesized from tyrosine via tyrosine hydroxylase Dopamine is precursor for norepinephrine and epinephrine Low levels associated with ADHD, Parkinsons, depression, addictions, and introversion High levels associated with mania, psychosis, and extroversion

Tyrosine

L-Dopa

Dopamine

Norepinephrine

GABA
Major inhibitory neurotransmitter in CNS Associated with relaxing, anti-anxiety,
anticonvulsant effects Vitamin B6

Synthesized in the brain from glutamate and L-theanine, kava, skullcap and valerian are
thought to increase GABA peripherally but do NOT cross blood-brain barrier

Glutamate

Major excitatory neurotransmitter in CNS Involved in learning, memory, and neuroplasticity (long-term-potentiation) Excessive glutamate binds to NMDA receptor and causes neuronal death (excitotoxicity) Found in cheese, soy sauce, and responsible for umami, one of ve basic tastes Sodium salt is food additive and avor enhancer: monosodium glutamate, or MSG

Glutamine
Conditionally essentially amino acid Used as source of cellular energy Produced from glutamate; muscle contains 90% of bodys total glutamine stores Uses: reduces healing time after operations, decreases muscle breakdown, enhances immunity; increases human growth hormone Other studies demonstrate stabilizing effect on blood sugar and decreased cravings for alcohol in recovering alcoholics Dietary sources: beef, chicken sh, eggs, wheat cabbage, beets, spinach, parsley Doses: 5-15 grams/day

Inammation and Mood

Inammation
Response of vascular tissues to harmful stimuli Cytokines are key messenger proteins that regulate inammatory process Inammation may have a role in various disease states including depression and Alzheimers disease Food and eating pattern can be inammatory Inammation and stress can lead to accumulation of visceral fat, which in turn can produce inammatory cytokines and other hormones that affect appetite

Inammation and Cortisol

Hypothalamic-pituitary-adrenal axis modulates reactions to stress and regulates mood, energy storage, sex, and immune systems Cortisol increases blood sugar through gluconeogenesis and suppresses immune system Altered patterns of in cortisol secretion in many conditions associated with stress, including MDD and PTSD Leads to accumulation of visceral fat

Inammation and Depression

Increases in stress-induced inammatory response in depressed patients Cytokines induce sickness behavior characterized by fatigue and depression Exists with other diseases of inammation: DM II, asthma, CAD Pro-inammatory cytokines (IL-1, IL-6, TNF) produce symptoms of depression and anxiety Cytokines overactive HPA axis

Effects of Cortisol on Hippocampus

Andreasen, Brave New Brain: Conquering Mental Illness in the Era of the Genome, 2001

Telomere Shortening and Mood Disorders

Simon NM, Smoller JW, McNamara KL, et al. Telomere shortening and mood disorders: preliminary support for a chronic stress model of accelerated aging. Biol. Psychiatry. 2006;60(5):432435.

Simon NM, Smoller JW, McNamara KL, et al. Telomere shortening and mood disorders: preliminary support for a chronic stress model of accelerated aging. Biol. Psychiatry. 2006;60(5):432435.

Antidepressants and Inammation

Depression associated with up-regulation
of inammatory response system

Hyperproduction of pro-inammatory
cytokines reversed by antidepressants

Antidepressants decrease gamma

interferon and TNF-alpha; and increase anti inammatory IL-10

Inammation and Alzheimers

Most common form of dementia Accumulation of b-amyloid plaques and tau
proteins (neurobrillary tangles)

Evidence of altered immune status in AD Long-term use of NSAIDs may protect

against AD but not vascular dementia

Anti-inammatory Nutrients

Anti-inammatory foods include fruit and vegetables, sh, walnuts, ax and whole grains Anti-inammatory spices include sage, ginger, chili peppers, black pepper, and curcumin Green tea may inhibit atherosclerosis and hypercholesterolemia Red wine contains resveratol which protects tissues inside blood vessels Moderate consumption of alcohol raises good cholesterol (HDL) Dark chocolate can reduce blood pressure and elevate mood

The Mediterranean Diet

Meat% %Sweets%

Poultry,%Eggs,% Cheese,%Yogurt%

Fish%and%Seafood%

Fruits,%Vegetables%Grains,%Beans,%Nuts,% Olive%Oil%

Physical%AcCvity;%Enjoy%meals%with%others%

Alzheimers Disease and Mediterranean Diet

Scarmeas N, Stern Y, Tang MX, Mayeux R, Luchsinger JA. Mediterranean diet and risk for Alzheimer's disease. Annals of neurology. 2006;59(6):912921.

A total of 2,258 community-based nondemented individuals in New York were prospectively evaluated every 1.5 years. Adherence to the MeDi (zero- to nine-point scale with higher scores indicating higher adherence) was the main predictor in models that were adjusted for cohort, age, sex, ethnicity, education, apolipoprotein E genotype, caloric intake, smoking, medical comorbidity index, and body mass index. Survival curves based on Cox analysis comparing cumulative Alzheimers disease (AD)incidence in subjects belonging to each Mediterranean diet (MeDi) tertile (p for trend =0.007). Low tertile (score 03; light gray lines) corresponds to lower adherence to MeDi,middle tertile (score 45; dark gray lines) to middle adherence, and high tertile (score 69;black lines) to higher adherence. Figure is derived from a model that uses all subjects and is adjusted for cohort, age, sex, ethnicity, education, apolipoprotein E genotype, caloric intake,smoking, comorbidity index, and body mass index. Duration of follow-up is truncated at 10 years

Omega-3 Fatty Acids

EFAs are required for normal metabolism but are not synthesized by body EPA, DHA and ALA Common sources include breast milk, wild sh, seaweed, algae, and axseed Believed to play key role in maintaining uidity of cell membranes May also stabilize blood glucose and thereby reduce hunger

Omega-3s and Depression

Several epidemiological studies suggest covariation between sh consumption and rates of depression 2004 study found that suicide attempt patients had lower blood levels of Omega-3 fatty acids Lower blood levels of DHA associated with higher suicide rates among U.S. military 2007 meta-analysis showed that Omega-3s signicantly improved depression in both patients with unipolar and bipolar disorder Health benets of Omega-3s may be especially important in patients with psychiatric disorder due to high prevalence of smoking and obesity

Hibbeln J. Fish consumption and major depression. Lancet. 1998.

Medium Chain Triglycerides

MCTs are medium-chains (6-12 carbons) fatty acids of glycerol Do not require energy for absorption, utilization, storage Coconut oil is composed of 66% MCTs MCTs promote fat oxidation and reduced food intake MCTs are used in treatment of neurodegenerative disorders; mechanism likely involves induction of ketosis.

Stress-Related Eating and Appetite

C.M.s Story

December 2010 March 2012 www.brainwebinar.com

Cortisol and Appetite

Main hormone associated with chronic stress Chronic elevated cortisol causes elevated blood glucose, which can lead to type 2 diabetes Cortisol also increases activity in amygdala, resulting in increased craving for sweet, salty, fatty foods Cortisol increased by loss of sleep, excessive exercise, psychological stress and restrictive dieting Excess cortisol associated with stress of restrained eating and body image disturbance Effects of chronic cortisol elevation may be mitigated by omega-3 supplementation

Endogenous Opiates

Endogenous opiates (endorphins) function as neurotransmitters and are released during exercise, eating, sex, excitement and pain B-endorphin, released by pituitary, is cleavage product from POMC B-endorphin may have role in mediating runners high Opiate blockers (naltrexone) used for weight reduction, alcohol abuse and for reducing euphoria associated with self-injurious behaviors

Regulation of Appetite

Human appetite control systems designed for survival in primitive times Regulated by lower brain structures (amygdala, hypothalamus), dopamine-driven reward circuits, and higher prefrontal cortex circuits Automatic, impulsive eating behaviors associated with primitive brain structures may be overcome by higher prefrontal cortex, responsible for decision-making and planning

The Starvation Response

Biochemical and physiological changes that reduce metabolism in response to lack of food During short periods of energy abstinence, body will burn FFA from body fat stores; after prolonged starvation, body will break down lean tissue and muscle Glucose in diet is used rst, then stored glycogen, then breakdown of fats into glycerol + free fatty acids

Caloric Restriction

Dietary regimen that restricts total calorie intake by 10-25% CR shown to reduce BP, fasting glucose, fasting insulin (65%), and c-reactive protein Believed to activate longevity genes (SIRT1) and reduce oxidative stress Shown to extend lifespan in many organisms, including primates but human studies are ongoing

Intermittent Fasting

Alternating periods of fasting with non-fasting, typically for no longer than 24 hours. Benets include improved regulation of blood glucose, reduction of chronic inammation, enhanced cognition and reduction of body fat while preserving lean body mass. In a common 18/6 variation, fasting is done from 6:00 pm until noon the next day. Nutritionally balanced meals favoring protein and healthy fats are recommended during eating period from Noon until 6:00 pm. BCAAs and MCTs may be used during the fast to manage hunger. To optimize health benets, resistance training is recommended immediately before breaking the fast (i.e. from 11:00-noon)

Resistance Training
1 day/week Heavy Singles

Sprint Training
2 days/week; 20/20

Intermittent Fasting
3 days/week

Omega-3 Fatty Acids

4 grams/day

Leisurely Nature Walks

5 days/week

Blood Sugar, Brain and Behavior

Glycemic Index

Glycemic index is the measure of how much and how quickly a food will raise blood glucose, which is then lowered by insulin Glycemic load is the measure of the total effect of a meal on blood glucose High glycemic index foods include rened grains products, potatoes, and sugary foods Low GI foods include legumes, fat-free dairy products, some fruits, and barley

Supplements for Stabilizing Blood Sugar

Stevia Rebaudiana

Platago Ovata

Stevia is a genus of about 240 species of herbs and shrubs in the sunower family (Asteraceae), native to subtropical and tropical regions from western North America to South America. The species Stevia rebaudiana, commonly known as sweetleaf, sweet leaf, sugarleaf, or simply stevia, is widely grown for its sweet leaves. As a sweetener and sugar substitute, stevia's taste has a slower onset and longer duration than that of sugar, although some of its extracts may have a bitter or licorice-like aftertaste at high concentrations. With its steviol glycoside extracts having up to 300 times the sweetness of sugar, stevia has garnered attention with the rise in demand for lowcarbohydrate, low-sugar food alternatives. Because stevia has a negligible effect on blood glucose, it is attractive as a natural sweetener to people on carbohydrate-controlled diets. Psyllium is produced mainly for its mucilage content, which is highest in P. ovata.[citation needed] The term mucilage describes a group of clear, colorless, gelling agents derived from plants. The mucilage obtained from psyllium comes from the seed coat. Mucilage is obtained by mechanical milling/grinding of the outer layer of the seed. Mucilage yield amounts to about 25% (by weight) of the total seed yield. Plantago-seed mucilage is often referred to as husk, or psyllium husk. The milled seed mucilage is a white brous material that is hydrophilic, meaning that its molecular structure causes it to attract and bind to water. Upon absorbing water, the clear, colorless, mucilaginous gel that forms increases in volume by tenfold or more.

Dietary Fiber

Fiber is a diverse group of compounds, including lignin and complex carbohydrates, that cannot be digested by human enzymes in the small intestine Viscous bers, such as those found in oat products and legumes, can lower serum LDL cholesterol levels and normalize blood glucose and insulin responses For adults who are 50 years of age and younger, the AI recommendation for total ber intake is 38 g/day for men and 25 g/day for women. For adults over 50 years of age, the recommendation is 30 g/day for men and 21 g/day for women

1. Chandalia M, Garg A, Lutjohann D, Bergmann von K, Grundy SM, Brinkley LJ. Benecial effects of high dietary ber intake in patients with type 2 diabetes mellitus. New England Journal of Medicine. 2000;342(19):13921398.

Psyllium and Blood Glucose

Anderson JW, Allgood LD, Turner J, Oeltgen PR, Daggy BP. Effects of psyllium on glucose and serum lipid responses in men with type 2 diabetes and hypercholesterolemia. The American Journal of Clinical Nutrition. 1999;70(4):466473

Background: Water-soluble dietary bers decrease postprandial glucose concentrations and decrease serum cholesterol concentrations. This study examined the effects of administering psyllium to men with type 2 diabetes. Objective: The objective was to evaluate the safety and effectiveness of psyllium husk ber used adjunctively to a traditional diet for diabetes in the treatment of men with type 2 diabetes and mild-to-moderate hypercholesterolemia. Design: After a 2-wk dietary stabilization phase, 34 men with type 2 diabetes and mild-to-moderate hypercholesterolemia were randomly assigned to receive 5.1 g psyllium or cellulose placebo twice daily for 8 wk. Serum lipid and glycemic indexes were evaluated biweekly on an outpatient basis and at weeks 0 and 8 in a metabolic ward. Results: In the metabolic ward, the psyllium group showed signicant improvements in glucose and lipid values compared with the placebo group. Serum total and LDL-cholesterol concentrations were 8.9% (P < 0.05) and 13.0% (P = 0.07) lower, respectively, in the psyllium than in the placebo group. All-day and postlunch postprandial glucose concentrations were 11.0% (P < 0.05) and 19.2% (P < 0.01) lower in the psyllium than in the placebo group. Both products were well tolerated, with no serious adverse events related to treatment reported in either group.1.. Conclusion: The addition of psyllium to a traditional diet for persons with diabetes is safe, is well tolerated, and improves glycemic and lipid control in men with type 2 diabetes and hypercholesterolemia. Am J Clin Nutr 1999;70:46673

Sugar and The Brain

Brain uses 25% of glucose that is available to body If blood glucose falls too low, mood can become impatient, irritable, and aggressive Self-control requires adequate glucose in the brain Sugar, fat, and salt activate reward circuits in the brain that override prefrontal circuits that govern higher cognitive function such as self-control

Insulin Resistance and Prediabetes

Prediabetes is a condition in which blood glucose levels are higher than normal but not high enough for a diagnosis of diabetes The U.S. Department of Health and Human Services estimates that about one in four U.S. adults aged 20 years or olderor 57 million peoplehad prediabetes in 2007 Studies have shown that most people with prediabetes develop type 2 diabetes within 10 years, unless they lose 5 to 7 percent of their body weightabout 10 to 15 pounds for someone who weighs 200 poundsby making changes in their diet and level of physical activity.

Obesity Trends* Among U.S. Adults BRFSS, 1990, 2000, 2010

(*BMI 30, or about 30 lbs. overweight for 54 person) 1990 2000

2010

No Data

<10%

10%14%

15%19%

20%24%

25%29%

30%

Source: Behavioral Risk Factor Surveillance System, CDC.

Advertisement for Desoxyn 1957: When She Cant Escape Temptation, Prescribe Dexosyn.

Appetite Suppressants

Psychostimulants: increase DA and NE Phentermine: primarily increases NE, but also increases 5-HT and DA Sibutramine: NE and 5-HT reuptake inhibitor Bupropion/naltrexone Orlistat: reduces absorption of fats from GI tract Natural appetite suppressants

Naltrexone

Opioid receptor antagonist used in treatment of alcohol dependence Believed to reduce dopaminergic activity in reward centers of brain Used to treat self-injurious behaviors, impulse control disorders (trichotillomania, kleptomania, compulsive gambling) May reduce reward associated with over-eating and is key component in weight loss drug Contrave

Branched Chain Amino Acids

Leucine, isoleucine, and valine are essential amino acids Used medically to treat ALS, hepatic encephalopathy, and tardive dyskinesia Used by athletes to improve exercise performance and reduce muscle breakdown during intense exercise May also blunt the release of insulin and may therefore reduce appetite associated with caloric restriction Recommended doses: 5-20 grams/day in divided doses

Optimizing Alertness and Sleep

Nutrients for Improving Mood and Cognition

Amino acid precursors for
neurotransmitter synthesis

Folate pathways in cofactor synthesis Enhance blood ow Antioxidants

SAMe

Donor of methyl groups in many essential biologic reactions, including the synthesis of neurotransmitters Efcacy equal to FDA approved antidepressants Expensive; may induce mania; GI upset; insomnia Doses range from 200-1,600 mg/day in divided doses

Folic Acid

Folate deciency associated with increased risk of depression In patients who suffer from depression, 7 out of 10 may have a specic genetic factor that limits their ability to convert folate from diet to L-methylfolate At risk populations for low folate levels: MTHFR polymorphism, diabetes, hypothyroidism, excessive EtOH and smokers Drugs that deplete folate include: oral contraceptives, antiepileptic drugs, metformin, methotrexate, niacin L-methylfolate (medical food product) crosses blood brain barrier to assist in synthesis of neurotransmitters

L-Tyrosine

Synthesized from L-phenylalanine; precursor to dopamine Diet sources include: chicken, turkey, sh, almonds, avocados, cheeses, yogurt, pumpkin seeds A number of studies have found tyrosine to be useful during conditions of stress, cold, sleep deprivation, and improvements in cognitive and physical performance Dosing: 1-6 grams/day in divided doses

St. Johns Wort

Effective for mild-moderate depression Response rate 64% v. 59% for TCAs MOA: the inhibition of cytokines; decrease
in 5-HT receptor density

Suggested dose: 900-1,800 in divided doses

Ginko Biloba
Long history of use for treatment of
cognitive decits in AD and vascular dementia

May also improve learning capacity Year long study with 309 patients suggest Suggested doses: 120-240 mg/day

that ginko may stabilize and improve cognitive performance in demented patients

N-acetylcysteine

Amino acid derivative used as medication and as nutritional supplement Precursor of antioxidant glutathione May be useful for OCD, trichotillomania, impulse control disorder, alcohol- and cocaine-related disorders, and schizophrenia Believed to counteract glutamate hyperactivity via NMDA receptor For impulse control disorders, dose 600 mg 3-4x/day

Cocoa
Derived from tree theobroma cacao Rich in avonoids which protect against coronary heart disease Health benets: antioxidant, lowers blood pressure, inhibits platelet aggregation, and reduces inammation Intake of avonoid-rich wine, tea, and chocolate by elderly men and women is associated with better cognitive test performance

Chocolate Red Wine Green Tea

Nurk E, Refsum H, Drevon CA, et al. Intake of flavonoid-rich wine, tea, and chocolate by elderly men and women is associated with better cognitive test performance. The Journal of Nutrition. 2009;139(1):120

1.

Nurk E, Refsum H, Drevon CA, et al. Intake of avonoid-rich wine, tea, and chocolate by elderly men and women is associated with better cognitive test performance. The Journal of Nutrition. 2009;139(1):120. Abstract In a cross-sectional study, we examined the relation between intake of 3 common foodstuffs that contain avonoids (chocolate, wine, and tea) and cognitive performance. 2031 participants (7074 y, 55% women) recruited from the population-based Hordaland Health Study in Norway underwent cognitive testing. A cognitive test battery included the Kendrick Object Learning Test, Trail Making Test, part A (TMT-A), modied versions of the Digit Symbol Test, Block Design, Mini-Mental State Examination, and Controlled Oral Word Association Test. Poor cognitive performance was dened as a score in the highest decile for the TMT-A and in the lowest decile for all other tests. A self-reported FFQ was used to assess habitual food intake. Participants who consumed chocolate, wine, or tea had signicantly better mean test scores and lower prevalence of poor cognitive performance than those who did not. Participants who consumed all 3 studied items had the best test scores and the lowest risks for poor test performance. The associations between intake of these foodstuffs and cognition were dose dependent, with maximum effect at intakes of ;10 g/d for chocolate and ;75 100 mL/d for wine, but approximately linear for tea. Most cognitive functions tested were inuenced by intake of these 3 foodstuffs. The effect was most pronounced for wine and modestly weaker for chocolate intake. Thus, in the elderly, a diet high in some avonoidrich foods is associated with better performance in several cognitive abilities in a dose-dependent manner. J. Nutr. 139: 120127, 2009.

Sleep and Mood

American adults average 6.5 h sleep, less than most other countries. Optimal functioning reportedly requires 8 0.5 hours Sleep maintenance through the night may be disturbed by major depression. Generalized and anticipatory anxiety is especially identied with trouble initiating sleep. Chronic insomnia increases the risk for depression 5 times, the risk for panic disorder 20 times Patients with major depressive disorder tend to go into REM (dream) sleep shortly after sleep onset,skipping the earlier stages of sleep

Kava Kava
Controlled, double-blind studies suggest it
may be helpful for mild anxiety

Works by conversion to kavapyrones:

NE uptake inhibition

central muscle relaxants and anticonvulsants

Involved with GABA receptor binding and Suggested dose: 60-120 mg/day

Valerian
Decreases sleep latency and improves sleep
quality

Decreases GABA breakdown Suggested doese is 450-600 mg taken 2

hours before bedtime

Melatonin

Hormone derived from serotonin Effective for people with insomnia caused by circadian rhythm disturbances Interacts with suprachiasmatic nucleus Resets circadian pacemaker and attenuates an alerting process Ambient light inhibits production of endogenous MT Recommended doses 0.25-3.0 mg/day

Magnesium

Functions include relaxation and contraction of muscles and production and transport of cellular energy Assists with cellular glucose utilization to improve insulin resistance Deciency results in hyperexcitability, muscle weakness, and sleepiness Deciency common with EtOH abuse, some medications (lasix, HCTZ), malabsorption syndromes Found in green, leafy vegetables, spinach, and unrened grains Magnesium sulfate, chloride, or lactate have better bioavailability than magnesium oxide RDA is up to 420 mg/day

Snake Oil? Scientic Evidence For Popular Dietary Supplements

Worth It Line

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"The wise man should consider that health is the greatest of human blessings. Let food be your medicine."

~Hippocrates

Food For Thought: How Nutrients Affect The Brain

For More Information: facebook.com/BrainMD twitter: @MichaelLaraMD mlaramd@gmail.com

When diet is wrong, medicine is of no use. When diet is correct, medicine is of no need
~Ayurvedic Proverb