Chocolate: A Smart Food

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By Dr. Laura Pawlak

There is universal agreement that chocolate is a feel good food.  Chocolate melts in your mouth, releasing its sweet, creamy, cocoa flavor, and the brain follows with a burst of “happy” chemicals.

Beyond the sensory joy of eating chocolate, there are claims that chocolate is a healthy food for the brain.  Most of us would gladly eat more chocolate if proven to benefit the brain.

Several ingredients in cocoa have been proposed to explain the possible cognitive benefits of chocolate.  Cocoa contains caffeine, a substance that enhances cognitive functioning and alertness.  Major nutrients have also been identified in the cocoa bean.  Presently, studies focus on the chemical group called flavanols.

Flavanols are micronutrients found in many fruits and vegetables, especially the fruit called the cocoa bean, the basis of chocolate.  Flavanols have antioxidant and anti-inflammatory properties — important for brain health.

Small studies, often supported by chocolate manufacturers, state that the cocoa flavanols can boost mood and cognitive performance — as well as blood flow to the brain.  Researchers are now evaluating the significance of these small studies by conducting large, clinical trials using a cocoa extract with known flavanol content, not chocolate.

A dose of 600-750 milligrams of flavanols is considered healthful for the brain.  To obtain this dose, you would have to consume 4.75 ounces of dark chocolate, a total of 750 calories, or 40 ounces of milk chocolate, which has 5,850 calories.

A day with adequate flavanols from commercial chocolate is also a day heavy in sugar, saturated fat, and calories — not a formula for a sharp brain.  Perhaps future studies examining chocolate’s healthful ingredients in the cocoa extract will provide more healthful ways to capture the goodness of the cocoa bean.

Meanwhile, manufacturers divert your focus from calories to health by presenting chocolate paired with a superfood, the avocado.  Called a health food, the Avocado Chocolate Bar is made of freeze-dried avocado pulp powder, 70 percent dark chocolate — plus added sugar — and has nearly 600 calories.

The bar is a convenient, but calorie-laden, snack.  The alternative — consuming whole, fresh plant food — is always a good choice for the brain.

My suggestion:  Eat dark chocolate in moderation if you like it, not because you think it will make you smarter.  For added flavanols, focus on the abundant amounts of this nutrient in grapes and berries.  Enjoy!


Dr. Laura Pawlak (Ph.D., R.D. emerita) is a world-renowned biochemist and dietitian emerita.  She is the author of many scientific publications and has written such best-selling books as “The Hungry Brain,” “Life Without Diets,” and “Stop Gaining Weight.”  On the subjects of nutrition and brain science, she gives talks internationally.

A Class Act

Posted on Posted in Continuing Education, Elder Care, Psychology, Seminars, Uncategorized

By Mary O’Brien, M.D.

The lady was a class act.  In a sea of loud, silly, and shallow people, Barbara Bush stood like a lighthouse, radiating wisdom and grace.  She demonstrated remarkable equanimity, regardless of circumstance.  Blessed with razor sharp wit and a penchant for fun, she was nonetheless known to her family as “The Enforcer.”  Candid, caring, committed, and tough, Mrs. Bush had a massive impact on everyone around her.  She set the standards high and refused to indulge any twinge of narcissism in herself or others.  It’s a testament to her character that everyone around her succeeded.  She had the longest marriage (73 years) in American presidential history and was the mother of two governors, one of whom (George W. Bush) was also the 43rd president.

There were, however, those who bemoaned the notion that she was “only” a wife and mother.  Those folks ended up looking foolish.  Mrs. Bush had no misgivings about the value of family.  She was fiercely loyal and protective, but she did have boundaries.  When pestered by the media about her role in the political campaigns of family members, she quipped, “I’ll do anything to help.  But I won’t dye my hair, change my wardrobe, or lose weight.”

The reality was that Barbara and George H.W. Bush, in the late 1950s, lost their three-year-old daughter, Robin, to leukemia.  Barbara’s hair turned white shortly after that tragedy.  She refused to hide her age, stress, or heartache by dyeing her hair.  There was nothing coy, contrived, pretentious, or conniving about Mrs. Bush.  She possessed a refreshing candor and confidence that come from authenticity.  It was clear she had no interest in impressing or manipulating others.  As was the case with Billy Graham, she said what she meant and she meant what she said.  This surely must have perplexed the glitterati in Washington.

Historians will write about Mrs. Bush for years to come.  She was a smart, gracious, strong, and virtuous woman.  Countless children learned to read as a result of her efforts.  No doubt her opinions influenced domestic and foreign policy behind the scenes.  However, Mrs. Bush possessed an uncommon degree of humility, maturity, forgiveness, and forbearance that enabled her to rise above conflict and petty partisanship.  As she once explained, “Politics is what we do.  It’s not who we are.”  Have we ever been in greater need of her example?

 

Steady As She Goes

Posted on Posted in Brain Science, Continuing Education, Homestudy, Psychology, Seminars, Webinars

By Mary O’Brien, M.D.

Are you afraid to open your financial statements for March? Have the recent market gyrations triggered a sudden interest in Xanax? Nonstop news cycles and social media postings have spawned massive overreactions to every comment made by political or business leaders. Down drafts of 1,000 points can cause even the most seasoned investors to panic. Over the past two months I’ve had to curtail my exposure to the business networks. Watching the Dow Jones Industrial Average plunge 700 points at 2 P.M. can make me feel as if I’m about to go into ventricle fibrillation. I’d rather stay in normal sinus rhythm.

Sadly, that is not a joke. I have a vivid memory of sitting at a stoplight in Little Rock, Arkansas, on October 19, 1987. It was about 5:30 P.M., and I was headed home from my office. Over the car radio I heard, “The Dow Jones Industrials are down 517 points.” I distinctly remember thinking, “Oh, he’s reading that wrong! The DOW couldn’t possibly be down that much.” It was.

Shortly after I arrived home, my beeper went off. One of my favorite patients was in the emergency room (ER) with a massive myocardial infarction. George A. was a 76-year-old gentleman from Hope, Arkansas. He had grown up in poverty but had educated himself and built up several successful businesses. He was bright, witty, charming, dapper, and gracious. But on that day, George A. had lost over a million dollars, at least on paper. He was devastated.

I grabbed my bag and raced back to the hospital. We got George admitted to the cardiac care unit (CCU). His electrocardiogram (EKG) looked awful, and he looked worse. He was utterly convinced that one dreadful day on Wall Street had destroyed his future. Around 8 P.M., George become very ill (coded). We worked on him frantically for over an hour, but we couldn’t bring him back. There was no doubt in my mind that the thought of financial ruin had literally scared George to death. I felt numb.

Later that week, two of my colleagues committed suicide. They had also lost a fortune, at least on paper. Everyone was stunned and afraid that week. One year later, however, the market had recovered nearly all of its losses. Thirty years later I still mourn the loss of three good people. For all intents and purposes, they died from acute financial panic.

I am no financial genius. But forty years of investing have taught me a few lessons that may help someone else:

  • Don’t watch market moves minute to minute. Before long, you’ll need heavy sedation.
  • Don’t dump stocks when everyone is panicking. You’ll almost always miss out on the best part of the recovery phase.
  • Remember the wisdom of the ancient Greeks: Moderation in all things. Balance stocks, mutual funds, bonds, certificates of deposit (CD’s), cash, real estate, and precious metals based on your age, health, family needs, and risk tolerance.
  • Don’t give in to ignorance, laziness, fear, or greed. Sixty-six percent of millennials have nothing stashed away for retirement. Failure to invest is one of the greatest mistakes of all.
  • No matter what happens, avoid the temptation to overreact. You are infinitely more important than your financial statements.

Now take a deep breath and open the statements from March. Steady as she goes. You’ll be fine.

A Very Long Reception Line

Posted on Posted in Continuing Education, Elder Care, Homestudy, Psychology, Seminars, Webinars

By Mary O’Brien, M.D.

He was a bright light shining in the darkness.  Billy Graham changed the lives of hundreds of millions of people.  His message was simple and consistent:  God loves you.  He wasn’t concerned about denomination or fine points of theology even though he knew the Bible about as well as anyone.  He was a bold but humble force for good in the world.

In an age when being snide and snarky is considered “cool,” Billy Graham’s sincerity, honor, and compassion provided a beacon of hope.  Today, few things come more easily than cynicism.  I struggle with it every hour of the day.  But Billy Graham managed to rise above that temptation throughout his long life.  He never worried that someone might ridicule, criticize, or dismiss him because he never worried about himself.  Few people manage to subdue their egos the way Billy Graham did.  His lifelong focus was to share God’s love with as many people as possible.

Living a faith-filled life is very difficult.  Mother Teresa understood that. Pope John Paul II knew it.  Brave souls like these never agonize over focus groups, polls, or surveys.  Political correctness and fence-straddling, psycho-babble have no place in their lives.  They really do answer to a Higher Power.

Billy Graham gave spiritual counsel to 12 presidents regardless of their political party or religious affiliation.  He didn’t need to play games, massage egos, or create clever sound bites.  He said what he meant and he meant what he said. He had a clear understanding of right and wrong, and he wasn’t embarrassed by it.

Status had no claim on him. He lived a simple, scandal-free life.  For decades he showed as much attention and kindness to orphans in huts as he did to heads of state in palaces.

Finally, Billy Graham gave us all a noble example of how to endure the ravages of illness and old age with grace and dignity.  As we have seen with other saintly individuals, his patience, courage, and good humor endured until the very end. Protracted illness, pain, and suffering could not conquer the Spirit that worked within him.

I’ve heard it said that when you die, all the souls you’ve helped along the way are there in heaven to greet you.  In Billy Graham’s case, it must have been a very long reception line.

One Devastating Flaw

Posted on Posted in Brain Science, Continuing Education, Homestudy, Psychology, Seminars, Webinars

By Mary O’Brien, M.D.

It happened again.  Seventeen precious lives were snuffed out by a vicious young man.  Before their bodies were laid to rest, “experts” began screaming at one another on TV.  However, finger-pointing, shouting matches, and emotional rants do not solve problems.  Thoughtful, well-informed, practical strategies solve problems.

Clearly what we have been doing to prevent school shootings has been inadequate.  The reasons are myriad.

  • Gun control laws are flawed.  I’ve long been baffled by the fact that there are more restrictions on me as a physician prescribing four ounces of cough syrup containing codeine than there are on a violent teen buying an assault rifle. Most reasonable people would probably agree:  This makes no sense.
  • Counseling is a fine endeavor.  We need more of it. But caring, prudent advice will not stop slaughter.  It’s impossible to reason with someone who is irrational.
  • School security needs attention.  In Israel, schools are locked at the final morning bell and teachers with military training carry hidden weapons. We now have hundreds of thousands of well-trained veterans who could help secure schools and do data mining of social-media sites to enhance intelligence analysis.  Why are we not enlisting their help?
  • Over the past 30 years, children have been exposed to tremendous levels of violence on TV, in movies, and perhaps most intensely, in video games.  Here there are no consequences to killing, apart from racking up points. Many kids who have been left to fend for themselves never have been taught to respect another person.

Additional resources providing better security, practical law enforcement, and sensible mental health care are needed almost everywhere.  But one devastating flaw remains.  Many people realized the shooter in Florida was dangerous.  The police had been called multiple times over the years.  He had beaten his mother and reportedly tormented and killed small animals.  His social media postings threatened murder.  Other students feared him and school authorities expelled him.  The FBI failed to follow-up on two credible reports.

Why do any of us fear getting involved in difficult situations?  It’s simple. We’re scared to death we might be sued.  We’re afraid of revenge or even the possibility of being called “mean.”

Many years ago, I had to confront a serious situation in a training program. Patient safety and professional standards were on the line.  I took action I deemed necessary and was clobbered with a lawsuit along with several other faculty.  It made our lives a living hell for nearly five years.  Other physicians and administrators simply looked the other way.  They suffered no retribution.  Some of us did what we believed was right.  Some chose to remain silent.

On February 14, 2018, many people did the right thing.  Some of them died trying to save others.  None of us is off the hook here.  Fear can have fatal consequences.  Courage is the antidote.

A Bit Of A Twist

Posted on Posted in Brain Science, Continuing Education, Homestudy, Psychology, Seminars, Webinars

By Mary O’Brien, M.D.

Have you given a thought to Valentine’s Day yet?  I suspect for most people it’s a last minute scramble for dinner reservations or roses.  The Valentine cards and candy in stores have been staring us in the face since Christmas Eve.  But most of us have had a few other things on our minds, things like floods, flu, holiday bills, and taxes.  Hearts and flowers aren’t top priorities for most folks unless they work for Hallmark or Russell Stover.

This year there’s a bit of a twist.  February 14th is Valentine’s Day and Ash Wednesday.  It’s most unusual.  As soon as I noticed this anomaly on the calendar, I realized several things would happen.  Some people would turn it into a theological controversy over which observance should take precedence.  I’ve always been perplexed by the propensity of some people to promote “either-or” thinking.  Sure enough, several prominent clerics have issued stern statements about the obligation of their members to fast and forego any Valentine treats.  That’s their call.

Some people will slog through the day unaware of either observance.  They don’t worry about philosophical or theological dilemmas, and, for the most part, they’re not terribly romantic or thoughtful to begin with.  No big deal.

I have a different take on this.  As a 63-year-old woman, I’ve had my share of lovely Valentine surprises and a few bitter disappointments.  That’s life.  As a geriatrician, I know how many sick, lonely, elderly people are ignored on Valentine’s Day.  That’s sad.  As a lifelong Catholic, I understand that Ash Wednesday is all about spiritual priorities and discipline.  We’re not supposed to be self-indulgent morning, noon, and night.  That’s prudent.

Here’s the good part:  Valentine’s Day and Ash Wednesday don’t have to be at odds with each another.  There is no need for “either-or” thinking.  St. Valentine was a real man, a priest who brought great kindness and love to persecuted people in third century Rome.  He was martyred for his devotion in 270 A.D.  Ash Wednesday is a major reminder that life is short.  The only thing we’ll take with us at the end is the love and compassion we have shown to others.

We all have patients, colleagues, neighbors, and even passing strangers in our lives who will be neglected on February 14th unless we remember them.  Valentine’s Day and Ash Wednesday.  Curious.  There’s never a need to “fast” from being thoughtful.

A Different Tradition

Posted on Posted in Brain Science, Continuing Education, Homestudy, Psychology, Seminars, Webinars

By Mary O’Brien, M.D.

Has your home returned to a relative state of post-holiday normality?  I’m almost there.  The boxes and bags and bows and ribbons have been put away until next year.  The “thank you” notes are in the mail.  And my kitchen table has been restored to an acceptable state of neatness.

Many people will start to focus on new year’s resolutions now, knowing full well the resolutions are unlikely to last.  I have a different tradition at the end of December.  It goes back quite a few years.  In a reflective state of blissful solitude, I write down my own little “year in review.”  It takes some time, thought, and effort, but it’s an exercise that can generate some profound insights.

  • What were the best or most positive events of 2017 — personally, nationally, and globally?
  • What were the worst or most tragic events of 2017 — personally, nationally, and globally? How did I cope or respond?
  • What event or situation made me feel most grateful?
  • What was the most beautiful, unusual, or remarkable sight I saw in 2017? (Personally, it would be difficult to top the perfect, unobstructed view of the total solar eclipse I had from my own backyard in August 2017.)
  • What was the biggest mistake I made in 2017? This one can be tough and sobering.
  • What was the most important lesson I learned in 2017? It’s often related to the biggest mistake I made.
  • What experience or moment touched me the most deeply?
  • What was the most noble, courageous, or generous thing I did in the past year? Coming up short on this one is not a good sign.
  • And finally, what could I do in 2018 to become a better person — physically, mentally, emotionally, and spiritually?

The little, personal “year in review” may not be as fascinating as a list of the year’s top news stories, viral videos, or celebrities who have passed.  It will, however, become profoundly revealing to you 10 or 20 years from now.

Have a happy new year.

 

Something Feels Different

Posted on Posted in Continuing Education, Psychology, Seminars, Webinars

By Mary O’Brien, M.D.

Are we there yet? I wonder as I stare at my kitchen table covered with gift bags, wrapping paper, bows, ribbon, tape, and scissors. Every year, I tell myself I’ll cut back a bit next year. It never happens. The pressure starts with Christmas-in-July sales on shopping channels. I confess I find it difficult to resist. I love buying and wrapping presents for people. It truly makes me happy, especially when someone is genuinely surprised and delighted. It’s a constructive way to take the focus off myself.

This year however, something feels different. It’s been a tough year with historic, natural disasters. Devastating hurricanes, floods, tornadoes, earthquakes, wildfires, and blizzards have wreaked havoc on tens of millions of people. Mass shootings, riots, and appalling, vicious acts of violence have left most of us stunned and horrified. My heart breaks for all of those who have lost loved ones and homes. How I wish I could ease their anguish.

I cannot restore lost loved ones, homes, and treasured possessions for people in California, Texas, Florida, and Puerto Rico. I can write a few checks and say a few prayers. Those are good things to do, but they never seem to be enough.

Then it dawned on me. There are lots of people suffering all around us every day. They just don’t appear on the evening news. Here, in Myrtle Beach, South Carolina, there are nearly 2,500 homeless teenagers. That seems ironic in a town that’s largely focused on tourism and fun. I decided to give some money to my almost-adult niece and nephew. I gave them instructions to go buy clothes for homeless teenagers. I have no clue what teenagers would want or need, but my niece and nephew do, and they did well. Unloading their bags full of jackets, hoodies, sweaters, socks, underwear, scarves, and hats, they announced they “had a blast” doing it. Surprise! Thinking of other people can be fun.

My kitchen table is still a mess. But this year, I realize how blessed I am to have a kitchen, messy table and all.

 

Let It Go!

Posted on Posted in Brain Science, Continuing Education, Homestudy, Psychology, Seminars, Webinars

By Mary O’Brien, M.D.

Did you survive Thanksgiving without major family stress or tension? If the answer is “no,” you’re not alone. Holiday gatherings don’t always bring out the best in everyone. Some folks are already frazzled by travel nightmares. Those hosting the feast are tense and worn down by days of planning, preparation, and cooking. No one ever has quite enough room in her kitchen for all the food, much less the guests who congregate in the middle of the mess. There’s nearly always one culinary mishap and someone is sure to announce she has a life-threatening allergy to gravy.

But wait! We haven’t even begun to address deeply ingrained differences in political perspectives, religious beliefs, and good, old-fashioned feuds and grudges. Was all of this supposed to be fun? Fortunately or not, many of us will have another crack at family festivity soon as we try to celebrate Christmas or Hanukkah. I have a few time-tested thoughts that might help—at least a bit.

  • Psychologists tell us that it takes 21 days to replace a bad habit with a good one. That means we have just enough time to make a difference. Starting now, try not to criticize, condemn, or complain. It’s not easy, especially in this culture. However, it will make the next family gathering much easier to endure, if not actually enjoy.
  • Remember some basic neurophysiology. The human brain cannot hold onto diametrically opposed emotions simultaneously. We can’t feel love and hatred at the same time. We can’t feel empathy and anger in the same moment. And we can’t experience gratitude and resentment all at once. It may sound simplistic, but gratitude is often the best remedy for resentment, anger, anxiety, and sadness. Those of us who have food, water, shelter, clothes, electricity, a little money, and a few loved ones have more than hundreds of millions of people around the world. Smile and say “thank you” — a lot.
  • Forgive yourself and everyone else. I’ve watched relatives feud for decades. They make themselves and everyone else miserable. None of us is perfect. We’ve all said and done things that were misguided or thoughtless. However, refusing to forgive is like drinking poison. It makes no sense. Forgiveness represents the ultimate act of overcoming ego. Let it go. LET IT GO!

Please don’t make me sing that song from “Frozen.” I have relatives who would never forgive me.

 

When Something’s Not Right

Posted on Posted in Brain Science, Psychology, Seminars, Webinars
(AP Photo/Laura Skelding)

By Mary O’Brien, M.D.

“Anyone who believes in God is stupid.”  This statement was among many posted by the monster who murdered 26 innocent people in November 2017 in a Texas church.  The victims ranged in age from 18 months to 77 years old.  Eight members of one family were killed, 20 people were wounded. No one had a chance to hide or escape.

The man who committed this atrocity had been seething with anger and brutality for years.  There were many red flags.  He had received a dishonorable discharge from the Air Force and served time for assaulting his wife and child.  His attack was so brutal, the baby suffered a skull fracture.  He was known to have beaten and starved his dog. Any man capable of beating a woman, a baby, and a dog does not turn into a decent human being after 12 months in prison.  The many pieces of this puzzle are already coming together.

In the realm of religious thought and theology, anger is considered one of the seven deadly sins.  Unjust anger, if allowed to smolder, can lead anyone down a vicious path of destruction.

In the realm of clinical medicine, anger and hostility are considered the two most deadly and dangerous emotions.  Those of us in health care encounter angry, hostile people almost every day.  In fact, all of us encounter angry, hostile people with increasing frequency.  Anger triggers a flood of potent hormones and neurotransmitters that can literally change brain function and even brain structure if the process lasts long enough.

However, pathologic anger, violence, and evil do not exist in a vacuum.  There are always warning signs.  All too often they go unnoticed or unreported.  Most of us have been well-schooled to “mind our own business.” After all, we don’t want to be called judgmental, and we certainly don’t want to be sued.  But considering the horrific happenings in Columbine, Aurora, Sandy Hook, Fort Hood, San Bernardino, Orlando, Las Vegas, and New York, it’s time to rethink a few things.

Folks in law enforcement have been begging us for years: “If you see something, say something.” That advice sounds painfully simple, but simple things often save lives. Most of us know when something’s not right. We need to trust our instincts.

The good people of Sutherland, Texas, trusted their instincts hours after the massacre.  In response to unfathomable evil and anger, they held a candlelight prayer vigil.  That doesn’t sound “stupid” to me.