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This Is Your Brain on Kale
By Drew Ramsey, MD
July 2, 2013
The frenzy over kale has turned from foodie buzz to eater roar. Around the country everyone is talking about kale. As a physician, nothing could please me more. Kale represents an important lesson for all us eaters about the power of food choices to transform our health. Sure, let's disclose my bias right away. My new book 50 Shades of Kale (Harper/Wave 2013,) co-authored with Chef Jennifer Iserloh, is just out. It is a gorgeous tribute to our muse kale and at its core a food prescription aimed to improve your brain health.
So what's all the kale hype about?
I love recommending kale for three fundamental reasons: Kale tops the charts of nutrient density, possesses incredible culinary flexibility, and is easy to grow almost anywhere. My ultimate measure of a food is its power to support brain health, and it is clear that more kale in your diet means a happier, healthier, sexier you -- all the basic signs that your brain is running well.
How does kale do this? What's the miracle in that crunch? Let's start with the power of phytonutrients, molecules in plants that do amazing things. One called sulfurophane travels from your kale smoothie to your liver where it amps up your body's natural detox power. Another called kaempferol is truly the fountain of youth -- it turns on the genes that promote longer life. (Move over red wine resveratrol.) Add to this mix carotenoids, which Harvard University just linked to one's overall sense of optimism, and glucosinolates, a known cancer fighter, and it is clear that kale is good medicine. Just step into the "Farmacy."
Brain health depends on picking the right fats in your diet, as the brain is about 60 percent fat. One vital set of fats most eaters need more of is the omega-3s, which happen to be the main kind of fat in kale. The plant-based omega-3 ALA (alpha-linolenic acid) is linked to numerous health benefits like lowering the risk of depression and diabetes. Both diabetes and obesity wreak havoc on the brain and kale is a great first step to fighting both. High blood sugar ages blood vessels and brain cells more quickly and fat cells create "pro-inflammatory" signals and frankly, who wants an inflamed brain? The fiber in kale is naturally filling and also promotes better gut health. And kale is a naturally low-carb food, so there is no spike in blood sugar.
The brain depends on essential vitamins and minerals to function. By these traditional measures of nutrient density, kale is at the top of the charts. A cup of raw kale has just 33 calories, yet you get a huge dose of vitamin C (134 percent RDA), pro-vitamin A (206 percent RDA), and a vitamin K (684 percent RDA). Those are some hefty numbers, but what is with all that vitamin K?! We don't hear much about this essential vitamin, but this is a nutrient to watch. Long associated with blood clotting, vitamin K is a powerful anti-oxidant that protects fat. It is a key co-factor need to make the specialized fats called sphingolipids that create the structure of our brain cells, and it promotes brain cells being more resilient by influencing gene expression. Vitamin K is also needed for bone health, and kale happens to be a great source of another bone-builder. Studies of calcium absorption from kale have shown its absorption to be superior to milk! That's because unlike many other greens such as spinach, kale has almost no oxalates that impair absorption. Kale also has a lot of protein for a leafy green. Add to this iron, folate, and vitamin B6, all needed to make brain molecules like serotonin and dopamine, and it is clear that kale is brain food.
Think kale is a trendy foodie food? Kale has always been a farmer food as it is easy to grow, resistant to pests and drought, and provides food late into the winter. Once kale endures a frost, the leaves become slightly sweeter. The hardy plant yields fresh greens late into the winter. You don't have to be a farmer to produce small kale crop for yourself, you just need a sunbeam and a window box. Kale can be used to cook everything from raw salads to soups to cocktails. With so many health benefits and so many ways to prepare it, it is no wonder kale is a staple around the world from Scotland to Kenya.
A Vermont folk artist T-shirt designer was recently sued for his hand-printed shirts that read: Eat More Kale. He is accused of infringing on the trademark of a certain fast food restaurant that promotes eating more chicken. But suggesting what people should eat for health is a really medical intervention. Plus, can anyone claim ownership of this phrase "eat more" except for perhaps Hippocrates himself. ("Let thy food be thy medicine and thy medicine be thy food.) So take this as medical advice* for your brain health: Eat More Kale America and know you are building a better brain
For unique, colorful and surprising ways to weave kale into your diet, please check out 50 Shades of Kale. If you want to help spread the health of kale in your community, school, church, or health care facility, Chef Jen and I founded National Kale Day, an initiative to get every American to eat kale on Oct. 2.
*If you take blood thinner or have an issue with blood clotting, contact your physician before increasing your kale intake, as it can interfere with anti-clotting medications like warfarin.
Crispy Kale "Chips"
- 1 head kale, washed and thoroughly dried
- 2 tablespoons olive oil
- Sea salt, for sprinkling
Preheat the oven to 275 degrees F.
Remove the ribs from the kale and cut into 1 1/2-inch pieces. Lay on a baking sheet and toss with the olive oil and salt. Bake until crisp, turning the leaves halfway through*, about 20 minutes. Serve as finger food.
*Use broiler pan so you don't have to turn them over
Recipe courtesy Melissa d'Arabian
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Asperger's and Autism:
Brain Differences Found
By Bahar Gholipour
August 5, 2013
Children with Asperger's syndrome show patterns of brain connectivity distinct from those of children with autism, according to a new study. The findings suggest the two conditions, which are now in one category in the new psychiatry diagnostic manual, may be biologically different.
The researchers used electroencephalography (EEG) recordings to measure the amount of signaling occurring between brain areas in children. They had previously used this measure of brain connectivity to develop a test that could distinguish between children with autism and normally developing children.
"We looked at a group of 26 children with Asperger's, to see whether measures of brain connectivity would indicate they're part of autism group, or they stood separately," said study researcher Dr. Frank Duffy, a neurologist at Boston's Children Hospital. The study also included more than 400 children with autism, and about 550 normally developing children, who served as controls.
At first, the test showed that children with Asperger's and those with autism were similar: both showed weaker connections, compared with normal children, in a region of the brain's left hemisphere called the arcuate fasciculus, which is involved in language.
However, when looking at connectivity between other parts of the brain, the researchers saw differences. Connections between several regions in the left hemisphere were stronger in children with Asperger's than in both children with autism and normally developing children.
The results suggest the conditions are related, but there are physiological differences in brain connectivity that distinguish children with Asperger's from those with autism, according to the study published Wednesday (July 31) in the journal BMC Medicine.
"The findings are exciting, and the methods are sophisticated," said Dr. James McPartland, a professor of child psychiatry at Yale University, who was not involved in the study.
Although the study included a reasonable number of children, like any new finding, the research needs to be replicated in future studies, McPartland said.
People with Asperger’s syndrome experience difficulties with social interaction, and can display unusual behaviors, such as repeating the same action or being excessively attached to performing certain routines. These symptoms overlap with those of autism disorder, however, children with Asperger's tend to show language and cognitive development that is closer to that of normal children, compared with children with autism.
Recently, the American Psychiatric Association decided to eliminate Asperger's syndrome from the newest revision of the Diagnostic and Statistical Manual of Mental Disorders (DSM 5) and instead put it alongside autism under an umbrella term, autism spectrum disorders (ASD).
The APA's decision raised voices of concern from several places. Parents worried that their children with Asperger's might not receive the special training they need, and experts said it was premature to combine the two conditions under one groupwhen it cannot be ruled out that there are biological differences.
"At present, it is hard to know whether [the new findings] reflect a core, intrinsic difference between Asperger's and autism, or whether it is a reflection of developing with different characteristics," McPartland said.
Duffy said the new findings fit with the notion that autism and Asperger's syndrome are similar in some respects; for example, both have difficulty getting along with other people.
However, stronger connectivity among the left hemisphere brain areas in children with Asperger's may be what makes people with Asperger's special in terms of their personalities and abilities, Duffy said.
"It's essential to separate these two groups, because they need different education and training and opportunity," he said.
Breakthrough Study Reveals Biological Basis for Sensory Processing Disorders in Kids
By Juliana Bunim
July 09, 2013
Sensory processing disorders (SPD) are more prevalent in children than autism and as common as attention deficit hyperactivity disorder, yet the condition receives far less attention partly because it’s never been recognized as a distinct disease.
In a groundbreaking new study from UC San Francisco, researchers have found that children affected with SPD have quantifiable differences in brain structure, for the first time showing a biological basis for the disease that sets it apart from other neurodevelopmental disorders.
One of the reasons SPD has been overlooked until now is that it often occurs in children who also have ADHD or autism, and the disorders have not been listed in the Diagnostic and Statistical Manual used by psychiatrists and psychologists.
“Until now, SPD hasn’t had a known biological underpinning,” said senior author Pratik Mukherjee, MD, PhD, a professor of radiology and biomedical imaging and bioengineering at UCSF. “Our findings point the way to establishing a biological basis for the disease that can be easily measured and used as a diagnostic tool,” Mukherjee said.
The work is published in the open access online journal NeuroImage:Clinical.
‘Out of Sync’ Kids
Children with SPD struggle with how to process stimulation, which can cause a wide range of symptoms including hypersensitivity to sound, sight and touch, poor fine motor skills and easy distractibility. Some SPD children cannot tolerate the sound of a vacuum, while others can’t hold a pencil or struggle with social interaction. Furthermore, a sound that one day is an irritant can the next day be sought out. The disease can be baffling for parents and has been a source of much controversy for clinicians, according to the researchers.
“Most people don’t know how to support these kids because they don’t fall into a traditional clinical group,” said Elysa Marco, MD, who led the study along with postdoctoral fellow Julia Owen, PhD. Marco is a cognitive and behavioral child neurologist at UCSF Benioff Children’s Hospital, ranked among the nation's best and one of California's top-ranked centers for neurology and other specialties, according to the 2013-2014 U.S. News & World Report Best Children's Hospitals survey.
“Sometimes they are called the ‘out of sync’ kids. Their language is good, but they seem to have trouble with just about everything else, especially emotional regulation and distraction. In the real world, they’re just less able to process information efficiently, and they get left out and bullied,” said Marco, who treats affected children in her cognitive and behavioral neurology clinic.
“If we can better understand these kids who are falling through the cracks, we will not only help a whole lot of families, but we will better understand sensory processing in general. This work is laying the foundation for expanding our research and clinical evaluation of children with a wide range of neurodevelopmental challenges – stretching beyond autism and ADHD,” she said.
Imaging the Brain’s White Matter
In the study, researchers used an advanced form of MRI called diffusion tensor imaging (DTI), which measures the microscopic movement of water molecules within the brain in order to give information about the brain’s white matter tracts. DTI shows the direction of the white matter fibers and the integrity of the white matter. The brain’s white matter is essential for perceiving, thinking and learning.
The study examined 16 boys, between the ages of eight and 11, with SPD but without a diagnosis of autism or prematurity, and compared the results with 24 typically developing boys who were matched for age, gender, right- or left-handedness and IQ. The patients’ and control subjects’ behaviors were first characterized using a parent report measure of sensory behavior called the Sensory Profile.
The imaging detected abnormal white matter tracts in the SPD subjects, primarily involving areas in the back of the brain, that serve as connections for the auditory, visual and somatosensory (tactile) systems involved in sensory processing, including their connections between the left and right halves of the brain.
“These are tracts that are emblematic of someone with problems with sensory processing,” said Mukherjee. “More frontal anterior white matter tracts are typically involved in children with only ADHD or autistic spectrum disorders. The abnormalities we found are focused in a different region of the brain, indicating SPD may be neuroanatomically distinct.”
The researchers found a strong correlation between the micro-structural abnormalities in the white matter of the posterior cerebral tracts focused on sensory processing and the auditory, multisensory and inattention scores reported by parents in the Sensory Profile. The strongest correlation was for auditory processing, with other correlations observed for multi-sensory integration, vision, tactile and inattention.
The abnormal microstructure of sensory white matter tracts shown by DTI in kids with SPD likely alters the timing of sensory transmission so that processing of sensory stimuli and integrating information across multiple senses becomes difficult or impossible.
“We are just at the beginning, because people didn’t believe this existed,” said Marco. “This is absolutely the first structural imaging comparison of kids with research diagnosed sensory processing disorder and typically developing kids. It shows it is a brain-based disorder and gives us a way to evaluate them in clinic.”
Future studies need to be done, she said, to research the many children affected by sensory processing differences who have a known genetic disorder or brain injury related to prematurity.
The study’s co-authors are Shivani Desai, BS, Emily Fourie, BS, Julia Harris, BS, and Susanna Hill, BS, all of UCSF, and Anne Arnett, MA, of the University of Denver.
The research was supported by the Wallace Research Foundation. The authors have reported that they have no conflicts of interest relevant to the contents of this paper to disclose.
UCSF Benioff Children’s Hospital creates an environment where children and their families find compassionate care at the forefront of scientific discovery, with more than 150 experts in 50 medical specialties serving patients throughout Northern California and beyond. The hospital admits about 5,000 children each year, including 2,000 babies born in the hospital. For more information, visit www.ucsfbenioffchildrens.org.
UCSF is a leading university dedicated to promoting health worldwide through advanced biomedical research, graduate-level education in the life sciences and health professions, and excellence in patient care.