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Archive of ‘cognition’ category

Flaxseeds: single most important food for mental health?


by R. Aiken MD PhD @rcaiken

Flaxseed helps lower cholesterol, lowers blood pressure, is anti-inflammatory, has good anti-oxidants, and fiber.  It is the single most neuroprotective food; oh yes, then there is the omega-3 content.

There is no doubt that this food is an excellent source of essential omega-3 fats in the form of alpha-linolenic acid, the basic building block to other omega-3s – eicosapentaenoic acid and docosahexaenoic acid. Omega-3, and a proper omega-3 to omega-6 ratio, is important in mental wellness and recovery from psychiatric disorders.

But flaxseed offers more than just the ideal omega-3 source; it contains many polyphenolic compounds such as phenolic acids[1], flavonoids and lignans along with vitamins C and E[2].  One study found that flaxseed significantly decreased chronic stress (cortisol) levels, indicating a possible synergistic effect between omega-3 fatty acid and polyphenols[3].  Other components such as a flaxseed lignan (a phytoestrogen compound called secoisolariciresinol) has been shown to have possible applications in post-menopausal depression[4].

Studies of flaxseed oil supplementation have indicated a good tolerance even in the pediatric population where one study indicated its effectiveness in child bipolar disorder[5].

I recommend a daily intake of one to three tablespoons of ground flax, each tablespoon of which contains about 30 calories, 2.5 grams fat, 2 grams fiber, and 1.5 grams protein[6]. Be sure to grind the flaxseeds as the fine seeds with their hard shell will likely just pass on through the gut otherwise. Flaxseeds can be ground in a coffee bean grinder and the ground powder added to grains, salads, beans – practically any dish for a little texture.

Note that the shelf life of the oily seeds is limited unless kept in an airtight container in the fridge or freezer.  Ground flaxseeds or flax meal should be kept in the freezer; at room temperature and exposed to air, use the ground seeds within one week. Smell the flax – if it has a strong odor such as fishy smell, it may be rancid.  A taste test should reveal a mild nutty flavor – if bitter or sour that also may be a signal that it is rancid.

For these reasons, chia seeds, rich in antioxidants and omega-3 PUFAs may be preferable to some.


[1] Oomah, B. D., Kenaschuk, E. O., & Mazza, G. (1995). Phenolic Acids in Flaxseed. J. Agric. Food Chem. Journal of Agricultural and Food Chemistry, 43(8), 2016-2019. doi:10.1021/jf00056a011.

[2] Bidlack, W. W. (1999). Functional Foods: Biochemical and Processing Aspects, G. Mazza, ed. Lancaster, PA: Technomic Publishing Co., Inc., 437 pp, 1998. Journal of the American College of Nutrition, 18(6), 640-641. doi:10.1080/07315724.1999.10718899.

[3] Naveen, S., Siddalingaswamy, M., Singsit, D., & Khanum, F. (2013). Anti-depressive effect of polyphenols and omega-3 fatty acid from pomegranate peel and flax seed in mice exposed to chronic mild stress. Psychiatry Clin Neurosci Psychiatry and Clinical Neurosciences, 67(7), 501-508. doi:10.1111/pcn.12100.

[4] Wang, Y., Xu, Z., Yang, D., Yao, H., Ku, B., Ma, X., . . . Cai, S. (2012). The antidepressant effect of secoisolariciresinol, a lignan-type phytoestrogen constituent of flaxseed, on ovariectomized mice. Journal of Natural Medicines,67(1), 222-227. doi:10.1007/s11418-012-0655-x.

[5] Gracious, B. L., Chirieac, M. C., Costescu, S., Finucane, T. L., Youngstrom, E. A., & Hibbeln, J. R. (2010). Randomized, placebo-controlled trial of flax oil in pediatric bipolar disorder. Bipolar Disorders, 12(2), 142-154. doi:10.1111/j.1399-5618.2010.00799.x.

[6] A very convenient way to have ground flax ready to serve is provided by Carrington Farms Organic Ground Milled Flax Seeds, two tablespoon packets sealed and lasting without refrigeration about one year.

Cocoa for vascular health: stunning anti-oxidant, anti-inflammatory – brain and heart wellness



by R. Aiken MD PhD @rcaiken

Foods and beverages made with beans from the Theobroma cacao tree  have been consumed by humans for over 5000 years, in pre-Colombian cultures along the Yucatan, including the Mayans[1].

Cocoa is the dried and fully fermented fatty seed of the fruit of the cocoa tree, native to the Americas. Cocoa liquor is the paste made from ground, roasted, shelled, and fermented cocoa beans, called nibs. It contains both nonfat cocoa solids and cocoa butter. Cocoa liquor is what is referred to as ‘‘percent cacao’’ on food packaging. Cocoa powder is made by removing some of the cocoa butter from the liquor.

Chocolate is a solid food made by combining cocoa liquor with cocoa butter and sugar. The proportion of cocoa liquor in the final product determines how dark the chocolate is. Milk chocolate, typically containing 10%–12% cocoa liquor, is made with the addition of condensed or powdered milk to the chocolate mixture and is the chocolate consumed most in the United States. Semisweet or bittersweet chocolate is often referred to as dark chocolate and must contain no less than 35% by weight of cocoa liquor.

Raw unprocessed cocoa is one of the richest antioxidant foods in the world. Studies indicate that cocoa has an effect on carbon dioxide levels that affect blood vessels and improve blood flow.  This has positive implications, for example, on reducing the risk of stroke.

Cocoa is a rich source of polyphenols, mainly flavanols, which have been recognized for having positive effects on vascular disease, cancer, diabetes, inflammation, oxidative stress, and blood pressure[2].  Because flavanols have the capacity to cross the blood-brain barrier, enhancing brain blood flow through the increased production of NO, which has been proposed as a mechanism involved in brain health[3]

Any form other than raw typically contains added fat and sugar and is to be avoided.

Overall, research to date suggests that the benefits of moderate cocoa or dark chocolate consumption likely outweigh the risks of obesity and glycemic load.


[1] Wood, G.A.R.; Lass, R.A. (2001). Cocoa (4th ed.). Oxford: Blackwell Science.

[2] Shrime, M. G., Bauer, S. R., Mcdonald, A. C., Chowdhury, N. H., Coltart, C. E., & Ding, E. L. (2011). Flavonoid-Rich Cocoa Consumption Affects Multiple Cardiovascular Risk Factors in a Meta-Analysis of Short-Term Studies. Journal of Nutrition, 141(11), 1982-1988. doi:10.3945/jn.111.145482.

[3] Nehlig, A. (2012). The neuroprotective effects of cocoa flavanol and its influence on cognitive performance. British Journal of Clinical Pharmacology Br J Clin Pharmacol. doi:10.1111/j.1365-2125.2012.04378.x.

Ground peppercorns for cognitive function, mood, and bioavailability.


by Aiken MD PhD @rcaiken

Black pepper has an ancient history of being a highly desirable but expensive spice.  It has even been used as a currency.

Piperine is a simple and pungent alkaloid found in the seeds of black pepper. Piperine is commonly known as a bioavailability enhancer for a number of nutraceuticals, including antioxidants[1] and anti-inflammatories[2], as well as for its neuroprotective activity[3]. The Journal of Food and Chemical Toxicology reported that the compound piperine in black pepper increases the cognitive function of the brain and helps mood disorder.

Piperine helps the body absorb curcumin and therefore enhances curcumin’s antidepressant effect long-term. There may be similar absorption assistance given to selenium, vitamin B12, and beta-carotene.

Piperine has shown multiple mechanisms of action, including inhibition of MAO enzymes, elevation of brain serotonin (5-HT) brain derived neurotropic factor (BDNF) levels, and modulation of HPA axis[4].

Because of its intense taste in small quantities, it is typically used as just a few “pinches” into turmeric recipes.

Typically 2.5 mg/ kg is used so for a 70 kg person that would equal 175 mg; a teaspoon of black pepper weighs about 2000 mg, so this is less than 10% of a teaspoon – otherwise known as a “pinch” or two.


[1] Johnson, J. J., Nihal, M., Siddiqui, I. A., Scarlett, C. O., Bailey, H. H., Mukhtar, H., & Ahmad, N. (2011). Enhancing the bioavailability of resveratrol by combining it with piperine. Molecular Nutrition & Food Research Mol. Nutr. Food Res., 55(8), 1169-1176. doi:10.1002/mnfr.201100117.

[2] Ying, X., Yu, K., Chen, X., Chen, H., Hong, J., Cheng, S., & Peng, L. (2013). Piperine inhibits LPS induced expression of inflammatory mediators in RAW 264.7 cells. Cellular Immunology, 285(1-2), 49-54. doi:10.1016/j.cellimm.2013.09.001.

[3] Shrivastava, P., Vaibhav, K., Tabassum, R., Khan, A., Ishrat, T., Khan, M. M., . . . Islam, F. (2013). Anti-apoptotic and Anti-inflammatory effect of Piperine on 6-OHDA induced Parkinson’s Rat model. The Journal of Nutritional Biochemistry,24(4), 680-687. doi:10.1016/ j.jnutbio.2012.03.018

[4] Mao, Q.Q., Xian, Y.F., Ip, S.P., and Che, C.T. (2011). Involvement of serotonergic system in the antidepressant-like effect of piperine. Prog. Neuropsychopharmacol. Biol. Psychiatry 35, 1144–1147

Ashwagandha roots for exercise recovery, insomnia, and cognitive health



The root of Ashwagandha (Withania somnifera) is used extensively in Ayurveda, the classical Indian system of medicine, and is categorized as a rasayana, an herbal remedy used to promote physical and mental health[1].

There are many claims concerning the health benefits of Ashwagandha root and most all of them concern reduction of adrenal stress (anxiety) and reduction of inflammation; there are many peer reviewed studies, including systematic review summaries that are rather convincing.  Positive influences on neurodegenerative diseases such as cognitive decline and dementias have been suggested[2].

It is likely helpful to ingest this substance after exercise, particularly endurance workouts or heavy lifting (supposedly it helps to stimulate muscle recovery).

Also this Ayurvedic has been used to help treat insomnia.

The amount suggested by the literature studies is one-half teaspoon, about 1600 mg.


[1] Bhattacharya, S., Bhattacharya, A., Sairam, K., & Ghosal, S. (2000). Anxiolytic-antidepressant activity of Withania somnifera glycowithanolides: An experimental study. Phytomedicine, 7(6), 463-469. doi:10.1016/ s0944-7113(00)80030-6.

[2] Manchanda, S., Mishra, R., Singh, R., Kaur, T., & Kaur, G. (2016). Aqueous Leaf Extract of Withania somnifera as a Potential Neuroprotective Agent in Sleep-deprived Rats: A Mechanistic Study. Molecular Neurobiology Mol Neurobiol. doi:10.1007/s12035-016-9883-5.