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.
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. 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
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.
 Wood, G.A.R.; Lass, R.A. (2001). Cocoa (4th ed.). Oxford: Blackwell Science.
 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.
 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.
by R. Aiken MD PhD @rcaiken
Turmeric is a spice with perhaps the highest antioxidant and anti-inflammatory properties of any culinary spice – or herb. One active component of turmeric is curcumin (the pigment responsible for the bright yellow color of the spice), which may have natural antidepressant qualities and has been shown to protect neurons from the damaging effects of chronic stress.
The beneficial effects of curcumin in the pathophysiology of major depression are probably related to its anti-inflammatory and antioxidant properties, inhibition of monoamine oxidase, and modulation of neurotrophic factors and hippocampal neurogenesis and neuroplasticity.
In a randomized controlled trial , a comparable efficacy was obtained after curcumin monotherapy (1000 mg/day) compared to fluoxetine monotherapy. Supplementation of conventional antidepressants with curcumin (1000 mg/ day) has shown to be an effective and safe enhancement.
Meta-analysis of data from the six clinical trials revealed a significant reduction in major depressive symptoms following the administration of curcumin in combination with piperdine (see below). These studies all used the 1000 mg/ day and the anti-depressant effect was best after a duration of six weeks.
Turmeric suppresses pain and inflammation similar to non-steroidal anti-inflammatories but without the potential side effects. The health benefits derive, as for Rhodiola and Maca, from “xenohormesis” – a biological principle that explains why environmentally stressed plants produce bioactive compounds that can confer stress resistance and survival benefits to animals that consume them (see Chapter 6).
Turmeric contains about 2% by weight curcumin, so a tablespoon of turmeric (6.8 grams) contains about 136 mg of curcumin. To get 1000 mg/ day curcumin from raw turmeric would then require more than seven tablespoons. Supplements that purport to contain 500 mg curcumin are commercially available.
One tablespoon of turmeric (1000 mg) per day with a pinch or two of ground pepper (see below) is recommended. If you grate the turmeric root yourself, be prepared to wear gloves as the color is so intense you will have yellow finger tips otherwise.
 Kulkarni, S. K., Bhutani, M. K., & Bishnoi, M. (2008). Antidepressant activity of curcumin: Involvement of serotonin and dopamine system. Psychopharmacology, 201(3), 435-442. doi:10.1007/s00213-008-1300-y.
 Liu, D., Wang, Z., Gao, Z., Xie, K., Zhang, Q., Jiang, H., & Pang, Q. (2014). Effects of curcumin on learning and memory deficits, BDNF, and ERK protein expression in rats exposed to chronic unpredictable stress. Behavioural Brain Research, 271, 116-121. doi:10.1016/ j.bbr.2014.05.068.
 Sanmukhani, J., Satodia, V., Trivedi, J., Patel, T., Tiwari, D., Panchal, B., . . . Tripathi, C. B. (2013). Efficacy and Safety of Curcumin in Major Depressive Disorder: A Randomized Controlled Trial. Phytother. Res. Phytotherapy Research, 28(4), 579-585. doi:10.1002/ptr.5025.
 Yu, J., Pei, L., Zhang, Y., Wen, Z., & Yang, J. (2015). Chronic Supplementation of Curcumin Enhances the Efficacy of Antidepressants in Major Depressive Disorder. Journal of Clinical Psychopharmacology, 1. doi:10.1097/jcp.0000000000000352.
 Al-Karawi, D., Mamoori, D. A., & Tayyar, Y. (2015). The Role of Curcumin Administration in Patients with Major Depressive Disorder: Mini Meta-Analysis of Clinical Trials. Phytother. Res. Phytotherapy Research, 30(2), 175-183. doi:10.1002/ptr.5524.
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 and anti-inflammatories, as well as for its neuroprotective activity. 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.
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.
 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.
 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.
 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
 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
Flowers of Hibiscus (rosa-sinensis Linn) popularly known as “China-rose flowers” contain significant flavonoids (such as anthocyanin and quercetin) known to have antidepressant activity.
The antidepressant effect may be from its antioxidant activity; there are few controlled studies on human populations. Hibiscus has been used in Hawaiian cultures to treat postpartum depression.
Another herbal tea, made from the sepals of Hibiscus flowers are beautiful, showy red flowers that are harvested and dried like most teas. This plant contains bioflavonoids, which are believed to help prevent an increase in LDL cholesterol, and to lower blood pressure. The research is quite clear on these effects. It may work by boosting nitric oxide production, generally an advantage for cardiovascular activities (aerobic exercise).
Again, why bother to make tea with this food and limit the nutrient availability when you can eat it! I use a heaping tablespoon in my morning smoothie. I also like to blend it with green tea and ice, then strain it into water bottles as a drink during exercise.
 Butterweck, V., Jürgenliemk, G., Nahrstedt, A., & Winterhoff, H. (2000). Flavonoids from Hypericum perforatum Show Antidepressant Activity in the Forced Swimming Test. Planta Medica, 66(1), 3-6. doi:10.1055/s-2000-11119.
 Vanzella, C., Bianchetti, P., Sbaraini, S., Vanzin, S. I., Melecchi, M. I., Caramão, E. B., & Siqueira, I. R. (2012). Antidepressant-like effects of methanol extract of Hibiscus tiliaceus flowers in mice. BMC Complementary and Alternative Medicine, 12(1). doi:10.1186/1472-6882-12-41.
 Kobayashi, J. (1976). Early Hawaiian Uses of Medicinal Plants in Pregnancy and Childbirth. Journal of Tropical Pediatrics, 22(6), 260-262. doi:10.1093/tropej/22.6.260.
 Siddiqui, A., Wani, S., Rajesh, R., & Alagarsamy, V. (2006). Phytochemical and pharmacological investigation of flowers of hibiscus rosasinensis linn. Indian Journal of Pharmaceutical Sciences Indian J Pharm Sci, 68(1), 127. doi:10.4103/0250-474x.22986.
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.
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.
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.
 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.
 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.