by Richard Aiken MD PhD
Zinc is an essential trace mineral, a component of hundreds of enzymes and proteins. It is required for intracellular message transmission, protein synthesis, maintenance of cell membranes, cellular and intracellular transmembrane transport, and is involved in regulation of the neuronal, endocrinal and immunological systems .
Zinc deficiency induces neurological symptoms as well as psychopathological symptoms that mostly correspond with clinical depression (e.g., poor appetite, reduced sense of taste, reduction in immune function, irritability, mood liability, cognitive impairment)
The mechanisms in which zinc is linked to antidepressant activity is a active area of research but there are indications that it is involved in the neurogenesis processes.
There is a delicate balance in the relation of zinc to copper, so supplementation is not recommended. A whole-food varied-plant diet is the best assurance of getting zinc in the correct doses and food context.
 Takeda A. Movement of zinc and its functional significance in the brain. Brain 224 Res Rev 2000;34(3):137–48.
 Swardfager W, Herrmann N, McIntyre RS, Mazereeuw G, Goldberger K, Cha DS, 226 et al. Potential roles of zinc in the pathophysiology and treatment of major 227 depressive disorder. Neurosci Biobehav Rev 2013;37(5):911–29.
 Levenson CW, Morris D. Zinc and neurogenesis: making new neurons from 388 development to adulthood. Adv Nutr 2011;2(2):96–100.
by Richard Aiken MD, PhD @rcaiken
Virtually any vegetable can be selected for sous vide cooking. Particularly excellent candidates would be those vegetables that are degraded most from high temperature cooking, such as cauliflower, carrots, green peppers, and zucchini. Green leaves can be processed with little nutrient loss or color change.
Recipe: Sous Vide
This recipe utilizes zucchini and green peppers, sensitive to high-temperature cooking. Makes enough for about 4 people.
- 1 medium size zucchini, quartered lengthwise, and cut into one half inch pieces
- 1 medium size eggplant, cut into 1/2-inch pieces (about 2 – 3 cups)
- 1 red bell pepper, chopped
- 1 onion, chopped
- 1 cup tomatoes, chopped course
- 2 garliccloves, minced
- ½ cup shredded fresh basilleaves
- ¼ teaspoon oregano
- ¼ teaspoon thymeor coriander
- Set the sous vide cooker for 185 F (85 C)
- Put the zucchini, tomatoes, bell peppers, eggplant, and onioneach in its own vacuum seal bag.
- Distribute the garlicand basil equally amongst each bag.
- Vacuum seal each bag.
- Once the waterhas reached the set-point temperature, submerge each bag.
- Set a timer for 30 minutes; once that time is up, remove the tomatoes.
- Set the timer for 30 more minutes; once that time is up, remove the zucchiniand peppers.
- Set the timer for one hour; once that time is up, remove the eggplantand onion.
- Mix the contents of each bag into a large serving bowl; season with black pepperto taste.
by Richard Aiken MD PhD @rcaiken
The US Department of Agriculture (USDA) on February 13, 2016, approved the first genetically modified (GM) apple developed to resist browning. They will go into production in the Midwest in the next few weeks (February, 2017).
Browning is caused by polyphenol oxidases (PPOs) naturally present in fruit and vegetables. When fruit is cut or bruised, these enzymes catalyze the oxidation of polyphenols to quinones, causing oxidative browning. The damage is superficial but can affect the taste and texture of the apple as well as its cosmetic qualities. In the Arctic varieties, the GM apples were genetically engineered with a transgene that produces specific RNAs to silence the expression of at least four browning PPO genes.
Is this a good idea?
The enzymes in the class polyphenol oxidase (PPO) appear to reside in the plastids of all land plants and are released when the plastid cell membrane is disrupted. PPO is thought to play an important role in the resistance of plants to microbial and viral infections and to adverse climatic conditions such as drought as although all land plants have PPO content, no PPO-like sequences have been reported in marine plants such as algae.
As stated above, in the presence of oxygen from air, the enzyme catalyzes the first steps in the biochemical conversion of phenolics to produce quinones, which undergo further polymerization to yield dark, insoluble polymers referred to as melanin. This is the same melanin that determines darkness of human skin and hair. In plants, melanin forms barriers and has antimicrobial properties that prevent the spread of infection in plant tissues.
Phenolic compounds are responsible for the color of many plants and impart taste and flavor, but more importantly, they are important phytonutrients and antioxidants.
Alteration of polyphenol oxidase
Given the activity of PPO in the adaptation of plants to, for example, plant dehydration, what are the implications of altered PPO activity on plant development, phenotype, and yield? A clear effect of PPO silencing was observed, for example, in walnut plants which developed spontaneous necrotic lesions in the leaves suggesting increased susceptibility to oxidative stress.
A potential role for PPO in photosynthesis has been speculated.
Data suggest that PPO activity can confer both a productive advantage and be associated with an increased risk of oxidative damage. While PPO activity can be associated with non-enzymatic reactive oxygen species scavenging involving flavonoid and phenolic acid substrates, a role for PPO in plant function may also be associated with its pro-antioxidant activity through the generation of secondary reaction products.
So it is obvious that the role of PPO is extensive and not fully understood. It appears premature to genetically modify plants to remove this complex molecule.
 Tran LT, Taylor JS, Constabel CP. 2012. The polyphenol oxidase gene family in land plants: lineage-specific duplication and expansion. BMC Genomics 13, 395.
 Araji S, Grammer TA, Gertzen R, et al. 2014. Novel roles for the polyphenol oxidase enzyme in secondary metabolism and the regulation of cell death in walnut (Juglans regia). Plant Physiology 164, 1191–1203.
 Vaughn KC, Duke SO. 1984. Function of polyphenol oxidases in higher plants. Physiologia Plantarum 60, 106–112
 Parveen I, Threadgill MD, Moorby JM, Winters A. 2010. Oxidative phenols in forage crops containing polyphenol oxidase enzymes. Journal of Agricultural and Food Chemistry 58, 1371–1382.
 Thipyapong P, Joel DM, Steffens JC. 1997. Differential expression and turnover of the tomato polyphenol oxidase gene family during vegetative and reproductive development. Plant Physiology 113, 707–718.
Adequate nutrition for younger children is a well-known critical factor for growth and development, not only in physiological terms, but also for optimal brain and cognitive function development. Inadequate nutrition has a detrimental effect on children’s health and predispose to childhood obesity, dental caries, poor academic performance, emotional and behavioral difficulties.
A cross-sectional analysis of the dietary patterns of Spanish school children ages 6 – 9 was compared with the Center for Epidemiologic Studies Depression Scale for Children Questionnaire to measure depressive symptoms. Their conclusion was that for children:
“Nutritional inadequacy plays an important role in mental health and poor nutrition may contribute to the pathogenesis of depression.”
The mechanisms behind these effects in children and adolescents are not well described.
Beyond the obvious neurologic development in utero, we know that neurologic development continues after birth and extends throughout childhood and adolescence into young adulthood. It therefore seems logical that a highly nutrient dense diet could result in an advantage in brain development with cognitive, emotional, and behavioral implications.
This could be an effect additional to the now apparent influence diet has on the mental health of adults through inflammation and the immune system, oxidative stress and neurotropic factors. Focus on psychiatric disorders in childhood and adolescence is particularly important given the fact that three quarters of lifetime psychiatric disorders will first emerge by late adolescence or early adulthood.
There is a multitude of reasons why judicious choice of dietary patterns is particularly important to establish early.
Therefore, in all practices of medicine, regardless of specialization, it is important to include nutritional habits in assessments of children, adolescents, and adults. Dietary advice and education enhances both physical and mental heath.
 Gómez-Pinilla, F. (2008). Brain foods: The effects of nutrients on brain function. Nature Reviews Neuroscience Nat Rev Neurosci, 9(7), 568-578. doi:10.1038/nrn2421.
 Rubio-López, N., Morales-Suárez-Varela, M., Pico, Y., Livianos-Aldana, L., & Llopis-González, A. (2016). Nutrient Intake and Depression Symptoms in Spanish Children: The ANIVA Study. International Journal of Environmental Research and Public Health IJERPH, 13(3), 352. doi:10.3390/ijerph13030352.
 Giedd, JN (2010) Structural MRI of pediatric brain development: what have we learned and where are we going? Neuron 67 (5), 728-34.
 Kessler, R. C., Berglund, P., Demler, O., Jin, R., Merikangas, K. R., & Walters, E. E. (2005). Lifetime Prevalence and Age-of-Onset Distributions of DSM-IV Disorders in the National Comorbidity Survey Replication. Archives of General Psychiatry, 62(6), 593. doi:10.1001/archpsyc.62.6.593.
Lithium was once used as a key ingredient in a soft drink invented in 1929 by Charles Leipe Grigg, an American from Price Branch, Missouri. He initially called his drink “Bib-Label Lithiated Lemon-Lime Sodas”. He later changed the name to ” 7 Up Lithiated Lemon-Lime”.
The “7” in the name comes from the atomic mass of lithium. He called his drink 7-Up presumably because of the ability of lithium to elevate the mood. These were obviously low concentrations of lithium citrate; as in deep warm springs yielding lithium salts that have been used for centuries to calm visitors at spas.
In 1962, George Winokur introduced lithium to Washington University in St. Louis (where I happened to do my adult psychiatric residency and child fellowship), having the Barnes Hospital pharmacy make up the pills and achieving an “amazing remission” in a patient who had failed on thorazine treatment and eighteen sessions of electroconvulsive therapy. This was the beginning of the widespread use of lithium in the United States for bipolar disorder and later for mania prophylaxis and still later as an adjunctive treatment for depression; it is today the only psychotropic medication that does not carry the “black box” disclaimer of potentially leading to suicidal thoughts.
The lithium ion is the third element on the periodic table and as it is just above sodium, it does have similar chemical properties to sodium. In the beginning of the twentieth century, lithium salt was prescribed as a substitute for table salt because it was not associated with high blood pressure; however, use in high arbitrary doses could lead to toxicity, so was discontinued for that purpose.
Lithium appears to be a nutritionally essential trace element found predominantly in plant-derived foods and drinking water, although its function has not been fully described. This trace element is typically present in all human organs and tissues, and is equally distributed in body water, as lithium is absorbed from the intestinal tract and excreted by the kidneys.
Recent research studies measuring the effects of trace levels of lithium, commonly found in lithia waters (on the order of 2 mg/liter compared to typical pharmacologic doses of 900 mg/ day), have demonstrated neuroprotective abilities, as well as improvements in mood and cognitive function.
Studies on the local concentration of lithium in some municipal water supplies suggest that lithium has moderating effects on suicidal and violent criminal behaviors. In addition to a whole-food varied-plant diet four 12 ounce glasses of water is recommended. I keep a paper cup dispenser near every source of water in my home and drink a five-ounce cup or two each time I wash my hands.
 Dr. Winokur, together with colleagues Eli Robbins and Samuel Guze — with whom I studied while at Washington University — established the first written formalized criteria for mental disorders, the so-called Feighner criteria, establishing the basic model for the Diagnostic and Statistical Manual series (DSM). The motivation for these criteria was totally as a way to compare research studies on similar patients and not to be taken too literally, a position lost in the many later DSM versions and now falling in disrepute. Dr. Winokur is credited with the statement “Making up new sets of diagnostic criteria in American psychiatry has become a cottage industry with little attempt at quality control”, source Glicksman, A. (2009). “Jesus Loves Me, that I Know, for the Chi-Square Tells Me So” Privileged and Non-Privileged Approaches to the Study of Religion and Aging: A Response. Journal of Religion, Spirituality & Aging, 21(4), 316-317. doi:10.1080/15528030903127155.
 Schrauzer GN (2002) Lithium: occurrence, dietary intakes, nutritional essentiality. J Am Coll Nutr 21:14–21.
 Xu, J., Culman, J., Blume, A., Brecht, S., & Gohlke, P. (2003). Chronic Treatment With a Low Dose of Lithium Protects the Brain Against Ischemic Injury by Reducing Apoptotic Death. Stroke, 34(5), 1287-1292. doi:10.1161/01.str.0000066308.25088.64.
 Schrauzer, De Vroey. Effects of Nutritional Lithium Supplementation on Mood. Biological Trace Element Research Volume 40 1994 pages 89-101.
 Schrauzer, G. N., & Shrestha, K. P. (1990). Lithium in drinking water and the incidences of crimes, suicides, and arrests related to drug addictions. Biological Trace Element Research, 25(2), 105-113. doi:10.1007/bf02990271
 Armstrong, L. E., Ganio, M. S., Casa, D. J., Lee, E. C., Mcdermott, B. P., Klau, J. F., . . . Lieberman, H. R. (2011). Mild Dehydration Affects Mood in Healthy Young Women. Journal of Nutrition, 142(2), 382-388. doi:10.3945/jn.111.142000.