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Contact Us: Faculty Development Information

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Contact Us: Faculty Development Information

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Camille Freeman, LDN: Herbalist, Nutritionist, Educator

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Camille Freeman offers support, education and advice for integrative herbalists and nutritionists. Come along for the ride!

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http://www.bevinclare.com/

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Affiliations

¹ Centre for Human Psychopharmacology, Swinburne University, Melbourne VIC 3122, Australia. andrew@scholeylab.com.

² Centre for Human Psychopharmacology, Swinburne University, Melbourne VIC 3122, Australia. amygibbs57@gmail.com.

³ Centre for Human Psychopharmacology, Swinburne University, Melbourne VIC 3122, Australia. chrisneale02@gmail.com.

⁴ Centre for Human Psychopharmacology, Swinburne University, Melbourne VIC 3122, Australia. naomiperry21@gmail.com.

⁵ Centre for Human Psychopharmacology, Swinburne University, Melbourne VIC 3122, Australia. apresgrave@gmail.com.

⁶ Centre for Human Psychopharmacology, Swinburne University, Melbourne VIC 3122, Australia. vanessa.bilog@gmail.com.

⁷ Centre for Human Psychopharmacology, Swinburne University, Melbourne VIC 3122, Australia. marni.kras@monash.edu.

⁸ Merck Selbstmedikation GmbH, Roesslerstrasse 96, 64293 Darmstadt, Germany. Claudia.Scholz@merck.de.

⁹ Rudolf Wild GmbH & Co. KG, Rudolf-Wild-Str. 107-115, D-69214 Eppelheim, Heidelberg, Germany. Matthias.Sass@wild.de.

¹⁰ Vital Solutions GmbH, Hausinger Strasse 6, D-40764 Langenfeld, Germany. Sybille.buchwald-werner@vitalsolutions.biz.

Free PMC article

Randomized Controlled Trial

Free PMC article

Affiliations

¹ Centre for Human Psychopharmacology, Swinburne University, Melbourne VIC 3122, Australia. andrew@scholeylab.com.

² Centre for Human Psychopharmacology, Swinburne University, Melbourne VIC 3122, Australia. amygibbs57@gmail.com.

³ Centre for Human Psychopharmacology, Swinburne University, Melbourne VIC 3122, Australia. chrisneale02@gmail.com.

⁴ Centre for Human Psychopharmacology, Swinburne University, Melbourne VIC 3122, Australia. naomiperry21@gmail.com.

⁵ Centre for Human Psychopharmacology, Swinburne University, Melbourne VIC 3122, Australia. apresgrave@gmail.com.

⁶ Centre for Human Psychopharmacology, Swinburne University, Melbourne VIC 3122, Australia. vanessa.bilog@gmail.com.

⁷ Centre for Human Psychopharmacology, Swinburne University, Melbourne VIC 3122, Australia. marni.kras@monash.edu.

⁸ Merck Selbstmedikation GmbH, Roesslerstrasse 96, 64293 Darmstadt, Germany. Claudia.Scholz@merck.de.

⁹ Rudolf Wild GmbH & Co. KG, Rudolf-Wild-Str. 107-115, D-69214 Eppelheim, Heidelberg, Germany. Matthias.Sass@wild.de.

¹⁰ Vital Solutions GmbH, Hausinger Strasse 6, D-40764 Langenfeld, Germany. Sybille.buchwald-werner@vitalsolutions.biz.

Abstract

Lemon balm (Melissa officinalis) has been used historically and contemporarily as a modulator of mood and cognitive function, with anxiolytic effects following administration of capsules, coated tablets and topical application. Following a pilot study with lemon balm extract administered as a water based drink, which confirmed absorption of rosmarinic acid effects on mood and cognitive function, we conducted two similar double-blind, placebo-controlled, crossover studies. These evaluated the mood and cognitive effects of a standardised M. officinalis preparation administered in palatable forms in a beverage and in yoghurt. In each study a cohort of healthy young adults' self-rated aspects of mood were measured before and after a multi-tasking framework (MTF) administered one hour and three hours following one of four treatments. Both active lemon balm treatments were generally associated with improvements in mood and/or cognitive performance, though there were some behavioral "costs" at other doses and these effects depended to some degree on the delivery matrix.

References

Kennedy D.O., Scholey A.B. The Psychopharmacology of European herbs with cognition-enhancing properties. Curr. Pharm. Des. 2006;12:4613-4623. doi: 10.2174/138161206779010387. - DOI - PubMed

Wake G., Court J., Pickering A., Lewis R., Wilkins R., Perry E. CNS acetylcholine receptor activity in European medicinal plants traditionally used to improve failing memory. J. Ethnopharmacol. 2000;69:105-114. doi: 10.1016/S0378-8741(99)00113-0. - DOI - PubMed

Kennedy D.O., Scholey A.B., Tildesley N.T.J., Perry E.K., Wesnes K.A. Modulation of mood and cognitive performance following acute administration of Melissa officinalis (lemon balm) Pharmacol. Biochem. Behav. 2002;72:953-964. doi: 10.1016/S0091-3057(02)00777-3. - DOI - PubMed

Kennedy D., Wake G., Savelev S., Tildesley N., Perry E., Wesnes K., Scholey A. Modulation of mood and cognitive performance following acute administration of single doses of Melissa officinalis (lemon balm) with human CNS nicotinic and muscarinic receptor-binding properties. Neuropsychopharmacology. 2003;28:1871-1881. doi: 10.1038/sj.npp.1300230. - DOI - PubMed

Kennedy D.O., Little W., Scholey A.B. Attenuation of laboratory-induced stress in humans after acute administration of Melissa officinalis (lemon Balm) Psychosom. Med. 2004;66:607-613. doi: 10.1097/01.psy.0000132877.72833.71. - DOI - PubMed

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national center for biotechnology information

# data[].attributes.attachment_link.title
Anti-stress effects of lemon balm-containing foods - PubMed

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Lemon balm (Melissa officinalis) has been used historically and contemporarily as a modulator of mood and cognitive function, with anxiolytic effects following administration of capsules, coated tablets and topical application. Following a pilot study with lemon balm extract administered as a water ...

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Abstract

Objective: The objective of this study was to investigate the effectiveness of Bacopa monnieri Linn. for improvement of memory performance in healthy older persons.

Study design: This was a randomized, double-blind, placebo-controlled trial.

Setting and participants: The trial took place in Lismore, NSW, Australia between February and July 2005. Ninety-eight (98) healthy participants over 55 years of age were recruited from the general population.

Interventions: Participants were randomized to receive an extract of Bacopa monnieri called BacoMind(TM) (Natural Remedies Pvt. Ltd.), 300 mg/day, or an identical placebo. Following screening, neuropsychologic and subjective memory assessments were performed at baseline and at 12 weeks.

Outcome measures: Audioverbal and visual memory performance were measured by the Rey Auditory Verbal Learning Test (AVLT), the Rey-Osterrieth Complex Figure Test (CFT), and the Reitan Trail Making Test (TMT). Subjective memory performance was measured by the Memory Complaint Questionnaire (MAC-Q).

Results: One hundred and thirty-six (136) subjects volunteered; 103 met entry criteria, 98 commenced, and 81 completed the trial. Bacopa significantly improved verbal learning, memory acquisition, and delayed recall as measured by the AVLT: trial a4 (p = 0.000), trial a5 (p = 0.016); trial a6 (p = 0.000); trial a7 (delayed recall) (p = 0.001); total learning (p = 0.011); and retroactive interference (p = 0.048). CFT, MAC-Q, and TMT scores improved but group differences were not significant. Bacopa versus placebo caused gastrointestinal tract (GIT) side-effects.

Conclusions: Bacopa significantly improved memory acquisition and retention in healthy older Australians. This concurs with previous findings and traditional use. Bacopa caused GIT side-effects of increased stool frequency, abdominal cramps, and nausea.

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Effects of a standardized Bacopa monnieri extract on cognitive performance, anxiety, and depression in the elderly: a randomized, double-blind, placebo-controlled trial.

Calabrese C, Gregory WL, Leo M, Kraemer D, Bone K, Oken B. Calabrese C, et al. J Altern Complement Med. 2008 Jul;14(6):707-13. doi: 10.1089/acm.2008.0018. J Altern Complement Med. 2008. PMID: 18611150 Free PMC article. Clinical Trial.

Bioactive Compounds and Traditional Herbal Medicine: Promising Approaches for the Treatment of Dementia.

Alzobaidi N, Quasimi H, Emad NA, Alhalmi A, Naqvi M. Alzobaidi N, et al. Degener Neurol Neuromuscul Dis. 2021 Apr 12;11:1-14. doi: 10.2147/DNND.S299589. eCollection 2021. Degener Neurol Neuromuscul Dis. 2021. PMID: 33880073 Free PMC article. Review.

Indian Medicinal Herbs and Formulations for Alzheimer's Disease, from Traditional Knowledge to Scientific Assessment.

Mehla J, Gupta P, Pahuja M, Diwan D, Diksha D. Mehla J, et al. Brain Sci. 2020 Dec 10;10(12):964. doi: 10.3390/brainsci10120964. Brain Sci. 2020. PMID: 33321899 Free PMC article. Review.

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national center for biotechnology information

# data[].attributes.attachment_link.title
Does Bacopa monnieri improve memory performance in older persons? Results of a randomized, placebo-controlled, double-blind trial - PubMed

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Objective: The objective of this study was to investigate the effectiveness of Bacopa monnieri Linn. for improvement of memory performance in healthy older persons. Study design: This was a randomized, double-blind, placebo-controlled trial. Setting and participants: The trial took place in Lismore, NSW, Australia between February and July 2005.

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Vocaroo is a quick and easy way to share voice messages over the interwebs.

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All Images are Creative Commons and Created with Haiku Deck

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Bacopa and Multitasking Stress Reactivity

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Bacopa and Multitasking Stress Reactivity

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Abstract

Little research exists in humans concerning the anxiolytic, antidepressant, sedative, and adaptogenic actions the traditional Ayurvedic medicine Bacopa monnieri (BM) possesses in addition to its documented cognitive-enhancing effects. Preclinical work has identified a number of acute anxiolytic, nootropic, and adaptogenic effects of BM that may also co-occur in humans. The current double-blind, placebo-controlled cross-over study assessed the acute effects of a specific extract of BM (KeenMind® - CDRI 08) in normal healthy participants during completion of a multitasking framework (MTF). Seventeen healthy volunteers completed the MTF, at baseline, then 1 h and 2 h after consuming a placebo, 320 mg BM and 640 mg of BM. Treatments were separated by a 7-day washout with order determined by Latin Square. Outcome measures included cognitive outcomes from the MTF, with mood and salivary cortisol measured before and after each completion of the MTF. Change from baseline scores indicated positive cognitive effects, notably at both 1 h post and 2 h post BM consumption on the Letter Search and Stroop tasks, suggesting an earlier nootropic effect of BM than previously investigated. There were also some positive mood effects and reduction in cortisol levels, pointing to a physiological mechanism for stress reduction associated with BM consumption. It was concluded that acute BM supplementation produced some adaptogenic and nootropic effects that need to be replicated in a larger sample and in isolation from stressful cognitive tests in order to quantify the magnitude of these effects. The study was registered with the Australian and New Zealand Clinical Trials Registry (ACTRN12612000834853).

Keywords: Bacopa monnieri; Brahmi; CDRI 08; RCT; cardiovascular; cognition; cortisol; mood; stress.

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Effects of a standardized Bacopa monnieri extract on cognitive performance, anxiety, and depression in the elderly: a randomized, double-blind, placebo-controlled trial.

Calabrese C, Gregory WL, Leo M, Kraemer D, Bone K, Oken B. Calabrese C, et al. J Altern Complement Med. 2008 Jul;14(6):707-13. doi: 10.1089/acm.2008.0018. J Altern Complement Med. 2008. PMID: 18611150 Free PMC article. Clinical Trial.

Neuroprotective Herbs for the Management of Alzheimer's Disease.

Gregory J, Vengalasetti YV, Bredesen DE, Rao RV. Gregory J, et al. Biomolecules. 2021 Apr 8;11(4):543. doi: 10.3390/biom11040543. Biomolecules. 2021. PMID: 33917843 Free PMC article. Review.

A Critical Review to Identify the Domains Used to Measure the Effect and Outcome of Adaptogenic Herbal Medicines.

Gerontakos SE, Casteleijn D, Shikov AN, Wardle J. Gerontakos SE, et al. Yale J Biol Med. 2020 Jun 29;93(2):327-346. eCollection 2020 Jun. Yale J Biol Med. 2020. PMID: 32607092 Free PMC article. Review.

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anti-anxiety agents / administration & dosage

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nootropic agents / administration & dosage*

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plant extracts / administration & dosage*

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national center for biotechnology information

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An acute, double-blind, placebo-controlled cross-over study of 320 mg and 640 mg doses of Bacopa monnieri (CDRI 08) on multitasking stress reactivity and mood - PubMed

# data[].attributes.attachment_link.description
Little research exists in humans concerning the anxiolytic, antidepressant, sedative, and adaptogenic actions the traditional Ayurvedic medicine Bacopa monnieri (BM) possesses in addition to its documented cognitive-enhancing effects. Preclinical work has identified a number of acute anxiolytic, nootropic, and adaptogenic effects of BM that may also co-occur in humans.

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Abstract

Background: Anxiety is a serious personal health condition and represents a substantial burden to overall quality of life. Additionally anxiety disorders represent a significant cost to the health care system as well as employers through benefits coverage and days missed due to incapacity. This study sought to explore the effectiveness of naturopathic care on anxiety symptoms using a randomized trial.

Methods: Employees with moderate to severe anxiety of longer than 6 weeks duration were randomized based on age and gender to receive naturopathic care (NC) (n = 41) or standardized psychotherapy intervention (PT) (n = 40) over a period of 12 weeks. Blinding of investigators and participants during randomization and allocation was maintained. Participants in the NC group received dietary counseling, deep breathing relaxation techniques, a standard multi-vitamin, and the herbal medicine, ashwagandha (Withania somnifera) (300 mg b.i.d. standardized to 1.5% with anolides, prepared from root). The PT intervention received psychotherapy, and matched deep breathing relaxation techniques, and placebo. The primary outcome measure was the Beck Anxiety Inventory (BAI) and secondary outcome measures included the Short Form 36 (SF-36), Fatigue Symptom Inventory (FSI), and Measure Yourself Medical Outcomes Profile (MY-MOP) to measure anxiety, mental health, and quality of life respectively. Participants were blinded to the placebo-controlled intervention.

Results: Seventy-five participants (93%) were followed for 8 or more weeks on the trial. Final BAI scores decreased by 56.5% (p<0.0001) in the NC group and 30.5% (p<0.0001) in the PT group. BAI group scores were significantly decreased in the NC group compared to PT group (p = 0.003). Significant differences between groups were also observed in mental health, concentration, fatigue, social functioning, vitality, and overall quality of life with the NC group exhibiting greater clinical benefit. No serious adverse reactions were observed in either group.

Relevance: Many patients seek alternatives and/or complementary care to conventional anxiety treatments. To date, no study has evaluated the potential of a naturopathic treatment protocol to effectively treat anxiety. Knowledge of the efficacy, safety or risk of natural health products, and naturopathic treatments is important for physicians and the public in order to make informed decisions.

Interpretation: Both NC and PT led to significant improvements in patients' anxiety. Group comparison demonstrated a significant decrease in anxiety levels in the NC group over the PT group. Significant improvements in secondary quality of life measures were also observed in the NC group as compared to PT. The whole system of naturopathic care for anxiety needs to be investigated further including a closer examination of the individual components within the context of their additive effect.

Trial registration: Controlled-Trials.com ISRCTN78958974.

Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

References

Ustun TB, Sartorius N, editors. Chichester, England: Wiley Press; 1995. Mental illness in general health care: an international study.

Lepine JP. The epidemiology of anxiety disorders: prevalence and societal costs. J Clin Psychiatry. 2002;63(Suppl 14):4-8. - PubMed

Alonso J, Lepine JP. Overview of Key Data From the European Study of the Epidemiology of Mental Disorders (ESEMeD). J Clin Psychiatry. 2007;68:3-9. - PubMed

Brawman-Mintzer O, Yonkers KA. New trends in the treatment of anxiety disorders. CNS Spectr. 2004;9:19-27. - PubMed

Howell HB, Brawman-Mintzer O, Monnier J, Yonkers KA. Generalized anxiety disorder in women. Psychiatr Clin North Am. 2001;24:165-178. - PubMed

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national center for biotechnology information

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Naturopathic care for anxiety: a randomized controlled trial ISRCTN78958974 - PubMed

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Background: Anxiety is a serious personal health condition and represents a substantial burden to overall quality of life. Additionally anxiety disorders represent a significant cost to the health care system as well as employers through benefits coverage and days missed due to incapacity.

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Affiliation

¹ Comprehensive Recovery Services, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, 3811 O'Hara St, Pittsburgh, PA chengappakn@upmc.edu.

Free article

Abstract

Objective: Cognitive impairments contribute significantly to inadequate functional recovery following illness episodes in bipolar disorder, yet data on treatment interventions are sparse. We assessed the cognitive effects of a standardized extract of the medicinal herb Withania somnifera (WSE) in bipolar disorder.

Method: Sixty euthymic subjects with DSM-IV bipolar disorder were enrolled in an 8-week, double-blind, placebo-controlled, randomized study of WSE (500 mg/d) as a procognitive agent added adjunctively to the medications being used as maintenance treatment for bipolar disorder. Study enrollment and data analyses were completed between December 2008 and September 2012. Cognitive testing at baseline and 8 weeks assessed primary efficacy outcomes. Psychopathology and adverse events were monitored at scheduled visits.

Results: Fifty-three patients completed the study (WSE, n = 24; placebo, n = 29), and the 2 groups were matched in terms of demographic, illness, and treatment characteristics. Compared to placebo, WSE provided significant benefits for 3 cognitive tasks: digit span backward (P = .035), Flanker neutral response time (P = .033), and the social cognition response rating of the Penn Emotional Acuity Test (P = .045). The size of the WSE treatment effect for digit span backward was in the medium range (Cohen d = 0.51; 95% CI, 0.25-0.77). None of the other cognitive tasks showed significant between-group differences. Mood and anxiety scale scores remained stable, and adverse events were minor.

Conclusions: Although results are preliminary, WSE appears to improve auditory-verbal working memory (digit span backward), a measure of reaction time, and a measure of social cognition in bipolar disorder. Given the paucity of data for improving cognitive capacity in bipolar disorder, WSE offers promise, appears to have a benign side-effects profile, and merits further study.

Trial registration: ClinicalTrials.gov identifier: NCT00761761.

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neuropsychological tests / statistics & numerical data

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national center for biotechnology information

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Randomized placebo-controlled adjunctive study of an extract of withania somnifera for cognitive dysfunction in bipolar disorder - PubMed

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1 Comprehensive Recovery Services, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, 3811 O'Hara St, Pittsburgh, PA chengappakn@upmc.edu. Free article Objective: Cognitive impairments contribute significantly to inadequate functional recovery following illness episodes in bipolar disorder, yet data on treatment interventions are sparse.

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Randomized Controlled Trial

doi: 10.1016/j.ctim.2016.03.018.

Affiliations

¹ Pharmaceutical Research Center, Department of Clinical Pharmacy, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran.

² Psychiatry and Behavioral Sciences Research Center, Ibn-e-Sina Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

³ Department of Pharmacogenosy, Pharmaceutical Research Center and School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran.

⁴ Gholampour Psychiatric Clinic, Mohtashami Avenue, Mashhad, Iran.

⁵ Pharmaceutical Research Center, Department of Clinical Pharmacy, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran. Electronic address: mohamadpoorAH@mums.ac.ir.

⁶ Neurogenic Inflammation Research Center, Biotechnology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran; Metabolic Research Centre, School of Medicine and Pharmacology, Royal Perth Hospital, University of Western Australia, Perth, Australia.

Randomized Controlled Trial

doi: 10.1016/j.ctim.2016.03.018.

Affiliations

¹ Pharmaceutical Research Center, Department of Clinical Pharmacy, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran.

² Psychiatry and Behavioral Sciences Research Center, Ibn-e-Sina Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

³ Department of Pharmacogenosy, Pharmaceutical Research Center and School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran.

⁴ Gholampour Psychiatric Clinic, Mohtashami Avenue, Mashhad, Iran.

⁵ Pharmaceutical Research Center, Department of Clinical Pharmacy, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran. Electronic address: mohamadpoorAH@mums.ac.ir.

⁶ Neurogenic Inflammation Research Center, Biotechnology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran; Metabolic Research Centre, School of Medicine and Pharmacology, Royal Perth Hospital, University of Western Australia, Perth, Australia.

Abstract

Background: Obsessive-compulsive disorder (OCD) is a chronic psychiatric disorder that is causally linked to dysregulation of the serotonergic system. The aim of this study is to investigate the efficacy of Withania somnifera (W. somnifera) root extract as an adjunct therapy to standard OCD treatment.

Methods: Thirty patients with a confirmed diagnosis of OCD according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR) criteria participated in this randomized double-blind placebo-controlled trial and were randomly assigned to the treatment group (W. somnifera extract, 120mg/day; n=15) or the placebo group (n=15). All patients were under treatment with Selective Serotonin Re-uptake Inhibitors (SSRIs), and were instructed to take 4 capsules of the extract or placebo per day, preferably after meals, for a period of six weeks. The Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) was used in order to assess the severity of OCD symptoms at baseline and at the end of the trial. Statistical analyses were performed using SPSS software and Y-BOCS values were presented as median and range (Min-Max).

Results: Comparison of the change in Y-BOCS score during the course of the trial revealed a significantly greater effect of W. somnifera (26 (14-40) [pre-treatment] versus 14 (4-40) [post-treatment]; change: -8 (-23 to 0)) versus placebo (18 (11-33) [pre-treatment] versus 16 (10-31) [post-treatment]; change: -2 (-4 to 0)) (P<0.001). The extract was safe and no adverse event was reported during the trial.

Conclusion: W. somnifera extract may be beneficial as a safe and effective adjunct to SSRIs in the treatment of OCD.

Keywords: Ashwagandha; Obsessive-compulsive disorder; Randomized controlled trial; Withania somnifera.

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obsessive-compulsive disorder / drug therapy*

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national center for biotechnology information

# data[].attributes.attachment_link.title
Evaluation of the efficacy of Withania somnifera (Ashwagandha) root extract in patients with obsessive-compulsive disorder: A randomized double-blind placebo-controlled trial - PubMed

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Randomized Controlled Trial doi: 10.1016/j.ctim.2016.03.018. 1 Pharmaceutical Research Center, Department of Clinical Pharmacy, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran. 2 Psychiatry and Behavioral Sciences Research Center, Ibn-e-Sina Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

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Abstract

Introduction: Ocimum sanctum (OS), known as Holy basil, has been documented to possess neuroprotective, cognition-enhancing and stress relieving effects in animal models. However there is paucity of clinical studies to document these effects.

Materials and methods: Effect of OS on parameters related to cognition and stress in humans was evaluated with administration of 300 milligram capsules of ethanolic leaf extracts of Ocimum sanctum (EtOS) or placebo per day, over 30 days.

Results: Intra-group comparison of Sternberg and Stroop test showed improvement in both the placebo and EtOS groups, however, the improvement stabilized after day 15 in the placebo group. Intergroup comparison revealed a significant improvement of the following cognitive parameters in the EtOS as compared to the placebo: reaction time (RT) and error rate (ER) of Sternberg test, RT of neutral task of Stroop, RT and ER of interference task of Stroop. The intra-group comparison of P300 latency, salivary cortisol, and State-Trait Anxiety Inventory showed improvement over time in the EtOS group alone, though the inter-group difference was significant in the P300 latency alone. There were no changes in heart rate (HR), AHR, or galvanic skin response (GSR) or AGSR.

Conclusion: Ocimum sanctum leaf extract seems to have potential cognition-enhancing properties in humans.

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Double-blinded randomized controlled trial for immunomodulatory effects of Tulsi (Ocimum sanctum Linn.) leaf extract on healthy volunteers.

Mondal S, Varma S, Bamola VD, Naik SN, Mirdha BR, Padhi MM, Mehta N, Mahapatra SC. Mondal S, et al. J Ethnopharmacol. 2011 Jul 14;136(3):452-6. doi: 10.1016/j.jep.2011.05.012. Epub 2011 May 17. J Ethnopharmacol. 2011. PMID: 21619917 Clinical Trial.

Randomized placebo-controlled, single blind trial of holy basil leaves in patients with noninsulin-dependent diabetes mellitus.

Agrawal P, Rai V, Singh RB. Agrawal P, et al. Int J Clin Pharmacol Ther. 1996 Sep;34(9):406-9. Int J Clin Pharmacol Ther. 1996. PMID: 8880292 Clinical Trial.

Therapeutic uses of Ocimum sanctum Linn (Tulsi) with a note on eugenol and its pharmacological actions: a short review.

Prakash P, Gupta N. Prakash P, et al. Indian J Physiol Pharmacol. 2005 Apr;49(2):125-31. Indian J Physiol Pharmacol. 2005. PMID: 16170979 Review.

Ocimum Sanctum Linn: A Potential Adjunct Therapy for Hyperhomocysteinemia-Induced Vascular Dementia.

Pasangulapati JP, Ravula AR, Kanala DR, Boyina S, Gangarapu K, Boyina HK. Pasangulapati JP, et al. Adv Exp Med Biol. 2020;1195:213-225. doi: 10.1007/978-3-030-32633-3_30. Adv Exp Med Biol. 2020. PMID: 32468480

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national center for biotechnology information

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Holy basil (Ocimum sanctum Linn.) leaf extract enhances specific cognitive parameters in healthy adult volunteers: A placebo controlled study - PubMed

# data[].attributes.attachment_link.description
Introduction: Ocimum sanctum (OS), known as Holy basil, has been documented to possess neuroprotective, cognition-enhancing and stress relieving effects in animal models. However there is paucity of clinical studies to document these effects.

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Randomized Controlled Trial

doi: 10.1016/j.ctcp.2015.04.001.

Affiliations

¹ Behavioral Sciences Research Center, Isfahan University of Medical Sciences, Isfahan, Iran. Electronic address: shakibaei@med.mui.ac.ir.

² Department of Psychiatry, Isfahan University of Medical Sciences, Isfahan, Iran. Electronic address: mehrsa.radmanesh@gmail.com.

³ Department of Psychiatry, Tehran University of Medical Sciences, Tehran, Iran. Electronic address: elsalari@yahoo.com.

⁴ Department of Biostatistics, School of Public Health, Isfahan University of Medical Sciences, Isfahan, Iran. Electronic address: behzad.mahaki@gmail.com.

Randomized Controlled Trial

doi: 10.1016/j.ctcp.2015.04.001.

Affiliations

¹ Behavioral Sciences Research Center, Isfahan University of Medical Sciences, Isfahan, Iran. Electronic address: shakibaei@med.mui.ac.ir.

² Department of Psychiatry, Isfahan University of Medical Sciences, Isfahan, Iran. Electronic address: mehrsa.radmanesh@gmail.com.

³ Department of Psychiatry, Tehran University of Medical Sciences, Tehran, Iran. Electronic address: elsalari@yahoo.com.

⁴ Department of Biostatistics, School of Public Health, Isfahan University of Medical Sciences, Isfahan, Iran. Electronic address: behzad.mahaki@gmail.com.

Abstract

Objective: To evaluate the efficacy of Ginkgo biloba as a complementary therapy for attention-deficit/hyperactivity disorder (ADHD).

Methods: Children and adolescents with ADHD received methylphenidate (20-30 mg/day) plus either G. biloba (80-120 mg/day) or placebo for 6 weeks. Parent and teacher forms of the ADHD Rating Scale-IV (ADHD-RS-IV) were completed at baseline, week 2, and week 6. Treatment response was defined as 27% improvement from baseline in the ADHD-RS-IV.

Results: Compared with placebo, more reduction was observed with G. biloba regarding ADHD-RS-IV parent rating inattention score (-7.74 ± 1.94 vs. -5.34 ± 1.85, P < 0.001) and total score (-13.1 ± 3.36 vs. -10.2 ± 3.01, P = 0.001) as well as teacher rating inattention score (-7.29 ± 1.90 vs. -5.96 ± 1.52, P = 0.004). Response rate was higher with G. biloba compared with placebo based on parent rating (93.5% vs. 58.6%, P = 0.002).

Conclusions: The G. biloba is an effective complementary treatment for ADHD. Further studies with longer treatment duration are warranted in this regard. IRCT2014111519958N1.

Keywords: Attention deficit disorder with hyperactivity; Complementary therapies; Ginkgo biloba; Herbal medicine; Methylphenidate.

Use of Non-Pharmacological Supplementations in Children and Adolescents with Attention Deficit/Hyperactivity Disorder: A Critical Review.

Rosi E, Grazioli S, Villa FM, Mauri M, Gazzola E, Pozzi M, Molteni M, Nobile M. Rosi E, et al. Nutrients. 2020 May 28;12(6):1573. doi: 10.3390/nu12061573. Nutrients. 2020. PMID: 32481502 Free PMC article. Review.

Natural Compounds for the Management of Parkinson's Disease and Attention-Deficit/Hyperactivity Disorder.

Corona JC. Corona JC. Biomed Res Int. 2018 Nov 22;2018:4067597. doi: 10.1155/2018/4067597. eCollection 2018. Biomed Res Int. 2018. PMID: 30596091 Free PMC article. Review.

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attention deficit disorder with hyperactivity / drug therapy*

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attention deficit disorder with hyperactivity / physiopathology*

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central nervous system stimulants / therapeutic use

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national center for biotechnology information

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Ginkgo biloba in the treatment of attention-deficit/hyperactivity disorder in children and adolescents. A randomized, placebo-controlled, trial - PubMed

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Randomized Controlled Trial doi: 10.1016/j.ctcp.2015.04.001. 1 Behavioral Sciences Research Center, Isfahan University of Medical Sciences, Isfahan, Iran. Electronic address: shakibaei@med.mui.ac.ir. 2 Department of Psychiatry, Isfahan University of Medical Sciences, Isfahan, Iran. Electronic address: mehrsa.radmanesh@gmail.com. 3 Department of Psychiatry, Tehran University of Medical Sciences, Tehran, Iran. Electronic address: elsalari@yahoo.com.

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Abstract

Context: Panax ginseng and Gingko biloba are commonly used herbal supplements in the United States that have been reported to increase alertness and cognitive function.

Objective: The objective of this study was to investigate the effects of these specific herbals on driving performance.

Materials and methods: 30 volunteers were tested using the STISIM3® Driving Simulator (Systems Technology Inc., Hawthorne, CA, USA) in this double-blind, placebo-controlled study. The subjects were randomized into 3 groups of 10 subjects per group. After 10-min of simulated driving, subjects received either ginseng (1200 mg), Gingko (240 mg), or placebo administered orally. The test herbals and placebo were randomized and administered by a research assistant outside of the study to maintain blinding. One hour following administration of the herbals or placebo, the subjects completed an additional 10-min of simulated driving. Standard driving parameters were studied including reaction time, standard deviation of lateral positioning, and divided attention. Data collected for the divided attention parameter included time to response and number of correct responses. The data was analyzed with repeated-measures analysis of variance (ANOVA) and Kruskal-Wallis test using SPSS 22 (IBM, Armonk, NY, USA).

Results: There was no difference in reaction time or standard deviation of lateral positioning for both the ginseng and Ginkgo arms. For the divided attention parameter, the response time in the Ginkgo arm decreased from 2.9 to 2.5 s. The ginseng arm also decreased from 3.2 to 2.4 s. None of these values were statistically significant when between group differences were analyzed.

Discussion and conclusion: The data suggests there was no statistically significant difference between ginseng, Ginkgo or placebo on driving performance. We postulate this is due to the relatively small numbers in our study. Further study with a larger sample size may be needed in order to elucidate more fully the effects of Ginkgo and ginseng on driving ability.

Keywords: Driving simulator; Ginkgo biloba; Panax ginseng.

Similar articles

[Comparative effects of ginkgo biloba extracts on psychomotor performances and memory in healthy subjects].

Warot D, Lacomblez L, Danjou P, Weiller E, Payan C, Puech AJ. Warot D, et al. Therapie. 1991 Jan-Feb;46(1):33-6. Therapie. 1991. PMID: 2020921 Review. French.

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national center for biotechnology information

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Effect of single-dose Ginkgo biloba and Panax ginseng on driving performance - PubMed

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The data suggests there was no statistically significant difference between ginseng, Ginkgo or placebo on driving performance. We postulate this is due to the relatively small numbers in our study. Further study with a larger sample size may be needed in order to elucidate more fully the effects of ...

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Abstract

Background: Declining cognitive function is relatively common and increasingly prevalent. Studies have shown that different nutrients (e.g., Ginkgo biloba and vitamin E) appear to be effective at improving memory and concentration, while less is known about their effect on immunity.

Methods: This study investigated the effect of Ginkgo Synergy(®) plus Choline (n = 33) and OPC Synergy(®) plus Catalyn(®) (n = 31) versus placebo (n = 33) in a 6-month, randomized, double-blind trial on cognitive and immune functioning among English-speaking, non-smoking, healthy older adults. The Stroop Color and Word Test, Trail Making Test A and B, Controlled Oral Word Association, Hopkins Verbal Learning, Mini-Mental State Exam, and Digit Symbol were administered at baseline and 3 and 6 months follow-up to assess cognitive functioning. Cytokines and growth factors were measured at baseline and 6 months to assess inflammation and immune functioning. Data were analyzed with linear mixed modeling.

Results: No serious adverse events were noted in this study. According to time on the Trail Making Test-B, the Ginkgo Synergy(®) plus Choline arm showed improvement from baseline to 3 months follow-up (mean difference = 24.2; SE = 6.4; 95% CI: 8.6, 39.7; p = 0.01). On the Controlled Oral Word Association Trial-S, the scores significantly increased for the Ginkgo Synergy(®) plus Choline arm from baseline to 6 months follow-up (mean difference = 2.1; SE = 0.8; 95% CI: 0.2, 3.9; p < 0.05) and for the OPC Synergy(®) plus Catalyn(®) arm from baseline to 3 months follow-up (mean difference = 2.1; SE = 0.8; 95% CI: 0.2, 4.0; p < 0.05). Epidermal growth factor significantly decreased from baseline to 6 months follow-up for the Ginkgo Synergy(®) plus Choline arm (mean difference = 120.7; SE = 28.4; 95% CI: 62.6, 178.8; p < 0.001).

Conclusions: Our study showed isolated and modest effects of a Ginkgo biloba plus choline-based formula on cognitive and immune functioning among healthy older adults with no history of significant cognitive deficits. Our trial was registered with clinicaltrials.gov (ID: NCT01672359). This study was supported by a grant from Standard Process, Inc.

Similar articles

Ginkgo biloba for preventing cognitive decline in older adults: a randomized trial.

Snitz BE, O'Meara ES, Carlson MC, Arnold AM, Ives DG, Rapp SR, Saxton J, Lopez OL, Dunn LO, Sink KM, DeKosky ST; Ginkgo Evaluation of Memory (GEM) Study Investigators. Snitz BE, et al. JAMA. 2009 Dec 23;302(24):2663-70. doi: 10.1001/jama.2009.1913. JAMA. 2009. PMID: 20040554 Free PMC article. Clinical Trial.

Screening for Cognitive Impairment in Older Adults: An Evidence Update for the U.S. Preventive Services Task Force [Internet].

Lin JS, O'Connor E, Rossom RC, Perdue LA, Burda BU, Thompson M, Eckstrom E. Lin JS, et al. Rockville (MD): Agency for Healthcare Research and Quality (US); 2013 Nov. Report No.: 14-05198-EF-1. Rockville (MD): Agency for Healthcare Research and Quality (US); 2013 Nov. Report No.: 14-05198-EF-1. PMID: 24354019 Free Books & Documents. Review.

References

Beers MH, Berkow R. The Merck Manual of Geriatrics. Whitehouse Station, NJ: Merck Research Laboratories; 2000.

Association A's. Alzheimer's disease facts and figures. Alzheimers Dement. 2012;2012(8):131-168. - PubMed

Nutrition Business Journal. Nutrition Business Journal Supplement Business Report 2010. Cleveland, OH: Pendon Media, Inc.; 2010.

National Health and Nutrition Examination Survey III: Use of Dietary Supplements. http://www.cdc.gov/nchs/data/nhanes/databriefs/dietary.pdf.

Winslow LC, Kroll DJ. Herbs as medicines. Arch Intern Med. 1998;158:2192-2199. - PubMed

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national center for biotechnology information

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A double-blind, randomized clinical trial of dietary supplementation on cognitive and immune functioning in healthy older adults - PubMed

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Our study showed isolated and modest effects of a Ginkgo biloba plus choline-based formula on cognitive and immune functioning among healthy older adults with no history of significant cognitive deficits. Our trial was registered with clinicaltrials.gov (ID: NCT01672359). This study was supported by ...

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Free & paid options available

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Unlock hundreds of mood-boosting meditations, relaxing sleep exercises, focus music, and more with our biggest offer of the year.

It's the healthiest, happiest deal you'll find this Black Friday, and it won't last long.

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Meditation and Sleep Made Simple - Headspace

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Live a healthier, happier, more well-rested life in just a few minutes a day with the Headspace app.

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Systematic Review of Mindfulness for Job-Based Stress Reduction

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Systematic Review of Mindfulness for Job-Based Stress Reduction

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Open-access via PubMed Central

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. Mar-Apr 2016;70(2):7002250020p1-7002250020p10.

doi: 10.5014/ajot.2016.016956.

Affiliations

¹ Michelle Luken, DScOT, OTR/L, is Chief, Occupational Therapy, Guthrie Ambulatory Health Care Center, Fort Drum, NY; michelle.l.luken.mil@mail.mil.

² Amanda Sammons, DScOT, OTR/L, is Chief, Occupational Therapy, Bayne-Jones Army Community Hospital, Fort Polk, LA.

Free PMC article

Free PMC article

. Mar-Apr 2016;70(2):7002250020p1-7002250020p10.

doi: 10.5014/ajot.2016.016956.

Affiliations

¹ Michelle Luken, DScOT, OTR/L, is Chief, Occupational Therapy, Guthrie Ambulatory Health Care Center, Fort Drum, NY; michelle.l.luken.mil@mail.mil.

² Amanda Sammons, DScOT, OTR/L, is Chief, Occupational Therapy, Bayne-Jones Army Community Hospital, Fort Polk, LA.

Abstract

Objective: A systematic search and critical appraisal of interdisciplinary literature was conducted to evaluate the evidence for practicing mindfulness to treat job burnout and to explore implications for occupational therapy practitioners.

Method: Eight articles met inclusion criteria. Each study was assessed for quality using the Physiotherapy Evidence Database scale. We used the U.S. Agency for Health Care Policy and Research guidelines to determine strength of evidence.

Results: Of the studies reviewed, participants included health care professionals and teachers; no studies included occupational therapy practitioners. Six of the 8 studies demonstrated statistically significant decreases in job burnout after mindfulness training. Seven of the studies were of fair to good quality.

Conclusion: There is strong evidence for the use of mindfulness practice to reduce job burnout among health care professionals and teachers. Research is needed to fill the gap on whether mindfulness is effective for treating burnout in occupational therapy practitioners.

Similar articles

The effectiveness of mindfulness based programs in reducing stress experienced by nurses in adult hospital settings: a systematic review of quantitative evidence protocol.

Botha E, Gwin T, Purpora C. Botha E, et al. JBI Database System Rev Implement Rep. 2015 Oct;13(10):21-9. doi: 10.11124/jbisrir-2015-2380. JBI Database System Rev Implement Rep. 2015. PMID: 26571279

Burnout among physicians.

Romani M, Ashkar K. Romani M, et al. Libyan J Med. 2014 Jan;9(1):23556. doi: 10.3402/ljm.v9.23556. Libyan J Med. 2014. PMID: 28156287

Mindfulness-based cognitive therapy: An efficacy study for mental health care staff.

Askey-Jones R. Askey-Jones R. J Psychiatr Ment Health Nurs. 2018 Sep;25(7):380-389. doi: 10.1111/jpm.12472. Epub 2018 Jul 30. J Psychiatr Ment Health Nurs. 2018. PMID: 29782077

Burnout among physicians.

Romani M, Ashkar K. Romani M, et al. Libyan J Med. 2014 Feb 17;9:23556. doi: 10.3402/ljm.v9.23556. eCollection 2014. Libyan J Med. 2014. PMID: 24560380 Free PMC article. Review.

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national center for biotechnology information

# data[].attributes.attachment_link.title
Systematic Review of Mindfulness Practice for Reducing Job Burnout - PubMed

# data[].attributes.attachment_link.description
Mar-Apr 2016;70(2):7002250020p1-7002250020p10. doi: 10.5014/ajot.2016.016956. 1 Michelle Luken, DScOT, OTR/L, is Chief, Occupational Therapy, Guthrie Ambulatory Health Care Center, Fort Drum, NY; michelle.l.luken.mil@mail.mil. 2 Amanda Sammons, DScOT, OTR/L, is Chief, Occupational Therapy, Bayne-Jones Army Community Hospital, Fort Polk, LA. Free PMC article Free PMC article . Mar-Apr 2016;70(2):7002250020p1-7002250020p10. doi: 10.5014/ajot.2016.016956.

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Task management system based on the "Getting Things Done" approach. (Similar to OmniFocus)

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CAPTURE

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CAPTURE Collect everything that catches your attention. Whether large or small, personal or professional, take it out of your mind and forget about it. CLARIFY Define the stuff you capture and decide what you do with it. Put each thing in its place; there is a place for everything.

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Effect of Transcendental Meditation on Employee Stress, Depression, and Burnout: A Randomized Controlled Study

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Effect of Transcendental Meditation on Employee Stress, Depression, and Burnout: A Randomized Controlled Study

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Your access to the NCBI website at www.ncbi.nlm.nih.gov has been temporarily blocked due to a possible misuse/abuse situation involving your site. This is not an indication of a security issue such as a virus or attack. It could be something as simple as a run away script or learning how to better use E-utilities, http://www.ncbi.nlm.nih.gov/books/NBK25497/, for more efficient work such that your work does not impact the ability of other researchers to also use our site. To restore access and understand how to better interact with our site to avoid this in the future, please have your system administrator contact info@ncbi.nlm.nih.gov.

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Sleep Deprivation and Circadian Disruption

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Sleep Deprivation and Circadian Disruption

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Stress, Allostasis, and Allostatic Load

Bruce S. McEwen, PhD

Correspondence

Affiliations

Harold and Margaret Milliken Hatch Laboratory of Neuroendocrinology, The Rockefeller University, 1230 York Avenue, New York, NY 10065, USA

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Ilia N. Karatsoreos, PhD

Affiliations

Department of Integrative Physiology and Neuroscience, Washington State University, 1815 Ferdinand's Lane, Pullman, WA 99164-6520, USA

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Sleep Deprivation and Circadian Disruption

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Sleep has important homeostatic functions, and circadian rhythms organize physiology and behavior on a daily basis to insure optimal function.

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Please be in touch with questions & comments. We'd love to speak with you at the conference or beyond.

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Of the academics contributing to this year's Times Higher Education University Workplace Survey, more than two-thirds agree that they "spend too much time working". Less than a third believe that their "work responsibilities allow for a healthy work-life balance". Despite satisfaction levels of more than three-quarters for both teaching and research, it is clear that many academics are in peril of drowning in the sea of things that they are expected (and often want) to do, while also trying to find time for family, friends and fun.

So are there ways of learning to prioritise better? What is the knack to knowing when and how to say no to attractive opportunities - not to mention tasks you feel you ought to take on? We asked a range of academics to recount their own experiences, and to draw out any lessons and practical tips.
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It is clear that no one finds the balancing act easy to pull off. Indeed, one contributor has gone so far as to form a mutual support group for "opportunities addicts" struggling with the "fine art of saying no". Members tempted to take on just one extra burden are nudged back towards sanity with a succession of sobering mantras, such as: "All baby opportunities are cute. Imagine this opportunity as a teenager."

But any academic tempted to put that phrase on a T-shirt and set up a stall at the next big international conference should first reflect realistically on the amount of work that would involve.

'I became aware of that prickly feeling on the back of my neck that the wildebeest at the waterhole must feel when the lions notice it...'

I used to think that being invisible in academia was a bad thing. Years ago, as a junior researcher quietly tinkering away on biological problems, my world didn't extend much beyond my laboratory, with its smattering of tubes, bottles and glass slides. But neither did my influence within the university.

If I wondered wistfully when I would ever be in the managerial cut and thrust, senior colleagues would retort that I was enjoying some sort of science nirvana, for ever lost to them: "All you have to do is research. Enjoy it while it lasts."

When my time came, it came quickly. After the first invitation to join a committee, I became aware of that prickly feeling on the back of my neck that the wildebeest at the waterhole must feel when the lions notice it, and begin to advance menacingly. Soon I was chairing sessions at research days, judging posters and mentoring more junior staff. More committee invitations followed, including a prestigious chairing role. When my funding became uncertain, many hours of teaching were heaped on to the load. In the evenings and weekends, I found myself constantly working on grants to keep my small team's research alive. Weeks went by without touching an experiment, then months.

Although at first it was flattering to be at the centre of things, the atmosphere soon took a sinister turn. Deadlines began to gather over my head, sucking away my oxygen. My diary slowly turned black, each square containing a dense list of tasks in increasingly small fonts. The weekend squares, once relatively free, began to take up the overspill, elbowing out the fulfilling, personal tasks I used to do much more of: writing, public engagement and political activism. When my husband and I moved out of London and put our toddler into a local nursery, my commute imposed uncompromising hours and involved pushing a pram for several miles a day. By the time I got home, I was exhausted; weekends felt like a convalescence. Despite my desperate need for more sleep, I found myself lying awake at night, clenched into endless cycles of anxiety about the things I had yet to do.

Why don't you just say no, non-academic friends asked? Because, I explained, when you don't have job security, you can't afford to. Even, they persisted, when saying no will allow you to publish the papers you need to achieve this security? Sadly, yes.

Last term, which I remember now only as a dark nightmare of stress and over-commitment, I started filling in a timesheet. I discovered that I spent a lot of days doing many things simultaneously, and realised that such diffusion was feeding my sense of being out of control. Over the Christmas break, once I'd caught up with my sleep and started feeling more human, I set about making changes in my life. I went through each week of the upcoming term, blocking out entire days in my diary that I would devote solely to research, or teaching or academic obligations. When necessary, I negotiated with the teaching admin staff to make this happen. I create detailed to-do lists for each day of the coming week, and try to stick religiously to them. If someone asks me to do something, I say that I am happy to help, but not right this second: it needs to be timetabled in. Surprisingly, the earth did not stop revolving.

I still don't feel fully in control. This piece is late, and I'm tapping it out on a weekend while my son plays with matches at the table opposite me, and my husband cooks dinner. But the panicked episodes have lessened, and I may soon start to enjoy my job again.
Jennifer Rohn is a principal research associate in the division of medicine at University College London. In her not-so-spare time she is also a writer, science communicator, pundit and mum.
'A key purpose of a PhD is to destroy a young person's ability to enjoy leisure. Presumably, this is what it is like to be in the SAS'

For most scholars, the idea of managing time sounds perplexing. That is because there are only two kinds of time: time when one is thinking about research at the front of one's mind, and time when one is thinking about research at the back of one's mind. The bottom line in academia is really just a question: how much stress can you tolerate in life? That will dictate how you manage your activities.

There is a reason for this apparently harsh fact. Our professional lives are extraordinarily privileged. Unlike those in virtually any other occupation in Western society, university scholars have the near-autonomy of a self-employed person and yet the relative financial security of an employee. Everything pleasant has to have an associated cost.

The downside of university life is that clear leisure time does not exist. There are no weekends with nothing to do. I have always thought that a key purpose of a PhD is to destroy a young person's ability to enjoy leisure. Presumably, this is what it is like to be in the SAS. Once you have passed through extreme training, most normal activities are no longer stimulating, because your brain's standard for what counts as excitement has been raised, and indeed can never go back.

For any young person considering an academic career, the following bit of arithmetic is useful. Let's say that 25 hours a week has to be spent on teaching, seeing students, preparation, departmental meetings and administration. This slice of your life is not particularly negotiable. Then, however, there are another three broad options. You can work another 15 hours on research. You can work another 25 hours on research. Or you can work another 35 hours on research (where "research" includes not just writing articles and books but also any activity such as going to conferences, refereeing and editorial work on journals).

It is straightforward to see the advantage of long hours. If you choose the 35 path, you will do more than double the amount of research of your neighbour who takes the 15 track. Some readers may think that the 35 track, which of course implies a 60-hour week, sounds extreme. Well, I have known literally hundreds of American economists who work far longer than 60 hours a week. If your priority is success in research, when measured by international standards, it will mean hellishly long hours.

Within your putative 60 hours a week, if that is your desired track in life, there is plenty of scope for different strategies. I know successful people who love conferences and successful people who virtually never go to them. There are also activities that count as service to the academic community. We are all aware of individuals who shirk their refereeing duties and others who are highly diligent. But if you wish to be a shirker, people will come to learn of it and you will eventually have to take the negative consequences.

What is the best strategy? I wish I knew. Personally, I suppose I just got swept along with ambition and the intrinsic interest of the topics.

A famous "happiness" researcher, the late Michael Argyle, was once asked: "What should I do to be happier?"

After a moment, he replied: "Sir, write out a list of all the things that make you happy. Then do them more."

That might be my general advice about academia and how to allocate time. A few things are not to be avoided. For the rest of your time, why not do the activities that make you happiest? It is decent to put some hours into service to the scholarly community. We should all do our duty - but not too much. The world does not prosper when humans are consumed by duty.
Andrew Oswald is professor of economics at the University of Warwick.
'Rather than harmlessly seeking to build an academic career, I had actually become an opportunities addict'

It was about three years ago when I first realised that I had a problem. Overwhelmed with multiple obligations, I reflected that many of the things I was struggling to accomplish had once lit up my daily routine with the enticing gleam of a new opportunity: a way to satisfy a burning curiosity and to follow ideas where they lead. (And after all, just one more little task wouldn't hurt; I could work around it and it would be rude to say no.) It dawned on me that the very presence of opportunities gives me a kick. And I concluded that rather than harmlessly seeking to build an academic career, I had actually become an opportunities addict.

Tentatively, I mentioned my problem to colleagues. I started with those who appeared - at least from a distance - to be similarly afflicted. The relief I felt at having "outed" myself was palpable. And it seemed that I was very far from being alone in my madness. Whether driven by a sense of curiosity, competition or obligation to pull their weight in the reciprocity-based academic community, many colleagues across the world seem incapable of managing their pursuit of opportunities and attaining that mystical state of work-life balance.

While opportunities addiction seems more prevalent among senior staff, many junior academics are also inclined to feel like small enterprises, concerned that no more "business" may come their way if they don't accept everything that comes in. This, they worry, may be their only chance to capture that grant, visit that place or turn that idea into something concrete. Others simply enjoy a challenge, or are lured by the possibilities of the unknown. But, whatever the cause of opportunities problems, one thing is clearer: sufferers need help.

For this reason, I formed Opportunities Anonymous: an informal self-help group of about a dozen close colleagues in my networks who are addicted to saying yes. The group acts as a forum in which to confess the opportunities that we are currently considering and to get feedback on them. Surprisingly, perhaps, it is very easy to see why other people should turn opportunities away - especially with the help of the rules of thumb that we have drawn up to help us to put opportunities into perspective and guide our decisions about them.

Most people's favourite is: "An urgent opportunity is usually someone else's problem". Others include: "All baby opportunities are cute. Imagine this opportunity as a teenager"; "An opportunity shared is an opportunity solved: pass on your unwanted opportunities carefully"; "Beware the opportunity bearing gold"; "Good opportunities come to those who wait"; "Let sleeping opportunities lie"; "Opportunities do not create time; they always destroy it" (also known as the Law of Opportunotropy); and "My chances of [please delete as appropriate] saving the world/changing the discipline/writing four world-class papers/finally getting all the recognition I deserve/being made a professor/appeasing my colleagues/being happy do not hinge on this opportunity."

The point is to support each other in the fine art of saying no. It is not about avoiding the responsibilities and reciprocities of academic life - the wheels of peer review, external examination, research assessment and the rest must keep turning. It is, rather, about recognising our capacities and limits. By acknowledging our addictions, we hope to be able to consume opportunities in moderation, and thereby rediscover the joy and excitement that they bring.
Harriet Bulkeley is a professor in the department of geography at Durham University. Thanks to the other members of Opportunities Anonymous: Ben Anderson, Michele Betsill, Vanesa Castan Broto, Anna Davies, Gareth Edwards, Mikael Granberg, Matthew Hoffmann, Simon Marvin, Kes McCormick, Kimberly Nicholas, Matthew Paterson, Johannes Stripple, Stacy VanDeveer and Yuliya Voytenko.
'I finally realised that actual time spent in the lab bears little correlation to what people actually achieve'

Most bookstores have a shelf in the self-help section devoted to life balance - or, more specifically, work-home balance. If you're an academic scientist, these are expensive paperweights. Everybody has their own personal perspective on this, but I've found the most interesting element to be the changing context with age.

If you choose to pursue academic research, your initial research environment will have a powerful imprinting effect on the rest of your life. When I started my PhD at the University of Dundee in the early 1980s, I was remarkably fortunate to land in a circle of people that included students, postdoctoral fellows and visiting professors. I asked the visiting professors how many hours I should work each day. They told me that, at my age, all hours were work hours and that the last hour you worked in a day would be the most productive. I had no one depending on me at that time, so I initially took them at their word. Fortunately, I also met someone I'm lucky to still depend on - in the lab, no less. "I" became "we", but my studies still tended to come first, and socialising was typically confined to our lab friends.

The next phase of the journey was a postdoctoral spell in San Diego, accompanied by stunning surroundings and amazing science. The hours were still long, but we both worked at the same research institute. Then our daughter muscled on to the scene, rightly demanding adjustments. I finally realised that actual time spent in the lab bears little correlation to what people actually achieve. Time management became a tunable skill.

My spouse chose to look after our kids. Many couples manage to juggle work and family; indeed, sometimes not through choice but to keep afloat financially. I was given a gift that was (and still is) a luxury that enabled me to cheat the clock with extended time to work, protected "quality" family time and less exhaustion. I know I was lucky.

Our next life step was an independent research group in London. We lived in the suburbs, so getting to the lab involved a one-hour commute, half of which was by train. Those 30 minutes each way became invaluable reading time. One morning the train was delayed outside Euston, compelling me to read a Nature article that I'd only glanced at earlier. It was a fruit fly orthologue of a gene I'd been working on in mammals. The appalling punctuality of Network Southeast changed my research.

A few years later, we moved to Toronto and the commuter train was swapped for a car. I couldn't read, so I listened to music or just drove. It's easy to fill your day and mind with transactions - but it's important to jealously protect time for free thought. Those flecks of serenity seem rarer these days; even an elevator ride has become a place to check your screen.

Like many academic researchers, my time for doing experiments in the lab became squeezed out by administrative hoops and responsibilities. But the time pressures grew worse still: there was never enough time in the day for what I needed to do to feel accomplished. So I did something about it. I cut down travel where possible, learned to better share responsibilities and left cancelled meetings in my calendar - often my only "free time" in a day.

My liberation was to realise that much of what your day consists of can be reconfigured, that deadlines are largely self-imposed procrastination limits and that we are not uniformly productive. Starting a piece of work in the wrong state of mind simply wastes that mind. We know ourselves best and we often beat ourselves up for failing to meet our expectations. Don't do that! Aside from life being too short, frustration is often a symptom of lack of control. That's something you need to take back.
Jim Woodgett is director of research and senior investigator at the Lunenfeld-Tanenbaum Research Institute in Toronto.
'I try to agree only to talks that move the writing forward, using them as deadlines for producing parts of a wider whole'

I recently spent three days at the Institut Mémoires de l'Edition Contemporaine at the Abbaye d'Ardenne, outside Caen in Normandy. This houses the archives of many French writers, publishers and institutions, including a valuable collection of papers by and relating to Michel Foucault.

The reading room is in the abbey itself; the other buildings have been converted into study-bedrooms, a refectory and conference rooms. Most people using the collections stay on site, take meals together and work in the reading room all the time it is open. There is a shared collective endeavour, a comfortable silence in working hours and a genuine interest in each other's work in the communal spaces.

All this is at some distance from the working lives of most academics today. Teaching, preparation, marking, office hours, meetings, emails, phone calls and so on make consolidated and protected time for individual study very difficult to obtain and protect. Yet much of our most important work, perhaps especially for academics in the social sciences and humanities, happens alone, in time that cannot easily be quantified, measured or evaluated. Journal articles, chapters and books need consolidated, isolated and protected time; the slow accumulation of reading, thinking and writing, repeated and repeated.

I'm in a privileged position in general in terms of my academic role, and especially this academic year, when I am on sabbatical. But I have an ambitious plan: one book was submitted in the summer before the sabbatical began, I have another that I want to complete and a third with which I want to make good progress. So I set myself some rules to try to structure the days and make the most of the time available (these work just as well for isolated research days, or even just a few hours of writing time).

Number one is not to check email in the morning; email has a habit of setting the day's agenda for you, instead of being but one of the tasks you need to address. I try to keep nothing in my inbox. This does not mean that every email is already answered, or the associated task completed. It means that the only ones in there are ones I have never seen. Some messages are sorted into consolidated folders - things to do in the office, things to read at some point - others are turned into tasks with scheduled dates and times. So, if nothing in my inbox is older than half a day, it can't be that urgent. If it is, it's the sender's problem, not mine.

I try to keep the morning, or the whole of a shorter slot, as consolidated writing time. I set the agenda. If I've had a few productive hours of writing, and feel I am moving things forward, then I am better placed to deal with other tasks - review work, editorial duties, reading PhD students' work, answering messages. I restrict social media use, usually by using a plug-in to block or limit time. I can always use my phone or iPad, but then it's really obvious that I'm not working.

I try to agree only to talks that move the writing forward, using them as deadlines for producing parts of a wider whole. There are always exceptions, but preparing a talk can become a major diversion from a focus. The same goes for writing or editing projects - often intriguing, flattering and tempting, and I do those that I can, but they have a cost.

Certain places are also associated with productive work. The specialist archives are one; I've also done good work in the British Library Rare Books room in the past. But the best place is still my home study. Close the door - physical and virtual - and get back to writing.
Stuart Elden is professor of political theory and geography at the University of Warwick and author of the forthcoming Foucault's Last Decade. He blogs at Progressive Geographies.
'I am seriously tempted to burn some of the papers which reach me for an opinion'

Among the more time-consuming tasks that academics are asked to perform is peer reviewing. Complaints about the burden it imposes are frequent, and there is a widespread sense that, amid the relentless increase in the number of papers published annually, the burden is only getting heavier.

Yet recently discovered reports from the Royal Society's archives reveal that referees have been feeling the burden for many decades. For instance, in a note accompanying one of his many referee reports to the assistant secretary at the Royal Society, the chemist Neil Kensington Adam wrote in 1950: "For mercy's sake, don't send me any more papers to referee for a long time! During the last five very busy weeks I have had five papers, not one of which was fit for publication in a first-class scientific journal."

His thoughts about the underlying problem are likely to resonate with modern ears: "The papers have been sent to the Society largely because the PhD supervisors feel that their protégés, or their laboratories, or both, will gain a little extra prestige if the Royal Society has published some of their work."

His laments about the consequences of the reviewing burden for his own science are also likely to sound familiar. "I get a much smaller fraction of my time for scientific work than the supervisors and heads of departments from whom such papers as these come, and the job of examining unsatisfactory communications is very exacting and time-consuming," he wrote. "If I get much more heavy refereeing like this, it is goodbye to any chance of doing real scientific work myself (and please remember that many other societies try and make me referee their papers also!). If I could only get some uninterrupted time, I could do real work of ten times the value of the sort of rubbish I have been required to report on lately...So, I warn you, you can expect a strike of referees or at least one of them, if these pot-hunting PhD supervisors don't take more trouble to censor their students' work. It's becoming a thorough nuisance, and a disgrace to the profession of science...I am seriously tempted to burn some of the papers which reach me for an opinion; I really believe that might be a good way of dealing with them!"

Adam was not alone in his views. Colleagues throughout the 1950s, from across the sciences, expressed similar frustrations. In October 1951, University College London crystallographer Kathleen Lonsdale wrote to the assistant secretary of the Royal Society, on receiving yet another revised copy of a manuscript: "Quite frankly I hope it will not be returned to me, even in a further revised form! I have spent an enormous amount of time on it, but I feel that it is still so badly prepared as to be almost unreadable - at least by me, and I just can't afford to give it any more time."

One positive side to all this is the seriousness with which reviewers took their responsibilities, frequently writing three or four pages of constructive criticism. The other is the crumb of comfort it offers to modern academics snowed under with dubious manuscripts to review. Not only are you not alone - it turns out that you never were.
Camilla Mørk Røstvik is a researcher on the Arts and Humanities Research Council-funded project "Publishing the Philosophical Transactions: the economic, social and cultural history of a learned journal, 1665-2015" at the University of St Andrews.

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Of the academics contributing to this year's Times Higher Education University Workplace Survey, more than two-thirds agree that they "spend too much time working". Less than a third believe that their "work responsibilities allow for a healthy work-life balance".

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Psychology researchers aren't necessarily Thanksgiving experts-they may not know how to make fluffy stuffing, say, or beat the traffic to your in-laws' house-but they have become a fount of wisdom on thanksgiving (with a small "t").

Over the past decade, they've not only identified the great social, psychological, and physical health benefits that come from giving thanks; they've zeroed in on some concrete practices that help us reap those benefits.

And perhaps the most popular practice is to keep a "gratitude journal." As we've reported many times over the years, studies have traced a range of impressive benefits to the simple act of writing down the things for which we're grateful-benefits including better sleep, fewer symptoms of illness, and more happiness among adults and kids alike. We've even launched our own digital gratitude journal, Thnx4.org, here on Greater Good.

The basic practice is straightforward. In many of the studies, people are simply instructed to record five things they experienced in the past week for which they're grateful. The entries are supposed to be brief-just a single sentence-and they range from the mundane ("waking up this morning") to the sublime ("the generosity of friends") to the timeless ("the Rolling Stones").

But when you dig into the research, you find that gratitude journals don't always work-some studies show incredible benefits, others not so much.

To understand why, I took a closer look at the research and consulted with Robert Emmons, arguably the world's leading expert on the science of gratitude and an author of some of the seminal studies of gratitude journals.

Emmons, a professor at the University of California, Davis, shared these research-based tips for reaping the greatest psychological rewards from your gratitude journal.

Don't just go through the motions. Research by psychologist Sonja Lyubomirsky and others suggests that journaling is more effective if you first make the conscious decision to become happier and more grateful. "Motivation to become happier plays a role in the efficacy of journaling," says Emmons.

Go for depth over breadth. Elaborating in detail about a particular thing for which you're grateful carries more benefits than a superficial list of many things.

Get personal. Focusing on people to whom you are grateful has more of an impact than focusing on things for which you are grateful.

Try subtraction, not just addition. One effective way of stimulating gratitude is to reflect on what your life would be like without certain blessings, rather than just tallying up all those good things.

Savor surprises. Try to record events that were unexpected or surprising, as these tend to elicit stronger levels of gratitude.

Don't overdo it. Writing occasionally (once or twice per week) is more beneficial than daily journaling. In fact, one study by Lyubomirsky and her colleagues found that people who wrote in their gratitude journals once a week for six weeks reported boosts in happiness afterward; people who wrote three times per week didn't. "We adapt to positive events quickly, especially if we constantly focus on them," says Emmons. "It seems counterintuitive, but it is how the mind works."

In looking over this list, what strikes me is how keeping a gratitude journal-or perhaps the entire experience of gratitude-is really about forcing ourselves to pay attention to the good things in life we'd otherwise take for granted. Perhaps that's why the benefits seem to diminish when you start writing more than once per week, and why surprises induce stronger feelings of gratitude: It's easy to get numb to the regular sources of goodness in our lives.

Indeed, Emmons told me that when people start keeping a gratitude journal, he recommends that they see each item they list in their journal as a gift-in fact, he suggests that they "make the conscious effort to associate it with the word 'gift.'" Here are the exact instructions he gives participants in his studies:

Be aware of your feelings and how you "relish" and "savor" this gift in your imagination. Take the time to be especially aware of the depth of your gratitude.

"In other words," he says, "we tell them not to hurry through this exercise as if it were just another item on your to-do list. This way, gratitude journaling is really different from merely listing a bunch of pleasant things in one's life."

So why might this particular practice do such good for our minds and bodies? Emmons points to research showing that translating thoughts into concrete language-whether oral or written-has advantages over just thinking the thoughts: It makes us more aware of them, deepening their emotional impact.

"Writing helps to organize thoughts, facilitate integration, and helps you accept your own experiences and put them in context," he says. "In essence, it allows you to see the meaning of events going on around you and create meaning in your own life."

It has become common for therapists to recommend writing about unpleasant, even traumatic events (a practice we'll discuss in the teleseminar I'll be participating in this Friday, hosted by the National Association of Memoir Writers). Similarly, says Emmons, gratitude journals may help us "bring a new and redemptive frame of reference to a difficult life situation."

Though he does have suggestions for how to keep a gratitude journal, Emmons also stresses that "there is no one right way to do it." There's no evidence that journaling at the start of the day is any more effective than journaling before you go to bed, for instance. And aesthetics really don't matter.

"You don't need to buy a fancy personal journal to record your entries in, or worry about spelling or grammar," says Emmons. "The important thing is to establish the habit of paying attention to gratitude-inspiring events."

Greater Good wants to know: Do you think this article will influence your opinions or behavior?

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Psychology researchers aren't necessarily Thanksgiving experts-they may not know how to make fluffy stuffing, say, or beat the traffic to your in-laws' house-but they have become a fount of wisdom on thanksgiving (with a small "t").

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Project management

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Gut clock: implication of circadian rhythms in the gastrointestinal tract.

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Gut clock: implication of circadian rhythms in the gastrointestinal tract.

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Affiliation

¹ Department of Medicine, Thuringia-Clinic Saalfeld, Teaching Hospital of the University of Jena, Germany. pkonturek@thueringen-kliniken.de

Free article

Abstract

Circadian and seasonal rhythms are a fundamental feature of all living organisms and their organelles. Biological rhythms are responsible for daily food intake; the period of hunger and satiety is controlled by the central pacemaker, which resides in the suprachiasmatic nucleus (SCN) of the hypothalamus, and communicates with tissues via bidirectional neuronal and humoral pathways. The molecular basis for circadian timing in the gastrointestinal tract (GIT) involves interlocking transcriptional/translational feedback loops which culminate in the rhythmic expression and activity of a set of clock genes and related hormones. Interestingly, it has been found that clocks in the GIT are responsible for the periodic activity (PA) of its various segments and transit along the GIT; they are localized in special interstitial cells, with unstable membrane potentials located between the longitudinal and circular muscle layers. The rhythm of slow waves is controlled in various segments of the GIT: in the stomach (about 3 cycles per min), in the duodenum (12 cycle per min), in the jejunum and ileum (from 7 to 10 cycles per min), and in the colon (12 cycles per min). The migrating motor complex (MMC) starts in the stomach and moves along the gut causing peristaltic contractions when the electrical activity spikes are superimposed on the slow waves. GIT hormones, such as motilin and ghrelin, are involved in the generation of MMCs, while others (gastrin, ghrelin, cholecystokinin, serotonin) are involved in the generation of spikes upon the slow waves, resulting in peristaltic or segmental contractions in the small (duodenum, jejunum ileum) and large bowel (colon). Additionally, melatonin, produced by neuro-endocrine cells of the GIT mucosa, plays an important role in the internal biological clock, related to food intake (hunger and satiety) and the myoelectric rhythm (produced primarily by the pineal gland during the dark period of the light-dark cycle). This appears to be an endocrine encoding of the environmental light-dark cycle, conveying photic information which is used by organisms for both circadian and seasonal organization. Motor and secretory activity, as well as the rhythm of cell proliferation in the GIT and liver, are subject to many circadian rhythms, mediated by autonomic cells and some enterohormones (gastrin, ghrelin and somatostatin). Disruption of circadian physiology, due to sleep disturbance or shift work, may result in various gastrointestinal diseases, such as irritable bowel syndrome (IBS), gastroesophageal reflux disease (GERD) or peptic ulcer disease. In addition, circadian disruption accelerates aging, and promotes tumorigenesis in the liver and GIT. Identification of the molecular basis and role of melatonin in the regulation of circadian rhythm allows researchers and clinicians to approach gastrointestinal diseases from a chronobiological perspective. Clinical studies have demonstrated that the administration of melatonin improves symptoms in patients with IBS and GERD. Moreover, our own studies indicate that melatonin significantly protects gastrointestinal mucosa, and has strong protective effects on the liver in patients with non-alcoholic steatohepatitis (NASH). Recently, it has been postulated that disruption of circadian regulation may lead to obesity by shifting food intake schedules. Future research should focus on the role of clock genes in the pathophysiology of the GIT and liver.

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national center for biotechnology information

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Gut clock: implication of circadian rhythms in the gastrointestinal tract - PubMed

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Circadian and seasonal rhythms are a fundamental feature of all living organisms and their organelles. Biological rhythms are responsible for daily food intake; the period of hunger and satiety is controlled by the central pacemaker, which resides in the suprachiasmatic nucleus (SCN) of the hypothal ...

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UK academics and professional and support staff inhabit "two parallel universes that have little point of contact".

That is one of the major conclusions to be drawn from the third annual Times Higher Education University Workplace Survey, according to Yiannis Gabriel, chair in organisation studies at the University of Bath and one of the designers of our inaugural survey in 2014.

Over the course of several months in 2015, almost 2,900 higher education staff, of all ranks and roles, from nearly 150 institutions across the UK gave us their views on a wide range of employment issues.

As well as answering specific questions, respondents also submitted almost 4,000 comments to the online survey, providing further context to many of the important issues raised by the survey.
Download the full results of the University Workplace Survey 2016 (PDF)
Download the full results of the University Workplace Survey 2016 (Excel)
All survey participants were verified as working in UK higher education institutions, with 49 per cent identifying themselves as academics and 51 per cent stating that they held professional or support roles. As well as the deep gulf between the two categories of staff in many areas of working life, the survey also highlights that:

Most university staff find their jobs rewarding, but most academics feel overworked, exploited and ignored by management

A majority of staff feel satisfied with pay, conditions and professional development opportunities

Half of academics are worried about redundancies related to metrics-based performance measures

Half of academics think that their institutions have compromised undergraduate entry standards as competition for students has increased, and half feel under pressure to award higher marks.

Overall, the vast majority of higher education staff are happy in their jobs. Some 80 per cent of university employees state that their work is a source of satisfaction - roughly the same proportion as in our previous two surveys. In addition, 70 per cent agree that their job is "rewarding", while 87 per cent enjoy working with their immediate colleagues.

"In moments of tiredness or frustration being surrounded by 10,000 (mostly) young people who are optimistic and keen to learn is a pick-me-up and a privilege," remarks one senior administrator at a post-92 university. A female academic at a Russell Group university also appreciates the "good pay, holidays and working hours", adding that her institution is "supportive of staff with young families".

Job satisfaction levels are slightly lower among academics (77 per cent) than among professional or support staff (84 per cent). But the academic-administrative divide is particularly evident around questions related to pay and working conditions. Just 43 per cent of academics believe that they receive a fair deal in terms of pay, compared with 74 per cent of administrators. (Overall, 59 per cent of respondents are satisfied, against 26 per cent who are not.)

"I am constantly being asked to do more with less, which translates into longer and longer working hours. As a result, the level of compensation is completely incommensurate with the working hours reasonably needed in order to do everything that is demanded," says a lecturer at one Russell Group university.

On working conditions and other benefits, the chasm in opinion is even greater: only 40 per cent of academics are happy with what their university offers, compared with 80 per cent of professional and support staff.

But the overall figure of 60 per cent is markedly higher than the 42 per cent satisfaction rate found in the overall UK economy, a spokesman for the Universities and Colleges Employers Association points out: "It is encouraging once again to note that the majority of participants believe their institution offers them a fair deal in terms of pay, as well as the sometimes overlooked but very important conditions of service and other benefits."

The spokesman adds that the survey results should be read alongside Ucea's own workplace survey, which "confirms that the sector continues to benefit from [having] few recruitment and retention difficulties" and that the "total reward package offered [is] competing well with packages in the private and public sectors".

The difference in opinion between academics and professional and support staff is also stark in other areas. Academics are more disillusioned with senior management, for instance. When asked if their university leadership is performing well, only 28 per cent agree, compared with 61 per cent of administrators. Academics are also markedly less likely to be excited about their university's plans (27 per cent felt this way, compared with 63 per cent of professional and support staff). And Gabriel flags up the fact that only 38 per cent of academics would recommend working at their university, compared with 77 per cent of professional and support staff. He describes such enormous discrepancies as "little short of staggering".

"Professional and support staff are proud of their institution, and appreciate the environment and conditions of employment," he says. "By contrast, academics report a substantial degree of stress and considerable dissatisfaction with the leadership of both their department and their institution, and a considerable number are looking to leave their current job."

Not all academics are entirely dismissive of management efforts. One senior lecturer at a post-92 university in the south of England sees his university's leadership as "good on the whole", if sometimes "cringingly corporate in its outlook".

But on their university's contribution to the community and society at large, academics are again less positive. While 80 per cent of professional and support staff express approval, only 49 per cent of academics do so. Among the latter is a medical professor at a university in the South West, who says that his institution enjoys an excellent local reputation for "engag[ing] effectively with regional development in many ways, including health promotion and green policies".

Despite limited enthusiasm for many aspects of higher education, academics still appear to enjoy the core parts of scholarly life. For instance, 77 per cent say that they derive satisfaction from their teaching.

The same proportion also agree that their research is a source of satisfaction, while the proportion that strongly agree with that proposition is even higher (44 per cent, versus 37 per cent). However, two-thirds of academics (67 per cent) also say that they do not have enough time to do the research they need to get ahead - almost four times as many as those who are broadly happy with the time available for research (17 per cent).

The anonymised comments suggest to Gabriel that academics are exercised by three main issues: growing managerialism and associated "market-driven and rankings-driven policies, constant performance monitoring and target setting"; escalating bureaucracy and "standardisation that erodes professional discretion"; and "excessive preoccupation with image and hype: the bullshit factor, where everyone must be a star, world class, cutting-edge and the like".

He also observes that academic respondents are more likely to strongly agree or disagree with statements, suggesting that those with "more extreme views were more likely to answer the survey than those with more moderate ones". However, he admits that "the conclusion that malcontents have crowded the survey is not inevitable" and it would need further evidence to substantiate.

Either way, the results of the survey are sure to provide much food for thought for university managers, who ultimately depend on academics to carry out the core missions of their institutions.

Workload and work-life balance

The excessive hours worked by academics are once again highlighted as a major problem by respondents to our survey. Most staff appear to routinely work beyond their contracted hours.

"I love my job and I'm prepared to put in extra time," says one administrator at a northern post-92 institution, who is paid for 23 hours a week, but "generally work[s] more than 40, often nearer 60".

However, professional staff are markedly less likely than academics to work beyond normal hours: 57 per cent report doing so, compared with 89 per cent of academic respondents.

Many of those who do so earn little credit. Overall, 44 per cent of respondents say their manager does not acknowledge the extra hours they work. And while 40 per cent say that their graft is appreciated, people with that perspective are unlikely to be academics. Only 21 per cent of academic staff say that their extra hours are acknowledged, compared with 58 per cent of professional staff. It is perhaps unsurprising, therefore, that the 51 per cent of all staff who feel that their university sometimes takes advantage of them rises to 67 per cent among academics.

"I feel unappreciated - I work 100 hours a week and I'm exhausted," says one senior lecturer at a London university.

"I thought this was my dream job and would stay until I retire, but [the] workload is unmanageable," adds a lecturer at a research-intensive university in the North. All her colleagues are also working "unspeakably long hours", with one even having worked on Christmas Day.

The 68 per cent of academic respondents who say that they work too much is two percentage points higher than in our 2015 survey (the 30 per cent figure for professional staff is the same as last year).

"Staff are expected routinely to work Saturdays without any additional remuneration," reports a social sciences lecturer at a Midlands university.

"I don't think I can realistically keep this up until retirement without making myself seriously ill from stress," adds a lecturer at a Russell Group university, who is considering a career change.

Indeed, just over a third of all respondents (35 per cent) say that their job has a negative impact on their health - which rises to half (51 per cent) among academics.

"Staff are being worked to their limits and the university is taking advantage of the workload models, which in themselves are horrendous tools to make us work even more," says a professor in an arts and humanities subject at a northern Russell Group university.

"Unmanageable workloads, poor work-life balance and the associated stresses are unsurprisingly top of the complaints list for lecturers again this year," comments Sally Hunt, general secretary of the University and College Union. "Survey after survey identifies increasing workloads and poor management as real problems for our universities, yet nothing is done to address the issues. Increasing workloads, higher rates of casualisation and diminishing support are not the way to deliver the world-class system that leaders and politicians say they want."

However, our survey does not paint an unremittingly bleak picture. Some 56 per cent of all respondents say that the workload assigned to them is "reasonable" - almost twice the 32 per cent who feel their workload to be unreasonable. That former proportion increases to 72 per cent for professional and support staff, compared with 38 per cent for academics.

Staff are also more likely than not to say that their university cares for the well-being of its workforce (49 per cent agree that they do, against 36 per cent who disagree).

"Having had a couple of very hard years personally, I've been blown away by the unconditional support I've received from my department," says one manager at a northern post-92 university.

"Having worked in the private sector for years, I am constantly surprised by the caring and paternalistic attitude of the university, right from the vice-chancellor down to the cleaner," adds an administrator at a medium-sized research-intensive in the South East. "I am always shocked by people who think that the university is a bad employer and [is] out to get them in some way - people [don't] realise how good they have it."

Gabriel believes that the huge gulf between the perspectives of academic and professional and support staff in this area can partly be explained by the fact that many of the latter compare their university jobs with earlier employment in other sectors, such as insurance and banking. "They find the terms and conditions of work in higher education far preferable to those in the private sector and are not put off by the managerial styles, bureaucracy or target-driven philosophy of their academic institutions. They enjoy what looks to them like a green, relaxed and pleasant campus atmosphere," he says.

By contrast, academics perceive a "continuously deteriorating situation, where standards are constantly eroding, conditions of work are dropping and extensive reports of bullying and harassment are not uncommon".

Nonetheless, our respondents tend to view employer attitudes towards their caring responsibilities in a positive light: the 47 per cent of all staff who say that their university is supportive is more than twice the 19 per cent who feel it is not.

Staff are also more than a third more likely than not to see their job as offering a healthy work-life balance, with 48 per cent overall agreeing that it does, as opposed to 35 per cent disagreeing.

"I have my own spacious office and supportive colleagues, excellent line management and opportunities to work at home, which allows me to work full-time, despite having a young family," says one female administrator at a large research-intensive university in the South.

However, the views of academics and administrators once again vary hugely on this issue: only 28 per cent of the former say that they have a good work-life balance compared with 67 per cent of professional and support staff. And only 28 per cent of academics believe that their university cares about the well-being of its staff, compared with 68 per cent of professional staff.

Academic standards

After decades of strict controls on student numbers, universities in England are now able to recruit as many undergraduates as they wish.

The end of institutional quotas, which fully came into effect last September, was hailed as a crucial step towards improving social mobility; in the words of the chancellor George Osborne, who announced the plan in 2013, the policy will end the "cap on aspiration". It is also meant to drive up quality and increase student recruitment competition between universities, but many academics appear to have reservations about their institution's response to the new admissions landscape.

Half of academic respondents to our survey agree that their university has compromised on student quality in its push to increase or preserve student numbers.

"What happens now is nothing short of criminal - we recruit anybody, no matter how bad they are," claims one academic at a post-92 university in the North. "We used to have [more than] 95 per cent graduate employment, now it is barely 80 per cent and falling, because of the dross we are turning out. No one seems to care one jot that we are turning out cheats and useless, incapable dolts with top marks."

Concern is less acute among administrators, of whom just one in five feels the same way.

Many academics also believe that their institution has let entry standards slip for international students; one-third say that they do not think overseas students in their department speak and write English at a level that is adequate for degree-level study.

"Now I feel that we just try and get as many students as possible, especially international, and that standards have dropped," says one administrator at a large northern university.

With most undergraduates in England now paying £9,000 a year, or close to it, just under half of academics feel under greater pressure to award higher marks, against less than a third who do not.

"[My] university is dumbing down courses," says a science professor at a Russell Group university, adding that this is "not challenging the students and is unfair to the best [ones]".

"This year, 15 firsts were awarded on [our] LLB course," reports one senior law lecturer at a modern university in the Midlands. "How is this possible when a redbrick university with straight-A students might award three or four?"

A lecturer at a Scottish university claims that its academics are "told to meet a target of an 85 per cent pass rate routinely, irrespective of student performance or ability".

Some 44 per cent of academics also say that their workload has increased since the introduction of £9,000 tuition fees, compared with 17 per cent who say it has not.

"I used to love working here, but my workload has quadrupled and staff morale is at rock bottom," says a senior lecturer at a Russell Group university in the Midlands.

Job security

Job insecurity is a key issue for many academics. Overall, 55 per cent of survey respondents feel secure in their jobs compared with 29 per cent who don't. But, among academics, the latter figure rises to 40 per cent (among professional and support staff, it falls to 19 per cent).

"We have had round upon round of redundancies and the university breaking [its] own redundancy avoidance policies," complains a long-serving administrator at a Russell Group university. "Workloads have increased significantly as staff who leave are not replaced - it is almost as though the intention is to force people to feel so uncomfortable that they wish to leave."

As Times Higher Education has reported, there is an emerging concern over the threat imposed by metrics-based performance measures. Just over half of academics believe that these could lead to redundancies in their department.

"University leadership are on record saying they want a high staff turnover and...[pursue] this perverse aim by setting unreasonable personal targets for all academic staff, enforcing them with a new draconian performance assessment system," one academic at a Russell Group university writes.

Others believe newly introduced targets have had a corrosive effect on departmental morale: "I love many aspects of my university, but the introduction of performance targets for individuals...is antithetical to good scholarship and teaching, to relationship-building and collegiality...and to the overall good of the profession," says an academic at a large research-intensive northern university.

"We are being set funding targets which, it is widely acknowledged, are impossible for even half of us to meet," says another academic at a Russell Group university. "The sense among many of us is that this is a first step in a process of [constructive] dismissal."

The medium-sized Midlands university where one professor works "has become a nightmare within just a year as the new dean of science has introduced metric-oriented, 'business-like' criteria of performance within the school. This has been introduced along with direct and explicit threats of dismissal for many members of staff, who became the subject of a 'research performance review'. My work at my university now feels highly stressful and insecure."

And a senior lecturer at a Russell Group university complains that "now it is all about metrics. Performance management is really a euphemism for: 'If we don't like you, we will get rid of you or bully you until you quit.'"

Listening to staff

The failure of managers to listen to staff views is a major source of frustration for the sector's workforce, our survey suggests.

Some 39 per cent of respondents overall, and 54 per cent of academics, say that they can't make their voices heard within their university. Only 25 per cent of professional and support staff feel the same way, but the comments suggest that the issue has a dispiriting effect on morale wherever it is felt.

"Directives and decrees come down from [on high]...without any consultation or any consideration of the practicalities of implementing them," states one IT technician at a large university in the North West.

"We get crazy diktats - like they want to take all our printers away," complains a senior lecturer in science at a Russell Group university. "Nobody bothered to ask us, or we would have told them that we need printers for our [scientific] instruments."

A senior lecturer at a post-92 university in the South of England claims that the views of academics are not heard by senior management: "Those on the ground, working with students, know what is going on and should be listened to, instead of middle managers who are merely yes-men."

A senior lecturer at a research-intensive university in London says exercises to engage with staff are a charade. His institution is "adept at pretending to solicit staff opinion on major [issues] affecting staff welfare and infrastructure while refusing to allow [that] opinion to affect final decision outcomes".

A senior lecturer in social sciences at a Scottish university claims staff are unwilling to speak out against institutional changes. "Most are too scared to say anything beyond grousing with peers and friends," he says, adding that the "academic senate just rubberstamps the demands of the principal, who attacks anyone who dares question his vision or ideas".

An early career academic at another Scottish university has been advised by colleagues to "keep my head below the parapet and avoid being noticed by senior management. This kind of environment is obviously not one that could be considered friendly, but it is even more damaging when...students and academics are supposed to participate in a free exchange of ideas and theories," he says.

However, not everyone is so gloomy. Indeed, 46 per cent of respondents feel that they can make their voices heard: a figure that rises to 58 per cent among professional and support staff.

"The university is making a concerted effort to listen to and engage with staff by arranging breakfast meetings and networking events," reports one administrator at a North East university.

However, only 34 per cent of academics feel heard by university leadership. One senior lecturer in social sciences at a post-92 university in the South of England complains: "Students are sick to death of being asked for their view on every little detail of the course, but the management never solicit the views of staff."

Things we like...

'The "army of administrators" identified by THE [in previous stories] is actually a set of strong support services: the disability, academic skills, careers, counselling and library services who are very good at offering personalised support'
Librarian at a large post-92 university in the North

'I have been well supported in my new role and relish the challenges that we will be facing over the coming years. For my family and myself, this has been my most positive working experience to date'
Administrator at a university in the North West

'I feel proud of working for my institution. It cares about the local community, opening up education for students in all circumstances and providing top-class facilities'
Administrator at a post-92 university in the North

'My current employer is by no means immune from the wider tendencies towards performance management, but it is by far the most sensibly managed, intellectually vibrant and happy place at which I have worked'
Business professor at a medium-sized London university

'I am impressed by the amount of opportunities for professional development afforded to me. The university has a great graduate internship scheme, which has helped many graduates like myself gain full-time employment and meaningful work experience'
Technician at a large modern university in the North West

'I like the fact we have students coming from very different experiences and backgrounds - mature students especially are a great source of inspiration to me'
Research fellow at a large London university

'The university environment is open and supportive, which promotes collaboration. The university is a physically pleasant place to work, with a nice campus and a diverse student body'
Lecturer at a Russell Group university in the Midlands

...and things we don't

'Every time I see the senior management team, I long for my retirement. HR view staff as a resource to be exploited, and ultimately, exhausted. The good news is that the students are fine'
Lecturer at a medium-sized university in the North West

'Senior management within my university are often out of touch with reality, incompetent, lazy, complacent, and unconcerned with fairness to other staff except in so far as this might help them win a prestigious award for the university'
Senior lecturer in social sciences at a London university

'Never before have I been aware of such an atmosphere of dissatisfaction, frustration at the senior management team and general unhappiness. The belief that we are "all in this together" has rapidly disappeared and I can't see how the goodwill of staff can be won back'
Administrator at a post-92 university in Scotland

'The university seems happy to compromise academic standards for vocational accreditation, which puts an industry-accredited underwater basket-weaving degree on a par with STEM subjects and traditional arts subjects, such as history and English'
Senior lecturer at a modern university in the South of England

'It has become increasingly rare for students to be motivated or engaged by their studies, or to possess what, for me, is an ordinary degree of cultural and academic hinterland'
Professor at a post-92 university in Scotland

'We currently live under a reign of terror. Senior management seems happy to sacrifice the careers of colleagues in many parts of the university to build a war chest for future expansion in "strategic areas" '
Senior lecturer at a research-intensive university in Scotland

'The university seems happy to compromise academic standards for vocational accreditation, which puts an industry-accredited underwater basket-weaving degree on a par with STEM subjects and traditional arts subjects, such as history and English'
Senior lecturer at a modern university in the South of England

Survey methodology

To compile the Times Higher Education University Workplace Survey 2016, we canvassed the opinions of higher education employees from across the UK between September and December 2015 in an online survey.

There were 2,852 respondents. Of those, 1,398 (49 per cent) describe themselves as "academics", with 1,454 (51 per cent) stating that they work in "professional and support" roles. The gender split is 1,564 female and 1,288 male.

Each respondent was presented with 37 statements about their institution, such as "I would recommend working at my university to others". They were asked to indicate the extent to which they agreed or disagreed with the statement on a five-point Likert scale: strongly disagree, disagree, neither agree nor disagree, agree, or strongly agree.

In the table, the total percentages of all respondents who disagree or agree with a question are based on the survey's raw data. As such, they may differ from the sum of the figures in the table, which have been rounded.

The survey also allowed participants to write comments about their institution in three categories: "things my university does well"; "areas in which my university could improve"; and an open box for any further comments.

To ensure that respondents completed the survey only once, and that they were affiliated to a university, only people with a working ".ac.uk" email address could take part. The owner of each email address could complete the survey only once.

The independent online survey was first developed by THE in consultation with Rob Briner and Yiannis Gabriel, professors at the University of Bath School of Management, after discussion with individuals from professional bodies and trade unions, including the University and College Union, the Association of University Administrators and Universities UK.
THE will publish further analysis of the results during 2016, and the Times Higher Education University Workplace Survey 2017 will be rolled out later this year.

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THE University Workplace Survey 2016: results and analysis

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UK academics and professional and support staff inhabit "two parallel universes that have little point of contact". That is one of the major conclusions to be drawn from the third annual Times Higher Education University Workplace Survey, according to Yiannis Gabriel, chair in organisation studies at the University of Bath and one of the designers of our inaugural survey in 2014.

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Online Mindfulness-Based Stress Reduction (MBSR)
This online MBSR training course is 100% free, created by a fully certified MBSR instructor, and is based on the program founded by Jon Kabat-Zinn at the University of Massachusetts Medical School.

[ Special note: see new COVID-19 and "Black Lives Matter" Resource page. ]

I'm so glad you found this website! Here you will find a complete eight-week MBSR course, designed for people who are not able to take a live MBSR course for financial or logistical reasons. All of the materials used in the live courses I taught, including guided meditations, articles and videos, are freely available here. - Dave Potter

Offering something for nothing does seem a little suspicious these days and I get many emails about this free online MBSR course, many of which ask one or more of the following questions:

The short answer is "yes". There is no catch: no fees, no spam, no cookies, you don't even need to identify yourself or give an email address. I receive no income personally from the site, not even indirectly. Contributions make the course even more accessible to people around the world, but this is not expected nor required - see About Contributions.(NOTE: Some of the videos have advertising, but the ad revenue goes directly to the creator of the videos and not to me.)

I am fully certified as an MBSR instructor by the University of Massachusetts Medical School and I taught live, in-person MBSR classes in my community for 12 years. I'm also a retired professional psychotherapist who has had a daily meditation practice for over 25 years, and when I discovered MBSR, I wanted to offer it to my clients and my community. I started teaching my twice-yearly in-person classes in 2004 and, as a service to my students, began to put some parts of the class online. I soon realized that with a little work, the material could be useful to people who are not able to attend a live MBSR class, either because of financial limitations or because no classes are offered nearby.

Creating and incrementally improving this resource has been a labor of love, and I'm happy to provide these materials without asking for a fee, something that is made possible given the economies of the internet, how the course is structured, and the generosity of other teachers* who have given their permission to make their teachings freely available on this website. It pleases me to know that anyone with an internet connection, whether they live in Moscow, Idaho or Moscow, Russia, can find and use the rich set of materials here. There is even a way for people without internet to have access to the course.

A live, in-person Mindfulness-Based Stress Reduction (MBSR) class is still the best way to learn mindfulness, because it is more likely that you will complete the course, due to the live interaction and group support.(NOTE: To find in-person MBSR offerings in your area, try a web search such as "MBSR Minneapolis" or "MBSR London".)

But doing an in-person course is not always possible, for financial and logistical reasons. This online course uses precisely the same course curriculum and resources that I used in my local in-person course, and if you follow the suggestions and practices for each of the eight weeks of the course, the learning can be just as deep and profound. In fact, the end-of-course reports I've received from online graduates indicate that they benefit just as much as people who complete the in-person course. For some recent end-of-course reports, see Testimonials / Gallery of Learning. There are over 3,000 graduates of the Palouse Mindfulness course from 90 countries (see the Map of Graduates and the Map of Palouse Mindfulness Visitors).

As an option, any student may join the Online Student Community, an online group in which members can share experiences and/or ask questions about the practices that are part of the course. There is no requirement to post anything - many people simply vicariously enjoy the sense of community and learn from others by viewing other peoples' posts. There are experienced graduates in the group who can answer specific questions and, on occasion, I may personally respond as well. It is a very lively group and most questions get answered within an hour or tw
Whether or not you join the online group, be sure to check out the Frequently Asked Questions page (see on menu above). The questions on the FAQ page are the ones most commonly asked in the online student group.
Even with the help of a group, it is a significant accomplishment to complete a course such as this on your own, and for that reason, I've done my best to make the experience interesting and engaging, something made possible by the generosity of the world-renowned teachers* whose videos and writings are posted on this site, including Jon Kabat-Zinn (Wherever You Go, There You Are), Thich Nhat Hanh (Peace Is Every Step), Tara Brach (Radical Acceptance), Pema Chodron (When Things Fall Apart), Sylvia Boorstein (Don't Just Do Something, Sit There), Sharon Salzberg (A Heart As Wide as the World), Robert Sapolsky (Why Zebras Don't Get Ulcers), Marshall Rosenberg (Non-Violent Communication), and Jack Kornfield (A Path with Heart).*

The Introduction is designed to give you a sense of mindfulness and an idea of how this course is structured. For each of the eight weeks, videos, readings and practices help you build a base of both knowledge and experience. MBSR "At a Glance" provides a brief outline of the MBSR course.

All of what you will need is accessible through this website, and whether or not you actually take yourself through the course, the wealth of material here, including videos and writings by the teachers mentioned above and others,is freely available to you.

This course is completely self-guided (there is no registration and only you will be monitoring your progress, using the provided practice sheets). If you successfully complete the eight weeks of practice and study and send the materials indicated inRequesting a Certificate of Completion, I will send you a personal note of congratulations along with a certificate of completion. There is no cost for this. You simply submit the seven sets of practice sheets and a one page description of what you've learned and how you will be incorporating what you learned into your life.
If you are ready to begin, or if you'd just like to know more about mindfulness or this program, go to the Introduction.
* NOTE: Much of the material in this course is drawn from the public works of other teachers and writers in the spirit of making mindfulness more widely available. I'm grateful to them for helping to make this free Online MBSR course possible. Those who have given their explicit written approval of how I've used their materials include Jon Kabat-Zinn, Thich Nhat Hanh, Tara Brach, Shauna Shapiro, Kristin Neff, Vidyamala Burch, Lynn Rossy, James Baraz, Ann Weiser Cornell, Daron Larson, and the University of Massachusetts Medical School.

All videos needed to complete the course, including the guided meditations, have accurate closed captions, with the exception of some that are in the "supplementary" sections or on the "Graduate" pages. [The captioning on this site thanks to Caption Access.]

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Online Mindfulness-Based Stress Reduction (MBSR) This online MBSR training course is 100% free, created by a fully certified MBSR instructor, and is based on the program founded by Jon Kabat-Zinn at the University of Massachusetts Medical School. [ Special note: see new COVID-19 and "Black Lives Matter" Resource page.

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Buddhify is a meditation & mindfulness app designed to fit busy lifestyles. With a beautiful design & easy user experience, it is loved all over the world.

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Shop bulk herbs and spices at Mountain Rose Herbs. Our herbs are trusted for their unmatched quality and freshness and are hand-selected from the finest harvests each year.

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Vocaroo is a quick and easy way to share voice messages over the interwebs.

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Best Teas for Relaxation and Stress Relief

Choose the relaxation tea that's right for you.

Herbs & The Nervous System

Herbalism acknowledges healing as a holistic process, especially in regard to the nervous system.

Plant Power Journal

Putting the power of plants into your hands with bits of inspiration, DIY projects, medicinal plant knowledge, and stories about our sustainable sourcing.

Plant Personality Quiz

Are you mostly calm and mellow, but get knots in your stomach when you're worried?

Take The Quiz

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All-Natural Organic Herbal and Medicinal Teas - Traditional Medicinals

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Choose the relaxation tea that's right for you. Herbalism acknowledges healing as a holistic process, especially in regard to the nervous system. Putting the power of plants into your hands with bits of inspiration, DIY projects, medicinal plant knowledge, and stories about our sustainable sourcing.

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Tulsi - Ocimum sanctum: A herb for all reasons

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Tulsi - Ocimum sanctum: A herb for all reasons

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Diseases of modern life

Despite the many wonders of science and industry, modern life is fraught with stress. Mobile devices and the web have vastly increased the pace of life so that many people feel that they are now drowning in an ever-expanding ocean of data, while industrial agriculture has burdened us with increasing exposure to unhealthy processed and packaged food and a plethora of pesticides, food packaging materials and other toxic industrial chemicals. Urban dwellers are also faced with increasing wealth inequality, social isolation, excessive noise, air, water and soil pollution and disconnection from nature. Thus, while industrialization has led to longer lifespans and vast increases in human populations, it is now recognized that the greatest causes of death and disease on the planet are preventable lifestyle-related chronic diseases.[ 1]

We are in the midst of a global pandemic of obesity, diabetes, cancer, dementia, depression and other chronic diseases caused by modern lifestyles and their associated lack of physical activity, high intake of sugar, fat, salt, alcohol and tobacco and exposure to a toxic cocktail of industrial chemicals. The solutions to this current health crisis are therefore more likely to be found in the homes and behaviors of individuals than in medical clinics, hospital or pharmacies.

Ayurveda and lifestyle medicine

As a science of life and the world's oldest medical system, Ayurveda has a holistic approach to health and disease that focuses on preserving and promoting good health and preventing disease through healthy lifestyle practices. These practices include consumption of fresh, minimally processed foods, the use of Rasayanas (formulas) that eradicate ageing and disease, sophisticated detoxification practices and regular consumption of adaptogenic herbs that enhance the body's capacity to maintain balance in the midst of a variety of stressors.

Ayurveda's use of medicinal and culinary herbs draws upon India's incredible biodiversity with a variety that is unsurpassed by any medical system; yet, of all the herbs used, none has a status comparable to tulsi or holy basil ( Ocimum sanctum).

Tulsi: A potent adaptogen

Tulsi is an aromatic shrub in the basil family Lamiaceae (tribe ocimeae) that is thought to have originated in north central India and now grows native throughout the eastern world tropics.[ 2] Within Ayurveda, tulsi is known as "The Incomparable One," "Mother Medicine of Nature" and "The Queen of Herbs," and is revered as an "elixir of life" that is without equal for both its medicinal and spiritual properties.[ 3] Within India, tulsi has been adopted into spiritual rituals and lifestyle practices that provide a vast array of health benefits that are just beginning to be confirmed by modern science. This emerging science on tulsi, which reinforces ancient Ayurvedic wisdom, suggests that tulsi is a tonic for the body, mind and spirit that offers solutions to many modern day health problems.

Tulsi is perhaps one of the best examples of Ayurveda's holistic lifestyle approach to health. Tulsi tastes hot and bitter and is said to penetrate the deep tissues, dry tissue secretions and normalize kapha and vata. Daily consumption of tulsi is said to prevent disease, promote general health, wellbeing and longevity and assist in dealing with the stresses of daily life. Tulsi is also credited with giving luster to the complexion, sweetness to the voice and fostering beauty, intelligence, stamina and a calm emotional disposition.[ 3, 4, 5, 6] In addition to these health-promoting properties, tulsi is recommended as a treatment for a range of conditions including anxiety, cough, asthma, diarrhea, fever, dysentery, arthritis, eye diseases, otalgia, indigestion, hiccups, vomiting, gastric, cardiac and genitourinary disorders, back pain, skin diseases, ringworm, insect, snake and scorpion bites and malaria.[ 3, 5, 6, 7]

Considered as a potent adaptogen, tulsi has a unique combination of pharmacological actions that promote wellbeing and resilience. While the concept of an "adaptogen," or herb that helps with the adaptation to stress and the promotion of homeostasis, is not widely used in Western medicine, Western science has revealed that tulsi does indeed possess many pharmacological actions that fulfill this purpose.

The medicinal properties of tulsi have been studied in hundreds of scientific studies including in vitro, animal and human experiments. These studies reveal that tulsi has a unique combination of actions that include: Antimicrobial (including antibacterial, antiviral, antifungal, antiprotozoal, antimalarial, anthelmintic), mosquito repellent, anti-diarrheal, anti-oxidant, anti-cataract, anti-inflammatory, chemopreventive, radioprotective, hepato-protective, neuro-protective, cardio-protective, anti-diabetic, anti-hypercholesterolemia, anti-hypertensive, anti-carcinogenic, analgesic, anti-pyretic, anti-allergic, immunomodulatory, central nervous system depressant, memory enhancement, anti-asthmatic, anti-tussive, diaphoretic, anti-thyroid, anti-fertility, anti-ulcer, anti-emetic, anti-spasmodic, anti-arthritic, adaptogenic, anti-stress, anti-cataract, anti-leukodermal and anti-coagulant activities.[ 4, 5, 6, 7] These pharmacological actions help the body and mind cope with a wide range of chemical, physical, infectious and emotional stresses and restore physiological and psychological function.

Protection and detoxification

Many of the physiological benefits of tulsi can be attributed to its ability to assist with the body's internal housekeeping and protection of the body from toxin-induced damage. These functions are often attributed to tulsi's high content of phenolic compounds and anti-oxidant properties, with Krishna tulsi (black/purple variety) having a higher phenolic content and anti-oxidant capacity than white Vana (wild) tulsi.[ 8]

Laboratory studies have shown that tulsi protects against toxic chemical-induced injury by increasing the body's levels of anti-oxidant molecules such as glutathione and enhancing the activity of anti-oxidant enzymes such as superoxide dismutase and catalase, which protect cellular organelles and membranes by mopping up damaging free radicals caused by lack of oxygen[ 9] and other toxic agents.[ 10, 11]

Tulsi also helps to prevent cancers caused by toxic compounds by reducing DNA damage[ 12] and inducing apoptosis in precancerous and cancerous cells, thereby reducing the growth of experimental tumors and enhancing survival.[ 13, 14] Furthermore, tulsi not only protects against the damage caused by toxic compounds, but also enables the body to more effectively transform and eliminate them by enhancing the activity of liver detoxification enzymes such as the cytochrome P450 enzymes, which deactivates toxic chemicals and enables them to be safely excreted.[ 15]

While these actions are vitally important for protecting against natural toxins produced within the body or by animals or plants, they are perhaps even more important in the modern age to protect against the vast range of pollutants, pesticides, pharmaceuticals, heavy metals, radiation and other industrial toxicants created from human activity.

Toxicant stress: Chemicals, heavy metals and radiation

The ability of tulsi to protect against the damaging effects of various toxicants has been documented in numerous experimental studies. These studies attest to the ability of tulsi to prevent liver, kidney and brain injury by protecting against the genetic, immune and cellular damage caused by pesticides, pharmaceuticals and industrial chemicals. Thus, tulsi has been shown to protect against the toxic effects of industrial chemicals such as butylparaben,[ 16] carbon tetrachloride,[ 17] copper sulfate[ 18] and ethanol,[ 19] and common pesticides such as rogor,[ 20] chlorpyrifos,[ 21] endosulfan[ 22] and lindane.[ 23] Tulsi has also been shown to protect against the toxic effects of many pharmaceuticals drugs including acetaminophen,[ 24] meloxicam,[ 25] paracetamol,[ 26] haloperidol[ 27] and anti-tubercular drugs.[ 28]

In addition to protecting against toxic chemicals, tulsi has also been shown to protect against the toxic effects of heavy metals such as lead, arsenic, cadmium, chromium and mercury[ 29, 30, 31] and the toxic effects of radiation.[ 32, 33, 34, 35] Tulsi exerts its radio-protective effects by scavenging free radicals and reducing the oxidative cellular and chromosomal damage induced by radiation,[ 33, 36, 37, 38] thereby reducing organ damage and enhancing postradiation survival in experimental animals.[ 39, 40, 41]

Physical stress

The actions that protect against the toxic effects of chemicals and radiation also help to address the toxic effects of many physical stressors. Prolonged physical exertion, physical restraint, exposure to cold and excessive noise disturb homeostasis by inducing physiological and metabolic stress. When the capacity to adapt to these stressors is exceeded, maladaptation occurs resulting in damage to biochemical pathways, organ function and health. Through enhancing various cellular and physiological adaptive functions, adaptogenic herbs such as tulsi are able to protect against this damage.

Studies using forced-swimming, restraint and cold-exposure stress in laboratory animals have shown that tulsi enhances aerobic metabolism, improves swimming time, reduces oxidative tissue damage and normalizes many physiological and biochemical parameters caused by physical stressors. Similarly, experimental studies have shown that tulsi helps reduce the effects of acute and chronic noise-induced stress in experimental animals, with enhancement of neurotransmitter and oxidative stress levels in discrete brain regions along with improved immune, ECG and corticosteroid responses.[ 42, 43, 44, 45]

Metabolic stress

Metabolic stress due to poor diet, low physical activity and psychological stress is a prominent feature of modern lifestyles and "metabolic syndrome" is estimated to affect as much as one-third of modern populations. Metabolic syndrome, also known as "prediabetes" or "Syndrome X," includes the "deadly quartet" of centripetal obesity, hypertension, high cholesterol and poor glucose regulation and is associated with chronic inflammation and a greater risk of diabetes, heart disease and stroke. While the exact causes of metabolic syndrome are still being debated, there is evidence to suggest that tulsi can assist in dealing with many features of metabolic syndrome and their consequences.

Numerous test tube and animal experiments as well as human clinical trials have shown that tulsi has anti-diabetic activity. Studies using diabetic laboratory animals have shown that tulsi can reduce blood glucose, correct abnormal lipid profiles[ 46, 47] and protect the liver and kidneys from the metabolic damage caused by high glucose levels.[ 48] Tulsi has also been shown to improve lipid profiles,[ 49, 50] prevent weight gain, hyperglycemia, hyperinsulinemia, hypertriglyceridemia and insulin resistance,[ 51, 52] and protect the organs and blood vessels from atherosclerosis[ 49, 53] in laboratory animals fed high-fat diets. Similarly, in human clinical trials, tulsi has shown to decrease glucose levels, improve blood pressure and lipid profiles[ 54, 55, 56] and reduce many diabetic symptoms in patients with type 2 diabetes.[ 57]

The beneficial metabolic effects of tulsi are multiple and include protecting the liver, kidneys[ 49] and pancreatic islet cells from free radical damage;[ 58] enhancing liver bile acid synthesis[ 49] and reducing liver lipid synthesis;[ 52] enhancing insulin secretion[ 59] and action;[ 60] lowering cortisol levels;[ 61] and reducing inflammation. The anti-inflammatory action of tulsi, which has been observed in both acute and chronic inflammatory models in animals,[ 62, 63, 64, 65] is attributed to tulsi's eugenol and linoleic acid content and the inhibition of both the cyclooxygenase and the lipoxygenase pathways of arachidonic acid metabolism.[ 66, 67] This enables tulsi to exert anti-inflammatory effects comparable to nonsteroidal anti-inflammatory drugs such as phenylbutazone,[ 68] ibuprofen, naproxen, aspirin[ 69] and indomethacin.[ 70]

Infection protection

Modern research has revealed that tulsi has anti-bacterial, anti-viral and anti-fungal activity[ 71] that includes activity against many pathogens responsible for human infections. Tulsi has also been shown to boost defenses against infective threats by enhancing immune responses in nonstressed and stressed animals[ 72, 73, 74, 75, 76, 77] and healthy humans.[ 78] While no human trials have been published, there is experimental evidence that tulsi may help in the treatment of various human bacterial infections including urinary tract infections,[ 79] skin and wound infections,[ 80] typhoid fever,[ 81] cholera,[ 82] tuberculosis,[ 83] gonorrhea,[ 84] acne,[ 85] herpes simplex,[ 86] leishmaniasis,[ 87] various pneumonias[ 88] and fungal infections,[ 89, 90, 91, 92] as well as mosquito-borne diseases such as dengue, malaria and filariasis.[ 93, 94, 95]

Tulsi has also been shown to be active against many animal pathogens, and this has led to tulsi being used in animal rearing to reduce infections in cows,[ 96] poultry,[ 97] goats,[ 98] fish[ 76, 77] and silkworms.[ 99] Tulsi's activity against water-borne and food-borne pathogens further suggests that it can be used in the preservation of food stuffs[ 100, 101, 102] and herbal raw materials[ 103] as well as for water purification[ 82] and as a hand sanitizer.[ 104]

Tulsi's broad-spectrum activity, which includes activity against Streptococcus mutans, the organism responsible for tooth decay, further suggests that it can be used as a herbal mouth wash for treating bad breath, gum disease and mouth ulcers.[ 105, 106] This has been confirmed in clinical trials that have demonstrated that rinsing with tulsi is as effective as 0.2% Chlorhexidine and Listerine in reducing the levels of Streptococcus mutans[ 107] and that a herbal mouthwash that includes tulsi is preferred for its taste and convenience.[ 108]

Tulsi's unique combination of antibacterial antioxidant, anti-inflammatory and analgesic activities also makes it useful in wound healing.[ 109, 110] This is supported by experimental evidence that has shown that tulsi can increase wound-breaking strength and accelerate wound healing in laboratory animals.[ 110, 111] Tulsi has also been shown to have anti-ulcer and ulcer-healing activity that has been observed in many different animal models including aspirin-, indomethacin-, alcohol-, histamine-, reserpine-, serotonin-, acetic acid-, meloxicam-, cold restraint-, pyloric ligation- and stress-induced ulceration models.[ 25, 112, 113, 114] This anti-ulcer activity is attributed to multiple actions including the reduction of offensive factors such as acid-pepsin secretion and lipid peroxidation and the enhancement of gastric defensive factors such as mucin secretion, cellular mucus and longevity of mucosal cells.[ 114, 115]

Mental stress

In addition to physical, toxic and infective stress, modern living is associated with heightened levels of psychological stress caused by the many demands and fast pace of modern life. This stress compounds the toxic effects of chemical pollutants and the constant fear of pervasive toxic chemicals can itself lead to even further stress and anxiety that may be just as toxic as the chemicals causing it. While the reality of daily chemical exposure cannot be denied, regular consumption of tulsi not only helps protect and detoxify the body's cells and organs, it can also help reduce toxic stress by relaxing and calming the mind and offering many psychological benefits including anti-depressant activity and positive effects on memory and cognitive function.

The psychotherapeutic properties of tulsi have been explored in various animal experiments that reveal that tulsi has anti-anxiety and anti-depressant properties,[ 116, 117, 118] with effects comparable to diazepam and antidepressants drugs.[ 119, 120] Animal studies further reveal that tulsi enhances memory and cognitive function[ 121, 122] and protects against aging-induced memory deficits.[ 123] Similarly, in human studies, tulsi has been observed to reduce stress, anxiety and depression,[ 124] with a 6-week, randomized, double-blind, placebo-controlled study reporting that tulsi significantly improves general stress scores, sexual and sleep problems and symptoms such as forgetfulness and exhaustion.[ 125]

While modern scientific studies suggest that tulsi is effective in treating a range of stressful conditions, within Ayurveda, tulsi is more commonly recommended as a preventive measure to enhance the ability to adapt to both psychological and physical stress and therefore prevent the development of stress-related diseases. To this end, many Ayurvedic practitioners recommend the regular consumption of tulsi tea as an essential lifestyle practice.

Liquid yoga

Regular consumption of tulsi tea may be compared with the regular practice of yoga, which can be considered "adaptogenic" through nurturing and nourishing the body -- mind -- spirit while fostering a sense of relaxation and wellbeing. In contrast, regular consumption of caffeinated beverages such a black and green tea ( Camellia sinensis L.) and coffee ( Coffea arabica L.) may be compared with more aerobic exercise, which confers health benefits through stimulation and activation.

Like yoga, tulsi has a calming effect that leads to clarity of thought, along with a more relaxed and calm disposition. The cognitive and memory-enhancing properties of tulsi therefore differ from those of caffeine-containing beverages such as coffee and tea, which heightens arousal and may cause physical and mental agitation. Furthermore, tulsi does not produce the same physical dependence as caffeine and can be safely consumed on a regular basis without the fear of withdrawal effects.

The drinking of tea and coffee has become an integral part of modern life and has been ritualized in many cultures to guide social interactions, set social agendas and invoke spiritual awareness. For example, sophisticated Asian tea ceremonies involve a whole set of rituals, tools and gestures that serve to transcend normal consciousness, while in the west the ritual of "afternoon tea" or "high tea" emphasizes the surroundings, equipment, manners and social circle. In less-formal situations, many people ritualize their morning cup of coffee and use the "meet-up for coffee" to arrange their social agendas, while the "tea break" is often built into the modern-day work routine. Yet, while tea and coffee have infiltrated their way into modern living, they have not yet attained the status that tulsi has within traditional Indian life.

Divine tulsi

In Hinduism, tulsi is worshipped as a goddess and every part of the tulsi plant is revered and considered sacred, including the leaves, stem, flower, root, seeds and oil. Even the surrounding soil, which has recently been found to harbor beneficial endophytic fungi,[ 126] is considered an aspect of the divine. As such, Hindi households are considered incomplete without a tulsi plant, typically in an ornate earthen pot situated in a courtyard where tulsi serves both practical and ceremonial purposes. For example, tulsi's distinct clove-like aroma arising from its high eugenol content serves to link the householder to the divine while also repelling mosquitoes, flies and other harmful insects. Tulsi is further integrated into daily life through evening and morning rituals and other spiritual and purification practices that can involve ingesting its leaves or consuming tulsi tea.

In addition to sanctifying the home, tulsi is used ceremonially in Hinduism and some Greek Orthodox Churches to create "holy water." Tulsi wood or seeds are also used to make tulsi malas, which are strings of beads used to help the mind focus during meditation, chanting and devotional practices and therefore ceremonially connect mind, body and spirit. Tulsi has also been used in cities to combat air pollution and hundreds of thousands of tulsi plants have been planted around the Taj Mahal in Agra to help protect the iconic marble building from environmental pollution damage.[ 127]

Nature nurture

The cultivation and reverence for the tulsi plant in the home not only serves specific religious purposes it also directly connects the devotee with the creative power of nature. Connection with nature is profoundly healing and life-affirming; yet, the potential health, emotional, social and cognitive benefits of connection with nature are only just being realized in the west where disconnection from nature and "nature deficit" are common. A review of the scientific literature on the health benefits of connection to nature suggest that "access to nature plays a vital role in human health, wellbeing and development that has not been fully recognized,"[ 128] and there is now a global movement to reconnect people with nature that has arisen out of concerns over nature deficit, sedentary lifestyles, obesity, mental health issues, excessive use of electronic media, environmental degradation, wildlife conservation, sustainability and climate change.[ 129]

The placing of a living tulsi plant at the center of the household, therefore, has applicability beyond the realms of Hinduism and may play a useful role in addressing modern day issues through embodying the healing power of the natural world and serving as a constant connection to living nature.

Quality assurance and identification

Like any medicinal plant, optimal cultivation, harvesting, preservation and storage methods are required to preserve tulsi's medicinal value. For example, it is suggested that tulsi should be grown employing organic methods in rural areas free from environmental pollution.[ 3] This is supported by the finding of toxic elements at almost twice the concentration in tulsi leaves grown in polluted compared with unpolluted areas.[ 130]

It is also important to ensure the correct herb is used and that manufacturers adopt stringent quality assurance standards and processes. Concerns about product quality in European "tulsi" products have been raised by reports of a high frequency of substitution with surrogate herbs such as Ocimum basilicum L.[ 131] This may be addressed using high-performance liquid chromatography fingerprints and microscopic assays to ensure batch-to-batch quality and the safety and botanical integrity of standardised extracts of standardized extracts.[ 131, 132]

Tulsi as a vehicle of consciousness

Perhaps one of the greatest of tulsi's benefits in the modern world comes from its global distribution based on its cultivation using ethical, fair trade, organic and ecological farming practices. There is a growing realization that in order to tackle issues of food security, rural poverty, hunger, environmental degradation and climate change a shift in agriculture is needed from a "green revolution" to an "ecological intensification revolution. This has been highlighted in a recent United Nations document titled "Wake Up Before It's Too Late," which calls for the global community to endorse and advocate for local solutions to toxicity, food insecurity and poverty, such as the use of organic and small-scale farming over the use of genetically modified organisms and monocultures.[ 133] While ecological farming methods are not specific to tulsi, they have been effectively applied to tulsi cultivation by Organic India Pvt. Ltd. This company, which was established as a "vehicle of consciousness," works with thousands of organic tulsi farmers in India to produce a business ecology whereby rural Indian farmers gain their dignity and a healthy and sustainable livelihood while serving to nurture the land they live on and produce a range of teas that enable consumers around the world to access the benefits of tulsi.

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Tulsi - Ocimum sanctum: A herb for all reasons

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Despite the many wonders of science and industry, modern life is fraught with stress. Mobile devices and the web have vastly increased the pace of life so that many people feel that they are now drowning in an ever-expanding ocean of data, while industrial agriculture has burdened us with increasing exposure to unhealthy processed and packaged food and a plethora of pesticides, food packaging materials and other toxic industrial chemicals.

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Examining the cognitive effects of a special extract of Bacopa monniera

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Examining the cognitive effects of a special extract of Bacopa monniera

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View of Examining the cognitive effects of a special extract of Bacopa monniera (CDRI08: Keenmnd): A review of ten years of research at Swinburne University

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Return to Article Details Examining the cognitive effects of a special extract of Bacopa monniera (CDRI08: Keenmnd): A review of ten years of research at Swinburne University

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Dietary and botanical anxiolytics

Elham Alramadhan, Mirna S. Hanna, Mena S. Hanna, Todd G. Goldstein, Samantha M. Avila, Benjamin S. Weeks

Med Sci Monit 2012; 18(4): RA40-48

DOI: 10.12659/MSM.882608

Drugs used to treat anxiety have many negative side effects including addiction, depression, suicide, seizures, sexual dysfunction, headaches and more. Anxiolytic medications do not restore normal levels of neurotransmitters but instead manipulate the brain chemistry. For example, selective serotonin reuptake inhibitors (SSRIs) prevent the reuptake of serotonin from the synapse allowing serotonin to remain in the area of activity for a longer period of time but does not correct the lack of serotonin production. Benzodiazepines, such as Valium and Xanax®, stimulate GABA receptors, thus mimicking the calming effects of GABA but again do not fix the lack of GABA production. Often, the brain becomes accustomed to these medications and they often lose their effectiveness, requiring higher doses or different drugs. In contrast to anxiolytic drugs, there are herbs and nutrients which can stimulates neurotransmitter synthesis and more naturally effect and even adjust brain chemistry in the absence of many of the side effects experienced with drugs. Therefore this paper explores several herbal and nutritional approaches to the treatment of anxiety.

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Drugs used to treat anxiety have many negative side effects including addiction, depression, suicide, seizures, sexual dysfunction, headaches and more. Anxiolytic medications do not restore normal levels of neurotransmitters but instead manipulate the brain chemistry.

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An Alternative Treatment for Anxiety: A Systematic Review of Human Trial Results Reported for the Ayurvedic Herb Ashwagandha (Withania somnifera)

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An Alternative Treatment for Anxiety: A Systematic Review of Human Trial Results Reported for the Ayurvedic Herb Ashwagandha (Withania somnifera)

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doi: 10.1089/acm.2014.0177.

Affiliation

¹ 1 Department of Family Medicine, SUNY Upstate Medical University , Syracuse, NY.

Free PMC article

Morgan A Pratte et al. J Altern Complement Med.

Free PMC article

doi: 10.1089/acm.2014.0177.

Affiliation

¹ 1 Department of Family Medicine, SUNY Upstate Medical University , Syracuse, NY.

Abstract

Objective: To assess existing reported human trials of Withania somnifera (WS; common name, ashwagandha) for the treatment of anxiety.

Design: Systematic review of the literature, with searches conducted in PubMed, SCOPUS, CINAHL, and Google Scholar by a medical librarian. Additionally, the reference lists of studies identified in these databases were searched by a research assistant, and queries were conducted in the AYUSH Research Portal. Search terms included "ashwagandha," "Withania somnifera," and terms related to anxiety and stress. Inclusion criteria were human randomized controlled trials with a treatment arm that included WS as a remedy for anxiety or stress. The study team members applied inclusion criteria while screening the records by abstract review.

Intervention: Treatment with any regimen of WS.

Outcome measures: Number and results of studies identified in the review.

Results: Sixty-two abstracts were screened; five human trials met inclusion criteria. Three studies compared several dosage levels of WS extract with placebos using versions of the Hamilton Anxiety Scale, with two demonstrating significant benefit of WS versus placebo, and the third demonstrating beneficial effects that approached but did not achieve significance (p=0.05). A fourth study compared naturopathic care with WS versus psychotherapy by using Beck Anxiety Inventory (BAI) scores as an outcome; BAI scores decreased by 56.5% in the WS group and decreased 30.5% for psychotherapy (p<0.0001). A fifth study measured changes in Perceived Stress Scale (PSS) scores in WS group versus placebo; there was a 44.0% reduction in PSS scores in the WS group and a 5.5% reduction in the placebo group (p<0.0001). All studies exhibited unclear or high risk of bias, and heterogenous design and reporting prevented the possibility of meta-analysis.

Conclusions: All five studies concluded that WS intervention resulted in greater score improvements (significantly in most cases) than placebo in outcomes on anxiety or stress scales. Current evidence should be received with caution because of an assortment of study methods and cases of potential bias.

Figures

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national center for biotechnology information

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An alternative treatment for anxiety: a systematic review of human trial results reported for the Ayurvedic herb ashwagandha (Withania somnifera) - PubMed

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All five studies concluded that WS intervention resulted in greater score improvements (significantly in most cases) than placebo in outcomes on anxiety or stress scales. Current evidence should be received with caution because of an assortment of study methods and cases of potential bias.

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Role of Walnuts in Maintaining Brain Health with Age

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Role of Walnuts in Maintaining Brain Health with Age

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Abstract

Because of the combination of population growth and population aging, increases in the incidence of chronic neurodegenerative disorders have become a societal concern, both in terms of decreased quality of life and increased financial burden. Clinical manifestation of many of these disorders takes years, with the initiation of mild cognitive symptoms leading to behavioral problems, dementia and loss of motor functions, the need for assisted living, and eventual death. Lifestyle factors greatly affect the progression of cognitive decline, with high-risk behaviors including unhealthy diet, lack of exercise, smoking, and exposure to environmental toxins leading to enhanced oxidative stress and inflammation. Although there exists an urgent need to develop effective treatments for age-related cognitive decline and neurodegenerative disease, prevention strategies have been underdeveloped. Primary prevention in many of these neurodegenerative diseases could be achieved earlier in life by consuming a healthy diet, rich in antioxidant and anti-inflammatory phytochemicals, which offers one of the most effective and least expensive ways to address the crisis. English walnuts ( Juglans regia L.) are rich in numerous phytochemicals, including high amounts of polyunsaturated fatty acids, and offer potential benefits to brain health. Polyphenolic compounds found in walnuts not only reduce the oxidant and inflammatory load on brain cells but also improve interneuronal signaling, increase neurogenesis, and enhance sequestration of insoluble toxic protein aggregates. Evidence for the beneficial effects of consuming a walnut-rich diet is reviewed in this article.

Introduction

In many countries, growing populations and increased mean life spans are leading to a large aging population. With this demographic shift comes an increased incidence of neurodegenerative diseases. Worldwide, >35.6 million people are living with dementia, and in the United States, nearly 7 million people have been diagnosed with dementia and other neurologic disorders ( 1). Neurodegenerative diseases are highly debilitating, severely affecting quality of life and imposing an economic burden on both individuals and society. Cures for most neurodegenerative disorders have yet to be discovered, in part due to irreversible loss of brain cells during the covert pathogenesis of these debilitating diseases, which often take 10-15 y to manifest clinically, and the poorly understood familial-genetic linkage ( 2).

Neurodegenerative diseases are associated with chronic exposure to oxidative stress and inflammation, loss of protective signaling, and the accumulation of toxic proteins. During aging, these factors trigger a cascade of altered molecular events, which ultimately disrupt or destroy cells within the brain. Damage to individual cells modifies interneuronal communications, causing deficits in memory, cognition, and motor function. These cellular modifications ultimately lead to the pathogenesis of neurodegenerative diseases, such as Alzheimer disease (AD), Parkinson disease, Huntington disease, amyotrophic lateral sclerosis, prion disease, and dementia ( 2, 3). Although the central nervous system is particularly vulnerable, the mutually perpetuating effects of oxidative stress and inflammation also affect other organ systems, increasing older adults' risk of developing other diseases such as heart disease, cancer, arthritis, diabetes, and other age-related disorders. Therefore, systemic protection from oxidative stress and inflammation could not only protect the brain from their direct effects but also from a variety of related pathologies.

Dietary interventions may be able to prevent or forestall neurodegeneration. Epidemiologic investigation of the Mediterranean diet, which consists of high amounts of fruits, vegetables, cereals, and fish and minimal amounts of alcohol, red meat, and dairy products revealed substantial reductions in the risk of AD in a large community-based, case-control cohort study in 194 AD patients and 1790 non-AD patients ( 4). A similar investigation reported a decreased risk of dementia with increased flavonoid-rich-diet consumption in a cohort study in 1367 participants > 65 y of age ( 5). A few other studies also indicated the benefits of the Mediterranean diet in reducing the risk of dementia, as well as mortality, in AD patients, indicating the vital role of fruit and nut bioactive compounds on cognitive health ( 6, 7).

English walnuts ( Juglans regia L.) are rich in α-linolenic acid (ALA; 18:3n−3) and linoleic acid (LA; 18:2n−6) as well as other polyphenolics, phytosterols, and micronutrients. Feeding studies from our laboratory have shown that dietary supplementation with walnuts can improve memory, cognition, and motor function in aged animals ( 8- 10). Although most of these studies have linked walnuts' effects to their high PUFA content, walnuts' notable polyphenol content plays an important role in reducing the inflammation and oxidative stress in the aging brain. This review addresses contemporary research into the effects of dietary walnuts on cognition, motor function, and brain health.

Aging and Metabolic Effects on Brain Health

The central nervous system is metabolically demanding, consuming nearly one-fourth of total oxygen intake and accounting for >20% of the metabolic rate at rest ( 11, 12). The brain's high metabolic rate results in the generation of disproportionate amounts of reactive oxygen and nitrogen species ( 13). The damaging effects of these free radicals are usually countered by endogenous oxidoreductase enzymes and intrinsic proteins, which act as molecular quenchers at the cellular level. However, aging, as well as other factors, alters the homeostasis between the generation and quenching of these highly reactive elemental species, leading to increased oxidation at the cellular level. Increased oxidative stress and lipid peroxidation initiate a cascade of proinflammatory signals, leading to the dystrophy and death of brain cells. Altered homeostasis of oxidation, inflammation, and protein aggregation has been attributed to the death of neurons, which is directly related to impairment in various cognitive domains, such as learning, decision making, judgment, problem solving, and memory ( 14- 17).

The coordination and execution of cognitive processes depends on the appropriate detection and propagation of signals from both the environment and surrounding cells in the brain. The responsivity of each cell depends on the composition of the cell membrane, through which all signals must pass. FAs are abundant within neuronal membranes, where they play a role in maintaining structural integrity, modulating enzyme activity, and generating secondary messengers and other signaling molecules ( 9). The PUFA composition of neuronal membranes decreases during aging and contributes to the decline of neuronal function observed in aging. This alteration is prevalent in the aged brain, particularly the cortex, hippocampus, striatum, and cerebellum, where reduced PUFA concentrations contribute to changes in neuronal morphology and a decrease in membrane fluidity and synaptic plasticity ( 18- 20). A number of neuronal functions are affected by deficits in membrane FA composition, all of which reduce the cells' ability to propagate and transmit signals within the brain. Therefore, increased availability of PUFAs may counteract PUFA depletion in neuronal membranes.

Walnut Phytochemicals and In Vitro Studies

Walnuts are a rich source of nutrients and bioactive phytochemicals. Walnuts contain large amounts of PUFAs such as ALA and LA, which have been shown to boost brain health and function even with an increase in age ( 8, 21). Every 100 g of walnuts ( Juglans regia) contain 38 g of LA and 9 g of ALA, as well as 4.4 g of saturated (palmitic acid, 16:0) and 8.7 g of monounsaturated (oleic acid, 18:1n-9) FAs. In humans, ALA from walnuts is then converted through a series of sequential desaturation and elongation reactions into essential PUFAs such as EPA (20:5n-3) and DHA (22:6n-3) in the liver. Both EPA and DHA play an important role in brain health not only by reducing oxidative stress and altering the immune function but also in maintaining synaptic plasticity, neuronal membrane stability, gene expression, and neurogenesis ( 8, 22).

Melatonin is another bioactive compound found in walnuts. Endogenous melatonin, which is primarily synthesized by the pineal gland, plays a critical role in regulating circadian rhythms ( 30). Melatonin deficiency has been linked to degeneration of cholinergic neurons in the basal forebrain and the deposition of aggregated proteins, such as amyloid β (Aβ) peptides, leading to cognitive impairment and dementia ( 31). Reiter et al. ( 30) reported that consumption of walnuts increased blood melatonin concentrations, which correlated with an increase in "total antioxidant capacity" of the serum with "total antioxidant capacity," indicating the ability of the blood to detoxify free radicals.

Mechanistic Animal Studies Supporting Walnut Effects on Cognitive Function

In an effort to determine the bioavailability of FAs in the diet, at the site of action, rats fed diets containing 15% LA and 3% ALA were examined for whole-body distribution of deuterated LA and ALA after a single-dose oral administration ( 36). The brain concentration of LA peaked at 8 h post-administration. Although ALA was not detected in brain tissue, ALA metabolites including EPA, DPA, and DHA remained elevated up to 25 d post-administration ( 36). Studies have also shown a decline in FA enzyme activity in the liver of aged animals ( 37), potentially allowing the presence of ALA and LA in the blood, where it could be taken up in the brain. Additionally, Davis et al. ( 38) found that mice fed a whole-walnut diet comprising 155 g of whole walnuts/kg diet, which is the equivalent of 80 g (∼3 ounces) of walnuts/d in humans, to provide 20% of energy from fat, had changes in plasma markers, which were echoed in the liver metabolomics results. It was concluded that the walnut diet's beneficial effects probably represent the effects of whole walnuts' multiple constituents and not a specific FA or tocopherol ( 38).

In isolation, dietary DHA can improve learning and memory in rodent models of aging. Aged mice (9 mo) whose diet contained 20% DHA in the form of the green algae Chlorella vulgaris for 8 wk made fewer working memory errors in an 8-arm radial water maze ( 39). Dietary walnuts can also improve cognition. In 1 study, rats that ingested 80 mg/d of walnuts, in addition to their standard diet, for 28 d had enhanced learning and memory in the radial arm maze and reduced anxiety on the elevated plus maze ( 40). In a recent study from our laboratory ( 9), 19-mo-old Fischer (F344) rats were fed diets containing 0, 2, 6, or 9% (wt:wt) ground walnuts with skin for 8 wk. Rats fed a diet containing 2 or 6% walnuts had improved balance, coordination, and strength; however, rats fed the 9% diet had impaired motor performance relative to controls. Working memory in the water maze was also enhanced in rats fed diets containing walnuts; however, rats fed the 9% walnut diet had impairments in reference memory. The 6% walnut diet produced the best overall results among the aged rats. The 6% diet contained 5.4 g of ALA and 22.9 g of LA/kg, which, interestingly, is equivalent to the recommended dietary intake of 1 ounce/d (∼28 g) of walnuts for humans ( 8, 22, 25). We subsequently found that walnut consumption was associated with substantially lower acetylcholinesterase activity in the striatum brain region of aged animals ( 22).

Older adults are at a higher risk of seizure disorders, the incidence and prevalence of which increase after 60 y of age ( 41). Acute symptomatic seizures among older adults are often the result of acute neural insults or metabolic disturbances. Asadi-Shekaari et al. ( 42) also showed that the addition of walnut kernels to the diet of male rats was preventive against experimentally induced epilepsy. In one of our recent studies on aged rats that were supplemented with 6-9% walnuts, walnuts substantially inhibited the activation/phosphorylation of P38 MAPK and the transcription factor NF-κB ( 43). The results also showed that 6% walnut supplementation activated cAMP response element-binding protein (CREBP), a constitutively expressed nuclear transcription factor that plays a critical role in neuronal survival in the hippocampus and striatum ( 43). n-3 FAs that are rich in walnuts are converted to EPA and DHA, which act as precursors for anti-inflammatory eicosanoids and neuroprotection D1 (NPD1), respectively. NPD1 has been shown to attenuate the activation of inflammatory signaling mediators such as prostaglandins synthesized from arachidonic acid (long-chain n-6 PUFAs) by cyclooxygenase-2 ( 44). Therefore, walnut phytochemicals, which can effectively inhibit pro-oxidant and proinflammatory mediators, may be 1 method of reducing the risk of dementia, seizure, and other neurologic disorders among older adults.

The loss of protein homeostasis in the brain, whereby brain cells accumulate insoluble, misfolded, or damaged protein or organellar structures, is the hallmark of many age-related neurodegenerative diseases. In a separate study, which used the brains of rats supplemented with 6 and 9% walnut diets, our laboratory showed substantially reduced aggregation of polyubiquitinated proteins and activated the neuronal housekeeping function, known as autophagy, in the striatum and hippocampus ( 43). The clearance of polyubiquitinated protein aggregates such as p62/sequestosome 1 was more pronounced in the hippocampus, a critical region in the brain involved in memory function ( 43). Importantly, the clearance of toxic protein aggregates was in conjunction with reductions in oxidative stress and inflammation.

Human Studies Linked to Walnut Consumption

Further supporting the benefits of walnuts on cognitive function, Pribis et al. ( 57) reported that daily supplementation with 60 g of walnuts for 8 wk substantially improved inferential verbal reasoning in a double-blind, randomized, placebo-controlled cross-over (6-wk washout) study in young college students. The study was conducted in healthy, cognitively intact young adults, which may explain why no differences in memory, mood, or nonverbal reasoning were detected between the control and diet group.

Walnuts may also play a role in preventing AD. Dai et al. ( 58) reported that supplementation with fruit and vegetable juice, rich in polyphenols, at least 3 times/wk was attributed to a slower onset of AD, particularly in patients who are apoliproprotein ɛ4 ( APOE4) carriers ( 58). APOE4 plays a critical role in promoting amyloid accumulation, neurotoxicity, oxidative stress, and neurofibrillary tangles ( 59). In 2 longitudinal cohort studies, the Washington Heights and Inwood Columbia Aging Project (WHICAP; population-based) and the Predictors Study (clinic-based), which followed people for an average of 4 y, researchers showed that the presence of at least 1 APOE4 allele was associated with faster cognitive decline in the earliest stages of AD ( 60). In another study, Yasuno et al. ( 61) supplemented 41 participants aged ≥65 y with n-3 PUFAs from fish, lycopene, and Ginkgo biloba extracts daily for 3 y and compared them with 622 participants of a similar age group without supplementation. They showed that the combination of antioxidants improved cognitive function in aged persons after 3 y, and the improvement in cognitive function with supplementation was observed both in APOE4 noncarrier (E4−) and APOE4 carrier (E4+) groups ( 61). Although n-3 PUFAs from animal sources differ from n-3 PUFAs from walnuts, because humans convert ALA from walnuts into EPA and DHA, it can be inferred that walnuts rich in n-3 PUFAs, in combination with other high-antioxidant compounds, may delay the cognitive decline associated with AD.

In conclusion, age-related increases in oxidative stress and inflammation, especially when coupled with metabolic and cardiovascular dysfunction, lead to neurodegeneration and cognitive decline. This process of brain aging occurs even in the absence of specific neurodegenerative diseases. Although most chronic neurodegenerative diseases cannot currently be cured, preventive measures earlier in life can protect cognitive function in old age and may prevent or delay the onset of debilitating neurodegenerative diseases. Dietary interventions provide a safe and palatable means of modifying the body's internal environment and, importantly, the neuronal environment within the brain. Walnut polyphenols and tocopherols can reduce oxidative stress and inflammation; furthermore, PUFAs help maintain neuronal membrane integrity and attenuate protein aggregation involved in AD. In rodent studies, the addition of dietary walnuts, equivalent to a single serving of walnuts for humans, was sufficient to improve both motor and cognitive behavior in aged animals. In humans, the inclusion of walnuts in the diet improved cardiovascular health, which is itself a risk factor for neurodegenerative diseases and age-related cognitive decline. Taken together, this evidence suggests that the integration of walnuts into a healthy diet could be an effective means of prolonging health spans, slowing the processes of brain aging, and reducing the risk of chronic neurodegenerative disease.

Acknowledgments

S.M.P. and M.G.M. wrote the manuscript, and B.S.-H. had primary responsibility for the final content. All authors read and approved the final manuscript.

Literature Cited

Abbreviations

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Role of Walnuts in Maintaining Brain Health with Age

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Because of the combination of population growth and population aging, increases in the incidence of chronic neurodegenerative disorders have become a societal concern, both in terms of decreased quality of life and increased financial burden.

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Cognition: the new frontier for nuts and berries.

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Cognition: the new frontier for nuts and berries.

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Supplement-Sixth International Congress on Vegetarian Nutrition

Plant-based dietary patterns, mortality, and healthy aging

Vegetarian dietary patterns, cardiometabolic diseases, and cancer

Foods of interest to vegetarians

Nutrients of interest to vegetarians

Vegetarian diets: a planet perspective

Temporal perspectives of vegetarian diets

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Volume 100 Issue suppl_1 | The American Journal of Clinical Nutrition | Oxford Academic

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Supplement-Sixth International Congress on Vegetarian Nutrition Plant-based dietary patterns, mortality, and healthy aging Vegetarian dietary patterns, cardiometabolic diseases, and cancer Foods of interest to vegetarians Nutrients of interest to vegetarians Vegetarian diets: a planet perspective Temporal perspectives of vegetarian diets

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Strategies for successful aging: a research update.

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Strategies for successful aging: a research update.

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Abstract

Population aging is an enormous public health issue and there is clear need for strategies to maximize opportunities for successful aging. Many psychiatric illnesses are increasingly thought to be associated with accelerated aging, therefore emerging data on individual and policy level interventions that alter typical aging trajectories are relevant to mental health practitioners. Although the determinants and definition of successful aging remain controversial, increasing data indicate that psychiatric illnesses directly impact biological aging trajectories and diminish lifestyle, psychological and socio-environmental factors that seem reduce risk of morbidity and mortality. Many interventions designed to enhance the normal course of aging may be adjunctive approaches to management of psychiatric illnesses. We highlight recent data on interventions seeking to promote healthy aging, such as cognitive remediation, physical activity, nutrition, and complementary and alternative treatments for older people with and without psychiatric illnesses.

Keywords: Geriatric psychiatry, Cognition, Psychiatric disorders, Aging, Interventions, Health behaviors

Introduction

While much of the focus of research on aging has been on the determinants of mortality, illness, and disability, a growing body of work has begun to assess modifiers and interventions to improve upon the usual course of aging. More recently, research has delivered promising data on strategies that might alter the course of typical aging among people with psychiatric disorders, which seem to be associated with accelerated aging. It is important to note that there is yet no consensus definition of successful aging. As such, there is no standard outcome upon which the effectiveness of successful aging strategies could be uniformly gauged. Several recent reviews have outlined the various operationalized definitions of successful aging , with variation both in the components of the definitions (e.g, freedom from disability, social engagement), the nature of their measurement (e.g, subjective, objective) and criteria upon which "success" is determined (e.g, normative, ipsative).

With the lack of a consensus on a definition of successful aging in mind, we define a "successful aging strategy" as a potentially modifiable characteristic or intervention that is intended to enhance the functioning of older adults who could be characterized as aging normally. We focus on recent research on established interventions, such as physical activity, cognitive training, and nutrition/dietary interventions. We also discuss earlier stage work in emerging interventions, such as complementary and alternative therapies, social interventions, and those focused on enhancing positive psychological traits.

Relevance to Psychiatry

There is accumulating evidence for "accelerated aging" in psychiatric disorders. Population-based estimates of the average years of life lost to diseases such as bipolar disorder or schizophrenia are between one and two decades. Although some of this increased mortality is due to suicide, the bulk of lost years of life appears to be attributable to the higher rate of age-associated medical comorbidities, which occur at an earlier age than in the general population. In addition, emerging biomarkers that may enable tracking of biological aging, such as the telomere, have been studied in schizophrenia, depression, and other psychiatric illnesses; there is some indication that these biomarkers indicate a faster rate of biological aging among people with psychiatric illnesses. Psychiatric disorders may have both direct impact on systems that are implicated in aging biology (e.g., immune system) and indirect effects through unhealthy health behaviors (e.g., smoking, sedentary lifestyle) and lower participation in activities that are associated with better functioning in aging (e.g., social and cognitive stimulation). Formal models of progressive lifespan courses of illness have been proposed, such as "neuroprogression" in bipolar disorder or accelerated aging in HIV ; these models integrate knowledge about disease course and brain aging. Thus, there is growing recognition of the overlap between the modifiers of long-term outcome in aging and in psychiatric illnesses. We review individual strategies, keeping in mind their relevance to psychiatric conditions, next.

Physical activity

Physical activity contributes to reducing the risk of several diseases associated with aging including cardiovascular disease, metabolic disease, and osteoarthritis. According to the American College of Sports Medicine guidelines, at least 150 minutes of moderate weekly physical activity (30 minutes, 5 days/week) is recommended to obtain health benefits . In a review by Brown, Peiffer, & Martins (2013), the authors describe several epidemiological studies demonstrating a relationship between higher levels of physical activity and lower levels of cognitive decline and/or enhanced cognitive functioning in domains such as verbal memory, executive functioning, attention, and global cognition. One study of 1324 subjects reported that moderate (as opposed to light or vigorous) exercise in mid-life and late-life was associated with a reduced risk of mild cognitive impairment . Other studies have used more objective measures of physical activity such as actigraph accelerometers (Barnes et al. 2008) or respiratory fitness estimates as assessed by having participants walk on a treadmill and measuring peak oxygen consumption . In these studies, individuals with the highest daytime movement performed better on cognitive functioning tests and individuals with the lowest baseline cardio-respiratory fitness performed the worst on all cognitive tests.

Several randomized controlled studies have attempted to increase physical activity in older adults with encouraging results. For example, Erickson et al. (2011) compared sedentary nondemented older adults participating in a walking program with a group who did only stretching exercises. The walking group demonstrated many positive outcomes including improved cardiovascular fitness as evidenced by a 7.8% increase in VO ₂ max, improvement in spatial memory, a 2% increase in hippocampal volume, and an increase in brain-derived neurotrophic factor (BDNF). In a large 24 week intervention program, 150 individuals aged 50 and over with subjective memory complaints and/or mild cognitive impairment were randomized to either an exercise intervention program which consisted of 150 minutes of moderate exercises three days a week over 18 months or a usual care control group. At the completion of the study, the intervention group improved in cognitive function significantly on the Alzheimer Disease Assessment Scale .

A number of studies have examined physical activity interventions in samples of patients with psychiatric illnesses. In a recent meta-analysis of thirty-nine randomized controlled trials across various types of physical activity in people with mental illness, reductions in depression and symptoms of schizophrenia were reported along with improvements in aerobic capacity and quality of life . Other studies have reported similar positive effects of physical activity in patients with depression , anxiety , PTSD and schizophrenia .

Cognitive Stimulation/Remediation

The evidence that neuroplasticity is preserved into later life has paved the way for cognitive interventions to attempt to slow or delay the onset of cognitive decline. It has been proposed that cognitively-stimulating activities may delay future decline. Consequently, many older adults are being encouraged to independently engage in daily cognitive stimulating activities such as reading, practicing crossword puzzles, and playing board/card games. There is some evidence to suggest that frequent engagement in cognitively stimulating activities for at least six hours per week may reduce the risk of incident dementia. Research has further suggested that participating in these activities may be effective in altering the rate of cognitive declined in persons diagnosed with dementia . Teasing apart causal effects, as well as which and how frequent/intense cognitive activities must be remains to be established.

In a systematic review of twenty-one cognitive intervention studies ranging from 13 to 242 healthy older adults (mean age 63.5 to 80.2 years), it was concluded that cognitive interventions can be effective in improving various aspects of objective cognitive functioning including memory performance, executive functioning, processing speed, attention, fluid intelligence, and subjective cognitive performance. These interventions varied in design with some addressing working memory by computerized training, teaching memory strategies, improving learning abilities by training metacognitive skills, or improving attention by promoting selective attention tasks. Important questions for the future are whether cognitive interventions generalize to improvements in activities of everyday living (e.g., driving, paying bills, medication management) and whether the mechanism of these interventions is by structural brain changes or alterations in neural activity.

There has been recent interest in cognitive rehabilitation in patients with psychiatric illness, with a particular focus on technology-assisted cognitive training. For example, in patients with schizophrenia, tablets and computerized cognitive training programs have shown some success in improving neuropsychological functioning . Moreover, computerized cognitive training three times per week for eight consecutive weeks in patients with unipolar depression and bipolar patients in the depressive phase of the disorder has been shown to result in fewer cognitive failures, fewer dysexecutive incidents, and improved neuropsychological scores .

Diet/Nutrition

Dietary and nutritional interventions are among the most studied strategies in animals for extension of the lifespan and prevention of morbidity. Caloric restriction, for example, has been associated with substantially enhanced longevity in rodents, and to a lesser extent in primates. Clinical trials in humans have also shown promise. There is some evidence that obesity is associated with heightened risk for dementia when individuals are followed longitudinally. A recent study found that obesity was related to cognitive impairment in bipolar disorder and schizophrenia.

However, intersection of more specific dietary interventions with cognitive and emotional health has received comparatively less research than cognitive or physical activity interventions described above. A number of large clinical trials evaluating dietary supplements, such as Gingko Biloba and Vitamin D, have not shown significant benefit for cognition. In contrast to isolated supplements, dietary patterns, in particular the Mediterranean diet, have shown associations with reduced rates of depression and lower risk for cognitive decline. Adherence to the Mediterranean diet includes high consumption of fruit and vegetables, high ratio of polyunsaturated to saturated fats and low glycemic load. Frontiers in the understanding of diet and aging include research on the relationship between genetic risk and nutrition, as well as the intersection of the gut microbiome with mood and anxiety symptoms.

Complementary and Alternative Medicine

Yoga and meditation are potentially impactful interventions since they can be tailored to ability levels, addressing the needs of those with limited mobility as well as those seeking more challenging physical activity. Although yoga is considered an ancient practice, the research exploring its impact on health outcomes is relatively recent. In one observational, cross-sectional study surveying a sample of 211 women yoga practitioners aged 45-80 years, increased yoga experience predicted higher levels of positive psychological attitudes, mental mastery, subjective vitality, and transcendence (i.e., feelings of oneness with surroundings and unity with the community). The authors found a dose-response effect in that regular and more frequent yoga predicted the highest levels of psychological well-being .

Another promising area where yoga interventions seem to be of benefit is in improving sleep. In a study of older men and women (aged ≥ 60) with insomnia, a 12 week, twice weekly intervention group (n = 59) including yoga postures, meditative yoga, and daily practice of meditative yoga showed significant improvements in several areas including but not limited to overall sleep quality, fatigue, general well-being, depression, anxiety, and stress relative to a control group .

Meditation is also becoming increasingly popular and has shown some associations with reduced age-related cognitive decline. For example, in a cross-sectional study of older adults comparing the cognitive performance of long-term meditators (>10 years, n=20) and non-meditators (n=20), long-term meditators performed significantly better on measures of attention, processing speed, the ability to shift attention, and on tests using distracting factors . Furthermore, in a review paper exploring the effects of meditation on attention, memory, executive functions, and other cognitive measures in older adults and adults suffering from neurodegenerative diseases, meditation techniques revealed a positive effect in several areas including attention, memory, verbal fluency, and cognitive flexibility .

Complementary and alternative treatments may also have a role in treating older adults with psychiatric disorders. For example, yoga interventions have shown some promise in helping older adults with late-life depression . Furthermore, a meta-analysis including studies with patients with schizophrenia, anxiety, depression, and PTSD concluded that yoga-based interventions have a statistically significant effect as an adjunct treatment for major psychiatric disorders . Additional studies have further corroborated the positive benefits of meditation in patients with schizophrenia , several types of anxiety disorders , and depression ..

Social Engagement

The association between social engagement and health and well-being has been well-documented throughout the lifespan. In many ways, increased age can be considered a risk factor for social withdrawal, as a result of physical decline and retirement. A recent meta-analysis found that social engagement was as strong a protective factor for health as many other established risk factors. Social engagement can be defined as making social and emotional connections with other people such as family/friends and the community (e.g., being an active participant in clubs, religious organizations, volunteer work). In 364 younger (21-59 years), older (60-89 years), and oldest-old (90-97 years) adults participating in the multidisciplinary Louisiana Health Aging Study, it was found that social engagement (indexed by hours spent outside of the home) was significantly associated with self-reported health as assessed by SF-36 physical component scores and a measure of objective health status . Besides the number of relationships and amount of time spent outside of the home, the complexity of one's personal network or the different types of relationships one has acquired has also been deemed as important. In a sample of 2959 Dutch participants aged 54 to 85 assessed at baseline and six times over a twenty-year period, older adults reporting a greater number of relationship types in their social network showed higher global cognitive functioning (as assessed by the Mini-Mental State Exam). Moreover, reductions in network complexity were associated with a decline in cognitive functioning . The authors postulate that being embedded in a variety of different types of relationships exposes an individual to a wider range of activities than those embedded in more homogenous networks.

Several intervention studies have aimed at reducing social isolation in later life by focusing on improving social skills, enhancing social support, increasing opportunities for social contact, and addressing maladaptive social cognition . One such intervention program is The Seniors Centre Without Walls, which provides free educational programming to older adults via telephone to try to address the social needs of older adults who are restricted due to physical, financial, or geographical reasons. Individuals are given a set time to be on the phone with a session leader as well as other participants of the program. Participants of this program reported making friends on the phone and feeling more connected to the community. These participants also said that the program made them feel less lonely, happier, and helped them cope better with depression .

In psychiatric disorders, a large number of studies show that social withdrawal, loneliness, and lack of support exacerbate or contribute to psychiatric symptomatology. Most of the focus in psychiatric disorders has been on targeting deficits in skills that arise from the illnesses. There are longstanding data on social skills training in patients with schizophrenia, with evidence for improvements in social isolation, social discomfort, and quality of life post-treatment . Social cognition training is another avenue to enhancing social functioning in schizophrenia .

Positive Psychological Traits

When older adults are asked about what defines successful aging in qualitative studies, a recurring theme is personality variables, such as resilience, adaptability and optimism. Adaptation to disability and losses is at the core of several major theories of successful aging. In recent work, higher scores on a self-reported measure of resilience were associated with a mitigation of the impact of depressive symptoms on subjective successful aging. There is emerging neurobiology of resilience that maps onto work in post-traumatic stress. Similar to resilience, there are striking associations between optimism at mid-life and longevity that remain even after multiple covariates are accounted for. There appears to be a complex genetic basis for these traits and both are heritable, with a large proportion of environmental variation. It is unclear how best to promote resilience and optimism, particularly in the specific context of age related changes, yet there are a number exciting biological and non-pharacologic interventions that are in early phases of development. Less well understood are psychological traits that are specifically associated with aging, such as wisdom or those that extend to the social domain, such as altruism and compassion. Each is associated with positive psychological adjustment in older age samples, and interventions such as intergenerational volunteering that taps into these traits appears to have a tangible impact on cognitive and emotional health in older adults as well as the communities they serve.

Conclusions

A number of themes are apparent in integrating the literature across the potential successful aging strategies. One is that attaining precision around the type, frequency and dose of each of these strategies is highly challenging and perhaps impossible to estimate. For example, it will likely never be known how frequently and at what level of difficulty one should perform crossword puzzles to achieve an effect. Moreover, variation in the dose and type of intervention intersects with the individual, in particularly their current capacity, vulnerability and subsequent adherence to the intervention. As such, there is increasing attention to systemic and ecological approaches to successful aging strategies. For example, dietary patterns are examined rather than specific nutrients, and neighborhoods are examined with regard to their support of healthy eating and exercise. Even broader still, policy efforts include alterations at the community and social policy level that may increase the likelihood of successful aging.

A primary implication for mental health practitioners is that it may be best to view depression and other psychiatric illnesses as having a direct biological impact on the phenotypes associated with successful aging, as well as an indirect and powerful reduction of access to successful aging through the diminished engagement in lifestyle and social behaviors that seem to lengthen the healthspan. Aggressive recognition and treatment of illnesses like depression may have salutary effects on aging trajectories that extend well beyond psychiatric symptoms. Interventions studied in healthy older adults such as dietary change or physical, social, and cognitive engagement could provide new avenues to diminishing the impact of psychiatric disorders on the aging process.

Footnotes

Compliance with Ethics Guidelines: Conflict of Interest: Colin A. Depp declares that he has no conflict of interest.

Alexandrea L. Harmell

Dilip Jeste

Human and Animal Rights and Informed Consent: This article does not contain any studies with human or animal subjects performed by any of the authors.

References

Papers of particular interest, published recently, have been highlighted as:

* Of importance

** Of major importance

# data[].attributes.attachment_link.title
Strategies for Successful Aging: A Research Update

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Population aging is an enormous public health issue and there is clear need for strategies to maximize opportunities for successful aging. Many psychiatric illnesses are increasingly thought to be associated with accelerated aging, therefore emerging data on individual and policy level interventions that alter typical aging trajectories are relevant to mental health practitioners.

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Low-grade inflammation, diet composition and health: current research evidence and its translation.

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Low-grade inflammation, diet composition and health: current research evidence and its translation.

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Biomarkers of inflammation in human nutrition studies

As explained previously, inflammation is a normal process, and there are a large number of cells and mediators involved; measurement of these is often used as a 'biomarker' of inflammation, i.e. an indicator that inflammation is occurring. These cells and mediators are largely involved in, or are produced as a result of, the inflammatory process, irrespective of the trigger or its location in the body, and are common to all inflammatory situations⁽ 1 ⁾. To monitor inflammation in a meaningful way, the markers used must be valid: they must reflect the inflammatory process under study and must be predictive of future health status. The range of potential biomarkers of inflammation was considered by an Expert Group of ILSI Europe, with the aim of identifying robust and predictive markers, or patterns or clusters of markers, which can be used to assess inflammation in human nutrition studies in the general population; markers indicative of a specific inflammatory pathology (e.g. rheumatoid arthritis) and/or in less accessible tissue sites (e.g. in lung lavage fluid or in intestinal biopsy material) were not considered to be relevant to more healthy populations⁽ 7 ⁾. Currently, there is no consensus as to which markers best represent low-grade inflammation⁽ 6 ⁾, or differentiate between acute and chronic inflammation or between the various phases of inflammatory responses⁽ 7 ⁾. Therefore, a range of blood cellular markers (e.g. total leucocytes, granulocytes and activated monocytes) and soluble mediators (cytokines and chemokines (TNF, IL-1, IL-6, IL-8, CC chemokine ligand 2 (CCL2), CCL3, CCL5), adhesion molecules (vascular cell adhesion molecule-1, intercellular adhesion molecule-1, E-selectin), adipokines (adiponectin) and acute-phase proteins (CRP, serum amyloid A, fibrinogen)) are frequently measured. Some of these are associated with future risk of CVD and with cardiometabolic health⁽ 1 , 6 , 7 ⁾. However, there are several key issues concerning the use of these markers as determinants of low-grade inflammation. First, they are non-specific acute-phase response and pro-inflammatory response markers, and, by themselves, do not represent metabolic low-grade inflammation. Second, even in healthy individuals, there is wide variation in the measurements made. This is because there are a number of modifying factors that affect the concentration of an inflammatory marker at a given time. These modifying factors include age, diet, body fatness, physical fitness and genetics, among others⁽ 1 ⁾.

One can question whether static measurements of single or complex biomarkers are truly informative about health status, reasoning from the concept that health is defined by the ability to adequately adapt to everyday challenges⁽ 123 ⁾. Measuring the concentration of inflammatory markers in the bloodstream under basal conditions is probably less informative and relatively insensitive compared with measurements of the concentration change in response to a challenge. A number of inflammatory challenges have been described. These include an oral glucose load⁽ 80 ⁾, an oral fat load⁽ 124 , 125 ⁾, acute exercise, administration of bacterial LPS⁽ 126 ⁾, exposure to UV irradiation⁽ 127 , 128 ⁾ and vaccination. Although each of these challenges has been used in nutritional studies, many are poorly standardised, limiting the comparisons that can be made. Most often, the markers measured in response to challenges are those mentioned earlier in the context of static basal measurements. Currently, a number of large European consortia, i.e. PhenFlex ( http://www.nugo.org/everyone/42 701/7/0/30), NutriTech ( http://www.nugo.org/nutritech) and BioClaims ( http://bioclaims.uib.es), are developing and validating the metabolic challenge test concept for application in the assessment of health status, including the study of inflammatory process markers⁽ 129 ⁾.

The past decade has seen huge growth in innovation in 'omics' technologies that provide enormous opportunities for high-throughput biological sample characterisation, with patterns and clusters of markers (signatures or fingerprints) emerging as robust biomarkers of inflammation⁽ 89 , 130 ⁾. The enormous challenge in this era of big data is making biological sense of different levels of data, including the transcriptome, proteome, metabolome and clinical chemistry data. Novel data analysis methodologies, such as machine learning, offer large potential for identifying relevant data for specific biological outcomes based on complex multidimensional datasets⁽ 131 ⁾. In addition, bioinformatic tools have been developed to interpret these complex data in the context of existing biological knowledge in the literature and databases, also termed network biology⁽ 132 , 133 ⁾. These technologies will be instrumental to the discovery of relevant biomarker signatures that reflect 'low-grade inflammation' based on inflammatory response networks connected to organ-specific metabolic derailment.

With the coming of age of the 'omics' technologies and bioinformatic tools, a large increase in the number, specificity and sensitivity of candidate biomarkers of inflammation can be expected in the next decade⁽ 134 ⁾. A screening of the 'Thomson Reuters Integrity SM Biomarker Database' reveals that as of May 2014, 945 candidate biomarkers of inflammation have been described, of which only seventeen, including CRP, TNF-α, serotransferrin and erythrocyte sedimentation rate, have been developed into biomarker assays approved and recommended by regulatory bodies for use in clinical studies. This represents the classical biomarker gap: many candidate biomarkers are identified based on preclinical and clinical studies; however, due to relatively limited efforts in validation and assay development, these are subsequently not further developed⁽ 135 ⁾. To accelerate biomarker development, a paradigm shift in this area is needed; instead of single companies developing a single biomarker assay, pre-competitive collaborations between different industrial, academic, and research and technology organisations have the advantage of a more efficient development process time- and cost-wise, by combining a wide diversity of expertise, in the development of a harmonised, standardised and accepted assay. In these consortia, ideally, companies from nutrition, pharma and diagnostics join forces in a pre-competitive way.

A major concerted effort should comprise (1) the discovery of context-based biomarker signatures for the assessment of the status of low-grade inflammation, (2) the development of challenge tests that determine the inflammatory response functionality in the context of metabolic stress-induced low-grade inflammation, and (3) the development of the identified biomarkers towards application in a clinically accepted assay, with normative data.

Low-grade inflammation and health claims

The European Food Safety Authority (EFSA) guidance document on scientific requirements for health claims related to gut and immune function⁽ 136 ⁾ specifically states that chronic inflammation is associated with the development of a number of diseases, and that 'altering levels of markers of inflammation might indicate a beneficial effect in the context of "a reduction of disease risk claim", if it can be demonstrated that altering the levels of inflammatory markers is accompanied by a reduced incidence of a disease for a specific dietary intervention'. No additional specificity is added for chronic low-grade inflammation. At present, the European Union health claim register ( http://ec.europa.eu/nuhclaims) does not contain any authorised or non-authorised health claims that specifically address the health benefit area of suppression or control of low-grade inflammation.

To build strong health claims on nutrition for improving inflammation control in the future, one of the key focus areas should be the need for clinically relevant prognostic marker(s) or marker signatures that reflect the inflammatory state in a context-specific manner, which have been well validated and for which a robust standardised assay is available. The lack of health claims is probably attributable to the fact that, although numerous biologically plausible mechanisms have been established to explain inflammation-disease associations, no single biomarker or cluster of biomarkers of inflammation has yet been robustly demonstrated to be sufficiently predictive of future disease. Based on the EFSA guidance on this topic⁽ 136 ⁾ and the classification of candidate biomarkers as described by the expert group of ILSI Europe⁽ 137 ⁾, the suggested strategy for building a EFSA health claim dossier () comprises (1) a definition of the composition of the product; (2) a well-founded selection of the target population; (3) the selection of a clinically relevant composite biomarker panel representing inflammation as well as the selected health benefit (or disease risk) endpoints; and (4) a number of sufficiently powered and well-controlled human studies assessing the effect of the test material (nutrient, food, product) on the relevant biomarkers in the relevant target population.

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Low-grade inflammation, diet composition and health: current research evidence and its translation

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As explained previously, inflammation is a normal process, and there are a large number of cells and mediators involved; measurement of these is often used as a 'biomarker' of inflammation, i.e. an indicator that inflammation is occurring.