December 11, 2012
Host: Ted Simons
Alzheimer’s Prevention Cookbook
- Dr. Marwan Sabbagh, Research Medical Director at the Banner Sun Health Research Institute talks about his book of recipes that promote a healthy brain.
- Dr. Marwan Sabbagh - Research Medical Director, Banner Sun Health Research Institute
| Keywords: alzheimer
Ted Simons: Recipes for a healthy brain are featured in the new "Alzheimer's Prevention Cookbook," one of the co-authors is Dr. Marwan Sabbagh, research medical director at the banner Sun Health Research Institute in Sun City. Earlier I spoke with Dr. Sabbagh about how food can help fight Alzheimer's. Thanks for joining us tonight on "Arizona Horizon."
Marwan Sabbagh: Thank you for having me.
Ted Simons: Let's talk about initially the impact, what do we know about the impact of food on Alzheimer's?
Marwan Sabbagh: Well, we know that it's very clear that once we have Alzheimer's, not clear that food can make a difference, this is more focused on the fact food may alter the risk of future development of Alzheimer's disease. And that -- Because we now understand that the first changes in the brain occur 25 years before the first day of forgetfulness. So the dimensions is actually the end of it, not the beginning of it.
Ted Simons: So it basically lowers the risk of Alzheimer's. Does it perhaps delay the onset of symptoms?
Marwan Sabbagh: It would be ideal to say so. Only one paper I know suggests that is the case. One that looks at the Mediterranean diet which I'm sure we'll talk about later on. We don't know the answer to that quite yet.
Ted Simons: What about the risk of cognizant decline in general? How could food impact that?
Marwan Sabbagh: We know that certain changes that Alzheimer's disease and cognitive decline in general could be offset by some of the dietary changes. We know that certain things are important for brain health, like Omega 3 fatty acids and B vitamins in particular. So food turns out to be an excellent source for these things.
Ted Simons: So with that in mind, what is the science regarding food and whether it's onset, whether it's risk, progression, these sorts of things, why leafy green vegetables and Omegas?
Marwan Sabbagh: That's a very good question. It boils down to the fact what I really want to do in the book was assemble the science by doing a critical review. This is not a feel good, do this because I said so. There's actually real science. And it starts with epidemiological surveys where they take surveys of people, populations around the country and the world and look at something called the food frequency questionnaire and assess what trends tend to help people. For example, if we look at fish, if we look at fish and we say that according to the Chicago health and aging project, people who ate three fish meals a week had a 20 to 40% reduction in the amount of Alzheimer's compared to people who didn't eat fish. And why is that? Because certain types of fish have certain cognitive health benefits, particularly rich Omega 3 fatty acids. There are certain diets like that, Mediterranean diets, spices. All these have bodies of evidence that support the truth.
Ted Simons: So the bodies of evidence are there to support the use, but we still aren't quite sure why the Omega 3s or the certain spice does what they do? Can we see the interaction happening in the brain?
Marwan Sabbagh: We do have some speculation, so if we look at Omega 3s, we know there are three Omega 3s and the one that has benefit is DHA - Docosahexaenoic. That's the one you get from the fish. So we know that it's not any Omega 3, it's specific to certain kinds. And we know the science suggest those actually have anti-Alzheimer's properties themselves. So the body of evidence suggests it and the basic science supports it.
Ted Simons: Do the anti-Alzheimer's properties, does this include plaque not forming or something like that.
Marwan Sabbagh: Correct.
Ted Simons: Is that basically what you're looking at?
Marwan Sabbagh: Coreect, yes. But I also want to be clear we're careful to separate treatment from prevention. They actually have done a treatment trial of Omega 3s, particularly DHAs to treat Alzheimer's and it didn't work. So if we know it's going to work it would be maybe in prevention, reducing the risk.
Ted Simons: So the progression of the disease not necessarily food all that much.
Marwan Sabbagh: There's not a lot of evidence to support that, no.
Ted Simons: OK. Let's get to the food now. What constitutes a brain-boosting recipe?
Marwan Sabbagh: A brain hitch boosting recipe I think you really have to be looking at what I think Chef Bo did, and I want to tell you in the book I wrote the science and then I had the opportunity to meet with a team up with celebrity Chef Bo McMillian from sanctuary who took my theme and recipe list, ingredient list and came up with the recipes. One of the things I love about what he did, he created a Brain-Boosting Broth, which is a reduction stock which is wound into many, many recipes full of spices, full of vegetables, really terrific.
Ted Simons: That's interesting. What's in the stock?
Marwan Sabbagh: It has onions and fennel, it has a lot of clove, it has some other like tumeric and other things. We know the antioxidants -- spices have a lot of antioxidant properties like Tumeric, Clove, Oregano, Thyme, Rosemary, so -- And it's low in saturated fat. One of the things I want to emphasize is the fact saturated fat seems to be a bad thing for the brain.
Ted Simons: Saturated fat includes --
Marwan Sabbagh: Red meat in particular. And so we know what is bad for the heart tends to also be bad for the brain. So high diets in saturated fat have been clearly shown to promote Alzheimer's changes.
Ted Simons: So rich in antioxidants, rich in anti-imflamatories—is that correct?
Marwan Sabbagh: Correct.
Ted Simons: Umm… Rich in Omega 3s, but not all fish?
Marwan Sabbagh: Not all fish. I wish I could say eating the frozen fish dinners would do the trick. But it's in fact you need Salmon, Tuna, Herring, Mackerel and hall but or the omega rich fish, and those are the ones we would recommend.
Ted Simons: But you also have to watch out for Tuna because of mercury poisoning.
Marwan Sabbagh: Yes. A lot more -- A little is good, more is not better. There's always the worry farm sources or domestic sources can give you heavy metals.
Ted Simons: It almost sounds like the idea of drinking a little bit of wine is good for you, too much wine, not so much. But there's somewhere in the middle.
Marwan Sabbagh: That’s the sweet spot. So we know something called a J-curve, so if you drink a little bit of wine that is one to two glasses of wine, or one or two beers or one or two spirits, not and. That has a 15% reduction in the rate of decline in Alzheimer's disease. But anything above that seems to increase the risk. So it's a J curve.
Ted Simons: So are Pomegranate and cinnamon included as well?
Marwan Sabbagh: Pomegranates have something called Resveratrol, the same thing you get out of red wine. And Resveratrol seems to have some wonderful drugs. It's a real ant aging compound, it's being looked at for anti-cancer properties as well. You've got to drink a lot of pomegranate juice. So you may not get all the Resveratrol as you have to get. And cinnamon actually has direct anti-Alzheimer's properties that offset tangles, which is another change in the brain.
Ted Simons: How difficult is it to find the stuff that's in this cookbook, in these recipes?
Marwan Sabbagh: I think that's -- I compliment my coauthor, Chef Bo. He didn't want to make it too exotic. Yes, he's a celebrity chef, hes on the food network and all that good stuff. But he said, you've got to be go to your own pantry. You don't want to go to every exotic food store around the town. I think the list is pretty basic, but it is really an emphasis on some themes, you really want to get more spices in your diet, less saturated fat, more fruits and vegetables.
Ted Simons: All this is great, but if I can't cook it it's going to sit on the shelf and gain dust. Can’t cook a stuff?
Marwan Sabbagh: I agree. I agree. I tried it myself, and it's quite tasty.
Ted Simons: All right. So it works.
Marwan Sabbagh: It works.
Ted Simons: Alright, it's good to have you again.
Marwan Sabbagh: Thank you, nice to have me.
Arizona Republic Series: “Macho B: Last Roar of the Jaguar”
- Arizona Republic reporter Dennis Wagner talks about his 2-year investigation into the 2009 capture of what was then the United States only known wild jaguar. In his series of reports entitled “Macho B: Last Roar of the Jaguar” Wagner reveals the truth behind the trapping, and subsequent death, of the jaguar known as Macho B.
- Dennis Wagner - Reporter, The Arizona Republic
| Keywords: Macho B
, Arizona Republic
Ted Simons: Good evening, and welcome to "Arizona Horizon." I'm Ted Simons.
Ted Simons: In 2009, the nation's only known wild Jaguar was captured in southern Arizona and subsequently killed. Facts surrounding the incident are the focus of "Macho B: The Last Roar of the Jaguar," a series running this week in the "Arizona Republic" and online at azcentral.com. The series is the result of a two-year investigation by reporter Dennis Wagner who joins us now to talk about this story. Dennis, it's good to have you here. This really is an amazing story. You don't have to be an animal lover to latch on to Macho B. Who was Macho B?
Dennis Wagner: So Macho B was a Jaguar that is believed to have been born in northern Mexico in Sonora. There's a population, a breeding population in Sonora about 130 miles south of the border, where there may be somewhere between 80-130 they think living down there. And it's kind after tropical animal, but it will cross through desert and go into forests, and occasionally Jaguars in the last 50 or 100 years, male jaguars specifically would travel across the border into Arizona and go into the sky islands, go into the high country in Arizona, and do their hunting and whatever, and this was one of them. And they were the subject of a lot of research and conservation interest.
Ted Simons: And as far as jaguars are concerned, again, these really only lions and tigers are larger? Correct?
Dennis Wagner: Correct. Lions and tigers are larger. This is the only big cat in the western hemisphere that roars, it's an extremely powerful animal. It's got shorter legs and its stocky, it's like the linebacker of big cats. It’s tough. And it will kill its prey by literally crushing their heads with its jaws, using its canine teeth to penetrate.
Ted Simons: A remarkable animal. The photos online at azcentral.com, you look at this thing and go, this is a majestic beast. How did he die?
Dennis Wagner: Well, that's the $50 million question in this case. There was two things going down by the border. This is all three years ago. To some extent this isn't a story after single cat that died, it’s the story of government misconduct, of cover-ups, greed, a whole lot of other things. I wouldn't spend this much time and energy covering just a cat that died. But in this case, there was two studies going on along the border at the same time. One was a camera study to see how many Jaguars there are, where they travel, what their travel corridors are, what their habitat is. They were trying to learn what kind of conservation measures would be needed. The second study was a lion and bear carnivore study where they were studying cross border travels of lion and bears, and part of the reason for that study was sort of as a surrogate for jaguars. Because there's so few Jaguars travelling in Arizona they thought, well lions might travel in the same general pathway and have similar behaviors, so we'll see if we can kind of figure out what they're doing also. And the same person, Emil McCain, a biologist under contract with the game and fish department, was doing both studies at the time.
Ted Simons: And so they tried, and this is where things get complicated. Did they try to trap this animal; did they try to trap this animal surreptitiously? Did they not trap? How did this happen? How did this animal get snared and why did the animal subsequently die?
Ted Simons: Well, what the records show, and I'm talking about thousands of pages of criminal investigative files from the fish and wildlife service, the federal agency and thousands more pages of investigative records from the Arizona Game and Fish Department. What those records show is that in the end what happened was there was a snare set in a border area where McCain knew that Macho B traveled, and had traveled in the past, and there was evidence he was in the area at the time in February of 2009. And that he had shared that information with federal biologist and with state biologists. What makes the thing so problematic was, it wasn't just a camera set there, there were snares set there, and they didn't just set a snare for lions and bears, which is what they initially claimed. They set a snare there and put the feces from a female Jaguar that had been in Estrus at the snare site, which becomes an attractant. So clearly there was a purposeful intent to capture that cat rather than an inadvertent snaring.
Ted Simons: And they were not supposed to have that intent. Correct? That was not OK'd or approved?
Dennis Wagner: That was not formally authorized, OK'd, or approved. Depending on how you read the records, the email exchanges between Emil McCain and many other people, you can certainly make an argument that there were people encouraging him to go forward, and in fact that's what Emil McCain says happened. He says he was set up by the Game and Fish Department.
Ted Simons: And the reason you didn't want to snare this animal, it was a 16 some-odd year old, and the trauma would certainly kill it, which it kind of did, didn't it?
Dennis Wagner: Well, yeah. Here's -- You have to put in some historical context. There's a lot of battles going on over how to conserve and whether a Jaguar that's this rare in the United States even deserves to be conserved. And in this case they had been planning to try to capture this cat for several years, and it had even been thwarted because of publicity against it by environmentalists who said it's a really bad idea. And so this kind of all seems to have transpired and welled up sub rosa when the opportunity arose.
Ted Simons: So the cat is snared, obviously traumatized, they had to euthanize -- How much, how long did --
Dennis Wagner: What happens is, Macho B steps in the snare, and it's a cold winter morning. And suffers hypothermia because the cat is there for quite some time before the biologists arrive. They set a trap and they come and check it each morning. Nobody knows when it stepped in the snare. By the time they got there -- They got there, it had broken off a canine tooth, it had left pieces of its claws in a tree trunk, its bodily fluids were found on the tree and in the ground in the area and it was completely exhausted. So then they used a dart gun to sedate it, and after it was out they put a bag over its head, put it in hobbles, took scat, did all kinds of sampling, and things like that. And then six hours later it gets up and wobbles away. And 12 days later -- They have a GPS collar on it, and that's the whole purpose. Just in fairness, the idea of collaring a Jaguar, therefore understanding where it travels, what its behavior is, I think most conservationists; most biologists say that's a good plan. There are two problems here. One of them is, this Jaguar was almost by every account was too old to be a candidate, and the second is - many of the researchers say you shouldn't be snaring a Jaguar, especially an old Jaguar, because they're so frantic, so wild, they'll go crazy in a snare. You can catch them, tree them with a dog and euthanize them, and they go through way less trauma. But this one lasted 12 days. The GPS system was showing it wasn't moving, so they went in, they treat it with dogs, they shot it from a helicopter with a dart gun, brought it to the Phoenix zoo, and decided it had kidney failure and they put it to sleep.
Ted Simons: My goodness. And really, that's just half of the story. The other half, we don't have nearly as much time to talk about this, is the incredible amount of cover-up, differing stories we've got. Everyone wants to be part of a conservation effort, but when it goes wrong, everyone starts running in different directions.
Dennis Wagner: Exactly. It goes from congratulations, everybody, slapping each other on the bag saying we got a collar on a Jaguar, to uh-oh. This sucker is going downhill fast. I had nothing to do with it. And that's kind of what the emails all show.
Ted Simons: So who wound up being held responsible? Was there anything in the way of prosecution? It sounds like some of the people responsible for this, who are being accused of lying and covering up, they're still involved with Jaguar conservation.
Dennis Wagner: Well, a few things happened. First of all, the initial cover-up was actually exposed by a woman who was a volunteer with McCain in setting the snares. And she felt so guilty about what happened, she went public with the use of the Jaguar scat on the snare. And that completely blew out of the water the story that this was an accidental catch. She ended up getting prosecuted, as did Emil McCain. She took a plea deal whereby the charges were dismissed in return for her saying, yes, I was involved in the illegal take of a Jaguar. McCain pleaded guilty, and was sentenced to probation with five years of not doing any big cat work in the United States. And nobody else in the government agency, five people were referred for prosecution, but no charges were filed. And in some cases the U.S. attorney's office decided that they had been disciplined or their agencies had asked they not be prosecuted so they didn't file charges.
Ted Simons: Last question here. A two-year investigation and anyone who reads this will see you really had to dig and do a lot of work on this. What do we take from this story?
Dennis Wagner: Well, that's difficult, but I think it's about doing the right thing. I think that starts with transparency. You have people in any walk of life, any governmental enterprise, who they may have jealousies, they may have -- There may be trying to build up their reputations, gain prestige, they may be trying to advance their careers. And you have to deal with all those situations the same way. In this case there was a lack of transparency, there was a lack of public communication. There were people doing things behind each other’s backs, they were betraying one another, and then there was the cover-up. And now, now the University of Arizona got the contract to do the study of jaguars on the border, and two of the individuals that were involved in the saga of Macho B are part of that contract team.
Ted Simons: All right. Remarkable work. Thank you so much for joining us. Great work on this, and we do appreciate you joining us.
Dennis Wagner: Thanks for having me here, appreciate it.
Ted Simons: You bet.
Suicide Prevention Award
- The Arizona Department of Health Services and Magellan Health Services of Arizona are recipients of a national award from the Council of State Governments for the Arizona Programmatic Suicide Deterrent System which launched in 2009. Dr. Karen Chaney of Magellan provides an overview of the program.
- Dr. Karen Chaney - Magellan
| Keywords: suicide
Ted Simons: The national council for state governments recently honored the Arizona Health Department with a 2012 innovations award for the state's suicide deterrent system. The Arizona program targets those diagnosed with a serious mental illness a high risk group for suicides. Joining us now is Dr. Karen Chaney of the Magellan Health Services, a behavioral health agency that partners with the state on implementing the suicide prevention program. It's good to have you here. Thanks for joining us.
Dr. Karen Chaney: Thank you very much for having me.
Ted Simons: The award seemed like it was an all-encompassing award, but among the many things that were focused on was the idea of silence and stigma when it comes to suicide. Is that true?
Dr. Karen Chaney: Yes, that is very true. This award was given to both ADHS and Magellan because of their guidance in working with people with serious mental illness, and with general mental illness, but also for anyone in the community, because this is a community problem. Suicide is. And basically what they were looking for is innovations and new programs and different way of looking at this to reduce stigma and to help the individuals and the public.
Ted Simons: What were some of those innovations and programs?
Dr. Karen Chaney: It started out very simply as a training program for behavioral health providers. Because we found that they were not comfortable, believe it or not, in asking the correct questions or dealing with suicidal people. And it was uncomfortable. So when you're uncomfortable with something you're not going to say, oh, are you suicidal, and get the answers. And so basically they kind of tiptoed around it. And behavioral health workers aren't supposed to do that. So knowing this, and knowing that their discomfort with it, they needed training, and a training program that was developed was used in the Maricopa County. We have trained something like 3500 behavioral health care workers since the inception of this. It started with that, but it has grown immensely into being all-encompassing program. Which includes making sure that family members have knowledge about this, and also that they are engaged with their loved one who is suicidal, or has attempted suicide. We also are looking at the cultural aspects of it and making sure we're touching everyone. So we've got a diversity and inclusion group, so that we make sure that when we're talking with our Latino members, that we are asking the right questions and making sure that they're comfortable with talking about this.
Ted Simons: In terms of recognizing at-risk signs, what are some of those signs?
Dr. Karen Chaney: Well, at-risk signs, basically we always need to know when we meet someone for the first time is if they've ever tried to commit suicide in the past. That would mean they would be at more risk. They've had family members that have died by suicide. But we also look at what are they doing, do they have depressive signs and symptoms do, they have another diagnosis like schizophrenia or a bipolar disorder; which makes them more at risk Those people with those types of diagnosis are six to 12 times more likely to harm themselves. So we'll ask those questions also, and determine what the diagnosis is. But we also will check and say, are they isolating? Are they giving their things away, are they just talking just about -- I just wish I wasn't here? Do they have a desire to be -- to die, and do they have an intent or capability? Because someone who becomes fearless about suicide becomes more capable of doing it.
Ted Simons: Is it difficult to assess those risks when you get maybe an answer yes, answer no, maybe a little bit here, a little bit there? It's one thing to ask the questions, it's another thing to assess the risk.
Dr. Karen Chaney: Exactly. And it's such a good question, because what we have done is we have developed a program called driving suicides to zero, which is beginning its implementation here within Maricopa County. And basically what that involves is a screening; three similar many questions that we -- three simple questions we ask of adolescents and three simple questions we ask of adults, and we even have it for children, because children are also at risk. Once we get a positive screen, we go on to a risk assessment, and we stratify exactly how risky is it right now. Are they at acute risk, are they at moderate risk or low risk? It doesn't matter which it is, if they have any sort of risk, we will be doing lots of interventions to assist them so that they are not suicidal.
Ted Simons: Last question here -- Was it difficult to get some of these changes through, people who maybe weren't that comfortable asking direct questions, maybe some other round about questions. Did that help or was it still pushing a little bit of a boulder up a hill here?
Dr. Karen Chaney: I can tell you that when we developed this program, we had the community providers come in and we had probably 20 provider groups in there, 50 people, and we sat down and talked about the risk of suicide in our populations. And we decided we were going to do something. And they weren't afraid of doing that at all. It was quite a collaborative effort, it was really very rewarding to sit down and talk and come up with our screens, our assessments, and the resources that we have to help people.
Ted Simons: Very good. Congratulations on the award. Thank you so much for joining us.
Dr. Karen Chaney: Thank you. Appreciate it.