June 2022
Do berries, exercise, and the gut microbiome synergistically support brain health?
A group of collaborators from NC State University, UNC-Chapel Hill, and Appalachian State University recently published a review article looking at the connections between brain health and flavonoids (in foods like tea, berries, and legumes), exercise, and the gut microbiome.

You can use these connections to further the conversations with your patients about their lifestyle choices and prevention and treatment of their diagnoses.
Brain Health
As the brain ages, there are several pathways that may cause decline in function. 

  • Inflammation can occur in the brain (neuroinflammation) just like in any other part of the body. Chronic inflammation causes damage to neurons and synapses. This inflammation can lead to decreased cognition and increases in psychiatric illnesses.1 
  • Oxidative stress caused by cumulative environmental factors can cause age related changes in the brain.2 As reactive oxygen species attack cells and tissues, the brain becomes less resilient and processing can slow. 
  • Decreased blood flow will cause age related changes in the brain. Atherosclerosis caused by hypertension, diabetes, and cardiovascular injury will often lead to decreased perfusion of tissues, including vital brain tissue.
Flavonoids are powerful phytochemicals that can help mitigate damage to cells. It is particularly important to note that the metabolites of many of the flavonoids can cross the blood-brain barrier and affect the tissues of the brain.2 Other research has confirmed that flavonoids found in food (including cocoa and cranberries) have improved cognition in older adults.3,4
The authors point out that a variety of studies have shown that exercise can have acute effects on brain function, including improved mood and sleep, and chronic effects, including attention and memory.2 Exercise also increases the rate at which we breakdown and integrate the compounds from foods into circulation.1
Gut Microbiome
The bacteria that live throughout the human GI tract work together to help break down food, make essential vitamins, fight disease, and, as it turns out, improve cognition. When we have a community of good bacteria in the gut, we can convert the flavonoid chemicals into their metabolites that work as active anti-inflammatories and antiaggregants in the brain.1 
Berries + Exercise + Gut Microbiome
The exciting piece is the connection between exercise, flavonoids, and the microbiome that help provide a cumulative effect on the brain. The gut bacteria break down the flavonoids into the metabolites that work through several pathways to decrease inflammation and oxidative stress. Exercise helps promote an increase in the metabolite concentration at the sites of neuroinflammation.
The bottom line for patients is that 150 minutes of exercise per week not only helps metabolism and fitness, but also influences the way a healthy diet, rich in flavonoids, can help slow the effects of aging on the brain. You can prescribe berries coupled with 150 minutes of weekly exercise, for example, to a patient with a family history or concern for neurodegeneration.
PhytoRx Recipe: Southwest Wrap
Black beans deliver protein and anthocyanins, leaving plenty of room to pile on the fresh garden veggies.

The Southwest Wrap is light and fresh for a sizzling summer fiesta. At around $2/serving, it's not only tasty and healthy, it's economical, too!
Fight Cancer with Broccoli Microgreens
While attending the North Carolina Integrative Medical Society Conference on June 10-11 in Raleigh, I heard Dr. Emily Ho, PhD, from the Linus Pauling Institute at Oregon State University share her passion for broccoli and its phytomedicine features.

Ho focused on the cancer fighting properties of this sulforaphane-rich vegetable. Sulforaphane is a phytochemical in the isothiocyanate family and can slow tumor growth and delay progression of cancer. It does this as an epigenetic modulator changing how genes are expressed. 

Ho noted that eating broccoli microgreens are a more potent way to get sulforaphane into the diet. She recommends eating the broccoli microgreens at about 10 days old when they have more than 10 times the sulforaphane of mature broccoli.

Microgreens are the 10-14 day old young seedlings of some vegetables and herbs. Although they have been served in restaurants for 40 years, we are still learning about their amazing benefits and just starting to incorporate them into our own meal prep. Just as different vegetables contain different beneficial phytochemicals, different vegetable microgreens have specific concentrations of different phytochemicals. This research, conducted at the University of Maryland, investigated four phytochemicals in 25 different types of microgreens comparing the concentration to that found in mature plant parts (more commonly consumed).

Adding a variety of microgreens to salads, sandwiches, bowls, and smoothies offers a phytochemical boost for general health. Cilantro or garnet amaranth microgreens specifically support eye health because of their high levels of lutein and zeaxanthin. Patients with cancer or a strong family history can take advantage of the sulforaphane levels in broccoli microgreens.

The great thing is, microgreens can easily be grown in the kitchen. No green thumb is required and they are handy to snip and add to whatever dishes are already being prepared. Watch (and share) this video from my PHHI colleague, Amy Bowman, to see how easy microgreens are to grow. You may even decide to start some in the office!

1. Cheatham, C. L., Nieman, D. C., Neilson, A. P., & Lila, M. A. (2022). Enhancing the Cognitive Effects of Flavonoids With Physical Activity: Is There a Case for the Gut Microbiome? Frontiers in Neuroscience, 16.
2. Caruso, G., Torrisi, S. A., Mogavero, M. P., Currenti, W., Castellano, S., Godos, J., Ferri, R., Galvano, F., Leggio, G. M., Grosso, G., & Caraci, F. (2022). Polyphenols and neuroprotection: Therapeutic implications for cognitive decline. Pharmacology & therapeutics, 232, 108013. 

3. Flanagan, E., Cameron, D., Sobhan, R., Wong, C., Pontifex, M. G., Tosi, N., Mena, P., Del Rio, D., Sami, S., Narbad, A., Müller, M., Hornberger, M., & Vauzour, D. (2022). Chronic Consumption of Cranberries (Vaccinium macrocarpon) for 12 Weeks Improves Episodic Memory and Regional Brain Perfusion in Healthy Older Adults: A Randomised, Placebo-Controlled, Parallel-Groups Feasibility Study. Frontiers in nutrition, 9, 849902. 
4. Garcia-Yu, I. A., Garcia-Ortiz, L., Gomez-Marcos, M. A., Rodriguez-Sanchez, E., Mora-Simon, S., Maderuelo-Fernandez, J. A., & Recio-Rodriguez, J. I. (2022). Effects of cocoa-rich chocolate on cognitive performance in postmenopausal women. A randomised clinical trial. Nutritional neuroscience, 25(6), 1147–1158. 
Let's connect!
Cheri Granillo • Translational Nutrition Program Manager [email protected] • 704-250-5492