On this episode, Anna Maughan tells us about her work on conspiracy theories and how emotions may play a role in who is susceptible to them. We also discuss the possible negative effects of medical conspiracy theories.
You can follow Anna’s work on Twitter @annafmaughan.
You can read one of Anna’s papers on Covid-19 Misinformation here.
If you’d like to stay up to date with the podcast, you can follow me on Twitter @browngenavee.
A study published last month revealed that adopting a diet high in whole grains, legumes, nuts, fruits, vegetables and fish and low in red and processed meat and sugary beverages could lead to an increased lifespan . The authors revealed that the greatest gains in life expectancy could be possible by changing to an optimal diet in your 20’s (10 years), but even changes later in life at the age of 80 might extend life by almost three-and-a-half-years.
When considering ‘optimal ageing’, thoughts may immediately turn to a long life free of chronic illness, especially non-communicable diseases such as cardiovascular disease, cancer and diabetes, and this study suggests that plant-based nutrient-dense foods are fundamental to ageing successfully. Of course, ensuring optimal mental health and brain function across the lifespan is equally important and here nutrition also has an important role to play. Indeed, a recent review found that dietary patterns containing the exact same beneficial food groups identified in the study above had a protective effect with regards to improving measures of cognitive impairment and/or reducing risk of cognitive impairment or dementia .
However, you don’t need to wait until older adulthood to feel the benefits of following a healthy diet; data from our lab at Nothumbria University collected over the last two decades has revealed beneficial effects of a wide variety of nutrients (e.g. vitamins, omega-3 fatty acids), herbal extracts (e.g. ginkgo biloba, ginseng, lemon balm) and plant compounds found in everyday products (tea, chocolate, berry fruits) on cognitive function and mood in healthy adults that are observable after the course of anything from a few minutes to a few weeks, depending on the item. In this blog, I’ve talked about some of our more recent findings.
There’s more than just caffeine to your morning coffee ‘hit’
The alerting effects of coffee are often ascribed to the beverage’s caffeine content. Although not untrue, caffeine is not the only ‘active’ ingredient in coffee; in fact, the coffee bean itself contains a plethora of different compounds that have the potential to either directly affect brain function or work together with caffeine to produce effects. The major group of compounds of interest in coffee are called chlorogenic acids (CGA) and are particularly enriched in the flesh of the coffee fruit itself (coffee berry) and green unroasted beans.
Although roasting the beans diminishes the amount of CGA found in your average cup of coffee they are still present, with one study reporting CGA espresso content in several European countries in the range of 6–188 mg per cup . Two recent studies from our lab investigated the effects of coffee berry extract on mood and cognitive performance and found a consistent pattern of alerting effects that was evident across the entire six-hour testing period, which cannot be attributed to the relatively small amount of caffeine found in the extract (22 mg vs 75 mg in an average cup of coffee) [4, 5].
The world’s most valuable spice: An unlikely mood enhancer
Saffron is known throughout the world for its distinctive colour and taste and has been used in culinary dishes across Europe and Asia for millennia. Saffron stigmas are naturally rich in several bioactive compounds and its pain-relieving and sedative properties are recognised by traditional Asian medicine where it is used to treat a range of physical ailments including menstrual disorder, inflammation and depression [8, 9].
The anti-depressant activity of this herb has recently been explored in controlled trials; a meta-analysis of these data revealed that 30 g/d saffron extract for six weeks significantly improved symptoms in patients with major depressive disorder compared to placebo, but also had similar antidepressant efficacy when compared with mainstream antidepressant medications .
Our lab investigated whether these mood effects could be seen in otherwise healthy adults who reported subclinical feelings of low mood and anxiety and/or stress, who would not meet a formal diagnosis of depression. Compared to placebo, we found that eight weeks’ supplementation with 30 g/d saffron extract improved depressive symptoms, although no effects were observed for stress or anxiety . Findings such as this are important as they highlight the potential for non-pharmacological plant extracts in supporting mental health.
A humble herb with an ancient medicinal past
Few would naturally think of their herb garden as a source of the next generation of dementia preventing products but the aromatic herbs belonging to the mint family such as peppermint, rosemary, lavender, lemon balm and sage are a rich source of phytochemicals with established psychoactive properties relevant to cognitive decline. Of all these culinary herbs, sage has the widest documented use in traditional medicine dating back to the ancient Greeks and is reputed to have cognitive or memory enhancing effects by several medicinal systems .
Our lab also recently demonstrated beneficial effects on working, or short term, memory performance after four weeks’ daily consumption of a treatment combining both these sage species , opening up the exciting possibility of exploiting the individual chemical profiles of both species for maximum benefit.
So what should we be eating?
These are just a few examples of some of the interesting effects of different dietary items, some of which are consumed every day. The plants we ingest, in whatever form, are packed with compounds that interact with the chemistry of our bodies and brains that have the potential to help us live healthier, happier, and ultimately longer lives. The best way to achieve this is to incorporate as wide a variety of plants into your diet as you can.
Fadnes, L.T., et al., Estimating impact of food choices on life expectancy: A modeling study. PLOS Medicine, 2022. 19(2): p. e1003889.
Boushey, C., et al., USDA Nutrition Evidence Systematic Reviews, in Dietary Patterns and Neurocognitive Health: A Systematic Review. 2020, USDA Nutrition Evidence Systematic Review: Alexandria (VA).
Ludwig, I.A., et al., Variations in caffeine and chlorogenic acid contents of coffees: what are we drinking? Food Funct, 2014. 5(8): p. 1718-26.
Jackson, P.A., et al., A Randomized, Crossover Study of the Acute Cognitive and Cerebral Blood Flow Effects of Phenolic, Nitrate and Botanical Beverages in Young, Healthy Humans. Nutrients, 2020. 12(8): p. 2254.
Jackson, P.A., et al., Acute cognitive performance and mood effects of coffee berry and apple extracts: A randomised, double blind, placebo controlled crossover study in healthy humans. Nutr Neurosci, 2021: p. 1-9.
Haskell-Ramsay, C.F., et al., The Acute Effects of Caffeinated Black Coffee on Cognition and Mood in Healthy Young and Older Adults. Nutrients, 2018. 10: p. 1386.
Tajik, N., et al., The potential effects of chlorogenic acid, the main phenolic components in coffee, on health: a comprehensive review of the literature. Eur J Nutr, 2017. 56(7): p. 2215-2244.
Rios, J.L., et al., An update review of saffron and its active constituents. Phytotherapy Research, 1996. 10(3): p. 189-193.
Akhondzadeh, S., et al., Crocus sativus L. in the treatment of mild to moderate depression: a double-blind, randomized and placebo-controlled trial. Phytother Res, 2005. 19(2): p. 148-51.
Hausenblas, H.A., et al., Saffron (Crocus sativus L.) and major depressive disorder: a meta-analysis of randomized clinical trials. J Integr Med, 2013. 11(6): p. 377-83.
Jackson, P. A., Forster, J., Khan, J., Pouchieu, C., Dubreuil, S., Gaudout, D., … & Kennedy, D. O. (2021). Effects of saffron extract supplementation on mood, well-being, and response to a psychosocial stressor in healthy adults: A randomized, double-blind, parallel group, clinical trial. Frontiers in nutrition, 365.
Kennedy, D.O. and A.B. Scholey, The psychopharmacology of European herbs with cognition-enhancing properties. Curr Pharm Des, 2006. 12(35): p. 4613-23.
Kennedy, D.O., et al., Monoterpenoid extract of sage (Salvia lavandulaefolia) with cholinesterase inhibiting properties improves cognitive performance and mood in healthy adults. J Psychopharmacol, 2011. 25(8): p. 1088-100.
Kennedy, D.O., et al., Effects of cholinesterase inhibiting sage (Salvia officinalis) on mood, anxiety and performance on a psychological stressor battery. Neuropsychopharmacology, 2006. 31(4): p. 845-852.
Tildesley, N.T., et al., Salvia lavandulaefolia (Spanish sage) enhances memory in healthy young volunteers. Pharmacol Biochem Behav, 2003. 75(3): p. 669-74.
Tildesley, N.T., et al., Positive modulation of mood and cognitive performance following administration of acute doses of Salvia lavandulaefolia essential oil to healthy young volunteers. Physiol Behav, 2005. 83(5): p. 699-709.
Wightman, E.L., et al., The Acute and Chronic Cognitive Effects of a Sage Extract: A Randomized, Placebo Controlled Study in Healthy Humans. Nutrients, 2021. 13(1): p. 218.
More and more people are going online to search for information about their health. Though it can be a minefield, where unverified sources abound, searching the internet can help people to understand different health problems, and give them access to emotional and social support.
For many in the UK, getting to actually see a GP remains difficult, and constraints around appointment times mean that some discussions are often cut short. But by using the internet, patients can prepare for appointments, or follow up on issues that were raised in the consulting room but left them with unanswered questions.
But not everyone is so keen on patients using the internet in this way. Some GPs and other heath professionals have doubts about the quality and usefulness of the information available. There are also suggestions that “cyberchrondria” may be fuelling a surge in unnecessary tests and appointments.
Similarly, though so many people are using online resources to fill in gaps in their knowledge, or to help them ask the right questions, they may not be comfortable bringing it up in the consulting room.
For our latest research project, we wanted to find out just why it can be so difficult to discuss online information with doctors. We found that in addition to people being embarrassed in case they have misunderstood the information, or can’t remember it accurately, they also fear a negative reaction from the GP who may think they are difficult or challenging.
How to make it work
So how can you as a patient bring up online information with your doctor? First, it sounds obvious but you need a good, open relationship with your GP. Tell them you have been looking online, but ask for their feedback on the information, and for any useful sites they know of. We found that patients with a good doctor relationship felt able to discuss information and ideas from websites and online forums in a considered and critical manner.
Importantly, it is not about the patient trying to be the doctor. Ideally, patients should bring along their information, use it to help explain their key concerns, or detail the options they’ve explored, but also make clear that they still want and value their GP’s input on their findings.
Some of the patients we spoke to told us that they are acutely aware of their doctor’s negative feelings towards the internet. In these situations, people are sometimes tempted to disguise the source of their information. Rather than openly discussing their findings from the internet, they may pretend they got the information elsewhere when mentioning it to their doctor or be very careful not to reveal its origin at all.
For some people we spoke to, the process of trying to integrate the results of their web searches into their communications with the GP was frustrating to say the least. They felt uncomfortable, embarrassed, and sometimes held back key information. This made for unproductive meetings which were felt to be a waste of time.
There needs to be a new and more productive way to integrate online information into doctor-patient discussions. First of all, there should be better ways for patients to collect and organise accurate information online so that they can organise their thoughts and prepare for a visit.
In the consulting room itself, GPs should use the research as an opportunity to have more productive discussions, and use it as a way to teach patients more about their own health issues. They need to question the information source, message and credibility, but GPs could also use it as an opportunity to nudge patients to think about their health options and consider what’s important to them.
Just as a GP is not solely responsible for the health of a patient, neither is the patient themselves. Internet research can no longer be dismissed. Even if inaccurate, it can help build a better relationship between patient and doctor, and give them both a better understanding of managing health in the modern world.