Follow the 9 month clinical trial I participated in for reversal of cognitive decline

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RECODE Wrap Up

For those who have been following my blog posts/newsletters, you know that I just completed a ReCode (Reversal of Cognitive Decline) 10-month clinical trial. In this, my final blog post on this topic, I’ll summarize key points, answer most commonly asked questions and hopefully, there will be a nugget or two here that might help you.  The main purpose of the trial was to try and halt quantifiable cognitive decline and improve cognition.

 

This newest book by Dr. Dale Bredesen, The End of Alzheimer’s Program-The First Protocol to Enhance Cognition and Reverse Decline is updated, has clearer guidelines on the diet, and is easier to understand than his first book. I would recommend it. I just got it on kindle. His protocol is the one followed in the ReCode clinical trial that I was a part of.

 

 

Clinical Study Results:

I’ve experienced improvements in cognition, weight loss, sleep, gum health, and overall energy.

 

My Cognition Improved which was my main reason for joining this trial
The Recode protocol which includes a combination of a Ketogenic diet, Intermittent Fasting, exercise, nutritional and hormonal supplementation, brain training, getting adequate sleep, and mindfulness training has helped me to crawl out of cognitive decline.

  • Cognitive function tests (both the MoCA (Montreal Cognitive Assessment) and the CNS Vital Signs (Computerized Neurocognitive Assessment Software) have all markedly improved since baseline testing in December of 2019 to the point of testing “out of the range” of cognitive decline to normal levels.  I was in the range of “mild cognitive decline” for my initial testing.  These are excellent tests to do if you’re concerned for yourself or a loved one.

 

“What do I think has made the most difference?” 

Honestly, I believe it’s a combination of many factors including:

  • Improved quality and quantity of sleep (this was huge for me)
  • The addition of targeted supplementation based on my lab tests
  • Balancing my hormones
  • Intermittent fasting to boost ones’ metabolism, for healing, and for weight loss.  We had to make sure we didn’t eat for 3 hrs. before going to bed. Our goal in the study is 12-16 hours of fasting each day. That may sound draconian at first but it’s not that bad. If you have your last meal at 7 pm, you can eat 12 hrs. later at 7 am the following morning. It also helps with sleep as your overactive digestive system won’t wake you up.
  • Getting the junk out of my diet!
  • Consistent and varied exercise has been key including my Pilates, HIIT workouts 2x/week, dancing, and walking my pandemic puppy regularly.  I learned through my research that aerobic exercise is critical for brain health but there’s more.  Our ability to dual-task deteriorates with age. Dual-Task Training– combining cognitive activity with physical activity helps promote neuroplasticity!  This is something I incorporate regularly into the virtual standing/mat Quarantine classes that I teach. An example of this is the new warm-up series I created which links various movements together into a brain-building, memory reinforcing challenge.

“We assume, that physical exercise increases the potential for neurogenesis while cognitive exercise guides it to induce positive plastic change”
~ Bamidis et al, 2014

  • Online brain training because I’ve seen objective improvement particularly in my focus and processing speed.  Online Brain Training was one of my daily requirements as a study participant. The program we were using, HQ.com is the most scientifically validated program on the market. This is way beyond crossword puzzles in sophistication and effectiveness. The exercises get harder as you become more successful so it’s continually challenging your brain.  Check it out!  You can do it on your phone, iPad, or laptop.

 

Insider’s tip-my nutritionist told me BrainHQ.com tends to run a subscription discount around Thanksgiving weekend.

 

So can I point to one thing that helped the most?  No. That’s why the Recode Protocol is a multi-modal approach and why a single pill that has not in the past, and continues to not plug up all the problems that contribute to cognitive decline.

 

In addition to improved cognition, I lost considerable weight.

I lost 15 pounds on this protocol, with a noticeable improvement around my waistline. I’ve lost fat but not muscle as evidenced by the physical testing that I underwent at the beginning and end of the study and by Body Mass Index (BMI) testing on special equipment.  For me, I believe the aspects that contributed to weight loss were intermittent fasting (no nighttime snacking), no sugar, and the high fat/low carb ketogenic diet which includes no bread.  Exercise is also very important but I was doing that already. It was the food and fasting that were the new variables.

 

What else improved?  I’m Sleeping Better

Since I’ve been in this study my sleep has markedly improved.  I used to get up repeatedly to go to the bathroom and at times would have difficulty getting back to sleep. I now sleep through the night and when I do get up, I can fall right back asleep easily.  A light-blocking eye mask ($10 for three on Amazon) at night helped tremendously with my sleep.  I had to get beyond the fact that they look like training bras for the eyes but the comfort and effectiveness won out!

 

From my understanding, the following that I’m taking positively affects my sleep. Remember the recommendations may look very different for you and your body.

Over the counter supplements:

  • NeuroMag by Designs for Health 3 capsules at bedtime  (=144 mg magnesium)
  • Melatonin SRT by Designs for Health 1 tablet bedtime (6mg)

Prescription meds

  • Progesterone 200mg cap (Costco has it the cheapest)

 

What else got better?  Improved Gum Health

Dentalcidin toothpaste with Biocidin by Bio-Botanical Research 

This is the natural toothpaste that was provided for me to use for the entire clinical study. My dental hygienist asked me what I was doing differently as my gum health improved significantly. I told her about the study and apparently, the change in diet and toothpaste resulted in this improvement. Warning, this stuff is not cheap-about $30 for a month supply.

 

How will I proceed now that the study is over?

Though it’s technically over,  my doctor is continuing to refine certain aspects of my protocol including potencies of hormones, etc so I’m doing more blood testing in Nov. and Dec. so she can dial in the correct dosing.

I will continue with many of the supplements I’ve been taking, though thankfully we did discontinue or minimize some. I’m remaining on all 3 bioidentical hormones.

I know I said previously that I’d be adding A2 milk back into my diet, probably in the form of lattes.  I’ve since changed my mind. Amazingly I now find I prefer the flavor of the oat milk in my coffee to regular milk so I’m sticking with that. BTW, oat milk has 240 mg of Calcium per 8 oz serving.

I’ve found that this Califia brand Oat Barista Blend is the best for foaming milk for lattes.

I will be adding in cheese here and there which is technically within a keto diet but was not part of the clinical study guidelines.

I’ll be continuing with Infra-Red sauna but on an intermittent basis.  It was hard on my family for me to disappear so frequently in the evening to detox during the study. I have to juggle the needs of many.

I’m sticking with the Biocidin toothpaste for my gum health. I don’t mess with good results and people I’ve recommended it to have had similar positive gum effects.

Intermittent fasting will continue to factor into my wellness plan.

My go-to snacks are now Macadamia nuts, Trader Joe’s Mixed nut butter with Jicama sticks, or cauliflower florets.  Avocados with olive oil are my healthy fat of choice along with fish.  I regularly cook with avocado oil now as it doesn’t degrade at high heat.

I will continue to prioritize quantity and quality of sleep over late-night TV or getting more “work” done.  The positive effects have been far-reaching including more energy, focus, and clearer thinking.

Re: the Keto diet, there are no studies about the effects of being on a keto diet long term.  I don’t particularly want to stay on keto long term.  I’m interested in carb cycling and one option that was presented by my study nutritionist is keto for morning and afternoon and higher carb allowance for dinner. That’s what I’m doing presently.   I’ve added back in my Puerto Rican rice and beans-very happy about that I must say.  Have also reintroduced higher carb foods like bananas and sweet potatoes.

On the last day of my clinical study, my son surprised me after dinner with a slice of my favorite chocolate fudge cake with cream cheese icing. Hadn’t touched that for 10 months. Decadent, delicious and you know what, I don’t crave it anymore which I’m grateful for.  It used to be a weekly indulgence!

In full transparency-I still eat high cacao count chocolate (over 80%) not a lot, just enough to satisfy my chocolate craving.  I particularly like the brand Blanxart at 82% cacao. I purchase it at my local Zanatto’s market.  I also sneak in occasional spoonfuls of ice cream.  I’m not a saint!

 

Protocol for the Study for those interested in the details

As a ReCode (Reversal of Cognitive Decline) clinical study participant these were my requirements:

  • Adhere to a Ketogenic diet
  • Be gluten-free, dairy-free, grain-free, alcohol-free
  • Agree to undergo various genetic tests, as well as blood, poo, pee, MRI and everything in between.
  • Prick myself daily to check my ketone levels to ensure adherence to the diet.
  • Take bioidentical hormones (testosterone, estrogen, and progesterone)
  • Daily online brain training through BrainHQ.com
  • Daily mindfulness training-I’d wear a biofeedback gadget that tracked heart wave variability and coherence to teach you how to reduce stress and bring your brain, body, and emotions into balanced alignment.
  • Take a heck of a lot of supplements
  • Do intermittent fasting (fast for 12-16 hrs each day-starting from your last meal of the day till your first meal the following day)
  • Exercise daily
  • Monitor quality and quantity of healing sleep (I did this with a FitBit)
  • Sauna or hot yoga regularly (3-5x wk) for detoxification
  • Document everything I eat and my lifestyle activities in the clinical study binder
  • Consult with the clinical study nutritionist and the exercise coach along with the medical doctor

 

Some people have asked-Why a ketogenic diet?

Here are some of the benefits of Ketosis as quoted by Dr. Jockers from DrJockers.com

  1. Reduced inflammation
  2. Enhanced mitochondrial health
  3. Reduced oxidative stress
  4. Increased mental clarity
  5. Abundant energy levels
  6. Reduced cravings
  7. Accelerated fat burning and Weight Loss
  8. Improved insulin sensitivity
  9. Reduced risk of chronic disease
  10. Anti-aging effects

 

If you are interested in trying this protocol, I would start with Dr. Bredesen’s newest book mentioned above and I would do a google search for Bredesen-trained practitioners in your area.  Given the complexity of the program and the multitude of tests that need to be done and interpreted, it is not something you want to embark on without guidance.

 

With that said there are many aspects of the protocol that you could start right away, like diet, intermittent fasting, focus on exercise, brain training, and sleep.

 

 

Wherever you are in your cognitive journey and whatever your concerns are for your cognitive health, I wish you all the best.  Please comment, offer your suggestions, or post your questions below.  I’d love to hear from you!

 

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Recode Finish Line

Here it is, almost 10 months after I started this ReCode (Reverse Cognitive Decline) Clinical Trial.

Allow me to back up for a moment and share with you what got me concerned about my brain health in the first place. Back in 2019 and before, I noticed I was forgetting people, appointments, names, why I was holding the object in my hands, and so on.  True it’s common for that to happen occasionally but it was happening more and more frequently. I have a strong family history of Alzheimer’s disease and I was worried.

Through clinical study genetic testing, I learned that I carry the ApoE4 gene, that sucky one that makes me susceptible to Alzheimer’s disease. The good news from the book “End of Alzheimer’s”  written by Dr. Dale Bredesen from which this clinical trial is based, is that your genes are not your destiny.  I believe that is true really of any genetic predisposition you might have for whatever disease. The genetic gun may be loaded but you have the power and choice to avoid the triggers that will tip the balance that puts you over the edge.  Those are the secrets I learned in this trial. How not to pull the trigger.

Time to celebrate!

What are my key learnings from this clinical trial that might help you?  I’ve experienced improvements in cognition, weight loss, sleep, gum health, and overall energy.  When reading the recommendations given to me, keep in mind that many of the nutritional supplements and hormone choices were selected for my unique biochemistry so the type and dosage may not translate to you. Best to consult with your own wellness practitioner for customization.

My Cognition Improved
The Recode protocol which includes a combination of a Ketogenic diet, Intermittent Fasting, exercise, nutritional and hormonal supplementation, brain training, and mindfulness training has helped me to crawl out of the abyss of cognitive decline.

  • Cognitive function tests have all markedly improved since baseline testing in December of 2019 to the point of testing “out of the range” of cognitive decline to normal levels.  I was in the range of “cognitive decline” for my initial testing.

I lost considerable weight

  • I lost 15 pounds on this diet, with a noticeable improvement around my waistline. I’ve lost fat but not muscle as evidenced by the physical testing that I underwent at the beginning and end of the study and by Body Mass Index (BMI) testing on special equipment.  For me, I believe the aspects that contributed to weight loss were intermittent fasting (no nighttime snacking), no sugar, high fat/low carb ketogenic diet which includes no bread. Exercise is also very important but I was doing that already. It was the food and fasting that were the new variables.

I’m Sleeping Better

  • Since I’ve been in this study my sleep has markedly improved.  I used to get up repeatedly to go to the bathroom and at times would have difficulty getting back to sleep. I now sleep through the night and when I do get up, I can fall right back asleep easily.
    From my understanding, the following that I’m taking positively affects my sleep. Remember it may look very different for you and your body.

Over the counter supplements:

    • NeuroMag by Designs for Health 3 capsules at bedtime  (=144 mg magnesium)
    • Melatonin SRT by Designs for Health 1 tablet bedtime (6mg)

Prescription meds

    • Progesterone 200mg cap (Costco has it the cheapest)
    • Naltrexone 3mg tablet

Improved Gum Health

  • Dentalcidin toothpaste with Biocidin by Bio-Botanical Research is the natural toothpaste that I’ve been provided to use for the entire clinical study. My dental hygienist asked me what I was doing differently as my gum health improved significantly. I told her about the study and apparently, the change in diet and toothpaste resulted in this improvement.  Marie, one of my Pilates students, started using this same toothpaste after I mentioned it in class and she shared this with me. “I went to my dentist yesterday and got a great review on how well my gums looked after using this natural toothpaste.”

Reflecting on this clinical trial I found further evidence of the efficacy of a multimodal approach to cognitive decline and the prevention of Alzheimer’s Disease.   Doctors often tell patients at high risk of Alzheimer’s due to having pre-dementia conditions—such as Mild Cognitive Impairment (MCI) or Subjective Cognitive Impairment (SCI)—that there is really nothing that they can do other than wait and monitor. A recent study from Australia suggests that advice may be out of date. Researchers found that modest lifestyle changes (e.g., a nutrition plan, a physical exercise plan, and BrainHQ brain training which was all included in my clinical trial plus more) significantly reduced Alzheimer’s risk after only eight weeks. You can read a news article about the study here.

As I contemplate life after ReCode, I know that I’ll continue brain training, sauna, intermittent fasting, and will continue with the Dentalcidin toothpaste. I’ll maintain aspects of the ketogenic diet, and will add some carb cycling in.  I miss things like my brown rice and beans, bananas, and sweet potatoes. I don’t really miss bread and will choose to keep that at bay. I believe dropping bread and sugar contributed to my weight loss.  As I prepare to have my final clinical study doctor appt on Oct. 8, I’ll be advised then on how to smoothly transition out of clinical study mode with guidelines on what supplements to continue and what I can drop.  I’ll fill you in on the details next month in my epilogue!

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The countdown is on for my Recode clinical trial

The countdown is on for my Recode clinical trial. 

For those not familiar, I’m embarking on the final month of a 9-month clinical trial for preventing and reversing cognitive decline.

This clinical trial follows Dr. Dale Bredesen’s approach that includes a ketogenic diet, intermittent fasting, nutritional and hormonal supplementation, detoxification, online brain training, and mindfulness training.

The trial is being conducted by a medical doctor, a physiatrist, a nutritionist, and an exercise coach.  It has been a journey of self-discovery, determination, new insights, memory improvement, and weight loss.

I am so thankful for having the opportunity to be included in this study. Having the accountability of keeping data charts and having regular meetings with the doctor and nutritionist helped me to stay on target. I knew that if I faltered or had questions, I could reach out for support. That is invaluable.

Brain Progress

Now, how has my brain been faring through all of this given that brain function was my ultimate focus in joining this clinical trial?

My different milestone cognitive tests along the 9 months have all displayed an upward trajectory, meaning my brain is clearer and the test numbers prove it!

I’ll have final cognitive testing done the first week of October to wrap things up including another MRI and a slew of other tests.

I’m hoping a lot of the junk in my system that was discovered like herpes zoster, Lyme, and mold will be cleared out with the various interventions the doctor has added to my protocol.

Brain Fun Fact – Learning Changes the Brain

     
Every time you learn something new or create a new memory, your brain physically changes. New connections are forged between neurons to represent the new thing.

That explains why the brains of people who have expertise in a certain field look a little different from the brains of people without that expertise.

For instance, London taxi drivers traditionally had a larger hippocampus than the typical person, because their brains were specialized to know all the complex intricacies of the London street map. Bilingual people and musicians, too, show brain growth in areas corresponding to language and playing music, respectively.

Each one of us has unique brain maps, reflecting our own life experiences!  Pretty cool right!  This underscores the fact that our brains are plastic, and are able to make new connections throughout our lifetime. Let’s keep learning new things and keep those connections going!

Pour on the olive oil and oil your brain!  

Keep in mind that not all olive oil is created equally.  It should be extra virgin, relatively fresh, and used raw or cooked only to low temperatures; otherwise, you may be missing out on some of the nutritional punch.

Why olive oil?
There’s a fair amount of scientific evidence that olive oil is good for the brain. For starters, it’s rich in polyphenols and vitamin E, both of which have been shown to protect against cognitive problems.

What’s more, it’s a key part of the Mediterranean diet, which multiple studies suggest is good for cognitive function. Martha Clare Morris, Ph.D., includes olive oil as one of the 10 essential brain-healthy food groups in her MIND diet (designed specifically for cognitive health) which has been shown to reduce the risk of Alzheimer’s disease by as much as 53%.

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Living the Keto Lifestyle Month 8

 

 

 

 

 

8th Installment

As most of you know, I’m part of a 9-month clinical trial to prevent or reverse cognitive decline. Based on my strong family history of Alzheimer’s, this is an area of concern.

Latest Additions

The latest addition in my protocol has been a 10-day colon cleanse.  This involves taking 2 Enzylase (enzyme) capsules along with 2 scoops of TruFiber in water for 10 nights.  According to my doc, this helps to “get the crud out”.  I kept expecting to see things like black tar or other strange things in my “specimens” but they never looked remarkably different. I definitely feel better though.

TOXINS and DETOX

My doctor shared something else new with me to help detoxify and get the mold and toxins out of my body.

An important aspect of this protocol for certain participants including myself is taking binders. These are substances you ingest, either pills or powder that bind in your system to internal toxins and flush them out.  One of the binders that I take is GI Detox -the binding ingredients include clay and activated charcoal.

People have all kinds of illnesses related to these toxins, including dementia.

Binders help with removing chemical toxins, Mycotoxins (related to mold), as well as Metals.

Watch this powerful 5 min video by Michael Gray M.D., which highlights the positive effects of using a binder like activated charcoal/clay twice a day vs once a day.

Apparently, that frequency of dosage helps keep our body’s inflammatory responses down and made the key difference with his patient.

Feel free as always, to ask your questions especially if you have any you want me to direct to my clinical trial physician.  I’m here for you.

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RECODE UPDATE – AlMOST 7 MONTHS

This is just shy of the 7 month mark-2/3 of the way through my Recode clinical trial.

I continue to feel strong, alert, and energized.  The lead investigator was thrilled with the improvement in my recent 6 MONTH cognitive testing.

I’m at and maintaining what I feel is an optimal body weight for my frame and I’m happy to have finally lost my belly fat with this program. I’m even comfortable wearing crop tops and athletic bras, something I would not have considered a year ago.

 

Nutritional adjustment due to Osteopenia

With my recent diagnosis of osteopenia, my doctor has added Vitamin K (specifically Designs for Health Tri-K, vitamin K in three synergistic forms that help the Vitamin D keep the calcium in the bones) to my already existing Vit D supreme (also Designs for Health brand) which is important for Ca++ absorption.

Exercise Adjustment with Bone Health in Mind

Because my spine is more compromised than my hips which are just over the borderline into osteopenia, I’m adding more spine extension exercises into my repertoire to address this deficit.  Think the Bird Dog exercise on all 4’s with the opposite arm and leg reach and the following 2 extension exercises.

Calcium Sources

Because this clinical trial does not allow dairy, I’m hard-pressed to get sufficient Ca++ through my diet as I’m not a big fan of sardines or tofu, two non-dairy high Ca++ options. In addition to my oat milk which has a decent amount, I’m independently adding Bone Builder Forte by Metagenics, a good bioavailable Ca++ supplement.

Ketone Levels

My blood ketone levels are finally consistent at the ideal levels of over 1.0 for the study. This is thanks in part to the addition of exogenous ketones, specifically Designs for Health Keto-Nootropic.

Keto Support Group

I belong to a local Keto lifestyle support group where we learn from each other as we share our trials and triumphs. Some of the topics we recently discussed I thought might be of interest to you.

What am I eating?
I start the day with an oat milk latte (which has a good amount of Ca++)

Lunch is typically an omelet with veggies and salmon or sometimes a slice of bacon and a whole avocado drizzled with plenty of olive oil.  Other times it’s a soup with extra olive oil for the increased healthy fat with an avocado.  A Sunday brunch favorite is almond flour waffles topped with crushed berries and nuts.

Dinner can fluctuate between chicken, fish, sometimes beef, with a side of veggies and salad.  Our zucchini crop is abundant so I’m having a lot of zoodles (zucchini noodles) with various toppings like ragu sauce or pesto.

 

Sauna
There are studies linking positive cognitive function with regular sauna use.  I’ve been without a sauna for the last 3 months as a result of the COVID lockdown. My friend recently invited me to use his own far infrared sauna so I’m adding that back in which feels wonderful.  I’m grateful for this detox opportunity.

What’s the Key?

“What do you think is making the most difference?” is a question I get asked a lot.

Honestly, I believe it’s a combination of many factors including:

  • Improved quality and quantity of sleep
  • The addition of targeted supplementation and balancing my hormones
  • Intermittent fasting for regulating my metabolism
  • Getting the junk out of my diet!
  • Consistent and varied exercise has been key including my Pilates, HIIT workouts 2x/week, dancing, walking, and biking.
  • Online brain training because I’m seeing objective improvement and I can see my focus and processing speed improving.

So can I point to one thing?  No. That’s why the Recode Protocol is a multi-modal approach and why a single pill will not address cognitive decline.

Question posed by a Reader

I wanted to share a question that one of you had which as requested, I posed to my doctor.

“If you have osteoporosis, can the Keto diet be followed? Everything I read is that it is acidic and you need an alkaline diet”

The doctor’s response:
“If you follow the keto diet according to our protocol, then it will be fine because ours is more of a Plant-Based diet with less emphasis on meat, especially red meat.  This keeps it less acidic.”

What I’ve learned independently is that eating too much animal protein also can leach calcium from your bones, so if you have osteopenia or osteoporosis, you should limit red meat to two times a week and keep portions small – 4 to 6 ounces.

A study published in Advances in Nutrition in January 2017 found that cutting down on red and processed meats as well as soft drinks, fried foods, desserts, and refined grains all had a positive impact on bone health.

According to the research, the best diet for the prevention of osteoporosis includes plenty of fruits and vegetables, low-fat dairy, fish and poultry, nuts, and legumes.

After this study is over

With my DXA (bone test) results, I will personally be adding pasture-raised dairy and A2 milk back into my diet after the study is over, to support my bones.  I’ll also be checking in with my doctor on which supplements I should stay on for the long term to support my cognition.

If you’re on or starting the Keto lifestyle or the Mediterranean diet, share your struggles and wins here.  I’d love to learn from and celebrate with you!

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Recode Blog update – almost 6 months June 2020    

What are your top concerns as you age?

For me, it’s the loss of my mind, my memories, my sense of who I am.
This clinical study I’m in (and Dr. Bredesens’ book) looks at Alzheimer’s Disease (AD) as not being caused by amyloid plaques or neurofibrillary tangles, but instead as a protective response to three different processes…
  • Inflammation (from infection, diet, or other causes)
  • Suboptimal levels of nutrients, hormones, and other brain supporting molecules
  • Toxic exposures (like heavy metals and mold)

ROOF with 36 HOLES

Dr. Bredesen uses the analogy of a roof with 36 holes. When you’ve patched enough of the 36 holes, it will be sufficient to protect the house from water damage.  Similarly, there are 36 factors that affect whether the brain goes down a synapse-destroying pathway that ends in AD.

We don’t know which holes will make the most difference so you want to address as many as possible to affect a change.  This analogy makes it clear that no single pill can address or patch all the holes that contribute to AD.

That’s why the ReCode approach is multimodal addressing sleep, nutrition, intermittent fasting, diet, hormone balancing, toxicity, infection, brain training, and mindfulness training.  People may have difficulties with one or more of these approaches but they’ve found that if you plug enough holes, it will make a difference.

My Progress So Far

I feel fortunate that I was accepted into this clinical study and receive excellent all-around support. When I started this 9-month trial, I fell squarely in the category of mild cognitive impairment (MCI) which is a precursor to AD. After just 3 months on this protocol, I tested out of MCI, so much so that I wouldn’t have qualified to enter the study with the new score I got.

If you’re wanting to try this approach, I’d recommend that you start with the NY Times bestselling book,  The End of Alzheimer’s: The First Program to Prevent and Reverse Cognitive Decline as a great first step.  I think there’s even a more recent version you might want to check out.

I’d then google Bredesen protocol-trained practitioners in your area.  The protocol can be overwhelming but doable with the right guidance.

Everyone’s treatment is individualized for that person’s unique biochemistry so there’s no blueprint treatment plan. With specialized tests that need to be run and interpreted by a medical professional, it’s daunting to even consider doing this protocol on your own.

 

Plug Those Holes

Our brain, our sense of who we are is priceless.  We know now that AD is a silent disease with pathology in the brain starting decades before clinical symptoms become apparent.  I think it benefits all of us to start plugging those holes as soon as we can and as best we can!

 

Webinar I Presented on the Brain

I recently presented a webinar for a Wellness Wednesday Series on the subject of Brain Power: Protecting against cognitive decline through a targeted research-based exercise program. Plainly speaking, it explores how to exercise and help your brain simultaneously.  The material in this webinar comes from my own research and what I’m learning through the ReCode (Reverse Cognitive Decline) clinical trial that I’m in.

Dual-Task Training

Key takeaway: Aerobic exercise is critical for brain health but there’s more.  Our ability to dual task-deteriorates with age. That’s our ability to perform two tasks that have separate goals-a necessary part of our complex life. With increased age, we see slower reaction time, reduced walking speed, increased run-ins with objects, and increased fall risk.

Research-based solution?  Dual-Task Training– combining cognitive activity with physical activity to promote neuroplasticity!  Check out the webinar for demonstrations.

“We assume, that physical exercise increases the potential for neurogenesis while cognitive exercise guides it to induce positive plastic change”
~ Bamidis et al, 2014

 

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Preventing and Reversing Cognitive Decline

5th Installment

CLINICAL TRIAL CHALLENGES

This is the start of 5 months on the ReCode Clinical trial, over halfway through.  I think the greatest challenge for me is not so much the keto diet, but just finding time to include all elements of this extensive and demanding protocol. It’s literally a full-time job to take all the supplements throughout the day (see photo below of all my supplements), get my exercise, brain training, and mindfulness breathing in, get a sufficient amount of sleep, and document everything in my binder.

I’m currently struggling with maintaining my ketone readings to desired levels (above 1.0) even though I’m consistently eating a high-fat low-carb diet. To ease my stress, I keep focusing on the fact that my cognitive scores have improved tremendously regardless of my current ketone levels. All I can do at this point is to do my best and try not to stress about it.

SHARING MY EXPERIENCE

Last week I had the honor of sharing my journey thus far in a Zoom meeting with a ReCode support group in Phoenix, Arizona. Doctor Dale Bredesen’s ReCode Protocol is quickly gaining worldwide attention as a viable preventative option to typical meds for Alzheimer’s disease.

EXERCISE QUESTION AND ANSWER

One of my subscribers recently asked me the following question on my BoneSmart Pilates Private Forum which I wanted to share with you.

Caroline: “I have been closely following your posts on the ketogenic plan you’ve been following. I have a question about the aerobic component: how do you fill the 30-minute requirement? Do you walk, hike, and run for 30 minutes each day? Or do you do different activities on different days of the week? Would you elaborate a bit about that?”

 

My response: “2-3x a week I do HIIT (High-Intensity Interval Training) in the form of running (3o sec of hard sprinting followed by 60 sec recovery period with walking for a total of 5-9 intervals. I recently added my daughter (seen in this photo behind me) to this program. 

On Fridays, at noon US Pacific time, I teach an online 30 minute HIIT class. You can get information and register for that class here. 

The variations I teach in HIIT include both low impact and high impact movements so you can choose the level and variation that suits you. The other days I do fast walking and shoot for greater than 10,000 steps. I walk fast enough to elevate my heart rate into my cardio zone. 

WEARABLE DEVICE FOR ACCOUNTABILITY

I depend on my Fitbit to keep me accountable and to provide the objective data that confirms I’m meeting or not meeting my goals.  Having a Fitbit also helps me track my sleep quantity and quality which is an important component of this study. When we’re sleeping is when so much of brain healing occurs.

 

I apologize for this short post.  I’ve had to focus on pressing family issues.  More to come next month.

 

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Preventing and Reversing Cognitive Decline

Month 4 Installment

So people wanted to know if I had cake on my birthday. Well, I didn’t but I savored every drop of wine in my glass at the last restaurant that we ventured out to before shelter in place.  Almost at the 4-month mark now, I wanted to update you on my 3-month benchmark appointment with another round of cognitive testing to check progress.

Test results are remarkable!

In Dec. 2019 for my baseline testing, I came out positive for mild cognitive decline in both the MoCA (Montreal Cognitive Assessment) and the CNS Vital Signs test. These are standardized tests that quantify cognition. What is encouraging is that I improved in 3 months’ time with brain training, exercise, diet, mindfulness, and supplementation to the point where I no longer am in the range of mild cognitive decline. If I had these results in December at baseline I would not have been accepted into the study. The clinical team is very encouraged and excited about my progress.

Question about Keto Diet and Bone Loss

Someone asked me what my doctor thought about the recent study showing bone loss with race walkers on the keto diet.

Here’s the doctor’s response:

  • We don’t know what kind of ketogenic diet the participants were on. In our study, we are encouraged to do a more plant-based keto diet.
  • The study didn’t actually measure bone loss. They did not look at the participants’ Dexa results before and after. They used just a blood marker which doesn’t measure the actual change in bone.
  • The study was short-term, just a few weeks, so it’s difficult to assess the effects of a keto diet on bone, longer-term.  Clearly, more research is warranted.

 

Gems to Share

  • Eating mushrooms is good for the immune system and the brain.

 

  • A recent study showed that people who consumed more than two standard portions of mushrooms weekly may have 50 percent reduced odds of having mild cognitive impairment. My nutritionist told me any mushrooms are good but Portabello and Lion’s Mane mushrooms are best for the brain while Shitake and Mytaki mushrooms are excellent for the immune system.    I’ve since added mushrooms to my veggie omelets a few times a week.

 

  • The “Ketoterrian” cookbook is the closest to what we’re trying to do by Will Cole. It’s a mostly plant-based cookbook. Here’s the Amazon link if you’re interested.

My Plans Post Clinical Trial

When this study is over, I plan to start a program of carb cycling, which is being keto for a week or so, then allowing more higher carbs for a day then repeating that cycle. There are two things I’ve noted that influence my decision.

    • There are no long-term studies for being on a keto diet. We don’t know how the body, in general, will react over several years.
    • The second thing I’ve realized is that people in the Blue Zones, those who live very long healthy lives, include beans in their diet so as a Puerto Rican, that makes me very happy. Beans and brown rice will definitely picture into my carb cycling.
    • For the sake of the study though I’m sticking with the guidelines for the 9-month duration.

My Clinical Study Recommended Workout Regimen

  • Strength training minimum 3x week (I do Pilates and when the Y is open, I add weights)
  • Aerobic 6 days/week  (walk, run, hike)
  • (minimum of ½ hr of each of the above)
  • HIIT (high-intensity interval training) 2x week (I’m teaching this in my Friday noon virtual online Quarantine class! Learn more and register here)

Doctor Recommended Nutritional Baseline Support

  • Fish Oil, Vit D, and B Complex.  No matter how good our diet is, it’s difficult to get all the nutrients we need from our food. She also has me on, among other supplements,  Curcumin and Avmacol which have bone-saving effects.

 

Anti-Aging Asparagus Soup Recipe

Thanks to my clinical study nutritionist for sharing this delicious, hearty keto-friendly recipe with me.  I love soup and this soup makes an excellent meal all on its own thanks to healthy fats from coconut milk, protein from healing collagen powder, and phytonutrients from asparagus, leeks, and garlic. Those benefits also make it a great way to fight the aging process and support a resilient body.  Recipe serves 4, Cook time 20 min.

Ingredients

  • 2 bunches of asparagus
  • 1/4 cup of pepitas (pumpkin seeds)
  • 3 TBS avocado oil
  • 1 medium white onion finely diced
  • 2 TBS grated peeled fresh ginger
  • 3 1/2 large leeks chopped (my first time cooking w/leeks!)
  • 3 TBS coconut aminos (this is a liquid in a small bottle you can find at Trader Joes or Whole Foods)
  • 4 cups vegetable broth (or chicken broth)
  • 1 tsp smoked paprika
  • 1 tsp garlic powder
  • 1/2 tsp sea salt
  • grated zest of 1 lemon
  • 1 cup of full-fat unsweetened coconut milk
  • 4 scoops (about 1/4 cup) collagen powder (optional, not vegan friendly)
  • freshly ground pepper

Directions

  1. Cut 4 of the asparagus spears into thirds and set aside for garnish. Roughly chop the remaining spears.
  2. Heat a medium saute’ pan over medium-high heat.  Add the pepitas and continuously stir and shake until the seeds are fragrant and toasted, for about 5 min. Remove from heat and set aside (I skipped these, my nutritionist just adds them to the blender at the blending point of the recipe)
  3. Heat the 3 Tbs avocado oil in a large pot over medium heat until simmering.  Add the onion and saute’ for 5 min.  Add the ginger, leeks, and coconut aminos, stir well and cook down for 5 min.  Add the chopped asparagus, broth, paprika, garlic powder, and salt and bring the mixture to a boil over medium heat. Reduce the heat and add the lemon zest and coconut milk.
  4. Remove the soup from the heat and allow to cool for several minutes. Pour into a blender, add the collagen powder (if using) and blend until smooth.
  5. Heat a little avocado oil in a small saute’ pan and add the reserved asparagus spears and lightly saute’ until tender, about 3 min.
  6. Divide into bowls and place pieces of the sauteed asparagus in the center of each bowl and sprinkle the toasted pepitas and freshly ground pepper.  Enjoy!

 

That’s it for now. I’ve been preoccupied, as most of us are, with staying safe and healthy in this age of COVID 19 prevention. Be well. Be safe. Be strong.   As always note your questions or comments below and/or email me.

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Preventing or Reversing Cognitive Decline

3RD INSTALLMENT

Next week will mark my 3-month milestone in this clinical study, and I’ll be repeating a battery of cognitive tests to see how I’m faring on this program-results in the next installment.

Progress

I’m down another 2 lbs but I’m holding steady in muscle mass as seen by my body composition analysis today. At 13.5% lean body mass I am in the best shape I’ve ever been, but more importantly, I’m feeling strong, healthy, and clear-headed.  Subjectively my memory and recall are improving but I won’t know objectively the changes until I get the results of the cognitive tests this Friday.

Surprising Discoveries

This keto journey is full of discoveries. I received the results of my DNA testing and am positive for 1 Alzheimers gene, ApoE4. In addition, I also learned I’m hypersensitive to a particular general anesthesia, to benzene in plastic bottles, and that I’m predisposed to diabetes and obesity.  However, the takehome message from this 68-page genetic profile is that our genes are not our destiny.  The information gleaned from this report will help drive changes in my lifestyle, my anesthesia choices, and supplementation to lessen the chances of falling victim to these propensities and other risks discovered in the report.

Exercise for Cognitive Health

As there’s a big focus on exercise in this clinical study, my daily Pilates practice reminds me how important Pilates is for improving the mind as well as the body. Pilates helps reduce stress (which interferes with cognition) by encouraging you to focus your attention on breathing, good posture, and efficient movement.

Pilates and Cognition

Does Pilates—with its emphasis on precision, concentration, and memorization of movement patterns—enhance brain function as well as physical function? Scientists from Yanshan University in Qinhuangdao, China, and Beijing Normal University in Beijing wanted to find out.

In preliminary research, the investigators measured changes in brain activity as a result of Pilates training—and found an increase in the brain’s alpha peak power after 10 weeks of training. Alpha peak power is believed to be related to increased neural network activity, memory performance, and other cognitive functions.

The authors of this study suggested the Pilates method may be a valuable intervention for people with brain-degenerative diseases and cognitive dysfunctions that affect learning, memory, and thinking.  The study is available in Computational and Mathematical Models in Medicine (2013; doi: 10.1155/2013/295986).

If you’re interested in learning more about the BoneSmart Pilates® method and my exercise DVDs which integrate the science of aging and neuroplasticity, check out my website

 

 

 

The Brain with Low Intensity and High Intensity Workouts

A recent new study shows how low intensity and high intensity workouts affect the brain differently.  Using resting-state functional magnetic resonance imaging (Rs-fMRI), a non-invasive technique that allows for studies on brain connectivity, researchers discovered that low-intensity exercise triggers brain networks involved in cognition control and attention processing, while high-intensity exercise primarily activates networks involved in affective/emotion processing. The results appear in a special issue of Brain Plasticity devoted to Exercise and Cognition. Though they were looking at low-intensity treadmill and high-intensity running, you can easily make the connection of low-intensity workouts with mind-body workouts such as Pilates. If interested you can read more about the study here.

CHALLENGES

Being a subject in this study is a full-time job and it’s challenging finding enough hours in the day to fit all the requirements in.  There are supplements that need to be taken before food, at breakfast, lunch, dinner, bedtime and binders (that clear out toxins) that need to be taken away from supplements and food which is the hardest to finagle the timing.

In addition we have to get our exercise in, sauna/sweating, online brain training and online stress reduction training and document everything in our binder pictured here. There are days when I’m bumping up against my bedtime and just need to prioritize sleep over all else.  I’m still teaching Pilates full time which I love, being a mom and wife and running my online business fulfilling orders and answering forum questions.  Not to mention the shopping, perusing keto recipes and cooking in this novel way. It’s enough to make my head spin!

RECIPES

I would be remiss if I didn’t mention that so many of you have reached out to me as I’ve embarked on this journey, to share your recipes and encouragement. My friend Cynthia even found a keto cooking class that I signed up for.  All your support has meant the world to me and I thank you from the bottom of my heart.

My favorite keto snacks

My favorites include macadamia nuts, hard-boiled eggs with salt, and pepper-great for on the run, avocados with olive oil, and raw cauliflower with mixed nut butter.

Three of my favorite Keto recipes

Keto Almond Flour Pancakes

These fluffy almond flour pancakes are delicious and so simple to make! Just a few common ingredients needed. For a topping skip the syrup and crush a few of your favorite fresh berries with a fork into a compote and place that on your pancake, topping it with crushed pecans or slivered almonds.  It tastes so good to me that it feels almost indulgent.  Here’s a link to this easy keto almond flour pancake recipe.

 

Cauliflower hashbrowns with eggs, bacon and avocado

Yearning for something hashbrownish, I’m thankful to my friend Anne B. for the idea of the cauliflower foundation of this recipe.

Ingredients:

  • small piece of onion diced
  • green pepper slice diced
  • riced cauliflower (i just put a 1/2 a head in my blender to rice it)
  • olive oil
  • salt/pepper/garlic powder to taste
  • 2 eggs
  • 1 or 2 slices of sugar free, nitrate/nitrite-free bacon
  1. Saute’ the onion and pepper in 2 TBsp olive oil  (I added some fresh rosemary from mygarden-add the herbs of your choice if desired)
  2. Add the riced cauliflower, mix and flatten out into a hash. Add salt, pepper, garlic powder. Allow to brown to your liking.
  3. Cook the bacon separately then set by the hash
  4. Create a hole in the hash for the eggs so you don’t need to flip it.
  5. Garnish with avocado drizzled with olive oil and Enjoy!

 

 

Keto Thai Vegetable Cashew curry w/Coconut (and Chicken)

Picture of my sisters and I cooking at my Mom's! Thanks to my friend Ylmia for this recipe. I tweaked the ingredients and added some protein by adding chicken which is not part of the original recipe.  As we made this recipe in NY last week, my mom commented that her 3 daughters orchestrated this meal like “Little Women” working industriously side by side for the whole family, and it was a hit!  If you are vegan or vegetarian just skip the chicken.

Serves 2 (we scaled this up for our family)

Ingredients:

  • 1/4 cup coconut oil
  • 1/4 cup chopped red onion2 tsp minced fresh garlicpicture of Keto Thai Vegetable Cashew curry w/Coconut (and Chicken)
  • 2tsp minced fresh ginger
  • 3 Tbsp sugar-free Thai red or green curry paste
  • 1 large yellow or red bell pepper cut into 1-in dice
  • 1/4 tsp sea salt
  • 2 Japanese eggplants, cut into 1 in dice
  • 1 cup full-fat coconut milk
  • 2 tsp fresh lime juice
  • 1/2 cup raw unsalted cashews lightly toasted and coarsely chopped
  • 3 TBS shredded unsweetened coconut, very lightly toasted
  • 1/2 tsp fresh lime zest
  • chicken thighs cut into 1 inch diced pieces
  1.  Heat the oil in a 12in skillet over medium-high heat. Add the chicken and brown on both sides. Set aside.
  2. Add the onion, garlic, and ginger and saute’ until the onion is translucent about 4 minutes.  Stir in the curry paste and cook for 1 minute.
  3. Add the bell pepper and salt and saute’ until halfway tender, about 5 min. Add the eggplants and saute’ for3 min. Add the chicken back in and cover the pan and reduce the heat to medium-low.  Cook until the eggplants and bell pepper are fully tender, about 10 min.
  4. Uncover the pan and stir in the milk and juice. Bring to a boil over high heat.  Boil until the sauce thickens slightly, about 4 min.  Check to see that the chicken is cooked through.
  5. Serve and sprinkle with the nuts, coconut, and zest.

(stats without the chicken)    Protein 11g       Net Carbs 29g      Fat 62 g

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Preventing or Reversing Cognitive Decline

2nd Installment

Read 1st Installment Here.

Since the start of my ketogenic lifestyle journey on Dec 7th, 2019, I’ve lost 9 lbs and 2 1/2 inches off my waist. Though brain and metabolic health is my primary goal, this is a welcome byproduct and actually an expected result on a ketogenic diet.

I’m consistently in nutritional ketosis confirmed by daily prickings/blood readings. This was not easy at first as I don’t like needles or eliciting pain on myself.  With that said, the lancet is tiny and relatively painless and has become so easy now that I take multiple readings daily to monitor how my food is affecting my body.

The fact that I’m preferentially burning more fat for fuel and less glucose is good for brain health, decreasing inflammation and improving energy levels.  I feel strong, alert and am not experiencing the dips in energy I used to feel during the day from erratic blood sugar levels.  I don’t feel deprived or hungry at all. My sleep has improved dramatically which helps my body to heal and my brain to detoxify and regenerate.

An unexpected bonus, I just got back from the dentist and my hygienist was amazed at the improved status of my gums. She asked what I was doing differently and when I told her, she said the gum improvement was a direct result of the anti-inflammatory effects from the Keto diet.

Nuggets to Share with You

Intermittent fasting is something that helps boost your metabolism, healing, and weight loss.  We need to make sure we don’t eat for 3 hrs prior to going to bed. Our goal in the study is 12-16 hours of fasting each day. That may sound draconian at first but it’s really not that bad. If you have your last meal at 7 pm, you can eat 12 hrs later at 7 am the following morning. It also helps with sleep as your overactive digestive system won’t wake you up.

Sleep  Install f.lux (a free app) on your computer so that the blue lights will dim as the sun goes down. This helps your natural melatonin to do its job.  I started wearing a light-blocking eye mask ($10 for three on Amazon) at night to help with sleep and it’s helping tremendously. I had to get beyond the fact that they look like training bras for the eyes but the comfort and effectiveness won out! I’m going to try earplugs next.

Sauna is great for sweating out toxins. I’ve discovered through my lab work, that I have a high toxic load and because I don’t naturally sweat, even when I exercise at normal ambient temperatures. Because of that, I don’t detoxify well. I’ve now added with my doctor’s recommendation, 4 days of hot sweaty yoga and  1-2 days of dry sauna to accelerate the removal of my toxin burden.

I found the following quite interesting and pertinent to my goals.  A 2016 study done in Finland found that among those who used a sauna 4-7 times a week, the risk of any form of dementia was 66 percent lower and the risk of Alzheimer’s disease 65 percent lower than among those taking a sauna just once a week.

You can read more about the study Here

Online Brain Training is one of my daily requirements as a study participant. The program we are using, BrainHQ.com is the most scientifically validated program on the market. This is way beyond crossword puzzles in sophistication and the exercises get harder as you become more successful so it’s continually challenging your brain.  Check it out!  You can do it on your phone, iPad or laptop.

Favorite Keto Foods
Thankfully I love avocados and eat them daily with olive oil as they are a keto superfood. Packed with healthy fats, antioxidants, fiber, potassium, and magnesium, you can eat them on their own or put them in salads, smoothies or enjoy some guacamole.

Eggs have gotten a bad rap but they’re one of the most nutrient-dense foods on the planet – especially the yolk! I’ve been advised to only purchase ” Pasture Raised” eggs as they are the safest and healthiest.

My two new favorite snacks are macadamia nuts and raw cauliflower florets dipped in Trader Joe’s Mixed Nut Butter, a delicious blend of almonds, cashews, walnuts, brazil nuts, hazelnuts, and pecans.

In January we had a gathering of the clinical study participants with our doctor, nutrition coach and fitness coach. This allowed the participants to meet each other and share insights and challenges. The highlight of the meeting was a call in from Dr. Dale Bredesen, the creator of the protocol that we’re using. He was inspiring, answered all our questions with wisdom and humor and let us know through our participation in this study, that we were becoming a part of history.

Keto 101 Basics

If you’re interested in trying a ketogenic diet here are some of the main points.  You can also find plenty of info and recipes on the web.

Under normal circumstances, the cells of our body rely on glucose as their primary energy source. Glucose comes from dietary sources and from the breakdown of glycogen in the skeletal muscle and liver.  When glucose is in short supply, the cells tap into fats as an alternative source of fuel. The breakdown of fats leads to the production of ketone bodies and a metabolic state called ketosis.  The benefits of being in ketosis are listed at the end of this post.

Keto diet principles:

  • Fat: 60-75% of daily calories of daily calories
  • Protein: 20-35% of daily calories
  • Carbs: roughly 5% of daily calories

Most people are in chronic sugar burning mode due to a diet high in carbs for many years. That’s why it can take days to weeks on a low-carb, high-fat keto diet to get keto-adapted as the body learns to preferentially use fat/ketones for fuel.

What to Eat

Your diet should be a majority of healthy fats, polyunsaturated fats, and some saturated fats such as avocados, olive oil, coconut oil, fish oil, and ghee. This increases ketone bodies making the body crave fat instead of sugar.

Veggies preferred are non-starchy above-ground low carb veggies such as broccoli, cauliflower, zucchini, cabbages, and leafy greens. I’ve substituted spaghetti with zucchini noodles using my spiralizer and honestly don’t miss the pasta!

Onions, garlic, cilantro, and basil are all great additions.

 

Fruits: best are organic berries such as blackberries, blueberries, raspberries. strawberries, as well as lemons and grapefruit. Other fruit like bananas and oranges and tropical fruits like pineapples and mangoes are higher in carbs and should be avoided or minimized.

Alcohol is not recommended on this clinical study diet although red wine (1x /wk is permitted later in the study protocol)  Woo hoo!

We’re instructed to stay within 50 net carbs per day.  To calculate your Net carbs,  look at the label for Total Carbs and subtract Fiber and that = Net carbs.

For example: 1 serving of my Mixed Nut Butter is 7g carbs minus 3g of fiber so it’s 4grams total Net Carbs.

 

Are you afraid that eating fat will make you fat? 

That has been proven scientifically as incorrect. One of the major causes of fat accumulation is inflammation. Being in ketosis reduces inflammation and helps you lose extra fat weight as I’m experiencing first hand.

What to Buy

We’ve been advised to buy organic as much as possible with grass-fed meat and pasture-raised eggs to minimize toxic exposure of antibiotics and GMO’s. Grassfed animal products have the proper ratio of omega 6 to omega 3 to support optimal brain health, fat burning and keep inflammation levels down.  You’d be surprised how much affordable organic food you can find in Costco and Trader Joes.

Measuring Ketone Levels

There are several ways to measure your level of ketosis such as urine strips, breath monitors, and blood meters. The blood ketone reader  (I use Keto Mojo) is the gold standard, most precise and is what we’re using in the study. Here’s a link to the Keto Mojo kit on Amazon.  Although nutritional ketosis is defined as above 0.5 ml/mm, in the clinical study we’re shooting for a ketone level of 1.0 or above ml/mm as that level has been shown to better improve brain function and cognition.  Though it took me a while, I’m now pretty consistently at or above 1.0

Benefits of Ketosis as quoted by Dr. Jockers from DrJockers.com

  1. Reduced inflammation                                                 
  2. Enhanced mitochondrial health
  3. Reduced oxidative stress
  4. Increased mental clarity
  5. Abundant energy levels
  6. Reduced cravings
  7. Accelerated fat burning and Weight Loss
  8. Improved insulin sensitivity
  9. Reduced risk of chronic desease
  10. Improved mood and emotional balance
  11. Healthier Skin
  12. Anti-aging effects

Comment or post your questions below (rather than emailing me) to consolidate things and I’ll answer them as best I can and will try to include them in my next installment!

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