A: Cellulose gum is a common ingredient in both food products, such as salad dressings, sauces, yogurts, and ice cream, and in pharmaceuticals, such as tablets and liquid medications. It’s an effective thickening agent, stabilizer, and an emulsifier. It has no calories or nutritional value and is used in very small quantities in processed foods. The gum comes from plant cell walls, often from wood pulp or cotton. The Food and Drug Administration and the Environmental Working Group, a nonprofit, nonpartisan organization that evaluates the safety of foods, among other things, have recognized cellulose gum as a safe ingredient in foods, pharmaceuticals, and even cosmetics. While cellulose gum is generally considered safe, some research has suggested that a diet that contains a lot of processed foods, with cellulose gum as an ingredient, could upset the balance of good to bad bacteria in the intestinal tract and cause bloating, gas, and diarrhea. Also, people with irritable bowel syndrome (IBS) may be more sensitive to the additive. 

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Overview. Mangosteen (Garcinia mangostana) is a tropical plant native to Southeast Asian countries including Malaysia, Thailand, and India. However, it wasn’t until 2007 that fresh mangosteen was imported into the U.S. due to previous concerns about invasive fruit flies. It is called “the queen of fruits” for its complex, sweet taste and extensive use in traditional medicine for skin infections, wounds, and diarrhea. Nutritionally, mangosteen packs a punch with nutrients that many U.S. adults may lack (fiber, potassium, vitamin C). It also contains a high concentration of phytochemicals that are thought to be antioxidant, anti-inflammatory, and potentially cardioprotective. Commercial interest in these benefits steered the development of mangosteen extract powders, capsules, and juice concentrates.

Evidence. Though early cell and animal data suggested a potential application of mangosteen-derived compounds in various therapies (cancer, neurological), there is limited strong clinical evidence linking mangosteen supplementation with improved outcomes. However, small studies suggest that mangosteen gel or extracts might be helpful for individuals with serious gum infections.

Safety. In its whole form, mangosteen is likely safe for most healthy individuals. However, while the safety of mangosteen extracts was demonstrated in animals, it is not as clear in humans. When taken orally as a supplement, 560 milligrams of daily mangosteen extract is reported to be possibly safe up to 12 weeks, though side effects were reported (constipation, nausea, vomiting, and fatigue). It may also increase the risk of bleeding in individuals with clotting disorders or upcoming surgery, since it contains xanthones that might slow blood clotting.

Interactions. If you are taking anticoagulant medication, be aware that they may interact with mangosteen supplements. The antioxidant effects of mangosteen supplements may also interact with cognition-enhancing medication (donepezil) or anti-cancer therapies. Please consult with your healthcare provider before changing your diet or adding supplements.

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Eating nutritious, whole, and minimally processed foods that are prepared in ways you enjoy has inherent value. So does moving your body regularly in ways that work your muscles, heart, and lungs. Here are six small-but-significant wins you may experience as you work towards your overall goals:

Better health markers. Positive changes in blood pressure, blood sugar, and cholesterol levels can be a sign that your new nutrition and exercise habits are “working.” However, genetics also plays a role, so some people will see more significant changes from diet and lifestyle than others.

More energy. Nourishing yourself with healthy meals and snacks spaced throughout the day will give your body the fuel it needs to run optimally, which can reward you with steady energy levels. Similarly, “spending” energy each day on physical activity will yield you even more energy.

Better digestion. Changes to eating patterns such as reducing meal skipping, eating more fiber-rich plant foods, putting down your fork when you are satisfied but not stuffed, and reducing late-night eating can all improve digestion.

Improved sleep. Shifting more of your food intake to earlier in the day—starting with eating breakfast, then making lunch a bigger meal than dinner if you can—can also promote more restful sleep and may have other health benefits. Regular exercise can also help you sleep better.

Increased fitness. Regular exercise doesn’t always lead to weight loss, but it does improve your strength, endurance, and flexibility. Not only is maintaining and building muscle and cardiovascular fitness important for health, especially as we age, but you’ll find that many routine daily activities become easier as you become stronger.

Greater resilience. Supporting your body with nutrition and the movement it needs supports physical and mental health, which can help you recover from stressful events big and small.

Another benefit of looking beyond the scale—even if you do hope to see the number on the scale shift—is that when you pay attention to how the results of your new habits make you feel every day, this can be more motivating than simply focusing on a far-off goal.

You may also notice a synergy to the changes you’re making. For example, eating better and staying active may improve your energy and help you sleep better, and feeling refreshed and energetic can make it easier to plan and prepare nutritious meals and decide to go for a walk instead of lounging on the couch…which continues to support energy and good sleep.

When you feel better and know you’re feeling better, this can strengthen your new nutrition and exercise habits. It becomes easier to do the work to maintain those habits long term, and to return to them if you find yourself off-track along the way because life threw you a curveball.

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An antihypertensive medication is usually the first-line treatment for high blood pressure. However, you may be able to achieve similar blood pressure-lowering results with a simple change in your diet, according to a small study published online recently by JAMA. Study par­ticipants included 213 people, ages 50 to 75, with normal blood pressure, controlled high blood pressure, uncontrolled high blood pressure, or untreated high blood pressure. They were asked to try two different diets. Half of the group was randomly assigned to eat a high­salt diet for one week that included 2,200 milligrams (mg) of salt per day. The other half of the group was randomly assigned to eat a low-salt diet for a week that allowed just 500 mg of salt per day. Study participants then switched diets for one week. Their blood pressure measure­ments and urine samples (to measure salt intake) were collected periodically throughout the study. Researchers found that when participants followed the low-salt diet, most of them experienced an eight-point drop in their systolic blood pressure (the top number in a blood pressure measurement), compared with when they ate a high-salt diet; and a six-point drop, compared with when they ate their usual diets. The low-salt diet reduced sodium intake by about a teaspoon of salt per day, compared with participants’ usual diet. Since most sodium in the diet is found in pre-packaged foods, take a careful look at the ingredients list of various products, and, when possible, opt for sodium-free or low-sodium options that you can enhance with seasonings that boost flavor but won’t boost your blood pressure.

Harvard Study: Smaller Hippocampus Associated with Cognitive Decline Researchers continue to seek a better understanding of memory loss and thinking skills changes that occur in people who develop Alzheimer’s disease (AD). Are those cognitive changes due to the buildup of two toxic proteins in the brain—tau and amyloid-beta—or perhaps other neu­rodegenerative conditions? One of the early consequences of AD is a loss of volume in the hip­pocampus, a region of the brain primarily involved with learning and memory. Abnormal levels of tau and amyloid-beta damage neurons, in turn causing brain atrophy, particularly in the hip­pocampus. But in a study published recently in Neurology, the medical journal of the American Academy of Neurology, researchers from Harvard Medical School found that loss of volume in the hippocampus was associated with cognitive decline irrespective of amyloid and tau levels. Hippocampus atrophy on its own accounted for about 10 percent of the difference in cognitive decline experienced by study participants between the start of the study and its conclusion about

seven years later. Researchers noted that dementia is a complex condition with many underlying causes, and that other disorders besides AD may contribute to shrinkage of the hippocampus and cognitive decline. The researchers added that monitoring hippocampal volume may help doctors determine which individuals may best respond to the new drugs being developed to halt or reverse the buildup of toxic proteins in the brain.

Reading and Writing Poetry May Help with Loneliness

Various COVID-19 pandemic coping behaviors continue to produce interesting findings for researchers trying to understand why certain people thrived and others struggled during that time. In a study published recently in the Journal of Poetry Therapy, researchers found that reading, writing, and sharing poetry can help people cope with loneliness or isolation and reduce symptoms of anxiety and depression. A team of British researchers found that many people who started writing poetry and discussing poetry with others experienced “demon­strable positive impacts on their well-being.” Study participants told researchers that reading and writing poetry helped them deal with challenging feelings of anxiety and depression. The findings were based on interviews with users of the former poetryandcovid.com website, which has since been archived as poetryandcovidarchive.com. Users who submitted original poems and offered reactions to the poems of others found a supportive community, as well as a way to give some structure to complicated emotions and experiences. Both of these benefits appear to help people endure difficult experiences by providing outlets that allow them to make sense of those experiences.

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A: As people get older, they can feel they have less control in their lives. Worries about health, money, and the passing of friends and relatives can trigger serious anxi­ety and depressive symptoms. So, it’s common for people to resist change more and more as they get older. Routines provide security and a level of comfort. Change introduces unpre­dictability into their lives and disrupts some of the things that give them peace of mind.

You can help by being understanding and reassuring that trying something new doesn’t mean giving up anything important in her life. Give your mother the space to feel how she feels, but don’t necessarily give up introducing new experiences into her life. Learning new things, seeing new places, meeting new peo­ple, etc., are all important for cognitive stimu­lation and mood enhancement. You may just need to start small. If she doesn’t want to go to a new restaurant in town, think about getting takeout from there so she can try a new dish in the comfort of her own home. If she likes it, she may be more willing to go to the restau­rant next time. If your mother’s resistance to change is accompanied by other concerning changes in memory or thinking skills, depres­sion or anxiety, or behaviors such as hoarding or diminished hygiene and self-care, then con­sider accompanying her to see her doctor or other medical professional and sharing what you have observed.

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You may be retaining too much fluid if there is swelling in the arms, hands, legs, or ankles, rapid weight gain, or increased waist size.

In conditions such as hypertension, liver failure, congestive heart failure, persistent swelling, and kidney disorders, it’s critical to get excessive fluid out of your body quickly. Diuretics (medications) are extremely efficient and fast-acting. Diuretic foods and drinks are not likely to produce such a dramatic effect. (https://universityhealthnews.com/daily/nutrition/diuretic-foods/).

There is no universally accepted “best” list of natural diuretic foods. Each person’s metabolism is different, and what works for one may not be effective for another. The 10 foods and drinks that follow were selected based on evidence, easy access, affordability, and taste.

1. Water—Drink Water to Lose Water?

The answer is yes. Water is one of the best natural diuretic fluids. One of the functions of hydration is to get rid of waste products, and water does that. Too much water, especially in those with kidney disease, stresses the system. Not enough causes   symptoms of dehydration (thirst, fatigue, lightheadedness, dark urine). The goal is to maintain fluid balance.

2. Caffeinated Coffee—Fast-Acting

The caffeine in coffee makes it perhaps the fastest-acting food or drink diuretic. The Centers for Disease Control and Prevention (CDC) says coffee can trigger the urge to urinate within a half-hour, which would normally be expected from a prescription diuretic. A single cup of coffee (47 milligrams of caffeine) won’t work. Two or three cups probably will. How much caffeine in coffee is too much? According to the Food and Drug Administration (FDA), more than 400 milligrams per day. (www.fda.gov/consumers/consumer-updates/spilling-beans-how-much-caffeine-too-much)

3. Caffeinated Tea—Green or Black

Green tea contains about 29 mg of caffeine per cup, suggesting that it would take a lot to promote urination. But black tea has twice that amount or more and may have the same diuretic effect as coffee. Hibiscus tea has been promoted as a diuretic drink, but research is still inconclusive.

4. Watermelon—91 Percent Water

Watermelon is near the top of every list of diuretic foods and not just because it’s 91 percent water. It has been associated with reduced inflammation and body fat, kidney and eye health, nerve regulation, lowered blood pressure, and cardiac function. That’s just the short list. Watermelon is nutrient-dense, with electrolytes to help off-load some of that unwanted fluid and salt, reaffirmed in a 2022 study published in Nutrients (https://www.mdpi.com/2072-6643/14/22/4883).

5. Grapes—High Potassium, Low Sodium

Green and black grapes don’t appear on every “best natural diuretics” list, but perhaps they should be included. The combination of high potassium and low sodium flushes out excessive water. Grapes also contain antioxidants that contribute to heart and skin health. Bonus feature: grapes are tasty.

6. Pineapples—Benefits, Risks

Pineapples may help those experiencing bloating. Although rich in folate, iron, magnesium, and vitamin B-6, pineapples are not for everyone. They contain the enzyme bromelain, which can interact with certain drugs and could cause an allergic response in some people. The Icahn School of Medicine at Mount Sinai says, ”Patients with kidney or liver disorders should avoid bromelain.” (www.mountsinai.org/health-library/supplement/bromelain) From NYU Langone Health: “Safety for those with kidney or liver disease has not been established.” (https://froemkelab.med.nyu.edu/surgery/content?ChunkIID=146651)

7. Citrus Fruits—Toxin Purge

Oranges, lemons, limes, and grapefruits clear out toxins and increase urine output. They are high in water content (87-91%) and potassium (1/2 cup of orange juice has 248mg of potassium). Lemon water/juice is one way to get its benefits without the strong acidic taste. All four fruits regulate fluid balance and reduce sporadic bloating.

8. Celery—Soups, Salads, Sandwiches

Celery contains more water than watermelon (95% to 91%), but you’d have to eat a lot of it to have a noticeable effect. Including celery in soups, salads, and sandwich spreads adds another natural diuretic food. It also has calcium, magnesium, and potassium, and may help lower blood pressure.

9. Asparagus—It’s the Asparagine

Asparagus is not the most popular vegetable, but it is a natural diuretic. According to the National Library of Medicine, asparagus contains the amino acid asparagine, which increases urination. It is fat- and cholesterol-free and provides multiple vitamins and minerals. Warning: Asparagus may cause urine to have a harmless sulfur-like odor.

10. Cucumbers—Losing Water Weight

Cucumbers, which can be classified as vegetables or fruits, promote loss of water weight (bloating). In addition, a medium-size cucumber is low in calories (30) and contains potassium, magnesium, fiber, and vitamins A, C, and K.

Herbs and Supplements—Inconclusive Evidence

Herbs like parsley, dandelion leaves, ginger, juniper, butcher’s broom, and horsetail (the plant) might reduce fluid retention, but the evidence is not conclusive. Herbs are unregulated—no guidelines regarding dosage. Talk with your healthcare provider before adding herbs or supplements to your diet. Some may have adverse side effects or interfere with medications.

Practical Applications

If you are retaining excessive fluid or exhibiting suspicious symptoms, the foods and drinks suggested here are first-step, self-care treatment options. Committing to a healthier diet, limiting salt intake to 2300mg per day (according to the CDC), and exercising daily are non-food ways to lessen the need for diuretic aids.

If there is even the slightest concern that your condition is more serious, consult your doctor. The treatment may include something you already have in your kitchen or pantry.

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In a study involving 80 participants, researchers from Massachusetts General Hospital (MGH) found that twice-weekly heated yoga sessions, conducted over a period of eight weeks, were associated with reduced depressive symptoms in adults with moderate-to-severe depression. The findings, published in the Journal of Clinical Psychiatry, also suggest that once-a-week sessions may be beneficial, too.

The participants were divided into two groups: one that received 90­minute sessions of Bikram yoga and one (the control group) that was placed on a waitlist and completed their yoga sessions after the first group concluded theirs. The individuals in the heated yoga group experienced significantly greater symptom reduction compared with those in the control group. Though the researchers aimed to have volunteers participate in two yoga sessions per week for eight weeks, by the end of the eight-week study, they attended an average of 10.3 classes.

“Yoga and heat-based interven­tions could potentially change the course of treatment for patients with depression by providing a non-medi­cation–based approach with addi­tional physical benefits as a bonus,” says lead author Maren Nyer, PhD, director of Yoga Studies at the Depression Clinical and Research Program at MGH. 

Yoga and Depression

Previous studies suggest that traditional yoga may be helpful in reducing depressive symptoms. The rhythmic breathing practices, along with the meditative/relaxation elements of yoga, are designed to promote calm and reduce stress, depression, and anxiety.

Dr. Nyer says new studies will try to determine specific benefits of heat and yoga in easing depressive symptoms. David Mischoulon, MD, PhD, a senior author of the study and director of the Depression Clinical and Research Program at MGH, notes that this research is of particular interest given the encouraging findings of studies of whole-body hyperthermia as a depression treatment. Whole-body hyperthermia involves spending supervised time in a personal sauna­like device. Whole-body heating appears to activate cells in the brain that synthesize the neurochemical serotonin, a substance that plays a key role in depression. The treatment also activates certain regions of the brain that tend to have lower activity levels in people with depression.

“Future research is needed to compare heated to nonheated yoga for depression to explore whether heat has benefits over and above that of yoga for the treatment of depression, especially given the promising evidence for whole-body hyperthermia as a treatment for major depressive disorder,”Dr. Mischoulon says.

Hot Yoga and Seniors

Yoga also supports better physical health by improving joint and muscle flexibility, muscle strength, and circu­lation. It can also help with balance.

The addition of a heated environ­ment can further enhance yoga’s ben­efits. The higher temperatures facili­tate safer stretching, for example. Bikram yoga practitioners sweat out toxins from their glands and skin.

Bikram yoga is also well-suited for many older adults, because it steers clear of some of the more ambitious traditional yoga postures, such as headstands or difficult arm balances. Heated yoga classes for seniors are also usually conducted with safety in mind, meaning that if a posture is too difficult or the heat is a problem you can rest or end your session early.

Heated yoga also comes with some important safety concerns. Individuals with cardiovascular problems, who take dehydrating medications, or are in active cancer treatment should consult their doctors before trying heated yoga, or just about any new exercise program.

Because heat helps loosen muscles, it can be easy to overstretch and strain muscles, tendons or ligaments. The extended time spent perspiring in the heat also raises the risk of becoming overheated or of becoming dehydrated. Consume fluids before, during, and after heated yoga. Dr. Nyer suggests trusting your instincts about your body (what you think you’re capable of) and paying close attention to any signs of distress. She adds that older adults may want to start with gentle stretching yoga before trying heated yoga.

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