Post-Traumatic Stress Disorder (PTSD) 

The American Psychiatric Association (APA) defines a traumatic event as “when the person experienced, witnessed, or was confronted with an event or events that involved actual or threatened death, serious injury, or sexual violence.” The traumatic event has caused a person to fear for their life, see horrible things, and feel helpless.  HealthLink BC adds that it is an event where you think your life or the lives of others are in danger. You do not have to personally experience the trauma – being a witness to someone else experiencing a traumatic event and even learning that a traumatic event occurred to someone close to you can lead to PTSD. Harvard Medical School says that the trauma must have involved death, or serious physical injury, or threat of serious injury or death. The Canadian Mental Health Association defines PTSD as a type of anxiety disorder. It can affect people of any age, culture or gender.

Canada has the distinction of having the highest number of cases of PTSD in a 24-country study, with an estimated 9.2 percent of Canadians developing PTSD in their lifetime. An estimated 75 percent of Canadians report having experienced a traumatic event in their lifetime. Traumatic event examples include the loss of a loved one, sexual assault, and seeing someone severely injured or killed. The most common events leading to the development of PTSD include being in the military, adverse childhood experiences (ACE), sexual violence, physical assault, being threatened with a weapon, and experiencing an accident. Other events include accidents, robberies, natural disasters, terrorist attacks, receiving a life-threatening medical diagnosis, being a refugee, being imprisoned in a concentration camp, or living in a war-torn country.  Reminders and anniversaries can make symptoms worse. In the US, the most common traumatic events causing PTSD in women are physical assault and rape, while for men, it is military combat.

Of the people who experience a traumatic event, 8 percent will develop PTSD. Women are more likely to have PTSD even though men experience more traumatic events.  More young people have PTSD because they have more exposure to the types of trauma causing PTSD. 

Making a diagnosis
The National Center for PTSD states, “If thoughts and feelings from a life-threatening event are upsetting you or causing problems in your life, you may have PTSD.” The condition is defined as a psychological reaction that can develop after a traumatic event. To be diagnosed, the symptoms must last more than 30 days and seriously affect a person’s ability to function normally at home, at work or in social situations. Individuals feel a loss of control – over their life and that the memory of the event is controlling them.  Four types of symptoms include:

• Intrusions or reliving the event - this means continuously re-experiencing the event by having unwanted/upsetting dreams or nightmares about the traumatic event, or intrusive/uncontrollable thoughts about the event (flashbacks)
• Avoidance or avoiding things that remind you of the event - unconsciously or consciously avoiding things (stimuli) having to do with the traumatic event e.g., avoiding places, activities or people that remind you of the traumatic event and trying to avoid thinking/talking about the traumatic event
• Negative mood or feelings - having more negative thoughts and feelings than before - negative thoughts or mood about self or world around them, hopelessness about the future, memory problems, feeling detached from others, lack of interest in activities that you used to enjoy
• Changes in physical/emotional reactions or feeling on edge or hyperarousal or having difficulty relaxing, irritability, difficulty sleeping, feeling constantly on guard, severe anxiety, panic attacks (sudden feelings of fear or worry that something bad is about to happen), self-destructive behavior, trouble concentrating, overwhelming guilt or shame, and being easily startled or frightened. Physically, people can experience dizziness, upset stomach, or the decreased ability to fight off sickness/infection.

The nature of symptoms
People with PTSD can exhibit a variety of symptoms. The symptoms can vary in intensity and symptoms may increase when you are stressed or come across reminders on television. Personal responses to a traumatic event vary widely and some people can develop mental health conditions other than PTSD. Harvard Medical School points out that the severity of the stressful event does not necessarily match the severity of symptoms. Symptoms can come and go over many years.

Timing of symptoms

• When symptoms develop within the first month of exposure to a traumatic event, it is called acute distress disorder
• When symptoms develop six months or more after exposure to a traumatic event, it is called PTSD with delayed onset (or delayed expression)
• A study in New York after 911 found that symptoms can appear up to two years after the traumatic event, and can be triggered by a stressful event such as job loss.  

Causes
According to the Mayo Clinic, the reasons why some people get PTSD are not known.  Some people experience a traumatic event and do not get PTSD. Most people exposed to trauma do not develop long-term PTSD. HealthLink BC explains that the traumatic event can bring up strong emotions that may create changes in the brain, and these changes can lead to developing PTSD.  Research is showing that a combination of factors can contribute to the development of PTSD:

• Stressful experiences (including the severity and amount of trauma experienced) or a lifetime of traumatic events (especially in childhood)
• Family history of mental health problems e.g., anxiety or depression
• Genetic (inherited) predisposition toward a more intense reaction to stress
• Temperament - features of a personality
• A person's physical response to stress (release of chemicals and hormones)
• Level of social support

Risk factors

• Intense/long lasting trauma
• Refugee
• Indigenous people who attended residential schools
• Disadvantaged people i.e., people who suffer from social, economic or educational disadvantage or racism
• Trauma in early life (ACES – adverse childhood experiences)
• Occupations where people are exposed to trauma e.g., police officers, soldiers, journalists, first responders (police, fire and ambulance), emergency personnel doctors and nurses - a UBC study found that first responders and emergency personnel had twice the rate of PTSD compared to the average population.
• Alcohol or drug abuse
• Lack of social support (being unmarried, socially isolated, or living in poverty)
• Family history of mental health problems
• Living in a rich country - a recent study found that a traumatic event in a rich country violates expectations i.e., if your world is basically safe, and an event happens that turns it upside down, it might be harder to get over

Complications
Complications from PTSD include an increased risk of other mental health problems e.g. depression and anxiety, drug and alcohol abuse, eating disorders, and suicidal thoughts/actions. It is also common to have problems at work, at home in relationships with family/friends, or with your physical health including chronic pain, hypertension or physical maladies; self injury; overwhelming fear of death; compulsiveness; personality changes; and self destructive incidents, to name a few. Some people will become workaholics.
 
When to see a doctor
The Mayo Clinic lists the following signs as indicators to seek medical help:

• When disturbing thoughts and feelings last for more than a month
• Symptoms are severe
• You have trouble getting your life back on track

The sooner you get treatment, the more likely you can prevent symptoms from getting worse or becoming long-term. The goal of treatment is to prevent normal stress reactions from developing into PTSD.
Other sources of help include: 

• Mental health professionals
• Veterans Affairs Canada for veterans
• A religious leader
• A close and trusted friend or family member  

Treatment
HealthLink BC lists the most effective treatments as being counselling (e.g., cognitive behavioural therapy that addresses negative thinking) and anti-depressant medicines (these are the most used medications). Other medications such as antianxiety drugs, adrenergic inhibitors (affect the nerve pathways responsible for the physical symptoms of anxiety), mood stabilizers and antipsychotic medications.  The Canadian Mental Health Association adds support groups for anxiety as another form of treatment. The aim of treatment is to help a person feel in control of their emotions, reduce symptoms and enjoy life again. A person may need to try different types of treatment before finding the one that works for them.  The good news is that effective treatments are available. HealthLink BC indicates, “It is never too late to get professional help or other forms of support that can help you manage the symptoms of PTSD.” Harvard Medical School comments that not all people who experience trauma want treatment because most people, with the help of family and friends, are able to recover. People who want treatment, however, should be offered treatment. Treatment takes time. The treatment dropout rate is high, with an estimated 3 of 4 people not finishing treatment.   

Suicidal thoughts
It is important to get help right away if you have thoughts about hurting yourself or someone else:

• Call the Crisis Line (in BC, call 1-800-784-2433 or 1-800-SUICIDE, or call your local crisis centre)
• Call 9-1-1
• Go to a hospital emergency room

If you know of someone with suicidal thoughts, call 9-1-1. Make sure someone is with the person to keep them safe, or, the Mayo Clinic says to take the person to the emergency department of the hospital if it is safe to do so.

How long do symptoms last?
The duration of PTSD symptoms varies from person to person, ranging from several weeks to several years, or becoming a chronic problem. For about half of the people with PTSD, symptoms will diminish in about one to two years. Harvard Medical School reports that about 30 percent of people recover completely while another 40 percent will still experience symptoms, but they will be less intense.

Resources

• PTSD Association of Canada website
• Veterans Affairs booklet Post Traumatic Stress Disorder (PTSD) and War-Related Stress 
• National Defence and Canadian Armed Forces PTSD article 
• US Department of Veterans Affairs, US PTSD: National Center for PTSD website - featuring a booklet Understanding PTSD

Sources: HealthLink BC website, Government of Canada website, CBC website, Canadian Mental Health Association website, The British Journal of Psychiatry website, Harvard Medical School website

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The average height for American men is 5 feet 9 inches, while for women it is 5 feet 4 inches.  Studies have looked at the relationship between chronic health conditions and height, finding that variations in height put people at risk of certain health conditions. An article published in 2018 in the journal BMC Medicine lists conditions related to height e.g., taller people have a lower risk of mortality from coronary artery disease and respiratory diseases, and an increased risk of atrial fibrillation, venous thromboembolism (VTE), cancer and cancer in specific sites. The researchers conducted an epidemiological and genetic analysis showing that adult height is associated with risk of many diseases affecting multiple body systems. It suggests a complex relationship between adult height and risk of diseases and shared biological mechanisms underpinning many of the observed height-disease associations. 

A person’s height is determined primarily by genetics (80 percent), with more than 700 different genes identified as determining an individual’s height. This explains why tall people tend to have children who grow up to be tall. During development, other factors that can impact height include hormones, medical conditions, and environment/behavioural factors such as activity levels and nutrition. By age 18, a person cannot increase their height. For children and teenagers, it is important to eat a healthful diet, get adequate sleep and exercise regularly. Pregnant mothers should eat in a healthful way for the future bone health and growth of their child. 

Cancer - when it comes to cancer, some research suggests that being taller increases the risk of several types of cancer for women including breast, ovarian, colorectal, skin, and kidney cancers, as well as leukemia. The risk, however, is exceedingly small. For example, the risk for breast cancer increases by only 1.2 percent for every four inches of height.

For men, height increases the risk of some forms of cancer and risk the of dying from cancer. A study from Britain found that in a group of 9,000 men between 50 and 69 years of age, shorter men had lower chances of developing prostate cancer. A 2016 study published the journal Lancet Diabetes & Endocrinology found that every 2.5 inches of height increased the risk of dying from cancer by 4 percent. Leonard Nunney, PhD, a researcher at UC Riverside, looked at the data on height and cancer cases and found that cancer risk increased by 10 percent for every four inches of height above the average. He states to Australia’s ABC, “If you were comparing a five-foot guy to a basketball player who’s over seven feet tall, then that basketball player has around twice the risk of cancer across the board.” Why might height be associated with an increased risk of cancer? Possible reasons include that the taller you are, the more cells you have, and this increases the chances that cells will grow or multiply chaotically. Another theory is that people who are taller have high amounts of high-calorie animal proteins and these activate growth processes that result in cells being more apt to mutate. Another area of research for the height and cancer connection is a protein called insulin-like growth factor 1, or IGF-1, produced in response to growth hormone. The protein encourages cells to divide and grow and plays a role in childhood growth and building up organs and tissues in adults. Taller people have slightly higher levels of this protein in their blood, which Nunney explains could mean a slightly faster rate of cell division responsible for extra cancer. In contrast, people with dwarfism living in a remote area of Ecuador were found to have a mutation in a growth hormone receptor that prevents IGF-1 from being released. They do not seem to develop cancer. 

Heart disease - shorter people have been found to have a greater risk of heart disease and heart attacks. Greater height might mean larger and stronger blood vessels, bigger lungs, and stronger hearts. It could be, however, that taller people had healthier diets growing up or had less exposure to infections. Researchers are trying to figure out if it is the height or whether it is something else which makes a person taller and protects them from cardiovascular disease, explains Mary Schooling, a professor at the City University of New York School of Public Health and Health Policy, to the Huffington Post. Another possible reason is genetics - some of the 180 genes associated with having a shorter stature are also the same ones that increase the risk of heart problems. A 2015 study published in the New England Journal of Medicine found that for a person 2.5 inches shorter than the average, the risk of heart disease goes up by about 13.5 percent. The shorter the person, the greater the effect. Only a third of the effect of height-related genetic variants were related to heart disease, meaning that most of the heart disease risk associated with being short is linked to other unknown factors. In the case of stroke, taller people have less stroke risk e.g., a study from Israel found that for every 2 inches of height, stroke risk decreases by 13 percent. WebMD cites the fact that people who are shorter than 5 foot 3 inches are about 50 percent more likely to develop coronary heart disease than individuals who are 5 foot 8 inches or taller. Possible reasons for this relationship include malnutrition or infections before birth or in childhood that affect height. Another possibility is nurture (e.g., diet or childhood illness) as opposed to nature, since studies of identical twins found that the shorter twin is more likely to have a heart attack. Because twins have the same DNA then genes are not affecting height but rather something in the environment is affecting height.

Blood clots - one health condition where being taller is a disadvantage is blood clots. Taller people have a higher risk of developing blood clots in the veins (and most commonly in one leg). Called venous thromboembolism or VTE, symptoms include pain, swelling, redness and warmth at the site of the VTE. This condition can be fatal if the clot prevents blood flow to the lungs. As the average height increases around the world, so do the number of cases of VTE. Blood clots may be more likely in taller people because the blood must travel more distance and therefore has more opportunities to clot. One study found that men 6 feet or taller were 2.6 times more likely to develop VTE than men at least four inches shorter; men who were both tall and obese were more than five times as likely to develop the condition.

Dementia, vascular dementia and Alzheimer’s disease - shorter people are at greater risk. This may be from the protective properties of growth hormone for taller individuals.

Longevity - short people may have the edge here. A gene called the Methuselah gene, named after a Biblical figure who lived to be 969, is much more likely to be found in short people who live over 95 years of age.

What can you do?
While you cannot change your height, the good news is that the potential impact of height on conditions and risk of death are likely very low. You can take actions to lower your risks, such as following a healthful diet, exercising regularly, not smoking and following low-risk drinking guidelines.

When it comes to cancer risk, Dr. Tim Byers, a professor of preventive medicine and biometrics at the University of Colorado Cancer Center says that taller people should not worry any more, nor should shorter people worry any less, about their cancer risk. He states, "Whether you're tall or short, staying away from tobacco, being physically active, eating a balanced diet and maintaining a healthy are beneficial behaviors for everyone. And get the recommended cancer screening tests, regardless of height." Smoking is a far greater risk than being tall, according to Andrew Brooks, a cancer biologist at the University of Queensland. Dr. Ninney agrees, cautioning tall people to not panic but be vigilant about cancer prevention e.g., having any concerns checked by their doctor.

Sources: TIME website, WebMD website, Harvard Heart Letter website, Patient website, Medical News Today website, ABC News website, Huffington Post website, Medical Xpress website, ABC Science website
 

Telomeres and Health

The mind/body connection 
Research has shown that mental health affects physical health e.g., people with depression, anxiety or other psychiatric disorders are at greater risk of developing chronic conditions such as heart disease, high blood pressure and diabetes earlier in life than people without psychiatric disorders. The mechanisms behind this are not clear. Recent studies have identified possible contributing factors - accelerated cellular aging (oxidative stress contributes to cellular aging and cellular aging is indicated by telomere length) and deficiencies in cellular protection.

The story of telomeres
DNA, making up all the cells in the body, is the genetic material that makes us who we are. Telomeres are short DNA sequences found at the ends of our 23 pairs of chromosomes (the twisted strands of DNA in the nucleus of each of our cells). Telomeres protect the chromosomes from damage. They shorten with every round of cell division or DNA replication - cells replenish by constantly copying themselves. The Berkeley Wellness Letter comments that half the variability in telomere length is inherited while the rest is influenced by lifestyle (smoking, obesity, physical activity) and environmental factors (pollution and toxin exposure). When the telomere becomes too short, the chromosome reaches a “critical length” where it can no longer be replicated, and this in turn results in programmed cell death. Mounting evidence shows a strong link between short telomeres and cellular aging. Unhealthy lifestyle factors e.g., smoking, poor diet, obesity, inactivity and chronic stress are associated with shorter telomeres, and shorter telomeres are associated with a shorter lifespan and higher rates of developing chronic diseases.  

Protecting the telomeres from shortening are the enzyme telomerase (with the role to rebuild telomeres) and the antioxidant enzyme glutathione peroxidase or GPx (with the role of protecting the cells against oxidative stress). Cellular protection comes from increases in activity of the telomere-preserving enzyme telomerase and antioxidant enzyme GPx. Oxidative stress is defined by the News Medical website as “essentially an imbalance between the production of free radicals and the ability of the body to counteract or detoxify their harmful effects through neutralization by antioxidants.” Free radicals are unstable atoms that the body produces in response to environmental or other pressures and can cause damage to cells and lead to illnesses and the aging process. Antioxidants are substances that can prevent or slow damage to cells caused by free radicals, also known as “free-radical scavengers.” Sources of antioxidants can be natural or artificial. Antioxidants occur naturally in plant-based foods e.g., fruits and vegetables. Oxidative stress can lead to the development of chronic conditions.
 
Stress and telomeres
Evidence is mounting for the importance of telomere biology in psychiatric disorders and that telomeres may be targeted using psychosocial and behavioral interventions. Shorter telomeres have been reported in mood and anxiety disorders. A 2019 study from Sweden’s Karolinska Institutet, published in the journal Translational Psychiatry, is the first study to investigate changes in telomerase and GPx activity after psychological treatment for a mental health disorder. The study involved 46 participants with social anxiety disorder, also known as social phobia. Blood samples were collected, as well as measurements of the participants’ telomere length and activity of telomerase and GPx. This was done at the beginning of the study and repeated following a nine-week cognitive behavioural therapy (CBT) intervention. CBT is defined by PsychCentral as “a short-term, goal-oriented psychotherapy treatment that takes a hands-on, practical approach to problem-solving." The goal of CBT is "to change patterns of thinking or behavior that are behind people's difficulties, and so change the way they feel." After nine weeks:

• The severity of social anxiety symptoms was significantly reduced post-treatment compared to pre-treatment
• GPx activity increased significantly during treatment, and increases were significantly associated with symptom improvement
• People who had a greater reduction of social anxiety symptoms saw an increase in telomerase activity
• Although enzyme activities did not increase in all patients, those who showed the greatest clinical improvement were more likely to show increases in telomerase or GPx activity over the course of treatment
• No changes were seen in the length of telomeres, but nine weeks may not have been long enough to see a change
• The results partly support the hypothesis that accelerated cellular aging in people with psychiatric conditions could be a reversible process, and some of these effects may be mediated by mechanisms involving telomerase and/or an antioxidant enzyme system

The findings suggest that behavioral changes can affect health at a cellular level. To the best of the knowledge of the researchers, this is the first to study to demonstrate evidence of increased cellular protection indices (markers) in psychiatric patients after a psychosocial intervention. Clinical psychologist and co-author Kristoffer Mansson states, “In our interpretation, it means that effective psychological treatment for anxiety can protect the cells against oxidative stress and cellular ageing…This is an exciting result that can eventually allow patients to be given effective treatment based on their biological profile. But more studies are needed before we can draw any real conclusions about causality." These findings could provide answers for understanding the mechanisms for remission, and help with the development of new treatment options. The T.A. Science website points out that individuals can restore telomere length or slow the rate of loss by reducing stress, losing weight, quitting smoking, exercising more and eating a healthy diet.

Interest has been growing in telomere biology over the 35 years since its fundamental mechanisms were understood. Researchers continue to determine how important telomeres are to the physical health, mental health, and life span of humans. For example, while longer telomeres are associated with longer life expectancy, they are also associated with an increased risk of various cancers, such as melanoma, basal cell carcinoma, and lung cancers. According to the Berkeley Wellness Letter, research in the area of telomere length, aging and disease is still preliminary. For example, it is not clear if short telomeres cause aging and disease or are a result of aging and disease, if they are indicators of an unhealthy lifestyle, or if interventions that increase or prevent loss of telomere length will help people stay healthy. Harvard Medical School professor Dr. William Hahn notes that having telomeres that are shortening doesn’t mean something bad will happen, and having long telomeres does not guarantee that something bad won’t happen.

Unfortunately, based on limited evidence, companies are selling telomere tests to help an individual make better lifestyle decisions to slow telomere shortening and increase telomere length, as well as selling dietary supplements they claim can increase telomere length or protect telomeres from damage. When it comes to testing, this information may motivate you to adopt healthy behaviours with telomere shortening, but as pointed out by Dr. Howard Lewin, assistant professor at Harvard Medical School, these are lifestyle choices you should be making anyway, whether or not you have shorter telomeres.

The bottom line from the Berkeley Wellness Letter is that the findings to date on telomeres “reinforce common sense advice about a healthy lifestyle - not smoking, exercising regularly, controlling stress, having a healthy diet, and so on.” Dr. Immaculata De Vivo, a Harvard Medical School professor and genetics researcher at the Dana-Farber/Harvard Cancer Center, agrees, stating, “There is mounting evidence that a healthy lifestyle buffers your telomeres.” 

Sources: Center for Science in the Public Interest website, Science Daily website, YG website, Khan Academy website, Medical News Today website, T.A. Sciences website, Psych Central website, Berkeley Wellness Letter website, Harvard Health Letter website, Harvard Health Blog website, Tribune Content Agency website, Cancer journal website
   

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Berries

Summer is berry time. Berries have higher nutritional value than other fruits. The two main highlights of berries are their low calorie and high fibre content. In addition to fibre, the nutritional components include flavonoids, complex carbohydrates, vitamins, some minerals and other important compounds. Oregon State University reports that fresh berries are some of the most powerful disease-fighting foods available.
 
Antioxidants
HealthLink BC explains that antioxidants are nutrients naturally found in foods. Sources of antioxidants include dark and brightly coloured vegetables and fruits like berries. Antioxidants include vitamins, minerals or phytochemicals (naturally occurring plant substances). The role of antioxidants is to counteract, reduce, and repair damage to cells which may help to prevent chronic conditions such as cancer, heart disease, age-related macular degeneration and diabetes.

Antioxidants are best consumed in real, whole foods like berries. Berries have some of the highest antioxidant levels of any fresh fruits. According to the Nutrition Facts website, berries are second only to herbs and spices as the most antioxidant-packed food category. They have more than 50 times the antioxidants than animal-based foods, and 10 times more antioxidants than other fruits and vegetables.

What to choose
Choose a variety of berries as they each provide different nutrients. Registered Dietitian Colleen Doyle tells Today’s Dietitian that, because it is not known which fruits are the most protective, one should eat a variety and choose those with the most colour as they are generally the ones with the most phytochemicals and antioxidants. Blueberries, strawberries and raspberries all make the list of the 100 healthiest foods on the World’s Healthiest Foods website. Registered Dietitian Kathleen Johnson of Johns Hopkins Medicine reminds us to eat berries in moderation because of the sugar content and to choose fresh or frozen over dried as dried have only 20 percent as many phytonutrients and more sugar. What is the best berry? Johnson ranks black raspberries as number one, with blackberries and marionberries tied for second. The most recommended fruit, according to a 2019 survey of registered dietitians in the US, was blueberries (86 percent said they recommended them frequently or always), with strawberries also making the list of the top recommended fruits.  

Selecting berries

• Blueberries - are the second most popular berry after strawberries. They are an excellent source of vitamin C and manganese and rich in antioxidants (being a dark coloured fruit with a higher concentration of phytochemicals). Blueberries have more sugar than raspberries with 15 grams per cup versus 5 grams per cup. One way to check their condition is to shake the container storing them. If the berries do not move freely, they may be damaged, soft and moldy. Do not choose dull coloured berries. Store in crisper in the fridge.
• Raspberries - are the most fragile of the berries, and are therefore more expensive than the other berries. Like blueberries, they too are an excellent source of vitamin C and manganese, and also a good source of vitamin K. They have more fibre than blueberries – one cup of raspberries has more than twice the fibre of one cup of blueberries, blackberries or halved strawberries. She also notes that raspberries are one of the top 7 fruits to support weight loss.
• Strawberries - these berries are one of the most popular berries in the world and have the most vitamin C of all the berries with more than 149 percent of the recommended daily value of vitamin C. They are also an excellent source of manganese and a good source of folate and potassium. One downside is that they are very perishable. When choosing strawberries, look for medium-sized ones because they have more flavour. Other characteristics to look for include bright red, red all over (no white, as strawberries don't ripen after harvest), plump, glossy, free of mold and not packed too tightly.  Strawberries have only 55 calories per cup and no fat or cholesterol. 
• Blackberries - are one of the top fruits for antioxidants, an excellent source of vitamin C, manganese, and vitamin K. As well, they provide vitamin E, folate (the highest level of the four berries listed, with strawberries coming in second), magnesium, potassium and copper. Choose those that are shiny, firm and not bruised or leaking. Kathleen Johnson, RD, points out that blackberries have been less cultivated than blueberries i.e., what is eaten today is closer to the fruit that once existed in the wild. Store them in the fridge uncovered and not the crisper.

What about washing berries in vinegar and water?
Some people recommend washing berries in a diluted vinegar bath to eliminate bacteria and mold and extending their shelf-life. According to Julie Albrecht, PhD, and Registered Dietitian, it is not necessary to use vinegar. This will not, in and of itself, extend the shelf-life of a fruit or vegetable that was not handled the proper way after harvesting. The key, Albrecht says, is to handle fruits and vegetables correctly after harvest and keep cool them as quickly as possible. She states that no amount of vinegar would substitute for the good practice of maintaining the “cold chain” which is the practice of cooling produce after harvest and keeping it at a consistently cold temperature through all the steps in transit, from trucks to warehouse to your supermarket shelves, and then on to your refrigerator at home. Therefore, if you purchase berries at a farmer’s market, use them as soon as possible. This guideline applies to all fruits and vegetables.
 
Storage
The bottom line from the Unlockfood website of the Dietitians of Canada is to eat berries as soon as possible. Don’t wash and hull them until you are ready to eat them. Always removed spoiled berries from the group to avoid contamination. Storing strawberries, blackberries, blueberries and raspberries at 32 degrees in the fridge will maximize their shelf life. Shelf life times vary by berry:

• Strawberries - up to 7 days (store in the original plastic clamshell container or in a plastic bag that is slightly open)
• Blueberries - up to 14 days
• Black and Raspberries - 2 to 4 days

Note that the longer the storage, the more nutrients lost. Don't forget that you can freeze berries. To do this, lay them on a sheet pan in the freezer until mostly frozen and then put them into freezer-safe storage containers.

Preparation
It is imperative to wash your berries because of the potential for contamination from soil, water, animal, and human sources along the journey from harvest to table.

• Blueberries: single layer in a mesh strainer and shake around a bit. Give them a quick rinse before eating
• Raspberries: smaller batches and gently rinse
• Strawberries: individually wash in and around the green leafy top. To freeze, wash gently, freeze on a cookie tray and then transfer to a plastic freezer bag or container

Resources (featuring recipes) 

• BC Blueberries website
• BC Raspberries website
• BC Strawberries website 
• California Strawberries website
• The Half Your Plate website has a section on berries  

Sources:  HealthLink BC website, Berkeley Wellness Letter website, Berkeley Wellness Letter website, Patch website, Have a Plant website, Johns Hopkins Medicine website, Everyday Health website, Eat Right website, David Suzuki Foundation website, Fresh Plaza website, Nutrition Facts website, The World's Healthiest Foods website, Unlockfood website 
 

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Mental Health Supports During COVID-19

Virtual Mental Health Supports During COVID-19
Are you feeling overwhelmed during the COVID-19 pandemic? Support is available in BC. The BC Ministry of Health website lists the province's expanding mental health programs. Services in BC are available for all age groups - seniors, adults, youth, and frontline health care workers experiencing anxiety, depression, or other mental health challenges arising from the COVID-19 pandemic. Visit the website for more information. 

Wellness Together Canada 
Wellness Together Canada is a mental health and substance use website to support people across Canada and Canadians living abroad in both official languages. They provide the following resources for you at no cost:

• Immediate text support - immediate crisis support is available by texting 741741 to WELLNESS (adults) or FRONTLINE (front line workers) 
• Information and videos on common mental health issues
• Mental wellness programs you can do on your own and with coaching
• Monitored communities of support
• Individual phone, video, and text counselling

This online service was launched in response to growing mental health concerns related to the COVID-19 pandemic. Wellness Together Canada was funded by the Government of Canada in response to the unprecedented rise in mental distress due to the COVID-19 pandemic. People are being challenged like never before due to isolation, physical health concerns, substance use concerns, financial and employment uncertainty, and the emotional dialogue around racial equality. Visit their website. For information on COVID and a physical self-assessment of COVID-19 symptoms, click here.
 

 

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How to Promote Brain Health 

The McMaster University Optimal Aging Portal is offering an online program outlining the six ways you can reduce the risk of dementia. Dementia is defined as a progressive brain disease that can have an adverse effect on your social activity and physical mobility.

By taking this interactive lesson, you'll learn how managing the following six factors can help to promote brain health and reduce your risk of developing dementia. 

• physical activity and weight management
• diet and nutrition
• blood vessel health
• smoking and alcohol use
• brain and social activity
• other health conditions and drug side effects.

This free educational opportunity is available on their website.