1. Holly, L. T., Blaskiewicz, D., Wu, A., Feng, C., Ying, Z., & Gomez-Pinilla, F. (2012).
Dietary therapy to promote neuroprotection in chronic spinal cord injury. Journal of
Neurosurgery, 17(2), 134-140. doi: 10.3171/2012.5.spine1216.
The above study, published in the Journal of Neurosurgery 4 years ago, examined the role
diets may play in the progression or possible amelioration of symptoms presented in rats with
spinal cord injuries. This particular spinal cord injury is abbreviated as CSM for cervical
spondylotic myelopathy. CSM is caused when the spinal cord is compressed or squeezed as a
result of an injury that narrows the vertebral foramen, restricting the blood supply of the
surrounding vessels that supply nutrients to the spinal cord. Holly et al ambitiously sought a way
to promote protection or regeneration of the damaged cells in a noninvasive way. There were 3
experimental groups, one that did not undergo surgery to induce CSM injuries and the other two
groups that were. The animal subjects with CSM received different diet treatments: one group
was treated with a diet resembling Western eating patterns that are high in saturated fats and
sucrose, and the other group received supplements rich in fatty acid and curcumin. Each group
received a gait analysis, a tool used to assess the way the animals move, walk or run and they
also underwent molecular testing. The results showed the group on the Western diet fared the
worst at every assessment, and there was little difference in the gait and molecular analysis
between the uninjured control group and the rats given Omega-3’s and curcumin supplements.
BDNF, known as brain-derived neurotrophic factor, is a gene that activates the production of
proteins that support the growth and protection of neurons. Levels of this protein were
significantly lower in the injured group that was fed a Western diet than the control group.
Surprisingly, levels of BDNF in the supplemented injured group were virtually the same as the
controlled uninjured group. There was also evidence healing was taking place because there was

2. increased grey matter in the lumbar area in the supplemented group, along with a decrease in
lipid peroxidation, or cell damage from free radical attacks, compared with the group on the
Western diet.
When Janine was told she would be disabled for life due to the extensive damage to her
spine, the best case scenario was she would regain 30% of the function of her lower body. Holly
et al (and similar research) have provided us with evidence that dietary changes may promote
healing of the nervous tissue in the spinal cord when damage occurs. If Janine integrated these
supplements into her diet after her accident, it could have maintained the integrity of these
neurons by minimizing the damage to cells, reducing inflammation and protecting neurons with
curcumin and Omega-3’s, thus she may have recovered feeling in her body at an even faster rate.
Liu, J. L., Crous-Bou, M., Giovannucci, E., & De Vivo, I. (2016). Coffee consumption is
positively associated with longer leukocyte telomere length in the Nurses’ Health Study.
The Journal of Nutrition, 146(7), 1373-1378. doi: 10.3945/jn.116.230490
Nutritionally informed health professionals and previous studies have confirmed the
antioxidant content of coffee, as well as its ability to improve alertness and evidence it can
reduce the risk of suicide and even brain diseases like Alzheimer's. In this study, Liu et al aimed
to determine how caffeine affects our telomeres, on a cellular level, and how much caffeine is
needed to produce said affects through the consumption of coffee. Their research was published
in the Journal of Nutrition this year, which is a journal acclaimed for its quality and mission to
publish peer reviewed papers on all things relevant to nutrition, including commentaries. Lin et
al conducted an observational study of 4780 female nurses who participate in the Nurse’s Health
Study and documented their caffeine consumption and measured the length of their telomeres.

3. These structures were collected from their white blood cells and measured with a sophisticated
tool known as qPCR or quantitative real-time polymerase chain reaction. They plotted these
values on a graph alongside the rate of consumption of caffeine and were able to visualize the
positive and significant relationship between the consumption of coffee and length of telomeres.
It appears that drinking between 2 to 3 cups of coffee a day or more correlates with having
longer telomeres.
Not only has the evidence that coffee may make people healthier grown in recent years
but these findings could imply that coffee may also help Janine live better, longer. Telomeres are
pieces of DNA that are bound to the ends of our chromosomes. These structures protect our
chromosomes from being damaged when they divide and are responsible for keeping them
organized within the nucleus of nearly every cell in our body. As we grow, our cells DNA
replicates and divides, so the telomeres that protect it begin to shorten. Eventually the telomere
will become too short and no longer be able to replicate, and the entire cell will destroy itself.
When we are young, our cells had up to 10,000 more telomeres than they will when we become
old, making it the center of the subject of how to slow the aging process. Telomeres are also
noted to be shorter in individuals who have been depressed, particularly for long periods of time.
There is little debate over the interrelation of the youth and function of our cells and bodies with
the length of our telomeres. The seemingly lack of function of Janine’s body was the greatest
false reality Janine had to overcome because of her physical injuries and consuming coffee may
have prevented her telomeres from deteriorating faster, a possible result of her depression, while
keeping her body and mind functioning better, for longer.

4. Streijger, F., Plunet, W. T., Lee, J. H. T., Liu, J., Lam, C. K., Park, S., Hilton, B.J.,
Fransen, B.L., Matheson, K.A.J., Assinck, P., Kwon, B.K., & Tetzlaff,W. (2013). Ketogenic
diet improves forelimb motor function after spinal cord injury in rodents. Plos One, 8(11).
doi: 10.1371/journal.pone.0078765
Every-Other-Day-Fasting has shown to be beneficial to the recovery of the nervous
system after a spinal cord injury. However, weight loss is undesirable and can have additional
negative effects because they are already at a high risk for being underweight, as Janine was.
Streijger et al wanted to reproduce the ketone bodies that are released when fasting without the
risk of patients losing more weight, so they put one group of rats on a ketone diet, with a ratio
3:1 of lipid to carbohydrate plus protein, four hours after they were subjected to cervical
injury/trauma, and the other group ate a standard carbohydrate diet. With KD treatment, there
was a significant increase in grasping and reaching with the affected limb, in addition to more
grey matter in their corticospinal tract, which implies there is more integration of stimuli in the
damaged area. This study was peer reviewed and published in the online journal Plos One 3
years ago.
This study is significant because it builds on previous studies that have discovered the
connection between healthy fats and the restoration of nerves in the spine following injuries.
When Janine was hit by a truck, parts of her spine were crushed and successfully rebuilt using
other pieces of bone. While she was diagnosed as a partial paraplegic and did not lose the
function of her arms or hands, there are few if any dietary guidelines for individuals suffering
from spinal cord injuries. In fact, Janine was a mere 80 lbs when she was discharged from the
hospital, 6 months after her injury. A KD diet is high in fats and low in carbohydrates, and
current dietary guidelines recommend a diet higher in carbohydrates than fat, yet Streijger et al

5. and their findings indicate neuroprotective benefits of consuming higher levels of healthy fats
immediately after injury because of the increase in ketones, which protect and heal nervous
tissue and function. Notably, these improvements appear to remain even after a change in diet
several weeks later, implying the timetable of consumption relative to the injury is an important
factor. Janine could have been put on this dietary change as soon as she was admitted to the
hospital to the benefit of her neurons, and other patients in the spinal ward.
Figueroa, J. D., Cordero, K., llán, M. S., & De Leon, M. (2013). Dietary omega-3
polyunsaturated fatty acids improve the neurolipidome and restore the DHA status while
promoting functional recovery after experimental spinal cord injury. Journal of
Neurotrauma, 30(10), 853-868. doi: 10.1089/neu.2012.2718.
The previous studies I mentioned above experimented with diet changes after injury, but
this study examined if pretreating rats with Omega-3 polyunsaturated fatty acid enriched diets
for 8 weeks will reduce the mechanical and biological effects that come with a spinal cord injury.
They split the rats into 2 groups, one was fed a regular diet and the other was enriched with
PUFAs or polyunsaturated fatty acids. 8 weeks later, they were divided into 4 more groups based
on their diet and whether they were subjected to actual spinal surgery or a simple procedure to
briefly expose the spinal cord. Not only did the injured PUFA group exhibit less deficits than the
injured rats on the regular diet, the rodents consuming fatty acids recovered the use of their
bladder and, more of them recovered movement than the untreated group. On a molecular level,
Figueroa et al discovered spinal cord injuries have a negative effect on DHA levels, which in
turn impairs the body’s ability to heal itself. Spinal cord injuries destroy the nerve cell
membranes, which evidently leads to a deficiency of fatty acids. PUFAs are necessary nutrients

6. for cells to function properly and maintain life and when cell membranes are damaged, a specific
type of fatty acid abbreviated as AA is released, which promotes inflammation and can lead to
nerve cell dysfunction. DHA, found in PUFAs, has anti-inflammatory properties which protect
the nerve cells and promotes cell repair.
This peer reviewed research published 3 years ago in the Journal of Neurotrauma. It is an
improvement on the other research examining the efficacy of fatty acids in the recovery or
regeneration of damaged nerve cells as a result of spinal cord injuries, which cause
inflammation, disturb the metabolic functions of neuronal cells, destroy neuronal fibers, damage
the protective layers of fat that insulate the neuronal fibers and kill neuronal cells. When Janine
was injured, she was informed she will have to use a catheter for the rest of her life, yet this
study provides evidence that consuming DHA regularly before injury can bring back autonomic
bladder function in the event that a SCI occurs. Injuries are an occupational hazard for athletes
like Janine and this study indicates that consuming fatty acids can be used preventatively to
reduce some of the debilitating mechanical and biological effects an injury to the spinal cord
may afflict.
Guo, X., Park, Y., Freedman, N.D., Sinha, R., Hollenbeck, A.R., Blair, A. & Chen, H.
(2014). Sweetened beverages, coffee, and tea and depression risk among older US adults.
Plos One, 9(4), doi: 10.1371/journal.pone.0094715.
In the health conscious community, people limit their consumption of sweet beverages
and opt for sugar free alternatives based on the idea that sugar is less healthy. Guo et al
conducted the first prospective cohort study examining the direct relationship between artificially
sweetened beverages and depression. This study observed over 250,000 participants, making it a

7. very large study. Their reliability stands out against similar studies because of its type that
reduces the likelihood of recall bias, which negatively affects the accuracy of data. It was
published online 2 years ago in the peer review journal Plos One. As the study’s title implies,
they looked at sweetened soft and fruit drinks, along with coffee and tea. They witnessed a
connection, although weak, to the consumption of caffeinated tea and coffee with a lower risk of
depression. The more surprising observation was the significant association between artificially
sweetened beverages, such as the use of aspartame and saccharin in diet drinks, and depression.
Adding these zero-calorie sweeteners to soft and fruit drinks increased their risk for depression
and even eliminated the positive association to caffeinated tea and coffee consumption.
However, adding sugar or honey to caffeinated coffee and tea did not increase the risk of
depression and lower rates of depression were still observed.
This research is relevant to Janine’s healing because when she was discharged from the
hospital, she became depressed. While she is physically functioning better than her doctors and
nurses had imagined she would, depression can have life-long trajectories and be something
Janine and other patients in the spinal ward will have to manage for years to come. Many people
opt for diet drinks that are artificially sweetened because they believe it to be the healthier
alternative, yet avoiding these drinks and consuming those sweetened with sugar or honey
instead may do less to aggravate and more to facilitate Janine’s mental healing, and others
suffering with depression.