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What is Mindful Eating?

This summer many of us will be getting together with our friends and families and firing up the grill. Its easy, when you’re hungry or distracted, to gorge yourself on delicious food. However, did you know that actually taking the time to savour every morsel and enjoy all the wonderful textures and flavors, has an amazing effect on your mind and body like the ability, for example, to help you lose weight? In a world where food is named the enemy and eating is regarded as a sort of sin, there seems to be little hope in making the act of eating an enjoyable one anymore. A notification on our smartphones, an urgent email, or a clickbait news story make the very act of eating a distracted chore. We inhale treats that are deemed naughty without so much as a single groan of pleasure, bypassing all of our favorite parts of the treat. Naturally, many are searching for a way to reconnect with food in a way that is enjoyable and nutritious.

Enter: mindful eating.

MIndful Eating
Mindful Eating (image credit: DolcePlacard.com)

Mindful eating is an approach to food that combines the tenets of mindfulness with the very simple act of eating. By being mindful with each bite we are opening communication between our brains and our appetites. By doing this, we are able to be more aware of our bodies’ desires and needs, thus truly feeding it exactly what it wants.

The Mindfulness Approach

Mindfulness is simply the act of being more present in every moment. Though it’s not entirely possible to be deliberately present in each moment of the day, it is the ultimate goal. To begin with, many experts practice mindfulness in small doses, such as with eating.

Being mindful is a lot less tricky than it sounds. It is intentionally being aware of what is happening, both inside and out, in any particular moment. The focus turns to your sensations, your feelings, your emotional reactions, and even your thoughts. Rather than trying to control each of these, the goal is simply to be aware of them.

Awareness is key in mindfulness because it detaches itself from any judgments or guilt. Rather than beating yourself up over your thoughts or cravings or hurry, you are meant to be aware of these things. Being fully aware of your experience, all the good parts as well as the bad, helps you to actually experience the moment. This is the entire idea behind mindfulness.

Mindful Eating

As you might suspect, mindful eating is just practicing mindfulness while eating. With each bite, attention is paid to the colors, textures, smells, flavors, and even sounds of the food. We also focus our attention on our own experience as we take the bite. What do we feel in our hands, our mouths, our stomachs, even our hearts? What does hunger feel like and, alternatively, what does it feel like to be satisfied?

Summer Barbecue
Summer Barbecues (image credit: parentmap.com)

Mindful eating slows the process of eating down so that we are actually involved in it. It allows us to view food for exactly what it is–a nutritive substance–and enjoy the process in the meantime. It is the perfect antidote to mindless eating, which often contributes to a poor diet and an emotional rollercoaster regarding food.

With a continued practice of mindful eating, we are able to return to the sense of ease and enjoyment in eating we once had as children. It is also the same experience that our ancestors had, too, making it the most natural and healthy way to eat. Breaking old, rushed habits isn’t easy, though. It takes practice and dedication. And, of course, awareness. Start small, perhaps with your morning coffee, and expand from there. Eventually, you will be able to eat mindfully with each meal.

Mindfulness, Students, and Classrooms

Children diagnosed with Autism Spectrum Disorder (ASD) are far more likely to participate in mainstream classrooms than in the past. However, this has created new challenges for teachers. Around one in every 68 children is affected by ASD, per the Centers for Disease Control (1). In comparison, ASD in 2002 occurred in just one in every 150 children (2). Meanwhile, youngsters with ADHD and Tourette Syndrome can also experience difficulties in school environments. Mindfulness practices are increasingly utilized by teachers to foster learning and social integration in these children.

Mindful Based Stress Reduction (MBSR) and Mindfulness Research in Youth

The MBSR therapeutic meditation program developed by Jon Kabat-Zinn in 1979 showed promising results in a study conducted by Saltzman and colleagues at Stanford University in elementary school-aged children (3). Meanwhile, findings published in Autism showed that mindfulness training in ASD adolescents was linked to an overall self-reported improved quality of life (4).

Other research studies focused on the utilization of mindfulness in school children are presently occurring. For example, the largest public school district in Colorado has enabled Denver public school students to have access to Muse—a neurofeedback technological device that trains students to practice mindfulness through a period of meditation (5). An article in 2016 in The Atlantic also described a federally-funded Erikson Institute study of a mindfulness program in Chicago public school students (6).

Three Outcomes of School-Based Mindfulness and Meditation

The following are three classroom-based outcomes of mindfulness programs presented in a research article published in 2012 (7):

  • Improved classroom behavior and social competence;
  • Increased student attentiveness to learning;
  • Reduced classroom aggression and bullying

 There are also mindfulness-based training programs for teachers described in this article as follows:

  • Mindfulness-Based Wellness Education (MBWE) – created at the Ontario Institute for Studies in Education (University of Toronto).
  • Cultivating Awareness and Resilience in Education (CARE) – offered in Denver, San Francisco, Philadelphia, and the Garrison Institute in New York.
  • Stress Management and Relaxation Techniques in Education (SMART) – offered in Vancouver, Canada.

How Meditation Aids Kids with ADHD

Holding the attention of students with ADHD is problematic for teachers in large public school classrooms. Not only does the inattentiveness of ADHD-afflicted children reduce their ability to learn, but these kids can distract other students through their excessive fidgeting and typical outbursts (e.g., throwing objects). Fortunately, the Wall Street Journal reported that the use of mindfulness practices and meditation continues to gain traction in public schools (8).

mindfulness meditation in classrooms
mindfulness meditation in classrooms

Since the transfer of students into special needs classes has been shown to lower self-esteem in students with ADHD, teacher employment of mindfulness techniques may particularly aid ADHD-afflicted children to better engage in the learning process.

School-age children have embraced learning new technological devices. Therefore, combining technology with a mindfulness program may increase their interest in daily meditation. The Assistive Technology Coordinator for the Denver Public School System noted that the data collected by Muse device technology will be analyzed to evaluate outcomes of the schools’ mindfulness program (9). This data-collection capacity will improve teachers’ ability to ascertain whether their mindfulness programs are effective within different types of classroom settings.

References:

  1. Centers for Disease Control. Autism Spectrum Disorder (ASD) – Data and Statistics. Webpage: https://www.cdc.gov/ncbddd/autism/data.html
  2. Centers for Disease Control. Autism Spectrum Disorder (ASD) – Data and Statistics. Webpage: https://www.cdc.gov/ncbddd/autism/data.html
  3. Child Mind Institute. The power of mindfulness: How a meditation practice can help kids become less anxious, more focused. Webpage: https://childmind.org/article/the-power-of-mindfulness/
  4. de Bruin EI, et al. (2015). MYmind: Mindfulness training for youngsters with autism spectrum disorders and their parents. Autism 19(8). Website: http://journals.sagepub.com/doi/abs/10.1177/1362361314553279?url_ver=Z39.88-2003&rfr_id=ori%3Arid%3Acrossref.org&rfr_dat=cr_pub%3Dpubmed&
  5. ChooseMuse.com. Denver Public Schools Incorporates Muse Into Curriculum. Webpage: http://www.choosemuse.com/blog/denver-public-schools-incorporates-muse-into-curriculum/
  6. Deruy, Emily. (May 20, 2016). Does Mindfulness Actually Work in Schools? The Atlantic Webpage: https://www.theatlantic.com/education/archive/2016/05/testing-mindfulness-in-the-early-years/483749/
  7. Meiklejohn J, et al. (2012). Integrating mindfulness training into K-12 education: Fostering the resilience of teachers and students. Mindfulness Webpage: http://www.mindful-well-being.com/wp-content/uploads/2014/07/Meiklejohn-et-al-2012.pdf
  8. Holland, Emily. (February 16, 2015). Can ‘mindfulness’ help students do better in school? Wall Street Journal Webpage: https://www.wsj.com/articles/can-mindfulness-help-students-do-better-in-school-1424145647
  9. ChooseMuse.com. Denver Public Schools Incorporates Muse Into Curriculum. Webpage: http://www.choosemuse.com/blog/denver-public-schools-incorporates-muse-into-curriculum/

6 Ways Meditation Can Change the Brain

Meditation is an ancient practice that is finally making waves in scientific research. For the past decade or so, scientists have been using modern technology to observe the reported benefits of meditation as they appear in the brain. Many are skeptical that meditation can have so many benefits, but indeed it does.

In 2011, a team at Harvard found that mindfulness meditation can actually change the structure of the brain. Eight weeks of Mindfulness-Based Stress Reduction (MBSR) was found to increase cortical thickness in the hippocampus, which governs learning and memory, and in certain areas of the brain that play roles in emotion regulation and self-referential processing.

Even just a few minutes of meditation a day can make rush hour traffic more bearable, work stress more tolerable, and sustained focus more achievable. Here are six proven ways that meditation changes the brain for the better:

1. Boosts Your Immune System

A mindfulness meditation practice has been shown to boost the immune system in two ways. First, the body has an increased antibody response when exposed to viruses, such as influenza.1 Second, the brain has a reduced stress-induced immune response that would otherwise lead to inflammation and a compromised immune system.2 An improved immune system means improved health, thanks to meditation.

Meditation and Gray Matter
Meditation and Gray Matter

2. Combats Depression

In an 8-week Mindfulness Based Stress Reduction course, participants were treated for depression and anxiety. The goal was to modify unhealthy cognitive practices that lead to rumination and dysfunctional beliefs. At the end of the study, the participants that had received the course showed significant reduction in their depressive symptoms than those who had not.3

3. Increases Gray Matter

Meditators have significantly larger volumes of gray matter in the regions of the brain most associated with positive emotions.4 So, not only can meditation increase your brain size but it can also improve your ability to remain positive in the process.

A large meta-analysis of 123 studies showed consistent positive differences in prefrontal cortex and body awareness regions. After reviewing all results, consistent and medium-sized brain structure differences were suggested.  In another study done in individuals suffering from Parkinson’s Disease, they found that an eight-week mindfulness-based intervention increased grey matter density in several areas of the brain compared to a control group receiving usual care. 

4. Increases Focus and Attention

While many people assume that a steady and dedicated meditation practice is required in order to receive its benefits, this simply isn’t true. According to one study, just four days of meditation practice can significantly improve your working memory, executive functioning, and visuospatial processing. 5

5. Slows Aging

Aging can be seen at the cellular level by the health and length of our telomeres, the protective caps on the ends of our DNA. Stress and time break down telomeres so that our DNA is less protected, allowing our cells to break down as well. This, essentially, is the process of ageing.

Meditation and Brain Health
Meditation and Brain Health

Meditation reduces the effects of stress on our telomeres so that they do not break down as quickly compared to those who do not practice meditation.6 Longer telomeres mean a slower ageing process, all thanks to meditation.

On top of stress reduction, given that the frontal lobe is one of the brain regions most disrupted by ageing, meditation’s ability to increase brain matter in this area highlights the potential for meditation as a tool to preserve cognitive health in older adults.

6. Reduces Anxiety and Mental Stress

An 8-week meditation course significantly reduced anxiety among participants both immediately at the end of the course and at a 3-month checkup, according to one study.7 The most impressive part of this study, though, was that after a 3-year follow up, the participants still demonstrated a significant reduction in anxiety compared to participants that had not received the meditation course.

So is meditation worth it? It depends on your end goal, though it seems like virtually anyone can benefit from any one of these effects. The biggest hurdle to meditation has very little to do with meditation, itself. Instead, many people are hesitant to give meditation a try because of the stigma that is attached to it. Previously assumed to be a spiritual practice, many people are afraid to incorporate meditation into their daily habits for fear of entering a sacrilegious practice. The truth, though, is that meditation is simply a practice of sustained attention. It can be religious if you’d like, though it’s mostly just an effective way to reshape your brain so that you can move through life more easily.

About Muse: the brain sensing headband: When accompanied with an app available for both iOS and Android the Muse headband is a sensory device that is designed to help with meditation more rewarding by providing real-time EEG based audio and visual feedback. Learn more at: http://www.choosemuse.com/


References

  1. Journal of Biobehavioral Medicine. URL Link.
  2. Psychoneuroendocrinology. URL Link.
  3. Cognitive Therapy and Research. URL Link.
  4. NeuroImage. URL Link.
  5. Consciousness and Cognition. URL Link.
  6. HHS Author Manuscripts. URL Link.
  7. General Hospital Psychiatry. URL Link.

How Meditation and Mindfulness Aid Drug and Alcohol Rehabilitation

How Meditation and Mindfulness Aid Drug/Alcohol Rehabilitation

Relapse is common in early recovery from drug or alcohol abuse. Many long-term alcoholics and drug addicts fail the first time they attempt to quit. This is because the intense cravings experienced by substance abusers are actually due to changes in brain chemistry. In turn, these changes promote feelings of anxiety and depression. The success rate following participation in recovery programs is only around 40-60 percent, according to the National Institute on Drug Abuse (NIDA) (1). Meditation and mindfulness can bolster the capacity to cope with the psychological effects of withdrawal, and thereby improve the likelihood of success!

The Quagmire of Opioid Use for Pain Relief

Progression to opioid addiction among people first prescribed these pills to relieve chronic pain is well known. Who wouldn’t want to stop a painful condition that prevents normal daily activities? Over 2.1 million Americans in 2012 developed an opioid addiction following the use of prescribed opioid pain relievers (2). For this reason, the Centers for Disease Control issued a guideline in 2016 to reduce the high level of opioid-prescribing among doctors throughout the United States (3).

Alcohol Abuse and Serotonin

Serotonin is a neurotransmitter in the brain that is activated in excessive alcohol intake, and it increases feelings of relaxation and well-being. In alcoholics who cease drinking, the chemically-heightened serotonin level suddenly drops (4). The result is that alcoholics in recovery often experience nightly insomnia and depression. Meanwhile, not getting a good night’s sleep has also been linked to depression. In contrast, meditation practices have been linked by numerous researchers to decreased insomnia, per the Harvard Health Letter in 2015 (5).

Drug Abuse and Dopamine

The neurotransmitter most affected by drug abuse is dopamine. Abusing drugs and alcohol in combination is typical in people with a longstanding addiction to heroin — which can make the withdrawal symptoms especially difficult to endure. This is one reason that relapse among heroin addicts is more common than among other substance abusers.

Drug Addiction Research and Meditation

Hundreds of  medical researchers have engaged in studies of addicts that have demonstrated

mindfulness meditation
mindfulness meditation

the benefits of mindfulness in treating drug-addicted patients, as compared to solely using other treatments. More recently, the results of a randomized trial of meditation was published in 2016 in an article titled Mindfulness Meditation Improves Emotional Regulation and Reduces Drug Abuse (6).

Meanwhile, Khanna and Greeson in 2013 presented the positive effects of an eight-week program termed Mindfulness-Based Relapse Prevention (MBRP), as conducted by different research teams in numerous clinical studies (7). Their systemic review article demonstrated the beneficial effects of mindfulness and meditation not only in alcoholics and drug addicts, but also in people addicted to cigarette-smoking!

Conclusions – Cognitive Behavior Therapy and Mindfulness

The primary therapy utilized to treat alcohol and drug addicts in inpatient and outpatient programs is Cognitive Behavior Therapy (CBT) (8). Unlike mental health counseling, the focus by practitioners of this form of therapy is on recognizing and changing addictive behaviors. Incorporating mindfulness—such as a sitting or walking meditation practice— can enable the person engaged in CBT to experience greater self-awareness and cope with the negative behavior patterns.

Barriers to developing a Mindfulness Meditation Practice

Mindfulness meditation is the practice of placing one’s attention on the breath. One cannot experience breathing in the future or the past, so in paying attention to the breath, they are anchored to the present. Eventually awareness of the breath can be extended into awareness of thoughts, feelings and actions. When one is able to “be with what is,” non-judgmentally, they are better able to make choices that enable positive change in their lives. Beginner meditators in the Western world often attempt to try meditation on their own. This can be tough to do, requires discipline and motivation, and the practice is difficult to sustain if one does not know what it is that they are supposed to be feeling or doing. In fact, studies have shown that individuals get the most benefit when they have a formal, ongoing mindfulness meditation practice. Formal practice options can include an 8-week, physician-supervised group mindfulness meditation programs that require a doctor’s referral and for which there are waiting lists. There are also non-clinical mindfulness meditation programs intended for individuals who are generally healthy, and who would like to learn to better manage their stress through meditation. Costs can vary widely but there are also free informal online programs of varying efficacy. A fairly new device being used in many countries is Muse: the brain sensing headband. Used with an app, Muse functions as an EEG device that provides real-time neurofeedback on one’s brain activity. In real-time, it lets the individual know when their brain is calm and focused so that they understand what it feels like and how to obtain the required state. It can be considered like a form of “training wheels” for meditation.

Muse: the brain sensing headband
Muse: the brain sensing headband

Feedback is provided in the form of “soundscapes” – auditory cues that mimic the sounds of virtual environments and consisting of sounds that can be found in the natural environment. The soundscape changes from stormy to calm as your brainwaves show signs of focus. Bird sounds might also be heard if you sustain a state of focused attention for an extended period of time. At the end of each session the meditator can review their progress and chart their history through data provided by the app which is available for both Android and iOS. Muse is extremely supportive in helping people to develop the habit of a mindfulness based focused attention meditation practice.

Muse is just one inspiring example of how the fields of neuroscience, technology and contemplative practice are, for the first time, working in tandem to help elevate techniques like meditation to aid in addiction rehabilitation.

For resources and research on the benefits of using Muse for meditation please visit: www.choosemuse.com

References:

  1. National Institute on Drug Abuse (NIDA). Drugs, Brains, and Behavior: The Science of Addiction. Webpage: https://www.drugabuse.gov/publications/drugs-brains-behavior-science-addiction/treatment-recovery
  2. National Institute on Drug Abuse (NIDA). (May 14, 2014). Testimony to Congress – America’s Addiction to Opioids: Heroin and Prescription Drug Abuse. Webpage: https://www.drugabuse.gov/about-nida/legislative-activities/testimony-to-congress/2016/americas-addiction-to-opioids-heroin-prescription-drug-abuse
  3. Centers for Disease Control. (March 16, 2016). CDC Guideline for Prescribing Opioids for Chronic Pain — United States, 2016. Morbidity and Mortality Weekly Report 65(1): 1-49. Webpage: https://www.cdc.gov/mmwr/volumes/65/rr/rr6501e1.htm
  4. Lovinger DM. (1997). Serotonin’s Role in Alcohol’s Effects on the Brain. Alcohol Health and Research World 21(2): 114. Webpage: https://pubs.niaaa.nih.gov/publications/arh21-2/114.pdf
  5. Corliss, Julie. (February 18, 2015). Mindfulness Meditation Helps Fight Insomnia, Improves Sleep. Harvard Health Letter Webpage: http://www.health.harvard.edu/blog/mindfulness-meditation-helps-fight-insomnia-improves-sleep-201502187726
  6. Tang Yi-Yuan, et al. (2016). Mindfulness meditation improves emotion regulation and reduces drug abuse. Drug and Alcohol Dependence 163(Suppl 1): S13-S18. Webpage: http://www.drugandalcoholdependence.com/article/S0376-8716(16)00117-4/abstract
  7. Khanna S, Greeson JM. (2013). A Narrative Review of Yoga and Mindfulness as Complementary Therapies for Addiction. Complementary Therapies in Medicine 21(3):244-252. Webpage: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3646290/
  1. National Institute on Drug Abuse (NIDA). Principles of Drug Addiction Treatment: A Research-Based Guide (Third Edition) – Cognitive-Behavioral Therapy (Alcohol, Marijuana, Cocaine, Methamphetamine, Nicotine). Webpage: https://www.drugabuse.gov/publications/principles-drug-addiction-treatment-research-based-guide-third-edition/evidence-based-approaches-to-drug-addiction-treatment/behavioral

Dementia and Mindfulness Meditation

Preventing Dementia – The Mindfulness Connection

Other forms of dementia exist besides Alzheimer’s disease, but this form is the most common.  It is also a disorder that strikes fear in most individuals entering middle-age. The National Institute on Aging reports that one in seven adults over the age of 70 in the U.S. has been diagnosed with dementia (1). Since there is no cure, preventing dementia is a public health focus. Mindfulness and meditation are effective as prevention tools according to recent Alzheimer’s disease research findings.

Symptoms of Early Dementia – Why Recognition is Important

Forgetfulness is not necessarily a symptom of dementia, but it is usually a feature. Lack of sleep and prolonged stress can also foster forgetfulness.

Can meditation help with the symptoms of dementia?
Can meditation help with the symptoms of dementia?

However, progressive short-term memory loss is the hallmark symptom of Alzheimer’s disease. In a person over 40 years old who formerly had a good memory, increasing forgetfulness may be a sign that some type of brain dysfunction is occurring. There are only five medications that are currently approved to treat Alzheimer’s disease, and all must be started at onset of this condition to be effective. The first pharmaceutical was not approved until 1993, and no effective drug treatment exists for any later phase (2).

Mindfulness and Cognition – The Relationship

Research studies have shown strong evidence that mindfulness practices, such as meditation, increase short-term memory and the ability to maintain attention. Indeed, a study that compared findings from a structured exercise program to a meditation program—in terms of the participants’ short-term memory abilities—found that meditation produced better results (3)!

An article in 2015 that reviewed studies focused on effective cognitive enhancers (CEs) included meditation (4). Specifically, it described a link between meditation and the following four cognitive processes: attention, memory, executive functioning, and processing speed. Study findings published in 2017 focused on “grey matter” degeneration; the article’s authors concluded that meditation increases “grey matter” volume and reduces its atrophy (5).

Researchers have also compared various mindfulness practices in terms of results in dementia patients, and—while beneficial overall—found no specific differences in results between the studied practices (6). These practices were as follows:

  • Zen meditation – originated in China (and spread to Japan);
  • Transcendental meditation – originated in India;
  • Vihangam yoga – originated in India;
  • Kirtan Kirya (Sa Ta Na Ma meditation) – originated in India

Difference Between Lewy Body Dementia (LBD) and Alzheimer’s Disease

An abnormal build-up of proteins in the brain—termed Lewy bodies—is found in people with the second-most common form of dementia. In contrast to PET scan images in persons afflicted with Lewy Body Dementia (LBD), the scans in Alzheimer’s disease patients typically show plaques composed of beta-amyloid protein. The cognitive feature most associated with LBD is an inability to control expressions of mood—especially anger and sadness. Unlike Alzheimer’s disease, there are no pharmaceutical treatments for LBD. However, mindfulness practices can be calming, and reduce feelings of both anger and sadness.

Tau Proteins vs. Beta-Amyloid Proteins – Which are More Important?

Tau deposits in the temporal lobe of the brain were more linked to deficits in memory than beta-amyloid protein deposits, according to an article in Science in 2016. Meanwhile, this article also notes that 30 percent of people without any symptoms of dementia have beta-amyloid plaques—which may mean that tau deposits are the more critical in the development of memory problems. This same article describes the findings of a study that suggests that tau deposits—as viewed by PET scan—are actually more predictive of who will develop Alzheimer’s disease than the beta-amyloid protein deposits in the brain.

References:

  1. National Institutes of Health, National Institute on Aging. (2007). Newsroom – One in seven Americans age 71 and older has some type of dementia, NIH-funded study estimates. Webpage: https://www.nia.nih.gov/newsroom/2007/10/one-seven-americans-age-71-and-older-has-some-type-dementia-nih-funded-study
  2. Alzheimer’s Association. Science and Progress – Major Milestones in Alzheimer’s and Brain Research. Webpage: http://www.alz.org/research/science/major_milestones_in_alzheimers.asp
  3. Zeidan F, Johnson SK, Diamond BJ, et al. (2010). Mindfulness meditation improves cognition: Evidence of brief mental training. Consciousness and Cognition 19(2): 597-605. Webpage: https://www.ncbi.nlm.nih.gov/pubmed/20363650
  4. Sachdeva A, Kumar K, and Anand KS. (2015). Non Pharmacological Cognitive Enhancers – Current Perspectives. Journal of Clinical and Diagnostic Research 9(7):VE01-VE06. Webpage: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4573018/
  5. Last N, Tufts E, and Auger LE. (2017). The Effects of Meditation on Grey Matter Atrophy and Neurodegeneration: A Systematic Review. Journal of Alzheimer’s Disease 56(1): 275-286. Webpage: http://content.iospress.com/articles/journal-of-alzheimers-disease/jad160899
  6. Marciniak R, Sheardova K, Čermáková P, et al. (2014). Effect of Meditation on Cognitive Functions in Context of Aging and Neurodegenerative Diseases. Frontiers in Behavioral Neuroscience. 8: 17. Webpage: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3903052/
  7. Underwood, Emily. (May 11, 2016). Tau protein—not amyloid—may be key driver of Alzheimer’s symptoms. Science Webpage: http://www.sciencemag.org/news/2016/05/tau-protein-not-amyloid-may-be-key-driver-alzheimer-s-symptoms