Susan Samueli Integrative Health Institute Announces Pilot Program Awards for 2022

Eight early-stage research projects that seek to expand the boundaries of integrative healthcare have been awarded UCI Susan Samueli Integrative Health Institute Pilot Program grants for 2022.

Projects were selected based on their potential to transform medicine by generating new insights into the mechanistic basis of integrative therapies or producing evidence of their clinical outcomes. Each study demonstrated a clear evolution towards novel, relevant, and untested research areas. Recipients receive a one-year award of $25,000.

The institute partners with the UCI Institute for Clinical and Translational Science on the award, participating in a national Clinical Translational Science Awards External Reviewer Exchange Consortium (CEREC), to provide a fair scientific review process and better match applicants with feedback from experts in their respective fields. Pilot awards are funded by the UCI Susan and Henry Samueli Endowment to encourage early exploration of research ideas to address growing health challenges while adding to the evidence base for integrative health practices.

This class of recipients represent every school in the Susan & Henry Samueli College of Health Sciences as well the UCI Schools of the Arts, Biological Sciences, Education and Humanities. Congratulations to the following teams and individuals.

Amal Alachkar, D. Pharm, PhD (PI)

Neural Mechanisms of Protective Effects of Acetyl-carnitine Supplementation on Trauma-induced Depression 

Our research focuses on how and when biological mechanisms lead to trauma transmission from parents or even grandparents to children, and how we can mitigate its deleterious impacts on the mental health of children. In our most recent study, we identified 2-hydroxyglutaric acid (2-HG) as a novel biomarker for early-life prediction of those at risk of developing depression in adulthood. We also found that early pharmacological interventions with acetyl-L-carnitine produced long-lasting protection against intergenerational trauma-induced depression.

Given the unique features of acetyl-L-carnitine, this natural supplement can represent an innovative and unique protective strategy, should it be administered early in life. The study is relevant at this moment in human history, as many pregnant women are exposed to stressful environments such as the COVID-19 pandemic. It is also timely, given the rise of the antiracism movement, as it tackles the biological mechanisms of collective transgenerational trauma of slavery, racism, and oppression. We believe that the results of this research could have transformative impact on the lives of millions of people globally who suffer from depression or have the risk of developing this devastating disorder, particularly those in which the depression arose from intergenerational trauma.

From left: Zhi-Ling Guo, MD, PhD (PI), Stephanie C. Tjen-A-Looi, PhD (Co-I), Liang-Wu Fu, MD, PhD (Co-I)

Central Neural Mechanisms of Cardiovascular Regulation by Acupuncture

Acupuncture has been used for centuries for many different indications, including lowering high blood pressure; however, the precise mechanisms underlying its effects have not been well elucidated. The major goal of our project, which addresses fundamental science research in body approaches, is to determine how the specific region in the central nervous system and modulatory endogenous neural substances respond in a coordinated manner to neurostimulation by electroacupuncture (EA) in the setting of elevated sympathetic drive associated with hypertension.

The endocannabinoid system has emerged as an alternative therapeutic target to manage pain and neurological disorders; however, its involvement in the EA’s action in regulating neural control of cardiovascular responses remains unclear. The effects of both EA and the endocannabinoid system are known to involve the modulation of neural activity in the brain. It is possible that endocannabinoids generated during EA may inhibit increased nerve activity in hypertension, leading to a decrease in blood pressure.

We propose to examine how EA stimulation can activate the specific brain area and how this region responds to EA stimulation with the release of endocannabinoids, substances involved in balancing processes in the body, including communication between the neural and the cardiovascular system. Our proposed studies are expected to unravel brain substrates responsible for EA’s long-term inhibitory effects on augmented neural activity that sustains hypertension. We will gain further understanding of how acupuncture could offer a way to control elevated blood pressure in the over 29 million people in the U.S. whose blood pressure is not controlled by current means.

From left: Susanne M. Jaeggi, PhD (PI), Mariya (Masha) Vodyanyk (Co-I)

Feasibility and Preliminary Effects of a Novel, Integrative Art-Based Intervention to Promote Visuospatial Reasoning and Well-Being in Older Adults 

Regular aging and the onset of more serious cognitive impairment are both associated with declines in the visuospatial domain. This can manifest in various ways, for example navigational issues, fear of driving, or misplacing frequently used objects. Additionally, more serious declines in the visuospatial domain are one of the earliest signs of Alzheimer’s disease and related dementias. Luckily, visuospatial reasoning is also a domain that is highly malleable to training and experience.

Extensive work with younger adults shows significant improvements in the visuospatial domain following targeted interventions. Additionally, brain plasticity persists into older age, and positive changes have been observed after visuospatial interventions for older adults. Especially for older adults, it has been suggested that implementing integrative activity-based approaches that involve learning a new skill can show greater effects than more focused computerized interventions.

Representational drawing is an example of a visuospatially demanding skill that can be used to improve the lives of older adults. The skill of representational drawing has been associated with mental representation and transformation, visual memory and attention, and other cognitive processes. Additionally, drawing is known to have mindfulness-related therapeutic effects and to enhance general wellbeing. It can also promote physical activity and social engagement.

In the current proposal, we plan to develop and implement a drawing-based intervention for older adults and test its efficacy on visuospatial reasoning and other cognitive domains, as well as general wellbeing. We will use these results to further our understanding of potential cognitive and neurobiological mechanisms that may play a role in promoting healthy aging through art-based interventions.

Michael Leon, PhD (PI)

Environmental Enrichment as a Treatment for Depression

Meta-analyses of clinical trials have shown that depression treatment outcomes can be poor and accompanied by significant side effects. At the same time, the prevalence of depression is increasing on college campuses. A 2020 survey of graduate students at nine public research universities found that 32 percent of respondents screened positive for major depressive disorder. This was two times higher than the prior year, according to the Student Experience in the Research University consortium conducting the research.

We propose to use our version of environmental enrichment paradigm that has been successfully used in multiple animal models of depression and has also been effective in other clinical trials, albeit with great difficulty maintaining compliance. We previously demonstrated that our approach assures ongoing compliance over the months that is needed for efficacy and is effective in improving cognition (Leon, et al., in preparation). We now propose to determine its efficacy for depression in college students.  

From left: Jaclyn Leong, DO (PI), Hayleigh Ast, ND (Co-I), Ryan McNally, ND (Co-I), Jacob Hwang, ND (Co-I)

Low-Dose CoQ10 in Management of Long-Term COVID-19 Neurological Sequelae

Patients with post-COVID-19 long-term symptoms are presenting to the Susan Samueli Integrative Health Institute. Common symptoms of presenting patients include fatigue, brain fog (known as cognitive fatigue), inattentiveness, and poor memory. While scientists do not know the exact route in which the virus infects the brain, brain models and studies completed on the deceased confirm that SAR-CoV2 does negatively impact the brain.

Our study will address one of the three proposed mechanisms–hematogenous, neural, or inflammatory, in which COVID-19 is causing prolonged neurological symptoms by providing an antioxidant intervention. The supplement coenzyme Q-10 (CoQ10) can act as an antioxidant to reduce cellular damage and elevated inflammatory response in the brain proposed to be caused by COVID-19 infection. In addition, it can improve the overall function of impaired cells by supporting their membrane and preventing further destruction. This supplement has been studied in animal and clinical research of neurological conditions, demonstrating improvement in overall neurological function due to reduction in harmful oxidants and improvement in cellular function.

We propose that CoQ10 will work similarly in patients suffering from post-COVID infection with neurological symptoms to improve or restore cognitive function. This pilot study will be a preliminary investigation of antioxidant therapy for neurological symptoms associated with long-term COVID-19. It will lay the scaffolding for future clinical trials to incorporate brain imaging, inflammatory blood markers, and wearable sensors to monitor overall health.

From left: Karen L. Lindsay, PhD (PI), Yuqing Guo, PhD (Co-I), Donna Baick, MD (Co-I)

Integrative Health and Wellness Program for Pregnant Women with Overweight and Obesity: A Feasibility Study

Poor nutrition and heightened maternal stress are two commonly occurring factors during pregnancy that have the potential to negatively influence fetal development, pregnancy complications, and downstream health and wellbeing of the child. Many behavioral studies with pregnant women aim to either reduce stress or improve dietary intakes and nutritional status, considering these factors as isolated components. There is, however, a growing body of evidence to indicate that maternal nutrition and stress interact with and influence one another. To effectively improve pregnancy outcomes, an integrative health approach that considers these mind-body interactions may be required.

Mindfulness practices have been shown to improve psychological wellbeing of pregnant women; however, the potential for mindfulness to augment the effectiveness of nutrition interventions in pregnancy has yet to be determined. To address this gap, we propose a pilot study of 16 non-diabetic pregnant women with overweight and obesity. Participants will be assigned to receive either a nutrition intervention alone—consisting of four pre-recorded culinary nutrition classes and four individual dietitian consults—or the nutrition intervention, plus mindfulness coaching—daily guided mindfulness practice supported by the Headspace app and coaching on mindful eating—from approximately 12-34 weeks of their pregnancies.

Our aims are to: 1) determine the acceptability of and compliance to each intervention component; 2) compare changes in subjective measures of maternal diet quality, eating behavior, stress, pregnancy-related anxiety, and state mindfulness from early to late pregnancy between groups; and 3) compare changes between groups in objective stress measured using heart rate variability (HRV). We hypothesize that both the nutrition and mindfulness components will be acceptable as measured by retention and compliance rates and feedback surveys, but that the combined nutrition and mindfulness group will show greater improvement in nutrition and psychological measures, as well as a smaller decrease in HRV across pregnancy.

Andrew O. Odegaard, PhD (PI)

A Randomized Pilot Study Investigating the Role in a “Natural” Low-Calorie Sweetener (Allulose) on Glycemic and Metabolic Measures

The average adult in the U.S. consumes over 1/3 cup of sugar each day, or nearly 300 calories worth, with the primary sources being from beverages, desserts and sweet snacks, candy, additions to coffee and teas, and foods such as breakfast cereals. This is far beyond what is considered a risky health behavior, as high added sugar intake relates to higher risk of gaining weight, blood sugar disorders such as type 2 diabetes, plus heart disease and various cancers. Thus, high added sugar intake is well accepted by physicians and public health experts to be problematic, and something in need of reducing.

We propose to test how commercial foods sweetened with allulose—a new, FDA-approved low-calorie rare sugar that is derived from dried fruits, brown sugar, and maple syrup and excluded from total and added sugars counts when used as an ingredient—may impact added sugar intake and usual blood sugar levels. We are proposing to do this by a randomized trial in which we will recruit participants with abnormal blood sugars (prediabetes or diabetes) and ask them in random order to include foods in their usual dietary intake that are sweetened by regular sugars (regular sugar), foods that are sweetened by the low-calorie rare sugar allulose (low added sugar), or low added sugar intake by higher intake of fruits, vegetables, and nuts in place of usual sweetened foods. We will measure their usual blood sugar levels for each of these three different two-week periods with a blood glucose monitor, along with what they eat each of those periods, their blood pressure, and how the different dietary approaches impact how they feel. Overall, this pilot study will be an important first step towards testing an approach to lowering added sugar intake, and if this improves blood sugar measures.

From left: S. Ama Wray, PhD (Co-PI), Dawn Bounds, PhD (Co-PI)

STREAM: Students who are Resilient, Empowered, self-Aware and Moving

Students who are Resilient, Empowered, self-Aware, and Moving (STREAM) aims to promote wellbeing, empowerment and flourishing among students of racially/ethnically minoritized (Black, Indigenous, and/or Hispanic/Latinx) backgrounds in the UCI Susan & Henry Samueli College of Health Science (COHS) and in science, technology, engineering and math (STEM) who are preparing for careers in healthcare. These minoritized students may disproportionately experience higher levels of stress due to the impact of COVID-19 and high levels of burnout already experienced by healthcare providers.

The STREAM project will explore the use of Embodiology®, a mindful movement practice grounded in African knowledge systems, to increase racially/ethnically minoritized students’ resilience and sense of well-being. Promotion of flourishing via self-regulation using movement-based modalities is central to integrative health practices such as yoga, tai chi, and qigong; however, traditional African practices that promote resilience and salutogenesis have been less studied. As an emerging wellbeing praxis grounded in African knowledge systems, Embodiology has the potential to improve health and wellbeing while recognizing Africa’s contributions to individual and community wellness.

Students will learn to use breath, sensation, rhythm and movement to manage stress through self-regulation while enrolled in the 10-week STREAM virtual stress management course. Feasibility, acceptability and cultural relevance of STREAM will be assessed, as well as effects on students’ perceived symptoms of stress, depression, anxiety, post-traumatic stress, well-being, and stress management via self-regulation.