4 New Ways You Should Be Thinking About Diet and Brain Health

It is hard to escape the barrage of messages about how the things we eat and drink impact our brain’s health. The popularity of the topic doesn’t help. The media seems bent on sharing every nugget of news, no matter the size of a study or the credibility of a source. How can we really know what matters, let alone what we can do to help those who look to us for guidance?

While as an expert I always keep a tab on cutting-edge research, I also know those findings do not always hold. I’ve seen many supplements (who remembers phosphatidylserine?) and diet fads come and go. Instead, I watch for the ideas that intuitively make sense, have staying power, and are confirmed over time by additional, larger studies. It also helps to see how such findings integrate with other areas of brain health science, such as physical activity or even social engagement. 

What’s important to know right now about brain health and nutrition? Here are 4 topics to think about right now, both for your community and for yourself. 

Your gut health impacts your risk for Alzheimer’s disease. An abundance of well-designed studies now demonstrates the significant role gut health plays in our risk for dementia. Researchers have long known that the belly and brain are closely linked along the gut-brain axis. Aging and disease can lead to a reduction of the healthy multitude of microbes in our gut and increased gastrointestinal permeability, which in turn contribute to neuroinflammation and neurodegeneration. Findings even suggest these gastrointestinal changes may be a cause of increased beta-amyloid, a recognized pathology linked to Alzheimer’s disease. Interventions such as gut protective supplements to support the brain-blood barrier as well as including foods high in probiotics, such as yogurt or kimchi, to our meals can bolster the aging gut and potentially reduce our risk for cognitive decline. Expect to see much more from this exciting area of research in the years to come.

Whoa on the wine. Many of us enjoy a good glass of wine with dinner or a bit of bubbly with friends, no matter our age. The perpetual myth that older adults don’t drink as much doesn’t hold out, especially as baby boomers age. In fact, the National Council on Aging reports that nearly half of adults over 65 report drinking alcohol over 2019. So why is wine – actually, all alcohol – on this list? As we age, our liver and kidneys become less efficient at metabolizing alcohol. Alcohol lingers for longer, impacting not only those organs but others, including our brains. This can lead to short-term difficulties with cognitive skills such as focus, processing speed, and memory. Heavy alcohol use can lead to cognitive loss, including Korsakoff syndrome, an alcohol-related memory disorder. And despite what the media says, red wine is not your best source of bioflavonoids. What’s the answer? Set some limits. The issue isn’t consuming alcoholic products, but how much we consume on a regular basis. As we age we should adjust how much alcohol we drink, and be wary of interaction with medications or underlying conditions. Check out the growing industry of high-quality natural wines that contain lower alcohol and sugar, or non-alcoholic brands that offer that drink in hand without the fuss.

Avoid toxins. A few years ago, a study came out showing a whopping 85% of us have detectable levels of DDT in our bodies. In speaking with my mother, she recalled playing in the spray of the pesticide trucks in her suburban neighborhood as a child. Is it any wonder that the pesticide, while banned in the U.S. almost 50 years ago, is still present in our food and environment? What you may not realize is that there is a growing body of literature linking environmental factors such as pesticides, air pollution, and heavy metals with Alzheimer’s disease and other dementias. While we cannot avoid environmental toxins totally, we can take steps to educate ourselves and others and to minimize exposure. Experts recommend simple steps such as avoiding foods produced overseas in countries where DDT is still used or buying organic products. Washing or cooking your produce is also helpful. Consider installing better air filtration systems or avoiding outdoor activities at times when air pollution is high.

Dehydration kills. The science behind hydration is quite established and straightforward. Yet it seems every heatwave a significant number of older adults die from dehydration. Why does this keep happening? Perhaps because older adults and those who care for them don’t know that as we age our ability to sense thirst can be diminished. Simply put, it isn’t that there is a lack of something to drink but rather a lack of recognition that we may need to drink. Educating adults who are at increased risk or the need to stay hydrated even if they don’t feel thirsty, as well as training those who care for them to the science behind dehydration and aging can make a big difference and save lives.

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To 100 and Beyond! 3 Key Lessons We Can Learn From “Cognitive Super-Agers”

When my grandmother turned 100, I had the chance to ask how she’d stayed so sharp, independent, and vibrant into her later years. Without missing a beat, she told me she thought it was always having a daily exercise routine, keeping your mind active, and not allowing emotional things to “fester.

It turns out my grandmother was spot on (she usually was!). Research has long demonstrated how central good health habits are to continued vitality. Now a study out of the Netherlands underscores exactly how critical staying active is to a life that is not only long but cognitively strong. Using data from the Amsterdam 100+ Study of centenarians, researchers followed 330 cognitively healthy 100+-year-old subjects for up to 4 years. Participants averaged 1.6 years of follow-up (not surprisingly given their age) with annual assessments including extensive cognitive testing. Results showed that the participants had relatively stable cognitive health over the 4-year study, with no meaningful change in their performance across multiple domains, and only a small decline in memory. In addition, while some subjects showed neuropathological changes typically associated with Alzheimer’s dementia at autopsy, they did not drive any cognitive worsening during the subjects’ lifetimes. Given that the expected incidence risk of developing dementia at this age hovers around 60% this study suggests these “cognitive super-agers” may have some resilience to dementia. 

What can “cognitive super-agers” teach us? And what can we learn to help us deliver healthy living experiences to ensure everyone has their best shot at staying cognitively vital and independent to 100 and beyond? Here are 3 lessons we can take away:

Lesson 1. Get physical. Not surprisingly, researchers found that good physical health was a significant buffer against cognitive decline. Being physically well and having healthy or corrected hearing and vision were all significantly linked to continued cognitive well-being in this group. This is of course consistent with what we have known for a while – good health habits such as regular physical activity, eating a brain-healthy diet and proactive medical care are essential ingredients for staying sharp.

Lesson 2. Get thinking. The study showed that “cognitive super-agers” had higher levels of cognitive reserve as estimated by the frequency of their cognitive activity, educational background, and estimated premorbid IQ. This suggests that being intellectually engaged over our lifetimes, including current experiences, may provide resilience against dementia. This is consistent with the science to date on cognitive engagement and is a reminder of why meaningful intellectual and creative pursuits matter regardless of age.

Lesson 3. Stay independent. Interestingly, the study found that living independently was associated with preserved cognitive ability. A whopping 56.7% of the centenarians in the study lived on their own, while the remainder lived in a “care home” (equivalent to assisted living or higher levels of care). This rather unique finding raises the question as to the benefits living independently may have to cognition. Perhaps managing on one’s own offers continuous opportunities to “work out” thinking skills such as attention, memory, and problem-solving. It is interesting to think about how we can foster more independence and personal agency for those in congregate housing, so they may also benefit from the cognitive stimulation taking care of oneself offers. 

Want to know more? Read the research article published this January here, or enjoy Jane Brody’s excellent New York Times article about the findings and its implications for understanding cognitive aging.

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October 2020 | MindBodyGreen  The study, published in the Journal of Clinical Endocrinology and Metabolism, found when people with type 2 diabetes improve their blood sugar levels, they also show improvements in cognitive functioning and memory. Click here to read the full article.

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September 2020 | Neurology Clinical Practice  Over-the-counter cognitive enhancement supplements may contain multiple unapproved drugs. The health effects of consuming untested combinations of unapproved drugs at unpredictable dosages without clinician oversight in supplements is unknown. Click here to read the full article. 

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October 2020 | Harvard Health  Can music really affect your well-being, learning, cognitive function, quality of life, and even happiness? A recent survey on music and brain health conducted by AARP revealed some interesting findings about the impact of music on cognitive and emotional well-being. Click here to read the full article. 

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Hot Off the Press! Blood Test for Alzheimer’s Disease, Flu Vaccines Reduce Dementia Risk, and More: Research Highlights from the 2020 Alzheimer’s Association International Conference You Need to Know

Each July the Alzheimer’s Association International Conference offers a glimpse of the cutting-edge research on Alzheimer’s disease and related dementias. This year’s conference, held online, included many exciting advances in the science of dementia. Here are a few that you need to know about.

Coming Soon to Your Doctor’s Office? A Blood Test for Alzheimer’s Disease.  Several researchers reported significant progress towards an easily available diagnostic blood test for Alzheimer’s disease. Studies found that tests for abnormal versions of tau protein, specifically p-tau217, could potentially identify the disease with more specificity than current methods and in some cases even two decades before dementia symptoms occur. This finding is particularly exciting as early biomarkers have long been the “holy grail” of Alzheimer’s research. Currently diagnosis of dementia is made once clinical changes are evident and significant deterioration has already been established. Early biomarkers like a blood test would allow scientists to identify those with the disease or at risk before clinical changes have been established, making it easier to design effective interventions to delay or arrest the disease. A simple serum test would also be less costly and more accessible than current diagnostic tests. But don’t expect your doctor to have an Alzheimer’s test available anytime soon. While these findings are a huge step forward, research must continue with larger, confirmatory studies prior to available testing for the general public. Not surprisingly, the idea that a blood test for Alzheimer’s disease is within reach gained a lot of press. For a good overview of the research, see this article from the New York Times. 

Get That Vaccine! Flu and Pneumonia Vaccines Shown to Reduce Dementia Risk. Looking for something you can do right now to reduce your dementia risk? Get your vaccines! Research presented at the AAIC showed that getting even one flu vaccine could reduce your risk for Alzheimer’s disease by 17%, with more frequent flu vaccination adding another 13% reduction in risk. Other research found that the pneumonia vaccine offered even greater protection against Alzheimer’s dementia, reducing risk by up to 40% in those ages 65-75 years. As Maria Carillo, Chief Science Officer of the Alzheimer’s Association, shared “It may turn out to be as simple as if you’re taking care of your health in this way — getting vaccinated — you’re also taking care of yourself in other ways, and these things add up to lower risk of Alzheimer’s and other dementias.” Given that the seasonal flu and pneumonia already carry greater health risks as we age, these additional findings make getting your flu and pneumonia vaccines a “no brainer.” Here’s a great article covering the vaccine research from NPR. 

Even More Proof that It’s Never Too Early to Think About a Brain Healthy Lifestyle. AAIC presentations included several confirming that a brain healthy lifestyle from an early age essential to reducing dementia rates. Of particular note are studies showing cardiac risk factors such as obesity, high blood pressure and being overweight in teenagers and young adults are associated with a significant decrease in late-life cognition, particularly among African Americans. Other researchers reported a higher body mass index (BMI) in adolescence was associated with greater dementia risk in older adulthood, a risk that was even more significant for women. Finally, other research demonstrated that high-quality early education was associated with significantly improved cognition, memory and reduced dementia risk in later years. While these findings confirm earlier research, together they continue underscore the need for a strong public health approach to dementia prevention that stresses the importance of brain health at every age. Dr. Maria Carrillo, Chief Science Officer, Medical and Scientific Relations, at the Alzheimer’s Association, speak to CNN about this latest research here.

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Feb 2020 | Healthy Day. A breakthrough study has identified a class of natural gene variants that may protect against Alzheimer’s disease. Click here to read the article.

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June 2020 | NIH National Institute on Aging. Combining more healthy lifestyle behaviors was associated with substantially lower risk for Alzheimer’s disease in a study that included data from nearly 3,000 research participants. Click here to read the article.

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When it comes to health, perhaps nothing captivates our attention more than advice about what we should – and shouldn’t – eat. Diet is all at once personal and political. While we all know that indeed “we are what we eat,” our food choices in reality reflect everything from our cultural influences, economic opportunities, health values, and susceptibility to the latest food craze. And this is nothing new. My grandmother, for example, told me that when she was young olive oil was considered terribly unhealthy, with “schmaltz” or rendered chicken fat thought to be a much better choice. Imagine that!

Over my 20+ years dedicated to knowing what we can do to build better brain health, I have seen many brain food fads, including supplements, wax and wane in popularity. As a result, I tend to take a fairly conservative view regarding what we should and shouldn’t be eating for better brain health. While we know more than at any previous time about how diet may influence our cognitive well-being, there in fact is limited evidence for a specific brain-saving diet or magic pill. After all this time, I have concluded that the best thing we can do is consider trends in the nutrition science that support better cognitive and overall health outcomes, rather than chasing every new craze.

So, what do these trends show us really matters when it comes to a better brain health diet? Here are 3 “no-brainer” tips that everyone with a brain can follow to boost cognitive well-being for both sharper daily thinking and long-term cognitive vitality:

1. Start with the Basics! Most of us can brain-boost our diet simply by eating healthier. The truth is, despite an apparent obsession with this fad or that, the majority of Americans don’t follow even the most basic nutritional advice. And, for many, this may not be a matter of choice, but access. What are the basics? Eating a diet that dominated by produce, with lean sources of protein, whole-grain sources of carbohydrates, mono-unsaturated sources of fat (MUFAs) and sparing in sweets. A shift to this scientifically sound, accessible nutritional plan can really move the needle towards better cognitive and overall well-being for everyone. Need a great resource for what the basics are? Try the U.S. government program (supported by our tax dollars!) “Choose My Plate” (www.choosemyplate.gov).

2. Weight Matters. Another clear trend in the research on nutrition and cognitive well-being is one that can be, well, hard to swallow. And that is that our weight matters. Large epidemiological studies have shown for years now that increased weight, especially when carried around our middle, increases our risk for dementia. Most recently, a study in over 9,000 subjects published in Neurologyshowed that increased weight, especially when concentrated around the belly, was significantly linked to decreased brain volume. This strong trend in the research suggests that we should do what we can to maintain a healthy weight and avoid “belly fat,” including following a healthy diet and getting regular aerobic exercise.

3. Drink Up! Water, that is. Many of us do not hydrate sufficiently every day. And that can affect our overall well-being and brain health. Why? Our bodies consist of a significant amount of water – in fact, scientists estimate that our brains are made up of about 70% water. Recent reports suggest that many of us are chronically dehydrated, and that this impacts our daily performance and vitality. This is especially true as we grow older and can have a harder time sensing thirst. Recent studies suggest that we need more than the previously recommended 8 glasses of water per day and should in fact aim for at least 11-12 glasses of water per day. If that seems like a lot to “drink up,” try adding fresh fruit to your water, or add herbal tea or sparkling water to your daily dose.That’s it – Just start with the basics, keep an eye on the scale, and make sure to get that daily dose of water. You really don’t need to do anything more complicated that these 3 “no brainer” strategies for a brain healthy diet we can all follow!

That’s it – Just start with the basics, keep an eye on the scale, and make sure to get that daily dose of water. You really don’t need to do anything more complicated that these 3 “no brainer” strategies for a brain healthy diet we can all follow!

Here’s to many happy memories!

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WHAT. Researchers in Europe looked at the impact of attention and planning on selected portion size in adults who were overweight, obese and of normal weight. They found that all participants reduced their portion size when focused on the health effects of the food, which increased their overall self-control network, as evidenced on neuroimaging (fMRI). The study also found that overweight and obese weight subjects selected larger portions than those in the normal-weight group when focused on the pleasure effects of the meal.

WHY IT MATTERS. Published online in the International Journal of Obesity, this small study is an elegant examination of the impact cognition may have on portion selection and obesity risk.

It suggests that cognitive modification may be an important way to address the growing obesity epidemic, including perhaps consideration of serving sizes. It is an interesting study from a brain health perspective, both because of the known health impact of diet and weight on dementia risk as well as the use of cognitive interventions to modify eating behavior.

THE TAKEWAY. Want to eat healthier and manage your weight more effectively? Keep your mind set on the health impact of your food as you select your meal and portion size, rather than only on the pleasure it may bring. Your choices can still be delicious, just perhaps better for you and for your brain!

Veit R, Horstman LI, Hege MA et al. Health, pleasure, and fullness: changing mindset affects brain responses and portion size selection in adults with overweight and obesity. Int J Obes 2019 Jun 18. doi: 10.1038/s41366-019-0400-6.

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