Episode 23: Health on YOUR brain

• Brief Summary of objectives (3):
  • Define dementia
  • Identify the differences between modifiable and non-modifiable risk factors
  • Explain how diet and exercise affect your brain

Topic 1: Dementia: What is it and how can it be prevented 

Dementia is a common term that we use but it may not be a term your doctor uses. Dementia is a familiar word for changes in your cognitive health that have gotten to be noticeable by you, or those around you. People living with dementia have several problems with certain kinds of cognitive functions like planning, remembering, focusing, following directions, etc. The diseases that can cause symptoms of dementia include:​

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• Alzheimer’s disease​
• Lewy body disease​
• Vascular dementia, usually after stroke​
• Frontotemporal dementia​
• and Parkinson’s disease, among a few other less common diseases.​

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The important thing about dementia regardless of the disease that causes it is that these losses in cognitive ability interfere with your ability to live life the way you want to live. As you can see by looking at the image on your screen, dementias involve changes to the brain. Dementias are not a normal part of aging. They are diseases, just like heart disease, arthritis, and cancer. ​

• Point 2:

Dementia is the umbrella term used to describe several conditions that result in cognitive decline. Of all the diseases we just mentioned that cause symptoms of dementia, Alzheimer's disease is the most common. About 60-80% of all cases of dementia are caused by Alzheimer's disease. Dementia is not limited to one condition at a time. An individual can develop multiple forms of dementia simultaneously, like Alzheimer's disease and vascular dementia after a stroke. ​

Let's take a minute and focus more closely on Alzheimer's disease. ​

CARE Center: https://dar.uga.edu/funder/campaigns/support-the-college-of-public-healths-care-center/

• Point 3

Alzheimer’s Disease is a progressive neurodegenerative disease that usually starts with memory loss, and then progresses to loss of other cognitive functions, like your ability to pay attention and plan. When it comes to Alzheimer’s disease, there is a common misconception that it is just the thing that happens when we age but it’s not.  If you are living your life and start to notice changes in your cognitive function and recognize that are not normal, I urge you to talk with your doctor.

Topic 2: Differences between modifiable and non-modifiable risk factors

• Point 1: Now that you know what dementias are, you might wonder who is most likely to get them. Many of you may have a family member who has had dementia, and you might be a little worried about whether you are at risk. ​

As far as we know, anyone can get dementias. You can do all the right things and still get them. That said, we can change our behavior, and change our risk. So, let's talk more about risk. ​

There are two major types of risk factors for dementias: non-modifiable risk factors, or things you can't really change, and modifiable risk factors, or things you can change. 

There are multiple known modifiable risk factors including: Diet, Cognitive Novelty, Stress Management, Sleep Health, Exercise, Medication Management, Cardiovascular Health, Weight Management, and Smoking. Today we will discuss a few of these.

• Point 2: Healthy diet and your brain.

Diet is perhaps one of the most important behaviors for your overall health. As you probably already know, a healthy diet improves your overall cardiovascular health. But a healthy dietary pattern also contributes to your brain structure and function. ​

First, let’s debunk the idea that a diet means you are limiting your calories. Diet is about the pattern of your eating behaviors. That means, it is the total food, beverage, and nutrients AND your HABITs surrounding what you eat. Your diet is what you eat every day and it's based on your family, culture, lifestyle, and preferences. ​

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Nutrition is based on what foods do once they are in your body. All foods have nutrients- like vitamins and minerals. But some have more nutrients than others. We call foods with high nutrients nutrient-dense foods. Foods that have less nutrients but a lot of calories, like a donut, are calorie dense foods, meaning they have more calories than nutrients. ​
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So why is vegetable like kale or spinach so good for you? Because it has high levels of vitamins and minerals compared to calories. They are nutrient-dense. In other words, you get a lot of “bang for your buck” in terms of nutrition. And what do vitamins and minerals do? They support healthy organ function, like brain function. So, eating a diet high in nutrients means you are getting the vitamins and minerals you need. ​

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In order to get a balanced variety of nutrients, you need a balanced diet. Eating a well-balanced diet can be daunting but the reality is, you just need to eat whole foods, and the more colorful they are, the better. When I say whole foods, I mean fruits, veggies, beans, peas, and lentils; not chips, and ultra-processed foods like sugary cereals and ramen. ​

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Brains are especially expensive in terms of nutrition. They need a lot of it! Your brain requires about 20% of your calories. But if you want it to run well, like your car, you need to put good fuel in it.  And while some nutrition supplements can be beneficial such a vitamin D, your nutrition can’t only really be supplemented by a pill. Dietary supplements are not meant to provide you with the bulk of your nutrients. ​

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• Point 3: Follow the MIND Diet

There is strong supporting evidence that eating a dietary pattern is more powerful for brain health than single foods or nutrients. ​

The MIND Diet, or Mediterranean-Dash Intervention for Neurodegenerative Delay, is an example of an especially effective dietary pattern to reduce the risk for cognitive decline and other dementias. The MIND dietary pattern prioritizes unsaturated fats, lean meats, whole grains, and fruits and vegetables over saturated fats, processed foods, and red meat. ​

Studies show that those who eat the MIND dietary pattern were up an equivalent of 7.5 years younger compared to those who did not follow the pattern (Morris 2015).​

The recommendations of the MIND diet are to

• eat more: green leafy vegetables, berries, nuts, olive oil, whole grains, fish, beans, and poultry
• Eat less butter/margarine, cheese, red meat, fried food, pastries and sweets

At first glance, these recommendations seem harsh, cheese is in the red, but that doesn’t mean we can't eat cheese. It means we need to be aware of how much cheese we are consuming and balance the traditionally delicious items like cheese and butter with equally delicious but more nutrient dense items like lean poultry and whole grains. The “eat less” category can and should be incorporated into your diet in moderation. 

Figure out how you can make little shifts in your current diet to eat healthier, and you are more likely to maintain them over time so that you can be healthier and active for longer.​

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It’s hard to eat healthy diets all the time and ultimately, unrealistic to ask everyone to do so. While our goal is to strive to eat our best 100% of the time, the “85-15” rule breaks it down into a more realistic approach. ​

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It advises that 85 percent of our calories come from healthfully, nutrient-dense foods. The remaining 15 percent of calories can come from a combination of added sugars, oils, or alcohol. Again, strive to eat healthy 100% of the time and realistically, you will meet the “85-15” rule. This is where cheese and brownies come in, we know life is better with these items, but moderation is key. ​

Topic 3: Physical Activities and Exercise

• Point 1: Moving your body is good for stress reduction.

Do you ever take a walk, do some yoga, or practice stretching when you feel stressed? The desire to move when you are stressed is natural. When we get stressed, one of those big changes our body experiences is sometimes called the "fight or flight" response for a reason – we feel the need to move when we are stressed, so the beautiful thing about physical activity and exercise is that you can kill two birds with one stone. Regular physical activity is an important part of a healthy lifestyle. Not only is it good for your muscles and bones, but it can also keep your brain healthy and reduce stress. ​

• Point 2: Physical activity and exercise are not the same

Physical activity and exercise are not actually the same thing, although they are related. Physical activity is all the movement that you do throughout the day. Any time you move, you are burning energy, or calories. But not all physical activity is exercise. When we think of physical activity, we often think of exercise, but physical activity is much broader. ​

Exercise is a planned, focused, repetitive, and structured type of physical activity that helps improve physical fitness. Exercise, as you probably know, makes your heart stronger. But did you know that exercise changes the function and structure of your brain? In fact, cognitive decline is almost 2x more likely for inactive adults compared to active adults. That said, if you are not active now, it's never too late to start. Research shows that non-exercising adults who begin to exercise, whether in middle age or even older age, show benefits to brain and improved cognitive function. ​

Physical activity is good, no question. But exercise is the thing that really moves the needle on brain health. What physical activities are most likely to get us there? ​

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Physical activity recommendations are generally described in terms of intensity. ​

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Of course, ANY amount of physical activity can help, but the recommendation is to get at least 150 minutes of moderate intensity exercise, or 30-minutes a day 5 times a week to see benefits. Recent recommendations also say you can do this in short 5–10-minute bursts throughout the day. ​

Light-Intensity Activities include many of the things people do to maintain their daily lives. Things like walking, cooking, chores, and grocery shopping are considered light-intensity activities. ​

Moderate-intensity activities require vigorous movement and should increase your heart rate. These activities include a brisk walk, tennis, and yard work. ​

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Vigorious-intensity activities will increase your heart rate more than moderate-intensity activities. You may feel out of breath when participating in these activities. Vigorous intensity activities include jogging, lifting heavy objects, and other strenuous physical activities. ​

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• Point 3: Exercise is good for your brain

Exercise can improve your cognitive health—helping you to think, learn, problem-solve, and enjoy emotional balance. Older adults who do cardio activity have greater brain volume than those who only stretch. ​

Exercise has an immediate impact on your brain—it immediately increases the levels of neurotransmitters like dopamine and serotonin which increases your mood after a workout. Neurotransmitters are chemical messengers in your brain that carry messages from one cell to another. ​

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Regular exercise reduces your risk of cognitive decline, including dementia. ​

• One study found that cognitive decline is almost twice as common among adults who are inactive compared to those who are active.​
• Think about your brain as a muscle, exercise strengthens your prefrontal cortex and hippocampus, the two regions of our brain that are most susceptible to neurocognitive diseases and normal cognitive decline in aging. ​

• Recap:

• Define dementia!
• Identify the differences between modifiable and non-modifiable risk factors
• Explain how diet and exercise affect your brain.

• Call to action: Do something to promote good brain health today. Go for a walk. Do a crossword puzzle. Make a healthy swap. The changes you make today attribute to a lifestyle pattern of healthy choices.