Keeping Your Brain Sharp isn’t About Working More Puzzles

Laura Williamson wrote . . . . . . . . .

Mental decline is one of the most feared aspects of growing older. People will do just about anything to prevent it, from swallowing supplements touted as memory boosters to spending hours solving Sudoku and crossword puzzles.

But do these things really keep the aging brain sharp? The short answer is, not really.

“It can certainly help you concentrate if you spend an hour or two doing puzzles,” said Dr. Vladimir Hachinski, a Canadian neurologist and global expert in the field of brain health. “It’s good because you’re exercising your brain. But don’t expect too much from it.”

One in 8 Americans age 60 or older report having at least some memory loss and roughly 35% of them report problems with brain function, according to the Centers for Disease Control and Prevention. While this doesn’t always lead to full-blown dementia, the number of older people in the United States struggling with cognitive issues is growing: The CDC predicts the number of people in the U.S. with dementia – including its most common form, Alzheimer’s disease – will nearly triple to roughly 14 million people by 2060.

Research suggests there are indeed ways to prevent or delay many types of cognitive loss, but they don’t involve fish oil supplements or brain teasers. Instead, Hachinski and others in the field agree, people who want to preserve good brain function should take the same steps they would to protect their hearts.

“If you have a good heart, you have a good brain,” said Dr. Rong Zhang, professor of neurology at UT Southwestern Medical Center in Dallas. “Whatever risk factors that are bad for your heart, such as high blood pressure, smoking, obesity or a lack of physical activity, these things are also bad for your brain.”

The link between heart health and brain health is well established.

The American Heart Association and an expert-led Lancet Commission advise people to focus on their risk factors for heart disease and stroke. These include lowering blood pressure, blood sugar and cholesterol levels; getting enough sleep; not smoking; limiting alcohol intake; eating a healthy diet; exercising at least 150 minutes per week; maintaining a healthy weight; and staying socially active. The Lancet Commission recently expanded its list of dementia risk factors to also include head injuries in mid-life and exposure to air pollution.

Researchers believe at least 40% of dementias can be prevented or delayed by modifying these risk factors. Hachinski said the percentage could well be higher if more strokes were prevented. He was the lead author of a 2019 paper published by the World Stroke Organization calling for the joint prevention of stroke and dementia.

Stroke doubles the chance of developing dementia and high blood pressure is a powerful predictor of stroke, Hachinski said, adding that an estimated 90% of strokes are preventable.

“All major dementias have a vascular (blood vessel) component,” he said, because the brain needs good blood flow to provide it with sufficient nutrients and oxygen to work properly. “If you control the vascular component, you can diminish or prevent dementia.”

While major strokes cause an obvious and sudden decline in cognitive function, it’s more common for people to have smaller, silent strokes they don’t even realize are happening, Hachinski said. These “mini-strokes” have been shown to accelerate mental decline, as does uncontrolled blood pressure at any age.

Type 2 diabetes, which often can be prevented or delayed by losing weight and increasing physical activity, also increases the risk of dementia by 60%.

“By and large, the onset of dementia is gradual,” Hachinski said, likening the process to “descending into an abyss. It can happen in different ways, at different rates and to different depths.”

The best way to slow that decline, he said, is to identify your personal risk factors and then tackle the biggest ones. Do you need to lose weight? Exercise more? Eat a healthier diet? Lower your blood sugar?

“Know your family history. Have some idea of what you’re facing,” he said. “Get your blood pressure taken. Risk factors love company. If you have high blood pressure, you undoubtedly have other things going on.”

During the day, the brain uses a lot of energy, in the process discarding excess proteins that build up like junk in a teenager’s room. “The brain needs a way to get rid of these bad proteins,” Zhang said, “to clear away the waste. When there is a lot of garbage in the environment, it hurts the brain.”

Exercise helps with this clearance, and so does sleep, he said.

Building good brain health habits should start long before cognition starts to decline, experts advise.

“In middle age, the risk begins to climb rather rapidly,” Hachinski said. “It’s never too late, but the earlier, the better. I think the most important thing is to begin.”

Source: American Heart Association

The Best Foods for Brain Health

Michael Merschel wrote . . . . . . . . .

It’s easy to see the connection between an unhealthy diet and an expanding waistline. The connection between food and brain health can be harder to get your mind around.

But experts agree. Eating right is essential for brain health.

“Of all the organs in our body, the brain is the one most easily damaged by a poor diet,” said Dr. Lisa Mosconi, director of the Women’s Brain Initiative and an associate professor of neuroscience in neurology and radiology at Weill Cornell Medicine and NewYork-Presbyterian Hospital. “From its very architecture to its ability to perform, every aspect of the brain calls for proper food.”

Mosconi, who has written books about the science of food and the brain, said many people have misconceptions about what “proper food” might be. One of the biggest fallacies she’s been hearing lately is the idea that a very high-fat diet is somehow helpful to the brain.

“This is not what most research shows,” she said.

Dietary supplements are another area where people get misled, said Dr. Kristine Yaffe, professor of psychiatry, neurology and epidemiology at the University of California-San Francisco. Except when someone is deficient in a specific nutrient, vitamin supplements don’t seem to improve brain health, she said.

Similarly, supplements that contain omega-3 fatty acids and fish oil have gotten a lot of attention. But while they might help certain heart patients when prescribed by a physician, research has not confirmed benefits for brain health. “There have been a number of trials, and they haven’t borne out,” said Yaffe, who was a co-author on a 2017 American Heart Association advisory on brain health.

So, what does work?

“We still have a lot to learn about that,” Yaffe said. But certain foods do seem to help when they’re part of an entire dietary pattern. And that diet looks similar to the ones physicians recommend for heart health.

A Mediterranean-style diet – heavy in fruits, vegetables, fish and nuts – lowers stroke risk in women and may lead to better cognitive ability in old age, studies have found. A 2018 study Mosconi led estimated it provided 1.5 to 3.5 years of protection against the development of biomarkers for Alzheimer’s disease. Another science-backed eating plan that limits red meat, sodium and added sugars and sweets, called DASH (Dietary Approaches to Stop Hypertension), may reduce stroke risk.

Mosconi highlighted some nutrients – antioxidants, such as vitamin C, vitamin E and beta-carotene, and anti-inflammatory B vitamins and omega-3 fatty acids – that she said are important for the health of neurons.

But neither Yaffe nor Mosconi is a fan of singling out something as the perfect brain food.

“I don’t believe in ‘superfoods,’ or that any one food or food group is key to brain health,” Mosconi said.

And not that there’s anything wrong with blueberries, Yaffe said, but “you wouldn’t want to be thinking, ‘If I only eat blueberries, that’s going to do it.'”

It’s also important to think of foods that are potentially harmful to brain health, Mosconi said. Saturated fat, especially from animal sources, is associated with a higher risk of cardiovascular disease, she said. And some research also shows it increases the risk of cognitive problems.

“When we eat a fatty, sugary meal and experience symptoms like sluggishness, brain fog and drowsiness – these symptoms originate not in the stomach but in the brain,” Mosconi said.

And the effects aren’t necessarily temporary.

Research indicates a poor diet may cause the loss of key structural and functional elements in the brain, she said, along with “a higher vulnerability to brain aging and dementia.”

A 2018 report from the Global Council on Brain Health, an independent group convened by the AARP, noted that foods and diets that are good for heart health are also good for brain health.

Yaffe, a member of that brain health council, said the mechanisms of the brain are complex, but it stands to reason that “if you’re eating a dietary pattern that is heart-healthy, it’s probably also healthy (for) the vessels in the brain.”

She acknowledged that some people have a hard time seeing the connections between brain health and their diet – or with other activities such as smoking, sleep and exercise.

Mosconi, also a member of the AARP brain health council, put it this way: “Day after day, the foods we eat are broken down into nutrients, taken up into the bloodstream, and carried up into the brain. Once there, they replenish depleted storage, activate cellular reactions and, finally, become the very fabric of our brains.

“Consider that the next time you reach for a brownie. Its ingredients will actually become part of your brain.”

Source: HealthDay

Study: Cocoa Might Give Your Brain a Boost

Alan Mozes wrote . . . . . . . . .

Could the main ingredient found in chocolate super-charge your brain, help young, healthy adults think better, faster and more efficiently? Just maybe, according to a small new study out of Britain.

The finding is based on work with 18 healthy men, aged 18 to 45. All underwent brain scans and mental acuity tests after consuming a cocoa drink packed with high levels of flavanols. They are naturally found in significant amounts in cocoa, grapes, apples, teas and berries, among other items.

“We have known for many years that flavanols from cocoa, in particular, can improve vascular function in humans,” said study author Catarina Rendeiro. She’s a lecturer in nutritional sciences with the school of sport, exercise and rehabilitation sciences at the University of Birmingham, in the United Kingdom. “These benefits are apparent even after only one single dose of cocoa. However, the extent to which some of these benefits could translate into the brain vasculature were less clear. That’s where this study comes in.”

The goal: “To investigate whether one single dose of cocoa flavanols could improve brain oxygenation levels,” Rendeiro explained.

None of the participants had any known heart, brain or respiratory issues. And each was tested twice, once after blindly drinking a high-flavanol cocoa mix and once after ingesting a low-flavanol version.

Two hours after each drink, participants were subjected to a standard “vascular challenge,” meaning they breathed in 5% carbon dioxide, roughly 100 times the normal concentration. Doing so can trigger dizziness, disorientation, exhaustion and an inability to focus. The typical response is for the body to jack up blood flow to the brain, to supply it with more oxygen and force out the excess carbon dioxide.

Brain-scanning technology was first deployed to assess the degree of this response after each drink, with a specific focus on activity in the frontal cortex, which is key to planning, regulating behavior and decision-making.

The researchers found that after drinking the flavanol-rich concoction, 14 of 18 men saw their oxygenation response rise more than three times higher than it had following a low-flavanol drink. The flavanol-heavy drink also triggered a one-minute faster response.

In addition, after drinking flavanol-enriched cocoa, the men were able to respond about 11% more quickly when asked to problem-solve, but only when the tests were at their most challenging. No difference in response was seen when posed with simple tasks.

“This suggests that the beneficial effects of flavanols may only emerge when the cognitive challenge is sufficiently high,” Rendeiro said.

Rendeiro also observed that those men who didn’t show any improvement in brain performance were also the ones who had the best blood oxygenation responses to begin with. “So it seems that these individuals won’t benefit further from intake of flavanols because they are performing already at their maximum,” she said.

“It is currently unclear why these subjects had higher responses, but it might be related to higher levels of fitness,” Rendeiro said. “But we did not measure this in the study.” Still, the findings suggest that “even in a healthy brain there is clearly still room for improvement, and diets rich in flavanols might do just that,” she suggested.

But does that mean chocolate lovers should start reaching for a Snickers? Maybe not.

“Unfortunately, it is difficult to know what the content of flavanols is in chocolate products as these are not disclaimed in labels,” Rendeiro explained. “Generally, scientific articles that have measured content of flavanols in commercially available chocolates do not seem to find any relationships between content of cocoa solids and levels of flavanols. This is mainly because the processing of cocoa to make chocolate can substantially damage flavanols. So having more cocoa solids does not equate necessarily to more flavanol content.”

Still, “consuming a variety of foods rich in flavanols — such as grapes, green tea, apples and berries — can provide levels of flavanols that are beneficial for brain and vascular function,” she said.

Meanwhile, Judy Pa, an associate professor of neurology at the University of Southern California, Los Angeles, said the findings “aligned with what we would expect.”

Pa said, “More research is needed. However, I think most of us would agree that a balanced diet with a healthy dose of fruits and vegetables is beneficial for numerous reasons, and perhaps those foods high in flavanols may provide some additional benefit.”

As to flavanol’s potential as a way to address dementia risk, a similar take was offered by Claire Sexton, director of scientific programs and outreach for the Alzheimer’s Association.

“It would be wonderful if a particular food or supplement could delay or prevent Alzheimer’s disease,” said Sexton, “but we do not have scientific evidence that these claims are true. We need randomized, controlled clinical trials to evaluate whether any of these foods or supplements has a scientifically proven beneficial effect.”

At this point, she said, “people should not put too much stock in specific nutrients — including subsets of flavanols — for reducing dementia risk until more research is done. Rather, they should focus on eating an overall healthy diet.”

Rendeiro and her colleagues published their findings recently in the journal Scientific Reports.

Source: HealthDay

Brain Healthy Holiday Foods

Jessica Ivey wrote . . . . . . . . .

Festive, tasty dishes that may support cognitive health offer a reason to celebrate.

The holidays are fast approaching. And while many people across the country won’t be able to travel and attend gatherings with loved ones like they used to due to COVID-19, many still will want to celebrate the holidays and enjoy festive meals with their immediate family and other members of their household.

For those concerned with cognitive health and reducing risk of Alzheimer’s disease (AD) and other dementias, diverse options abound for healthful holiday appetizers, sides, main dishes, and desserts. RDs can help clients incorporate a variety of potentially neuroprotective ingredients while pleasing everyone’s palate during this joyful time of year.

Alzheimer’s Defined

AD and other dementias affect millions of Americans. There are more than 5 million Americans living with AD and over 16 million Americans providing unpaid care for them. One out of 3 seniors will die with AD or another dementia. It isn’t surprising that many clients are seeking guidance from dietitians regarding nutrition interventions for the holidays and beyond to help prevent or delay the onset of this widespread disease.

Dementia is a broad term for symptoms associated with a decline in memory, reasoning, and other cognitive skills beyond what’s considered a normal part of aging. There are numerous types of dementias and causes, but the No. 1 cause of dementia is AD. AD is a complex neurodegenerative disease that leads to dementia symptoms that get progressively worse. Typically, the first symptom is difficulty recalling new information, followed by disorientation, confusion, and eventually trouble speaking, swallowing, and walking.

The greatest risk factor for AD and dementia is age, and most individuals with the disease are older than 65. Other risk factors include family history, genetics, previous head injury, and preceding chronic health conditions, including heart disease, diabetes, stroke, high blood pressure, and high cholesterol.

The pathology of AD is multifactorial, but the key characteristics are amyloid plaques and neurofibrillary tangles and inflammation in the brain, leading to nerve cell death and eventual cognitive impairment. To date, lifestyle interventions, including nutrition, exercise, and cognitive training seem to be more promising than pharmaceuticals in terms of prevention and treatment, suggesting that dietitians have an important role to play in the battle against this debilitating disease.

Neuroprotective Diets

Current research shows dietary patterns are more important factors than individual nutrients or specific foods in preventing or slowing the progression of AD. Whole foods containing nutrients with brain health benefits, such as nuts, winter greens, and fish, consumed together as part of an overall diet convey a synergistic effect. Dietary patterns rich in unsaturated fats, polyphenols, and vitamins have been shown to be protective against AD; specifically, the Mediterranean diet, the DASH (Dietary Approaches to Stop Hypertension) diet, and the MIND (Mediterranean-DASH Diet Intervention for Neurodegenerative Delay) diet all have been found to reduce the rate of AD.

The culturally based Mediterranean diet consists of foods traditionally eaten in countries surrounding the Mediterranean Sea, and includes vegetables, fruits, whole grains, fish, olive oil, and moderate consumption of red wine. Many health benefits have been attributed to the Mediterranean diet, such as a reduced rate of overall mortality, CVD, some cancers, Parkinson’s disease, and AD, and protection against cognitive decline.

The DASH diet also has shown promise in improving neurocognitive function.8 The diet focuses on fruits, vegetables, whole grains, low-fat dairy, and lean protein, and is low in salt.

The MIND diet is patterned after the Mediterranean and DASH diets but with a special focus on foods that have been shown to benefit cognitive health, such as green leafy vegetables, which have been associated with the greatest protection against cognitive decline. While all three diets are rich in vegetables and fruits, the MIND diet doesn’t emphasize overall fruit consumption but does include at least two servings per week of berries, which have been specifically identified as protective against cognitive loss.

Unlike the Mediterranean and DASH diets, the MIND diet doesn’t specify high dairy consumption (two to three servings per day in the DASH diet) or high potato consumption (about two servings per day in the Mediterranean diet), and is lower in fish, recommending at least one serving per week vs six or more servings per week in the Mediterranean diet. A recent study found that strong adherence to the MIND, Mediterranean, or DASH diet may reduce AD risk, while even a moderate adherence to the MIND diet also may lower risk.

While a growing body of research shows that individual components of a dietary pattern may have interactive, synergistic, and even cumulative effects on AD risk, some foods are common in each of these three diets.

Fish and Seafood

Lean white fish is low in fat, while oily fish, such as salmon and albacore tuna, are rich in omega-3 fatty acids. One large prospective study found that weekly consumption of fish and dietary omega-3 fatty acid intake were associated with a decreased risk of developing AD, and a recent systematic review found that higher fish intake could be correlated with a reduced risk of dementia of Alzheimer type.

According to the 2015–2020 Dietary Guidelines for Americans, seafood intake is below the recommended amounts for all age-sex groups. To address barriers, dietitians can provide education regarding how to prepare fish and seafood before, during, and after the holidays (see “Meeting Weekly Seafood Recommendations” in the October issue of Today’s Dietitian), as well as budget-friendly tips, such as purchasing frozen and low-sodium canned options.

Green Leafy Vegetables

A large prospective cohort study found that high vegetable consumption was associated with a slower rate of cognitive decline in older adults and that green leafy vegetables had the greatest benefit.14 As with seafood, intake of dark green leafy vegetables is below the recommended amounts for all age-sex groups. Dietitians can host virtual cooking classes or demonstrations focusing on how to prepare and cook different types of greens or how to make green salads to promote the consumption of this category of vegetables.


Greater intake of flavonoids from berries has been associated with a slower rate of cognitive decline in women. Clients can purchase berries fresh or frozen for the holidays and easily incorporate them into the diet as part of a snack or breakfast, in a salad or side dish, or in place of a dessert.

Olive Oil

Olive oil is rich in omega-3 fatty acids and polyphenols. Research shows olive oil polyphenols can interfere with the formation of amyloid plaques and neurofibrillary tangles in the brain, and a Mediterranean diet intervention enhanced with olive oil can promote better cognitive performance. Olive oil is versatile and can be used for sautéing, roasting, grilling, preparing salad dressings, and baking during the holidays.

Source: Today’s Dietitian

Study: High Levels Air Pollution Associated with Women’s Brain Shrinkage Patterns Common in Alzheimer’s

Older women who live in locations with higher levels of air pollution may have more brain shrinkage, the kind seen in Alzheimer’s disease, than women who live in locations with lower levels, according to a new study published in the online issue of Neurology®, the medical journal of the American Academy of Neurology. The study looked at fine particle pollution and found that breathing in high levels of this kind of air pollution was linked to shrinkage in the areas of the brain vulnerable to Alzheimer’s disease.

Fine particle pollution consists of microscopic particles of chemicals, smoke, dust and other pollutants suspended in the air. They are no larger than 2.5 micrometers, 30 times smaller than the width of a human hair.

“Smaller brain volume is a known risk factor for dementia and Alzheimer’s disease, but whether air pollution alters brain structure is still being researched,” said study author Diana Younan, Ph.D., of the University of Southern California in Los Angeles. “Our study found that women in their 70s and 80s who were exposed to the higher levels of air pollution had an increased risk of brain changes linked to Alzheimer’s disease over five years. Our research suggests these toxins may disrupt brain structure or connections in the brain’s nerve cell network, contributing to the progression toward the disease.”

The study involved 712 women with an average age of 78 who did not have dementia at the start of the study. Participants provided health histories as well as information on race/ethnicity, education, employment, alcohol use, smoking and physical activity. All women received MRI brain scans at the start of the study and five years later.

Researchers used the residential addresses of each participant to determine their average exposures to air pollution in the three years before the first MRI scan. They then divided participants into four equal groups. The lowest group was exposed to an average of 7 to 10 micrograms of fine particle pollution per cubic meter of air (µg/m3). The highest group was exposed to an average of 13 to 19 µg/m3. The U.S. Environmental Pollution Agency (EPA) considers average yearly exposures up to 12 µg/m3 to be safe.

Researchers used a machine learning tool to measure signs of Alzheimer’s disease in the brain, a tool that had been trained to identify patterns of brain shrinkage specific to an increased risk of Alzheimer’s disease by reading the brain scans of people with the disease.

Participants’ MRI brain scans at the start of the study and five years later were assigned scores based on how similar they were to Alzheimer’s disease patterns identified by the machine learning tool, specifically brain changes in regions found to be vulnerable to Alzheimer’s disease. Scores ranged from zero to one, with higher scores showing more brain changes. Overall, the women’s scores changed from 0.28 at the start of the study to 0.44 five years later.

For each 3 µg/m3 increase in air pollution exposure levels, researchers found a broader range of scores between the two scans and an average increase of 0.03, showing a greater extent of brain shrinkage over five years, which was equivalent to a 24% increased risk of Alzheimer’s disease. The increases remained the same even after adjusting for age, education, employment, cardiovascular disease, high blood pressure, physical activity and other factors that could affect brain shrinkage.

“Our findings have important public health implications, because not only did we find brain shrinkage in women exposed to higher levels of air pollution, we also found it in women exposed to air pollution levels lower than those the EPA considers safe,” said Younan. “While more research is needed, federal efforts to tighten air pollution exposure standards in the future may help reduce the risk of Alzheimer’s disease in our older populations.”

Limitations of the study include that it only looked at the brains of older women, so results may not be the same for men or younger women. It also examined only regional fine particle pollution, not other sources of pollution such as traffic emissions. Researchers were also not able to estimate participants’ exposure to fine particle pollution in middle-age and young adulthood due to nationwide data not being available for those years.

Source: American Academy of Neurology