Fit Brains - Guilt Free Fun!

We have known for some time that some persons do not manifest the clinical pathology of Alzheimer’s disease (AD) even though their brains have the hallmark plaques and tangles at autopsy. How this occurs is still not known, but one theory is that those persons who are able to fight the clinical aspects of the disease off may have more brain reserve, developed over the course of their lifetime. It is further thought that particular lifestyle factors such as exposure to enriched, novel and complex environments can help to build reserve.

A new study indicates that the size of the hippocampus, the structures that lie deep in the temporal lobe and help to form new memories and learning, may be important. Researchers at Oregon Health and Science University in Portland found that those persons who avoided dementia had larger hippocampi relative to those who did not avoid the manifestation of the disease. Both groups had the pathologic markers of AD.

Interestingly, the researchers did not find any difference in the two groups on education level or socioeconomic status. However, the study did not explore what the person did in their lifetime, the type of activities he or she pursued, or the quality of learning after graduation. While education level has correlated with reduction in the risk of dementia in other studies, the hippocampus may be stimulated by much more than formal education.

This is most likely the case given the research in 1998 that found the human hippocampus can generate new brain cells. Our goal should be to grow larger hippocampi through enriched environments across our lifetime as a health promoting behavior (see Dr. Nussbaum’s brain health lifestyle www.paulnussbaum.com). In this case, it is to potentially delay onset of dementia.

Two recent studies have further underscored my long held belief that many diseases, including those of the brain, actually begin early in life, perhaps even in childhood. The idea that a disease is proactive demands that we are adopt an equally proactive healthy lifestyle.

One study found that high cholesterol levels in the 40s may raise the chance of developing Alzheimer’s Disease (AD) decades later. The findings presented at the American Academy of Neurology in Chicago studied over 9,000 people in California and found that those with high cholesterol levels between the ages of 40 and 45 were about 50 percent more likely than those with low cholesterol to later develop AD.

Another study from Sweden found those with diabetes in midlife are 1.5 times more likely to develop AD later in life. This study followed over 2000 men for 32 years and while other risk factors for AD were found, the most significant was low insulin secretion in midlife.

These studies and others indicate the lifelong development of AD and that we really should not consider this disease a late life disorder. The studies also underscore our need to develop interventions much earlier in life and to adopt a brain healthy lifestyle regardless. Such a lifestyle should be a national priority and begin in early childhood if not earlier.

I was very proud of myself recently when I generated enough determination to quit my perceived addiction to caffeine in the form of coffee. While it is true that I only consumed one cup of coffee in the morning to get my jump on the day, it is also true that my brain demanded that one cup. I know this because when I stopped or missed my cup of coffee I felt a bit sluggish and then the headaches set in if I did not get the fix for several days. We refer to this as an addiction, though some do not like to hear that word to describe their (my) behavior.

After nearly one month of not consuming any coffee and getting through the withdrawal symptoms, I pick up a new research discovery in the Journal of Neuroinflammation (volume 6, 2008) that reports caffeine blocks disruption of blood brain barrier in a rabbit model of Alzheimer’s disease. It seems caffeine consumed in the equivalent of one cup of coffee daily protects against high cholesterol diet induced increases in disruptions of the blood brain barrier, and caffeine might be useful in the treatment of Alzheimer’s.
If high levels of serum cholesterol and disruption of the blood brain barrier are indeed underlying mechanisms in the pathogenesis of Alzheimer’s it suggests I need to reconsider starting my habit again!

The important message in the story is that we continue to monitor the new findings of lifestyle and brain health and change our behavior accordingly. This should not occur in an impulsive way. Rather, the negative effects need to be weighed against the positive effects of particular behaviors. For me, I think I will restart my consumption of coffee, but keep it to ½ cup a day. Moderation is typically a great idea. In the meantime, I will keep an eye out for replication of this finding on the relationship between caffeine and protection against Alzheimer’s.

What a great time to be alive if you are interested in your own brain and how to promote its health! With the daily reports of a new finding on how to promote brain health, the development of new companies with products for brain health, and with the boomers generating a booming interest in this part of their being, we really are in the “golden era of brain health.”

I am so very fortunate to have been involved with brain health more than a decade ago and to witness what I described then as the emerging “Brain Wave” that was coming. It is here and we will all be better for the fact that the human brain has found its way onto the radar screen of health.

A national and world wide discussion of the human brain with a focus on proactive lifestyle towards promotion of brain health is a great and needed thing. Dementia is a real problem and a growing concern. We have the ability to be proactive and to focus on an optimistic and positive path forward as we try to implement research-based behaviors to brain reserve. By building our own brain reserve across our lifespan we probably increase our chances of delaying the onset of neurodegenerative diseases such as Alzheimer’s.

The next step to this growing brain wave is for the governmental bodies to pass legislation that incorporates national emphasis on the brain similar to what we have done for the heart; for health care payers to include incentives for leading a brain health lifestyle that might recognize lifelong learning, use of pedometers, diet, and meditation as critical ingredients to brain health, and for continued innovation in the business world to apply research to the market.

What a great day to be interested in promoting your own brain health!

A study published in online Neurology 3-27-08 indicates belly fat is linked to increased risk of dementia. Rachel Whitmer, a researcher at Kaiser Permanente Division of Research noted that belly fat increases the risk of diabetes, heart disease, and stroke. However, her research on 6,583 men and women ages 40-45 living in northern

Indeed those who were obese (30 pounds or more over a healthy weight) and had collected belly fat in their 40s were 3.6 times more likely to develop dementia during the 30 to 40 year study. Even those who were not obese, yet had extra weight around the waist or belly, were 1.8 times more likely to develop dementia compared to those who were lean all over.Whitmer stated that “it is not simply about weight, but where you carry your weight.” She noted that people who are predisposed to carry their fat in their belly region may be at risk. Fat cells in the stomach secrete hormones that may play a role in diseases such as diabetes, heart disease, and now perhaps dementia.

The good news is that anyone with belly fat in their 40s can adopt a lifestyle of diet and exercise that can reduce such fat and reduce the risk of disease related to the fat. Time to get moving and eating healthier!

We have no cure or perfect prevention against progressive dementia such as Alzheimer’s disease (AD). However, research over the past decade or more has established consistent links between lifestyle and the ability to delay the onset of such dementias. I have proposed a “Brain Health Lifestyle” to include five major factors: (1) physical activity, (2) mental stimulation, (3) socialization, (4) nutrition, (5) and spirituality.

 A recent interview on ABC News suggested that physical exercise may be the best means of preventing AD today, better than medications, intellectual activity, and supplements. Studies on mice bred to develop plaques in their brains consistent with AD were exposed to an exercise regimen or not. Those mice that exercised had 50 to 80 percent less plaque than the brains of mice that were passive. Other studies have demonstrated generation of new brain cells in animals that exercise and a relationship in humans between physical exercise and increased cognitive performance.

One important point is that our body does not operate in a fragmented manner. I describe the brain and body as a miraculous symphony. One system directly impacts another and both health and disease effects can be experienced as a result throughout the body. Exercise is one example of a behavior that has positive impact on multiple systems of the body including the brain. The same can be said for the other four brain health lifestyle behaviors noted above.

 While I am not yet sure that any one behavior such as exercise is better than another in promoting brain health, I do champion regular exercise as a very important behavior with positive brain health effects. My view is to approach brain health from an integrated manner using the five part brain health lifestyle. This approach fits with the complex integrated reality of our bodies and brains.

 A recent report from the National Alzheimer’s Disease Association estimates nearly 10 million to 14 million of the baby boom generation (76 million strong) will be at risk for developing Alzheimer’s disease (AD). These numbers may actually underestimate the overall prevalence of boomers who will develop AD in their lifetime. This estimate places a heavy emotional, family and economic burden on the U.S. States given our current approach and over all understanding of the caregiver demands posed by AD. There is no reason to believe that similar nations across the world will be any different.

 One method to begin addressing the rising epidemic of dementia is to establish a national or world priority on the human brain and dementia. Citizens of the great planet Earth need to have a basic understanding of their brain, something that is completely missing even in 2008. We cannot expect citizens to care for their brain if they do not understand it or the importance of a proactive healthy lifestyle across their lifespan. One idea is to include basics of brain and brain health in every elementary curriculum in the world.
 National policy also has to prioritize research on treatment and prevention of dementia in ways we have not yet. Research is needed on how the brain functions, how diseases begin, new treatments for dementia, and innovation in the area of prevention. Health insurance companies should begin to incentivize lifestyles that promote brain health including lifelong learning, diets, meditation, and physical exercise. Those who continue to work or remain involved in society may be rewarded with some type of tax break. We need to think in terms of a Brain Enlightened Society.

Everyone experiences moments when we feel sluggish or perhaps hyperactive. Sometimes our brains feel like they are stuck in mud while other times we can solve almost any problem we confront. Interestingly, these cycles of mental energy or arousal may occur within a 24 hour time period, our circadian rhythm.

Some of us have our creative time or the time we perform best mentally in the morning hours. Others have their greatness expressed in the evening hours. There is no right versus wrong, simply different. Some people who work after midnight or in a mine shaft that has no natural light can experience a different circadian rhythm than those who work during the day and have exposure to natural sunlight. Sleep disorders, depression, and cognitive problems can result from altered sleep wake cycles.

There is no clear explanation for when arousal is highest in some and lowest for others. Some factors that can enhance or reduce mental energy or arousal include the following:

•  Amount of daily exercise
• Amount of sleep in 24 hours
• Types of foods consumed
• Water intake and hydration
• Exposure to sunlight
• Prescribed Medication and substance abuse
• Mental challenge during the day

One of the best methods to increase mental energy is to increase blood flow to the brain through movement. This can include a brisk walk, aerobics, swimming, and even a dance. Fresh air can also rejuvenate a sluggish brain and increase water intake to remain hydrated during the day. Sugar can put the brain to sleep in some cases or make it feel like a good nap is needed. Caffeine can provide a quick boost, but may result in a type of mental crash later in the day.

 It is a good idea to first identify what periods of the day your brain is alert and productive and when it is sluggish. Try to identify what factors might be causing the onset of sluggishness and consider the tips suggested above.

A mentally alert brain is critical to health and to productivity.

Stroke is a clinical term that describes cell death in the brain. Stroke is a permanent and can result in significant functional impairment and even death. There are two types of strokes. The first is the most common and is referred to as ischemia. Nearly 80% of all strokes are ischemic and involves a blockage of blood flow that results in cell death. The other 20% of strokes are hemorrhagic that involves a bleeding outward from a weakened artery wall. As the blood gathers increased pressure can be placed on the surrounding brain tissue causing additional damage to the brain.

Both types of stroke are dangerous and can result in deficits of language, attention, information processing speed, and motor skills. Risk factors for stroke include advanced age, high blood pressure, diabetes, obesity, smoking, and poor diet. Typical preventative measures for stroke include the same protocol as used for the healthy heart. We have learned relatively recently how important blood flow to the brain is, particularly when we recognize that the brain commands 25% of the blood from every heart beat.

The human brain left to its own would likely create in unthinkable ways. Creativity most likely occurs when structure is limited and free flow of cognition can take place. It is suggested that Einstein’s most creative moments occurred when he took his morning walk or bike ride.

 Recent research suggests creativity relates to advanced age. It is important to note that older brains tend to lose a disproportionate number of brain cells in the frontal lobe, the area of the brain that helps to impose structure in our lives and perhaps on our thinking. With less capacity to impose structure, creativity may be unleashed.

 Given this, it is interesting to consider how much brain expression our world suppresses. Our classrooms impose enormous structure as do our jobs. We are highly routinized animals and probably rely as much on our subcortical brain regions as we do our cortex. We tend to refrain from new experiences or pathways to a similar endpoint. We also do not free our brains from structure long enough to express creativity.

 It is important to provide your brain with some time to simply think or exist without any task to be completed. Such time may help the brain express itself in ways it otherwise cannot. One prescription is to give your self 30 minutes a day of quiet or idle time. Einstein used such time to take a walk or ride a bike. By releasing structural restraints on your brain, you may create an entire new reality and future for your self and for others.