Life Style Factors That Improve Brain Health

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In recent years there has been controversy over whether Alzheimer’s disease can be prevented, delayed, or even reversed.  At present mainstream medical scientists claim there is no conclusive evidence that Alzheimer’s disease can be prevented or cured.  However, scientists have identified risk factors contributing to Alzheimer’s disease.  Most often Alzheimer’s disease develops through the interaction of multiple risk factors, such as age, genetics, family history, lifestyle, and environmental factors.  While age, genetics, and family history cannot be changed, evidence is mounting that certain lifestyle and environmental changes can be made to reduce both the overall risk of acquiring Alzheimer’s disease and the risk of its progression.  Life style and environmental risk factors are many and they include environmental toxins, infections, chronic inflammation, insulin resistance, poor sleep, gum disease, nutrient deficiencies, cardio-vascular disease, hearing loss, and head trauma.  Most of these risk factors can be addressed to lower your risk of acquiring Alzheimer’s disease.  Here are some references used to write this article.  They can also be of use to you in learning more about brain health.

Understanding Alzheimer’s Disease

Alzheimer’s disease is a progressive brain disorder that causes the brain to shrink and brain cells to die. Understanding what causes Alzheimer’s disease starts with amyloid precursor protein (APP), which is attached to brain cells.  Depending on the brain’s state of health, APP responds in two different ways.

First, in a healthy brain, APP signals neurons and other cells to function properly to communicate with each other, to metabolize chemicals and nutrients, and to repair, rearrange, and regenerate cells as needed.  When brief episodes of insults to the brain occur – such as infections, inflammation, insulin imbalances, toxins, reduced blood flow and poor oxygenation of cells, or loss of hormones and growth factors –  APP signals a temporary protective response to overcome the insults.

However, a brain with Alzheimer’s disease has been subjected to some of these various insults over a long period of time.  As a result, APP shifts from signaling repair and regeneration of brain cells to signaling highly reactive immune responses leading to severe inflammation of the brain.  The connections between brain cells are destroyed and brain cells die.  Eventually this degenerative process leads to cognitive decline and death.

Specific causes of the degenerative process described above have been difficult to identify because there are many risk factors and the influence of any of these factors in causing Alzheimer’s disease can differ from person to person.

Two proteins that normally function well to maintain brain health have been found to function abnormally in the brain of someone with Alzheimer’s disease.  Normally, beta-amyloid protein is a sticky substance that as a line of defense binds to foreign microbes or toxins and then is removed from the brain.  Sometimes beta-amyloid molecules clump together to form plaques which build up in the brain and collect between neurons.

Another protein called tau functions within neurons to move nutrients and molecules from the neuron to axons and dendrites.  Under challenging conditions tau molecules bind together to form neurofibrillary tangles inside the neuron that block the transport and communication systems between neurons.

The beta-amyloid plaques and tau tangles do not directly cause Alzheimer’s disease.  According to Dr. Rudy Tanzi, a leading Alzheimer’s researcher, the plaques and tangles are likened to the match that over many years  leads to neuro-inflammation, which is the fire that causes Alzheimer’s disease.

Basic Steps to Brain Health

Everyone at any age can take preventive measures to reduce their risk of acquiring Alzheimer’s disease later in life and even halting or reversing its progression if caught early enough.  And these same life style practices can be adopted at any age to promote overall brain health.

The foundation of supporting brain health is adopting practices that promote metabolic health.  These practices are exercise, a plant-rich ketogenic diet and supplements, intermittent fasting, and optimal sleep.  Here is a description of these foundational steps along with three other basic steps everyone can take to keep their brain healthy.

  • Exercise.  Dale Bredesen, M.D., states in his book, The End of Alzheimer’s Program, The Protocol to Enhance Cognition and Reverse Decline at Any Age, that “Being active is the single most important strategy you can employ to prevent and remediate cognitive decline.”  A combination of aerobics and strength training is found to be most effective.  Exercise increases blood flow to the brain and throughout the body.  In addition, exercise improves cellular function in several ways.  The condition of the cardiovascular system is strongly associated with the health of the brain.  Set a goal of exercising at least three or four times per week for a total of at least 150 minutes per week.
  • Diet, Fasting, and Supplements.  A plant-rich ketogenic diet with intermittent fasting helps reduce the risk of  insulin resistance, diabetes, obesity, inflammation, ingesting toxins.  Here are some tips to move in a healthy direction.  Fast for at least 12 hours each day between your last meal of the day and your first meal on the next day.  When you are comfortable increasing the duration of your fast, go to 16 hours per day.  Eat at least 6 to 9 cups per day of leafy green vegetables and cruciferous vegetables (broccoli, cauliflower, cabbages, brussels sprouts).  In addition, eat healthy fats (avocados, nuts, extra virgin olive oil), herbs and spices –  preferably organic, non-starchy, season, locally grown.  Incorporate pre-biotic fibers (asparagus, artichokes, jicama, mushrooms, garlic, onions), probiotics (sauerkraut, kimchi, pickles) into your diet.  For fat and protein – wild caught, high in omega-3 fatty acid, low-mercury fish such as salmon, mackerel, sardines, herring), wild caught shellfish, crustaceans, mollusks;  eggs from pastured chickens;  grass fed meat and pastured poultry.  Limit fruits to wild berries such as blueberries, blackberries, raspberries, currants, strawberries.  Avoid or eliminate sugars, carbohydrates, processed foods, and vegetable oils.
  • Sleep. Adults should get 7 to 9 hours of sleep.  If you are 65 years old or older get 7 to 8 hours of sleep.  Too little sleep or disturbed sleep adversely affects our ability to focus, learn, form memories, and decision-making.   Healthy sleep also helps clean up waste products, damaged cells, micro-toxins.  Obstructive sleep apnea reduces oxygen saturation of the blood, whcih is a risk factor for Alzheimer’s disease.  If you snore, get tested for sleep apnea.  Here are some tips for better sleep.  Getting as much natural morning light as possible is very useful in stabilizing the sleep/wake cycle. If you nap during the day, limit it to 20 minutes and not within 6 hours of bedtime. Exercise, but not too close to bedtime because it may delay sleep onset.  Try not to eat within 3 hours of bedtime because this may disrupt your sleep and lead to weight gain.  Avoid excessive consumption of caffeine-rich drinks, especially in the afternoon, as this will keep you awake and delay sleep onset at night.  Avoid stressful situations during the day and try to release stress well before you go to bed.
  • Stress Reduction.  Chronic, unresolved, or severe stress can adversely affect our immune systems in a way that increases our risk of cognitive decline.  Short term stress in response to external threats can protect us by supplying energy to overcome the threat.  Problems arise when we can’t turn off the stress response and we perceive relatively harmless stress signals as serious threats.  These chronic exposures to stress signals can contribute to hypertension, heart disease, obesity, sleep disorders, diabetes, and dementia.  We are all exposed to stress but some of us may have been exposed to severe traumatic experiences at a young age or a recent traumatic experience such as physical or emotional assault; a car accident; or loss of a job, a loved one, or a relationship.  These early chronic, or severe assaults can change our brain and result in intense stress responses because we respond worst even when there is no threat.  Some ways to reduce stress include:  mindfulness (engaging all senses in present moment awareness), meditation, breathing exercises, cognitive reframing, exercise, a plant-based whole foods diet (i.e., leafy green vegetables, berries, fish, olive oil, nuts, poultry), and healthy sleep.
  • Brain Stimulation.  Experts used to say that once brain function declines it cannot come back.  Current research into neuroplasticity (the brain’s ability to grow and adapt)  shows that our brains can grow new neurons in response to mental and social stimulation as well as during the healing process.  By challenging our brains through learning, games, planning, executive decision-making, movement, and so on, we can protect, strengthen and even heal our brains after neurodegeneration.  The best thing you can do to stimulate your brain is to build a strong social network.  Join teams, clubs, groups, and classes.  Participate in community activities.  Do these things face-to-face, not through social media.  Connect with people you meet every day.  Talk with them, ask questions, share interests.  Next, find a purpose…  Keep learning…  Take a class, learn a foreign language, learn a musical instrument, do puzzles, listen to music, dance, get outside and play. There are many brain training resources out there.
  • Detoxification.  Exposure to toxins and infections increases the risk of Alzheimer’s disease.  Toxins that can lead to dementia are called dementogens and include (with examples) metals (e.g., mercury, lead, arsenic, cadmium), organic chemicals (e.g., glyphosates contained in RoundUp) , biotoxins (e.g., mycotoxins or mold), infections (e.g., gingivitis, herpes, Lyme disease).   Although preventing exposure to dementogens would be ideal, in today’s world most people have varying levels of these toxins in their bodies so detoxification and limiting further exposure is an important part of preventing or reversing Alzheimer’s disease.  Exposure to dementogens leads to chronic inflammation in the body and the brain which is a major risk factor for Alzheimer’s disease.  Some ways to improve brain health and fight the negative effects of dementogens are to maintain the health of your:  gut, oral and nasal microbiomes; immune system; and mitochondrial function.

Get Tested

The most important step to take in preventing Alzheimer’s disease and improving your overall brain health is to adopt the Basic Steps to Brain Health described above as early as possible in your adult years.  If you have not started yet, start now.  If you  want to improve your brain health, it would be important to promote the repair and regeneration of brain cells, and to reduce or eliminate those contributors to destruction of brain cells.

Since the causes of Alzheimer’s disease are multi-factorial and vary from person to person, it is important to know your specific contributors to cognitive decline.  Being forewarned is being forearmed. If you have any of the contributing factors, the earlier you start addressing them the better.  The major drivers of Alzheimer’s disease are – chronic inflammation deficiencies in nutrients, hormones, and cell growth factors; high blood sugar and insulin resistance; exposure to toxins; cardiovascular disease; head trauma.  If you have one or more of these drivers it is necessary that you identify them and take steps to correct or mitigate them.  If any of them are present to a significant degree, cognitive decline will likely persist until they are dealt with.

So where to begin with testing?  Find a physician who is willing to work with you to identify your risk factors and determine if and to what extent you are in cognitive decline.  What tests to perform will depend on your medical history, symptoms, conditions, and prior results.  It would be helpful to start with a cognitive test like the Montreal Cognitive Assessment (MoCA) to identify any level of cognitive impairment you may be experiencing.  Other testing that you and your physician might start with could focus on the major risk factors including but not limited to the following – chronic inflammation and immune system problems; insulin resistance, diabetes, and pre-diabetes; deficiencies in levels of nutrients, hormones, trophic factors; bacterial, virus, or parasites infections, such as herpes, Lyme disease, gingivitis; toxins such as mercury, mold-produced toxins, glyphosate; cardiovascular disease; hearing loss.

Make an Action Plan

Ultimately, achieving brain health and especially preventing Alzheimer’s disease is a highly complex problem.  There are no easy approaches or solutions.  However, the problem of preventing Alzheimer’s for a specific individual can be simplified.  Here are some suggested steps to follow in developing your own action plan.

  1. Do I have Alzheimer’s disease or its early stages?  Have a cognitive assessment done.
  2. Do I have any of the conditions that are major contributors to Alzheimer’s disease (e.g., chronic inflammation immune system conditions, insulin resistance, infections, toxins, nutrient deficiencies, cardiovascular disease, chronic stress, metabolic insufficiencies, hearing loss, etc.)?  Work with your physician to test for these conditions and have them treated.
  3. Based on my answers to the first two questions, develop detailed action plans to reduce or eliminate each underlying contributor.
  4. Develop an action plan for the basic steps to brain health (i.e., exercise, diet, fasting, optimal sleep, brain stimulation).
  5. Define and track metrics for progress on improving outcomes for each contributor and life style change.
  6. Monitor your results and adjust your plan accordingly to maintain desired outcomes.

No doubt, The material presented here seems overwhelming.  You may prefer to take one step at a time and work on, say, diet first, or exercise, and then move on to the next basic step to brain health.  An incremental approach like this may assure that each lifestyle change in behavior is well established.  An incremental approach would be preferred if you are not already in the early stages of cognitive decline. That is why it is important to get a reading on your current situation.  Are you now in a state of subjective cognitive impairment or mild cognitive impairment?  Do you have any of the major contributors to Alzheimer’s disease listed in step 2 above?  If so, a focused approach is necessary to prevent or forestall progression of the disease.  On the positive side, once these beneficial changes are established, life can become less complicated, easier, and more enjoyable.

Keep Learning

Each stage of life has its challenges.  As we grow older maintaining our health requires more attention and effort.  Maintaining a healthy brain is no exception.  In fact, brain health plays an increasingly important role in our overall health and quality of life as we age.  Fortunately, learning and staying mentally active help us maintain brain health as we age.  Although aging itself is a major risk factor for dementia, by learning we can not only discover ways to prevent dementia but learning itself helps keep our brains healthy and thus avoid dementia.  Marcus Aurelius, the ancient Roman emperor and stoic philosopher, wrote, “The mind adapts and converts to its own purposes the obstacle to our acting. The impediment to action advances action. What stands in the way becomes the way.” It is from his Meditations, Book 5.20.  If the risk of cognitive decline is a growing obstacle as we age, we can concentrate our mental efforts, our learning, on overcoming the obstacle of cognitive decline and help our brains stay healthy through the very act of learning.

So this is our challenge as a society and as aging individuals.  Until recently medical science has held that Alzheimer’s disease cannot be cured, that once changes in the brain leading to Alzheimer’s disease have started the progression of the disease cannot be reversed.  Now there is growing evidence that if lifestyle and environmental conditions can be optimized early enough in one’s life, Alzheimer’s disease can be prevented and even reversed in some cases.  While medical science advances toward a cure for Alzheimer’s disease by viewing the disease as a multi-factorial network failure rather than a disease with a single cause curable by a single pill, you as an individual can also conduct our own experiment of one to promote your own brain health.

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