How to start Now - AT ANY AGE - to Reverse and Prevent Insulin Resistance of the Brain, Sharpen Cognitive Function
Intro/9 if you could protect yourself from the illness you fear most, what would ti be?
Cancer? Heart disease? when I ask my patients this question, I almost always get the same answer: memory loss.
the brain is the very essence of your being. every day it fires up all your senses, bring you pleasure (and yes, pain), catalogues a lifetime of memories, solves an array of problems and connects you to the world around you. it makes you human. you can live with a mechanical joint, without kidneys on dialysis with a transplanted heart, liver or other organ, but nothing can substitute for a healthy brain. without memory, we require constant care from family, friends or total strangers and we become a burden on the people we love the most. like many other physicians, I put memory loss at the top of the list of conditions I wish we could permanently vanquish.
despite billions of dollars of research, we've had no significant cures for medical problems such as dementia and Alzheimer's disease (the most common form of memory loss). in the US we now have nearly 6 million people diagnosed with Alzhiemers disease and the annual bill for dementia care now tops $215 billion, more than is spent on cancer or heart disease. the number of victims is predicted to increase 200% by 2030 and to increase 400% by 2050 - that's 24 million Americans with this disease - when the cost of Alzhemer's care will exceed $1.5 trillion yearly. on a global level, the numbers are even more staggering. in 2010 there were 36 million people with Alzhemer's; in 2050, at its current rate, there will be 115 million men and women worldwide with disabling memory loss - a 320% increase....
Intro /11 simply put, arterial plaque growth leads to heart attacks, strokes and sudden death. we know it cause heart disease, but it belongs in this discussion about the brain because it had emerged as one of the most powerful predictors of memory loss and cognitive dysfunction including Alzheimer's disease. longitudinal data collected in my clinic illustrates this link between arterial plaque growth and the loss of cognitive function and brain speed....
Into/14 here are my promises to you. I will offer you:
* an easy-to-understand connection between blood sugar control, heart disease and memory loss
*a practical way to assess your cognitive function
*a list of factors that increase your risk for memory loss and tips to stop them in their tracks
*a medically sound program to improve your brain function
*a scientifically proven plan to help prevent memory loss
* recipes that are easy to prepare, with foods that are great for your brain and body and (tasty)...
* activities that will tune up your brain, rev your metabolism and help you get trim...
*a program that you can share with (others) ...that is safe for all ages. \
*a plan that is realistic if you have a busy schedule
* results that you can feel and measure within 30 days...
Chapter 1 - The Brain-Blood Sugar- Heart Connection
*3 Your heart gives you circulation and blood flow, bringing your physical body to life.
Your brain gives you cognition, igniting your mind and your spirit.
Cognition is the act of knowing or thinking and having optimal brain function means being capable of properly inputting information, processing the information, responding appropriately and in a timely fashion and remembering that activity. but should the heart fail, the brain may also decline. and while the heart can sometimes be repaired,, in many cases the brain will not recover.
as a physician, I've met many families who've lived through a relative's struggles with memory loss, but I have also experienced it on a personal level and know how very painful it can be.
I met Chuck Odegaard, the man who'd become my stepfather, when I was in high school, after my parents had divorced. i remember encouraging my mom to marry this really nice guy, who was so king to me and such a loving, supportive partner to her. she did, they had a wonderful marriage and Chuck - always there when I needed him -would go on to become a terrific grandfather to my 2 sons.
Chuck had been both a Washington State and regional national park director. a few days after he retired, he was walking down a street, on his way to a meeting where he'd be volunteering for the city of Seattle, when he developed serious chest pains. he was taken to the hospital,
*4 and as a result of a cardiac procedure that dislodged a section of arterial plaque, he suffered a sever stroke that triggered immediate, profound dementia.
that is when I saw, firsthand, what dementia truly means and how it impacts loved ones.
Chuck couldn't get dressed, shower, shave or make himself a snack or cup of coffee.
he couldn't remember what he'd eaten 20 minutes before.
unlike someone with Alzheimer's disease, he could recognize people he knew,
but he couldn't learn anything new.
he wandered around the condo where he lived with my mother as if in a fog, bewildered and lost.
this once energetic, sharp and thoughtful man, so professionally accomplished and looking forward to a happy retirement with my mom, lost it all in an instant.
about 7 years later, as he became increasingly confused, he fell and broke his hip.
in terrible pain, he stopped eating and drinking..\Chuck was dying and i came home to say goodbye.
by the time I arrived, others told me I was probably too late - he had not opened his eyes all day and was no longer speaking. but upon hearing my voice, Chuck actually sat up and grasped my hand. 'Don't let what happened to me happen to others,' he said...
*8 Understanding Memory Loss: From Mild Cognitive Impairment to Dementia and Alzheimer's Disease.
one of the very easiest signs that you are losing memory over time isn't that your memory fails.
let's say, for instance, you go into a meeting at work and are sitting across the table from a business associate you've met before, but you have totally forgotten her name, and professionally speaking, you really should be able to remember that information. you get through the meeting without having to say her name or introduce her to a colleague (thankfully). then, as you are walking back to your office, you suddenly remember her name - as well as her phone number and where her son goes to college. usually you're so good with names and faces. Is This, you wonder, The Beginning Of a Serious Problem? probably not.
here's what just happened: your internal processor - your executive
*9 function - was sluggish. you were able to access your memory but not as quickly as you wanted to. maybe you were sleep deprived, you had eaten poorly and /or you were stressed. that kind of memory mishap is not uncommon, and it doesn't mean you're heading toward sever memory loss. (it does, however, mean that you should make some changes to stop your executive function from sliding.)
but the first true sign of memory loss is that sharpness and executive function decrease Gradually over time. some of that decline may be due to normal aging - but even that process can be slowed. now, instead of occasionally forgetting a name or two in a meeting, you experience a steady decline in your ability to hold on to important information, on a regular basis. (you can't recall that colleague's name, you also can't focus on the content of the meeting and you are unclear about what tasks you're supposed to carry out as a result of the meeting.) that pattern of memory loss is more worrisome, but once again, by making the right lifestyle changes, you can reverse your decline or slow it significantly.
there is a wide spectrum of brain function that varies from
optimal.
to normal,
to sluggish,
to having mild cognitive impairment,
to becoming disabled and dependent upon others for daily function, which we call dementia.
70% of dementias are caused by Alzheimer's disease, a state where brain cells gradually die and the whole brain volume shrinks (with the formation of unusual brain proteins, called betaamyloids and neurofibrillary tangles). most of us, when we think of extreme memory loss and dementia, think of Alzheirmer's disease - but it's not the only cause.
by the time the brain reaches full-blown dementia - shrinking from a plump grape to a shriveled raisin - and the victim is fully disabled, the damage is likely permanent. at this time, I know of no treatments or lifestyle changes that will reverse the death of healthy brain cells, which is way we must do more early on to prevent it entirely.
*27 Chapter 2 - How Sharp Sis Your Brain?
...at our peak, the brain's total memory capacity is amazing and exceeds that of a computer. each year after 30 , most people have a natural, gradual drop in mental speed. this is normal, but it isn't always noticeable because as we gain experience and retain memories, we make up for it with knowledge. as you age (particularly after 40" , it is almost as if you have to work with a slightly slower computer, but with experience, you don't need to rely as much on that computer.
memory and attention also decrease over time, but these functions should decline more slowly thatn processing speed does. many people are capable of maintaining their memory and attention into their 80s and 90s, even if it takes them more time to access the information; the knowledge ma still be in their brains - it just requires a little longer to pluck that book off the shelf, so to speak and look up the fact. losing memory isn't a balanced process: typically we lose the ability to
*28 recall a name or fact before we lose the ability to recognize. hence we are likely to forget someone's name before we forget who they are.
executive function or mental sharpness is different from memory - it is the ability to problem-solve and jump from one task to another. the better your executive function, the more complex work you can accomplish in a given amount of time. (for patients in my clinic, executive function seems to be the most important aspect of cognitive function that makes them successful in their work and person lives; we,ll look at how it impacts productivity shortly.) if your executive function is sluggish or impaired, however , your memory will underperform as well.
Brain Structure Basics
the brain and its functions can be divided into 3 major parts: the forebrain, the midbrain and the hindbrain.
the hindbrain, which some scientists call the reptilian brain, is the primitive part of the brain that controls the basic 'automated' body functions we don't think about every time they occur: the beating of our hears, breathing and blood circulation. the hindbrain, which all (note: author makes us, created in the image of God into 'animals' at this point)...
...(next) is the midbrain, which regulates what we sense and controls basic instincts, such as seeking food and reproducing - aspects related to basic survival. it has a broad range of duties as it regulates motor control, hearing, vision, body temperature, thyroid and adrenal function, fertility, libido and our wake and sleep cycles. it controls involuntary processes, such as coughing, swallowing, sneezing and vomiting....
.....(also, the midbrain)..sends us into survival mode. when we are stressed, this part of the brain tends to take over., whether we're escaping from a burning building or are sleep deprived and juggling multiple deadlines at work.
*29 the forebrain (also called the neocortex) is what makes humans different from animals. it is reponsible for processing sensory information from vision (eyes), smell (nose), sound (ears), taste (tongue) and touch (skin). the forebrain's frontal loves allow humans to process complex information and problem -solve, while the temporal lobes hold memories and process language.
Brain action - body reaction
for every food action, there is a brain reaction. hen we eat the wrong foods, hormonal shifts blunt our satiety - that important sense of feeling satisfied...
cravings win out over willpower...
*34 The brain symptom Score: testing for early signs of memory loss.
1. do i lose things (keys, pens, cellphone, glasses) more often?
2. is it harder to find my car in a big parking area?
3. is it difficult to e remember a bank password and enter it, or a 7 digit phone number and dial it?
4. do I find myself writing lists to help my memory more than I used to?
5. am I forgetting names of movie and sports stars or other well-known figures I once knew well?
6. is it easier to remember an event from 20 years ago than two days ago?
7. do I have trouble dealing with everyday math problems, like reviewing personal finances, working with numbers at my fob, calculating percentages for tipping and performing household measurements?
8. am I challenged when I have to learn a software program or assemble a piece of furniture?
9. if I'm in a meeting at work or listening to a detailed lecture, does my mind start drifting sooner than it used to?
10. when I'm working on a project, do I find it hard to get back into the groove after being interrupted by a phone call, text/e-mail or an office visitor?
# of questions you answered 'yes' to..
0, ask yourself these questions yearly.
1-2, fine, watch for further cognitive loss.
3-4, cause for concern. check in with your doctor.
5+ clearly, further mental function testing guided by your doctor suggested.
*36 ...the earlier we identify , the easier it is to get better and prevent further loss.
...a person with dementia doesn't want or need to be told that they can't remember things. such reminders from friends, family members, or caregivers may be done with the best intentions, but telling someone, 'You already asked me that question -don't you remember the answer? or 'I've already told you that 4 times...' (is not helpful).if they truly have established cognitive impairment, there is no sense in responding (like this)...they may no longer be able to remember things, but at a certain fundamental level, they know that their brain function is in deep decline and it's...painful for the. as my loving mother -in-law Joy once said, 'I know I'm losing my memory, but I want to maintain my dignity. please don't point out that I'm forgetting things. its humiliating'...
*38 with long-term cognitive decline, brain cells are not only functioning more slowly; they are dying. over time the brain shrinks in volume. once it has shrunk dramatically, I don't know of any realistic way to bring it back to normal. that;s why the Better Brain Solution is so important, because it gives you the tools to optimize your current performance and slow or prevent cognitive decline.
what kind of testing should you have...
start by making an appointment with your own physician, who knows you and your medical history....many physicians will look at standard factors that clarify your risks for developing Alzheimer's disease.
*41 ...depression?
1. do you have trouble sleeping?
2. do you have trouble with concentration?
3. do you have decreased energy and drive for exercise, sex, and work?
4. do you have feelings of sadness and pain?
5. do you lack enjoyment? do you go about your daily activities and do things with others because you should, but nothing feels like fun anymore?...
Head Injury and Dementia Risk
just one incident of serious head trauma can increase a person's risk of Alzheimer's by 450(note - in my case, I had a concussion in a bike accident when 55...because they would not accept my health coverage this was never treated..)
*42 if you aren't depressed by are having troubles with memory and cognitive function, some useful laboratory tests can identify problems that are generally treatable. if such issues are missed, some of them can result in permanent memory loss.
a chemistry profile (also called Chem 20 or CMP) blood test is a good start. if it's done while yo are fasting, it will give you a FASTING BLOOD SUGAR (glucose)LEVEL, which is absolutely essential. given the connection between abnormal blood sugar and dementia, you should know your own fasting blood sugar level and I hope it is less than 95 mg/dL. this test can also identify low sodium, which impacts memory, liver and kidney disease and other basic illnesses that impact cognition.
in addition to fasting blood sugar, if I'm assessing for cognitive decline or assessing elevated blood sugar, I will also measure a Fasting insulin Level, to identify people with insulin resistance who still have normal blood sugar levels. a level greater than 5 *mIU/mL suggest early signs of insulin resistance and clearly an insulin level greater than 10* shows signs of insulin resistance.
*43 THYROID testing is essential to identify a treatable cause of cognitive dysfunction, as low thyroid function can be effectively addressed with the right medication...
I always want to assess inflammation, and the easiest test is for HIGH-SENSITIVITY C-REACTIVE PROTEIN (hs-CPR), a marker for systemic inflammation. ..(before testing ) you should be well and fully healed for at least 30 days before taking this test, to get an accurate result...
adequate NUTRIENT LEVELS are essential for protecting brain health, but during a regular physician evaluation, nutritional needs are often not addressed and nutrient levels are not tested. I'll discuss these specific nutrients in detail in Chapter 5, but keep in mind that vitamin D deficiency will increase your your risk for memory loss.
testing for TOXINS is an essential part of cognitive function testing. in particular, Lead and Mercury can impact brain function...your lead level should be zero. (see Chapter 8)
*44 MERCURY TOXICITY is far more common and is associated mostly with large-mouth fish intake. rising up the food chain from plankton to tiny copepods, to shrimp, to small fish, to bigger fish, to large-mouth fish (like tuna, grouper , bass, kingfish and swordfish), mercury levels increase exponentially. the larger and older fish, the higher the mercury levels. still, seafood, safely consumed, is an excellent source of brain-healthy nutrients, especially omega-3 fatty acids and it should be a part of your diet. if you eat more than 3 or 4 servings of bigmouth fish per month, ask your doctor to measure your mercury level with a 'whole blood' mercury test, not just a serum level...
the final lab testing I consider for people with cognitive dysfunction is SEX HORMONE TESTING, looking at DHEA-S and total and free testosterone for men and total testosterone, estradiol, progesterone. and DHEA for women. women going through menopause can have major brain fog, though it is different for every woman. men going through andropause can have depression, anxiety and decreased cognitive performance when their testosterone levels drop and how they feel varies significantly...
ARTERY PLAQUE TESTING (Carotid IMT) ...several cardovascular risk factors -including fitness and dietary intake of fiber, B vitamins and fish oil - impacted cognitive scores. by far the strongest predictor of cognitive function was carotid intimal media thickness, which can be determined through carotid IMT testing . if you are growing plaque in your arteries, your cognitive function is declining.
*45 ...the challenge is that this type of testing is considered age management, not disease testing, so typically it isn't covered...
FITNESS TRAINING aerobic fitness is one of the strongest predictors of better brain performance and executive function. the gold standard for testing aerobic fintness is to measure the maximum amount of oxygen that you can burn with peak exercise, usually on a treadmill or stationary bike. the resulting score is called your VO2max, as in maximum oxygen volume burn rate per minute per your weight in kilograms.
pp45-9 mentions Cognitieve Testing , Structural Brain Imaging , Functional Brain Imaging, Genetic Testing, ApoE, Genetic Methylation Testing
Chapter 3 - Boost Your Brain with 12 Smart Foods (try to eat as many of these foods as you enjoy and can realistically fit into your lifestyle.)
*59-80
ONE* GREEN LEAFY VEGETABLES - ONE CUP of green leafy vegetables EVERY DAY will make you, on average, 11 years physiological younger than someone who skips them. (they)...are packed with fiber, vitamin K, folate, potassium, flavonoids (antioxidant and anti-inflammatory compounds) and carotenoids (valuable plant pigments). they decrease inflammation system-wide and because they provide fiber with little to no sugar, they improve blood sugar control. green leafy veggies are fantastic for your brain, arteries, bones and waistline.
TWO* OTHER VEGETABLES (except potatoes) at least THREE CUPS DAILY...whole are preferable because of their superior fiber content.
THREE* OMEGA-3-RICH SEAFOOD (or a long -chain omega-3 supplement) a FIVE OUNCE serving of omega-3-rich seafood at least TWICE A WEEK , or take a high-quality fish oil supplement.
FOUR* OLIVE OIL and other healthy cooking oils. recommend ONE or more TABLESPOONs A DAY of Extra Virgin Olive Oil. extra obtained from crushing the olives again. regular, which does not include the words
Extra Virgin or Virgin on the label - may be produced with heat and chemicals to pull out additional oil from the olives , processes that commonly damage the oil.
NUT OILS good. (almond, pecan)... a tablespoon a day of heat-stable cooking oil in addition to olive oil is good, COCONUT OIL is good.
FIVE* NUTS AND OTHER HEALTHY FATS. ALMONDS, PISTACHIOS, PECANS, HAZELNUTS, WALNUTS and MACADAMIAS (ONE OR TWO HANDFULS DAILY)
SIX* BERRIES AND CHERRIES; .5-1 CUP DAILY many flavonoids, but especially blue, purple and red plant pigments are associated with increased cerebral blood flow.
SEVEN* COCOA AND DARK CHOCOLATE (one or the other daily) need sweetened? stevia or xylitol.
EIGHT* CAFFI
Subscribe to:
Post Comments (Atom)
No comments:
Post a Comment