Dr. Sara Gottfried Shares Tips to Keep Your Brain Sharp with Age

by Sara Gottfried, MD

My granny blinked behind her glasses as she drove us to her home after school, trying to conceal her panic. It was 1975. I was 7 years old, and she was 50. Granny wasn’t sure where to turn her Oldsmobile Cutlass Supreme next. The distance between the school bus stop and her home was only 5 miles, but we were lost.

When my grandmother’s memory and then her personality drained out of her due to Alzheimer’s disease, I didn’t know that women are at double the risk of Alzheimer’s compared with men.1-3 I didn’t recognize that her risk began in her 40s, at the time that she was taking caring of me after school because my parents both worked full time. Now I understand that her cognitive decline was probably due to issues related to her blood sugar, fondness for drinking two or three martinis every night, and loss of estrogen associated with perimenopause and menopause.

As one of the top 10 leading causes of death in the US, Alzheimer’s disease has a weighty burden.4 While an estimated 5 million Americans 65 years or older have Alzheimer’s, that number is predicted to triple by the year 2060.5 I went to medical school because I wanted to help people. When I was 21 and my beloved grandmother was in a nursing home unable to recognize me, I got clear about my “why.” I wanted to cure Alzheimer’s disease.

At Harvard Medical School, I learned the wretched news about Alzheimer’s disease. Not only was it miserable for the patient, caregivers, and family—but the lack of treatment made the medical training grim. Neurologists were beaten. Their mantra was, “Diagnose and adios,” because there was no reliable way to prevent or treat it. I chose instead to go into gynecology. Since then, more than 99% of drug trials for Alzheimer’s have been total failures.6-7 Currently approved medications fail to stop or slow the progress of the disease; the four Alzheimer’s drugs on the market that may reduce memory loss and confusion do so only for a limited time.8

But as a gynecologist, I discovered another approach. It’s called personalized lifestyle medicine, and it acknowledges that all chronic disease—including Alzheimer’s disease,9 cancer, diabetes, high blood pressure, and cardiovascular disease—stems from inflammation that begins years, maybe decades, before the diagnosis.10-11 So the strategy is to work upstream and systematically with lifestyle changes—the way you eat, move, think, and supplement—in order to prevent the inflammation and therefore the diagnosis. (Inflammation, which I think of as a frat party gone wrong, starts in your brain in your forties, like it did with my grandmother.) In mainstream medicine, the old-school idea is that there’s a pill for every ill, but that hasn’t worked in Alzheimer’s. But there is a multidimensional approach, which ultimately has pleiotropic effects, meaning that it is simultaneously capable of producing multiple benefits—it lowers inflammation, increases brain metabolism and connections between nerve cells, increases remembering and decreases forgetting, and may even reverse cognitive decline. Lifestyle medicine serves as the basis of the work of my friend and colleague Dale Bredesen, MD, who has improved or reversed early Alzheimer’s disease in a series of 100 patients.12 He describes Alzheimer’s as a disease where you have “36 holes in the roof.”13 You need to patch all of the holes to see improvement.

In my medical practice, I do not take care of patients with Alzheimer’s disease. Instead, I take care of women aged 35 and older who are noticing the earliest signs of cognitive issues, like the forgotten keys or appointments, the stopping mid-sentence because they can’t find the word they are looking for. They don’t have 36 holes in their roof;13 they have 3 or 5. Together we patch the holes, they feel better, and we may have dodged a diagnosis in their future.

In this blog series, I’ll be writing about my experience with helping women care about their brains much earlier—ideally in your 30s, 40s, and 50s. I’ll describe what has been most effective based on which holes you may have in your roof.

Here’s today’s tip: One of the best ways to stave off a scary diagnosis like Alzheimer’s is to pay attention to your blood sugar. Know your fasting blood sugar, a simple test that most patients undergo once every year or two. According to the latest estimates from the CDC, more than 100 million US adults are now living with diabetes (i.e., fasting blood sugar ≥126 mg/dL) or prediabetes (i.e., fasting blood sugar ≥100 mg/dL).14 I don’t want you to be one of those statistics; I want you to live long and well with a healthy brain clear of debris and deposits. Starting at age 40, fasting blood sugar climbs about 1-2 mg/dL per decade (and blood sugar levels following a meal increase up to 15 mg/dL per decade),15-16 unless you are actively doing something about it. High blood sugar levels (e.g. diabetes) pointedly increase risk for developing dementia, by about 60%.17-18 Make normalizing your blood sugar a top priority by doing the following.

• Know your numbers, including fasting blood sugar and hemoglobin A1c (HbA1c is a 3-month average of your blood sugar levels).
• Keep your blood sugar from rising too high by avoiding sugar and foods that trigger inflammation for you, which may include gluten and dairy, among others. Follow an elimination diet.
• Limit alcohol. The latest research shows there is no safe level, especially for women.19 Alcohol is a brain toxin and increases the risk of many cancers, including breast.20
• Exercise a minimum of 30 minutes per day and ideally 1 hour. Perform high-intensity interval training (HIIT) to make your cells hungry for glucose so that the glucose can be pulled out of the bloodstream to feed your muscles.
• Meditate, pray, or find some other way to objectively witness your experience so that stress doesn’t raise your cortisol (stress hormone) and drive up blood sugar.21
• Optimize your levels by keeping fasting blood sugar 70-85 mg/dL and HbA1c < 5%.
• To learn more about personalized lifestyle medicine for the prevention of Alzheimer’s disease, check out Alzheimer’s-related science and educational tools.

If you remember nothing else from this column, know that rising blood sugar leads to metabolic inflexibility, which decreases plasticity of the nerve cells, particularly in the hippocampus,22 the part of the brain involved in memory consolidation and emotional regulation. So the trick is to stay metabolically flexible with lots of connections between nerve cells in the brain. Pay attention to “holes in your roof” and patch them early, starting with your blood sugar. My granny didn’t, but you can.

Citations

1. Hamilton J. NPR. Women’s brains appear more vulnerable to Alzheimer’s than men’s. https://www.npr.org/sections/health-shots/2015/07/21/425054345/womens-brains-appear-more-vulnerable-to-alzheimers-than-mens. Accessed November 7, 2018.
2. Fifield K. AARP. What being a woman means for your dementia risk. https://www.aarp.org/health/dementia/info-2018/women-alzheimers-pregnancy-link.html. Accessed November 7, 2018.
3. Lin KA et al. Marked gender differences in progression of mild cognitive impairment over 8 years. Alzheimers Dement (N Y). 2015;1(2):103-110.
4. Xu J et al. Deaths: final data for 2007. Natl Vital Stat Rep. 2010;58(19):1-19.
5. Matthews KA et al. Racial and ethnic estimates of Alzheimer’s disease and related dementias in the United States (2015-2060) in adults aged ≥65 years. Alzheimers Dement. 2018;S1552-5260(18)33252-7.
6. Cummings JL et al. Alzheimer’s disease drug-development pipeline: few candidates, frequent failures. Alzheimers Res Ther. 2014;6(4):37.
7. Bushak L. Medical Daily. 99% of Alzheimer’s drug trials in the past decade have failed, and there’s an ‘urgent’ need to improve therapies. https://www.medicaldaily.com/99-alzheimers-drug-trials-past-decade-have-failed-and-theres-urgent-need-improve-therapies-291566. Accessed November 9, 2018.
8. Alzheimer’s Association. Medications for memory. https://www.alz.org/alzheimers-dementia/treatments/medications-for-memory. Accessed November 9, 2018.
9. Kinney JW. Inflammation as a central mechanism in Alzheimer’s disease. Alzheimers Dement (N Y). 2018;4:575-590.
10. Hunter P. The inflammation theory of disease. The growing realization that chronic inflammation is crucial in many diseases opens new avenues for treatment. EMBO Rep. 2012;13(11):968-970.
11. Minihane AM et al. Low-grade inflammation, diet composition and health: current research evidence and its translation. Br J Nutr. 2015;114(7):999-1012.
12. Bredesen DE et al. Reversal of cognitive decline: 100 patients. J Alzheimers Dis Parkinsonism. 2018;8:5.
13. Ash M. Clinical Education. https://www.clinicaleducation.org/resources/reviews/36-holes-in-the-roof-the-dawn-of-the-era-of-treatable-and-preventable-alzheimers-disease/. Accessed November 9, 2018.
14. CDC. https://www.cdc.gov/media/releases/2017/p0718-diabetes-report.html. Accessed November 7, 2018.
15. Samos LF et al. Diabetes mellitus in older persons. Med Clin North Am. 1998;82(4):791-803.
16. Pani LN et al. Effect of aging on A1C levels in individuals without diabetes: evidence from the Framingham Offspring Study and the National Health and Nutrition Examination Survey 2001-2004. Diabetes Care. 2008;31(10):1991-1996.
17. Chatterjee S et al. Type 2 diabetes as a risk factor for dementia in women compared with men: a pooled analysis of 2.3 million people comprising more than 100,000 cases of dementia. Diabetes Care. 2016;39(2):300-307.
18. dLife. Type 3 diabetes. https://dlife.com/type-3-diabetes/. Accessed November 7, 2018.
19. GBD 2016 Alcohol and Drug Use Collaborators. The global burden of disease attributable to alcohol and drug use in 195 countries and territories, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet Psychiatry. 2018;5(12):987-1012.
20. McDonald JA et al. Alcohol intake and breast cancer risk: weighing the overall evidence. Curr Breast Cancer Rep. 2013;5(3).
21. UCSF. Diabetes Education Online. https://dtc.ucsf.edu/types-of-diabetes/type2/understanding-type-2-diabetes/how-the-body-processes-sugar/blood-sugar-stress/. Accessed November 9, 2018.
22. Kanoski SE et al. Western diet consumption and cognitive impairment: links to hippocampal dysfunction and obesity. Physiol Behav. 2011;103(1):59-68.

Sara Gottfried, MD

Sara Gottfried, MD is a board-certified gynecologist and physician scientist. She graduated from Harvard Medical School and the Massachusetts Institute of Technology and completed residency at the University of California at San Francisco. Over the past two decades, Dr. Gottfried has seen more than 25,000 patients and specializes in identifying the underlying cause of her patients’ conditions to achieve true and lasting health transformations, not just symptom management.

Dr. Gottfried is the President of Metagenics Institute, which is dedicated to transforming healthcare by educating, inspiring, and mobilizing practitioners and patients to learn about and adopt personalized lifestyle medicine. Dr. Gottfried is a global keynote speaker who practices evidence-based integrative, precision, and Functional Medicine. She has written three New York Times bestselling books: The Hormone Cure, The Hormone Reset Diet, and her latest, Younger: A Breakthrough Program to Reset Your Genes, Reverse Aging, and Turn Back the Clock 10 Years.

Resveratrol - Powerful antioxidant support for youthful, healthy aging

Resveratrol is one of the most amazing nutrients known to modern science. Known as a longevity nutrient that gives red wine it's amazing benefits on heart health, resveratrol continues to be widely studied for applications in treating cancer, diabetes, and even chronic inflammation. Several drug companies have already attempted to copy the resveratrol molecule and turn it into a "miracle drug" that would be patented and sold at huge profit margins.  While red wine is a good source of resveratrol, you would have to consume about 100 glasses a day which of course is never recommended.  Red wine is recommended in moderation of 1-2 glasses a day.  Resveratrol is now available in capsule form. 

Powerful antioxidant support for youthful, healthy aging

Resveratrol Youthful Aging™ combines the activated form of natural trans-resveratrol with red wine extract, green tea extract and grape seed extract. The research indicates that combining natural trans-resveratrol with other polyphenols provides greatest efficacy. 100% vegetarian product.

Each capsule contains the following youthful aging nutrients:

• Red Wine Extract
• Potent Natural Trans-Resveratrol
• Grape Seed Extract
• Green Tea Extract

The benefits of each of these nutrients are:

• Red Wine Extract
• Contains the group of polyphenols known to be the source of the French Paradox (a high fat diet but with much less cardiovascular health issues than Americans)
• Possess synergistic antioxidant and longevity attributes
• Nurtures healthy cardiovascular function
• Potent Natural Trans-Resveratrol

The most researched polyphenol found in red wine grapes, berries and Japanese Knotwood plant (polygonum) 

Includes only the bioactive form - natural trans-resveratrol

• Standardized for consistent efficacy in every capsule
• Promotes a healthy inflammatory response
• Positive impact on youthful gene expression
• Supports healthy dendrites formation in the brain
• Positive impact on healthy clotting levels

Grape Seed Extract

• Contains proanthocyanins (a class of polyphenols), which act as antioxidants and thought to be instrumental in combating oxidative stress
• Protect cells against free radical damage and resulting oxidative stress
• Animal studies indicate increased efficacy of resveratrol when combined with grape seed extract

Green Tea Extract

• Contains the powerful EGCg polyphenol
• EGCg is the polyphenol most closely associated with healthy cell expression

Beat Depression Naturally

Friday, April 01, 2011 by: Dr. David Jockers

NaturalNews) People with chronic depression often times have significant biochemical imbalances in their neurological tissue. New research has indicated that this imbalance is not a genetic flaw as was once thought. Instead it is due to a heavy onslaught of toxicity or severe nutritional and lifestyle based deficiencies that cause massive brain inflammation; this in effect disrupts normal neurological processing. Fortunately, when these causative factors are addressed, one can overcome the chemical imbalances and beat depression naturally.

Depression and neuro-emotional diseases such as bipolar, schizophrenia, etc. are at an all-time high. The pharmaceutical industry has brought out dozens of blockbuster drugs to treat all of these conditions with billions of $ of revenue every year. Unfortunately, none of these drugs treat the cause of the chemical imbalance, but they merely treat the symptoms and come with a whole host of frightening side effects. In fact, years back the FDA mandated labeling requiring anti-depressant manufactures to include a warning that these drugs increase suicide risk (which is one of the things they are supposed to prevent).

The true cause of depression from a biochemical and lifestyle perspective is due to toxicity or deficiency at the cellular level. Common toxicity problems associated with depression include heavy metals like mercury, lead, aluminum, etc. that accumulate in the fatty tissue of the brain and create massive free radical damage and inflammation that alters neurological function. Viruses and environmental toxins are common inflammatory agents in the brain as well.

Another common toxin that causes massive inflammatory conditions in the brain is certain food intolerances. The most common food allergens to avoid include gluten containing grains such as wheat, barley, rye, oats, kamut, & spelt. Soy products, different nuts, eggs, and heavy proteins are often not tolerated well. Obviously all processed and man-made foods need to be avoided at all costs. Other common allergens include those of the nightshade family such as eggplant, tomatoes, & onions.

An anti-inflammatory diet and lifestyle are critical for full recovery from these conditions. Anti-inflammatory foods help to modulate the immune system and give it a more accurate pair of eyes so as to not over-inflame when stimulated. To effectively de-inflame it is key to completely avoid man-made foods, sugars, and food allergens as listed above. The long chain omega 3 fatty acids EPA and DHA not only are critical for healthy brain function, but also powerfully de-inflame the body by restoring natural balance to the lipid wall of the cell membrane.

Healthy movement patterns produce proprioception (movement information) which is a critical essential for healthy brain enhancing and mood regulating patterns. Boosting proprioceptive input through maintaining healthy spinal function and exercise training has been shown to prevent and reverse depression. Regular chiropractic care and customized physical therapy exercises are critical lifestyle factors for maintaining healthy spinal function. A daily exercise regimen of a high-intensity burst and resistance training program that incorporates core stability and functional balance training enhances proprioceptive input into the brain and balances key hormones that play a role in weight regulation and muscle tone which are factors involved in mental health as well.

Other critical nutrients that are key for mood stabilization include Vitamin D, Folic acid, Pyridoxine (B6), Vitamin B12, Zinc, CoQ10, and trace minerals. Vitamin D levels should be between 60-100 ng/ml. Boost Vitamin D naturally with 20-60 minutes of healthy sunlight every day or 10,000-50,000 IU of emulsified vitamin D3 daily to get the levels where they should be. A raw, whole-food multi-vitamin that supplies ample amounts of folic acid (400 mcg), B6 (4mg), B12(100 mcg), Zinc (15 mg), trace minerals, & CoQ10 (500 mcg) should be consumed daily.

Learn more: http://www.naturalnews.com/031916_depression_remedies.html#ixzz1MuPXNaVu