BRAIN HEALTH: HOW TO REDUCE YOUR RISK OF DEVELOPING DEMENTIA

One in every seven Americans older than 71 years of age has some form of dementia, most commonly Alzheimer’s disease. However, new research has proven that you can do some things to reduce your risk of developing dementia.

Exercise Your Mind:  Leisure activities that “sweat the brain,” such as board games, crossword puzzles, writing, dancing, playing musical instruments, and reading are proven to stave off the development of dementia.  Obtaining higher levels of education also is shown to correlate with a delayed presentation of dementia; although once dementia has developed its progression is not slowed by these exercises.

Exercise Your Body:  Studies have shown that it does not matter what form of exercise you choose. Anything from water aerobics to hiking will work, but the frequency and intensity does matter. In fact, in one study of nearly 1500 people who were tested at midlife before displaying any symptoms of dementia and then tested again between 65-79 years of age, those who exercised at least two times each week during middle age had a significantly decreased risk of dementia development, even after all other variables were ruled out.

Doing challenging physical activity increases blood flow and oxygen to the brain, and helps to form new cells. In fact, physically active people actually have a larger hippocampus, the area of the brain that helps with learning and memory. Physical activity also produces endorphins and other “feel good” chemicals that lead to calming and improved focus. It appears that the more energy expended during physical activity, the greater the reduction of risk. Even after dementia has begun to develop, exercise can improve concentration and brain plasticity.  

Eat a Healthy Diet & Maintain a Healthy Weight:  The relationship between diet composition and brain health is a subject of ongoing research.  Diets high in fruits, vegetables, and whole grains and low in saturated fats are associated with better brain health.  On the reverse read about some specific nutrition recommendation for keeping the brain healthy including consuming/supplementing with fish oil and eating a diet rich in plant foods. 

Research clearly indicates a strong relationship between maintaining a healthy weight and decreased risk of dementia.   Individuals who are obese, especially those with central obesity (weight in the abdominal area) appear to have higher risk for developing dementia. In one study of 6500 individuals within the Kaiser Permanente Northern California system, those with the largest abdominal measurement had three times the risk of developing dementia, compared to those with the smallest waist measurement.

Think Positively & Be Friendly: Depression is positively linked to a person’s chance of developing cardiovascular disease, which in turn is linked to development of vascular dementia.  Similarly, persons who maintain positive social relationships (spouses, family, friends, etc.) appear to have better brain health outcomes.

Control & Treat Chronic Diseases: Diabetes is linked to development of dementia. Control of preexisting diabetes and prevention of diabetes is critical to maintaining brain health.  Similarly, uncontrolled high blood pressure is also linked to the development of both Alzheimer’s disease and vascular dementia.

Get Enough Sleep: Sleep deprivation temporarily decreases levels of brain-derived neurotrophic factor, which is crucial for storing information.  Many studies have also found a correlation between chronic sleep deprivation and increased rates of heart disease, which in turn puts one at risk for decreased brain health.

Quit Smoking, If You Smoke: Smoking increases your risk of developing cerebrovascular disease, a condition that causes your brain to not receive all of the blood necessary to operate properly.

NUTRITION TIPS FOR KEEPING YOUR BRAIN HEALTHY

There is good evidence that maintaining a healthy weight significantly reduces your risk for brain health problems.  Thus, in terms of diet, the most important thing you can do for your brain is manage your weight.

In addition managing your weight, following these dietary tips may help to reduce the risk of dementia:

Have Plenty of Fruits and Vegetables: Consume plenty of fresh fruits and vegetables because these are rich sources of plant compounds that may help to protect against dementia. One study completed in France with 8000 people showed that dementia was reduced by 28% among people eating fruits and vegetables on a daily basis.  To ensure you are getting a variety of phytonutrients try to consume a range of colors of fruits and vegetables including green (leafy greens, green beans, honeydew, kiwi, etc.), yellow-orange (carrots, sweet potatoes, oranges, mangoes, etc.), red (tomatoes, red cabbage, raspberries, pomegranates, etc.), blue-purple (eggplant, plums, blackberries, blueberries, etc.), and white (mushrooms, garlic, bananas, jicama, etc).

Get More Fatty Fish: Eat several servings of fatty fish, such as salmon, mackerel, and tuna, each week.   Regular consumption of oily fish is associated with reduce better heart health and a reduced risk of Alzheimer’s disease.  Fish oil supplements containing essential omega-3 fatty acids DHA and EPA are widely available.  Persons taking blood thinners should not take fish oil without consulting their doctor.

Limit Red Meat, Cream, & Other Saturated Fats: Diets high in saturated fat found primarily in the fat of meat and dairy are associated with heart disease and increased risk of dementia.  Try to minimize your intake of “saturated fats” by noting them on food labels, and choosing lean sources of dairy, meat, and poultry.

Supplement with Vitamin D: Make sure you get plenty of vitamin D. Inadequate vitamin D levels are linked to possible cognitive decline and dementia. Foods rich in vitamin D include fortified milk as well as other fortified products.  Our bodies can make vitamin D when exposed to the sun but people with darker skin as well as older people are not as effective at making vitamin D, so it may be advisable to supplement with a daily 1000-2000 IU of vitamin D.  You can also request your vitamin D level be checked when you get bloodwork. 

Vitamin E & Coenzyme Q10: Diets rich in antioxidants, such as vitamin E and coenzyme Q10 (CoQ10), may slow the risk of cognitive decline and help your brain to get more oxygen. Good sources of vitamin E include soybean oil, corn oil, safflower oil, wheat germ, whole grains, green-leafy vegetables, nuts & seeds, and olives.  CoQ10 is found in oily fish and whole grains.

Folic Acid: Eat plenty of foods rich in folic acid and consider taking a multivitamin that contains folic acid.  In a study of 579 people older than 60 years of age, those who consumed at least 400 micrograms of folic acid were less likely to receive a diagnosis of dementia. Foods rich in folic acid include green-leafy vegetables, fortified grains, whole grains, wheat bran, citrus, beets, broccoli, and tomatoes. 

EXCESS BODY FAT, ESPECIALLY IN THE ORGANS, MUSCLES, & BONES, INCREASES THE RISK OF OSTEOPOROSIS

It was once believed that excess body weight decreased risk for low bone density known as osteoporosis.  However recent studies indicate that being obese actually increases the likelihood of having inadequate bone density. A number of recent studies have found that excess fat in the abdomen, particularly fat deposited between the organs, increases osteoporosis risk.  Adding to these findings, a new study lead by Dr. Miriam Bredella at Massachusetts General Hospital has found that excess fat in the blood, liver and muscle is especially linked with greater fat in the bone marrow, and reduced bone density. 

In Dr. Bredella's study, researchers used magnetic resonance spectroscopy (MRS) to assess fat in more than 100 obese but otherwise healthy men and women, ages 19-45.  MRS allowed them to accurately assess levels of fat in the liver, muscles, and bone marrow.   The MRS results showed that people with more liver and muscle fat had higher levels of fat in their bone marrow, independent of body mass index, age, and exercise status.  Levels of fats in the blood also correlated with increased bone marrow fat.  Specifically, elevated blood levels of triglycerides and lower “good” HDL cholesterol were strongly associated with higher levels of fat in the bone marrow.     

Researchers are still trying to understand how excess fat impairs bone health.  Excess fat tissue in the bones appears to displace mineralized bone tissue. Cells in the bone marrow are stem cells that can develop into different kinds of cells including bone building cells, osteoblasts, and fat cells, adipocytes.  When there are high levels of fat in the blood, it appears that more stem cells are devoted to becoming fat stores and fewer develop into bone builders.  Additionally, high levels of fat in the blood, especially elevated triglycerides, appear to stimulate osteoclasts, the cells responsible for breaking bone down.

What to do:  Besides excess fat between the organs and in the liver, muscles, and blood, some of the other risk factors for osteoporosis include being female, advanced age, a family history of osteoporosis, inactivity, being underweight, vitamin D deficiency, and inadequate intake of calcium.  Many medicines and health problems also increase your risk.  It is recommended that women over 65 and younger post-menopausal women with risk factors for low bone density get a dual energy x-ray absorptiometry (DEXA) scan of their bones.  Discuss the status of your bone health with your provider.  To help prevent osteoporosis, maintain a healthy weight and blood cholesterol levels, get regular weight bearing activity (such as lifting weights, walking), have your doctor monitor your vitamin D levels and supplement when necessary, and include plenty of foods rich in calcium such as nonfat/lowfat dairy and dark green vegetables.

Adapted from article available at:

http://www.nlm.nih.gov/medlineplus/news/fullstory_138755.html

http://www.sciencedaily.com/releases/2013/07/130716080021.htm

Sources:

Radiological Society of North America, news release, July 16, 2013.  Available at:  http://www2.rsna.org/timssnet/media/pressreleases/pr_target.cfm?ID=681

Bredella MA, Gill CM, Gerweck AV, et al. Ectopic and serum lipid levels are positively associated with bone marrow fat in obesity radiology. Radiology, 2013; DOI: 10.1148/radiol.13130375.  Available at: http://radiology.rsna.org/content/early/2013/06/27/radiol.13130375.

EAT LESS RED MEAT TO CUT YOUR RISK OF HEART DISEASE, CANCER, & DIABETES

High-red-meat consumption has been linked to increased risk of coronary heart disease, stroke, diabetes, cancer, and premature death.  Here’s some of the latest research on how red meat impacts our disease risk as well as tips on how to minimize your risk.

 4 Reasons to Eat Less Meat

Protect your heart and vascular system. Many large studies show a clear association between red meat consumption and higher rates of heart disease and stroke.  For example, when researchers tracked more than 84,000 women in the U.S. Nurses’ Health Study for 26 years, they found that those who ate the most red meat (at least two 3-oz. servings a day) had a 29% higher risk of heart disease than those who ate the least (half a serving a day or less).  And, for each additional 1 oz. of processed red meat or 4 oz. of unprocessed meat consumed daily, non-hemorrhagic stroke risk increased by 21%.

One of the reasons red meat intake increases the risk of heart disease is due to the unhealthy saturated fats found in red meat that raise blood cholesterol levels and contribute to atherosclerosis, clogging of the arteries.  Choosing lean cuts helps to reduce intake of saturated fat. 

In addition to saturated fat, there are other components in red meat that appear to increase risk for heart disease and strokes.  Preserved meats such as deli meats contain high sodium content associated with increased blood pressure and stiffening of the arteries.  Also, just recently, researchers found that carnitine, a compound plentiful in meat, has a damaging effect on the health of arteries.  They found that when carnitine is broken down by bacteria in the digestive tract, a substance that promotes arterial inflammation and clogging of the arteries, trimethylamine-N-oxide (TMAO), is produced.  So, high TMAO levels along with high blood cholesterol appears to especially increase the risk of clogging of the coronary arteries and heart attack.  TMAO is also produced from the breakdown of choline and lecithin found in high amounts in egg yolks and liver as well as red meat.  Those who consume high levels of meat appear to have more of the bacterial that produce TMAO from carnitine, so eating meat less often not only decreases intake of carnitine but also the rates at which carnitine is converted into the damaging TMAO.

Cut your cancer risk.  There is growing consensus that high red meat consumption, especially processed red meats, increases risk of colorectal cancer.  Studies have also suggested red meat consumption increases risk for pancreatic, prostate, and esophageal cancer. The U.S. National Cancer Institute has estimated that for each additional 3 oz. serving of daily red meat consumption, risk of colorectal cancer increases by 20%.  Therefore they recommend limiting red meat to no more than three 3 oz. servings per week and avoiding processed meats altogether.   

The association between red meat and cancer is believed to stem from different compounds found in meat.  Most preserved meats such as bacon, sausage, and lunch meats have added nitrites that preserve the quality and color of the product.  In the gut, bacteria convert the nitrite to N-nitroso compounds which have been found to cause cancer in laboratory animals.  Preserved meats labeled nitrite-free use celery powder or sea salt as preservatives which, in combination with meat still cause nitrites to be produced in the gut, though the levels may be lower.

Other carcinogens known as heterocyclic amines (HCA) and polycyclic aromatic hydrocarbons (PAH) are produced when meats (as well as other animal proteins such as chicken) are cooked at high temperatures or over an open flame.  In the NIH-AARP Diet and Health Study, researchers found a 20% higher risk of colorectal cancer among people who consumed the highest levels of two heterocyclic amines from meats cooked at high temperatures. Fortunately, this risk can be readily reduced because the levels of HCA’s and PAH’s are much lower in meats that are cooked at lower temperatures and are not well done.

Dodge diabetes.  While excess weight is the most potent risk for type 2 diabetes, multiple large studies link intake of red meat, especially processed red meat to rates of diabetes.  For example, a recent Harvard study tracked more than 200,000 men and women for up to 28 years. The risk of type 2 diabetes increased by 32% for every 1 ½ oz of processed meat—and by 12% for every 3oz. of unprocessed meat—eaten per day.  The link between red meat and diabetes is still being investigated.  It is believed that the saturated fats in meat increase overall inflammation which can increase insulin resistance in the cells of the body.  It is also believed that the N-nitroso compounds found in processed meats can damage the beta pancreatic cells that produce insulin.  

Live longer. Research has found that those who consume less meat tend to live longer.  For example, in 2012, scientists at the Harvard School of Public Health published data on more than 120,000 participants in the Health Professionals Follow-Up Study and the Nurses’ Health Study. After 28 years, those who ate the most red meat (roughly two servings a day where a serving was 3 oz of cooked meat or 1 oz of preserved meat such as deli meat) had a 30% higher risk of dying than those who ate the least (about half a serving a day).  Similarly, in 2009, the U.S. NIH AARP Diet and Health Study reported results on over 500,000 seniors they had tracked for 10 years.  They found that after the 10 year period, those who ate the most red meat (about 5 oz. a day) were 30% more likely to die than those who ate on average, less than 1 oz. per day.

Follow These Tips to Minimize Your Disease Risk from Red Meat

• Limit your intake of red meat.  Health organizations advise limiting intake to 9-15 oz. per week.  It’s not unusual for a restaurant steak to be a week’s worth of meat.  Remember, a 3 oz. serving of red meat is only about the size of a deck of cards.
• Instead of meat opt for other lean protein sources including skinless poultry, fish, lowfat/nonfat dairy, beans, and soy-based veggie “meats”.
• Eat as little processed meat as possible.  Use frozen products as convenience options.  When having processed meats, opt for those with no added nitrites and nitrates.
• Avoid supplements with carnitine, lecithin, or choline.  For frequent meat eaters, these supplements likely have an especially detrimental effect on heart health. 
• Cook meats at lower temperatures. Boiling, steaming, poaching, stewing, and microwaving generate no HCA’s because the temperature never tops the boiling point of water. If not using a moist heat preparation, opt for baking, roasting, and stir-frying which are safer than the high heat methods such as grilling, broiling, and deep-frying.

Healthier Grilling

Grilling is a fun summertime pastime and a tasty way to prepare proteins with minimal added oil.  However exposing meat and chicken to open flames and high heats produces carcinogens.  Here’s how to minimize carcinogens next time you grill.

• Microwave before cooking. You can eliminate 90% of the HCA’s if you microwave meat, chicken first for 1½ to 2 minutes and pour off the juices.
• Keep it moist. The drier and more well done the meat, the more HCA’s you get.
• Marinate. This helps the meat stay moist.  It doesn’t seem to matter what’s in the marinade or how long the food sits in the liquid. You can dip it in right before you throw it on the grill.
• Try seafood. As long as you don’t char seafood, it should have fewer HCAs than meat or poultry.
• Flip frequently. Turning over meat or poultry every minute cuts the HCA’s by 75-95% because the surface temperature stays lower.
• Eat your veggies. Veggie burgers and cooked vegetables generate few or no HCA’s. And cruciferous vegetables like broccoli and Brussels sprouts may actually help the liver detoxify HCA’s.