For the most part, we take our brains health for granted. Even if we are on a health journey, we never think about the brain (or not in the past, anyway). We attend to all other organs of the body, not to the brain. But recently the brain health paradigm is changing. There is compelling evidence that the brain is connected with the gut and the heart, and cognitive decline conditions such as Alzheimer’s are no longer mysterious conditions that come out of nowhere due to simply genetic predisposition. The new paradigm is that cognitive decline is a lifestyle, autoimmune condition, with a complexity of root factors that need to be addressed. The bad news is that living a classic western lifestyle is most probably leading us to neurodegeneration, but the good news is that we can do something about it before it happens. And sometimes is as simple as changing your diet or making sure you sleep better. Sometimes is more complicated, that’s why I decided to gather all the information I came across so far and put it in this article in a form that easy to digest and to make you take action (I hope!). Disclaimer: these are not my personal opinions, these are conclusions taken by pioneers, scientists, medical experts who have studied cognitive decline in the past two decades.
Every 65 seconds, someone in the US develops Alzheimer’s
Chances are, if you are reading this, you have someone in your family or know someone in your circle that has or had Alzheimer’s or any other form of cognitive decline or neurodegenerative condition. At this point, in my (Romanian) family have been two cases that I know of (two aunts on my mom’s side) and one that is really close to me right now, who has just been diagnosed (all these are in Europe). The three of them are females. My good friend’s mom (in the US) just passed away from Alzheimer’s. I hear people talking every day about it. And you know what’s sad, in my country I think many people go undiagnosed because it is still a huge stigma around being brain sick, and you are labeled “crazy”. So people prefer to hide it or just pretend is a sign of advanced age (which is not even the case most of the time).
Genetic predisposition is real, and it’s what gets me worried because both my husband and I have family members with a form of dementia. According to Dr. Dale Bredesen, the author of The End of Alzheimer’s and the creator of the RE-CODE protocol to prevent and reverse cognitive decline, states that if you have one Apoe4 gene (also called the Alzheimer’s gene), there are 30% chances you will develop the condition. For those who have two copies of Apoe4 (Apoe44), the risk is over 50%. Someone who doesn’t have any of these genes has a 7 to 9% chances to develop Alzheimer’s during their lifetime. However, there is a catch when we look at this data: this only applies to the US (and the western world in general), because it is known people with the same genes living in African countries like Nigeria and Ghana, do not develop the disease.
So the question has been, for these experts, what is causing cognitive decline to raise as such a pace in the western world? Is it our lifestyle and if so, what exactly? And is there a way for us to prevent cognitive decline? According to Alzheimer’s Association, these are some of the facts:
Every 65 seconds someone in the US develops the disease 5.8 million Americans are living with Alzheimer’s. By 2050, this number is projected to rise to nearly 14 million. And because the costs of cognitive decline for a society are enormous, it is predicted they will raise from $290 billion in 2019 to 1.1 trillion in 2050. 2/3 of those who are diagnosed are women – and no one knows why. After 60, a woman has 1 in 5 chance of developing Alzheimer’s.
We have 20 years for prevention
“Everybody knows a cancer survivor, but nobody knows an Alzheimer’s survivor and there simply haven’t been many breakthroughs recently in dementia research. […] there is about a 20-year period between when the underlying process actually starts in your brain and when you receive a diagnosis of Alzheimer’s. Thus, there is a tremendous window of opportunity to remove what’s causing problems and to build resistance to cognitive decline. Start learning how to do that today.” – Dr. Dale Bredesen
Cognitive decline is a growing concern in the western societies and is a lifestyle disease. What today is diagnosed as Alzheimer’s (by the presence of amyloid plaque), is in fact a protective response of our brain to a lifetime exposure to different lifestyle factors. The root cause of cognitive decline is in fact a complex of factors and these factors can be different for each person.
Associations / Facts / Articles:
So what can we do to mitigate our risk for cognitive decline?
1. Heal The Gut
There is compelling evidence that your gut is connected to the brain and an unhealthy gut contributes greatly to neuroinflammation. The old theory about Alzheimer’s was that the brain produces the amyloid which kill the neurons and cause the disease. The new paradigm is that the amyloids are not coming from the brain at all; they are coming from the gut.
“Just as your gut bacteria create LPSs each time they divide and / or they die, they produce amyloid when their own proteins die or become dysfunctional. They are called shed molecules because they literally split off from healthy bacteria and then travel through the body either by penetrating a vulnerable gut wall or by climbing the vagus nerve to the brain. Once they reach the brain, they stimulate the brain to produce more amyloid, therefore becoming self sustaining. In addition to disrupting normal cellular function, amyloid proteins then interfere with communication between cells.” – Dr. Steven Gundry, The Longevity Paradox, pg 151
So a healthy gut comes into play: if you have a healthy gut population, they won’t make amyloid proteins to begin with. And even if they do, if your gut lining is healthy and impermeable, they won’t cross the blood-brain barrier. And even if they reach the brain, it doesn’t necessarily mean that they will cause damage. If your brain clean up system – the glymphatic system – does its job properly, damage will not happen. The catch is, the glymphatic system is twenty times faster when you are in deep sleep, and is most active early in the sleep cycle. So there are two things that need to happen if you want to wake up with a refreshed and rejuvenating mind every day: to have a good sleep, and to not eat to close to going to sleep. If you eat too late at night, your blood flow and energy will prioritize digestion as opposed to give your glymphatic system full power to clean your brain.
“Your gut and brain are connected physically through millions of nerves, most importantly the vagus nerve. The gut and its microbes also control inflammation and make many different compounds that can affect brain health.” More here.
So how do you know your gut is healthy or not? Constant bloating, acid reflux, constipation, diarrhea, abdominal or stomach pain, food intolerances, bad skin, fatigue, brain fog, all these and more are signs that your gut is not doing well. Asses your symptoms, do some tests, find a specialist who can diagnose your gut problem and help you fix it. Diet is a big part of fixing your gut. It can be done in different ways, and bio-individuality is really important, but there are few things everyone should and can implement, that are common to most healthy eating lifestyles:
Eat real food, a lot of plants, seasonal and organic when possible, keep it diverse. Prioritize leafy greens, cruciferous and non starchy vegetables.
Eliminate processed food. Cook your own meals. Buy from the produce section of supermarkets and from the farmer’s markets. Don’t buy packaged food and make a habit to read labels. Get familiar with what certain labels and ingredients mean. Many unhealthy processed foods have health claims like “heart healthy” or “all natural” – they mean absolutely nothing, they are just a marketing gimmick.
Keep simple carbohydrates low (or just remove them), and make the better choice: replace white potatoes with sweet potatoes and yams, reduce or eliminate grains, and if you have to eat bread every once in a while choose real, slow fermented sourdough bread, made with only four ingredients: flour, water, salt, sourdough starter. Or make bread from alternative flours.
“Gluten sensitivity – with our without the presence of celiac – increases the production of inflammatory cytokines, and these inflammatory cytokines are pivotal players in neurodegenerative conditions. “, David Perlmutter, Grain Brain, pg. 73
Make animal protein a “condiment” not the main feature of your meals. Make sure it comes from trusted sources and it was raised and fed in a natural way (grass-fed, grass-finished for cows, pasture raised for chicken, wild caught for fish, etc). There is compelling evidence that animal protein plays an important role in the aging process. You don’t have to give it up, just be mindful of the quality of it and of how much are you having. You can implement a meatless day in your family, or have animal protein only once a day, or reduce your portions to 2-4oz. Whatever suits your lifestyle and context.
Stay away from eating and drinking sugar. By eliminating all processed foods and soft drinks, you’ve already eliminated a big chunk of all the added sugar. Learn to read ingredients lists; sugar is added on labels under 56 different (and weird) names! And honey, maple syrup, agave syrup, dates syrup, they are all sugars, so keep that in mind, especially if you have any condition related to insulin resistance.
Treat fruit like candy. Most fruits are high in sugar, eat those who are the lowest in sugar (like berries) and keep it seasonal. Eat them whole (not juiced), have them as a treat. Practice reversed juicing. If you feel like an orange, juice it, throw the sugary water away and use the pulp. That’s where most of nutrients are anyway.
Eat the healthy fats: avocados, extra virgin olive oil, avocado oil, nuts. Remove the highly inflammatory vegetable / industrial oils like canola, sunflower, soybean, cotton seed, grapeseed etc. The point is to balance your ratio of omega-3 to omega-6, which is in average 20 times higher than it should be when eating a standard American diet.
Experiment with a low lectin diet; although not a mainstream theory yet, there is more and more evidence that a diet high in lectins contributes greatly to leaky gut. To seal that gut back you may have to eliminate some of the high lectin foods (like nightshades and grains) or learn how to prepare legumes to reduce the amount of lectins (like pressure cooking lentils and beans).
Note: Most of you reading this know I am on a lectin-free (or at least low lectin, because nothing is really lectin-free, we use the term more like a convention) diet, following The Plant Paradox guidelines, and all the recipes on this website follow the same guidelines. But, again, I recognize that we are all unique and different things work for different people. We just need to be open to experiment and honest to ourselves. The simple, overarching rule is: Love the food that loves you back. It’s not normal to have headaches, migraines, aches and pains on a regular basis, it’s not normal to crash after a meal, it’s not normal to lack energy during day, it’s not normal to be “hangry” etc… As you will see in the points below, changing your diet is one of the easiest things to do, you can have full control over it, you just have to want to do it.
“One of the ways we can test for a leaky gut, is to look for lipopolysaccharide (LPS) in the blood. […] In patients with Alzheimer’s, ALS, major depression and even autism, levels of LPS are often elevated.” – David Perlmutter, Grain Brain, pg. 64-65
WHERE TO START: Clean your pantry from all the unhealthy food and replace them with healthier alternatives (few suggestions here). Start going more often to the Farmer’s Market. Buy your food from the produce area in your grocery store and avoid packaged food. Cook more at home. Be prepared, especially when you travel or have a busy schedule.
2. Achieve mild, nutritional ketosis
Contrary to what we see a lot in the mainstream media, mild ketosis can be achieved by simply following the steps above (point 1.). You don’t need to over do it with fat bombs and fatty coffees and meat. Just keep it low carb and eat the healthy fats (avocados, extra virgin olive oil, nuts) and non starchy vegetables. How do you know you are in ketosis?
Anecdotally, you will know you are in ketosis because you will feel better: your brain is sharp, you have lots of energy, you don’t crave unhealthy food, you are able to manage hunger (you won’t get ‘hangry’); also you may feel more thirsty than usual, and things will taste sweeter, even water. You may also experience the keto flu, which is not pleasant but it only happens at the beginning, until your body gets adjusted to burning ketones.
The more exact way to find out if you are in ketosis is to measure it with a special meter like a KetoMojo. But to get an accurate interpretation of your ketosis level, measure both glucose and ketones and calculate your Glucose Ketone Index (GKI) using the below formula:
[Glucose reading (mg/dl)/18] / Ketone Reading (mmol/L) = GKI
If your GKI number is between 3-6 you are in a moderate level of ketosis, if it’s between 6-9 you are in a low level of ketosis. You don’t have to be in crazy high ketosis (it’s not even recommended), you just need to be somewhere in mild / nutritional ketosis. Other than what you eat or don’t eat, the practice of intermittent fasting is important to achieve metabolic flexibility (for your body to be able to easily switch from burning glucose to burning ketones / fat for fuel). The easiest way to practice intermittent fasting is to have a window of about 14-16 hours between your last meal of the day and the first meal the second day.
Where to start: Try to skip breakfast, or dinner. Whatever fits our lifestyle better.
3. Address insulin resistance / type 2 diabetes
Chances are you will know if you have type 2 diabetes, but a lot of people don’t know if they are insulin resistant. Work with your doctor to find out where you stand. The signs of insulin resistance are usually weight gain, especially around the waist, hormonal imbalances, fatigue, auto-immune conditions. With the help of your doctor and implementing the two steps above, you can bring your insulin levels back to a healthy range.
4. Identify sources of inflammation / environmental toxins and remove them
You may follow all the steps above, but your level of inflammation can still be high. In this case, once the diet is ruled out as the culprit, you have to search for what else in your lifestyle is causing the inflammation. It can be mold, it can be toxic chemicals or heavy metals you are exposed to, it can be chronic stress, it can even be electromagnetic fields (EMF), it can be contaminated water, endocrine disruptors in personal care products, or viruses etc. There are tests you can have done – especially by naturopaths and functional medicine practitioners – that can help you identify what the source of your inflammation is. You can also test your home for toxic mold and other pollutants.
THINGS YOU CAN DO:
You can assess levels of toxicity in your body by doing specific tests with a help of a functional medicine practitioner.
Purify the indoor air. Did you know the air indoors can be up to 500 times more polluted than air outside? Open the windows every day. Invest in a good quality air purifier, which is a great way to improve the air quality in your home or office.
It is estimated 100 million homes in the US are contaminated with toxic mold. If you suspect your house or office is contaminated to toxic mold, hire a company to do a test and if positive, take the next steps: remove yourself from the environment, start a detoxification process, remove the mold. If you live in areas with high humidity, get a system that can control indoor humidity to prevent development of mold.
Minimize exposure to mercury. Eat less sushi and especially tuna. See a biological dentist if you have metal fillings, but it is said that if you don’t find a safe way to remove them, better don’t touch them.
Reduce exposure to electromagnetic fields (EMFs). Since these are everywhere, the first step we can take is to minimize our exposure during sleep, when your brain is in recovery mode. You can do that by not keeping any electronic items in your bedroom. Don’t sleep with your phone in the bedroom, don’t keep a router or a TV in your bedroom.
Switch to safer cosmetic and personal care products, as well as any household products, from laundry care to cleaners. Avoid phthalates, fragrances, aluminum. Check out the below list of toxic chemicals that are banned in Europe and other countries but ubiquitous in US in cosmetic products. Check labels or buy from a company that is committed to not using any of these. I use BEAUTYCOUNTER for make-up and skin care, and PRIMALLY PURE for deodorants. For laundry care I use MY GREEN FILLS.
Drink clean water. Avoid drinking water from the tap or plastic bottles. A convenient solution is to get a good water filter. I got one last year and I feel is the best investment I’ve ever made: BERKEY WATER FILTER. A shower filter is as important: SHOWER FILTER.
5. Everybody, starting with the age of 45, should get a cognoscopy.
Ask your medical practitioner.
6. Getting appropriate support: nutrients, hormones, trophic factors
I’m not going to go into much details here, because is way above my competence, but it is something to have in mind and discuss with your health practitioner. Make sure you don’t lack any essential nutrients, take the appropriate tests and supplements to bring all nutrients at optimal levels to support your health. Many hormonal imbalances will be addressed and corrected with a healthy lifestyle.
From Wikipedia: “Neurotrophic factors (NTFs) are a family of biomolecules – nearly all of which are peptides or small proteins – that support the growth, survival, and differentiation of both developing and mature neurons.”
This is a list with supplements and superfoods often mentioned by experts as a support for optimal gut and brain health. Keep in mind we are all different and it’s best to first assess your needs with the help of a medical practitioner and personalized tests. Also, be aware that some supplements may interfere with certain medication. The specific brands below are based on my research for some the best quality supplements on the market, some of them I personally take. My selection process starts with making sure they are Plant Paradox compliant, they don’t have sugar, soy, or other unnecessary fillers and come from trusted sources like GundryMD, Mercola, Nordic Naturals, Bulletproof, etc.
CBD OIL – Charlotte’s Web
Essential oils are also considered by specialists when it comes to optimizing brain health and dealing with mood disorders, focus problems, brain fog, anxiety, depression, mental fatigue, stress. As with supplements, make sure they come from trusted sources and are high quality (preferably organic). Young Living and DoTerra are some of the most known brands, but you can also find good quality essential oils in natural stores like WholeFoods (Aura Cacia brand have a line of organic supplements), Few examples below:
- Uplifiting effect (for anxiety): lavender, orange, lemon (citrus in general), bergamot, peppermint
- Calming, balancing, grounding: vetiver, lavender.
- To support your right brain (the creative side): winter green, cinnamon, clove, Roman camomille, etc
- To support your left brain (the analytical side): lavender, orange, geranium.
- LEMONGRASS is considered great for brain for, mental fatigue, and if mixed with Myrrh, great for Hashimoto’s, auto-immune conditions.
7. Optimize vascular support
Again, this can be done with a healthy lifestyle: diet, physical activity, stress management and a purposeful and fulfilling life. And don’t be afraid to eat your healthy fats. Also, check in with your cardiologist and supplement if necessary.
8. Minimize exposure to toxic chemicals
SEE POINT 4. You can do this by eating organic food whenever possible, using non-toxic cosmetic and household products, reducing exposure to plastic and non-stick cookware, drink filtered water, purify your air, spend time in nature, sweat to help your own body’s detoxification process (by doing sauna or exercising) etc. Check in with your medical practitioner if a liver support supplement can help you.
9. Make self-care a priority
Identify and address other areas in your life that you fell are keeping you from living to your full potential. It can be relationships, un-addressed trauma, your career, your life purpose, your spiritual life, passions, finances, physical activity, etc. Keep your brain active by staying curious, and keep learning new things. Find ways and techniques to keep stress under control and sleep well. Connect with nature and community in an authentic way. Speak your truth. Find ways to serve your community. Learn how to meditate. Laugh. Love.
“Meditation improves areas associated with memory, sense of self, empathy, and stress. A study from Massachusetts General Hospital shows that meditation can actually rebuild grey matter in the brain. Grey matter atrophy is associated with various types of neurodegenerative diseases.” – Dr. Mark Hyman
How I learned how to meditate (disclosure, it’s not complicated at all): from reading Emily Fletcher’s book, Stress Less Accomplish More.
10. Find your WHY
I heard Dr. Oz once say that “people don’t change what they do based on what they KNOW, they change what they do based on how they FEEL”. I think is important we all find our WHY, which is what will motivate us to change our habits.
So, before your think all the above is too overwhelming, take a moment and think about WHY would you want to be healthy or, as Dr. Steven Gundry puts it, why would you want to die young at a ripe old age? Is it because you want to have a beautiful and fulfilling life with your spouse until the end of your days? Is it because you don’t want to be a burden to your family? Is it because you want to be fully aware and functional and present for your grand children and children as much as possible? Or want to watch them graduate, get married and have their own kids? Is it because you feel you have so much more to learn, or you want to start a new adventure, or have a passion or hobby you want to practice as long as possible? Is it because you want to fully enjoy your retirement years? You want to travel? You want be able to serve others? Whatever that is, write it down and let it fuel you. What is your WHY?
Strive for progress, not perfection
One last thought. Any step in the right direction matters. Don’t worry if you can’t do everything. Just be aware of your body’s signals and try to do the best with what you have. Have small achievable goals and action them one by one. You are unique, your needs are unique and you know better how you feel. Never give up searching for answers. Do not accept if someone dismisses your symptoms. Move on and look for answers until you find them. Take the next best step.