The Healthy Librarian's Brain Back-Up on a Better Brain: Midlife Cholesterol, Belly Fat, Grape Juice, Berries, Blood Sugar, Naps, and Better Sleep

Once You're Through Learning, You're Through"

-John Wooden, retired UCLA basketball coach, 98 years old-

My piles of interesting health-related articles for my blog have been growing exponentially this crazy busy summer. Now it's time to either blog about it--or dump the piles in the recycle bin. 

This time I'm zeroing in on the brain--how to keep it going for as long as possible.  Here's my brain prescription based on my piles of files:

• Make sure your cholesterol numbers are down earlier than your 40's--or you risk both vascular dementia or Alzheimer's.
• Keep that waist whittled when you're middle-aged.  Banish the belly fat.  Weight in your middle during middle-age ups your dementia risk.
• Bring on the berries and the Concord grapes to protect your brain through old age.  Research shows both protective benefits from aging, and improvements in learning and motor skills.
• Keep your blood sugar stable (even if you're healthy) by exercising and eating high-fiber low-glycemic foods like beans, nuts, oatmeal, and quinoa.  Blood sugar spikes damage the memory center of the brain.
• Indulge in a mid-day nap of at least 1 hour.  Mid-day REM sleep enhances problem-solving.
• For the best sleep, keep your bedroom cool.

Dementia Risk is Linked to Even Slightly High Levels of Cholesterol at Midlife

I was all ears when I read this study.  As far as I'm concerned--it's all about protecting the brain as we age, trumping heart disease and cancer.  This study out of California underscores the advice we've been hearing for years:  If it's good for the heart--it's good for the brain.

Alzheimer's Disease gets all the attention, but tiny silent strokes diminish the blood supply to the brain resulting in a slow progression of vascular dementia.  Both diseases are years in the making.  Too bad we wait until it shows its ugly face in our 70's or 80's before we scramble to do something about it. 

Finally, we have a large study of almost 10,000 multi-ethnic participants who were followed for almost 40 years through Kaiser Permanente in California to provide epidemiologic evidence that even modest increases in cholesterol at midlife result in a substantially increased risk of dementia 20 to 40 years down the road.

Bottom line:  Those with blood cholesterol levels over 240 in their mid-40's were 57% more likely to develop dementia than those who were at optimal levels.  Even borderline cholesterol levels between 200 and 239 were at a 50% greater risk of developing dementia.

If you don't take statins--or if you don't want to take statins--now you have one more good reason to consider a plant-based diet to prevent both heart disease and dementia is one fell swoop.  The cholesterol drops are considerable with a plant-based diet.  "Yes, You Can Prevent and Reverse Heart Disease, But Are You Up for the Challenge?  Let, Dr. Esselstyn Convince You!"

Source:  Whitmer, RA, Solomon, A. et al.  "Midlife Serum Cholesterol and Increased Risk of Alzheimer's and Vascular Dementia Three Decades Later,"  Dementia and Geriatric Cognitive Disorders; 2009 Aug. 4;28:75-80.

Read more about the study here.

 Rachel Whitmer--Kaiser Permanente's Dementia Guru.  A Fat Belly at Midlife Increases the Risk of Dementia

Bells went off when I read about the Kaiser cholesterol-dementia-midlife study.  Rachel Whitmer--the senior epidemiologist--sounded so familiar.  Where had I heard that name before?

Sure enough, Dr. Rachel Whitmer, who was the chief investigator in the cholesterol study, was also involved in a 2008 study linking excess belly fat to dementia.  I wrote about it in April 2008.  It bears repeating.

Belly Fat & the Dementia Connection.  Rachel Whitmer, a research scientist at Kaiser Permanente in Oakland, California, reported in the March 26 2008 online issue of Neurology on her study that followed 6,583 Kaiser Health Plan members.  The study began in the late 1960s and early 1970s and measured the abdominal fat of this large group of 40 and 45 year olds.  She followed up with them between 1994 and 2006 when they had reached their 70s and beyond.

Back in 2005 Whitmer had previously reported that senior citizens who were overweight at middle age were 74 percent more likely to develop dementia.  This new study specifically looked at whether belly fat was the culprit.

• Those people who were obese and had the most belly fat in their 40s were 3.6 times more likely to develop dementia than those with the least amount of belly fat.
• Those who were overweight--a step below obese--and had large bellies in their 40s, were 2.3 times more likely to develop dementia.
• 21 percent of those with high levels of belly fat developed dementia.
• The belly fat dementia connection persisted, even when researchers adjusted their statistics to take into account the effect of stroke & diabetes.
• Other recent studies found that obese middle-aged adults have decreased brain volume compared with those of normal weight, decreased hippocampal (the memory center) brain volume and greater brain atrophy. These findings imply that the harmful effects of belly fat on the brain may start long before clinical signs of dementia appear and are not limited only to those whom are overweight.  Rather chilling, I'd say!
  

Waist circumference guidelines:

Women-Keep it at 30 inches or under

Waist of over 31 inches (about 80cm) indicates slight health risk.
Waist of over 35 inches (about 90cm) indicates substantially increased risk.

Men-Keep it at 36 inches or under

Waist of over 37 inches (about 94cm) indicates slight health risk.
Waist of over 40 inches (about 102cm) indicates substantially increased risk.

Read more:  This Belly Fat Is Going to Be the Death of Me and Now I Understand Why.

Source: Whitmer, R. et al.  "Central obesity and increased risk of dementia more than three decades later,"  Neurology; 2008 Sep 30;71(14):1057-64. Epub 2008 Mar 26

Read more of Rachel Whitmer's articles on the relationship between dementia & cholesterol, body fat, type 2 diabetes, and exercise.

It's Grape Juice and Berries to Improve the Aging Brain

James A. Joseph is the Director of the Neuroscience Lab at the Jean Mayer Human Nutrition Research Center on Aging at Tufts University in Boston.  He is THE expert in the health effects of berries & grapes.  Check out some of his research projects, here.  I had heard him speak on brain nutrition on a People's Pharmacy podcast back in April 2009.  Click here to hear it.

So, when my friend Anna told me he had a "just published" review article in The Journal of Nutrition called "Grape Juice, Berries, and Walnuts Affect Brain Aging and Behavior",  I couldn't wait to get my hands on it.

Yes, we all know that berries & grapes are full of potent antioxidants and anti-inflammatory properties that both protect & enhance the brain--at least in lab rats--but does this research translate to humans?

Joseph's own lab studies have suggested that blueberries, strawberries, walnuts and Concord grape juice can decrease the damaging oxidative stress and inflammation in the aging brain, as well as improve the ability of neurons to communicate with each other--faster thought processing and word retrieval.  In this hot-off-the-press article he reviews the extensive brain-berry-grape research.

In a "walnut" shell, here's the real exciting news:

• Concord grapes & humans. Dr. Robert Krikorian of the University of Cincinnati  "has shown that older adults with memory declines, but not dementia, had significant improvements in several measures of cognitive function when supplemented with 12 ounces of Concord grape juice a day  for 12 weeks compared with the placebo.
• Berries and grapes in animal studies. Rats enhanced their cognitive, spatial, and motor skills when their diets were supplemented with strawberries, blackberries, and Concord grapes.  There's evidence that supplementation even reversed age-related cognitive dysfunction, as well as improving balance and coordination.  Stay tuned to see how well this translates to humans. 
• Berry protection for the brain in animal studies. Rats who feasted on blueberries and strawberries were able to protect their brains when they were irradiated to simulate the kind of cognitive & memory damage the brain sustains through normal aging.  The interesting point:  the blueberries and strawberries actually protected different parts of the brain--so diversify your berry munching.
• Blueberries & humans.  Once more, Dr. Robert Krikorian is the man doing the research on people.  He has recently shown that a number of learning and memory skills improve when humans supplement with blueberry juice.  He's planning to also assess the effects of blueberries on behavioral skills.
• Berries & grapes may increase the "health span" (better than "life span") by reversing the damaging effects of aging on cognitive and motor behavior.  According to Joseph, if you are waiting for a molecular biologist to come up with a magic pill to protect you against the diseases of aging you'll be waiting a long time.  His advice:  eat a diet high in anti-oxidant rich berries, fruits & vegetables, get plenty of exercise, and exercise your brain by staying engaged & challenged throughout life!

Source:  Joseph, JA et al, "Grape Juice, Berries, and Walnuts Affect Brain Aging and Behavior," The Journal of Nutrition first published ahead of print July 29, 2009 as doi:10.3945/jn.109.108266.

Keep Your Blood Sugar Stable--Even Moderate Spikes Are Responsible for Memory Decline

The damaging effects of spiking blood sugar just may be one of the reasons for the widespread memory declines we see as we age.  Turns out that up & down blood sugar damages the "dentate gyrus", which is within the hippocampus--the part of the brain responsible for forming memories.

Using a high-resolution functional MRI to map the brain regions of 240 elderly subjects, the Columbia University researchers (lead by Dr. Scott Small) found that when blood sugar (glucose) was elevated, the cerebral blood flow in the brain's memory center was reduced.

Then, the researchers cleverly played with the blood sugar levels of mice & monkeys to confirm this association between rising blood sugar & damage to the dentate gyrus.

The disturbing part of the study is that even slight elevations of blood sugar--less than those seen in type-2 diabetes can cause memory decline.  Because blood sugar tends to rise as we age--even in healthy people--this study is a wake-up call to take steps to keep the blood sugar stable.

Earlier studies have shown a link between type-2 diabetes & damage to the "dentate gyrus", but this study demonstrated the hippocampal damage in people who are other-wise healthy.

What's the antidote for keeping a stable blood sugar and protecting the brain? 

"This is news even for people without diabetes since blood glucose levels tend to rise as we grow older. Whether through physical exercise, diet or drugs, our research suggests that improving glucose metabolism could help some of us avert the cognitive slide that occurs in many of us as we age," reported lead investigator Scott A. Small, M.D., associate professor of neurology in the Sergievsky Center and in the Taub Institute for Research on Alzheimer's Disease and the Aging Brain at Columbia University Medical Center.

Exercise.  Regular physical activity has been shown to offset the damaging effects of type-2 diabetes on cognitive function.  Because exercise improves the ability of muscles to process glucose, it makes sense that it helps protect cognitive function as we age, according to Small.

Low-Glycemic Diet.  Eat high fiber low-glycemic foods like beans, nuts, oats, and quinoa.  Dr. David Jenkins' study found that low-glycemic foods were superior to even whole grains, like whole-wheat bread and brown rice when it comes to keeping the blood sugar stable.  And processed foods should definitely be avoided.

The University of Sydney maintains a Low-Glycemic website and database with a wealth of excellent information on the subject.  Take a look at their FAQs if you want to learn more.  Click here.

Sources:  Jenkins, DJ et al, "Effect of a low-glycemic index or a high-cereal fiber diet on type-2 diabetes: a randomized trial,"  JAMA 2008 Dec. 17; 300(23):2743-53.

Small, SA et al, "The brain in the age of old; the hippocampal formation is targeted differenially by diseases of late life,"  Ann Neurol 2008 Dec;64(6):698-706.

Do Your Brain a Favor--Take An Afternoon Nap

This is my kind of study--the benefits of napping.  As far as I'm concerned, naps are revitalizing and reading Dr. Sara Mednick's nap study that was published June 8th in the Proceedings of the National Academy of Sciences made my day.

Here's the scoop:  The right kind of nap--one that is long enough to include dreaming (REM sleep) will enhance creative problem-solving and "foster the formation of associative networks in the brain."   REM sleep directly enhances creative processing  more than any other sleep or wake state and it helps the brain to make new and useful associations between unrelated ideas.

Mednick found that a nap with REM dreaming improved creative task performance by almost 40% over quiet rest or non-REM sleep. 

The catch:  to have REM sleep, your nap will need to last at least an 1 hour long.

"Dreams are fanciful.  They incorporate strange ideas that you would never have put together in waking life.  In REM sleep, it becomes more likely that ideas might come together in a solution,"  according to Dr. Mednick.

Source: Mednick, SA et al.  "REM, not incubation, improves creativity by priming associative networks,"  Proc Natl Acad Sci U S A. 2009 Jun 23;106(25):10130-4. Epub 2009 Jun 8. 

For the Press Release, click here.

Check out Dr. Mednick's 2007 book, "Take a Nap! Change Your Life"  I really enjoyed this reviewer's comment:

"This book has made a big impact on how I view my study time. Medical school is difficult and exhausting. If I attend all my lectures, eat three meals day, maintain good hygiene, commute to/from the university and get 7 hours of sleep, I only have 3 hours on the weekdays to study. I used to hardly be able to keep my eyes open during that study time and I couldn't remember anything I studied.

After reading Take a Nap! Change your life, I have the skills to use napping as part of my study routine. I used to feel guilty when I napped because I thought I was wasting valuable study time. I was just too tired to study. Now I plan naps into my study schedule and it is amazing how much better I recall everything. My test scores in Pathology have improved an average of 8 points since I started napping and my scores keep improving despite no other changes to my study routine. If you subtract out my naps, I'm actually studying less but getting better grades! As I prepare for my USMLE Step 1 Board Exam, consolidating memories and enhancing recall is especially important. I now consider napping a study skill and regular naps are part of my board prep study schedule. Naps have truly changed my life."

For a Good Night's Sleep--Keep the Room Cool

If I want to feel and think my best I need a good night's sleep.  In the winter we lower our heat to 55 degrees and I sleep great.  But come the summer--and even with the air-conditioning on--our bedroom temperature often climbs to over 82 degrees and my sleep starts slumping.

Check out Anahad O'Connor's August 3rd piece in the New York Times, "Really?  The Claim: Cold Temperatures Improve Sleep"

"Studies have found that in general, the optimal temperature for sleep is quite cool, around 60 to 68 degrees Fahrenheit."

Bingo!  As of 2 weeks ago, my husband and I came up with a solution.  We purchased an easy-to-use-portable-on-wheels room air conditioner with enough BTUs to cool our bedroom down to a comfortable 73 degrees.  Now we can turn off the useless-at-night whole house air conditioner and enjoy a peaceful sleep--and hopefully conserve on fuel costs.

The added bonus:  it has just enough white noise to block out the morning shower and kitchen sounds of the early risers in our house.

Comments

[bellyman]

is there a way to reduce belly fat that is different from just reducing fat, period?

[Ryan Bright]

I've developed a habit of taking mid-day naps, and it has greatly increased my alertness throughout the day. As an engineering student and software developer, this allows me to approach problems with greater clarity without feeling as if I'm working against the clock. I attempt to maintain a stable blood sugar level through observation of my reactions to spikes, but I was not aware of the relationship between spikes and damage to memory centers. Very interesting read!