Every one of us knows someone, or has at the very least heard of someone, who is well into their 80s, 90s, or even 100s who is as sharp as a tack. Their cognitive functioning has not significantly declined with age, while the majority of others has lost long- and short-term memory, processing, and certainly the ability to absorb and retain new information. The exciting thing is that this means it is possible to gain years without losing brain power! If some people manage, is it not a possibility for all of us? Wouldn’t we all love to be honored and revered for our wit, wisdom and intelligence in our later years? What the scientific community cannot agree upon is exactly what makes the difference between those who truly experience golden years and those who stumble deeper into a painful and undignified decline. Indeed, up until recently, most of the efforts in looking for a cure for—or even a way to halt the progression of—different kinds of dementia have focused on undoing cellular abnormalities observed in brain tissue.
Strangely, this did not help patients get better. It turned out those abnormalities were there as a result of the brain trying to protect itself. Protect itself? From what? Is it inflammation? Is it poor diet, the SAD (standard American diet)? Is it lack of exercise? Is it toxins, like in air pollution, mercury in our fish or fillings or aluminum cookware? Studies show that, like autism, any and all of these can be contributing factors. Is Alzheimer’s disease caused by a deficiency of neurotransmitters, or a deficiency of acetylcholinesterase inhibitors? If you look at the current pharmacological treatment available after hundreds of millions of dollars of research over the years, you would think so. According to the Alzheimer’s Association, “Alzheimer’s disease is the sixth-leading cause of death in the United States and the only cause of death among the top 10 in the United States that cannot be prevented, cured or even slowed,” and no current pharmaceutical drug can “treat the underlying disease or delay its progression.”
Interestingly, there are well-established “Blue Zones” in five geographical areas around the world in which people live well into old age with none of the physical or cognitive decline we seem to have come to expect. What do these five areas have in common? Lifestyle! It is really not that difficult, and yet it must be rocket science or everyone would be doing it, no? According to journalist Dan Buettner, who co-developed this anthropological theory on the back of demographic work done by Gianni Pes and Michel Poulain, there are several factors that each of these areas have in common: moderate but consistent exercise, moderate caloric intake, dietary focus on plants, moderate polyphenol-rich alcohol intake, absence or reduction of stress, and a purpose to one’s life with engagement socially, spiritually and with family. Of course, in our reductionist culture, we all jumped on the alcohol: A glass of red wine every day? I can do that! But I cannot reduce my stress when my life is so stressful! So how do we create a Blue Zone in our own living rooms?
First of all, many of us cannot completely control the environment in which we live. Whether for financial, physical reasons, social or family reasons, or other reasons, many of us may be unable to move to a place with abundant sunshine, fresh air, access to good clean food, and a less urgent pace. Secondly, even if we could move there, we may be unable to make the kinds of social connections that are important; we might not fit in. Or we might just bring our problems with us. Thirdly, we can all make excuses for not eating better: I don’t live near a good supermarket; I can’t afford healthy foods; I don’t know how to prepare that kind of food; my husband/wife/children won’t eat the same things I want to eat; I don’t have time; it stresses me out to try to make those changes; it’s all just a bunch of baloney anyway. Furthermore, can we really create good family and social connections where they don’t exist in our lives? Can we come up with a purpose to our lives when we just don’t feel like we ever really had one? And stress, it’s just like insomnia, the more you try to get rid of it the more of it you have. As practitioners, we’ve heard all this and probably more.
But here’s the thing, all the experts we’ve been reading and hearing from over the last decade and more in the integrated health field of “natural practitioners” have all been saying the same thing. There are certain changes our patients absolutely must make in order to improve and, ideally, get better from whatever conditions they are suffering. In his newly released, and now best-selling, book, Dr. Dale Bredesen lays out The End of Alzheimer’s. It is the culmination of decades of his own work and research, as well as compiling the tireless efforts of other pioneers before and alongside him. The diet is not something new and earth shattering, but it is in the context of other important lifestyle changes that are specially tailored to each individual’s particular combination of risk factors that has put them on the path of unnecessary cognitive decline. This is what is complicated: each of us possesses biochemical individuality; each of us begins our life in our own way with our own genetic pre-programming; each of us has our own path through life with its unique insults and challenges (epigenetics); and each of us possesses our own capacity or inability to change. While we all know that exercise can be as effective as any pharmaceutical or nutraceutical anxiolytic or anti-depressant, there is no ethical way to force an anxious or depressed person into regular moderate exercise. While we all know that vitamin D3 is crucial for so many areas of our health and wellness including memory and mental functioning, and it is best when we make it from exposure to photons of light, there are so many reasons why so many people fail to achieve an optimal level of D3. We all know that more vegetables are so important in our diets, and yet most of us fail to include them at the level necessary to make a real, lasting health impact. With years of consulting nutrition clients under my belt, I and so many of my colleagues have learned that the main reason people don’t get better is because of an inability or unwillingness to change the inputs. And so, I’ve learned to simplify it. If you cannot do the simple stuff, then you certainly don’t need to read the whole book! Interestingly enough, many of the recommendations for cognitive health as we age are the same as for anxiety and depression when we are younger. Here are the basics:
BDNF (brain derived neurotrophic factor) has been found to play an instrumental role in neurotransmitter balance and, thus, protection and regeneration of brain cells—neurons, really. BDNF is like growth hormone for the brain, and has been the most important neuroprotective protein discovered in neurology. While there are an increasing number of supplements on the market to improve BDNF levels, there are several things we can do every day to make sure we produce it naturally:
- Exercise—just like in the Blue Zones, consistent, daily, moderate exercise.
- Sleep—no electronics, no blue lights, no TV noise, deep proper sleep.
- Meditate—to compensate for poor sleep, to manage stress, to floss the mind.
- Hold your breath—breathing exercises, pranayama, calming breath work.
- Sunshine—to bathe the pineal gland for better biorhythms and to make vitamin D3.
- Community—be a part of something greater, stay connected, laugh.
- Eat flavonoid-rich polyphenols in foods, herbs, and spices—berries, coffee (fruit especially), dark chocolate, turmeric, green tea, grape seeds and skins, broccoli, onions, spinach, tomatoes and legumes.
- Eat proper fats—all cell membranes are composed of a phospholipid bilayer; balancing omega-3s with healthy plant saturated fats and anti-inflammatory plant monounsaturated fats give us the best cellular building materials to support the making of new neurons and the repair of damaged ones.
- Feed your minions—growing a healthy microbiome probably ensures that those polyphenols you eat get properly translated at the gut lining to encourage BDNF production. A healthy microbiome ensures we get more nutrients from both our foods and our supplements, and supports both detoxification and healthy inflammatory pathways. This is where the plant-based and low-sugar diet becomes important and is a major factor for people in the Blue Zones.
Simple enough, yes? Nobody gets out of having to make these changes.
The complicated stuff is identifying each person’s toxic exposures that may be putting them at risk, and supporting their bodies in coping with and eliminating them. Additionally, other health concerns put some people at higher risk for anxiety, depression and all forms of dementia. Metabolic syndrome, for example, with escalating levels of insulin due to insulin resistance, not only is associated with lower levels of BDNF, but also allows the formation of amyloid-beta plaques while the enzyme that would break them down is distracted with dismantling excess insulin. Being on a statin pharmaceutical medication to lower cholesterol levels has now been correlated with increased risk of Alzheimer’s, as the LDL (low-density lipoprotein) and total cholesterol levels are reduced. Lack of exercise, lack of sunshine, and the elevation of inflammatory cytokines produced by abdominal adipose tissue all contribute to cognitive decline—not to mention the recent correlation between an increasing waistline and a shrinking hippocampus. Thus, it is obviously important for each person to be assessed as an individual, relevant to their own health issues that may be contributing to cognitive decline.
Decline in brain function does not have to be a part of aging. But, like every other system in our body, the brain is not an island. It should come as no surprise that the health of the brain is intimately intertwined with the health of all systems, organs and tissues. Gone are the days of Rene Descartes and the belief that the mind and the body are separate and only merge in the pineal gland. Now we understand that all aspects of health and disease in our body can and will affect our mental capacity. We also now have a better scientific grasp of the ancient observations of Chinese and ayurvedic medicine that all health and disease have an origin in the digestive tract. Most of the dietary recommendations for overall brain health, especially the intake of polyphenols, result in lowered inflammatory markers. The correlation between less inflammation and better overall health is demonstrated in hundreds of studies, and when we take a look around the world as in these Blue Zones and places like them, we find less chronic degenerative disease of all types. It’s simply time to bring these ideas home to our own patients—there is no magic pill, but there is certainly an answer.
Amber Lynn Vitale has practiced as a certified nutritionist, ayurvedic specialist, advanced bodyworker and yoga therapist since 1996. Much of her nutrition practice was in collaboration with functional medicine doctors and other integrative practitioners. Since 2008, she has produced written and video educational content for many publications, as well as for her own clients and an interested public audience. By 2012, she realized that raw materials sourcing, labeling transparency, legitimate certifications and educational support were the criteria that would set quality natural products companies apart from others; and she made it her mission to educate the public on the importance of education before supplementation. In 2014, Vitale became the north east regional educator for Garden of Life and continues to write, lecture and produce online content on health and wellness topics important to the practitioner and the patient alike.