It's All In Your Head
With the prevalence of Alzheimer’s and dementia rising in our society, there is good reason to harbor some anxiety about growing older. However, evidence is emerging that shows the risk of developing these conditions can be dramatically reduced—and the best news is that taking these steps can improve your life right now.
For years, we have all known about factors that can damage our brains: lead, drugs, alcohol, and trauma are all near the top of the list. But damage to the brain was in many ways thought to be irreversible.
The work of psychiatrist and bestselling author, Daniel Amen, MD, has shown conclusively that in many cases brain damage can be reversed, even for those who have suffered trauma and after dozens of years have passed.
The Light Goes On
In 1991, Amen attended his first lecture on single-photon emission computer tomography, otherwise known as a SPECT scan. “It changed everything I did,” explains Amen. “I could become better at diagnosing my patients because I had more information.” The SPECT scan does not take a “picture” of your brain, but rather represents the activity and blood flow coursing through your brain at a given moment.
Of course, curiosity got the better of him and it wasn’t long before Amen put his own head under the microscope. “I scanned myself, and it wasn’t that good.” he says. “I realized that your brain is involved in everything you do—how you think, how you feel, how you act, how you get along with other people—and I wanted my brain to be better. So I studied how to help people have healthier brains, and in the process, I realized that’s also where psychiatry should be going.”
Amen maintains that the psychiatry profession should become the “champions” of brain health, rather than merely treating illness reactively. “With a healthy brain, people are happier, physically healthier, wealthier, wiser, and they make better decisions, so they are more successful,” he says. “When the brain is not healthy, for whatever reason, people are sadder, sicker, poorer, less wise, their decisions are not as good, and they’re not as successful.”
Seen in this light, the difference seems very clear, but on a day-to-day basis, poor decisions and odd behavior are often written off as selfishness, foolishness, stubbornness, impulsiveness, inattention, or ineptitude. According to Amen, much of this can be attributed to the overall health of one’s brain.
“Nobody thinks about their brain because you can’t see it,” he explains. “You can see the wrinkles in your skin or the fat around your belly or the roots in your hair, and you can do something when you don’t like how it looks. Because very few people do brain imaging, people don’t get a look at their brain; so they just don’t care. And our society acts like we are brain damaged.”
Healthy Brain Strategy
Amen rates our current attitudes toward brain health as poor, overall, and suggests three steps for improving the situation: wanting a better brain, which he terms “brain envy”; avoiding things that hurt your brain; and doing things that help it.
To adopt the principle of brain envy, first, one must consciously desire a better brain. Set the goal of having a healthy, well-functioning brain and strive to follow through with the protocols that enhance this.
As for things to avoid, Amen puts drugs and alcohol at the top of the list. “Many people think of alcohol as a health food,” he says. “Our imaging work says that it’s not a health food. People who drink every day have smaller brains, and when it comes to the brain, size matters. Pharmaceuticals commonly prescribed for mental health issues can also fall into this category, according to Amen. “When I first started doing imaging, a lot of the medicines I was giving actually made the brain look toxic,” he says. “It was quite horrifying.”
Brain injuries should also be an obvious addition to the list, but seem to be so tightly woven into the fabric of society that we are blind to many of their sources. “We cheer at mixed martial arts events,” says Amen. “We cheer for football players when they get creamed. We allow our children to hit soccer balls with their heads or box [in the ring]. We need to do so much better.” Part of the issue with trauma is that the inside of the skull is not smooth and consistent, according to Amen. It has many sharp, bony ridges that can cause damage internally following a blow to the head. “It’s clear in the medical literature: people who have traumatic brain injuries can’t sleep, often have anxiety or panic attacks, and can get depressed or even suicidal.”
Being overweight or obese is another marker for poor brain health that should be avoided. Amen calls this influence the “dinosaur syndrome” in reference to the combination of big body and small brain. “Eighteen studies now show that as your weight goes up, the actual physical size and function of your brain go down,” he says. “That should scare the fat off anyone.” After reading these results, Amen acknowledges that it motivated him to drop 30 pounds.
Furthermore, Amen singles out several chronic conditions—some associated with obesity—as brain-busters: type 2 diabetes, hypertension, low thyroid, and low testosterone. Although it makes up just two percent of your body weight, your brain uses a full 20 percent of the calories you consume and the oxygen in your bloodstream. Any condition that impairs the delivery of nutrients and oxygen is going to affect brain function.
“We know that high cholesterol will kill you,” he says, “but most people don’t know that low cholesterol is associated with both homicide and suicide.” Chronic exposure to stress hormones also kills cells in the memory centers of the brain, according to Amen.
Last, he cautions people to avoid “the four white powders”: white rice, white flour, white salt, and white sugar. “All of those things are addictive and not helpful for you.”
Things To Do
It is probably no surprise that many of the things you should do to promote brain health are good for the rest of your body, too. Amen’s list includes supplements, exercise, adequate sleep, proper diet—including plenty of healthy fats and lean protein, hydration, regular check-ups, maintaining a healthy weight, meditation, positive thinking, healthy and regular sexual relations, and challenging your mind.
“Exercise is one of the fountains of youth,” says Amen. “Exercise boosts blood flow to the brain. It increases chemicals, like brain-derived neurotrophic factor, and it increases hormones, like testosterone, that help our brains work better.” He says people often write off the drop in testosterone as they age as “normal.” “It may be normal, but it’s not good for you,” he says. “When testosterone levels get low, people have lower libido, but in addition they have low memories and they are more likely to be depressed. So if you have no interest in sex, it may mean more trouble than you want.”
Amen shares that the best way to boost testosterone naturally is to stop eating sugar. Sugar drops your levels of this important hormone. Another, of course, is exercise. “The amount of lean muscle mass on your body is associated with longevity,” says Amen. “The stronger you are as you age, the less likely you are to get Alzheimer’s disease.”
Amen says his routine includes four 45-minute walks each week where he “walks like he is late for an appointment.” He lifts weights for 30 minutes twice a week, and then plays a physical game, such as table tennis to stimulate the coordination centers of his brain, “which just happen to be very important to things like judgment and impulse control.”
Sleep is critically important to a healthy brain. “People who get less than six hours of sleep at night have lower overall blood flow to their brains, which means more bad decisions,” he says. Chronic insomnia triples your risk of death from all causes. Your health routine should also include getting a complete blood work-up including vitamin D, an HgA1c, a full metabolic panel, thyroid hormones, C-reactive proteins, homocysteine, ferritin, and testosterone. Also know your body mass index (commonly known as BMI) and blood pressure.
Diet and nutrition are also paramount. A brain-healthy diet includes lots of healthy fats. Why? “Sixty percent of the solid weight of your brain is fat,” says Amen. A steady diet of unhealthy fats makes the brain rigid and impermeable, while healthy fats contribute to a supple brain that allows nutrients in and pushes toxins out. Healthy fats are found in avocados, walnuts, green leafy vegetables, salmon, tuna, and lamb. Low-glycemic carbs are essential for energy, while proteins provide the building blocks for the neurotransmitters that help the brain function properly.
At 80 percent water, anything that dehydrates you makes it harder to think,\ according to Amen. Daily hydration with water is a must. Amen also recommends a fish-oil supplement to bolster the healthy fats in your system. Fish oil not only helps your brain, but also keeps your heart healthy and pumping oxygen to your brain.
When it comes to meditation, Amen has published three studies on a Kundalini yoga form of meditation called Kirtan Kriya. His research revealed that the 12-minute meditation increased blood flow to the front part of the brain. “That’s the most human, thoughtful part of the brain,” he says, “so wouldn’t that be a cool thing to do?”
Amen has a special term for the negative thoughts and nagging doubts we encounter in our minds each day. He calls them “Automatic Negative Thoughts” or ANTs. “You have to have an anteater patrolling the streets of your brain to keep your mind clean, and it takes a little bit of discipline not to believe every stupid thought that you have.” Amen illustrates this point through a study he performed with one of his patients. Focusing on what was happy and fulfilling in her life, her scan came up very positive. Then he had her focus on the things she hated about her life. “It completely disrupted her brain function,” he says. “Where you bring your attention determines how you feel. “I teach my patients, when feeling sad, mad, nervous, or out of control, to write down what they are thinking and evaluate it. Is it true? If not, then learn to get rid of them.”
Last, Amen says it is important to regularly engage and challenge your mind through games, puzzles, or learning new skills.
Lower Alzheimer's Risk
According to a study by the Veterans Affairs Hospital in San Francisco, 50 percent of Alzheimer’s cases can be prevented. “I think the best way to prevent Alzheimer’s is to prevent the illnesses that are associated with it,” says Amen. Obesity doubles your risk. Sleep apnea doubles your risk. Hypertension, heart disease, heart arrhythmias, cancer treatment, and depression all elevate your risk for Alzheimer’s. To which Amen notes, “All of these diseases are treatable and preventable.”
The bottom line is that your fate is largely in your own hands. Take steps to take care of your brain now and you will not only find a better life now, but will likely remain lucid and increase your level of independence throughout your golden years.
Research for this article included an interview by Karen Burnett.
Dr. Amen’s new book, Use Your Brain to Change Your Age, (Crown, 2012) is currently available.
Diet is extremely important to promoting brain health according to psychiatrist and author, Daniel Amen, MD. Supporting your daily nutrition with supplements can magnify the impact of good dietary habits. The following supplements have shown particular significance when it comes to brain health and function.
Multivitamin • No one consumes the ideal amount of every vitamin and mineral every day. A good-quality multi-vitamin fills in the gaps and will provide the essential minerals you need to meet at least your minimum daily needs. Remember that you get what you pay for—cheap vitamins are often chock full of synthetics and poorly absorbed molecules.
Omega-3 Fatty Acids • If you get no farther down the list than this, you will do yourself a huge favor by adding an omega-3 supplement to your regimen. Omega-3s are not only critical for your brain’s structure and function, they have benefits throughout your body—benefits such as improving cardiovascular health, which then affects blood flow to the brain. There are literally dozens of studies that demonstrate the measurable effects of omega-3s that support cognitive function, prevention and management of Alzheimer’s disease and other forms of dementia, depression and mood disorder treatment, and prevention of neuronal atrophy. Choose a product that eliminates the presence of marine-life toxins such as mercury or PCBs.
Citicoline • This compound is found in every cell in the body and plays a key role in the construction of cell membranes. Perry Renshaw, MD, PhD, a leading researcher on the benefits of citicoline, explains that as a supplement, citicoline is broken down into choline, which enters the brain and supports synthesis of acetylcholine, and cytidine. Acetylcholine is a neurotransmitter that is responsible for memory function. Cytidine plays a role in many brain functions, including energy metabolism and synthesis of critical neurotransmitters, hormones, and compounds found in cell membranes. Citicoline is effective for improving memory, concentration, attention, and mood.
Astaxanthan • As an antioxidant and anti-inflammatory, astaxanthan has recently been shown to be a very powerful supplement for protecting the brain. Astaxanthan is derived from algae and is the nutrient that causes the pink coloration of salmon, shrimp, crab, and flamingoes. Flamingoes, in fact, are not born pink, but pick up the color as they consume organisms that feed on the algae containing astaxanthan.
Glutathione • Within the brain, glutathione acts as both an antioxidant and a detoxifier. Its presence is critical to a healthy brain. In fact, many beneficial herbs and supplements have been found to support the action or synthesis of glutathione in the body and this may be one way to quantify their benefit. However, glutathione does not survive oral supplementation, so it is best to supplement using the precursors used by the body to create it. Two of the three primary building blocks for glutathione are common in our diet, so focus on the third: cysteine. This, too, is hard for the body to process orally, so supplement with N-acetylcysteine (NAC) and non-denatured whey protein, which provide forms that survive the digestive process.