Power Foods for the Brain
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Power Foods for the Brain
Neal D. Barnard, MD Physicians Committee for Responsible Medicine
Adjunct Associate Professor of MedicineThe George Washington University School of Medicine
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What Matters Most?
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Alzheimer’s attacks half of us by age 85.
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2010 2020 2030 2040 20500
5
10
15Alzheimer's Prevalence in the U.S.
(mill
ions
)
Hebert LE. Arch Neurol. 2003;60:1119-1122
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Memory ProblemsLapses
Mild cognitive impairment
• Learning, remembering • Reasoning• Visual-spatial ability• Language • Personality
Alzheimer’s disease =
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APOE epsilon-4 Allele
From one parent: 3x risk
From both parents: 10 - 15x risk
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Chicago Health and Aging Project
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Saturated Fat
13 grams 25 grams
Alzheimer’s Risk
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Add Up the Saturated Fat
2 large eggs 3.2 g 1 slice bacon 1.0 g Chicken thigh, skinless 4.7 g Whole milk (1 cup) 4.6 g DiGiorno Pizza for One 12.0 g
Total 25.5 g
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Cardiovascular risk factors, Aging, and Dementia (CAIDE) study, FinlandEskelinen MH. Int J Geriatric Psychiatr. 2008; 23: 741–747.
1,341 adultsAverage age: 50Followed 21 years
Mild Cognitive ImpairmentSaturated fat per day
Low (<21.6 grams)
High (>21.6 grams)
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Cardiovascular risk factors, Aging, and Dementia (CAIDE) study, FinlandEskelinen MH. Int J Geriatric Psychiatr. 2008; 23: 741–747.
1,341 adultsAverage age: 50Followed 21 years
Mild Cognitive Impairment APOEε4
Low(<21.6 grams)
High (>21.6 grams)
Saturated fat per day
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Trans FatsLow:
1.8 gramsHigh:
4.8 grams
Alzheimer’s Risk
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Cholesterol and Alzheimer's Risk
<198
198-2
20
221-2
4824
9+0
1
2
Serum Cholesterol (mg/dL)
Rel
ativ
e R
isk
9,844 participants in the Kaiser Permanente health plan.Solomon A. Dement Geriatr Cogn Disord. 2009;28:75–80.
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Alzheimer's Risk
25.1
0
1
2
3
4
Saturated Fat per Day (grams)
Rel
ativ
e R
isk
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Alzheimer's Risk
25.1
20.7
0
1
2
3
4
Saturated Fat per Day (grams)
Rel
ativ
e R
isk
Alzheimer's Risk
25.1
0
1
2
3
4
Saturated Fat per Day (grams)
Rel
ativ
e R
isk
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Alzheimer's Risk
25.1
20.7
13.0
0
1
2
3
4
Saturated Fat per Day (grams)
Rel
ativ
e R
isk
Alzheimer's Risk
25.1
20.7
0
1
2
3
4
Saturated Fat per Day (grams)
Rel
ativ
e R
isk
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Alzheimer's Risk
25.1
20.7
13.0 3.3
0
1
2
3
4
Saturated Fat per Day (grams)
Rel
ativ
e R
isk
?
Alzheimer's Risk
25.1
20.7
13.0
0
1
2
3
4
Saturated Fat per Day (grams)
Rel
ativ
e R
isk
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Meat vs. Plant-Based Diets
Proportion remaining free of dementia
Loma Linda University, 272 participants Giem P. Neuroepidemiology. 1993;12:28-36.
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Meat vs. Plant-Based Diets
Loma Linda University, 272 participants Giem P. Neuroepidemiology. 1993;12:28-36.
Proportion remaining free of dementia
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What else is lurking in plaques?
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Plaques
Β-amyloid protein
Cholesterol
Iron and copper
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Copper
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Another Culprit?
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Aluminum in Drinking Water
88 county districts in Britain
Aluminum in water: Low (<0.01 mg/L) High (>0.11 mg/L)
Similar findings in France.
Martyn CN. Lancet 1989;333:61-62.Rondeau V. Am J Epidemiol 2009;169:489-96.
→ Alzheimer’s ↑ 50%
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Vitamin E
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Vitamin E and Alzheimer’s Risk
Risk over 3.9 years of follow-up Morris MC. JAMA. 2002;287:3230-3237
Low vit E:(4.2 mg)
High vit E:(7.6 mg)
%
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Vitamin E
Walnuts Sesame seedsSunflower seedsAlmonds Pecans PistachiosFlax seed
BroccoliSpinachSweet potatoes MangoesAvocados
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Food versus Pills
Foods have 8 forms of vitamin E. Chicago study: ~8 mg per day
1 ounce nuts or seeds = ~5 mg of vitamin E
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Folate
Vitamin B6
Vitamin B12
More Power for the Brain
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B-Vitamins for Brain Power
Folate: 800 mcgVitamin B6: 20 mgVitamin B12: 500 mcg
223 people over age 70 with MCI, homocysteine ≥11.3 µmol/LUniversity of Oxford, VITACOG studyde Jager CA. Int J Geriatr Psychiatry. 2011; [Epub ahead of print]
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Hopkins Verbal Learning Test, revised, with delayed recallUniversity of Oxford, VITACOG study de Jager CA. Int J Geriatr Psychiatry. 2011; [Epub ahead of print]
0 1 25
6
7
8
9 Memory(Delayed Recall)
Years
Placebo
6.9
5.9
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Hopkins Verbal Learning Test, revised, with delayed recallUniversity of Oxford, VITACOG study de Jager CA. Int J Geriatr Psychiatry. 2011; [Epub ahead of print]
0 1 25
6
7
8
9 Memory(Delayed Recall)
B-Vitamins
Years
Placebo
6.9
7.2
5.9
6.8
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Placebo B-VitaminsHcy 22 → 30, atrophy 2.5%/y Hcy 24 → 12, atrophy 0.5%/y
Brain changes over 2 years. Blue indicates contraction. University of Oxford, VITACOG studySmith AD. PLoS ONE. 2010;5(9):5(9): e12244. doi:10.1371/journal.pone.0012244
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Concord Grape Juice Mild cognitive impairmentAverage age: 781 pint daily
0 1 2 330
35
40Learning
(California Verbal Learning Test)
Grape Juice
Months
Placebo
33.2
38.6
33.2
35.2
University of Cincinnati Krikorian R. Br J Nutr. 2010;103:730-4.
0 1 2 34
5
6
7
8 Recall(California Verbal Learning Test)
Grape Juice
Months
Placebo
5.4
7.2
5.0
6.0
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Blueberry Juice Mild cognitive impairmentAverage age: 761 pint daily
0 1 2 3
5
10
15Learning
(Verbal Paired Associate Learning Test)
Blueberry Juice
Months
University of Cincinnati Krikorian R. J Agric Food Chem. 2010;58:3996-4000.
0 1 2 35
6
7
8
9
10 Recall(California Verbal Learning Test)
Months
Blueberry Juice
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Who eats that way?
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Are there extra benefits from avoiding “bad fats”?
1 gram of fat = 9 calories
1 gram of carbohydrate = 4 calories
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Physical Activity
University of Illinois, 120 adultsBrisk walk, 3 times per week
Reversed brain shrinkage Improved memory
Erickson KI. Proc Natl Acad Sci USA. 2011;108:3017-22.
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Dr. Barnard’s Exercise Tips
1. Arrive at airport as late as possible. 2. Carry massively heavy luggage. 3. Run for the plane.
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Beginning Aerobic Exercise
Begin with 10-minute brisk walk.
Increase 5 minutes per week, up to 40 minutes.
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The Bilingual Advantage
Languages protect your brain.
Delays cognitive decline by ~5 years.
Craik FI. Neurology. 2010;75:1726-9.
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Mental Activity Reduces Alzheimer’s Risk
• Intellectual activities
• Documentaries, newspapers
• Crosswords, anagrams
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WELLILL
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Online Cognitive Training
Lumosity.comFamiliar Faces
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Online Cognitive Training
Lumosity.comWord Bubbles
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WordsFacts
SkillsEmotions
Slow Wave Sleep REM Sleep
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Amyloid Production Falls During Sleep
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But wait, there’s more….
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Medications That Affect Memory
Midazolam (Versed) Cholesterol-lowering drugs Sleeping medicationsAntidepressants Antihistamines Anxiety medications Blood pressure medications Acid blockers
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Medical Conditions That Affect Memory
Depression Thyroid disease InfectionsMigraines Chemotherapy Gluten intolerance
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□ Avoid “bad fats” □ Avoid excess metals□ Vitamin-rich foods□ Vitamin B12
□ Physical activity□ Mental stimulation □ Sleep □ Medications
Checking our Scorecard
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PCRM 2009 USDA 2011
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Beginning a Healthful Diet
Step 1. Check out the possibilities
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Breakfast
Lunch
Dinner
Snack
Foods to Try
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Healthy Breakfasts
• Cinnamon Raisin Oatmeal• Blueberry Pancakes
• Hot Whole Wheat with Dates• Breakfast Scrambler
• Fantastic Fruit Smoothie• Whole-Grain Bagel with Jam
• Swiss Style Muesli• Slow Cooker Whole-Grain Porridge
• Orange-Pineapple Crush
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Lunches and Dinners• Chunky Vegetable Chili
•Chuckwagon Stew • Seitan & Mushroom Stroganoff • Portobello Mushroom Steaks • Oven-Barbecued Tofu Steaks
• Roadhouse Hash • Sweet & Sour Tempeh
• Southern Beans & Greens • Seitan Cassoulet • Mandarin Stir-Fry
• Stuffed Vegetable Rolls • Zucchini & Herb Calzones
• Chili Bean Macaroni
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Italian Cuisine
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Mexican Cuisine
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Chinese Cuisine
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Japanese Cuisine
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Fast-Food Options
Veggie delight
Bean burrito, hold the cheese
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Beginning a Healthful Diet
Step 1. Check out the possibilities
Step 2. Do a 3-week test drive
Optional: Use transition foods
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Resourceswww.pcrm.org
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PCRM.org
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PCRM.org
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PCRM.org