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Best Diet for Your Over 50 Brain

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Herckleperckle
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11-20-2003

Wednesday, May 18, 2005 - 3:45 am   Edit Post Move Post Delete Post View Post    
Source: Ivanhoe.com
Reported February 1, 2004

Life After 50: Best Diet for Your Brain

Full-Length Doctor's Interview


In this full-length doctor's interview, Jeff Victoroff, M.D., explains how simply adjusting your diet can preserve your memory.

Ivanhoe Broadcast News Transcript with
Jeff Victoroff, M.D., Neuropsychiatrist,
University of Southern California, Los Angeles, California,

TOPIC: Life After 50: Best Diet for Your Brain


At what point does the brain start to age?

Dr. Victoroff: Sometime before you’re born. It’s actually fascinating to think about aging not as the bad thing that happens as you get older, but instead the process that continues over the course of development and that changes and in some ways improves your brain and makes it fit for the stuff you’re going to have to do at that point in your life. Let me give you an example of the early brain aging that we’re all familiar with. If you teach a 3-year old to speak French, Spanish, Russian or German, they can learn to do that virtually without an accent. If you try to teach a 7-year old to do the same thing, they’ll always have an accent. And, if you try to teach a 15-year old, not only will they have a great deal of trouble ever learning to speak fluently, but their accent will be atrocious. That means the brain is fit for learning language when you’re 1, 2 and 3, and it actually begins to lose some of that capacity before you’re 7 or 8 years old.

So, rather than thinking everyone has a brain that’s intact and gets better and better until age 65 and then it goes downhill, a more accurate description would be everyone has a brain that develops, and those developments make it better for what you’re supposed to do at that age until, perhaps at a very advanced age for the average person, when you begin to lose the capacity for short-term memory. The average person loses short-term memory capacity beginning around age 35, but it doesn’t affect them. It doesn’t make their life worse. It doesn’t make their job more difficult to do. But, it’s there, and if you do neuropsychological testing, you’ll find it. If they’ve had a high school or college education, it improves their chances of retaining their short-term memory later into their adulthood. If they haven’t, they have a worse chance of retaining short-term memory. But, by the time people are 40 or 45 years old, everyone has measurable losses of short-term memory. That means that there’s stuff going on that we may or may not be able to do something about early in your adulthood. Things get a lot worse the older you get. The average 85-year old is on the verge of what you might call Alzheimer’s disease, or at least called dementia, which means a significant, clinically distressing decline from your previous level of mental function. But the decline starts much earlier, and that’s why there’s the potential for using what we know about the risk factors for mental decline and changing your lifestyles and saving our brains.


Going back to the issue of the memory loss and whether it’s Alzheimer’s or not, a lot of baby boomers worry when they start forgetting things that they are developing Alzheimer’s, and it’s more than just being forgetful. Is it really something that they need to worry about?

Dr. Victoroff: Yes, and the reason for that is there’s something of a misunderstanding of what Alzheimer’s is. Alzheimer’s consists of certain changes that happen in the brain. There are things called plaques and things called tangles. They accumulate at a certain rate, and it’s different in different people. But every single human being, if they live long enough, will have a brain that meets the criteria for Alzheimer’s disease -- everyone. So, rather than thinking of it as necessarily a disease, they might think of it as a syndrome. It’s like wrinkling of skin, developing cataracts, or in men, getting a big prostate gland. It’s going to happen to you. You can’t escape it. If you live long enough, you will develop the evidence in your brain of Alzheimer’s. However, some people develop those changes earlier in life and have a catastrophic experience. Some people develop them much later and may not experience the significant decline until they die of something else. That’s why there’s good reason for figuring out why some people develop Alzheimer’s type changes in their brain at age 60 and some people at age 90, and trying to educate everyone in the United States and around the world that you can do things that will make it more likely that your Alzheimer’s-type changes won’t happen until you’re 90.


How big of a role is diet in that?

Dr. Victoroff: Well, think of it this way. About 50 percent of the chance of developing Alzheimer’s earlier in your late adulthood is due to genes, and you can’t do much about that -- at least not at this stage. About half of it is due to your environment, and there are a bunch of environmental risk factors that we’ve discovered that you can change that will reduce your risk of developing Alzheimer’s-type brain changes. One of those is diet, and it’s tricky to say just how big a deal diet is because no one has done a study where you’ve taken a group of people and said, ‘OK, you’ve got to do all the things that are bad for your diets and you guys over here are going to do all the things that are good for your diets, starting at age 15. We’re going to come back when you’re 85 years old and measure your memories.’ You can’t do such a study. It’s impossible. So, what we do instead is relatively short-term studies where we study one factor, say vitamin E, alcohol consumption, eating fish, and keeping your cholesterol low, and we look at how that influences your chances of saving your brain.


What is the typical American diet doing to our brain?

Dr. Victoroff: The typical American diet is almost perfectly designed to wreck your brain, and I mean that in a number of different ways. The obvious thing is that the typical American diet is enormous. We’re surrounded by what some people call a toxic food environment, just meaning that rather than hunting or foraging or taking some time and some energy to gather our calories, we go to the store and buy a basket of Twinkies in 10 minutes. So, it’s very easy to get an enormous number of useless calories into your body in modern American society. Unfortunately, a lot of people do just that. So, obesity is one of the factors in the American dietary lore that relates to your chances of losing your memory cells. That’s the first thing we can talk about, but we can come back to that.

The second issue is exactly what do you eat during the day that might make you alert or groggy. Most people are going to eat high glycemic index carbohydrates, and by that I mean there’s stuff you can eat like white bread or potatoes that have high glycemic indexes. When you eat them, they are converted into glucose or sugar really fast, so you get a brief boost in energy. Then, insulin pours out, the glucose disappears, and you want to go to sleep. The reason it’s best to look for low glycemic index carbohydrates, stuff like wheat germ, bulgur, granola, or amaranth -- now that’s a particularly great grain -- is that those whole grains are dissolved a little bit more slowly. They don’t turn into glucose right away, and very gradually they release their energy into the bloodstream. So, you’re less likely to be groggy and mentally deficient an hour after a meal. That’s just one of many factors in the American diet that’s way off.

The second specific food is red meat. There are all kinds of opportunities to eat red meat in the American diet that didn’t exist at the time that humans evolved. We are designed to hunt and eat red meat, but the red meat that we ate when we evolved was very, very lean because the animals spent their days running away from our hunters. That doesn’t happen with cattle. Cattle are fat. Their vessels get clogged with cholesterol. They produce highly saturated, fatty meats filled with trans fats and they, in turn, clog our arteries. The reason that’s relevant to what happens to your brain is that clogged arteries or cerebral vascular disease is now known to be a cause of Alzheimer’s disease. We used to look at them as two different things. We used to say well, this person has dementia or memory loss related to vascular problems in their brain, but this person has Alzheimer’s disease. We now know that that distinction or that dichotomy is a false one. If you eat fatty foods, particularly high saturated fatty foods or trans fatty foods, you’re going to clog up your arteries, you’re going to decrease blood flow to your brain, and you’re going to increase your risk for Alzheimer’s.


Is there a connection between obesity and memory loss?

Dr. Victoroff: There are probably many reasons that obesity is related to an increased risk of memory loss. We know from studies both in Europe and the United States that as people get older, the effects of obesity on their mental status gets more serious, so if you take 40-year olds who are fat and 40-year olds who are thin and compare their mental status, you won’t see a big difference. But, where it matters is after age 65, and if you’re still fat after age 65, you do stand a significant chance of having lower cognitive function than your neighbor who’s thin. Now, why is that the case? We don’t know all of the reasons, but an obvious one is that fat people are more likely to develop clogged arteries. Clogged arteries not only decrease blood flow to the brain and put you at higher risk of Alzheimer’s, but also seem to be associated with increased inflammation in the brain and increased delivery of free radicals that tear up your normal membranes. So, there are several reasons to believe that Alzheimer’s might be related to obesity. I have to clarify that there is no study in the literature to my knowledge that shows that very obese people are at higher risk of Alzheimer’s and, in part, that’s because very obese people die long before they’re going to get Alzheimer’s disease. But if we know that people who are obese have poorer cognitive function as they get older than people who aren’t obese, that’s a heck of an incentive to watch your weight.


Going back to the specifics of what we should be eating, and one of the ones that we talked about too is vitamin E. Why consume it? What does it do, and specifically how much do you need to be taking in to actually make a difference?

Dr. Victoroff: Many studies now show that people who either take in more vitamin E in their diet or take vitamin E supplements are less likely to get Alzheimer’s disease. There is a magnificent study that was done by Martha Morris in Chicago that showed in particular that folks who get vitamin E from their diets are 70-percent-less likely, to develop Alzheimer’s at an early age. She did a different study with a different group of people that showed that people who use vitamin E supplements are also less likely to get Alzheimer’s. So, it seems as if however you get your vitamin E, from diet or from supplements, you’re’ going to be saving your brain. Now, why is that the case? Vitamin E is a magnificent antioxidant. It fights the free radicals that tend to kill your neurons in a variety of ways, and we now know that Alzheimer’s disease functions partly by amyloid creating free radical damage to neurons.

Now, just to clarify, Alzheimer’s disease involved plaques and tangles. The plaques are made out of stuff called amyloid. It’s highly toxic, impossible to dissolve, and it hurts neurons. But, how does it hurt them? By creating free radical damage. So, antioxidants, by blocking free radical damage, decrease the chances that the amyloid, even if you’ve got it in your brain, will produce damage to your neurons.


How much vitamin E do you need to make a difference?

Dr. Victoroff: No one knows the exact, precise, best amount of vitamin E. Probably that’s because people vary in their metabolism of vitamin E. But you have to come up with a recommendation, and what I would suggest is that you want to take at least 400 international units of D-alpha tocopherol. Now, I’m saying D-alpha tocopherol for the first time for a reason. You’re going to go to the food store, you’re going to go to the nutrition center, and you’re going to see all kinds of vitamin E on the shelf. Most of it is going to be DL-Alpha tocopherol. That’s the dextrolevo form. It’s a mixture. It’s unnatural. It’s synthetic, and there’s evidence that it’s less likely to raise your vitamin E levels in your blood. If you spend just a little bit more, and buy natural vitamin E, the D-alpha tocopherol that’s made from vegetable oils, it’s more likely to get into your bloodstream and to raise your blood level of vitamin E, which means you’re more likely to protect your brain.


What about fish? What does that do?

Dr. Victoroff: The fish story is fascinating. We’re not completely sure why fish saves brains. The usual argument is that fish contains PUFAs. PUFAs are actually two-thirds of the weight of a human brain. In other words, our brain is a very fatty device. It turns out that most of the fats in the brain are polyunsaturated, and maybe by coincidence, maybe not, people who take in more polyunsaturated fatty acids in their diet are less likely to develop cognitive losses. So, how are you going to get them? You can take omega-6 fatty acids. Those are the ones that are widely available in the foods that Americans eat. But, there’s evidence that people who take omega-3 polyunsaturated fatty acids are more likely to protect their brains from brain aging and Alzheimer’s. So, it may be that omega-3 fatty acids in fatty cold-water fish such as sardines, herring, mackerel, tuna, salmon, are more likely to save your brain than the typical sources of protein that Americans take in. You need to be a little bit concerned about swordfish. It’s not very high in omega-3s, and it can be very high in mercury. So unlike the other fishes that I mentioned, and unlike even canned tuna, which is modest in its omega-3s but is safe and widely available and cheap, you want to stay away from swordfish and seriously consider tuna. Maybe a tuna sandwich three times a week.


So three times a week is what you recommend?

Dr. Victoroff: Yeah. There are many fish that are good sources of omega-3 fatty acids. These include sardines, mackerel, herring and even salmon, which is a favorite of mine. But you get perfectly good supplies of omega-3 fatty acids from canned tuna fish. In fact, studies that have been done in Scandinavian countries that looked at fish consumption and rate of Alzheimer’s disease found that people by and large got their fish out of the can. They were eating canned tuna, and those who ate canned tuna on a regular basis has a much lower rate of Alzheimer’s disease and normal brain aging.


What is the effect of alcohol on the brain?

Dr. Victoroff: A study came out from the University of Bordeaux suggesting that white wine or red wine would be great for your brain. Of course people chuckled because they seemed to have the potential for being biased on the subject. But then, an even bigger and better conducted study came out from Holland. Then a second big and very well conducted study also came from Holland, and it also showed the same thing. People who drank moderately, that is one to two glasses of wine a day or hard liquor or beer, had a lower risk of Alzheimer’s disease, and that was a substantially lower risk. So, the question came up, ‘Why would this happen?’ What’s the benefit of alcohol? The argument came from some that it was the flavonoids in red wine. Particularly there’s a flavonoid called resveratrol, hard to pronounce but probably good for you. However, the study showed it didn’t matter what you drank. You could drink Jack Daniels and get the same benefit, so there must be something in alcohol itself that’s good for brains.

It turns out there are two explanations. One is that alcohol of any source will increase your HDL, that’s your good cholesterol. It decreases the chances of clogged arteries. It decreases the chances of cerebral vascular disease. And, it means you’re less likely to lose your neurons as you age. But, the second discovery that’s relevant to why alcohol might save your brain is a more recent one, and that’s something called C-reactive protein. We now know that people with high levels of C-reactive protein are more likely to have strokes, to have heart attacks, and we suspect have lower cognitive function. It turns out that alcohol is a great way to lower your C-reactive protein. So, by lowering your C-reactive protein and raising your HDL, you knock out two of the risk factors for vascular disease in your brain, and you increase the chances that your brain will keep perking along.


I know you had a specific reason why you recommend red wine as compared to the other alcohols that will give you the same benefits.

Dr. Victoroff: OK. Now we have to choose the type of alcohol that we’re going to drink. I think it’s important to emphasize that about 15 percent of Americans have a problem with alcohol. They can’t control their intake, and that’s the reason that it’s very hard for the medical community to come out with a firm recommendation -- drink alcohol, save your heart, save your brain. We don’t want to encourage drinking for everyone. However, that’s no reason to discourage the other 85 percent of people to recognize the health benefits of alcohol. What kind of alcohol do you want to drink? You can drink beer, but if you drink beer, you’re going to take in so many calories that it’s almost not worth the benefit you’re going to get from the alcohol. You’re going to become somewhat obese, you’re going to get clogged arteries from the obesity, and your back in the soup. You can drink hard liquor, but hard liquor contains stuff called congeners. Congeners are sometimes neurotoxic. That’s why if you drink whiskey, you’re more likely to get a hangover the next day than if you drink wine. You can drink red wine, and actually that might be a very good choice for many people, but 20 percent of women get rip-roaring headaches when they drink red wine. Therefore, if you had to recommend one type of alcohol, you’d probably want to recommend white wine. It’s not going to cause headaches. It’s not going to cause much of a hangover. It doesn’t contain all that many calories. And, it goes down sweetly. California Chardonnay.


What is your opinion on calorie restriction? Some researchers that say a calorie-restricted diet is the best way to go to protect your brain.

Dr. Victoroff: There’s fascinating research that goes back almost 50 years that you can increase the life span of a rat if you just restrict his access to calories. It works in other rodents. It might work in Rhesus monkeys, and the proposal has come out, well let’s do it in humans. Why don’t we just restrict their caloric intake? But, it turns out you have to lose about 20 percent of your body’s weight in order to get this longevity benefit. In other words, you can ask a woman who’s 5’4” and weighs 115 pounds to simply drop to 95 pounds for the rest of her life. I don’t think you’re going to get that many people agreeing to the degree of caloric restriction that’s necessary to protect your brain from brain aging. However, a little bit may go a long way. There’s evidence that folks in Okinawa who live very frugal lives, who exercise regularly, who maintain community contacts, and who don’t eat very much, who have lower body mass indexes than Americans by far, are still satisfied in their diets and yet maintain the lifestyle of a perky young adults in terms of their brain for longer than virtually anyone on earth. So, I don’t recommend severe dietary restriction. It’s not going to catch up. Never. But, I do recommend protecting yourself from obesity and trying to stay at the lower part of the body mass index in so far as you can without becoming miserable.


If somebody was reading this and wanted to make three changes to their diet to protect their brain, what would you say?

Dr. Victoroff: If you wanted to save the brains of Americans in 30 seconds, you’d say take 400 international units of vitamin E every day, eat fatty fish three times a week, and drink white wine, one to three glasses a week. Those three changes in and of themselves would probably make a remarkable difference in the quality of life, in the longevity of Americans, and in their thinking abilities.

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Copyright © 2005 Ivanhoe Broadcast News, Inc.