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Proactive Aging: Food and Lifestyle Choices
Majid Fotuhi, MD PhD
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New Discoveries
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Objectives Why does the brain shrink with
aging? Which foods increase or
decrease age-related brain atrophy?
What else can be done: Brain Fitness Program
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Objectives Why does the brain shrink with
aging? Which foods increase or
decrease age-related brain atrophy?
What else can be done: Brain Fitness Program
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Memory Lapses
Memory Lapses or Alzheimer’s?
Age-Associated Memory
Impairment MCI
Alzheimer’s
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Short-term: HippocampusLong-term: Cortex
Cortex Hippocampus
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With Aging, Hippocampus Atrophies Faster
than the Rest of the Brain
Hippocampus shrinks by about 0.5% per year after age 50
That is the reason memory lapses become more frequent after age 50
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Overlapping Causes of Brain Atrophy with Aging
Obesity Diabetes
StrokeSleep Apnea
Concussion Alzheimer’s
Inflammation
Stress
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Less Brain Volume in Patients with Sleep Apnea
Am J Respir Crit Care Med 2002; 166:1382–7
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Multiple Vascular Risk Factors: Worse Brain Atrophy
Multiple Vascular
Risk Factors
No Vascular
Risk Factors
HippocampusHippocampus
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Stress Shrinks Brain Cells in Hippocampus
StressControl
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Alzheimer’s: Plaques and Tangles
Plaques: gum-like collection of a protein called Amyloid
Tangles: abnormal aggregation of a protein called Tau
Inflammation
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DiabetesHypertensionObesitySleep ApneaHead TraumaGenesStress
Brain-healthy DietPhysical FitnessCognitive StimulationMeditation
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Objectives Why does the brain shrink with
aging? Which foods increase or
decrease age-related brain atrophy?
What else can be done: Brain Fitness Program
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Obesity Shrinks the Brain
Associated with reduced brain volume
Ward, et al., 2005
Slows cognitive function
Debette, et al., 2011
Brains of overweight and obese individuals appeared 8 and 16 years older, respectively
Raji, et al., 2010
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Brain Research Volume 1280, 14 July 2009, Pages 186–194
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Step Away From the Sugar
Increases insulin resistance
Slows cognitive performance
Reduces hippocampal BDNF levels
Agrawal & Gomez-Pinilla,
2012.
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Neurology. 2005 May 24;64(10):1704-11.
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Trash Trans Fats
Trans fats typical found in foods such as:- Cookies, crackers, muffins,
donuts- Fried foods like French fires,
chicken nuggets- Chips and other snack foods
Increase the risk of cardiovascular disease - Increases LDL (bad cholesterol)- Decreases HDL (good
cholesterol)
Linked with brain shrinkageAgrawal & Gomez-Pinilla, 2012
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Alcohol Shrinks the Brain
Alcoholics shows significant brain atrophy
Jacobson, 1986. Mann, et al., 1992.
Heavy drinking is associated with learning and memory problems
Nixon, et al., 1995.
Women appear to be more susceptible to damage
Hommer, et al., 2003.
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Three Types of Food for Reversing Brain Atrophy with Age
1. Increasing levels of a healing protein: BDNF- BDNF helps with growth of new brain cells
2. Reducing levels of toxic amyloid in the brain- Too much amyloid kills brain cells
3. Increasing blood flow in the brain- Reducing risk of stroke is the best way to keep
your brain young
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More BDNF: Bigger Hippocampus
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Erikson, PNAS 2011
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Food That Increase BDNF Levels
Omega-3 Fatty Acids: DHA and EPA Vitamin D Rich Foods Cocoa Blue Berries Grapes Caffeine
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More DHA-EPA: Bigger Hippocampus
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Pottala J V et al. Neurology 2014;82:435-442
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Good sources of DHA:
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Vitamin D
Associated with increases in BDNF
Low levels are linked to fatigue, cognitive deficits, and poor mood
Good sources include:- Sunlight- Milk, yogurt, & cheese- Salmon (especially wild-
caught) and Mackerel- Fortified cereals- Mushrooms - Egg yolks
Llewellyn, et al., 2010.; Wilkins, et al., 2006.
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Cocoa
Increases BDNF levels
Improves blood flow
Prevents inflammation
Enhances memory, learning and cognitive function
Can help to prevent heart disease, high blood pressure, stroke and dementia
One ounce a day (more is not better)
Spencer, 2009., Fisher et al., 2006., Reid et al.,2012
Crimini et al., 2013
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Blueberries
Strongly increases BDNF in the hippocampus
Enhances memory and motor performance
Good source of vitamins A,C and K
Rendeiro, et al., 2009.
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Grapes
Increases BDNF Excellent source of
Resveratrol Increases blood flow
to the brain Reduces the risk of
heart attack Darker the grape- the
better
Rahvar, et al., 2011. Marques, et al., 2009.
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Wine
Source of resveratrol
Moderation is key!
Recommendations:- Women- 1 drink / day- Men- 2 drinks / day
Memory problems?—Avoid alcohol completely!
Gómez-Pinilla, et al., 2008.
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Coffee
Increases BDNF levels in the hippocampus
Increases attention and concentration
Increases cerebral glucose uptake
One cup a day; more is not better
Moy & McNay, 2013.; Cao, et al., 2009.
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Food That Reduce Levels of Amyloid in the Brain
Curcumin Walnuts Pomegranates
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Curcumin
Yellow spice commonly found in Indian foods
Reduces levels of amyloid in the brain
Reduces inflammation Improves memory Absorption is a
problem; more research is needed
Gómez-Pinilla, et al., 2008.
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Walnuts
Reduces amyloid toxicity in the brain
Enriched with beneficial fatty acids, vitamins and polyphenols
Associated with a lower incidence of neurodegenerative disease
Gómez-Pinilla, et al., 2008.
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Pomegranates
Reduces amyloid plaques in the hippocampus
Antioxidant rich
Good source of vitamins C and K
Gómez-Pinilla, et al., 2008.
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Food That Increase Blood Flow to the Brain
Tomatoes Avocados Beets Vitamin B12
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Tomatoes
Increases blood flow to the brain
Source of vitamins A, B6, and K
Reduces inflammation
Contains lycopene which prevents platelet aggregation
Gómez-Pinilla, et al., 2008.
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Avocado
Increases blood flow
Excellent source of Vitamin B, C and E
Reduces risk of diabetes and stroke
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Fulgoni et al., 2013 Image source: Huffingtonpost.com
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Beets
Increase blood flow to heart and the brain
The benefits of beets include:- Lowers blood pressure- Reduces inflammation- High in fiber and low in
calories- Helps with weight loss- Improves “running
performance” (more blood flow to muscles)
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J Acad Nutr Diet. 2012 Apr;112(4):548-52. doi: 10.1016/j.jand.2011.12.002.
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Vitamin B12
Improves blood flow to the brain
Low levels are linked to smaller size of hippocampus
Increases cognitive function and processing speed
Reduces risk of inflammation, stroke and heart attack
Ho, et al., 2011.; den Heijer, et al., 2003.;
Firbank, et al., 2010.38
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Best Brain Diet
Low Carb - No white rice- No white bread- Just a touch of cakes
High protein- 1-2 lean meats / week- 1-2 salmon / week
Lots of fruits and vegetables
Plenty of water DHA supplements
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Physical Activity and Mediterranean Diet, More Effective
Together
Scarmeas et al., JAMA 302 (6):627–37, 2009
Scarmeas et al, 2009
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Objectives Why does the brain shrink with
aging? Which foods can increase or
reduce age-related brain atrophy?
What else can be done: Brain Fitness Program
41
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Comprehensive Diagnostics to Evaluate Brain
Health
Customized Treatment Program to Maximize Brain
Performance
NeurExpand’s Unique Integrative Approach
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Remarkable Results
Hippocampus
HC
After
Before
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Overlapping Causes of Brain Atrophy with Aging
Obesity Diabetes
StrokeSleep Apnea
Concussion Alzheimer’s
Inflammation
Stress
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DiabetesHypertensionObesitySleep ApneaHead TraumaGenesStress
Brain-healthy DietPhysical FitnessCognitive StimulationMeditation