Last week I posted Part One of my interview with Dr. Annie Fenn, a brain health expert specializing in the link between diet and Alzheimer’s disease. This is Part Two, which digs further into foods to eat (and to avoid), other lifestyle factors that can promote brain health, some thoughts on supplements,  and a few favorite brain-boosting recipes. 

Are there certain, specific foods that you personally try to eat daily or almost daily?

At least one cup of berries every day, which is easy when they are in season, trickier when they’re not. One study showed that just ½ cup of blueberries twice a week improved memory and cognitive function in a group of healthy aging women.

Nuts every day, either as a snack or as nut milk or cream.

Leafy greens and another serving of veggies every day.

Something whole grain at least twice a day; the MIND diet recommends three ½ cup servings of whole grains each day! I love having farro or quinoa for breakfast as a warm porridge. Or I’ll put a scoop of forbidden rice in my salads. Forbidden rice, a blue/black variety, contains more anthocyanins than blueberries.

Fish or chicken a few times each week and try to keep my red meat intake under four 3-ounce servings each week.

And I find it easy to drink a glass of red wine with dinner — I adore red wine.

And what foods should we look to minimize?

Processed foods, packaged foods, pastries and sweets, red meat, cheese and butter.  I would love it if everyone cleaned out their pantries of processed foods containing unhealthy fats. The brain thrives on omega-3s and the poly- and mono-unsaturated fats in olive oil, avocado oil, walnut oil, pecan oil and some high quality canola oils.

Another important food to minimize: sweetened and artificially sweetened drinks. One study last year showed that dementia and stroke risk increased with the consumption of these drinks. It’s so important for our kids to not expect everything to taste very sweet.

Cheese and butter are tough ones for those of us who love food. I no longer snack on cheese; instead I serve crudité and dips, such as hummus, when the family needs a snack. I have converted most of my baking recipes to using olive oil instead of butter. Now when I slather butter on toast, as I love to do occasionally, I really relish the rich flavor and texture. 

Is there a certain point at which dietary intervention is too late or does diet have an impact at any stage of cognitive decline?

Yes, and this is such an important question. Most of the research on nutrition and the brain pertains to those with healthy brains and how not to get Alzheimer’s. We don’t know if a brain healthy diet can help someone with Alzheimer’s. But some studies show that we can maybe prevent the earliest stage of Alzheimer’s, called mild cognitive impairment or MCI, progress to overt Alzheimer’s. This is very exciting because there are millions of people in the U.S. diagnosed with MCI who are able to live independently with some help. Once their cognitive function declines, they will need full-time care.

There’s so much controversy about the “best” diet for health. What popular diets do you think are not in service to good health, and specifically brain health?

There is not a lot of data to guide us with many of these diets; only the Mediterranean diet and the MIND diet have good studies to back them up as brain healthy. As for other diets:

Vegan — It is very likely that a vegan diet will prove to be brain healthy as well, as long as one makes sure to get enough omega-3s, like we get from fatty fish, from plant sources.

Gluten-free — Gluten can certainly be inflammatory if you are one of the 1% of the population with celiac disease, or the 5% who are allergic or sensitive. There is no evidence that the rest of us should give up gluten, as long as we are consuming whole grain foods, a great source of fiber and vitamin E. We do need to give up foods made from processed white flour, which is what makes up 98% of the gluten Americans eat.

Ketogenic — The ketogenic diet is so popular now and there are good studies to show it can help with weight loss. But I can’t believe a diet that is high in saturated fats and red meat will ultimately be proven to prevent Alzheimer’s. Also, limiting carbohydrates can be a good thing because it gets rid of a lot of junk food in the diet. But many of our carbs come from plants, and we want to eat a large amount and a huge variety of plant foods.

Intermittent fasting — Research shows that giving the brain a break from food by fasting for 10 to 16 hours a few times a week helps clear out toxins like amyloid. This can be as easy as eating an early dinner and a late breakfast the next day.

Whole 30 — I would not advocate doing any diet that eliminates entire food groups, such as Whole30, for long term. It can be great to jump-start a weight loss program or identify food sensitivities. But we want to eat as many whole foods as possible — such as beans, nuts, and whole grains — to keep the diet diversified.

Beyond what you eat, what other lifestyle factors prevent cognitive decline? Should we all be doing the crossword puzzle, for example?

Be a Lifelong Learner

People who are lifelong learners have less Alzheimer’s. People with higher education have less Alzheimer’s. Interestingly, a lack of early childhood education is thought to be a risk factor for Alzheimer’s later in life. So we want to keep all our neurons firing by challenging our brains, especially from mid-life and beyond, to enhance neuroplasticity. Crossword puzzles are great but other activities are better. Learn a new language, a musical instrument, or how to dance. Socialize frequently, especially when it involves in-depth conversation and physical exercise. Those sharp-as-a-tack ladies who play bridge are onto something — bridge is a complex game that requires social intelligence and a great memory! 

Reduce Stress

Stress reduction is another huge factor. We know stress raises cortisol levels, leading to brain inflammation. There is a large body of data that shows meditation calms the brain and makes it more resilient to stress.

Get Physical

Physical exercise is incredibly important. Our bodies need vigorous, heart-pumping exercise at least 30 minutes each day to keep our blood vessels healthy, elastic and free of plaque. We also need resistance training a few times a week. Both types of exercise increase brain derived neurotropic factor, or BDNF, which is like Miracle Gro for brain cells. High intensity interval training is shown to specifically enhance the size of the hippocampus, the part of the brain most vulnerable to Alzheimer’s. Two thumbs up for Spin class!

Sleep!

The explosion in sleep research in the last few years shows that we need high quality sleep to fend off Alzheimer’s. While we sleep, the brain’s newly discovered glymphatic system acts like a dishwasher on the rinse cycle — it flushes amyloid protein, among other things, from the brain. Food and alcohol intake have a large impact on sleep. I advise not eating (or drinking) within three hours of bedtime. Give your brain a break from metabolizing food and alcohol so it can shift into cleanup mode. 

There are a lot of supplements marketed to promote brain health. Gingko bilboa and fish oil comes to mind. Can any of these make a difference?

No supplement has ever been proven to reduce the risk of Alzheimer’s or alleviate its symptoms. Certain nutrients found in whole foods are crucial for brain health. But every study that has looked at isolating those nutrients in pill form — such as vitamins E, A or selenium — has failed to show a positive impact. That’s probably because these molecules don’t get absorbed properly if not in their whole food form. Fish oil has failed to prove beneficial, and now most medical organizations no longer recommend it. Vitamin D is an exception; I do recommend taking a D supplement if you are deficient, as many Americans are. A blood test can help you determine if you need to take vitamin D.

I love the work that you do. Where people can find you?

Readers can find me (and many of my recipes) at www.BrainHealthKitchen.com and contact me at [email protected]. I’m also posting over on Instagram @brainhealthkitchen and on Facebook @Brain Health Kitchen. Visitors to my site can sign up for a free monthly newsletter with updates on Alzheimer’s research, new recipes, and upcoming events. They can also hop onto my yearlong Dementia-Proof Your Brain program in which we aim to adopt one brain healthy habit each month. This month we are memorizing easy recipes to streamline our cooking. It’s hard to develop new habits alone…Much easier with a group!

Below are a few favorite recipes from the Brain Health Kitchen:

diet and Alzheimers disease

Moroccan Forbidden Rice Salad (pictured above)

Cauliflower Couscous with Turmeric, Blueberries, and Apple

Roasted Broccoli Salad with Avocado and Tahini