APRIL 2013
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Brain Foods
 s the parent of a seven-month-old, I know all too well the havoc that sleep deprivation can wreak on my
brain function. I'm grateful to be past the sleepless nights stage, but I feel like that period gave me a glimpse into what life would be like with a poorly aging brain.
Feeling foggy, having difficulty performing basic tasks, and making poor decisions was scary. I was anxious to snap myself out of my haze and find ways to prevent myself
from ever feeling that way again. To that end, I've been researching ways to keep the brain healthy and functioning optimally as it ages. I am happy to report that there are
plenty of delicious and simple dietary and lifestyle tweaks that can help our brains stay healthy and robust as we age.
Think like a Mediterranean
Brain health and heart health are closely linked, so what is good for your heart is generally good for your brain, too. Therefore, the best framework for a brain healthy
diet is the Mediterranean Diet, a plant-based style of eating that incorporates plenty of vegetables and other wholesome plant foods. It includes two vegetarian
meals a day and one meal that contains animal flesh daily. The benefit of this open-ended approach is that you can get creative with your cooking and add various
ethnic flairs to your dishes to keep the diet interesting and exciting. People who follow the Mediterranean Diet tend to have better cognitive performance, fewer strokes, and
less incidence of dementia and small vessel disease of the brain, than those who follow a more "Western" diet that is lower in total fat but higher in saturated and trans
fats. Researchers have found that people who have higher levels of certain nutrients in their blood also have better mental function. These nutrients—vitamin C, D,
and E, as well as the B vitamins—are found in foods that are included daily and weekly in the Mediterranean Diet.
THE DAILY DIET
Foods and beverages that should be a daily part of a plant-based diet are extra virgin first cold pressed olive oil, vegetables, fruit, whole grains, beans, legumes,
nuts, seeds, yogurt, cheese, wine, and water. These nutrient-dense, minimally processed foods supply antioxidants and other health promoting nutrients that boost cognitive
performance and slow mental decline. Replacing processed foods and animal based foods with these satisfying foods can promote a healthy weight, which in turn
leads to better cognitive health. Here are the details on brain foods to include daily:
 Olive Oil
Eating the right kinds of fats can promote brain (and heart) health. Research indicates that one of the most significant steps toward preventing cognitive decline (including
memory loss and decline in language, attention and mental processing speed) is substituting extra virgin first cold pressed—preferably organic—olive oil in place of
other sources of fat, especially saturated fats and trans fats. Instead of butter, margarine, vegetable oils, soybean oil, peanut oil, other oils, shortening, lard, and partially
hydrogenated oils (the ingredient name for trans fat), use extra virgin first cold pressed olive oil for cooking, as a dip for bread and as a salad dressing.
Detailed research on Mediterranean populations has revealed links between the use of olive oil and reduced risk of mental decline, Alzheimer's, heart disease, and
lower rates of inflammation. Substituting foods cooked with olive oil for other fattier, less healthful foods, such as deep fried foods, baked goods, fast food, and fatty
meats, is especially important for preserving brain health. Studies have found that people whose blood contains trans fats from foods have poor overall cognitive function in areas
of memory, language, attention, and mental response time.
Most other fat in the Mediterranean Diet comes from daily consumption of nuts, avocado, and cheese and weekly consumption of fatty fish. Total fat in the
diet can provide anywhere from 25-40% of total calories, which means you can adjust it to suit your personal preferences for fat. The important thing to remember is that the
monounsaturated fat from olive oil should replace most of the saturated and trans fats in your diet, which means you'll have to minimize your consumption of processed
foods and meat-centered meals.
Vegetables and Fruit
Produce is your best friend when it comes to brain health and weight control. Research shows that a healthy weight is related to a healthy brain, while being overweight or
obese is associated with impaired cognitive function in adults and is also strongly associated with diabetes, which doubles the risk of developing Alzheimer's and is related
to small brain size and deteriorated language skills in older adults.
Fruits and vegetables are sources of the key brain nutrients riboflavin (vitamin B2), folate (vitamin B9), and vitamin C, which help maintain our abilities
to pay attention, organize and prioritize as we age. Produce, preferably in its fresh, minimally processed form, is low in calories and high nutrients and fiber, all
of which work together to control weight, blood sugar, blood pressure, cholesterol, and inflammation for optimal brain health.
Vegetables are often eaten in salads and are incorporated into cooked mixed dishes. Especially prominent healthful items in the Mediterranean Diet are leafy greens
and fresh herbs, root vegetables (including garlic and onions), and tomatoes. Anti-inflammatory fresh herbs are used in place of salt to flavor foods. Fruit is also a large
part of the native diet and is often eaten at the end of the meal for dessert. Blueberries seem to have especially important brain benefits, but all fresh fruits are
considered to be a healthful part of the diet. Fresh fruits and vegetables, both raw and cooked, are to be eaten daily in abundance to maximize antioxidant intake.
Try to include at least one vegetable or fruit at each meal and snack.
Grains and Cereals
Whole, minimally processed grains—such as bulgur, barley, buckwheat, brown and wild rice, farro, oats, quinoa, and wheat berries—are satisfying, good for your
brain and an important element of the Mediterranean Diet. These whole, intact grains help to control blood sugar, which in turn can help prevent diabetes—a
condition notoriously linked to stroke, poor memory, cognitive problems, and dementia. In the short term, good blood sugar control helps us feel more focused and
alert. Whole grains also supply important brain-boosting B vitamins to our diets. Polenta, whole-grain pasta, couscous, and various types of flat and crusty breads are
also included in the diet, though they are more refined and therefore less satisfying than the whole, intact grains previously listed. Starchy vegetables like potatoes and
corn are considered part of this food group rather than the vegetable group, so keep in mind that you don't need bread or any other grain if you're serving potatoes or
corn with a meal. Each of these varieties of grains are readily available at Gelson's, but it's important to make a little extra effort to make sure that the grains you choose
are minimally processed (for example, eat mostly oats instead of cereal made with oat flour and brown rice instead of white). Whole grains and starchy vegetables are to
be eaten daily, but limited to one to two half-cup servings per meal at most. For optimal blood sugar control, combine these starches with protein and healthful fats.
Beans, Other Legumes, Nuts, and Seeds
Beans and other legumes, especially lentils, are heavily relied-upon plant proteins in the Mediterranean Diet. Beans are extremely rich in protective antioxidants (red and
kidney beans have more antioxidants than blueberries!) and they are high in both fiber and protein, for ultimate blood sugar control and satiety. Raw nuts and seeds,
such as almonds, cashews, hazelnuts, pine nuts, sesame seeds, and walnuts, contribute healthful fats, protein, and fiber to the diet and lend texture and flavor to dishes.
Beans, nuts, and seeds provide vitamin B6, folate, and vitamin E for better cognitive functioning. Substitute beans, legumes, nuts, and seeds for animal proteins to
build your vegetarian meals. Add them to salads, soups, stews, sautéed vegetable dishes, and snack on edamame, hummus, walnuts, almonds, and cashews. It will probably take
some effort to make beans a regular part of your daily diet, but it is crucial to replace servings of red meat and poultry with these plant proteins. Start by adding a small
amount of these foods to your diet, then gradually increase your portion sizes and drink plenty of water with them to prevent bloating and gas.
Yogurt and Cheese
Rejoice! Cheese is eaten daily on the Mediterranean Diet, usually as condiments or "accent cheeses" in the form of Feta, Mozzarella, Ricotta and Reggiano
Parmesan. Dairy contains brain-boosting vitamin D, B2, and B12. Although dairy products also contain saturated fat, they are eaten in small enough quantities to keep
saturated fat to a reasonable 7-8% of total calories. Yogurt consumption has been shown to help lower blood pressure, which in turn reduces stroke risk. Dairy is eaten
each day but in small amounts as cultured and fermented products, like yogurt and cheese, and rarely as fresh milk. Low-fat and non-fat dairy are good choices for yogurt
and milk—try plain 0% Greek yogurt with granola for breakfast.
Wine
Wine, especially red wine, contributes significant amounts of antioxidants to the diet and has been shown to protect against Alzheimer's disease. Studies have shown
an association between daily moderate alcohol consumption and a lower risk of cognitive decline and dementia. Wine is typically consumed daily with a meal, but
in moderation—up to just five ounces a day for women and ten ounces for men. Discuss this aspect of the diet with your doctor. You should not start drinking if
you currently abstain.
Water
Water is essential to life—and optimal brain function. Our brains work best when we are fully hydrated and studies have shown that even slight dehydration can impact
visual-spatial processing, focus, energy levels, and mood. Water is the primary beverage choice on the Mediterranean Diet and it contributes to overall health, wellbeing
and energy levels since water carries nutrients throughout the body. It's also the ideal beverage for weight control since it is naturally calorie-free. Water needs can vary
based on body size, climate and activity level, but most adults need at least 64 ounces a day to prevent dehydration.
THE WEEKLY DIET
The Mediterranean Diet is not a vegetarian diet, but it does emphasize eating most of your food from plant sources. I like to think of this style of eating as flexitarian,
or flexible vegetarian, which includes two vegetarian meals a day and one meal that contains animal flesh. It is important to rotate in a variety of animal sources, while
mainly emphasizing a variety of fish over poultry and red meat, though poultry can be eaten two or three times a week.
Fish and Shellfish
Fish is the ultimate brain food—it is considered the healthiest of animal proteins and is therefore eaten two to four times a week. Wild, fatty fish are rich
in cardio-protective omega-3 fats, vitamin D, and selenium, an antioxidant. Omega-3 fatty acids from fish are strongly associated with better
"executive" brain functions, including the ability to organize, plan, and prioritize. Adequate omega-3s are also associated with better emotional well-being
and can aid in the prevention and treatment of many mood disorders. Since our brains are 60% fat, these essential "good" fats help improve the supply
of oxygen and other nutrients to the brain to keep it functioning optimally. Fish is also an important source of vitamin B12, which is
essential to preventing age-related cognitive impairment and brain shrinkage. Salmon, black cod, tuna, rainbow trout, sea bass, halibut, sardines, and herring are highest
in omega-3 fats, but no fish or seafood is restricted. Try to eat at least seven ounces of a variety of different fatty fish and seafood each week.
Poultry
Free-range or organic poultry is a small part of the Mediterranean Diet, which means that you may have to cut back from choosing chicken breasts as your daily
default protein to having it only every two to seven days. Fish is favored over poultry since it contributes important but scarce healthful nutrients, while poultry's
nutrients, such as protein, iron, zinc and B vitamins, are easily obtained from other foods. Nonetheless, skinless poultry is a good source of vitamin B12, which is
associated with the ability to maintain brain volume, process visual information quickly, and preserve the type of memory associated with experience, events, facts, and concepts.
It is important to note that after age 50 our
ability to absorb naturally occurring vitamin B12 diminishes and it is recommended that older adults have their blood levels tested
periodically and either take a supplement or eat foods fortified with the vitamin. Eat chicken, turkey and other poultry up to twice weekly, and in slightly smaller
amounts than fish.
Eggs
Up to seven free-range or organic eggs are eaten weekly on their own as omelets, for example, or in pasta, breads, and cakes. Organic omega-3 eggs are my favorite
choice. Choline, a nutrient abundant in egg yolks, improves cognition, and if your eggs contain omega-3 fatty acids, you will also reap those cognitive benefits. Enjoy a
Mediterranean-style omelet or frittata once or twice a week by first sautéing vegetables like onion, garlic, tomatoes, and spinach in olive oil and then adding in the eggs.
Sweets
Mediterranean dieters love their sweets and, although fruit is usually eaten for dessert, they do indulge in small treats weekly. The sweets, however, are usually sweetened with
honey instead of high-fructose corn syrup or sugar. Small portions of treats, such as dark chocolate, fruit preserves, gelato, and sorbet, are eaten just a few times a week. Of all the
treats, dark chocolate is the best choice, as it is associated with better cognition, memory, and verbal fluency.
THE MONTHLY DIET
Red Meat
An important distinction of the Mediterranean Diet is that red meat is only eaten a few times a month and in small portions. This may be a particularly
challenging change for most people since the average American eats a third of a pound of red meat per day! Reducing red meat in your diet can have beneficial effects on cognition
and replacing red meat with beans, legumes, nuts, and seeds for protein and olive oil for healthful fat is one of the most healthful and significant dietary changes you can
make. When you do eat red meat, make it count and choose leaner cuts of excellent quality grass-fed, organic meat such as filet mignon, New York strip, rib eye (small
end), and flank. Try to limit your red meat consumption, including lamb, pork, veal, venison and buffalo, to 12-16 ounces a month.
OTHER BRAIN-BOOSTING PRACTICES
Social Interactions
Social networks are an important part of the Mediterranean Lifestyle that help support good mental health. Life-long learning and social interactions aid the prevention
of Alzheimer's and dementia. Surround yourself with people, make new friends, and create an active social life to fend off depression and mental decline.
Mental Stimulation
The brain needs to learn new things and be challenged in order to stay healthy. Make an effort to challenge your brain with an activity that requires problem solving,
like puzzles, and keep your mind active by reading, visiting museums, playing an instrument, or learning a foreign language.
Exercise
Daily physical activity plays an important role in the healthfulness of the Mediterranean Lifestyle. Cardiovascular exercise increases brain matter and improves
memory. Walking in particular is great for preventing brain shrinkage, memory loss, and dementia. Adding strength training to your workout routine can improve your
focus, decision making abilities, and boost conflict resolution skills. Physical activity also contributes to a healthy weight and better blood sugar control.
Avoid Cigarettes and Tobacco Smoke
Smoking and tobacco use put you on the fast track to stroke and cognitive decline. The good news is that quitting smoking and adopting a healthier lifestyle
can actually improve cognition. Low rates of tobacco use are a hallmark of the Mediterranean Lifestyle.
Sleep
As I explained earlier, my sleep deprivation motivated me to learn more about brain health. It turns out that adequate sleep plays a critical role in optimal brain
function. Chromic sleep deprivation can accelerate brain aging and memory loss, as well as decrease insulin sensitivity (a precursor to weight gain and diabetes).
Make an effort to get adequate sleep and remedy any sleep problems you may be experiencing.
Preventing nutritional deficiencies and maintaining good nutritional status is vitally important to keeping our brains healthy as we age. Research
shows that it is our overall dietary pattern and lifestyle that play a significant role in this process. Nutrient supplements have not for the
most part been shown to be protective in the same way that nutrients from food have been. That means that if we want to keep our minds sharp, prevent strokes, and
balance our moods as we age, we need put the Mediterranean Diet and Lifestyle into practice. The happy reward for a lifetime of good eating can be optimal mental and
cognitive health, as well as a lower risk of heart disease, diabetes, and obesity. The Mediterranean Diet and Lifestyle are intended to be just that—a way of living
that incorporates all of the foods and activities described here. You can't pick and choose the parts you like or use them as an excuse to eat gelato every day. The
health benefits arise from doing everything I describe.
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