Your Guide to a Healthy Brain

Y O U R G U I D E T O A H E A LT H Y B R A I N

As we age, worrying about losing our memory or suffering from a dementia-related disease is something many of us have in common. Luckily, there has been a lot of research on the topic of brain health and what can be done to combat cognitive decline as we age. We have compiled a host of helpful information and suggestions throughout this guide on how to keep your brain healthy, which is not just good for your brain, but beneficial for overall health.

WAYS TO KEEP YOUR BRAIN HEALTHY Your brain is an incredible organ that runs everything in your body. It must be protected, nourished, supported, and treated with the best care possible. Everything affects your brain — your diet, the amount of water you drink, the amount of exercise you do, your stress levels, mental health, your engagement with friends and family, and even how much you sleep. We’ve outlined seven different areas to focus on in your everyday life.

While looking at all of these may seem daunting, don’t tackle them all at once. Start by making small but important changes that will lead to long-term beneficial effects.

DIET AND YOUR BRAIN Our overall health is affected significantly by our diet and bad habits can start at an early age. These habits are often very difficult to change as we get older but with some knowledge and understanding of how our diet truly affects all of our body, including our brain, we can begin to make changes and reap the rewards.

Several diets have a similar focus that can all be beneficial for the brain and overall health. We’ve listed three below which should help you create a healthy diet plan. It is normal to have fluctuations on some weeks but the overall goal is to minimize red meat, processed foods, added sugar (natural sugars are acceptable), and limit alcohol.

Introduce a new diet plan into your life gradually. Your chances for success will be higher if you eliminate things step by step instead of trying to change everything at once.

We recommend speaking with a dietitian for advice and checking with your doctor to see how any changes may affect current health issues and/or medications.

MEDITERRANEAN DIET OR THE BLUE ZONE DIET The Mediterranean and Blue Zone diets are quite similar because they are primarily plant-based. Meat is eaten minimally 1-2 times a week and it is suggested to completely avoid added sugar, refined grains, trans fats, processed meats, and highly processed foods. Both diets are inspired by parts of the world that have communities where people eat food in its most natural state, are more active, live in engaging communities, and tend to live longer as a result. These lifestyles focus on being less sedentary. Exercise is achieved through walking, chores, gardening, and even harvesting food.

Add to your shopping list: vegetables, fruit (avoid fruit juices; rely on the whole fruit which has more fiber and is more filling), seeds, legumes, nuts, potatoes, whole grains, herbs, spices, bread, seafood, extra virgin olive oil, and red wine.

Add in moderation: cheese, yogurt, and poultry.

Add once in a while: red meat.

Avoid all together: processed meat, sugar-sweetened drinks, added sugars, refined grains, and oil.

DASH DIET The DASH diet (Dietary Approaches to Stop Hypertension) was created to prevent high blood pressure but it offers many other health benefits. It keeps a closer eye on sodium levels — the standard DASH diet encourages 2,300 mg or less per day. The lower sodium DASH diet recommends no more than 1,500 mg per day.

In addition, the diet recommends: • Grains: 6-8 servings a day • Vegetables: 4-5 servings a day • Fruits: 4-5 servings a day • Dairy: 2-3 servings a day • Lean meat, poultry, or fish: 6oz or fewer a day • Nuts, seeds, legumes: 4-5 servings a week • Fats and oils: 2-3 servings a day • Sweets: 5 servings or fewer a week

MARIA GLEASON, DIETITIAN, MAPLEWOOD SENIOR LIVING Maria’s job at Maplewood is to review menus with our culinary teams. She advises on menus for residents on therapeutic diets and completes nutrition screens for them. Maria also maintains the allergy list for our culinary teams. Menus at Maplewood are based on all the diets listed above. She told us: “My goal as a dietitian is to provide an atmosphere of tasty food that provides good nutrition and is lower in salt and fat. I help residents transition to community living by learning how to select menu items that they enjoy and meet their needs.”

MIND DIET This diet is a combination of the Mediterranean Diet and the DASH Diet. According to the Mayo Clinic, there is great evidence that diet can not only improve brain health but potentially lower cognitive decline and dementia, including Alzheimer’s disease.

The MIND Diet includes many of the foods we have already highlighted.

Vegetables such as leafy greens like kale, spinach, and lettuce. Do your best to get one serving a day of greens but add in another serving of other vegetables daily as well.

Berries are real winners and great for sweet treats.

Despite the old “an apple a day”, berries, especially blueberries and strawberries, have proven to result in the slowest rate of cognitive decline.

While nuts are caloric, they have beneficial fatsoluble vitamin E which has a reputation for its brainprotective attributes. Grab a handful of dry-roasted, raw, or low sodium nuts.

Olive oil is a must for a healthy kitchen. Choose extra-virgin over “light” and select a bottle in a dark glass container – since light makes it go bad faster.

Meat-free meals are important to incorporate into your weekly menu. A healthy brain thrives on less meat, especially red meat. The best way to

accomplish this is to plan. Great substitutes for red meat are skinless chicken and fish. Any types of pulses, including beans and lentils along with soybeans are great alternatives — not only are they full of vitamin B but they also fill you up.

Have wine with your meal. We are not encouraging excessive drinking; however, studies have shown that a glass of red wine with your meal may lower the risk of dementia.

HYDRATION/BRAIN CONNECTION Brain cells depend on water to carry out essential functions. According to Betsy Mills, PhD, if a person is dehydrated their brain cells cannot function properly. Their brains must work harder to complete a task which can lead to a decline in cognitive performance. In the elderly, the prolonged cellular stress of dehydration may promote brain disease and continued cognitive decline. Decreased water levels in brain cells prevent the clearance of toxic proteins, causing them to build up in the brain.

This is why it is important to stay hydrated. Adults should drink 8 to 10 cups of fluids per day, though individual needs may vary depending on activity level and medication use.

Fermented Foods: These are particularly good for boosting probiotics in your gut. They include things like Kefir, a cultured dairy product made from kefir grains. It is very similar to yogurt which is also good with active cultures. Kombucha, a fermented black or green tea is an easy way to add probiotics. Soybased foods such as miso, often enjoyed as soup, or tempeh, made from fermented soybeans, can be used in stir-fries, baked or steamed. Sauerkraut, pickles, and pickled fruits and vegetables are also good for your gut. (Kombucha and yogurt can often have added sugar so be sure to check the label — select non-fat plain yogurt).

THE GUT/BRAIN CONNECTION The health of our gut has become more important recently as studies have proven that our gut impacts our health more significantly than we originally thought. Your gut and your brain have a connection called the gut-brain axis. They are connected in three ways. First, through the vagus nerve, second, through neurotransmitters that connect from the brain to the gut, and third, through the immune system.

Keeping a healthy connection is important and can be incorporated into your diet with relative ease.

Many of the foods listed below are included in the diets we highlighted earlier, but there are a few additions to consider. Several core groups of food are beneficial for the brain/gut connection.

Omega-3 Fats: These are found in oily fish including mackerel, trout, salmon, seabass, sardines, and oysters. For vegetarians, Omega-3 can be found in seaweed, algae, chia and hemp seeds, edamame, kidney beans, walnuts, and soybean oil.

High Fiber Foods: Whole-grain bread and pasta, nuts, seeds, fruits, and vegetables are all prebiotic foods.

They not only contribute to gut health but are also known to reduce the stress hormone cortisol.

Foods Rich in Polyphenols: These foods not only boost brain health but also digestion in addition to protecting against some cancers, heart disease, and type 2 diabetes. They include antioxidants.

Foods in this category include dark chocolate, berries, green tea, coffee, red wine, and olive oil.

Tryptophan Foods: In addition to memory skills, tryptophan helps with mood, depression, visual cognition, learning, and aggression control.

Tryptophan can be found in turkey and chicken, canned tuna, milk, oats, cheese (cheddar is best), nuts and seeds, chocolate, and fruits.

EXERCISE AND BRAIN HEALTH If you are currently very sedentary, you’d be surprised how even just little exercise can make a difference to your overall health. As little as 45 minutes 3 times a week can make a difference in your cognitive function.

Dr. Wendy Suzuki, a neuroscientist at New York University, who is best known for her studies of the brain areas important for memory, studies the defining effects of physical activity on the human brain and its cognitive functions. Her book Healthy Brain, Happy Life speaks about the brains capability to change throughout our lives, and how movement offers great benefits. Dr. Suzuki is a collaborative partner with Maplewood Senior Living and works with us to help residents keep moving for improved brain health.

According to the Cleveland Clinic, and explained by Dr. Bonnor-Jackson “physical activity may benefit the brain in several ways, such as promoting cardiovascular health, improving blood flow to the brain, reducing inflammation, and lowering levels of stress hormones. All of these can adversely affect cognition.”

Begin slowly if you haven’t done much exercise before but anything counts. The easiest is walking. Start by walking your hallway or around your block. As you strengthen you can build up to do longer distances. Play golf, swim, or go for a bicycle ride. Even walking around the supermarket counts – you’d be surprised how many steps you get doing that.

SLEEP Sleep affects almost every aspect of our health including our immune system, attention, reasoning, working memory, and long-term memory. It is, as Harvard Medical School refers to it, “a housecleaning process that prevents the build-up of toxic substances, including beta-amyloid (the destructive protein in the brains of Alzheimer’s patients).”

When you live without enough sleep, especially chronically, the ramifications can be dire. A minimum of 7 hours per night is recommended. It is crucial for memory as during the time you sleep it gives your brain time to absorb all the new information it received during the day.

MENTAL STIMULATION The brain likes to be challenged and stimulated. By “keeping it on its toes” you may lessen your cognitive decline and potentially lower the risk of dementia. Did you know that challenging your brain supports the process of neurogenesis — the birth of new neurons in your brain? This in turn keeps your memory sharp and enhances your ability to learn.

If you’ve let your brain get a bit lazy, you may be wondering where to start?

You can start anywhere!

Study a new language. Maybe you are planning a trip soon or have a friend who speaks another language and you’d like to converse with them.

There are plenty of apps to learn a language and online programs.

Games and puzzles. Cards and board games force you to rely on your memory or strategize.

If you play with friends you are also adding in an important social element.

Pick up a new hobby. You may be an avid reader but don’t stop there. Challenge your brain to try something like an art class or take up doing puzzles. Puzzles include crosswords, Sudoku, or word scrambles and increase the level of difficulty as you improve. Do something with your hands such as woodworking, gardening, or cooking.

Cultural activities and travel. New technologies allow you to experience museums, plays, films, and concerts online. While we wait for global restrictions to lift for travel, in the meantime, you can travel online. In some senior living communities, virtual reality is used to engage residents and transport them to another part of the world. The shared experience gives them something to talk about together and engages them in learning about another country.

SOCIAL CONNECTIVITY If the COVID-19 pandemic has shown us anything, it is how quickly we can feel isolated and cut off from the world. Humans are naturally social creatures and it is important for us, at any age, to remain connected with peers, family, and friends throughout our lives.

Adults who are socially active typically have better cognitive function while people who feel lonely tend to experience faster cognitive loss.

This can get more difficult as you age and it is important to actively find ways to remain socially engaged.

MENTAL HEALTH/ STRESS MANAGEMENT The effects of stress and our mental health can sneak up on us and suddenly it affects our entire body. This in turn, of course, then affects brain health. Stress raises the level of cortisol in our bodies and that may impair thinking and memory. Stress also manifests itself in many aspects of our lives — you may drink more, eat more of the wrong foods, decide not to exercise and this can become a vicious cycle. All the lifestyle changes we listed above will improve both mental health and stress levels but be sure to include others such as deep breathing and ask your doctor about medications that may help. Be positive. Avoid constant multi-tasking. Add music into your daily life. Make sure you laugh regularly.

Don’t isolate yourself.

How can you avoid getting isolated or lonely?

Here are some things to consider: • Join a bridge or book club • Make a weekly coffee date with friends • Volunteer at a local community center • Move into a senior living community •P ick up a new hobby such as gardening or an art class • Talk to friends online via Zoom or FaceTime

HEALTH TIPS: Protect Your Head: Wear a helmet when bicycling.

Be aware of your surroundings – look for holes and broken sidewalks. Avoid falling and hitting your head. Strengthen thigh and buttock muscles to keep you standing upright.

Give Up: Smoking and limit excessive alcohol intake.

MEDICAL CONDITIONS THAT AFFECT THE BRAIN While we may work hard to eat well, exercise regularly, and socialize with friends, our general overall health also affects the brain and several specific conditions can do more harm than others.

Dementia: Dementia is the most recognized condition that affects the brain. Changes in the brain often occur many years before any symptoms emerge so it is advisable to keep your brain fit as early as possible. By following the lifestyle suggestions earlier in this guide, you may slow down your cognitive decline and/or the onset of dementia.

Traumatic Brain Injury (TBI): One of the leading causes of a brain injury is a fall. In people over 65, 81% of emergency room visits were due to falls. To avoid falls, do a safety check of your home. Are there trip hazards?

Do rugs slide or do you need a grab bar near the shower? You should also drink lots of water to avoid dehydration and be sure to get enough sleep. Strengthen buttock and thigh muscles to keep you upright and able to prevent a fall.

Diabetes: This disease is referred to as an epidemic in this country as 10% of Americans now live with Type 2 Diabetes. This is particularly worrying as diabetes is strongly linked with dementia. The high levels of sugar in the body due to the disease not only affect your brain but also your nerves, blood vessels, eyes, kidney, and heart. Diabetes shrinks the hippocampus, the part of your brain that works with memory formation. Insulin levels in the body drop due to diabetes and that in turn also affects the brain as the brain needs insulin for neurons to survive and grow.

Obesity: Obesity, like diabetes, affects the hippocampus in the brain by causing shrinkage. Obesity also affects the brain/gut connection, highlighted earlier in this guide, by limiting the diversity of the microorganisms that live in your gut. Many of these can be reversed or improved by a more plant-based diet and increased exercise.

(All significant lifestyle changes should be discussed with a doctor to ensure a safe and healthy path forward.)

Heart disease and stroke: Any condition that limits oxygen or blood flow will affect cognitive function. The build-up of plaque along the arteries leads to clots or stroke. Without blood, cells in the brain die and therefore, often a stroke victim will lose cognitive abilities.

Other causes of cognitive decline: Memory slips and decline make most people worry that it could be a dementia-related disease. It is important to know, however, that there are a group of medical conditions that affect memory and can cause confusion, cognitive failures, or forgetfulness. Before assuming that dementia is to blame – be sure to look for these problems that mimic dementia.

They include but are not limited to alcoholism, brain infection or tumor, depression, exposure to a toxic substance, Lyme disease, build-up of fluid on the brain, deprivation of oxygen (due to heart or lung problems), sleep disorders, a subdural hematoma (often due to a fall), thyroid disorder, urinary tract infection, or vitamin B12 deficiency.

HOW MAPLEWOOD SENIOR LIVING SUPPORTS BRAIN HEALTH At Maplewood Senior Living, our communities support brain health and overall health with everything we do. Our goal is to help you live a healthy, independent lifestyle. We support brain health through delicious dining and the help of our nutritionist. Meals are inspired by Mediterranean, MIND, and DASH diets and our culinary teams create meals that are delicious and healthy giving residents one less thing to worry about. Our Life Enrichment teams consistently offer activities that include fitness classes that meet residents at the level they need and hands-on activities including gardening, games, and art classes that provide brain benefits along with mental stimulation. Additionally, we use our IN2L, brain stimulating activities and plenty of socialization. Living in our communities helps minimize stress.

Instead of worrying about house bills, when to do the laundry, and figuring out what to cook for dinner — we do it all for you to give you peace of mind and the time to do the things you love. Our care teams work to help each resident either regain or maintain independence by challenging them and inspiring them to live an active and healthy lifestyle.

SEEKING ADDITIONAL HELP — RESOURCES: In addition to this guide, we encourage you to use other resources to help you improve brain health.

Many provide diet plans and other suggestions for changing your lifestyle, and also offer links to research and the latest news.

Alzheimer’s Association www.alz.org

Mayo Clinic www.mayoclinic.org

Columbia/Zuckerman Institute zuckermaninstitute.columbia.edu/

Drexel University School of Education drexel.edu/soe/

Harvard Health Publishing/ Harvard Medical School www.health.harvard.edu/

Brain & Life www.brainandlife.org

Subscribe for their FREE magazine

Dana Foundation www.dana.org

Mount Sinai — The Barbara and Maurice Deane Center for Wellness and Cognitive Health www.mountsinai.org/locations/center-cognitive-disorders

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