by Barbara Berkeley MD
An email from a friend of mine started me thinking about this topic again and it's a fascinating one. I am interested in the fact that we spend so little time thinking about the territory above our shoulders. Why is that? Maybe because we can't see our brain so we are continually looking out from it, perusing other parts of our bodies, but largely ignoring the place where we truly exist: in the neural net that composes our grey matter.
My friend was interested in a recent radio program that discussed the possible benefits of Intermittent Fasting (IF) on brain health. A family history of dementia is concerning to him and he is looking for ways to prevent cognitive decline. This particular segment on PBS's Diane Rehm show featured three proponents of IF. You can hear the full show here, but the summary is as follows: animal models show that decreasing calories over the long haul increases lifespan and boosts cognition. It appears that another way to achieve the same effect may be to fast the animal over short periods rather than continually lower calories. Whether this translates to humans or not is still unresolved (at least in my mind), but those who follow IF lifestyles tend to create a very low calorie state in small bursts. Some do this by lowering calories to 500 or so for two days a week. Others skip a meal each day. If you get far enough into the program, you'll hear the participants talk about their various ways of achieving a lowered calorie state. One thing that you'll notice is that none of these approaches actually feature "fasting" (eating nothing). In each case, the person is eating....just alot less than they do on other days.
My take on brain health---and all health---is that it revolves around keeping inflammation as low as possible. If we look at just about every modern disease, it is inflammation that provides the common pathway. Over the years, my reading and personal experience has boiled down to a handful of maxims:
1. Too much insulin is inflammatory 2. Obesity is inflammatory 3. Overeating is inflammatory 4. Eating inflammatory foods (like lots of omega 6 fatty acids) is inflammatory 4. Not exercising allows inflammation to progress 5. The body needs to spend time each day in "burn" mode, and not be constantly placed in "store" mode.
In 2009, I wrote a post about then-current research on insulin and the brain, specifically dementia risk. You can access that here. Today, the New York Times published an article on the same topic detailing some fascinating studies in mice. Researchers have shown that interleukin 6, an inflammatory chemical produced by fat cells can reach the brain causing inflammation in our synapses. We had previously thought the brain to be immune from the chemicals produced by fat because of something called the "blood-brain barrier" which is a defensive wall that prevents harmful toxins from crossing into the brain. Not so. The obese state appears to turn the barrier into a sieve, allowing inflammation to get a foothold. This is particularly interesting because a similar phenomenon occurs in the gut. When we eat inflammatory foods, the gut can become leaky and lose it's ability to act as a proper barrier.
Intermittent fasting is just one way to skin the inflammatory cat. In my book, I recommend that maintainers eat one major meal per day. This is a way of keeping calories low for longer periods during which time the maintainer eats much smaller amounts. I have also written about a maintenance technique that I use personally and which accomplishes much the same thing. I skip dinner (or eat a very light meal) on two to three nights per week. I also exercise on those evenings. This allows me to put my body into burn mode and keep it there for a prolonged period that extends from mid afternoon through to the next morning. It's a great way to keep weight off and also mimics an intermittent fasting period.
If I had to suggest my personal recommendations for keeping brain inflammation as low as possible they would be:
1. Spend part of each day in a longer fasting or low calorie state. Avoid grazing and feeling that you have to eat every five minutes. Alternatively, substitute two to three days per week of eating lunch and eating a minimal dinner.
2. Insure that food itself is not inflammatory by avoiding seed oils and vegetable oils (olive oil is ok) and foods that come in a box or passed through a factory for production. Eat real food from real plants and animals that haven't been much tampered with.
3. Vastly curtail the starches and sugars in your diet. For me, that includes grains which I believe can contribute to inflammation and autoimmune problems in many people. Get your sugars and starches from vegetables and fruits, but try to minimize very sugary fruits like the tropical varieties.
4. Lose whatever visceral fat you can. This is your belly fat and the fat that you can't see which is inside your body and around (and inside) your organs. Generally, your external belly size is a reasonable marker for how much fat is sitting inside. Lose the belly and you'll most likely lose most of the inner fat as well.
5. Exercise at least 5 days per week to keep the fat off and to sensitize your body (and probably your brain too) to insulin. Challenge yourself by doing exercise that LEADS somewhere....like to your first 5K, a spot on the tennis team, or even moving into the front row of your zumba class! Don't do exercise you hate. Exercise releases a flood of uppers in the brain, but only if you get good enough to exercise fairly intensely and only if you enjoy it. So look for the activity that you know you could enjoy if you get better at it. Stop thinking of exercise as "exercise" and start thinking of it as a fun, challenging new world that you are going to locate, enter and engage with.
My beloved Uncle Daniel always used to say, "Be true to your teeth or they will be false to you!" Truer words were never spoken.
Be true to the brain cells that form your reality. There are no replacements yet available.