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Do You Know the Four Pillars of Brain Health?

Published on

30 July 2019

Mind, body and soul: we need more than good thoughts alone to keep our brains healthy. Brain health is supported by an active body, good nutrition, intellectual stimulation and social engagement. A recent clinical trial showed that a multidimensional brain health intervention combining diet, exercise and brain training could support cognition in elderly people at risk of cognitive decline1. No matter what our age, we can support our brain by focusing on these four areas of a brain-healthy lifestyle2.

The nourished mind

The brain is the most metabolically active organ in the body. Although the brain only makes up about 2 percent of the body’s weight, it uses 20 percent of the energy when the body is at rest3. As energy comes from the foods we eat, good nutrition can support brain health.

Breakfast is known as the most important meal of the day, and this is particularly true for the brain. The brain’s preferred energy source is glucose4. While we sleep, our blood glucose levels gradually decline after our evening meal. This restricts the energy available to the brain when we wake up. The carbohydrates in breakfast supply glucose that we need for our brains after waking up. Eating breakfast has been shown to support memory and cognition in adults and children5-7. In particular, breakfasts that supply a steady supply of glucose appear to be best for cognition.

Long term, the type of diet that we eat also affects our overall brain health8, 9. Dietary patterns that are good for the heart are also good for the brain because the same processes that age our heart also affect our brain. Healthy brain diets include:

  • The Mediterranean Diet
  • The Dietary Approaches to Stop Hypertension (DASH) Diet
  • The Healthy Eating Index
  • National food consumption guidelines in many countries

What these diets have in common are an emphasis on fruits, vegetables, high fiber grains, and oily fish, while salt, saturated fat and refined sugar are restricted. These diets are nutrient-rich and provide sustained energy to the brain, supporting normal brain function.

The mentally-engaged mind

Just like our muscles, our brains can be trained to increase their performance. The more active our brains are during our lifetime, the easier it is for us to maintain our mental performance when we are older. Experts call this our “cognitive reserve”10, 11.

Cognitive reserve is based on the mental abilities that we are born with, and the brain workout we get from our education, occupation and leisure-time activities11. The more mentally engaged we are, the higher our cognitive reserve. Taking a course, learning a language, and trying out new activities are all ways that we can increase our cognitive reserve. Brain training exercise and puzzles can help keep the mind sharp12. Also, hobbies and pastimes that we already are familiar with like reading, knitting, volunteering or playing music are all ways of keeping our brains active.

The socially-connected mind

Having a cup of coffee with a friend might be an enjoyable way to spend a morning, but it can also help your brain! Humans enjoy contact with others. Our family, friends and the community provide us with essential social support. Social activities are also cognitively demanding. Our social networks both support us and challenge our brains.

Evidence from population studies supports the role that social engagement plays in maintaining cognition in older adults13, 14. For example, in a large analysis of 30,000 Europeans, researchers found that participants’ satisfaction with their social networks and engaging in non-professional social activities helped older adults maintain their cognitive abilities14.

The physically-active mind

Staying physically active is more than just good for our bodies. Our minds benefit from a good workout as well15, 16. It’s likely that exercise affects the brain in several ways. There are direct effects such as increased blood flow to the brain from aerobic exercise that gives the brain a boost. Exercise also releases growth factors that are regarded as protective for the brain15. The indirect effects relate to improvements in risk factors of cardiovascular disease including weight loss and improved blood glucose management from regular exercise15, 17. Studies in adolescents18, adults19, and even elderly patients with dementia20 show that exercise can improve cognitive performance.

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REFERENCES

  1. Ngandu T, Lehtisalo J, Solomon A, Levälahti E, Ahtiluoto S, Antikainen R, Bäckman L, Hänninen T, Jula A, Laatikainen T, et al. A 2 year multidomain intervention of diet, exercise, cognitive training, and vascular risk monitoring versus control to prevent cognitive decline in at-risk elderly people (FINGER): a randomised controlled trial. The Lancet 2015;385(9984):2255-63. doi: 10.1016/S0140-6736(15)60461-5
  2. Khalsa DS, Perry G. The Four Pillars of Alzheimer's Prevention. Cerebrum 2017;2017.
  3. Attwell D, Laughlin SB. An energy budget for signaling in the grey matter of the brain. J Cereb Blood Flow Metab 2001;21(10):1133-45. doi: 10.1097/00004647-200110000-00001
  4. Mergenthaler P, Lindauer U, Dienel GA, Meisel A. Sugar for the brain: the role of glucose in physiological and pathological brain function. Trends Neurosci 2013;36(10):587-97. doi: 10.1016/j.tins.2013.07.001
  5. Edefonti V, Bravi F, Ferraroni M. Breakfast and behavior in morning tasks: Facts or fads? J Affect Disord 2017;224:16-26. doi: 10.1016/j.jad.2016.12.028
  6. Adolphus K, Lawton CL, Champ CL, Dye L. The Effects of Breakfast and Breakfast Composition on Cognition in Children and Adolescents: A Systematic Review. Adv Nutr 2016;7(3):590S-612S. doi: 10.3945/an.115.010256
  7. Galioto R, Spitznagel MB. The Effects of Breakfast and Breakfast Composition on Cognition in Adults. Adv Nutr 2016;7(3):576S-89S. doi: 10.3945/an.115.010231
  8. Cheung BH, Ho IC, Chan RS, Sea MM, Woo J. Current evidence on dietary pattern and cognitive function. Adv Food Nutr Res 2014;71:137-63. doi: 10.1016/B978-0-12-800270-4.00004-3
  9. Alles B, Samieri C, Feart C, Jutand MA, Laurin D, Barberger-Gateau P. Dietary patterns: a novel approach to examine the link between nutrition and cognitive function in older individuals. Nutr Res Rev 2012;25(2):207-22. doi: 10.1017/S0954422412000133
  10. Clare L, Wu YT, Teale JC, MacLeod C, Matthews F, Brayne C, Woods B, team CF-Ws. Potentially modifiable lifestyle factors, cognitive reserve, and cognitive function in later life: A cross-sectional study. PLoS Med 2017;14(3):e1002259. doi: 10.1371/journal.pmed.1002259
  11. Stern Y. Cognitive reserve. Neuropsychologia 2009;47(10):2015-28. doi: 10.1016/j.neuropsychologia.2009.03.004
  12. Rebok GW, Ball K, Guey LT, Jones RN, Kim HY, King JW, Marsiske M, Morris JN, Tennstedt SL, Unverzagt FW, et al. Ten-year effects of the advanced cognitive training for independent and vital elderly cognitive training trial on cognition and everyday functioning in older adults. J Am Geriatr Soc 2014;62(1):16-24. doi: 10.1111/jgs.12607
  13. Kelly ME, Duff H, Kelly S, McHugh Power JE, Brennan S, Lawlor BA, Loughrey DG. The impact of social activities, social networks, social support and social relationships on the cognitive functioning of healthy older adults: a systematic review. Syst Rev 2017;6(1):259. doi: 10.1186/s13643-017-0632-2
  14. Miceli S, Maniscalco L, Matranga D. Social networks and social activities promote cognitive functioning in both concurrent and prospective time: evidence from the SHARE survey. Eur J Ageing 2019;16(2):145-54. doi: 10.1007/s10433-018-0486-z
  15. Kirk-Sanchez NJ, McGough EL. Physical exercise and cognitive performance in the elderly: current perspectives. Clin Interv Aging 2014;9:51-62. doi: 10.2147/CIA.S39506
  16. Ahlskog JE, Geda YE, Graff-Radford NR, Petersen RC. Physical exercise as a preventive or disease-modifying treatment of dementia and brain aging. Mayo Clin Proc 2011;86(9):876-84. doi: 10.4065/mcp.2011.0252
  17. Rabin JS, Klein H, Kirn DR, Schultz AP, Yang HS, Hampton O, Jiang S, Buckley RF, Viswanathan A, Hedden T, et al. Associations of Physical Activity and beta-Amyloid With Longitudinal Cognition and Neurodegeneration in Clinically Normal Older Adults. JAMA Neurol 2019. doi: 10.1001/jamaneurol.2019.1879
  18. Vazou S, Pesce C, Lakes K, Smiley-Oyen A. More than one road leads to Rome: A narrative review and meta-analysis of physical activity intervention effects on cognition in youth. Int J Sport Exerc Psychol 2019;17(2):153-78. doi: 10.1080/1612197X.2016.1223423
  19. Marston KJ, Peiffer JJ, Rainey-Smith SR, Gordon N, Teo SY, Laws SM, Sohrabi HR, Martins RN, Brown BM. Resistance training enhances delayed memory in healthy middle-aged and older adults: A randomised controlled trial. J Sci Med Sport 2019. doi: 10.1016/j.jsams.2019.06.013
  20. Jia RX, Liang JH, Xu Y, Wang YQ. Effects of physical activity and exercise on the cognitive function of patients with Alzheimer disease: a meta-analysis. BMC Geriatr 2019;19(1):181. doi: 10.1186/s12877-019-1175-2

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