I’ve shared with you before that I carry the APOE4 gene which puts me at a higher risk to get Alzheimer’s. I also have close friends and family (obviously) who are concerned by this gene, so brain health is a topic very close to my heart.
But here's the thing: cognitive decline actually starts in our 30s, and our nutrition and lifestyle play a significant role. So, whether or not you have the gene, brain health should be a priority for everyone in their 30s and beyond!
You may have come across recent news about a breakthrough drug that can help with Alzheimer's. Does this mean we no longer have to worry about it? Unfortunately, the answer is no. This new drug only prevents further accumulation of amyloid plaque in the brain, which is fantastic, but it doesn’t address the underlying issues.
The other thing is that there’s new research showing that there’s other very important components to Alzheimer’s:
“Some people have believed that amyloid is driving the vascular disease,” Dr. Montagne said. “The authors of the current study show that there are two different processes. It is helping us enter a new era, where we see that amyloid is not the only factor, that the vascular component is important too.” Source
Just to make this clear: we always talk about Dementia AND Alzheimer’s: Alzheimer’s disease is actually a type of Dementia. The other 2 main types are: Small Vessels Disease and Vascular Dementia.
Aside from genetics, the next most common risk factor for Alzheimer’s is vascular disease.
The factors that increase your risk for atherosclerosis – such as high blood pressure, smoking, and elevated apoB (that’s a cholesterol marker) – also increase your risk of dementia. So anything that’s bad for your heart is also bad for your brain!
Let’s summarize what puts you at a higher risk of getting any of these neurodegenerative diseases?
Carrying the APOE4 allele (if you have 1 from one parent your risk is 2x, if you have 1 from each of your parents your risk is 10x)
Type 2 diabetes: 80% of people who have Alzheimer’s also have Type 2 diabetes.
High glucose: Too much glucose is linked to memory and cognitive deficiencies. Chronic diabetes, including both type 1 and 2, negatively impacts brain neurons and connectivity. It also causes restricted blood flow in the brain, which results in cognitive difficulties that can eventually develop into vascular dementia or Alzheimer’s Disease. (Source)
Insulin resistance or consistently high blood glucose can also trigger lower levels of sex hormone binding globulin (SHBG), the hormone that binds to excess estrogen and testosterone.
High blood sugar = lower SHBG = PMS, hormonal migraine, acne, fibroids, cysts….
But that’s not all: when you have prolonged high glucose levels, it leads to the formation of AGEs - they literally make you age faster! You’d think the name was picked for that reason, but it actually stands for Advanced Glycation End Products (AGEs). AGEs are compounds formed when glucose reacts with proteins or lipids in a process called glycation. These compounds can accumulate in tissues, including the brain, over time. AGEs can have several negative effects:
Neuronal Damage: Excess glucose can lead to oxidative stress and inflammation, which can damage neurons and their supporting cells. This can contribute to cognitive decline and increase the risk of neurodegenerative diseases.
Impaired Insulin Signaling: Elevated glucose levels can interfere with insulin signaling in the brain. Insulin plays a crucial role in brain function, including memory formation and synaptic plasticity. Impaired insulin signaling may impair these processes and contribute to cognitive impairment.
Blood-Brain Barrier Dysfunction: High glucose levels can disrupt the integrity of the blood-brain barrier, leading to increased permeability. This can allow the entry of harmful substances into the brain and contribute to inflammation and neuronal damage.
Vascular dysfunction to the brain - this is where it starts: obstruction of one or more arteries that supply blood to the brain. Brain function relies on blood flow – it’s how the brain receives nutrients essential for neurotransmitter function and, equally important, how carbon dioxide and metabolic wastes are removed. Neurons require oxygen and glucose as fuel and this essential energy source is required to remove protein buildup that can interfere with synaptic activity.
Leaky brain: Several studies have suggested that a leaky blood-brain barrier may play a role in various neurological conditions, including Alzheimer's disease, multiple sclerosis, and certain infections of the brain.
What is “leaky brain”? The blood-brain barrier (BBB) is a protective barrier in your body that separates the blood circulating in your bloodstream from the fluid surrounding the brain and spinal cord. It acts as a gatekeeper, allowing only certain substances to pass from the blood into the brain while keeping harmful substances out.
When the blood-brain barrier becomes "leaky," it means that the barrier's integrity is compromised, and it becomes permeable. This can happen due to various factors such as inflammation, trauma, infection, or certain diseases. Also, with age, your number of Pericytes naturally start to decline and they are there to keep your BBB intact and also help ensure blood supply to the brain. That’s why with age, we need to work even harder to keep our brain healthy.
You can imagine that a permeable blood-brain barrier cannot be a good thing: toxins, pathogens (like bacteria or viruses), or even immune cells are able to enter the brain this way and they’ve got no business there! This influx of unwanted substances can trigger inflammation and damage to brain cells, disrupting the normal functioning of the brain.
Also consider that if your blood-brain-barrier is permeable, your brain will not be able to detoxify at night as it will not be able to hold the pressure of the lymphatic flow that occurs at night when your brain is detoxifying from amyloid plaques and other debris.
On the other hand, your transporters (that transport nutrients, oxygen, glucose etc) will get dysfunctional too, which will impact the glucose supply of your brain.
Low estrogen: women have an extra “handicap” when it comes to blood sugar regulation when your hormone levels decline or are simply imbalanced: you can become "insulin-resistant". This happens when your estrogen levels decline, because estrogen also is key to glucose utilization in the brain.
Furthermore, the hippocampus has many receptors for estrogen and when estrogen begins to wane, it can result in brain fog as the brain adjusts to working without as much estrogen as it used to.
Proper methylation ensures that homocysteine stays at a healthy level. When homocysteine elevates, it is destructive to cerebral blood vessels and increases the risk of stroke and vascular dementia. Increased homocysteine has been associated with increased neurodegeneration and is an independent risk factor for Alzheimer’s Disease (Source). Proper methylation is critical for the synthesis of neurotransmitters and improves neurochemical efficiency.
So all that to say that it pretty much comes down to:
Keeping your blood sugar stable
Keeping your cells healthy
Making sure you are not depriving your body of essential nutrients
Keeping your gut and liver happy
And your hormones balanced
So here are some easy things that you can do to keep your brain healthy:
stay away from sugars but also pay attention to fruit juices or high sugar fruit and minimizing grains in general (my cookbook for blood sugar & hormone balance is a good reference that gives you all the indications from a dietary standpoint)
eat enough healthy fats! They provide a steady and slow burning source of energy while carbohydrates provide a less stable and fast burning source of fuel. Also, especially EPA and DHA from Omega 3s are important for brain health.
eat a protein-rich and high fat breakfast - your blood sugar is the most sensitive in the morning so if you start with a high carb breakfast you set yourself up for the blood sugar roller-coaster for the rest of the day
avoid snacking between meals - you may need to have some nutrient-dense snacks in the transition time, but normally you should be able to go at least 3-4 hours between meals without the need to snack.
move your body every day! exercise is not only important for your physical fitness and mood, but also to keep your brain healthy
And let’s not forget about stress (physical or mental) that will impact your cortisol and hence your blood sugar levels: use apps like Insight timer to get started with (even 5-10 mins) meditation each day, try breath work, yoga or journaling or take a nice Espom salt bath!
meal prep! If you cook ahead or have a plan, you are less likely to make bad last minute choices and you have less mental stress trying to come up with a last minute plan for dinner, possibly rushing to the store and not finding the ingredients you need...
learn something new every day
engage both sides of your brain daily with different exercises (movement, like brushing your teeth with the left hand and things like sudoku, puzzles etc)
If you are interested in a targeted protocol designed for your bio-individual needs, book your free clarity call to discuss how I can help you.