Trust me, nobody wants to grow old without taking your brain along for the ride. I’m 68 years old and I have a three-year old daughter, so leaving my brain behind would be a very poor personal choice and trust me when I say choice. When it comes to protecting and enhancing brain function, we definitely are in the driver’s seat.
Old Brains—Are They Inevitable?
The traditional view in medicine is that as we age our brain tends to slowly fail, leading to various forms of cognitive dysfunction and dementia. To a limited degree this is true. It is also assumed that if you end up with chronic diseases like obesity, heart disease or diabetes your brain will eventually take in on the chin. This implies that a healthy diet might delay these devastating brain changes and that is also likely to be true, but my perspective is a little different than most physicians. I believe that when you eat a poor diet loaded with processed food, your brain is the first rather than the last organ to be adversely affected.
As a practicing physician with a special interest in Neuroscience (the science of the brain) I have spent many decades trying to figure out what it takes to optimize brain function and to prevent the brain from being adversely affected by a poor diet and the passage of time. Because they didn’t teach this stuff in medical school I had to carefully look at both sides of science—the empiric side that is based on observations made in the real world and the controlled science side where well-conducted studies help us to understand what variables are critical for optimal health.
Side-ways Falling Balls
There’s only one problem with this “scientific” approach. Your empiric observations may be totally different than mine. That being said, there are some consistencies in nature. For example, a dropped or thrown ball always eventually falls down rather than sideways—that is unless your favorite baseball player whacks it over the center field fence and then it falls to earth. By watching what happens to dropped or hit balls you can start to understand the physics of gravity.
Let me first clear one thing up. Making observations on dropped or hit balls is a fairly simple endeavor. Biology however is extremely complex, so consistent empirical observations can be very useful in the clinical world even though they can be very hard to find. Over 35 years of clinical practice I have noticed which factors seem to play a key role in maintaining optimal brain function as you age. Through trial and error, I have narrowed it down to six guaranteed brain enhancers and protectors. I believe in keeping things as simple as possible so I won’t be discussing any pie in the sky type methods—these are the real deal. Each of these brain enhancers is also supported by some level of controlled studies.
Brain Enhancer Number 1: Diet.
As they say, this is a “no brainer”. If you consistently consume a diet of highly processed food as most folks do in modern societies, at some point you will end up frying your brain. In my opinion this type of diet can trigger a form of food induced brain dysfunction called Carbohydrate Associated Reversible Brain syndrome or CARB syndrome. With this disease, over time you will develop an array of symptoms that will qualify you for the diagnosis of a long list of common disorders. I discuss this disorder in more detail in other posts. Suffice it to say that you do not want to have CARB syndrome at any age if you hope to be a productive person in our society.
So, what exactly is the ideal diet? This is a somewhat complex question because each person has a unique genetic makeup that influences the type of food they should try to eat. To keep things simple, I need to generalize a bit. I think science supports the idea that everyone should consume a whole foods diet that consists of real food, not processed fake food. Highly processed food contains the deadly triad of excessive sugars, excessive high glycemic carbohydrates especially from grains and excessive omega 6 fatty acids relative to omega 3 fatty acids. In my opinion healthy fats should always be included in such a diet. Mediterranean, Paleo and ketogenic diets tend to be my favorites but even a whole foods vegan diet is better than the Standard American Diet (SAD). Reducing calories might be helpful as long as you reduce the right calories. Intermittent fasting has recently caught a lot of attention and I think this approach can be incorporated into any healthy whole foods diet. Because people with CARB syndrome tend to crave sweet and starchy food leading them to consume the very food that is frying their brain, an effort must be made to suppress these cravings with supplements like L-glutamine and CARB-22. Low dose medications can also be useful in reducing these cravings. I discuss this approach in other blog posts.
For more information on eating a healthy diet I recommend visiting Dr. Mercola’s site. It is loaded with solid information about both diet and exercise. I also recommend visiting Robb Wolf’s, Loren Cordain’s and Jimmy Moore’s web sites. They have a lot of great information on the healthiest way to eat. All four of these nutrition leaders have written great books about how to eat a healthy diet. You won’t get this information from your local dietician (it’s a long story) so when it comes to eating a healthy diet you really need to become self-educated
Brain Enhancer Number Two: Exercise.
Exercise has been touted to be the fountain of youth and the key to optimal health and longevity. I’m not sure if this is the case, but I do know one thing—exercise is very, very good for your brain. There are almost endless studies documenting how any type of exercise enhances brain function. Anaerobic exercise, aerobic exercise, strength training—do them all if you can. It comes down to getting up off your butt and doing something, anything to get you moving and into shape. It seems that every conceivable form of exercise is good for your brain so go for it! I am out of work because of a back injury and I became quite de-conditioned. I recently signed up for a local CrossFit site and I think their approach to exercise is top notch. They now have CrossFit centers around the country and world so I recommend you check them out.
One of the key ways that exercise enhances brain function is by stimulating the production of brain-derived neurotrophic factor (BDNF). This remarkable growth protein enhances and stimulates synapses, improving communication between neurons. It is also critical for memory and it promotes neurogenesis. It also appears to lower the risk of many common brain diseases and I suspect that it also reduces the risk of CARB syndrome.
Brain Enhancer Number Three: Lower Your Homocysteine.
This one is a bit boring but please don’t tune out—this information could literally save your life and your brain! Most people and physicians don’t have a clue when it comes to homocysteine. This amino acid has a very complex biological profile, but all you need to remember is that a high homocysteine is very bad for your circulation and your brain. High homocysteine is also a marker for inadequate folic acid in the brain. You need folic acid in your brain to make the key monoamine neurotransmitters serotonin, dopamine and norepiphrine. In today’s world virtually no one is low on folic acid because it is added to all processed foods to prevent neural tube defects in developing babies. Folate is the natural form of the vitamin found in food whereas folic acid is the unnatural chemical that is converted to tetrahydrofolate (THF) in the liver. Folate from food is converted to THF in the small intestine. To get into the brain THF must be converted to L-methylfolate and for various reasons some folks don’t make enough L-methylfolate for optimal brain function.
The best marker for low brain folate is an elevated homocysteine. For optimal brain function your homocysteine should be below 7. The easy work around if your homocysteine is too high is to take L-methylfolate as a supplement. It’s interesting to note that L-methylfolate is the only vitamin to be approved by the FDA to treat a disease. It’s called Deplin and it is approved for depression. Once it was approved there was an effort by the drug company that sells Deplin to limit the OTC availability of L-methylfolate, so it’s a bit hard to find. I buy mine from Life Extension (lef.org) as Optimized Folate. I recommend taking a minimum of 5 mcg daily and the dose can be adjusted as needed.
To knock down your homocysteine you will also likely need two or three other B vitamins. You should take around 5,000 mcg of vitamin B12. I prefer the form that dissolves under your tongue. You should also take vitamin B6 100 mg daily. I personally prefer the more bioavailable form called pyridoxal 5’-phosphate 100 mg daily. It is also available at Life Extension although you can also buy it from various venders on the Internet.
I would wait 2-3 months and then recheck your homocysteine level. This is a test that is readily available through your PCP. If the level is still above 7, I would add trimethylglycine (TMG) 500-1,000 mg daily. This dose can be increased as needed to get the level below 7. I know a lot about this topic because high homocysteine runs in my family. At one point mine was above 18 and now it averages 5-6. Who knows, in a few decades I might be the smartest 100 year old on the block!
Brain Enhancer Number 4: Optimize Your Fatty Acids.
Fatty acids are fats that are critical to our health. There are two essential fatty acids that we need for optimal health: omega 6 fatty acids like alpha lipoic acid and omega 3 fatty acids like EPA and DHA. Humans evolved with about equal amounts of these fatty acids, but our diet of highly processed food has loaded us up on mostly omega 6 fatty acids and minimal omega 3 fatty acids. The chemistry is a bit complicated, but let me summarize things and state that omega 3 fatty acids tend to be anti-inflammatory and omega 6 fatty acids tend to be pro-inflammatory. We need both in balance and one of the best ways of measuring this is to do an AA/EPA ratio. For optimal health, this ratio should be between 1 and 3. This simple blood test is available from OmegaQuant.
Most Americans (including myself) can only attain a healthy ratio by supplementing with a high quality omega 3 supplement. I prefer Omega Rx sold by Barry Sears of Zone diet fame. It’s important to remember that you need to take enough omega 3 to make a difference. Most people and many medical studies use low placebo doses that won’t have much clinical benefit. I managed to reduce my ratio to 1.9 by taking about 8 capsules of Omega Rx daily. I endorse eating some fatty fish but I wouldn’t try to get to an ideal ratio just by eating fish because of the issue of mercury poisoning. Small fish are the best because they are less likely to be contaminated by dioxins and mercury.
It’s interesting to note that we have known the chemistry of omega 6 fatty acids and inflammation for quite some time. Our bodies need to mount an inflammatory response when faced with infections and other environmental dangers. We have also known that if the inflammatory response doesn’t get turned off, it can end up harming our bodies. For many years we didn’t know how inflammation was turned off, but over the past 10 years chemicals called resolvins have been discovered that act to turn off inflammation when it is no longer needed. Where do resolvins come from? Omega 3 fatty acids.
For more information about fatty acids I recommend visiting Dr. Sear’s excellent site.
Brain Enhancer Number 5: Neurotransmitter Precursors.
If you bring this topic up with your physician you most likely will be met with a blank stare. The biology of your brain is very complex. Neurons communicate with each other through various chemical messengers called neurotransmitters. There are over 50 identified neurotransmitters but the most important group is made up of monoamine molecules. They include serotonin, dopamine and norepinephrine. Disruption in these key chemical messengers is likely the root cause of most common psychiatric symptoms. If you lack adequate serotonin you will likely experience fatigue, anxiety, depression, mood swings, poor sleep and cravings for sweet and starchy foods. If you are low on dopamine you will likely experience physical and mental fatigue, difficulty concentrating and focusing, depression and cognitive problems. Low levels of norepinephrine tend to duplicate the symptoms of low dopamine levels because dopamine is the source of norepinephrine.
In the real world serotonin and dopamine play a delicate dance—if you affect one you will also affect the other. Enhancing serotonin can diminish dopamine and vice versa. We know that both these chemicals are gone missing in common psychiatric disorders, but in today’s world most people who have problems with low levels of these key chemicals don’t have a traditional psychiatric disorder. They have low levels because they have been consuming a diet of highly processed food often for decades. This leads to excessive dumping of these chemicals from the neurons and over time they become depleted of neurotransmitters. We now call this form of food-induced brain dysfunction Carbohydrate Associated Reversible Brain syndrome or CARB syndrome. People with CARB syndrome can have up to 22 brain dysfunction symptoms reflecting low levels of dopamine and serotonin. Because the CARB syndrome disease was missed by the medical profession and scientists, people with these symptoms end up being diagnosed with a long list of psychiatric disorders. I call this “labelitis”. In my opinion they don’t have a dozen diseases, they only have one—CARB syndrome.
The traditional drug-centric approach to this problem is to prescribe drugs like SSRIs (Celexa, Prozac, Lexapro and many others) or stimulants like Ritalin and Adderall. These drugs don’t increase the levels of serotonin and dopamine in your brain—they simply leave then in the synaptic space between the cells for a bit longer to boost their effectiveness. Over time the effect wears off and the drugs are no longer effective because receptors tend to down-regulate. There is one simple workaround—take the amino acids that are the precursors of dopamine and serotonin as a supplement on an empty stomach. That would include L-tyrosine, the precursor of dopamine and L-tryptophan or 5-htp, the precursors of serotonin. Through lots of trial and error we determined that the optimal ratio of tyrosine to 5-htp is about 10 to 1. Throw in some vitamin co-factors, a bit of L-glutamine and chromium picolinate to suppress sugar cravings and you are good to go.
I have recommended this type of supplement to my patients for decades with excellent results. I sell a product like this on my web site called CARB-22 because it’s relatively difficult to find. If you look around you can find similar products but they are usually much more expensive than CARB-22. I have taken this type of supplement for years to ensure that my neurotransmitter levels are ideal. It is extremely safe to take and it can be combined with many psychiatric drugs if the doses are kept low.
You wouldn’t try to drive your car if it was 5 quarts low on oil, so don’t try to operate your brain if it is severely depleted of critical neurotransmitters.
Brain Enhancer Number 6: Learn Something New.
This is another “no brainer”. If you love to play the piano, take up tennis. If tennis is your game, take up the piano. Learn a foreign language, take a different route to work or change the people you hang out with. It doesn’t matter what you do, you just need to do something different. Like your muscles, your brain responds to learning new things by changing its structure and function. My own solution to this was to have a baby daughter in my mid-60s. Believe me, Rafaella has kept me on my toes and my brain is working extremely hard to keep up with her! It’s very difficult to be a crusty old fart when you are constantly interacting with a two-year old!
There you have it. Six simple, inexpensive and safe things you can do to maximize your brain function. I tend to like smart people because I can usually learn a thing or two from them. Make yourself smarter and perhaps you can add to my knowledge base! In my opinion, each of us has unique skills and knowledge to add to the world, but to do so you will need optimal brain function. I humbly suggest that you follow my road map to get there.
