By Gabrielle Echevarrieta
The Aspen Brain Institute presents the first-ever Brain-Healthy Cooking Series, a virtual, five-part educational deep dive into the science of individual and family brain health. Each session, led by Annie Fenn, MD, features a leading expert in the medical field who breaks down best practices for preserving brain wellness. After practicing as a board-certified obstetrician/gynecologist for more than 20 years, Dr. Fenn has channeled her belief in the healing powers of healthy food to create the Brain Health Kitchen Cooking School. Specifically focused on resisting Alzheimer’s disease and other dementias, the Brain Health Cooking School uses Fenn’s medical expertise and culinary training to inform the public about neuroprotective foods and brain-friendly cooking techniques. Here, Fenn examines the link between diet and brain health for Purist.
At what age should we begin prioritizing brain health and taking active steps to prevent Alzheimer’s disease?
We used to think that Alzheimer’s happened to the brain late in life. Now we know that the process that leads to Alzheimer’s can be detected in brains 20 to 30 years before symptoms like memory lapses and getting lost. Midlife, between the ages of 45 and 65, is an especially crucial time in which taking care of our brains yields a huge payoff in less cognitive decline decades later. But the changes that lead to Alzheimer’s have even been detected in brains as young as 25. This concept of cultivating lifelong brain health, starting with developing good lifestyle habits in young people, and focused on taking proactive steps at midlife, is one of the most important advances in Alzheimer’s prevention.
What specific vitamins and nutrients should we fill our diet with to support our brain?
The best way to get all the brain-healthy nutrients is by focusing on a diet based on a wide variety of whole foods. There are a handful of dietary patterns proven to support brain health. Two of the most evidence-based are the Mediterranean Diet and its spin-off, the MIND diet. Both emphasize a mostly plant-based diet that includes vegetables, fruit, fish and seafood, whole grains, beans and legumes, and nuts and seeds. Olive oil is the primary cooking oil used, and it’s proven to have many brain health benefits. Not only is olive oil a brain-friendly type of fat (being primarily mono- and polyunsaturated), it provides polyphenols, which act as powerful antioxidants in the brain. And when olive oil is enjoyed in combination with whole foods, it helps us absorb the phytonutrients that are beneficial to the brain, such as flavonoids (the pigments found in fruits and vegetables) and fat-soluble vitamins D, E, A and K.
Break down the specific ways these nutrients boost the health of our brains.
The brain-healthy nutrients in foods include vitamins, minerals, flavonoids and fatty acids. Each plays a key role by supporting the creation of new brain cells, preventing early brain-cell death, protecting the brain from oxidative stress (aka inflammation), and facilitating the communication between cells. When the brain receives a constant supply of these building blocks that come from food, it ages more slowly. It becomes a brain that resists shrinkage with age, as is seen in dementia, and continues to thrive. When the diet is deficient in key nutrients, or bombarded with pro-inflammatory foods (such as foods high in unhealthy saturated fats, refined sugars and environmental toxins), brain aging is accelerated.
Take the omega-3 fatty acids DHA (docosahexaenoic acid) and EPA (eicosapentaenoic acid), for example. Both are critical for brain health. They’re considered particularly essential because the body doesn’t produce this type of fatty acid; you must get it from food, primarily fish and seafood. And the brain requires these particular omega-3’s to repair and build brain cells throughout life.
Besides DHA and EPA, fish and seafood are good sources of other key brain health nutrients, like selenium, vitamin D and vitamin B-12. B-12 is arguably the single most important vitamin for brain health as it is essential for building the myelin sheath that protects nerve cells.
A deficiency of DHA in the diet is associated with a 70 percent greater likelihood of developing Alzheimer’s or another type of dementia. Conversely, the MIND diet showed that eating just one fish or seafood meal per week was sufficient to significantly reduce Alzheimer’s risk.
What are the other benefits of a brain-healthy diet beyond the prevention of Alzheimer’s disease? For instance, can a brain-healthy diet help with depression, anxiety, and memory?
Yes. One of the most exciting findings in recent years is that the same approach to diet can not only fend off Alzheimer’s, but also help cultivate mental health and mental acuity now. That’s why we wanted to include psychiatrists who integrate nutrition into their practices—a field now called nutritional psychiatry—as guests on the Brain-Healthy Cooking Series.
I think of brain-healthy eating as checking off many boxes that will also reduce your risk of heart disease, diabetes and other chronic diseases, all of which are rooted in an environment of chronic inflammation in the body and the brain.
What are the best ways to incorporate brain-healthy foods into our existing diet?
Start by taking an honest assessment of what you eat on a regular basis. I ask my cooking school students to keep a food diary for a week or so to see if they are getting enough of the 10 brain-healthy food groups (berries, leafy greens, vegetables, nuts and seeds, whole grains, beans and legumes, fish and seafood, chicken, olive oil, and red wine). I also want to see how much of the diet comes from the five brain-unhealthy food groups (fast and fried foods, red meat, cheese, butter and processed foods). In addition, I ask students to tally up how many different kinds of plant foods they consume each week. That’s because eating a diversity of plants (30 or more different types each week) is key for cultivating a healthy gut microbiome that supports brain health.
Once you know where you stand, you can start boosting your diet with the brain-healthy foods you are missing out on. For example, if you never eat berries, just adding two half-cup servings of berries to your diet each week can reduce dementia risk by as much as 50 percent. It’s the same with leafy greens: Study participants who eat leafy greens at least once each day have brains that look 11 years younger on MRI scans.
A food diary is also a good way to become aware of the foods you may be consuming that will contribute to cognitive decline. Fast and fried foods, for example, are best eaten rarely—if at all. Cutting back on saturated fat-laden foods, like butter, cheese mayonnaise and coffee creamer, is proven to reduce the risk of Alzheimer’s. That’s because these foods have been found to be inflammatory to the brain, especially when consumed along with sugar.
How can we add healthy brain food into traditional holiday meals, like Thanksgiving dinner?
Many of the recipes I create for the Brain Health Kitchen are comfort foods everyone loves, revamped with brain-healthier ingredients. So for the holidays, start with foods that are familiar and comforting, like a creamy artichoke-and-spinach dip. Now replace the sour cream or cream cheese with a healthier fat, like a plant-based cheese (I like cashew cream, which you can make in about three minutes in a blender) or a vegan mayo (like one made from avocado oil). Instead of adding a ton of gooey cheese, add just a sprinkling of a cheese that’s highly flavorful yet lower in saturated fat, such as Parmesan. Serve with fresh vegetables, like spears of cucumber and endive, along with some whole-grain pita chips. Be sure to add enough spices—cumin, paprika, cayenne—which are anti-inflammatory in their own right, to bring out the flavors of the spinach and artichokes.
Another trick is to make sure your plate is at least half plant foods—leafy greens, vegetables, whole grains, etc. The fiber in these foods will make you feel satisfied and less likely to overeat.
After attending culinary school, what inspired you to create the Brain Health Cooking School and specifically focus on targeted nutrition for the brain?
After spending more than 20 years focused on women’s health, I had already seen firsthand the impact of a healthful diet. My patients with good nutrition had easier childbirth, fewer symptoms at menopause, and fewer complications after surgery. It was my menopausal patients who taught me the most: Those with the most debilitating symptoms described it as feeling like they were “getting Alzheimer’s.” (Now, we know that dropping estrogen levels make women vulnerable to the protein plaques seen with Alzheimer’s during perimenopause.) A few years after I retired, the scientific literature exploded with several key studies, including the MIND diet study in 2015, that linked a poor diet to a greater risk of Alzheimer’s. That same year, my mother was diagnosed with mild cognitive impairment, the earliest stage of Alzheimer’s. So I actually had one of those epiphanies where it became very clear what I was to do: use my medical background along with my culinary training to teach people how to cook and enjoy brain-healthy foods. Alzheimer’s is mostly preventable, we are learning, and my mission is to reverse the current trend of an impending dementia epidemic by empowering people to take care of their brains.
Besides a healthy diet, what are other ways we can prevent Alzheimer’s Disease?
Exercise is key, both aerobic and resistance training. Getting enough high-quality sleep is important to help the brain filter out toxins and the sticky proteins that lead to Alzheimer’s. It’s important to maintain a healthy weight, especially at midlife, and to keep blood pressure under excellent control. Stress mitigation is evolving as another important factor—finding ways to deal with stress, such as mindfulness training and meditation. In addition, correcting hearing loss at midlife may reduce dementia risk later. Loneliness is strongly associated with Alzheimer’s, so it’s important to keep cultivating healthy relationships throughout life, and not slip into isolation as we get older.
How does this series further Aspen Brain Institute’s mission to democratize access to top health experts and evidenced-based research?
We are bringing top brain-health experts into everyone’s home, free to anyone who can access the internet. It’s a powerful way to share information about brain health. And our experts are doing more than talking about brain health; they are showing what it looks like to eat a brain-healthy diet, and follow a brain-healthy lifestyle. It’s helpful for everyone to see how these extremely busy individuals can find time to cook in real life as a way to prioritize brain health.
How did the Aspen Brain Institute curate this lineup of experts? What do they each add to the discussion on the link between our diet and brain health?
When Glenda Greenwald [CEO and founder of Aspen Brain Institute] came up with the idea for the Brain-Healthy Cooking Series, we discussed that it would be key that our guests shared practical advice on cooking. We really want this series to show people that it doesn’t have to be difficult, and that the foods are truly delicious and satisfying. We brainstormed as a team as to what each guest would offer to the ABI audience. We wanted physicians and scientists who had a strong academic focus on nutrition and brain health. But we also wanted to find guests who modeled a brain-healthy lifestyle in real life, who had figured out a way to cook and eat brain-healthy for themselves and their family. We couldn’t be more proud of the line-up of guests we came up with. Dr. Drew Ramsey and Dr. Uma Naidoo are both nutritional psychiatrists, which means they integrate evidence-based nutrition into their practices to help people figure out how to best nourish their brains. Drs. Ayesha and Dean Sherzai are neurologists focused on dementia prevention who do work in communities to make the brain-healthy way of life more accessible to people. Dr. Lisa Mosconi is a neuroscientist and researcher focused on women’s health, Alzheimer’s prevention and how what we eat impacts dementia risk. She literally wrote the book Brain Food. Our last guest in the series, Eric Adams, is not a physician or scientist but he has a powerful impact on getting the word out about the importance of nutrition. Adams is the Brooklyn borough president and author of the new book Healthy at Last, which tells his story of being diagnosed with diabetes—actually waking up blind—and how he reversed his disease with a plant-based diet. Now he inspires his constituents in the African American community that they can take back their health by following a plant-based diet. Diabetes, for many, is a major risk factor that leads to Alzheimer’s disease.
What are the links between a plant-based diet and a healthy brain?
All of the dietary patterns with good evidence to say they prevent Alzheimer’s and other dementias are mostly plant-based. I prefer the term plant-rich because it sounds more delicious, but plant-based eating means that 90 percent or more of what you eat comes from these categories: vegetables, fruits, nuts and seeds, beans and legumes. This diet floods the brains with enough phytonutrients and brain-friendly fats to keep it running smoothly, while also providing plenty of fiber, which serves to slow down the absorption of sugar (and the resultant spiking of insulin that, over time, can result in diabetes) and feed the gut microbes necessary for a healthy gut microbiome. For the ABI series, we selected guests who have their own stamp on what it means to be plant-based. Naidoo is vegetarian; Adams and the Sherzais are whole-food, plant-based (meaning they do not eat animal products at all); and Ramsey and I follow our brain-healthy take on the Mediterranean diet: about 90 percent plant-based, 10 percent high-quality fish and seafood, dairy and meat. We don’t have sufficient data as of yet to prove one approach is superior to the other. The point is that moving toward a more plant-rich way of eating is better for the brain.
Why is it important to focus on women’s health when examining prevention tactics for Alzheimer’s disease?
Women are at the epicenter of the Alzheimer’s epidemic. Not only do they make up two-thirds of all persons with Alzheimer’s, they make up two-thirds of all dementia caregivers. Researchers like Mosconi are starting to figure out why women are more vulnerable to this disease, and, as you would guess, it is a complicated interplay of many factors, including the hormonal milieu at menopause. It is absolutely essential to tease out these gender differences in research; by learning more about why women get more Alzheimer’s than men, we will be able to help both men and women prevent cognitive decline. On a practical note, most women are still the ones making decisions about what the family eats. When a woman starts focusing on a brain-healthy food, this filters out into her family and her community.
November 10: Guest Drew Ramsey, MD, farmer, nutritional psychiatrist and author of four books, including Eat to Beat Depression and Anxiety
November 17: Guest Lisa Mosconi, PhD, neuroscientist and author of Brain Food & The XX Brain: The Groundbreaking Science Empowering Women to Maximize Cognitive Health and Prevent Alzheimer’s Disease
December 1: Ayesha Sherzai, MD and Dean Sherzai, MD, PhD, co-authors of The Alzheimer’s Solution
December 8: Eric Adams, Brooklyn borough president, plant-based foods advocate and author of Healthy at Last: A Plant-Based Approach to Preventing and Reversing Diabetes and Other Chronic Illnesses
December 15: Uma Naidoo, MD, director of nutritional and lifestyle psychiatry at Massachusetts General Hospital, mood-food expert at Harvard Medical School and author of This Is Your Brain on Food
Register for free online at aspenbraininstitute.org
