Building a Better Brain
Karen Koffler, M.D. Director of Functional Medicine, Rezilir Health
Team Rezilir
1 Help you appreciate your brain
2 Help you understand conundrum of demen5a
3 Help you to appreciate that we can improve brain func5on
What I hope to accomplish
Understanding our most complex organ
As a fetus, a trillion neurons are produced 100 billion neurons remain 100 trillion connections As we age, we lose 7 milliseconds per decade from age 20 We become slower Misjudge distances
“Mild cognitive impairment� is loss of brain speed and we all experience it Many of us see this showing up in our 40s
A single neuron can have 100,000 dendrites
A Quick Tour: Baby’s Brain
Ages 1-3: baby’s brain has 2x number of neurons, connections vs. adults • Faster loss if not touched • Cortisol plays a major role Neglect/abuse has the same effect in dropping IQ Memory storage starts as early as 2
Adolescent Brain “All anybody expects of an adolescent is that he acts like an adult and be satisfied to be treated like a child.”
Burst of connections between ages 6-12: learning is accelerated Between puberty and 25, neurons are pruned The more we learn, the less neuronal loss The more we practice, the thicker the white matter
Adolescent Brain
Growth begins in the rear of the brain nd moves forward • Sensory cortex is first to develop • Prefrontal cortex is last to develop (executive center) nformation tends to be processed more in the amygdala (emotional enter) vs frontal lobe in adults rationality)
Brain changes with age:
% volume loss over time • Men lose more mass than women • Especially left hemisphere (language) • 2 oz drop brain weight in women at menopause
eaction time doubles from age 20 to 60
e get less efficient at retrieval
3 of those over 70 will have memory issues that impair day-to-
y life (without being diagnosed with Alzheimer’s)
Brain Changes With Age (the upside)
Brain keeps growing in the temporal lobe and frontal
lobe • emotional development and wisdom • moral decision-making • regulation of emotions • reading social situations • We also are better at remembering positive images vs. negative ones
Is there a difference between men’s and women’s brains? • Corpus callosum is bigger in women • Men have 6x more gray matter (nerve cells) • Women have 10x more white matter (connections) • Men have larger parietal lobes: space & perception • Women have larger limbic system: regulation of emotions
Is there a difference between men’s and women’s brains?
Men and women access different parts of brain while performing tasks • Listening to a story activates left hemiphere in men; both hemispheres in women • Navigation involves cerebral cortex in women, hippocampus in men Women are faster and more accurate in identifying emotions
Is there a difference between men’s and women’s brains?
• Women diagnosed more often with anxiety and depression • Men diagnosed more often with autism, Tourette’s, dyslexia and schizophrenia • Girls diagnosed with ADHD show more inattention; boys show reduced impulse control
Differences between male and female brains: plasticity
Men store more information in visual-spatial dimension • Pilots, architects, engineers
However, environmental input for women can drive the same capacity
Is there a difference between men’s and women’s brains?
• IQs are the same • Rates of development of different areas are different: • Boys are superior in math and geometry; these areas matu about 4 years prior to girls • girls may get frustrated and give up • Studies of male and female soccer players show similar spati abilities Brain is influenced by biology and environment Differences may be complementary, support survival of the specie
“I am having a senior moment”
• When we forget something at a certain age, we become concerned • Memories may be there, decreased speed of retrieval • The issue of attention
30 million with Alzheimer’s
By 2050, there will be 160,000,000
Currently, 1 in 9 adults over 65 has Alzheimer’s
Not all forgetting is Alzheimer’s: Types of Dementia
What you might notice
Forgetfulness Inability to recognize common objects. May get lost in a familiar place. Store things in unusual locations Comprehension: Challenged by following a conversation Coordination: Reach for an item and miss it. Difficulty navigating. Inability to perform complex routine tasks
Ways to differentiate…
More than just memory is perturbed New learning is impaired Must be a clear decline from previous level of functioning
Rudy Tanzi, PhD. Dale Bredesen, M.D.
Dale Bredesen, M.D., Buck Institute “Most of the causes of Alzheimer’s Disease are related to lifestyle factors”
Drugs to treat Alzheimer’s has been abysmal 243/244 drug trials have failed
My approach to improving brain health
hat we explore when optimizing brain alth:
ne6cs: ApoE4, MTHFR xins uma ec6ons amma6on ood
• Nutrients • Hormones • Exercise • Stress • Sleep
at are we doing to contribute to the s of brain function?
cohol: up to 60,000/d urons lost in heavy drinkers • Inac6vity • Hypertension edica6ons
ronary Artery Disease
ec6ons
sence of a s6mula6ng rtner or environment
flexible personality style
• Malnutri6on • Depression • Diabetes • Smoking • Stress
Food and your Brain
Diet • Cornerstone of Prevention: Antiinflammatory Diet • Plant-based • Minimize carbohydrates • No gluten • No processed food
Cut Out The Sugar!!!!
Grain Brain
• Concern for gluten and gut inflammation • Gut inflammation has a negative impact on brain function
Role of Omega 3 Fats
Principal brain fatty acid is DHA We know that low blood levels of DHA is a risk factor for dementia • Studies show lower level of DHA in demented and impaired patients vs. controls (Lipids 2000 Dec;35(12):1305-12.)
Let thy food be thy medicine‌
Other Foods Rich in Omega 3
Walnuts, pumpkin seeds, hazelnuts, almonds Venison, buffalo Green leafy vegetables Chia seeds
Energy Prevent plaque
Calorie Restriction
Takeaways on food and brain health
Plant-based diet Organic No sugar; fruit is ok Healthy fats and plenty of them Timing is important Cease overeating
Supplements: specific to improve cellular function
Use of Vitamin E By Patients With Mild to Moderate Alzheimer Disease Slows Decline
Food sources of vitamin E
•  400iu mixed tocopherols
Many nutrients have been studied and found to be helpful:
cetyl-l-carnitine -acety-cysteine tocholine RF2 Activators vitamins agnesium
• Ashwaganda • Cat’s Claw • Bacopa • Vinpocetine • Huperizine • Maca • Tumeric
Hormone Replacement Therapy
Estradiol Pregnenolone Thyroid Testosterone Cortisol Dhea
OPTIMIZED
Exercise
Physical activity maintained throughout life is associated with lower incidence and of chronic diseases: cancer, diabetes and cardiovascular and coronary heart diseases Recent studies suggest that physical exercise also protects against dementia Non-negotiable Do not over train!
Exercise and he Brain
Exercise stimulates release of brainderived neurotropic factor BDNF stimulates the growth of new nerves and preserves existing ones
Why I Try to avoid surgery…
• “Post-operative cognitive dysfunction”: cognitive decline associated with anesthesia • Affects the elderly most • Worsened by mechanically-circulated blood (“bypass”) • Not sufficiently studied…
Toxic Exposures and the Brain
• In essence, we are all “fat heads” • Brain is composed of 60% fat! • Worrisome considering at any one time, we are carrying more than 700 toxins (EPA)
Some of our more concerning toxic xposures: Plasticizers BPA and Phthlates
Mercury: effects on human health
• Depression • Difficulty concentrating • Fatigue • Fearfulness • Indecisiveness • Irritable • Memory changes
Tooth loss linked to mental decline • 3166 adults > 60 years old • Memory and walking speed evaluated • 10% decline in both if no longer possessed their own teeth
Medications can be helpful…and harmfu
Tylenol Sleep and anxiety medications Antidepressants Statins Beta blockers Narcotics Incontinence medications Antihistamines
Sleep • Deep sleep consolidates all your memories from the day • Deep sleep clears out the debris
Perception of stress activates hypothalamus Adrenals release cortisol: fight or flight Cortisol at persistently elevated levels damages the hippocampus New memory formation is mpaired
Anxiety and Brain Health
  Anxiety medications are associated with increased risk of dementia
How the Mind Affects the Body Which Affects the Mind Impact of cortisol: acute and chronic • Raises blood sugar, mobilizes fatty acids, protein breakdown from muscle • Antagonizes insulin • Increases blood pressure • Thickens blood to prevent loss • Inhibits immune function • Steals progesterone • Causes injury to hippocampus and pre-frontal cortex • Augments the amygdala
The good news: we can manipulate the brain
What neuroplasticity teaches us:
The brain changes its structure with every different activity performed If certain “parts” fail, other “parts” can take over And that thinking, learning, acting can turn on and off different genes!
What meditators teach us: • Increased grey matter (nerve cells) • Increase hippocampus (memory) • Increase prefrontal cortex (reasoning) • Reduce cortical thinning (age-related atrophy) • Improve attention • Improves mood • Strengthen immune function • Improve sleep
Why meditation is an essential part of our program:
Stress makes it harder to remember things Stress leads to anxiety, depression, and insomnia Meditation lowers stress and improves brain function and memory Meditation reduces anxiety and depression, both risk factors for Alzheimer’s Most studied meditation techniques include: a. The Relaxation Response – 20 min/ twice a day b. TM – 20 min/twice a day c. Mindfulness – 47 min average d. Kirtan Kriya (KK) – 12 min
What about Brain Gyms?
  No compelling evidence to date that computer-based brain gyms make a difference in reducing or reversing cognitive decline
Learning Something New is the Key
coming Expansive as We Age
se who explore, take on new challenges,
ment, retain greater brain capacity is a challenge for those of us “set in our ways�
the degree of brain usage as we age that determines our mental
acity
e demanding tasks recruit more tissue
The healing benefits of music‌..
How to protect your brain
member the basics: eat well, sleep well, move, relax propriate supplementation nimize unnecessary exposures estion your medications a life-long learner
karen.koffler@rezilirhealth.org