How we can fight Alzheimer’s: Lisa Mosconi, Ph.D. | mbg Podcast

foreign [Music] hi thank you for having me it is so great to have you here we are a big fan of your work and so excited for your new book The xx brain and me particularly I am surrounded by women I married my wife obviously we have two little girls and I'm very close with my mother so I'm surrounded by women and I'm very interested in the XX brain because it's all about women yes and brain health unapologetically and and we're in a real crisis I had no idea how bad the numbers were with regards to brain health specifically Alzheimer's women outnumber men two to one right in Alzheimer's yeah what's going on that's a great question what is going on and it's also interesting that it's not just Alzheimer's so to add more stress to the conversation women are twice as likely as men to have anxiety and depression not to mention headaches and migraines but also three times more likely to have an autoimmune disorder including those that attack the brain like multiple sclerosis were far more likely to have a meningioma which is the most common form of brain tumor and would also find more likely to die of a stroke should a stroke take place so Alzheimer's I think is the most is this curious disease perhaps where women are overrepresented and because the numbers are incredible so Alzheimer's disease is the most common form of dementia it currently affects almost 6 million people in the United States alone and is projected to Triple by the year 2050 with an expected 15 million patients in the United States which for context is the population of New York Chicago and Los Angeles put together wow so it's an enormous amount of people and the thing is that almost two-thirds of all these patients might be women so for every man suffering from Alzheimer's right now there are two women and the question like your question is a great question is why is that what could potentially account for that and I'm so glad you asked because that was my question since College the reason being I have a family history of Alzheimer's disease that really seems to Target the women in my family so my grandmother had three siblings they were three sisters and one brother and all three sisters developed and died of dementia whereas the brother did not so that really let me personally to look at adult sinuses the main focus in my research because at first I just wanted to understand what causes Alzheimer's and how do we stay away from it but then I started thinking well is it just my family or is it really something that affects women perhaps more than men and it turns out statistically that yes that is the case so women are more frequently affected by alzheimer's than men but for a really long time that was kind of just explained Away by saying that well you know women live longer than men and Alzheimer's is a disease of old age so chorus there are more women than men with Alzheimer's and that was slightly upsetting for me it's just dismissive it's like ah whatever you live longer right it's like with every kind of answer which was not just people but also the government really looking at that was not a priority however do women live that much longer than men that was my point that was like 19 was like what is that the case so in the United States women live on average four years longer than men not 20. and in other counters they can in the UK women live about two and a half to three years longer than men however Alzheimer's and Dementia is the number one cause of death for women and not for men you know you would think that the 10 years Gap would really explain that but they were talking two four years there must be more to that and more importantly it turns out that Alzheimer's disease is not a diseasable date so many studies recently including my a lot of my own work has shown that Alzheimer's disease starts with negative changes in the brain ears if not decades prior to clinical symptoms and our work has shown that for women we seem to develop that earlier than men so it's not just that women live longer women tend to develop Alzheimer's changes in their brains before men do and specifically emit life during menopause I'm gonna pause because there was a lot so what have we gotten so wrong it's like here we are at 2020 this has been around for so long and yeah we're talking about it now but we weren't talking about it years ago no no I think it's it's become more an arm to the conversation in the past four years perhaps maybe three I think largely because of you but seriously what have you picked up on that other people haven't was it just curiosity uh looking at the data in a different way yes I think it's really about thinking about women's Brains differently than it was done before well also just for context I've been trying to look at women's Brains for 20 years I really started I was 19 when I started and I moved to the United States to do that and they just could not get a grant to do it and now just in this past couple of years I was able to raise enough money to have enough funds to launch the women's brain initiative a wild Cornell in New York City which is a research program entirely dedicated not just the women's Brains but also really to understanding how brain health plays out differently in women than in men we're also very interested in men and what causes Alzheimer's in men because one-third of all the time is patients are men so the question is really what kind of risk factors seem to activate the Alzheimer's police position in women and men are they different and the answer seems to be really yes it's more like I'm sorry what you had this great term bikini medicine yes yes can you explain that I think gladly so very good I believe in many people believe that they feel the medicine has been biased in that historically medical professionals actually believed that men and women were essentially the same person with different reproductive organs and that specifically women were the same as men except for these body parts they would be covered under the bikinis or breasts and tubes and that's obviously a reductive understanding of what a woman is but it really permeated the field of medicine until very recently to the point that women ended up being excluded from research for decades in part because of concerns about pregnancies and really protecting women which is quite nice but the end result was done for many many years women were just not part of research or clinical trials and therefore women were not informing research either so a lot of medical research has been based on men and the recommendations and the understanding of a disease that we have is largely based on the disease manifestations in men and not in women but then we treat them the same way so that's been a real issue for for women in so many fields so you mentioned menopause starts in the brain yeah what why menopause what what happened what's going on there yeah um so I'm very surprised that I'm talking about menopause because there's this this issue in medicine I think that number one we believe the women are the same thing as men right except for reproductive organs but at the same time we tend to think of our bodies as different parts say the end like an endocrinologist only studies hormones and a cardiologist only studies the heart and the neurologists only studies the brain but the truth is that our brains are in constant interactions with rest device and then the interactions between the brain and the reproductive organs are really crucial for brain health and brain aging especially in women in the reason is that as everybody knows men and women have different hormones somewhat so men have more testosterone and women have more estrogens in both these hormones are really important to give your brain energy they're very energizing hormones we tend to think of testosterone estrogens as involved in reproduction and having kids but in reality these hormones have a lot of effects inside their brains in particular they literally push on neurons to bring glucose to make energy so if your hormones are high your brain energy is high but then what happens to testosterone is that it kind it doesn't quite decline that much over time whereas for women estrogens pretty much plummet when women go through menopause so if you think is this hormones is having some kind of superpowers for the brain women lose the superpower around the time the menopause hits right and it's like the brain is left a little bit more vulnerable has less of a it's like a whole Army is kind of gone so if you have a predisposition for example to Alzheimer's disease that's when the predisposition tends to become a natural risk that we can see using brain scans so in women who are going through menopause we have shown that the brain starts showing reductions in brain energy levels in that kind of correlates with the formation of amyloplex or Alzheimer's plaques in women's Brains so we're talking women in their 50s Not in their 70s it really gives us a completely different timeline to start doing risk assessments especially in women so if you're a woman who's going through menopause what's on your checklist of what to do well right now your tax list says go to the doctor and find out if your impedimental points postmanopause do you want to take hormones do you not want to from my perspective and we were talking about thinking about things a little differently I would strongly recommend the brain health assessment because if you have medical risks menopause seems to be the turning point for those medical risks to become potential medical issues like if you are for any reason predisposed to depression menopause for so many women is when depression actually hits right right most like first major depressive episodes for so many women really come up to the menopause actually the perimenopause which could be when you're 45 years old if you have a predisposition to Alzheimer's disease for many women that really manifests itself as the brain started to accumulate Alzheimer's plaques around that time so for me it's really helpful if I can see that right now the year 35 or 50 so we can get a really strong Baseline and just put you on an Alzheimer's prevention plan and then keep doing brain scans over time to make sure that the plaques don't increase we want to stabilize it as much as we can so one no family history in genetics that's a big one yes that's a very good one but we find it also in people without a family history I was going to ask you where I was going was how do we know of the of of women who have Alzheimer's how many had a family history what percentage of this of those women had in family history versus those who did not that depends um it's about 30 percent for a maternal family history and about nine percent for a paternal family history like having a maternal family history so if your mother or Grandmother Had It mother yes and then father got it yes there are more people with a mother affected by Alzheimer's disease than people with the founder affected and then there's a minority of people with both parents with Alzheimer's is unfortunate if you what if you have no family history still be concerned you're just not as likely it's still a concern but I always say it is a concern because time is patients do not have an obvious family history and so there's also a genetic risk factor for alzheimera that's become very very trendy it's called the apoe genotype but the typical e right apoe yep talking to the guy he gets the labs and the 23 and me and all that stuff so I I love it right so it comes in three different variants it's called an Epsilon two three and four the E2 or Epsilon two variety seems to be protective against Alzheimer's the E3 is kind of neutral the E4 it has been associated with an increased risk it doesn't cause Alzheimer's disease it just puts you at higher risk but even then more than 60 percent of all Alzheimer's patients don't have any pre-4 genotype so there's something more and even if you look at the genetic mutations the cause Alzheimer's they're very rare but there are a couple they are found in no more than two percent of all the time is cases so there's more to alzheimer's than genetics and you know when I started obviously I was looking at genetics I was working with people with the genetic mutations and it was just so obvious that was not the entire story that there was more to it which led me and my colleagues to look in medical history was the most obvious thing to look at but also lifestyle and environment and it turns out all of those are really important so I want to go to Lifestyle actually next but before we go there is there a certain age where you're over the hump so if it starts in like perimenopause menopause in the 50s if you're 70 and you're sharp and you're feeling great are you out of the woods or I would say your likelihood of developing Alzheimer's is is lower if you have no subjected cognitive complaints and no objective kind of impairment so if you test normal is then your likelihood of getting Alzheimer's is low but it's not yeah what is a neuropsych test neuropsychological testing is what we do to assess cognitive function um by age so it's like asking questions around it's really testing like it's a solid hour hour and a half probing different I don't know if I could pass that right now with two kids well you know you would be yeah I set my black coffee so let's go back to stress and lifestyle and environment and all those and sleep I'll throw sleep in there as I'm short on sleep today all those things and how they play a role yeah sure so there are many risk factors so Alzheimer's is is probably probably caused by genetic and non-genetic risk factors and we also call as modifiable and non-modifiable so non-modifiable risk factors are all those things that we just can't touch for now it's like your age your family history your DNA your sex your family right so we can we can't change that for you however there's a number of things that we can actually modify that really have been linked to a higher risk of Alzheimer's like your medical history if you have a heart disease that's a that's a risk factor for Alzheimer's like things like high blood pressure high cholesterol hydroglyceride levels they seem to potentially affect your brain as well by possibly reducing blood flow and oxygen supply to the brain there's diabetes it's been shown to also negatively impact the brain and about six to seven percent of all Alzheimer's cases have also diabetes so there seems to be a trigger for some people as obesity is right and then there's lifestyle like Diet exercise sleep stress toxin exposure what we have been doing which I think is quite interesting is to look at how these risk factors impact brain health differently in women and in men and if you really look at associations at least between these risks and future risk of Alzheimer's and Dementia there are very different Pathways towards Alzheimer's that are really based on sex so for men the major risk factor foreign the research started a long time ago so the only information we have is about regular couples I would argue that you don't have to be married to a woman you should be in a relationship just being in a solid relationship nurturing relationship with your husband or your spouse or your friend partner is actually supportive of your health as well and you you help each other I was saying that's the bottom line basically men need to be in a relationship yeah men just can't do it alone yeah they get lonely they don't know what to do they start drinking bad things happen they don't eat right they don't go to the doctor I hear you I hear you say that but I think it's funny it's actually really nice now to know that support having a support system is so important for men for women that needs are bad need women it's not the other way around you're right you know the research supports that exactly what you just said yes like for me women being married or not married whether they're like whatever we don't need you guys that's the same thing congratulate with the risk of dementia but there are other things to do and the number one thing for women is hormonal health and it's really important to me as a brain person to acknowledge that because when we talk about risk factors where Alzheimer's we're not looking for cholesterol they have high cholesterol what's your insulin level they have diabetes pre-diabetes do they smoke what's your diet what's your exercise for women our research really showed that menopause is the number one factor that determines whether or not a woman in midlife gets the Alzheimer's plaques followed by hormonal therapy and hysterectomies so this is something I want to touch on but one in nine American women gets preview there is and or over is removed often prior to menopause and I I want to mention that because nobody seems to know that having the uterus and or the ovary is removed before menopause correlates with a much higher risk of Alzheimer's in women and the number one cause of that surgery is fibroids which should not lead to removing the ovaries in many cases what happens is that you get the surgery and it's just easier to take everything out you know sure but in some cases it's not need is not necessary so I think it's a good topical conversation and discussion with your doctors I was the safest way to really protect our bodies and brains so what do you say to someone who's listening right now who's had that surgery and is saying to themselves silently like oh what what can assuming they have no signs right right they do it's like I've already done it like I had it I've done it I had a hysterectomy and with or without the over is removed I think it's really important to understand that that could potentially increase a woman's risk of Alzheimer's and that risk uh increases there's a little bit of an increase of your uterus if only your uterus was removed and not the ovaries the risk is higher if one of the ovaries was removed with or without the uterus in this highest for both ovaries being taken out it seems however that doing hormonal therapy starting from the time of surgery or as close as possible to the time of surgery and continuing to take hormones until the natural age of menopause which is usually 50 51 for most women is protective and seems to really revert back to risk so this is something that is important to discuss with your doctors and so what if it happens during menopause that doesn't seem to to increase risk a lot of time got it got it so go back to Lifestyle yeah we got it we got on the the we got a little not off track but so with lifestyle how do you let's go through like each category if you will okay so nutrition stress sleep yeah movement just keep on saying sleep um how do you rank them can you rank them I'm not sure I think it depends I think every person is different right and there are things that work better depending on age and we can just stage of life you're in like if you're a sleep deprived parent perhaps high intensity interval training may not seem as appealing as sleeping right I think it's really you know we can't effectively rank um these things unless you use a statistical approach and the way we have been doing it is by doing brain scans and then we have a number of papers published in good journals showing that if you if you use the brain scan that's the thing you're trying to predict by brain aging or brain health over time which lifestyle factors are the most impactful usually diet and exercise come up on top accounting for the other ones which really does not apply to new parents I I also you know my daughter is four and a half and she did not sleep for over two years and obviously if you're sleeping prior then sleep is the most important thing if you're not eating healthily then you need to you need to fix your diet if you're not exercising at all you have to start moving so so if we focused on diet and exercise what is the optimal diet for brain health and does it differ between men and women well thank you for asking so there is evidence that actually it does a little bit and differ between men and women in general I think a healthy diet is like a Mediterranean style Mediterranean Mediterranean is getting a lot of points these days well you know there's a lot of research on it so as a scientist it's important to me to look at start is like a diet that's been validated by hundreds of studies that's been really looked at India where you're smiling I love that you say as a scientist I like validation from hundreds of studies I just we love that too and it's important some people say well I got validation on Instagram I got a lot of likes and oh I think we sold a lot of books so I like validation I I love that approach right well the I think the problem with diet and nutrition is that it it's really very important to to check your sources there's so much confusion out there and everybody eats and loves food and everybody has opinions so there are opinions and then there's actual data for me I go by the data and it's very important to me as to you um do not follow Trends you know Trends come and go and science moves a lot slower than any Trends so very often all of a sudden there's this diet everybody follows but there's really no data to back it up but the Mediterranean diet is good because it's a very flexible diet it's a very sensible diet it's rich in veggies and fruits and whole grains and legumes if you don't want to eat whole grains don't eat them for me as long as you have enough fiber in your diet that's really the important thing and then there's fish and we know that omega-3 fatty acids from fish especially the polyunsaturated ones so DHA and EPA are really crucial for brain health they're part of our cell men a brain cell membranes and then smaller amounts of meat and dairy which is like not not eating them you know even it just you can't eat them all day long only huge quantities you just do it sensibly in sweets are also part of the diet but as a treat as they should be and they're not processed foods it's a diet that is very fresh you know it's a sun-kissed diet I'm Italian so I can attest to that the food is really good it's really fresh and it's very it's very clean there are very little pollutants in the food and this diet has been shown to be particularly supportive of women's brain brains in women's health overall so women on this diet as compared to women on the western diet have a much lower risk of cognitive decline or depression of heart disease or stroke of cancer and they also have fewer hot flashes we pretty much hit every major killer of Americans next to car accidents like everything yeah yeah but it's true you know we know that it works but why not it's a bit very tasty you you missed olive oil I missed the other one you're right those are the good friends so they're protective of this olive oil and avocados and nuts avocado is not part of the Mediterranean diet but it's delicious and they think it's not I did not know that but they don't grow in the Mediterranean that makes sense we just don't have it yeah can we eat avocados of course okay well we have valtter long going here one time and he was like you know what I'm not sure about avocados and I felt like someone told me Santa Claus didn't exist I was like a couple years old um so that was for women what about men yeah well this tire seems to work really well for women and for men okay however most of the research that we have on diets is based on the average person genderless person and a lot of the studies had a lot more men than women in the studies of diets because they were all based on heart disease so historically diet was used really to lower the risk of heart disease so they would Target men mostly because men have a higher risk of that sure so it's really important for me as the Director the women's rain initiative to also local studies they look specifically at women but it looks like it really works for men and women the one difference that I find interesting is the way the men and women process energy source is so the main energy sources are glucose the simple carbohydrate and fat from saturated fat mostly right we can burn them to make energy but the way that our bodies burn and handle and store these energy sources is different a little bit between men and women because of our hormones in part so estrogens are really good at stabilizing glucose metabolism which means that women can handle carbohydrates a little bit more efficiently than men whereas men are better at burning fat interesting which is one of the reason that I think now everybody's going on high fat diets and they seem to really work well for a lot of men and women get mixed results brain so that's interesting to me isn't it well you were talking about Trends I think when I think of Trends I think of intermittent fasting I think of Keto yes yeah yes uh gluten-free vegan um what's your take on all those different Trends they come and go what what what's what is the let me rephrase that what does the cyan say with regards to brain health in terms of called intermittent fasting and Keto right so they're two different things yes there's quite a bit of science on fasting and I think it's it's good science it's strong solid science it was started at the NIH but Dr Matson who's the big hero of mine really loved his work and he did show how not starving new neurons but um short times of food deprivation seems to strengthen your system and makes your neurons more resilient to oxidative stress which makes sense as an evolutionary mechanism right back then when the brains were really developing our ancestors had to go Winters with very little food it was scarcity and that's really when your brain needs to be at its best to be resourceful and find alternatives so it makes sense that the brain can handle these periods of scarcity and not being weakened by that so that's really good and I I think that well intermittent fasting is a convenient way to think about it and I hit the mic in case um it's very popular right now to stop eating at a certain time and then go like 12 15 hours without eating which when I was growing up which is called night time we call it sleeping right so technically you shouldn't be eating at night makes a lot of sense but if we want to call it intermediate fasting that's fine by me I think it's good in general I think it's good to eat a little bit less I find that there's a tendency to overeat or just be constantly snacking or eating anything that could really help in making people more aware that you can live even if you're on an airplane for five hours and there's no food you'll survive right you don't have to run to Starbucks right before you board the plane or and what about Keto a keto diet uh there's there's perhaps less evidence than people think that it might be good for the brain there are a few studies that are like clinical trials and some failed like one was this study uh you know model time is patients with um what's the name of the drug no I can't remember that but I wrote about it in the book in another Advisory board at some point the company is called axira and they showed that treatment with this precursor the Ketone board is actually not improved conditioning model Alzheimer's patients then there are a few studies bioca level a colleague of ours Dr Krikorian showing cognitive improvements in patients with my cognitive impairment but they were like 20 patients and that's about it like there isn't a lot of strong research to support the notion that people should eat all that fat and really go completely carb green so I don't know I think I think it would be nice to have more research before really adopting such a restrictive diet like my concern is really the restrictiveness right of these approaches and potential nutritional deficiencies because you know some people in case I have some friends but on keto diets and they're doing fantastic they eat a lot of salmon and a lot of avocado but most people who go high fired either ton of meat and dairy yeah yeah and we know it is just not healthy so it's a bit of an excuse to just overdo it in a way that may not be as healthy as you think well what's interesting too in the back of my mind you're saying this change happens with women so me I'm 45 I used to eat a whole lot of meat you do I used to in my 40s and I had low cholesterol everything in my 40s all that stuff started to catch up and so like my lipid profile you started going the wrong way if I started to eat a lot of meat and I take out the meat boom so but like something changed in my 40s it wasn't that way I might even 38 39 and so it's like oh maybe something's going on there too for men okay proud of it but also I think everyone's reaction to diet is very personal that's why not the problems I have with Trends you know that maybe it's not the right trend for you but you feel like you should do it because it's been pushed on you but I think it's much more reasonable to really find what kind of foods and nutrients your body needs very specifically about being tested like oh I'm all about testing you know I did blood tests to myself to see all my nutritional profile where is my vitamin A you know CG my lipids obviously is you measure them all the time and they think it's a good way to look at your brain what does your brain need and so you mentioned being restrictive and so I'm curious about coffee alcohol grains and and carbs so let's go one by one we could start with coffee as I sip my black coffee right so coughing has actually been associated with a perhaps lower risk or developing dementia at a reasonable dose so these Studies have shown that there's a little bit like an inverted u-shape but if you drink no coffee actually this other way your coffee is as high you have risk of Alzheimer's diseases as high as that of a person who drinks a ton of coffee but if you're right in the middle which is about one espresso a day or two cups of your coffee a day that seems to be really helpful because I think the reason that caffeine is a stimulant it is a vasodilator so it increases blood flow to the brain and that is helpful to brain cells into the vascular system but it has to be the right amount your heart needs to be well it's actually good oh great no but so back to this you mentioned espresso though you like espresso better than coffee black coffee yes so espresso has been scientifically proven to have the highest antioxidant power of all beverages it's it's true I have references I love it yes yes and it's important because of the way the coffee beans are treated and processed so you don't want the caffeine to just sit in the tank for the day you know you want a freshly brewed minimally processed and it's right it just also is the antioxidant content because it's very concentrated so it's a big shot I love it espresso guys science supports espresso it does well you know I think it makes sense but then again it's a very personal response and I want to add for women I have a lot of friends who go to Starbucks and just tell me I can't drink the coffee I cannot sure if I haven't espresso Starbucks I'm just going to fold my like palpitations and Jitters and it's also important for women to know that the response to caffeine alcohol and all stimulants really depend on your menstrual cycle so as long as your estrogens are higher which is the first two weeks you don't need as much or the stimulants to have a good response in the second part of the month because your progesterone is higher and this is an inhibiting hormones the soothing hormone then you're gonna feel like that cup of coffee is not doing it for you and you're going to drink three times as much and it's still not working because your hormones won't let it work for you but your heart will suffer you sleep will suffer so I think it's important to know that you need to you really need to think about your hormones and how the hormones affect your reactions to food and drinks and everything else and what about alcohol same same for alcohol do you have a do you have a approved or favorite type of alcohol some people you know Mediterranean people think red wine and you think it's the most obvious thing the only research showing positive effects on cognition or at least on a lower risk of dementia looks of red wine is the one that's been shown to be potentially supportive because of the high antioxidant content so I just want to explain here the brain is the organ that is most easily affected by oxidative stress that's because the brain runs on glucose before we get to gluten-free in glucose metabolism is highly efficient otherwise our brains will not be burning glucose for energy but it creates a lot of oxygen radicals the free radicals and that is oxidative stress so in order to protect our brains we need to get antioxidants in the brain and the only way to do it is through our diets which is why any food that is high in antioxidant nutrients will benefit your brain so red wine contains polyphenols which are antioxidant in nature so that's probably why it's good for your brain pomegranate juice it's almost as rich as rich as red wine in antioxidants so if you don't like red white like me which is bizarre you can do pomegranate juice what are your favorite antioxidant Foods I'm sorry what are your favorite antioxidant rich foods blackberries I really like diet um everybody goes for blueberries but blackberries actually contain more antioxidants that blue varies and I really like Blackberry butter we get it at the farmer's market you can also find it sometimes in health food stores so you have it in winter I really like that I like berries a lot goji berries um a fruit fruit has a lot of antioxidants okay but also vegetables and the gums and some nuts and seeds so you're you're so you brought up before I go to legumes you mentioned gluten and a lot of people you know our friend Dr Pearl mutter who we love is very strong opinion on he wrote a book called Grain Brain absolutely what's your take on grains gluten well let's see Friend or Foe I think it really depends on your genetics so gluten soy eggs fish those are really common allergens and some people have very strong reactions some people have intolerances and for some people is a natural big deal so if we're people with celiac disease they should obviously completely avoid gluten and it looks like another six to seven percent of people has sensitivities and probably in the United States even more than 67 percent of people has sensitivities because we're constantly exposed to gluten like there are so many foods that are enriched we glue them when they shouldn't be the same for soy soybean oil is just everywhere so we're really Overexposed to something that is a potential allergen I think I think it depends I think it depends on your diet on your genes and your your own individual response there are people who don't do well on grants and there are many people who do and again I would recommend to really know yourself right if eating grains is an issue for you just make sure that you replace them with other fiber rich foods especially if you're a woman again because we know that fiber is really crucial for Women's Health there's a ton of scientific studies showing that fiber really has an incredible effect not just on digestion which is kind of obvious but those in regulating hormones so even in women who have a history of breast cancer for example and they are not able to take hormonal therapy for menopausal for hot flashes induced by therapy there are studies showing that those who follow fiber rich diet have a lot really much fewer symptoms as compared to those who are on diets high in animal food and low in fiber so however you want to get this fiber in that fiber in just it's really important to do that see if we mentioned hormone therapy a few times yeah any advice for someone who's interested in hormone therapy yes I have a lot of advices and in fact buy the book well well you know if you buy it is probably the best way just because I want to show you one thing in the book is this chapter is all about hormones and how hormones are very personal and every woman's response to hormone is very different some women swear by hormonal therapists and women swear at it and everything else true and the points that a lot of women are not eligible and for those who are eligible you might have like it's not a yes or no go do this and that it's requires some some real thought it requires some thinking and as a scientist I want to give myself but the point is some women are eligible some women are not and it it really calls for an informed conversation with your doctor and I'm hoping to help all women get informed because you know 850 million women have just entered or are about to enter menopause wow and for many it's it's incredibly confusing this time of their lives and it's really important to have the right information so that then you can go to your doctor armed with at least the information that you need to ask the right questions and you need to know what your options are and then you can discuss with your doctor and so on the on the opposite end of the the 850 million women entering menopause you know you have a young daughter we have two young daughters what advice do you have for parents out there who are trying to raise healthy young daughters to have healthy healthy brains well well so they would love to share and I want to say that I really walk my talk with my daughter like she knows that she's not allowed to have white sugar for example say sure she goes to a birthday party fine no problems but we have no white sugar in the house she understands that some foods are really good for you and some are not and that she needs to really focus on the good ones she understands the importance of exercising from a young age because there's so much research showing that especially for women if you have a decent level of Fitness throughout your lifetime you risk a dementia is so low when you are in your 70s and 80s it is really worth the investment so she's doing karate she's four and a half and she's she's almost an orange belt I love it I think it's so funny and the other thing that is really important to me as a parent of a young girl is a young girl is really to avoid toxin exposure as much as possible so there's evidence that there are very specific chemicals in the environment with us in the household that could potentially disrupt estrogens they're called xenoestrogen or estrogen disrupting chemicals you do seeds and for many years no one believed that they could impact the health especially brain health and now this position has been revised especially by the American Institute of Pediatrics in the American Society of endocrinology by saying that this compounds are indeed health hazards especially for women pregnant women and children especially girls so for me it's really important that we have hardly any plastic in the house they live in plastic there are they mostly found in plasma and where do you find them they're yeah mostly in plastic especially you know even when you read that your plastic containers BPA free there are still chemicals that can leak inside your food or your drinks especially as you reheat the container so let's say that you microwave your dinner and your dinner is in a plastic container you're immediately polluting your dinner with these things then act like estrogens inside your body but in a really bad way and have been shown to possibly negatively impact thyroid function and reproductive functions like leading to all sorts of issues from infertility precocious puberty miscarriages endometriosis so for me I really pay a lot of attention to that I we eat organic as much as possible when it makes sense to do that right there are some foods to their best consumed in their organic form not all of them so you don't have to necessarily go broke thirty thousand and clean 15. yeah yeah exactly um it's really important to look at even things like toothpaste why do you need to have titanium dioxide in your toothpaste what's your favorite toothpaste I'm curious uh uh I don't remember the name of the brand it's a French one that I buy all the time I'll find out okay we'll also come back to that I'm curious so plot so I'm curious is it plastic with regards to food and what you're putting in your body not not necessarily like toys right no you need to yeah but like oh my God we throw out all the toys everything's plastic no no no things they can actually get in your skin and your body so even lotions I'm very careful because 60 of everything that you put in your skin actually gets inside your bloodstream sure and from that it goes everywhere in your body including potential your brain so I'm very careful in plastic bottles I try to avoid them we have glass so you also mentioned you know fish EPA DHA I'm curious like what other mineral supplements vitamins are good for brain health with regards to to women and men and that was highly individualized but then well yes no so I'm important I'm part of the global Council on brain health sponsored by AARP and just recently we had this really long conversation about supplements especially supplements for brain health and it was a 30 or 36 of us all scientists are doing clinical trials or other types of studies about foods and diets and nutrition and the general consensus we had a consensus statement at the end and the consensus with that there is no evidence the supplements can replace a healthy diet for brain health and also the many supplements available on the market are just no the claims that they make are just not backed up by size 100 okay well there are so many people no but for example I take a fish oil I was just for me personally so I I love wild salmon I I subscribe to smash salmon mackerels salmon mackerel anchovy uh what's the other uh sardines and Herring nice I've heard like the smash like in terms of like if you're ranking your fish in terms of health benefits yeah that's wonderful but I also take a fish oil so just an addition to that right do you need to take the fish oil well have you been tested that's what I was saying before right so supplements I did originally were you deficient I was I was now I'm not okay and now I'm experimenting with like going off and I I I do all these tests I get my to see what works and what doesn't but that's the right approach I believe so in this statement there was these consensus and then I was like well but if people have deficiencies the deficiencies need to be corrected so that the other thing was like well supplements have little value and less they've really supplement so if you are a deficient they have a subclinical deficiency or I would add you are in a point in your life where you could use a little extra help for me it makes sense that's why they're called supplements they're supplement yeah but the tendency is to take like a multivitamin that contains all these different things that you probably don't need yeah they don't work very Mega doses that are potentially some nutrients can be toxic you know like vitamin A if you take too much you can read toxes although of course you need the tone of that must be vitamins you just pee them out you know your body won't help you but your liver eventually and your kidneys will be like hello I have to filter all this stuff out of you so I think there's a there's a reason there's a reasonable approach supplements that really depend on where you are in your life like again if you're a woman there are times of your month where you do need more iron you may need not all women but some women need more iron there are some other parts of your life when you're going to need more protein and more fat like when you're pregnant right and especially if you're a smoker or an egg smoker there's really a ton of evidence that taking vitamin C and vitamin E is actually protective also of your brain and it really helps counterbalance the effects of menopause so smoking is the number one cause of early menopause in women and this is really it kills you know what it is it's just in in 2020 it's like what are you doing if you still smoke you know how many people would say I know I don't think many of our listeners smoke good but maybe they know somebody who does I'm sure they do it's really more of a reason to quit or if you're an ex-smoker because so many people are it is good perhaps to consider taking antioxidant supplements so even if you only smoked 100 cigarettes in your entire life there is evidence that is good for you to take the supplements this is the only supplement I will recommend sometimes so what about purpose spirituality what role does that play in brain health you mentioned earlier that men need women in their life that's good for their their sanity for their for their brain what about purpose I think purpose is really important important because it has an antidepressant effect so we know that depression in midlife is the strongest factor for Alzheimer's disease or dementia later on in life and for many people depression is linked to Solitude or to anxiety and having a support system or a spiritual practice or anything it just makes you feel grounded and centered and supported seems to have also a positive effect on brain health long term also short term so my last question other than obviously everyone's going to pick up the XX brain but any advice to someone out there who's you know has a loved one that's maybe struggling or just concerned about developing Dementia or Alzheimer's and sort of I think people you know often it can be you know information is tough to process and people get overwhelmed and they start to get worried like any advice any advice for someone who's kind of struggling with this right now my best advice is to work with a medical professional who actually knows what they're doing and how to interpret all the tests that people do because those tests are only as good as the doctor who's going to guide you to address them right so if you know your apoe genotype you might be freaking out because they never pay for a carrier and then you go to the internet and you find out that according to some people you have to eat a lot of fat according to other people you shouldn't eat any right the same with family history you might I have so many patients who come to us terrified who said to me like my mom had early Alzheimer's disease it's like okay what age was your mom when she started having symptoms 60. on clinical purposes you know from a clinical perspective sixth is not early Alzheimer's disease it's late onset Alzheimer's because the real genetically determined cases of Alzheimer's develop Alzheimer's when they're 40. wow yes those are the genetically determined Alzheimer's disease patients they're 40 45 they're definitely younger than 60. so if your parent was over 60 when they developed the symptoms of Alzheimer's chances are there is no genetic mutation involved it's much more likely to be something else that that's causing the ultimate symptoms and then it's really important to get tested you know there's there's a tendency to just say oh you know my my mom my dad has Alzheimer's disease but it might be something else and a good strong differential diagnosis is really important and the sooner you start working with a neurologist that you really trust or a medical profession that you really trust the better for you and for your family amen to that Dr Lisa Moscone thanks so much thank you thanks guys

Channel: the mindbodygreen podcast

Views: 10,055

Keywords: dr. lisa mosconi, brain health, lisa mosconi, mental health, brain food

Id: SiuJYrgZgvU

Length: 54min 23sec (3263 seconds)

Published: Fri Aug 04 2023