1. Proactive Aging: Food and Lifestyle Choices Majid Fotuhi, MD PhD Friendship Heights Village Center Chevy Chase, MD October 1, 2014

2. New Discoveries 2

3. “This book may be the most important you’ll ever read. Certainly, what Dr. Fotuhi teaches in this book has changed my life.” Michael Roizen, M.D. Chairman of the Wellness Institute- The Cleveland Clinic 3

4. “Dr. Fotuhi has summarized the latest discoveries that show how we can grow our brains bigger and stronger…” Mehmet Oz, M.D. The Dr. Oz Show 4

5. Objectives  What happens to our brain with aging?  Best Nutrition for a Healthy Brain  Brain Fitness Program 5

6. Short-term: Hippocampus Long-term: Cortex Cortex Hippocampus 6

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8. Beautiful Neurons in Hippocampus 8

9. With Aging, Hippocampus Atrophies Faster than the Rest of the Brain  Hippocampus shrinks by about 0.5% per year after age 50  That is the reason memory lapses become more frequent after age 50 9

10. What Causes Atrophy in Hippocampus? Obesity Stroke Sleep Apnea Concussion Alzheimer’s Diabetes Hypertension Stress 10

11. Alzheimer’s: Plaques and Tangles  Plaques: gum-like collection of a protein called Amyloid  Tangles: abnormal aggregation of a protein called Tau  Inflammation 11

12. Brain is a Highly Vascular Organ Zlokovic et al. Neurosurgery 43(4), 877–78, 1998 12

13. Multiple Vascular Risk Factors Shrink the Brain, Especially the Hippocampus Multiple Vascular Risk Factors No Vascular Risk Factors Hippocampus 13

14. 14 Diabetes Hypertension Obesity Sleep Apnea Head Trauma Genes Stress Brain-healthy Diet Physical Fitness Cognitive Stimulation Meditation

15. Objectives  What happens to our brain with aging?  Best Nutrition for a Healthy Brain  Brain Fitness Program 15

16. Obesity Shrinks the Brain  Associated with reduced brain volume Ward, et al., 2005  Slows cognitive function Debette, et al., 2011  Brains of overweight and obese individuals appeared 8 and 16 years older, respectively Raji, et al., 2010 16 Brain Research Volume 1280, 14 July 2009, Pages 186–194

17. Step Away From the Sugar  Increases insulin resistance  Slows cognitive performance  Reduces hippocampal BDNF levels Agrawal & Gomez-Pinilla, 2012. 17 Neurology. 2005 May 24;64(10):1704-11.

18. Trash Trans Fats  Trans fats typical found in foods such as: - Cookies, crackers, muffins, donuts - Fried foods like French fries, chicken nuggets - Chips and other snack foods  Increase the risk of cardiovascular disease -Increases LDL (bad cholesterol) -Decreases HDL (good cholesterol)  Linked with brain shrinkage Agrawal & Gomez-Pinilla, 2012 18 Image source: Bantransfats.com

19. Alcohol Shrinks the Brain  Alcoholics shows significant brain atrophy Jacobson, 1986. Mann, et al., 1992.  Heavy drinking is associated with learning and memory problems Nixon, et al., 1995.  Women appear to be more susceptible to damage Hommer, et al., 2003. 19 Image source: Lisabauman.blogspot.com

20. Three Types of Food for Reversing Brain Atrophy with Age 1.Increasing levels of a healing protein: BDNF - BDNF helps with growth of new brain cells 2.Reducing levels of toxic amyloid in the brain - Too much amyloid kills brain cells 3.Increasing blood flow in the brain - Reducing risk of stroke is the best way to keep your brain young 20

21. More BDNF: Bigger Hippocampus 21 Erikson, PNAS 2011

22. Food That Increase BDNF Levels  Omega-3 Fatty Acids: DHA and EPA  Vitamin D Rich Foods  Cocoa  Blue Berries  Grapes  Caffeine 22

23. More DHA-EPA: Bigger Hippocampus 23 Pottala J V et al. Neurology 2014;82:435-442

24. Omega-3 Fatty Acids: DHA 24

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26. Good Sources of DHA: 26

27. Foods That Reduce Levels of Amyloid in the Brain  Curcumin  Walnuts  Pomegranates 27

28. Foods That Increase Blood Flow to the Brain  Tomatoes  Avocados  Beets  Vitamin B12 28 Image source: Good housekeeping.com

29. Vitamin B12  Improves blood flow to the brain  Low levels are linked to smaller size of hippocampus  Increases cognitive function and processing speed  Reduces risk of inflammation, stroke and heart attack Ho, et al., 2011.; den Heijer, et al., 2003.; Firbank, et al., 2010. 29

30. Mediterranean Diet 30

31. The MIND Diet: Mediterranean + Low Salt Makes Your Brain 7 ½ years Younger  Berries  Nuts  Apples  > 3 servings of bean  Olive Oil  1-2 servings of fish/week  Low in trans-fats  Junk food (zero)  <4 servings of meat/week  Low in cheese and butter Presentation by Martha Claire Morris, Alzheimer’s conference, Denmark 2014 31

32. Physical Activity and Mediterranean Diet, More Effective Together Scarmeas et al, 2009 32

33. Objectives  What happens to our brain with aging?  Best Nutrition for a Healthy Brain  Brain Fitness Program 33

34. Brain Fitness Program Goals Short Term  Think faster  Remember more  Improve efficiency of problem solving  Sharpen focus  React quicker  Enhance self esteem  Brighten mood Long Term  Help to regrow brain cells in hippocampus  Establish a brain healthy lifestyle change that results in lifelong benefits  Reduce risk of dementia in late-life 34

35. BFP: Evaluating &Treating All Causes of Cognitive Impairment in Elderly 35 Medicine Neurology Psychology

36. Comprehensive Tests to Evaluate Brain Health Customized Treatment Program to Maximize Brain Performance NeurExpand’s Unique Integrative Approach 36

37. Improvement in Memory 37

38. Remarkable Results 38 Hippocampus After Before

39. Sustained Benefits 39 Hippocampus Volume (cm 3 ) 8.6% increase in HC volume = brain that is approx. 16 years younger

40. 40 Diabetes Hypertension Obesity Sleep Apnea Head Trauma Genes Stress MIND Diet Physical Fitness Cognitive Stimulation Meditation

41. THANK YOU! INFO@NEUREXPAND.COM 1-855-638-7397 41 5550 Friendship Blvd. Chevy Chase, MD 20815