1. Best Nutrition for a Fit Brain Majid Fotuhi, MD PhD Vantage House Columbia, MD October 16, 2014

2. Objectives  Which foods harm the brain and cause atrophy?  Which foods boost brain health and make it stronger? 2

3. 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 3 Brain Research Volume 1280, 14 July 2009, Pages 186–194

4. Step Away From the Sugar  Increases insulin resistance  Slows cognitive performance  Reduces hippocampal BDNF levels Agrawal & Gomez-Pinilla, 2012. 4 Neurology. 2005 May 24;64(10):1704-11.

5. 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 5 Image source: Bantransfats.com

6. 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. 6 Image source: Lisabauman.blogspot.com

7. Objectives  Which foods harm the brain and cause atrophy?  Which foods boost brain health and make it stronger? 7

8. 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 8

9. More BDNF: Bigger Hippocampus 9 Erikson, PNAS 2011

10. Food That Increase BDNF Levels  Omega-3 Fatty Acids: DHA and EPA  Vitamin D Rich Foods  Cocoa  Blue Berries  Grapes  Caffeine 10

11. More DHA-EPA: Bigger Hippocampus 11 Pottala J V et al. Neurology 2014;82:435-442

12. Good Sources of DHA: 12

13. Foods That Reduce Levels of Amyloid in the Brain  Curcumin  Walnuts  Pomegranates 13

14. Foods That Increase Blood Flow to the Brain  Tomatoes  Avocados  Beets  Vitamin B12 14 Image source: Good housekeeping.com

15. 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. 15

16. Best Brain Diet  Low Carb - No white rice - No white bread - Just a touch of cakes  High protein - 1-2 lean meats/week - 1-2 salmon a week  Lots of fruits and vegetables  Plenty of water  DHA supplements 16

17. Physical Activity and Mediterranean Diet, More Effective Together Scarmeas et al., JAMA 302 (6):627–37, 2009 Scarmeas et al, 2009 17

18. 18 Diabetes Hypertension Obesity Sleep Apnea Head Trauma Genes Stress Brain-healthy Diet Physical Fitness Cognitive Stimulation Meditation

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