June 28th, 2014
June 2014 | Science Update

This summer we are proud to feature Science Updates written by our awesome summer interns. June’s updates focus on recent findings about nutrition and long-term dementia risk.

Can Nuts Keep You Brain Healthy? Sara Skutch, UNC-Chapel Hill

What: Nuts are an invaluable food for brain health because they contain essential fatty acids and support cardiovascular health, which has been highly correlated with better brain function. Data was collected from 15,467 women, aged 70 or older, who completed 4 interviews on their average nut consumption and 4 cognitive assessments over six years. Women who reported being in the highest group of nut consumers (>3 servings/month) showed higher performance after age 70 on memory tests, had higher recall speeds, and did better on general cognition assessments. The cognitive scores of the highest group were about two years better than the lowest group when controlled for age. They also were more likely to have lower body mass indexes, have attained higher levels of education, and were much less likely to have a history of high blood pressure.

Why it Matters: This study was the first one to focus on nuts having a direct impact on cognitive function. The findings were very valuable because they showed that eating nuts more frequently is a simply way to sustain brain health as people age. Including more nuts in one’s diet is relatively easy intervention, something that many people can do.

The Takeaway: Including more nuts in your diet is an easy way to keep your brain healthy at any age. And the benefits are not limited to your brain; the findings also showed that people who ate more nuts had lower body mass and blood pressure. You can’t lose with nuts!


Do We Age out of Anti-Oxidants? Andrea Schneider, Denison University

What: This study was conducted in 2013 to test if there was a relationship between the amount of antioxidants in the diet of elderly adults and the chance of them having a stroke or getting dementia.  The researchers used a sample of about 5,400 participants, all 55 or older, either stroke-free, dementia-free, or both.  The participants had to complete a meal-based checklist at the beginning of the process in order to measure their antioxidant levels throughout the study.  Over the 14-year time frame there were three follow-up assessments, which indicated over 600 cases of stroke/dementia, leading them to conclude that there was no apparent connection between the levels of antioxidants in their diets and the participant’s risk for neurological disorders such as dementia or stroke.

Why This Matters:  Better nutrition and the diet of elderly people has been associated with the improvement of cognitive function. This study is significant because it shows a lack of support for one aspect of this idea: that total antioxidant levels in the diet of elderly people can improve their brain health.  Other studies referenced in the article highlighted that in other age ranges there were improvements in brain health as a result of antioxidants, but for this particular age range there showed little to no connection.

The Takeaway:  While this study shows that increasing the amount of antioxidants in one’s diet does not influence the risk for stroke or dementia in older adults, it is still beneficial to include a well rounded amount of foods rich in antioxidants in our diets, including berries, beans, and dark greens.

June 19th, 2014
Brain Diet Fads: Fact, Fiction or Fashion? What You Should Know to “Eat Smart” Now

When it comes to brain health, it seems nothing is more confusing than advice about what we eat and drink. The media’s obsessional reporting of every new finding on diet and memory (no matter how small or obscure the study) merely reflects our own anxieties about how the food on our table may literally turn the tables on our long-term vitality. Strident statements and specific instructions are increasingly made. Yet as a recent editorial in the Neurobiology of Aging journal states, “(s)o far, no nutritional intervention has been proved to be effective in reducing the risk or severity of Alzheimer’s or any dementia.”

While some may feel that there is little risk in making such diet recommendations regardless, this is not truly the case. Some trends may be risky  - for example the supplement ginkgo biloba can increase risk for bleeding in older adults, and is contraindicated in individuals taking blood thinning agents).  Others may be expensive, creating a potential economic burden for the user. Finally – and most ironically — too many of us live with a dose of disconnect between how we eat and what we know is good for our brains and our general health. Our population is increasingly overweight and consequent medical conditions that are known to impact brain health over the long-term, such as obesity and diabetes, are on the rise as a result. If we cannot follow even the simplest diet recommendations for our overall health, how are we going to get on board with a more complex one focused solely on boosting brainpower?

As an expert in brain health, I have long advocated that we “eat smart” by following a healthy, well-rounded diet and maintaining a healthy weight rather than focusing on a specific food fad or the supplement of the moment. The bulk of the science still falls firmly in favor of such an approach. A summary of  dietary guidelines from the 2013 International Conference on Nutrition and the Brain underscores this reasoned attitude regarding brain health and diet. The guidelines offered include limiting intake of saturated fatty acids, eating more vegetables and whole grains and including aerobic activity in one’s daily routine. These common sense suggestions are hardly revolutionary and confirm a simple strategy for those of us seeking ways to stay healthy.

Yet isn’t there something we can learn from the current trends and fashions in brain healthy eating? Let’s face it — they are hard to ignore. After all, at some point all science was once too “young” or “inconclusive” – I recall my grandfather telling me when he was a young boy olive oil was considered unhealthy (hard as it may be for us to imagine). While we do and should look to the hard science first, what if, as the evidence builds, these newer recommendations have merit?

When we consider the many “brain diets” popular today, I suggest that we can indeed find recommendations that can easily be accommodated within what the science supports, without significant risk or cost. In addition, many of these trends jive with cutting edge advice on eating for better overall health.

In that spirit, here is the Total Brain Health® take on how we can “eat smart” with an eye to some new nutritional ideas for better brain health:

Buck Tradition. If you eat the traditional American diet, it’s time to make a change. One of the most valuable things we can learn from looking at the dietary trends for both brain and body health is that we aren’t eating what the current science suggests we should. First step? Shift the balance of power on your plate by making veggies and fruits the main event with your protein of choice as the side. When grains are included, make sure they are whole grains and not of the refined variety. These simple moves will get you in line with the “greater food majority,” as everyone from the USDA to food guru Mark Bittman have been making this a priority recommendation for, well, years. In addition, it will up your chances of eating a more brain healthy diet, lowering your intake of saturated fat while upping your chances of getting more antioxidants.

Be Daring. Dare to be different — vary your diet so that you are constantly trying new foods and even new cuisines. Many of the current nutrition trends point to the pitfalls of always eating in the same familiar way. They suggest that it is the very lack of variety that may rob us of certain nutrients, increase our sensitivity to certain foods, or just simply keep us from making healthier choices. Follow more of a Mediterranean-style diet, found in many studies to potentially lower dementia risk. Eat more foods high in Omega-3 fatty acids, such as cold-water fish (not just salmon but also sardines, mackerel, or anchovies), which seems to support better brain function over our lifetimes. If you don’t already, make non-meat based protein a regular part of your meal plans. You don’t have to stick to tofu – there are lots of ways to get that protein in, including beans, nuts and berries that substitute for grains (quinoa or buckwheat, for example). Mixing up your diet by daring to try new things can also offer you a different kind of brain boost, as the intellectual challenge of eating differently is a great way to “stretch” your mind as well.

Go Against the Grain. One of the hottest trends in brain health is the idea that eating gluten (found in grains such as wheat, barley, rye and spelt) or even carbohydrates significantly increases our risk for Alzheimer’s disease and other dementias. The science here, while interesting and with some merit, remains controversial. However it should make us at least think twice about the amount of gluten in our diet, which frankly is a lot. Bagels for breakfast, sandwiches for lunch, and pasta for dinner? Even if we aren’t ready to get on board the “grain brain” trend, isn’t it time we got rid of some of that gluten? Luckily if we are bucking tradition and daring to eat differently, it will be easier to do just that. Gluten-free alternatives include potato, rice, soy, and oats. You may also look to try quinoa, millet or amaranth, all ancient grains seeing resurgence due to greater interest in gluten-free eating. To get started, you can check out our Total Brain Health® Maple Grains Granola recipe, a simple yet delicious breakfast or snack alternative that uses these grains.

Savor Your Sustenance. Fostering mindfulness, or our ability to be present in the moment, has been shown in several studies to boost attention and improve intellectual performance. Making mindfulness a regular mealtime habit offers us a wonderful opportunity to practice being in the moment as we do something that we otherwise might do without further thought. Some experts suggest that we may even eat healthier and be more likely to maintain a healthy weight by practicing mindfulness as part of our mealtime routine. What does it take to eat mindfully? Simply shifting our focus and attention to the full experience of eating. To get started, check out yoga teacher Jillian Pransky’s Mindful Eating Meditation or pick up the book Savor by meditation expert Thich Nhat Hanh and Dr. Lillian Cheung.

I hope you find these tips for integrating the latest brain healthy nutrition trends into your daily eating routine helpful. Have some advice or tips to share? Let us know, we’d love to hear what you do for yourself, your family or your clients. Happy eating to all!

June 19th, 2014
Total Brain Health® Maple Grains Granola

This delicious granola is great for breakfast with milk or over yoghurt as a snack. It offers a terrific gluten-free alternative sweetened only with a bit of maple syrup. Expect a crunchy, small pieced granola with a nutty flavor. The dried cherries and cranberries provide an antioxidant boost, while the nuts give a brain empowering dose of Vitamin B. This recipe will make about 3-4 cups of granola, and can be varied according to your taste once you’ve made a few batches. Feel free to vary the fruit and nuts as you like — you may even decide to add dark chocolate chips!


300 Degrees Fahrenheit    30-40 Minutes (10 minutes prep; 20-30 minutes baking)


1 cup quinoa, uncooked
1 cup millet, uncooked
1 cup buckwheat, uncooked
2 tablespoons maple syrup
1 cup mixed raw nuts, chopped (almonds, walnuts, pecans)
1/2 cup dried sour cherries, unsweetened
1/2 cup dried cranberries, unsweetened
Oil spray or 1 teaspoon vegetable based oil to coat the baking tray


1. In a large bowl, combine the quinoa, millet, buckwheat, nuts and maple syrup. Stir to coat.

2. Spread the mixture in a thin, even layer on a lined cookie sheet coated lightly with oil.

3. Bake the mixture for approximately 20-30 minutes at 300 degrees Fahrenheit, tossing gently several times. Remove from the oven when it seems slightly toasted. Do not overbake.

4. Scrape the mixture to a bowl, breaking up any larger pieces. Add the dried fruit and toss gently.

5. The granola will keep in an airtight container for  approximately 2 weeks.

May 29th, 2014
May 2014 Science Update | Why Work May Ward off Dementia and Whether the Internet Can Make You Happier

This month’s science update focuses some news about the benefits of keeping busy, both at work and online.

Your Brain @ Work: Challenging Work May Reduce Dementia Risk

What: German researchers conducting a review of the literature found that a work environment that offers a rich intellectual experience, engagement with others, work with data as well as a high degree of job control may lower risk for dementia later in life. A systematic review of the literature resulted in 17 studies qualifying for inclusion in their analysis. Their findings, published in Occupational and Environmental Medicine, suggest that our work environment may play a protective role in brain health.

Why This Matters:  The evidence regarding the impact of social factors such as work environment on long-term brain health is limited. Findings such as these suggest the critical role intellectual challenges gained through work – and the characteristics that matter most about that work – may play in lowering our risk for serious memory loss.

The Takeaway: We have much to gain and little to lose by seeking work throughout our lifetime (paid or unpaid) that is intellectually challenging, collaborative and meaningful. While this review study supports the need for further exploration in this area, we already know that a complex work environment offers intellectual engagement, skills challenge and opportunities to connect with others, all of which already are known to support better brain health.

Over 50 and Feeling Blue? Getting Online May Boost Your Mood

What: Researchers found that adults over 50 were significantly less likely to report symptoms of depressed mood if they regularly used the internet. The study, first published online in the Journals of Gerontology, Series B: Psychological Sciences and Social Sciences, used Health and Retirement Survey data from 2002-2008, and included a cohort of approximately 3,000 persons followed over 4 assessments. Their findings suggest that Internet use reduced depressive symptoms by a whopping 33%, and was especially effective in older adults living alone.

Why This Matters: Depression is a critical behavioral health issue in the U.S., especially among older adults. This study suggests that Internet use may offer a simple, powerful tool in reducing depressive symptoms in older adults, especially among those who live alone and face potential isolation.

The Takeaway: More effort should be made to teach adults 50+, especially those living alone or otherwise isolated, the skills necessary to use the Internet. Programs serving this population may want to invest more in providing training, online communities and equipment (such as tablet computers) to make it easier for their older adults to get online.

May 14th, 2014
Getting Ready for Dad: Brain Boosting Activities to Celebrate Father’s Day

This Father’s Day, why not plan some activities that bring the fathers (and everyone else) in your community the gift of better brain health? Here are some ideas for a few things to do that may be a bit different and will help everyone both celebrate the day and have a chance to exercise their brain in a fun way.

7 Words of Advice from Dad:  Wise advice from those in the know can be a valuable gift. What words of wisdom can your folks pass down to new dads (or parents) in just 7 words?  Provide them with a few examples (“take the time to toss that ball”, “raise them well, then let them go”) to get started. Your clients can write their “7 Words from Dad Wisdom” on index cards. Or have them use them in making Father’s Day cards that they can also then decorate, which you can then distribute through a local maternity ward or prenatal clinic.

Dad Movie Night: Hold a movie night – or even a film series – that celebrates fathers of all kinds. Suggested films include Father of the Bride, Cheaper by the Dozen, We Bought a Zoo, The Pursuit of Happyness or Mr. Mom. Up the brainpower for this activity by holding a discussion after the film about the father’s character and his impact in the film. Don’t forget the popcorn and other treats.

Tall Dad Tales:  We all also have our favorite “dad” moments to share. Challenge everyone’s mind with the traditional American “tall tale”: Have them write a short story featuring a fatherly feat, throwing in a bit of an exaggeration to make the story fun. You can look online for examples of some tall tales from American folklore featuring figures such as Paul Bunyan. Let them use an example of their own dad based experience as a jumping point, or create prompts they can use such as “I didn’t know how Dad was going to stop that runaway train until …” or “My dad was so strong that …”.

Happy Father’s Day from all of us here at Total Brain Health!

April 28th, 2014
April Science Update | New Findings on the Brain Benefits of Exercise You Should Know

This month’s science update focuses some news about exercise and the brain:

Trouble Sleeping? Exercise Might Help Your Memory Despite No Zzzzz’s

What: A recent finding from the Healthy Women Study found that moderate exercise had a moderating effect on the impact of poor sleep on executive function in older women. The study followed 121 women in their mid-70s for one week, keeping track of their sleep and exercise activity. Researchers report that the women who slept poorly but were physically active did better on tests of cognitive executive function than those women who also slept poorly but were physically less engaged.

Why This Matters:  Many older adults, including women, complain of not getting a good night’s rest, which in turn can affect everyday intellectual performance, including executive function ability (judgment and reasoning, for example). This study suggests that exercise may moderate this relationship providing older adults with a way to minimize the impact a poor night’s sleep has on their functioning.

The Takeaway: This study provides just another reason why we should all be exercising regularly. It may also give older adults who do not sleep well a way to gain more control over the impact poor sleep has on their daily performance.

Can Moderate Aerobic Activity Slow Dementia Progression?

What: A recently published study found that patients with mild dementia who exercised twice a week showed less improvement on tests of cognition, whereas the control group who did not exercise showed decline on the same tests. Subjects were randomly assigned to either a treadmill exercise group (30 minutes, twice a week) or to a control group that did not participate in exercise training. Outcome measures included the Cambridge Cognitive Examination, on which the exercise group subjects showed improvement after the 16 weeks.

Why This Matters: Exercise is a relatively low risk intervention that can easily and safely be added to the regimen of treatment for many individuals diagnosed with Alzheimer’s disease or a related dementia. This study shows the benefits of even a modest level of aerobic activity on the disease course. While the study was small (with 20 subjects in the experimental group), the finding not only of improvement in the exercise group but also the continued decline in the control group is a powerful indicator that exercise should be taken as a serious augmentation to any treatment protocol for dementia.

The Takeaway: Regular aerobic activity should be considered as a way of supplementing any treatment plan for someone diagnosed with a cognitive impairment. Even moderate activity, such as a “sit and be fit” class, may have benefit and should be encouraged.

April 17th, 2014
Watch Your Noggin | 3 Easy Steps to A Brain Healthy Spring

Spring has finally arrived here in the Northeast, in a way that this year felt much more hard-fought than usual. What a relief to be able to finally shed our coats and savor the sunshine and warm breezes April brings.

The return of warmer weather (and for those in perpetually warm climates, to spring activities) finds us getting back outside, reacquainting ourselves with activities such as cycling, skating, or even just diving into some spring cleaning or gardening. Yet our “spring awakening” also brings with it some risks that matter to brain health. Here at Total Brain Health, we find our thoughts turning to head injury and some easy steps we can take right now to better “live with our brains in mind.”

Head injury can affect anyone, no matter their age. Active boomers enjoying cycling, running, and the like can keep up with the best of them, but may run an increased risk for falling due to slower reaction time and changes in balance that comes with age. The Centers for Disease Control reports that falls alone account for slightly over 40% of head injuries in the U.S., and are the leading cause of head-injury related death in adults over 65.  In addition, sports-related activities that affect the head – think heading the ball in soccer, for example — are increasingly a concern in children, with growing attention to both the short-term and long-term consequences they bring. Clearly head injury is something that should be on our minds.

The good news? There are some very simple steps we can all take right now to reduce our risk for head injury. Here are 3 simple ideas on ways you can share with your clients of all ages and use yourself to “spring clean” your routine for falls risk:

1. Re-Train Your Balance. Many of us think of balance training as something only necessary for older adults. Yet balance exercises should be part of our everyday workout routine, especially if we enjoy fast-paced activities such as biking or in-line skating. As we age, we experience changes in our proprioception, or the “feedback” loop our body uses to manage our sense of ourselves in space. This, along with slower reaction times, can make it harder for us to “recover” when our bike hits a divot in the road or we hike or even walk on uneven terrain. Simple routines, such as the one here from the Mayo Clinic, help us better maintain our balance and should be part of everyone’s workout. You can also look to balancing boosting activities such as yoga and tai chi, which are great for brain health overall as well.

2. Trip Patrol.  Tripping is a significant cause of injury, including head injury. Many “trip and fall” injuries are avoidable if we simply identify and remove things that well, trip us up! Here’s a great way to get everyone on board in reducing fall hazards: set up a “Trip Patrol.” Lead a group of residents and clients through your community or center and look together for things that could be trip hazards. Talk about ways to avoid these hazards, such as surveying your surroundings, moving small pieces of furniture to a better location, removing small area rugs or runners, etc. Bonus points to folks who then help you keep track of potential trip hazards going forward!

3. Spring Clean for Trip Risks.  Here’s something we can do not only for our clients but also for ourselves: Spring clean with your head in mind. Just as we’ve learned to make checking our smoke detector batteries part of our “fall back” time change in the autumn, let’s make inspecting for trip risks part of our spring- cleaning routine. Check for uneven stone pathways in the garden, frayed or turned edges on rugs, objects that have somehow found their way onto staircases or hallways, or lighting on stairways (especially the ones to the basement) that could be a bit brighter. Its just another way to make common-sense prevention part of our routine!

Happy spring to all!

Dr. Green

April 10th, 2014
Brain Healthy Eating from Cal-a-Vie Health Spa | Chef Curtis Cooke’s Awesome Savoy Cabbage Salad with Walnuts

I was recently the featured guest presenter at the spectacular Cal-a-Vie Health Spa in Vista, CA. In addition to the opportunity to engage in great discussions about brain healthy living with the spa guests, I had the chance to get to know the spa’s talented chef, Curtis Cooke, and amazing nutritionist, May Tom. The week featured some brain healthy recipes they have given us permission to share with our readers. Just a little way you can bring Cal-a-Vie home to your own kitchen!

First up — a brain healthy salad that combines the antioxidants of crucifers with the omega-boost of walnuts. This delicious salad is a great lunch main course or side for dinner with a lean protein such as chicken or salmon. Enjoy!

Dr. Green

Cal-a-Vie Savoy Cabbage Salad with White Balsamic Vinagriette Dressing

March 29th, 2014
March 2014 | Total Brain Health Science Update

This month’s science update focuses on new findings on Alzheimer’s disease risk:

Why Women Should Worry About Their Brains First: Important New Statistics from the Alzheimer’s Association

What: Recent findings from the Alzheimer’s Association show that women run an estimated 1 in 6 chance of developing Alzheimer’s disease during their lifetime, a significantly increased risk compared to men (who run an 1 in 11 chance). The numbers, released as part of the Alzheimer’s Association’s “2014 Facts and Figures” show that women 60 and over are twice more likely to develop dementia than breast cancer, and that women also bear the brunt of the collateral costs of the disease, through caregiving and its associated economic and health-related tolls.

Why This Matters: While being female has always been a top risk factor for developing Alzheimer’s Disease, the real significance of the impact the disease has uniquely for woman is rarely considered.

The Takeaway: These findings underscore the reasons why women should start now to take good care of their brains. Following a better brain fitness plan such as our Total Brain Health® blueprint can help reduce risk for the disease. In addition, as the primary health advocates within their families, women can set good role models for brain healthy living for their spouses, children, relatives and friends.


More Coffee or Tea?  Caffeine May Protect Your Brain from Dementia

What: A recent review article in the Journal of Nutrition, Health and Aging showed the potential long-term benefit of caffeine use in lowering dementia risk.  Researchers reviewed the existing data to consider the possible benefits of caffeine for reducing dementia risk, as well as the potential mechanisms by which caffeine may work to lower that risk. They found a strong association between regular use of coffee, tea, or other caffeine-containing foods and reduced dementia risk.

Why This Matters: Caffeine has been associated with improved everyday cognitive performance. However, its effect on long-term dementia risk remains unclear, as does the means by which it might reduce that risk. Since coffee, tea and other caffeinated products are popular in diets around the globe, more knowledge about potential positive benefits of caffeine vis-à-vis dementia risk would be an important to know. In addition the researchers question whether there may be differential effects based on one’s genetics or metabolism or caffeine, such that there might be a way to determine an optimal “dose” of caffeine for dementia risk reduction.

The Takeaway: It appears that caffeine, most specifically coffee, may have long-term benefits for our brains. While the current studies looking at these long-term effects are small, this review offers compelling reasons for further research. It also gives us a great excuse to have that extra cup!