Brain Health [From a Dietitian Who Works in the Neuro ICU]

1140-eat-your-way-to-healthy-brain.imgcache.revb67821eca3f1d3fcf837ae8f928a7fb5

Alright!! Brain health. So important. It falls to the back of people’s minds sometimes because cardiac health is usually at the forefront and weight loss and yadda yadda yadda. Truthfully, they are all intertwined. What’s good for your brain, is great for your heart too and weight management AND your body as a whole- so that’s an awesome plus! Nutritional cognitive neuroscience is an emerging area of research and the goal is to basically understand nutrition’s impact on cognition and brain health across the life span. If we could see our brain (like we can see our skin, our hair, etc) you would see that it ages too! So if we’re going to take care of our skin and buy all kinds of lotions so on and so forth- we should definitely care about the healthy aging of our brains too! Alzheimer’s, dementia, memory loss – we all want to avoid these disease states. The research is clear: What you eat has a big impact on your brain.  The right foods [and combinations of foods] can enhance memory, build new brain cells + even help ward off disease. 

It is a critical time in our little world to discuss brain health. Why? Researchers say one new case of dementia is detected every four seconds globally. They estimate that by the year 2050, more than 115 million people will have dementia worldwide. We blame it on poor diet, isolation, and technology but you all keep reading and draw your own conclusions!

Of note, I know some of my dietitians were hoping for a clinical outlook on brain health and that will definitely happen too BUT will be saved for a different post!

First off, for my folks who prefer tables over reading- this is an AWESOME guide from PubMed on important food/nutrition for brain health [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2805706/table/T1/]. For my people who love reading, read on!

the brain + nutrition

The brain is highly susceptible to oxidative damage because of its high metabolic load and its abundance of oxidizable material. This is why anti-oxidants and an anti-inflammation lifestyle are so important for brain health.

  • Berries: Have been shown to have strong antioxidant capacity. This is because polyphenols increase hippocampal plasticity by maintaining metabolic homeostasis. Futhermore, providing protection against oxidative damage and benefiting learning and memory performance.
  • Alpha lipoic acid [spinach, kale, broccoli and potatoes]. This is a coenzyme that is important for maintaining energy homeostasis in mitochondria. Alpha lipoic acid has been shown to improve memory deficits in animal models of Alzheimer’s disease and reduce cognitive decay.
  • Vitamin E. Vitamin E has also been shown to aid in cognitive performance, as decreasing serum levels of vitamin E were associated with poor memory performance in older individuals. Vitamin E is found in vegetable oils, nuts, green leafy vegetables and fortified cereals, and has been shown to extend lifespan and improve mitochondrial function and neurological performance. This is likely because Vitamin E protects synaptic membranes from oxidation.
  • Curcumin [active component of turmeric]. This has been shown to reduce memory deficits in  Alzheimer’s disease and brain trauma. Given the high consumption of curcumin in India, it is possible that it might contribute to the low prevalence of Alzheimer’s disease in that country Curcumin is a strong antioxidant that seems to protect the brain from lipid oxidation and nitric-oxide-based radicals.
  • Olive oil + Green tea: Helps fight inflammation. And while inflammation is the body’s natural response to injury, uncontrolled inflammation over time can damage the brain. “By intervening with these anti-inflammatory foods before neurons die, and you may be able to restore normal brain function,” says Paula C. Bickford, professor of neurosurgery and brain repair at the University of South Florida. You know what most people over 100 all have in common? They drink green tea. Yes. I kid you not. I personally adore matcha- but you pick what’s right for you!
  • Beets, tomatoes + avocados: These foods ensure that your brain receives the blood it needs to stay sharp. Studies suggest increased blood flow to the brain promotes neuron growth in the hippocampus, the area of the brain associated with learning and memory.
  • Nuts (especially walnuts) + pomegranates. These foods fight off amyloid plaques. While amyloid is required for brain cells to communicate, when it accumulates several thousand times beyond normal levels, it forms plaques. These plaques kill neurons while creating inflammation, which kills even more neurons.
  • Fish, blueberries, grapes, + dark chocolate. These foods increase the level of brain-derived neurotrophic factor (BDNF), a protein that supports the growth of new neurons. Scientists have compared it to “miracle grow” for the brain. “Stimulating the release of BDNF not only reverses the effects of aging, but also triggers the brain to make more neurons.”
  • Ginger. Bioactive compounds found in ginger increase activity of acetylcholine, a neurotransmitter that plays an important role in learning and memory.There is evidence that ginger can protect against age-related decline in brain function.
  • Onions + Garlic. Onions are rich in the antioxidant quercetin, which has been shown to protect against ischemic brain damage (a type of stroke) and may improve impaired memory. Garlic has been shown to enhance memory in a multitude of studies.
  • Dates. Studies have shown that increased consumption of dates has beneficial effects in lowering the risk, delaying the onset or slowing down the progression of Alzheimer’s disease. A diet rich in date palm (aka dates) was shown to improve memory, learning and reduce beta amyloid.
Tip: our favorite good for the brain smoothie? Blend 1 C almond milk, 1/2 combo of pecans and walnuts, 1 tsp cinnamon [or to taste- I like a lot!], 3 Medjool Dates, and ice to taste [I do about 1/3 C]. I make this drink at least 4 times a week because we looooove it!

exercise + the brain

  • Exercise changes the brain in ways that protect memory and thinking skills.
  • In a study done at the University of British Columbia, researchers found that regular aerobic exercise, the kind that gets your heart and your sweat glands pumping, appears to boost the size of the hippocampus, the brain area involved in verbal memory and learning. Resistance training, balance and muscle toning exercises did not have the same results.
  • Indirectly, exercise improves mood and sleep, and reduces stress and anxiety. Problems in these areas frequently cause or contribute to cognitive impairment.
  • “Even more exciting is the finding that engaging in a program of regular exercise of moderate intensity over six months or a year is associated with an increase in the volume of selected brain regions,” says Dr. Scott McGinnis, a neurologist at Brigham and Women’s Hospital and an instructor in neurology at Harvard Medical School. This is major!

sleep + the brain

  • Sleep is important to a number of brain functions, including how nerve cells (neurons) communicate with each other.
  • Recent findings suggest that sleep plays a housekeeping role that removes toxins in your brain that build up while you are awake.
  • Lack of sleep increases risk of Alzheimer’s disease. Why? Studies have shown that slow wave sleep disruption increases cerebrospinal fluid amyloid-B levels; therefore, many scientists believe chronic poor sleep during middle age may increase the risk of Alzheimer’s later in life.

social engagement + the brain

  • The “use it or lose it” theory of healthy aging suggests that the mental workout associated with social engagement could help to maintain your mind and memory. Because conversation is a particularly challenging activity, it engages multiple mental skills, including attention, listening, reasoning, language, and memory. “It involves mental gymnastics,” one researcher says. “And you also have to stay abreast of topics, like the news, weather, sports, or politics.”
  • How connected you are to other people can be as important to healthy aging as not smoking or maintaining a good weight.
  • Social engagement may also help to preserve your memory.
  • Dr. Suzanne E. Salamon from Harvard medical center says, “Talking and interacting with people takes energy and makes you work harder, which stimulates your brain.”

cognitive exercise + the brain

  • Healthy practices: Innovation, brain rest, sequential tasking, prioritizing
  • Unhealthy practices: Tied to technology, multitasking (in an unorganized fashion), information overload, “cruising on autopilot”
  • Practice challenging your brain- do not rely on technology to remind you of daily tasks. As awesome and great and innovative as technology is – we have to remember to use our brains to (use it or lose it).

Some ideas of how to challenge your brain (these are kinda silly- but I loved it and it gives you an idea of how to challenge your mind in simple ways)

  • brush your teeth with your non-dominant hand
  • shower with your eyes closed (but be safe!)
  • switch around morning activities
  • turn things upside down (literally). Ex: calendar, photo, clock – doesn’t have to be permanently
  • switch seats at the table- I know we all have a favorite spot BUT switch it up. Variety is the spice of life!
  • smell new things every once in awhile and become familiar. Ex: I purchased ylang ylang essential oil- this is something I have never smelled before but after using it for a week- my brain now recognizes it
  • Open the window in the car (see and smell new things) or spend more time outside
  • Play with coins and try to figure out by touch alone which type of coin you’re holding (at a stop light for example)
  • While at the grocery store, look at new foods you’re not used to picking up- read the label. This way you are getting away from auto-pilot (just picking up what you’re used to)
  • Challenge yourself to small talk- this one is the hardest for me!!! I like real, lengthy conversations where you delve into the juicy stuff (which is good too) but sometimes small take can almost be MORE challenging because you’re thinking of relate-able topics with someone new
  • Eat unfamiliar foods

Hope you enjoyed this read. As a dietitian who works in the Neuro ICU, I LOVE this topic. Feel free to email me with any thoughts/ideas!

omega3-foods-720x480

references

  1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2805706/
  2. https://www.ncbi.nlm.nih.gov/books/NBK92775/
  3. https://www.aarp.org/health/brain-health/info-2015/brain-diet.html
  4. https://www.health.harvard.edu/blog/regular-exercise-changes-brain-improve-memory-thinking-skills-201404097110
  5. https://alzheimersnewstoday.com/2017/07/17/alzheimers-risk-may-be-worsened-by-chronic-sleep-deprivation-study-sugggests/
  6. https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Understanding-Sleep
  7. https://www.health.harvard.edu/staying-healthy/social-engagement-and-healthy-aging
  8. https://www.rd.com/health/wellness/brain-exercise/
  9. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4484046/

My Journey to the Neuro ICU + Its Impact

1262574-Robert-Cheeke-Quote-Your-health-and-well-being-should-be-your

I know we have done a lot of recipe posts recently but whenever I take it back to nutrition, I’m in my happiest place. Plus I wanted to give you some background info about me before my next post about nutrition + the brain. Neuro health is near and dear to my heart because- these are the patients I see!! I have the Neuro ICU and then I also have the Neuro stepdown unit (where they go when they leave the ICU). I also have the psych lockdown unit- but that’s a story for another day. Just for some background info…I started my career in dietetics in a 1200 bed hospital in Orlando almost four years ago. There, I started on general floors and after about 4 months-ish I moved to the VTICU and cardiac floors. I looooooooved these patients. The VTICU (vascular thoracic ICU- is where patients go after vascular or thoracic surgeries- CABGs etc.) is special because it’s also where I met my husband. At the time he was a med student doing an ICU rotation. I love the ICU setting for so many reasons. Typically, for nutrition, our interventions are clear cut in the ICU. This is because whether the Neuro ICU or VTICU, the patients are, a lot of the time, intubated (need ventilator support to breathe) and a lot of the times on enteral nutrition (aka tube feeding). Therefore, in the ICU it’s more math than diet education. We take into account- labs, disease state, height/weight history, medications, and nutritional needs when deciding what form of nutrition intervention these patients need. I know a lot of people hear dietitian and they think we are throwing around diet plans like little fairies- not the case. It just depends which unit you’re on. So moving on- I left the hospital in Orlando and we moved to northern Florida for my husband’s residency. I started on general floors again, moved to Oncology/BMT unit and then finally moved back to the ICU – but this time, Neuro! My heart has always been in the ICU. As a dietitian, sometimes you have to wait until certain units become available. So the Neuro ICU was the first ICU available and actually – I wasn’t that excited about it. Fast forward and it is by far my favorite patient population. 

The Neuro ICU, and the hospital we’re currently at in general, has had a major impact on honestly even my daily life- both positive and negative. The negative- I’m finally now spinning as a positive though! It took me awhile but I was able to pinpoint why the current hospital I’m at was giving me SO much more anxiety than the previous hospital I worked at. I loved my first job but I did my job, went home and didn’t really think much of it. The patients I have now, have had SUCH an impact. I finally realized it came down to the type of patients I was now seeing. The hospital I currently work for is a Level One Trauma and we also have a Burn ICU. While my first hospital was gigantic – it did not have trauma. Everything but! I see a lot of patients with traumatic brain injuries from the worst of the worst kinds of accidents. It has in turn, increased my anxiety outside of the hospital. Driving, flying…you name it. I’ve had a pretty challenging time separating patients from personal life. But I’ve been working hard to spin it into something positive. I feel so thankful for my health and my family’s health every. single. day. There is something about seeing an innocent 20 year old, in the hospital for a TBI from a car accident, and they’re mind just isn’t there anymore. Seeing how this impacts their parents and their families… I mean it’s very, very heartbreaking. Not to say that patients in the hospital with other disease states don’t hit home too but for some reason or another Neuro has left a tad more of a mark.

Every morning I come to work- my office is on the same floor as the Neuro ICU- and I see these families that literally sleep there for weeks and don’t go home. We have showers in the waiting room and a lot of them will bring pillows, their kids, blankets, sleeping bags and just stay there…waiting on their family or friend to get better and sometimes they don’t/sometimes they do. There isn’t a morning though that seeing that doesn’t effect me. In the best of ways.

Patrick and I always say we wish we could give people just a glimpse into what disease and trauma looks like- people would change their lives immediately. Health is important – THE most important thing. Losing it, is not fun- to put it lightly. It’s agonizing. A lot of these families and patients (if not all) wish they had the opportunity, that most of you reading this blog have- to change your life for the healthier and be thankful for every day. We are all taught to worry about other things- our hair, our cars, our homes- really none of that is important in comparison to your health.

nothing-is-more-important-than-empathy-for-another-human-beings-28630918

Ok I went deep with you all and now we can get on to Neuro Health!!! But I had to share my experience in Critical Care + the Hospital setting. If it motivates even one person- totally worth it!

download

-The Neilan Family-