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7 Steps for Optimal Brain Health

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The American Heart Association and American Stroke Association have issued an advisory on maintaining optimal brain health throughout life. After reviewing 182 scientific studies of brain and heart health, they issued a seven step plan for helping to keep the brain in top working order and to keep Alzheimer’s at bay in old age. The advisory reflects a growing body of evidence that what’s good for the heart is good for the brain.

“Research convincingly demonstrates that the same risk factors that cause atherosclerosis,” or hardening of the arteries, “are also major contributors to late-life cognitive impairment and Alzheimer’s disease,” said Dr. Philip Gorelick, the chair of the advisory group. “By following seven simple steps — Life’s Simple 7— not only can we prevent heart attack and stroke, we may also be able to prevent cognitive impairment.”

Don’t smoke. If you smoke, quit. If you don’t smoke, don’t start. Many studies show that smoking can damage blood vessels throughout the body, including in the brain.

Get regular exercise. Regular physical activity is good for the heart — and the brain. Numerous studies show that staying active helps to maintain brain health, and especially a region of the brain called the hippocampus that is important for learning and memory.

Maintain a healthy weight. Obesity at midlife is a risk factor for Alzheimer’s disease and other forms of dementia. Strive for a body mass index below 25. Body mass index is a measure of height and weight. Online tools to calculate BMI are widely available, including this one at the National Institutes of Health: https://www.nhlbi.nih.gov/health/educational/lose_wt/BMI/bmicalc.htm

Eat a heart-healthy diet. The Mediterranean diet, rich in fruits, vegetables, whole grains, healthy fats like olive oil and fish, has been shown to be good to the heart and may help to keep the brain in top working order. The DASH diet, also rich in these foods and low in salt, may also help.

Keep blood pressure in check. Aim for a blood pressure below 120/80. High blood pressure affects some one in three adults and increases the risk of Alzheimer’s and other types of dementia. It can damage blood vessels throughout the body, impairing the flow of oxygen and vital nutrients to the brain and other organs. Narrowing of the blood vessels can also lead to strokes that damage the brain and lead to dementia. “Over time we have learned that the same risk factors for stroke are also risk factors for Alzheimer’s disease,” Dr. Gorelick said.

Maintain a healthy cholesterol. Aim for a total cholesterol below 200 milligrams per deciliter (mg/dL) with less than 100 mg/dL of the bad cholesterol (LDL) and at least 40 mg of the good cholesterol (HDL); above 60 mg/dL is ideal. High cholesterol is a known risk factor for Alzheimer’s.

Control blood sugar. A fasting blood glucose below 100 mg/dL is best. Higher levels can predispose to Type 2 diabetes, a risk factor for Alzheimer’s disease.

The advisory, published in the American Heart Association’s journal Stroke, stresses the importance of taking steps to keep your brain healthy as early as possible, since damage to the arteries is a process that can begin in childhood and just accumulate over time. “Studies are ongoing to learn how heart-healthy strategies can impact brain health even early in life,” Dr. Gorelick said. Although more research is needed, he said, “the outlook is promising.”

By ALZinfo.org, The Alzheimer’s Information Site. Reviewed by Marc Flajolet, Ph.D., Fisher Center for Alzheimer’s Research Foundation at The Rockefeller University.

Philip B. Gorelick, Karen L. Furie, Costantino Iadecola, et al: Defining Optimal Brain Health in Adults: A Presidential Advisory From the American Heart Association/American Stroke Association. Stroke, Sept. 7, 2017

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