Lifestyle interventions to support Memory

I often hear people say ‘memory is declining due to age’ however there is more and more evidence that clearly states that cognitive decline related with ageing can be improved by choosing healthier lifestyles (1).

There is growing evidence that the modifiable risk factors related to memory loss in Alzheimer’s disease include diabetes, midlife hypertension, midlife obesity, smoking, depression, cognitive inactivity as well as physical inactivity (2). The sad thing is that the changes in memory start much earlier than we think. Looking at the above list, one can very easily see that improving well-being at whatever stage of life you are, does have its benefits.

Good metabolic health where sugar level, blood pressure and weight are within the normal range, seem to be the biggest protective factors when it comes to preserving memory. In fact, in a study in 2010 it was noticed the adults who are not yet diabetic but have insulin resistance, did worse in the cognitive function tests (3). Blood sugar fluctuation with high spikes due to poor diet choices or inactivity seem to be the leading cause for this (4). One can very easily see that by making simple lifestyle changes to improve the glucose response and metabolic fitness, can lead to improved mental clarity.

Inflammation within the nerves of the brain and oxidative stress have been associated with dementia. Chronic inflammation can be reduced by improving dietary and lifestyle choices (5). 

Let’s have a closer look at what these interventions can be as part of day to day routine.

• Diet – This can be huge topic on its own however the main things which have been seen to make a difference include a plant predominant whole food diet, omega 3, fibre rich food choices as well as healthy levels of protein in each meal. It goes without saying the elimination of processed food, specifically refined carbohydrates like sugar, rice, pasta, bread and white flour would be helpful. Opting for meals cooked from scratch, where the toxins from additives have been reduced, would be the prefered option.

Saturated fat has been associated with poor vascular health, which is the leading cause of Alzheimer’s disease. Hence use of healthy sources of unsaturated fat from olive oil, nuts, seeds and avocadoes would be helpful. I would like to highlight at this point that a plant predominant diet would be low in saturated fat and high in fibre. The fibre in the diet not only protects the glucose spikes but also feeds the gut bacteria, both of which have an important role in reducing overall inflammation.

Over the last few years the Mediterranean-DASH Diet Intervention for Neurodegenerative Delay, or MIND diet has been popular in targeting ageing brain health. Research shows that MIND diet which is a combination of the DASH diet for hypertension and the Mediterranean diet, has been effective in reducing cognitive decline (6). This diet mainly includes plant-based foods like wholegrains, legumes, green leafy vegetables, nuts and berries with limited intake of animal and high saturated fat foods. The diet contains foods rich in certain vitamins, carotenoids, and flavonoids that are believed to protect the brain by reducing oxidative stress and inflammation. It also includes daily serving of olive oil, with small portions of fish and poultry per week. My take on the MIND diet it to basically include as much colour on your plate as possible. Aim to eat a ‘rainbow’ and don’t forget the spices and herbs which are extremely rich in anti-oxidants.

Blueberries have gained specific interest in prevention of memory loss. Some small studies have shown that regular consumption of blueberries may have beneficial effects but more research is needed to confirm this (7) (8). I feel including this humble fruit as part of your fruit platter has so many benefits that one does not need to wait for more evidence.

Omega 3 has not shown to be beneficial in randomised controlled trials when specifically tested for Alzheimer’s. However, as it has positive effect on reducing oxidative stress as well as cellular inflammation, which has a major role to play in cognitive decline, I would certainly recommend to make it a part of daily diet. Adding walnuts, chia seeds or linseeds can be good options of plant based omega three. 

Saffron has been seen to be effective in improving mild to moderate cognitive decline (9). I advise people to include it into their plant based milk as a comforting drink. Some people like to use it in savoury dishes like biryani or paella too.

• Maintain healthy weight– Evidence shows that losing extra weight is associated with improvement in memory and cognition (10). This can be done with combination of diet as well as exercise. In the meta-analysis (10) this improvement with memory was seen in patients who had lost weight through bariatric surgery as well.

• Physical movement- Exercise and physical movement has not directly shown improvement in memory when randomised controlled trials have been done. I still would say that this is an important pillar of lifestyle medicine which will improve the overall metabolic health as well as physical fitness (11). Both factors would have an overall improvement in health. Aiming for at least 30 minutes of moderate exercise per day is what is recommended. There is evidence that exercise improves BDNF (brain derived neurotrophic factor), which is a protein found in the brain and has a role in improving neuroplasticity.

• Reducing toxins- try and reduce exposure to alcohol, smoking as well as environmental toxins found in pesticides, personal products and chemical added to processed food (12).

• Vitamin D – The vitamin D supplementation has been seen to improve cognitive decline (13). Using 1000-2000 IU of vitamin D regularly would be a good dose for maintenance of healthy levels. Fortified food as well as exposure to sunlight can be supportive too. It would be fun to share that if you leave mushrooms in the sun for 30 minutes, they are able to make their own vitamin D. So enjoying some mushrooms can be helpful too!

Finally, I would like to mention that memory decline is still not treatable but as you have seen above, it can be prevented with healthy lifestyle choices (14).

References

1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4906299/
2. https://pubmed.ncbi.nlm.nih.gov/21775213/
3. https://www.tandfonline.com/doi/full/10.1080/13803390903224928
4. https://www.sciencedirect.com/science/article/pii/S1568163719300157?via%3Dihub
5. https://www.sciencedirect.com/science/article/pii/S1568163716301027
6. https://pubmed.ncbi.nlm.nih.gov/26086182/
7. https://www.mdpi.com/2072-6643/14/8/1619/htm
8. https://www.tandfonline.com/doi/full/10.1080/09637486.2020.1852192
9. https://pubmed.ncbi.nlm.nih.gov/20831681/
10. https://www.sciencedirect.com/science/article/abs/pii/S0149763416303542
11. https://www.sciencedirect.com/science/article/pii/S2095771816300949
12. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4247328/
13. https://europepmc.org/article/med/33164936
14. https://pubmed.ncbi.nlm.nih.gov/20182017/