Dr Estep’s rules for keep­ing your brain young

China Daily (Hong Kong) - - HEALTH -

Eat at ev­ery meal:

Eat a few times a week:

It’s the dis­ease that ter­ri­fies us more than any other: de­men­tia robs a per­son of not only their mem­ory, but also their iden­tity and in­de­pen­dence. Two thirds of Bri­tons be­lieve a di­ag­no­sis with de­men­tia would mean life was over, ac­cord­ing to a study pub­lished ear­lier this year by the Alzheimer’s So­ci­ety — and now it’s been re­vealed that the steady rise in life ex­pectancy has stalled in Bri­tain for the first time in 100 years, due in part to the toll de­men­tia is hav­ing.

Deaths from de­men­tia have risen by 100 per cent in the past decade, ac­cord­ing to Pub­lic Health Eng­land — while de­vel­op­ments in treat­ments are drag­ging.

But is the dis­ease re­ally an in­evitable price we must pay for long life? In a re­mark­able book pub­lished in 2016, a lead­ing re­searcher in age­ing ar­gues not. Dr Pre­ston Estep, direc­tor of geron­tol­ogy at Har­vard Med­i­cal School, be­lieves the high rates of de­men­tia in coun­tries such as the UK and the United States are strongly linked to our di­ets.

By study­ing coun­tries with low rates, he has de­vised an eat­ing plan that he claims pro­motes not just quan­tity of years, but qual­ity — main­tain­ing one’s men­tal fac­ul­ties well into old age.

“There aren’t any re­ally promis­ing Alzheimer’s drugs in the pipe­line — it will be years be­fore we have any ef­fec­tive ones on the mar­ket,” says Dr Estep. “Chang­ing our life­style is some­thing we can do to­day, right now, at the very next meal.”

In The Mindspan Diet, Dr Estep in­ves­ti­gates the di­ets of an elite group of re­gions of the world where peo­ple en­joy both long life and low rates of cog­ni­tive de­cline. Chief among th­ese is Ja­pan, and close be­hind are what he refers to as the Mediter­ranean riv­ieras — coastal ar­eas of south­ern Europe, such as Lig­uria and Sar­dinia in Italy, and the Provence-Alpes-Côte d’Azur re­gion of France, and cer­tain ar­eas of north and west­ern Spain.

What is there to sug­gest that it’s the di­ets of th­ese coun­tries that are keep­ing their in­hab­i­tants’ brains young, and not a ge­netic his­tory, or some other as­pect of their life­style? Dr Estep points to the fact that obe­sity and dis­eases in­clud­ing heart dis­ease and de­men­tia are grow­ing in coun­tries such as Ja­pan and Italy as their tra­di­tional di­ets are re­placed with more mod­ern, pro­cessed foods — but older peo­ple in ru­ral parts of th­ese coun­tries, which haven’t been so ex­posed to West­ern in­flu­ences, seem to re­main as healthy as ever.

The cuisines of th­ese coun­tries might not seem to have a lot in com­mon, but Dr Estep has iden­ti­fied one vi­tal com­po­nent — and it’s not, as you might ex­pect, olive oil or even oily fish. In­stead he be­lieves th­ese pop­u­la­tions’ low rates of de­men­tia come down to some­thing they don’t eat, and that’s red meat or, more specif­i­cally, iron.

Some re­search sug­gests that iron re­acts with oxy­gen to cause “rust­ing” in the body, lead­ing to the de­posit of waste prod­ucts, such as the plaques in brain cells seen in peo­ple with de­men­tia.

“We al­ways hear about an­tiox­i­dants, whose job is to counter the work of ‘pro-ox­i­dants’ in the body,” says Dr Estep. “Iron is the most abun­dant and po­tent pro-ox­i­dant in the body, and the more we have of it in our bod­ies, the more ox­ida­tive stress and dam­age.

“Iron, from red meat and iron-en­riched grain prod­ucts, is the rea­son we see high lev­els of Alzheimer’s in coun­tries such as the US and north­ern Europe.”

Dr Estep says that he is not ad­vo­cat­ing cut­ting out meat al­to­gether — iron is an im­por­tant nu­tri­ent, par­tic­u­larly for younger women, many of whom are de­fi­cient in the min­eral be­cause of men­stru­a­tion. “We should keep it in a range I gen­er­ally de­scribe as suf­fi­cient but low,” he says. “I eat a lit­tle bit, but not much.

“In­di­vid­u­als are go­ing to vary in how their bod­ies process iron, so they should have their lev­els tested rather than us­ing a one-size-fits-all di­etary rec­om­men­da­tion.

“I cer­tainly wouldn’t rec­om­mend that any­one with iron-de­fi­cient anaemia avoid meat, or other sources of iron,” he says.

An­other sur­pris­ing find­ing Dr Estep made when study­ing “Mindspan elite” coun­tries was that their in­hab­i­tants ate high lev­els of car­bo­hy­drates — the white, re­fined car­bo­hy­drates we’re so of­ten told to avoid.

“We’ve been re­peat­edly told by nu­tri­tion­ists over the years to eat whole­grains such as brown rice and pasta, but I’ve al­ways known that the Ja­panese didn’t eat brown rice; they eat white rice,” he says.

“And for the longest-liv­ing Mediter­raneans, the pri­mary source of en­ergy isn’t olive oil — it’s ac­tu­ally re­fined car­bo­hy­drates, bread and pasta. They are the very foun­da­tions of th­ese cuisines.”

Dr Estep says car­bo­hy­drates pro­vide a smooth, steady re­lease of glu­cose — the best fuel for the brain — and many re­fined carbs, such as white pasta and tra­di­tion­ally made white bread, have a rel­a­tively low gly­caemic in­dex and var­i­ous other ben­e­fits for health.

“We think about foods from an overly purist per­spec­tive, but na­ture doesn’t nec­es­sar­ily know best.”

He warns, though, that bread and pasta in many West­ern coun­tries is of­ten en­riched with iron (in the UK, by law, all white flour must be for­ti­fied by iron — this isn’t true, though, of bread and pasta made in coun­tries such as Italy).

So could a diet re­ally keep your brain young?

Dr Rosa San­cho, head of re­search at Alzheimer’s Re­search UK, says iron is an es­sen­tial build­ing block of red blood cells and both too much and too lit­tle can have a neg­a­tive ef­fect on health, so bal­ance is key.

“There is mixed ev­i­dence for how iron is as­so­ci­ated with de­men­tia — some stud­ies have shown be­ing anaemic can in­crease de­men­tia risk, while oth­ers have found iron built up in the brains of peo­ple who died with Alzheimer’s.

“While there is ev­i­dence that a Mediter­ranean diet is as­so­ci­ated with re­duced cog­ni­tive de­cline, we don’t know for sure that adopt­ing such a diet could pre­vent de­men­tia.

“The cur­rent best ev­i­dence for re­duc­ing de­men­tia risk is that what is good for the heart is good for the head. Eat­ing a healthy bal­anced diet, keep­ing phys­i­cally and men­tal- ly ac­tive, not smok­ing, drink­ing in mod­er­a­tion, main­tain­ing a healthy weight and keep­ing choles­terol and blood pres­sure in check are all things we can do to re­duce our risk.”

For years, we’ve been told that omega-3, from oily fish such as salmon or mack­erel, is the best thing to eat for brain health. Dr Estep says: “Fish is im­por­tant, but you don’t need a lot of it.

“We have this im­pres­sion that the Mediter­raneans eat a huge amount of fish, but the Med is very poor in fish stocks. They do eat it rou­tinely, but only a small amount.

“I eat a small amount ev­ery day — a cou­ple of pieces of pick­led her­ring, per­haps.

“Carbs — by which I mean veg­eta­bles and grains — are re­ally the base of the Mediter­ranean and Ja­panese diet.”

Por­tion size is also cru­cial to the Mindspan diet: “The Ja­panese and the Mediter­raneans are eat­ing less food, and they’re thin­ner than other de­vel­oped coun­tries, but the peo­ple I in­ter­viewed never said they were go­ing hun­gry.

“The foods they eat give a slow, long last­ing re­lease of en­ergy into the sys­tem: one re­cent study done in Italy found the more pasta you eat, the thin­ner you are likely to be.”

It will be mu­sic to the ears of many: ac­cord­ing to this lead­ing ex­pert in age­ing, pasta, bread and wine are all back on the menu.

Eat oc­ca­sion­ally or never:

The Mindspan Diet by Pre­ston W. Estep is pub­lished by Oneworld (£14.99).

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