How to prevent dementia – according to a brain surgeon

Dr Rahul Jandial has some simple advice on how to keep your brain healthy.

Surgeon tells how to prevent dementia

There’s nothing we can do about the biggest risk factor for developing dementia – getting older. But there’s lots of evidence that lifestyle factors can potentially make a big difference.

Around 50 million people worldwide have dementia, according to the World Health Organisation (WHO), with about one in 14 over-65s affected, as well as a significant number of younger people. But the disease doesn’t have to be an inevitable part of ageing.

Brain surgeon and neuroscientist Dr Rahul Jandial, who works at City of Hope Hospital in Los Angeles, has seen for himself in thousands of operations the difference between a young brain and an ageing one, and how the way a person lives their life can affect their grey matter – which he explores in his new bestselling book, Life Lessons from a Brain Surgeon.

“I’ve operated on over 5000 skulls, and they’re all different ages so you see the developing brain to the ageing brain, and everything in between,” says Dr Jandial, who also spent years trawling through scientific research in order to come up with what he believes are the best ways to help boost memory, manage stress and reduce Alzheimer’s risk.

“There are habits some people have, that tend to link with them having resilience of thought and emotion as they get older. Since we don’t have a medicine for dementia, it’s really about lifestyle modification. And doing it early – early being your 40s, 50s, even 60s. There’s always a window to make a difference,” he adds.

“Fortunately, our brains ask so little of us that very manageable changes, like replacing your steak for salmon a few times a week, eating more plants, less fried food, a bit of brisk walking – all these changes add up. It would be great to have this be a new focus because there’s no treatment if you get dementia,” he says.

“Let’s see if we can make a difference with small changes, rather than waiting for a silver bullet or a single pill or food that fixes everything.”

Remember, whatever health advice you follow right now, staying sensible and following the guidelines on minimising the spread of coronavirus is everyone’s top priority. So, don’t adopt any lifestyle changes without considering whether it’s sensible to do so at this time.

Here are five changes Dr Jandial recommends.

1. Eat a Mediterranean ‘mind diet’
“The brain’s 90 billion neurons share the garden inside the skull with supporting cells called glia. They’re sort of the shrubs around the roses that protect the brain environment. Those glia create fatty insulation for the neurons, so the electricity can bounce around inside our heads faster and more organised.

“That fatty sheath at the microscopic level is the good fat that comes from fatty fish – and there are some good choices for vegans as well. That’s an essential part of the Mediterranean diet, and huge studies over decades show eating mostly plants, fatty fish, nuts, and drinking occasional red wine, really makes a dent in the chances of getting dementia.

“It’s not about how much you eat, it’s about what you eat,” he adds. “These are the nutrients that are helpful and not difficult to adhere to, to help reduce our dementia risk. So, the first and most fundamental thing is the mind diet – essentially the Mediterranean diet.”

Dr Jandial warns that people should be wary about other so-called ‘brain foods’, however, as nutrients have to get past the gut wall, into the blood, and are then filtered by the liver before passing through the blood-brain barrier. “Getting to the brain requires passing three barriers and the Mediterranean diet and its nutrients, whether it’s flavonoids, antioxidants or all of them, really is an effective strategy,” he says.

“So, the first thing to do is to switch to more components of the mind diet. Occasional cheesecake or burger or chips isn’t an issue – it’s not the indulgences, it’s the regular things we put inside us [that matter].”

2. Standing and walking
Right now, with coronavirus on everybody’s minds, getting out and about for exercise may not be as straightforward as usual. Generally speaking though, when it’s safe to do so, being active is among the brain surgeon’s top tips for brain health. Until the coronavirus situation settles, could you stretch your legs with a stroll in the garden, or do some exercise in the living room?

“The second most important thing is exercise – and I don’t mean becoming super-athletic, I mean simply standing and walking. The neurons and their supporting cells are floating in liquid – our brain is like densely packed tissue in an aquarium. The tissue doesn’t physically touch, it gets very close to each other and sprays chemicals at each other called neurotransmitters.

“But there’s also something called brain-derived neurotrophic factor (BDNF), which the brain showers on itself, and the trigger for that is being vertical and moving. It doesn’t have to be a marathon; a 30-minute brisk walk gets you to a sweet spot where your brain is showering itself with BDNF – it’s a growth factor, like Miracle-Gro for the flesh of the brain. It’s something anybody can do, it’s free and can be just a micro-change in your week.”

3. Learn something new
“The brain is thinking flesh. Life is brain training – you don’t need to buy an app or pay money – but you do need to learn. Engaging the brain, learning, reading, trying to learn a new instrument or language, even if you fail miserably, just the effort of trying to learn anything will engage wider swathes of your brain, and that serves as the engagement of those brain cells,” he says.

Even thinking about planning something for the future, like how you would run a company or keep up with friends, could count, he says: “Any time you’re thinking.

“But it has to challenge you just a bit. If it’s too easy, your brain doesn’t need to think and you’ll rely on habits. If it’s too hard, your brain won’t engage and you’ll say it’s impossible. So, the trick is to find just that one level past your comfort zone. That’s the trigger for the brain to say it’s got to dial it up.”

4. Socialise
Again, socialising isn’t as easy right now, as non-essential contact should still be kept to a minimum.

Now is the time to make use of our phones and laptops to keep in touch with friends we can’t see in person. And when the pandemic settles, we can embrace our social lives again.

“Socialising is also considered an advantage because it’s forcing you to think – about others, what you’re going to wear, where you’re going to go, etc. For people who are lonely, part of the risk is that they’re thinking less and they’re thinking negative thoughts.”

5. Try to maintain a healthy heart
“If the arteries in your brain aren’t open, just like those in the heart, you can have small swathes of brain tissue wither, much like a garden that doesn’t get irrigated goes dry. Exercise helps with that, and good heart health with control of blood pressure, diabetes and cholesterol is fundamental to keeping the plumbing of the brain open, so it’s getting the blood flow it wants. It’s an amazing amount of blood it demands – 20 per cent of our blood flow goes to our 3lb (1.36kg) brain.”

Life Lessons from a Brain Surgeon: The New Science and Stories of the Brain by Dr Rahul Jandial is available now.

Do you incorporate any of these healthy habits into your daily life? If not, what would encourage you to make the changes?

– With PA

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    To make a comment, please register or login
    26th May 2020
    I would have thought proper sleep may have got a mention
    27th May 2020
    Yes, I agree because lack of sleep results in an increase in stress hormones and more high caloric foods consumed for quick fixes, resulting in weight gain which in turn predisposes one to a greater likelihood of falling to many cancer and coronary diseases, and also COVID - 19!

    26th May 2020
    Did you know the brain cannot feel pain, no pain receptors, this is the reason surgeons can operate on your brain while you are completely awake...I mean who wouldn't want to be awake when something goes wrong.
    26th May 2020
    I don’t want to down play all the great ideas about remaining healthy to counter act dementia but both my parents to lived to 91 and 93 did hardly any of these things.
    Both passed away with full use of their cognitive abilities. Unfortunately it was just the rest of their bodies that failed them over time. I believe that we still have no real idea the true cause of this terrible disease and therefore have no real idea how to prevent it. We are just clutching at straws when we say lead a healthy lifestyle as that would apply in helping to stop most ailments.
    27th May 2020
    At least you must have inherited good genes, Paicey58
    26th May 2020
    There is an old joke - my apologies to those who may be offended - “Would you like to lose 3lbs of unsightly fat?
    Cut off your head!”
    26th May 2020
    Actually the brain is 60% fat.
    26th May 2020
    I follow Mediterranean diet. I try to exercise but with osteoarthritis in both knees and one hip plus torn tendons in both shoulders I am limited in what I can do..
    29th May 2020
    I have just been diagnosed with osteoarthritis in my shoulder but I also have arthritis throughout my body which isn't causing me any discomfort at the moment. But I have been researching the Mediterranean diet but just finding it hard as to where to start.
    Fortunately I am able to exercise which I feel is a big plus but yeah just getting started on the regime of changing my diet etc.
    How is the diet working for you with your exercise limitations?
    27th May 2020
    Yes I eat only plant food, exercise daily, learn new things by reading a lot, and do not drink alcohol or smoke. I agree with Gerry you need good sleep to, this is when your brain and body have a rest and rejuvenate.
    27th May 2020
    Both my parents suffered with alzheimers disease for 10 or more years before they finally passed away. In both there cases they had a very good balanced diet and never ever ate junk food. My mothers weight was 50kgs and my fathers was 75kgs. They both got heavily involved in setting up a new lawn bowl club and playing 4 or 5 days every week. This gave them plenty of exercise and good form of socializing opportunities. So after doing all the good things printed above in their case it made little or no difference in halting dementia.
    Until a cure can be found sadly many families are going to see there loved ones slowly slip away then sadly pass away.

    27th May 2020
    Agree & my dad was fitter than most people I know (still used chainsaw gathering firewoid & worked hard all his life) right up until he got dementia around 82 yrs of age! Him & my mum had the exact same diet (& my mum whos still alive at 83 has a better memory than i do & is still very switched on). Go figure..oh & she has been a lit more sedentary & anti social compared to my dad..if this brain surgeons theories are right then it shouldve been my mum with dementia or Alzheimer's & not my dad!

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