Brain Health
July 2023 (2746 Words, 16 Minutes)
Brain health refers to the preservation of brain integrity and cognitive function [1]. Because brain health does not depend on a single factor [2-7], the multi-model approach to maintaining brain health is proposed.
Contents
- Avoid head injuries
- Improve your sleep hygiene
- Follow a plant-rich diet
- Excercise regularly
- Prevent blood vessel damage
- Take care of oral health
- Stay socially engaged
- Spend more time in the rural areas
- Follow lifestyle habits for mental health
Avoid head injuries
Although the human brain is the best-protected organ in the human body, the brain’s softness makes it vulnerable to damage from contact with the skull’s interior and compression [8]. Thus, even mild traumatic brain injuries increase the risk of cognitive decline or dementia years after the original brain injury [9].
Improve your sleep hygiene
The suprachiasmatic nucleus (SCN) of the hypothalamus is a bilateral structure containing 20,000 neurons that generate circadian rhythms, i.e. synchronizes the mammalian body’s cycles of alertness and sleepiness to the external 24-hour light-dark cycle [10-11]. If these neurons are weakly coupled, the circadian rhythm of the SCN is weakened, and vice versa. Circadian rhythms rely upon circadian time cues (zeitgebers), such as light, eating, or drinking patterns, so the individual can be appropriately oriented to the environment and use the least amount of energy. Melatonin secretion also serves as a zeitgeber and promotes sleep anticipation in the brain default mode network. The daily rhythm of plasma melatonin concentrations peaks between 2 and 4 a.m., and gradually falls during the second half of the night [12].
Recommendations
- Go outside for 10 minutes after you wake up [13].
- Aim for a minimum of 7 hours of sleep regularly [14].
- Stop drinking caffeine 4 to 6 hours before bed [15].
- If you need a nap and you are not sleep deprived, keep it short - about 20 minutes, but no longer than 30 minutes - eight or more hours before bedtime, so it doesn’t affect your next sleep session [16-17].
- Avoid bright light 2-3 hours before bedtime [13].
- Drink 1 or 2 glasses of water 2 hours before bedtime, thus, you will stay hydrated at night and it will not affect your sleep [17-18].
- Consider trying static stretching exercises before bedtime [20-21].
- The best time for most people to fall asleep is between 10 and 11 p.m. [22].
- The sleep environment should be as dark as possible [13].
Follow a plant-rich diet
Specific nutrients in food - such as omega-3 fatty acids, flavonoids, vitamins B, D, and E, and choline - have been associated with improved cognitive function in older people [23-28]. DASH, Mediterranean, and MIND diets are examples of dietary patterns that are rich in these nutrients and have repeatedly shown positive effects on health [29-31]. (For more information about evidence-based nutrition patterns, read a separate article on this topic).
Excercise regularly
The physically inactive adults between the ages of 25 and 60 experience a gradual decline in both muscle mass and strength [32-33], with a loss rate of 0.5 percent per year [32]. Once a person reaches the age of 60, the rate of muscle loss doubles to approximately 1 percent per year [32]. Aerobic exercises, including jogging, swimming, cycling, walking, and dancing, along with stretching exercises, have been shown to reduce anxiety and depression [33-35], as well as boost self-esteem and sleep quality [36-37]. Whereas anaerobic exercises help increase lean muscle mass and strength [38-39]. Importantly, all three types of physical activity trigger molecular processes, which lead to the formation of new neurons and increased synaptic plasticity [40-41].
Prevent blood vessel damage
By adulthood, the human body on average contains about 100 000 kilometers of blood vessels [42]. The overall condition of these blood vessels is critical not only for maintaining heart health but also for maintaining the viability of any other organ in the human body [43-45].
Recommendations:
- Try massage therapy - it can have a beneficial impact on circulation - at least in the short-term [46-47].
- Control blood pressure and blood sugar on a regular basis.
Take care of oral health
Epidemiological studies indicate that periodontitis and tooth loss are associated with an increased likelihood of experiencing cognitive decline and dementia. <a href= “#link46-48”> 46-48</a>
[Asher S, Stephen R, Mäntylä P, Suominen AL, Solomon A. Periodontal health, cognitive decline, and dementia: A systematic review and meta-analysis of longitudinal studies. J Am Geriatr Soc. 2022;70(9):2695–2709. doi: 10.1111/jgs.17978] [Chen, CK., Wu, YT. & Chang, YC. Association between chronic periodontitis and the risk of Alzheimer’s disease: a retrospective, population-based, matched-cohort study. Alz Res Therapy 9, 56 (2017). https://doi.org/10.1186/s13195-017-0282-6] [li Fang W, jun Jiang M, bei Gu B, et al. Tooth loss as a risk factor for dementia: systematic review and meta-analysis of 21 observational studies. BMC Psychiatry. 2018;18(1):345. doi: 10.1186/s12888-018-1927-0]
Furthermore, tooth loss is considered a risk factor for ischemic stroke due to the chronic inflammation it can cause.
[Fagundes NCF, Almeida APCPSC, Vilhena KFB, Magno MB, Maia LC, Lima RR. Periodontitis As A Risk Factor For Stroke: A Systematic Review And Meta-Analysis. Vasc Health Risk Manag. 2019;15:519–532. doi: 10.2147/VHRM.S204097] [Cheng F, Zhang M, Wang Q, et al. Tooth loss and risk of cardiovascular disease and stroke: A dose-response meta analysis of prospective cohort studies. PLoS ONE. 2018;13(3):e0194563. doi: 10.1371/journal.pone.0194563]
Stay socially engaged
In terms of effects on the brain, building social networks and participating in social activities are similar to physical exercise, because they lead to the formation of new neural connections, stimulate attention and memory, in conjunction with helping ward off depression and stress [48]. On the contrary, both social isolation and loneliness are significantly associated with an increased risk of all-cause mortality [49].
Spend more time in the rural areas
Living in a rural area has a list of benefits. For example, compared to urban areas, it is associated with a lower risk for mental disorders such as anxiety disorders, depression, and schizophrenia [50-52], along with decreased levels of heart rate, blood pressure, and the stress-related hormone cortisol [50,53].
Follow lifestyle habits for mental health
Recommendations
- Get a personal “Not to-do list”.
- Practice a foreign or a programming language.
- Avoid overheating under sun [54].
References
- Wang Y, Pan Y, Li H. What is brain health and why is it important? BMJ 2020; 371 :m3683 doi:10.1136/bmj.m3683
- Kim, M., & Park, J. M. (2017). Factors affecting cognitive function according to gender in community-dwelling elderly individuals. Epidemiology and health, 39, e2017054.doi:10.4178/epih.e201705</li>">https://doi.org/10.4178/epih.e201705<
- Li, W., Wang, T., & Xiao, S. (2016). Type 2 diabetes mellitus might be a risk factor for mild cognitive impairment progressing to Alzheimer's disease. Neuropsychiatric disease and treatment, 12, 2489–2495. doi:10.2147/NDT.S111298<
- Kim, E. J. (2010). Factors influencing cognitive impairment of the elderly residents. Journal of East-West Nursing Research, 16(2), 122-130
- Park, H. K., & Song, H. J. (2016). Predictors of cognitive function decline of elderly: using living conditions and welfare needs of older Korean persons panel data. The Korean Journal of Health Service Management, 10(3), 147-158.
- Lin JS, O'Connor E, Rossom RC, et al. Screening for Cognitive Impairment in Older Adults: An Evidence Update for the U.S. Preventive Services Task Force [Internet]. Rockville (MD): Agency for Healthcare Research and Quality (US); 2013 Nov. (Evidence Syntheses, No. 107.)
- Park, J. S., Lee, Y. W., & Kim, H. S. (2015). Cognitive impairment risk factors in elders. Journal of Korean Gerontological Nursing, 17(3), 121-130.
- Johnstone, D. M., Mitrofanis, J., & Stone, J. (2023). The brain’s weakness in the face of trauma: How head trauma causes the destruction of the brain. Frontiers in Neuroscience, 17, 1141568. doi:10.3389/fnins.2023.1141568">https://doi.org/10.3389/fnins.2023.1141568
- Schneider, A. L. C., Wang, D., Ling, G., Gottesman, R. F., & Selvin, E. (2018). Prevalence of Self-Reported Head Injury in the United States. The New England journal of medicine, 379(12), 1176–1178. doi:10.1056/NEJMc1808550">https://doi.org/10.1056/NEJMc1808550
- Touitou, Y., Reinberg, A., & Touitou, D. (2017). Association between light at night, melatonin secretion, sleep deprivation, and the internal clock: Health impacts and mechanisms of circadian disruption. Life sciences, 173, 94–106. doi:10.1016/j.lfs.2017.02.008">https://doi.org/10.1016/j.lfs.2017.02.008
- Hirota T, Fukada Y. Resetting mechanism of central and peripheral circadian clocks in mammals. Zoolog Sci. 2004;21(4):359–68. Epub 2004/05/01.
- Grivas, T. B., & Savvidou, O. D. (2007). Melatonin the "light of night" in human biology and adolescent idiopathic scoliosis. Scoliosis, 2, 6. https://doi.org/10.1186/1748-7161-2-6
- Brown, T. M., Brainard, G. C., Cajochen, C., Czeisler, C. A., Hanifin, J. P., Lockley, S. W., Lucas, R. J., Münch, M., O'Hagan, J. B., Peirson, S. N., Price, L. L. A., Roenneberg, T., Schlangen, L. J. M., Skene, D. J., Spitschan, M., Vetter, C., Zee, P. C., & Wright, K. P., Jr (2022). Recommendations for daytime, evening, and nighttime indoor light exposure to best support physiology, sleep, and wakefulness in healthy adults. PLoS biology, 20(3), e3001571. https://doi.org/10.1371/journal.pbio.3001571
- Li, J., Cao, D., Huang, Y., Chen, Z., Wang, R., Dong, Q., Wei, Q., & Liu, L. (2022). Sleep duration and health outcomes: an umbrella review. Sleep & breathing = Schlaf & Atmung, 26(3), 1479–1501. https://doi.org/10.1007/s11325-021-02458-1
- Clark, I., & Landolt, H. P. (2017). Coffee, caffeine, and sleep: A systematic review of epidemiological studies and randomized controlled trials. Sleep medicine reviews, 31, 70–78. https://doi.org/10.1016/j.smrv.2016.01.006
- Yang, Y., Liu, W., Ji, X., Ma, C., Wang, X., Li, K., & Li, J. (2020). Extended afternoon naps are associated with hypertension in women but not in men. Heart & Lung, 49(1), 2–9.
- Qu, H., Wang, H., Deng, M., Wei, H., & Deng, H. (2014). Associations between longer habitual day napping and non-alcoholic fatty liver disease in an elderly Chinese population. PLoS One, 9(8), e105583.
- Rosinger, A. Y., Chang, A. M., Buxton, O. M., Li, J., Wu, S., & Gao, X. (2019). Short sleep duration is associated with inadequate hydration: Cross-cultural evidence from US and Chinese adults. Sleep, 42(2), 10.1093/sleep/zsy210. https://pubmed.ncbi.nlm.nih.gov/30395316/
- Aristotelous, P., Aphamis, G., Sakkas, G. K., Andreou, E., Pantzaris, M., Kyprianou, T., Hadjigeorgiou, G. M., Manconi, M., & Giannaki, C. D. (2019). Effects of controlled dehydration on sleep quality and quantity: A polysomnographic study in healthy young adults. Journal of Sleep Research, 28(3), e12662
- D'Aurea, C. V. R., Poyares, D., Passos, G. S., Santana, M. G., Youngstedt, S. D., Souza, A. A., Bicudo, J., Tufik, S., & de Mello, M. T. (2019). Effects of resistance exercise training and stretching on chronic insomnia. Revista brasileira de psiquiatria (Sao Paulo, Brazil : 1999), 41(1), 51–57. https://doi.org/10.1590/1516-4446-2018-0030
- Pa, J., Goodson, W., Bloch, A., King, A. C., Yaffe, K., & Barnes, D. E. (2014). Effect of exercise and cognitive activity on self-reported sleep quality in community-dwelling older adults with cognitive complaints: a randomized controlled trial. Journal of the American Geriatrics Society, 62(12), 2319–2326. https://doi.org/10.1111/jgs.13158
- Shahram Nikbakhtian and others, Accelerometer-derived sleep onset timing and cardiovascular disease incidence: a UK Biobank cohort study, European Heart Journal - Digital Health, Volume 2, Issue 4, December 2021, Pages 658–666, https://doi.org/10.1093/ehjdh/ztab088
- Bauer, I., Hughes, M., Rowsell, R., Cockerell, R., Pipingas, A., Crewther, S., & Crewther, D. (2014). Omega-3 supplementation improves cognition and modifies brain activation in young adults. Human psychopharmacology, 29(2), 133–144. https://doi.org/10.1002/hup.2379
- Calis, Z., Mogulkoc, R., & Baltaci, A. K. (2020). The Roles of Flavonols/Flavonoids in Neurodegeneration and Neuroinflammation. Mini reviews in medicinal chemistry, 20(15), 1475–1488. https://doi.org/10.2174/1389557519666190617150051
- Kennedy D. O. (2016). B Vitamins and the Brain: Mechanisms, Dose and Efficacy--A Review. Nutrients, 8(2), 68. https://doi.org/10.3390/nu8020068
- Navale, S. S., Mulugeta, A., Zhou, A., Llewellyn, D. J., & Hyppönen, E. (2022). Vitamin D and brain health: an observational and Mendelian randomization study. The American journal of clinical nutrition, 116(2), 531–540. https://doi.org/10.1093/ajcn/nqac107
- La Fata, G., van Vliet, N., Barnhoorn, S., Brandt, R. M. C., Etheve, S., Chenal, E., Grunenwald, C., Seifert, N., Weber, P., Hoeijmakers, J. H. J., Mohajeri, M. H., & Vermeij, W. P. (2017). Vitamin E Supplementation Reduces Cellular Loss in the Brain of a Premature Aging Mouse Model. The journal of prevention of Alzheimer's disease, 4(4), 226–235. https://doi.org/10.14283/jpad.2017.30
- Blusztajn, J. K., Slack, B. E., & Mellott, T. J. (2017). Neuroprotective Actions of Dietary Choline. Nutrients, 9(8), 815. https://doi.org/10.3390/nu9080815
- Dinu, M; Pagliai, G; Casini, A; Sofi, F (10 May 2017). "Mediterranean diet and multiple health outcomes: an umbrella review of meta-analyses of observational studies and randomized trials". European Journal of Clinical Nutrition. 72 (1): 30–43. doi:10.1038/ejcn.2017.58. hdl:2158/1081996. PMID 28488692. S2CID 7702206.
- Liu, X., Morris, M. C., Dhana, K., Ventrelle, J., Johnson, K., Bishop, L., Hollings, C. S., Boulin, A., Laranjo, N., Stubbs, B. J., Reilly, X., Carey, V. J., Wang, Y., Furtado, J. D., Marcovina, S. M., Tangney, C., Aggarwal, N. T., Arfanakis, K., Sacks, F. M., & Barnes, L. L. (2021). Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) study: Rationale, design and baseline characteristics of a randomized control trial of the MIND diet on cognitive decline. Contemporary clinical trials, 102, 106270. https://doi.org/10.1016/j.cct.2021.106270
- Filippou, C. D., Tsioufis, C. P., Thomopoulos, C. G., Mihas, C. C., Dimitriadis, K. S., Sotiropoulou, L. I., Chrysochoou, C. A., Nihoyannopoulos, P. I., & Tousoulis, D. M. (2020). Dietary Approaches to Stop Hypertension (DASH) Diet and Blood Pressure Reduction in Adults with and without Hypertension: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Advances in nutrition (Bethesda, Md.), 11(5), 1150–1160. https://doi.org/10.1093/advances/nmaa041
- Martin, P. E., & Morgan, D. W. (1992). Biomechanical considerations for economical walking and running. Medicine and science in sports and exercise, 24(4), 467–474.
- Hurley, B. F., & Roth, S. M. (2000). Strength training in the elderly: effects on risk factors for age-related diseases. Sports medicine (Auckland, N.Z.), 30(4), 249–268. https://doi.org/10.2165/00007256-200030040-00002
- Paolucci, E. M., Loukov, D., Bowdish, D. M. E., & Heisz, J. J. (2018). Exercise reduces depression and inflammation but intensity matters. Biological psychology, 133, 79–84. https://doi.org/10.1016/j.biopsycho.2018.01.015
- Stonerock, G. L., Hoffman, B. M., Smith, P. J., & Blumenthal, J. A. (2015). Exercise as Treatment for Anxiety: Systematic Review and Analysis. Annals of behavioral medicine : a publication of the Society of Behavioral Medicine, 49(4), 542–556. https://doi.org/10.1007/s12160-014-9685-9
- Moreno Reyes, P., Muñoz Gutiérrez, C., Pizarro Mena, R., & Jiménez Torres, S. (2020). Efectos del ejercicio físico sobre la calidad del sueño, insomnio y somnolencia diurna en personas mayores. Revisión de la literatura [Effects of physical exercise on sleep quality, insomnia, and daytime sleepiness in the elderly. A literature review]. Revista espanola de geriatria y gerontologia, 55(1), 42–49. https://doi.org/10.1016/j.regg.2019.07.003
- Jak A. J. (2012). The impact of physical and mental activity on cognitive aging. Current topics in behavioral neurosciences, 10, 273–291. https://doi.org/10.1007/7854_2011_141
- Aouadi, R.; Khalifa, R.; Aouidet, A.; Ben Mansour, A.; Ben Rayana, M.; Mdini, F.; Bahri, S.; Stratton, G. (2011). "Aerobic training programs and glycemic control in diabetic children in relation to exercise frequency". The Journal of Sports Medicine and Physical Fitness. 51 (3): 393–400
- Hooge, R.; Hellinckx, T.; Van Laethem, C.; Stegen, S.; De Schepper, J.; Van Aken, S.; Dewolf, D.; Calders, P. (2011). "Influence of combined aerobic and resistance training on metabolic control, cardiovascular fitness and quality of life in adolescents with type 1 diabetes: a randomized controlled trial". Clinical Rehabilitation. 25 (4): 349–359. doi:10.1177/0269215510386254
- Cassilhas, R. C., Tufik, S., & de Mello, M. T. (2016). Physical exercise, neuroplasticity, spatial learning and memory. Cellular and molecular life sciences : CMLS, 73(5), 975–983. https://doi.org/10.1007/s00018-015-2102-0
- Huang, J., Wang, X., Zhu, Y., Li, Z., Zhu, Y. T., Wu, J. C., Qin, Z. H., Xiang, M., & Lin, F. (2019). Exercise activates lysosomal function in the brain through AMPK-SIRT1-TFEB pathway. CNS neuroscience & therapeutics, 25(6), 796–807. https://doi.org/10.1111/cns.13114
- Lymphedema Management. (2013). Physiology. https://doi.org/10.1055/b-002-89585
- Carmeliet, P. Angiogenesis in health and disease (2003). Nat Med 9, 653–660.
- Deanfield JE, Halcox JP, Rabelink TJ. Circulation (2007). 115:1285–1295.
- Melo L.G., Gnecchi M., Ward C.A., Dzau V.J. (2007) Vascular Remodeling in Health and Disease. In: Willerson J.T., Wellens H.J.J., Cohn J.N., Holmes D.R. (eds) Cardiovascular Medicine. Springer, London.
- Tiidus P. M. (1997). Manual massage and recovery of muscle function following exercise: a literature review. The Journal of orthopaedic and sports physical therapy, 25(2), 107–112. https://doi.org/10.2519/jospt.1997.25.2.107
- Fazeli, M. S., Pourrahmat, M. M., Liu, M., Guan, L., & Collet, J. P. (2016). The Effect of Head Massage on the Regulation of the Cardiac Autonomic Nervous System: A Pilot Randomized Crossover Trial. Journal of alternative and complementary medicine (New York, N.Y.), 22(1), 75–80. https://doi.org/10.1089/acm.2015.0141
- Nelson, L. A., Noonan, C. J., Goldberg, J., & Buchwald, D. S. (2013). Social engagement and physical and cognitive health among American Indian participants in the health and retirement study. Journal of cross-cultural gerontology, 28(4), 453. https://doi.org/10.1007/s10823-013-9213-6
- Wang, F., Gao, Y., Han, Z. et al. A systematic review and meta-analysis of 90 cohort studies of social isolation, loneliness and mortality. Nat Hum Behav (2023). https://doi.org/10.1038/s41562-023-01617-6
- Park B-J, Tsunetsugu Y, Kasetani T, Hirano H, Kagawa T, Sato M, et al. Physiological effects of shinrin-yoku (taking in the atmosphere of the forest)—using salivary cortisol and cerebral activity as indicators—. J Physiol Anthropol. 2007;26:123–8.
- Tost H, Reichert M, Braun U, Reinhard I, Peters R, Lautenbach S, et al. Neural correlates of individual differences in affective benefit of real-life urban green space exposure. Nat Neurosci. 2019;22:1389–93.
- Oh B, Lee KJ, Zaslawski C, Yeung A, Rosenthal D, Larkey L, et al. Health and well-being benefits of spending time in forests: systematic review. Environ Health Prev Med. 2017;22:71.
- Mao GX, Lan XG, Cao YB, Chen ZM, He ZH, Lv YD, et al. Effects of short-term forest bathing on human health in a broad-leaved evergreen forest in Zhejiang Province, China. Biomed Environ Sci. 2012;25:317–24.
- Cedeño Laurent, J. G., Williams, A., Oulhote, Y., Zanobetti, A., Allen, J. G., & Spengler, J. D. (2018). Reduced cognitive function during a heat wave among residents of non-air-conditioned buildings: An observational study of young adults in the summer of 2016. PLoS medicine, 15(7), e1002605.