The Heart Mind Connection
New studies show the heart and brain are connected by more than just poetry and puns. Indeed, researchers say high levels of heart-busting cholesterol might also make brain cells more prone to brain-busting dementia.
My family tree is riddled with heart disease. Growing up I listened to my father and aunts swap hospital stories and cardiologists鈥?phone numbers over buckets of Kentucky Fried Chicken.
Eventually, their conversations about stents and statins gave me a ticking-time-bomb mentality about my own heart. I don鈥檛 deserve to be labeled a hypochondriac, but I did see my doctor roll her eyes the last time I asked her to double check my cholesterol. She assured me I鈥檓 one of her healthiest clients. Aside from swearing off meat, I feast on organic fruits and veggies, lope around the neighborhood with my dog, and twist myself into yoga poses that make my relatives wince.
But as the years tick by, I鈥檝e worried that protecting my heart is only half the battle. When I鈥檝e blanked on the name of a street or the title of a favorite book, I鈥檝e wondered if I should expend more energy preserving my gray matter. After all, 30 years from now what satisfaction will I glean from a healthy low-density lipoprotein (LDL, the 鈥渂ad鈥?cholesterol) score if I don鈥檛 remember to care? But a spate of new studies has eased my anxiety and added new resolve to my heart-healthy habits. According to the experts, the efforts I鈥檓 making to protect my heart now may be the brain boost I鈥檓 after in the future.
In fact, new studies show a healthy heart actually may be one of the best-kept secrets to preventing dementia. And holding onto one鈥檚 wits is no small feat. Roughly 4.5 million Americans have Alzheimer鈥檚 disease, the leading cause of dementia. By 2050, the Alzheimer鈥檚 Association expects that number to potentially quadruple to 16 million. Aging baby boomers are only partially to blame for the senility glut. Added to the equation are the effects that rising tides of heart disease and diabetes will have. Truth be told, the more scientists discover about the roots of dementia, the more they are shifting their focus from the brain to the heart.
What affects the heart also affects the brain
The recipe for heart health rattles off the tongue as easily as the Pledge of Allegiance: fill your plate with fruits and vegetables, get plenty of exercise and steer clear of artery-clogging evils such as trans fats. But while Americans are conditioned to strive for clean arteries, we rarely apply the same logic to the blood vessels in our brains. Yet, both heart and brain rely on healthy circulation.
Indeed, the brain is a voracious consumer of the body鈥檚 blood and oxygen supply. Of the blood flow from the heart, roughly 20 percent goes straight to the head.
Although a tissue-paper thin barrier protects the brain from direct contact with blood (a safeguard against potentially harmful toxins), nutrients easily pass through the blood-brain barrier. Circulation is what connects heart disease to dementia, says Decker Weiss, ND, a naturopathic physician at the Arizona Heart Hospital in Phoenix. 鈥淭he same things that help the heart to beat help the brain to work.鈥?
Factors that impede blood flow to the heart, such as high cholesterol, also slow blood flow to the brain. 鈥淲hen you鈥檙e looking at heart disease and dementia, what you really have is micro and macro circulation issues,鈥?Weiss says. In other words, what damages large arteries like those in the heart also affects the tiny ones such as those found in the brain鈥攐nly sooner because of their size. As examples he points to arteriosclerosis (hardening of the arteries), hypertension and diabetes. 鈥淭hey are all systemic diseases,鈥?he says. 鈥淭he smallest blood vessels are affected first, including those in the brain.鈥?/FONT>
Experts know that vascular disease, such as stroke and diabetes, ups a person鈥檚 risk of Alzheimer鈥檚 disease. But the exact relationship between the two problems is murky. Vascular disease and Alzheimer鈥檚 clearly overlap, according to
Kenneth Langa, MD, PhD, a dementia expert at the University of Michigan, Ann Arbor. 鈥淭antalizing research says these two things are not just coexisting but that the vascular risks actually cause Alzheimer鈥檚,鈥?he says.
Recent long-term, observational studies support the idea that heart disease in middle age spells trouble for the brain. Rachel Whitmer, PhD, a research scientist at the Kaiser Permanente Division of Research in Oakland, Calif., studies the connections between midlife risk factors for heart disease and dementia. For one of her most recent studies, published last January in the journal Neurology, Whitmer and colleagues traced the medical records of nearly 9,000 seniors (all Kaiser patients) from present day back to 鈥渕idlife,鈥?when the patients were between the ages of 40 and 44. They compared who had heart disease risk factors at middle age with who鈥檇 been diagnosed with dementia. What they found supports the heart-brain connection.
Each one of the four heart-disease risk factors the researchers charted carried a significant risk of dementia. Participants with hypertension had a 24 percent increase in risk, smokers a 26 percent increase, those with high cholesterol a 42 percent increase and diabetes a 46 percent increase. 鈥淚 was surprised by the strength of these findings and the fact that we found an effect for all four risk factors,鈥?Whitmer says, 鈥済iven the fact that all the patients were members of a health maintenance organization and probably received corresponding treatments.鈥?/FONT>
Likewise, Langa notes a connection between high cholesterol at midlife and an elevated risk of Alzheimer鈥檚 published in a review study last year in the Journal of the American Medical Association (JAMA). The two defining characteristics of Alzheimer鈥檚 disease are amyloid plaques, (protein fragments that clump outside the brain鈥檚 nerve cells) and neurofibrillary tangles (twisted strands of a different protein inside brain cells). Langa believes high cholesterol leads to the buildup of the protein that eventually becomes amyloid plaque.
鈥淓arly evidence shows that too much cholesterol causes changes in how brain cells process this protein,鈥?he says. 鈥淗igh levels of cholesterol might make brain cells more prone to Alzheimer鈥檚.鈥?
Langa says his research armed him with new tools to coerce his heart-disease patients into eating right and exercising. 鈥淔or some people, the idea that brain health is connected to heart health is a radical idea,鈥?he says. During office visits, he tells his patients to do what their mothers and doctors have been telling them forever鈥攚atch their diet and stay active. 鈥淚t鈥檚 not rocket science,鈥?he says. 鈥淭he key is to remember you鈥檙e getting two bangs for the buck. You鈥檒l not only prevent a heart attack, but also keep your mind sharp as you age.鈥?While Langa鈥檚 advice is a good starting place, consider acting on one or more of the following tips to avoid a future brain drain.
Five Ways to Protect Your Brain
1. Take B vitamins
All vitamins help keep the body running like a well-oiled machine, but your brain, in particular, benefits from Bs. New research highlights the importance of B vitamins in protecting seniors from stroke and dementia, two main causes of disability in the elderly. Specifically, B vitamins can help quench homocysteine, an amino acid that damages blood vessels. In 2002, a study published in Stroke: Journal of the American Heart Association found people with moderately high levels of homocysteine had a more than fivefold increased risk of stroke and a threefold increased risk for Alzheimer鈥檚 disease compared to those with low levels of the substance in their blood.
Vitamin B3 (niacin) also has been linked to brain health. Researchers at the Chicago-based Rush Institute for Healthy Aging found in 2004 that seniors with flagging levels of niacin were more likely to suffer from Alzheimer鈥檚 than those with niacin to spare. Although researchers have yet to pinpoint what鈥檚 going on, they suspect that B vitamins protect and nurture dendritic growth, a key component of the nervous system and brain health. 鈥淵ou鈥檝e got to get in the habit of taking B vitamins every day,鈥?Weiss says.
2. Try ginkgo
Extracted from the ancient ginkgo tree, ginkgo (Ginkgo biloba) is considered the best of all brain-boosting supplements on the shelf. Studies of people with Alzheimer鈥檚 disease show that ginkgo enhances blood flow to the brain and ameliorates memory recall. It also adds tone and spring to aging blood vessels. In addition, ginkgo is a potent anti-inflammatory and antioxidant. 鈥淕inkgo will be one of the most valuable herbs for the next 100 years,鈥?Weiss says.
For minor memory loss associated with aging, take 40 to 60 mg of ginkgo biloba extract (GBE) three times a day. For Alzheimer鈥檚 disease, up each dose to 80 to 120 mg three times per day. Ginkgo is generally safe for long-term use; however, the extract does thin the blood and can clash with some medications, especially blood thinners.
So if you take prescription drugs, consult with your doctor before tossing ginkgo into the mix and make sure not to take it before a surgery.
3. Snuff out inflammation
Inflammation comes to the rescue when the body is hurt or ill, but the immune system鈥檚 Dr. Jekyll can morph into Mr. Hyde if the inflammation switch gets stuck in the 鈥渙n鈥?position.
Chronic inflammation, whether from an irritated bowel, inflamed gums or autoimmune disease, weakens arteries in both the heart and the head. Making the arteries more vulnerable to rupture, the damage opens the doorway to heart attack and stroke. The key to prevention is keeping an eye on the early warning signs. 鈥淚nflammation is cumulative. It may end up in the blood vessels, but that鈥檚 not where it starts,鈥?Weiss says. 鈥淚f you have inflamed joints, gums or gastrointestinal tract, your whole body is loaded, and the immune system will hype up heart disease progression.鈥?/FONT>
The good news is you can combat inflammation naturally by bulking up on specific foods, herbs and supplements. Start with omega-3-rich fish. People who eat two servings a week of coldwater fatty fish, such as mackerel, wild salmon and tuna, cut their risk of heart attack, stroke and Alzheimer鈥檚 disease, according to dozens of scientific studies. If you aren鈥檛 a fish fan, consider taking fish oil supplements ( between 1,000 and 2,000 mg daily). Other supplements to help douse the fire include turmeric (400 to 600 mg three times per day) and ginger (500 to 1,000 mg twice per day).
If you鈥檙e still concerned about inflammation, ask your doctor to test your C-reactive protein levels (CRP for short). A blood marker for inflammation, levels of CRP creep up as inflammation heats up. Although the CRP test is not yet considered standard fare, its use is becoming more mainstream. Two studies in the January 2005 issue of The New England Journal of Medicine indicate CRP may be as important as cholesterol in establishing cardiovascular risk. The CRP test is most useful for people with a moderate heart disease risk whose cholesterol levels are seemingly normal. As more doctors subscribe to the importance of uncovering inflammation, CRP tests may rival cholesterol tests as a diagnostic tool.
Another test to consider is one that measures levels of white blood cells (WBC). After studying the link between high levels of WBC and heart disease in the 72,000 participants of the Women鈥檚 Health Initiative, authors of a study published in the March issue of Archives of Internal Medicine concluded that unusually high levels of WBCs may be useful for detecting heart disease in otherwise healthy-looking people. (Food allergies, especially to wheat, gluten and dairy, also create inflammation in the body over time; so does over reliance on nonsteroidal anti-inflammatory drugs and antibiotics.)
4. Exercise your brain
You know exercise ensures muscular brawn, but it鈥檚 easy to forget the brain鈥檚 need for heavy lifting. The importance of performing mental gymnastics was first foretold by a 2002 study published in JAMA. For the research on mental acuity and aging, scientists at the Rush Alzheimer鈥檚 Disease Center recruited 801 Catholic nuns, priests and brothers from around the United States. All were at least 65 years old, and none had a clinical diagnosis of dementia. The seniors completed a survey designed to measure, among other things, how much time they devoted to seven different activities, ranging from watching television to playing card games. Over the next 4.5 years, the scientists periodically evaluated the seniors鈥?brainpower for signs of slippage. During the study, more than 111 participants were diagnosed with shades of Alzheimer鈥檚. When researchers compared those struck by the disease with their activity level, they found that those who flexed their mental muscles the most were 47 percent less likely to develop Alzheimer鈥檚 than those who taxed their brains the least. Weiss wasn鈥檛 surprised by the results. 鈥淚n the brain, there is a big, big difference between watching television and reading a book,鈥?he says. 鈥淵our brain makes new neurons when you process information. I see lots of older folks who are readers stay sharp while those who watch TV melt into the couch.鈥?/FONT>
5. Get diabetes under control
If you have diabetes, you have extra incentive to pamper your brain. Diabetes puts people at a higher risk of dementia. Experts know that diabetes is damaging to blood vessels, but they are just beginning to understand the relationship to dementia. A groundbreaking study published last March in the Journal of Alzheimer鈥檚 Disease confirmed not only that the brain makes insulin but also that people who die from Alzheimer鈥檚 disease lack insulin in key areas of their brains. 鈥淪ome people think of Alzheimer鈥檚 disease as diabetes of the brain,鈥?Whitmer says. 鈥淢ore and more evidence shows that insulin plays a direct role in the neurodegeneration seen with Alzheimer鈥檚.鈥?/FONT>
If there鈥檚 a final analysis to be made here, it might be that while eating right, exercising and taking vitamins and supplements might not be, as Weiss says, a rocket-science Rx for heart and brain health, it鈥檚 one each of us can follow with relatively little pain in exchange for considerable long-term gain.
Catherine Gutherie is a freelance writer in Bloomington, Ind.
This article appears in July/August 2005 Alternative Medicine Newsletter
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