powerful tools are accessible to everybody and, if taught appropriately, research shows can be very effective.
+ Exercise High intensity interval training (HIIT) and endurance exercises reduce the incidence of cardiovascular disease, which would ultimately reduce the likelihood of cognitive decline. But exercise itself also induces the production of ‘neurotrophic’ factors that enhance nerve cell generation and protect against shrinkage of the brain that occurs as we age.33 Our bodies are designed to move constantly, but I find that many patients are confined to their desks in their working environments. Whether it’s a case of getting a standing desk or taking the stairs, I advise to try to move as much as possible throughout the day – exercise is not confined to the gym. Your brain will thank you for it.
+ Sleep Sleeping to both protect and greatly enhance brain function is the lowest hanging fruit, yet few of us practise good sleep hygiene. The constant stimulation from TV platforms and mobile electronic devices creates an environment associated with disrupted sleep. During sleep your brain’s lymphatic system (the system that removes toxins and waste products as a result of normal cellular processes) gets to work to clear debris that can impact the functioning of your nerve cells.34 There is a clear link between poor sleep and a higher likelihood of cognitive decline, and on the other side of the spectrum, boosted cognitive performance when you are well rested. Getting a good quality 8–9 hours of rest per 24 hours is one of the simplest ways to boost brain health. Make yourself a promise: try it for 7 days and monitor how you feel. It will revolutionise what you prioritise.
By employing all these tactics we can positively impact our brain on multiple levels. We have the power with our diet to reduce inflammation, stimulate brain growth factors, promote neuronal cell production, reduce oxidative stress and improve many other processes that we have yet to discover. As well as all these dietary and lifestyle changes being protective, the aforementioned activities are also being considered in management to improve outcomes or prevent further decline in patients to good effect. This is where we need to invest more of our time and resources, but I’m making this vital information accessible to you right here. Don’t wait for the prescription pad. Take advantage of these points and start looking after your brain health right now. As you’ll discover in all the other chapters in this introduction, eating and living well doesn’t solely effect your brain health, but rather your entire ecosystem.
If you’re tempted to skip over this chapter because you’re in your mid-twenties or early thirties and you believe heart disease is only something of concern in later life, think carefully about flicking past these pages. Heart disease isn’t something that suddenly becomes relevant as soon as we reach a certain age threshold. We build the foundations for a healthy or unhealthy heart in our childhood and we are starting to see the early signs of atherosclerosis (narrowed, inflamed arteries) in those as young as teenagers.35 But rather than scaring you into booking a CT angiogram to determine the state of your vital organ, I want to show you how much control you have using your fork.
Our heart is a complex machine that generates electrical energy to synchronously contract its muscles, pumping blood around our network of vessels. The blood contains vital oxygen molecules, as well as nutrients to feed every cell in our body, but the heart itself is desperately reliant on the same nutritional need. Micronutrients like potassium, magnesium and calcium are essential to ensure the contractility of this muscular organ that, hopefully, will never stop throughout our entire existence.
If you hit the gym harder than usual and you’re dehydrated, or perhaps you haven’t had adequate nutrition prior to your workout, your muscles will feel stiff and generally fatigued. Feed yourself the right fuel, however, and you’re less likely to feel the negative effects of training. Our heart muscles are categorically different from the skeletal muscles in our limbs, but the general principles of feeding our muscle tissue still apply. It’s vital to ensure your heart is adequately nourished to perform its function throughout its lifetime and make lifestyle choices that nurture this beautiful, industrious machine. Thankfully, this isn’t hard, and the food you can enjoy is still incredibly delicious and exciting.
It’s important to remember that the heart (like most organs) is incredibly resilient. As demonstrated by some impressive studies, reversal of atherosclerosis can be achieved with a lifestyle that encourages your body to look after itself.36 A number of cardiologists have demonstrated, using both blood tests and imaging to look at the vasculature of the heart, that a healthy lifestyle can reduce blockages of the arteries.37, 38 This is absolutely groundbreaking and something not thought possible up until a few years ago. In fact, some lifestyle medicine programmes have become so effective at reversing cardiovascular disease that they’re now covered by American health insurers.39, 40
But rather than trying to just reverse heart disease, I want to focus on the habits that will prevent the life-changing event of a heart attack that happens to over 100,000 UK citizens each year. Yes, there is evidence to suggest that we can drastically improve post-heart attack symptoms with intense lifestyle changes, but the better and more effective aspiration is to prevent that stage in the first place.
THE MEDITERRANEAN WAY
The Mediterranean diet has been heralded as the most heart-healthy diet and evidence supports this. When we look at large population studies, it’s clear that a Mediterranean way of eating, that includes plenty of fruits, vegetables, good-quality oils and healthy fats, significantly reduces the likelihood of high blood pressure, strokes and heart disease.41, 42 A representative dish of how to eat with this focus in mind is my Roast Walnut and Squash Medley with Persillade (see here) or the Aubergine and Walnut Ragu (see here).
We can analyse why this may be the case by examining the components of a Mediterranean way of eating. The focus is on colourful vegetables such as tomatoes, squash, lentils and dark leafy greens, which are fantastic sources of the micronutrients necessary for optimum cardiac muscle function.43, 44 The most extensively studied of these micronutrients include potassium, calcium, magnesium and co-enzyme Q10,45 but there are a huge number of other plant chemicals found in the same foods that we still haven’t fully investigated the effects of.46
There are now over 30 years of data, including the results of the Lyon Heart Study, PREDIMED studies and other large research projects that all point towards Mediterranean-style diets and lifestyle modifications as being significantly more effective at prevention of cardiovascular disease than drugs combined.41 To put this another way, if you change your lifestyle and eating habits, it has a more powerful effect on your health than any number of medication combinations I can prescribe. This is simply not common knowledge among our population, nor medical professionals and, quite frankly, it should be printed on the front door of every cardiac unit and general practice surgery in the country. Considering the exorbitant cost of medications and interventions directed at preventing cardiovascular events that our healthcare system invests in,47 there is simply no excuse for why diet education should not play a central role in healthcare. We do ourselves a disservice by not engaging in this
