Can Diet, Exercise, and Essential Oils Support the Brain and Prevent Alzheimer’s Disease and Cognitive Decline?
Recently, I’ve been very interested in preserving brain function. I don’t know how it happened, but many of my new clients are coming to me with concerns that relate to struggling with brain fatigue, memory, and concern for dementia. This makes sense, as Alzheimer’s disease appears to be the most feared or second only to cancer as the scariest diagnosis someone can receive.1,3 In 2011, an international survey of about 500-640 people per country put Alzheimer’s in second place; 1 whereas, the Marist Institute for Public Opinion survey in 2012 of more than 1,200 Americans listed it in first place.2
I have written previously on some of the facts of Alzheimer’s disease and dementia and some good news on how lifestyle can modulate risk. In this article, I wanted to focus specifically on how eating, exercise, and essential oils can aid the brain.
Still, I don’t want to make it appear as simple as a healthy diet, exercise, and sniffing a lovely scent are all you need to do to prevent brain decline. More comprehensive approaches and searching for underlying causes are imperative to correct as well.
In another blog, I discussed the complexity of factors involved in mental and emotional health. Although it can look daunting, a naturopathic and/or functional medicine doctor can assist in digging into a person’s health history, labs, and use their detective work for determining what that particular person needs to address.
Below I’ve listed a few of the factors (and some of their references) that I consider whenever someone approaches me for emotional health. These include the following:
- Inflammation and oxidative stress
- Genetic variations (such as SNPs related to MTHFR, DRD2, DRD4, COMT, CBS, serotonin transporters (5HTT))
- Nutrition and assimilation
- Dietary triggers and deficiencies (including cerebral folate deficiency)
- Mitochondrial dysfunctions and imbalances
- Hormonal imbalances
- Stress & cortisol levels
- The microbiome
- Environmental toxicants
- Blood sugar levels
- Stealth infections
- Childhood adversity
- Emotional tone and spirituality
- Brain trauma
- Hyper or hypo-activity in a brain region
- …and more!
Mold: A big trigger I noticed that can cause systemic inflammation, immune issues, and resultant brain attack is mold exposure. In fact, psychological and mood imbalances can be a direct result of this toxic exposure and it can also be a trigger for autoimmunity.
Medications: Certain medications have been shown to increase risk for dementia and cognitive issues. Recently, anticholinergics and heartburn medications were in the press.
Anticholinergics4-6– A 2015 study in JAMA reported, “The most common anticholinergic classes used were tricyclic antidepressants, first-generation antihistamines, and bladder antimuscarinics… Higher cumulative anticholinergic use is associated with an increased risk for dementia. Efforts to increase awareness among health care professionals and older adults about this potential medication-related risk are important to minimize anticholinergic use over time.”4
Prescribers and consumers can access the Anticholinergic Burden Scale here to determine the effect of a drug on the mind.5 According to the resource, here is the criteria for categorization used:
Score of 1: Evidence from in vitro data that chemical entity has antagonist activity at muscarinic receptor.
Score of 2: Evidence from literature, prescriber’s information, or expert opinion of clinical anticholinergic effect.
Score of 3: Evidence from literature, expert opinion, or prescribers information that medication may cause delirium.5
Heartburn Meds (proton pump inhibitors, PPIs)7-8– a recent study in JAMA Neurology reported, “The avoidance of PPI medication may prevent the development of dementia. This finding is supported by recent pharmacoepidemiological analyses on primary data and is in line with mouse models in which the use of PPIs increased the levels of ?-amyloid in the brains of mice. Randomized, prospective clinical trials are needed to examine this connection in more detail.”7
AARP’s Top 10:
AARP lists the following classes of medications that may impair the brain which includes:
- Antianxiety drugs
2. Cholesterol drugs
3. Antiseizure drugs
4. Antidepressant drugs
5. Narcotic painkillers
6. Parkinson’s drugs
7. Hypertension drugs
8. Sleeping aids
9. Incontinence drugs
3. Functional Neurology Factors
Dr. Datis Kharrazian is a leading expert in treating chronic illness, autoimmune disease, and neurological issues. He is a faculty member at the Institute of Functional Medicine. There are many functional neurological factors to consider when someone has brain issues. Here are the three main ones I share with my clients, and they often see them on their summaries from our visits:
- Mitochondrial and neurological stimulation (exercise)-which I’ll review a little below.
- Oxygenation and circulation- in order for the brain to function, it needs proper oxygen. Factors that affect oxygenation and circulation are chronic anemias (inspect for infections10, toxins, and the factors listed above), blood volume (assessing for volume depletion or orthostatic hypotension11), and neurovascular issues.
- Blood sugar- spikes in blood sugar and chronic high blood sugar cause stress on the neurological system and can be linked to inflammation in the brain and risk for dementia. The brain needs proper sugar balance. 12-13 (Oh, and careful with those artificial sweeteners too!)
(Note: these factors are also essential for brain fatigue, energy issues (mitochondrial health), and other neurological issues.)
Food On the Brain
One study of 255 participants aged 60-64 years at baseline in 2001 completed a food frequency questionnaire and had two magnetic resonance imaging scans approximately 4 years apart.
This study of community-based older adults determined that “lower intakes of nutrient-dense foods and higher intakes of unhealthy foods were each independently associated with smaller left hippocampal volumes.” What this translates to is that diet can not only promote hippocampal health, an area associated with memory, but also prevent age-related brain atrophy.
The authors concluded the following on their findings:
They also support the extensive data from human observational and intervention studies showing that unhealthy dietary patterns are associated with increased prevalence or risk, and healthy dietary patterns with reduced risk, of depression [6, 7, 60] and reinforce the imperative to improve dietary intakes at the population level and in clinical settings for better mental health outcomes .
Their results were very impressive supporting nutrient density in the diet:
Every one standard deviation increase in healthy “prudent” dietary pattern was associated with a 45.7 mm3 (standard error 22.9 mm3) larger left hippocampal volume, while higher consumption of an unhealthy “Western” dietary pattern was (independently) associated with a 52.6 mm3 (SE 26.6 mm3) smaller left hippocampal volume. These relationships were independent of covariates including age, gender, education, labour-force status, depressive symptoms and medication, physical activity, smoking, hypertension and diabetes. While hippocampal volume declined over time, there was no evidence that dietary patterns influenced this decline. No relationships were observed between dietary patterns and right hippocampal volume.15
A 2013 meta-analysis of twenty-two studies demonstrated the power of the Mediterranean diet in modulating stroke, depressive, and cognitive health risk. This lead the authors to conclude that adherence to the Mediterranean diet (a form of a nutrient-dense eating pattern) may prevent brain diseases. Here are the specific results for the study lovers:
Twenty-two eligible studies were included (11 covered stroke, 9 covered depression, and 8 covered cognitive impairment; only 1 pertained to Parkinson’s disease). High adherence to Mediterranean diet was consistently associated with reduced risk for stroke (RR?=?0.71, 95% confidence interval [CI]?=?0.57–0.89), depression (RR?=?0.68, 95% CI?=?0.54–0.86), and cognitive impairment (RR?=?0.60, 95% CI?=?0.43–0.83). Moderate adherence was similarly associated with reduced risk for depression and cognitive impairment, whereas the protective trend concerning stroke was only marginal. Subgroup analyses highlighted the protective actions of high adherence in terms of reduced risk for ischemic stroke, mild cognitive impairment, dementia, and particularly Alzheimer disease. Meta-regression analysis indicated that the protective effects of Mediterranean diet in stroke prevention seemed more sizeable among males. Concerning depression, the protective effects of high adherence seemed independent of age, whereas the favorable actions of moderate adherence seemed to fade away with more advanced age.16
Another study was a prospective evaluation of 2,258 nondemented individuals in New York who were followed up every 1.5 years. The authors used a method to score compliance to the Mediterranean diet (MeDi) and controlled for age, sex, ethnicity, education, apolipoprotein E genotype, caloric intake, smoking, medical issues, and body mass index. The results indicated a reduced risk for Alzheimer’s disease on those who adhered strongly to the Mediterranean diet.17
Furthermore, in one study, researchers compared those who followed a traditional, western, and modern diet and scored their diet quality. The authors explain, “A traditional dietary pattern comprised mainly vegetables, fruit, beef, lamb, fish, and whole-grain foods, while a western pattern comprised foods such as meat pies, processed meats, pizza, chips, hamburgers, white bread, sugar, flavored milk drinks, and beer. A modern pattern consisted of foods such as fruits and salads plus fish, tofu, beans, nuts, yogurt, and red wine. High factor scores indicate greater consumption of these types of foods, and low scores indicate lower consumption.” (Note that the traditional diet was very similar to the Mediterranean diet). Although this study was assessing mood issues rather than cognitive health, it was found that dietary quality with a traditional eating pattern was associated with lower odds of major depression, dysthymia, and anxiety.18 This is important because mood issues can be linked to cognitive health.19
Animal Studies and Mechanisms
Animal studies which used rodents have shown links between diet and brain health. One study investigated how a high fat and refined sugar diet could influence their brains. The authors found that this dietary pattern reduced hippocampal level of brain-derived neurotrophic factor (BDNF) and negatively impacted spatial performance. There were downstream effects in the cellular signaling response for neurotransmitter release, cyclic AMP-response element-binding protein (CREB) which is required for memory, and growth-associated protein 43 mRNA, which relates to neurite outgrowth, neurotransmitter response, learning, and memory.20
Another study supported that a high fat diet also impacted BDNF and CREB, impacting synaptic plasticity in the brain and cognitive function.21
In a study with rats being fed a “cafeteria diet”, a diet high in sugar and fat or just fat without sugar, the rrats who were exposed to the sucrose had both increased hippocampal inflammation, oxidative stress, and upregulation of a signaling molecule related to neurite growth. Interestingly, the rats not given sucrose but eating “cafeteria style” didn’t show the same patterns after 5, 11, and 20 days as the rodents who got the fatty sugary meals.22
Several studies have shown that lowering caloric intake can also increase BDNF.23-24
A wonderful review on brain foods and specific nutrients can be read here. It includes the impact of omega-3 fatty acids, caloric restriction, gut hormones, flavonols, folic acid, and antioxidants (such as curcumin, vitamin E, alpha-lipoic acid, anthocyanins and phenols) on brain function.24
Exercise on the Brain
Exercise and movement have been demonstrated to be very effective for brain health.25
Click here to read more.
Essential Oils for Memory
Recently, I did a two-part series on Natural Path and I posted it on Facebook. I will be posting it soon on this website as well. It discussed the biochemistry behind essential oils and emotions, which I wrote about above as a risk factor for dementia.
As I mentioned in a previous blog, essential oils can work by more than one mode of action: biochemical, physiological, and psychological. One 2006 article review discussed the use of essential oils for mood issues. They termed it “pyschoaromatherapy.” The article, entitled, “Aromatherapy in the Management of Psychiatric Disorders: Clinical and Neuropharmacological Perspectives,” reviewed various clinical studies and mechanistic in vitro trials. The authors of this literature analysis supported a dual nature of the “indirect” and “direct” effect of aroma related to essential oils various mechanisms of actions.33
In one trial, inhalation of clary sage oil increased 5-hydroxytrptamine (the monoamine, serotonin), decreased cortisol, and alleviated mood in 22 menopausal women in their 50s.34 Furthermore, inhaling neroli (Bitter orange) excreted positive effects on menopausal symptoms, stress, and estrogen levels in another study that included sixty-three postmenopausal women.35 These two studies further demonstrate the biochemical, physiological, and psychological impact of essential oils.
Here are three more of my favorite oils to support memory and brain health:
1. Lavender- I wrote a doozy of an article on lavender a few weeks ago that discussed the many wellness effects of this calming oil. Although this oil is more for relaxation, not improving memory or focus, it can be used to protect the brain from oxidative stress and the negative impact of the stress hormone, cortisol.36
3. Rosemary- as mentioned above, rosemary may be the choice to use for cognitive performance in comparison to a more relaxing oil. One study reported:
Analysis of performance revealed that lavender produced a significant decrement in performance of working memory, and impaired reaction times for both memory and attention based tasks compared to controls. In contrast, rosemary produced a significant enhancement of performance for overall quality of memory and secondary memory factors, but also produced an impairment of speed of memory compared to controls. With regard to mood, comparisons of the change in ratings from baseline to post-test revealed that following the completion of the cognitive assessment battery, both the control and lavender groups were significantly less alert than the rosemary condition; however, the control group was significantly less content than both rosemary and lavender conditions. These findings indicate that the olfactory properties of these essential oils can produce objective effects on cognitive performance, as well as subjective effects on mood.37
Still, the combination may be a good idea. In one study, both lavender and rosemary were shown to increase antioxidant capacity and decrease cortisol. The study included 22 healthy volunteers and measured salivary cortisol and FRSA (free radical scavenging activity).38
In another correlation study with 20 volunteers, the concentration of the constituent 1,8 cineole (found in the participants’ blood after inhaling rosemary) was found to be associated with an improvement in cognition. In the study, the “participants were randomly assigned to be exposed to the aroma in the cubicle for 4, 6, 8 or 10 min prior to completing the cognitive tests. This period was not kept constant so as to facilitate a range of levels of absorption of compounds to take place across the participant group.”
The authors felt this was through several independent neurological pathways. They suggested the effects may be due to the blocking of acetylcholinesterase and butyrylcholinesterase enzymes 40 and its monoamingeric effects (antidepressant) effects.41 The authors wisely imply that synergism of various constituents may also be at play and that the mood effects of the scent may also impact cognitive results.
Interesting, in this study, rosemary had a negative correlation on contentedness and did not seem to impact attention or alertness. One downfall was the small sample size, but the statistical analysis and the mechanisms support the results. 39
In another study from the University of Northumbria presented at the Annual Conference of the British Psychological Society in Harrogate, it was suggested that “this essential oil may enhance the ability to remember events and to remember to complete tasks at particular times in the future.”42
I like to combine rosemary, peppermint, and lavender for my clients with memory concerns. I suggest using the lavender at bedtime and the rosemary and peppermint during the day. Frankincense is another favorite due to all its modes of actions which you can read about in my articles on my essential oils database. My database also contains information on safely using essential oils and dosages.
Although the concern for Alzheimer’s disease and cognitive decline is a real issue, by addressing the root causes and eating a nutrient-dense diet, exercising, applying functional neurology principles, and using essential oils, we can support our brains to be healthy and happy throughout our lives.
- Harvard TH CHAN. Press Release: International survey highlights great public desire to seek early diagnosis of Alzheimer’s. July 22, 2011. http://www.hsph.harvard.edu/news/press-releases/alzheimers-international-survey/
- Americans Rank Alzheimer’s as Most Feared Disease, According to New Marist Poll for Home Instead Senior Care. Reuters. November 13, 2012. http://www.reuters.com/article/idUS129170+13-Nov-2012+BW20121113
- Alzheimer’s Association. Nearly 60 percent of people worldwide incorrectly believe that Alzheimer’s disease is a typical part of aging. June 19, 2014. http://www.alz.org/news_and_events_60_percent_incorrectly_believe.asp
- Gray SL, Anderson ML, Dublin S, et al. Cumulative Use of Strong Anticholinergics and Incident Dementia: A Prospective Cohort Study. JAMA Intern Med. 2015;175(3):401-407. doi:10.1001/jamainternmed.2014.7663.
- Anticholinergic Burden Scale: 2012 Update. 2008, 2012. Regenstrief Institute, Inc. http://www.agingbraincare.org/uploads/products/ACB_scale_-_legal_size.pdf
- Merz, B. Common anticholinergic drugs like Benadryl linked to increased dementia risk. Harvard Health Blog. January 28, 2015. http://www.health.harvard.edu/blog/common-anticholinergic-drugs-like-benadryl-linked-increased-dementia-risk-201501287667
- Feller, B. Heartburn medications associated with higher dementia risk. February 15, 2015.
- Gomm W, von Holt K, Thomé F, et al. Association of Proton Pump Inhibitors With Risk of Dementia: A Pharmacoepidemiological Claims Data Analysis. JAMA Neurol. Published online February 15, 2016. doi:10.1001/jamaneurol.2015.4791.
- Neel A. 10 Drugs That May Cause Memory Loss. AARP. http://www.aarp.org/health/brain-health/info-05-2013/drugs-that-may-cause-memory-loss.html#quest1
- Pieracci FM, Barie PS. Iron and the risk of infection. Surg Infect (Larchmt). 2005;6 Suppl 1:S41-6. doi: 10.1089/sur.2005.6.s1-41.
- Freidenberg DL, Shaffer LE, Macalester S, Fannin EA. Orthostatic hypotension in patients with dementia: clinical features and response to treatment. Cogn Behav Neurol. 2013 Sep;26(3):105-20. doi: 10.1097/WNN.0000000000000003.
- Improving blood sugar control could help prevent dementia in patients with type 2 diabetes, study suggests. ScienceDaily. 14 September 2015. www.sciencedaily.com/releases/2015/09/150914224312.htm.
- Harvard Health Publications. Blood sugar on the brain. April 1, 2015. http://www.health.harvard.edu/diseases-and-conditions/blood-sugar-on-the-brain
- Deans E, Ramsey D. Medscape Psychiatry: Commentary-How Diet Influences Mental Health: New Findings, New Advances. Medscape. UPI. February 11, 2016. http://www.upi.com/Health_News/2016/02/15/Heartburn-medications-associated-with-higher-dementia-risk/8821455567164/
- Jacka FN, Cherbuin N, Anstey KJ, Sachdev P, Butterworth P. Western diet is associated with a smaller hippocampus: a longitudinal investigation. BMC Med. 2015;13:215.
- Psaltopoulou, T., Sergentanis, T. N., Panagiotakos, D. B., Sergentanis, I. N., Kosti, R. and Scarmeas, N. Mediterranean diet, stroke, cognitive impairment, and depression: A meta-analysis. Ann Neurol. 2013; 74: 580–591. doi: 10.1002/ana.23944
- Scarmeas N, Stern Y, Tang M-X, Mayeux R, Luchsinger JA. Mediterranean Diet and Risk for Alzheimer’s Disease. Annals of neurology. 2006;59(6):912-921. doi:10.1002/ana.20854.
- Jacka F, Pasco J, Mykletun A, Williams L, Hodge A, O’Reilly S, et al. Association of Western and traditional diets with depression and anxiety in women. Am J Psychiatry. 2010;167:305–11.
- Thompson D. Light Shed on Link Between Depression, Dementia. WebMD- Health Day News. July 30, 2014. http://www.webmd.com/depression/news/20140730/scientists-shed-light-on-link-between-depression-dementia
- Molteni R , Barnard RJ , Ying Z , Roberts CK , Gomez-Pinilla F : A high-fat, refined sugar diet reduces hippocampal brain-derived neurotrophic factor, neuronal plasticity, and learning. Neuroscience 2002; 112:803–814
- Wu A, Ying Z, Gomez-Pinilla F. The interplay between oxidative stress and brain-derived neurotrophic factor modulates the outcome of a saturated fat diet on synaptic plasticity and cognition. Eur J Neurosci. 2004;19:1699–707.
- Prats E, Monfar M, Castellà J, Iglesias R, Alemany M. Energy intake of rats fed a cafeteria diet. Physiol Behav. 1989 Feb;45(2):263-72.
- Guimaraes LR, Jacka FN, Gama CS, Berk M, Leitao-Azevedo CL, de Abreu MG B, et al. Serum levels of brain-derived neurotrophic factor in schizophrenia on a hypocaloric diet. Prog Neuropsychopharmacol Biol Psychiatry. 2008;32:1595–8.
- Gómez-Pinilla F. Brain foods: the effects of nutrients on brain function. Nature reviews Neuroscience. 2008;9(7):568-578. doi:10.1038/nrn2421.
- Bergland C. Why Is Physical Activity So Good for Your Brain? Exercise improves the structure, function, and connectivity of your brain. Psychology Today. Sep 22, 2014. https://www.psychologytoday.com/blog/the-athletes-way/201409/why-is-physical-activity-so-good-your-brain
- Ahlskog JE, Geda YE, Graff-Radford NR, Petersen RC. Physical Exercise as a Preventive or Disease-Modifying Treatment of Dementia and Brain Aging. Mayo Clinic Proceedings. 2011;86(9):876-884. doi:10.4065/mcp.2011.0252.
- Duzel E, van Praag H, Sendtner M. Can physical exercise in old age improve memory and hippocampal function? Brain. 2016;139(3):662-673. doi:10.1093/brain/awv407.
- Scarmeas N, Luchsinger JA, Brickman AM, et al. Physical Activity and Alzheimer’s disease course. The American journal of geriatric psychiatry?: official journal of the American Association for Geriatric Psychiatry. 2011;19(5):471-481. doi:10.1097/JGP.0b013e3181eb00a9.
- Middleton LE, Barnes DE, Lui L-Y, Yaffe K. Physical Activity Over the Life Course and its Association with Cognitive Performance and Impairment in Old Age. Journal of the American Geriatrics Society. 2010;58(7):1322-1326. doi:10.1111/j.1532-5415.2010.02903.x.
- Jedrziewski MK, Ewbank DC, Wang H, Trojanowski JQ. Exercise and cognition: Results from the National Long Term Care Survey. Alzheimer’s & dementia?: the journal of the Alzheimer’s Association. 2010;6(6):448-455. doi:10.1016/j.jalz.2010.02.004.
- Geda YE, Roberts RO, Knopman DS, et al. Physical Exercise and Mild Cognitive Impairment: A Population-Based Study. Archives of neurology. 2010;67(1):80-86. doi:10.1001/archneurol.2009.297.
- Demirakca T, Cardinale V, Dehn S, Ruf M, Ende G. The Exercising Brain: Changes in Functional Connectivity Induced by an Integrated Multimodal Cognitive and Whole-Body Coordination Training. Neural Plasticity. 2016;2016:8240894. doi:10.1155/2016/8240894.
- Nicolette P, Elaine P. Aromatherapy in Management of Psychiatry Disorders: Clinical and Neuropharmacological Perspectives. CNS Drugs. 2006; 20(4): 257-280.
- Lee KB, Cho E, Kang YS. Changes in 5-hydroxytryptamine and cortisol plasma levels in menopausal women after inhalation of clary sage oil. Phytother Res. 2014 Nov;28(11):1599-605.
- Choi SY, Kang P, Lee HS, Seol GH. Effects of Inhalation of Essential Oil of Citrus aurantium amara on Menopausal Symptoms, Stress, and Estrogen in Postmenopausal Women: A Randomized Controlled Trial. Evidence-based Complementary and Alternative Medicine?: eCAM. 2014;2014:796518. doi:10.1155/2014/796518.
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- Atsumi T, Tonosaki K. Smelling lavender and rosemary increases free radical scavenging activity and decreases cortisol level in saliva. Psychiatry Res. 2007 Feb 28;150(1):89-96. Epub 2007 Feb 7.
- Moss M, Oliver L. Plasma 1,8-cineole correlates with cognitive performance following exposure to rosemary essential oil aroma. Therapeutic Advances in Psychopharmacology. 2012;2(3):103-113. doi:10.1177/2045125312436573.
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