Healthy diet for a healthy brain
View(s):This month the world commemorates World Alzheimer’s Month with the focus on better awareness and research about the disease. With Sri Lanka’s fast ageing population (currently 147,000 people are estimated to be living with dementia in the country) the time is ripe for a discussion on lifestyle choices that can perhaps prevent or even delay the possible onset of Alzheimer’s disease.
In this issue of MediScene, we speak to Dr. Shehan Williams, a Consultant Psychiatrist and Head, Department of Psychiatry at the University of Kelaniya about the role nutrition can play in possibly alleviating the risk factors for Alzheimer’s; Dr. Renuka Silva, a senior lecturer on Human Nutrition at the Wayamba University on a healthy diet for a healthy brain and Milithra Wickramarachchi, Director of Care at Cinnamon Care on useful tips on caring for the nutritional wellbeing of a person already identified as having Alzheimer’s.
Alzheimer’s disease is one of the main causes of dementia, a condition which results in brain cells degenerating at a faster rate than normal, causing impairment in memory, thinking, orientation, language and social behaviour. Several animal and laboratory studies have shown that Alzheimer’s involves oxidative and inflammatory processes; the ultimate outcome is the disruption of neuronal cell function and signalling, leading to neuronal cell death.
The importance of a preventive measure for Alzheimer’s disease is heavily underscored by Dr. Williams, who admits that “we’re in one sense clutching at straws” but that lifestyle changes are more important than ever, with nutrition being a main modifiable factor. Any risk factor for vascular diseases or stroke can also increase the risk of getting Alzheimer’s, he says – “it is essentially about the integrity of the circulatory system with age.” Thus countering the risk factors associated with vascular disease in particular- such as diabetes, midlife hypertension, midlife obesity, smoking and physical inactivity- is recommended based on available evidence.
Understanding of dietary influences on Alzheimer’s disease is still at a formative stage, with no conclusive evidence to establish with absolute certainty that certain nutrients may prevent or cause the condition. The best evidence of disease prevention involves the antioxidant nutrients vitamins E and C. Animal and laboratory studies demonstrate that the antioxidant nutrients and vitamin E in particular, protect the brain from damage due to oxidative and inflammatory mechanisms.
“It’s very important that we consume more anti-oxidants with our food,” Dr. Williams notes. Other nutrients he recommends include B12 and folic acids, plus omega three fatty acids. These nutrients can be found commonly in many food items that we consume in Sri Lanka (see box above).
“Asians have smaller arteries in comparison to Caucasians in for instance, Europe or America. We are nevertheless now adopting Western food habits. This is in stark contrast to what we used to eat traditionally for generations” notes Dr. Williams. “We ate a lot of vegetables, little meat and very little processed substances. The oils we consumed were usually in coconut, and even then it was through something like a mallum. Now we’re on a diet of tempered and fried food made up of processed ingredients and we do a lot less physical activity on top of all this. The Body Mass Index of the average Sri Lankan is also increasing-this generation will live to regret their eating habits.”
| Raising awareness In Sri Lanka the Lanka Alzheimer Foundation has taken on the role of raising awareness about the condition and providing information and assistive measures for those with Alzheimer’s and their families. Call them on 0112667082 for more information. |
Dr. Renuka Silva advocates obtaining your nutrients through natural produce as much as possible. “As a nutritionist I would prefer if vitamins E and C, folate (folic acid), B12, and B6 nutrients are obtained in their natural form. Pills must act as insurance, not a replacement,” he warns. Dr. Silva also recommends less saturated fat intake, advising instead to opt for unsaturated fats found in oily fish like mackerel and tuna.
He stresses the lack of conclusive medical evidence that shows a strong association between nutrients and Alzheimer’s but notes that preventive measures for vascular disease in particular have found to be beneficial in ensuring the health of your brain.
Milithra Wickramaarachchi strongly recommends simplifying mealtimes for those with Alzheimer’s. “Most have no idea what they’re being served, so it’s important to keep portions small and regular and very easily consumable,” she says.
Milithra’s tips:
1. Soups are a great way to ensure that the right nutrients are received. Blend and serve in a mug/cup with a handle, and not a bowl.
2. Finger food (eg: sandwiches, vegetable sticks, etc)
3. Porridge and bananas for breakfast for fibre, which will aid with digestion.
4. Describe what’s being served to encourage taste and smell perception.
In addition she recommends incorporating physical activity during the day.