August 2023 Newsletter | Smarter Maybe Not Harder
My mission is to be the first woman in 4 generations to not develop Alzheimer’s Disease (AD). On my journey of discovering ways to mitigate my risk, I pass this information on to you in this Brain-Body-Health (BBH) Newsletter.
“Summertime and living is easy…”
by Louis Armstrong
Many of us recall childhood summers filled with lots of free time to play, explore, or just hang with friends. With school out and 3 months off it felt like true freedom. That’s what I have been exploring lately… this feeling of ease and freedom.
It comes as a welcome reminder that one does not always need to push, drive, and strive for optimal health. This is the season to relax as summer beckons us to slow down and take it easy. In France, where I completed my first 2 years of medical school, I was pleasantly surprised that the whole country goes on vacation for the month of August. And one of my favorite summers was the year I decided to postpone my residency so I could spend time with my then 5-year-old son, Ross. The fond memories of picnics, museums, and camping together, still linger.
Ease and freedom… got me hooked on the new book “Smarter Not Harder” after my sister sent me this podcast. Some may recognize the author Dave Asprey who is best known for Bulletproof Coffee and his infamous biohacking.
The question arising for me is: Could optimizing BrainBodyHealth be any easier?
According to Mr. Asprey, probably everything could be easier and require less time. Since I do a lot of exercise I was most interested in the section on exercise. There is a plethora of evidence-based studies on exercise showing improvement in cardiorespiratory health and related brain health. Could we reduce our time exercising and still get benefits? Mr. Asprey explains that doing the right amount of exercise, intensity and time is important but the 'real secret' is what he calls the “slope of the curve” based on how quickly you do your workout and how quickly your body returns to baseline. He is talking about a time-efficient alternative to Moderate-Intensity-Continuous Training (MICT) which most of us would consider a typical aerobic workout. Doing High-Intensity-Interval-Training (HIIT) has cardio and aerobic benefits. The new kid on the block is called Reduced-Exertion-High-Interval-Training (REHIT), and to complicate acronyms, there is Sprint-Interval-Training (SIT). The studies are showing quite impressive improvements in cardiorespiratory health, aerobic capacity, and reduction in adiposity compared to MICT with a much shorter time actually spent exercising. Sounds counterintuitive, right? The idea for REHIT/ SIT is you push yourself to maximum aerobic capacity for 20 seconds essentially sprinting and then resting for a period until your heart rate returns to normal. This takes about 5-10 minutes. Then you repeat the sprint and rest period. Maximum time spent of 10- 20 minutes and that’s it. Think of it like you are resetting your computer and reaping the benefits for your heart and brain.
This is just one example of how we can utilize new strategies for getting ‘Smarter Not Harder”. In the meantime, I’m making my way through more ‘hacks’ and finding interesting ways to create better health while having more ease and freedom to play the ukulele, do art, or maybe just stare at the clouds and smile back. ;) Hope you are enjoying your summer with ease and freedom as well.
LESSONS FROM COACHING:
What exactly is MCI or Mild Cognitive Impairment and how does it relate to dementia?
More people are coming into my coaching practice with a diagnosis of MCI. First off, let's be clear MCI can be a precursor to AD. Like Cancer, we can stage AD (BBH Newsletter July) but there is nothing about it that should include the word mild. When one is diagnosed with cancer there is NO mild type of cancer, just like there is no mild type of AD. MCI has become a catch-all term that came along when we didn’t understand memory impairment very well and before our current staging system. The MoCa test (Montreal Cognitive Assessment) is based on a total of 30 points. A score of 25 or less is considered to be an indication of some form of cognitive impairment, 18-25 points is mild, 10-17 moderate, and below 10 severe. The value of the MoCa is that it is a simple test 10-15 minutes long and can be administered by clinic staff. It doesn’t require a doctor.
MCI indicates something has gone wrong in the brain causing a decrease in cognition attention, mood, or behavior. It is not something to be taken lightly. A lack of energy to certain areas of the brain is occurring and sending a message to you. The brain is saying “I am not well”. Remember the brain is an energy hog requiring 20% of all energy produced by the body.
At best, MCI is a diagnosis that lets you know something is not right with the brain but it’s not a time to stop searching for the root cause of this energy imbalance. It's more of a smoke signal or call for help.
Like our car not working well, there are many causes of cognitive/ memory impairment. The real issue is seeing a skilled provider who, like a good mechanic, will not give up until there is a clear understanding of why these symptoms are happening in the brain and make sure they are addressed. Time is of the essence because we know that sometimes MCI can be completely reversed but the longer it goes on the more likely it will progress to dementia at a rate of 15% per year.
Most importantly we know early diagnosis means better treatment options and planning for the future.
Dementia, on the other hand, is an umbrella term. It is defined as a decline in mental ability that interferes with daily life accompanied by cognitive, memory, personality, and behavioral changes. There are many causes of dementia. AD is the cause of 60-70%, 10-20% vascular disease, other causes include alcohol substance abuse disorder, traumatic brain injury, vitamin deficiencies, toxic exposures, biochemical imbalances, etc… Dr. Dale Bredesen likens MCI and dementia to a leaky roof with 39 holes. You have to plug all 39 of the holes or the roof will continue to leak. If you just plug a few the brain/ roof may get a little better, but you need to keep searching and patching all of the holes. The aging brain is tricky. It needs more frequent inspections or it will become like our leaky roof. Make sure you see a qualified healthcare provider who works with persons with memory impairment to help you sleuth out the holes, repair them, and keep searching for more possible leaks in the system.
I continue to offer coaching to help get you started in the process of deciphering your brain's health. Don't forget to give me a call if you're concerned about your brain's health or the brain health of a loved one. These sessions can be done through Zoom too!
I mentioned the new criteria for staging AD in last month’s BBH Newsletter and will go over this in future newsletters.
LESSONS FROM SCIENCE:
Randomized Controlled Study (RCT). Sprint-interval cycling reduces adiposity and increases aerobic capacity more than continuous moderate-intensity cycling of equal estimated energy expenditure in overweight/obese young women.
This study showed REHIT was associated with a significantly larger increase in maximal aerobic capacity compared with walking.
Greater increases in VO2max were achieved for L-HIIT (p = 0.04) and S-HIIT (p = 0.01) in comparison to the MICT group, with no significant difference between L-HIIT and S-HIIT (p = 0.9).
An RCT shows that reducing REHIT training frequency from 3 or 4 to 2 sessions/week does not attenuate (reduce) improvements in the key health marker of maximal aerobic capacity. In other words, less REHIT is better than more.
Interval training has recently become popular because it is more time-efficient and sometimes more enjoyable than MICT (Bartlett et al., 2011; Jung et al., 2014).
To our optimized health!
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“If you want to go FAST, go alone. If you want to go FAR, go together."
- African proverb
To our optimized health!