We often think of how our diets contribute to our physical fitness, but we shouldn’t discount how they impact our brain health, too. Dr. Annie Fenn is the founder of the Brain Health Kitchen and, in partnership with the University of Texas at Dallas Center for Brain Health, she talks to host Krys Boyd about brain-friendly eating patterns, understanding how “good” and “bad” fats affect us, and offers simple recipe ideas for incorporating these foods into every meal. Her book is “The Brain Health Kitchen: Preventing Alzheimer’s Through Food.”
This episode first aired Sept. 19, 2024
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Transcript
Krys Boyd [00:00:00] Waking to that impossibly early alarm, slipping on our running shoes and hitting the pavement for a quick jog, boosts endorphins, keeps us trim, and we now know there’s a lot of science that says physical activity keeps our brain healthy, too. But how does what we eat contribute to brain health? Does sneaking that cookie after lunch or drinking a second cup of coffee affect our odds of developing things like dementia in our older years? Turns out, just like that daily morning jog, there is a diet regimen you should be following to keep your brain in tip top shape. From KERA in Dallas. This is Think I’m Krys Boyd. Doctor Annie Fenn is a board certified Ob-Gyn who left the profession to found the Brain Health Kitchen. It’s a cooking school focused on preventing cognitive decline through food. Her book is “The Brain Health Kitchen: Preventing Alzheimer’s Through Food.” I spoke with her in front of a live audience recently at the University of Texas at Dallas’ Center for Brain Health. And today, we’re going to hear that conversation. So, Annie, you are a board certified Ob-Gyn. You’ve always had an interest in healthy cooking. But tell us about the confluence of events in your life that really led you to shift your full time focus to food.
Annie Fenn [00:01:17] Well, my story is a little bit different. And, you know, I would not have predicted the way things played out for me, but when I look back on it, it makes perfect sense. I think my story is, one of someone who just follows their passion like we’re all supposed to, right? But it’s hard to do that sometimes. So I loved being an Ob-Gyn more than anything in the world. But 20 years in, I was getting a little antsy. I can’t barely explain it, except that I wanted to do something more creative. And I was very tied down by having a medical practice and having my schedule booked out for many months in advance. And of course, the lifestyle is very unhealthy. If there’s any MDS in the in the room, I just I just feel for you, you know, the lack of sleep, the poor food that you have access to in hospital systems. Usually it’s getting better. And also the an ordered amount of stress. So I was feeling it 20 years and I was just starting to feel it. So I did something completely radical. I decided to give up my practice. My patients said they would never forgive me. I had some older ladies who said that I was supposed to be their doctor until they passed, and I said, sorry, I’ll find you another doctor. And I didn’t know what I was going to do, but I knew I was interested in was following some creative passions, and one of those was cooking. I’ve always been a cook, and, I’ve always loved to share recipes. I even had a food blog. I’m from Jackson Hole, Wyoming, I had this food blog called Jackson Hole Foodie. While I was a doctor, where I would just basically write recipes and share it. So I decided to pursue some culinary training and I had this dream. It was sort of a naive idea back then that I would open a cooking school and help people eat better to reduce their risk of chronic disease, because even as an Ob-gyn, I felt like that was the root cause of most of people’s problems. And so it all really became a true epiphany for me when my mother was diagnosed with mild cognitive impairment, which you all probably know is an early stage of Alzheimer’s disease. And so when my mom was diagnosed, it could not have been more crystal clear that I should use my medical background, whatever culinary training I picked up, and use it to spread the word that Alzheimer’s is largely preventable and that lifestyle is our most important tool.
Krys Boyd [00:03:37] We’ve all heard for so long about our eating habits and the role they might play in cardiovascular disease and diabetes. Why did it take so long for science to pay serious attention to the links between diet and brain health?
Annie Fenn [00:03:52] Oh boy, do I love that question. You know, they say that it takes about 17 years between when a scientific study is published in a medical journal until it filters down into common knowledge amongst the public. All I can say is that, you know, medicine is very conservative and it takes years and years of study. And I know you all know this, where it comes to studying dementia and Alzheimer’s and other neurodegenerative diseases. It takes decades of studies and large clinical trials to see any difference at all. So, you know, the idea was just really not taken seriously. When I was starting out in this field, even in 2013, 2014, the fact that food is neuroprotective and dietary pattern is preventative, it just wasn’t taken seriously until the data got people’s attention and it just started piling up.
Krys Boyd [00:04:46] Lifetime risk for Alzheimer’s disease is higher than people may realize, and especially for women. Is that perhaps because our brains and bodies are different, or because our lives are different?
Annie Fenn [00:04:58] Well, I think it’s. multifactorial. Just like everything that is complicated in medicine and in life, there are many factors is never one reason someone goes into pre-term labor. There’s ever one reason someone has a heart attack. Usually it’s the same thing with developing Alzheimer’s or other dementias. And for women, you know, luckily, this is finally becoming an area of research like, why are women getting more Alzheimer’s in women? Why are two thirds of all Alzheimer’s victims female? Is that something structural in the brain? Is it because women go through periods with a life where they’re not sleeping? You know, when they are, you know, pregnant or postpartum or during the menopause? I think it’s all contributing. But there’s some really great research going on now looking at the female brain and what happens to it during menopause. And I know you’ve all probably been following the research, doctor Lisa Mosconi and Doctor Roberta Brinton and others, but now we know that menopause is actually a transition time, that the brain is vulnerable to the very earliest signs of Alzheimer’s. So now we’re paying more attention to women at that stage of their life to see what we can do to prevent Alzheimer’s later.
Krys Boyd [00:06:07] I think for a long time, people avoided even thinking about their Alzheimer’s risk because the perception was there was absolutely nothing that could be done. It turns out that is not the case.
Annie Fenn [00:06:18] That is not the case. It’s still out there. That idea is still out there. And I know all of you are brain health ambassadors. I know all of you are spreading the word, but it’s so important that people know, you know, in their bones that Alzheimer’s is largely preventable. The most conservative body, the Lancet Commission, is a group of Alzheimer’s experts who meets every few years, and they talk about what are the preventable risk factors for Alzheimer’s. They just convened and updated it to 14 modifiable risk factors. Now, this is the most conservative body looking at the most critical data, the data that, you know, has to be a randomized controlled trial of super high quality. And they have determined that 45% of all worldwide cases of dementia can be eliminated if these 14 factors are addressed. Now, other people in the brain health world think that number is closer to 60% or even 70%. But we’re getting there. We’re getting there. It’s a lot of brains, a lot of brains.
Krys Boyd [00:07:18] So the Brain Health kitchen and the recipes that come from it are very much incorporated with the Mind Diet. Can you explain what that is?
Annie Fenn [00:07:25] Yeah. So the Mind Diet is a spinoff of the Mediterranean Diet, and it was created by Doctor Martha Claire Morris, who was a nutritional epidemiologist at Rush University. Now, what Martha Claire did, she had this brilliant idea, and she’d been studying food and the brain for over 20 years. At this point, we know that the Mediterranean diet had about 35 studies to show that it’s associated with longevity and heart health, and we know that what’s good for the heart is good for the brain. It’s an axon of brain health, right? So she asked the question, what did you take the Mediterranean diet. And you make it more brain specific. And that’s what she did. She took that Mediterranean dietary pyramid, which there’s a picture of it in my book. I’m sure you know what it is. And she pulled out the different food groups that she had been studying and made them their own brain healthy food groups, like berries. She had a pile of research showing that people consume berries twice a week. They had better memories. They do better in cognitive tasks and people that don’t eat berries. Same thing with leafy greens. At that point, she had already had MRI data showing that people’s brains look younger if they eat a big salad most days compared to people that don’t. So we are she was putting all this together in the mind diet, and it’s basically a hybrid, Mediterranean and the Dash diet, which is used to reduce hypertension. So this was a very landmark study that came out in 2015, looking at over 900 adults who were dementia free. They were tested cognitively to make sure they didn’t have dementia. At the beginning of the study, they were given mind diet guidelines, ten brain healthy food groups five food groups to limit or avoid. If you have a bookmark with one of your books, I have those listed for you for handy reference. But the landmark thing about the study was over four and a half years doing nothing else but changing what they ate, just changing up the food groups, what they ate. They were able to reduce the risk of Alzheimer’s by 53%, 53%. And another great thing I love about the study is that people that didn’t follow the diet very well, you know, there’s people that will adhere to guidelines and people that will cheat all the time. And the people that were kind of cheating on the diet, but following it, sometimes they had 37% less Alzheimer’s at the end of the study. These are remarkable numbers.
Krys Boyd [00:09:41] To be clear, you’re not talking about a detox. You’re not talking about an eight week program. You’re talking about changing for the rest of our lives the way we eat. But I should say, this is not a disappointing set of changes, like the things that we can eat on the this mind diet from the Brain Health kitchen are things most people like.
Annie Fenn [00:10:01] That’s the that’s the beauty of it, Krys. Honestly, it’s very simple. It’s very accessible. It’s not expensive. You don’t need special food. You you might love lion’s mane mushrooms, but you don’t have to go buy those. They’re very expensive. The food is delicious. The preparation is simple. It is very simple. And I think that nutrition has gotten way too complicated for most people. So this is a way to distill it down into a way of eating that is sustainable. I mean, this is not a diet. You go on in January and then you go off of it in February. This is a way that I know it’s not Whole30. It’s not Whole30. It’s a way of eating that you figure out for yourself what is the best version of this dietary pattern in a way that makes it delicious and easy and doable, so that you just eat that way for the rest of your life.
Krys Boyd [00:10:52] So what is it about berries that get their own special line as a food group? What makes them better even than some other healthy fruits?
Annie Fenn [00:11:00] Well, berries are the only fruit that’s called out as a brain fruit. It’s not that the other ones don’t have merit, but berries are special. They’re packed with fiber. Fiber is a very important component of brain healthy foods. They are packed with flavonoids. Flavonoids are basically polyphenols, which are antioxidants in food. But this particular type of polyphenol passes the blood brain barrier has special, specific roles in the brain to block oxidative stress. And people eat a lot of berries are basically flooding their brains with these flavonoids that have been shown to be very powerful in reducing Alzheimer’s risk.
Krys Boyd [00:11:38] Is it okay if they’re not in season? Can we buy frozen berries and get some benefits?
Annie Fenn [00:11:42] Absolutely. Frozen is just as good as fresh. In fact, frozen is sometimes better than fresh depending on where you live. If you live in Wyoming like I do, you’re only going to get really good, fresh, nutritious berries for a few months of the year. So I always keep my freezer stocked with frozen berries, and they’re more economical too for most people.
Krys Boyd [00:12:00] So as you mentioned, leafy greens are also their own category, separate from other vegetables which are also there. How can we work in enough servings of leafy greens without eating three salads a day?
Annie Fenn [00:12:10] Well, the the guidelines for the mind diet, as well as a mediterranean diet, is roughly one cup of leafy greens raw per day. That’s a small handful. I upped it to two cups based on some recent data that came out since the mind diet about increasing the plants in your diet because it nurses your gut microbiome by increasing the fiber in your diet, and also flavonoids. So I’m asking two cups a day, two cups raw. It’s really not that much. And I like to get off to a good start in the morning by taking a box of arugula or a box of baby spinach. That’s pre-washed I take the box out, I throw two handfuls in a in a sauté pan, and I use it to poach my eggs. So I like to start the day with some leafy greens or some vegetables just to get off on the right track.
Krys Boyd [00:12:56] As for the other vegetables we eat, you think a third of them should be cruciferous? So things like broccoli, bok choy, cauliflower. What’s so special about cruciferous vegetables?
Annie Fenn [00:13:05] Cruciferous vegetables are probably the most nutrient dense vegetables. They also contain a powerful antioxidant called sulforaphane. And you’ve probably, you know, know that this compound has anti-cancer properties. There’s also has anti-inflammatory properties. Now, when I say anti-inflammatory, I mean that when you eat these foods, it gets broken down into their components in your gastrointestinal tract. And these nutrients actually cross the blood brain barrier. And their job is to really quell chronic inflammation in the brain. You know, if you’ve been reading about Alzheimer’s, you know that Alzheimer’s is not one thing. There’s all these different pathways to Alzheimer’s. But most experts believe the chronic inflammation is the root cause. So anything you can do to reduce inflammatory particles in the brain, like, you know, eating a lot of healthy cruciferous foods or reducing responder pollution or reducing stress, it’s all sort of the same, the same process.
Krys Boyd [00:14:03] You’ve mentioned mushrooms here a couple of times. They’re an honorary vegetable for you, even though they’re actually a fungus.
Annie Fenn [00:14:09] Yes, mushrooms are a fungus. We all know that. But there’s some very interesting studies about mushrooms, so I wanted to include them somehow. They’ve never really been addressed in any of the the Mediterranean or mind diet studies or the green med study or some of the other ones. But there are four population trials, in Singapore, Asia, Japan, northern Italy, looking at elderly populations who consume mushrooms twice a week. And they’re serving size is one half cup cooked. So it’s very small serving the mushrooms and their dementia rates. Just from this one. Food is about 40 to 50% lower depending on where they live. So interesting. But there’s also basic science data to support that. There are bioactive some mushrooms that may be helping our brains. It doesn’t mean you have to start drinking mushroom coffee or mushroom matcha if you don’t like it. Obviously this is being. Marketed to the hilt, right? And anything that tells you it’s going to improve your brain health is, you know, probably on some flimsy data. But eating mushrooms is definitely a good thing if you like them, if you like them.
Krys Boyd [00:15:12] Fish has long had this reputation as brain food. Does that actually hold up to science?
Annie Fenn [00:15:17] Fish is absolutely brain food. Is there anybody here who does not like to eat fish? Most people eat fish. That’s really great. Most Americans don’t do really well when it comes to fish and seafood. Unless you live on the coast. Hard to get good quality fish inland. But there’s one thing in fish that you can’t get from your body that your body cannot manufacture. It’s the essential omega three fatty acids, which are DHA and EPA. You have to get these from marine base fish, simply cold water fish. And these are crucial brain health nutrients. So there’s a strong argument for vegetarians and vegans. If you don’t wanna eat fish and seafood, that’s completely fine. You can still be a very brain healthy person. Have a brain healthy diet. But there’s a strong argument for supplementing with these omega threes because of that. Important.
Krys Boyd [00:16:06] If I walk into a pharmacy they want to tell me you don’t need to eat fish. You can just buy these capsules of things like fish oil. What do we know about the effectiveness of those as compared with the actual food?
Annie Fenn [00:16:17] Well, it’s you basically have to have a bit of a chemistry degree to read those labels. It’s very, very complicated. Most of the data on fish oil, supplements and health pertains to cardiovascular health. Okay. And there’s a long, decades long story of research of taking fish oil to reduce the risk of heart attack and stroke. Now, the omega three that is cardioprotective is EPA. The one that is brain protective is DHA. So if you’re shopping for a fish oil supplement and you want it to penetrate the brain and be brain protective and reduce your risk of dementia later, then it has to be mostly DHA. So that’s one trick that’s important to know. It also needs to be bound to the same thing it’s bound to in fish, which is a phospholipid. So you look for that word phospholipid on the label. Like I said, you basically have to have a chemistry background. And those can be very beneficial for brain health, but there’s no randomized control trials to prove. So it’s all riding on a lot of basic science knowledge.
Krys Boyd [00:17:21] What about canned fish?
Annie Fenn [00:17:24] Can fish can be fantastic, especially canned salmon. Yeah. So the cold water fish that are highest in DHA and lowest in mercury and other environmental toxins have an acronym called S.M.A.S.H. Does anybody know S.M.A.S.H? So it’s salmon, preferably wild caught salmon, mackerel, anchovies sardines and herring.
Krys Boyd [00:17:47] A lot of little fish.
Annie Fenn [00:17:48] Yeah, a little fish. And you know, the great thing about that is they’re more environmental friendly, too, because they’re small. They’re less likely to bio accumulate toxins like a big fish, like a shark or a swordfish or tuna. So that little fish are they’re they’re better for brain health. They’re more economical. They have more of these omega three fats that you need, and you can get them in a can.
Krys Boyd [00:18:12] I had heard the warnings about not over consuming tuna because of the mercury hazard, but you would explain in the book that there are some things we gotta understand about those warnings.
Annie Fenn [00:18:22] Yeah, you don’t have to be as concerned about light tuna. And light canned tuna is I mean, it’s a staple of the American diet, right? It’s an inexpensive whole food that people can afford to eat a lot. It’s an important source of protein. I don’t want people to be concerned about that. And the other thing about mercury in the brain is it’s kind of hard to think of it this way, but mercury is more detrimental to a young brain than an older brain, because when the nervous system is rapidly changing, like an a baby or a child, it can accumulate this mercury more in older adults, not so much. So, doctor Martha, Doctor Martha Claire Morris, the Rush University, researcher, she actually did a study on this. She looked at people’s brains after they passed away. She measured the mercury level. She looked at their brain volume. She looked at how whether or not they got Alzheimer’s disease. The people that ate more fish, they had less Alzheimer’s.
Krys Boyd [00:19:24] Nuts and seeds. Do you recommend four servings a week? A serving is not big, right? Like a quarter cup.
Annie Fenn [00:19:31] A quarter cup. So the nuts and seeds data as straight from the cardiovascular literature. If you eat a handful of nuts four times a week, you will reduce your risk of heart attack and stroke. That’s been shown for a very long time. We think it’s because of the monounsaturated fats. When you’re boosting your diet with mono and saturated fats more than the saturated ones, then you’re really changing, you know, the milieu of your cardiovascular system. It’s so important. I added seeds. I think it was a bonus brain healthy food group because a lot of people are allergic to nuts, and they always ask me that question in cooking classes and seeds give you the same benefits as nuts really. And some even more. Like pumpkin seeds are super good for you. Chia seeds. Hemp hearts are one of my favorites. They have monounsaturated fats. They have a good amount of protein, and they also have a lot of the brain health nutrients you get from nuts.
Krys Boyd [00:20:23] In most grocery stores, there are actually two places where you can find nuts. You can find them in the baking aisle, or you can find them in the snack aisle. Does it matter which aisle we choose?
Annie Fenn [00:20:33] It does matter because, you know, a lot of the foods that are marketed to be healthy for us are actually processed in such a way that they accumulate a lot of inflammatory particles along the way. These are called advanced glycation end products, or ages. So roasted nuts you buy in the snack aisle is a perfect example. It looks healthy, right? You look at the sodium count. Oh, not too bad. You know, it’s just nuts and salt. But these have been treated in a factory with high heat and dry roasted or whatever, and they become more inflammatory than if they hadn’t gone through that process. So I would recommend buying your nuts from a really good source. It might be your grocery store. It might be the baking section. It might be like an online distributor, or it might be Costco or something like that, they have really high quality nuts. And if you want to roast them or toast them, just do it yourself. They’ll have more nutrients and their fatty acids will hold up longer if you do it yourself.
Krys Boyd [00:21:28] Legumes like beans and lentils are associated with gut health. Is there a link between gut health and brain health?
Annie Fenn [00:21:36] There is a link between gut health and brain health that we are just starting to understand. It’s so much fun because it’s like the Wild West of medicine right now between gut health and brain health. We know the gut in the brain are talking to each other. We know that when you eat a brain healthy diet and if you look at the brain healthy guidelines, mine and others, this is a gut healthy diet, too. It’s high in fiber and it’s high in plant foods, right? And the reason for that is when you feed the microbiota that live in your GI system, all the bacteria, the viruses, the protozoa, the fungi, all of them, when you feed them a lot of plants and fiber, they give back. They make things. They’re like little factories in there. They synthesize neurotransmitters that get depleted with age and are sometimes associated with more Alzheimer’s risk. They make something called short chain fatty acids, which crosses the blood brain barrier and is anti-inflammatory in the brain. They do millions of things that we haven’t even figured out yet, so we know it’s important, and it’s really fun that more and more papers are coming out. Now, just to show that it’s matter of fact, I added fermented food as a brain healthy food group to my pyramid because I hadn’t been addressed in any of the other studies. But based on the study that came out of Stanford a few years ago, we know that consuming a fiber rich diet, or one that has fermented food like kimchi or sauerkraut or lacto fermented vegetables — a lot of traditional foods, right, will increase the diversity and variety of your gut microbes. And that’s good for brain.
Krys Boyd [00:23:07] What is kombu and why is it a bean’s best friend?
Annie Fenn [00:23:12] Kombus. Anybody know what kombu is? It’s seaweed. You buy it in the Asian isle of your super market or an Asian grocery store. Kombu is actually a laminaria. I use it as a drug when I was an obstetrician to help people go into labor. Coming full circle of my kombu. But I like to cook beans from scratch. You can certainly open a can, and it’s just as nutritious. We’ve got a really, like, delicious experience with a pot of beans. You cook them from scratch in a pot on the stove, or in a slow cooker, an Instant Pot, and adding some of the seaweed to the beans actually just really tenderizes them, gives them this great flavor and takes away some of the gassiness too.
Krys Boyd [00:23:56] Do you take the kombu out before you serve?
Annie Fenn [00:23:59] I do, for most people, because it doesn’t look very attractive once it’s been sitting in the pot for hours. But you can eat it, you can chop it up and eat it like you would, you know, a nori snack or some other seaweed.
Krys Boyd [00:24:11] You are a fan of sea vegetables in general, which is something I don’t think I’ve ever said to anyone before. What are what are some that we can try that we may not have been familiar with before?
Annie Fenn [00:24:21] So sea vegetables are really the first thing about, you know, sea vegetables. You don’t usually cook them. You know, kombu you use sort of as a conduit. But things like nori, when you go to the snack aisle, you might see something like nori, or it might be where you buy supplies to make sushi at home. And there are nori snacks. I mean, seaweed is super nutrient dense, and it’s just a fun way to add variety to your diet.
Krys Boyd [00:24:49] Foods like soybeans and miso and tofu are legumes. People may remember some anxiety years ago about the phytoestrogens in soy, and whether those could mess with our body’s natural hormones. What can you tell us about that?
Annie Fenn [00:25:02] Well, I’m really happy to say that you don’t need to worry about soy foods. If you’ve had breast cancer, if you’re worried about breast cancer, it’s actually the opposite. Back when I was a resident, which was a long time ago now, we were taught that women who have breast cancer probably shouldn’t eat soy foods like tofu or seitan because in a petri dish, the soy was causing proliferation of certain breast cancer cancer cells, and so it just wasn’t really known. So even as early as like ten years ago and colleges would say to stay away from it, but there’s been some really good randomized control trials, even, one trial in women who have are living, post breast cancer showed that they had a reduced risk of breast cancer recurrence if they increase the soy in their diet. So we’re no longer afraid of isoflavones. Isoflavones are actually a category of polyphenols. These are the good things in plant foods that we want more of. And soy foods are particularly useful for anyone who has worried about their cholesterol. It’s actually one of the food groups for lowering cholesterol, especially if you have a high LDL or APOB. So soy proteins are way more delicious than you might think. I’m a big fan and I wasn’t before, and I am now, and so I would be really open minded about soy foods. They’re really good for you.
Krys Boyd [00:26:24] Three servings a day, half cup servings of whole grains. What can we look for beyond brown rice and quinoa?
Annie Fenn [00:26:30] Number one, it does say three servings a day. And that’s right out of the mind diet. That’s right out of the Mediterranean tradition, but serving sizes are very small. Like a half cup cooked of quinoa or brown rice or forbidden rice or black rice. All the colorful prices are going to be higher in fiber and flavonoids than your typical white rice. So when you go to the grain aisle, you know, look at look at the different grains. Farro is like a wheat berry. It’s going to be more nutrient dense, have more fiber and protein than, you know, a simple rice that you’re going to buy.
Krys Boyd [00:27:02] Is there any reason that people without celiac disease or a wheat allergy need to avoid gluten?
Annie Fenn [00:27:08] No. In 2024, we do not think gluten is going to be increasing your risk of Alzheimer’s or other dementias unless you have a sensitivity of which 3% of the population does, or celiac, which is 1%. So under 5% of people should be avoiding gluten. The rest of us, the other 95, 96%, do not need to avoid gluten. For a brain health perspective at all.
Krys Boyd [00:27:36] You say it’s okay to have small portions of meat or poultry up to four times a week, and by small you mean three ounces, which is not as much as most Americans are eating. Most of us are eating much more than that. Three ounces is like this part of your hand, right?
Annie Fenn [00:27:51] The three ounces is like a deck of cards. That’s a big difference for Americans. It’s really difficult to, have a mindset where when you have dinner or lunch, three quarters of your plate should be plants, should be grains or beans or vegetables or salad, and that meat is no longer the main event. And I know that’s really difficult change for a lot of people. And it doesn’t have to happen overnight, but it is part of the magic and the science behind these dietary patterns that are helping people live without dementia. It really is. I’ve traveled extensively in Italy, where my grandparents come from, and the way they eat meat is completely different than the way we eat meat. You know, they eat it as a special occasion on Sunday, when they have a steak, they would never eat a large steak all by themselves. A large steak would basically feed a family. So there’s a different mentality and a different mindset when it comes to eating animal products.
Krys Boyd [00:28:53] Why is olive oil better for our brains than other kinds of plant derived oils?
Annie Fenn [00:28:58] So extra virgin olive oil, you probably know I’m a big fan of olive oil. My whole chapter about cooking with olive oil in my book and olives, which I made honorary fruits. So extra virgin olive oil is different from all the other cooking oils that you have in your kitchen and at the supermarket. And one reason is it has the perfect fat profile of a brain healthy diet. 80% mono, 15% poly, less than 5% saturated fat. It depends on the quality of the oil, for sure. But olive oil has something that most oils do not have and that is polyphenols. So, you know, when you get a bottle of fresh olive oil that has been freshly pressed, maybe it was a gift, or maybe you were on a trip to Greece or Italy and you brought it home, and it’s like green and it’s got particles in it. It’s actually got like pieces of olives in it. That is a high polyphenol olive oil, and that is probably the key to its brain healthiness. It’s a delivery system for a large amount of high quality polyphenols in the diet. Mediterranean people consume about a quarter cup of this type of olive oil every day. The American typical American. How much do you think we consume of olive oil in a day? Teaspoon, a teaspoon. And we have really good data to show that if you swap out something that saturated fat rich in your diet, like mayonnaise or butter or like a salad dressing. Or something like that from a store with a teaspoon of olive oil, a teaspoon for a teaspoon swap. You can reduce your risk of dying from any cause by 17%. All cause mortality. And that’s straight from the cardiology literature. So we know that extra virgin olive oil in small doses and big doses in any kind of dose is, is health promoting. And those polyphenols are flooding the brain with anti-inflammatory properties.
Krys Boyd [00:30:46] So we want to look for extra virgin olive oil. Are there any other clues as to the quality besides the shocking price tag that some olive oils have?
Annie Fenn [00:30:55] It’s true. It’s it’s you’re not going to find a super inexpensive, high quality olive oil. It’s true. You should be shopping just for extra virgin olive oil. That is food grade olive oil that has quality standards. It includes polyphenols. So you don’t want virgin olive oil or just plain olive oil. You don’t. You want to ignore all the marketing terms like light or I don’t know, what are some of them like? There’s so many marketing terms cold pressed. Sometimes it’s important, but you know, most good olive oils are cold pressed. Honestly, they don’t do it in a hot room. Italians and Greek people, they know about preserving the polyphenols. The most important thing to look for on the bottle is a harvest date. Okay. You want an olive oil that is made from one cultivar, one type of olive not pooled from all these different countries. Okay, that’s a sign of an inferior oil. And you have to look for the harvest date. Sometimes you have to get out your reading glasses and look really hard on the bottle, because it might be stamped on the cap, it might be stamped underneath, might be part of the glass. And it should be in a dark bottle or tin because light oxidizes the polyphenols, right? So you have to do a little sleuthing and be a little savvy when you buy your extra virgin olive oil. But it’s worth it. It’s worth it.
Krys Boyd [00:32:16] So coffee and tea I was happy to read can be part of a brain healthy diet. Is it the caffeine content in them that’s good for our brains or something else?
Annie Fenn [00:32:24] No, it’s not the caffeine. I mean, caffeine is a sort of a separate thing. It’s of course, it’s a bioactive substance that gives people energy. But everyone in this room has a different way of metabolizing caffeine. It’s actually a genetic variant that you inherit. Either you’re a rapid metabolizer or you’re a slow metabolizer or you’re somewhere in the middle. So caffeine doesn’t sit well with everyone. Some people get jittery or the heart races, or it might feed their anxiety. So caffeine’s not for everyone. But the good news is that if you like caffeine, it’s fine. And if you like coffee, it’s probably the most polyphenol rich beverage that is consumed widely in the world. A cup of coffee, a cup of black coffee has over 200 different types of antioxidants in it. And caffeine is a very small part of that. So decaf is totally fine. Tea as well doesn’t have as much data behind it to show that it protects the brain from dementia. There are large studies and, you know, mostly in European countries looking at coffee drinking cultures and their dementia rates are less. But we’re starting to see some really good studies with tea as well, especially with green tea and black tea and white tea and oolong tea. These types of teas all come from the same plant, Camellia sinensis. So herbal tea is a different thing: ginger tea, turmeric tea, hibiscus you know, that might have some health benefits based on the plant that it’s being used. But actual real tea is also teeming with brain health nutrients.
Krys Boyd [00:33:56] Alright, we have to move on to the list of foods we ought to avoid, which, will surprise no one. Includes fast food, ultra processed foods, sweets. Why is too much sugar bad for our brains?
Annie Fenn [00:34:09] Well, like we were saying, you know, there’s not just one type of Alzheimer’s. People get to Alzheimer’s different ways. They can get it through, genetic risk. They can get it by having cardiovascular disease, which damages the small blood vessels in the brain, reduces blood flow, which is damaging over the long term. They can get it because they become insulin resistant. So we know that diabetes doubles the risk of getting Alzheimer’s. We know that borderline diabetes or prediabetes, just even in borderline testing, does almost the same thing. It almost doubles the risk. And we know that that’s an epidemic in this country, now, is poor metabolic health, And sugar is one of the reasons, not just like putting sugar in a coffee, but the sugar that’s in all of the food products that are available to us. So our taste receptors have like really changed to expect everything to taste sweet. And it’s not that way with traditional cultures and traditional foods. Sweets are sweets, the things you drink are not sweet, you know, the food you buy is not sweet. It doesn’t have added sugar, hidden sugar. And if you’re going to have a treat, you’re going to have a treat. That’s going to be sweet. So. Different mentality there, but reducing the amount of sugar that you consume is really important strategy for protecting your brain health. Really important.
Krys Boyd [00:35:32] Lots of us were raised to believe that dairy foods were not only healthy, but essential. What can you tell us about that?
Annie Fenn [00:35:40] Well, dairy is really complicated, honestly, because on the one hand, dairy products are a big part of the American diet, and they’re a big source of saturated fat in the American diet. Right. And a lot of our dairy products are processed. The worst ultra processed foods you can consume, we know now from so many studies is ultra processed meats and ultra processed dairy products like, you know, the cheese that comes in a pot or like the cheese whiz or the queso? I hate to say it. The queso.
Krys Boyd [00:36:12] Is this Texas you’re talking to?
Annie Fenn [00:36:14] I’m so sorry. I have a queso recipe that you are going to love. Okay. That you can make from scratch, and the best nachos. I can send you that recipe if you want. But these are all processed dairy products. They have a lot of AGEs, a lot of saturated fat, a lot of sodium. There’s nothing in there that’s good for your brain. So cheese is a difficult one in the mind diet study, Doctor Martha Claire Morris and her colleagues at Rush; they decided to cut way back on dairy, and that’s probably one of the reasons they had such an incredible result with their population reducing Alzheimer’s. They recommended butter no more than a tablespoon a day and cheese no more than an ounce a week. This is the mind diet study. An ounce is a one ounce cube. Okay. I know this always makes me the most unpopular person in the room. I did not write that data. Okay. In the second part of the mind diet trial that came out in 2021, Doctor Martha Claire increased the cheese to two ounces a day just because she was given such a hard time, but dairy products in general are responsible for a lot of the bad things about the American diet. So when they did the mind diet study and they were really strict and draconian about these dairy products, I bet that they lowered the LDL cholesterol of the participants in that group by at least 50%. And we know that the higher your LDL cholesterol, the greater your risk of Alzheimer’s. It’s just true. It’s a very, very important biomarker for your risk. So that’s one reason why dairy products are we backed off on them. There are there are nonfat dairy products, of course. So here’s what happens if you take milk, like whole milk for a cow and you take all the fat out of it. All the vitamins go with it. Because the vitamins in milk or fat soluble, the D, the E, the A, the K, these are really good things for your brain, your body. But they all come out with the fat. So nonfat milk and skim milk has to be fortified and have these things put back in there along with calcium. So it’s kind of a not super nutritious choice, honestly. The plant milk aisle is also, you know, just as fraught with junk food as, you know, as the yogurt aisle. Right? But there are some plant milks, like soy milk has phyto estrogens in it, which we want to have a lot of in our body. There are other plant milks like almond and cashew milk that are beneficial. I don’t really like to buy my plant milk at the grocery store. I just make it at home. It’s just so much simpler. easier. cheaper, better.
Krys Boyd [00:38:41] Okay, we’re back on your side after the cheese thing, but now we have to talk about alcohol and wine. We’ve been around and around on this, but it turns out even red wine doesn’t have the miraculous benefits we hoped it did.
Annie Fenn [00:38:53] Yeah, and that’s really disappointing for a red wine lover like me, who grew up in an Italian household and wine was always at the table. And my husband collects wine. You know, we have, like, a new world cellar. We have an old world cellar. You get the picture. You know, we’re we’re food people. We love wine, too. So I’ve been following this with great interest over the years. All of this data. So the old standard byline that your doctor may have told you, for years, is that moderate drinking like they do in the Mediterranean is perfectly fine. And it might be really good for your heart and your brain. Moderate drinking is defined as one drink a day for women and two drinks a day for men. Right. So this has been called into question, in small studies here and there. And then finally in 2022, the UK Biobank study came out. And you you probably know about this study. There are like 80,000 MRI’s in this study at like more than 80,000 brains studied in this large trial in the UK. And they’re pulling all this data on it. Like if you eat processed meat, how fast does your brain shrink? You know, if you eat processed dairy, how fast does your brain shrink? So when the alcohol data came out, they called this into question, what if you drink moderately one for women to for men compared to light which is 0 to 4 drinks a week versus not drinking at all. And what do you think that they found not drinking at all is better than drinking alcohol. We used to think the people that didn’t drink were missing out on something. Some sort of health benefit, right? I know back in the day, doctors used to say. You know your cholesterol is up. You should drink a little bit of red wine. That might help. So we’re not really talking about that any more. So non drinking is better than not drinking at all. Light drinking under four drinks a week does not, was not associated with brain shrinkage in the study. But they started to see brain atrophy starting at four and up a week. Which is not a lot of wine. Not a lot of wine. So the moral of the story is, you know, if you enjoy wine, just be really, really mindful about the way you drink it or any, any type of alcohol for that matter. And the way that Americans have enjoyed drinking for many, many years is probably not not serving our brains that well, unfortunately.
Krys Boyd [00:41:15] Short of knowing that we shouldn’t be deep frying everything we eat. How much does it matter how we cook brain healthy foods?
Annie Fenn [00:41:24] It does matter. So there’s kind of two pieces to the equation here. When you want to have a brain healthy eating pattern. You want to choose the foods that have the nutrition that your brain needs. Right. All these brain healthy food groups that we’ve been talking about and avoiding the ones that accelerate brain aging. Right. So we got that down. But once you bring them home, you want to treat them well. You want to cook them gently. So I call this brain friendly cooking techniques. It’s the opposite of what happens in a factory. In a factory, industrially produced food has high heat. You know, roasting chemicals, or at a restaurant. Think of a fast food restaurant. They’re frying things. They’re putting things hot in a grill. This destroys the nutrients inherent in the food, and it also increases those AGEs. Those are advanced glycation end products. And AGEs there’s a large body of science, just about advanced glycation end products from, cooking foods at high heat. So what I want you to do instead is just treat your food very gently. Braising, steaming. You know, you can sauté a piece of fish or a piece of meat in a pan, but don’t get it blazing hot. And those grill marks. Sorry to say, probably not the best idea. You can still grill, I grill all the time. I have a Traeger grill, which has a lower temperature so you can grill at a lower temperature with more flavor with hardwoods, which is lower, control it better, and I use indirect heat rather than direct heat. Another thing you can do with grilling is just have a barrier between the food and the heat. Like a cedar plank is a great idea. Sometimes I just use a large cast iron pan and I put it on the grill, and then I cook that on it. Again, it’s a barrier to the heat. Things like that. Tricks like that are really helpful.
Krys Boyd [00:43:07] The last thing I want to ask you is, I think a lot of people may leave this conversation and want to go home and, you know, sweep out the pantry and sweep out the fridge and buy all new things. You actually don’t recommend that you think we should maybe take one step and change a habit and change something else?
Annie Fenn [00:43:23] I think the psychologists in the room would say that would be a better idea than saying gung ho. I’m going to do only brain healthy things from this day forward. You want to set yourself up for success? For sure. One of the easier things you could do, though, is to clean out your pantry. Like, for example, look at the cooking oils you have. I’d be willing to bet you got like more than five types of cooking oil in your pantry, and you really only need two. You need extra virgin olive oil, something for high heat like avocado oil or pecan oil. I’m a big fan of, you don’t need all these other oils, and they’re not necessarily very good for you. You can take a hard look at the ultra processed foods in your pantry. We all have them. I’m constantly cleaning up my pantry. They constantly reappear. The kids come home for a visit, and there’s, like, Nutella, you know? Where did that come from? It happens. But don’t give it to your food pantry. The people that are, you know, food insecure, they need the highest quality food. They don’t need that stuff. Okay. That stuff goes in the trash. So you can clean out your pantry. You can slowly replace things. You can get curious at the grocery store. Maybe you’re going to say, oh, Nori, seaweed. Maybe I’ll snack on that. That sounds kind of good. Put that in my lunch box. Get curious about food. Increase the diversity of your diet. When you check out at the grocery store, I know a lot of people get food delivered, right? I still go to the grocery store, but, you know, take a look at your cart before you check out. There should be a lot of colors. There should not be very many packages. You know, it should be mostly whole foods, like apples and oranges and beets and salad and, you know, you name it. Bags of grains, bags of pasta, some meat, some chicken, some fish, what have you. But the overall things should be very colorful. Very, very colorful.
Krys Boyd [00:45:14] Thank you so much for this conversation.
Annie Fenn [00:45:16] Thank you. Thank you for the wonderful questions.
Krys Boyd [00:45:22] That was my guest, Doctor Annie Fenn, a board certified Ob-Gyn and author of “The Brain Health Kitchen: Preventing Alzheimer’s Through Food.” We spoke at the University of Texas at Dallas Center for Brain Health in front of a live audience. Think is distributed by PRX, the Public Radio Exchange. You can find us on Facebook and Instagram and listen to our podcast wherever you get your podcasts. Just search for KERA Think. Our website is think.kera.org. You can go there to find out about upcoming shows and sign up for our weekly newsletter. Once again, I’m Krys Boyd. Thanks for listening. Have a great day.
