Preventive Medicine for Brain Health

Giv­en the cur­rent polit­i­cal cli­mate, we are pleased to host this thought-pro­vok­ing arti­cle by 2 of our Expert Con­trib­u­tors. Dear Mr or Mrs Next Pres­i­dent: how can you help our minds take bet­ter care of our brains?

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Ask Not What The Health Sys­tem Can Do For You… 

– By Simon J. Evans, PhD and Paul R. Burghardt, PhD.

With the pres­i­den­tial debates gear­ing up again we are sure to hear more about health care. But we pro­pose a slight­ly dif­fer­ent ques­tion. In addi­tion to ask­ing how we can get more peo­ple health­care cov­er­age, we should also ask why so many peo­ple are sick in the first place.

The words of John Kennedy might today be, “Ask not what the health care sys­tem can do for you. Ask what you can do to reduce the health care burden”. But before delv­ing into what we can do, let’s take a look at some real­i­ties that our next pres­i­dent could face in their first ‘State of the Union’ address.

On the down­side –

* We are not healthy: 60% of adults and 20% of kids are over­weight; 30% of today’s kids are antic­i­pat­ed to become dia­bet­ic; 20% of high school kids have ear­ly stages of heart dis­ease. The esti­mat­ed eco­nom­ic bur­den of depres­sion for the year 2000 (most recent esti­mate) was $83.1 bil­lion, and this is just one of many brain-relat­ed diseases

* We are aging: with­in the next cou­ple of decades, about 20% of the pop­u­la­tion will be of retire­ment age; 4.5 mil­lion peo­ple already have Alzheimer’s dis­ease and by 2050 there will be 16 mil­lion cases.

* We are heav­i­ly med­icat­ed: anti-depres­sants are the lead­ing sell­ing drugs in the Unit­ed States; record num­bers of chil­dren are on these and anti-psy­chotics; for adults, cho­les­terol and blood pres­sure med­i­cines are becom­ing as com­mon as break­fast cereal.

On the upside –

* The US gov­ern­ment esti­mates that health­i­er lifestyles could save $71 bil­lion per year in health care costs and anoth­er $14 bil­lion in lost productivity.

* 1 out of 7 deaths are pre­ma­ture and could be avoid­ed with bet­ter diets and active lifestyles.

Per­haps the next pres­i­dent should spend a lit­tle effort pro­mot­ing meth­ods to improve these sta­tis­tics. But how?

We typ­i­cal­ly think of heart dis­ease, dia­betes, depres­sion, and Alzheimer’s demen­tia as very dif­fer­ent prob­lems. But the more we learn about dis­ease, the more we real­ize that these seem­ing­ly dif­fer­ent dis­eases often have a lot in com­mon at the cel­lu­lar and mol­e­c­u­lar lev­el. They also have a lot in com­mon when it comes to how they gained a foothold in your brain and body to get start­ed in the first place.

How­ev­er, we have an arse­nal of tools proven to help reduce com­mon cel­lu­lar dam­age to main­tain fit brains and bod­ies. What are those tools? Some high tech drugs and med­ical equip­ment that is out of reach for much of the pop­u­la­tion lack­ing health care insur­ance? Actu­al­ly, no. These tools are very low tech and avail­able to every­one. They are:

1. Eat­ing a qual­i­ty diet

2. Get­ting reg­u­lar phys­i­cal activity

3. Keep­ing your mind active and engaged

4. Get­ting enough sleep and rest

Sounds easy, right? So why don’t we all do it, and why didn’t we have all of these prob­lems 50 and 100 years ago?

First of all, in yes­ter­year a break­fast muf­fin con­tained about 150 calo­ries. Today that muf­fin is 400 calo­ries. A large drink at the soda foun­tain totaled 12 ounces. Today, that drink is the small­est size on most menus. Yes, we are suf­fer­ing from pro­por­tion dis­tor­tion. We love to eat, and it ain’t peas and car­rots we are a cravin’.

Sec­ond, for many peo­ple going to work actu­al­ly meant going to work, phys­i­cal­ly. Today, the extent of our office exer­cise is fin­ger aer­o­bics on our QWERTY key­boards. Phys­i­cal activ­i­ty used to be a reg­u­lar part of every­day life, not a chore that you have to sched­ule into your day.

Third, as Alvaro point­ed out on a recent arti­cle, many of us ‘outsource our brains’ and no longer think for our­selves. With mass media mes­sages, GPS sys­tems, cal­cu­la­tors, spell check­ers and elec­tron­ic orga­niz­ers, we must ask the ques­tion how well we could func­tion with­out them. I know I am guilty of this one, myself.

Final­ly, we are stay­ing up lat­er and get­ting up ear­li­er to meet those dead­lines. On aver­age, we get 1.5 hours less zzzzzs than we did about 100 years ago. Not only that but we spend far more time busy, busy, busy when we are awake than we ever used to.

Now, change hap­pens. We shouldn’t expect to always do things the way we used to, and we’re not sug­gest­ing that. Food, in all its irre­sistible vari­eties, is much more avail­able. Are we sup­posed to just not eat it. Well, uh, it wouldn’t hurt to pass on the sec­ond help­ing of triple choco­late cheese­cake now and then.

And no, we can’t jog around our office but we can do sim­ple things to intro­duce more activ­i­ty into our day. Walk instead of dri­ve those 1‑mile errands. Park fur­ther from the door, take the stairs … you’ve heard all this before. So why don’t we do it?

One rea­son is that no one likes to be told what to do and sub­ject­ed to some guilt trip, most peo­ple just don’t respond to that. Also, most peo­ple haven’t real­ly thought about what they real­ly want their health to look like or devel­oped a rea­son­able plan to reach their health-goals. As the old adage says, “If you don’t know where you are going, you are sure to get there”, plus it helps to have a map. Final­ly, even with a plan many folks will give up after the first sign of fail­ure or fatigue. These changes don’t become easy until we make them an inte­gral part of our lives.

So how do you moti­vate peo­ple to take action to main­tain their health? Since every­one is dif­fer­ent, many options exist. The obvi­ous answer, that will moti­vate the most peo­ple, is mon­ey, mon­ey, mon­ey … mon­ey (did you hear ‘The Apprentice’ theme song).

At a pol­i­cy lev­el, it would be excep­tion­al­ly help­ful if the next pres­i­dent worked to cre­ate incen­tives for healthy lifestyles and behav­iors. Now, I know this is easy to say, prob­a­bly not as easy to do (and keep every­one hap­py), but you have to walk before you run. What if the next pres­i­den­tial admin­is­tra­tion actu­al­ly incen­tivized (is that a word yet?) us to take bet­ter care of our­selves? What if health insur­ance com­pa­nies gave dis­counts to peo­ple that tried to live a healthy lifestyle?

What if the gov­ern­ment gave us tax breaks to eat health­i­er food and exer­cise? What if each indi­vid­ual had one gov­ern­ment sub­si­dized con­tin­u­ing edu­ca­tion, or self-enrich­ment class each year? Would this reduce the over­all health care bur­den for employ­ers and make it more afford­able to cov­er more peo­ple? Help reduce sick days and increase pro­duc­tiv­i­ty and cre­ativ­i­ty? Hmmm….

We real­ize there are many caveats to imple­ment­ing such a plan but some­thing has to be done and maybe some bright politi­cian can fig­ure out how to do it. Who would lose if the coun­try were to improve their health?

Insur­ance com­pa­nies wouldn’t have to fork out as much. Med­ical providers would be able to divert more of their atten­tion to pre­vent­ing dis­ease, instead of man­ag­ing chron­ic ill­ness. The gov­ern­ment wouldn’t be in such a hot seat for the health care cri­sis. Big Phar­ma might sell few­er drugs, but there are sev­er­al new health-relat­ed indus­tries that they have the exper­tise to tap into. Basi­cal­ly, we would all win.

So back to our ini­tial ques­tion: “Why are we so sick in the first place?” If you step back and see the for­est for the trees, our world has changed dras­ti­cal­ly in the last 50 to 100 years. With tech­nol­o­gy, and the avail­abil­i­ty it brings, we may have become a lit­tle com­pla­cent, a lit­tle too trust­ing that the mag­ic cure-all pill is there for us.

It is true that we are liv­ing longer. But I’m sure with increased longevi­ty, every­one would want at least a rea­son­able qual­i­ty of life and cur­rent­ly that isn’t the sta­tus quo. So the answer to our ques­tion seems to be….lifestyle choic­es. Mak­ing the best lifestyle choic­es, and main­tain­ing them, isn’t always easy but the best things in life rarely are.

So Madam or Mis­ter Pres­i­dent, will you help us help ourselves?

– This arti­cle was co-writ­ten by Simon Evans and Paul Burghardt. Drs. Evans and Burghardt cur­rent­ly col­lab­o­rate in the Uni­ver­si­ty of Michigan’s Depart­ment of Psy­chi­a­try, and the Mol­e­c­u­lar and Behav­ioral Neu­ro­science Insti­tute to study the effects of nutri­tion and exer­cise on brain func­tion. They host the Brain Fit for Life blog and are col­lab­o­rat­ing on an upcom­ing book on the subject.