Neal D. Barnard is an American physician, author, clinical researcher, and founding president of the Physicians Committee for Responsible Medicine (PCRM), an international network of physicians, scientists, and laypeople who promote preventive medicine, conduct clinical research, and higher standards in research.
Michael Tobias: Dr. Barnard, in your soon-to-be-published new book, Power Foods for The Brain (due out February 19 –- Grand Central) you impart some very new insights and synthesis of biochemical data from research around the world pertaining to the impact of food on the mind. People, and government agencies, have long acknowledged the role of diet with respect to obesity, heart disease and diabetes. You take the correlations much deeper: into the secrets of the brain itself.Neal Barnard: The fact is, we can look into the brain in ways we were not able to before, and what we’ve learned is both hopeful and disconcerting at the same time. The disconcerting part is that threats to the brain are all around us, which is why Alzheimer’s disease hits half of us by age 85. We can see the beginnings of Alzheimer’s disease in individuals who, on the surface, seem fine. The hopeful side comes from careful studies of large populations showing that a particular pattern of dietary habits appears to protect the brain to a very substantial degree.
Michael Tobias: One of the areas you discuss in your book that is particularly fascinating to me is what you refer to as the “Blue Zones.” Talk about this.
Neal Barnard: Yes, some years ago, Dan Buettner, working with National Geographic, began studying areas where people lived extraordinarily long lives: Okinawa, parts of Costa Rica, Sardinia, and Greece, as well as Loma Linda, California. Their name comes from the color researchers used to mark them on the map. So the question was, what do these long-lived people have in common? The first thing to leap off the page was that they all have largely plant-based diets. People in the Blue Zones also tend to avoid tobacco, are physically active, and put an emphasis on family and social engagement. I grew up in Fargo, North Dakota, where sausage and eggs were more our thing, and unfortunately Fargo is not a Blue Zone.
Michael Tobias: But within these longevity zones?
Neal Barnard: These areas are remarkable for more than longevity. They are marked by robust mental health, too. So I began to visit the Blue Zones myself. The dietary staple in Okinawa, surprisingly enough, is the sweet potato, and animal-based foods are few and far between. In Hojancha, Costa Rica, I was struck by the casado, a generous plate of black beans, rice, a vegetable, and sweet plantains, with meat strictly optional. The casado is the everyday plate in that part of Costa Rica. Its name refers to a man who, being happily married, stays in his casa, presumably eating healthful food and living a long, contented life. In Loma Linda…
Michael Tobias: Near Los Angeles?
Neal Barnard: Yes. There, I met a remarkable surgeon, Dr. Ellsworth Wareham, who continued his operating room career until age 95. He and his wife shared their healthy plant-based lunch with me. At nearly 100 years of age, he is as sharp as a tack.
The point is this: It’s not genes that carry us into a healthy old age—or not genes alone. Lifestyle factors are very, very influential in determining who survives and who does not—as well as in determining who can think clearly decade after decade and who succumbs to the tragedy of dementia.
Michael Tobias: The ecology of Alzheimer’s, and of dementia in general, suggests a strong correlation between a vast disease arena afflicting people (and possibly other species, like canines) throughout the world, and the environment. The intersection, as you describe it, might well be our diet. Given the alarming prevalence of Alzheimer’s and dementia, in your opinion what do you think is going on, in terms of the fundamental diets that may be contributing to the breakdown of mental faculties, and – in so many instances – widespread mortality?
Neal Barnard: Within the brain of an Alzheimer’s patient, strands of beta-amyloid protein ooze out of the brain cells. It is a bit like sausage coming out of a sausage-maker, and these protein strands collect between the brain cells in microscopic clumps called amyloid plaques. This process appears to be fueled, at least in part, by fatty, cholesterol-laden foods. The more these foods are on your plate and the higher your cholesterol level rises, the more plaques accumulate. And also hiding in those plaques are tiny traces of metals—iron, copper, and aluminum—and these appear to be potentially neurotoxic.
Michael Tobias: What about natural foods that combat these alleged toxins?
Neal Barnard: Yes. Apart from these threats, we also have our defenders. The vitamin E in nuts and seeds, the anthocyanins that give grapes and berries their color, and the omega-3 traces in green vegetables all play protective roles. They can add up to a big drop in the risk of cognitive problems.
Michael Tobias: One of the sub-headings in your book is entitled “Bad for the Heart, Bad for the Brain.” What are some of the explicit links researchers like yourself are starting to uncover?
Neal Barnard: The first was the cholesterol link that I hinted at just now. A high cholesterol level is bad for the heart, of course, and it is clearly linked to Alzheimer’s risk, too. Taking a step further, it turns out that the most notorious gene linked to Alzheimer’s risk—called the APOE epsilon4 allele—actually has the job of transporting cholesterol particles in the blood and the brain. Here’s what I believe is going on: For many years, people have lamented that this gene condemns people to Alzheimer’s disease. However—and this is one enormous however—if we skip the foods that cause our bodies to make extra cholesterol, it may be that we can leave that gene with nothing to do—that is, with not much cholesterol to transport. So you may still have the gene, but your food choices protect your heart and brain at the same time.
Michael Tobias: And saturated fats?
Neal Barnard: Precisely. There is more to the heart-brain link. As you know, scientists observed long ago that saturated fat—the kind that makes bacon grease solid at room temperature, as opposed to olive oil, for example—is strongly linked to heart disease. Well, researchers at the Chicago Health and Aging Project began observing thousands of healthy individuals, starting in 1993, to try to sort out who stays healthy and who does not.
Michael Tobias: The results?
Neal Barnard: Ten years later, it became clear that those who got the most saturated fat in their foods had a much higher risk—not just of heart problems—but of brain problems, too. Their Alzheimer’s risk was more than three-fold higher, compared with those who generally avoided “bad fats.” And then, looking at trans-fat, that oft’ maligned grease in donuts and snack foods, they found the same thing. A snack-food junky mainlining plenty of trans-fats could end up with five times the risk of Alzheimer’s, compared with a person who skipped these foods.
Michael Tobias: And the ascribed-to suite of cholesterol-lowering drugs, in your opinion?
Neal Barnard: That is the logic. If high cholesterol is bad, cholesterol-lowering drugs must be good, right? Well….not necessarily. Statin drugs can sometimes be a double-edged sword. They definitely lower cholesterol and do seem to reduce the risk of dementia. But they can actually cause quite serious memory problems in rare cases. And that really makes the case for dietary changes as our first line of defense.
Exercise plays a huge role, too. It protects the heart and brain, and even reverses age-related brain shrinkage.
Michael Tobias: You’ve looked at healthy diets from countless studies and one of the most stunning comparisons was that of broccoli versus cheese. The inherently different properties and pathways through our bodies of these two food types would suggest a veritable poster child for your message. Could you clarify?
Neal Barnard: Dairy products and green leafy vegetables are both calcium-rich. So, yes, broccoli and cheese both bring you calcium. But that is where the similarity ends. A cup of broccoli has essentially no saturated fat, while a one-ounce slice of cheddar cheese has 6 grams of it. The tiny fat traces in broccoli are heavily balanced in favor of “good” omega-3 fats, unlike cheese, which mainly delivers “bad” fats. Broccoli has no cholesterol—ditto for all vegetables while, ounce-for-ounce, cheese has about the same cholesterol as a steak. And green vegetables also deliver vitamin E, folate, and iron.
Michael Tobias: Folate – the water-soluble B vitamin?
Neal Barnard: Yes. And by the way, I have a tip for any broccoli haters out there: Add a little spritz of lemon juice. Somehow the sourness of the lemon juice combines with the bitterness of broccoli to make an almost sweet taste that even a broccoli-avoiding president would have loved.
What counts here is that, when we are looking for nutritious foods, we need to look at the whole package. Not just, “will it give me calcium,” or “is this a source of iron.” Rather, we need to look at the range of nutrients packed into a food to see if it helps us or harms us overall. And basically, your brain is happiest at the produce counter.
Michael Tobias: While many specialists have looked at meat and dairy products, and their impacts on human health, you have also brought forward some compelling new data –albeit, as yet apparently inconclusive – with respect to fish and saturated fat. Could you elaborate and describe some of the studies you’ve examined, both the positive and negative correlations in terms of what may be happening, in your opinion, in terms of human consumption of fish?
Neal Barnard: As you know, there has been a lot of enthusiasm for fish in some circles, and fish do contain omega-3s. However, studies show that people who eat fish tend to have more weight problems and a higher risk of diabetes, compared to people who skip animal products altogether.
Michael Tobias: And studies regarding the impact of human consumption of fish on the human brain? Because this is pretty big news.
Neal Barnard: When it comes to the brain, fish get a mixed verdict. Some studies show benefits, but others do not. There certainly are omega-3s in fish. But if you were to send a vial of fish fat to a lab, you would find that 70-85 percent of the fat in fish is not omega-3s. Just like chicken fat and beef fat, fish fats are mixtures, including substantial amounts of saturated fat. And studies of fish-oil supplements for heart or brain health are really running aground—showing no benefit at all.
Michael Tobias: A lot of fish eat other fish.
Neal Barnard: Exactly. It is important to remember that fish are carnivores, which sets them apart from many other animals people eat. That means they are part of a long food chain, and they accumulate whatever toxins their prey have swallowed. They live in the oceans and waterways that have effectively become the human sewer, so they are an abundant source of toxins we want to avoid.
Michael Tobias: You speak at length about toxic metals in our body, like copper, iron and aluminum. What are we consuming and surrounding ourselves with that we might want to think twice about, in terms of such metals and complex metallic alloys?
Neal Barnard: We need traces of iron to make the hemoglobin our blood cells use to carry oxygen. And we need traces of copper to make several key enzymes. But iron rusts. Copper corrodes, too, which is why a penny does not stay shiny forever. This is oxidation. And it doesn’t just happen in a frying pan you accidentally left on your backyard picnic table for a few days. It also happens to the iron and copper within your body. As these metals oxidize, they produce free radicals, which are like little sparks damaging your brain cells and every other part of you.
Michael Tobias: OK, we’re living in a world of sparks and free radicals, toxins and a mishmash of threats. What do we do?
Neal Barnard: All three of these metals—iron, copper, and aluminum—are found in the plaques in the brains of Alzheimer’s patients. Where do they come from? Many municipal water treatment plants add aluminum to drinking water to precipitate out solids (so bottled water or reverse-osmosis filtered water is a better choice for drinking). Aluminum or cast-iron cookware and copper pipes will leach metals into whatever they come into contact with. Meats are loaded with iron—which, of course, we had thought was an advantage until we realized that most of us get too much iron.
Michael Tobias: But what about the supposedly good iron derived from vegetables?
Neal Barnard: The iron in green vegetables and beans is easier for the body to keep out when the body already has enough. Multiple vitamins often have added iron and copper, so it pays to read labels and select brands without these metals. Aluminum also turns up in some antacids, in baking powder, and as an additive in a number of foods; aluminum-free brands are right next to them on the store shelf.
Michael Tobias: Ultimately, are you and your scientific peers beginning to sense a kind of diet that could truly liberate us from the debilitating, tragic and life-altering demographic avalanche of Alzheimer’s and/or dementia, and how does that fit in to your own life story?
Neal Barnard: When my father succumbed to dementia, I realized that he was walking down the same dismal pathway that had consumed his parents, as well. And there is nothing more tragic than seeing your loved ones drift further and further away with each passing day. The financial cost is back-breaking, but the personal cost is far worse.
We need a take-no-prisoners assault on this disease. And I believe we can do it, if we take advantage of what science has shown us and set aside some of the habits we grew up with. The previous generation dealt with smoking. The current generation is in an identical battle with unhealthy foods. But just as the war on tobacco was much slower than it should have been, we are taking our sweet time in getting the courage to do something about the garbage on our plates, and we are putting our children at risk, too. But we know what we have to do, and it’s time to get started.
Michael: Thank you, Neal.
Statistics: Posted by Mirza Ghalib — Mon Dec 17, 2012 12:21 pm