Richard Carmona, MD, MPH, FACS, is the President of the Canyon Ranch Institute, Vice Chairman of Canyon Ranch, and the Distinguished Professor of Public Health at the University of Arizona. He also served as the seventeenth Surgeon General of the US from 2002 to 2006.
Canyon Ranch 30 Days to a Better Brain Chapter 1
HOW THE BRAIN WORKS
If you’ve been taking your brain for granted, you’re not alone. Most people assume their brain is working just as well as ever, even as they get older. But the reality can be far different.
The brain is a highly responsive organ that is involved in every internal function of the body, from regulating metabolism to controlling balance and coordination to governing our sex lives and, of course, all the activities associated with the senses and the mind, particularly mood and memory. The brain’s functioning is central to the concept of the mind-body connection, the way the body’s health responds to our thoughts, feelings, and actions. This connection illustrates how our emotional life can both positively and negatively affect our physical health and how our physical health can affect our mood and cognition. The truth is that the brain and the rest of the body are one unit of health; the brain is affected by many of the same diseases and conditions that distress our physical health. At the same time, it is also susceptible to aging and even injury.
Monitoring the brain’s health is not always as obvious or easy as evaluating changes to the rest of the body. Many of us notice the aches and pains as well as the signs and symptoms of physical aging. You know when you’ve put on weight even though your diet hasn’t changed, and you can tell when your joints hurt more than they did last year. But you might not notice that your thinking has slowed down or your attention is not sharp or your moods or anxiety levels have changed. This is mostly due to the fact that the brain is hidden from our view; we can’t see it aging as clearly as we can see the gray hairs coming in or our jawline slackening.
The brain also has enormous biological reserve, the extensive backup plan to keep all aspects of your health—physical as well as emotional—running smoothly. This reserve allows the body to continue functioning as we age and gives us a false sense of security in terms of our cognition; we actually can get by with substantial loss of brain function without realizing that changes have occurred. This reserve makes it very difficult to recognize if there has been a slowing in our mental capacity until there is a significant change. Yet unfortunately, once you do notice, it means that the underlying problem that has caused this change has been going on for a very long time.
The good news is that just like the rest of your body, your brain can get better. By starting a program based on improving your brain health now, you can begin to recognize subtle changes and have the opportunities to enhance your brain’s capabilities so that it can serve you well now and for years to come. Science has only just recently confirmed what we at Canyon Ranch have believed all along: your lifestyle can influence your health. This research has blossomed into a new field called epigenetics, which suggests that it is possible to alter one’s genetic destiny by changing nongenetic factors—such as lifestyle choices. These specific behaviors can actually cause a person’s genes to turn on or off without changing the underlying DNA sequencing. In other words, to a very large extent, you are in control of your own health. And nowhere is this more exciting to consider than in terms of your brain’s potential.
This book is meant to set you on the path to better brain health. We believe that this is the highest pursuit in wellness that you can become engaged with, because you really can’t be healthy without a healthy brain. And it terms of your longevity, your brain’s functioning is as important as that of any other organ in your body, including your heart.
We all hope for and have come to expect to live long lives. A hundred years ago, the average person could expect to live between forty-nine and fifty-one years. Today if you are in good health, it’s reasonable to assume that you will live well into your eighties and even beyond. Medical technology is one of the underlying reasons for this enormous increase: we have easy access to a host of treatments and procedures that can keep our internal organs and bone structure from failing. However, our ability to increase longevity has not fully addressed many of the problems associated with an aging brain. The truth is, half of the people who reach eighty-five years of age will have some form of dementia or cognitive dysfunction. This knowledge alone is exactly why improving brain health is so critical: we want not only to maintain a vibrant, healthy body for years to come but for those years to be of the highest quality. And the only way to ensure that is by maintaining—or even enhancing—a vibrant, healthy brain. By doing so, you’ll increase your capacity to live life to its fullest every day.
UNDERSTANDING YOUR BRAIN
The brain is a complex and sophisticated organ, and to work on improving its health, it’s important to understand both its structure and how it functions. On the smallest scale the brain is made of 100 billion individual neurons, or brain cells. Neurons are the electrically excitable cells that process and transmit information to each other through neurotransmitters, or brain chemicals. Together, these neurons and neurotransmitters form a specialized network that governs how we feel and think.
Each neuron is composed of a cell body, dendrites, and one axon. More than 150 different types of neurons exist, so they are some of the most diverse cells in the human body. Dendrites and axons are thin structures that branch off the neuronal cell body. Each cell body is surrounded by multiple dendrites, but never more than one axon. In simplest terms, one neuron’s dendrite connects to another’s axon, but the two do not completely touch. With 100 billion neurons, this allows for 100 trillion connections between them. Each connection creates a synapse, the place where the chemical and electrical signals of the brain are sent and received.
The axon is protected by a myelin sheath, an insulation barrier much like the material surrounding an electrical wire. The myelin sheath helps the axon hold on to its chemical message until it’s delivered to the next cell.
A NEURON OR BRAIN CELL
The brain’s function is measured by how well your neuronal network is working: Are the neurons hooked up to each other in the right way? Are they making the same or new connections? Are there any short circuits? And most important, how quickly can they transfer information? This transmission is referred to as brain processing speed. Damage to any part of this system limits or prevents the neuronal message from transferring from one cell to the next. Speed, then, is important in the sense that it is necessary for maintaining the information traveling through the axon so that it can be relayed to the next neuron. A normal brain responds to stimuli at a speed of at least one-third of a second. Typically, we lose seven to ten milliseconds of brain speed per decade from age twenty on. The difference between a resourceful mind and senility is only one hundred milliseconds. When this loss occurs, the neurons can no longer fire their chemical messages fast enough to affect the actions they were governing. That is why as we age we move more slowly, misjudge distances, and make mistakes.
This loss of brain speed is one of the main causes of mild cognitive impairment, or MCI. People generally start to see these declines when they reach their seventies, yet they can begin to notice changes in their thinking in their forties. By the age of forty, 25 to 50 percent of Americans are already affected by MCI, even though less than 1 percent will show any symptoms. In an aging brain, the neurons themselves, the quality and quantity of their neurotransmitters, or the neuronal connections can be altered, and thereby affect your brain’s health. Brain cells die off, or their connections become broken, making it more difficult to retrieve stored information, or what we refer to as memories.
As we get older, we think that we are becoming more forgetful. The truth is that we don’t actually lose memories; instead, we lose the capacity and the speed required for retrieving them. The goal, then, for enhancing brain health is to maintain and improve these neurons, as well as their connections, for as long as possible, because an efficient brain is a smarter brain.
This strategy is particularly true when it comes to those myelin sheaths surrounding the axons. These protective coverings can disintegrate, and plaques made up of sticky proteins called beta-amyloid can build up on them. Or these axonal connections become entangled with accumulations of other proteins. Both of these scenarios are present in the diagnosis of Alzheimer’s disease, the most invasive form of dementia.
THE REGIONS OF THE BRAIN
Depending on where neurons are located in the brain, their function changes. For example, there are sensory neurons that respond to touch, sound, light, smell, and taste. Motor neurons receive signals from the brain and spinal cord, causing muscle movement. Each neuronal network creates distinct lobes, or regions of the brain, and each is responsible for different aspects of our mental, physical, and cognitive health. However, these brain regions are often responsible for multiple tasks, and their functions often overlap.
The brain is composed of three distinct parts: the cerebrum, the brain stem, and the cerebellum. The cerebrum, or forebrain, is the largest part of the brain. It is covered by the cerebral cortex. This is the collection of folded bulges—known as gray matter—that comes to mind when we think about the brain. These bulges increase the brain’s surface area and enable us to fit a great volume into a small area. Together, the cerebral cortex and the cerebrum play a key role in memory, attention, awareness, thought, language, and consciousness.
REGIONS OF THE BRAIN
The next region of the brain is the cerebellum. It is a ball of tissue below and behind the cerebrum that decodes sensory information and integrates it with your body’s muscles to coordinate movement. Finally, the brain stem links the brain to the spinal cord. It controls bodily functions such as heart rate, blood pressure, and breathing.
Analyzing the Cerebrum
The cerebrum is divided into two hemispheres, left and right, that are linked by a thick band of nerve fibers called the corpus callosum. Messages to and from one side of the body are usually handled by the opposite side of the brain, meaning the left hemisphere controls the right side of the body.
The hemispheres are identical in that they contain the same types of lobes. Each hemisphere is further divided into four lobes, all of which create and retrieve memories. From the descriptions below, you can see how their functions often overlap:
· The frontal lobes control thinking, planning, organizing, problem solving, short-term memory, and movement.
· The parietal lobes interpret sensory information, such as taste, temperature, and touch.
· The occipital lobes process visual information and link that information with memory.
· The temporal lobes process smell, taste, and sound. They also play a role in memory storage.
LOBES OF THE BRAIN
Within the middle region of the cerebrum lie several small structures that form the limbic system, which is involved in many of our emotions and motivations, including fear, anger, and pleasure. Certain structures of the limbic system are involved in creating and maintaining memory.
Amygdala: This is located in the temporal lobe and is responsible for determining how memories are stored and where the memories are stored in the brain. It is thought that this determination is based on the emotional response an event invokes.
Hippocampus: This is where short-term memories are stored before they are moved to the appropriate lobes of the cerebrum, and it organizes how memories are retrieved when necessary. Damage to this area of the brain may result in an inability to form new memories; the hippocampus is one of the primary areas of the brain affected by Alzheimer’s disease.
THE LIMBIC SYSTEM
Hypothalamus: This controls emotions, eating, and sleeping. About the size of a pearl, this structure, in concert with the pituitary gland, indirectly affects adrenaline production when needed for the control of emotions. Adrenaline is a hormone involved in making you feel exhilarated, angry, or unhappy, as well as activating the fight-or-flight response.
Thalamus: This transfers messages from the spinal cord to other areas within the hemisphere.
AN AGING BRAIN IS A SMALLER BRAIN
Healthy brains can maintain their original structure, but an aging brain is drier and smaller than a young brain. By the time you reach your seventies, the brain will have shrunk about 10 percent and will look more wrinkled than a younger version. The change in the size of your brain doesn’t cause pain, and you can’t feel it occur. And because the brain is encased in the skull, you can’t see these changes, either.
When Does Decline Begin?
According to the Baltimore Longitudinal Study of Aging, adults reach their physical peak somewhere between ages twenty-eight and thirty-two. Beyond that, your brain will age either at the same rate as the rest of your body or faster or slower. Damage or dysfunction in any one of the regions ages the brain, sometimes faster than your chronological age. This means that a head injury—even one sustained when you were younger—can affect your thinking later in life, aging your brain faster than the rest of your body.
One way to identify a prematurely aging brain is through your sense of smell. Losing it is one of the first signs that there is a problem with the brain and can predict memory loss. Sense of smell declines because the type of cells in the nasal cavity of the brain (known as granule cells) are the same type as the cells in the hippocampus, where short-term memories reside, and both these cells age at the same rate.
The entire brain is surrounded by blood vessels that continuously nourish it and by cerebrospinal fluid, which bathes, protects, and cushions it. The ventricles, the areas beneath and around the brain, produce a bath of cerebrospinal fluid that moves all the way around the outside of the brain and the spinal cord. As the brain shrinks, the ventricles enlarge by filling the void with fluid. Enlarged ventricles may be an indication of brain shrinkage and are a common finding in those with dementia.
THE BASICS OF BRAIN CHEMISTRY
The structure of the brain tells only half the story; the rest of brain health is related to how the brain functions. The neurotransmitters, the chemical messengers sent between the neurons, are created in the cell body and transported from the axon into a synapse, where they bind to chemical receptors located in the dendrites. You can think of a neurotransmitter as a key and a receptor a...