Exercise to protect your brain

January 28, 2007 12:50 am

A S WE RATTLE along into old age, it's not heart attacks, strokes or cancer that worries most people. It's the specter of losing our grip through the advent of Alzheimer's, whose sine qua non is memory loss.

But memory loss is not the principal failure of our brains as we grow older, contrary to popular belief, says Dr. Steven C. Masley. It's loss of mental speed and flexibility.

Masley should know. He is medical director of the Carrillon Executive Health Center in St. Petersburg, Fla., where he runs the "Ten Years Younger, Trimmer, Fitter" program.

Masley cited this slightly heretical idea and various others at the recent Scientific Assembly of the American Academy of Family Physicians, in a speech called "Lifestyle Program to Enhance Physiological Age."

He said Americans are about 10 years older, physiologically, than they were in the 1960s--meaning they are feeling the ill effects of age faster than they should be.

As you lose mental speed and flexibility, it takes longer to balance your checkbook, for example, or you have trouble catching on to new ideas. (Masley cites difficulty installing a new software program as a great example.)

The best prevention for cognitive decline is aerobic exercise, Dr. Masley tells us, and it's an integral part of the whole program he runs to get people feeling younger.

Masley advocates 30 minutes of exercise five to six days a week--and for it to be aerobic, you have to get your heart rate between 70 percent and 85 percent of the maximum rate. Maximum heart rate is roughly 220 minus your age. But a ballpark way of knowing if it's aerobic, I tell my patients, is when you're out of breath to the point of being unable to carry on a conversation.

Vitality foods

During Masley's description of his program, he shared some of his other slightly heretical ideas.

Heresy No. 2: Low-carb diets are all wrong. "It makes me crazy," he says, when his patients tell him they can't eat fruit and vegetables because they're on a low-carb diet. "Almost all the anti-aging nutrients come from carbohydrates," he says.

Avoid the bad carbs by all means--white flour, sugars and in particular corn syrup, which he describes as "one of the most common toxins." Also avoid hydrogenated fats--which he refers to as "embalming fluid."

But instead of focusing on what you shouldn't eat, in his program he emphasizes 16 "vitality foods" people have to eat. These include green leafy vegetables, lean protein from seafood and poultry, beans, soy products, whole grains, cruciferous vegetables such as broccoli, berries, nuts, ground flax, garlic, herbs, green tea, non-fat yogurts with fruit, red wine, dark chocolate and cocoa. (For more information, see tenyearsyounger.net.)

Heresy No. 3: Don't count calories. If you have to count something, count the grams of fiber. You should consume 30 grams a day, and half should come from fruits and vegetables. Whole grains have lots of fiber, and his maxim is "whole grain or no grain." So brown rice, whole-wheat pasta and whole-grain bread are best (though check out the bakery section of any supermarket, and it's 99.9 percent nasty white-flour products).

Heresy No. 4: Don't weigh yourself. Well, I may be over-extrapolating his comments, but just measuring weight is not a good assessment of health. What matters is lean muscle mass. The "Oprah diet"--where you lose weight, then put it back on, then lose it again--is bad because when you lose, you lose fat and muscle. When you regain, you usually just gain fat, unless you are working on strength training at the same time.

So, measure fitness, not pounds. One measure is how quickly your pulse rate returns to normal after you exercise. In the first minute after you stop, your pulse should drop by 25 beats. If it drops only 12 beats or less, this is "alarming," said Masley.

Predictors of aging well

Fitness, strength and endurance are the best predictors of whether you will maintain any weight loss you have achieved. Maybe more importantly, they're also the best predictors of:

surviving pneumonia after age 60

avoiding nursing home admission due to fracture during your 70s

living independently into your 80s and 90s

And, as noted, exercise is the best prevention for cognitive decline.

In his attention-getting presentation, Masley covered a lot of other fascinating ground. He talked about the detrimental effects of toxins, oxidative stress, inflammatory factors and unmanaged psychological stress--all of which have a profound effect on aging and cognition.

I have been meaning to write about cognition and in particular memory for a long time, but I keep forgetting.

Maybe, memory willing, we can revisit some of these topics in the future, and bring you further secrets of longevity.

DR. PATRICK NEUSTATTER can be reached at pneustatter@pratt med.com.

Brain Symptom Score

The standard assessment for an elderly patient you think is losing it is to use the Mini Mental Status Exam, which is primarily a test of memory.

But Dr. Steven C. Masley advocates the Brain Symptom Score, where you ask patients if they lose things such as keys, pens and glasses.

The 10-question test also asks if patients have trouble remembering a phone number long enough to dial it, and whether they forget the names of movie and sports stars they previously knew well.