Women: Mind Your Brain!

June was Alzheimer’s and Brain Awareness Month[i]. In my previous post, I discussed 6 steps men could take to help maintain a healthy brain. This post focuses on brain health for women. The steps are much the same as for men as recommended by the Centers for Disease Control (CDC)[ii], but the information below is geared specifically for women and reveals some interesting differences – so read on

6 Steps to a Healthy Brain for Women

1. If you smoke: STOP!

Cigarette smoking is the leading cause of preventable disease and death in the United States. Smoking damages the brain. It increases the likelihood of having a stroke by 200-400%.

Smoking also negatively impacts cognition. Several studies have shown that there is a larger negative impact of smoking on cognition in women. But in a new study, the largest ever to study the association between smoking and cognitive function (involving ~70,000 people aged 18-85), researchers found that the effects of smoking impaired verbal learning and memory performance – and this was more pronounced in women than in men. 

2. Get moving! 

Overwhelming science shows that exercise increases brain blood flow, increases the volume of the hippocampus (the region of the brain primarily associated with memory) and stimulates the growth of new brain cells

Regular exercise has shown promise in both the prevention and treatment of Mild Cognitive Impairment (MCI), Dementia, and Alzheimer’s Disease (AD). And with regard to AD (the most common cause of dementia), a recent review stated that “physical inactivity is one of the most common preventable risk factors for developing AD” [iii]

More to the point of this discussion – the benefits of exercise may be greater for women. In a recent review of 39 randomized controlled human trials that examined different types of exercise intervention in older adults, greater benefits were observed in women. Women make up 2/3 of AD patients! A review of 16 studies with more than 160,000 participants found a 45% reduction in the risk of developing AD from regular exercise. Just do it! Your brain will thank you!!

3. Maintain a healthy blood pressure (BP)

A healthy BP is 120/80 or LESS. Persistent hypertension in midlife (from aged 40 yrs. onward) is associated with increased risk of dementia in later life[iv]. And a new study, which involved over 500,000 individuals followed for almost 12 yrs., found that having high BP in middle age puts women at higher risk of dementia, even after accounting for other risk factors. (By the way, reasonably priced BP monitors are available from your local drug store or online.)

4. Maintain a healthy blood glucose level

What’s “healthy”?  For both women and men, “healthy” means a fasting blood glucose level between 70-99 mg/dL and a blood glucose level less than 140 mg/dL two hrs. after eating. High blood glucose can damage blood vessels and nerves in the brain, raising the risk for dementia. 

A study in the New England Journal of Medicine showed for the first time that even in people without diabetes, blood glucose levels above normal are associated with an increased risk of developing dementia. So be sure to get a blood glucose reading as part of your annual physical. (Inexpensive blood glucose monitors are also available.)

5. Be a Healthy Eater!

Eat a diet that does not increase inflammation. Inflammation is associated with worse cognitive function and a higher risk of MCI and dementia, especially in older women. This was demonstrated in The Women’s Health Initiative Memory Study which studied women for almost 10 yrs.  

What kind of diet increases inflammation? One that is low in fruits and vegetables and high in calorie-dense, ultra-processed foods. In contrast, the Mediterranean dietary pattern—rich in fruits, vegetables, fatty fish, extra virgin olive oil, and whole grains—is associated with reductions in systemic inflammatory markers such as C-Reactive Protein (CRP). 

Adhering to a Mediterranean dietary pattern has been shown in many studies to reduce inflammation, including in a recent study involving over 16,000 subjects followed for more than 20 years. That study found that greater adherence to the Mediterranean Diet pattern was associated with a 20% lower risk of dementia. The association was more significant for women. And it was even stronger for women with non-Alzheimer’s related dementia!  

6. Consume alcohol in moderation

What does “moderation” for women mean? The 2020-2025 Dietary Guidelines for Americans[v] recommends: “limiting intake to 1 drink or less in a day.” And of course women who are pregnant should not drink at all.  

What is ONE drink? According to the CDC Guidelines for Alcohol[vi], it means 5 oz of wine (12% alcohol). Five ounces is less than 2/3 of a cup. Just for context, a standard (750 ml) bottle of wine contains five (5 oz) servings. 

What about red vs. white wine? The Mediterranean Pyramid[vii], created by Oldways in partnership with the Harvard School of Public Health, recommends red wine in moderation. Red wine is rich in polyphenols. The polyphenol concentration of red wine is 5 to 10 times higher than in white wines (because the red winemaking process involves more extended contact with grape skins). But just because a little wine is good doesn’t mean a lot is better. A 2017 review of 20 studies involving over 175,000 subjects found that a glass of wine was protective against dementia, but excessive drinking (3-4 glasses/day) elevated the risk. 

Other research has shown that alcohol-related cognitive decline and brain shrinkage develop more quickly for women than for men. And here are some cautionary notes for women from the CDC[viii]. Because of biological differences in body structure and chemistry, most women absorb more alcohol and take longer to metabolize it than men. And after drinking the same amount of alcohol, women tend to have higher blood alcohol levels than men, and the immediate effects of alcohol usually occur more quickly and last longer in women than men.

These differences make women more susceptible to the long-term negative health effects of alcohol compared with men.

And finally – don’t forget that the health of your brain and your heart are connected. By keeping your heart healthy, you also lower your risk for brain problems such as stroke and dementia.    

[i] https://www.alz.org/abam/overview.asp

[ii] https://www.cdc.gov/heartdisease/brain_health.htm

[iii] https://journals.lww.com/acsm-csmr/Fulltext/2017/01000/Alzheimer_s_Disease_and_Exercise__A_Literature.9.aspx

[iv] https://www.thelancet.com/action/showPdf?pii=S0140-6736%2820%2930367-6

[v] https://www.dietaryguidelines.gov/sites/default/files/2021-03/DGA_2020-2025_ExecutiveSummary_English.pdf

[vi] https://www.cdc.gov/alcohol/fact-sheets/moderate-drinking.htm

[vii] https://oldwayspt.org/traditional-diets/mediterranean-diet

[viii] Excessive Alcohol Use and Risks to Women’s Health | CDC

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Dr. Clare Hasler-Lewis

Dr. Hasler-Lewis holds a Master's Degree in Nutrition Science and a dual Ph.D. in Environmental Toxicology and Human Nutrition. Following graduate school, she did post-doctoral research at the National Cancer Institute, part of the National Institutes of Health (NIH) in Bethesda, MD. During her 24 years at both the University of Illinois and the University of California, Davis, she lectured around the world on diet and health issues, and co-authored dozens of research papers on this topic. Diet and health are her passions.