Health advice seems to evolve daily, but one topic is steadfast: our diet has huge impacts on our overall well-being, including our brain health.
Jason Maljaars, MD, neurologist with St. Francis Health and medical director of the St. Francis Stroke Program, discusses the link between food and neurological conditions.
The Influence of Diet on Cognitive Function
“The impact of nutrition on our brain health is tremendous and very complicated,” Dr. Maljaars says. Our dietary choices play a significant role in shaping our brain’s health and function, and Dr. Maljaars offers hope.
“If we eat the way that we’re supposed to, which is whole, unprocessed, naturally occurring foods, we can not only prevent a lot of the diseases that we suffer from, but also treat the ones that we are currently suffering from,” he says. “There isn’t an inevitability to most of the conditions that we develop. We can absolutely make a difference in our own lives based on paying attention to what we do.”
Historical Context of Dietary Recommendations
Dr. Maljaars explains the evolution of dietary guidelines in the U.S., noting their historical focus on heart health. Since their introduction in 1980, the guidelines have been largely unchanged, promoting low-fat diets and advocating for vegetable and seed oils over animal fats. This approach stemmed from early hypotheses about cholesterol and heart disease.
“In the original food pyramid, the bottom is entirely carbohydrates — breads, pastas, white rice, potatoes, etc.,” Dr. Maljaars says. “It was recommended to have six to 11 servings per day, which is just about a loaf of bread.”
Most Americans do follow the U.S. dietary guidelines, but Dr. Maljaars points out that subsequent research has challenged their original premises.
“The evidence behind those recommendations has always been very shaky,” he says. There is a disconnect between guideline adherence and improvements in chronic conditions like obesity and diabetes.
Nature vs. Nutrition
Dr. Maljaars has always had an interest in why we develop the conditions we do, whether it’s simply the luck of the draw of our genetics or something more.
“The biggest driving factor in many neurological conditions is ultimately what our bodies are exposed to. And that is, of course, primarily what we are eating,” he says.
You can’t change your genetics, which may mean you have a higher risk of developing neurological conditions later in life.
“But one of the most important things to know is that you can do things to prevent these conditions, even if you have a strong family history,” Dr. Maljaars says. And changing your diet is a primary way to reduce the risk of cognitive decline.
Fuel Your Brain with Better Food Choices
The brain is a highly metabolic organ, and what we eat directly influences its ability to perform optimally.
“The brain can use two sources of energy: glucose and ketones,” Dr. Maljaars says. Maintaining a balance is crucial for long-term cognitive health.
Chronic exposure to high levels of glucose, such as from a diet high in sugars and refined carbohydrates, can lead to insulin resistance in the brain. This resistance over time can impair memory formation and cognitive function.
Harmful Effects of the Standard American Diet
Discussing the detrimental effects of the standard American diet (aptly referred to as SAD), Dr. Maljaars paints a stark picture. SAD is characterized by its high intake of processed foods, sugars and unhealthy fats.
“The problem is that the insulin levels in our bloodstream are always elevated,” he says. And persistent elevation of insulin levels can exacerbate neurological conditions such as dementia and Alzheimer’s disease.
“Artificial sweeteners actually spike your insulin levels,” Dr. Maljaars says. “They don’t spike your blood sugar, but they spike your insulin levels even more than sugar does.”
Although it can tolerate this for a while, eventually your brain cannot metabolize the glucose when it’s unable to get insulin, specifically in the hippocampus, the part of the brain involved with forming memories.
“The hippocampus needs surges of glucose metabolism when it’s making new memories,” Dr. Maljaars says. “So, if your brain has gotten resistant to insulin, the memory doesn’t get made. This is one example of how what we eat leads to impaired cognitive function.”
The things that drive insulin up are primarily carbohydrates, sugars and artificial sweeteners.
“So, you reduce those or you get rid of them, and then you give your brain what it needs,” Dr. Maljaars says. “Your brain is actually about 70% fat, and it desperately needs good quality fats to function properly.
Understanding Alzheimer’s and Insulin Resistance
Alzheimer’s disease, the most common form of dementia, is also known as Type 3 diabetes in some circles because it’s due to insulin resistance like Type 2 diabetes.
“You don’t necessarily have to be diabetic at all to have a level of insulin resistance in the brain,” Dr. Maljaars says. But the two often do go together. A person with Type 2 diabetes has a much higher risk of developing dementia in their lifetime than someone who does not have diabetes.
Adopt a Brain-Healthy Diet
What we eat matters deeply. It’s not just about preventing diseases; it’s about strengthening and protecting brain health throughout our lives. Dr. Maljaars advocates for a diet rich in whole, unprocessed foods. He recommends plenty of fresh vegetables, healthy proteins and fats.
“A rule of thumb that I often tell my patients is to simplify. Artificial is not better,” he says. “Eating natural, unprocessed foods is important for optimizing brain health.”
He does recommend the Mediterranean diet to some patients, which when compared to SAD has always shown to be better. “Is it the best possible diet we could eat? We don’t know,” he says. The diet encourages a daily glass of wine, which Dr. Maljaars says is not a great option for someone already experiencing cognitive decline.
Reevaluate Caloric Intake
A common formula in diet culture is calories in less than calories out, which many say leads to weight loss and therefore better health. Dr. Maljaars says that is somewhat of a fallacy, and all calories are not created equal.
“If you’re going to eat a thousand calories of broccoli or a thousand calories of Mountain Dew, are those going to affect your body the same way?” he asks. No. Calories serve as a measurement of the potential energy in a food source and can’t provide information about how it will affect you.
“I never worry about counting calories with my patients — or myself,” Dr. Maljaars says. “I do practice what I preach to my patients, and it’s very much about the nutritional content of what you’re eating.”
Tackle Brain Fog with Diet
“We can never underestimate how much our diet, what we eat, is affecting our health,” Dr. Maljaars says. In the case of post-COVID brain fog, he recommends trying a kind of elimination diet to identify any foods.
If you have any health conditions, check with your primary care provider before an elimination diet, which can be done in two ways. Either remove things one at a time from what you’re currently eating, or scale back entirely to eat very few items and then gradually add foods back in one at a time to see how you react.
“What I usually recommend is a month with no sugar, definitely no artificial sweeteners and no gluten,” Dr. Maljaars says. “Gluten actually seems to affect a lot of people neurologically without having the classic GI stomach upset issues.”
Dr. Maljaars has had patients with migraines and other similar conditions experience significant improvement of symptoms by eliminating something from their diet.
Empowering Yourself with Nutrition
Dietary choices today shape brain health tomorrow. By prioritizing whole, nutrient-dense foods, you can reduce your risk of cognitive decline and enhance your overall well-being.
What steps are you taking to support your brain health through diet? Share your thoughts with us on our social media channels.
