This month I want to emphasize one key point about brain function: ten steps of lifestyle prevention works to prevent more than 70% (maybe 90%) of dementia, but so far with some exceptions (getting rid of toxins, or mold, or heavy metals), treatments (even lifestyle treatments) have been disappointing at reversing disease once established. So start doing preventive stuff today, including not holding it n (see below)!!!

Let me expand on what works and what doesn’t by describing three important groups of articles reported this month about brain dysfunction—While two of these three are very hopeful, the third group would be discouraging save it gives you who do not yet have overt brain dysfunction action steps to start now. The three groups of reports can be summarized:

1. Exercise after dementia has developed only seems to change the course of disease in select Parkinson’s patients but didn’t affect outcome once Alzheimer’s dementia is present in one large and well done study (4);

2. Over 1000 drug trials have now been done in established Alzheimer’s, and there doesn’t seem to be any that result in major modifications in disease course;

3. The diet choices we wrote about the last several months have been confirmed in more studies to make a difference not only to memory and general brain function, but also to preserving your hearing (5,6);

For you who do not have dementia yet or only are worried your memory isn’t as good as it has been, know new data further supported a few diet choices you can make (avoid the 5 snake oil foods and go Mediterranean with a lot of vegetables and salmon or Ocean trout, use olive oil, and enjoy walnuts and coffee) that do make your brain better.

Here are 10 Steps that have solid scientific data (at least 4 “good” studies in humans and animal data) that you can take to prevent brain dysfunction:

  1. Learn To and Do Manage Stress Daily
  2. Do 4 Components of Physical Activity
  3. Do “Speed Of Processing Games”
  4. Eat 10 ounces of Salmon/Ocean Trout a week or 900 mg DHA a day:

5. Avoid SSSSnake oil Foods

6. Give Sleep Respect

  1. Avoid Unforced Errors Including Toxins, and behaviors that might result in an unprotected brain and injury or concussion
  2. Drink Coffee-No Additives Please; Enjoy Nuts
  1. Take the Fab 8+2+1
  2. Enjoy An Infrared Sauna for 20 min 4 Times Each Week

In the last two months we talked about how great black coffee and walnuts were, and to Veg big for a big Hippocampus. The only organ in your body where size matters is your hippocampus—the memory relay center in your brain. To reinforce the point, to recall information, your neurons need to communicate with each other. One sends a message to another; the receiver gets the message—and that connection is what basically build bridges of information that you can use and recall whenever you need to. And those bridges increase your hippocampal size. Breaking down or not building those bridges causes a small hippocampus. What breaks those bridges down? For one, lack of use, or lack of requiring yourself speed in using.

That’s why speed in timed chess or timed bridge or speed of processing games works or dancing or music works, but crossword puzzles and memory games only help you do crossword puzzles or memory games, and have not in randomized studies prevented dementia over a ten year period in people over age 70. If you don’t constantly send and receive messages and force a discipline to send ‘em fast, those bridges won’t get traveled on, nobody will maintain them, and they’ll eventually crumble and fall apart.

Now while this month’s reports confirmed the benefits of a vegetarian diet in increasing hippocampal size (and in preventing hearing loss) over a 38 year period beginning at an average age of 44, and of coffee in making arteries and brain younger (5,6,7), another set of scientific reports confirmed the hazards of unforced errors in worsening brain function. Toxins like tobacco (marijuana for women under age 18 and men under age 21), and concussions increase the risk of memory dysfunction as we age. But here is a weird one that may act like alcohol acutely and has an easy action step—don’t pass a bathroom up.

Yes, Manny did it behind the Green Monster while playing left field for the Boston Red Sox. LeBron has taken himself out of the game for it. Michael Phelps did it in the pool and a “slow release” is the favorite of many an NFL player. “Every single athlete has to deal with this,” says U.S. women’s national hockey team forward, Jocelyne Lamoureux-Davidson, “No one ever talks about it.[1]

It? Coping with the need to pee.

Uber-hydrated athletes often have to confront the urgent feeling, but on a long drive or in an intense meeting chances are you’ve had to decide, should I hold it in?

Medically speaking, urologists say it’s always better to respect nature’s calling. But the truth is before the age of 50, you have the ability to hold urine in for about eight hours and that’s okay to do as long as you don’t do it all the time.

However, some professions, such as a nurse, teacher, surgeon or anesthesiologist or a truck driver seem to demand that you hold it in frequently. In those cases, you’re risking infections, long-term damage to your bladder[2], and even possible kidney damage. Another huge drawback? A neurologist from Brown University. Peter Snyder, MD, reports that holding back impairs higher-order cognitive functions on a level similar to drunken driving[3]. “They made it to the bathroom, but it was a pretty ugly scene,” said Peter Snyder, professor of neurology. “There was a bit of some pushing to get into the stalls.”

Snyder was not describing the men’s room during a basketball game time out or the mad dash for the ladies’ room during the intermission of a lengthy play. As subjects’ self-reported pain levels increased from holding it in, so too did their levels of cognitive impairment as measured by attention and working memory tasks. We do not know if this has long term effects, but I imagine that bouts of pain can cause destruction of neuronal connections in your brain.

So when nature calls, it’s okay to hold it in for a little while—but avoid making it a habit or one day you may lose the ability to hold it in at all. And when you find that urge to pee relieved, vow to and develop a plan to immediately implement some to the ten lifestyle prevention choices that preserve and increase brain functioning as for your brain, an ounce of prevention is really worth a ton of non-effective cures.

Next month we’ll talk about another choice that keeps you younger and thriving.

Thanks for reading. Feel free to send questions—to [email protected]

Dr Mike Roizen

You can follow Dr Roizen on twitter @YoungDrMike (and get updates on the latest and most important medical stories of the week).