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Sanjay Gupta on How to Keep Your Brain Sharp

CNN's Chief Medical Correspondent, a brain surgeon, shares his advice

By Richard Harris

Your New Year's resolutions will require more creativity this year since the pandemic is keeping many gyms closed. But CNN's Chief Medical Correspondent Dr. Sanjay Gupta says it's not only important to find a way to stay active in 2021, but to put more focus on the control center of the body: our brain.

Sanjay Gupta, keep your brain sharp, Next Avenue
Credit: Adobe

He should know. The man who has guided us through the spikes and surges of COVID-19 somehow finds time to perform brain surgery at Atlanta's Grady Memorial Hospital where he's associate chief of neurosurgery. And he's now out with the book, "Keep Sharp: Build a Better Brain at Any Age," an outgrowth of what Gupta has called his "longstanding love affair with the brain." I spoke with him about why it's important to keep your brain sharp and how best to do it:

Next Avenue:  Why should our New Year's resolution begin with improving our brain health?

Dr. Sanjay Gupta: Everything else is derivative from that. You're much more likely to improve all other aspects of your health if you start with your brain health. If for no other reason, you'll have better judgment. You'll make better decisions about the other things in your life that affect your health, such as how you nourish your body.

Before you recommend what we should do to get our brains in shape, take us inside the brain so we know what the goal is.

You're trying to create a way of life that is constantly recruiting all these different parts of your brain. If you draw a surface map of your brain and you say we have a million roads in the brain, know that we may be really good at using only a hundred thousand of them.

Whatever way you're living, your life has a really predictable, repetitive nature to it. And it works really well for you because you are a highly functioning person. But once you start to actually open up other roads in your brain, other things happen as a result. One is that you start to connect patterns from different parts of your life that you were missing before.

"It really made me think about this idea that we think it's preordained that we're going to lose cognitive function."

So while we may think we're stuck with the brain we have, we can actually improve our brain's performance?

Absolutely. There are ways to optimize your brain now. For so many people, it's seen as an impenetrable, immutable, unchangeable organ. It was seen that way even in the medical community for a long time. That's how I was trained — neurogenesis (the birth of new brain cells) wasn't something that we really thought of until I finished my neurosurgery training in 2000.

Since then, the neuroscience community has learned that what will improve your cognitive reserve, your brain's resiliency, make you less likely to develop dementia — able to remember things better and consolidate memories, no matter your age.

So, what's the best technique to open up new roads and make new connections?

The way to get there is to basically shake it up a little bit, get outside your comfort zone, do something that scares you every day.

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When you do that, you also find that as you get older, inevitably, some of the roads that you're using all the time can lead to construction or they become blocked. And for a lot of people, when that happens … they start to have symptoms of a brain that is not working as well.

Your reasoning skills and ability to connect patterns — even things like empathy — they start to decrease as well if the roads are blocked. But if you have a lot of ancillary roads and trails, it's not only serving you well now in your life when you when you're highly functioning, but it's also creating that cognitive reserve and acting as a buffer, a resilience against disease later on. 

You debunk the common belief that cognitive decline is inevitable as we grow older.  It's one of the twelve destructive myths about the aging brain that you call the "dirty dozen."

About a year and a half ago. I was in the operating room. A  patient had just come into the emergency room with a subdural hematoma (a blood collection between the outer layer of the brain and the brain itself that puts pressure on the brain). I'm told the patient is ninety-three years old and ask, 'What kind of shape is this person in? Is an operation warranted?'

Sanjay Gupta's new book, "Keep Sharp," Next Avenue, brain sharp

His family said he's an incredibly high-functioning person. In fact, he got the injury because he had fallen off the roof of his house, blowing leaves off the roof with a leaf blower. When I talked with him, he was clearly a very high-functioning person. He was looking at his device, following election results in East Africa, where he once did relief work.

He had this subdural and it was clearly causing symptoms. The concern with those subdurals is they can continue to grow… So, I took him to the operating room, removed this collection of blood that was on top of his brain…The brain reliably shrinks with age, but the function of his brain was incredible. What he was able to remember, the things that he engaged in, all these things were at a level that seemed  decades younger.

So, it really made me think about this idea that we think it's preordained that we're going to lose cognitive function because the organ itself will start to wear and tear with age. And the reality is the organ does wear and tear with age. But what it's capable of still doing is different than any other organ in the body.

Even if it physically changes, what it cognitively can do can actually reliably get stronger if you continue to engage it. 'Like a Ginsu knife,' as my daughter said the other day when I was explaining this to her. 'The more you use it, the sharper it gets.'

When you're learning about new things all the time, this isn't about improving your IQ or your ability to even recall those things that you just learned. It's about recruiting new neural pathways that connect different parts of your brain that you're not typically using. And that allows you to see a new pattern that allows you to experience things for the first time

How do we make our brains more resistant to dementia?

It's becoming increasingly clear that while amyloid plaque was a great hypothesis [for why some people have dementia],  these strategies to decrease the amount of plaque in the brain have not clinically improved patients. The trials just haven't worked.

There are a few new medications — not plaque reducers, but other medications — that can basically slow down progression of Alzheimer's. But there is no significant therapeutic that works. 

So, all of that to say that people don't want to develop the cognitive dysfunction in the first place. And I think that this pre-clinical window — the time between what we call 'disease onset' in the brain and symptomatology —is a very critical window. And when you look at the work of people like Richard Isaacson and even Dean Ornish, to some extent, you realize that these lifestyle changes that they talk about can dramatically lower the likelihood of someone going on to develop what I'll call cognitive dysfunction, as opposed to specifically Alzheimer's.

And the fact that you could actually target those forty-six million or so people who are in that position through these lifestyle changes was really inspiring to me. And one of the reasons I decided to write the book is these lifestyle changes could make a difference. We've known that about heart disease for a long time. But now we're seeing the same thing with all types of dementia.

Among the lifestyle changes you recommend is nourishing the brain with the 'MIND diet,' which took the basics of two popular diets (Mediterranean and DASH) and incorporated dietary changes that promote brain health — more vegetables, nuts, berries, beans, whole grains, fish, poultry and olive oil and less red meat, butter, stick margarine, cheese, sweets and fries or fast food. Why is this good for the brain?

There's some merit to the adage that what is good for the heart is good for the brain. The brain is two percent body weight. It takes twenty percent of your blood flow. For the same reason the MIND diet would help keep your coronaries clean, it would help with your overall brain health.

Unlike your heart or your stomach or other organs in your body, your brain is constantly nourished by everything it takes in…Having an overall healthy diet, like the MIND diet, is critical for your vascular system, of which the brain is the most demanding organ. 

Older Politicians and Their Brains

We now have seven senators in their eighties, and Dianne Feinstein, who's eighty-seven, announced she was stepping down as the ranking member of Judiciary Committee. There were some concerns that she's having memory issues. Of course, President-elect Biden is going to be seventy-eight at his inauguration. Should members of Congress or the executive branch take a competency test before running for office if they're at a certain age?

I think it's a really challenging issue. And I would draw a distinction between electoral politics and other jobs, even within public service… If someone has cognitive decline, to know would require actually studying someone over time…There are certain things that clearly are worrisome or indicate some sort of pathology, like, a person clearly is having memory issues that are absolutely interfering with their way of life… With Dianne Feinstein, she was in the job for a long time. And I don't know if she's said it openly, but I know she has discussed this with other people, her difficulties with memory loss. 

The recent New Yorker article about her said she asked exactly the same question twice in a hearing.

Right, exactly. But I think competency exams in general are hard to interpret… It's hard.

I will tell you, this came up with this recent election — you have a seventy-four year old and a seventy-eight year old running for office.

"When TV producers tell a colleague, 'This isn't brain surgery, what do brain surgeons say about their jobs?'" 

Cognitive dysfunction is actually a really hard thing to to establish unless you follow somebody over time. People can have periods of memory loss that can be due to a poor night's sleep, inattention because of  lots of things are being thrown at them, new medication…It's very involved to try and actually establish competence in a non-criminal sort of setting.

If there's an organic problem like a tumor or a stroke or something like that, that's different. But just general competence is hard to establish. So, I don't know that I'd be in favor of [a competency test]. And I worry that they might be abused.

For many years, I was a television news producer. And you'd often hear this crack in the newsroom: 'TV news isn't brain surgery.' I was always curious what brain surgeons say about their profession. So one day, the father of one of my daughter's friends came by and he's a brain surgeon, so, I asked him: 'When TV producers tell a colleague, 'This isn't brain surgery, what do brain surgeons say about their jobs?  And he said, 'That's easy, we say it isn't rocket science'. So now that I'm talking to a brain surgeon who spends a lot of time with his journalist colleagues at CNN, what do you say when they say television news isn't brain surgery?

It's funny, I can't tell you how many times I've heard this since I joined CNN twenty years ago. But the funniest thing I ever saw was when I came back to my office years ago and someone had taped a cartoon to my door. It was two guys operating on somebody's brain. And the caption was one guy saying to the other, 'Hey, come on, man, it isn't television.' No lie. No lie.

Sanjay Gupta's 'Dirty Dozen' Myths About the Aging Brain

Myth #1: The Brain Remains a Complete Mystery

Myth #2: Older People Are Doomed to Forget Things

Myth #3: Dementia Is an Inevitable Consequence to Old Age 

Myth #4: Older People Can't Learn New Things

Myth #5: You Must Master One Language before Learning Another

Myth #6:  A Person Who Has Memory Training Never Forgets

Myth #7: We Use Only 10% of Our Brains

Myth #8: Male and Female Brains Differ in Ways That Dictate Learning Abilities and Intelligence

Myth #9: A Crossword Puzzle a Day Can Keep the Brain Doctor Away

Myth #10: You Are Dominated by Either Your "Right" or "Left" Brain

Myth #11: You Have Only Five Senses

Myth #12: You're Born with All the Brain Cells You'll Ever Have, Your Brain Is Hardwired, and Brain Damage

Richard Harris is a freelance writer, consultant to the nonprofit iCivics, former producer of NPR's "All Things Considered" and former senior producer of "ABC News Nightline with Ted Koppel." Follow him on Twitter @redsox54.  Read More
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