Nutrition and the Brain Part 2 – Sleep and Vegetables!

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July 29, 2013

Much of the conference I attended last weekend, titled Nutrition and the Brain, was about Alzheimer’s dementia (AD). There are genetic factors for AD which we’re handed at birth, like it or not, and environmental factors, which we can control. The latter include exercise, sleep and nutrition. We covered exercise in detail in Part One, so in this article, we’ll look at how sleep and nutrition affect our brain function. Part three will be about brain exercises.Let’s start with sleep, to follow-up on Linda’s article in the reading section. Restorative sleep that cycles properly through all the stages can improve overall quality of life, mood, and brain function. It also has a positive impact on blood pressure control and heart disease. Good quality sleep allows for the normal rhythm of hormones that might be helpful for weight loss. Also, it has been shown to decrease the level of amyloid beta 42, a protein that accumulates in the brain in AD. When mice are sleep-deprived, they have increased amyloid deposition in their brains.

Many of us have marveled at teens who can sleep 12 hours, given the chance. With age, and with menopause, people generally have impaired sleep patterns. There is usually increased wakefulness during the night and more brain activity during sleep compared with younger people. This poor sleep pattern is associated with impaired memory retention.

In general, we should aim for 7-8 hours of sleep nightly. With less, we might think we’re doing well, but not realize we have symptoms due to chronic sleep deprivation. This applies to so many of us.

To appreciate what the issue is, let’s consider people who have sleep apnea. They wake up many times during the night without realizing it. If they complain about fatigue, snoring, or morning headaches, their physician might order a sleep test. It would show that they stop breathing and wake up very briefly many times during the night. I have had patients with 50-60 of these episodes per hour. They are not aware this is happening; they know that they feel tired the next day, but attribute the fatigue to many other things, not realizing that they’ve been up so many times during the night. We used to think sleep apnea only occurred in significantly overweight males, but now know that it can occur in anyone, including relatively thin females, so we are testing more people.

When they are started on treatment with a CPAP (constant positive airway pressure) mask, which allows them to sleep through the night (if they tolerate the mask and machine), people with sleep apnea suddenly appreciate how tired they were before. They usually feel more alert, better able to concentrate, more productive at work, and happier overall.

For those of us who don’t have sleep apnea, we can have the same symptoms of irritability and difficulty concentrating from just not allowing adequate time for sleep. It may not be obvious that it’s from sleep deprivation, but it well might be! I’m guilty of working late into the night on whatever project – related to patients, pleasure reading, writing…. – but have been trying to aim for 7 hours a night. When I start feeling ‘clumsy’, I know I’m not taking good care of myself, but that’s probably a late sign that I’ve been sleep-deprived for a while.

So treat your brain to 7-8 hours of sleep per night if possible – now onto nutrition. Essential tremor, or shakiness, usually of one or both hands, is seen commonly. Dr. Michael Greger, who writes extensively on nutrition and health (see stated that essential tremor is 21 times more common in frequent meat eaters. One of the articles he quoted stated, “Vegetarian diets could have some beneficial effects probably due to the increase in antioxidant intake.” He cited numerous studies, but they each included few subjects, so in my mind, were thought-provoking, but not definitive.

Other information he presented also focused on plant-based diets. His point was that eggs, chicken and beef include high levels of arachadonic acid, which is then broken down in our body to produce inflammatory products. Inflammation is the process by which our bodies heal themselves, but excess inflammation, in general, is something to be avoided. It is associated with damage to our cells. When we eat fruits and vegetables that are high in anti-oxidants, such as berries, sweet potatoes or kale, we provide our bodies with the means to take care of free radicals associated with inflammation. I don’t mean to suggest that he favored countering meats with vegetables – all of the speakers were in favor of vegan or vegetarian diets.

Let’s move from tremors to multiple sclerosis, a neurologic disorder that is characterized by intermittent or progressive symptoms. Multiple sclerosis has also been associated with diets high in animal fats. Longterm studies have shown that patients who have been on an up-and-down course stabilize at a better level on a vegetarian starch-based diet.

Many of the talks focused on vegan or vegetarian diets – the difference between these being that some vegetarians will eat eggs or dairy (ova-vegetarian or lacto-vegetarian), or even fish (pesco-vegetarian), whereas vegans will not eat any of those. In any of these plant-based diets, but particularly in vegans, vitamin B12 levels should be checked, as 50% may be deficient. Low B12 levels are associated with tremors, imbalance, numbness and decreased cognitive status.

Finally, Susan Levin, a registered dietician and director of nutrition for the Physicians Committee for Responsible Medicine ( spoke about overall nutrition recommendations. In brief, with a vegan diet, nuts and seeds should be included for adequate vitamin E. As noted above, Vitamin B12 level should be checked. B12 is a protein present in meat and eggs, and to some extent in nuts and seeds. Vegetarians may need to supplement their diet with B12 pills, which are over the counter, but should not choose to use a multivitamin to get the B12. Most multivitamins contain iron and copper, and neither is needed in our bodies; they may accumulate in the brain and contribute to dementia. In terms of vitamins, my preference is also to eat a diet rich in fruits, vegetables and whole grains to fulfill the body’s vitamin requirements, rather than using vitamin pills (other than Vitamins B12 and D as indicated by blood levels).

Aluminum should also be thought of as a toxin, and be avoided in pots and pans and in deodorants. Be sure to buy baking soda that is aluminum-free, as well. She stressed the importance of ‘walking the walk’ in terms of what you do and eat to be a role model to others in your household.

So, what should we do with all this information? Over the years, I have been trending more and more toward a plant-based diet. I think the fiber, nutrients, anti-oxidants and low calorie-to-volume ratio is healthy and helps with weight control. Although I rarely have red meat, I still think there is benefit to eggs, yogurt and some other animal products. Above all, variety in what you eat is key. At least that dilutes the evils of any one food. And who knows what will be tomorrow’s ‘bad food’?! For those with a tremor or multiple sclerosis, assuming a full medical workup has already been done, I would recommend at least giving a plant-based diet a try, based on these talks. It may help alleviate the symptoms while nourishing the body; the decision can always be changed if it doesn’t seem to be beneficial.

In Part 3, I’ll give you some information about brain exercises, some precautions, and some sites available online. For now, here’s a new recipe for tofu, thanks to Ellen, who I met at the conference. And, a recipe for green beans with sesame vinaigrette, which can be adapted for other veggies. They are both easy and delicious, and can add to your repertoire of vegetarian recipes! In the fall, I’d share my family’s favorite butternut squash chili with you – a powerhouse of anti-oxidants.


1 lb block extra-firm organic tofu
4 Tbsp brown rice syrup
2 Tbsp low sodium soy sauce (or Tamari gluten-free)
1 Tbsp toasted sesame oil
1 small clove garlic, finely minced
1/8 – 1/4 tsp chili powder, to taste
1/3 cup water
toasted sesame seeds

1) Mix all ingredients for sauce.
2) Drain tofu of all water. If time permits, let it sit in a colander and drain. Cut into squares.
3) Mix tofu and sauce; marinate for a few hours if able.
4) Cook tofu over medium to medium-high heat until the liquid is absorbed, turning periodically. Add water if pan is dry before tofu is cooked through. It should take about 20 minutes, but watch carefully to avoid burning the pan.
5) Sprinkle with sesame seeds, to taste.


Adapted from Makes 6 servings.


1 1/2 lbs green beans, trimmed
3 Tbsp olive oil
1 tsp Asian sesame oil
1 Tbsp white wine vinegar
2 tsp Dijon mustard
1/4 – 1/2 tsp salt, to taste
1/4 tsp black pepper
2 Tbsp sesame seeds, toasted (you can purchase them toasted or bake at 325 for a few minutes in a Pam-sprayed toaster oven pan. Watch carefully, or they will burn.)


1) Steam green beans for 3 minutes. If you don’t have a steamer, you can cook uncovered in salted boiling water until crisp-tender, but you will lose some of the nutrients this way. If cooked this way, douse with cold water to stop cooking. Drain beans and pat dry.

2) Whisk together oils, vinegar, mustard, salt and pepper in a large bowl until combined well. Then add beans and sesame seeds and toss to coat.



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