Recap: Simple steps to prevent dementia | Dr Claire Steves

Summary

ZOE Science & Nutrition Podcast Summary Episode: Recap: Simple Steps to Prevent Dementia | Dr. Claire Steeves
Release Date: January 7, 2025
Host: Jonathan Wolf
Guest: Dr. Claire Steeves

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Introduction

In this insightful episode of ZOE Science & Nutrition, host Jonathan Wolf delves into the pressing topic of dementia prevention with renowned expert Dr. Claire Steeves. Challenging the common misconception that dementia is an inevitable part of aging determined solely by genetics, Dr. Steeves emphasizes the pivotal role of lifestyle choices in reducing the risk of developing this debilitating condition.

Understanding Dementia and Cognitive Reserve

Dr. Steeves begins by elucidating the concept of dementia, highlighting how it impairs daily functioning. She introduces the idea of "cognitive reserve," which refers to the brain's ability to withstand damage without showing clinical symptoms. Maintaining a high level of cognitive reserve can significantly delay the onset of dementia symptoms.

Dr. Claire Steeves [00:38]: "Dementia is something whereby our functions are interfering with daily life... It's about cognitive reserve—the kind of maximum cognitive ability that we might have."

Diet and Nutrition: The Mediterranean Connection

A significant portion of the discussion centers on the impact of diet on brain health. Dr. Steeves advocates for a Mediterranean-style diet, rich in diverse fruits and vegetables, plant-based fats, and phytonutrients like flavonoids. She underscores the importance of variety in plant-based foods to support the brain's high metabolic demands.

Dr. Claire Steeves [01:23]: "It's about getting as many different colours of fruit and vegetables into your diet as possible and making sure that you're getting good plant-based fats."

The conversation further delves into the scientific backing for the Mediterranean diet. Dr. Steeves references large randomized controlled trials across Europe that demonstrate the diet's effectiveness in improving cognitive health, linking cardiovascular health directly to brain health.

Patient [02:48]: "There is real scientific evidence that this shift in diet really can reduce your risk of dementia."

Physical Activity: Moving for the Brain

Transitioning from nutrition, the discussion moves to the critical role of physical activity in dementia prevention. Dr. Steeves recommends regular exercise—specifically walking for at least 45 minutes three times a week—as a practical and effective strategy to enhance both physical and cognitive health.

Dr. Claire Steeves [04:07]: "Make sure you're physically active at least three times a week and you're going out every day."

She clarifies that even moderate increases in physical activity can yield significant benefits, debunking the notion that only intense workouts are beneficial.

Dr. Claire Steeves [05:45]: "Even being more up and about, less sedentary time makes a difference."

Dental Health: An Overlooked Factor

An unexpected yet crucial aspect discussed is the relationship between dental health and cognitive function. Dr. Steeves reveals that approximately 35% of older adults in the UK suffer from periodontal disease, which is strongly linked to cognitive decline. She emphasizes the importance of maintaining good oral hygiene as part of a holistic approach to dementia prevention.

Dr. Claire Steeves [07:06]: "There is a quite a strong relationship between periodontal disease and cognitive disease."

Cognitive and Social Engagement: Building Cognitive Reserve

Beyond physical health, the podcast explores the significance of cognitive and social activities in bolstering brain resilience. Dr. Steeves points out that engaging in complex social interactions can serve as a powerful exercise for the brain, potentially more effective than solitary brain games like crosswords.

Dr. Claire Steeves [08:38]: "Interacting socially is one of the most complicated things that we do in our brain."

She clarifies that while brain games can be beneficial, their impact is limited compared to the multifaceted stimulation provided by social interactions.

Dr. Claire Steeves [09:24]: "Social interaction is so complicated for our brain... it's really good for your brain."

Practical Takeaways and Conclusion

Dr. Steeves offers actionable advice for listeners aiming to reduce their dementia risk:

1. Adopt a Mediterranean Diet: Incorporate a variety of colorful fruits and vegetables, plant-based fats like olive oil and nuts, and minimize intake of red meats and processed foods.
2. Engage in Regular Physical Activity: Aim for at least 45 minutes of walking three times a week to enhance both physical and cognitive health.
3. Maintain Oral Health: Regular dental check-ups and good oral hygiene practices are essential to prevent periodontal disease and its associated cognitive risks.
4. Foster Social Connections: Prioritize meaningful social interactions to stimulate the brain and build cognitive reserve.

Patient [06:50]: "Is there anything else I could be doing with my brain over the next 20 years that will change my risk factor? Is there anything I can do there that is actually going to shift it?"

Dr. Claire Steeves [09:55]: "Loneliness is another reason why loneliness is not good for us."

In conclusion, the episode reinforces the empowering message that while genetics play a role in dementia, proactive lifestyle choices can significantly influence one’s risk. By embracing a healthy diet, staying physically active, maintaining dental health, and engaging socially, individuals can enhance their cognitive reserve and potentially delay or prevent the onset of dementia.

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Note: This summary omits the podcast's promotional segment as per the instructions, focusing solely on the substantive content discussed between the host and Dr. Steeves.

Transcript

[Host]

Hello and welcome to Zoe Recap, where each week we find the best bits from one of our podcast episodes to help you improve your health. Today we're discussing dementia. Many believe that dementia is inevitable, something solely determined by our DNA. But this isn't the case. In fact, lifestyle choices play the most significant role in determining if we develop this disease. So what changes can you make today to reduce your chance of Getting dementia tomorrow? Dr. Claire Steeves joins us to share simple steps that will protect your brain for years to come.

[Dr. Claire Steeves]

Dementia is something whereby our functions are interfering with daily life and obviously if we start off with really high functioning, then we get to that point much later in any disease process. So you can put off significantly the time at which you fall below that threshold of being able to function in daily life. It's about cognitive reserve. So that's the kind of maximum cognitive ability that we might have, not just in terms of sort of intellectual ability, but also psychological state as well.

[Patient]

So, you know, I'm someone in my late 40s. I really want to make sure that I don't have dementia. Give me the advice. If I was walking into your clinic, tell me what you would be saying that I should be doing in order to try and make sure I never had to come back to your clinic. And, you know, 20 years.

[Dr. Claire Steeves]

So actually what I realistically say to patients is it's about getting as many different colours of fruit and vegetables into your diet as possible and making sure that you're getting good plant based fats into the diet. Because the brain is hugely metabolically active, it needs a lot of nutrients and we know that a wide variety of plant based nutrients is really important for brain health. And I talk about colors because actually there's evidence that flavonoids are really key phytonutrients for brain development. It may be because you're changing the microbiome because there's such a thing as a gut brain axis. So we think that there's a very strong relationship between what's going on in our gut.

[Patient]

Lots of plants with lots of fiber, lots of different colors. And then you said lots of healthy fats, which means a lot of plant based fats. And so I think you were mentioning nuts. We often talk about things like avocados. Right. At Zoe, these are the sorts of things that you're. You're talking about.

[Dr. Claire Steeves]

Yeah. And I think olive oil, I guess that's right. And you know, there's quite a number of studies now showing Mediterranean diet, it helps to improve cognitive health.

[Patient]

So that there is Real evidence that the Mediterranean, like, changing this. This isn't just like something. Because, you know, doctors always say you should eat more healthily. Right. And everyone's like, yeah, yeah, yeah. There's real scientific studies that show that switching to this Mediterranean diet, which is high in the things you're describing and low in, like, the more traditional Western diet of meats and, like, white bread and all the rest of it, like, that actually has an effect on dementia.

[Dr. Claire Steeves]

Yeah. And then you. So you've just mentioned the other thing, which is meats and white bread. Yeah. So we know that there's a relationship between vascular health and brain health.

[Patient]

And vascular health means the blood vessels.

[Dr. Claire Steeves]

Within your body and your heart. That's because one of the other types of dementia we haven't really talked about is a vascular dementia. And often there's a combination actually of vascular factors that then bring on those other processes, like Alzheimer's.

[Patient]

So if you're eating a diet that's good for your heart, basically, and you're.

[Dr. Claire Steeves]

Good for your heart and your blood.

[Patient]

Vessels, also going to be good for your brain.

[Dr. Claire Steeves]

Yeah, it's going to be good for your brain. And it's going to put backwards the balance of things that are going on in your brain that might relate to Alzheimer's.

[Patient]

There is real scientific evidence that this shift in diet really can reduce your risk of dementia.

[Dr. Claire Steeves]

So, for example, in the Mediterranean diet, there have been really large randomized controlled trials that were conducted over a year period in five different countries in Europe. And when they compared the group that were randomized to the Mediterranean diet against the control group, they didn't find very significant differences.

[Patient]

If you manage to change your diet in a sustainable way, it really can reduce your risk of dementia. But you have to stick at it.

[Dr. Claire Steeves]

You have to stick at it.

[Patient]

You can't just do it for a few months.

[Dr. Claire Steeves]

And the trouble is, that's difficult.

[Patient]

What else would you tell?

[Dr. Claire Steeves]

So the second thing is about physical activity. So, you know, I do tell all my patients to make sure they're physically active at least three times a week and they're going out every day. These are really important things to do, and that can help preserve your physical function as well and your cardiovascular function. It's probably the biggest thing that you can do to help your overall fitness.

[Patient]

And when you say physical activity, when you think about dementia, what's really required, because we talk, you know, to a very wide range of people who vary between, you know, if you even get up from your chair for two minutes, you've done everything like Amazing to, you know, if you're not doing a massive workout four times a week, then you're sort of dooming yourself. But what, what should people be thinking? Like, this is what I really need to make sure that I'm building into my life.

[Dr. Claire Steeves]

So to improve your cognitive health, you need to do more exercise than you're doing now.

[Patient]

Okay.

[Dr. Claire Steeves]

Okay. Up to a point. Unless you're like an Olympic athlete. I'm not an Olympic athlete. And that's the key thing. Okay. And this is again about the difference between scientific proof and practical advice. So the reason why there's this debate between scientists about what is the dose required of exercise is because to show a change over a short period, you have to have a big enough dose to be able to detect that effect. Whereas if we look at really big population studies, we can see effects even with minimal levels of exercise. And it's fairly linear. So even being more up and about less sedentary time makes a difference. But then you can still make more difference by putting every egg on. So whatever you're doing, if you go up by a third, you'll be improving yourself.

[Patient]

And is there any particular sorts of exercises you're thinking about this?

[Dr. Claire Steeves]

So probably the most evidence is around resistance training exercise for overall frailty and so on. Then, you know, for cardiovascular fitness, there's aerobic exercise.

[Patient]

I'm one of your patients. I'm not very physically active. What would you be telling me that I should do that can really make a difference?

[Dr. Claire Steeves]

Walking.

[Patient]

Walking.

[Dr. Claire Steeves]

I think you need to get out and do walking 45 minutes at least three times a week, and that will.

[Patient]

Really make a difference. If I'm not doing that, that will really make a difference. So that, I think, again, is amazing. Claire, I think you're like, well, it seems sort of obvious, but again, I think many people listening to this grew up with the assumption there is nothing you can do about your. It's just literally a consequence of getting older. And you're saying actually if you went for a walk three times a week compared to just not doing that, you were going to make a really significant reduction in risk. Is rather extraordinary and does suggest that our current way we live our life is not very well optimized for avoiding this. If that is almost like your starting advice, people, is that one thing I.

[Dr. Claire Steeves]

Haven'T really talked about ever before with you is teeth, the importance of teeth. In the UK population, about 35% of older adults have periodontal disease, inflammation of their gums. And we know there's a quite a Strong tight relationship between periodontal disease and cognitive disease.

[Patient]

And this is. You believe this is true because we had somebody on just. If anyone's interested a few weeks ago, we'll put a link who was a dental researcher saying this. But I was curious because obviously if you're a dentist, you're going to be convinced that the teeth.

[Dr. Claire Steeves]

Oh, no, no, I really think it's really true and it's.

[Patient]

You're not a dentist, so therefore I'm not a dentist. You're unbiased on this. This is really true, isn't it?

[Dr. Claire Steeves]

It's really true. There is a vicious cycle though, obviously, because as you start to get dementia, it's more difficult to look after your teeth. And also we know that looking after teeth, actually diet is really important in looking after teeth. So teeth are much more healthy if you have a good varied diet that we've been describing and less sugar and so on and so forth. But actually, you know, this is a very common inflammatory load which is tickling the systemic.

[Patient]

It's amazing. I just heard this literally a few weeks ago. I was shocked to hear.

[Dr. Claire Steeves]

Yeah. And actually when I see my patients in clinic. Okay, the thing that sort of, you know, just eyeballing the thing that's related to that cognitive reserve we were talking about, I. E. The difference between what's in their brain and how they're actually living, you know, how they actually present. The people that have the bad teeth will be doing badly. The people that have the good teeth will be doing well.

[Patient]

You would be saying, if someone is having problems with their teeth, like, absolutely, go and get it fixed right away. Because that really could be a big risk factor. What else could people do? And I feel like you mentioned a little bit about intellectual stimulation and social stimulation. Is there anything you can do with your. Is this all fake that doing things with the brain can help prevent dementia, or is there something real about this?

[Dr. Claire Steeves]

Well, no, I think the thing is it's about that cognitive reserve as well. Again. Okay. So I don't think we mustn't be getting the idea that if you have got a managerial, high paid job, whatever, you're doing lots of intellectual activity, that you're immune to dementia. Everybody can get dementia. It's just that you will present later.

[Patient]

So I'm in my late 40s, I'm thinking about this right now. Is there anything that I could be doing with my brain over the next 20 years that will change, Change my risk factor? Is there anything I can do there that is actually going to shift it.

[Dr. Claire Steeves]

Probably one of the most complicated things that we do in our brain is to really interact socially. And so that's.

[Patient]

So that is better than a crossword puzzle.

[Dr. Claire Steeves]

That's better than a crossword puzzle.

[Patient]

But that doesn't I think much more fun as well. So it's good news. I know not everybody feels that way. Some people who are more introverted feel this is hard work but it's really good for your brain.

[Dr. Claire Steeves]

But it doesn't necessarily mean that some of these brain games aren't helpful. I think the thing is that what brain games tend to do is they 10 make you better at that brain game. They don't necessarily.

[Patient]

You need to have lots of different brain games.

[Dr. Claire Steeves]

Yeah, you'd have to have lots of different brain games.

[Patient]

Okay, so it's not that bad. But actually you're saying social interaction is so complicated for our brain. That's really exciting. Which also I guess ties into why loneliness is another reason why loneliness is not good for us.

[Dr. Claire Steeves]

Yeah. And then physical activity, certain physical activities are really taxing for the brain, aren't they, in terms of activity. So if you're like cycling in London, that's for sure quite taxing.

[Patient]

Yes. I always think that it might be lowering your life expectancy for other reasons.

[Dr. Claire Steeves]

Yes. Yeah. But there are other sort of forms of physical activity like dancing, whatever, which is quite a good cognitive task you're.

[Patient]

Saying, because your brain is having to think quite a lot as well stuff. Basically what you're saying is using your brain, making it have to do something that is actually going to build what you're calling this reserve, which is basically meaning you're less likely to your tank.

[Dr. Claire Steeves]

What's in the tank? Yeah.

[Host]

That'S it for this week's recap. If you're hearing this, you're already on your way to making smarter food choices with world leading sites. Speaking of making smarter food choices, Zoe membership helps you to do just that with scientific solutions that let you listen to your gut. Listening to your gut starts with an at home test kit that helps you understand your body's responses to food and the good and bad microbes in your gut. Then Zoe's app helps you build life changing nutrition habits step by step. Become a Zoe member today and give your gut the love it deserves. The first step is easy. Go to Zoe.com and use the code podcast to get 10% off. As a Zoe member you'll get a comprehensive at home test kit and personalized nutrition program. So go to Zoe.com and get 10% off with code podcast.