I’m going the extra mile for myelin.
I travel the world to deliver neurological care in places with limited resources. Along the way, I have learned several important lessons about protecting brain health and preventing brain disease.
My perspective was forever altered on one of my first trips to Uganda for the Department of Neurology at NYU Grossman School of Medicine.
I met a 14-year-old boy unable to move the left side of his body. Our medical team discovered the teen had undiagnosed and undetected HIV since birth.
I was surprised to learn that HIV could be associated with stroke because it is an advanced feature of the virus that is infrequent in the US now. That knowledge changed my perceptions and attitudes towards brain health.
Here is some wisdom from my visits to Uganda and Ghana, including two simple steps to halt and reverse brain damage.
US vs the world
The biggest difference in brain health challenges in the US and places like Ghana is simply access to care.
Most Americans can see their primary care physician to screen for risk factors leading to brain disease. Most Ghanaians do not have this level of access, so they are silently living with many risk factors. That leads to brain disease manifesting as a stroke or some other preventable brain disorder.
A major, under-the-radar risk factor
One risk factor for dementia that doesn’t get a lot of attention is undetected hearing loss.
Hearing loss is common with age. The problem is that good hearing is crucial for feeding the language centers, primarily located in the left hemisphere of the brain, with the proper information to produce language.
If hearing loss is not detected in a timely fashion, there might be improper funneling of information to this language area, increasing the risk of memory loss and dementia.
Screening timetables
Patients should be screened for brain-related conditions such as cognitive decline and stroke risk at least once a year.
A preventative primary care physician will measure blood pressure, heart rate and cholesterol levels.
Cardiovascular brain damage is tricky because it often has no immediate warning signs. High blood pressure is known in medicine as a “silent killer” because you don’t feel it as you’re walking around.
High blood pressure causes arteries and veins to narrow, which decreases nourishment and blood flow to the brain. This leads to changes detectable by modern MRI.
Thankfully, these changes are in silent regions of the brain, so you will not have a disability. However, over time, memory loss, dementia and other harmful brain diseases can develop.
High cholesterol, along with high blood pressure, contributes to these very same changes because it leads to blockages in important arteries that feed your brain with blood.
Physical inactivity fuels high blood pressure, high cholesterol and other cardiovascular risk factors.
Fortunately, brain damage from poor cardiovascular health can be stalled and even reversed.
The traditional risk factors of high cholesterol, high blood pressure, diabetes and smoking are addressed by two behaviors — diet and exercise.
Two ways to protect brain health
When I traveled to Uganda and Ghana, one aspect of their diet that surprised me was their natural portion control.
The average Ghanaian and Ugandan meal is half or one-third the size of what we would expect of a meal in the US.
American restaurants offer huge portions based on the idea that bigger is better, especially because it’s more value for your money. But these larger meal sizes are just not meant for one person.
So much of brain health is linked to the quality of your diet, including the amount you consume in one sitting.
Smaller portions and a lack of snacking between meals are inherent to cultures in Uganda and Ghana.
Just by making more modest food choices at home, you can lessen your risk of brain disease.
The right type of diet is not specific to one culture. Dietary approaches to stop hypertension or Mediterranean diets are rich in fruits and whole grains with low salt and less saturated fat.
Exercise, which can occur in many different forms, is also essential to brain health.
No matter what neurological disease you may have heard of, the rate and severity of that disease are lessened with regular exercise.
Exercise crosses cultures — I’ve seen it manifested in different ways as I’ve traveled the world and delivered neurological care.
The other aspect of the culture in Uganda and Ghana that really struck me — in a good way — was the lack of alcohol and cigarette use.
Drinking less alcohol and smoking less are well-established behaviors that lead to better brain health. The vast majority of both populations do not regularly partake in these activities.
Follow these recommendations to protect your brain as you age — and consult your physician with any concerns.
Dr. Jaydeep Bhatt is the director of the Division of Global Health for the Department of Neurology at NYU Grossman School of Medicine.
