Self-Assessment

o. Self-Assessment What Are Your Risk Factors? WE TEND TO think of brain disease as something that can strike us at any time, for no good reason other than genetic predisposition. Unlike heart disease, which progresses over time due to a combination of certain genetic and lifestyle factors, brain ailments seem like conditions that befall us by chance. Some of us escape them, while others become “afflicted.” But this thinking is wrong. Brain dysfunction is really no different from heart dysfunction. It develops over time through our behaviors and habits. On a positive note, this means we can consciously prevent disorders of our nervous system and even cognitive decline much in the way we can stave off heart disease: by eating right and getting our exercise. The science now tells us, in fact, that many of our brain-related illnesses, from depression to dementia, are closely related to our nutritional and lifestyle choices. Yet only one in one hundred of us will get through life without any mental impairment, let alone a headache or two. Before I delve into the science behind the bold statement that brain disorders often reflect poor nutrition, as well as a lot of other aggressive assertions, let’s start with a simple questionnaire that reveals what habits could be silently harming you right now. The goal of the questionnaire below is to gauge your risk factors for current neurological problems, which can manifest in migraines, seizures, mood and movement disorders, sexual dysfunction, and ADHD, as well as for serious mental decline in the future. Respond to these statements as honestly as possible. Don’t think about the connections to brain disease implied by my statements; just respond truthfully. In upcoming chapters you’ll begin to understand why I used these particular statements and where you stand in your risk factors. Note that if you feel like you’re in between true and false, and would answer “sometimes,” then you should choose true. 1. I eat bread (any kind). TRUE/FALSE 2. I drink fruit juice (any kind). TRUE/FALSE 3. I have more than one serving of fruit a day. TRUE/FALSE 4. I choose agave over sugar. TRUE/FALSE 5. I get out of breath on my daily walk. TRUE/FALSE 6. My cholesterol is below 150. TRUE/FALSE 7. I have diabetes. TRUE/FALSE 8. I am overweight. TRUE/FALSE 9. I eat rice or pasta (any kind). TRUE/FALSE 10. I drink milk. TRUE/FALSE 11. I don’t exercise regularly. TRUE/FALSE 12. Neurological conditions run in my family. TRUE/FALSE 13. I don’t take a vitamin D supplement. TRUE/FALSE 14. I eat a low-fat diet. TRUE/FALSE 15. I take a statin. TRUE/FALSE 16. I avoid high-cholesterol foods. TRUE/FALSE 17. I drink soda (diet or regular). TRUE/FALSE 18. I don’t drink wine. TRUE/FALSE 19. I drink beer. TRUE/FALSE 20. I eat cereal (any kind). TRUE/FALSE A perfect score on this test would be a whopping zero “true” answers. If you answered true to one question, your brain—and your entire nervous system—is at greater risk for disease and disorder than if you scored a zero. And the more trues you tallied up, the higher your risk. If you scored more than a ten, you’re putting yourself into the hazard zone for serious neurological ailments that can be prevented but cannot necessarily be cured once you are diagnosed. TESTING, TESTING, 1-2-3 “What are my risks?” It’s a question I am asked countless times every day. The great news is that we now have the means to medically profile individuals to determine their risk for developing certain diseases—from Alzheimer’s to obesity (which is now a well-documented risk factor for brain disease) —and to follow them along their journey to mark their progress. The laboratory studies listed below are available today, are economical, and are generally covered by most insurance plans. You’ll learn more about these tests in later chapters, as well as ideas for improving your results (your “numbers”). The reason I list them here, however, is that many of you want to know right away what tests your doctor can perform that will help you get a true sense of your risk factors for brain disease. Don’t hesitate to bring this list with you to your next doctor’s visit and request the following lab work. • Fasting blood glucose: A commonly used diagnostic tool to check for pre-diabetes and diabetes, this test measures the amount of sugar (glucose) in your blood after you have not eaten for at least eight hours. A level between 70 and 100 milligrams per deciliter (mg/dL) is considered normal; above this, your body is showing signs of insulin resistance and diabetes, and an increased risk for brain disease. • Hemoglobin A1C: Unlike a test of blood sugar, this test reveals an “average” blood sugar over a ninety-day period and provides a far better indication of overall blood sugar control. Because it can indicate the damage done to brain proteins due to blood sugar (something called “glycated hemoglobin”), it’s one of the greatest predictors of brain atrophy. • Fructosamine: Similar to the hemoglobin A1C test, a fructosamine test is used to measure an average blood sugar level but over a shorter time period—the past two to three weeks. • Fasting insulin: Long before blood sugar begins to climb as a person becomes diabetic, the fasting insulin level will rise, indicating that the pancreas is working overtime to deal with the excess of dietary carbohydrate. It is a very effective early warning system for getting ahead of the diabetes curve, and so has tremendous relevance for preventing brain disease. • Homocysteine: Higher levels of this amino acid, produced by the body, are associated with many conditions, including atherosclerosis (narrowing and hardening of the arteries), heart disease, stroke, and dementia; it can often be easily lowered with specific B vitamins. • Vitamin D: This is now recognized as a critical brain hormone (it’s not a vitamin). • C-reactive protein (CRP): This is a marker of inflammation. • Cyrex array 3: This is the most comprehensive marker of gluten sensitivity available. • Cyrex array 4 (optional): This measures sensitivity to twenty-four “cross-reactive” foods to which a gluten-sensitive individual may also react. Even if you don’t choose to have these tests done today, having a general understanding of them and what they mean will help you embrace the principles of Grain Brain. I will be referring to these tests and their implications throughout the book