Author Archives: Dr. Paul Nussbaum

Stress and the Nervous System

We all have heard about “stress” and the negative impact it can have on our body and brain. Nearly all of us deal with stress on a daily basis and while some acute stress can be advantageous, the chronic effects of stress can lead to physical problems such as headache, backache, stomach and gastrointestinal distress, ulcers, high blood pressure, poor eating habits, and chest pain. Stress can also cause psychological problems such as irritability, impatience, anger, sleep disturbance, fatigue, depression and anxiety. Clearly, stress is both a universal phenomena and unfortunately relates to or causes many of the major daily aches, pains, and emotional distress in our lives.

I believe it is important to always be conscious of our bodies and our brains (minds) so we can identify when we lose balance or symmetry in our natural state. I also believe it is important to understand the physiological mechanisms that underlie stress so we can make changes and achieve equilibrium. In order to achieve the latter, we need to understand our “autonomic nervous system” that has two major parts to be discussed in this blog: the “sympathetic nervous system and the parasympathetic nervous system.”

The Autonomic Nervous System (ANS) is located in the brain and has effects on the entire body. One major part of the ANS is the Sympathetic Nervous System (SNS) that helps our bodies and brains get into a “fight or flight” state and have actually helped our species survive until today. Recall that dinosaurs and other potentially catastrophic events or threats that required us to fight or flee confronted our ancestors. Without the SNS we would have expired as a species.

The SNS serves as a type of alert and action system in which specific structures in our brain and body engage to enable us to fight or flee. Once the SNS kicks in our brain releases norepinephrine and our body releases epinephrine (adrenaline) to get our system hyper-engaged. The brain is also alerted by the hypothalamus (master gland), which triggers the pituitary gland that in turn triggers the adrenal gland (periphery of the body). These glands release hormones including cortisol and glucocorticoids that put our amygdala on overdrive and our hippocampus (learning center) on hold. These physiological reactions result in our heavy breathing, a restriction in body fluids leading to dry mouth, halt in the digestive system, and in the reproductive system. Our brains become hyper focused and vigilant as we try to deal with the threat in front of us.

Our bodies can tolerate this jolt to our equilibrium for some period of time, particularly as it helps us to survive. However, our bodies are not designed to handle such acute stress for extended periods of time. It is important to note that dinosaurs no longer confront us and life-threatening stressors on a daily basis typically do not confront us. Despite this, we continue to respond to small, non life-threatening stressors with the same SNS response.

Fortunately we have a counterbalance to the SNS known as the Parasympathetic Nervous System (PNS) sometimes referred to as the “rest and digest” system. Our bodies do quite well with our natural balance of PNS and SNS and in fact our resting state is the PNS. Our reactions to daily non-life-threatening stressors results in the SNS overpowering the PNS and increasing our risk for the physical and psychological problems noted earlier. How can you engage the PNS to keep it at least in balance if not the lead in your daily management of life stressors?

Consider the following tips to finding and engaging your PNS:

1.    Stop and identify (make a list) of your daily life stressors.
2.    Identify where your body feels stress (physical and psychological).
3.    Practice rhythmical breathing by taking a slow and deep breath in for four seconds and exhaling slowly for the same four seconds.
4.    Practice the breathing for five minutes, three to four times daily.
5.    Give yourself at least thirty minutes daily of sitting upright in a quiet place where you can simply turn inward and let all stimuli flow over and through you. Be patient and focus on simply being.
6.    Self-talk using positive words such as “love, joy, patience, forgiveness, kindness, happiness, trust, and peace.”
7.    Work daily to not react negatively to small things your brain may have considered “big” in the past.
8.    Do something nice each day for someone.
9.    Slow your pace down and work consciously on inner balance.
10.    Understand this is a lifetime effort and you will experience positive steps and some setbacks. Simply remain conscious of your inner balance and remind yourself “I am trying to reach and use my PNS”

Good Luck!

More Research on Lifestyle and Risk Reduction in Alzheimer’s Disease (AD)

For the past decade or more I have advanced the idea that a proactive lifestyle can be beneficial to the human brain. I have not been the only one to discuss or study this point, but it remains a central focus of my work. There has been a rather robust collection of studies that have shown correlations between particular lifestyle behaviors and reduction in the risk of dementia. It was from these studies that I published my own proactive brain health lifestyle ® to include physical activity, socialization, spirituality, nutrition, and mental stimulation.

Criticism against the existing research on lifestyle and risk reduction of dementia has generally been that more controlled and randomized studies are needed to move from the correlational to the cause and effect. This is fair and represents ongoing efforts by many to show such a cause and effect. Lifestyle does matter for the brain as it does for the rest of our body.

A new study to be published in Lancet Neurology provides the latest support for lifestyle and reduction in risk of dementia, including AD. Indeed, according to this study, about half of the risk factors for AD are potentially changeable and that reducing them could substantially decrease the number of new cases of the disease worldwide.

Factors that increase one’s risk for AD that are modifiable include diabetes, hypertension, obesity, smoking, sedentary behavior, depression, and low education level. In the United States, the most significant modifiable factor is physical activity accounting for 21% of the risk for AD, followed by depression and smoking. Added together, the three factors account for 50% of the risk.

The authors of this study indicate that if these risk factors were decreased by just 10%, about 184,000 AD cases in the U.S. and 1.1 million cases worldwide could be prevented. A reduction of 25% on all seven risk factors could prevent nearly half a million cases in the U.S. and more than three million world-wide.

With 5 million cases of AD in the U.S. and nearly 35 million in the world, this analysis is significant as maybe as many as 50% of all AD cases could be modifiable and that by changing the risk factors increased quality of life could be achieved. This and more research will be published to further support the importance of a proactive brain health lifestyle for everyone.

Brain Health in the Summer

Summer is here in a big way splashing the heat and humidity upon us. This is a great time of the year to get outdoors and is far better than shoveling a foot of snow off the driveway. Being able to move outdoors is a great opportunity to expand our list of activities and to increase quality time with our brain health lifestyle ®.

Consider the following 20 activities as part of your daily routine:

  1. Take a daily walk and use Arookoo (www.arookoo.com) or a pedometer count your steps.
  2. Go swimming, as it is good aerobic exercise and will cool your body.
  3. Get the bike out and ride around the block a few times.
  4. Play some sports with the kids.
  5. Cook some fish and chicken on the grill.
  6. Enjoy a cool salad on the deck.
  7. Enjoy a glass of red wine.
  8. Read the book you have been holding.
  9. Kids get started on your summer reading.
  10. Go to a sporting event as a family.
  11. Go to the zoo as a family.
  12. Go to a theme park or water park.
  13. Enjoy a vacation together.
  14. Increase your hours of sleep.
  15. Get involved in a hot yoga class.
  16. Pray daily.
  17. Attend a formal place of worship with the family.
  18. Take a walk in the woods or on the beach.
  19. Plant your garden and clean the yard.
  20. Drink plenty of water.

Consider this a reasonably good start to a brain healthy summer! Take it one step at a time and your body and brain will thank you.

Forgiveness in Our Daily Lives

This week marks a holy week for millions of people worldwide. It provides a time of reflection and renewal and also a time to consider important and basic virtues we all possess. One of them is forgiveness and the simple act of forgiving can be health promoting. It seems forgiveness, for many of us, however, can be a difficult action.

Most if not all humans have some interpersonal conflict with another. Perhaps our conflict is with a peer at work, a friend or former friend, a family member or other. We may carry a grudge, feel uncomfortable and anger towards this person. Who is hurt by these chronic and sustaining feelings and what does such toxic emotion do to the body?

Research is generally robust on the negative effects of chronic anger and stress. It is far better for us to get rid of these emotions, and even better to recognize their emergence and stop them prior to their taking hold of our interactions with others. We are blessed as humans to be able to say, “I am sorry” and to forgive. This is not hard to do unless we get stuck in pride and other face saving roadblocks.

Perhaps this week we can all forgive one person in our lives who has hurt us. Forgiveness is a cleansing of your body and spirit, it does not necessarily indicate right or wrong judgment. Maybe we can tell someone we have hurt “I am sorry.” If millions of us do this we will not only be healthier on an individual level, we will create a more peaceful planet to live.

Hearing Loss and Dementia

Hearing loss is associated with an increased risk of developing dementia according to a prospective analysis of more than 600 people free of cognitive decline. Of those studied, the risk of all-cause dementia rose 27% for every 10-decibel loss of hearing at the start of the almost 12-year study. The risk of Alzheimer’s disease (AD) rose in a similar fashion, but did not reach statistical significance. The study appears in the February issue of Archives of Neurology.

The findings support the idea that social isolation caused by deafness may be part of the cause of dementia. This may be particularly true as the association to dementia was only seen for deafness above the level at which verbal communication was impaired.

Over a five-year period from 1990 through 1994, 795 participants had both hearing and cognitive testing as part of the Baltimore Longitudinal Study of Aging. Of these, the current study consisted of 639 people, ages 36 to 90, free of confirmed or suspected dementia.

The participant subset was followed until May 31, 2008, for a median of 11.9 years. During this time, researchers found 58 participants to be diagnosed with dementia from all causes, including 37 with AD. Most of the participants (456) had normal hearing at baseline with a mean age around 60, while 125 had mild hearing loss, 53 had moderate hearing loss, and six had severe deafness.

Interestingly, in the 15 years before the study period, those who developed dementia had an average yearly hearing loss that was nearly twice average for those who did not develop dementia.

Maybe even a Third Language

Almost as fast as my recent blog on bilingualism and the benefit to the human brain was posted I read a research report that learning a third language can help to reduce risk of dementia. This research from the Public Center for Health in Luxembourg does suggest more languages equal a lower risk of cognitive impairment. The research was to be presented at the American Academy of Neurology in April

Seniors who practice foreign languages over their lifetime and have the ability to speak more than two languages demonstrate the cognitive protection. The research studied 230 people with average age of 73 and findings support the growing body of literature that describes cognitive reserve thought to be developed by engagement in the complex and novel.

Similar studies have shown the health promoting effects of language development and in this case development of more than two languages. In this particular study, participants who had spoken three languages were significantly more likely to be protected against cognitive impairment. Those with four languages were even better off in terms of cognitive health. Those with five or more languages had similar protection to mastering four languages.

We all might want to get started on our second, third, or fourth language today!

Computers, Exercise Linked to Lower Mild Cognitive Impairment

Moderate physical exercise combined with computer use late in life is associated with a lower risk of mild cognitive impairment (MCI). The research indicated that while both elements related to lowered risk of MCI, there was an additive interaction that created enhanced value according to Yonas Geda, M.D. who presented the research at the annual meeting of the Academy of Neurology.

A random sample of 926 elderly, ages 70 through 90, completed questionnaires on physical exercise, cognitive activities, and caloric intake during the previous year. All were considered non-demented and the diagnosis of MCI, if appropriate, came later. 817 of the original sample were considered normal cognitively and 109 were diagnosed with MCI.

Significant differences were found between the two groups as the normal subjects were younger, better educated, less likely to suffer depression, and had fewer medical problems. When these factors were controlled, the following was found:

  • Any frequency of moderate exercise was cognitively protective.
  • Any frequency of computer use was cognitively protective.
  • Caloric intake was deleterious.

When caloric intake was controlled, physical exercise and computer use had an additive interaction that was significant. For purposes of this study, computer use seemed to have more value than other cognitive enhancing activities such as reading

This study adds to other research that demonstrates brain health promoting effects of computer use with physical exercise.