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Brain Food

The Surprising Science of Eating for Cognitive Power

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How to eat for maximum brainpower and health, from an expert in both neuroscience and nutrition.

"Powerful advice on how to eat for maximum brainpower."
     --Mark Hyman, MD, New York Times--bestselling author of Eat Fat, Get Thin

In this eye-opening book, Dr. Lisa Mosconi, a neuroscientist and integrative nutritionist, explains why the dietary needs of the brain are different from those of other organs. Her innovative approach to cognitive health encompasses a complete food plan, including comprehensive lists of what to eat and what to avoid as well as information to help you determine where you are on the brain-health spectrum. Brain Food can help improve memory, prevent cognitive decline, eliminate brain fog, and lift depression.

"Incredible." --Maria Shriver

"This fascinating book not only reveals the science behind neuro-nutrition, it shows us what we could be eating for maximum brain power." --Sara Gottfried, MD, New York Times-bestselling author of Younger, The Hormone Reset Diet, and The Hormone Cure

"An empowering resource for anyone who wants to take their brain health into their own hands (and spoons and forks)." --Kelly McGonigal, PhD, author of The Willpower Instinct, The Upside of Stress, and The Joy of Movement
"In her new book, Brain Food: The Surprising Science of Eating for Cognitive Power Dr. Lisa Mosconi highlights the connection between diet and brain function and shares approachable, actionable tips to put that research into practice."
–Forbes

“Incredible.”
Maria Shriver
 
"Brain Food: The Surprising Science of Eating for Cognitive Power" [is] a guide to the latest research on the links between nutrition and brain health.”
Los Angeles Times

“By drawing on more than fifteen years of scientific research and experience, Dr. Mosconi provides expert advice to prevent medical decline and sharpen memory. Her brain healthy recipes will help you maintain peak cognitive performance well into old age and therefore delay and may even prevent the appearance of debilitating diseases like Alzheimer’s.”
—KTLA “Good Morning LA”

"At last we are beginning to acknowledge how important nutrition is to brain health.  And in Brain Food we have a superb guide!  As a neuroscientist with a degree in nutrition, Dr. Lisa Mosconi gives us powerful advice on how to eat for maximum brain power as well as maximum pleasure.  Highly recommended!"
—Mark Hyman, MD, New York Times bestselling author of Eat Fat, Get Thin
 
"If we knew what our brains looked like, we’d take better care of them. Often surprising, always accessible, this fascinating book not only reveals the science behind neuro-nutrition, it shows us what we could be eating for maximum brain power."
—Sara Gottfried, MD, New York Times bestselling author of Younger, The Hormone Reset Diet, and The Hormone Cure
 
"Scientists know that diet plays a huge role in brain health--and now Brain Food distills this research into a practical guide. Mosconi provides accessible advice and lots of options for fueling your brain and aging well. This is an empowering resource for anyone who wants to take their brain health into their own hands (and spoons, and forks)." 
—Kelly McGonigal, PhD, author of The Willpower Instinct and The Upside of Stress
 
"Brain Food is a critically important book. Food is medicine or it is poison. The brain uses 20-30% of the calories you consume. If you want to keep and save your brain you have to get your food right.  Brain Food will help you do just that in a delicious, easy way."
—Daniel G. Amen, MD, Founder, Amen Clinics and author of Memory Rescue
 
"Can a Mediterranean diet help avert Alzheimer’s? Mosconi’s persuasive account of the surprising connection between food and brain health sparkles with well-researched nutritional evidence. Brain Food offers culinary wisdom and reasons for hope in equal measure."
—Richard Wrangham, PhD, Ruth B. Moore Professor of Biological Anthropology at Harvard University, author of Catching Fire
 
"Over the years, I have learned so much from the work of Dr. Mosconi, whose accomplished credentials spanning both neuroscience and nutrition are wholly unique. This book represents the first time her studies on the interaction between food and long-term cognitive function reach a general audience. Dr. Mosconi always makes the point that we would eat differently and treat our brains better if only we could see what we are doing to them. From the lab to the kitchen, this is extremely valuable and urgent advice, complete with recommendations that any one of us can take."
—Richard S. Isaacson, MD, author of The Alzheimer's Prevention and Treatment Diet and Alzheimer's Treatment Alzheimer's Prevention
 
"In an era of confusion about what we should eat, Brain Food is a shining light. This is the straight story about 'neuro-nutrition' firmly rooted in research by a neuroscientist who has a deep understanding of how food affects our cognitive health. Dr. Mosconi gives us advice we can easily implement into our lives and a story about the science behind it that is both delightful and accessible. A must read!"
—Elissa Epel, PhD, Professor, UCSF, New York Times bestselling co-author of The Telomere Effect

“If you’ve ever suspected you could be giving your brain better food for thought, this is the book to pick up.”
—New York Post

“Think sharper by eating meals like grilled salmon in ginger-garlic marinade from this neuroscientist and nutritionist. How genius.”
Marie Claire

“In this fascinating investigation, Lisa Mosconi presents research that crosses disciplines to argue that what goes on in your brain—from your mood to your cognitive abilities—is very closely tied to what you put on your plate. In addition to being a compelling read, readers will find tips and outlines on ways they can change their diets for optimal brain health.”
Real Simple

“This book is as timely as it is eye-opening, in a period when life spans are increasing and awareness grows about the way brain chemistry is shaped by emotional history and environment in addition to food. That synchronicity gives this reader a bit of a rush.”
Spirituality & Health

“An important shift needs to be made in the latter: we should pay attention to the way food makes us feel, not to the way it makes us look. This is why it was so refreshing to stumble across Dr. Lisa Mosconi's new book Brain Food.”
—PsychologyToday.com
© Allison Hooban
Dr. Lisa Mosconi, PhD, INHC, is the associate director of the Alzheimer’s Prevention Clinic at Weill Cornell Medical College (WCMC)/NewYork-Presbyterian Hospital, were she was recruited as an associate professor of Neuroscience in Neurology. She also is an adjunct faculty member in the Department of Psychiatry at NYU School of Medicine, in the Department of Nutrition at NYU Steinhardt School of Nutrition and Public Health, and in the Departments of Neurology and Nuclear Medicine at the University of Florence (Italy). Formerly, Dr. Mosconi founded and was the director of the Nutrition & Brain Fitness Lab at New York University School of Medicine (NYU), and an assistant professor in the NYU Department of Psychiatry, where she served as the director of the Family History of Alzheimer’s disease research program. Dr. Mosconi holds a dual PhD degree in Neuroscience and Nuclear Medicine from the University of Florence, Italy, and is a board certified integrative nutritionist and holistic healthcare practitioner. She is well known for her research on the early detection of Alzheimer’s disease and is passionately interested in the mitigation and prevention of memory loss through lifestyle modifications including diet, nutrition, and physical and intellectual fitness. View titles by Lisa Mosconi PhD

The Looming Brain Health Crisis

The Good News

Let’s start with some good news. We, as a human race, are living longer than ever before. Life expectancy has been steadily on the rise for over two hundred years. During the twentieth century in particular, there has been nothing less than a downright boom in human longevity. This dramatic increase in life expectancy ranks as one of society’s greatest achievements. According to the Centers for Disease Control and Prevention, while most babies born in 1900 did not live past age fifty, life expectancy now averages just under eighty years old in most industrialized countries.

It turns out that the secret behind our recently extended life span is not due to genetics or natural selection, but rather to the relentless improvements made to our overall standard of living. From a medical and public health perspective, these developments were nothing less than game changing. For example, major diseases such as smallpox, polio, and measles have been eradicated by mass vaccination. At the same time, better living standards achieved through improvements in education, housing, nutrition, and sanitation systems have substantially reduced malnutrition and infections, preventing many unnecessary deaths among children. Furthermore, technologies designed to improve health have become available to the masses, whether via refrigeration to prevent spoilage or systemized garbage collection, which in and of itself eliminated many common sources of disease. These impressive shifts have not only dramatically affected the ways in which civilizations eat, but also determined how civilizations will live and die.

In the end, we are living longer and longer lives. In most industrialized nations old age is now a reasonable expectation, so much so that scientists are adamant: an older society is here to stay. That’s good news—news that is hard won over the millennia of the history of humankind.

 

The Not Such Good News

Now for the flip side. As it turns out, to some degree, we might be -victims of our own success. Unfortunately, this increase in life span has not necessarily provided us with additional years of particularly high-quality health. Old age can come with wisdom, but it just as regularly arrives with some less illustrious additions. Hearing loss, bifocal glasses, slower reflexes, and common medical ailments such as arthritis, rheumatisms, and respiratory problems are examples of those side effects we’d rather do without. What is of greater concern is that deterioration of the brain sneaks up on many of us as we age, making us vulnerable to memory deficits and loss of cognitive function.

Over the years, I’ve asked countless patients, “What concerns you most about your future health?” More often than not, it wasn’t the condition of their heart or even the risk of cancer that came to mind. Today, the greatest fear for most people is that they might end their days -battling dementia.

The most common cause of dementia, and probably the most feared, is the memory-robbing Alzheimer’s disease. The idea of losing track of one’s own thoughts, or being unable to remember our loved ones, is cause for great anxiety, fear, and stress. Equally daunting is our inevitable grief at seeing a relative or close friend suffer from this devastating disease.

This concern is understandable. Of all the challenges to aging in the twenty-first century, nothing compares to the unprecedented scale of Alzheimer’s. According to recent reports from the Alzheimer’s Association, the number of people living with Alzheimer’s in the United States alone is an estimated 5.3 million. As the baby boomer generation ages, the number of patients is predicted to reach a staggering 15 million cases by 2050. This is the population of Los Angeles, New York, and Chicago all together.

A similar trend is observed planet wide. Today more than 46 million people live with dementia the world over. This number is estimated to increase to 132 million by the year 2050.

Further, while Alzheimer’s represents the most recognizable (and most common) framework for dementia, there are many ways a healthy brain can go awry: other forms of dementia, Parkinson’s disease, stroke, depression, and so forth. As more countries reap the benefits of longer lives, the burden of all these disorders is reaching an alarming proportion. If that weren’t enough, beyond specific disorders, general age--related cognitive impairment might affect three to four times as many people, with extraordinary psychological, social, and economic consequences.

As we take in the challenges of such an unprecedented brain health crisis, the year 2050 doesn’t seem so far away.

We need a cure, and we need it fast.

 

The Breaking News

Now for the news that provides us with hope. Recent medical breakthroughs have radically changed our understanding of aging and disease by showing that the brain changes leading to dementia unfold over -decades before anyone ever forgets a name or loses their keys. These findings have revealed a much more complex picture than previously imagined.

Two technologies in particular have deeply changed the way we understand brain aging. On the one hand, we finally have access to “cheap genomics” (affordable DNA testing), which allows us to take an important peek into our genetic predispositions. While just five years ago we would have had to spend thousands of dollars to do a proper genetic screening on patients, today anyone can obtain such precious information for just a few hundred.

In addition, we have lab tests such as brain imaging that allow us to view how the brain is functioning over time, in response to both our genetics and our lifestyle choices. Scientists now have access to sophisticated brain imaging techniques, such as magnetic resonance imaging (MRI) and positron emission tomography (PET), which allow a view of the human brain from the inside out. Brain imaging has given us a rare and opportune window from which we can catch a glimpse of the actual progression of many brain diseases years in advance of any noticeable clinical symptoms. Finally, we can track the development of diseases like Alzheimer’s as they unfold, and use that knowledge to identify people at risk many years, if not decades, before clinical symptoms emerge.

As you’ll notice, a large part of the discussion around nutrition for brain health references Alzheimer’s. This is primarily because Alzheimer’s is one of the few neurological diseases reaching epidemic proportions that scientists can agree is influenced by diet, and as such, it is the instigator for much of the funded research in the space. In order to figure out what people need to eat to improve or maintain optimal cognitive capacities, we need to compare people who age gracefully (from the brain’s perspective) to those who unfortunately do not. In this context, Alzheimer’s is in effect shorthand for the most extreme responses of the brain to the nutrients we provide. The lessons learned, and behaviors to follow, apply therefore to broader cognitive health as well as many, if not all, forms of cognitive decline associated with brain aging. In much the same way that following the guidelines to prevent heart disease is good for everyone—not just those at risk for cardiac events—the newly discovered dietary strategies to prevent Alzheimer’s are also those that optimize cognitive health overall, over the course of a lifetime and with benefits across the board. Research findings in Alzheimer’s can then be used as a framework that stands in for cognitive decline of the aging brain as as a whole.

By using brain imaging, several teams across the world have been successful in mapping the development of Alzheimer’s over time, showing how it occurs gradually in the brain and progresses over a twenty-to-forty-year period before clinical symptoms emerge. In other words, cognitive impairment is not a mere consequence of old age, but rather represents the endgame of years after years of accumulated insults to the brain. What’s even more disconcerting is that the brain changes leading to dementia can begin as early as young adulthood, and in some cases, even from birth. As it turns out, Alzheimer’s is not a disease of the old, nor does it hit without warning.

Currently, our understanding is that many genetic, lifestyle, and environmental factors can potentially damage the brain while one is still young, triggering a cascade of pathological events that ultimately lead to cognitive deterioration. Whether we’re referring to the somewhat typical forgetfulness and mild memory issues that many people experience around age sixty, or to the full-blown dementia and loss of independent function in older age, there is a long period of time during which brain changes can be under way without the disease yet causing any noticeable symptoms.

If this sounds frightening, take heart.

The key message from these studies, including my own work, is that this lengthy gap leaves a precious window of time to finally and thoroughly explore the power of prevention. There is increasing evidence that implementing the lifestyle changes -described in this book has the potential to prevent Alzheimer’s from developing and also to help slow down or even halt progression of the disease in those who are currently suffering from -dementia.

If that weren’t enough, eating for your brain isn’t just a powerful -preventative against disease—it actually helps you achieve peak performance in every part of your life. Beyond the specific fears over any particular desease and toward a more general hope for better brain health over a longer life, this is a call to action. Anyone who is old enough to consider how their brain will remain healthy into old age is old enough to start making vital changes to address that immediately.

About

How to eat for maximum brainpower and health, from an expert in both neuroscience and nutrition.

"Powerful advice on how to eat for maximum brainpower."
     --Mark Hyman, MD, New York Times--bestselling author of Eat Fat, Get Thin

In this eye-opening book, Dr. Lisa Mosconi, a neuroscientist and integrative nutritionist, explains why the dietary needs of the brain are different from those of other organs. Her innovative approach to cognitive health encompasses a complete food plan, including comprehensive lists of what to eat and what to avoid as well as information to help you determine where you are on the brain-health spectrum. Brain Food can help improve memory, prevent cognitive decline, eliminate brain fog, and lift depression.

"Incredible." --Maria Shriver

"This fascinating book not only reveals the science behind neuro-nutrition, it shows us what we could be eating for maximum brain power." --Sara Gottfried, MD, New York Times-bestselling author of Younger, The Hormone Reset Diet, and The Hormone Cure

"An empowering resource for anyone who wants to take their brain health into their own hands (and spoons and forks)." --Kelly McGonigal, PhD, author of The Willpower Instinct, The Upside of Stress, and The Joy of Movement

Praise

"In her new book, Brain Food: The Surprising Science of Eating for Cognitive Power Dr. Lisa Mosconi highlights the connection between diet and brain function and shares approachable, actionable tips to put that research into practice."
–Forbes

“Incredible.”
Maria Shriver
 
"Brain Food: The Surprising Science of Eating for Cognitive Power" [is] a guide to the latest research on the links between nutrition and brain health.”
Los Angeles Times

“By drawing on more than fifteen years of scientific research and experience, Dr. Mosconi provides expert advice to prevent medical decline and sharpen memory. Her brain healthy recipes will help you maintain peak cognitive performance well into old age and therefore delay and may even prevent the appearance of debilitating diseases like Alzheimer’s.”
—KTLA “Good Morning LA”

"At last we are beginning to acknowledge how important nutrition is to brain health.  And in Brain Food we have a superb guide!  As a neuroscientist with a degree in nutrition, Dr. Lisa Mosconi gives us powerful advice on how to eat for maximum brain power as well as maximum pleasure.  Highly recommended!"
—Mark Hyman, MD, New York Times bestselling author of Eat Fat, Get Thin
 
"If we knew what our brains looked like, we’d take better care of them. Often surprising, always accessible, this fascinating book not only reveals the science behind neuro-nutrition, it shows us what we could be eating for maximum brain power."
—Sara Gottfried, MD, New York Times bestselling author of Younger, The Hormone Reset Diet, and The Hormone Cure
 
"Scientists know that diet plays a huge role in brain health--and now Brain Food distills this research into a practical guide. Mosconi provides accessible advice and lots of options for fueling your brain and aging well. This is an empowering resource for anyone who wants to take their brain health into their own hands (and spoons, and forks)." 
—Kelly McGonigal, PhD, author of The Willpower Instinct and The Upside of Stress
 
"Brain Food is a critically important book. Food is medicine or it is poison. The brain uses 20-30% of the calories you consume. If you want to keep and save your brain you have to get your food right.  Brain Food will help you do just that in a delicious, easy way."
—Daniel G. Amen, MD, Founder, Amen Clinics and author of Memory Rescue
 
"Can a Mediterranean diet help avert Alzheimer’s? Mosconi’s persuasive account of the surprising connection between food and brain health sparkles with well-researched nutritional evidence. Brain Food offers culinary wisdom and reasons for hope in equal measure."
—Richard Wrangham, PhD, Ruth B. Moore Professor of Biological Anthropology at Harvard University, author of Catching Fire
 
"Over the years, I have learned so much from the work of Dr. Mosconi, whose accomplished credentials spanning both neuroscience and nutrition are wholly unique. This book represents the first time her studies on the interaction between food and long-term cognitive function reach a general audience. Dr. Mosconi always makes the point that we would eat differently and treat our brains better if only we could see what we are doing to them. From the lab to the kitchen, this is extremely valuable and urgent advice, complete with recommendations that any one of us can take."
—Richard S. Isaacson, MD, author of The Alzheimer's Prevention and Treatment Diet and Alzheimer's Treatment Alzheimer's Prevention
 
"In an era of confusion about what we should eat, Brain Food is a shining light. This is the straight story about 'neuro-nutrition' firmly rooted in research by a neuroscientist who has a deep understanding of how food affects our cognitive health. Dr. Mosconi gives us advice we can easily implement into our lives and a story about the science behind it that is both delightful and accessible. A must read!"
—Elissa Epel, PhD, Professor, UCSF, New York Times bestselling co-author of The Telomere Effect

“If you’ve ever suspected you could be giving your brain better food for thought, this is the book to pick up.”
—New York Post

“Think sharper by eating meals like grilled salmon in ginger-garlic marinade from this neuroscientist and nutritionist. How genius.”
Marie Claire

“In this fascinating investigation, Lisa Mosconi presents research that crosses disciplines to argue that what goes on in your brain—from your mood to your cognitive abilities—is very closely tied to what you put on your plate. In addition to being a compelling read, readers will find tips and outlines on ways they can change their diets for optimal brain health.”
Real Simple

“This book is as timely as it is eye-opening, in a period when life spans are increasing and awareness grows about the way brain chemistry is shaped by emotional history and environment in addition to food. That synchronicity gives this reader a bit of a rush.”
Spirituality & Health

“An important shift needs to be made in the latter: we should pay attention to the way food makes us feel, not to the way it makes us look. This is why it was so refreshing to stumble across Dr. Lisa Mosconi's new book Brain Food.”
—PsychologyToday.com

Author

© Allison Hooban
Dr. Lisa Mosconi, PhD, INHC, is the associate director of the Alzheimer’s Prevention Clinic at Weill Cornell Medical College (WCMC)/NewYork-Presbyterian Hospital, were she was recruited as an associate professor of Neuroscience in Neurology. She also is an adjunct faculty member in the Department of Psychiatry at NYU School of Medicine, in the Department of Nutrition at NYU Steinhardt School of Nutrition and Public Health, and in the Departments of Neurology and Nuclear Medicine at the University of Florence (Italy). Formerly, Dr. Mosconi founded and was the director of the Nutrition & Brain Fitness Lab at New York University School of Medicine (NYU), and an assistant professor in the NYU Department of Psychiatry, where she served as the director of the Family History of Alzheimer’s disease research program. Dr. Mosconi holds a dual PhD degree in Neuroscience and Nuclear Medicine from the University of Florence, Italy, and is a board certified integrative nutritionist and holistic healthcare practitioner. She is well known for her research on the early detection of Alzheimer’s disease and is passionately interested in the mitigation and prevention of memory loss through lifestyle modifications including diet, nutrition, and physical and intellectual fitness. View titles by Lisa Mosconi PhD

Excerpt

The Looming Brain Health Crisis

The Good News

Let’s start with some good news. We, as a human race, are living longer than ever before. Life expectancy has been steadily on the rise for over two hundred years. During the twentieth century in particular, there has been nothing less than a downright boom in human longevity. This dramatic increase in life expectancy ranks as one of society’s greatest achievements. According to the Centers for Disease Control and Prevention, while most babies born in 1900 did not live past age fifty, life expectancy now averages just under eighty years old in most industrialized countries.

It turns out that the secret behind our recently extended life span is not due to genetics or natural selection, but rather to the relentless improvements made to our overall standard of living. From a medical and public health perspective, these developments were nothing less than game changing. For example, major diseases such as smallpox, polio, and measles have been eradicated by mass vaccination. At the same time, better living standards achieved through improvements in education, housing, nutrition, and sanitation systems have substantially reduced malnutrition and infections, preventing many unnecessary deaths among children. Furthermore, technologies designed to improve health have become available to the masses, whether via refrigeration to prevent spoilage or systemized garbage collection, which in and of itself eliminated many common sources of disease. These impressive shifts have not only dramatically affected the ways in which civilizations eat, but also determined how civilizations will live and die.

In the end, we are living longer and longer lives. In most industrialized nations old age is now a reasonable expectation, so much so that scientists are adamant: an older society is here to stay. That’s good news—news that is hard won over the millennia of the history of humankind.

 

The Not Such Good News

Now for the flip side. As it turns out, to some degree, we might be -victims of our own success. Unfortunately, this increase in life span has not necessarily provided us with additional years of particularly high-quality health. Old age can come with wisdom, but it just as regularly arrives with some less illustrious additions. Hearing loss, bifocal glasses, slower reflexes, and common medical ailments such as arthritis, rheumatisms, and respiratory problems are examples of those side effects we’d rather do without. What is of greater concern is that deterioration of the brain sneaks up on many of us as we age, making us vulnerable to memory deficits and loss of cognitive function.

Over the years, I’ve asked countless patients, “What concerns you most about your future health?” More often than not, it wasn’t the condition of their heart or even the risk of cancer that came to mind. Today, the greatest fear for most people is that they might end their days -battling dementia.

The most common cause of dementia, and probably the most feared, is the memory-robbing Alzheimer’s disease. The idea of losing track of one’s own thoughts, or being unable to remember our loved ones, is cause for great anxiety, fear, and stress. Equally daunting is our inevitable grief at seeing a relative or close friend suffer from this devastating disease.

This concern is understandable. Of all the challenges to aging in the twenty-first century, nothing compares to the unprecedented scale of Alzheimer’s. According to recent reports from the Alzheimer’s Association, the number of people living with Alzheimer’s in the United States alone is an estimated 5.3 million. As the baby boomer generation ages, the number of patients is predicted to reach a staggering 15 million cases by 2050. This is the population of Los Angeles, New York, and Chicago all together.

A similar trend is observed planet wide. Today more than 46 million people live with dementia the world over. This number is estimated to increase to 132 million by the year 2050.

Further, while Alzheimer’s represents the most recognizable (and most common) framework for dementia, there are many ways a healthy brain can go awry: other forms of dementia, Parkinson’s disease, stroke, depression, and so forth. As more countries reap the benefits of longer lives, the burden of all these disorders is reaching an alarming proportion. If that weren’t enough, beyond specific disorders, general age--related cognitive impairment might affect three to four times as many people, with extraordinary psychological, social, and economic consequences.

As we take in the challenges of such an unprecedented brain health crisis, the year 2050 doesn’t seem so far away.

We need a cure, and we need it fast.

 

The Breaking News

Now for the news that provides us with hope. Recent medical breakthroughs have radically changed our understanding of aging and disease by showing that the brain changes leading to dementia unfold over -decades before anyone ever forgets a name or loses their keys. These findings have revealed a much more complex picture than previously imagined.

Two technologies in particular have deeply changed the way we understand brain aging. On the one hand, we finally have access to “cheap genomics” (affordable DNA testing), which allows us to take an important peek into our genetic predispositions. While just five years ago we would have had to spend thousands of dollars to do a proper genetic screening on patients, today anyone can obtain such precious information for just a few hundred.

In addition, we have lab tests such as brain imaging that allow us to view how the brain is functioning over time, in response to both our genetics and our lifestyle choices. Scientists now have access to sophisticated brain imaging techniques, such as magnetic resonance imaging (MRI) and positron emission tomography (PET), which allow a view of the human brain from the inside out. Brain imaging has given us a rare and opportune window from which we can catch a glimpse of the actual progression of many brain diseases years in advance of any noticeable clinical symptoms. Finally, we can track the development of diseases like Alzheimer’s as they unfold, and use that knowledge to identify people at risk many years, if not decades, before clinical symptoms emerge.

As you’ll notice, a large part of the discussion around nutrition for brain health references Alzheimer’s. This is primarily because Alzheimer’s is one of the few neurological diseases reaching epidemic proportions that scientists can agree is influenced by diet, and as such, it is the instigator for much of the funded research in the space. In order to figure out what people need to eat to improve or maintain optimal cognitive capacities, we need to compare people who age gracefully (from the brain’s perspective) to those who unfortunately do not. In this context, Alzheimer’s is in effect shorthand for the most extreme responses of the brain to the nutrients we provide. The lessons learned, and behaviors to follow, apply therefore to broader cognitive health as well as many, if not all, forms of cognitive decline associated with brain aging. In much the same way that following the guidelines to prevent heart disease is good for everyone—not just those at risk for cardiac events—the newly discovered dietary strategies to prevent Alzheimer’s are also those that optimize cognitive health overall, over the course of a lifetime and with benefits across the board. Research findings in Alzheimer’s can then be used as a framework that stands in for cognitive decline of the aging brain as as a whole.

By using brain imaging, several teams across the world have been successful in mapping the development of Alzheimer’s over time, showing how it occurs gradually in the brain and progresses over a twenty-to-forty-year period before clinical symptoms emerge. In other words, cognitive impairment is not a mere consequence of old age, but rather represents the endgame of years after years of accumulated insults to the brain. What’s even more disconcerting is that the brain changes leading to dementia can begin as early as young adulthood, and in some cases, even from birth. As it turns out, Alzheimer’s is not a disease of the old, nor does it hit without warning.

Currently, our understanding is that many genetic, lifestyle, and environmental factors can potentially damage the brain while one is still young, triggering a cascade of pathological events that ultimately lead to cognitive deterioration. Whether we’re referring to the somewhat typical forgetfulness and mild memory issues that many people experience around age sixty, or to the full-blown dementia and loss of independent function in older age, there is a long period of time during which brain changes can be under way without the disease yet causing any noticeable symptoms.

If this sounds frightening, take heart.

The key message from these studies, including my own work, is that this lengthy gap leaves a precious window of time to finally and thoroughly explore the power of prevention. There is increasing evidence that implementing the lifestyle changes -described in this book has the potential to prevent Alzheimer’s from developing and also to help slow down or even halt progression of the disease in those who are currently suffering from -dementia.

If that weren’t enough, eating for your brain isn’t just a powerful -preventative against disease—it actually helps you achieve peak performance in every part of your life. Beyond the specific fears over any particular desease and toward a more general hope for better brain health over a longer life, this is a call to action. Anyone who is old enough to consider how their brain will remain healthy into old age is old enough to start making vital changes to address that immediately.