Doctor’s Tip: What’s good for the heart is good for the brain |

Doctor’s Tip: What’s good for the heart is good for the brain

Dr. Greg Feinsinger
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As people age, one of the things they fear the most is getting dementia, and rightly so because the older we get the more apt we are to develop it. Although dementia is common in older people in America and other Western countries, it is not a normal part of aging, and dementia is very rare in some parts of the world.

There are primarily two types of dementia: multiple small strokes aka vascular dementia, and Alzheimer’s dementia. The risk factors for vascular dementia are the same as those for coronary artery disease: hypertension, high cholesterol, diabetes/ pre-diabetes, age, family history of cardiovascular disease, sedentary lifestyle, inflammation (e.g. rheumatoid arthritis, dental disease), sleep apnea, the S.A.D. (Standard American Diet) and smoking.

The cause of Alzheimer’s is less clear, but evidence is accumulating that the risk factors for Alzheimer’s are the same as those for cardiovascular disease, and evidence is mounting that there is an association between atherosclerosis of arteries in the brain and Alzheimer’s.

It’s true that there can be a genetic predisposition for developing Alzheimer’s, and the ApoE4 genotype is one genetic marker. But remember, “genetics loads the gun, but environment pulls the trigger.” So if you have a family history of dementia, or if your ApoE genotype increases your risk, you can improve your chances of avoiding this dreaded disease by lifestyle modification. The best example of this is the following: The highest incidence of the ApoE4 genotype is in Nigeria, but Nigerians have a low rate of Alzheimer’s, thought to be due to having very low cholesterol due to a plant-based diet.

So here’s what you can do to decrease your chances of developing both vascular dementia and Alzheimer’s: (1) Keep your blood pressure at goal (less than 120/80), your cholesterol at goal (ideal is a total cholesterol of less than 150, LDL or “bad cholesterol” in the 30s and 40s), keep your weight at goal to help avoid diabetes/pre-diabetes, treat sleep apnea and inflammation, avoid tobacco. And get at least 30 minutes of aerobic exercise a day.

Regarding diet, the people in the world with the lowest rate of Alzheimer’s are on a plant-based, whole (unprocessed) food diet. When these same people start eating a Western diet, which is high in meat and dairy products and low in vegetables, fruit and whole grains, their rate of Alzheimer’s increases dramatically.

According to Dr. Michael Greger’s ( new book, “How Not to Die,” a senior scientist at the Center for Alzheimer’s Research wrote a recent review article titled “Alzheimer’s Disease Is Incurable but Preventable.” The dietary centerpiece of the 2014 “Dietary and Lifestyle Guidelines for the Prevention of Alzheimer’s Disease,” published in the journal Neurobiology of Aging, was vegetables, legumes (beans, peas, and lentils), fruit and whole grains, which should replace meat and dairy products as primary staples.

Dr. Feinsinger, who retired from Glenwood Medical Associates after 42 years as a family physician, now has a nonprofit Center For Prevention and Treatment of Disease Through Nutrition. He is available for free consultations about heart attack prevention and any other medical concerns. Call 970-379-5718 for an appointment. For questions about his columns, email him at

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