Excerpts

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But for all the discussions around the many ways women are treated differently from men, one topic that remains woefully neglected is the one that is closest to my heart: the notion of gender disparity around health and wellness.

As surely as women’s social, financial and physical security remain inequitable, so women’s health is in deep jeopardy. Women were promised we could ‘have it all’. We’ve discovered that means ‘doing it all’ instead. And not only do we now get to do it all, but we do so for lower pay, less recognition, and not at all surprisingly, at the expense of our health. We are trained and encouraged to see how many balls we can keep in the air at any given time, and to apply our deepest determination to keep them there, just so.

We tend to hold ourselves to very high standards as we navigate this awkward obstacle course, many of us severely over-taxing ourselves in the process. As we juggle madly, society pushes us to do so without breaking a sweat, a broad smile on our face, all the while keeping an eye on the mirror to make sure we ‘look good’ in the process. Looking at the long list of societal, cultural, and familial demands of all a woman should be, being healthy just doesn’t seem to make the cut. It doesn’t take a scientist to point out that there is something askew here.

But it does take a scientist to denounce that women are also overlooked medically, where our needs too often go unrecognized, misattributed or unaddressed. This is in large part due to the fact that the field of medicine has been historically male-dominated, which led to the fundamental model for most medical research being not a person, but a man. For a number of reasons, which we’ll discuss shortly, medical interventions have been largely tested with, dosed for, and modeled based on their effects on men.

This is not the basis for a conspiracy theory, but rather simply the compound downstream effects of assumptions made over centuries past, which led to our teaching and practicing “bikini medicine”. For those of you not familiar with the term: Historically, medical professionals believed that the only thing that set women apart from men were those body parts that lie beneath the small triangles of a bikini—namely, our reproductive organs. Setting these ‘parts’ aside, as if one could, meant that most doctors would diagnose and treat both sexes in the same, exact way. This biased approach remains just as prevalent and deeply destructive in the hard sciences as it is in many other aspects of culture at large.

Given the worldview derived from that model, the very notion of women’s health is problematic. If you ask a doctor to look at a female patient through the lens of ‘women’s health’, they will likely run a mammogram, or collect cells from the cervix to examine them for cancer. Doing blood tests for estrogen and other hormones is just as common practice. In other words, women’s health is confined to the health of our reproductive organs. Let’s be clear that all these procedures have indeed changed and bettered the lives for hundreds of millions of women around the world. However, these same lines of research, inquiry and intervention are a direct consequence of the reductive understanding of what a woman is.

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This work led me to direct the Family History of Alzheimer’s disease program at the NYU School of Medicine. The program focuses on the children and family members of Alzheimer’s patients. Everyone there has broadly the same concern: “Am I at risk for Alzheimer’s and what can I do to make sure I don’t get it?”

Over the years, I experienced a change in the kind of questions I was asked by our research participants, much like the olive oil question at the conference. Beyond the discussions about genes and DNA, sooner or later the conversation turned to food. “What should I eat it to keep my brain healthy?”

While all my research draws on my education as an adult, everything I associate with food comes from my upbringing in Florence, Italy. I developed a heartfelt appreciation for wholesome, healthy food from a very young age, which I took for granted until I moved to the United States during my PhD. I had not anticipated the challenge of finding a flavorful tomato, nor the artery-clogging danger hidden within a seemingly innocent chocolate chip cookie. As I struggled with my own diet in my new environment, I learned from my study participants that I was not alone. By their own accounts, more than half of the participants in my studies reported only trace amounts of vegetables and fruits in their diets.

I wasn’t just far from home. I was also far from the original theses about the genetic aspects of dementia. In fact, over the years I learned that the role of genetics in Alzheimer’s, and dementia in general, is not as major as we previously thought. While some patients carry genetic mutations that cause dementia, for the vast majority of the population, risk is influenced by a variety of medical and lifestyle factors -- including a person’s diet. When my research revealed how important, and how oddly neglected, diet and nutrition had been in the field, I went back to school and completed a third degree in Integrative Nutrition. I drew upon that and other work to found the Nutrition & Brain Fitness Lab at NYU, with the goal of identifying lifestyle factors that support the brain, safeguarding it against dementia. A few years later, I initiated the ‘Brain Nutrition’ coursework and began teaching at the NYU Steinhardt School of Nutrition and Food Studies. This work has led me to dive head-first into the complex relationship between our brains and the foods we eat, and to educate the public as to how to eat healthfully for their brains.

As with anyone who has ever gone down a dietary path towards optimal nutrition, I quickly realized that the available advice was often conflicting and incoherent. But as a scientist, I was above all surprised at the volume and effect of pseudo-scientific information available on the internet, especially in comparison to how little had been published with the rigor of peer-reviewed medical journals.

We’ve heard a lot about what is and isn’t good for our brains. For example, many of us have recently become aware of an American gluten panic. But only a few years ago, people were terrified of eating fatty foods. While many of the recommendations you can find online promote a scientific worldview, very few have been substantiated by peer-reviewed research. Internet and media in particular have a tendency to make broad extrapolations on limited findings, and sensationalize everything. At least once a week some friend will ask my opinion on the latest “miracle drug” for Alzheimer’s. I’ll look up the study. More often than not, it’s true that the drug worked… but in a population of 10 mice. So that’s great news if you are one of those 10 mice. Whether or not those findings are relevant to ‘people’, is a wholly different story.

This is where scientific literacy comes into play. Which sources of information are the most credible? How can we know if the study we heard about in the evening news is worth acting upon?

Make no mistake. There is a bottom line when it comes to what’s good for your brain and what’s not. In Brain Food, I draw on my background as a neuroscientist to build a neurological and nutritional framework around the ways that food is so specifically vital in promoting optimal brain health. In the pages that follow, we will get down to the details of what science has discovered so far by exploring neuro-nutrition, or nutrition for the brain. We’ll look at how food breaks down into nutrients, and to what degree these nutrients feed our brains. We’ll talk about how the brain actually works, and the specific influence diet has on our cognitive performance. But mostly, we’ll see how the human brain has its own unique diet, different from that of the rest of the body. Just as we eat differently to slim down than to train for a triathlon, when optimizing for long-term cognitive health, the brain has its own demands. As it turns out, our future lies in our own hands – and what’s on our menu.

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