Dr. Larry McCleary Interview Part OneJuly 22, 2011 Written by JP [Font too small?]
The term “brain food” is bandied about in magazines, podcasts and television exposés seemingly on a daily basis. Foods such as blueberries, fish and green leafy vegetables are often singled out as supporting neurological health. But, the same is also true of granola bars, low fat diets and even whole grain bread. In short, there are broad and sometimes differing views about what exactly constitutes good choices with respect to brain functioning and wellness. So who better to clear up this confusion than Dr. Larry McCleary? If you aren’t already familiar with the good neurosurgeon, you should know that he brings to the table not only an impressive curriculum vitae, but also a track record of giving back to the community.
To date, Dr. McCleary has written three highly acclaimed books: “The Brain Trust Program”, “Feed Your Brain, Lose Your Belly” and “Bald is Beautiful: The Shining Stars Foundation Guide to Living with Childhood Cancer”. In this two-part interview, he’ll address some of the specific recommendations outlined in his books. For more information about any of the topics discussed here or related subject matter, pick up one or all of these inspiring and thought provoking publications.
JP – In a recent column, you described a phenomenon known as “brain starvation”. Can you please explain the basic concept behind this metabolic process that appears to contribute to the development of Alzheimer’s disease?
Dr. McCleary – Brain starvation refers to inadequate nutrition being available to neurons — the functional brain cells. We’ve all experienced this phenomenon when we haven’t eaten for awhile. We get hungry and feel lack of mental energy, difficulty concentrating, find ourselves reading the same paragraph over and over and might even feel light-headed or jittery. The hunger, which is a brain state, occurs because the appetite centers detect an energy shortfall and stimulate our appetite and the need to eat. The other “symptoms” are related to the same energy shortage in the “thinking” parts of the brain — those regions whose job it is to focus, learn, remember, solve problems and mediate complex social functions.
This is what happens when there is a short term nutritional deficit. When this process is repeated again and again the brain suffers. A good analogy is your household budget. If your income covers your expenses then all is well. If you come up short, then something has to give. You’ll still put food on the table, but the new paint job for the peeling boards on the front of the house might not get done. This illustrates how the brain cells need to allocate their available energy and how an energy deficit can compromise cellular structure and function. Cells in this circumstance need to prioritize how they allocate their available resources. Cellular damage might not be repaired. Cellular pumps that keep the cell membranes functioning might deteriorate. Memory consolidation might be impaired. Cellular deterioration then ensues. This predisposes to the production of plaques and tangles — the microscopic findings seen in the brains of patients with Alzheimer’s disease.
Glucose is the primary fuel in the brain and when the ability to process it and extract energy from it fails (as happens to the cells in the body when diabetes develops) detrimental cellular changes occur motivating some researchers to refer to Alzheimer’s disease as Type 3 diabetes. This is the basis for the metabolic cascade that develops when brain starvation is present in a sustained fashion.
JP – Your current book, “Feed Your Brain, Lose Your Belly”, draws an association between the worldwide obesity epidemic and various neurological disorders. Why are you convinced that there’s a direct link between what we’re eating and the state of our brains and waistlines?
Dr. McCleary – This is fairly clear cut. When you look at the correlation between various metabolic disorders associated with the obesity epidemic and serious neurological disorders such as memory loss, mild cognitive impairment and Alzheimer’s disease the connection is apparent. Insulin resistance (meaning a decreased responsiveness of the body to the hormone insulin — a condition linked to obesity) doubles the risk for AD; pre-diabetes triples the risk; and diabetes quadruples the risk. Each of these disorders of glucose and insulin metabolism are directly related with weight gain, overweight and obesity.
JP – It might surprise some to know that you don’t necessarily advocate lowering calories to lose weight. Why is severe caloric restriction an ineffective means of promoting long term weight loss and wellness?
Dr. McCleary – I believe that if we overeat, we will gain weight. However, in this context I define overeating as consuming more than our body requires. What I think is a recipe for failure is the recommendation that most health care professionals make, which is to “eat less and exercise more.” This will only make us very hungry and such an approach will make it difficult to stay on any diet very long. It also begs the question of why we eat too much in the first place.
A better question to ask, which illustrates the inadequacies of current approaches, is why people who are overweight still get hungry even though they are storing enough calories to allow them to go for several months without eating. The short answer to the question is that they have plenty of fuel available but are unable to easily access it. It’s like having money in the bank, but the bank being closed. It’s like you never made the money in the first place. With stored fat that is inaccessible, it’s like your body is unaware that you have eaten it or that it exists. The end result is that you get hungry because it can’t be tapped into as a fuel source. So what happens then is that you get hungry and eat.
This happens not only to overweight people, but it can even happen right after a meal. It can easily be illustrated as follows. Imagine what happens after a meal. We eat, burn some of the calories in the food and store the rest in fat cells for use in between meals when we need food energy but are not eating. This is normal. When the fat cells release the calories when required, we don’t get hungry, don’t gain weight and can do all that needs to be done (exercising, thinking, beating of the heart, etc.).
However, what happens after we eat a meal if, between meals, the fat cells don’t release the fat for us to use. That sends a signal to the brain that there is a fuel shortage. The brain reacts by stimulating the appetite centers, we get hungry and end up eating again even before we have used all the calories in the meal we just ate. This is how by making improper food choices we store too much energy as fat and eat to compensate. That’s why we overeat in the first place.
When our fat cells refuse to release stored fat in a timely fashion I refer to them as “sticky” fat cells. So, as you can see, I believe that gaining weight is a fat storage disorder, not the result of gluttony. Once this is understood, a solution is readily at hand. If eating too much and exercising too little was the real problem, then eating less and exercising more would be the solution. However, we have been told that for decades and it hasn’t made us any thinner. Just the opposite. We are fatter than ever.
If the problem is a fat storage disorder — meaning the development of sticky fat cells — then eating less is not the solution. What is required is making food choices that prevent the development of sticky fat cells. If we do this, then we won’t think about food, become addicted to food and we surely wont overeat as a result. If we severely cut calories (meaning eat much less than our bodies need) we will end up getting very hungry — not a good long term solution.
JP – Can you please give us an example of a brain healthy breakfast, lunch, dinner and snack?
Dr. McCleary –
- Breakfast: Eggs (preferably not scrambled because it will damage the delicate fats in the yolk) — a good source of balanced protein, anti-oxidants and poly- unsaturated fats containing healthy omega-3 fats sprinkled lightly with ground oregano and ground basil, several slices of avocado (healthy mono-unsaturated fat source) and a cup of green tea.
- Lunch: A chicken wrap in lettuce, a garden salad and sparkling water with a slice of lime.
- Snack: 10 -12 mixed nuts (pistachios, almonds, walnuts) and some cherries. A glass of iced tea.
- Dinner: Poached salmon with fresh dill, grilled asparagus, sauteed onions and red and orange peppers and for dessert berries and a scoop of whipped cream, a glass of white wine.
How Insulin Resistance Contributes to Poor Cognition and Health
Source: J Alzheimers Dis. 2009;16(4):693-704. (link)
JP – There are many controversial foods and ingredients in the modern marketplace. Please share your opinions about the following:
Dr. McCleary – a) Coffee: I drink it and it has been suggested that it diminishes the risk of developing Alzheimer’s disease. b) Eggs: See above. I believe eggs should be part of a healthy diet. Their cholesterol content is a non-issue in my opinion. c) Natural, non-caloric sweeteners such as monk fruit extract (luo han guo) and stevia: I don’t use them. If they suit your palate, go for it. d) Red wine: In moderation I believe it enhances meals and has nutritional benefits. Overdo it and it is bad business. e) Whole grains: I try to avoid grains of all types. When you eat whole grain bread, for example, and glucotest your saliva, it immediately contains sugar (glucose). I believe the best diet for health and longevity is one that minimizes insulin levels and sugar (and foods that are broken down rapidly into sugar) are not healthy.
JP – Of all the dietary pitfalls, it seems to me that you consider fructose and hydrogenated fats to be among the worst offenders. Why should we make it a point to avoid these much maligned and omnipresent ingredients?
Dr. McCleary – Fructose is a lipogenic sugar, meaning that it stimulates fat synthesis (especially in the liver). This is a potent risk factor for development of the Metabolic Syndrome — one of the most important health risk factors we face as a society. One or two grams is OK. However, many Americans consume over 100 grams a day. I also believe it is a potent appetite stimulant and is a powerful tissue glycator — meaning it causes inflammation in the body and damages the delicate building blocks of our cells such as the functional fats, proteins and DNA molecules.
Hydrogenated oils (“trans fats”) counteract the beneficial properties of the essential fats we need in our diet. They also raise “bad” cholesterol (LDL cholesterol) and lower “good” cholesterol (HDL cholesterol).
JP – Many people wonder whether a diet such as the one you advocate is appropriate for all ages. Is your high fat, nutrient dense diet suitable for children?
Dr. McCleary – It helped the brains of children who I cared for as a pediatric neurosurgeon recover from brain tumors, head trauma, and conditions of pressure on the brain more quickly and more fully. Also, our brains are primarily made up of the delicate fats I suggest in the diet and in brains that are forming (in children) this is especially important. As a matter of fact, low fat diets, which are low in the essential fats, have been linked to ADD-like behavior.
JP – Are there any dietary modifications that ought to be made in the senior population?
Dr. McCleary – Not really. They burn fewer calories and thus require fewer calories, but the physiology is basically the same.
In Monday’s second installment of my Q & A session with Dr. McCleary, we’ll explore the role that exercise and mind/body approaches play in the promotion of healthier cognition. We’ll also spend some time on an aspect of his work that is particularly close to his heart – working as the medical director of the non-profit Shining Stars Foundation. Other topics on board for the conclusion of our interview are Dr. McCleary’s views about ketogenic diets, specific fatty acids and the use of culinary herbs and spices. And last, but not least, I’ll introduce you to his new, online radio program, Brain-Body Breakthroughs.
Note: Please check out the “Comments & Updates” section of this blog – at the bottom of the page. You can find the latest research about this topic there!
Tags: Brain, Memory, Metabolic Syndrome
Posted in Diabetes, Diet and Weight Loss, Interviews